You are on page 1of 252

500 gii p y hc theo yu cu bn c

L Trng Bng

L Trng Bng

500 gii p y hc theo yu cu bn c


Cho mng cc bn n c u sch t d n sch cho thit b di ng Ngun: http://vnthuquan.net/ To ebook: Nguyn Kim V. MC LC Chng 1: Sc khe Chng 2: Dinh dng, thuc men v cc vn khc Chng 3: Ngoi hnh, chuyn ph n v nam gii Chng 4: Chuyn la i v chm sc tr Chng 5: Cc bnh tai mi hng, rng hm mt, tim phi v bnh bng Chng 6: Bnh t chi, xng khp, h tit niu v h sinh dc Chng 7: Bnh da, tc, lng, bnh ly qua ng tnh dc v mt s bnh khc

L Trng Bng 500 gii p y hc theo yu cu bn c Phn 1: Kin thc cn thit Chng 1: Sc khe

1. Ln nhanh nht tui no? "Xin cho chng em bit, t nh n khi thnh ngi ln, c th pht trin nhanh nht v chiu cao vo lc no?". Cha c thng k ln no nc ta v vn m cc em quan tm. Gn y, mt nghin cu ca Nht Bn tin hnh trn hn 200 sinh vin (c nam ln n) cho thy: con gi 8 tui v con trai 11 tui c bc ngot v pht trin chiu cao. n 15 tui (gi) hoc 17 tui (trai), tc gim xung, mi nm c th ch cao thm cha y 1 cm. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

S liu trn l ca nc ngoi, nhng cc em c th tham kho vn dng cho bn thn v gia nh nhm c mt ch n ung, rn luyn th lc thch hp trong bc ngot quan trng . 2. C nn i ngh mt hng nm? "Hai a con ti ngoan v hc gii. H no cc chu cng i i ngh mt, nhng v chng ti qu bn rn nn khng i c. Va ri b ch ng x M v chi, ti ti b b mng cho mt trn v chuyn ...". Hai bn khng b mng oan u. Cc bn b mt nhng dp tt cho cc chu c tip xc vi thin nhin, ht th khng kh trong lnh. V chng bn cng b mt nhng dp tt cng c thm tnh ngha gia hai v chng, gia con ci vi b m, b mt nhng dp tt gn gi mi ngi, t cng c thm lng nhn i cho mnh v cho cc con . Ngoi mt s iu trn, i ngh mt rt c li cho sc khe. Mt nghin cu ko di 9 nm ti M, tin hnh trn gn 13.000 ngi c nhiu nguy c b bnh tim, pht hin ra rng: nhng ngi i ngh mt u n hng nm, nguy c t vong gim 17% so vi nhng ngi ch ngh ngi ti nh. Qua , cc nh khoa hc nhn nh, i ngh mt l dp thot ra khi stress, dnh c nhiu thi gian hn cho gia nh v bn b trong mt mi trng mi y hp dn. 3. Sng lu c di truyn khng? "c im sng lu c di truyn khng? ng ni ti, ba ti u th ngoi 80 tui. Liu anh em ti c tha hng c iu ?". Nhiu thng k khoa hc cho thy trong mt s dng h, c nhng th h sng lu lin tip. Nhng th h ny gn nh cng c cc c im l: iu v mi mt, n nhiu rau qu, khng ht thuc, khng nghin ru, a hot ng, sng ni thong ng... Cc nh khoa hc Canada tm ra mt gene ca ngi mang tn gene SOSI m h cho l c vai tr bo v c th chng li hin tng xy ha. H a gene ny vo t bo thn kinh ca mt loi rui nh v thy chng sng lu gn gp ri bnh thng. Th nghim trn ang c tip tc, c ci tin mt ngy no c th ng dng cho con ngi nhm ko di tui th. Vy l cc thnh vin trong gia nh bn c c s hy vng sng lu, vi iu kin l bit gi gn v m bo cuc sng an ton. 4. i b u n gip sng lu " khu ph chng ti c mt cp v chng vin chc v hu tuy trn 75 tui nhng vn khe mnh. H cho bit 10 nm v trc bn xe p i b n c quan nhm rn luyn th lc, v hin h vn nghin i b. Xin cho bit i b nhiu c li ch g?". Cch y chng hai chc nm, H Ni v mt s thnh ph khc c "phong tro" i b trong vin chc, nht l la tui 45-50. H tnh ton chnh xc, i b thong dong, n c quan rt ng gi, tan To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

tm cng i b v nh. C l h ch thy i b lm con ngi khe ra, hot bt, yu i, th thi. V khoa hc ngy cha thy c g hn. Phi n u nm 1998 mi c kt qu nghin cu u tin trn th gii v vn ny. Trong sut 19 nm, cc nh khoa hc thuc i hc Helsinki (Phn Lan) theo di 16.000 anh ch em song sinh v nhn thy i b c tc dng ko di tui th. nhng ngi i b mi thng 6 ln, mi ln na gi (bc u chn), t l t vong ch bng non mt na so vi ngi khng i b. Hin tng ny khng ph thuc vo yu t di truyn. Mt nghin cu thc hin trn gn 26.000 ph n c cc nh khoa hc Nauy cng b nm 1999 cho thy, nhng ch em vn ng th lc ti thiu 4 gi/tun (d ch l i b), t l ung th v gim 37%. Theo mt nghin cu ca Vin ung th quc gia M, t l ny gim 60% nhng ch em c vn ng th lc. 5.Thm mt li ch ca i b "Bc s khuyn nhng ngi bo nh chng em phi n t i v vn ng nhiu. Em khng bit chi th thao th tnh sao y? Cn tp th dc th em thy khng gim cn c my. Xin cho chng em mt li khuyn". Cc em cn nh l nu rt bt khu phn n th ng c v i bng m tng cng n vt, nu khng th ch hoi cng. Cn ch iu chnh khng cho xung cn qu nhanh, nh hng khng tt n sc khe v kt qu hc tp. Mi thng c cho xung u 1 kg l tt ri, khng vi c u. Tt nht l em nn i b thng xuyn vi cch thc nh sau: Mi ngy i b ng 45 pht vi vn tc ng 6 km/gi, khng c chm hn (v khng tc dng) v khng c nhanh hn (v gy mt nhc v ch). Nu khng tin hnh c mt lc th c th chia ra lm ba ln trong ngy, mi ln 15 pht, cng vi vn tc trn. Phng php ny c rt ra t mt nghin cu mi y ca M, tin hnh trn 2.000 ngi bo ph, kt qu l gip t nht 13 kg sau 1 nm. 6. Tui th trung bnh trong th k 21 "Vi nhng thnh tu k diu ca khoa hc, c ng l con ngi s c nhiu kh nng sng trm tui hn trong th k 21?". Khi c thnh tch, con ngi thng hay bc ng. S thc khng phi d dng nh vy. u nm 2001, nh khoa hc M Holshansky cn c vo s liu thc t trong 10 nm (1985 1995) m kt lun rng: Nhn loi nu mun c tui th trung bnh l 100 th phi gim c 85% s ca t vong thuc mi la tui ngay c nhng nc vn c t l t vong thp. Theo ng, nu khng c mt cuc cch mng sinh y hc thc s, tui th trung bnh ca nhn loi gii lm ch t 85 tui (88 tui n v 82 tui nam) trong th k 21. Mc tui trn s t c Php vo nm 2033, Nht nm 2035, cn M th phi sang nm 2182. Holshansky qu bi quan chng? Nm 1990, khi ng cng b trn tp ch Science nhng iu tng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

t, ngi ta ch trch ng. Nhng 11 nm sau, h thy ng c l khi nhn thy tc gim t vong qu chm chp. 7. Ht th khi thuc l c vic g khng? "Khi thuc l c hi cho ngi xung quanh n mc no m cm khng c ht thuc ni cng cng, ch lm vic...?". T thp nin 1970, cc bc s nhi khoa khi nghin cu nh hng c hi ca mi trng nhim khi thuc l i vi tr em nhn thy, nhng tr sng chung vi ngi nghin (b xng khi thuc trin min) thng mc cc bnh ng h hp (vim hng, vim ph qun, hen...) phi nm vin, chc nng h hp suy yu v chm pht trin. Nm 1981, ln u tin cc nh khoa hc cng b kt qu nghin cu cho thy, nguy c ung th phi tng nhng tr em phi thng xuyn ht th khng kh nhim khi thuc l. Nm 1977, ti M c mt v kin c o. Mt cng chc lm vic ti c quan bo him x hi Baltimore thng b chy nc mt, nn ma, c ln b xung huyt phi. Anh ta cho rng mnh nhim phi khi thuc l do cc ng nghip thng xuyn ph ra ni cng s, bn lm n khiu ni ti c quan php lut. y ban ha gii lin bang M xc nhn ngi ny c l v phn quyt l anh c bi thng mi thng 1.400 USD. Nm 1986, hai bn tng trnh ti M (mt ca B Y t, mt ca Vin Hn lm khoa hc) da trn kt qu 12 cng trnh nghin cu kt lun rng, vic thng xuyn ht th khng kh nhim khi thuc l ca ngi khc c th dn n ung th phi nhng ngi khng ht. Tuy nhin, kt lun trn cha thc s c sc thuyt phc v ch mi c thc hin trn gn 1.000 bnh nhn. T , c hn 16 cng trnh nghin cu tin hnh trn gn 3.000 bnh nhn na c cng b. Qua , ngi ta thy rng nhn nh nm 1986 ca cc nh khoa hc l ng. Chnh quyn M hin chnh thc xc nh rng, khng kh nhim khi thuc l ti ni lm vic l nguyn nhn gy ung th phi cho nhng ngi khng ht thuc phi hot ng trong mi trng . V sau, ti phng Ty din ra mt s v kin ln v thuc l: - Nm 1991, mt s hng thuc l ln ca M b 60.000 tip vin hng khng kin tp th, i bi thng 5 t USD, v tuy h khng ht nhng phi thng xuyn ht th khi thuc l ca cc hng ny trong khi lm nhim v nn b nh hng n sc khe. n nm 1997, cc hng b kin phi bi thng 300 triu USD. - Trong nm 1997, mt v kin tp th khc do 500.000 ngi nghin tin hnh, i cc nh sn xut thuc l bi thng 200 t USD. Ta n thnh ph Miami, bang Florida, vn ang xem xt. Mt cuc iu tra tin hnh trong 5 nm trn 5.000 ngi hn 48 tui (cng b nm 1998) cho thy, khng ch nhng ngi nghin m c nhng ngi phi thng xuyn ht th khng kh cha khi thuc l, nguy c gim thnh lc (tai b nghnh ngng) tng 70%. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

u nm 1999, mt hng thuc l ni ting phng Ty! phi bi thng 80 triu USD cho gia nh mt bnh nhn cht v ung th phi sau khi ht thuc l ca hng ny trong 40 nm lin. Trong th cc bn khng thy ni n khng kh nhim khi thuc l trong cc gia nh do mt vi thnh vin nghin ht ph ra cho ngi thn ht th u u! Phi chng v y l gia nh, ni khng cn chp hnh lnh "cm ht thuc l ni cng cng"? C l v cc bn cha bit rng: - Trong s 16 cng trnh nghin cu b sung ni trn, c 10 cng trnh chuyn theo di nhng trng hp ph n khng ht nhng chng h li nghin thuc l. Kt qu l nguy c ung th ngi v bng 1/3 ngi chng. - Mt nghin cu ca Australia cng b thng 5/1999 cho thy, nhng ngi khng nghin nhng thng xuyn phi ht th khi thuc l ca ngi khc (ni lm vic, trong gia nh, nht l gia v chng) c nguy c t qu cao gp i ngi bnh thng. 8. Thuc l i vi thanh thiu nin "Anh Hai em l hc sinh xut sc lp 11, cc thy c tin rng nh sau ny s thnh t. Nhng em rt lo v nh xi mi ngy ti hn mt gi thuc l. Em phi lm g by gi?". Trc tin, em hy bo anh l ht thuc l d dn n ung th (phi, thc qun, ty, bng quang, thn, c t cung...) v bnh tim mch, vim ng mch, vim ph qun mn tnh. Nu anh x mt ci v ni: "Bit ri, kh lm, ni mi. Ung th hay bnh tim cng phi vi chc nm na, cn ht by gi vn khe v t", th em hy cho anh y bit thng tin st do sau y va c ng trn tp ch ca Hip hi y hc M: Sau khi tin hnh nghin cu trn 700 thiu nin mi bc sang tui thanh nin, cc nh khoa hc nhn thy, nhng em nghin thuc l nng t nh u hay b chng u lo, tinh thn bt n, s hi v c v ngi tip xc vi m ng, thm ch b chng trm cm. Nguyn nhn l cht nicotin tc ng tiu cc ln h thn kinh trung ng. Nghe vy, chc anh y s suy ngh, bi v nu b chng trm cm th lm sao hc hnh tt c. Hng ngy nu c lo u, s hi th cn g l thoi mi; nu ngi tip xc th cn u nhng ln i pcnic th v... Nu anh vn khng nghe, em hy tuyn b khng mua gim thuc l na. Nu anh t i mua, em hy mch ba m. Mt lng trc, c lng sau, anh c th gin em nhng ri s bit n em. Cn nu em c "ng la" nh hin gi l lm hi s nghip ca mnh. 9. Thai ph ht thuc l gy hi g cho con? "Ch du chu cn tr nhng nghin thuc l nng t lu. Ph n nghin thuc l sinh con c b g khng?". Con ci ngi ph n s phi ht th th khng kh pha khi thuc l trong gia nh t lc lt lng. Sau n s bt chc m, cng ph pho thuc l, ri cng vi m ch n nguy c b ung To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

th phi v bnh tim mch. Mt vn nghim trng hn vn ang c cc nh khoa hc tip tc lm sng t l: Liu ngi m nghin thuc l c ra c nhng a con bnh thng nh mi ngi? Mt nghin cu nm 1992 trn gn 6.000 nam gii ti Phn Lan cho thy, trong s nhng ngi hay vi phm php lut, manh ng v thiu kh nng tp trung t tng, nhiu ngi c m ht thuc l trong nhng thng cui ca thai k. Cc nh nghin cu an Mch cng tin hnh kho st trn 4.200 nam gii sinh t nm 1959 n nm 1961, tng "c vn " vi cnh st. H nhn thy, nhng ngi c m ht 20 iu thuc/ngy trong 3 thng trc khi sinh ra h, t l b bt v nhng ti nh cao gp 1,6 ln, v ti bo hnh gp 2 ln so vi nhng ngi m m khng ht thuc. Trong hai nghin cu ln tin hnh c lp ti hai quc gia khc nhau trn y, ngi ta khng thy tc ng ca cc yu t giu ngho, tui i, sc khe ngi cha... Nu ch du ca chu cha nghe ra, th c l vi s liu sau y c th gip ch sm tnh ng: - Cui nm 1998, M cng b kt qu ca mt cng trnh nghin cu trn 50 tr s sinh: Nu thai ph ht thuc l trong thi gian mang thai, t l cht nicotin trong nc tiu u tin ca a con cng y ht nh ca m. - Thng 5/1999, mt thng k Php cho thy, ph n nghin thuc l thng gp rc ri khi thai nghn, d b ung th c t cung v bnh tim mch. - Cui nm 2000, mt thng k thc hin trn 4 triu h s M cho thy: Thai ph ht thuc l thng sinh con b h hm ch (st mi) d hng ngy ch ht t 1 n 10 iu. - Thng 5/2001, mt nghin cu Anh pht hin ra rng, ngi nghin thuc l, gene NMP-1 (ph trch vic tng hp ra loi men chuyn ph hy collagen - cht to tnh chun gin cho da) b kch hot mnh m, k c khi khng phi nng. Do NMP-1 b kch hot, da ngi nghin thuc l sm nhn nheo v biu b v chn b b lo ha trc tui. 10. Trong thuc l c nhng cht g? "Chu ang hc lp 12, nghin thuc l t nh nhng thi hn c hn 3 nm nay. Gn y, chu nghe ngi ta bn tn chuyn cc hng sn xut thuc l M b t co l lu nay b mt cho vo thuc l ti 600 cht c hi. Chu lnh tot c ngi". Gn y, cc nh sn xut thuc l M li b t co mt ln na. ICRF, t chc chng ung th c u y tn ca M, Hip hi chng thuc l Anh v chnh quyn bang Massachusetts son tho v cng b mt bn bo co cho thy: Trong vng 30 nm nay, t khi c quy nh bt buc phi lp b lc vo u iu thuc l ( gim lng nicotin c ngi ht hp thu), cc nh sn xut thuc l lo s rng lng nicotin thp s khng lm cho ngi nghin l thuc vo cht c ny nh trc. Li dng quy nh cho php thm vo thuc l mt s cht lm "du v", h dng mt s To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

cht lm cho nicotin khuch tn nhanh vo no v tc ng ngay ln cc t bo thn kinh. H thm cc mui ammonium, ly c l iu thuc l c v du hn. Nhng trn thc t, tc dng chnh ca mui ammonium l bin nicotin thnh nicotin kim, mt dng d bay hi hn, c th ln ti no ch sau vi giy. Vic thm ng vo thuc l cng c chp nhn, coi nh b vo ch thiu ht cht thm do lc bt hc n. Nhng trn thc t, cht acetaldehyde (dn xut pht sinh t vic t chy cht ng) lm cho ngi nghin tr thnh l thuc hn vo nicotin. Cacao c thm vo vi l do lm du v cht ca khi thuc l; nhng thc ra cht ny lm gin ph qun, gip cho nicotin i vo phi d hn. 11. o tng v thuc l khng nicotin "Nghe ni ngi ta sn xut c thuc l khng nicotin, c ng khng? c vy, dn ghin chng ti lo bnh tt bit my!". Hng sn xut thuc l Vector Group ca M va c cp giy php bn mt loi thuc l bin i gene mang tn Omini-Free, c gii thiu l hu nh khng cha nicotin, khng lm ngi ht ph thuc vo cht ny. Mi nghe, tng l mt cuc cch mng lm cho dn nghin thuc l phn chn khng cn lo cht non, cn nhng ai ang "tp te" ht th yn tr t tin m khng s nghin v... "b ht d t!" Nhng thc t khng n gin nh vy. Trong thp nin 1950, thuc l khng nicotin (x l bng cch nhng vo ammoniac ty ra) tng xut hin m i din l thuc l iu Gauloises mu xanh ca Php. Nhng ch t lu sau, loi thuc ny ri vo qun lng v ht vo ch thy c hi nng v mi rm kh, khng m ni. Trong iu thuc l ngy nay, cc nh sn xut thm vo nhiu ph gia khc. Do , ngoi cht nicotin, ngi ghin cn ph thuc vo cc ph gia to mi v ny, v rt kh b. Thuc l chuyn gene cha t nicotin th ngi ph thuc cht ny phi ht nhiu hn mi "", s tn thm nhiu tin, v nguy c mc bnh s cao hn! V sao vy? V thuc l khng nicotin vn ta khi, vn cha oxyt carbon v cc cht hc n nh thuc l thng, ngha l vn cha y cc nguy c gy ung th. 12. Liu c cai c thuc l khng? "Ba em c sc khe, lm ngh th mc kim c kh tin, nhng li ht thuc l d qu, cai my ln nhng ri nghin li. C cch g gip ba em cai thuc l khng?". Nhiu ngi nghin bit thuc l nguy hi nn cng c cai vi ba ln, nhng cui cng vn ht li. phng Ty c cc thuc cai thuc l dng ung, dng cao dn cho thuc ngm qua da, nhm lm cho ngi cai nghin khng c cm gic kh chu. Thc t cng ch l cht nicotin m thi. Nu tin hnh cai nghin, ngi ht thuc s phi tri qua hai giai on tip ni nhau. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

- Giai on mi b ht (khong 3-4 thng), ngi cai nghin b nh hng mnh v th cht, do cn n s h tr ca nicotin. Chnh trong giai on ny, ngi no quyt tm cao s c iu kin tm ra nhng hot ng c li b hn ht. - Giai on cng c: Ngi cai khng cn l thuc thuc, nhng vn cn c ch xa lnh nhng cm d c th lm nghin li. Mi y, cc nh khoa hc khm ph ra tc dng cai nghin ca mt loi thuc lu nay vn dng tr chng trm cm, l cht Bupropion (tn thng mi: Zyban). Bupropion ngn chn hin tng ti hp thu dopamin (ngun gc ca s l thuc vo nicotin). Khi phi hp Bupropion vi cht nicotin, kt qu cai nghin tng gp ri so vi dng nicotin n thun. Australia v M ang cho s dng rng ri bin php phi hp ny. Tuy nhin, hiu qu ca n cng ch l 60% (40% cn li l nhng ngi thiu ngh lc). Nu ba em c quyt tm, th hy th li mt ln na vi bin php no trc y gip mnh "sp b c" thuc l. Ln ny hy cng quyt xa lnh nhng mi trng ht ht. M em nn lm mt t mt gng tht ngon ng nhm nhp khi bun ming. Em nn nhc thm ba rng, nhiu ngi nghin lu nm b hn c thuc l m khng tn mt xu, v h c quyt tm cao. 13. Tp v, tp xic c hi g khng? "C phi vic tp v hay tp xic s nh hng n bung trng, tinh hon, gy v sinh?". Bn thn em hoc bn trai ca em mun hc v hay chn ngnh xic? Xin c yn tr. Nhiu gia nh ngh s xic hoc v s v ang phi ht sc "k hoch ha gia nh" y. Ch cn ch khi nh v, nam gii ng cho u th nn trng "ca qu". Khi luyn cc tit mc xic, c nam ln n u phi tun th cc quy tc an ton, khng xy ra iu g nguy him cho tnh mng ni chung v cho b my sinh sn ni ring. 14. C nht thit phi khi ng trc khi tp th thao? "Trc khi lm cc ng tc th dc th thao, c nht thit phi khi ng khng (em khng khi ng m chng vic g)?". Chc em ch lm nhng ng tc khng nng lm, nu khng th b tn thng dy chng hoc c bp. C vn ng vin chi tennis, ch mt ln vi vng khng khi ng nn ngay c nhy u tin vt bng, anh ta b chy mu bn trong cng chn (do tn thng mt s th c), khng bc c na. Anh ta phi cha chy cch sut my thng tri mi au v sng n. Em ch ch quan, nu khng th "i m c ngy gp ma". Ngoi vic lm cho cc c v dy chng t ch ang ngh ngi quen dn vi cng hot ng cao, cc ng tc khi ng cn gip cho h h hp v h tun hon quen dn vi mc p ng cao v sau, khng b t ngt (nhp th v nhp tim tng). Em cng cn nh, ngay sau khi tp xong, khng c ng li hoc ngi, tri li phi bc i, khi To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

nhp th tr li bnh thng mi ngi ngh v nu kht th ung t t mt lng nc va phi. 15. Ti sao nh vy? "Ti sao sau khi ngi xm lm vic g , lc ng ln em hay b chng mt, sau vi giy th ht? Em i khm th ng thy lang cho bit b bnh thn. C ng vy khng, cch cha ra sao?". Hy quan st ngi phng Ty khi h c vic g phi ngi xung t: Bao gi h cng thng lng, gi t th mt chn co mt chn dui thay phin nhau, hoc hai gt chn cng nhn ln gi cho hai u gi hi "nhp nhm" nh l xo, ngha l vn vn ng, mu vn lu thng. Tuy nhin, t khi h dng t th g b . Cn t th ngi xm ca ta (b gi bt ng trc ngc, cong lng li) gy cn tr lu thng mu t hai chi di tr v tim. Hin tng chng mt trong "vi giy" ca em c th gii thch nh sau: Trong t th ngi xm, tuy tng lng mu lu thng b gim (do mu li hai chi di), nhng tim vn m bo c mu cho no, v p lc ct mu gim do gim chiu cao. Nhng lc ta t ngt ng ln, p lc ct mu tng vt t ngt, tim cha kp i ph, khng kp cung cp mu ngay cho no, khin no ri vo tnh trng thiu mu nh nht thi (biu hin l chng mt, xy xm mt my, thm ch ngi chao o mun ng). Ngay sau , nhanh hay chm ty trng hp, tim li thch ng c v coi nh khng c chuyn g xy ra. (Em c th kim chng gii thch trn y bng cch ngi xm trn ging mt lc, ri khng ng ln m nm dui chn; em s khng thy chng mt, do p lc ct mu chng nhng khng tng m cn gim xung khi nm). Nh vy, ta thy t th ngi xm tuy "c truyn" tht nhng li thiu khoa hc v c hi. Em c th bt chc ngi phng Ty trong t th ny. Tt hn ht l dng gh thp khi b cc ng lang vn phn l "bnh thn". 16. Khing vc nng hi ct sng "Chu l con trai, 17 tui. B m, anh ch chu v c chu thng xuyn phi khing nhng bao hng nng t 50 n 75 kg. Hin c nh chu ai cng ku au lng. Chu i khm th bc s nghi l c bnh thn. Xin cho bit c ng l vic khing vc nng nh vy d gy bnh thn khng?". Vic khing vc nng rt c hi cho ct sng v khi c vng lng, nht l i vi tui ang ln nh chu. Gia nh chu nn bn nhau t to ra hoc sm mt dng c chuyn ch ti ch (nh kiu ca hnh khch ti sn bay), khng tn km my u. Chc chn tnh trng au lng ca gia nh chu l do mang vc nng gy nn. Chn on "b bnh thn" chu l thiu c s. Khng thy chu ni l c cc triu chng bnh ca b my tit niu, cho nn thn ca chu chc khng vic g u (nu b si thn hoc si niu qun th phim X-quang hay siu m s cho thy hnh si; nu b vim cu thn th trong nc tiu s c tr hnh ht). 17. Ch c thi ngt v xoa bp tim To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

"Chng em sp c i tri h vng bin, phn ng khng bit bi. Nu chng may c ai b cht ui th x tr ra sao?". Nu ban t chc tri h qun l tt, c cc bin php d phng v cc em bit vng li th chc chn s khng xy ra chuyn cht ui. Nhng cc em cng cn nm c phng php cu cha phng xa. Ngay sau khi ngi cht ui c vt ln, ta phi ht sc nhanh chng lm my thao tc sau y: - Dc ngc u v xc mnh, v mnh vo lng, gip cho nc trong phi c ht ra. - Ngay sau , t nn nhn ln mt nn cng (vn thuyn, sn, nn nh...), u nghing hn sang mt bn ( ngn khng cho gc li tt v pha sau lm tc ng th), lau nhanh ct hoc di trong mi ming, ly rng gi ra nu c ( khi ri vo kh qun), v thc hin hai ng tc cn bn: thi ngt (thi thc s ch khng phi ch "h hi") v xoa bp tim ngoi lng ngc. Ty theo s ngi tham gia cu cha m cch tin hnh c khc cht t: 1. Ch c 1 ngi cu cha - Qu pha u ca nn nhn, hai bn tay chng ln nhau ( khe), tht mnh ln cui xng c, lm sao cho xng c ln xung di tay mnh, xong nhc tay ln ngay. Vng ny nm trc tim, xng sn ton bng sn, nn khi n ln xung th tim b bp v s y mu i; khi ta nhc tay, tim li n ra v thu nhn mu, ch tay ta tip. Lm 10 ln lin, vi tn s khong 90 ln/pht. - Ngay sau , rng ht vo ht sc ( cho phi mnh cha mt lng khng kh gp i bnh thng), vn gi cho u nn nhn nghing sang bn, ly tay bp cho ming nn nhn khp li v ngm ly mi, thi tht su, tht mnh (kinh nghim cho thy ngm vo mi thi d hn l ngm vo ming), sao cho ngc nn nhn phng ln h xung. Thi xong th ming nn nhn h ra, li ko ra ngoi cho khng kh t ng tr ra. Thao tc nh vy 5 ln lin tip, vi tn s khong 25 ln/pht, v ln no cng phi rng ht vo tht su. (Trng hp nn nhn b hn mnh nhiu, c th bt mi nn nhn li thi vo mm). Khn trng xen k hai thao tc ny, khng ngng ngh. Nu thy c di, phi nhanh chng lau sch trc mi ln thi ng th c thng, nhng khng mt thi gian. V b no ch thiu xy trong 5-6 pht l cht vnh vin, nn nhn s khng cn tri gic. 2. C 2 ngi cu cha - Mt ngi qu bn tri, i mt vi nn nhn, xoa bp tim. - Mt ngi qu pha u, tin hnh thi ngt. 3. C 3 ngi tr ln cu cha - Ngi th ba nng cao hai chi di, gip cho mu d dng tr v tim. - Ngi th t gip m ming nn nhn v ko li ra ngoi vo lc th ra. - Nhng ngi khc quan st cch lm sn sng thay th. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Vic cu cha phi kin tr, lin tc ngay c trong khi vn chuyn nn nhn ti trung tm hi sc. Ngi b ngt nc qu 5-6 pht vn c hy vng cu sng, v nhit thp ca nc gip ko di thm thi gian chu ng ca v no. c bit, vi tr nh, do c phn x khp kn dy thanh i nn nc khng trn vo phi; nn nhn khng cht ui m ch b ngt th. No tui ny li c kh nng thch ng cao. Nh vy, c trng hp tr b chm trong nc sui 2 gi m vn c cu sng v sau pht trin bnh thng. 18. Mui t "Ti sao ma xun lm mui? Khi b mui t, chu thy ni ln mt nt bng ht bi l, khong vi gi sau th tan. Nh vy da c b nh hng khng?". Khng c g ma xun. H tit tri ht lnh l loi mui sinh sn nhanh v hot ng mnh. Khi mui t, n phng ra cht lm gin mch v lm cho mu chm ng. Ch t b sng, nga l do huyt tng thot khi thnh mch, thm nhp vo cc m vng . Phi mt thi gian sau, cc m ny mi x l ht hu qu, v ni chung khng cn du vt g. Nu mui mang vi khun c, bnh nhn s c hin tng nhim khun cp (sng n ti ch, st, thm ch mng m vt t). Mui vn cn truyn bnh st xut huyt, vim no Nht Bn B; mui anophen truyn bnh st rt. V vy, v m, trong khi n cm, xem tivi, nghe i, hc hnh..., c gia nh nn dng hng mui hoc bi kem chng mui ln nhng vng da ng (mt, c, tai, bn chn...). Khi dng kem, nh ng b st mt vng nh no, bi v bn mui s tranh nhau b vo vng an ton. Nu chu thng xuyn hc khuya th nn thu xp ngi trong mn. bt mui, nh phi c nhiu nh sng; loi b bt nhng vt dng gm ging, gm bn. V chiu, cn m toang tt c ca (mui c v mui ci thng giao hoan vo lc nh nhem ti) v ln n mun, sau khi ng kn ca hoc h cc mnh xung (mnh chng mui rt tt). Cn pht quang cy bi xung quanh nh. 19. Nn ci trn hay mc o? "Tri nng, em nn trn hay mc qun cc, o lt?". Mt s kh ng ngi c thi quen trn thng xuyn vo ma h. Mt s khc, d tri nng n u, cng qun o chnh t. l do thi quen. Nhng nu phn tch khoa hc, em s thy bn no li hn: - Cng ngy, nhn loi cng s tc dng c hi ca tia t ngoi trong nh sng mt tri, trc ht l i vi ln da. Cha ni n chuyn phng rp do phi nng nhiu, nu c ra nng thng xuyn, cc t bo da s chng gi lo. nhiu thnh ph, phn ng ngi p khi ra ng u trm mt bng th mng v eo gng di ln gia cnh tay. H phi lm nh vy trn ng mt tri, mi mong tr c lu. - Nu mc qun o (nht l bng vi bng), m hi thm t s bay hi t t, lm cho nhit ti To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ch h xung, to mt. Qun o che chn nh sng, cn trng, bi bm (k c bi ha cht)... - Mc qun o th c iu phin l phi nng tm git, khng nhn bng nhng ngi "mc o da"; nhng khi c ai n nh th khi phi chy vi i mc hoc c xu xa trn, phi c rn ra m tip khch! 20. Kem chng nng khng bo v c da "Chng ti cng bit tia nng c hi, nhng vn thch phi nng tht nhiu khi i tm bin. Gia nh ti nc ngoi va gi cho my loi kem chng nng, ni l loi tt nht. Chng ti c nn bi kem u v tm nng cho "" khng?". Trc y, nhiu ngi cng t nim tin tuyt i vo cc loi kem chng nng vn c qung co rm r. Nm 1995, nh nghin cu H. Luther thuc i hc tng hp Ruhr (c) thu c nhng bng chng v s v hiu ca kem chng nng, k c nhng loi c qung co l hiu qu nht. Nhng b phi gi im lng, mi n nm 1998 mi cng b trong mt hi tho quc t. Ti hi tho ny, Marianne Berwick (Trung tm ung th S-K ti New York) cng a ra nhng c liu vng chc bc b huyn thoi "hu hiu", "an ton"... ca tt c cc loi kem chng nng. Lun im ca b c nhiu nh khoa hc cc nc ng h: Cc loi kem chng nng ang lu hnh khng c cht tc dng bo v da no; v s liu th nghim m cc hng bo ch trng ra trc y ch l kt qu trong ng nghim, ch khng phi kt qu thu c trn c th sng. th, kem chng nng cn c hi khin ngi ta phi nng "v t" ri gnh chu nhng liu tia t ngoi rt ln. Mt nghin cu di ngy trn 631 tr em cho thy, nhng em thng xuyn bi kem chng nng, nguy c mc u hc t c tnh cao gp i nhng em khng bi v vn ra nng mc bnh thng. n y, chc cc bn cng thy mi huyn thoi v "kem chng nng" vnh vin chm dt, v s lo bo v da ca mnh tt hn. Bi v trong nh nng mt tri c ba loi tia gy hi: Tia t ngoi B (UVB) nh thng vo rn di truyn ca cc t bo; tia t ngoi A (UVA) i su vo cc lp trong ca da v gin tip lm tn thng ADN ca t bo; cn tia hng ngoi th lm gia tng sc ph hoi ca cc tia t ngoi. Ngoi ra, cc tia t ngoi cn lm cho h thng min dch ca da b suy yu r rt: ch cn phi nng mt ln, da s phi mt t nht 3 tun phc hi sc khng ca n. V vy, vo ma h, ta thng hay b chc l, mn rp. 21. Cht bo v rng tuyt vi " phng su rng, ch nh rng nhiu ln tht sch bng bn chi m khng cn kem nh rng, c c khng? Ti sao li phi pha cht fluor vo kem nh rng?". nh rng ngay sau mi ba n hoc nh rng vo bui sng v ti u rt tt. ng tc ny ngn thc n cn st to thnh mt mng mng trn rng, lm mi trng pht trin ca vi khun. Hn na, trong khi ta ng, do khng c ng tc nh ra hoc nut nc bt xung rut nn vi khun c iu kin tp trung hn (y l l do ti sao phi nh rng trc khi i ng). Vic nh rng u To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


n cng gip ngn chn s hnh thnh cao rng, trnh gy tn thng cho li.

L Trng Bng

Kem nh rng gip cho vic "k c" ny hu hiu hn. Trc y, ngi ta cho rng nu nh rng tht t m th khng cn kem nh rng na. Lc , tc dng bo v rng tuyt vi ca cht fluor cha c pht hin; cht ny cng cha c trn vo kem nh rng nh hin nay. Fluor l cht duy nht c kh nng lm cho men rng (lp ngoi cng, ph ln ng rng) khng b ha tan trong mi trng axit. Men rng l cht cng nht ca c th, ch yu gm cc apatite. Fluor khi ngm vo men rng s bin cc apatite thnh fluoroapatite, lm cho men rng cng thm. Mi y, cc nha s ca Anh sng to mt phng php mi nga su rng: dng mt vin nh bng ht go gn vo mt rng hm ca tr; vin ny thng xuyn gii phng cht fluor trong hai nm lin, kt qu l t l su rng gim 76%. Cc bn nn nhc nh v kim tra con em trong nh, k c cc chu nh ch mi c rng sa, nh rng tht k, nht l bui ti, v ch dng kem nh rng c fluor. 22. Huyt p cao hay khng "B ti gn 70 tui nhng cn sung sc, lao ng tt, n ng bnh thng. Va ri c o huyt p, ch s l 140/100; c ngi ni cao, c ngi cho l bnh thng. Cch o hin nay khng ging nhau. Vy cch o no tt nht, v ch s ca ngi cao huyt p l bao nhiu?". Vi ngi cao tui nh c nh, chng ti xin gii thiu mt cch tnh mc huyt p bnh thng n gin theo t in y hc Flammarion nm 1994 ca Php: Huyt p ti a = S hng chc ca tui + 10, Huyt p ti thiu = Huyt p ti a + 01. Cng theo t in ny, cao huyt p l khi trng thi ngh ngi m huyt p ti a (lc tim co bp, gi l tm thu) bng hoc trn 17 cm Hg, v huyt p ti thiu (lc tim ngh ngi, gi l tm trng) bng hoc trn 10 cm Hg. Theo th ch s huyt p l thuyt ca c nh (70 tui) l: Huyt p ti a = 7 + 10 = 17 cm Hg (170); Huyt p ti thiu = 17 + 01 = 9,5 cm Hg (95). Bn ni huyt p ca c l 140/100. Chng ta kim tra li mt ln na cho chc chn: c nm nga thoi mi trn ging (khng ly huyt p khi ngi). Nn o vo mt thi im nht nh trong ngy c c nhng iu kin tng t. Bp bng cho ln cao trn 200 ri bt u nghe t (khng nghe t 150-140 loi tr hin tng nghe c huyt p ti a lc khi u, nhng ngay sau b ngt qung; nu ch ly t mc cao hn th d tng nhm s o ny l ca huyt p ti a). Vi huyt p ti thiu, ta theo di cho n khi khng cn nghe c na hoc nghe m sc ca ting p thay i hn ( loi tr khong im ng ngay pha trn huyt p ti thiu, lm ta tng nhm l s o ca huyt p ti thiu. Nu kt qu kim tra li vn th th, i chiu vi ti liu ni trn, huyt p ti thiu ca c tng cht t (ng l l 95 th y l 100). Trong khi , huyt p ti a ca c khng khc g ngi 40 tui To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

( cc vn ng vin, nhng ngi lun th gin v hot ng, khng ht thuc l, sng trong mi trng lnh mnh... cng c hin tng tng t). Bn khng c g phi lo lng c bit, ch cn nhc c gi sc khi lao ng, khi thay i thi tit, v khuyn khch c dng du thc vt hoc n chay. Theo s liu JNC nm 1998 ca M, ch gi l cao huyt p khi huyt p ti a trn 140 hoc huyt p ti thiu trn 90. Vit Nam, trong khi cha c s liu thng k ln, c th ty theo tui tc m vn dng linh hot cc s liu ca hai nc ni trn. 23. Pht dc sm "Xin cho bit r bnh pht dc sm l g, nguyn nhn v tc hi ca bnh y?". Pht dc sm khng phi l bnh, m l mt hin tng sinh l gn nh bnh thng, ch khc mt iu: tui dy th xut hin qu sm so vi thng thng. con gi, thng t tui 13-14, ngc bt u n; lng mu mc ( pha trn b phn sinh dc ngoi); c kinh nguyt (ban u c th cha u n), i v mng to ra; c lc thy au nhi mt s ni; ging ni bt thanh, thm ch trm hn xung, nhng s c ngy thanh tr li; hay hi hp, bn chn v c, thm ch hay gin hn, thy thch bn trai... con trai, thng t tui 15-16, ging ni trm xung v s vnh vin trm; lng mu v ria mp xut hin; m ng c th xut tinh trong gic m; tnh hay qun, m mng, thy thch bn gi... Gi l pht dc sm nu cc du hiu dy th xut hin trc cc la tui trn, thm ch rt sm, c th lm b, lm m ngay c khi cn tui v thnh nin. C th l: v to ra trc 8 tui, lng nch v lng mu mc trc 9 tui, cng v en nhnh; kinh nguyt c trc 10 tui; m vt hay dng vt to ln qu c so vi tui. Ngoi ra, cc du hiu dy th khc nh v ging, mc ria mp, trng c, nm v v c quan sinh dc bt u thm en... xut hin trc 10 tui. Vi nhng trng hp pht dc sm, cc bc ph huynh phi ch gip , ng vin cc chu vt qua cc ri lon tm sinh l tip tc hc tp tt, ng thi tnh to trng nom v qun l cc chu khi b nhng k xu li dng v tnh dc. 24. nh gi mc bo "Xin cho bit cch nh gi mc bo ca tng ngi". nc ta cha c thng k ln cho php xc nh mc bo ca ngi Vit Nam. Xin gii thiu mt trong nhng cch nh gi ch s khi lng c th BMI (Body Mass Index) ca quc t: Ly th trng (tnh bng kg) chia cho bnh phng chiu cao (tnh bng mt). Vi ngi trng thnh, ch s BMI bnh thng n l 19-24, nam 20-25; trn 25 l b bo ph; 25-30 c th coi l bo ph 1, c tng 5 n v l thm mt bo ph. 25. Nguyn nhn bo ph "V u m bo ph? C gene gy bo ph khng? Cch cha?". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Bo ph l hu qu ca s mt cn bng gia s calo thu nhn c bng n ung v nng lng tiu hao. C th c mt h thng cc k tinh vi cho php iu khin vic d tr m v cn bng nng lng; s trc trc ca n s dn ti n bo ph. Nguyn nhn bo ph c th do li sng v mi trng sinh hot (n ung v , ng qu nhiu, t vn ng...). Trng hp ny c th cha khi hoc nhiu ch yu bng ch n ung, tp luyn v sinh hot, kt hp vi cc phng php cha bnh khng dng thuc (chm cu, kh cng, nhn in...). Mt nguyn nhn quan trng na l di truyn, khng ch ca mt gene m ca mt h thng kh phc tp gm nhiu gene. Qua th nghim trn ng vt, ngi ta pht hin cc gene c vai tr trong vic "cn bng thu chi" ni trn: ob, agouti, pat, db, tub... v gene ca th th 3-adrenergic. V vy, phi bng cch no tc ng ln ton b cc gene ny th mi gii quyt c vn . 26. Ai suy gim tr tu nhanh hn "Chng em thy hnh nh s c ng b suy gim tr nh ng hn cc c b, c phi vy khng, v nguyn nhn do u?". Cc em nhn xt ng y, s c ng b suy gim tr tu ng hn cc c b nhiu. Nguyn nhn ch yu l do mc thay i ca no ngi gi khc nhau theo gii tnh. Kt qu chp qut no bng phng php cng hng t (IRM) trn 330 ngi hn 65 tui M cho thy, khi v gi, theo nm thng, no n ng thoi ha nhanh hn no n b. Khi no gim th tch, lng dch no ty tng. nam, dch no ty xung quanh v no tng trung bnh 32%, trong khi n ch tng 1% (no cc c b gim th tch t hn rt nhiu). nam, dch no ty tch t nhiu hn trong thy trn v thy thi dng, nhng khu vc kim tra cc chc nng t duy, tr nh v kh nng t chc. Ngoi ra, cng theo cc nh nghin cu ni trn, vic sn sinh oestrogene c tc dng bo v no ca n v h thp nguy c suy gim tr tu n. Thng 6/2001, mt nghin cu ca M trn kh ci mn kinh cho thy, trong m no ca kh n nhiu u nnh, t l protein tau (loi protein cn thit cho hot ng ca t bo thn kinh) vn nguyn vn, cn nhng con khng n u nnh th t l ny thay i. Nh vy, u nnh c tc dng chng xy ha, vic n u nnh u n gip phng nga bnh Alzheimer. 27. Bnh Alzheimer c di truyn? "Bnh Alzheimer c ly nhim hay di truyn khng m trong gia nh mt ngi bn ca ng ni em c n ba ngi cng b?". Bnh Alzheimer (suy gim tr tu, xy ra ngi c tui, c Gio s Alois Alzheimer pht hin vo cui th k 19) khng phi l mt bnh ly, m xut hin do s tch t protein amyloid-beta trong cc t bo thn kinh ca no (bnh thng th cht ny b c th thi ra ngoi). Hin ti, t l b To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


bnh ny tui ngoi 65 l 10%, ngoi 85 l 50%.

L Trng Bng

Lu nay, do thy trong mt s gia nh c nhiu ngi mc bnh ny nn ngi ta nghi ng c yu t di truyn. Nhng iu ny cha th khng nh v thiu bng chng khoa hc.. Cui nm 1998, khi nghin cu cc thnh vin trong mt s gia nh c t nht 2 ngi b Alzheimer, cc nh khoa hc ti Bnh vin Massachusetts (M) phn lp c mt gene, gi l A2M, c vai tr iu chnh protein amyloid-beta. Khi gene A2M gp trc trc th protein ny khng b o thi nh thng l m tch t trong cc t bo thn kinh ca no thnh cc mng bm. T , cc nh nghin cu d kin s hiu chnh c mt loi thuc bt chc tc ng tch cc ca gene A2M lnh mnh, ngn chn s tch t protein amyloid-bta. Vin Nghin cu L sinh Dusseldorf ca c cng tm ra c phng cch pht hin protein amyloid-bta trong dch no ty, to thun li cho vic chn on sm bnh Alzheimer. Nm 1999, cc nh nghin cu Ailen cho bit h ch to thnh cng mt vacxin mang tn AN.1972 c tc dng ngn nga v cha tr bnh Alzheimer trn chut, hy vng s c th dng th trn ngi. Ngoi ra, ngi ta sn xut c vacxin tim phng bnh Alzheimer. Vacxin ny ang c th nghim trn ngi ti M, Php v nhiu nc khc trong Lin minh chu u, 28. T t c di truyn khng "T t c di truyn khng m em thy trong mt dng h ln lt c my ngi t t?". Mt s bnh tm thn thng hay xy ra trong mt dng h. C l v vy m cc c ngy xa khuyn con chu "ly v chn tng, ly chng chn ging". Ngi b bnh tm thn d ri vo tnh trng khng lm ch c bn thn, dn ti nhng hnh ng xm phm n ngi khc (gy g, git ngi...) hoc gy hi cho mnh (t vn) m khng thc c. Mi y, cc nh khoa hc Canada pht hin ra hin tng t bin gene ca c quan th cm truyn tn hiu thn kinh mang tn 5-HT2A. Bnh thng, 5-HT2A vn truyn cc tn hiu t cht serotonin (do no tit ra, c tc dng c ch nhng hnh vi bc ng ni con ngi). Khi b t bin, c quan th cm ny hot ng chuch choc, khng kim ch c nhng hnh vi , lm cho nguy c t t tng gp i. Vn l xt xem hin tng t bin ni trn c di truyn hay khng. Ch bit rng t l ngi t t nam cao gp 4 ln n. 29. Gene chng ung th "Bo ch ni h nghin thuc l l mc ung th phi, nhng ti sao c ngi nghin nng my chc nm vn bnh yn?". Khoa hc khng h tuyn b "h nghin thuc l l mc ung th phi" m ch ni "nghin thuc l lm tng nguy c ung th phi; lng thuc ht cng ln, nguy c cng cao". Khoa hc cng cha hiu nh u m mt s ngi tuy nghin nng lu vn khng h hn g. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Mi y, cc nh khoa hc pht hin ra trn chut mt enzyme tn l glutathion S-transferase c tc dng ph hy cc cht gy ung th. Nu gy t bin cho gene chu trch nhim v vic sn sinh enzyme ny, chut rt d b ung th do khi thuc l. Cc chng nghin lu nm c th hy vng l may ra mnh thuc vo danh sch "c t thn chm gi v chu tri". Cn nhn loi ni chung th thc s vui mng v kt qu nghin cu ny, v n m ra trin vng dng tc ng gene cha tr cc loi ung th do cht c gy ra, k c do ht thuc l. 30. Sn c mp c cha c ung th? "Nghe ni sn c mp cha c ung th, c ng khng?". Mt nghin cu trn cc bnh nhn ung th giai on mun c cng b thng 3/2001 cho thy, cht chit t sn c mp gip km hm qu trnh pht trin bnh bng cch ngn chn s hnh thnh cc mch mu nh nui khi u, lm cho khi u "cht i". Mt ti liu khc li cho rng chnh c mp cng b ung th (k c sn ca n). Xin hy rng ch kt qu cui cng. 31. V bnh i tho ng (tiu ng) "Bo ch ni bnh tiu ng c 2 type. Xin ni r hn cho chng em c th phn bit d dng". Tuyn ty tit ra cht insulin, mt ni tit t gm 51 axit amin gi vai tr iu chnh t l ng glucose trong mu (75-115 mg/100 ml). H ng huyt tng qu mc , ty lp tc tit insulin, gip cho ng nhanh chng i vo cc t bo c bp, t bo m v bch cu. Insulin cng km hm vic bin glycogene ca gan thnh glu-cose. Ngi ta phn chia bnh i tho ng (tiu ng) thnh type 1 (ph thuc insulin) v 2 (khng ph thuc insulin). - Type 1: Chim 10%, pht sinh t tui nh do ri lon chc nng ca h min dch. Cch cha duy nht l hng ngy tim mt liu insulin tng hp. Nguyn nhn bnh cha r l do di truyn hay do b nhim virus. - Type 2: Xy ra la tui trn 40. C th c tit insulin nhng mc rt thp; cc b phn th cm ca t bo i vi insulin qu km. Hu ht bnh nhn b bo ph. Cha tr bng ch dinh dng hp l v vn ng th lc. 32. Ghp ty cha bnh tiu ng "Xin cho bit v vic ghp ty cha bnh tiu ng". Lc u, ngi ta ghp ty trn ch. Nhng con c ghp c u cht v thiu men tiu ha. Nhng con c thay ty (ct b ty v thay ty khc vo) cng cht v mnh ghp b loi tr. Ch c 20% m ty (gm cc tiu o Langerhans) m ng nhim v ni tit (t bo A tit glucagon lm tng ng huyt, t bo B tit insulin lm gim ng huyt). Mt s tc gi tm cch ly ring r cc tiu o Langerhans ghp. Ban u, h ghp vo ty nhng ri phi b v rt To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

kh thc hin. Sau , ngi ta ghp vo thnh bng, vo lch, vo tuyn thng thn. Cui cng, mt s tc gi tim vo tnh mch ca: ly 350 tiu o Langerhans ca chut bnh thng tim cho 1 chut c gy bnh tiu ng. Kt qu l chut khi bnh. Vi kh v ln, kt qu cng tt. Nhm trnh vic m bng tim vo tnh mch ca (nm di gan), ngi ta dng kim tim thng cc tiu o Langerhans vo gan ca chut; chut khi bnh. Cc t bo ty nm trong gan vn sng v tit insulin bnh thng. Mt s tc gi tin hnh nui cy cc tiu o Langerhans ca ln trong phng th nghim nhm hai mc ch: sn xut insulin mt cch cng nghip v nghin cu kh nng dng cc tiu o ny tim vo gan ngi. 33. ghp ty thnh cng trn ngi "Ch em ang iu tr bnh tiu ng type 1. Trc y, bo ch c ni n ghp ty trn ng vt nhm p dng cho ngi. Xin cho bit vic kt qu ra sao? Bnh tiu ng type 1 l g, c nng lm khng?". Sau khi tht bi trong vic ghp ton b ty trn ng vt cha tiu ng, ngi ta ch cy ghp cc tiu o Langerhans (chim 20% m ty). V kt qu l c th ly cc tiu o Langerhans (TL) ca ngi khe mnh em tim vo gan bnh nhn tiu ng type 1 vi iu kin phi sut i dng thuc chng min dch trnh hin tng thi loi mnh ghp. iu tr ngi l a s bnh nhn khng chu ng c thuc chng min dch, nn gn 95% ngi c cy ghp cc TL phi tim li insulin sau vi ba thng lm th thut ny. Nm 2000, mt nghin cu ca Canada thc hin thnh cng 7 ca cy ghp TL kt hp vi s dng cht chng min dch mi (dn xut ca cyclosporin). mt nm nay, 7 ngi ny ngng tim insulin m mc ng huyt vn bnh thng. y l tin vui lm nc lng cc bnh nhn b bnh tiu ng type1. Nhng vn tn ti hai vn : Thi gian 1 nm vn cha khng nh bnh c ti pht hay khng; s lng 1 triu TL dng cho 1 bnh nhn (tng ng vi 2-3 tuyn ty nguyn vn) l qu ln, kh p ng ni nhu cu, v s ngi cho khng nhiu. Mt phng php mi rt c trin vng c xut v ang hiu chnh: Dng cc t bo gc (cha thnh thc) ly t tuyn ty ca con ngi em nui cy trong phng th nghim, cho n khi chng bit ha thnh cc TL th em cy ghp. Bnh tiu ng type 1 (ph thuc insulin) gy ra do cc bt thng v gene, biu hin bng s ph hy tun t cc TL. V khoa hc cha tm ra phng php ngn chn tin trnh bnh l ny nn bnh nhn phi o mc ng huyt hng ngy nhm x tr kp thi khi ch s ny ln qu cao (ti a cho php l 1,2 g/lt). Trong khi , bnh nhn tiu ng type 2 (khng ph thuc insulin) do bo ph gy ra, c th t To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


cha bng mt ch n ung v sinh hot hp l. 34. Mt v thuc nam cha tiu ng

L Trng Bng

"M em hn 60 tui, ngi kh mp, va b cao huyt p va b bnh tiu ng, thng xuyn phi dng my loi thuc ty nhng khng my. Xin cho m em mt li khuyn". Em nhc m iu chnh ch n cho hp l v vn ng th lc nu iu kin sc khe cho php. M em c th vn dng cch cha ca dn gian n gin m hu hiu sau y: Nhm trong vn nh hay vn ca ai my cy chui ht ln. Vo lc sng sm, dng dao sch ct ngang thn cy ri khot mt hc thn su chng 10cm; ly t nylon bao kn li, i khong na gi th m ra, dng ng ht ung ht ch nc m cy tit ra. Nu thy cy chui tit nc km th dng cy khc. Ung khong 30-40 ngy s hy vng thnh cng. Khi hay khi vn phi duy tr ch n ung v vn ng. 35. Tc hi ti nh ca trng in t "Chng em ang hc cp 3, lu nay thy bo ch ni n tc hi ca trng in t i vi sc khe. Vy m v nh cht, chng em phi ng cnh t lnh, ngi hc th quay lng li st my thu hnh (phi m cho c nh xem), nh vy c hi g khng?" Gii p ny c th lm cc em khng vui v gia nh mnh (cng nh gia nh nhiu bn khc) s kh khc phc. Ch mong cc em nm c vn phn u dn trong hon cnh c th. T lu, cc nh khoa hc lo lng v tc hi ca trng in t (TT) i vi sc khe con ngi. Gn y, h thu c nhng bng chng u tin trn ng vt. Cc nh khoa hc c tin hnh nghin cu trn 120 chut ci c tim cht gy ung th v, c t vo nhng TT c mc khc nhau. Sau 3 thng, h nhn thy: - mc TT = 1mG (milligauss) - mc trung bnh trong cc gia nh - s chut mc ung th rt va phi. - TT = 100 mG, s chut mc ung th tng 10%. - TT = 500mG: tng 25%. - TT = 1000 mG: tng 50%. Cc nh nghin cu khng nh rng TT lm gim tit cht melatonine, mt hoc mn do no gii phng vo ban m, c tc dng bo v c th chng ung th v. TT pht ra t cc my in gia dng lm thay i s sn sinh mt s hoc mn v lm ri lon phng thc tc ng bo v c th ca chng trc s tn cng ca ung th. Mt s nghin cu cn cho thy, TT lm cho c th ph n tng tit cht oestrogene, c th gy ung th v. Cn n ng, TT lm gim tit cht testostorone, tng nguy c b ung th tuyn tin lit hoc ung th tinh hon. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


36. Khi mun lm tip vin hng khng

L Trng Bng

"Chu mun tr thnh n tip vin hng khng nhng nghe ni bay trn cao d b nhim phng x. Xin gii thch r iu ny v nhng vn khc lin quan n sc khe trong cc chuyn bay xa". Mi ngi sng trn mt t hng nm hp thu mt liu phng x khong 1 milisiviert (1 mSv) do phi thng xuyn tip xc vi cc bc x ion ha t v tr, t cc ng v phng x hin hu trong khng kh, nc, t...(trong , phn t v tr chim hn 1/4). Cng ln cao, bc x cng ln. cao 6.000-8.000 m, bc x tng ti 55-70 ln. Do , cng bay cao, bay lu, con ngi cng phi hp thu liu phng x ln hn. Ch trn mt chuyn bay trong 12 gi t Paris i Tokyo, mi hnh khch phi hp thu 0,20-0,25 mSv. Theo T chc phng v phng x th gii, liu hp thu phng x cho php hng nm ca ngi bnh thng l 1 mSv, ca ngi lm ngh c lin quan n phng x l 20 mSv. Mt cng trnh nghin cu ti c cho thy, cc phi cng v tip vin hng khng thm nin ca nc ny c hin tng bin i bt thng nhim sc th, ging nh ngi nhim x. So vi nhng ngi lm vic trong nh my in nguyn t, h hp thu mt liu bc x cao gp 5 ln. Cng theo cng trnh trn, khi xem xt 23 triu hnh khch ca Hng hng khng Lufthansa, cc nh nghin cu thy trung bnh mi nm c khong 140 ngi cht v ung th do nhim x, mt con s cao hn t vong v tai nn my bay. Nh vy, khng ch phi cng v tip vin hng khng m c nhng khch hng thng xuyn ca cc hng hng khng cng phi hp thu mt liu bc x ln hn nhiu so vi khi trn mt t. l cha k n trng hp hp thu phng x khi tin hnh kim tra hnh l bng tia X, s dng cc ngun bc x gamma do yu cu ca thit b k thut, hay vn chuyn tri php cc ngun phng x... Hng khng, v vy, khng phi l mt ngnh "d chu" nh ta vn tng khi ch nhn b cnh hp dn ca tip vin, trang phc sng ngi ca phi cng, khi hnh dung ra cnh phiu diu trn chn tng my v s tin lng kha kh. Khi phi qua nhiu mi gi, c th ngi i my bay tri qua nhng thay i v ng h sinh hc, lm nh hng n no. Gia nm 2001, mt nghin cu ca Anh trn tip vin nhng chuyn bay qua hn 7 mi gi cho thy, nhm ch c ngh 5 ngy gia hai chuyn bay, thy thi dng phi ca no b teo nh, km theo ri lon ghi nh v tip nhn; cn nhm ngh 14 ngy vn bnh thng. Ngoi ra, khi bay ng di, nhng ai ngi qu lu mt ch m khng vn ng s d b vim tc tnh mch chi di, c th dn n nguy c tc huyt, gy t vong. 37. Bo ng v in thoi di ng "Chng em giao thip rng, nh sm thm mt my in thoi di ng. Em c bo thy ni vic s dng my ny nhiu c th gy ung th no, nn cha mun cho anh y mua. Xin cho chng em mt li khuyn". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Sau khi my in thoi di ng (TD) ra i t lu, cc nh khoa hc nghi ng v s nguy him ca n, v n pht ra cc tn s radio khng li cho c th. Gia nm 1977, qua thc nghim trn chut, ngi ta pht hin ra tnh d gy ung th bch huyt ca TD, nhng cha thy biu hin ngi. Mt nghin cu Australia nm 1998 cho thy, t nm 1982, t l ung th no tng 50% nam v 63% n, nguyn nhn c th l do s dng TD. Nc ny buc phi trin khai vic nghin cu vn TD vi Php, Italy, Anh, Canada v cc nc Bc u. Cui nm 1998, Anh cng b mt nghin cu cho thy, TD lm gim tr nh, gy tr ngi cho vic tp trung t tng v cm nhn khng gian, do tc ng ca trng in t m TD pht ra. u nm 1999, c, cc nh khoa hc pht hin TD tc ng ln huyt p ca ngi s dng 5 ln/24 gi, mi ln 35 pht lin tc. Theo mt nghin cu Php, cng vi s gia tng s ngi s dng TD, c mt s gia tng t l ung th no: nm 1975 c 2.300 trng hp, nm 1995 ln ti 4.700. Cc nh khoa hc Php cn t vn liu c nn ghi trn TD dng ch cnh bo "Tc hi nghim trng n sc khe" hay khng. Gia nm 2001, B y t Php a n ra khuyn co nn thn trng khi s dng TD: - Khng ni chuyn lu khi my nghe khng r (sc thu km, do my phi tng cng sut). - S dng loi my c che tai ( bt nng lng hp thu qua da). - Khng t my vo nhng vng nhy cm (thiu nin hay nht my vo ti qun, thai ph th nht trc bng, gn c quan sinh dc). - Hn ch tr em dng TD. Mt thc t hin nhin l, do li nhun c bit cao, cc nh sn xut TD vi v tung cc sn phm mi ra th trng m cha nghin cu tht k cng pht hin mt nguy hi ca n. Mc d cho n nay, khoa hc vn cha khng nh c TD c gy ung th hay khng, nhng trc nhng li cnh bo ca cc nh nghin cu, ngi ta ch to nhng TD c tai nghe trnh tc ng ln no. Cn chuyn gia nh cc em c th ra sao, t cc em phi x l cho ng mc. Hy vng rng nhng s liu khoa hc nu trn c th gip cho u c con ngi tnh to ra, trnh vic lm dng TD. 39. Ly bnh vim gan t bc s m "Phu thut vin b vim gan B c th ly bnh ca mnh sang nhng bnh nhn c ng ta m khng?". T lu, ngi ta bit rng cc phu thut vin rt d b ly bnh vim gan B (VGB) t bnh nhn m h tin hnh phu thut, vi mt t l rt cao, v ly bnh vim gan C (VGC) vi mt t l thp hn. Nguyn nhn l dao ko hay kim tim lm rch da tay ca ngi m trong qu trnh phu thut To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


(cho nhng ngi c bnh vim gan km theo).

L Trng Bng

Cn vic ly ngc VGB t phu thut vin sang bnh nhn t c cp nn tng chng nh khng xy ra. Vy m c y! Mt tp ch thc hnh y hc ca Php thng k c 11 trng hp cng b. Trong , c 5 bc s nha khoa, 3 bc s ph sn v 3 bc s khoa phu thut lng ngc. Khi nh rng, tay phu thut vin c th b thng do rng bnh nhn hay dng c nha khoa, v virus t mu ca bc s nhim vo vt nh rng ca ngi bnh. Bc s ph sn c th b mi kim m trng khi tin hnh th thut thm d; cn bc s phu thut lng ngc c th b thng tay khi c xng c. iu c bit l: - C 11 phu thut vin gy tai ha ni trn trc u khng c tim chng vacxin phng VGB. - C 2 ngi b VGB cp tnh; 9 mang virus B mn tnh. Cc cng trnh nghin cu ni trn cng cho thy s cn thit phi tim phng bnh VGB cho cc phu thut vin, khng nhng bo v bn thn h m cn m bo khng ly VGB t h (nu c) sang bnh nhn. Vacxin chng VGB phi c tim nhc li u n 5 nm mt ln, nhng nhiu ngi qun mt iu . Tuy nhin, vic tim vacxin cng khng gii quyt c vn mt cch trn vn. Nhng ngi trn 40 tui thng t p ng min dch, nn vic tim phng VGB tui ny cho kt qu khng cao. Ngoi ra, nu trc khi c tim phng, bnh nhn mang virus B mn tnh th cng khng c tc dng. trnh ly vim gan cho bnh nhn, nhn vin y t cn nh: - Khi nh hng nghip theo ngoi khoa, hy i th mu tm khng th vim VGB. Nhng ngi mang virus VGB mn tnh khng nn vo ngoi khoa. - Mt phu thut vin nu khng may b VGB cp tnh hoc VGC trong giai on ti li, phi nh ch ngay vic m x v cc th thut (soi bng, chc ht mng bng, mng phi...), ngha l trnh mi nguy c mu mnh giy sang mu bnh nhn. C th xem xt vic tip tc hnh ngh ngoi khoa vo giai on khng ti li ca VGB mn tnh; tuy nhin, khng c g m bo rng nhng phu thut vin ny s khng ly VGB sang bnh nhn do h m. Tt nht l ngh hn vic phu thut cng nh cc th thut trn bnh nhn. Tp ch y hc ni trn cng cho bit, pht hin c 1 trng hp ly VGC t mt chuyn gia m tim sang bnh nhn ca ng. Cc nh nghin cu thy rng, sau khi c tim bng kim c giy mu ca ngi b VGB, nguy c ly bnh s l 30%, cn nu l VGC th t l ny ch c 3%. Cng may, bi v cho n nay ngi ta vn cha ch to c vacxin tim phng VGC. 39. C th dng thuc cha ung th ti ch khng? "M ti b ung th i trng m, sau vn phi dng tip ha cht chng ti pht v di cn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

nn xanh xao, n ung km. Y hc c cch g a thuc trc tip vo dit t bo ung th ngay ti ch cha?". Mong c ca bn, cc nh nghin cu y hc cng nung nu t lu, nhng "lc bt tng tm", cha thc hin c. Tuy nhin, h vn khng b cuc m vn ngy m tm ti, bc u thu c mt s thnh tu trn ng vt, chun b cho vic ng dng trn ngi: - Sn xut mt s dng nang thuc c cu trc c bit, khi vo n b phn b bnh th mi gii phng thuc ra, trnh h hao trong qu trnh chuyn vn, do gim c liu dng v tng hiu qu. - Da vo thnh tu ca cng ngh nano, ngi ta d kin ch to nhng bng rng siu nh (ng knh 2-3 micron) bng cht polymer, mt ngoi c gn mt enzyme, bn trong mang mt lng thuc cc nh. Cc khng th hoc khng nguyn gip n hng ng vo v tr mong mun. Khi my siu m xc nh bng n ng ch, ngi ta tng cng sut my rung lc cho thnh bng v ra, gii phng cht thuc cha tr cho cc t bo b bnh. Cng theo hng ny, ngi ta s ch to cc bng cha y xy ri a vo mu, cung cp xy thng xuyn cho nhng vng thiu mu ca tim. - V dng c y hc, cng nh cng ngh nano, M ch to thnh cng loi ng c in c h thng bnh rng cc nh dng cho cc my bm in c lun vo c th. H cng ch to c nhng u d c ng knh bng 1/1.000 ca si tc, s c a vo tn tng khu vc nh b bnh.... Australia cng lm gim c bnh ic bng cch gn nhng in cc nh xu vo cc dy thn kinh thnh gic. Hy vng c thn sinh nh ta, nh kin tr dng ha tr liu, s c c may c hng nhng thnh tu khoa hc tuyt vi ny. 40. C th b nhim khun khi bc m "Nhn dn ta c tp qun ci tng. Nu lc sinh thi, ngi qu c b mt bnh g do vi khun th bnh c ly sang nhng ngi tin hnh ci tng khng, v sau bao nhiu lu th khng cn ly c na?". Ni chung, vi khun c loi hiu kh ( sng v pht trin trong mi trng c khng kh) v ym kh (sng v pht trin trong mi trng khng c khng kh). Theo tp qun ti mt s a phng, ba nm sau khi chn ct ngi cht, ngi ta tin hnh ci tng (bc m, thay o). Lc by gi, vi khun ym kh vn sng nh m c vi khun hiu kh cng cha cht ht. V vy, khi tin hnh th tc ny, con chu phi ch ng da d mnh b sy st. Nu b, phi bi ngay thuc dit khun, tim phng un vn v dng thm thuc khng sinh nu cn. V thi hn vi khun khng cn hot ng th tht kh ni, v cc nh khoa hc phc hi c

To Ebook: Nguyn Kim V

Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


mt s vi khun b chn vi trong lng t cch y hng triu nm.

L Trng Bng

L Trng Bng 500 gii p y hc theo yu cu bn c Phn 1: Kin thc cn thit Chng 2: Dinh dng, thuc men v cc vn khc

41. Lm g trnh ng c thc n? "Thy nhiu ngi b ng c thc n, b tiu chy phi i cp cu, chng em hong qu, h ny chng dm i chi xa". Cc em hy xem k li my khu sau y, nu nh gi l t yu cu ri th s khng phi lo lng g ht. - C thng xuyn ra tay khng, nht l trc khi n bt c th g? b hn c thi quen xu l nhm nc bt vo ngn tay khi c sch? - Trc ba n, c gip m, gip ch nhng tt c bt a vo nc si khng (hay vn ch dng gi lau nh trc)?. - C gip gia nh kim tra li thc n vt b cc th bt u i thiu khng, k c nhng th trong t lnh? Nh rng nu khng c tng v sinh thng xuyn, t lnh s l ni dung dng v pht tn vi khun ng gm. - Trc khi mua bt c thc n thc ung g, c xem n m bo v sinh hay khng (c b rui, gin, thnh sng "s" vo, c tay bn ca nhng ai m vo, nc th thit hay lm t nc ging, thm ch nc sng) v tm cch khc phc trc khi n (t li bnh m trn cho nng chng hn...)? Nu bnh t xy ra th tht kinh khng, v nhng ci bn cu (h x) di ng ca ngnh ng st vung vi trn ng s l tr th c lc cho mm bnh dch t trong cc chuyn chu du nam bc. Tuy nhin, trong tnh hung khng may , nu cc em t "im 10" v my vn trn th vn i du lch c trong dp h, vn tm bin an ton nu c dn cc vng ny khng c thi xu phng u lung tung. 42. n qu mn rt nguy him "ng bc rut ca chu lm th mc, c thi quen n mn v t. Chu c bo thy ni n mn l khng tt, nhng ng ni n mn mi khe ngi. Xin cho bit thc h". n mn l mt thi quen khng tt m con ngi mc phi trong qu trnh tin ha, v s thc c th To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

khng cn mt lng mui ln nh hng ngy chng ta n vo. Tuy nhin, trc y, ngi ta cha bit n hu qu tai hi ca vic s dng qu mc mui n (NaCl) i vi sc khe con ngi. Cch y khong 20 nm, phng Ty bt u c nhng cnh bo u tin ca gii khoa hc v chuyn ny, nhng lp tc b cc ng ch chuyn ch bin thc phm tm cch chng li v chi b. V sao vy? Rt n gin l v vn li nhun. NaCl l cht gi m trong sn phm; cng nhiu mui, trng lng ca sn phm cng tng theo, m trng lng ca sn phm thc phm tng ng vi vng rng! Mui cn c coi nh mt cht "gy nghin" lm cho ngi s dng gn b vi thc phm. l cha k n li lc ca cc ng ch chuyn sn nc ng chai (n mn kht phi ung nc thm). Ch cn gim 30% lng mui trong thc phm l mi nm, cc ng ch "n theo" ny s tht thu ti 40 t frng Php. Nhng chn l l chn l. Cc nh khoa hc c bng chng cho thy vic s dng nhiu mui lm tng huyt p, bung tim tri to ra (tht tri ph i), cc chng bnh v tim mch pht trin, lm tng nguy c long xng v ung th d dy. Nm 1990, chnh ph Phn Lan buc cc nh sn xut thc phm gim mt na lng mui a vo c th mi ngy (t 12 g/ngi xung cn 6 g), lm cho t l t vong do bnh tim mch sau gim mt na. iu ny khin Phn Lan quyt nh phn u h xung cn 4 g cho n nm 2002. Chnh ph Anh hng ng ngay, quyt nh gim mc tiu th mui mi ngy xung cn 5 g/ngi; v nm 2002, tai bin v tim mch Anh gim xung cn 22%. T nm 2000, ngy 30/1 Anh c gi l "ngy khng dng mui". Ring ngy ny nm 2001 loi tr 1.000 tn mui ng l c dng cho thc phm. Php vn cha nhc nhch g v cuc tranh lun cha ng ng, trong khi ngi dn nc ny s dng mui gp 10 ln nhu cu ca c th. Php c ti 25.000 trng hp t vong v cc chng bnh c lin quan n mui. Nh vy, chu c th tranh th lc ngi bc thoi mi, c gii p ny cho bc nghe, may ra ng s bt ghin mui, v ai trn i ny chng mun sng thm c di di m vn mnh khe. Ngoi ra, nu gp bt c b m no ang nui con nh, chu nn cho h bit thm mt s liu sau y. Mt nghin cu tin hnh trn 476 tr s sinh 6 thng tui ti th Amsterdam ca H Lan cho thy: huyt p nhng tr dng sa b cha 0,1 g mui/ngy thp hn nhm dng sa b cha 0,15 g mui/ngy. 43. Khng n ti c hi g khng "Bn chu a no cng mp nn ch n sng v tra, cn ti th nhn. Xin cho bit nh vy c hi g khng?". Ti mt s vng min Bc nc ta, ngi dn qu nhn ba ti v i ng bnh thng, nm ny qua nm khc m khng thy g nguy hi. C l do lao ng mt nhc nn ti n h ln ging sm, tuy To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


bng rng khng m vn ng say.

L Trng Bng

Trng hp cc chu, nu cn i hc th ban m phi lm bi, nu bng qu i e khng li. Cc chu nn tnh ton xem lng v cht n vo hng ngy bao nhiu l va (khng cho tng cn nhiu), ri chia u ra lm ba ba. Nu thy bng "lng lo" qu th n thm rau xanh, rau c, hoa qu (tr chui v chui cng c th gy bo) cho cht d dy, nhm "nh la v an i n" trong khi mnh cn thc hc. Phi kim tra th trng hng tun trnh mt ch n thiu calo v cht dinh dng, c hi cho sc khe. 44. Phi n sng tht tt mi c "Hai chng em l n sinh lp 11, u thuc loi chng thon th g, li khng c cao ro nn nh nhn n sng bt mp. Xin cho bit c nn khng?". Nhn n sng chng nhng khng lm bt mp m cn khin em n hng hn vo cc ba n khc, li hay n thm nhiu m. Nhiu nghin cu cho thy, nu mun gim hoc khng tng cn, tt nht l n sng v n tra y , cn ba ti n nh. Cc nh nghin cu kt lun rng, vi s calo nh nhau, mt ba n phong ph dng ban sng gip gim th trng hn dng ban ti. Ngoi ra, vic n sng tt gip t kt qu hc tp cao hn: Trong nhng nm u ca thp nin 1980, ti M c nhng nghin cu cho thy, nhng hc sinh n u n hoa qu hoc nc p hoa qu trong ba sng, s im hc tp tng 16%. u nm 1999, mt nghin cu ti Boston (M) cng cho thy, nhng hc sinh c n sng t t s c kt qu hc tp cao hn (nht l v mn ton), li bt lo lng, bt nghch ngm v vui tnh hn so vi nhng em khng n sng. 45. Tc dng ca c rt "c bo, chu thy ni mt cht trong c chua chn c tc dng lm gim s pht trin ca mt s dng ung th ng rut, tuyn tin lit... C rt cng c mu nh c chua, vy n c cht chng bnh ung th khng?". Mt cng trnh nghin cu ti M c thc hin trn 13.000 ph n cho thy, nhng ngi n c rt t nht 2 ln mi tun, nguy c ung th v gim 44% so vi nhng ngi khng n. C rt cha mt lng ln cht carotenoid, c tc dng ngn nga ung th (ngay sau khi c nu chn, hm lng cht chng xy ha tng gn 35%, v vy n c rt nu chn tit kim hn n sng). C rt li khng gy bo ph. Ngoi c rt, ci bina (pinard) cng c tc dng nh trn. 46. Nn n nhiu c chua nu chn "n c chua c tt khng, v nn n sng hay nu chn?". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

u nm 1999, M cng b kt qu 35 cng trnh nghin cu cho thy, nhng ngi n nhiu c chua v cht ch bin t c chua, nguy c ung th gim 40% so vi nhng ngi n t. Kt qu r rt nht i vi bnh ung th tuyn tin lit, ung th phi v ung th d dy. C chua n sng cung cp nhiu vitamin hn do khng b nhit ph hy trong qu trnh xo nu c in; v li, n n cng khoi khu hn. Cn v c chua chn th gn y, kt qu mt nghin cu chu u trn hng nghn ngi cho thy, c chua ch bin (xo nu, nht l st c chua) cung cp mt lng lycopene di do. Lycopene c tc dng lm gim s pht trin ca mt s dng ung th ng rut, ung th tuyn tin lit, chng chng nhi mu c tim. N khng cho cc gc t do ph hy cc t bo lnh mnh ca c th. Lng lycopene trong c chua tng nhiu nu c nu chn (chng hn, st c chua c lng lycopene cao gp 5 ln so vi c chua sng). Nhit cao gip gii phng lycopene d dng, v cht bo dng trong qu trnh ch bin to thun li cho vic hp thu n. Cng trnh nghin cu ni trn cng cho thy, c chua chn cy c nhiu lycopene hn c chua chn sau khi hi. Ngoi c chua, lycopene cn c trong da hu, bi iu, tm, cua... 47. Li ch ca mt ong "M em b m nng, ang hi phc, c bi dng v ung mt ong, nhng c ngi bo ung mt ong ch nui thm bnh. Em nn ngh th no?". n mt ong khng h nui thm bnh, tri li, mt ong gip cho c th thm sc mnh chng bnh v chng hi phc. Mt ong cha 65-70% ng tri cy (glycose v levulose), mt s mui khong, axit hu c, cc men tiu ha, cc vitamin A, D, E... Ngoi tnh cht b dng, mt ong cn c tc dng tiu dit mt s vi khun c hi, cha hoc khi mt s bnh gan mt, thn kinh, lot d dy - t trng, cao huyt p, to bn, nhc u, ng km... Cui nm 1998, mt nhm nghin cu M bang Illinois cho bit, trong mt ong, nht l mt ong mu sm, c cht chng xy ha, gip c th chng tc hi ca cc gc t do. mt s nc, k c phng Ty, mt ong cn c dng phi hp vi bt qu (cinnamon) cha mt mi, cm cm, vim khp, cholesterol mu cao, bo ph, sc nghe gim, bnh tim, d dy, v sinh, au nhc (k c rng), rng tc, mn nht, eczema, hi ming. 48. Cho dinh dng n lin lina "Gn y trn th trng c loi cho dinh dng Lina n lin, c qung co l c to Spirulina giu m, khong v vitamin. C tht vy khng?". Nhiu nc trn th gii nghin cu v pht trin Spirulina platensis, loi to d nui trng, pht trin nhanh v cha nhiu cht dinh dng. N c hm lng protein (cht m) cao gp 3 ln tht b hoc tht g, 18 axit amin, trong c 8 thuc loi khng th thay th, nhiu vitamin A, B, E, PP... c bit, hm lng vitamin B12 trong to Spirulina cao gp i gan b, lng beta-caroten To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


cao gp 10 ln c rt.

L Trng Bng

Vi nhng c tnh qu bu ny, to Spirulina c trin vng c s dng rng ri trong dinh dng v iu tr nh mt loi thuc b v cha bnh, va tt va r tin. nc ta, vic nghin cu to Spirlina c tin hnh t hn 20 nm nay. Gn y, t kt qu nghin cu ca Trung tm Dinh dng tr em TP HCM, c s thc phm ng Tm sn xut mt loi cho dinh dng mang tn Lina, n lin, ng thnh gi 35 g, gm ch yu l to Spirlina. Cho cung cp 138 calo; 4,5 g cht m; 3,5 g cht bo, 22 g cht ngt, cc vitamin v cht khong. 49. C nn n ri? "M chu b cm cm, b ni l khng th n ri (con ri thng ni ln cnh ng ngoi bi qu chu vo thng 9-10). Vy b bnh g th khng c n ri?". V n ung, trong Ty y, ngi ta thng ch cp n tnh cht ca thc n (giu hay ngho protein, cht m, cht x..., nhiu hay t cc vitamin v cht khong no, c hay gy d ng khng, nn n chn, ti hay sng...) s dng ph hp cho tng i tng. Theo , m chu khng nht thit phi king ri. Tuy nhin, do ri c th gy d ng nh tm, cua (gy au bng, tiu chy, ni m ay...) nn phi cn thn, u tin hng n t . Ri cha nhiu protein, rt b dng, khng nn b ph, c th lm thnh mm ri n dn. 50. Mc kh "n mc kh li hay hi, v c nn n nhiu khng?". Mc kh cung cp mt lng protein (cht m) ng k. Ngoi ra, n cn cha mt s cht khong m ch cc loi sng bin mi c, trong c cht it. Chu l n, nu trong gia nh thng xuyn dng mui it, nay thnh thong n thm mc kh na th s khng lo b bu c. Tuy nhin, khi nng mc ch chy, chng nhng n khng ngon m cn c hi. Bo ch nhiu ln nhc cc b ni tr ng chy tht c khi rn v hn ch vic cho chng con n tht c nng, phng nga nguy c ung th rut. n g qu nhiu cng u khng tt, hung chi mc kh l loi hi sn t tin. Cn ang i hc m c thi quen n mc kh "x lng" th e rng khi thnh cn b lng s khng xi! 51. C nn n ma v c ng? "n ma nhiu hng ngy c mc bnh tiu ng khng? C phi c ng c, n vo l tc ngc v au ngi?" n nhiu ma khng gy bnh tiu ng, nhng nn n va phi v theo di th trng khng tr thnh bo ph. C ng giu cht dinh dng v cc mui khong, li khng c. Nn chn k trnh c n. V khi n bt c hi sn no cng phi xem chng phn ng ca c th, nht l nhng ngi "yu bng"; v d, n tm cua c th ni mn hoc au bng, ln cn hen... To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Cc nh khoa hc pht hin tc dng tt ca cc loi c bo (c trch, c thu, c hi, c vc, c ng...) do chng cha cc axit bo khng bo ha (nht l omega-3, lm gim triglycerid trong mu). Chng c tc dng tt trong vic phng nga mt s bnh tim mch. 52. n tht c nng c li hay hi "Mt hm chng em r nhau i picnic. Sn c c vng , chng em t la nng n, ngon lm. Tht bun ci, c mt bn nht nh khng ng n, ni l n nng s mc bnh ung th. Xin cho bit bn y ng hay sai?". Khng bun ci u, chuyn nghim tc y. Bn ca em va ng li va sai. ng nhiu v sai cht xu. ng ch bn c c sch bo hoc nghe ni v tc hi ca thi quen n nng trn la, trn than, hoc nng trong l, quay. Lu nay, nhiu nh nghin cu ln ting cnh bo rng, khi nng tht hoc c trn than nhit 500-600 C, m git xung than hng s hnh thnh cc phn t hydrocarbure thm a vng (HAP); l nhng cht gy ung th. Cn trong l, nhit 80-100 C, cht creatin (hoc creatinin) trong tht c l s tr thnh amin thm d vng (AHA). Cht ny khi vo ti gan th bin thnh cht c, sau i xung rut, to ra nguy c ung th i trng. Nhng cht tit ra lc u, nc tht nc c dnh l (m ta thng thu gom li) rt d chuyn thnh AHA. Nu v khoi khu hoc tic r m n vo, sau mt thi gian di, ta d c nguy c mc ung th. nhit trn 200 C, nhiu loi AHA khc c th hnh thnh do s phn hy axit amin. Nhng AHA ny nm ti ch tht quay b chy. Cho nn, un nu thc n bng nc, bng hi nc, xo rn va la, khng chy l an ton nht. n tht c nng thng xuyn l iu nguy him, tuy ngon ming nhng hu qu tht kh lng. Bn ca em nhn thc ng. Nhng bn y sai khi t chi tham gia ba tic . Ch n mt ba c nng, cho d n ht c chng na, th lm sao b ung th c! My khi c gn nhau, l ra c... chu kh cng n cho "vui v c nh"! 53. n g c th gy d ng? "M em hay b ni m ay, c bc s chn on l bnh d ng, cho n thuc v cn dn khng c n tm, cua, ri. Em mun bit m em cn king thm nhng g na?". D ng c th hiu nm na l "phn ng mt cch d thng i vi mt s tc nhn no ", nh hoa l (phn hoa, nha cy), vt l (bi bm, lng mo, lng chim), thuc men (penicillin, novocain), n ung (tm cua, bia ru), m phm (kem thoa mt, thuc nhum tc), thi tit ( m, nhit , p sut khng kh)... Bng lit k cc tc nhn gy d ng kh di. Nhng may mn thay, ngi b bnh d ng khng phn ng mt cch d thng vi mi tc nhn, m ch i vi mt s tc nhn nht nh thi. Chng hn, c ngi hay ni m ay khi thay i thi tit c th n nhu thoi mi m khng h hn g; c To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ngi nhp mt ngm bia thy ton thn ni mn nga, nhng c th khng s gi ma ng bc rt but. Khi bit mnh d ng vi tc nhn no th phi trnh tht xa tc nhn . D n v hi i vi ngi khc nhng rt c th gy cho mnh mt cn sc phn v rt kh cu cha (phn v c th hiu nm na l "phn li s t bo v ca c th"). Ngoi ra, ngi c c a d ng phi ht sc cn thn khi tip xc ln u vi mt tc nhn m mnh cha tri nghim, v c th s phn ng mt cch d thng vi n. Mt chuyn gia v vn ha (ngi phng Ty) khi n cng tc nc ta thng a cho ngi phc v n ung xem mt mnh ba ghi bng ting Vit: "Ti b d ng i vi m ng vt, gng, ht tiu v lc. Xin ng cho vo n ca ti nhng th ny trnh nguy him n tnh mng ti". u nm 1999, Vin nghin cu d ng, hen v min dch ca M cho bit, khong 1% dn s ca nc ny b d ng vi lc, trong s t vong v ng c thc n hng nm, phn ln b d ng vi lc. Trc tnh hnh , mt s hng hng khng trn th gii hn ch vic bn lc rang hay bnh ko ch bin t lc, s rng hnh khch c th ht phi bi lc tung ra t trong bao gi! Cc nh khoa hc M cng pht hin ra mt gene nghi l th phm gy d ng, l gene pCMVArah2. H ang s dng n vo vic ch to mt vacxin tim phng. Trng hp ca m em, v th ni khng chi tit, nn khng bit m d ng vi nhng tc nhn no v bng con ng no (n ung, ht th hay do thay i thi tit...). Tuy nhin, c th gip c th m em bt dn d ng bng mt v thuc ung kh hu hiu, d kim v r tin. 54. Rau sn ph "Ti thy mt s ngi hay n rau sn ph, nh vy c tt khng? Rau thai cha c nhng bnh g? C cch g ch bin n tin dng?". Rau sn ph rt giu protein (cht m), m li l protein ca ngi, d hp thu hn c, c th ni l loi tht b nht trn i; tic rng trc nay ta thnh kin cho n l bn nn chn mt. Tr b suy dinh dng, ngi mi m dy, ngi gy yu t ng dng rt tt. Theo cc ti liu c, rau sn ph c tc dng i b kh huyt, dng cha gy yu, hen suyn, ra nhiu m hi, au nhc xng, di tinh, hot tinh. Cch ch bin: -Rau b mng i v cung rn, thm kh, t vo t sy cho kh gin, em nghin thnh bt, ng vo l kn dng dn. - Ngm rau vo mt ong mt thi gian cho tan ra, vt b b. Khi dng, c th thm cht ru thuc cho d ung. Phi mt ong tht th rau mi tan. Trong thi gian ngm, khng nt l qu kn khi n v. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


- Ngm rau vo ru. Ngi bo khng nn dng. 55. Tha st li hay hi

L Trng Bng

"Ti cn nh trc y c quan dc phm pha Bc c sn xut vin st dng cho ngi thiu mu, v sao hin nay khng thy bn? Con gi u lng ca ti c thai ln u, ti mun chu c thm cht st cho khe c con ln m". u tin, xin trao i vi bc v chuyn thai nghn. Ta hay ngh gin n v lch lc l h c thai th ci g t nht cng phi "gp i", phi thuc men, tm b, d tn km my cng vui lng, c m trn con vung. Trong khi , khoa hc li thy rng c th ca thai ph v thai nhi bit cch iu chnh hp l con pht trin bnh thng m khng gy hi cho m. V vy, ngi c thai ch cn n ung cht u n bnh thng l . Tuy nhin, d phng khi ch n thiu mt s vitamin ti cn cho thai, ngi ta khuyn co thai ph nn dng thm 2 vitamin chnh: - Vitamin B9, tc axit folic, c vai tr quan trng i vi s pht trin ca ng thn kinh ngay t nhng ngy u ca thai, ung lin tc trong thi gian thai nghn, 500 microgram/ngy. - Vitamin D, cn cho s pht trin xng, ung t thng th 7 tr i, 100.000 IU/ngy. V cht st, trc y do nhn thc sai, ta hay "v st" cho cc ch em c thai, do bt p h n nhiu gan n pht khip (gan cha nhiu st hn tht). Trong chuyn ny, ngi thy thuc do trc cng c li v cho rng st ch c mt tch cc. Mt cng trnh nghin cu ca Italy, tin hnh trn 826 ngi ln c nam ln n, tui t 40 n 79, cho thy r mi lin quan gia m st trong mu v tc tin trin ca chng x va ng mch. Nghin cu khng nh rng, vic tha st s c hi cho tim mch. Ngi n qu nhiu tht ln, tht b, ngi dng a sinh t vi liu qu cao... thng xuyn a vo c th mt lng st ln, chng nhng khng ch li g m cn c hi. Cui nm 1997, on bc s ph sn quc t ca Php tuyn b chng li vic s dng st ng lot cho thai ph. 56. Mi lin quan gia ng v bnh tiu ng "Chu 19 tui, ang tp th hnh v rt thch ung nc ng sau cc bui tp. Xin cho bit vic ung nhiu ng c gy bnh tiu ng khng?" Mt nghin cu ca nc ngoi c cng b nm 1997 cho thy, nhng ngi s dng ng mt cch v , nguy c b bnh tiu ng gia tng. Cc nh nghin cu bang California (M) th nghim trn chut v nhn nh rng, mt ch n nhiu m v ng dn n hin tng gia tng tnh khng insulin ca c th, triu chng m u cho s xut hin bnh tiu ng khng ph thuc insulin (type 2) con ngi. Chu vn cn ung ng b p cho vic tiu hao nng lng, nhng ng thi qu; nn n To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

thm cm, chui v cc cht bt khc. Dng thm mi ngy 1 vin a sinh t b sung vitamin v cht khong. 57. Mi lin quan gia ru v ng "Nhiu ngi ni, ru pha ng hay mt ong ung say hn ru nguyn. iu c ng khng, ti sao?". Nhn nh khng ng. Tri li, khong t cui thp nin 1920, ngi ta bit rng cc loi ng, nht l ng fructose (ly t qu cy), c tc dng lm chm vic hp thu ru ca c th v thc y qu trnh phn hy ru ca gan; v ru pha ng ung t say hn ru nguyn. Ngi ta dng ng thng cho ru vo d dy chut, sau cho thm mt dung dch ng (trong fructose chim 36%) ri t chut ln vn bp bnh kim tra hot ng thn kinh. H dng my t ng ly mu ui chut xt nghim xc nh lng ru trong mu tng na gi mt. Kt qu cho thy, so vi nhm i chng, nhng con chut ny, lng ru trong mu thp hn 29%, thi gian phn hy ru ngn hn 31%; thi gian ru lu thng trong mu gim 24%. Ung ng cng lc vi ru hay 3 gi sau khi ung ru u c tc dng tt ngang nhau. Cc nghin cu v tc dng ca ng fructose trn ngi cho kt qu nh sau: ngi khng ung ru, thi gian phn ng ca thn kinh l 0,48 giy. Lc ru ngm ti a vo mu, thi gian ny ko di ti 0,56 giy. Sau khi dng 50g ng fructose, thi gian phn ng tr li 0,49 giy (gn bnh thng). iu c bit l, nu dng 100 g ng fructose th thi gian phn ng ch cn 0,47 giy (nhanh hn bnh thng); mc d lc , lng ru trong mu vn cn mc 0,35 g/l. Ngi ta cng thy, ng fructose c tc dng tt i vi hot ng thn kinh ca ngi ung ru. Liu 100 g lm cho lng ru trong mu gim 50%. R rng, ng fructose c tc dng "gi ru" rt tt (cc ng khc nh glucose, lactose, saccharose c tc dng km hn). Nhng iu khng c g ng con ma ru phn khi c. Theo cc bc s chuyn nghin cu v ru, ngi thng xuyn s dng ng vi liu cao s b chng bo ph, cao huyt p, bnh mch vnh... 58. Thm ng sa vo tr "Ung nhiu ch (tr en, tr xanh) c tt khng? Mt s ngi ghin ch ni rng pha ng hoc sa vo ch l khng tt. Xin cho bit ti sao?". Tr en cha cht catechine, c tc dng chng bnh tim mch. Tr xanh lm gim 1/3 nguy c mc ung th d dy nhng ngi ung t nht 7 tch mi ngy. Mt nghin cu ca M tin hnh trn 680 ngi cho thy, ngi ung t nht 1 tch tr mi ngy, nguy c b cn au tim gim 46% so vi ngi khng ung. Tr sung hay pha ng, sa u c tc dng nh nhau (sau khi ung, ngi ta thy lng catechine trong mu c hai trng hp thm hoc khng thm ng sa l ngang nhau). D nhin, To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ng sa cung cp thm nng lng cho c th, nht l sau khi vn ng th lc. Nu s bo ph th ng cho vo. Nu cha quen dng tr th ng pha m (lm tim p mnh) v trnh ung tr vo ban ti, thm ch bui chiu (v d b mt ng). Trnh ung tr c ngay sau ba n v s gy kh tiu. 59. Qu ng c yn tm ung c ph "Chng ti c thi quen ung c ph hng ngy. Hm qua, ti nghe mt anh bn bo rng v c ph gy ung th nn mi b rt gi". Chc ngi ni a thi. ng l c ph rt gi, nhng khng phi do nguyn nhn nh bn ni. Mi gi c trn th trng u c th bin ng, tri st. Xin ng v tin n nhm m lo lng hoc ng x khng ng ri phi hi tic. Nu khng b cao huyt p v khng hay mt ng, qu ng c yn tm ung c ph, v cho ti nay, cha c cng trnh khoa hc no kt lun l c ph gy ung th. Ngc li, mt nghin cu ca Nht Bn tin hnh trn 1.700 bnh nhn ung th ng tiu ha v 21.000 ngi khe mnh cho thy, nhng ngi dng t nht 3 tch c ph mi ngy, nguy c ung th i trng (rut gi) gim 54%. Cn cc qu b nn lu : Theo mt nghin cu ca Thy in, thai ph ung mi ngy 5 tch c ph, t l sy thai cao gp i so vi cc thai ph ch ung 1 tch, d l c ph nguyn hay kh cafein. 60. C nn dng l vi sng? "V chng chng ti va c chu nh nn c nh mua mt l vi sng. Nhng c ngi ni l vi sng lm cho thc n bin thnh cht c. Xin cho bit kin". Cho n nay, cha thy thng bo khoa hc no ni l l vi sng (viba) bin thc phm thnh cht c. Cc bn c yn tm mua, min l theo ng ch dn ca nh sn xut. L vi sng dng rt tt cho c, rau, cht lng, thc n khng bo, gi c vitamin v cht khong. Ch xin cc bn lu : - Khi un nu bng l vi sng, do nhit phn b khng u trong thc n nn c th khng dit ht c vi khun trong thc phm. Ngi ta pht hin vi khun salmonella gy bnh ng rut trong mt s trng lacoc un bng l vi sng. Cc bn nh kim tra mc chn ca tng loi thc n duy tr cho thi gian chn u. - Mt s thnh t ca bao gi v nhng cht hin din trn bao gi plastic (t mc in nhn) c th i sang thc n un nu bng l vi sng. - Khng dng l vi sng nu tht ln p hoc thn ln hun khi (c cha mui nitrit) v vic ny s to ra cc nitrosamin - nhng phn t gy ung th rt mnh. 61. Nc thi phn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

"Nc ging ca gia nh ti lun lun trong nhng li b thi phn, nu cm b vng... Liu c cch no lm ht c?". Ngun nc ging nh bc c nhiu st, v iu ny khng gii quyt c t gc. Nc mi u trong v cht st c ha tan (st 2), khin bc khng nhn thy. Khi gp xy trong khng kh, cht st kt ta (st 3), c mu vng l lng trong nc. Cch khc phc nh sau: - Nc mc t ging ln c cha vo thng v khuy o nhiu ln trong vi ba ngy cht st ha tan b kt ta (nc t ch trong vt chuyn sang vng kh, cho vng ti a). - em nc ny vo b lc thng thng (gm ct, si l ch yu), cng nhiu lp cng hay. Nc ln ny trong v li cn st kt ta trong ct. nh k sc b, ra sch ct si tip tc lc c tt. Xin bc lu l nu em lc nc va mc t ging ln th s khng kt qu, bi v cht st ha tan khng b ct gi li, nc "lc" ri vn gi nguyn cht st v vn tr thnh vng nh thng. 62. Nc c cht vi "Ti gn ni , ging nc bnh thng nhn trong nhng dng nu nc ch xanh th ung nht v nc c mng, luc rau mung th nc xanh nh nc ru, un si ngui th bn di c mt lp phn nh vi. Xin hi n vo c vic g khng?". Nc vng c nhiu cht canxi ha tan; khi un si ngui, n lng xung y chai. Mi khi ung, phi gn cho kho trnh a vo c th mnh qu nhiu canxi. Ngoi ra, bn cn ch dng mui it u n v cng b con c bc trong vng lun cnh gic vi bnh bu c. 63. Phi ung t t "ang kht chy c m ung tht nhiu nc mt lc th c hi g khng?". Khi ta nhn ung, lc u, lng nc b thiu cha nhiu, cc t bo ca c th t iu chnh c bng nc hin hu trong mu. Do mu thiu nc nn nim mc (trong c nim mc ming) b se, khin ta c cm gic kht, gi l kht nim mc. Ch cn mt lng nc nh b sung cho mu l s ht kht. Nu c tip tc nhn ung, nht l khi ang ra nhiu m hi, cht nc trong mu s cn, cc t bo lm vo tnh trng thiu nc (cng lc cng nghim trng), gi l kht t bo. Lc ny, d ung ngay mt lc bao nhiu nc cng vn thy kht, bi l nc cha kp ti cc t bo. Nh vy, bn thy ngay rng, d kht chy c, bn vn nn ung c chng mc, chia thnh nhiu ln, t tn, u n cho ti khi ht hn cm gic kht. Tt nht l ung qua ng ht d ch ng. Vic ung ngay mt lng nc ln l iu rt nguy him v c th gy hin tng ph no, hn m, d dn ti t vong. V vy m ngi nui nga c bao gi cho nga va ua xong mc sc ung nc u! Trong sinh hot hng ngy, nn duy tr thi quen ung nc mt cch u n, cho d lc by gi To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

khng c cm gic kht thc s. Bi v khi cho mnh thy kht l kh mun. Lc , lng nc mt i t nht bng 1% th trng; ngha l mt ngi nng 50 kg mt ti thiu 0,5 lt nc khi anh ta bt u thy kht. Ngay c khi nm ngh ngi thoi mi, mi ngy m, c th cng thi ra khong 2,5 lt nc (bao gm nc tiu, m hi v hi nc qua phi). Cn khi i b bnh thng, mi gi c th thi ra t nht 0,5 lt m hi. Nhng con s ny s tng ln khi thi tit nng nc. 64. Ti sao vn khng kht "Chng em thuc i bng ca nh trng. Sau mi trn u, c bn thng r nhau i ung nc ngt; nhng ung ht c tin m vn khng kht. Xin cho bit ti sao?". Theo cc ti liu nghin cu mi nht, sau mt trn bng quc t, mi cu th thng thi ra 3-4 lt m hi. Cc em l cu th "nh", tm cho l ch mt 1/3 lng . K nc tiu v hi nc bc ra theo ng h hp, c tm c tnh khim tn l 2 lt. C th cc em ung vo hn 2 lt nc ngt, tng ri, nhng vn kht ch g? Nguyn nhn u tin l cc em ung nhanh qu. iu ny kch thch m hi tit nhiu hn, lm cho cc em tip tc mt nc thm mt lc na. Nhng vn ny khng ln. Nguyn nhn quan trng hn l cc em ch ung nc ngt, c ng kh cao, gy tr ngi cho vic hp thu nc ca c th (bn thn nc ngt l mt dung dch u trng, khng d g "chia bt nc" cho c th). Cch khc phc khng kh: Khng ung nc ngt nguyn cht m pha long mc 60 g ng trong 1 lt. Dng nc tri cy, rau m, nc ru ng (bp), hay nc ch xanh, nc rau luc ca gia nh cng rt tt (lng ng pha vo khng c qu mc trn). Phi ung t tn tng ngm nh mt, tt nht l qua ng ht m bo ung tht chm. iu quan trng l tp thi quen ung khi cha thy kht. Trong qu trnh thi u, cc em phi tranh th mi thi c b sung nc thng xuyn. Nhiu nghin cu cho thy, nu c th vn ng vin mt mt lng nc bng 1% th trng, thnh tch thi u ca anh ta s gim 20%, anh ta li d b chut rt. 65. C nn ung nhiu nc? "Ung nhiu nc th phi i tiu nhiu, nh vy c lm mt cho thn khng?". Ngc li. Ta ung nc th thn lc nh nhng, vt v; cc cht cn b ha tan trong mu c pha long nn d i qua mng lc. Nu ta n mn, thn phi lm vic cng hn thi cht mui (ch gi li mt t l khng i l 0,9%). Ta thng n mn do thi quen ch khng phi do cn thit; ngi thng xuyn n qu mn d b tng huyt p. Mt cng trnh nghin cu ca Anh tin hnh trong 10 nm trn 48.000 ngi cho thy, nu trung bnh mi ngy ta ung 1,5 lt nc, t l ung th bng quang s gim 50%. Vic i tiu nhiu ln s lm cho cc cht gy ung th khng nm lu trong bng quang gy hi. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


66. Ch em c nn dng ru b?

L Trng Bng

"Em l con gi nhng trong ba n, c thy ng ni nhm nhi ly ru b thm phc l em pht thm. Xin th ni khng cho v bo th ny ch c nam mi dng c. Xin cho bit c loi ru b no dnh cho n khng?". ng ni em ni ng y. Nam thuc dng, n thuc m nn theo y hc phng ng, vic s dng thuc cng nh king c trong thi gian mc bnh 2 gii c nhng ch khc bit. V thuc b cng vy, khng phi bt c thuc g b cho nam cng s b cho n. Ring vi em, do thy em hnh nh hi c "mu" thch ru ging ng ni nn ti mun cung cp kt qu mt nghin cu ca M: nhng ph n ung u n mi ngy 1 ly ru, nguy c ung th v tng 11%, ung 2 ly: tng 24%; trn 2 ly: tng 40%. Ngi ta thng bo nh vy, khng bit ch em nh ta c nn dng ru b hay khng? 67. C nn dng nhiu cam tho? "Em l con trai, ang hc lp 12 mt trng kh xa nh. ng ni em l lng y nn t b em thch nhai cam tho. Liu c nn cho nc sc cam tho vo nc gii kht sau khi i hc v?". Cam tho l mt v thuc dng phi hp trong ng y cha mt s bnh. Nhc im quan trng ca cam tho l gi nc li trong c th nn nu c dng trong thi gian di, n s d gy ph n (m mi u ta tng l tng cn nhanh nn rt phn khi!). Do , t lu, cc thy thuc phng Ty i n ch kt lun rng cam tho khng tt i vi huyt p. Mt nhm nghin cu Italy cn pht hin thm nhc im ca cam tho l gim sc khe gii tnh ca nam gii. H cho 7 thanh nin (22-24 tui) ung mt cht thuc trong ch yu l cam tho sut mt tun lin. Kt qu l t l hoc mn nam ca c 7 ngi u gim st. R rng l cam tho can thip vo v c ch dy chuyn tng hp hoc mn nam, t dn n nhng ri lon sinh dc lm gim hng th la i. Nh vy, i lc nhm nhi cht xu cam tho "cho zui" th c, cn tuyt i khng nn dng n thng xuyn, nht l con trai. 68. Nn l bng cha bnh ng rut "Em b si bng lin tc v hay i tiu phn lng nn ngi rt gy...; M chu b bnh ng rut lu, ung rt nhiu loi thuc Ty, thuc Bc nhng khng khi, sc khe suy sp...; Em b vim i trng v d dy - t trng, ung nhiu thuc khng ...; Ti c bc s kt lun l vim i trng mn v tr, hay b to bn xen k i tiu phn nhy, au v si bng thng xuyn..." C mt v thuc khng c, d kim v khng mt tin mua, c b con mt s vng qu min Trung dng cha bnh mn tnh ng tiu ha. Thuc ny cho kt qu kh quan v lm sng, k c lot hnh t trng. l nn l (t non) ca cy bng. Cch dng nh sau: Hi nhng nn l bng lnh ln (ma khng cn nn th dng nhng l non nht To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

bn trn cng c), nh tay ra sch, thi nh, rang vng (khng chy) ri sc vi nc, ung thay nc ch (c th thm ng). Theo tin s dc hc Tt Li th v, l v nhn ht ca cy bng u c tc dng cha bnh v khng c. Tuy vy, ln u, nn dng mt nm nh ri tng dn ln cho ti liu hu hiu. Khi mi ung c 1-2 ngy, bnh nhn c th i lng rt nhiu nhng ng s, c tip tc s c kt qu. 69. Tm sen "Mi ln ung tr, ti thng b mt ng nn phi dng tm sen ch nc ung hng ngy, thy ng c. Nhng c ngi bo tm sen gy ung th v n l phn vt i. Xin cho bit tc dng ca tm sen. C nn dng n ung thay tr?" Tm sen (chi mm nm trong ht sen) gi l lin tm hay lin t tm, em phi kh hay sy kh c tc dng cha hi hp, mt ng, di mng tinh; mi ngy ung 4-10 g di dng thuc sc hay thuc pha (hm). Bn thuc dng thn kinh nhy cm vi cc cht kch thch, khng nn ung tr (hoc ch xanh) vo bui chiu. Nu mun c gic ng tra, khng nn dng tr mun trong bui sng v d nhin l khng nn ung c ph. i vi tm sen, khi thy ng tt, nn gim dn liu lng xung mt mc thch ng, tin ti thi hn v dng nc chn. Ngoi tm sen, cy sen cn cho ta nhiu v thuc nh: - Ng sen, gi l lin ngu, dng lm thuc cm mu. - Ht sen c v (ni "qu sen" mi ng) c gi l thch lin t, dng cha l cm khu. Ht sen b v c gi l lin nhc hay lin t, dng lm thuc b, cha di tinh, mt ng, suy nhc thn kinh... - Gng sen gi b ht ht, phi kh (lin phng) v l sen (h dip) u c dng lm thuc cm mu. - Tua nh sen b "ht go", phi kh, gi l lin tu, dng cha xut huyt, di mng tinh. 70. H th "Chu l con gi, gn y trn u thy nhiu si tc bc, mt s bn chu cng vy. Nghe ni h th c th lm en tc?". H th c nhn dn dng lm thuc b, tr thn kinh suy nhc, khe gn ct, sng lu, lm en tc... c mt s phng thuc kt hp h th vi cc v thuc khc cha bnh. Ring v tc dng ca h th i vi chng tc bc sm, cho n nay, cha c cng trnh nghin cu nghim tc no khng nh hay ph nh. Tuy nhin, theo mt quan nim thng thng, ngi ta cho rng nhng cht c mu en (vng en, u en, g en...) c th gip lm tr ngi, en tc... Trong dn gian lu nay vn lu hnh cch h th vi en, em phi kh, xong li tip nh trn ng 7 ln ( dng cho nam) hoc 9 ln ( dng cho n); n lin tc thng xuyn cho ti khi To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


t kt qu. Nu c iu kin, chu th vn dng xem. 71. Mch mn, tam tht

L Trng Bng

" lm nhun phi, long m v tr ho, nn dng c mch mn c v hay kt hp vi cc v khc? Tng t, dng tam tht trc huyt cho sn ph nh th no?". C mch mn (cn gi l mch mn ng, lan tin) c th dng c v (mi ngy 6-20 g di dng thuc sc) hoc phi hp vi mt s v nh trong bi thuc cha ho, kh th, ho lu ngy sau y: C mch mn ng 16 g, bn h 8 g, ng sm 4 g, cam tho 4 g, go np sao vng 4 g, i to 4 g, nc 600 ml. Sc trn bp nh la cn 200 ml, chia ung lm 3 ln trong ngy. Tam tht (cn gi l sm tam tht) c th s dng di dng thuc sc hay thuc bt, mi ngy 4-8 g. Dng trong cc trng hp b chn thng c huyt, sng au. Ngoi ra, theo kt qu mt s cng trnh nghin cu trong nc, tam tht c tc dng phng nga hin tng ung th ha. Cch dng tit kim nht l ngm mt mu c, cho thuc ngm dn qua nim mc ming, khng b dch tiu ha tc ng (ban u thy ng, nhng v sau li thy v ngt d chu). 72. V cy dn "V cy dn c tc dng g m mt s ngi thng dng nu nc ung?" Cy dn cn c tn l cy sai, cy thi rut (v ngay t khi cy cn non, ty cy b tiu hy), tn khoa hc Xylopia vielana Pierre, c th cao ti trn 20 mt, v mu nu tm rt d bc. V ly t cy ti, em phi hay sy kh dng dn. Nhn dn dng v cy dn sc ung cha kinh nguyt khng u, thiu mu; dng l cy sc ung cha au nhc t thp. min Trung, min Nam, ngi ta dng v cy dn tn bt hay ngm ru cha st rt v lm thuc b. Liu dng hng ngy: 5-10 gam v kh. 73. Hy th "lm cho ngc n nang" "Gn y, ti c gii thiu mt bi thuc lm ngc n nang dn gm: thuc cu (ngi dip) 1 nm, ngh sng 1 c bng ngn tay ci, c rt 200 g. Ba th gi nt, vt vi nc da no, ung hng m. Bi ny c cng hiu khng? Thuc cu cn c tn g khc khng?". Theo ti liu ca gio s Tt Li, cy thuc cu cn c tn gi l ngi cu, tn khoa hc Artemisia vulgaris L., thuc h Cc. Trong ng y, n c dng lm thuc iu ha kinh nguyt, an thai (khng kch thch d con nn khng gy sy thai); tng cng tiu ha, cha au bng... My th bn k u l thc n thng thng, trong ngh c tc dng kch thch s tit mt ca t bo gan, lm h cholestrol trong mu; c rt cung cp caroten (tin vitamin A), chng li tc ng nguy hi ca cc gc t do, chng i lng (tiu chy); ci da cha nhiu cht bo, glucid v protid; nc da cha nhiu axit amin, li tiu...Nu dng th chc cng tt, li r tin. Tuy nhin, khi "n To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

nang" c kh xinh ri l phi gim liu trnh nguy c tr thnh ... thng ton n. Cc v thuc trn u khng c tc dng lm ngc to ra. 74. Thuc dn gian cha vim a khp dng thp "Ti c bc s chn on l vim a khp dng thp, cho dng nhiu thuc ty khng khi. Xin cho ti mt cch cha no n gin m hu hiu". Nu ng bnh ca bn l vim a khp dng thp (khc vi bnh thp khp v bnh sinh, din bin, tin lng...), th xin mi bn dng th my v thuc dn gian d kim sau: 1. L cy chay qu (ging cy chay cho v n tru, nhng c qu chn mu vng, bn trong cha cm mu , v chua ngt) ra sch, sao vng, sc ung, mi ngy 20 g. 2. Hai ngy u dng nc nho ti hoc nc bi (0,5 lt/ngy). Hai ngy k tip dng mi ngy 0,5 lt nc cn ty. Hai ngy tip dng mi ngy 0,5 lt nc p c rt v cn ty. Nn chia lm 2-3 ln ung mi ngy. Nu khi, ung tip 1 tun c rt + to ty + cn ty (ba th bng nhau, cho ra 0,5 lt/ngy). Nu cha khi, lm li t u. Trong khi dng liu php ny, khng nn dng bt c thuc g. 75. Cy c mc (cy nh ni) "Trong mt n thuc nam ca ngi nh, em thy ghi cy c mc. N l cy g, cng dng ra sao, c phi l cy c lng vc nh mt s ngi bo?". y l hai loi cy khc nhau. C lng vc l loi c di hi cy trng. Cy c mc (cn gi l cy nh ni, hn lin tho) l mt v thuc nam qu gi. Cy c mc mc hoang khp nc ta. C mc mc thng ng, c th cao ti 80 cm, thn c lng cng, l mc i c lng hai mt, di 2-8 cm, rng 5-15 mm. Cy c mc khng c, ti hay kh u c tc dng cm mu nh lm tng t l prothrombin ton phn. Dn gian dng thn l gi nt, vt nc ung cha rong kinh, tr ra mu, vt thng chy mu, cha vim hng, nm da... C ni cn sc ung hoc ngm vo du da em bi ln u cho en ru tc. 76. Cy h "Ti thy dn gian hay dng l h cha mt s bnh. Xin cho bit khoa hc xc nh c tc dng ca cy h cha? C phi trong nam gi h l nn khng?". Ti vng trung Trung B c c nn, hi ging c hnh tm ngoi Bc nhng mi hc, khng thm bng hnh tm, c trn, to v chc hn; chng ti cha tm c ti liu nghin cu v c nn. V cy h, Trung Quc t hn 50 nm nay c mt s nghin cu kh su, cho thy: Nc p h ti cha cht odorin, c tc dng dit t cu vng v mt s vi khun gy bnh ng rut, k c thng hn v l. Tc dng trn s mt hon ton nu nc p c un nng. nc ta, nhn dn thng dng h (l, r, c) cha ho tr em, gip tiu ha tt, b gan, cha l, To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

giun kim... Liu dng hng ngy 20-30 g (trn ng, hp cm hay un cch thy). Ht ca cy h (cu t, cu thi t) c dng cha mng tinh, mi gi, au lng... vi liu 6-12 g (nc sc) mi ngy. 77. C ngh en "Xin cho bit ngh en cha c nhng bnh g?". ng y dng ngh en (nga trut) cha chng au ngc hoc bng, n ung kh tiu. Ngh en cn c tc dng cha ho, b kinh, kinh nguyt khng u. Mi ngy dng 3-6 g di dng thuc sc, thuc bt hay thuc vin. Ngh en c v ng, cay nn ngi ta thng thm mt ong hay lm thnh t cho d ung. 78. Cy inh lng "Nh chu trng inh lng c 10 nm. Va ri b chu o ly c, thi ming, phi kh, hm vo nc si ung nh nc ch. Xin cho bit nh vy c tt khng?". Cy inh lng (cn gi l cy gi c) c tc dng tng sc do dai ca c th, chng mi mt (r inh lng thi mng, phi kh 0,5 g; cho vo 100 ml nc, un si trong na gi, chia thnh 2-3 ln ung trong ngy); cha tc tia sa (r inh lng 30-40 g, cho vo 1/2 lt nc, sc cn 1/4 lt, ung nng trong 2-3 ngy lin). Nhiu ti liu cng cho bit inh lng c tc dng li tiu, tng cng h hp, lm tng nh co bp t cung... Nh vy, b chu c th dng thng xuyn "nc ch inh lng", nhng cn ch n liu lng hng ngy ni trn. 79. L cy ct ln cha vim xoang "Chng em b vim xoang, cha mi khng khi, m nghe ni n m li s. Xin cho bit hin c phng php no hu hiu cha khi vim xoang?". Cc bin php cha vim xoang bao gm s dng khng sinh ton thn, chc ht xoang kt hp vi bm ti ch cc thuc khng sinh v chng vim. Phu thut c xoang l bin php cui cng, nhng c kh nhiu trng hp ti pht. C mt loi cy d kim nhng c th cha vim xoang kh cng hiu: Cy ct ln (cn gi l cy c hi, cy b xt, c ct heo), tn khoa hc Ageratum cony-zoides L., thuc h Cc. y l mt cy nh, mc hoang, cao khong 30-60 cm, thn c nhiu lng mm. L mc i, hnh trng hay ba cnh, di 2-6 cm, rng 1-3 cm, mp c rng ca trn, hai mt l u c lng (khi v ra c mi hng hc, nhng khi un nc li c mi thm, thng c mt s ch em nng thn dng gi u). Hoa nh mu tm, xanh. Ly mt nm l ti, ra nh tay cho sch, gi nt ri vt ly nc em nh vo hai l mi. Nm nga chng 10-15 pht, di hai vai c k gi l mi dc ngc, cho php thuc ngm vo To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


xoang. Lm mi ngy 1-2 ln cho n khi khi. 80. Ung ch hoa ho c hi khng

L Trng Bng

"Ti nghe cc c ni ung ch hoa ho s b long tinh v khng c con. iu c ng khng?". Hoa ho (tn khoa hc Sophora japonica L.) c nhn dn ta dng lm thuc cm mu khi b ho ra mu, mu cam, tiu tin ra huyt, tr chy mu (mi ngy ung 5-20 g n hoa ho phi kh di dng thuc sc). Ty y dng cht rutin chit xut t hoa ho cho nhng bnh nhn cao huyt p tng cng sc chu ng ca mao mch. Cho n nay, cha c ti liu khoa hc no cho thy hoa ho gy hi cho h sinh dc nam ni ring cng nh i vi cc c quan ni chung. 81. Cy sng i "Xin cho bit tc dng ca cy sng i". Cy sng i (cn gi l cy trng sinh, cy thuc bng...) c nhn dn dng lm thuc cha bng, cm mu, p vt thng, cha mt , sng au. Cc nh khoa hc n chit c t cy sng i mt hot cht gi l bryophulin c tc dng khng khun, c th dng iu tr mt s bnh ng rut. Khi dng cy ny, bn nh ra sch t ct cng nh cc cht l bm vo. 82. L cy gy nga "Va ri chng chu v chi vng ni, khi chui vo bi chm phi loi cy g l to v c lng, b nga gh gm. l cy g vy, ti sao l n nga th?". l cy l han. Trn b mt l ca mt s cy nh l han, tm ma c nhiu gai nhn di, dnh h vo t chc ca l bng mt t bo n c. Ch cn chm nh l nhng gai nhn ri ra ngay v cm vo da, gii phng 2 cht acetylcholin v histamin, lm cho da ng , va but va nga kinh khng; nu b nhiu c th d ng ton thn. Cc c gi sng mt th trn ca tnh H Tnh cn nh, hi nm 1945, c ln my tn lnh pht xt i tin ba bi xong hi l han chi. Ngay sau chng phi chy v ni tr qun, cha mng ra bt my a khc va qut va di nc mi vn khng . 83. Mt gu "Xin cho bit tc dng ca mt gu v cch s dng. C phi mt gu cha khi bnh vim gan mn khng?". Theo ti liu c, mt gu v ng, tnh hn, c tc dng thanh nhit, dit khun. Trong cun Nhng cy thuc v v thuc Vit Nam, gio s dc hc Tt Li vit: "Mt gu l mt v thuc rt qu trong nhn dn, dng cha au d dy, au nhc, gip tiu ha, gii c, cha hong n. Dng ngoi, mt gu c tc dng lm ht xung huyt, nh mt cha au mt; xoa bp cha sng au do ng hay b thng". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


Liu dng: Mi ngy c th ung t 0,5 g n 1-2 g.

L Trng Bng

cha mt sng , dng mt gu mt lng bng ht go mi cho tan vo khong 1 ml nc chn, nh mt. xoa bp ch sng au, dng mt gu 5 g ha tan trong 100 ml ru 35 . n nay, cha thy thng bo no cng b no v kt qu cha khi vim gan mn ca mt gu, nhng bnh nhn c th dng th v theo kt qu nghin cu ca Hc vin qun y v Vin cng ngh sinh hc, nhiu trng hp x gan c cha khi bng mt gu nui. phng Ty, t hn 10 nm nay, ngi ta dng mt gu ch thuc cha vim ti mt mn vi bit dc Ursolvan. Vi nm gn y, nhiu ngi Vit Nam tm mua mt gu cha bnh ung th. C ngi ni , thm ch khi; nhng cha thy c cng b no v kt qu cha tr. 84. Phn con quy dng lm thuc "Ti nghe ni phn con quy c tc dng cha cam, si cho tr, khng bit c ng khng?". Theo gio s dc hc Tt Li, con quy (cn gi l mt go, mt ng) l mt loi cn trng nh di 2-3 mm, rng 1-2 mm, cnh cng mu en, thng thy cc kho ng cc hoc trong thp go h lu. Mt i v chng con quy sau khong mt thng sinh ra chng 35-50 con quy con. Mt s ni dng bng ng nui con quy ly phn lm thuc. Ry phn ri em sao trn cho nh la cho kh v thm. C th dng ring (mi ngy t 2 n 4 g) hoc kt hp vi mt vi v thuc khc cha tr em gy cm, bing n, tiu ha km: Bch ch 2 g, s quan t 2 g thi mng, sao vng cho thm, trn u vi 10 g phn quy sao vng, tn nh. Mi ngy dng 2-3 g bt ny, chia lm 2-3 ln ung. Nm 1978, i hc y Bc Thi tin hnh phn tch v thy phn quy c cc axit amin cn thit cho c th nh: lysine, arginine, histidine, leucine, isoleucine, valine, threonine, methionine, phenylalanin. 85. Cao d ton tnh " qu em, mt s ngi trc y thnh thong nu cao xng h, xng kh, xng trn..., chia nhau dng hoc em bn. Nay h nu cao d, khng phi ch xng m nu c con d, ch co lng v vt b rut. Xin cho bit loi cao ny c tc dng g khng?". l cao d ton tnh, c sn ca mt s vng Lng Sn, Cao Bng, Ngh An, H Tnh. Trong mt cng trnh ca Vin nghin cu y hc qun s trc y, tin s ng Hanh Khi cho bit: Cao d ton tnh cha khong 10% nit ton phn, 0,8% nit amin, nhiu nguyn t vi lng cn thit nh st, mangan, ng, magi, nhm, thic, canxi, sillic, nicken... N c tc dng kch thch sinh trng, gip c th pht trin nhanh v mau lnh vt thng; lm tng sc do dai ca c th (do lm tng mnh h hp ca t bo c bp). Tc dng ny gn gp i cao xng voi v gn gp ba cao ban long (gc hu). To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Theo ng y, tit, tht, gan, tinh hon v d dy d u c tc dng cha mt s bnh. Cao d ton tnh cha gy cm, thiu mu, hay au bng, au mi lng. Trong iu kin phi gn gi v bo v ng vt hoang d qy him, ch bin cao d ton tnh l vic lm ng khch l. 86. Loi a sinh t no tt hn "Chu thy c my loi a sinh t nhp t nc ngoi nh Theravit (M), Therazym, Cenovis (Australia), gi c c chnh lch nhau cht t. Xin cho bit loi no tt hn?". Xin gii thiu bng hm lng cc vitamin v cht khong trong ba loi a sinh t va nu: Lng vitamin v khang/vin Theravit Therazym Cenovis Vitamin A 6.000 IU 5.000 IU 1.250 IU Beta Caroten 1.250 IU 0 0 Vitamin C 90 mg 80 mg 75 mg Lysine 0 40 mg 0 Vitamin B1 3 mg 1,5 mg 10 mg Vitamin B2 3,4 mg 1,7 mg 10 mg Vitamin B3 0 0 25 mg Niacin 30 mg 20 mg 0 Viatmin B6 3 mg 2 mg 2 mg Vitamin B12 9 mcg 9 mcg 2 mcg Vitamin D 400 IU 400 IU 400 IU Vitamin E 30 IU 0 10 IU Pantothenic acid 10 mg 10 mg 8 mg Folic acid 0,4 mg 0,4 mg 0 Biotin 35 mcg 15 mcg 0 Calcium 40 mg 40 mg 10 mg Phosphorus 31 mg 31 mg 7,5 mg Iodine 150 mcg 150 mcg 150 mcg St 27 mg 18 mg 5 mg Magnesium 100 mg 50 mg 36 mg ng 2 mg 2 mg 1 mg Km 15 mg 5 mg 1,5 mg Maganese 5 mg 2 mg 1 mg Crom 15 mcg 15 mcg 0 Selenium 10 mcg 10 mcg 0 To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


Molipen 15 mcg 15mcg 0 Kalium 7,5 mg 7,5 mg 5 mg Chloride 7,7 mg 7,5 mg 0 87. Tc dng ca vin Belaf

L Trng Bng

"Ti l k s, hng ngy phi tip xc vi ha cht, my vi tnh, in thoi di ng... Va qua, ti c t qung co thuc Belaf, thy ni thuc c th gip chng lo ha, tng tui th, c bit hu ch cho nhng ngi tip xc vi cht c hi, nhim. Thuc c thnh phn: bta-caroten thin nhin 15 mg; vitamin E thin nhin 400 IU; selenium thin nhin 50 mcg; vitamin C 500 mg. Xin cho bit kin ca bc s v vn ny". Cc cht cha trong vin Belaf c vai tr chng tc hi ca cc gc t do, chng lo ha, chng c r rt. Ch xin nu hm lng cc cht ny trong 1 vin Theravit loi mi ca M bn tin so snh (theo khuyn co th mi ngy, mi ngi sng trong mi trng bnh thng ch cn ung 1 vin Theravit): - Beta-caroten: 1.250 IU (ca Belaf tnh theo mg nn khng th so snh; v tnh theo IU l tnh theo tc dng thc s ch khng theo cn nng ca dc cht). - Vitamin E: 30 IU (ca Belaf gp 13 ln) - Selenium 10 mcg (bng 1/5 Belaf) - Vitamin C: 90 mg (bng 1/5 Belaf) Trong hon cnh cng tc ca bn, ngoi vic dng vin Belaf, nn b sung cho c th cc vitamin v cht khong khc c trong vin a sinh t, phng khi ch n ung khng cht . Nn tng cng ung sa ti gip c th loi tr cc cht c hi. 88. a sinh t v ung th rut gi "C ngi khuyn chng ti ung a sinh t thng xuyn gim nguy c mc bnh ung th rut gi. iu ny c ng khng, hay ch l qung co bn thuc?". C nhiu loi a sinh t bn trn th trng, c ni ln ngoi. Loi a sinh t mang tn Theravit c nhiu loi vitamin v cht khong hn c. Mi ngy ung 1 vin l c th b p vo nhng thiu ht bt thng trong dinh dng. iu m hai bn nghe c l mt tin vui c c s. Gn y, Gio s E. Giovannucci thuc Trng Y Harvard (M) cng b kt qu mt nghin cu tin hnh trn gn 89.000 n y t M, cho thy tc dng tt p ca vin a sinh t n gii. nhng ch em ung u n a sinh t trong sut 15 nm, t l mc ung th rut gi gim 75% so vi nhng ch em khng ung. Cng trnh nghin cu nhc n tc dng to ln ca vitamin B9 (axit folic) trong vic phng nga To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ung th rut gi: nhng ch em khng ung vin a sinh t nhng trong khu phn hng ngy c 0,4 mg vitamin B9 (nh trong vin a sinh t), t l mc ung th i trng cng gim c 31%. ng l tin vui, nhng mi ch c ch em phn khi thi. Bi v cha c cng trnh nghin cu tng t no c tin hnh trn nam gii. Tc gi cng trnh ni trn ch mi tuyn b rng ng hy vng nam gii, kt qu thu c cng ging nh vy. 89. Thuc n t m o "Chu l con gi, i khm ph khoa c bc s cho n thuc n t vo m o. Chu ngi thuc ny s lm rch mng trinh, nn cn ngn ngi cha mua". C mt s thuc, nht l thuc cha nm, phi c t trc tip mi t hiu qu cao. V vy, nht thit chu phi theo ng ch dn ca bc s. Thuc n t vo hu mn hay m o u nhn nhi, c kch thc v chc va phi nn khng h lm toc nim mc trc trng hay lm rch mng trinh. Ngay khi khm cho cc c gi, bc s vn kim tra c m o bng cch lun mt m vt c nh (Cusco) qua l mng trinh m khng h hn g. Xin hoan nghnh vic chu chu i khm bnh nh va qua. Bi v c nhiu chu, phn s xu h, phn coi thng bnh c quan sinh dc nn mun, rt kh cha. 90. Thuc dit khun ng tit niu "B ti 72 tui, 3 nm trc c chn on u x tuyn tin lit, nhng cha c iu kin m nn c ung thuc vin Mictasol bleu trong 20 ngy, kt qu l i tiu c bnh thng. Nay thy c i tiu kh, ti li cho ung mi ngy 1 vin thuc ni trn v thy hn. Xin cho bit Mictasol bleu l loi thuc g, dng di ngy c hi hay khng?". Mictasol bleu l mt bit dc ca Php, thnh phn bao gm: cht tho dc ly t cy Purpurea malva 250 mg; long no monobrom 20 mg; methylthionin hay xanh methylen 20 mg; cao lanh, tinh bt khoai ty, mage stearat, bt talc, nha cy acacia, saccharose, sp, parafin; cht xanh lm t dc. Thuc c tc dng dit khun ng tit niu. N ngm qua thnh rut, i vo mu ri c thn bi tit vo nc tiu; v hin din trong nc tiu nn n pht huy tc dng dit khun ti ch. Bnh nhn u x hoc ph i tuyn tin lit thng b vim nhim ng tit niu ni chung v bng quang ni ring; Mictasol bleu lm ht vim nhim, gip h tiu tin c d dng. Khng c dng Mictasol bleu cho ngi b suy thn. Thuc ny khng nm trong bng c, liu dng hng ngy cho ngi chu u l 6-9 vin (ung vo cc ba n, chiu vi nc), cho nn vi liu thp nh vy khng c g ng ngi. 91. Khi dng thuc voltarne "M ti 50 tui, 2 nm trc b au khp gi, c cha tr ti bnh vin; sau ny mi ngy u To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

dng 1 vin Voltarne. Nu ngng thuc hoc n mp ng, c tm th b nhc. Xin cho bit m ti cn king nhng thc n g, dng Voltarne thng xuyn c b nh hng khng?". Voltarne c mui natri diclofenac, mt cht khng steroid c tc dng c ch qu trnh sinh tng hp prostaglandine (chnh cht ny ng vai tr ch yu trong vic gy vim, au v st), cho nn n c tc dng chng thp khp, gim au, chng vim v h nhit. Voltarne khng c dng cho ngi b bnh d dy (v c th gy chy mu, thng d dy) hoc ngi b d ng vi axit acetylsalicylic. Khng dng trong 3 thng u v 3 thng cui ca thai k. Bn khng ni r dng vin thuc c hm lng bao nhiu (25 mg hay 50 mg). Tuy nhin, vi liu duy tr 1 vin m cho hiu qu nh vy l tt, khng nn ngng. Ung thuc trong cc ba n. Voltarne cn c dng tim bp, hm lng 75 mg v dng kem bi ngoi da Voltarne mulgel. Khng ch ring mp ng hay c tm m bt c thc g b c th m bn "t chi" u phi king, trnh xy ra d ng. 92. Tin vui cho c dn vng st rt "K sinh trng st rt ngy cng khng thuc, khng bit c th thuc cha st rt no tt hn chloroquine?". iu bn quan tm cng lm cc nh dc hc trn th gii au u, v v thuc ch bi chng st rt l chloroquine ngy cng b k sinh trng ca bnh ny coi khinh. Vo qu 1 nm 2001, gio s Surolla thuc i hc Bangglore (n ) khi nghin cu mt cht tng hp chng vi khun l tri-closan (vn dng lm cht kh mi trong nh tm) nhn thy, cht ny km hm s pht trin ca k sinh trng st rt, k c Plasmodium falciparum khn g cloroquine. Triclosan s sm c mt trn th trng. 93. Thuc mi chng ung th "Chng ti nghe ni c thuc cha khi hn bnh ung th, xin cho bit l thuc g?". Cho n nay, vic iu tr ung th v cn bn da trn ba bin php kt hp: ct b khi u, x tr (chiu tia X. vo khi u hoc khu vc m ct khi u), ha tr liu (dng ha cht a vo ngi) tiu dit cc t bo ung th. Kt qu t c ph thuc vo vic pht hin v x tr sm hay mun cng nh vo mc "c" ca tng loi ung th v vo sc khng ca tng ngi. Vic chiu tia X. liu cao v vic dng ha cht u c mt tri l nh hng khng tt ln sc khe. T lu, ngi ta nhn thy rng: Khi ung th pht trin l nh n kch thch cho h thng mch mu ca chng ta pht trin "nui" n. Do , mt s phu thut vin xut vic tht cc ng mch i ti khi u (trong trng hp khng th ct b) cho ung th "cht i"! Tic thay, vic lm ny khng thnh cng v cn bit bao nhiu mch ni khc s b cho ch b tht, v khi u vn khng h g. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Gn y, ngi ta tm c hai cht c tc dng c ch s hnh thnh mch mu mi ca ung th, l angiostatin v endostatin. Trn c s ny, cc bit dc mi mang tn Anti-VEGF, TNP-470 ra i, c s dng cho mt s trng hp ung th mun, bc u cho kt qu ng mng. Tuy nhin, mc d phn khi l i ng hng, cc nh nghin cu thy vn cn phi ch mt thi gian na, sau khi cc loi thuc mi ny c dng trn din rng, mi c th khng nh c. Ngoi ra, ngi ta cn pht hin rng cht telomerase (hin din trong 85% t bo ung th) c tc dng lm cho cc t bo ny "sng lu mun tui" (cc t bo lnh v khng c cht ny nn khng th "trng sinh bt lo"). Nu c cch g v hiu ha telomerase th s git cht c t bo ung th. Mi y, cc nh khoa hc Canada li tm thy mt protein mang tn *hnRNP A1 cng c tc dng lm cho t bo ung th "vn th v cng", li hi hn telomerase ch n hin hu trong 100% cc khi u. Nu v hiu ha c *hnRNP A1, ta cng s lm cho cc t bo khi u gi i v cht. Nhng pht hin ni trn rt quan trng, m ng cho vic sng to cc thuc chng ung th hu hiu hn v khng c hi i vi c th. 94. Trin vng ca thuc vacxin chng ung th "Nghe ni c thuc tim phng chng bnh ung th. Xin cho bit thc h". Chuyn c tht y. C 2 thnh tu, mt trn ngi v mt trn chut th nghim. 1. Cui nm 1997, mt ph n c 65 tui c chn on qua lm sng v nh scanner l b ung th thn di cn, cm chc ci cht. B xin lm ngi u tin th nghim mt vacxin loi mi (do nhm nghin cu ca gio s G. Muller thuc Bnh vin Gottingen ca c sng to) v b khi bnh hon ton, cc di cn ung th hai phi cng bin mt, sau hai nm ri khng xut hin li. Nh vy l vacxin c tc dng cha ung th r rt. Vacxin chng ung th ca c c ch to theo cc bc sau: Ly mt s t bo ung th em nghin nt. Ly cc bch cu n nhn trong mu ngi bnh thng em nui cy 37 C trong mi trng c cytokin. Sau 7 ngy m, cc bch cu ny bit ha v tr thnh t bo si nhnh cha thnh thc. em cc t bo ung th trn vi cc t bo si nhnh ny ri t vo mt thit b, chng hp nht thnh cc t bo lai di tc ng ca mt c sc in. Sau khi t bo lai ny c tim cho bnh nhn ung th, chng kch thch bch cu lympho T (LT) tit cytokin kch hot nhiu tc nhn ca h min dch, ng thi thc y bch cu lympho B (LB) sn xut khng th hng vo khng nguyn ca khi ung th. Nh , h min dch tn cng thng li vo t bo c tnh v di cn. Cc LT nhn din ra ngay v ph hy chng. Cc bch cu n thun, cc i thc bo hay cc bch cu lympho khc cng nhn din ra cc khng th dnh trn b mt ca t bo ung th v tiu dit chng. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

2. Vin Pasteur ca Php hiu chnh c mt vacxin tng hp mang tn MAG (Multiple Antigenic Glycopeptide) gip 70% chut khi bnh nh loi tr c khi ung th. MAG gm mt trung tm lysine v 4 peptide m phng khng nguyn ca virus st bi lit, c gn thm ng Tn (khng nguyn c hiu ca t bo ung th). Khi tim MAG cho chut b ung th, khng nguyn ca virus st bi lit b t bo si nhnh ca chut thu ly v a ti LT; bch cu ny bn kch thch LB bng cch phng thch cytokin. LB nhn din ra khng nguyn Tn trong vacxin, bn t tng cng s lng v sn xut cc khng th gn ln cc ng Tn ca t bo ung th. Nh vic "nh du" ny, cc tc nhn ca h min dch nhn r mc tiu tn cng v ph hy t bo ung th. Hai thnh tu ni trn m ra trin vng tt p trong vic cha tr cc bnh nan y, k c HIV/AIDS. 95. Coi chng d ng thuc "Chu 17 tui, t khi ln 10 ti gi, mi ln dng thuc ty (ung hoc tim) l da ni mn , rt nga, sau phng ln nh b bng, c tun mi khi. Chu iu tr nhiu cch nhng khng ht". Chu khng cho bit trong nhng ln b d ng, chu dng thuc g, nhng theo cch ni th c th on chu b d ng vi mt vi loi khng sinh no . Chu hy tm li cc n thuc dng v tuyt i trnh s dng cc khng sinh . Do khng nm c vn nn by nm qua chu a vi la m khng bit. Hin tng d ng thuc rt kh lng v mc nguy him, c ngi ch tim trong da mt nt nh th phn ng m cng xy xm mt my, mch nhanh, run tay chn. Trng hp d ng mnh s dn n sc phn v, nguy him n tnh mng. 96. Mu nhn to "Ti nghe ni vi ba nm na s c mu nhn to s dng rng ri. Mu nhn to c ging ht mu ngi v thay c mu ngi khng?". Hin cha c cht g bt chc c y ht mu ngi. "Mu nhn to" nh bn nghe ni ch l cht thay th mu tm thi trong mt giai on no , chng hn nh khi b chy mu nhiu hoc trong phu thut; lc by gi iu quan trng hng u l m bo xy cho c th duy tr s sng. Nhim v ny do huyt cu t (hemoglobin) ca hng cu m nhim; vn t ra l nghin cu mt cht no c kh nng vn chuyn xy ging nh huyt cu t. Hng th nht l ch to huyt cu t t nhng chai mu ngi qu hn dng, hoc t mu b, mu ln; hay bt cc vi khun qua tc ng gene sn xut. Nu to ra c huyt cu t nguyn cht th khng cn phi quan tm n nhm mu na, vic s dng s an ton v tin li. Tuy nhin, vic sn xut huyt cu t cc chai mu ngi qu hn nh vy vn phi ph thuc vo ngun cho v khng th cung cp kp thi vi mt lng ln, chng hn khi c thin tai, xung t v trang... To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Hng th hai l s dng cc fluorocarbure - nhng cht hu c tr nht, m c nht, d nn nht v k nc nht - c kh nng thu xy t phi, sau em phn phi cho cc c quan qua h thng mao mch. Hng Alliance Pharmaceutical (California) ca M ch to c mt cht lng trong sut khng mu mang tn Oxygent. l mt nh tng gm perfluoro-carbure, nc v cc cht nh ha. Hn s dng Oxygent (bo qun nhit 5 C) l mt nm ri. Oxygent cn "cao th" hn hng cu v n lun c su vo cc mao mch. Nh c "mu nhn to", loi ngi s gim thiu, thm ch trnh c nhng iu phin phc hoc nguy him ca vic truyn mu nh hin nay, n mc m ngi M coi truyn mu l mt ng tc nguy him cng trnh c cng tt. 97. C insulin ng ung khng? "M chu b tiu ng, lu lu phi n bc s t tim insulin. M chu s au v c nhng ln tr nhiu hm mi i tim. Xin hi c loi insulin dng ung khng?". Insulin hin cha c loi ung, bi v nu ung theo cch thng thng th n khng th chui qua mng rut vo mu nh mt s ln cht khc. Tuy nhin, c hai tin mi c th lm cho ngi tiu ng nh m chu hy vng c dp c ung insulin thay tim: 1. Nhm nghin cu ca Gio s Fasano, i hc Maryland (M) pht hin ra mt c t mi ca vi khun bnh t, c t tn l c t ZOT. Chnh c t ZOT ny lm cho nhng ngi b bnh t lin tc b tiu chy, mt nhiu nc v cc cht in gii, c th cht rt nhanh nu khng c cu cha kp thi. S d nh vy l do ZOT lm tng khong cch gia cc t bo mng rut (t ch p st nhau nay h rng ra). Cc nh khoa hc bn trn ZOT vo insulin ri cho chut b tiu ng ung; kt qu khng km insulin tim. Hin thuc c chuyn sang th nghim trn kh (h hng gn ca con ngi v di truyn cng nh sinh l) v thu c kt qu y ht nh chut, khng c phn ng ph. Mt nhm nghin cu khc ca M hiu chnh c, trn cc chut th nghim, mt phng php mi cho php s dng insulin ung: bo v insulin khng b cht axit ca d dy ph hy, cc nh nghin cu bc n trong mt mng li polymer. Khi gp mi trng acid, mng li "thng minh" ny s co kht li, ch khi xung n rut non n mi li ra, gii phng insulin cho mng rut hp thu. Phng php mi ny ang c th nghim trn ngi. 2. Gn y, ti Lin hoan khoa hc nm 2001 ti Edimbourg (Anh), cc nh nghin cu cho bit hiu chnh c mt k thut mi ch to cc cht thuc di dng cc nh, c th vo mu d dng qua vic trao i kh phi. Do , m chu chc s c dp c dng insulin di dng xng hi, khng cn tim m cng chng cn ung. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


98. c th ph bin mt phng thuc hay

L Trng Bng

"Ti l gio vin, nhng v yu thch ngh thuc nn t 20 nm nay, ti my m tm ra v ng dng c kt qa mt phng thuc cha bnh thp khp. Ti mun c gip c th ph bin n". Xin hoan nghnh nhit tnh ca bc trong vic ny. Tht vy, bnh thp khp gy tai ho cho bit bao nhiu nam n thanh nin nc ta do nhng tn thng tim. Tuy y hc hin i c thuc cha bnh ny nhng n cn kh t, ng o ngi ngho cn kh vi ti lm! V chng, thuc Ty y vn c nhng phn ng ph phi d chng. Bc cha c mt s trng hp, nay mun ph bin rng phng thuc y, l mt thin ng hoan nghnh. Xin gi vi bc mt s im nh sau: - Tuy phng thuc c ng dng nhiu m khng gy nguy him, bc vn nn r li dc tnh, c tnh cng nh tnh tng k ca tng v ( ghi trong cun Cy thuc Vit Nam), ri chp thnh mt ti liu ring. Nhng v no cha c trong danh mc hoc cha c tn Latin, bc nn nh cc nh dc hc xc nh gip. - Lin h vi mt vi c s ng y gn h chp thun cho s dng trn bnh nhn. Mun c thun li, c l bc u bc cha nn thu tin, tuy c kh khn v ti chnh nhng cng chuyn s tri chy hn. Da vo kt qa trn tng bnh nhn, cc bc s s c nhn xt v phng thuc . 99. Ghp khc vi ni "Chng em ang hc lp 11. Sau khi c c bi bo v ca m ghp bn tay thnh cng ln u tin trn th gii, chng em tranh ci. a th bo ng y l ln u, a th bo trc y m thnh cng nhiu trng hp tng t. Xin cho bit ai ng ai sai?". Hn l cc em tranh lun v s kin ngy 24/9/1998: Ln u tin trn th gii, mt ca ghp bn tay c thc hin thnh cng. Bnh nhn l mt ngi n ng 48 tui phi ct ct bn tay trc 9 nm. Nguyn nhn gy tranh lun c l l do c "hai phe" ca cc em u cha nm chc hai thut ng "ghp" v "ni". ng l ngi ta nhiu ln ni thnh cng bn tay b ct t do ri ro. Ngay sau tai nn, bn tay b ct ri c kp thi chuyn theo ngi ti bnh vin, v kp m thc hin cng mt lc cc phu thut kt xng, ni mch mu, ni dy thn kinh, ni cn c... V cn bn, l bn tay ca bn thn cho nn h n "cn sng" l c, ch cn luyn tp cho tt. Cn "ghp" l em bn tay ca ngi khc (thng l ngi va mi cht) ghp ln mm ct bn tay ca bnh nhn. y khng phi bn tay ca bn thn nn rt d b o thi; bnh nhn s phi lin tc dng thuc chng li hin tng . Ngoi ra, do bn tay b ct kh lu nn c th trn v no khng cn v tr i din ca n; iu ny s lm hn ch chc nng ca bn tay ghp. Xin biu dng cuc tranh lun ca cc em. Bi v ch qua tranh lun, ta mi phn nh c chn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

l. Ch xin nhc l trc khi tranh lun, "hai phe" phi thng nht v nh ngha thut ng. V d: ghp xng (t cc mnh xng, on xng vo gy, gip cho xng lin li) khc vi kt xng (dng inh, vt, np... bng kim loi c nh n); gii phu (m t hnh dng, v tr, chc nng ca cc b phn c th) khc vi phu thut (dng dao ko m x c th)... 100. Nhn g s b lang ben? "Chu s qu, xin cu chu vi! Hm qua, chu k vi bn l nhn thy g mi trng; bn ni rng ai nhn g s b bnh lang ben. Chu rt s sau ny s b nh vy, v nh bn chu ni, lang ben lm cho khun mt tr nn d s". G mi trng hay ln ni sinh con l ng tc sinh sn ca loi vt. Lang ben l bnh ngoi da con ngi. Hai hin tng ny khng lin quan g n nhau. C l bn chu cn nhm ln gia bnh lang ben v bnh bch tng. Lang ben l mt bnh ngoi da thuc loi nh nht; c mt s trng hp t nhin khi khi ln ln. Cn bch tng l mt bnh bm sinh: mt s t bo b mt hc t, tr nn trng bch. Tn thng c th lan rng dn; nu chng may b mt th trng cng d s, nhng bnh ny khng ly. 101. Vt chm trn ngi "T lc lt lng, chu c mt vt chm trn ngi. Khi ln ln, chu hi m th b bo "b chm vo ngi v ti ngang bng c mun u thai". Lu nay chu c trn tr v iu ny m khng ti no hiu c. Khoa hc c cch g gip chu xa n i khng, khi c mc cm ti li?". Theo thuyt lun hi, mi con ngi c nhiu kip sng ni tip nhau: sinh ra - ln ln - cht i - u thai lm con ca hai b m khc c sinh ra ln na... C th cho n khi no tr nn "hon thin hon m" th c thot khi cnh lun hi, hng hnh phc vnh cu... Trc y, khi gp cnh tr s sinh b cht yu lin tip, ngi ta cho l "ti mt k u thai ri cht ngay, lp i lp li nhiu ln". Do vy, mt s ngi chm, mc tu ln thi hi a con cht yu nh du, phng khi n u thai li th nhn ra! Cn theo gii thch ca khoa hc, vt chm, vt bt bm sinh xut hin do hin tng i mu ca sc t da ti vng trong qu trnh bo thai. Nguyn nhn ca n cha c xc nh r. Khng c cht g lm cho n mt i c. Mt s anh ch em rut c vt chm gn ging nhau, c th do gene. Nh vy, chu chng ti g m phi trn tr ngh ngi v li ni khng u. 102: Phi phng ra sao? " thn chu, vo khong na m n 2-3 gi sng, thng c mt ngi n ng chuyn i ly cp lt ca ph n, c khi ch ly o hoc qun thi. Mi ngi khuyn nn vt ci qun hay ci o m hn li, ni l trnh bnh lu. Nh vy tn kia b bnh g, v chng chu phi phng ra sao?". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Ngi hay n cp mc trong ca ph n hn ht, m p... nhm to khoi cm tnh dc (thc hin ngay ti ch hoc mang vo ch kn) l ngi mc chng lon dm vt (danh t chuyn mn l fetishism). Khng c g m bo l h khng cng bc ph n khi c iu kin. V vy, cc chu nn cng gia nh kn o xc nh ngi l ai phng. Trong khi ng, bt k ngy hay m, phi ch ci then ca phng nguy c b t nhp. Ngoi ra, nn phi qun o ch khng ai vi ti c. C l li khuyn ca b chu l ng, bi v ngi kia c th "s dng" ti ch ci o hay ci qun kia ri b li, v khng c g m bo l anh ta khng mc bnh c quan sinh dc. 103. Chuyn ngi ra chut "Chu nghe n l vic dng bng v sinh Tu s nh hng khng tt cho s sinh sn sau ny, thm ch c ngi ra ton chut, chuyn c ng khng ?". Khi t cu hi v chuyn ngi ra chut, chc chu qun mt cc kin thc s ng v sinh hc. Cch y chng chc nm, c nh khoa hc cho lai c mt trng hp cu - d v c th sau ny, nh k thut gene, ngi ta c th to ra cc giao loi khc (giao loi l con lai gia hai loi khc nhau, v d nh b - ln). Tuy nhin, chuyn tinh trng ca chut th tinh c cho non (trng cha th tinh) ca ch em l iu qu phi l. l cha ni n chuyn tinh trng chut (nm trong bng v sinh) khng th "thng th" n th (tinh trng ca ngi, nm trong c quan sinh dc n, cng ch sng c c 12-16 gi). Cn v cht lng bng v sinh th, qua iu tra s b, ngi ta thy loi c nhn ch Trung Quc (thng c gi l bng v sinh Tu) mng hn nn thm km hn cc loi bng khc; mt s trng hp gy nga nu khng c thay kp thi; ngoi ra khng c g khc bit. 104. ng nh nc bt "Ti sao khi em n ht da, ko..., nc bt ca em tit ra nhiu, phi nh ra lin tc?". Vic tit nhiu nc bt khi n ht da, ko... chng t c th em "m" cc th lm, khng sao c. Nc bt l mt cht dch qu bu gm nc, men tiu ha, cht lm tan vi khun..., khng ai di g em nh i. Ngoi ra, ng tc nh nc bt l mt thi quen khng hay ho g, khin nhng ngi c vn ha khng thch, thm ch kh chu ra mt. V vy, v phn em, nu khng c gng nut c ht nc bt th hy thi, ng n vt cc th kia lm g. 105. Hy cho m hi ra nhiu hn "Chng vi nm nay ti hay i tiu nhiu, nht l vo nhng ngy mt m v sau khi ung nhiu nc. Bc s khm v cho chp X quang ri kt lun l thn khng vic g, nhng ti vn lo. Xin ni thm l ti khng h tp th dc hay chi th thao, h ung tr l m khng ng c v cng i To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


tiu nhiu ln".

L Trng Bng

Nu chn chn khng c vn g thn, khng phi bnh tiu ng hay tiu nht (do rc ri tuyn yn v nu vy phi c hin tng thm ung v lng nc tiu thng xuyn phi rt ln) th nguyn nhn rt c th l do bn khng hot ng th lc. Cc tuyn m hi khng hot ng my, ch li vo hai qu thn nn bn mi i tiu nhiu nh vy (nh rng khi i b bnh thng, mi gi c th thi ra t nht 0,5 lt m hi). Bn hy bt u tp th dc vi mc tng dn. V sau, khi thy quen hn, bn nn tham gia mt vi mn th thao thch hp. M hi ra ng mc th nc tiu s t i, v thn ca bn nh gnh bit my! Lc by gi, c khi bn phi ung nhiu hn mi c nc tiu y. Cn hin gi, bn hy hn ch vic n canh, nht l canh c rau (ci, ci bp...), chua (tri cy, yaourt...), gim bt lng nc ung vo (c theo di cht ch) ... phn khi bc u , sau ny s iu chnh li. V d nhin bn khng nn dng tr hay c ph v c th bn thuc dng d b kch thch. 106. Ch khi tip xc vi ch mo "Cc con ti rt yu sc vt, c bit l ch, mo. Bn tr hay hn ht chng, cho n cng mm, ng cng ging. Ti thy phng Ty, vt nui cng c yu qu v chm nom nh vy. Gn y, tnh c thy trong phn mo c my t sn ng nguy, ti mi hong hn. Vy sn ch, mo c ly sang ngi khng?". Con ngi (nht l tr em, ngi c n, bnh tt, tn ph) quen vi s c mt ca cc vt nui. Ngoi ch mo, cho ti nay danh sch vt nui c thm nhiu loi th hoang d. Ti cc nc pht trin, ngi ta lun theo di pht hin nhng k sinh trng trn "vt cng" (giun sn, b cht, chy rn...) chng khng th gy hi cho ngi. Thm ch ngi ta cn pht hin nhng mm bnh tim tng trong c th "vt cng" kp thi cha tr. Ngoi ra, do thi quen s dng h x t hoi (bt) t tui u th, h gi cho mi trng t khng b cc mm bnh hay vt k sinh t phn xm nhp. Vit Nam, tnh hnh c nhng khc bit: - t nc ta hu ht b nhim phn do nn phng u ba bi v do vic s dng phn ngi mt cch ty tin (thi gian phn khng dit ht trng giun v mt s mm bnh khc; iu ny c th khc phc d dng bng cch dng h x bt). Ch mo gim vo t bn nhiu khi vn c leo ln ging ng chung vi ngi. - Do b i, ch mo thng tm xi mi th mi ni, nn ming chng khng th l "ming ngi yu du" c th hn ht. - Ch mo c th mc mt s bnh nh cm, di, thm ch c con ch b lao hang phi do thng xuyn n m ca b ch b lao nng. Bn cng cn bit rng, trong cc con b cht ca chut c u trng Toxoplasma gondii (mt loi k To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

sinh trng n bo). Nu ch mo n tht chut, u trng s trng thnh trong rut non ch mo, trng. Trng theo phn ra ngoi, c kh nng gy bnh trong vng my thng. Ngi b nhim k sinh trng Toxoplasma gondii s c nhiu nguy c b cc chng sau: - Sy thai, non, thai nhi b d tt bm sinh, cht yu. Tr s sinh c m nhim k sinh trng ny thng c u rt b, vng da, lch to, vim ph qun, ng kinh, khim th, khim thnh, chm pht trin tr tu... nhiu a tr, nhng triu chng trn ch xut hin sau my nm cho i. - au mnh my, st nh, ni hch c hay nch. Cc triu chng ny thng ht sau mt thi gian ngn; nhng cng c trng hp bin chng vim phi, vim no, mng no, tim...(thng gp nhng bnh nhn b suy gim min dch). - B mt s tn thng mt. Con mo nh bn b sn, vy con bn rt c th nhim loi sn ny. 107. Chng mc qun o "Qun o chu mc hay b mc, mc d chu cho mui vo nc lc git gi. Xin cho bit cch x tr". Chu phi luc k qun o dit cc bo t nm (nc mui khng n thua u); khng qun o b mc ln vi mi ( nm mc khng lan sang). Qun o thay ra phi git ngay v phi ch thong, khng phi sng. Cn tm git hng ngy. 108. Ngh un tc c nguy him khng? "Chu lm ngh un tc c 5 nm nay. Chu nghe ni vic n huyt b gip thi c bi tc ra ngoi theo ng phn, c ng vy khng? Nu hay ht mi thuc un tc th c b nhim ha cht khng?". Nu khng phi l hng gi th thuc un tc khng gy hi cho c th un tc v khch hng, v cc sn phm ny c kim tra cht ch trc khi tung ra th trng. Thuc nhum tc cng vy, hng gi gy rng tc dn, cn hng tht th khng. Khi ct ta tc, tuyt i chu phi eo khu trang trnh ht phi tc vn v nhng cht bn t u ngi khc. Cn chuyn huyt b th chu hy qun i, v lm sao m tc ang nm ng h hp li chui vo rut c. Chu c yn tm lm n, nh ng bao gi dng chung khn cho khch trnh ly bnh t ngi n sang ngi kia. 109. Bao dng vt c t bao gi Thi tin s, dng vt khi b gai m hoc cn trng cn, n ng bo v n bng cch ly cc mnh v cy di qun li, hoc dng mt ci v cng p ln, hay t n vo mt vt hnh tr (tp qun ny hin vn tn ti mt s b tc t ngi). T thi xa, n ng bit phng ly bnh hoa liu bng cch dng cc dng c bo v vi nhng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

tn gi khc nhau ty theo a phng. Paris (Php), ngi ta gi n l "o ui tm Anh Quc". i li, ngi London (Anh) gi n l "mng rut gi Php". Ngi chu Phi t tn cho n l "m i rng"; ngi Brazin gi n l "o s mi nh"... Sut ba nghn nm nay, ngi ta dng bng quang ln, rut cu, rut th, bong bng c (c bit ca c tm v c heo)... lm bao dng vt trnh ly "cc bnh ca thn V N". T th k 10, ngi Nht Bn sn xut c nhng dng c bo v c quan sinh dc nam gii bng da thuc hoc vy ra. Nm 1564, trong cun sch nhan De morbo gallico, chuyn gia tnh dc hc ni ting Gabriel de Fallope gi nn dng mt dng c hnh m chp c pht mt th nc l cy sc c, t ln b phn sinh dc nam ngay sau khi giao hp trnh mc bnh. Mi ti th k 17, ngi ta mi dng bao dng vt vo vic trnh thai. Vua Charles ca Anh v vua Louis ca Php l nhng ngi u tin s dng n vi mc ch ny. T , bao dng vt c ph bin nhanh chng. Trong thi gian ny, n mang mt ci tn m miu l "gng tay ca qu b", c ch to bng rut hay bng quang sc vt, i khi lt bng la hoc nhung (ngi Trung Quc thng dng la mng thm du). Trong khi giao hp, nam gii lun phi gi cht trong tay mt di bng c dnh vo dng c. Mt thoi mi nh, dng c ny li khng tht m bo, n ni n vn s Php Mme de Svign phi tht ln: " l tm o gip chng lc th v l mnh mng nhn chng him nguy". Vo nhng nm 70 ca th k 20, trit gia Php Condorcet v nh kinh t hc Anh Malthus rt nhit thnh bo v ch trng dng bao dng vt hn ch sinh . T , dng c ny tr nn thc s ph bin. Bao dng vt cng c nhng bc thng trm, c ci tin dn v hnh dng v cht liu, nht l t khi c k thut lu ha cao su. Hin c nhng loi cc mng v bn chc, bo hnh 5 nm. Tuy nhin, ngi ta cn mun yn tr v tit kim hn nn to ra mt thit b nh mang tn Vrifior km theo bao cao su "kim tra, hong kh v qun li" 110. Th tinh nhn to v th thai trong ng nhim nhm s dng c nhiu ln. "Bn em ni th tinh nhn to v th tinh trong ng nghim l 2 k thut khc nhau, cn em th cho rng ch l 2 tn gi ca mt k thut. Xin bc s lm trng ti gim". Em th chc chn sai ri, cn bn em cng khng ng nt, bi v trong u bn c th ngh ng nhng li ln ln v thut ng. gi l nh khoa hc th khng nn dng sai thut ng khoa hc, bi l thin h s hiu nhm iu mnh nh gii thch, nguyn nhn do dch sai thut ng ca nc ngoi. Th tinh nhn to (insminatinon artificielle) l bm tinh dch vo m o ng gia ngy rng trng, vi hy vng tinh trng c th gp c non ti ng dn trng v th thai; trng c th tinh To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

s i xung t cung lm t v pht trin . Nh vy c ngha l tuy tin hnh th tinh nhng cha chc th thai. Tinh dch c th ti (ly xong em bm ngay) hoc ng lnh, c th l ca ngi khc (v ca ngi chng yu hoc khng c) hay ca chnh ngi chng (vn tt, nhng v axit m o ngi v qa cao, lm cht tinh trng, phi bm "nhn to" mi thot him c). Th thai trong ng nghim (fcondation in vitro) l ly non cho tip xc vi tinh trng th thai thnh trng; phi c gi trong ng nghim chng 2-3 hm, khi pht trin thnh 4 t bo th c em cy vo t cung (ca ngi mang thai h hoc m rut). C th tin hnh to cng lc vi nhiu phi c 2-3 con, thm ch ng lnh phi dng dn. 111. Li ch v nhc im ca nhn bn v tnh "K thut nhn bn v tnh trn ng vt mang li li ch thit thc g? Nu nhn bn ngi th iu g s xy ra?". K thut nhn bn v tnh (NBVT) c hiu mt cch khi qat l: Ly 1 t bo thng thng trn c th ca con c hay con ci, rt nhn. Ly 1 non ca con vt khc cng loi, b ht nhn ri cho nhn kia vo; khi n pht trin thnh phi 4 t bo th em cy vo d con. Nh vy, vt liu di truyn ca c th mi s ch c ngun gc t mt ngi, b hoc ca m; ci non ny ch "nui gim" m thi. Trn ng vt, NBVT m ra trin vng phc hi mt s ging loi tuyt chng hoc c nguy c tuyt chng; em li tnh a dng cho qun th ng vt trn hnh tinh, qua nghin cu su hn cc quy lut tin ha. K thut NBVT ng vt gp mt tr ngi ln cha khc phc c: Cc con vt c nhn bn u cht sm sau khi cho i. Trn con ngi, vic NBVT cc ph tng s to thun li cho vic thay th cc c quan h hng trong c th m khng phi s dng thm thuc chng thi loi nh hin nay (v l "ca chnh mnh" nn c dung np d dng). Qua , c th tin hnh th nghim cc phng thc iu tr v ngn nga bnh tt, khc phc cc khuyt tt. V dng nh nhn loi buc phi dng li . Bi l: - Nhng c th sinh ra do NBVT l bn sao nguyn xi ca b hoc m, khng c c tnh ring; khng tin ha, m khng tin ha th phi chu o thi theo quy lut. - Ngi con thu c bng NBVT ch sng c phn cn li ca cuc i b hay i m mnh, nh ni trn. - Vic NBVT trn ngi b cc nh o c hc v cc t chc tn gio phn i quyt lit. 112. Hu cao c v c quan NASA "Chng em nghe ni ngi M ang nghin cu hu cao c chun b a n ln v tr, c ng khng?". Chc cc em nghe nhm. Trong iu kin hin ti, vic a cc sinh vt bc thp (to, vi khun, cn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

trng...) vo v tr nghin cu cng phi tnh ton cn thn, ni g n chuyn a nhng ng vt bc cao cng i vi con ngi. Hu cao c mi lt lng c chiu cao 2 m, cn nng trung bnh 60 kg, cng knh hn c nh du hnh. Tuy nhin, chuyn nghin cu hu cao c nhm phc v cho cng cuc chinh phc v tr M li l iu c tht. T nm 1985, cc nh khoa hc ti C quan hng khng v tr M (NASA) ch n nhng c tnh qu bu ca hu cao c: Chng cao t 5 n 6 m, c p lc ct mu rt ln; qu tim cc khe, nng ti 11 kg, mi pht bm c t nht 60 lt mu. H c vng dc theo ng mch c ca con vt cho php n a mu ln tn ci u tt trn cao. Tnh mch ca hu cao c c nhng van c bit gip cho p lc mu khng thay i qu t ngt mi khi con vt ci u, v nhng thay i ny nu xy ra s lm n ngt xu. Chn ca hu cao c, ni p lc mu rt ln, c mt h thng mao mch rt chc gip trnh c hin tng ph thng. l nhng c tnh m cc nh du hnh v tr c ao c c, bi l h phi chu ng hin tng gia tc trng trng khi xut pht v tnh trng v trng lc khi sng trn qu o. Cc nh khoa hc ca NASA cho bt 8 hu cao c nghin cu. Hai con c phu tch xem xt cu trc c th, c bit l b my tun hon. Su con c ci t cc ng thng vo mch mu v eo mt my pht tn hiu c ri c th ra theo di. Kt qu thu c gip h ci tin b qun o bo v cho cc nh du hnh v tr. 113. Bnh thp tim "Bnh thp tim nn cha bng ng y hay Ty y, sau khi cha khi c b di chng g khng?". Hin nay, Ty y c thuc hu hiu cha bnh thp khp v ngn nga thp khp ti pht. Ngi bnh cn nghim tc thc hin phc iu tr v tr li ti khm ng hn. Bn cnh , nu c nhng bi thuc gia truyn qua ng dng nhiu i, khng gy nguy him th dng phi hp thm cng tt. Ngi bnh thp khp d c cha tr vn phi lun cnh gic vi nguy c ti pht. Nn nh rng bnh cng ti pht nhiu ln, nguy c i vi tim cng cao. 114. eo qu s b ung th? "Nhn dp k nim m ci vng, ti nh mua tng b x mt si dy chuyn mt kim cng rt p m gi r; nhng li nghe ni eo qu s c ngy b ung th nn ti vn cha quyt. C tht th khng, hay y l tin n tht thit trc vic nc ta bt u khai thc qu?". Khng phi tin n nhm ph hoi kinh t u, nhn nh "eo qu c ngy b ung th" xut pht t mt s tht khoa hc. qu nguyn th khng phng x, nhng mu sc thng khng p lm. Nu em qu vo my gia tc hay l phn ng ht nhn bn ph bng ht neutron, mu sc ca n s p hn, a dng hn, bn c nhiu tin hn, nhng chng li tr thnh ngun phng x mc rt cao. Do To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

vy, ngi ta phi lu gi trong kho an ton trn di 24 thng chng gim nng phng x, lc by gi mi em ra bn. Mc phng x cho php i vi qu lu hnh M l 1 nanocurie/g, Vit Nam v cc nc khc 2 nanocurie/g. Nu khng lu kho (do s hng tn ng lu s li t), nhng vin qu ny c mc phng x ti 52 nanocurie/g, ngha l cao gp 26 ln quy nh ca Vit Nam v gp 52 ln quy nh ca M. Khi eo lin tc hoc tip xc nhiu vi nhng "ca qu git ngi" ny, ngi ta s c nguy c b ung th da, xng, mu. Tic rng v thiu kin thc v ham r, nhiu ngi mua dng chng v mang ha vo thn; v v thiu kim tra ngn chn, Vit Nam cho bn gian thng tun nhng ca n ny vo ni a. V phn bc, nu giu c th nn mua qu t tin ti mt hiu kim hon ng tin cy. Nu cha giu, bc hy mua mt tng vt khc, ng giy vo th " qu st nhn" kia. 115. Nhn in cng l mt phng php cha bnh "Gn nh chng em c mt im cha bnh bng "nhn in" kh nhn nhp. Thy thuc cha bng cch t tay ln u, lng v mt s im tay chn bnh nhn. Thot u, chng em khng tin, v sau thy khng nht thit phi tr tin nn thay nhau vo "th" (a b au rng, a sng khp c tay hoc nhc u...). Ngay ln u tin, my a thy , v sau by ln th tt c u ht bnh! Xin cho bit v phng php cha bnh l lng ny". Phng php cha bnh m cc em cho l l lng tr nn kh quen thuc ti mt s nc. M, c nhiu trng v phng php nhn in. nc ny, nhn in (cha tr bng nng lng sinh hc, Bioenergotherapy) c coi nh mt phng php b sung cho y hc hin i, c php lut cho php. Nguyn tc ca phng php nhn in rt n gin v d hiu: Con ngi tn ti khng ch nh n, nc ung, khng kh m cn nh ngun nng lng v tn ca v tr. Nng lng ny ra vo c th qua mt h thng lun xa (Chakra, ting Phn c ngha l "bnh xe quay"). Nu chng lu thng tt, con ngi s khe mnh, chng li c mi tc ng; nu vic vn hnh ca nng lng b ri lon th bnh tt xy ra. H thng lun xa c tn cng l bng cc huyt chm cu, cng v hnh nh bn thn n. Con ngi c th luyn tp nng lng c vn hnh mnh m qua c th mnh, chng nhng lm cho bn thn trng kin, khng m au, t cha c bnh ca mnh v ca ngi khc m cn truyn c kh nng ny sang mt s ngi. iu xy ra vi cc em l h qu ca s vn hnh ni trn, chng phi thn b g ht; bc vo tui trng thnh, cc em c th c sc mnh y nu bit luyn tp ng phng php.

To Ebook: Nguyn Kim V

Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


L Trng Bng 500 gii p y hc theo yu cu bn c Chng 3: Ngoi hnh, chuyn ph n v nam gii

L Trng Bng

116. Vc ngi thp "Chu 21 tui, cao 145 cm, nng 43 kg d vn n y cht dinh dng. B m chu u thp. Nn ung thuc g c th pht trin thm chiu cao? V n tui no th khng nn ung thuc na?". Nu c b ln m u thp, con ci t kh nng cao. Nu b m thp nhng ng b ni ngoi l ngi cao ln th chu c th tha hng gene cao ln th ln. Nu vy, t nay n tui 25, chu vn cn cht t hy vng l gene ln c th pht huy. Cn nu c hai bn ni ngoi khng c ai cao hn b m chu th nh chu. Tuy nhin, trong gia tng chiu cao hin nay ca lp tr trn ton th gii, c th chu s nhnh hn i cht so vi b m. Hin c thuc hoc mn tng trng (hGH) s dng cho nhng trng hp thp b do trc trc tuyn yn. Thuc ny khng c tc dng trong trng hp ca chu. 117. Ngi gy "Chu 19 tui, cao 161 cm m ch nng 46 kg. B m chu ai cng cao ln nhng chu gy g, c tay nh xu, cc u xng u nh ra. Xin cho chu mt li khuyn". Chu cn may mn hn nhng ngi bo ph, bi v chu c tha h n ung, tha h ng ngh m khng s g ht. Mt s nghin cu cho thy, nhng ngi gy nu khng nghin ru, khng ht thuc l s sng lu. Hung chi gene tim tng trong ngi chu li l gene cao to ca b m. Chu nn tm cch n thm nhiu cm, nhiu tht, c, trng, tm cua, sa, bnh ko; tranh th ng trn 8 gi mi ngy (trong c 1 gi ng tra), dng thm u n mi ngy 1 vin Theravit (a sinh t km cc cht khong ti cn cho c th). Nn tp th dc ton thn u n, vi mc tng dn khng qu sc. Trong khi thc hin, nu thy kt qu tt, phi bt n, bt ng i mt cht, phng nguy c tr thnh bng ph. 118. Bng qu to "Chu 18 tui, cao 150 m, nng 46 kg. Khng hiu sao t my nm nay, bng di ca chu li phnh ra nh ngi mang bu c hai thng. Xin cho bit cch khc phc". Chu hy o v ghi chp s cn nng, vng eo ca mnh dng lm s liu so snh, ri kin tr thc hin my bin php n gin sau (khng c ngt qung): - Nm nga, hai chn dui thng, dang rng, na thn trn dng dy dy, a bn tay bn n chm To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

vo bn chn bn kia. S ln tng dn. Tp vo lc tnh dy l thch hp nht. C th thay bng ng tc: ng ging chn ri ci xung ngng ln, chm tay bn n vo chn bn kia. - Lc vng: Nn vng cnh bn hc thnh thong lc gii lao. - i b nhiu, bi li thm nu c iu kin. Khng ng qu 7 gi /ngy. Ngoi ra, chu ch ng tng cn (thm ch gim i cht t cng tt) bng cch: hn ch cht bt, cht ng (k c chui), khng n m; n tht nhiu rau xanh cc loi v hoa qu. Tm li l dng nhng thc n t calo, khng gy tch ly m. 119. B ch l ln "Em 21 tui nhng ch cao 160 cm, nng 48 kg. Mt s ngi ch em ln, nhiu lc em bc lm, nhng khng bit lm sao. Em nn chi nhng mn th thao no cao thm c t na?". Vic tp th dc dng c hoc chy nhy, bi li, duy tr mt cuc sng nng ng yu i s lm cho c th em thon th, d coi, nhng khng c tc dng tng chiu cao. Em bc lm g vi nhng li ni thiu xy dng nh vy, bi l ti tr cng nh o c con ngi u c ph thuc vo chiu cao! Hy chm lo hc hnh, lm vic cho tht thnh t chng minh iu . M ti sao li gi ngi cao 1,6 m l ln? 120. Sao li gim chiu cao? "Mun gim chiu cao th lm th no? Lu nay em n t i nhng chiu cao vn khng ngng pht trin. Xin cho bit nn ung thuc g hm n li?". Khng th v cng khng nn lm gim chiu cao ca mnh. Em ng c di dt n t i, v nh vy s tr thnh lu u. Nn n ung tht tt v tp th dc th thao u n. Dng hai t nh ri tng cho nng dn, hoc c t cng theo phng thc t nh n nng. Trc bui tp, phi khi ng cn thn, tp xong nn tin hnh t xoa bp, ri thng thc mt cc sa hay nc ng (c pha thm ch cng tt). Nh vy, c th em s cn i, to khe, p lm y. Hoa hu n ngy nay u thuc loi cao; l con trai, em phi hn h mt u ch! 121. Sinh vo ma no th v sau cao ln? "Sinh vo ma no th sau ny s c thn hnh cao ln? C phi l ngi sinh vo ma rt s thp b?". Cu hi ny ca cc em rt hc ba, v cho ti nay, Vit Nam cha c mt thng k khoa hc no v vn ny. Mt cng trnh nghin cu ko di 10 nm ca o thc hin trn 507.000 nam thanh nin 18 tui cho thy, nhng ngi sinh vo ma xun (thng 4) cao hn 6 cm so vi cc ngi sinh vo ma thu (thng 10). Qua phn tch, cc nh khoa hc nhn thy rng, chiu cao trung bnh ca h t l thun vi thng sinh, c ngha l t l thun vi chiu sng ca mt tri. Mt nghin cu ca an Mch trn 1.160.000 thiu nhi (c trai ln gi) ra i t nm 1973 n nm To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

1994 cho thy, nhng tr sinh gia ma xun cao hn tr sinh vo ma ng hay ma h trung bnh 2,2 cm. 122. C th do c th pht trin hi nhanh "Em 18 tui m cao 180 cm, nng 72 kg. C ny th khi 20 tui, em s cao ti 2 m! Xin cho em mt li khuyn". Th em ni khng chi tit, nn ti phi nu ln my hng v c on: - Nu em tng ngi cao ln, trong gia nh t phi c nhiu ngi ging em, thn th cao to m vn hi ha, khng c bt thng no v ni tit. - Nu em b tng nng thy trc tuyn yn th phi c thm hin tng to cc u chi (to cc) hay g vo ct sng. Trng hp ca em c th l do c th pht trin hi nhanh trong giai on ngn. Sau ny, qu trnh ny s chm li (con trai 17 tui, con gi 15 tui mi nm ch cao thm cha y 1 cm) hoc ngng sm (thng xng ngng pht trin sau 25 tui). V li, chiu cao v cn nng ca em so vi cc bn tr cng trang la mt s nc th c g gh gm u. Em nn tp c t theo li tng dn mc c mt thn hnh cng trng, khng cao lu u. Ch n ung v lng v cht. Ngoi ra, phi tranh th ng nhiu hn gim vic tiu hao nng lng. 123. Ngi pht trin nhng chn tay nh "Chu l con gi, 20 tui. T nm 14 tui, c th chu pht trin nhng chn tay li nh (nht l chn), lm chu rt xu h. C cch g gip chn to thm khng?". Chc chu nh ni "i bp chn nh", phi khng? Bi v mt c th n pht trin bnh thng, cp i t khi thua km. gip i bp chn to ln, chu nn thc hin theo hng dn sau: - Nm nga, hai chn gi ln tri ri "p xe", va p va ln lt co dui bn chn ti a. - Vn trong t th , xoay trn hai c chn tht mnh theo chiu kim ng h, sau xoay ngc li. Hai ng tc ny lm cho bp chn hot ng nhiu v n nang. Ch : - Mi ln tp xong, dng tay xoa nn nh nhng hai bp chn. - Nu mun hn ch s vn ng ca i v mng, mi ln "p xe" phi gi cho hai gi vo gn st bng, ch cho hai cng chn vn ng thi. - C th kt hp nhy dy (b dy ca th thao c 2 tay cm, lm cho c tay xoay trn v n nang; cn si thng bnh thng th khng th). Nhy nhn chn bt bp chn lm vic nhiu hn. - Trc khi bc vo t tp luyn, chu nn o chu vi c chn, bp chn, c tay... lm mc so To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


snh v sau. Nh rng trong 1-2 thng u cha c g hn u, ch st rut. 124. Bn chn qu to "Chu c i bn chn qu to. C th phu thut cho nh li c khng?".

L Trng Bng

Ngy xa, mt vi nc phng ng c tc b bn chn ca cc b gi li, lm cho bn chn v sau tr nn nh nhn, xinh xo, nhng cng rt yu t. Cn khi bn chn c nh hnh ri th khng c cch g lm n nh li. Hn na, chn l im ta ca c c th, cn phi vng chc, khe khon. 125. cho bt mp "Em nm nay 15 tui m nng 50 kg, rt bo. C ngi cho rng ung gim hoc n nhiu chua s bt bo, c ng khng?". Tuyt i khng c dng gim hoc chua cha bo v va v ch va c hi cho d dy. Trng hp ca em, phi cng lc thc hin my vic sau: - Tng cng mc tiu hao nng lng bng cch i b, lc vng, bi, bng chuyn... thng xuyn. S nng lng tiu hao trn 1 m2 da khi p xe l 1,5 calo; i b trong nh 1,7 calo; i b ngoi tri 3 calo; chi bng chuyn 4,3 calo; chi bng 5 calo; bi li 6 calo; ln cu thang 10 calo. - Nu em thuc loi ng trn 8 gi mi ngy th phi gim dn thi gian ng mt cch hp l. - Rn luyn c c phong thi nhanh nhn hot bt nhm tiu hao thm nng lng. - Gim hoc khng dng cc thc n bo nh tht m, b... Gim bt ngt nh ng, mch nha, bnh bch quy; khng n qu nhiu cm. Thay vo , n nhiu rau, c, hoa qu khng c cm gic i (trnh chui chn). - Li qu da cha cht Bromelin c tc dng lm tiu m; em c th n u u v khng hi g. 126. Thuc nhum tc "Thuc nhum tc en cha nhng cht g, c gy hi hay khng?". Thuc nhum tc bc thnh en c hai yu t: - Cht nhum en P-phenylenediamine dng lng, bt hoc kem. - Dung mi hydrogene peroxyde (nc xy gi). Hai yu t ny thng c ng trong 2 l hay tup khc nhau, khi dng mi em trn ln. Cng c loi thuc nhum ch cha trong mt l duy nht, khi dng th pha thm nc sch (Bigel bt, loi l con). Thuc nhum tc chnh hiu, cng nh cc loi m phm chnh hiu, u c kim tra nghim ngt trc khi cho lu hnh trn th trng, do khng gy tc hi g cho ngi s dng. Ch cn theo ng ch dn ghi trn bao gi, th phn ng trc khi s dng ln u, khng giy thuc vo mt, v d nhin khng cho tr em ng ti. Bn nn mua thuc nhum ti cc ca hiu c uy tn trnh hng gi (nhum cng en, gi rt r, nhng s gy rng tc v cc tai bin khc). To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


127. Hy yu ln da tri ban cho

L Trng Bng

"Chu c mt ngi bn gi da hi en, mun bi thuc Leucodinine cho da c trng, c nn khng?". Kem Leucodinine B (dng cha tn nhang) c tc dng "lt da", lm cho nhng ch b tn nhang nay c th tr li bnh thng. Bnh nhn phi trnh nng k trong tin trnh iu tr (nu khng, da s b nm nh trc hoc hn trc). Cn chuyn "lt ton b da" lm cho da en bin thnh da trng nh trng hp ca s da en Michel Jacson th khng hiu cc nh khoa hc M lm theo phng php no, cha thy cng b cc thuc men c th; nhng chc chn l tn km kinh khng, khng hp vi ti tin ca bn chu. Hy bo bn chu yu qu nhng g tri ban cho; v li da nu hin ang l mt y, "c gi" hn da trng nhiu. 128. Lng tay, lng chn "Lng tay chn ca chu di v en. Nghe ni c thuc lm rng lng, xin cho bit c th mua u v c t khng?". Mc lng, mc tc l qu trnh sinh l c vai tr quan trng nh: chng rt (lng rm ngc, bng gip ngi x lnh gi c nhit); chng nng (lng nch gi m hi v cho bc hi dn ta nhit); chng bc x ca nh nng (mi tc di ca cu th bng ...); chng ma st v to khoi cm (lng mu)... Hin tng c nhiu lng m, mp ( n nhn nh th c ria), tay chn, ngc... l do c a, thng c yu t di truyn. Khoa hc cha c cch g gip chu "lm p tay chn" mt cch trit v lu di. Cc bin php thm m ch gip "vt lng" ch khng th ngn c lng mc li. Trn th trng hin c kem lm rng lng, rng ru mp ca Php mang tn Veet, ng trong tup ln, gi khong 42.000 ng. Cch s dng nh sau: Dng con dao pht (c sn trong hp) ly kem trt mt lp ln m lng cn lm rng, gi trong 3-5 pht (khng c qu 10 pht), ri li dng dao pht g b lp kem , ra sch da bng nc (khng cn x phng), lng hoc ru s tri theo. C th dng kem Evaclin cha hot cht l acid thioglycolic, dng tup 30 g, gi khong 30.000 ng. Dng gc bi thuc ln da, gi thuc trong 5-15 pht ri dng tay hay khn mm lau i. Ch : Khng bi cc loi kem ni trn vo ch xc, khng kem dy vo mt (nu b dy vo, phi cho mt vo ngay mt cc nc sch, chp mnh nhiu ln lm tri thuc). HIV/AIDS ly thuc xong, nh nt kn tup thuc ngay dng c nhiu ln. Mun n gin v t tn tin hn, c th bi nc xy gi. Cht ny lm cho lng mt mu (tr thnh trng) nhng khng lm mt lng. Khng nn co lng tay, lng chn, v iu ny s lm cho lng cng hn, en hn v mc khe hn. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


129. C nn nh lng mi?

L Trng Bng

"Chu l con trai, 16 tui, c thi quen nh lng mi; gn y thy lng mi cng v di ra. Xin cho bit cch gii quyt". D thi. Chu ng nh lng mi na, thng xuyn dng mi ko xn bt khi thy n sp thi ra (cn thn khi ct phi cnh mi). Chuyn ny cng bnh thng nh co ru vy, nhiu ngi rt in trai cng phi thng xuyn xn ta lng mi y. Chu cn t tui, nn tm ch kn o m ta tt trnh b cc bn tru chc. 130. Ru quai nn "C thuc g tr ht c ru quai nn khng? Em cn t tui m ru quai nn tm lum, b cc bn tru chc, tc mun cht!". Cha c cch g. V li cng chng cn lm tiu ru quai nn, bi l ngi mang ru quai nn s c dng v mnh m rt n ng. C iu l em phi nng co hng ngy, trn m s c mt vng mu l p mt, ch nn khng tm lum rt kh coi. Em nn xin b mua ring cho mt b co ru, v hy cn thn ng lm rch da trnh nguy c ly nhim mt s bnh. 131. Mun m ko chn cao thm "Chu ch cao c 1,47 m, b bn b tru chc rt kh s. Nghe ni c th phu thut ko di chn, c ng khng? Nu c th lm u v c tn km lm khng, xng c nh hng g khng?". Hin nay, ngi ta c th phu thut lm cho mt hoc hai chn vn vn lnh ln nhng "hi b ngn" c di thm ra. Phng php ny do chuyn gia chn thng - chnh hnh ngi Nga Ilizarov xut t nhng nm 60 ca th k 20, bao gm cc bc: - Dng ca in ca vng quanh ci xng nh ko di, lm thnh hai on trn v di (ty xng vn c gi nguyn vn). - Dng thit b ni trn ko v gi cho on di tch xa dn khi on trn 1 mm/24 gi. Trong mt ngy m, cc m mi s bi p vo 1 mm , ban u m cn mm yu, v sau vng chc dn. Sau khong t na nm n mt nm ri, bnh nhn s i li c bnh thng (ban u phi dng nng, gy h tr). Trong trng hp ch ko di mt chn (cho bng chn bn kia), an ton s cao v bnh nhn vn c mt chn lnh h tr. Nn cn nhc vic ko di c hai chn v khi c 2 xng u yu, bnh nhn rt d b gy chn khi ng (do khng c xng vng chc lm im ta). V vy, chu hy cn nhc k trc khi quyt nh. 132. Tm hiu bn thn "Chu c mt chuyn khng dm hi m v bn b, nh hi bc s. m o ca chu 2 l, ci pha trn i tiu, pha di ra kinh nguyt v c cht nhn. C bn n no ging chu khng? Trng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


hp nh chu c sinh con c khng?".

L Trng Bng

C l chu cha hc gii phu v sinh l ngi, hoc hc ri m qun. Xin nhc li: Pha trn l l niu o, thuc b my tit niu. Pha di l l ca mng trinh ( kinh nguyt v cc cht xut tit i ra). Ch khi mng trinh rch th mi trng r m o. Nh ca chu l hon ton bnh thng. 133. Ch c ct n "Chu l con gi, va bc sang tui 18. Thy b phn sinh dc mc nhiu lng di, chu dng ko ct i li thy n mc tip v nga. Chu phi lm g by gi?". Chng lm g c. Hy cho n c yn. Khi mc di, lng mu s chng li, khng sao u. Nu b ct, n s mc tip, tr thnh cng, to si hn v gy nga ngy kh chu. Nn dnh thi gian vo vic hc hnh th hn. Cn nga th mt thi gian ngn na s ht. 134. Ri lon dy th "Chu 16 tui, hi gy mt cht. T nm 12 tui, chu hay nhc mi khp ngi, tim p hi mnh, i khi nhc u, au bng; di vai tri hay nhc mi khi ngi hc lu. C ngi bo chu b bnh gan, bo nn nut thn ln. Chu cng lm theo nhng khng ht". Nhng iu chu k thuc phm vi mt s ri lon tui dy th; mt thi gian na s ht, chu ng qu quan tm. Hy tp trung vo hc tp v tch cc vn ng thn th, gii tr lnh mnh... Nh rng gan nm kh thp bn phi; v ng nut thm mt con thn ln no na y. 135. Chng c chng bnh g u "Chu l con gi, 16 tui, gn y thng mt ht can m, run ry v thiu t tin, ni nng thiu t nhin khi c mt ngi khc, nht l vi nhng ngi khc gii cng trang la. Chuyn ny lm chu lo bun qu. Xin cho bit chu mc chng bnh g vy?". Chu khng b bnh g c. Con gi, con trai trong tui dy th t nhiu u c hin tng nh chu, nht l khi t c tip xc rng ri t lc cn nh. Vic khc phc khng kh nhng phi kin tr v b mt. Trc khi ra khi nh, chu phi kn o t kim tra xem mt mi c vt nh khng, hai hm rng c sch khng, ming thm tho cha (nht l sau khi n hnh ti), tc tai gn gng, qun o tm tt ng n cha (ch mc nhng kiu l lng s lm thin h t m thm); cp sch v cha; c tht thuc bi, hiu bi hm cha; c thy bng i khng (ng ci, bng i cng lm chng mnh run y)... Tm li, ch khi no thy mnh "ht ch", ngha l d ai c bi lng tm vt cng khng lm g ni mnh, th ln ng mi tht vng d. Cng vi vi bn gi thn, chu hy tp lm quen dn vi mt vi bn trai hin lnh, nghim tc, sau c th bt quen c vi nhng bn "a t m v hay ". Chc chn rng cui cng chu s thy h cng khng gh gm nh chu ngh. Tranh th nhng lc ri ri, chu c th b mt ngi mt mnh trc gng i thoi vi chnh To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

mnh, thy ng tc no "v duyn" th chn chnh (nh thi quen ni to, a tay che min g khi ci, ci ng c, ci ha h, bu mi, nhn mt, khua tay ma chn...). Dn d chu s ng x c vn ha, c mi ngi tn trng, lm chu cng thm t tin. Ngoi ra, chu nn tm mt hot ng vn ha lnh mnh hoc mt mn th dc th thao tham gia ht mnh. 136. C th khc phc c "Chu l con gi, hc lp 8, ang mang mt cn bnh qui c l ni trc qun sau. nh, chu hc bi cn thn, nhng khi c gio bc vo, nht l khi b gi ln bng, chu run n ni khng ni c cu no. Xin cho chu bit cch khc phc". Chng phi bnh tt g u, chu . ang tui dy th, ngi ta thng c nhng trc trc nh th. Chu ch bun lo, dn d mi chuyn s tt p thi. khc phc, chu hy tp thi quen ghi ln giy bt c vic g ai dn (ni dung, thi gian, a im c th) ri thng xuyn xem li, thc hin n u ghi chp n . Vi nhng vic mnh d nh lm cng vy. Chu s t b m mng cho m xem. V hc tp, khi nh, chu theo cung cch sau: Tay cm sch v, va i bch b va ni tht dng dc, hnh dung ngi nghe lc chnh l thy c gio ang mm ci v bn b ang thch th nghe chu ni. Lc nm vng bi, chu b ti liu v tip tc nh c, n khi thy ni tri chy l c. Nh gi b mt, nu khng s b ch giu l "chp mch" y. 137. Bn to bn nh "Chu l con gi, 17 tui. Vi nm gn y, chu pht hin thy hai bu v mnh tuy khng au n g nhng khng cn i, bn phi ln hn bn tri. Chu lo lng qu chng!". Thng thng, trn c th ngi, hai b phn i din (tai, mt, cnh mi) khng hon ton nh nhau nhng t ai ch ti, v s khc bit cng khng nhiu. Nhng vi b ngc, do n ln, d l nn ngi ta cm nhn ngay c iu . c bit, cc chu gi nng thn phi sm tham gia lao ng, do u tin s dng tay phi nn cnh tay phi thng to hn cnh tay tri, na ngc bn phi cng to hn bn tri. Nu cha tin, chu r mt s ch em cng hon cnh v trang la, dng thc o kim tra cho nhau m xem. Khi tin ri, cc chu c th khc phc mt phn bng cch u tin cho tay tri hot ng nhiu hn, nhng phi lu di y, khng vi c u. Tt nht l khuyn cc em nh chng bit m trnh trc. 138. Ch l do hoc mn sinh dc "Nm nay ti 29 tui, c gia nh v mt con. T khi bt u c kinh cho n nay, mi ln chun b thy thng l hai u v ca ti ni ln tng cc, n vo thy au, ht kinh nguyt th tr li bnh thng. Xin cho bit y c phi l triu chng ca bnh ung th v khng?". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Tnh trng ca bn, m s ch em khc cng gp. Tuyn v tng th tch di tc ng ca hoc mn sinh dc. Khng phi l ung th v, v cng khng cn iu tr g. Nu au nhc kh ng, bn c th dng cc thuc gim au thng thng; cn nu khng kh chu lm th thi. 139. B ngc v kh nng sinh con "Em vo tui 22 m khng hiu sao b ngc li qu nh. Em rt bun v lo lng v nghe ni con gi khng c ngc s khng c kh nng sinh con". Nu em v bn i ca em khng c bnh tt th ch s ly chng ri em s sn sn nm mt y. Bi v tng ngi gy khng h ng ngha vi chng v sinh! Sng trong nim hnh phc la i trn vn, chng nhng em s c con m c th cng tr nn cn i hn, vi iu kin l phi duy tr mt ch n cht cho c v ln chng, nng vn ng, th dc, ng 7-8 gi mi ngy, tinh thn thoi mi. Sau ny, trong ln mang thai u tin, em s ln cn, ngc s n, v s c nhiu sa cho chu b, bi v cc c thng ni, "v mp" ca ngi nhng nhng nh em c nhiu sa hn, tuy hnh thc khng hp dn bng "v tht" ca ngi qu mp. 140. Nh hoa b tt vo "Nm 12 tui, em bt u c ngc, n nay 20 tui ri m vn cha c u v. Khng c u v th sau ny lm sao cho con b; v vy nn em khng dm nhn li yu ai. Xin cho em mt li khuyn". Em soi gng k li xem, chc l 2 nh hoa ca em b tt vo y. Hy dng mt ci ht sa (ca mt s b m ang cho con b) p vo v tm cch ko n ln dn; hoc dng tay y ra thng xuyn lau ra v day n nh nhng. Sau ny, khi em chun b lm m, trong qu trnh thai nghn, em nn thng xuyn xoa vut hai nh hoa ng ln; nu c "ng x" gip cho cng tt. D nhin l em khng nn s dng nt v. 141. Ri lon kinh nguyt tui dy th "Bn em 15 tui, hc lp 9; sau khi c kinh nguyt ln u (trong khong 4 ngy) th mt lun, my thng nay khng thy na. C gio ni ai ang tui c kinh m khng thy na ngha l c thai, bn em rt lo. Vy bn em c thai hay khng? Hay n khng c kh nng sinh con, v phi cha bng thuc g?". Trong mt s trng hp, nhng k kinh u tin trong i ngi con gi c th khng u n, s lng v thi gian thay i. Dn d n s n nh bnh thng. Khng th vi vng "chp m" l khng c kh nng sinh con. Cn v chuyn kia th cc em nn nh rng: Ngi ph n ch c th mang bu sau khi sinh hot tnh dc vi nam gii hoc th tinh nhn to. Kt qu c xc nh rt sm v d dng ti phng khm thai. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Trng hp ca bn em, nu c hin tng chm kinh th nn i khm ti mt c s ph khoa c trang b tt. Cc em nn ghi chp u n tnh hnh kinh nguyt vo mt cun s ring, lm ti liu cho mnh v khi cn th a cho bc s tham kho hi kin. 142. Kinh nguyt khng u "Chu l con gi, nm nay gn 17 tui, bt u hnh kinh t nm 15 tui. T mt nm ri nay, kinh nguyt khng u, lng kinh ln nhiu ln t, c khi 2-3 thng mi c mt ln". Chu hy cha theo cch n gin, t tn km sau (theo kinh nghim ca Lng y Hong Duy Tn): ch mu ti 40-50 g, nh tay ra sch (trnh lm gip), thi nh. G gi 1 con (700-800 g) lm sch lng, m bng b ht lng, phi v hai cc sp trn phao cu, khng b hai ht c (tinh hon). Cho ch mu vo bng g, khu kn li, chng cch thy (khng luc) cho n khi chn nh. Ngay trong ngy hnh kinh u tin, n 1 con (chia thnh 2 lt). Sau , c 2-3 ngy li n 1 con. K kinh sau, nu thy th n tha dn ra cho n khi hon ton bnh thng th thi. 143. Khi no th ng lo? "Chu l con gi, 19 tui. Trong tai nn cch y 3 nm, chu b khung xe p p mnh vo vng bn, khng chy mu, t n nay sc khe mi mt vn bnh thng. Vy chn thng c nh hng n chuyn sinh n sau ny khng, v chu c nn ly chng khng?". Nn ly chng qu i ch. Chn thng vng bn do khng gy nh hng g u; nu "c vic g" th ngay sau nht thit phi chy mu nhiu hay t. Ch c chn thng nghim trng lm v xng chu (sau xng lin li trong trng thi lch vo, gy hp khung chu) mi nh hng n sinh n. Trong trng hp ny, thai ph phi c bc s ph sn theo di st c th m ly thai ng lc, bo m an ton tuyt i cho c m ln con. 144. Hnh kinh v vn ng th lc "Vic nh cu lng, ln xung cu thang... trong khi hnh kinh c nh hng g n vic sinh sn sau ny khng?". Sau khi sch kinh, nim mc d con bt u dy ln, n ngy th 14 (ngy th nht l ngy u tin thy kinh), n "tch ly" c mt lng mu ti a, sn sng cho trng ti lm t v pht trin. Nu khng gp trng, s mu ny bin cht dn, nim mc d con bong ra v c o thi ra ngoi cng vi s mu , sau khong 3-5 ngy th ht; l nhng ngy c kinh. Ngi ph n ang tui sinh sn mi thng mt mt lng mu nht nh, nhng khng sao, tri ph cho h kh nng b p nhanh chng s "mt mt" thng xuyn . Lng mu b mt ny mc ti a ngay sau ngy th 14 ca vng kinh, ch khng phi ch n ngy th 28 l ngy n c o thi ra ngoi. Cm gic mt ca ch em vo nhng ngy ny l do n tng ch quan (thy ra mu), ch khng phi do mt mu (y l mu c bin cht, khng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


phi mu mi). Ni l cm gic kh chu th ng hn.

L Trng Bng

Mi phin phc c th c gii quyt tt bng bng v sinh nh gn c kh nng thm ht ln. Nh vy, cc n vn ng vin in kinh, bng , n din vin xic, trt bng ngh thut... vn tp luyn, biu din khng ngng ngh. Chi cu lng v ln xung cu thang so vi cc mn th thao kia thm vo u. Tuy nhin, trong nhng ngy hnh kinh, nim mc c ca d con va rng, nim mc mi thay th cn non, rt d b bnh nu nhim khun. Do , vo thi im ny, ch em khng nn m mnh vo nc bn, khi lm v sinh khng dng nc mnh pht ngc mang cht bn ln theo. Sau khi i tin, nn dng nc ra hu mn, khng chi bng giy v d qut phn sang m h. 145. Ngc nh "Nm nay em 20 tui ri m ngc vn rt nh. C mt anh ng li yu em, nhng em ngh rng n b khng v ly g nui con nn trn trnh anh y. B m mng em v li c x . Xin cho em mt li khuyn". C x nh em, b b m mng cho l ng. Em c yu anh chng khng? Nu yu tht lng th ng trn trnh na! Sao em li ni l em khng c v? V em pht trin hi km thi, ng lo. Vi tnh yu nng thm, sng trong hnh phc la i, chc chn c th em s khc xa hin nay. ng di dt m t to ra cho mnh mt s mc cm khng ng c. Em c th tham kho thm Mc 73. 146. C nh ngi mang bu "Chu 17 tui, hnh kinh t thng hai nm nay, 7 ngy sau th sch, nhng t khng thy c kinh. Ngoi ra, bng chu c to dn, n nay nh ngi c thai 3-4 thng! Chu cha h quan h nam n, chc chn khng c bu, nhng m chu li nghi ng v mng chu, lm chu rt kh tm. Xin cho bit chu phi lm g by gi?". Chu ni s si qu, nn trc tin phi loi tr nhng tnh hung khng th c, sau nu ln vi kh nng chu lin h xem. - Trc ht, cn loi tr hin tng mu kinh trong t cung. y l tnh trng l c t cung b bt li t trc, khin mu kinh hng thng tch t li, t cung c to dn, s bng di thy c mt khi nhn, n tay vo thy cng v hi tng tc. Chu c kinh mt ln nn khng phi b chng ny. - Chu cng khng b ri lon kinh nguyt do bo ph v nu b bo ph, khng ch bng m ton thn u to ra (r nht l mng, i). Hn na, bng cng to va phi thi. Ch cn hai hng chn on kh d i vi chu: - C th tin li chu ni l "cha h c quan h nam n" v chu cha xy dng gia nh. Tuy nhin, trong thc t, khng t thiu n khi gn gi bn trai cho php bn mnh thc hin nhng ng tc gy ra nguy c mang bu, nhng bn thn h li ng nhn l an ton v tng nh khng c my may ci gi l quan h tnh dc. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Nu chu c bn trai nh vy, cn mua ngay que th thai. Nu phn ng dng tnh, chu nn ni tht vi m c hng x tr. - Chu b u nang bung trng, v u ny kh to, cn phu thut ct b. 147. Hin tng v mao "Em l n, 18 tui, c th pht trin bnh thng, nhng nch v ni khc u khng pht trin lng mao. Ti sao vy? iu ny c nh hng g n tng lai khng?". n, hin tng v mao (lng nch, lng mu b phn sinh dc tha tht hoc khng c) thng do yu t di truyn, hin cha c cch khc phc, k c thuc men. Tuy nhin, n khng nh hng g n quan h tnh dc hoc vic sinh con ci. 148. Nhng trc trc v gii tnh "Chu 17 tui nhng ngc khng pht trin v cha c kinh nguyt; ging ni li m m nh con trai, thn hnh to ln, mi cao. Chu rt mc cm, khng bit sau ny c xy dng gia nh c khng. Xin cho chu mt li khuyn". Nhng g chu ghi trong th cha khng nh l chu c hin tng bt thng v nhim sc th gii tnh (NSTGT) nhng cng lm ta kh b qua hin tng ny. V vy, xin cung cp mt s im v l thuyt bn thn chu v gia nh lin h, xem xt thm: Ta bit rng NSTGT ca nam l Y, NSTGT ca n l X. Ngi nam c 22 cp nhim sc th bnh thng v cp th 23 l XY). Cn ngi n c cp nhim sc th th 23 l XX. Cc hin tng sau c coi l bt thng: - N, c 46 nhim sc th, cp th 23 l XX (gi tt l 46, XX), vn c bung trng nhng b nam tnh ha do b trc trc trong vic tng hp cc hoc mn. Trng hp ny rt hay gp trn th gii. - Nam 46, XX (mang X ca n, tinh hon khng c t bo tinh), chim t l t 1/20.000 n 1/5.000 ( chu u). - Nam 46, XY nhng b n tnh ha (vn c tinh hon, c trng hp thm c d con), chim t 1/40.000 n 1/10.000. - N 46, XY (mang Y ca nam), rt him. Mt s trng hp (hy hu): Nam 47, XXY (c 3 nhim sc th gii tnh); N 47, XXX (c 3 nhim sc th gii tnh); N 45, X (ch c 1 nhim sc th gii tnh). Vn ca chu rt h trng v t nh. Tt nht l nh cha m a n khoa ph sn ca mt bnh vin trung ng c xc nh r. Qua khm xt lm sng v cn lm sng, bc s s bit c tnh hnh c th ca c quan sinh dc ngoi cng nh trong (nghing v gii no), bit c bnh ca chu thuc dng no, t s quyt nh cha tr bng thuc hay phu thut. 149. C phi u v khng? "Chu 21 tui, cha xy dng gia nh. T tui dy th, hai bn v c cc hi rn, chng ln ln To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

theo s pht trin ca ngc. C gn n ngy hnh kinh, cc cc ny tr nn rn hn v chm tay vo rt au. Chu rt lo y l triu chng ca bnh ung th". Nhng cc hi rn xut hin ngc chu t tui dy th chnh l tuyn v. Sau ny, khi chu xy dng gia nh v c con, nhng cc ny s cn to hn na tit sa cho b b. Cn vic nhng cc ny tr nn rn hn, chm vo thy au lc sp hnh kinh l do lc , c th thiu hoc mn progesterone. Cch cha n gin nht l thng xuyn dng thuc m Progestogen (bn ti cc nh thuc) bi ln v. Tt nht l bi vo ban m, trc khi i ng khi vng vu v khng b m hi lm tri mt thuc (thuc s thm qua da). Thng mt tup thuc m dng c khong 3 tun. Nu l u v th thng ch c mt khi, s nn khng au, mc rn khng thay i, kch thc ch ln ln (chm hay nhanh) ch khng b li hoc mt i, khng din bin theo chu k kinh nguyt. Chnh v u v khng au nn nhiu ch em coi thng, khng chu i khm sm pht hin v cha tr kp thi. n khi nn vo thy da nhn nheo nh v cam (chng t c nhng si x chy t khi u n di da, ko mt da xung tng im, lm cho da ch nhn nheo khi nn) th s pht hin ny khng cn sm na! 150. U x tuyn v "Chu xy dng gia nh v c mt con 7 tui. Gn y, chu thy au v phi, s vo thy mt cc cng, bc s cho xt nghim chn on l vim x tuyn v, k n thuc v bo khng vic g. Chu dng thuc thy , nhng sp n ngy hnh kinh li thy cc to ln v au; khi ht kinh li bnh thng. Chu nn ung thuc tip hay phu thut, v liu n c tr thnh ung th v khng?". n thuc ca chu c mc ch va iu tr va thm d (th chu khng ni nhng chc l bc s cho chu ung Orgametril vin 5 ml, mi ngy 2 vin trong 15 hm, sau dng tip mi ngy 1 vin 5 mg trong 15 hm), v hiu qu ca n gip bc s khng nh chu b u x tuyn v. V cha tr th ty tnh hnh, c th c hai hng: - Nu dng n thuc ni trn thy tnh trng tt ln (mc au khng tng, khi khng ln hn trc...), nn nh bc s cho cha v theo di tip. Thng xuyn bi ln v phi thuc m Progestogen mi ngy 1 ln, vo bui ti trc khi i ng. Chu nn ti bnh vin xin chp v tiu chun xem c g bt thng khng, nht l nu trong gia tc c nhng ngi b bnh v. - Trit v gn gng nht l phu thut ct b khi , ngay sau bc s s cho lm xt nghim gii phu bnh khng nh thm chn on. M xong, chu vn nn bi u m Progestogen ln vt so. Sau ny, nu chng may b li v tr khc (tuy kh nng ny khng nhiu), chu cng nn xin m li sm, khi khi cn nh, mi vic s n gin hn nhiu. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Nn nh rng, u x tuyn v l mt chuyn, cn ung th v l li chuyn khc. V li, v, "cc g au au" thng khng ng s bng "cc g khng au". Chu c yn tr. 151. Triu chng ung th v "Xin cho bit bnh ung th v c nhng triu chng g, cch cha tr ra sao?". Khi u, bnh nhn thy mt cc hi rn bng u a hoc nh hn nm hi su trong v, s vo th ln di tay, khng au, khng st, ti ch khng thy sng. Ch c nhng ch em quan tm n sc khe ca mnh, thng xuyn kim tra i v mi pht hin c v i khm bnh ngay ti mt bc s chuyn ngnh. Lc ny, vic phu thut (ly khi u) n gin, nh nhng, sau c th kt hp vi ha tr liu nu cn. Kt qu thng tt p. Nu khng pht hin c, mt thi gian sau, khi u ln hn, rn thm, ko mt da xung lm cho da ti ch nhn nheo (du hiu da cam) khi ta bp vo. U vn khng au, khng gy st, nhng s vo thy t ln di tay hn do c dnh. thi im ny, vic phu thut ly khi u c th phi km theo ct b v. Sau khi m, bnh nhn c th phi ha tr hoc x tr. mun hn, khi u to thm, rn thm, s vo thy bt ng (do thm nhp ra xung quanh), xut hin mt s hch ln nh nch. By gi vic phu thut thng phi m rng, ct b v v ton b khi c ngc, ly b dy hch bch huyt c lin quan. D nhin l phi kt hp ha tr liu v x tr trc v sau m. Kt qu rt hn ch, khng trnh c di cn. 152. Bung trng c b nh hng khng? "Chu 20 tui. Hi ln 10, chu b cng hip. Liu mng trinh c vic g khng? Bung trng ca c b nh hng khng (kinh nguyt vn u)? Ngi yu ca chu khng chu hiu cho chu c, khin nhiu khi chu ch mun cht". Cu hi th nht rt kh tr li dt khot v chu khng ni r tnh hnh hi . Nu 10 tui m b cng hip th chc chn mng trinh b rch, thm ch m o cng b tn thng, th no cng chy mu nhiu (do m o cn b, thnh mng v khng c bi trn). Cn nu khng thy chy mu, khng au n g, c ngha l tn ti phm khng thc hin c nh ca hn. L ra sau vic ng tic , chu phi bo ngay cho b m hoc ngi thn lm gp my vic: - a chu n bnh vin gim nh y khoa, lp mt bin bn hp php vi y chng c khoa hc. Ti liu sau ny cng s minh chng cho tit hnh ca chu. - T co tn ti phm cng vi tang vt, trong c nhng vt tinh dch ca hn trn thn th chu (ti bnh vin, ngi ta s ly mu th tinh dch ny truy xt th phm nu hn chi ci; vi trnh khoa hc ngy nay, vic lm ny khng kh). Nh rng cng hip v thnh nin thuc loi ti rt nng. Cu hi th hai khng cn t ra, v nu hot ng bung trng b trc trc th kinh nguyt khng th bnh thng. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Cu cui cng th t chu phi bnh tnh suy xt t gii quyt ly. Ch xin nhc: Vic mng trinh khng cn, d do b cng hip hay do hu qu ca cuc tnh qu kh, u khng quyt nh nhn cch ca chu hin ti. Ngi yu ca chu chc cha c Truyn Kiu v cha suy ngm v thi ca Kim Trng i vi ngi yu sau khi nng qua tay bit bao ngi (m chng phi l lc no Kiu cng b p ung c u). Ngi ca my th k trc cn t ra tin b hn chng trai ca chu nhiu lm ! 153. C vic g khng? "Con v anh y hn nhau rt nhiu. nh hay mt nm v ca con v b phn sinh dc ca hai a chm nhau qua ln vi qun. Vy con c b rch mng trinh hay s ngc khng? Con rt thng nh, nhng li mun ch trao ci qu nht ca ngi con gi trong m tn hn thi! Xin cho con mt li khuyn". Mng trinh ch b rch khi c mt vt cng chui kht vo m o. V cng to t khi bt u mang thai, v ch s ra vo thi gian cho con b nu thiu bin php gn gi. Con ngh ng, hy dnh ci qu nht ca ngi con gi cho m tn hn! ch gip ch c cho bao nhiu cuc i, bi v khi b "tht thn", ngi con gi thng mc cm t ti v ri vo th b ng "cng liu nhm mt a chn", chp nhn mt cuc hn nhn khng nh . l cha k trng hp b nhng tn S Khanh la gt. 154. Cn khm cha ngay "Chu l con gi, mc thi xu th dm t tui dy th, lu nay thy thng xuyn ra cht dch l nh hi vng. C phi l vim nhim ng sinh dc khng, cn x tr nh th no?". Chu b vim nhim ng sinh dc, c th do a tay bn hoc vt bn vo m o. Tc nhn gy vim c th l vi khun hoc nm, hoc c hai. Chu khng th t cha ly mt cch ty tin. iu lm cho bnh ko di, nng thm, kh cha. Hy nh b m a ti mt c s y t xin khm cha. Ti y, cc bc s s xc nh chu b nhim loi vi sinh vt g ( c loi thuc thch hp). Chu s c theo di st sao cho n khi khi hn. y l vic rt quan trng. Nu chu c xu h m b qua th s hi khng kp. 155. Vim tuyn bartholin "Em l con gi, 20 tui, t 3 nm nay c 2 cc nh v tr gia mi ln v mi b. Chng ln dn, khng au, ti nay to bng u ngn tay t. Em rt hoang mang, nhng khng bit hi ai". Nhiu kh nng em b vim tuyn Bartholin hai bn, khng nguy him, nhng khng nn thm v n s gy mc cm. Em nn nh gia nh a i khm ti khoa ph sn ca bnh vin. Nu ng l vim tuyn Bartholin th nn m (sau khi gy t ti ch). Vt m s khi hon ton sau chng 1 tun. So s nm n mnh gia ranh gii ca mi ln v mi b. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


156. Bnh quai b v bung trng

L Trng Bng

"Nghe ni con trai mc bnh quai b th teo tinh hon, vy con gi mc quai b c b teo bung trng khng? Em hi b mc bnh ny ri th c b li khng?". Bnh quai b thng gp nhiu nht la tui t 5 n 15, ngi ln c khi vn mc. b mt ln ri th coi nh c sc min dch chng bnh vnh vin. Tuy nhin, vn c 5% trng hp b li. Do vy, em vn phi cn thn khi tip xc vi bnh nhn quai b v bnh ny ly qua nc bt. Nam hay n u c th mc bnh quai b; tinh hon hay bung trng u c th b virus quai b tn cng. Tuy nhin, c th thy rng nhng ngi mc quai b lc cn nh hu nh khng b tinh hon hay teo bung trng. Cc bin chng ny thng xy ra khi c th pht dc (tui dy th) hoc trng thnh. Do , nu tui ny, em phi c bit ch gi gn. Trong thi gian b bnh, cn hn ch ti a vic i li (nn nm ngh trn ging), c gng n ung cht u n, dng thm cc vitamin, cht khang v khng sinh chng bi nhim. Hin cha c thuc chng c virus quai b. Em cng cn nh thm rng, virus quai b t tuyn nc bt khng ch tn cng tinh hon hay bung trng, m cn c th "hi thm" mng no, tuyn ty, thm ch c thn, khp, tim, gan...Bin chng cc c quan ny thng xy ra trong 4-7 ngy sau khi sng tuyn mang tai. 157. Phi lm g khi b xm phm tnh dc? "Bn gi ca chu b mt a bn trai cng hip, sau thy vi ba git mu qun; vy n c b mt trnh khng v sau ny chng c bit khng? Bn chu c ngi yu xa, nay xu h, li s c thai nn mun tm n ci cht". Chc mng trinh ca bn chu b rch. Cn kh nng c thai th ty thuc vo thi gian xy ra s vic: Nu thy kinh c 13-14 ngy, kh nng th thai rt cao, nu thy chm kinh l phi i th nc tiu ngay c ht thai sm, khng au n g. Mun mt cht s phi no thai, c au t nhiu; mun na s phi cho con, phc tp hn, nhng an ton. V vic bn chu mt trinh, mt ngi chng khng c kinh nghim v kin thc y hc c th s khng bit. Nhng khng nn giu gim ngi yu. Nu anh ta thng cm v chp nhn th tt, nu anh ta c h khng chu th cng nh chia tay. Cn nu giu gim th bn thn bn chu sng trong gin vt nh, m nh ra b pht hin s ht sc kinh khng. Sao li ngh chuyn cht trong tnh hnh ? Bn y c ti li g u; phi sng v sng tt khng nh mnh v vn ln. 148. Ba ng tc khn cp chng cng bc "Cch y chng mt nm, mt ngi bn trai, trc khi b chu dng v lc cng bc chu. Chu khng thy chy mu, cng khng thy au, cn anh ta th cho ra mt cch nhanh chng ri rt lui . Nh vy chu c b rch mng trinh khng? Xin tr li gp, v chu sp xy dng gia nh". Nhiu kh nng l trong cuc vt ln , tn v li kia cha gy tn hi cho mng trinh ca chu. Rt To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

c th lc by gi, chu bt tro hai i li nn hn khng thc hin c y hnh vi cng dm v "bnh ra" u bn ngoi m o ri "xu lun". V vy, chu khng chy mu, cng khng h au. Nn nh rng khi b cng bc, cc tuyn ca m o khng tit dch, m o khng c bi trn, ng tc giao hp s gy au nhiu sau cn au do rch mng trinh. Tuy nhin, tht chc chn, chu nn n mt c s ph sn tt xin khm. Mt bc s n s khm xt kn o, cn thn v kt lun chnh xc. Ti , ngi ta s khng ghi danh chu u, cng nh s khng ai "bt m" chuyn ca chu ht, c yn tr. Nhn chuyn khng may ny, nh chu ph bin cho bn b 3 ng tc khn cp lc b cng hip: - Bt tro chn ngay kp cht hai i li, v c gi n cng th phng v hu hiu ny (trong khi vn cnh gic thn xc khng b kch thch v nhng vut ve kho lo ca tn v li). - Bp tht mnh vo hai tinh hon ca hn. Hn s au khng chu ni v b cuc. - Tranh th thi c, ku cu ngay v chy tht xa, d khng c g che thn cng ng xu h. 159. Tnh trng ca mng trinh "Khi 12 tui, v t m mun bit mng trinh nh th no, chu dng mt vin si sc cnh kch thch b phn sinh dc ca mnh v sau thy ra vi git mu. Nay chu 22 tui, cha quan h tnh dc vi ai. Ngi yu chu quan tm nhiu n vn trinh trng. Chu s mng trinh b rch do vic lm trc y...". Mng trinh khng th b rch nu khng b mt vt cng chui cht vo m o. Nu mi nm v trc, vin si ca chu khng ln n mc nh vy th mng trinh ch b sy st v chy mu, m khng b x rch nh trng hp ph n ly chng. Tuy nhin, chu nn i khm li mt c s ph khoa bit r. Nu khng vic g th cng rt kinh nghim dy d con ci sau ny. Phi cung cp cho chng nhng kin thc ti thiu v chnh c th chng, ch khng pht l i nh nhng th h trc y! Cn nu n b rch tht th chu nn ni r tnh hung o le ny cho ngi yu trc khi quyt nh xy dng, khng nn giu gim hy vng "may ra", bi l th no bn tnh cng bit, v nh vy s l tai ho. Nu anh ta khng tin, nghi ng chu v khng khoan dung th cng nh vy. 160. Ch mt l nh, nhng chng sao "Con 28 tui, chun b lp gia nh. Hin con tuyt vng v pht hin ra b phn sinh dc ca mnh khng bnh thng: phn m o ch l mt l rt nh, xung quanh c nhng mng tht che chn (con vn hnh kinh bnh thng). Nh vy c phi l d tt khng, nu ng th c th cha bng phu thut khng. Tnh trng ny liu c nh hng n hot ng tnh dc v kh nng sinh ?". Ring vic con vn hnh kinh u n c th gii ta mi ni lo lng. Mi th ni con u bnh thng, ch c mng trinh hi "khc kiu". N khng x dc theo hng trc-sau m li c mt l gia. mt s t thiu n, l ny cng khng c nt, khin mu kinh li trong m o, mt thi To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

gian sau mi pht hin c. Lc bc s ch cn chc cho mng trinh thng ra l xong. Tnh trng ny lm cho m tn hn tr nn hi vt v mt cht. C du phi c kch thch tht y c ham mun mnh lit, gip lm nh bt cm gic au do x rch mng trinh. Tt nht l nn r tai bo cho ch r bit trc lc ng phng. ng xu h, hy cho chng quan st k cng cng nhau x tr. Nu chng may (him thi) mng trinh qu dy th ngay hm sau, hai v chng hy cng i khm ti mt c s ph sn. Cc bc s s rch rng gip mt cch d dng (xin nhc li, ngi chng phi cng i trnh mi nghi k). D tnh hung no, kh nng lm v v lm m ca con vn nguyn vn, khng suy suyn my may. Chc cc con dng cm v tnh to gi gn hnh phc. 161. Ch c di dt "Chu 18 tui, cha c chng, nhng li rt mun quan h tnh dc. Chu lc no cng ngh n chuyn , nht l vo bui ti, khi tm chu hay th dm, thm ch dng c c bt bc v. Lm nh vy, chu thy hi khoi cm nhng au. Xin cho chu mt li khuyn". Chu ht sc di dt. T dng chu t lm cho mng trinh ca mnh b rch bng cch nht c khoai vo. Ri y khi xy dng gia nh, m tn hn chu s gii thch th no nu chng chu pht hin ra v gn hi? Nhng tai hi kia khng ln. iu sau y tai hi hn nhiu: nu chu tip tc t kch thch t to khoi cm (th dm) th dn d, c th chu s b "tr", khng cn p ng hoc p ng km i vi nhng kch thch ca ngi khc gii. i vi trng hp ca chu, c my vic cn lm: - Chm dt ngay vic th dm. - Khng xem nhng phim c cnh lm tnh. - Khng nhn cc ging vt ang giao phi. - Lm nhng cng vic i hi lao ng tay chn, hoc th thao th dc (chy ng di rt tt i vi chu); nu l th thao theo nhm th chu nn chn nhm gm ton n thi, trnh tip xc vi nhiu nam. - Hng s ch ca mnh vo nhng hot ng vn ha lnh mnh; trnh xa khi c ngi ni chuyn tc tu. - Bui ti, trc khi i ng, chu i bch b mt lc, trong u hnh dung ra nhng phong cnh p, ngm nga nhng vn th hay... - Nhanh chng hc ly mt ngh nghip t t gip chu t lp. Nh , chu c th kt hn sm hn cc bn cng trang la. 162. Hn nhau c sao khng? "Hn nhau th c b nhim HIV/AIDS khng ? M chu xem phim thy trai gi h c hn nhau, nh To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


th lm g, tha bc s?".

L Trng Bng

Cu hi ca chu cha c chi tit lm, nhng v thiu a ch c th ca chu, khng th hi li cho k, nn ti nh gii p "theo tnh hung" vy: Chu c yn tr, nu nim mch ming hoc li (nu hn mi) v da mt (nu ch thm ln m) khng c vt xc th virus HIV khng th ly truyn. N hn chn thnh v say m to nn nhng hng phn rt c li cho hot ng ca no, lm cho hai c th yu i hn, lm vic hng hi hn, v nhau m vt kh tt hn. Cn hn nhau trn phim nh li l chuyn khc, bi v din vin ch hn gi, thm ch cnh lm tnh xem rt cng nhng cng ch l cnh gi. in nh m! Ngnh ngh thut tuyt vi c mnh danh l "ngh thut lm gi" ny nhiu khi cn hay hn tht. Chu thng cm cho h nh: Nu hn tht th c sau mt cnh quay, nu khng c loi vt liu ha trang cc k hin i, din vin n phi t li mi son, nh li m phn, cn din vin nam phi lau sch cc vt son trn mt, trn c, thm ch trn o qun. Cha k l: nu hn tht th cc ng chng, cc b v tht lm sao chu cho v hay chng mnh ng nhng cnh i n vi ngi khc? V li hn gi ng k thut trng s hp dn hn hn tht rt nhiu. 163. Hn nhau lm ngc to ln? "Nm nay chu 18 tui, anh y hn chu 2 tui. Tnh yu ca chng chu rt trong sng. C my ln anh y hn chu. Sau t lu chu thy ngc mnh to ln, rt cng. Chu lo lm, khng bit c vic g khng?". Nu qu ng nh li chu ni, rng hai chu ch hn nhau thi, th hin tng ni trn hon ton bnh thng: Tnh yu thit tha v trong sng truyn cho chu ngun sinh lc mi (qua vic tng cng sn xut ni tit t). Hai chu cn tr lm, hy cng nhau khai thc sc mnh k diu ca tnh yu trong hc tp, lao ng chng c iu kin t lp, cng nhau xy dng hnh phc lu di. 164. H va "Em l th may, tng yu tha thit mt ngi v nui hy vng ci nhau. Nhiu ln anh y nh lm chuyn y nhng em dt khot khng cho. Anh ta bn dng ngn tay a vo ca em. Sau mt thi gian, anh ta hng h v coi nh khng yu em na. Xin cho bit em c b rch mng trinh khng?". H va! Chng trai khng tht bng yu m ch chc li dng em thi, cng may l em thot "n". Cn v "nn" th em hy xem li: Nu ln u tin, anh ta x s nh vy m em khng chy mu, hoc v sau cng khng thy ln no chy mu, th chc chn mng trinh ca em cha vic g. Cn nu thy c cht mu tc l n rch. 165. Mi c trng "Chu 15 tui, khng bit b bnh g m cch y my thng b phn sinh dc c mi khm khm rt kh ngi, tm ra xong my ting li vn th. C phi l bnh thn khng, v cch cha nh To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


th no?".

L Trng Bng

Nhiu kh nng y khng phi bnh m l mi c trng ca cht xut tit trong b my sinh dc "trng thnh" ca chu. Khng ging nh dch tit hi chu cn nh tui, n d ln men v bc mi. Chu cn lm v sinh vi ln trong ngy (thi im s do chu da vo tnh hnh c th m ln lch), lm sao khng mt ai bit c ci mi c trng ca chu. Tuy nhin, tht yn tm, chu nn nh b m a ti khm ti mt c s ph sn. Qua xt nghim, bc s s loi tr hoc khng nh mt bnh do vi khun hay nm. Vic cha tr s c kt qu tt nu c tin hnh sm. 166. Mt dng c bit "Con trai u lng va chn 3 thng th anh y xng my tao vi chu, bo rng anh bit v khng cn trinh trng ngay t m tn hn, nhng v a con nn phi im lng n by gi. Chu chong vng v trc khi ly chng, chu khng h c quan h tnh dc. Hi k mi bit rng anh y khng nh iu v thy chu khng ra mu trong m tn hn. Chu au kh qu, oan ung qu. Hnh phc gia nh tan v n ni". Oan ca chu ng l oan Th Knh. Nhng ngy xa Th Knh nh phi chu thua; cn ngy nay, nhng tnh hung o le nh ca chu c cc kin thc y hc bo v mt cch vng chc. iu ng bun l trong x hi hin nay c mt s ngi "bit mt c tng bit mi", nn ch quan, nghi oan ngi khc v ng x mt cch sai tri. Nh bit, t khi lt lng, b gi c mt mng che bo v m o, gi l mng trinh. Mng trinh thng mng v d rch, nhng cng c trng hp dy v bn chc, n mc ngi chng phi nh bc s ph khoa rch gip mi quan h c. Hnh th v kch thc ca l mng trinh cng khc nhau mi ngi. - phn ng ch em, mng trinh c mt rnh na vi x dc theo hng trc-sau. Loi ny d rch lc quan h, chy mu v au theo tng mc (rnh ngn th chy mu v au nhiu hn). - mt s trng hp, rnh mng trinh x dc ton b t trc ra sau, khng gy tr ngi g khi quan h; ch hi rt hoc khng au, hi rm mu hoc hon ton khng chy mu. - Mt s mng trinh c l gia, khi rch s au n "pht khip", c khi chy mu nhiu phi i cp cu (thc t th ch bng p l ngng). - C loi mng trinh b bt kn hon ton. Do , t sau tui dy th, mu kinh nguyt s tch t li trong m o, phi rch mng trinh tho ra. Trng hp ca chu, cng nh ca mt s "Th Knh" khc, thuc nhm th 2. Oi om thay, trong trng hp ny, l ra cc c ng chng phi cm n tri t ban tng cho mt ca qu n vy (v khng au, khng chy mu, mi vic c th tin hnh thun li, sun s...) th li khng kt ti To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


oan cho v, lm thng tn hnh phc gia nh! 167. Sp ly chng, kinh nguyt b ngng

L Trng Bng

"Ti 38 tui, sp lp gia nh, rt lo s v chuyn nh sau: Kinh nguyt ca ti trc y rt u, cch y 1 nm nay b ngng, sau thy li 2 thng ri thi, ti nay 4 thng khng thy kinh. Ti vn khe mnh, siu m khng thy g c bit. Xin cho bit kin sm ti c th quyt nh nn hay khng nn kt hn". Nhng ngi chm lp gia nh cng hay gp trng hp tng t nh bn. Sau khi ly chng, h tr li bnh thng v sinh con. Bn sp thnh la i, l mt thun li, khng nn ngh n vic chi b. Tuy nhin, nu sau khi lp gia nh, tnh hnh vn khng c tt hn, bn nn i khm ti mt c s ph sn c gip . C th bn s c dng thuc ti to vng kinh, dng thm hoc mn n... 168. a cn khng sao "Nm ln by tui, chu i tm th b mt con a chui vo ca mnh, sau vi ting n chui ra. Mu chy rt nhiu, cn nhiu hn mu kinh nguyt hin nay, mt ting ng h th ht. Xin hi mng trinh ca chu c b a lm rch khng?". Khng h g. Con a mm v nh, lm sao gy rch mng trinh; ch c vt cng v ln mi lm rch c. V chng, ngy , cha chc n chui vo su m ch cn trong phm vi mi ln v mi b ca m h. Mu chy nhiu l do a tit ra mt cht chng ng lm cho mu kh cm. Trng hp chy mu ko di, c khi phi bng p; nu chy su c th phi ln gc (bc s s tin hnh thn trng, khng gy rch mng trinh khi thao tc). Khi tm sng sui, cc b gi cng phi mc qun lt cn thn. D nhin l ch tm ao, a c th chui c vo tai, vo mi. 169. C kinh v picnic "Lp em thng t chc i picnic, nhng li trng nhng hm em hnh kinh nn nh vng mt. Bn b hiu lm l em tic tin, khng ha nhp... Em chng bit gii thch th no v rt hay ngng. Xin cho bit c thuc g khi c kinh na?". Ch ni di! Kinh nguyt u n hng thng chng t em c sc khe sinh sn tt. Bao nhiu ch em kh s v thiu "n", v "n" khng hon ho; sao em li ngh ra chuyn "tr" n? Em hy tm mua loi bng v sinh c sc thm ht mnh m khng cng knh, ngoi cng c m ni cng c, bn ti hiu thuc (ng mua linh tinh ngoi ch v d gp phi ca rm). 170. Cht mu trng trc khi hnh kinh "Hng thng, trc khi hnh kinh trn di mt tun, em thy ra mt cht dch sng, trong, nh c si di, khi nhiu khi, 3-4 ngy th ht. Xin cho bit c phi em mc bnh huyt trng khng?". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Khng h! l chuyn thng c mt s ch em. bo m an ton cho trng, trong nhng ngy non sp rng (t khong ngy th 10 ca vng kinh), nim mc t cung tit ra mt cht nhn nt kn l c t cung li. s ng ch em, lng cht nhn ny khng ng k, nhng mt s khc li di do v chy ra ngoi, khin h tng lm l do bnh tt. Thm ch c ch ly chng mi m khng c con v h thy cht nhy ny ra l ch bo chng "ch, ch" (s nh hng n chng). D nhin, sau khi c gii thch, h d "trng s c c" nh vai tr ch im ca ci cht qu ha . Nh vy, chu c li th l c bo trc nhng ngy c kh nng rng trng. Sau ny, khi xy dng gia nh, cc chu s d tin hnh k hoch ha gia nh (th thai hoc trnh thai). Ch cn lu gi gn v sinh ti ch ging nh trong khi hnh kinh, v mi th dch tit u rt d gy nhim khun. Cn chng huyt trng (kh h, bch i), cht dch c mu trng c, mi hi, khng xut hin theo vng kinh m theo mc tin trin bnh, thng gy kh chu m h. Nguyn nhn thng do bnh m o hay c t cung (vi khun, nm...). Bnh nhn phi i khm bc s ph khoa cha tr tht sm, tht kin tr mi mong dt im, khng ko lai rai. 171. C g m hoang mang "Vng kinh ca chu khng u, thng th 32, thng th 42, 45 ngy. Cch y vi thng, chu mc mt cn bnh rt ng s: mi ln hnh kinh l ra 1-2 cc nh ming tht. Chu rt hoang mang, mc d c bc s khm chu bo c yn tm". Bnh thng, vng kinh l 28 ngy. T ngy th nht (tc l ngy bt u thy thng), cng vi s ln ln ca mt non no ni bung trng, nim mc t cung cng dy dn ln, cc mch mu li ti trong rng ra, cha nhiu mu hn. n ngy th 14 l iu kin n nhn trng th tinh ti lm t. Giai on ny thng ch 14 ngy, ni chung khng thay i mi c th. Nu trng khng ti, mu tch t ni t cung s bin cht dn, nim mc cng mng ca t cung s gim dn kch thc v n ngy th 28 s bong ra: ngi n bt u c kinh. Mu kinh nguyt c ln nhng mnh nim mc bong ra, nhng thng khng phn bit c v mnh nh. Tri li, mt s ngi (nht l ngi c vng kinh ko di) thy tng mng nim mc kh to, ging "nhng cc tht" nh chu ni. C bc s khuyn chu yn tm l ng, v iu cng bnh thng. Tuy nhin, chu nn khm mt bc s ph sn gii iu chnh li vng kinh cho u n sau ny, khi lp gia nh, c th th thai theo k hoch. Mt s ch em dng cao ch mu thy c kt qu, chu th dng xem. 172. Thng kinh v "huyt trng" "Em c kinh t khi 12 tui, chu k 28 hoc 30 ngy, mu mu , sau 4 ngy l ht. Tuy nhin, h sp c kinh l em au bng d di, dng thuc ung gim au ch ch khng ht hn. Khong To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

hn mt tun trc ngy hnh kinh, em b ra huyt trng rt nhiu. Xin sm cho em mt li khuyn trc khi xy dng gia nh (em cha sinh hot tnh dc ln no)". Chu k v s ngy hnh kinh ca em nh vy l tt. V chng thng kinh, em c th t cha ly theo cch sau: Trc ngy hnh kinh khong 48 gi, cn ngm t rn tr xung vo nc m gi (cho tay vo th thy kh nng l c) mi ngy hai ln, mi ln 20-30 pht. Dng mt chu to v su, t hn hai mng vo thoi mi, thy nc hi ngui phi thn trng thm nc nng vo. Nu cn, em c th ung 1-2 vin Panadol 500 mg/ngy. Chc em khng b chng huyt trng u. Nhiu kh nng em thuc loi ngi c nhiu dch tit ng sinh dc. Dch ny c tit ra nhiu nht vo ngy gia k kinh, sch, kh trong, c mi c trng nhng khng hi, khng gy kh chu nh trong bnh kh h. Tuy nhin, y ch l "chn on t xa", li da trn nhng t liu thiu chi tit. yn tm, trc khi v nh chng, em nn i khm ti mt c s ph khoa. 173. Kinh nguyt hai thng mt ln "Chu 14 tui, 8 thng trc thy kinh ln u, n nay c 2 thng c mt ln, mi ln khong 4 ngy. Chu gh lm. C cch no rt ngn ngy c kinh v lm cho lng kinh t hn khng?". C kinh trong 4 ngy l tt, nhng 2 thng mi hnh kinh mt ln th cha ; chu k l tng l 28 ngy. Nhng chu ng lo, mi u th l rt ri, dn d chu s t c mc l tng. Khng nn v "gh" m tm cch "sa cha" quy lut ca to ha. 174. King chua, king ngt khi hnh kinh "C phi khi hnh kinh th khng nn n ca ngt v ca chua khng?". Hnh kinh l hin tng mt lng mu c tch t t trc trong nim mc t cung chy thot ra ngoi do khng c hin tng th thai. Thc ra mu tp trung t cung trc khi hnh kinh 14 ngy ri! Ngy hnh kinh, bn n thy kh chu v "n th no y", ch c mt do mt thm mu u. iu quan trng nht l gi gn v sinh v t bo t cung ang rng hng lot, d gy vim nhim. Cn chuyn n ung xin ch em c thoi mi. 175. ng ln ngi xung b chng mt "Chu hc lp 11. Sau nhng hm thc khuya, mt chu b cng v nhc; khi c nhiu cng th. Chu c kinh t nm 14 tui, mt nm nay c 20 ngy li c kinh mt ln, liu c sao khng? i lc chu thy au nhi tim, khi xc ng cm thy tc ngc v nght th, ng ln ngi xung chng mt, liu y c phi l bnh tim khng?". Vng kinh thng thng l 28 ngy; ca chu 20 ngy l ngn. Tnh hnh ny c th lm cho chu b thiu mu, khi ang ngi nu ng ln t ngt s thy chng mt. Khi c iu kin, chu nn tm n mt bc s ph khoa giu kinh nghim h gip chu sm t c vng kinh 28 ngy. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Hin tng au nhi trc ngc hoc mt vng no thng xy ra tui mi ln, sau ny s ht, ng qu lo lng. T th ngi xm b gi trc ngc l kiu ngi thiu khoa hc, khng li cho vic lu thng mu chi di (c l ch c chng mnh v mt s rt t dn tc khc l ngi theo kiu c o ny thi, ngi phng Ty dng h x bt l v h khng c thi quen ngi xm. Nu phi ngi thp, chu nn dng gh thp. Nn trnh thc khuya, phi ng 7-8 gi vng ngc, trong bt buc phi c t nht 15-30 pht ng tra. Khi c sch, mun khng nhc u th ng ci u; u phi thng, thm ch hi nga ra sau v dui chn cng tt (ngi phng Ty thch ngi sa lng, da c thoi mi vo nm th) hoc nm ln vng m c. Tt nhin, nu c v bc s no giu kinh nghim kim tra tim cho chu th cng tt. 176. Cha c kinh "Chu 19 tui m vn cha c kinh nguyt. Chu t mua thuc vin ung nhng khng kt qu". Chu khng ni chi tit v s pht trin c th ca chu cho nn ti ch phng on thi. Chu c th thuc mt trong hai tnh hung sau y: - C vn thuc ni tit, hot ng ca tuyn yn b trc trc. Trong trng hp ny, b my sinh dc km pht trin (bung trng hot ng yu, t cung b, v khng n, khng c kinh nguyt). iu tr: Kch thch hot ng ca tuyn yn, ng thi dng thuc c vng kinh nhn to. - Lu nay chu vn "c kinh", nhng do mng trinh ca chu khng c l thot nn ton b mu kinh tch t trong m o, lu dn thnh mt bc ln, khin ngi khc c th nhm l mang bu. Khi khm, bc s pht hin mng trinh cng phng, khng c l, n vo c cm gic cht dch bn trong. Trong trng hp ny, c th vn pht trin tt. iu tr, ch cn rch mng trinh cho mu kinh chy ra. Trong c hai trng hp, chu u phi nh cy mt bc s ph sn gii gip , khng dng thuc ty tin v rt nguy him. 177. C v li c khng "Nm 15 tui, chu b bn xu cp i i con gi. Nay n tui ly chng, chu khng mun mnh l con gi mt trinh. Nghe ni y hc c th m v li mng trinh. Vic phu thut c nh hng g n sc khe v ng con ci sau ny khng, v ni m no ng tin cy nht?". Cch y khong 10 nm, ti c c mt truyn ngn vi ni dung tm tt nh sau: Nng T Trinh xinh p ngh ra cch v mng trinh lm cho cc chng trai tng nng cn trinh nguyn. V i v li qu nhiu ln, mt nng km dn, cui cng nng chc nhm kim vo mt huyt him v cht". Chc ai c truyn ny v tng tht, ni li vi chu; hoc gi c ngi no ni to lao cho To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

vui thi, ng tin. T B trong Truyn Kiu bt nng bi "nc v lu, mu mo g", chng qua ch l cch t trn an. Phu thut hin i c th lm gi "ci ", c th rt ging v hnh th, nhng khng ti no phc hi nguyn xi ci mng c cht liu c bit ny. Trng hp ca chu c g nghim trng u m phi che giu. Tt nht l sng lc quan, n khi gp ai mun tm hiu th ni r cho ngi y bit, nu h xa lnh chu th qu h l con ngi c h, km xa chng Kim trong tc phm ni trn ca Nguyn Du. 178. Khi hnh kinh c nn tm gi? "M chu thng khuyn l khi hnh kinh khng c n chua, ung nc , c bit khng c tm hoc gi u, nu khng nghe m th c ngy mc bnh in. Chu c mun tm ra m s qu!". Chc m chu s con gi cm lnh, nhng nhng iu cm k c th m c a ra l khng khoa hc. Chu c tm gi, nhng khng nn tm lu, k c khi tri nng nc. Nu n chua v ung nc th cng va phi thi (k c nhng ngy "khng c vn ") ko b bnh ng rut. Trong thi gian hnh kinh, thnh ca d con trong trng thi "b ng", d b vim nhim hn. V vy, phi trnh li nc ngp bn, nht l nc bn, nc bn. Lc ny, c th cng km khe khon hn, d b cm lnh, say nng. V vy, phi gi m v ma ng, khng di nng h khi khng i m nn. 179. Dng nt v c hi khng? "Ngi chu hi y, nht l sau khi sinh. Chu phi thng xuyn eo nt v cho ngi nom thon bt. Gn y nghe phong thanh l nt v gy th v, chu s qu!". Khng nn lo s mt cch qu ng, nhng chu cn bit mt iu nh sau: Qua thng k trn 5.000 ch em, cc nh khoa hc M nhn thy, nguy c th v nhng ch em eo nt v lin tc 12 ting mi ngy cao gp 20 ln; nhng ch em eo sut c ngy cao hn 100 ln so vi nhng ngi t dng hoc khng dng nt v. Do , ch em khng nn dng nt v qu 12 ting mi ngy, v trnh nhng nt v qu cht. Trng hp ca chu, khi b thi b, chu nn cn li th trng bt u theo di, ri thc hin mt ch n hp l (ngho calo, nhiu rau v tri cy), thng xuyn i b hay th dc mm do. Nn ch vng ngc (quay trn vai - cnh tay) v vng eo - mng (lc vng). Khng ng qu 7 gi/ngy; t rn luyn lun nhanh nhn, hot bt ( tiu tn thm calo). Chu c th tip tc dng nt v, nhng phi gim thi gian s dng, cng t eo cng tt, v dng loi long lng thi. 180. C nn lc vng u u? "Cng vi vic tp th dc u n, bn chu v chu lc vng vo bui sng v chiu, mi ln 30 pht. Gn y, nghe ngi ta ni lc vng s khng c con, chng chu s qu. Xin cho bit s tht To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


ra sao? Liu lc vng c lm trt rut?".

L Trng Bng

"Ngi ta" l ai vy? Chc chn khng phi sch bo, i pht thanh hoc truyn hnh ri. Cc chu ch nh d m tin nhng ngi "ni i, ni di" kiu . C yn tr lc vng u n, cc chu s c vng eo tuyt vi y. V nn kt hp vi ng tc th su tng lng khng kh lu thng qua phi, gip cho lng ngc cn i, n nang. Trong y hc khng thy c bnh g gi l bnh "trt rut". Ch c bnh sa nim mc trc trng (li dom), thot v bn (rut chui qua mt vi ch yu ni thnh bng bn), thot v rn (rut chui qua im yu vng rn, thng gp tr s sinh)... Nhng bnh k trn khng phi l hu qu ca vic lc vng. 181. Tnh nht nht "Chu tuy ln m vn nht nht, rt r. Nhng ln pht biu trc m ng hay tr chuyn vi ngi i din, chu rt hi hp, tim p nhanh, cm gic ngt ngt kh th. Liu chu c b bnh tim khng, v c cch g khc phc nhc im ?". Nht nht, rt r nhiu khi do thiu t tin. Trong trng hp ny, trc khi pht biu, chu phi chun b tt, nu cn th ghi cc im chnh ln giy, di dng dn bi, c khi phi tp dt bng cch ni trc gng hoc trc ngi thn cho thng tho. Ch trng i bch b chm ri trong sn, trong vn, kt hp th su, tp ni nh ang ng trc mt i tng no . Cn khi ni chuyn vi nng m tim nh mun nhy ra khi lng ngc th bc s cng chu; v li c khi thy vy nng li thng cm hn cng nn. Nu mun chc chn tim c chuyn g khng, chu nn n mt c s c bc s gii v phng tin, xin kim tra mt hm l xong; ch chn ch phi tip tc lo lng nh hin nay. 182. l chuyn thng tnh "Chu 20 tui, cha h c quan h tnh dc, khng s dng ma ty, vy m khng hiu sao gn y mi ln ng cnh ngi yu l chu thy tinh trng c ra, lm chu s qu!". Tht ti nghip chng trai ngoan ngon ng yu, ngn y tui ri m cha c trang b mt cht kin thc g v gii tnh! Li ti ai, sau ny ta s c dp lun bn. Cn by gi xin ni ngay chu r v yn tr: - Ci m chu gi l "tinh trng" ch l cht nhy do mt s tuyn trong c quan sinh dc tit ra khi c th b kch thch v gii tnh. Cht ny i xung, r qua l ming so u dng vt, s thy nhn nht. y l hin tng sinh l bnh thng, ch khc nhau mc nhiu t ca tng c th m thi. Cht ny khng phi tinh dch cha tinh trng, v vic tit ra n khng nh hng g n sc khe. - Thanh nin cha v hoc ngi xa v lu ngy c th nm m thy quan h tnh dc vi mt ngi khc gii no v phng tinh hn hoi, y ht nh trong ng tc giao hp thc s. Hin tng ny To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

gi l mng tinh, cng l bnh thng nu mt vi thng xy ra mt i ln. Tuy nhin, do vic ny "v b" v cng l "mt sc", cho nn cng hn ch c bao nhiu cng tt cho sc khe by nhiu. 183. Lng xung quanh hu mn "Em l con trai, 19 tui, thy xung quanh hu mn mc nhiu lng. iu ny c nh hng g n sc khe khng, c phng php g cha?". Lng mc t nhiu xung quanh hu mn l hin tng hon ton bnh thng, khng phi bnh tt, do chng cn cha chy g. Rt nhiu ngi (nht l ngi nhiu lng ngc hoc mang ru quai nn) cng c lng hu mn nh chu, chng qua v h khng "bt m" nn ta khng bit y thi. Ch cn ra sch s sau mi ln i tin. Ch nghe xui di m nh hay co v n s mc li cng hn v rt nga. 184. U nang mo tinh hon "Chu 18 tui, khng hiu sao cch y na nm tinh hon bn phi ca chu li c thm mt hn na b bng 1/5 n, v tinh trng ca chu ra tht thng, lc nhiu lc t. Liu c nh hng g khng?". Nhiu kh nng chu c mt u nang mo tinh hon (mo tinh hon hi cong cong, p ln tinh hon nh mt ci g). Nn i khm sm mt khoa ngoi chung (hoc tit niu - sinh dc nam) ca bnh vin. Nu ng c u nang th m ct b v khng th cha bng thuc. Phu thut ny kh tinh t, phi l bc s c tay ngh vng mi lm c tt, khng li di chng. Chu ng lo. Nhiu ngi b thng mt mt tinh hon, vy m phi cht ch lm mi m bo c ch tiu tng dn s y! V tinh trng, ch c xt nghim qua knh hin vi mi bit c s lng, hnh th v hot ng i n kt lun. Chc chu nh ni "tinh dch"? Nu vy, c l chu th dm thng xuyn nn mi bit c n "lc nhiu lc t"? Cn thi ngay trc khi qu mun. 185. Phi sm m hp bao quy u "Chu 25 tui, cui nm nay s ci v. Nhng dng vt ca chu hi nh, bao quy u khng tut ra c, thng i tiu ra khng ht, nc c li lm cng da. Chu chn i lm. iu ny c nh hng g n tng lai ca chu khng? Nghe ni c th m ct b bao quy u. Nu ct i th c sao khng". ng l khng bao gi chu phi chn i nu nh hi cn tui thiu nin, chu cho gia nh bit chuyn ny. Hin tng hp bao quy u (phimosis) thng gp trong mt s dng h, chng tc. ngi rp, chng hp bao quy u l ph bin nn h c tc l ct bao quy u cho tr ln, tin hnh hng lot, rt trang trng, vo dp l Ramadan hng nm. Chu nn n ngay mt trung tm y t hot ng tt, xin khm c m ct b bao quy u. M To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

gy t thi, sau 7-10 hm l lnh so, trng tm tt, v sinh v thun tin hn nhiu. Nu khng m, chu s c th gp nhng rc ri sau y: - Trong m tn hn, dng vt b "tri g" li trong ng tc giao hp, danh t chuyn mn gi l tht bao quy u (paraphimosis) phi i m cp cu. Chu th tng tng xem, ngay trong m tn hn m ch r phi i m cp cu ct bao quy u, sau cn phi "king khem" mt vi tun th cn ra th thng g na! - Rnh quy u lun c nc tiu st li, gy nga ngy, vim nhim, thm ch lng ng li thnh nhng vin si ti ch. - V t m hoc v thi quen, ng s hay tut ln ko xung, d dn n thi xu th dm t tui v thnh nin. - Lu ngy, chng hp bao quy u c th dn n ung th dng vt, buc phi ct dng vt. Trong y vn th gii c trng hp sau y: Mt b qu phi nghi ng chng ngoi tnh nn dng mt ci kha kp nh xu bng vng h chng i u l b ta kha quy u li, nhm ngn chn vic giao hp do quy u b "cm t". Tng l diu k gi chng, ai d mt thi gian sau, c ng chng b ung th dng vt phi ct b. Cn v kch thc dng vt th chu khi lo. Sau khi quy u c hng t do, hot ng tnh dc c sun s, dng vt ca chu s ln mnh do c th thch thng xuyn. V m hp bao quy u, hin c k thut Circumfix, bc s tin hnh ct mt cch nhanh gn v khng phi khu ch ct; c th p dng tt cho nhng trng hp cn nh tui (trc y cha m "thng b phi chu au sm qu" nn thng chn ch ch cho tr ln thm). 186. Tt l i lch thp "Chu sp ci v, nhng c mt chuyn lm chu bn khon l dng vt c hai l i, 1 quy u v 1 mt sau dng vt; khi xut tinh ch thy ra l pha sau. Xin cho chu mt li khuyn". Chu b mt dng ca tt l i lch thp (coi nh l i ca chu b r mt ch pha sau). Nu c vy th khi giao hp, tinh dch khng c phng qua u dng vt i qua l c t cung, do vy chu khng th c con. Chu nn hon vic ci v, khn trng n khoa tit niu - sinh dc nam ca mt bnh vin ln H Ni hoc TP H Ch Minh, xin m. Trong trng hp ca chu, vic phu thut khng phc tp lm v khng phi to tnh on niu o (ng tiu) pha di, bi n c sn ri. 187. Mng tinh "Em 16 tui, thnh thong m thy mnh quan h tnh dc vi ai v xut tinh. Khi c sch bo ni chuyn tnh dc hay xem ti vi c cnh hn nhau, dng vt ca em c cng ln. Mt s ln i tiu xong em thy c cht nhn chy ra. Em rt au bun v nhng hin tng ny v lo lng khng bit sau ny c th sinh con c khng". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Khng c chuyn g ng phi au bun, v khng phi cha chy g u, em . Nhng hin tng ni trn chng t c th em trng thnh v sinh dc. Nu cn h tc to hn th nh em l lm b c ri y! Mng tinh (xut tinh trong khi ng) l hin tng thng gp thanh nin cha v hoc ngi xa v lu ngy; nu mi thng thy mt i ln th khng nh hng g; nu nhiu qu s gy mt mi, bun ng, ngi gy st do mt nhiu "cht" mt cch v ch. Cch khc phc nh sau: - Trnh xem phim nh hoc sch bo ni chuyn lm tnh, nht l trc khi i ng. - Tham gia cc hot ng vn ha lnh mnh: ca ht, nhc nh, dn ca... - Th dc th thao u n, lm cho c bp hot ng nhiu c gic ng su, yn. - Mc qun xp gi cht dng vt t th xui xung nh khi ta ng, ngn khng cho n ngc ln khi cng cng ( n khi phng tinh trong khi ng). Nhng qun phi ch khng p vo b phn sinh dc; nu cn, em phi may o. Nu cn, em c th dng thm bi thuc cha mng tinh sau y ca Lng y Hong Duy Tn: Ht sen ti 20 g, l sen ti 10 g, khim thc (ht cy sng) 40 g, bch qu 3 tri. Sc ung hng ngy thay nc ch. Dng 2 thng lin. Cht nhn em thy u dng vt lc tiu tin hay lc xc cm tnh dc (ch khng phi sau khi mng tinh) khng phi l tinh dch, khng c g phi quan tm. 188. D ng vi cao su "Chu 15 tui. V t m, chu ly mt ci bao cao su lp vo dng vt mt lc lu, sau thy nga ngy, phi gi nhiu, sng ln. Xin cho bit nguyn nhn v cch cha". Chu b d ng vi cao su. Hy nh li xem trc y c ln no mang dp cao su m b nga chn khng. Gi sch s, my hm s ht. T nay, chu phi cn thn, trnh tip xc vi cc dng bng cao su. 189. Th dm "Chu 17 tui. Hai nm nay, chu thy dng vt thnh thong cng ln. Mi ln nh vy chu thng nghch ngm v thy n phng ra mt cht mu trng nh nc vo go, mi tun ti 5-6 ln. iu ny c nh hng ti sc khe v cuc sng sau ny khng? Tinh hon ca chu bn to bn nh, liu c sao khng?". Chu khng c vic g hay hn lm ? Lu nay chu c mt thi quen khng tt, l lm dng th dm. Cn ci cht c mu nc vo go l tinh dch, cha hng triu tinh trng do hai tinh hon ca chu ngy m sn xut ra. Hy lm ch bn thn khi ri vo thi xu tai hi y. Vic th dm hay giao hp qu nhiu u c hi cho sc khe. Nu chu c theo trn th ly u ra thc n b dng b p? Lm g cn sc hc hnh, lao ng gip gia nh? To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Ring thi th dm c th dn n mng tinh thng xuyn, xut tinh sm khi quan h v chng, thm ch lit dng (ngi v thng xuyn khng c tha mn c th xin ly hn hp php hoc ln i tm bn tnh, th l gia nh tan nt). Cch x l khng kh, nhng phi c ngh lc. H "hn" gi chng, chu hy tm ngay mt hot ng c ch tp trung vo, "hn" s yn ngay, khng cn phi roi vt. Lu dn "hn" s tr nn ngoan ngon. Ty hon cnh ca chu, c th tp th dc th thao (bi li hoc c t), nghe nhc nh, dn ca (trnh nhc kch ng), xem phim khoa hc, phim tm l x hi (trnh phim c nhng cnh lm tnh). Trc khi tin hnh "cai th dm", chu nn kim tra cn nng, vng ngc, vng i... Chng ba thng sau, chc chn c th chu s cng trng hn, kt qu hc tp th no cng tt hn. Chuyn tinh hon bn n hi b hn bn kia mt cht l chuyn bnh thng, cng nh hai tai chu, khng ging y chang u! 190. Hu qu khn lng ca th dm "Xin tr li gp cho mt vn ang gy tr ngi cho cng tc ca chng em. Tc hi ca thi xu th dm c cnh bo nhiu ln, chng em cng cm nhn iu qua tm s ca mt s bn trong chi on, v ang vn ng ngn nga. Nhng gn y, c bc s vit trn bo rng "t kch dc l bnh thng, khng c hi, t nht l trong tui dy th". Sch ca mt s bc s khc cng ni i nh vy. Xin cho bit thc h". Cch nay hn 60 nm, di thi h, mt hc gi nc ta cnh bo v tc hi ca thi th dm trong cun sch "Thanh nin SOS". Ngy nay, qua hng trm th bn c gi ti ta son t hi hn v au kh v chuyn ny, chng ta mi thy ht gi tr ca cun sch . Hc gi n khng thuc ngnh y nhng nm bt c mt thc trng x hi thi by gi v rung chung cnh tnh cho ni ging. Vy m khong vi chc nm sau, vn c v bc s vit sch gii thch vic th dm tng t nh "ta x mi tng mt cht thi ra ngoi"! Qua hai vic trn, chng ta thy rng gia nhn thc ca con ngi v thc trng x hi i khi khc r rt, dn n hai thi tri ngc i vi cng mt vn . Thi xu th dm (t mnh kch thch b phn sinh dc gy khoi cm) c th xut hin t tui nh nhng tr t m, nghch ngm, nht l nhng tr sm bt gp cnh sinh hot gii tnh ca b m, anh ch... hoc nhn thy sc vt giao hoan. tr em nam, tt th dm xut hin c th do bao quy u b hp gy nga ngy, phi gi nhiu, ri v thy "hay hay" nn c mn m hoi d khng b nga. Ln ln cht na, tr "c" nhng bn ln tui hn r r v by v cho. Nu gia nh khng bit, thi xu ny s tip din v pht trin mnh vo tui dy th; by gi, vic th dm s dn ti cc khoi km theo phng tinh. iu nguy hi l chuyn ny ta nh mt th ma ty khng tn tin mua, li qu n gin; v vy s c tip din v To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

hn (c bn c th l l mi ngy lm ti 2-3 ln trong c nm tri, khin ngi xanh lt, khng cn hc hnh g c na, nhng khng ngh lc "cai"). Hu qu l khi trng thnh, cc em c th b xut tinh sm, di tinh v lit dng. n, thi xu th dm thng xut hin vo tui dy th, khi b gi bt u ngc nhin trc s thay i v c th v sinh l. N t dng ngn tay hoc vt th dm. Qua th gi v ta son lu nay, chng ti thy nhiu trng hp do th dm m rch mng trinh, nhim khun v nhim nm m o, s ln tui hn th b chng lnh cm. Thc trng trn cho thy khng th "tha hip" vi thi xu th dm, khng th ni n l v hi c, nht l i vi tui dy th. iu tr tru l hin c mt s thy thuc mun dng th dm nh "mt bin php quan trng chng ly AIDS". Mt khi trt "nm mi" th dm ri s rt kh b. Tt nht l ngay t u, cc bc ph huynh ch ngn nga thi xu bng cch: - C gng thu xp cho tr ng ring; kn o khi quan h vi nhau. - Xem xt xung quanh, nu thy tr c th nhn thy sc vt giao hoan th chuyn chung i ch khc hoc thi chn nui. - Nu tr b hp bao quy u, nn cho m khi 6-7 tui, chm nht l trc tui dy th. Khi ln bao quy u ra ra ry, cn nh tay khng gy hng phn cho tr ti . - Khng cc b gi ci trung trnh vim nhim m h, thm ch m o khin tr b nga, phi gi nhiu vo c quan sinh dc. - Cung cp cho cc em nhng kin thc cn thit v gii tnh theo la tui. - Duy tr trong gia nh v tp th nhng sinh hot vn ha vn ngh lnh mnh, hp dn. - Nn c danh mc nhng phim cm tr em v mi ngi tun th vic ny. - Nn ph phn chm dt nhng cnh lm tnh cu khch r tin trn phim nh. V cha tr xut tinh sm, di tinh cng nh lit dng, hin cha thy c phng thuc no tht hu hiu. 191. nn ly v cha "Em 27 tui, t nm 15 tui n nay thng c thi xu th dm. Em sp ci v. Xin cho bit sau ny em c th c con hay khng?". Em lo lng nh vy m lu nay khng h "ngng tay" th dm, chng t thi xu ny n su nh th no (ngi th dm lc no cng mc cm ti li, lo s hu qu nhng thng thiu quyt tm ri b n). Th em ni thiu chi tit, nn ti ch nu ra hai im rt chung: - Nu em khng b xut tinh sm (ngha l va "mi" "phng" lun), th hy vng cuc sng la i s m , chc nng lm b ca em vn bnh thng nh mi ngi. Tuy nhin, cn ch , thi th dm lm cho nam gii tr nn nhy cm qu mc i vi kch thch gii tnh. V vy, phi dng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ch t lm chm qu trnh hng phn trnh b xut tinh sm trong m tn hn v c sau ny na. - Nu em b xut tinh sm, hay t hi hn, b di tinh (ngha l tinh dch r ra thng xuyn, khng nht thit phi sau mt kch thch gii tnh) hoc lit dng, phi lo cha chy ngay cho khi bnh . Bi l vic xy dng gia nh trong tnh hung y ch gy au kh cho c hai ngi, vic chia tay s kh trnh khi. 192. Cha nn ci v trong tnh hung . "Chu 22 tui. Do lm dng th dm, chu b chng xut tinh sm, sau l lit dng; nhng gia nh khng bit, c gic chu ci v (con gi ca bn b m chu). Xin cho chu mt li khuyn". Chu hy xin tr hon cha bnh . Bnh ny rt kh, tuy nhin nu su tm k chc s tm c mt s bi thuc dn gian c hiu lc nht nh. Cc v thuc sau y v ang c mt s ngi dng: hi m (mt loi sinh vt bin, bn thnh tng cp), tc k, tinh hon ch vng (mt s ni qung co l "hi cu hon", nhng gia thi bui ny ly u ra m d th, chng qua ch l "hong cu hon" thi). Khng nn ci v trong khi mnh ang b lit dng, bi v hnh phc la i s tan v ngay t nhng giy pht u tin. Ngi bn i ca chu hoc s nhn nhc chu ng au kh ko di, hoc s ch ng xin ly hn sm, hoc s ln vi ngi khc. Tr khi chu c iu kin dng thng xuyn thuc vin Viagra ca M (ung trc khi hnh s 1 gi v c tc dng trong 1-2 gi) th li l chuyn khc. Chu cn tr, cn c thi gian cha chy, hy cn nhc k trc khi quyt nh. 193. Ph i tuyn v "Chu l con trai, 19 tui, b bnh v sng hn 4 nm nay. Hin ti hai bn v ca chu vn sng to hn ngn chn ci ngi ln, lm chu rt mc cm. Xin cho chu mt li khuyn". Chu b chng ph i tuyn v. Cch cha duy nht l phu thut bc b cc tuyn ph i . M gy t ti ch, ng rch thm m; m xong, hnh dng ca v bnh thng, khng c ri lon no). Khoa phu thut lng ngc ca cc bnh vin ln c th x l tt trng hp ca chu. M xong, chu khng phi nm vin. 194. Khng phi bnh giang mai "Em c bo, thy ni giang mai l bnh ly qua ng tnh dc. Em nm nay 16 tui, cha tng lm chuyn y. Vy m cch y 5-6 tun, trn u dng vt ca em xut hin mt chm , n nay vn khng mt, ngoi ra cn c mt chm bng con rm trn mt da. C phi em b giang mai khng?". Nu ng l em cha tin hnh "chuyn y" th chc chn em khng b mt bnh g v sinh dc. Hy c yn tm hc hnh. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Em nn dng thuc tm pha tht long vi t l 1/4.000 (mu hi hng hng nh nc ngm rau sng), hng ngy dng gc thm thuc t ln hai nt trong mi pht, mi ngy hai ln. Em kim tra xem ngun nc tm git c m bo v sinh khng (ch tm ao hoc ngi nc bn). Nu cn, em luc qun o hoc l trc khi mc. 195. Khng nn lm dng "Chu 20 tui, c ngi yu. Khi chng chu m nhau, dng vt ca chu cng ln v xut tinh, nhng khng nhiu. Vic c nh hng g n sinh hot v chng sau ny? V chng chu vn c con ch bc? Chu lo lng lm!". Khi gn gi ngi yu v b kch thch, cc tuyn tit cht nhn b phn sinh dc nam n u tng cng hot ng; ring nam c th thy t dch ra ming so. l chuyn bnh thng. Cn nu m nhau qu cht, dng vt gh vo c th n, ngi nam c th c cc khoi v phng tinh. iu ny cng t nhin thi nhng khng nn lm dng. V nu lp i lp li nhiu ln, n s dn n hin tng xut tinh sm - mt iu tai hi cho hnh phc la i. 196. Khi b xut tinh sm "Xut tinh sm c tr c khng? Em rt au kh v mi u ym s bn ngoi m xut tinh lun, ch nhy mt l xong. Do , em e ngi khng dm ly v. Cch cha ra sao?". Yu t tm l ng vai tr rt quan trng trong trng hp ca em. Em hy t rn luyn theo cch sau xem: Ngi thoi mi mt mnh ( khng b quy ry) trc mt tm gng ln. Nhn thng vo ngi trong gng, v hnh dung anh ta trong nhng tnh hung ging nh lc "gay cn nht" ca em trc y. Lun gi mt khong cch vi ngi trong gng, ngha l c gng gi mt thi khch quan, khng cho bn thn em b xc ng nh anh ta. Lu dn, em s t nh "chuyn y cng bnh thng thi, c g m phi hp tp, v s c c thi quen gi bnh tnh trc mi tnh hung. C mt iu em cn ch v yn tm l: Nhng lc nh vy, c th thy dch nhy tit ra u dng vt - v l bnh thng -, khng phi l hin tng phng tinh lc cc khoi. Bn cnh , trong cuc sng thng ngy, em hy rn luyn cho mnh lun bnh tnh, khng cu gin, khng bc ng, dnh nhng khong thi gian thch ng cho vic suy tng v ci p, v lng khoan dung, nhn c..., to iu kin cho con ngi em ngy cng trm tnh hn. Ngoi ra, em c th dng th bi thuc sau y (mt s ngi cng cnh ng nh em ung bc u thy c kt qu) Tri u cn non (bng qu hng xim hay nh hn mt cht, rng rn), ra nh tay cho sch, ct ngang pha trn (lm thnh mt ci np y), ng knh vo cho y, ri ly si ch ct np li y nguyn nh c. t vo bt, y kn v un cch thy cho chn. Mi bn lm 2-3 qu nh vy, n ht trong ngy (lc no). Mi tun n 1-2 ln, ti khi t hiu qu. Mn ny rt ng, phi chu kh v kin tr. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


197. Lit dng c cha c khng?

L Trng Bng

"C phng php g cha c lit dng? Chng chu c hn gn hnh phc nhng chc l s phi chia tay, v bn thn chu b cn bnh c c y". l mt vn rt ln, gy tan v hnh phc cho bao cp v chng; bi v d tnh yu su sc n my, ngi chng b lit dng vn khng th lm cho v mnh hng hnh phc trn vn. d phng chng lit dng, ngi ta khuyn t b thi xu th dm, cn sinh hot tnh dc iu , n cht ti, cht m... V cha tr th t trc n nay, Ty y vn s dng hoc mn nam, liu php tm l...; ng y dng chm cu, thuc trng dng... nhng kt qu khng chc chn. Mt nhm nghin cu thuc i hc tng hp Nam California (M) khc phc chng lit dng bng mt phng php c o: Bm hoc mn prostaglandin (c tc ng lm cho c trn co bp) vo niu o. Trong hn 1.500 n ng b lit dng (tui t 27 n 88) c p dng phng php ny, 66% c th cng cng kh lu, giao hp bnh thng. Phng php ny c hiu qu i vi bnh lit dng do bt k nguyn nhn g (bnh tim mch, tiu ng, chn thng) nhng cch dng cn hi lnh knh, km thoi mi. Thng 3/1998, C quan Qun l Thuc v Thc phm M chp thun cho bn rng ri mt loi thuc vin cha lit dng u tin mang tn Viagra. Nu ung 1 vin trc khi giao hp 1 gi v c v kch thch y , nhng ngi "yu sinh l" s cng cng bnh thng, m bo cho vic quan h. Tuy nhin, gi thuc cn cao (mi vin gi 7 USD); kt qu tt ch t trong 80% trng hp. Thuc c th gy nhc u hoc kh tiu, hoa mt. Thuc khng cha c nguyn nhn gy lit dng. V chng chu nn kin nhn thm mt thi gian, chc rng thuc vin Viagra s sm c mt trn th trng nc ta. Trong khi ch i, chu nn kt hp ng Ty y m cha tip. 198. Ch mt tinh hon cng "Chu 15 tui. Cch y 2 nm, chu ng, b sng mt tinh hon, c cha tr kp thi nn khi. Hin gi thy n nh hn bn kia, nom hi lch. iu ny c nh hng g n ng con ci khng?". Khng h g, nu chu khng mc thi xu th dm dn n ch khng th quan h v chng. Vi mt tinh hon hot ng bnh thng, chu vn c th "con n chu ng", hung chi y vn cn c b, tuy mt bn c nh hn (do nhng ch bm gip lnh so co ko, trong khi nhng ch khc vn pht trin bnh thng). 199. Khng vic g nhng hy cn thn "Bc s i, cu chu vi. Chu 19 tui nhng sao dng vt khi cng ln th rt to. Chu s khi xy dng gia nh, ngi v s khng chu ni. Vy m m chu c gic chu ly v gp b sm c To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


chu ni. Y hc c cch g lm cho n cng va va, to va va khng?".

L Trng Bng

Chu hy bnh tm. C g u m ku kh. Cc ch lnh kh ca ta ngy xa sang bn Ty, b gi im nc ny ch "nh" lm cho h thy "nhc", bit c ca nc ngoi nh th no! (Theo s liu ca y ban Tiu chun ha chu u th kch c bao cao su ca nam gii trc y di 16 cm, rng 5,4 cm, v hin ti l 17 cm v 5,6 cm). ng s vic ly v nu ch v chuyn y. Bi v sau khi c kch thch y , m o s rng ra v di thm ln rt nhiu, cha ni n chuyn cht xut tit s bi trn m o, to thun li cho vic quan h. Cho nn, iu chu cn nh khi lp gia nh l: cha kch kch v y th ch quan h, nu khng s c th nguy him cho nng. Cn nu cha mun ly v v chuyn khc nh: hc hnh cha i n u, cha c ngh nghip t lp... th hy tha r vi m chu. V thng con, chc b s chiu chu thi. Y hc khng h c ch trng lm gim hin tng cng cng, bi l n l iu ti cn, l ci qu nht, chng nhng cho ring ngi n ng m c cho ngi v. Khng c hin tng th lm sao c nhn loi, c mi ging loi! Y hc ang rt au u v iu ngc li: hin tng bt lc (lit dng); my m mi ti u nm 1998 mi tm ra c mt loi thuc gip cho dng vt cng cng, nhng phi ung 1 vin trc 1 gi mi ln chung chn gi! 200. Trn dch mng tinh hon "Chu cm thy hai tinh hon b au, mt bn to nng ln, bn kia hi nh li. C bn bo rng nu b sa hay lch tinh hon th v sau khng c con v c th nguy him n sc khe". V chu ni thiu chi tit nn ch c th d on my kh nng: - Trn dch mng tinh hon (tinh hon vn bnh thng, nhng xung quanh n c cht dch bt thng). Nu ng vy th khi ny cng nhng n nh khng au, ch thy tng tc, c cm gic nh khi n vo mt qu bng hi. Mc ln nh khng thay i trong ngy. mt n pin pha sau s thy vng ln mt mu hng xung quanh (cht dch), gia m hn (tinh hon). Trc mt, chu mc x lp gip nng n ln cho vng, tc. Khi c iu kin, chu xin c phu thut ln mng tinh hon (gy t, chng mt tun l lnh vt m v tinh hon ny vn tip tc tt nh hin nay). Cn tinh hon bn kia, c th n vn bnh thng nhng do kt qu so snh sai lc nn chu tng l n nh i. - Thot v bn. Ni dung ch to ln thng l rut, khi n vo thy mm, i li nhiu th to hn, ngh ngi hoc dng tay y ln th ht; v d nhin soi n pin khng thy hnh nh nh m t trn. Thot v bn cng c ch nh phu thut; ngi ta s ti to thnh bng. M di gy t khu vc, t khi phi gy m. Trong khi cha c iu kin m, phi dng my lp bng p vo "l" thot v v eo x lp cht; ch y rut ln ngay nu n tt xung, nga bin chng tc rut, rt nguy him. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

C hai trng hp trn (trn dch mng tinh hon v thot v bn, m hoc cha m) u khng nh hng n hot ng tnh dc v sinh con ci. - Vim tinh hon: Tinh hon sng ln, n vo thy chc nch v au. S nh hng n ng con ci nu c hai tinh hon cng b m cha tr khng tt. D bn my chu cng nn i khm khi canh cnh bn lng mt chuyn h trng nh vy. 201. Tinh hon lc ch "Chu 19 tui. Tinh hon bn tri trc kia nm trn cao, chu ly tay n mnh vo n v n tt xung, thnh thong li co ln. Hin n ch nh bng na tinh hon phi. Xin cho bit ti sao". Chu b tinh hon lc ch, c th l tinh hon tri khng nm bu m c lng l trn cao, ni np bn, mc d ng ch tng li n xung. Khi cn trong bo thai, ban u hai tinh hon (hnh thnh vo tun th ba) vn nm trong bng, cho n thng th 6 ca thai k mi i xung bu. T khi ta lt lng, hai tinh hon vn ln u theo tui. c bit, t tui dy th, n bt u pht trin mnh sn xut hoc mn nam v tinh trng. Ch c mi trng mt m ni bu l thch hp i vi tinh hon. Nhng oi m thay, mt s ngi li c hin tng tinh hon lc ch mc khc nhau: - Tinh hon nm hn trong bng (n tinh hon), mt bn hay c hai bn. Sau ny, khi sinh con trai, chu nn s ngay bu ca cng t xem c my tinh hon, hay ch thy "chim". - Tinh hon thp th l bn, khi thy khi khng. - Tinh hon nm np bn, xa hoc gn bu, nh trng hp ca chu. Chu ng ht hong, c th phu thut a tinh hon lc ch kia v v tr. Kt qu ca phu thut ty thuc vo di ca ng dn tinh (ng dn tinh di th d tinh hon nm cao vn d dng ko c xung bu) v thi im m (nn m lc 5-6 tui, chm nht l trc tui dy th). Tinh hon tri ca chu khng th ln thm c na, v trong thi k pht trin, n phi nm mt mi trng km thun li. Nhng do v tr nm ngoi bng, n s khng b teo nho hon ton v khng c nguy c b ung th ha nh trng hp nm l trong bng. Chu khng gp nguy c g nhiu trong tng lai. Nhng chu vn nn khn trng i khm ti mt c s tit niu - sinh dc nam c nh gi c th hn. V chng, tinh hon lc ch thng i km thot v bn bm sinh, phi m mi khi. Nu vy, bc s s kt hp x tr lun c hai. 202. Chuyn gin thi "C cch g pht hin ngi con trai trc y c quan h tnh dc? Em nghe ni l c th hi mt tri u non a cho ngi ngi, nu tri u chy m th ng l anh ta quan h ri". y l chuyn gin thi. Tri u non no chng c m; c "ly chng" theo kiu th chc l "trm phn trm" ht, k c nhng ch nhc cn cha v ging. Sau na, em quan tm n nhng chuyn nh vy; tht v b v chng gii quyt c g. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


203. Hy xa lnh "tn trn lt"

L Trng Bng

"Chu l con trai. Gn y, mt ngi c v v mt con ti xin chu "tinh trng". Anh ta to bo nhng li ni l h n k m khng c n th s au v rt kh. Chu bn khon, na mun cho, na khng. Xin cho chu gp mt li khuyn". Khng bit k bnh hon no r tai h m gn y, mt s ngi, k c cc b mn kinh, cho rng h ung tinh dch (gm tinh trng v cht xut tit ca tuyn tin lit) th ngi tr nn cng trng v gi c tui xun! D thuyt ng hay sai th vic lm ny cng gy hi n i tng b khai thc: - Mt tinh dch cng l mt tinh lc (hai tinh hon phi cht lc tinh ty ca con ngi mi sn sinh c nhng ch tinh trng qu bu ny). Tr vic hin tng c s ph sn, bn khng nn mang i cho. - Mun cho tinh dch, ngi n ng phi ngi khc lm "ng tc gi" hoc t mnh phi dng tay kch thch, ngha l thc hnh ng tc th dm, rt nguy hi v sau. Vic ny d dn n tru lc v tnh dc, dn n cc bnh hoa liu hoc HIV/AIDS. Chu cn bn khon g na. Hy t lng thng ngi cho ng ch, v hy tm cch xa lnh ngay "tn trn lt" kia

L Trng Bng 500 gii p y hc theo yu cu bn c Chng 4: Chuyn la i v chm sc tr

204. V sao khng c kt hn cn huyt "Sau tit hc sinh vt lp 9 v t th phn v giao phi gn, c gio t thm cu hi: Hy gii thch c s khoa hc ca vic cm kt hn thn thuc . Em cha th tr li c cu hi ny". Ni "kt hn cn huyt" c l chnh xc hn "kt hn thn thuc". Em hy quan st hin tng sinh sn trong ln g th thy: Nu cho nhng con vt cng la (hoc la ngay trc ) giao phi vi nhau, con ci ca chng s ngy cng km ci. Tri li, nu cho giao phi vi nhng con xa l, chng s pht trin tt. con ngi cng tng t. Mt s b tc, thm ch dn tc, cho anh em, ch em con ch bc rut,

To Ebook: Nguyn Kim V

Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

c cu rut hay d gi rut ly nhau. Nhng gia nh nh vy hay gp hin tng "thoi ha" v ni ging (tr lc gim st, mt s d tt bm sinh lan trn...). V sao nh vy? Ta c th hnh dung mt cch d hiu nh sau: Trong tng c th, bao gi cng c mt s gene xu nhng khng biu hin (gene ln). Khi giao phi cn huyt, cc gene xu tng t ca non v tinh trng c iu kin kt hp vi nhau tr thnh gene tri, biu hin ra ngoi. Nu giao phi cn huyt tip tc qua nhiu th h th s thoi ha nghim trng l iu cm chc. Trong lch s, c mt s dng h do tp tc kt hn cn huyt m tr thnh ti t, thm ch tiu vong. Chnh v vy m trong hn nhn, ngi ta cm cc c th cn huyt tr thnh v chng. Trong hn phi, 2 c th cng khc nhau xa v di truyn cng tt, con ci s pht trin c tnh v hn ch nhc im (c dn tc nh giao lu ri kt hn rng ri vi ngi cc dn tc khc m dn d c c tr c thng minh hn v th tng khe p hn so vi thu cn "tru ta n c ng ta"). 205. Cn bn khon khi n hi "Ti 23 tui, c ngi yu tui Nga. Cc c ni tui ny phi ly chng mun, nu khng s kh, cht chng hoc khng con, lm cho ti bn khon qu. Ti cng ang bn khon, khng bit l khi n hi ri th c c gi b m ca nhau l b m khng?". Hai cu hi ca bn xem ra tri ngc nhau: n hi ri m cn bn khon v tui tc! Tuy nhin, cng xin p ng yu cu ca bn nh sau: "Ni c sch, mch c chng", nht l thi bui khoa hc pht trin ny, vic khng nh vn g nht thit phi da vo thng k, s lng thng k c cng ln th chnh xc cng cao. Cho n nay, cha thy ti liu khoa hc no ni nh iu bn nghe c. Sch T vi cng khng c cu c quyt "ng tri" nh th. Ngay n cc thy tng s cng phi cn c vo nhiu "cung" ca tng tui theo con gip, tnh ton chn ch ri mi dm "phn" v s phn ca mt ngi hay mt cp no . V trch nhim lm con, th chc chn sau khi k vo "t khai kt hn", chng r v nng du u phi chu ton i vi c i bn b m; nu khng, lut php s "hi thm" ngay. Cn ngi yu hoc v chng cha ci gi cc c nh nh th no l chuyn "ty tm", chng c lut l no rng buc c. 206. Lo u trc khi lp gia nh "Em 25 tui, sp ci v. Nhng em lo v dng vt ca em vn nh hn ca cc bn cng tui, s nh hng n hnh phc gia nh. C cch g lm cho n ln hn khng?". Em hy nhn nhng bc tng nam kha thn ni ting xa nay xem: ca h cng kh nh, c khi cn thua ca em na. Bi v tiu chun ca n khng phi l kch thc, m l s do dai. Em ci v, s l dp rn luyn cho n nhnh ln hn hin nay. Bi v, nh em thy y, lc n cng cng l lc c mt lng mu kh ln ti i vo th hang v th xp ca n, lm cho th tch tng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


ln. Em cng ko di thi gian cng cng th thi gian rn luyn cng di.

L Trng Bng

V em cng nn bit thm: Mt s ch em kh cao ln nhng c chng b ln, th m h vn hng hnh phc trn vn, k c v tnh dc. 207. Khng nn tip tc "Chu 25 tui, bn trai 27 tui, chng chu yu nhau thc lng v ngy no cng gp nhau. C mi ln m hn chu, anh y u xut tinh lm t qun chu. Chu lo b mang bu, nht l gn y thy nht ming, rt hay chng mt... Xin cho bit chu c b khng, v c nh th c hi g khng?". Nu ng l chu khng thot y, hoc thot y nhng khng quan h thc s, th chu khng c thai. Hin tng nht ming, chng mt l hu qu ca vic lm ngc vi sinh l din i din li hng ngy ca hai chu: Trong khi ngi nam phng tinh v t cc khoi th tri li, ngi n b kch thch nhng li phi chu "d dang", khng t c nh im ca khoi cm, ri vo mt tnh trng stress ngy cng tng. Do , cc chu ng ng ngi gn nhau qu, hoc ch tm gp nhau qu nhiu; hoc cc chu c gng to iu kin c th kt hn sm i thi. Bi l, nu c tip tc nh hin nay th ngi nam c nguy c b xut tinh sm (mt tai ha trong cuc sng la i), cn ngi n d b suy sp v mt ng (do khng c tha mn), chn n (do lo lng, mt nhc, thiu ng) ko di. 208. Lm sao chng minh mnh cn trong trng? "Chu l gio vin mu gio, cha tng quan h vi ngi khc gii. Anh y l mi tnh u ca chu. Khi chng chu "i li" vi nhau ln u tin, c mt t mu chy ra ca mnh. Nhng ln sau, anh y bo chu "bu v b nng, khi giao hp l m o m to" l mt trinh! Lm sao gii thch cho anh y hiu?". Chuyn ca chu va ng mng, va ng lo v ng trch. 1. ng mng v: - Chc chn trm phn trm l trc khi chu "trao xng gi tht" cho ngi yu, chu vn cn trinh trng, biu hin hin tng chy mu ra m o lc giao hp (nhng anh chng c h thng lt vi trng di mng v trong m tn hn kim tra xem mng trinh cn hay khng; nu thy c mu l anh ta yn tr!). - Khi ngi ph n c kch thch y , chng nhng lng m o tr nn rng hn m chiu di ca n c th tng thm ti 2 cm (to ha tht thng minh, bi v con ngi vn cao thp, gy bo khc nhau, nu tri khng ph cho mt s iu chnh tuyt vi nh vy th lm sao nhng b v b nh c th sng hnh phc vi nhng c ng chng cao ln!). 2. ng lo v: To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

- Chu c tht chc chn l "chng" khng b HIV dng tnh? (thi bui ny, nu sng bung th v tnh dc th c ngy "lnh " vi bnh AIDS; l cha ni n bnh lu khng thuc, bnh giang mai...). - Chu khng ngh l mt ba no chu c th mang bu ngoi mun? Cn nh rng trng rng 6 ngy - tc l ngy th 20 ca vng kinh - vn cn kh nng th thai trong 10% trng hp. 3. ng trch v: - Vic chu bung th bn thn lm cho ngi ta coi khinh chu. Gi nh chu gi gn, tip tc tm hiu xem c kh nng ly nhau hay khng, nu thy hp th bn chuyn ci xin ng hong ("chuyn y" l chuyn c i ngi, g m phi vi), th ngi ta s sut i tn trng chu. Bi v tn trng ln nhau l yu t quyt nh hnh phc la i. - Chu c chc l ngi ta cng trong sch nh chu, ngha l yu nhau ci nhau, ch khng phi ch li dng, gii tr bun? Vi cch n ni nh vy ca ng s, e rng chu chn nhm ngi, v ngn t kia l che y d tm chng? 209. Hin tng kh xut tinh "Chu c gia nh ring, nhng khng hiu sao khi quan h v chng, chu rt kh xut tinh. Vic ny lm cho c v ln chng u mt. Xin cho bit cch cha". Chng kh xut tinh (aspermatism) c th gp mt s thanh nin "trinh trng, rt r" mi ci v. Sau mt thi gian chn gi, h s t rt ra c cch khc phc (ch kh xut tinh km theo khng c tinh trng mi ng lo). Cc chu cn c ht sc t do thoi mi (phng ng ring bit, khng c nguy c b quy ry), cn phng trang tr m cng, hp dn vi nh sng thch hp, tranh tng c thn hnh p ni ting; c th vy cht nc hoa, khi ng tht y trc khi quan h. Trc mt, mun khi mt th sau khi ngi n t nh im, ngi nam phi lp tc "rt lui", d bn thn cha t nh im. Sau ny, khi khc phc c, th c hai s cng t mt lc. Xin ni thm cc chu an tm: Mt s nam gii c gng t rn luyn v tm l v v thao tc t ti trnh ch ng chm xut tinh, thm ch khng xut tinh, bo ton tinh lc. H cho y l mt u th, v va p ng c yu cu cao ca bn chn gi, gip bo v vng chc hnh phc gia nh, va gi c sc khe dnh cho vic dy d con ci, hot ng th thao, vn hc ngh thut, kinh doanh, x hi (ngc hn vi ngi xut tinh sm phi lun sng trong tm trng hi hn, mc cm ti li, suy gim tr lc v th lc, b v chn ngn hay rung b). H t c thnh cng ni trn do xc nh c iu cn bn trong quan h chn gi l "ngi chng c trch nhim to khoi cm cho ngi v l chnh", ch khng ch k ch cho ring mnh ri sau th no mc k! 210. Khi nam b n cng bc To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

"Chu p trai, hc kh, b m giu c. Trc y chu yu mt c nhng ri quyt nh thi v bit c ny quan h tnh dc vi ngi khc. C ta mi chu n nh, ni l n ba cm chia tay, ri cho chu ung nc cam, ung xong chu m man, khi tnh dy thy mnh b tri nga trn ging, khng cn qun o, chu nh ku ln nhng mm b nht vi. C y kch thch chu ri ch ng nm ln ngi chu, k cho n lc chu xut tinh mi thi. Chu rt lo c y dnh bu ri bt chu ci, khng cn hc hnh g c na. Xin cho chu mt li khuyn". y l trng hp nam b n cng bc. iu t hi l ng c khng phi do thm mun thn xc, m l mt mu m bt chu phi ci h. ng l ngay sau khi xy ra s vic, chu phi trnh by vi b m, sau n cng an bo co. Vi nghip v ca mnh, chc chn c quan chc nng lc by gi d lm sng t vn . y l mt bi hc cho nhng "chng trai ngy th p trai, con nh giu" b p duyn. H s phi chu au kh gin vt sut i nu ng k kt hn v "s d lun", "n mt gia nh", "s b kin ri mang ting"... Ngi cng bc chu rt tho chuyn ny, v nhiu kh nng c thm ai gip sc (chn thuc m, tri chn tay chu...). Nhng c y li qun rng: c bu hay khng l chuyn ca c y, cn vic chu kt hn vi c y hay khng l chuyn ring ca chu, l quyn ca chu. Chu cn lm nhng vic sau y: - Khng c giu gim, tri li phi bo co ngay chuyn ny vi gia nh cng nhau nh liu. - C phn u tip tc hc tp, ng x tt, v ch i 9 thng 10 ngy k t ci ngy "kinh hong" . Trong thi gian ny, d b bt k ai thc p, chu cng khng di g m ng k kt hn vi hng ngi y. - Nu c y sinh con ri kin co, ni l con ca chu, th chu xin c quan chc nng cho xt nghim i chiu gene, xem c phi l ca chu khng (c th lin h vi T chc Gim nh php y trung ng, B y t, T 04-8252930, nh gip ). Nu l con ca chu th gia nh chu c th xt xin np tr cp nui a tr. - V sau, khi nh tm hiu ai th chu phi ni cho h r chuyn va xy ra. 211. Vin nga thai cho n "Xin cho bit: N ung vin nga thai c hi g khng? C my loi, v loi no tt nht?". 1. Thnh phn vin thuc nga thai bao gm: - Cht to progesterone. - Cht oestrogene tng hp (ethinyl-estradiol). Progesterone lm bung trng ngng tit hoc mn n (oestrogene t nhin), ngn khng cho trng lm t, v cn li tinh trng t nhp vo d con. Oestrogene tng hp b tr cho lng hoc mn n b thiu ht do tc ng ca progesterone. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


2. Cc loi vin ung nga thai:

L Trng Bng

- Th h 1: Gm hai thnh phn ni trn vi hm lng ln, d gy nguy c tai bin tim v mch mu no. - Th h 2 (vin mini)L: C cng thnh phn nhng vi hm lng rt nh, gim thiu c cc nguy c trn. - Th h 3 (cng mini): Progesterone c ci tin. - Vin micro: Ch c progesterone vi hm lng cc nh. 3. Thi gian v cch thc s dng - Cui thi k dy th (13-16 tui) mi c dng. - Dng lin tc khng ngh n 45 tui cho ngi bnh thng v 35 tui cho ngi nghin thuc l (nu ngng thuc th trong nhng k kinh ngay sau rt d th thai). Qu nhng hn tui ny, phi s dng cc bin php nga thai khc. - Vin nga thai th h 1 t c a chung do cc nguy c trn. Vin micro phi ung hng ngy, vo mt gi nht nh. Vin mini c mt khong linh hot 12 ting ng h nn tin dng hn (v d m qun ung th ung vo sng sm hm sau), kt qu cng chc chn hn vin micro. 4. Chng ch nh: - Khng dng cc loi vin nga thai khi b cao huyt p. y l mt phn ch nh tuyt i. Ngoi ra, trong sut thi gian s dng, phi thng xuyn theo di huyt p. - Khng dng vin nga thai th h 1 v mini khi: + Ngay sau khi sinh, v by gi c nhiu nguy c vim tnh mch v tai bin mch no. Ch c kinh tr li mi c ung tip. + Sut thi k cho con b, v cc hoc mn i vo sa m c th gy ng c cho tr s sinh. Bc s phi ht sc thn trng khi k n vin nga thai th h 1 v mini cho ngi nghin thuc l, bnh nhn tiu ng, ngi c tin s vim tnh mch. 5. My iu cn lu khi dng vin nga thai - Vin nga thai khng phng hi n kh nng tnh dc, kh nng th thai cng nh sc khe chung, khng gy mp ph, khng gy ung th. - Nu qun ung, nht l i vi vin micro, phi kp thi dng cc bin php nga thai khc, nh bao cao su chng hn. - Vin micro c th dng cha trng c km theo ri lon kinh nguyt thiu n tr. - Vin nga thai khng ngn c bnh ly nhim qua ng tnh dc (do , ta thy bao cao su u vit v a nng hn). - Trong 3 thng u s dng vin mini, c th xy ra ri lon kinh nguyt; nu tnh trng ny khng dt sau khi dng ht v thuc th 3, phi i loi thuc khc. Nh rng ph n nghin thuc l hay To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


gp rc ri ny.

L Trng Bng

- Mun c con, sau khi ngng thuc phi ch n k kinh th hai mi th thai, v trong k kinh u tin, d con cha sn sng cho trng th tinh ti lm t, kh nng sy thai rt ln. - Sau 3 thng u s dng, phi xt nghim mu nh lng cholesterol, triglycerid v glucose; sau 6 thng, nu mi s bnh thng l n. 6. C hai u im ph ca vin nga thai - Mt s ng ch em dng vin nga thai thy gim hoc mt hn hin tng mc trng c mt. - Theo kt qu mt nghin cu ca Anh cng b nm 1998, nhng ch em dng vin trnh thai lin trong 6 nm, nguy c mc ung th bung trng gim 60% so vi nhm i chng. Ngay c trng hp c nhng d thng ca hai gene BRCA1 v BRCA2 (vn d b ung th bung trng), nguy c ung th cng gim vi t l tng t. 7. Vin nga thai khn cp Postinor 0,75 mg Phi ung ngay 1 vin chm nht l 1 gi sau khi quan h; mi thng khng c dng qu 4 vin. 212. Vin trnh thai cho nam " thc hin k hoch ha gia nh, nam gii dng bao cao su hoc m tht ng dn tinh. Nay nghe ni li c vin trnh thai cho n ng. Kt qu ra sao, v so vi hai bin php trn, vin ny liu c tt hn?". Mt nh nghin cu Anh, bc s Fred Wu, thnh cng trong vic ch to vin trnh thai cho n ng, t kt qu trong hn 98% trng hp, ngha l khng thua km vin trnh thai ca ph n. Vin trnh thai cho nam gii t nay s thay th loi thuc tim trnh thai hng tun kh phin phc v rt au, khin nhiu qu ng thy n. Cng nh vin trnh thai ca ph n, vin trnh thai ca nam gii khng hi sc khe, khng nh hng n kh nng tnh dc, v nu mun c con th ch cn ngng s dng mt thi gian l c th t nguyn vng. Vin trnh thai cho nam gii t ra tin li hn bao cao su v khng phi lp vo tho ra lm gim hng th, khng b thng lm v k hoch, khng phi tnh ton thi im dng hay khng dng (tnh ri vn s nhm), khng lo qun hoc tc li linh ng... V so vi vic tht ng dn tinh th vin trnh thai qu u vit. Gii my ru rt ngi phu thut ny v ngh "th l ht ng con ci" d gy mc cm trong i sng cng nh sinh hot v chng, v s khng th c con tr li khi cn thit (trong trng hp i bc na hoc con ci b cht hay tt nguyn). Tt nhin, vin trnh thai ny cng khng ngn c bnh ly nhim qua ng tnh dc. 213. C cch g tin hn thuc trnh thai? "Ti ung thuc trnh thai ti nay 3 nm, nay nghe ni ung thuc nhiu s b ung th, khng r To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

thc h ra sao? Ti nm nay 34 tui, vy s cn ung trong bao lu? Nu khng dng thuc th s dng bin php g cho ph hp?". Bn c yn tr. Thuc trnh thai c nhp nc ta khng h gy ung th. Nu ch ung thuc nh hin nay, bn s ngng s dng khi mn kinh, tc khong 10-15 nm na. C bn bin php trnh thai ph hp, li n gin v khng tn km, bn hy chn ly mt: - Hng thng, ngh quan h mt tun lin (t ngy th 11 n ngy th 17 ca vng kinh); ng ring trong thi gian ny l tt nht. Bn nh ghi chp t m v thng xuyn vo s tay kinh nguyt, khi nhm. - Dng bao cao su 100% vo tun l ni trn. - Trong tun l ny, nu "trt quan h t do", th mun nht l 1 gi sau , bn ung 1 vin thuc nga thai khn cp Postinor 0,75 mg; mi thng khng c dng qu 4 vin. - Cn nu bn khng mun ghi chp, tnh ton, th dng bao cao su 100% trong tt c mi ln. 214. Phi tho b kp thi "Chu 24 tui, c chng v mt con, t vng c 4 nm th b tut, phi i t li cch y 7 thng. T n nay, chu thng xuyn ra kh h, kinh nguyt tht thng v thi im, thi gian cng nh lng huyt. Chu c nn tho b vng khng?". ng l chu phi xin tho vng sm hn. iu kin nh cc chu, ngi ta khng t vng m dng bao dng vt hoc thuc nga thai (nga thai thng xuyn hoc nga thai khn cp). Vic t mt d vt - d lm bng cht liu tuyt diu my chng na - vo mt ci hc t nhin nh bung t cung khng phi l iu hp l t nhin v chng phi lc no cng tuyt i bnh yn v s. Thc ra, nu c l nghi dnh bu th c xt nghim nc tiu nhanh ti nh, sau kp thi ht thai nh nhng ti c s y t, c g ng phi "khng khip" u! 215. Git cht tinh trng nga thai "Khoa hc c ch c cht g git cht tinh trng phng ra nga thai khng?". T lu, y hc cng my m theo hng nhng mi vn cha thnh cng. C cht git c tinh trng nhng li gy tn thng cho nim mc m o, ch t cng gy kh chu ni ngi n. Cht "d chu" th khng git c ht tinh trng. Cht " tiu chun" th vic s dng li lnh knh, lm mt c hng th cho c i bn. V th, bao cao su vn c coi l u vit, nht l loi cc mng, cc chc nh hin nay. C quan Qun l Thuc v Thc phm M (FDA) chp thun v cho bn rng ri trn th trng mt phng tin nga thai n gin, thun tin v hu hiu mang tn VCF (mng phim nga thai t trong m o). l mt mng phim mng hnh vung, mi cnh 5 cm, rt d tan trong cht dch m o, cha 75 mg Nonoxynol-9, c tc dng dit ht tinh trng nhng li v hi i vi c th, khng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

gy cht kh chu no cho c i bn. Cch s dng n gin: Trc mi ln quan h, ngi n ch vic b mt gp i n li, t ln u ngn tay gia ri nht vo m o, mng phim s tan ngay khng cn du vt, thi gian tc dng trong 1 gi; nu quan h lu hn, phi b sung thm. D nhin mng phim khng dit c cc tc nhn gy bnh hoa liu ni chung v virus HIV ni ring. 216. C my tnh hung "Chng chu ci nhau hai thng, nhng phi dng chuyn i n do ba ln quan h trong thng u u tht bi (khng th vo c). Mi ln nh vy chu cm thy au khng chu ni mc d chng chu ht sc c gng v ng vin chu. Xin cho bit ti sao, cch khc phc nh th no bo ton hnh phc?". Th chu ni thiu chi tit, cho nn ch c th a ra my hng v nguyn nhn trong trng hp ny, v chng chu tham kho, lin h v ng x cho thch hp: - Mng trinh qu dy: Nu ng nguyn nhn ny th rt n gin, bc s ph sn s tin hnh rch rng, chng dm hm l quan h v chng c. - Tuyn Bartholin (chuyn tit cht nhn) b vim, nn khi ng n l au. M ct b tuyn ny l ht trc trc, khng li di chng. Thng t gp ngi tr tui, nhng vn c. - Cht xut tit ca m o qu t, khng bi trn, cho nn kh cho vo. Cch khc phc: Ngi nam phi kin nhn kch thch bng cch, khng n h bt c bin php no lm cho ngi n ham mun tt , t mnh s ch ng, khng cn s au nh trc. Nu thc hin tch cc iu ny ri vn thy ca mnh khng t m, c ngha l cc tuyn bi trn ca n hot ng km, phi bi Vaseline pure (c bn cc nh thuc) cho c v ln chng. - Nu nam kch thch tt nhng n khng thy hng phn (khng c cm gic thm mun) th phi d chng chng lnh cm. Cch khc phc nh phn u ca tnh hung trn, vi phm vi rng hn nhm xc nh mt s im nhy cm nht trn c th tc ng. - m o c vch ngn: Sau khi c x tr n gin, mi chuyn s m p. - Nu chu cha h hnh kinh, hy coi chng d tt khng c m o. Cch khc phc l phu thut to hnh m o. Nu nh gii php di dng ny (do thiu c liu) khng gip c g cho v chng chu th hy sm thu xp i khm ti mt bnh vin ph sn trung ng c chn on chc chn v cch x tr thch hp nht. 217. Khi quan h v chng "Xin cho bit khi quan h v chng th c nhng cht g c sn sinh ra?". Ngoi tc ng lm tng tit cht bi trn ca mnh n gii, cc kch thch v th gic, khu gic v xc gic s tc ng ln cu to di i ca no (vn c chc nng kim sot tuyn yn), lm To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

cho tuyn yn tit ra cc hoc mn FSH, LH. Cc hoc mn ny s ra lnh cho tuyn thng thn, tinh hon v bung trng tit ra cht testosterone c vai tr to ham mun. Bn cnh , s kch thch gii tnh s c ch cc si thn kinh giao cm v kch hot cc si ph giao cm, lm cho cht monoxyd nit (NO) c phng thch. Cht NO cho php dui cc th c trn ca th hang cng nh th xp ca dng vt, v th hang ca m vt. Mt lng mu ln s ti, lm cho dng vt cng nh m vt cng cng. Ring n, lc by gi tuyn cht nhy m h cng tng tit mnh (to ra dch bi trn), m o cng rng ra v di thm. 218. Khi thiu cht xut tit "Chu ly chng nm 22 tui, n nay gn 3 nm. Trong quan h v chng, cha ln no chu c bit n khoi cm, mc d chng chu c ng tc t tn, t nh v a dng, k c dng nc bt. Mi ln nh vy, m o ca chu khng tit c cht nhn nn c phi chu au rt chiu anh y. Chu thy b tc v lo s c th ny s khng gi gn c hnh phc. Xin gip chu cch cha tr, v cho bit dng nc bt nh vy c nguy him g khng?". Nc bt ch yu cha men ptyalin chuyn ha cht bt, cht lysozyme lm tan mt s vi khun. Nc bt ca chng a vo m o cng chng sao, nhng bn thn n khng th bi trn m o thay cho cht xut tit ca cc tuyn sinh dc n. Chu lin h vi bc s mun mt gn ba nm nn phi chu "au kh" qu lu v s chm tr . Nhng khng sao, hy ti mt hiu thuc ty, mua vi tup Vaseline pure (vadlin nguyn cht) dng dn. Hai v chng dng tay sch t bi hoc bi tht m vo b phn sinh dc ca nhau, sau tin hnh theo thng l. Nh m o c bi trn, ngi n s khng cn cm gic rt nh trc, lu dn s t c khoi cm nh mong mun, ng thi ngi nam cng s va . Khng c dng m penicillin trnh nguy c b d ng. 219. Hy chun b cho nhau tht tt "Chu 25 tui, va mi lp gia nh. Mi ln quan h v chng, chu khng c cht nhy nn kh khan v rt au. Xin cho chu mt li khuyn gp". Vn quan trng m th chu vit s si qu, nn xin nu ln mt s tnh hung chu cng chng lin h v gip nhau khc phc: 1. Trc gi ng, khng kh gia nh phi m cng, m i; nu c chuyn g cng b qua. Khng c tm nc nng (v s lm gim hng phn). 2. Trc khi quan h, hai chu cn chun b tt cho nhau. Ngi nam khng c vi vng m phi t tn, dng li ni, dng ng tc vut ve tc ng vo nhng vng m ngi n thy nhy cm nht ( l v chng th khng n h bt c vic g, cho d ngi thiu hiu bit bo "k cc" cng khng s, min l em li hnh phc cho ngi bn i). Ch n khi no thy ca ngi n t m mi tin hnh. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

C chun b tt th m o mi n rng v di thm, tuyn tit cht nhn m h hot ng bi trn, to thun li cho quan h; nu khng, vic quan h s gy au, thm ch gp nguy c rch cng ngi n (do ca nam qu di m n khng c chun b thch ng). 3. Nu cn, trong khi cha thnh tho, hai chu c th tm khc phc bng cch bi Vaseline pure (c bn hiu thuc); khi tt ri th thi. 4. Nhn chuyn ca mnh, hai chu cng nn ni cho cc bn nam n chun b xy dng gia nh: m tn hn cng phi chun b k cng, v mng trinh rch s gy au nhiu nu ngi nam vi v, ch ngh n bn thn m thi. 220. No thai v ht thai "Nm nay chu 26 tui. Trc y chu no thai 2 ln v ht thai 1 ln, liu iu c nh hng g n chuyn sinh sau ny khng?". Trong ng tc no thai trc y, iu ng ngi nht l nguy c no c vo phn nim mc d con gn, thm ch kh xa v tr ca phi. Nu c "lm m" nh vy qu nhiu ln, nhng ch ny s khng m bo cho vic lm t v pht trin bnh thng ca phi, c th dn n nguy c b sy thai, rau bm thp... Th thut ht thai gip trnh c cc nguy c ni trn. Phng php xt nghim thai n gin ti nh gip pht hin thai sm kp thi ht nu khng mun sinh con. Trng hp ca chu khng c g ng lo. Ch xin nhc l: Khi c thai, th trong thng th ba nn hn ch quan h v chng, nu khng c th b sy; v trong thng th 7 cng phi chu kh "nhn" nga nguy c non. Ngoi ra, khng c thi im no phi king c. 221. Thai nghn v tit sa "Chu 24 tui, mi lp gia nh, mang thai c 1 thng th lun b au bng; chu i ht thai v s nh hng n con sau ny. T ngy c kinh tr li, chu bp vo ngc thy c sa ti chy ra, nm hi ngt, mt tun vn thy. Nghe mi ngi ni cha con u lng kh c sa. Xin cho chu mt li khuyn". Nu no ht thai, khong 5-10 hm sau c hin tng ln sa (lng t, long, c v hi ngt) l chuyn bnh thng; hin tng ny s ht dn, khng lo. Khng h c chuyn sinh con u lng kh c sa; sa nhiu hay t l ty tng ngi, v khng ph thuc vo s ln sinh. Chu nn i xem c bnh g v ni khoa gy au bng khng, cha tr trc khi c thai ln sau; khm ph khoa xem v tr ca t cung c bnh thng khng. Cn hin tng au lng trong vi ba thng u ca thai k l chuyn bnh thng. C mt s vn c nh hng n thai nhi m chu cn bit trnh: ch n qu thiu thn, thiu cht, thiu cc vitamin cn thit, b cng p thn kinh (stress), b cc bnh do virus trong vng ba thng u ca thai k (cm)...Ngoi ra, chu cn nh rng, nu khng gi gn th thng th 3 d b To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

sy thai v thng th 7 hay b non. Chu cn nhc chng lu cc thng ny. 222. Panadol v thai nghn "V khng bit mnh c thai nn chu trt ung my vin Panadol. Nay chu lo khng bit nh vy c nh hng g n a con trong bng khng?". Panadol (paracetamol) l loi thuc gim au v h st c kt qu tt v nhanh, dng cho mi la tui (ngi ln dng vin nn 500 mg, khng qu 8 vin /ngy; tr em di 12 tui dng hn dch ung vi liu tnh theo th trng). Gia nm 2001, mt hi tho ti Anh cho bit, c nhiu trng hp tn thng gan nng do dng paracetamol liu qu ln. V vy, cc bc s cm dng thuc ny cho ngi c mn cm vi n. Tuy nhin, paracetamol khng c chng ch nh i vi thai ph, chu c yn tm. 223. Trc trc nh "Chng chu mi xy dng gia nh hn 10 thng. Ln u tin quan h, chu thy ra mu v au; mi v sau ny, cm gic au vn cn, lm chu rt ngi quan h v lo lng. Xin gip chng chu". y l mt trc trc nh thng gp, c th khc phc nu hai chu cng bn cch phi hp: Chu b au c th do s kch thch ca chng chu cha c kt qu, ngha l cha lm cho chu ham mun thc s. Hy chng pht hin trn c th chu nhng im no nhy cm nht v kch thch vo , bng bin php no m cc chu thy thch hp nht. Cng c th cc tuyn ni tit ca chu tit dch qu t, khng bi trn. Trong trng hp ny, hoc mt mnh chu, hoc c hai ngi phi bi Vaseline pure, c bn cc nh thuc, di dng tup nh, gi di 3.000 ng, c th mua vi ba tup v dng dn. 224. au khi quan h "Chu rt xu h v s hi, nn ch dm hi bc s qua th. Chu 20 tui, khi quan h vi chng ln u cm thy au nhi. Chu s hi ngng quan h th mu ra rt nhiu, t m c qun ngoi. Nh vy c sao khng, tha bc s?". Chc chn khi th tr li n ni th chuyn cc chu sun s, khng cn phi gip g. Nhng v cu hi ca chu cho thy nhng l hng ng tic lp tr v kin thc gii phu, sinh l v gii tnh, nn ti cng xin ni di dng i cht: 1. T khi lt lng, b gi c mt mng che bo v m o, gi l mng trinh. Mng trinh c th dy hay mng khc nhau tng ngi, hnh th v kch thc ca l mng trinh cng vy. Do , khi quan h v chng ln u tin, c th xy ra mt trong cc tnh hung sau: - Rt au v chy nhiu mu (nu bn thn khng b ri lon v ng mu, ch cn bng p bng gc v khun l ht; n hm au c th tip tc quan h). - au t v chy mu khng ng k, khng gy tr ngi g cho vic quan h ln th hai. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


- C cm gic rt v khi dng khn thm ch thy rm mu.

L Trng Bng

- Hon ton khng au v khng chy mu (do "l" mng trinh rt rng, mng trinh chun gin dng vt i qua m khng h hn g; trong trng hp him hoi ny, ngi v c th b nghi oan l mt trinh t trc). 2. Do , v chng mi ci nn nh mt i iu: - Trong m tn hn, ngi nam khng vi v, tri li phi kin nhn chun b tht y cho n (bng ng tc mun hnh mun v v li ni thch hp cng a dng nh th), n mc ngi n tr nn hon ton ch ng. Cn ngi n th phi vo cuc mt cch ht mnh, tn thm gi tr ca bn thn bng cch x l y phc, hng liu... c nh vy th ngoi s hng phn v tinh thn, m o chc chn c bi trn y gip gim "ni au" v bt " mu". - Trong phng tn hn ch t cng phi c bng gc v khun phng khi cn n (c gp khng bit xoay x a nhau i cp cu bnh vin). - Vi nhng cp cha mun mang bu ngay: Trnh quan h trong khong t ngy th 10 n ngy th 16 ca vng kinh (ngy bt u thy kinh c coi l ngy th 1). Nu ngy ci qu l "ngy lnh thng tt" nhng khng th v s mang bu m lui li th sau l ci, cc ng s phi kin tr ch i cho qua tun l oi om ni trn, v khng nn dng bao cao su trong nhng ln u. 225. M xong s ht "Lu nay, v chng chng ti vn sinh hot bnh thng, nhng 6 thng tr li y, mi ln nh vy ti cm thy au rt, cht xut tit cng hi t. Gn y, bng thy pha ngoi m o c mt cc tht bng u ngn tay t tr con. Ti khng cn c khoi cm, ch mong cho chng kt thc, lm chng ti rt bun. Xin gip chng ti bo ton hnh phc". Nhiu kh nng b b vim tuyn Bartholin (nm gia mi ln v mi b). Trong khi giao hp, ch vim b va chm, b p mnh, c vng ny b au rt, khng nhng lm gim khoi cm m cn bin mi ln n i thnh mt cc hnh thc s. Nu c nh vy, b s c nguy c mc thm chng lnh cm. Cch gii quyt kh n gin: B nn sm ti mt c s ph khoa tt ca ngnh y t xin khm v m b ci tuyn b vim . y ch l mt phu thut nh, gy t, m bo thm m v vt m ln vo np gp gia hai cp mi, khng th pht hin. Mi chuyn s m p nh xa. Nu b cn thy m o xut tit km, c th s dng cht bi trn nh du paraffin hay vaselin v khun. 226. Th m khng i khm "Em l con gi, 21 tui, cn ang i hc. T 3-4 nm nay em b 2 khi u hai bn ca mnh, khng au, lc u b, nay bng khong ngn chn ci, n vo thy chy i chy li; khi em nm xung th li khng thy. Em lo qu, nhng v mc c nn khng dm i khm". Tri t, chuyn quan trng nh vy m em ti gi cha i khm bc s! To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Nhiu kh nng em b thot v bn c hai bn (do bm sinh, n tui ny mi bc l), qu lu nn ni dung bn trong sa xung thp (khi nm, do p lc ti ch gim nn n tr ln bng). Mt bc s chuyn v ngoi khoa tng qut s pht hin v x tr tt. Nu ng vy, phu thut s c kt qu, khng nh hng g v sau. Nu hai khi ny rn v lun c mt ti ch (ngha l khng h bin mt khi em nm th l do vim ph i tuyn Bartholin (t thy ngi tr, nhng vn c. Trong trng hp ny, phu thut s do bc s ph sn tin hnh, cng an ton v khng thy c so. 227. Xut tinh sm "Chu xy dng gia nh, nhng b xut tinh sm, ch gi c lu nht l 10 pht, thng ch 5 pht. Trong khi , theo ch chu c bit, ngi ph n phi sau 30 pht mi t nh im. V chu l con nh nho, nn khng bao gi bn ti chuyn ny, nhng t chu thy l c y rt kh tm. Xin cho bit chu phi lm g?". Tnh hnh ca hai chu hon ton c th ci thin c theo cch sau: - V chng hy quan nim ng hn v chuyn chn gi: l v chng th khng qun ngi bt c vic g (d nhng ngi thiu hiu bit hoc o c gi c th ch bai) min l vic mang li khoi cm ti a cho ngi bn i. V chng phi thng xuyn trao i v chuyn ny t hiu qu ngy cng cao. - "nh im" n thng n chm hn nam, v vy ngi chng phi c phng cch thch hp cho khi "lch pha", khi "v ch" mt mnh ri ln ra ng m mt, v cng thng tinh thn cho ti hm sau. khc phc, mt mt chu phi ht sc t kim ch cm xc, lun t nh (v s thc cng ng nh vy) rng "mnh lm th ny khng phi cho ring mnh, m chnh l nng c tht s hnh phc". Mt khc, chu vn dng nhng ng tc vut ve ln nhng vng nhy cm, thm ch dng c "ng tc gi" nu v chu ng tnh. C nh th, bn thn chu khng b kch thch nhiu (do ch tm vo "nhim v"), cn v chu th cng lc cng hng phn. Nh vy, ch sau mt vi pht, thm ch na pht, l "nh im" n ngay vi ngi n, c khi cn trc c ngi nam. Trong thc t, nhng ln u c th cha thnh cng lm, nhng ng nn ch, dn d s rt c kinh nghim v thng li. C iu th v na l: Nu kin tr phn u theo cch trn, mt ngi vn b xut tinh sm s c th ko di cuc chi theo mun, lm cho ngi v hi lng. 228. Phi i khm xem kh nng no "Bn chu ly chng hi 18 tui, n nay 2 nm vn cha c con. Nghe bn chu ni l mi ln quan h th c hai v chng u thy au rt, dng vt khng vo c, do ngi chng bo c y khng th sinh con. Hnh phc gia nh ny c nguy c tan v. Xin khoa hc gii ta gim". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Vic trng i hng u nh vy trong i sng v chng m cc v ko di hai nm tri! Chu hy bn ngay vi bn chu v hai kh nng sau y: 1. Mng trinh ca bn chu qu dy, qu chc nn i phng khng th i qua. Nu vy th tht v cng may mn v ch cn mt vi ng tc ca bc s ph sn l s m p mi b. 2. Bn chu khng c m o, hoc va khng c m o va khng c d con (kh nng ny nhiu hn v cng kh khn hn). Nu ng vy, phi lm phu thut to hnh m o (to mt m o mi bng chnh t chc ca c th bn chu). Nu khng c d con th vic phu thut ch nhm mc ch cho php quan h v chng. Nu c d con bnh thng, ngi ta s c gng ni lin m o mi vi d con, vi hy vng c th thai nghn c (nhng cui thai k phi m ly thai). Nh vy l bn chu phi sm n mt c s ph sn tt ca ngnh y t xin khm v gii quyt. 229. tui no th thai l tt nht? "Kh nng th thai ca ngi n c thay i khng, v tui no l cao nht? Cu Trai ba mi tui ang xoan, gi ba mi tui toan v gi ng hay sai?". Cu ca trn tng lm mt s ch em lo st v, trong khi mt s khc vn nhn nh, cho rng cc c xa "phn" mt cch sai lm. Xin nu mt kt qu nghin cu tin hnh trong nhiu nm ti Australia c cng b gn y bn tham kho v rt ra cu tr li v vn dng cho bn thn: - Ngi con gi tui 20 tui c xem l c kh nng sinh sn cao nht. Lc ny, mc sn xut cc hoc mn n (ni tit t) n nh, hai bung trng mang nhiu non (trng cha th tinh) c cht lng tt nht. - Sau 30 tui, c hi th thai trong mi vng kinh cn 15-30%. - tui 40, c hi ny ch cn 7-10%; t l sy thai tng, khong 4 ngi cha th c 1 ngi b sy thai. Cht lng ca s non cn li ni bung trng khng cn c nh tui 20; bung trng khng cn mm mi, do vy m vic phng non rt kh khn. 230. Khi vn yu nhau "Chu 32 tui, lp gia nh 4 nm nay, vn cha c con. Chng chu trc y b quai b, teo tinh hon (mt bn 10, mt bn 8); tinh dch xut ra rt t. Chng chu vn rt yu nhau, nhng ng con ci chc l kh khn. Xin cho chu mt li khuyn". Trc ht, chng chu nn i khm xem cht phng ra c phi l tinh dch (c mang tinh trng) hay ch n thun l cht tit ca tuyn tin lit. Nu c tinh trng nhng khng tiu chun v s lng v cht lng th c th dng mt s thuc c truyn (tc k, hi m...). Nu chng may khng c tinh trng th coi nh khng th c con. Sau , hai chu th bn bc tm ra cch gii quyt. Hoc l tin hnh th tinh nhn to cho chu bng tinh dch ca ngi khc (do c s ph sn ca ngnh y t cung cp, m bo mi mt, k c b mt v ngi hin tinh dch). Hoc hai chu xin con nui, bng cch ng k ti c s ph sn, km To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


theo cc yu cu v gii tnh cng nh v ngoi hnh ca hi nhi.

L Trng Bng

Tnh yu chn chnh v su m lun sn sng vt qua mi tr lc, mi nh kin. 231. Dng t th thch hp "V chng con mi ci nhau. m u, con l n ng, nm trn, v con ku ngt th. m sau, con nm di, v con nm trn, th khng sao giao hp c. Chng con lo c nh vy mi s khng c con. Xin cho mt li khuyn". Trc tin, con phi a v i khm bc s xem c bnh tim hay hen ph qun (suyn) khng ; ty tnh hnh, bc s s cho phng php cha. V "chuyn y" th khng kh: Hy s dng t th "p tha", ca nam t pha sau a ngc ln, di s hng dn ca bn tay n (t th no lm cho c hai v ln chng u thoi mi th hy s dng). Ch kch thch y trc khi tin hnh, v trong qu trnh giao hp, chng lun tay di vai v t vo ngc; cn tay kia a xung kch thch m vt, bi l nhc im ca t th ny l dng vt khng gh ln m vt gy khoi cm cho n nh thng l. y l mt vic lm khoa hc nhm bo m hnh phc la i, cho nn hai con ng mc c. Ln u c th kh lng tng, nhng hy cng nhau trao i, rt kinh nghim dn, c khi cn pht hin c nhng t th khc thch hp hn. Khi mun c con, hy theo lch kinh nguyt v li dn ca bc s. 232. Hy lm theo trnh t ngc li "Ti ly v c 5 thng, nhng c iu cha n m khng bit hi ai: khi quan h, nh ti khng t c nh im, nhng khi ti ly tay mn trn vo m vt th li t c. Xin cho bit cch gii quyt c th gip gia nh ti gi c hnh phc trn vn". Hy tp kin nhn, v ln lt tin hnh hai vic trn theo trnh t ngc li. Lc "nh ti ca bn" t c nh im, by gi bn hy bt u "quan h". Chc chn nh im s cao ln gp bi, cng cao hn v ko di hn nu bn chu kh kin nhn hn. 233. Thiu ham mun tnh dc "Em l mt c gi 22 tui, nng 44 kg, th trng gy, kinh nguyt tht thng, v iu quan trng l t khi ln ln n gi em cha h c ham mun tnh dc, k c khi ngi khc gii kch thch cc im c coi l nhy cm. Em rt bun v lo lng v chng em sp ci vo thng ti; nghe ni ngi con gi khng bnh thng v sinh l s t kh nng c con v sng vi chng khng hnh phc. Xin mt li khuyn". V tnh trng thiu ham mun tnh dc, c th l v em sng trong mt hon cnh b c ch, sau em mang mc cm ri th vi iu . Hy vng rng vi cuc hn nhn v tnh yu ny, em s c c n mt cch trn vn. Tuy nhin, nu chng may xy dng gia nh ri m khng c "tin b" g, th nhiu kh nng em c To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

vn v hot ng ni tit (m biu hin l kinh nguyt tht thng). Trong trng hp ny, em phi i khm mt bc s ph sn giu kinh nghim c hng dn cha tr tt: gip chu k kinh nguyt u n, tng ham mun tnh dc, th thai v sinh . Trong bt c hon cnh no, em cng phi gi mt nim tin vng vng rng tnh yu la i lun cho ta hnh phc. Hy tch cc cng chng tham gia "cuc chi", ch th trc mun nng chy ca chng d ch mt ln, ri dn d em s c ht. V ng cho bn thn ri vo mt tnh trng bnh l l lnh cm, ngha l khng thit g n tnh dc, mt iu rt nguy hi, nguy hi nhiu mt cho ngi ph n c chng. 234. Lnh cm "Ti c chng c ba nm nay nhng mc chng lnh cm, mc du rt yu chng. Ti ngi khng i khm. Xin cho bit cch cha tr". B ni cha c th v trng hp ca mnh nn chng ti khng r c mc lnh cm. Ch xin a ra mt s gi b i chiu v ty m t mnh khc phc dn: 1. Trc khi giao hp, b cho ng nh kch thch y cha? Trn c th ca b, c nhng im no p ng (ngha l khi c vut ve vo b thy c khoi cm)? Hy chn ly mt vi im p ng mnh nht. Ngoi ra, b nh gi xem ng nh dng tay hay dng mi, dng li kch thch th c tc dng mnh hn? "Bn tng kt" ny cn ht sc c th, v vy b ng mc c, tri li phi th l cho ng nh bit thc hin t kt qu cao nht, kt hp vi nhng li ni nh vo tai b. 2. Khi c kch thch y , s c nhiu dch tit t m ca mnh; lc ny c th b c i hi r rt, v ng l thi c ca c v ln chng. 3. V ngoi cnh, ng b cn c hon ton t do, ring bit, khng k ban ngy hay ban m, khng nn tt n m gi mt nh n m hoc sng hn, nhm nhn thy mi hot ng ca nhau tng hng phn. 235. Ngi lnh cm c th hy vng "Ti c mt ngi bn xy dng gia nh nhng khng c hnh phc, v trong khi ngi chng sung mn th ch y li lnh cm. Xin cho bit nguyn nhn ca bnh ny. c cch g cha tr hu hiu cha?". 1. C bn nguyn nhn chnh gy ra chng lnh cm (n khng c ham mun tnh dc): a) Hon cnh sng trc : B cm on tip xc vi bn trai t khi cn nh tui, ln ln khng bit tnh yu l g, do th trc nhng biu hin tnh cm ca ngi khc gii, thm ch th vi mi ngi ni chung. b) Tng b stress trong chuyn yu ng: Gia nh khng chp nhn ngi mnh yu, hoc b ngi yu phn bi... To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


c) B ri lon hoc mn.

L Trng Bng

d) Do thi xu th dm: Quen a ngn tay hoc vt l vo m o hoc kch thch m vt (pha trc l tiu, tng ng vi dng vt nam gii). n khi ly chng th khng cn nhy cm trc nhng vut ve mn trn, khng c hng phn tnh dc, khin m o khng tit dch, vic giao hp kh khn v gy au.(iu ny cng lm cho chng lnh cm trm trng thm). 2. Cha tr bng tm l l ch yu, vic ny rt kh khn, i hi s kin tr ca bnh nhn, s cm thng v gip ca chng. Vic phng nga d dng hn nhiu: Qua gio dc gii tnh nh trng, cho lp tr thy r tc hi ca thi xu lm dng th dm (nam th dm qu nhiu s d b chng xut tinh sm hoc lit dng). 3. May mn thay, mi y mt hng dc phm lin kt gia M v Nht Bn hiu chnh thnh cng mt loi thuc ung cha lnh cm (tng ng nh vin Viagra ni ting cha lit dng, nhng tc dng nhanh hn, ch sau 10 pht; trong khi Viagra bt ng s ch c ting ng h). Thuc c th nghim thnh cng trn th ci, nay ang dng th cho 50 ch em lnh cm. Hin thuc ny cha c t tn chnh thc, mt thi gian na chc chn s c mt trn th trng. Ngi bn ca b c th hy vng. 236. Kh nng iu chnh tuyt vi "Ti c mt ni kh tm m khng bit th l cng ai. Khng bit kch thc dng vt nh hng nh th no n khoi cm ca ngi n m v ti c ku l ca ti to qu, mi ln quan h ch au m khng thy khoi cm? Cch khc phc ra sao?". Hai bn cha bit y thi, tri ph cho ph n mt kh nng iu chnh tuyt vi: khi c kch thch y , m o s di ra, lng m o cng rng thm rt nhiu. Hn na, lc by gi m o tit ra nhiu cht nhn, lm thnh mt cht bi trn rt tt. Trc trc ca bn c th khc phc nh sau: t nay, hai bn ch vi vng nh trc. u tin, phng the phi tht kn o c hon ton t do. Phi chun b tht tt bng bt c ng tc g m hai bn thy thch hp, khng cu n. n khi thy ca ngi n t m hng tin hnh. By gi, c khi chnh ngi n li ch ng, v d nhin s c cc khoi v khng au n. Nu cha tht an tm th ngi nam bi thm cht Vaseline pure, cng thun li hn. 237. C nn xut tinh ra ngoi? "Chng chu xy dng gia nh mt nm nay. Do cha mun sinh chu nn mi ln quan h, chng chu u xut tinh ra ngoi. Xin cho bit vic ny c hi g khng? C phi v vy m gn y chu thy gim hng th?". V chng chu hy lm quen vi thut ng khoa hc: hin tng cc khoi khi giao hp. l lc con ngi t c tt nh ca khoi cm. Lc by gi, nam c s phng tinh dch km theo nhng co tht lin tc ca dng vt; cc ng tc ny u c ngi n cm nhn. n, lc cc To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

khoi, m o co tht lin tc, v cc ng tc ny cng c ngi nam cm nhn. Nu bit chun b cho nhau mt cch khoa hc th hin tng cc khoi xy ra cng lc c v ln chng. Nu thiu khoa hc, ch ngi nam t cc khoi, cn ngi n th khng t v b ri vo mt tnh trng rt cng thng, c hi cho sc khe, dn d c th dn n chng lnh cm, rt kh cha. Hiu c iu , cc chu thy ngay rng, nu hon cnh khch quan khng thun li ( chung phng vi gia nh, ca khng kha), hoc bn thn lo lng hay bc mnh th khng th t n cc khoi tnh dc. Xt trng hp ca hai chu m xem: Chng th lo ngay ngy, ch s "li ra khng kp"; v th lo chng "chm chn", cn tinh thn u m cng nhau i ln nh im! l cha k i bn khng cn cm nhn cc ng tc su kn ni trn. trnh thai, t ngy th 10 n ngy th 16 ca vng kinh (ngy bt u c kinh c tnh l ngy th 1), hai chu nn s dng bao cao su, hin c lm rt mng, mn, bi trn tt nn khng gy gim khoi cm. Cn trong cc ngy khc, xin c t do, c iu phi ghi chp chnh xc ngy gi vo s tay kinh nguyt, tht yn tm. Trong thi gian cha mun c con, nu chng may b v k hoch, hy n ngay c s ph sn, vic ht thai s rt nh nhng, khng c g phi lo ngi. 238. Ch c p t "Chu 28 tui, ly chng c 6 nm. Chng chu rt ng n nhng i hi qu nhiu, c cch 2 ngy li phi 1 ln n i! Ch 1 thng sau khi sinh con u lng (nm chu 24 tui), chng chu lm chuyn y, mc d theo cc c th phi 4 thng sau mi c tin hnh. T khi sinh, chu tr nn m yu, mc d vn n ung y . Xin cho bit c phi chu b "hu sn mn" khng, v vn sinh l ca chng chu c cch g cha khng?". 1. T "hu sn mn" khng cn tn ti trong ngn ng y hc chnh xc. l mt cch ni dn gian khi thy sn ph sinh xong c qut quo, m au hoi. Ngy nay, trc tnh hnh nh vy, cc bc s s tm ra nguyn nhn cha tr mt cch hu hiu. Chu khng ni c th v sc khe nn rt kh on, nhng chu cn lm r my vn sau y: Phi c vn g khng? Ng c 8 gi mi ngy khng? Thc n c cung cp vitamin v cc cht khong ti cn khng? Tm t c g mc mu khng? Trong khi ch i kt qu c th, chu nn tng cng n hoa qu ti, rau cc loi, c chua nu chn hoc st, gi , mm cy... Nu cn th tng cng thm mt ba n na trong ngy. Mi ngy ung 1-2 vin thuc b Theravit (cha y vitamin v khong cht). 2. V tnh dc, chu hy t xem mnh c khoi cm hay th trc ng tc ca chng (vut ve, quan h); do bn thn chu khng c hay do chng chu v qu vi vng khng kch thch chu mt cch y ? V chng phi bn bc vi nhau tm ra gii php tha ng. Chng chu phi To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

th th, kin nhn hn mi ng thao tc khoa hc. Trong quan h v chng, ngi ta khng n h bt c vic g, min l n to khoi cm ti a, to hnh phc cho nhau. Cc chu ng e ngi, y l chuyn chnh ng v h trng bc nht trong cuc sng la i! Khng chp m u, nhng ngn t ca chu t ra c thi coi nh, th , thm ch coi khinh vic sinh hot v chng, chc l do nh hng ca mt li nhn c k thiu khoa hc, hoc ca thi o c gi. Ngy nay, khoa hc chng minh rng: Sinh hot v chng u n lm cho con ngi khe ra, yu i v t tin hn, d thnh t hn v cng sng lu hn. Mc quan h cn thit m mt s nh nghin cu nu ra l mi tun 2-3 ln. Nh vy, "ch tiu" m chu ra trc y l qu thp v cc chu cn tr, v trong ngn y nm tri chu p t n cho mt ngi chng sung sc v rt yu v (nu khng th chng c th phi i "ci thin" thm ri). V ci thi hn "phi 4 thng sau khi sinh mi c quan h v chng" sai bit chng no, thm ch cn nguy hi (mt s nghin cu trn th gii cho thy rng ngay sau khi v sinh, hin tng ngoi tnh gia tng ni ngi chng). Vo ngy th bao nhiu ? Bt c vo ngy no m c hai ngi cng thch; nhng phi c bin php trnh th thai ngoi mun, nht l khi sn ph cha hnh kinh li. Hy nh rng, nhng trc trc trong tnh dc gy nn hin tng stress (cng p thn kinh), thuc loi kh cha tr nht. Cui cng, chu khng phi cha chy g cho ng x c, v iu m chu coi l tt y li l tiu chun s mt ca ngi n ng. V chng, nu cc chu c bin php tt, chu cng s khe ra, v bit u s c ngy chu t ho v mt ngi chng nh vy. 239. au u sau khi quan h "Ti l nam gii, 42 tui, xy dng gia nh 17 nm, v chng vn quan h bnh thng. Nhng t 2 thng nay, c mi ln quan h xong l ti au u but c, u nh mun v tung ra. Xin cho ti mt li khuyn". Trc tin, bn cn c kim tra cn thn v huyt p, e rng huyt p ca bc hi cao. Khi quan h v chng, c th b kch thch mnh, mch mu rt nhanh, lng mu ti cho no tng ln; vi ngi bnh thng th khng sao, nhng ngi huyt p cao c th thy nhc u, t nhiu ty trng hp. Nu ng l b cao huyt p, bn cn c theo di huyt p nh k (tt nht l sm mt huyt p k v hc cch o, d thi), v dng thuc theo n bc s. Hng ngy, nn n thm nhiu canh l du tm non (c tc dng cha huyt p cao) v ung nc hoa he (lm bn vng thnh mch cho ngi cao huyt p). Nhng hm huyt p khng bnh thng th tm "cch ly". tht an ton, nn hon v t th trn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

di gia v chng trong khi quan h; mi u thy c v k cc nhng t th ny gp phn ngn nga tai bin "thng m phong" n ng cao huyt p. Nu huyt p hon ton bnh thng, bn nn i khm nu cn s kim tra xem no c vn g khng. 240. Do nguyn nhn g vy? "Chng em ly nhau mi c 3 thng nay (em 37 tui, nh em 29) nhng gp trc trc ln: Khng bit do chng bnh g m h c quan h v chng xong l c y rt run cm cp nh ln cn st vy, trng rt thng". Hai em hy ch thc hin my iu sau y: - Nhng hm " vo chng trnh" th ba ti phi n cht nhng khng nng bng. - Gi cho phng ng khng b gi la. - C sn mt tm chn mng, mt tch nc nng pha cht ng v vi ba nht gng, ngay sau khi quan h xong, em cho v ung nc, nh gng v trm chn. Th thi, khng phi lm g hn. Nguyn nhn cng d hiu: Bnh thng, trong khi quan h v chng, c th tng cng hot ng rt mnh, c hin tng tng ti mu cc ph tng v da do gin mch; sau khi kt thc s c tng tit m hi, v d nhin qu trnh va ri cng tiu hao nhiu nng lng. Mt s ngi, k c ng my ru, do cha quen vi chuyn ny, thy n lnh v run ry. Khng phi bnh tt g u, hai em ng lo. Nhn y, cng nn bit rng, ngay sau khi quan h v chng, lng mu tng cng cho c bp, tim, phi, no... vn cha thi gian tr li bnh thng, mch vn cn nhanh, hi th vn gp, thm ch tay chn cn run. Nu t ngt ng dy hoc vi vng i ra ch gi la th s rt nguy him. 241. ch g chuyn hnh ti nhau "Chng ti lp gia nh c 4 nm, c mt chu trai 3 tui. Trong thi gian mang thai chu, ti c quan h vi ngi yu c nn cho n nay, nh ti vn nghi ng l chu khng phi con anh y, nhng ha khng b ri n. Nghe ni khoa hc c th th mu m bit c iu ny, xin cho bit tin hnh u? Hin gia nh ti rt cng thng". Ti cc nc pht trin, vic ny khng kh, ch cn chi tr mt s tin dch v kha kh lm xt nghim di truyn hc. Kt qu chnh xc tuyt i; thm ch vi c nhng ngi khut vn c th xc lp c quan h huyt thng. nc ta, c quan ph trch hnh s lm c cc xt nghim di truyn hc trong vic iu tra ti phm (qua cc vt mu, lng, tc, mng tay, tinh dch lu li hin trng). Cc xt nghim ny rt tn km, nhng khi cn thit vn phi tin hnh. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Trng hp ca gia nh cc bn tht o le. Nhng ch g ci chuyn hnh ti nhau khi c hai u yu thng v ha khng b ri n. B ri sao c khi cn c lut php, c ta n lng tm. Hoc cc bn tip tc b stress (cng p thn kinh) n mc tr thnh ngi bnh hon, ko theo xung vc thm mt a tr v ti. Hoc cc bn n tn ngi li vi nhau, ai ny nhn ly phn thiu st ca mnh trong qu kh xa cng nh trong qu kh gn, cng nhn v tng lai ca gia nh v nht l ca con ci (nu qu tht cc bn cn thng cm vi nhau, thng nhau, yu nhau). Hoc cc bn nn sm chia tay nu trong lng khng cn li cht g l tnh ngha. t ra trong trng hp ny, con trai ca cc bn vn au kh hn khi ngi ta c tnh truy tm tng tch ca chu. 242. Ging hay khng ging "Chu va mi ly chng. Trc y, chu yu v c quan h vi mt ngi. By gi chu lo khng bit a con s sinh ra c ging ngi khng?". Chu ni khng r, nn phi t ra hai tnh hung chu t lin h: 1. Nu do y, chu v "ngi " quan h vo thi im d th thai (ngy th 12 n ngy th 14 ca vng kinh; ngy bt u thy kinh c coi l ngy th 1), hoc sau chu thm thy kinh, thm ch xt nghim nc tiu xc nh c thai, th "con cha chu ng, khng ging lng cng ging cnh", sm hay mun mt s c im v ngoi hnh ca "ngi " thng s r thm nhiu hay t. 2. Nu thi im kia nm vo khong an ton, th a con sp ti ca chu s khng mang mt c im no ca "ngi " c, cho d chu vn nui tic v ngy m tng nh anh ta! 243. Nn lm xt nghim gene "Chng ti c mt chu gi ln by, v ti ang mang thai 3 thng. iu ti day dt lu nay l chng ti nghi ng v chu khng ging b, cng khng ging m. Khoa hc c cch g minh oan cho ti, k c v ci thai ang trong bng?". 1. C nhiu trng hp con rut m khng ging b m cht no, v ging mt ng c c hay b c c bn ni hoc bn ngoi. Thm ch c chu mang mt mu ui, ngha l ging ... t tin ca loi ngi! 2. Trng hp ca bn rt nghim trng v nh hng n tng lai cc chu. Do vy, bn nn ni thng vi chng xin lm xt nghim i chiu gene ca hai b con. Xt nghim ny c quan hnh s ca ta thc hin tt, nhng chi ph cn cao. Tuy nhin, v hnh phc ca nhiu ngi, trong c hai a tr v ti, gia nh bn nn ngh tin hnh v trang tri chi ph. 244. Tui cao cha c con "Hai v chng ti tui kh cao, xy dng vi nhau hai nm nay m cha c con. Ti i khm, c bit mi chuyn u bnh thng, k c siu m, ch c khi bt u giao hp thy hi but. Chng ti th rt sung mn. Chng ti c th c con c khng?". Nu s lng v cht lng tinh trng ca ng nh bnh thng v kinh nguyt ca b u n, th To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

c th th thai t ngy th 12 n ngy th 14 ca vng kinh (ngy bt u hnh kinh c tnh l ngy th 1). Tuy nhin, m bo thnh cng th: - Trc vi tun, hoc hn ty theo tnh hnh, hai ngi nn "tm cch ly", ngh ngi v bi dng tt, m bo mt tinh trng tht cao (ch mt con lt c vo non, nhng li cn n sc cng ph ca nhiu con khc). - T ngy th 12 n ngy th 14, ng b phi "tin hnh" lin tc, c 8-12 gi mt ln, nhm duy tr s c mt ca c m tinh trng sung sc trong m o, sc cng nhau bi ngc ln tip cn vi non. Sau khi phng tinh, ngi nam "rt lui" ngay, cn ngi n vn gi t th nm nga v bt tro hai chn, nh ngi nam k gip mt chic gi mng gi ti a lng tinh dch trong t cung m o, thi gian khong 20-30 pht. Trong nhng ngy ny s rt mt, nht l ng nh, cn ng b v dinh dng tt, nhng ng b hy v hu du m gng sc nh! - Cn cm gic but lc mi u ca b c th do dch tit hi t lm cho m o km c bi trn. khc phc, b hy bo ng ch vi, tri li phi kin nhn tip tc kch thch cho n khi dch ra t m hy "tin hnh". 245. Khi no th ly b vng trnh thai "Ti 40 tui, c y t huyn t vng trnh thai cch y 9 nm, sc khe bnh thng. Xin cho bit n bao gi phi ly ra?". Ngi ta ly b vng trnh thai (VTT) trong cc trng hp: - VTT gy ri lon kinh nguyt, nh hng n sc khe. - V chng thng nht kin tho VTT khi sp phi xa nhau lu ngy ( trnh nghi k trong thi gian ). - Thay th VTT bng thuc nga thai (v vic t mt vt l vo d con, xt cho cng, l chuyn khng hay ho g, chng qua do qu cn thit). - Khi mun c con (sau 3-6 thng l c th th thai). - Khi mn kinh (chm dt giai on sinh sn). Trng hp ca bn chc vn "chung sng ha bnh" lu lu c vi VTT. 246. Ht thai c nh hng g khng? "Chu cha xy dng gia nh nhng ht thai hai ln v hon cnh ring (ht ch khng no). Mt thi gian na chng chu ci nhau, liu c th c con nh mi ngi khng?". Ht thai l mt th thut hu hiu, an ton v khng li hu qa g cho nim mc t cung. Xem ra v chng chu s phi cht ch lm mi khng b "v k hoch" y! Xin ni thm: Trng hp mun, khng cn ht thai c, th no thai cng khng nh hng g n To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

chuyn sinh con, min l no ti mt c s ph sn, no ng ch nh, ng k thut v khng no qa nhiu ln. 247. Liu con c b li ra nh m "Lc sinh, chu c ly ra bng phoc xp, hu qa l ln ln chu b vo ct sng, chn tri ngn 2 cm, nhn k mi thy; may l sc khe tt. Chu mun bit, nhng a con chu sinh ra sau ny c phi chu bt hnh nh chu khng, v nhng ngi nh chu c nn sinh con khng?". Chu v cc bn trc y khng may gp cnh "b li ra cho i" khng phi lo lng cho tng lai con ci, v nhng l do sau: 1. y khng phi chuyn di truyn, cho nn khng phi h ngi m ngy trc b li ra bng phoc xp (ci cp thai) th con ci h nht thit cng s cho i theo cch . 2. Nhn vin y t ngy nay n ci li ko thai ny, tuy rng trc nhng nm 1960 h phi hc v thc tp n kh k cng. Bi v, bn cnh nhng nguy him cho ngi m, k thut ny gy nhng tn thng cho b no ca tr s sinh, ch t l cho cc dy thn kinh mt. Ngoi ra, trong trng hp kh, u ca thai nhi d tn thng khi b thc p phi chui qua mt ci ng khng thch hp vi n nn n d ui sc. 3. Nh s tr gip ca cc phng tin hin i, cc bc s ph sn hin lng c nhng bt thng ca thai ph t rt sm trc ngy mn nguyn khai hoa, c th m ly thai ng lc v an ton cho c m ln con, vi iu kin l thai ph phi sm n vi h v tun th nghim ngt mi iu h dn. Nh vy, bc s s khng phi b ng i ph vi tnh hung bt ng bng cch dng "phoc xp" nh trng hp ca chu. 248. Nn sinh hai con cch nhau bao lu "Chng em c mt chu gi hn 1 tui. Em mun sinh thm mt chu na, sau s ri ri hn v c iu kin phn u tt hn. Nhng nh em li mun ch chng 5-6 nm na cho con ch ln c th trng em. Xin cho bit sinh hai con nn cch nhau bao lu th tt?". Tht kh tr li cu hi ca em mt cch dt khat, v mi bn u c l l ring, khng d bc b. Bn mun sinh con th hai sm cn nu thm l do kinh t na: t lt, qun o, xe c ca anh ch c th dng lun cho em, khng phi em biu cc b m mi cho h gp hn (may mn); lu ngy mi mang bu th s rt ngi; l cha k mt s b m sinh con th hai qa mun gp kh khn khi sinh... Bn mun sinh con th hai mun thng nu ln chuyn "phn u", nu li lin ngay th coi nh vng mt ni lm vic qa lu; nh khi con m s kh trng nom ng thi c hai... Ch xin cung cp cho hai em s liu thng k y hc v vn ny ca mt trung tm nghin cu M, ty tnh hnh c th m vn dng. Qua 173.000 trng hp sinh t 1989 n 1996, cc nh khoa hc thy rng: To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

- Nu sau khi sinh di 18 thng m ngi m mang bu (chnh xc l bt u hnh thnh bo thai), t l tr sinh ra thiu thng, thiu cn cao hn 40% so vi trng hp mang bu sau t 18 n 23 thng. - nhng ngi m i cho n khi a con c trn 23 thng mi mang bu li, kh nng sinh tr thiu thng, thiu cn cng chim t l cao. - Khong cch gia hai ln sinh n l 2 nm c coi nh ti u i vi sc khe ca c m ln con. 249. Thi im th thai v gii tnh con ci "Nghe ni v chng quan h ngay sau khi va rng trng th chc chn mang bu v thng sinh con trai, c ng khng?". Theo nhng cng trnh nghin cu ri rc mt s nc v mt cng trnh nghin cu tin hnh trn 221 ph n Bc Carolina, ngi ta thy rng: - Khong cch gia ngy gi rng trng v ngy gi sinh hot v chng khng h nh hng n gii tnh con ci. Trc y c gi thit cho rng, v tinh trng XY "yu mnh" hn, cho nn khi trng rng, v chng quan h cng sm th cng nhiu kh nng c con trai. Gi thit ny cho n nay vn cha c khng nh. - Hin tng lo ha ca tinh trng dng nh t gy nh hng xu n s pht trin ca thai. Tri li, hin tng lo ha ca non c th tinh mun mng s c th gy hi. Nh vy, sinh con mun khng tt bng sinh con trong tui t 20 n 30; trong thi gian ny, kh nng th thai ca n mc cao nht. - Tuy vic quan h v chng lin tc trong giai on sung sc c nht thi lm cho s lng v hot ng ca tinh trng gim xung, nhng iu khng nh hng g n kh nng th thai. 250. Mi ci t vng trnh thai "Chu 27 tui, lp gia nh ba nm nay. Nm u tin, chng chu k hoch ha bng cch i t vng cho b x; sau khi ly vng ra th gn mt nm th c thai, nhng 3 thng thai hng phi ht; ti nay mt nm ri vn cha c thai li. Chng chu phi lm g by gi?". Chng lm g c. Ch thi! Ch s phc hi ton din ca t cung sau khi t vng trnh thai. Trng hp ca hai chu, sau khi ci m cha mun sinh con, ng l ch dng bin php trnh thai n gin (khng quan h vo nhng thi im "nguy him"; hoc, an ton v tin li nht l dng bao cao su), khng nn t vng trnh thai, bi v bin php ny c nhng mt tri ca n, trong c th gy sy thai v sau. Ngi ta ch t vng trnh thai sau khi sinh mt i ln, trong iu kin tht bt buc, khng th no s dng cc bin php n gin c. 251. C con trai vo ngy kinh no? "C phi k t khi sch kinh n ngy th 13, nu sinh hot v chng s c con trai? Ti sao?". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Xin nhc li em r: Ngy u tin thy thng l ngy th 1 ca vng kinh, vo ngy th 14 s c hin tng rng trng; nu gp tinh trng " tiu chun" th non s th tinh. Giai on 14 ngy ny l c nh, v vy, bao gi cng tnh t ngy bt u hnh kinh. Cn ngy sch kinh khng th dng lm chun, v di ngn thay i ty ngi. Do , ngy mc m em nu ra khng chnh xc. Hin gi khoa hc cha bit cch c c con gi hay con trai. Non b mt m tinh trng bao quanh cng ph v non, nhng ch mt v lt vo; v ny va vo xong l "ca bn khp kn". S l thng cu hay ci hm, tht v cng kh on. 252. Lch tnh kh nng sinh gi hay trai Theo truyn thuyt chu, cch y hng my nghn nm, do c s ghi chp u n tui ca cc cung phi, cung n, m nhn c vua cha vi ti cng vi ngy thng "c ban n sng" (nhm m bo ng huyt thng), ngi xa thu c nhng thng k ln v thy c mi lin quan gia tui ca ngi n (tnh theo con gip ca m lch) v thng th thai (m lch) vi gii tnh ca a con sinh ra, v ghi thnh mt lch tnh c th. Tuy nhin, cho n nay, vn cha c cng trnh nghin cu no chng minh lch tnh ni trn l ng hay sai. Ngy nay, nu lp lun theo thi sinh hc (chrono-bilol-gy), chng ta c th suy ra rng: Do Mt Trng nh hng nhiu mt n hot ng ca con ngi nn non ca ngi c tui m lch no , vo mt thng m lch no , s d chp nhn tinh trng XX hay tinh trng XY, quyt nh con gi hay con trai. Vi nhng suy ngh trn, v th theo yu cu ca mt s bn c, chng ti xin trn trng gii thiu lch tnh (do chng ti thu thp c nm 1972 t nhiu ngun, em so snh cc bn ghi chp thy ging ht, v qua ng dng cho mt s ngi thn thy c kt qu) mi ngi c th tham kho, i chiu. Trong bng, con gi nh du "-", con trai nh du "+". Thng tui 1 2 3 4 5 6 7 8 9 10 11 12 17 - + - + + + + + + + + + 18 - + - + + + + + + + + + 19 + - + - - + - - - - + 20 - + - + + + + + + - + + 21 + - - - - - - - - - - 22 - + + - + - - + - - - 23 + + - + + - + - + + + 24 + - - + - + + - - - - 25 - + + - + - + + + + + 26 + - + - - + - + - - - To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


27 - + - + - - + + + - + + 28 + - + - - - + + + + - 29 - + - + + + + + + - - 30 + - + - - - - - - + - + 31 + - + - - - - - - - + + 32 + - + - - - - - - - + + 33 - + - + + - - + - - - + 34 + - + - - - - - - - + + 35 + + - + - - - + - - - + 36 - + + - + - - - - + 37 + - + + - + - + - + - + 38 - + - + + - + - + - + 39 + - + - + - - + - + - 40 - + - + - + + - + - + 41 + - + - + - + + - + - + 42 - + - + - + - + + - + + 43 + - + - + - + - + + + + 44 + - + + + + - + - + - 45 ? + + - + - + - + - + +

L Trng Bng

Khi chn ngy thng th thai, phi chn thng no m trc v sau u cng du "gi" hay "trai"; ngha l phi tm nhng cm c t nht ba thng lin cng du, th thai vo thng gia cm. Nh rng ngy thng th thai cng nh tui ca ngi n u tnh theo m lch; ring v tui, khi cn th tm trong Lch th k c chnh xc (tui m lch thng hn tui dng lch 1 nm). T lch ni trn, c th rt ra hai nhm kh nng: 1. Kh nng chc c con gi 19t: Thng 8,9. 21t: Thng 3,4,5,6,7,8,9,10,11,12. 22t: Thng 10,11. 24t: Thng 9,10,11,12. 26t: Thng 10, 11, 12. 28t: Thng 5. 29t: Thng 11. 30t: Thng 5, 6, 7, 8. 31t: Thng 5, 6, 7, 8, 9. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


32t: Thng 5, 6, 7, 8, 9. 33t: Thng 10. 34t: Thng 5, 6, 7, 8, 9. 35t: Thng 6, 10. 36t: Thng 7. 39t: Thng 12. 2. Kh nng chc c con trai 17t: Thng 5, 6, 7, 8, 9, 10, 11. 18t: Thng 5, 6, 7, 8, 9, 10, 11, 12. 20t: Thng 5, 6, 7, 8, 12. 23t: Thng 10. 25t: Thng 8, 9, 10. 27t: Thng 8, 12. 28t: Thng 8, 9. 29t: Thng 5, 6, 7, 8. 31t: Thng 12. 34t: Thng 12. 35t: Thng 1. 42t: Thng 12. 43t: Thng 10, 11, 12. 44t: Thng 4,5.

L Trng Bng

Theo chng ti, nhng tui v nhng thng khng nm trong tm tt u khng ng tin cy. Tuy nhin, nu bt buc th thai trong nm th phi da vo nhng ghi chp kinh nguyt ca mnh m chn thi im th thai ng gia thng trnh sai lch. 253. Cn xem cho ng tui m lch "Va qua, hai tp ch Kin Thc Gia nh v Ti Hoa Tr c ng lch tnh sinh con gi hay con trai. Chng ti c mt chu gi, nay mun p dng c np c t, nhng cn bn khon khng bit khi tnh tui m c tnh tui m khng?". Lch tnh kh nng sinh con gi con trai hon ton theo m lch (tui m, thng th thai). Tui m lch bao gi cng hn tui dng lch 1 nm. Tuy nhin, nu ngi m trc y sinh vo cui nm hoc u nm s d b nhp nhng khi tnh tui; do vy, trong trng hp khng chc chn, hai bn phi xem trong Lch th k xut bn lu nay trong nc, xem tui g nm trong 12 gip (Ng, Mi, v.v.). 254. Ti sao phi c nhiu tinh trng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

"Chu nghe ni c ch cn trinh i tm sng vn mang bu v ngay pha trn c my chng trai ang tm, tinh trng tri xung m chui v. Hoc con gi dy th m vng lt c dnh "ci y" ca ngi ln vo lt ca mnh, cng c th b mang bu. Chu ngh nh vy ch cn 1 tinh trng lt vo non l th thai, nhng ti sao khi xt nghim tinh dch, thy c triu tinh trng m bc s vn ph l khng t tiu chun?". Nhng chuyn chu nghe ch l chuyn to lao hoc chuyn tiu lm thi; cng c th l cung cch bin bch ca nhng ai trt b l s khanh la di ri b mc. C my ni dung khoa hc chu cn nm vng khi nhm: 1. Sau cuc chy ua t m o ln ng dn trng, s tinh trng ti c ch khng nhiu. Khi c m tinh trng (khong 40 con) gp non t bung trng rng xung, chng lin bu ly non v tm cch chui vo bng cch tit ra mt cht c bit "lm mm" v non; phi ngn y tinh trng tc ng cng mt lc th mi t hiu qu. Nh vy l "cng lao do tp th, nhng ch mt c nhn hng", bi v cui cng ch mt tinh trng lt c vo non m thi; h n vo xong l v ca non lin bin ngay thnh "b tng ct thp", khng cho ai vo quy ry na (by gi non th tinh, c gi l trng). Nh vy, mun th thai c th trc ht tinh dch phi c mt tinh trng cao. Ngi ta thy 1 ml tinh dch cn c khong 100 triu tinh trng (mi ln phng 2 ml, gm 200 triu con), th mi c kh nng th thai, tt nhin c x dch cht t v cng ng tinh trng cng tt. 2. Nhng s lng khng thi vn cha n. Bi v non rng xong ch sng c khong 6-8 gi, do cuc giao duyn cng ch xy ra trong ngn y thi gian, cho nn cuc k ng ny phi tht ng lc. Vy m non rng ngy no, c th d on mt cch tng i (thng thng vo ngy th 12 n 14 ca vng kinh), nhng tht kh bit gi G ca hin tng rng trng "n sng"! Th l vn "tui th" ca tinh trng c t ra: Ngi ta thy rng nu mun th thai, t l tinh trng hot ng phi trn 50% (t l cng cao, hot ng cng lu cng tt, chng hn tht tuyt vi nu trong gi u l 80%, sau 3 gi: 60%, v sau 18 gi vn cn 25% tinh trng hot ng). Tinh trng phi dai sc cng nhau nm ch cuc tn cng t ni trn nu lc y non cha rng. 3. Hai tiu chun va nu vn cha . Phi m bo l s tinh trng "qut quo" khng qu ng (u qu nh hay qu to, thm ch hai u, khng ui hoc ui ngn). Ngi ta thy rng t l tinh trng bt thng nh vy khng c qu 10%, tt nhin cng t cng tt. Chu nn nh rng cc kt qu xt nghim tinh dch ch chnh xc khi: - Tm ngng giao hp 5-7 ngy trc khi th, khi b xt oan l "long, khng t tiu chun". - Ly mu th ngay ti c s xt nghim, trnh lm hng n khi di chuyn. 255. Thai ht khng ht "Em c quen vi mt bn trai v b la, c thai 2 thng. Mt c y t quen a cho em 4 vin thuc To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

hon tn mu en, ung vi nc ch ti; ung xong th ngi bn rn, mt i tiu, sau lin tip ra ba ln ba cc mu nh nh bng u ngn tay. Nhng sau vn khng c kinh nguyt. Ln ny c y tc ni rng em li c thai 2 thng (mc d em khng h quan h tnh dc mt ln no na!). Em n bnh vin ht, 49 ngy sau vn cha c kinh nguyt. Chng l ch ng chuyn tr m cng c thai sao?". Nu ng l sau ci ln di dt , em khng quan h thm na th nhiu kh nng ci thai vn tr li c sau khi b bn vin thuc lang vn tn cng (may m em khng vic g!). Cn ln ht ti bnh vin, khng r h c ht c thai ra khng? Ch s h khng ly c, bi v lc thai trn 3 thng, m th thut ht ch kt qu chc chn trong 2-3 tun u ca thai k. C tnh hnh ny, s rng "hn" vn cn y cng nn (bi v bnh thng ngy no thai c coi nh ngy 1 ca chu k mi, v sau 28 ngy s c kinh, nu em c vng kinh 28 ngy). Cho nn, nu vn cha hnh kinh tr li, em phi t theo di vng bng ca mnh, tt nht l i khm ti mt c s ph sn. Nu vn cn thai, ngi ta ch n thng th by s s dng phng php cho non, nh nhng thi v rt gn, chi ph khng ng k, c s tin hnh s khng hi tn tht ca em v gi b mt chuyn , ng lo! Cui cng, em cng nn nm vng l: Tr quan h tnh dc v th tinh nhn to, khng vic g c th lm cho ph n mang bu; em c thoi mi chuyn tr vi bt c ai! 256. Ti sao vn c thai "Ngi yu ca chu c chu k kinh nguyt 25 ngy; ti sao quan h vi nhau vo ngy th 33 vn c thai? Vy l quan h khi sch kinh (tc u k kinh mi) vn th thai?". Trc ht, phi ni rng phn sau ca cu hi ny khng ng: Khng bao gi ly ngy sch lm ngy th 1 ca k kinh c! Xin nhc li: Ngy th 1 tnh t hm bt u hnh kinh, ngy th 14 rng trng; v sut t ngy th 10 cho n ngy th 16 l khong thi gian c kh nng th thai cao nht, m theo cch ni "k hoch ha" gi l "khng an ton", "nguy him"... V khng bit chnh xc thi im th thai c th cho nn sut trong c tun l ny, ng s nh phi "nhn", hoc s dng bao cao su trnh v k hoch. Tr li phn u cu hi ca chu. Vng kinh ca bn chu l 25 ngy, ngy rng trng vn l ngy th 14 (v l thuyt, khong thi gian ny xp x nhau trong cc loi vng kinh); ngy th 25 hnh kinh v d nhin l ngy th 1 ca vng kinh mi. Cc chu gp nhau ngy th 33, nu tnh ton chi li l vo ngy th 9 ca vng kinh mi, cn nu tnh i khi th vo ngy th 10, thm ch ngy th 11, st ngy rng trng; trng vo khong "nguy him" ni trn. l cha k n mt tnh hung c bit c th xy ra: Non cha n ng thi im rng theo l thuyt, nhng do lc by gi ch nhn hng phn cao, bung trng xung huyt mnh lm cho non rng sm hn thng l (hin tng ny xy ra mt s ng vt: ng vo lc giao phi th non To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

mi rng th thai ngay, ch khng phi rng trc ri ch i nh ngi). 257. V sinh cha mi khng c "Xin cho bit, trng hp v sinh cha mi khng c th lm th no c con?". Ngoi hin tng i nam i n, ta ln lt xem xt v sinh hai gii nam v n. nam gii 1. Khng c tinh trng (tinh hon b teo do bin chng ca bnh quai b hay hu qu ca bnh lu), hin tng hy tinh trng (lnh tinh): Khng th c con. 2. Tinh trng tiu chun, nhng giao hp khng ng thi im rng trng: Cn sinh hot ng ngy (ngy th 12 n th 14 ca vng kinh). 3. Tinh trng tiu chun, nhng b suy yu v axit qu cao trong m o ngi v: Th tinh nhn to bng cch ly tinh dch ca chng bm qua l c t cung, vo thi im rng trng. 4. Tinh trng tiu chun, nhng c d tt dng vt: Th tinh nhn to bng tinh dch ca chng bm qua m o, vo thi im rng trng. 5. Tinh trng tha tht v hot ng yu: Th tinh trong ng nghim c vin tr (S ni thm di). 6. Khng c tinh trng (ch c tinh bo hoc tin tinh trng): - Phng php th nht, cng b u nm 1999 Italy: Ly tinh bo ca ngi v sinh em cy vo tinh hon ca chut; sau 3 thng, cc tinh bo ngi pht trin dn thnh tinh trng bnh thng, c kh nng th thai. - Phng php th hai, n gin v nhanh chng hn, cng b thng 4/1999 Php: Qua sinh thit tinh hon ca ngi v sinh, ly tin tinh trng cho vo ng nghim kt hp vi non thnh trng; sau mt s ln phn chia thnh phi tiu chun th em cy vo d con. n gii 1. T cung khng pht trin (do ri lon ni tit), teo bung trng: Khng th c thai. 2. Khng c m o: Phu thut to hnh m o, sau kh nng th thai ph thuc vo tnh hnh v mi quan h t cung - m o mi. 3. Kinh nguyt bnh thng nhng giao hp khng ng thi im rng trng: Chnh li cho khp. 4. Tc ng dn trng, cn bung trng vn bnh thng: Th tinh trong ng nghim, ri chuyn phi vo t cung ca bn thn hay ca ngi khc. 5. Di chng vt thng hoc d tt khng th mang thai, cn bung trng bnh thng: Th thai trong ng nghim, ri chuyn phi vo t cung ca ngi khc. Ni thm: Sau s ra i ca mt a b bng k thut th tinh trong ng nghim (TTTN) vo thng 7 nm 1978, ti nay, k thut TTTN tr nn ph bin (ring nc Php mi nm tin hnh 10.000 To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

trng hp), c ci tin nn t kt qu chc chn hn. Xin nu my im v k thut . - TTTN c in: Kch hot bung trng, sau chc ht bung trng ly cc non, cho th thai vi tinh trng trong ng nghim, ri chuyn phi vo t cung. - TTTN c vin tr: Khc vi c in ch khng tinh trng t chui vo non (nu yu qu th chui sao ng!), m dng mt cy kim siu nh tim tinh trng xuyn qua v non. Mt ci tin ng k na l ng lnh phi ch ng khi mun sinh thm, khi phi chc li bung trng, rt phin h. Ngoi ra, ngi ta ang hng ti vic loi b nhng gene bt li ca phi, gip n pht trin thnh con ngi khe mnh bnh thng. 258. Khng c d con "Nm 17 tui, ngc em bt u pht trin y n nh mi c gi khc, nm 19 tui em xy dng gia nh, khi sinh hot v chng vn thy c hng th, nhng lc cht dch nhy tit ra t hai bn mp m h. Nhng hin em 28 tui m vn cha c kinh nguyt (sau khi ly chng hai nm em i khm bnh vin, c chn on l khng c d con). Xin hi y hc c cch no cho em c lm m?". Trng hp khng c d con (t cung) m tnh hnh bung trng bnh thng, mun c lm m, ch c th khc phc bng phng php th thai trong ng nghim (ly non t bung trng, cho th tinh vi tinh trng ca chng), sau em "cy" vo t cung ca mt ph n bnh thng ang trong giai on sinh sn. T l thnh cng cao, c th cho sinh i, sinh ba... Cc em hy lin h vi Bnh vin T D ( TP HCM) hoc Vin Bo v B m & Tr s sinh (H Ni) xin khm kim tra xem c iu kin thc hin k thut trn hay khng ( n, phi c hin tng rng trng sau khi tim thuc kch thch; nam, tinh trng phi tiu chun...). Nu c, phi nh mt ph n tnh nguyn mang thai gip. Cn nu chng may khng c, cc em c th ng k xin con nui. 259. Tnh dc khi mang thai "Ngi ph n mang thai thng th 4-5 nu vn sinh hot v chng th c nh hng g n thai nhi khng?". Thng th 3 v thng th 7 l hai thi im m thai gp nhiu nguy c nht. Mt s cp uyn ng mi xy t m v khng bit ngi v mang bu nn vn duy tr cng sinh hot "ht mc", ngay c khi bc vo thng th 3 ca thai k, nn gp tai bin sy thai. Hin tng non thng gp khi v chng quan h nhiu trong thng th 7. Ngoi ra, khng c thi im no cm k c nu i bn ng s thoi mi ng tnh. Tuy nhin, trnh "vng mc", nn dng cc t th khc thch hp hn t th c in. V d nhin, t th ca b m khng nh hng g n a con trong bng. Bn ng xu h, v hy nh rng: Cm k ng x qu gt gao l to nguy c cho chnh bn thn! To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


260. Ngi c thai king chp nh, king a n du?

L Trng Bng

"Chu nghe ngi ta ni, khi c thai phi king chp nh, king a n du. Chu c thai nhng khng bit, nn trt chp nh vi em gi; nay chu rt lo, ch s con mnh s b nh hng!". Chu nghe nhm, hoc ai ni sai thi! S tht l trong thi gian mang thai, ngi ph n khng c chiu chp X-quang, v tia X c hi cho s pht trin bnh thng ca thai nhi. Khi cn, cc bc s s dng siu m chn on, v siu m khng c hi cho thai. Cn vic chp nh khng nh hng g ht. Cn chuyn king a n du th cng phn no c l. V khi ra ch ng ngi, thai ph d ly cc bnh do virus, nh cm chng hn. Trong vng ba thng u ca thai k, nu b mt loi bnh nh vy th thai nhi c th gp trc trc trong qu trnh pht trin. 261. ang b bt v gy xng liu c th "quan h"? "Chu l n, c gia nh, b tai nn gy tay, phi x tr phu thut ri b bt. Hin chu m c 10 ngy, khng cn thy au nhc na, liu c sinh hot v chng c khng?". Chu khng ni r l gy xng cng tay hay cnh tay. Nu gy xng cng tay th b bt ln qu khuu tay, v khuu gp 90 . Trong trng hp ny, trc khi sinh hot, chu dang rng tay v nh ng x dng my chic gi chn gi cho bt ng thng, c thoi mi. Cn nu gy xng cnh tay th bt ln ti vai v da ln phn bt ni thnh ngc, kh vng vu. Trong trng hp ny, hai chu phi dng t th nm nghing p tha, ri tin hnh t pha sau. D tnh hung no cng ng s nh hng n ch gy (sau ny, khi lin xng, ngi ta phi dng km mi ph ni bt, chng t n vng chc lm), hai chu c yn tm. Hn na, hnh phc la i s gip mi th bin chuyn tt hn nhiu. 262. C thai cn n thm g, ung thuc g? "Chu c thai ln u. Xin cho bit c cn ung thuc v n thm g khng?". V mc n, ch cn chu duy tr u n nh mi ngi l , khng cn tm b qu, v thai nhi cng "bit iu" lm, n s t xoay x ly trong hon cnh c th ca m. Nhng nhng vitamin sau y li ti cn: - Vitamin B9 (axit folic): Ti cn cho s pht trin ca ng thn kinh. Vic thiu vitamin B9 s dn n nhng d tt ng thn kinh ca thai nhi (ty sng khng bt kn hon ton hoc khng c no). Hng ngy, chu cn ti 500 mcg cht ny (trong sut thi gian thai nghn). Vitamin B9 c khuyn co s dng cho tt c nhng ch em chun b c thai, bi n tc ng rt sm ln thai nhi, ngay t vi tun u tin. Vitamin B9 c nhiu trong rau xanh, bp (ng), ci bina, mm thc, men, gan... Trong 1 vin a sinh t Theravit c 400 mcg cht ny; chu dng mi ngy 1 vin l . To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


- Vitamin D: T thng thai th 7, cn b sung mi ngy 100.000 IU vitamin D.

L Trng Bng

Vic b sung cc sinh t trc v trong khi mang thai mang li hiu qu r rt: gim c 25-30% d tt hng - mt, 85% d tt tit niu, 43% d tt tim. Trong vin Theravit c vitamin v cc cht khong cn thit. Cn mt vn quan trng cha thy chu cp, l cn thng xuyn ngh n ci thai, nh nhng vut ve, ni chuyn vi n (c b ln m cng tt), cho n nghe nhc nh, cc ln iu dn ca... Mt s nghin cu cho thy, vo nhng thng cui, thai nhi thng hay np st vo thnh bng ca m c gn gi hn. 263. Phi ht sc cn thn "Ti mi kt hn c 3 thng, chng khng mc bnh tim mch. Hin ti rt lo lng v gn y, 3-4 ln, sau khi quan h, anh y l i, mt nhm nghin, tim p khng u, hi th rt yu, ti phi lay gi 1-2 pht anh y mi m mt". Trc tin, chng bn phi c khm tim mch cn thn, c mt chuyn gia gii c in tm v kt lun chnh xc (b bnh tim mch vn quan h v chng c nhng phi ng mc). Rt c th t th nm sp khng thch hp vi chng bn. Cc bn ng xu h, hy tm cch thay i (hon v cho nhau hoc cng chuyn sang t th khc). Hy nhc chng bn khng c tm m, cn ban ngy phi tp th dc thng xuyn hn, nht l phi tp th vo tht su bng mi. Nn th cng lu cng tt ri th ra chm chm bng mm cho tht ht kh. Trnh quan h ngay sau khi n qu no hoc ung bia, ru. 264. C thai khi ang b si thn "Ti b si thn hai nm nay, lp gia nh v c thai c hai thng. Xin cho bit c phi cha tr g khng?". Si thn nu khng c bin chng (i tiu ra mu, si tt xung niu qun...) th khng c ch nh m tuyt i. Ch cn ung nc v i tiu u n; trong thc n thc ung nn c thm cht cht chua lm cho nc tiu bt kim. Ngoi ra, thai ph c th c hin tng vim b thn, nn bn cn i khm bc s nu thy au ngang rn hoc h chu (nu au bn phi, cn chn on phn bit vi vim rut tha cp). Th bn khng ni r hnh th v kch thc cc vin si thn. V vy, xin nu ra c hai tnh hung bn i chiu: - Nu si thn gm mt vi vin nh, c nguy c si ri vo niu qun, gy cn au qun thn pha . Nn ung nhiu nc v i li lm cho si tt xung nhanh, ri vo bng quang (bng i) v c nc tiu tng ra ngoi. - Nu si thn ca bn kh to th khng s "s c" trn. 265. ang b bnh van tim c nn mang thai? To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

"Chu 25 tui, dy hc vng cao, mi ly chng. Chu b bnh tim v khp t nh, ung thuc tr tim v thuc nam nhiu nhng khng . Ba nm nay, chu li au lng, hay au 2 ng chn; bn chn thng xung mu. Hin chu hay kh th, tc ngc nn cha dm c con, nhng gia nh chng khng my thng cm". Vn tht h trng, nhng chu qu xa, khng th thu thp c liu gii p chnh xc. V vy, ch nu mt s im rt chung chu lin h v c th theo m ng x cho thch hp: Bnh tim ca chu l bnh tim g? Nu l hp van hai l, hoc hp-h hai l th nu khng ch gi gn (lm vic nng, leo dc, khng iu trong sinh hot) v khng tip tc dng cc thuc chng thp khp, tr tim, li tiu... th bnh c nguy c nng dn ln. Tri li, nu c theo di v cha tr tt, li bit gi gn sc khe, bnh s cm chng, khng gy bin chng. V vy, nhng ngi mc bnh van tim khng nn mang thai nu cha c cha khi, v thai nghn s lm cho bnh nng thm (v d nu b hp van hai l n thun th phi m nong van xong, mt thi gian sau mi c mang thai). Nu trt mang thai, ngi ta khuyn h ht thai, no thai hay cho sinh con. Bnh van tim c th x tr tt bng phu thut, t phu thut n gin l nong van bng dng c n phu thut phc tp l thay hay to hnh mt lc c 2 van; m bo kt qu lu di, thm ch v sau c th cha . Bn cnh cc phu thut tim ni chung, t nhiu nm nay, Vin Tim ca TP HCM vn thc hin thnh cng cc phu thut thay van tim, to hnh van tim, cu sng v em li hnh phc cho nhiu ngi. Vo dp ngh h ny, chu hy sm nh gia nh chng thu xp a v khm chuyn khoa tim mch v khp ti Bnh vin Bch Mai, H Ni. Cc chuyn gia ti y s c chn on v hng x tr chnh xc (iu tr ni khoa, ngoi khoa). Trong khi ch i, chu hy coi trng sinh mng mnh hn na, trnh nhng g qu sc hoc phng hi n sc khe. Du hiu "hai chn hay xung mu" ca chu rt c th km theo "gan to kiu n c coc" (vn ng nhiu th to, ngh ngi li ht), bo hiu rng c suy tim. Cn cc triu chng au lng, au chn... tuy lm chu kh chu, nhng trc mt cha c g ng quan ngi. 266. Hin tng hy tinh trng "Ti 30 tui, ly chng c 2 nm, cha c con. T trc n nay, mi khi quan h (1-2 thng mt ln v chng ti cng tc xa), ti s vo ngi anh th thy da rt lnh; tinh dch cng lnh v long. Sau mi ln chn gi, ti u thy au lm rm vng bng di. Liu hin tng c lin quan n vic chm con?". Nhiu kh nng chng bn c hin tng hy tinh trng, dn gian gi l "lnh tinh". Bnh nhn vn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

c ham mun tnh dc, tinh hon vn sn xut tinh trng, nhng v nguyn nhn no cha r, cc tinh trng b hy hoi dn. Nhng tht chc chn, bn nn bn vi chng i xt nghim tinh dch. Y hc hin i c phng php iu tr bnh ny. Trong dn gian cng c mt s bi thuc cha, bn th nh su tm xem. 267. Tui gi v chuyn phng the "Ti 60 tui, b nh ti 61. tui nh chng ti c nn qun v thi hn chuyn y khng? V chng ti vn u u na thng mt ln, nhng sau ti thng thy mt v au lng, ngm cu ng b ni "a tu bi tm, a dm bi thn" thy c l ng. C phi ph n mn kinh l ht ham mun, khng cn i hi? Nam gii n tui no th nn chm dt?". V chng gi ch ht i hi v tnh dc khi b lnh cm hay lit dng, hoc khi h khng cn yu nhau na m thi. D mn kinh hay rng rng cng khng h hn g (tic rng mt s con chu khng hiu iu nn kh thng cm v khng to thun li cho b m hoc ng b mnh). l cha ni n hin tng hi xun lm cho c c ng ln c b cn nng nn hn trc. Cu ni kia ca t tin cn c hiu mt cch chnh xc hn: Ru chng nhng lm "bi tm" chung chung m r rng l hy hoi t bo gan, dn n x gan. Cn a dm d dn n lit dng. Nhng v chng quan h mi tun, thm ch mi ngy 1-2 ln, th khng th gi l a dm. Giao hp khng khi no dn n bnh thn. Hn na, au lng cha hn l biu hin ca bnh thn; ngc li, khi c bnh thn cha chc au lng. Hin tng au lng ni c ng rt c th do t th khng thch hp, cn thay i. Cm gic mt ca cc ng s l do bun ng, mt trng thi sinh l bnh thng sau mi ln quan h (no hng phn xong bn chuyn sang c ch t bo v); nu ng b kp thi th s ht. Xin thng bo thm vi hai c tham kho: Theo cc kt qu nghin cu cng b, vic sinh hot v chng u n lm cho con ngi khe khon, yu i, t tin, tr ra, d thnh t hn, sng lu hn. Mc quan h cn thit do mt s chuyn gia nu ra l mi tun trung bnh 2-3 ln. 268. Hu qu ca vic lm dng vin viagra "Nghe ni thuc Viagra (cha lit dng) c th gy bin chng, thm ch cht ngi. Xin cho bit thc h v gii php x tr?". Trc ht, xin hai bn lu iu sau y: Vin Viagra c ngi lit dng ung trc khi quan h nam n 1 gi, s lm cho dng vt cng cng trong khong trn di mt ting ng h, cho php thc hin ng tc giao hp nh ngi bnh thng. Ngha l sau khi thuc ht tc dng th u li hon y. V r rng Viagra khng phi l thuc cha tn gc bnh lit dng, m ch tm thi gip dng vt cng cng nu n c phi n kch thch, coi nh mt loi thuc "cha triu chng". Ch c th thi, nhng Viagra cng tuyt vi lm ri, v n mang li hnh phc tht bt ng cho To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


hng triu la i.

L Trng Bng

Ti M, thuc c bn rng ri theo n bc s; ngha l c quan hu trch cng d chng nhng trng hp dng Viagra khng c li, thm ch nguy him (bui u, ngi ta lo lng nhiu nht n vn th lc). Nhng h khng lng trc c hu qu ca vic lm dng "vin thuc hnh phc" ny. Nhiu trng hp c th c vn (bnh tim mch kh nng, tui qu cao, c mt s bnh mn tnh) li dng qu liu (c ngi dng ti 2-3 vin, mong cng cng c cng lu cng tt), dn n t vong. Hin c ti my trm trng hp t vong do dng Viagra. Nh vy, r rng, li do ngi dng lm dng ch khng phi do nhc im ca thuc. 269. Tt hn Viagra "Nghe ni thuc Viagra khng hiu qu trong mt s trng hp. Hin c thuc g hay hn khng?". Viagra tuy u vit vy nhng khng c hiu qu trong 40% trng hp lit dng. T my nm nay, ngi ta nghin cu mt loi thuc lm cng cng dng vt theo kiu Viagra nhng tc dng mnh hn nhiu; qua th nghim 44 ngi lit dng thy khng c phn ng ph no. Thuc ny c hng dc phm ICOS t tn l IC 351, hy vng s sm c mt trn th trng. u nm 2001, qua th nghim trn chut, cc nh khoa hc M li tm ra thm mt cht na mang tn Y-27632, tc ng ln hin tng co mnh, khin mu ti nhiu, gip dng vt cng cng. 270. Bnh st rt cha khi c nh hng n ng con ci? "Chu 30 tui, con trai. Nm 1990, chu b st rt, bc s tim cho 21 mi quinine vo mng; sau ny ngi khng bo tr li. iu ny c nh hng n sc khe v ng con ci khng?". Bnh st rt ca chu nh vy l khi hn; ch ng nhim li k sinh trng st rt khi c vic phi i vo vng c lu hnh bnh ny (mc qun o di tay chng mui t, nm mn, ung thuc phng). C yn tm ly v v lu khi "v k hoch", v bnh c v 21 mi tim khng nh hng g n ng con ci. Chu mun bo ? ng! Bo ph kh lm: s s th c ch nng n, bng ph phi ci tht lng di rn, nng na th d b cao huyt p, bnh tim mch, i tho ng. Nhiu ngi khng thy iu nn n ung v (xi ngt, b, tht m, ung bia x lng), hay "tm b" cho con chu lm chng mp t tui cn th. Trng hp ca chu ch cn: khng ht thuc l, tp th dc u n, ng 7-8 gi/ngy, c mt gic ng tra 15-30 pht, n ung tt (nu lo thiu vitamin v cc cht khong cn thit th mi ngy dng mt vin a sinh t Theravit ca M, gi khong 400 /vin), lm vic iu , lun tm kha cnh tt p ca cuc i sng tht s thoi mi. 271. C nn lt nylon vo t? " phi thay t nhiu ln, nht l v ma ng, ti lt mt mnh ni lng vo t. Nh vy c tt khng? To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Cha thy c sai tri g trong chuyn . Nhng vo cui nm 2000, mt nghin cu c cho thy: Khi lt thm ni lng vo t, nhit ca tinh hon cc chu tng 1 C. Ta bit rng tinh hon ch a ni mt m mi pht trin tt (v vy, nhng tinh hon lc ch nm li trong bng u thoi ha sau thi k pht dc, sau d gp nguy c c tnh ha). Lu nay, ngi ta vn khuyn n ng hn ch vic ngm mnh trong bn tm nc nng, v nhit cao khng li cho tinh hon, thm ch c th gy v sinh. V th, tuy cha thy tc hi c th cc chu nh, nhm nghin cu c vn khuyn cc bc cha m ch nn dng t dt bng bng vi v khng lt ni nng vo t, phng hu ha. 272. Cch tnh u lng thuc cho tr "Trong gia nh, khi xa bc s m mun cho cc chu ung kp thi nhng thuc ty thng thng ca ngi ln, th tnh ton lm sao khng qu liu quy nh?". V l thuyt, vic quy nh liu lng thuc ty chnh xc nht l da vo th trng (cn nng) ca tng ngi; nhng trong thc t, iu ny t khi vn dng c mt cch trit . Ngi ta phn nh thnh liu ngi ln (trn 17 tui hay trn 20 tui ty tc gi) v liu cho tr em tnh theo tui. Xin gii thiu vi gia nh bn mt s cng thc v phng php tnh tham kho v vn dng trong nhng tnh hung bc xc (, tt nht l phi bc s quyt nh vic dng thuc g, vi liu lng bao nhiu v cch dng c th nh th no). 1. Cng thc Dilling, s dng mu s 20: Liu ca tr = (tui/20) x liu ngi ln. V d: Tr 10 tui, thuc ca ngi ln c liu ti a/ngy l 200 mg, th liu ca chu s l: 10/20 x 200 mg = 100 mg ti a/ngy). Cng thc Dilling c nh gi l thch hp nht, gn khp vi ng biu din th trng. 2. Cng thc Young, p dng cho tr di 12 tui, dng s cng 12: Liu ca tr = tui ca tr /(tui ca tr + 12). V d: Tr 8 tui s c liu bng 8/(8+12) = 2/5 liu ngi ln. 3. Cng thc Cowling, dng mu s 24: Chia tui ca tr vi 24, s c t l liu lng V d: Tr 8 tui s c liu bng 8/24 = 1/3 ca ngi ln. 4. Cng thc Pincus Catzell, trong liu ca tr s sinh bng 1/8 liu ca ngi ln; ca tr 12 thng bng 1/4; ca tr 7 tui bng 1/2; ca tr 14 tui bng 3/4 liu ngi ln. 5. Phng php Gaubius, trong liu ca tr di 1 tui bng 1/12 liu ngi ln; di 2 tui bng 1/8; di 3 tui bng 1/6; di 4 tui bng 1/4; di 7 tui bng 1/3; di 14 tui bng 1/2; di 20 tui bng 2/3 liu ngi ln. 273. Nn cho tr thi b vo thng th my? To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


"Ti mi sinh con, mun hi n lc no th nn cai sa cho b?".

L Trng Bng

Mt s ngi ngh rng, vic "tch m" sm s to iu kin gip tr t lp. Mt s ngi khc th ngc li, ch trng "tch m" mun hn, ng thi tranh th thi gian qu bu ny by cho tr bit t lp. u cng l do hon cnh ca tng gia nh, quan nim v kinh nghim ca tng ngi trn tng a tr c th. Bi l khng ai ging ht ai, k c song sinh. Gn y, cc nh nghin cu Canaa pht hin, sa m (nht l sa non) cha mt protein ha tan mang tn sCD14, c tc dng kch thch cc bch cu lympho, nh hot ha c h min dch, gip c th chng bnh tt. Protein qu gi ny vn tn ti trong sa m ti 400 ngy sau khi sinh n. Pht hin trn khin chng ta phi suy ngh thm v thi im thi b c nh trc y l 6 n 8 thng tui. 274. ng ch "mi th tht r rng" "Con trai ti 13 tui, t 2 nm nay thnh thong au nh khp hng, 3 ngy th khi, tip l au ngc tri. Bc s khi th bo l thp khp, khi th ni au dy thn kinh c tim. Gn y, chu ti khm v lm cc xt nghim ti mt bnh vin ln th c kt lun l cha c g c bit. Nhng chu vn au ngc tri. Xin cho ti mt li khuyn". Ngoi nhng th nng hoc c triu chng r rng, bnh thp khp thng hay "nh la" bnh nhn v thy thuc bng li din bin "m h": au nh ti 1-2 khp trong dm ba hm ri ht; nhng ln sau cng din ra ng hay gn ng ba hm ri ht... Hy coi chng! Cng v sau, tnh hnh cng tr nn xu hn, bi v c mi ln nh th l tim li b "p" thm mt bn. Cc bc thy trong ngnh y vn nhc i nhc li cu "thp khp lim khp, p khp" nhm nhc nh chng ta cnh gic, trnh cho xy ra bin chng tim ri mi lo chy cha. Theo chng ti, trng hp con trai bc cn c mt chuyn gia gii v khp theo di st sao trong mt thi gian di, c lin tc dng thuc cha thp khp v nga thp khp ti pht (nh k tim khng sinh thi tr chm), cng nh theo di nng tim trong qu trnh iu tr. Nh ni trn, ng ch "mi th tht r rng"; v lc by gi mun, nu khng ni l qu mun (khi chu b kh th khi gng sc, khi nghe tim c ting rung, ting thi, khi in tim c vn ). 275. Khi tr b lao hch "Con ti 7 tui, trc y c chn on l lao hch c; mt bc s chuyn khoa lao bo phi m ly hch, nhng chu s qu khng cho m. Bc s ny khng cho thuc men g, ch dn l nu hch b mng m th em chu tr li m. Mt thng sau, ti cho chu ti trm chng lao ca tnh, c trm cho ung thuc n nay. Hin gi hch khng pht trin nhng vn cn, v trm cho ngng thuc. Va qua, ti cho chu khm nhi khoa th bc s bo l chu b s nhim lao. Xin cho bit s To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


nhim lao c ly khng, hch lao ca chu c phi m khng?".

L Trng Bng

Lao hch tr em c iu tr bng thuc chng lao ch khng phi bng phu thut; vic ch nh m chu nh vy l vi vng v khng cn thit. ng l phi cho chu dng ngay thuc cha lao hch (theo phc ca ngnh y t) ch khng phi c mc cho hch ha m ri a tr li m! V chng, vt m ni mt hch lao ha m thng c nguy c kh lin ming do b r. Vic cha tr ca trm chng lao nh vy l tt, nhng hch khng mt hn do khng c cha sm, v rt c th do chu b thm s nhim lao ( phi); khi phi cha ht s nhim lao th hch c cha th tr li bnh thng. Do , bn nn cho chu: - Chp li hai phi (phim phi tht chun) bc s nhi khoa hay chuyn khoa lao cn c vo m xc nh bnh. Nu s nhim lao th trn phim s thy hnh nh mt qu t gm hai hnh cu hai u; u ngoi l vng phn ng ca t chc phi, u trong l bn thn mt ci hch trong ngc b sng. - Kim tra li phn ng lao b sung vo chn on v ch nh ca bc s. Nu ng l c s nhim lao, phi cho chu cha tr kin tr theo n bc s trnh hu ha phi, v hch c nh dn. Bn cnh thuc men, cn cung cp cht b dng, ch yu l m (tht c, tm cua, u tng...), cc vitamin v cht khong (c nhiu trong hoa ququ rau xanh). Gia nh bn c yn tm v s nhim lao khng ly. C chu sinh hot bnh thng, trnh gy mc cm khng ng v bt li cho chu. 276. Coi chng b b nhim giun a "Con gi ti 1 tui, khi ng nm nga chu hay b ho 1-2 ln trong m. Ti c cm gic chu b nc bt chy vo ng h hp. Xin cho bit cch x tr". Nhiu kh nng chu b b nhim giun a. Bn hy i th phn cho chu, nu c giun th cho ty; sau trnh chu l la ra t phng nhim giun li (u trng giun a sng y ry trong t ti nhng a phng c thi xu phng u ba bi hoc s dng phn bc cha c x l tt). Bn nn tp cho chu nm nghing tri hay nghing phi, khng cho nm nga, v kim tra cht ch t th ny. Khi nm nghing th nc di nu tit ra nhiu s chy ht ra ngoi theo khe ming, nn chu khng b sc. 277. C th chu b giun kim "Chng em c mt chu trai gn 5 tui, my thng nay i tin phn khng c tt lm, v m chu ku nga hu mn, phi gi". C th chu b giun kim. Em cho chu i ngoi vo b v xem k, s thy nhng con giun kim ng nguy. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Giun kim c tp tnh l vo lc m khuya i xung hu mn trng, lm cho tr nga ngy a tay gi, do tay s giy trng giun. Khi chu a tay vo mm, n s nut s trng ny vo bng "b sung qun s giun ca mnh", to thnh mt vng lun qun lm cho bnh giun c dai dng mi. Ngoi ra, trng giun cn giy ra qun o, chn mn, gp phn tng cng cho vng lun qun v ly sang cc thnh vin khc trong gia nh. V vy, nu ng chu b giun kim th i i vi vic cho ung thc ty, em phi: - Dn chu khng c cho tay vo ming v c thi quen ra tay trc khi n bt c th g. - Luc qun o, chn mn, thay vi tri hoc chiu hng ngy trong khi cha cha ht giun. - Hng m, b m nn dng n pin soi sng, nh tay bnh hu mn ra bt giun cho con; b m cng ch cn thn bn thn khng b nhim giun trong khi thao tc. 278. Khi tr ung nhiu v i nhiu "Em c mt b trai 6 tui. T nm 2 tui tr i, chu ung rt nhiu nc, trung bnh khong 1-1,2 lt mi ngy, v c tt i dm (th lc chu vn tt, n ng bnh thng)". Khi thy mt chu b thng xuyn ung rt nhiu nc km theo i dm, ngi ta thng ngh n kh nng b bnh i tho ng (tiu ng). Em hy xem ch chu i tiu ra c b kin bu khng? Hoc em nm nc tiu ca chu xem c v ngt khng? Bnh ny khng ph bin, nhng vn c mt s tr em; nu c pht hin sm v cha tt s khng sao. Em nn cho chu i khm, lm xt nghim mu xc nh t l glucose huyt (bnh thng: 75-115 mg/100 ml; trn mc ny l b i tho ng). 279. Khi tr vim amian v st "Con trai ti 5 tui, b vim amian mi ngy mt nng, 1-2 thng ti pht mt ln, st cao trn 40 , c m, 5-7 ngy mi khi. Ngoi ra, chu cn b d ng, ra m hi trm. ngh cho bit phng php phng v cha hu hiu nht". V amian, phi thng xuyn gi sch ming cho chu (chi rng ngay sau mi ba n, sc ming bng nc mui long nhiu ln trong ngy). Nu vim th cha khng sinh liu trnh nhn thuc (nn i loi khng sinh m chu dng qu quen), thi gian (khong 5-7 ngy d ht st). Nu cha tr v d phng tt th sau ny chu ln ln khng nht thit phi ct amian, tr trng hp c hc m dai dng, nh hng n sc khe. Hy nh: Khi tr b st cao bt c do nguyn nhn g, ta khng c bc kn tr hoc cho mc nhiu qun o; tri li phi b bt qun o, b chn (d l ma lnh; ch cn gian phng khng b gi la) gip tr thi nhit tt; nu khng, tr d b co git. V m hi trm th bc cn a chu i khm xem c phi l mt du hiu ca s nhim lao hay khng (phn ng lao dng tnh, X- quang cho thy hnh qu t tp th dc). Nu ng s nhim lao th cha cng d khi trong vng 6 thng hoc hn mt cht. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

V d ng, bc khng ni r l da hay b my h hp (hen ph qun), mt (vim kt mc theo ma). Ch on l bc nh ni "ni mn"; nu vy hy xem nu chu c giun a th cho ty. 280. Di trc hay trn trc " vng ti, cc chu b bao gi cng mc rng hm di trc. Nhng con trai ti li mc rng hm trn trc, nh vy c vic g khng?". y l chuyn bnh thng; v t l mc rng hm trn trc kh thp nn ta tng khng c y thi. Chuyn ny cng tng t nh vic c ngi thng thnh ch mc 28 rng (khng h c 4 mm rng khn nh s ng), hay ngi gi rng rng ri thy mc li chic rng , ngha l tuy him nhng vn xy ra, khng c g ng ngi. 281. Khi tr nn nhiu "Ti c a con gi gn 4 tui, t khi sinh n gi thng b nn nhiu ln trong ngy. V gia nh ngho, chu cha c khm bc s ln no. Ti phi lm g cho chu?". Th bn khng ni r v qu trnh nui dng, nn kh ni chc. Nhng cng xin trao i mt s quan im sau y: - Nhiu kh nng chu hay b nn l do phn x t b: Thng ngi m mun con chng ln, cho b qu mc, chu nn do d dy qu y phi tng ra, dn d hnh thnh phn x nn rt kh cha. Vi nhng tr nh vy, mi ba n thc s l cc hnh cho c con ln m, thm ch c gia nh ny ra "sng kin" cho n khi b ang ngi ng, coi nh mt bin php nh la gic quan ca b. i vi chu th hai sau ny, bn nn p dng li khuyn ca cc c "cn thm thm cng thi", gi cho tr s ngon ming, trnh chuyn p n, d gy nn. - Nay chu kh ln, bn nn cho chu t xc ly n (gi mu gio tt hn, nh cc c dy cho thi quen t lp v ua n do vui bn b). Vo tui ny, b d nhim giun, do bn nn cho th phn; nu c th cho ty, khi ln ln chng nn n vi chng nn kia. Mi ln nn, chu b mt mt lng dch v men tiu ha, cha k vic tng nguy c vim nhim ng th; cho nn c "b i" i cht vn hn l p n nn ra. Hy pht hin thc g chu thch v to khng kh thoi mi khi n chu c ngon ming. - Bn c th t lm ly mt t ko gng (chn gng non v luc k cho bt cay), thnh thong cho chu ngm; gng c tc dng chng nn rt tt. - Tuy xa cc bc s, bn cng nn tip cn vi y t c s c gip kin thm, k c vic tim chng ng lch cho chu (nht l i vi nhng ln tim nhc li, cn ng thi im mi c hiu lc phng bnh). 282. iu gi khi tr ni lp (c lm) "Em c a con gi 10 tui th bt u b c lm (ni lp). Chu rt kh s v b bn b ch giu, nht l khi thy c gio gi ln pht biu. Xin bc s cho mt li khuyn". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

S rt kh cha nu c chu trong mt mi trng nh vy. Do b tru chc, chng ni lp s nng thm, v tai hi hn, s dn n mt mc cm su sc c th tr thnh bnh l. Trong khi ch i mt chuyn gia tm l tho v lnh vc ny, xin xut mt cch gii quyt gia nh em tham kho: ngh vi nh trng cho chu tm ngh hc mt nm. Sm cho chu lm quen vi m nhc (tn nhc hay c nhc u c) ri cho hc n (hin i hoc dn tc ty theo tnh hnh). Trong thi gian nh hc n, nhc, b m c th dy chu hc thm theo chng trnh nh trng, hay ch n bi khi qun vn c m thi. Cng trong thi gian ny, khuyn chu ni t v ni chm (khng ni cn hn l ni lp), v c bit khng la mng hay t ra st rut hay bc mnh. Khch l chu kp thi khi n c cht tin b. Nhng khng nhn mnh hay nhc nh nhiu v chuyn ny, coi nh khng c g quan trng. Cc thnh vin khc trong gia nh cng phi c thi nh vy. i vo th gii m nhc, chu s suy tng nhiu hn ni, v ni cng s chm ri hn. Nhng thnh cng nh nhoi u tin trong lnh vc ny s lm chu t tin hn. V c bit l khng ai tru chc c chu. D nhin, trc phi bn bc vi chu v c chu tht thun tnh. Nu cc em c iu kin, th cho chu hc piano l l tng nht, kt qu s khng tng tng c. Khi no chu ni c tht bnh thng hng cho i hc (ti mt trng khc th hay hn). 283. Khi chu b va cm va ic "Em c mt chu trai 4 tui cha bit ni, lc gi cng khng quay li. Khi em ni trc mt chu, n c nhn m ng ng, khng hiu g. Tnh chu hi ngang tng. C phi chu b cm khng?". Ch khng ni hon cnh nui dy chu trc y nn khng r c phi do chu t c tip xc v t tp ni khng (mi lin kt gia cc t bo thn kinh no c trch v ngn ng din ra rt sm, trong nhng thng u i ca tr, cho nn nu chu khng nghe c th nhng t bo ny s lin tip pht trin theo mt phng thc khc, gy tr ngi cho vic pht trin ngn ng). Nu do li ca ngi ln th iu c th t nhiu c khc phc, v tnh trng ca chu c th kh ln. Nhng y c nhiu kh nng chu ca ch va b cm va b ic (do d tt bm sinh). Nu khng may b nh vy th tt nht l trong thi gian ti, ch sm cho chu hc ngn ng iu b (dng ngn tay din t iu mun ni); nh , chu s giao tip c vi ngi thn, cng s bt bc bi v "ngang tng" nh ch ni. Tr thng minh ca chu vn pht trin tng i tt, vn c th hc ch, v sau ny c ngh nghip thch hp. Ch nn sm cho chu i kim tra ti mt chuyn khoa tai mi hng gii; c chuyn g th ni s gip chu tt hn. Nu ng chu c d tt, ch hi xem u c c s dnh cho cc chu nh vy, tnh chuyn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

chun b cho chu ti hc. B m cng phi hc c th giao tip m ng vin h tr cho con. 284. C nn cho b sm hc ngoi ng? "C nn cho cc em b tui mu gio hc ngoi ng khng? Em c b ch ly chng ngi Php, anh y rt tt, mun dy cho con em hc, nhng chng em s s kh khn cho chu khi hc ting m ". Vic hc ting m s khng gp kh khn g nu c quan pht m ca b bnh thng, cho d b c c dy thm ngoi ng, d nhin b phi thch th khi hc mi c. Cho tr hc thm ngoi ng t nh rt c li. Mi y, cc nh thn kinh hc thuc i hc tng hp Cornell ca M tin hnh chp no bng phng php cng hng t nghin cu so snh. Trn cc phim chp, h thy rng: - nhng ngi ch c hc ngoi ng t bc trung hc, c hai khu vc no tch bit nhau r rt trong vng trn chuyn trch v ngn ng (vng Broca). - Ngc li, nhng ngi c hc ngoi ng t tui u th, hai khu vc ny kt li thnh mt, n mc ha trn vo nhau. Cc nh nghin cu cho rng: tui u th, vic hc ting do nghe ni s quyt nh s hnh thnh khu vc ti vng no Broca. Mt khi khu vc ny hnh thnh ri, th vic hc mun mt ngn ng na v sau s i hi b no phi to ra mt khu vc bn cnh, iu ny kh hn gp bi. R rng l: Mun gii ngoi ng n mc nhun nhuyn nh ting m , nht thit phi hc t b. Hung chi ting Php li l mt th ting rt kh; nu cc em mun chu sau ny tht gii ting Php th phi cho hc t tui u th mi c (Thc t cho thy, nhng ngi hc mun ting Php c nhiu "l hng" hn so vi ngi c hc sm). 285. Nn dy ci g trc "Ti c mt chu gi ln 3 tui, nay mun cho chu hc ch ci c c khng?". Nu chu t ra c tr thng minh c bit th t chu s quan st cc anh ch v "tham gia" mt cch ho hng, s "ngn ch" rt nhanh. Nhiu thn ng trn th gii ng x nh vy, v b m cc em phi chy theo p ng v gip cc em pht huy. Cn thng thng th ngi ln khng nn v kht vng mun con mnh hn ngi m g p con, nu n khng thch. iu cc k quan trng trong tui ny l to cho chu tr thnh ngi "c tm hn" bng cch cho nghe nhng ln iu dn ca, nhng bi ht ru, truyn c tch khng c cnh gh rn, cho xem tranh nh mu ti sng, to iu kin cho chu tip cn thin nhin bit yu thng mun loi. Nhng iu ny s bi b cho tr nng ca chu trong vic hc ch v sau (ngi ta thy r tc ng ca m nhc i vi vic hc ton, l ha, sinh, ngoi ng). C mt mn c th hc sm, l ngoi ng, nhng ch bng cch dy ni qua cc bi ht, tranh nh v qua pht m, vi iu kin l "hc To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


chi", khng lm chu mt.

L Trng Bng

C cho chu thoi mi. Cc c mu gio s bit cch chun b tt cho chu gii giang bc vo lp 1, sc bt cho nhng lp tip theo nu b m quan tm v ng x mt cch khoa hc. 286. Chu b hay b nga "Ti c con trai 3 tui ri. My thng gn y m ng chu hay nga bng, lng v u, sau khi gi th mc ln tng mn, bi du thy khi, nhng my hm sau li ti pht. Xin cho bit l bnh g v cch cha tr?". Bn m t khng c chi tit, kh tr li chnh xc; ch xin nu my im chung nht nh sau: Nhiu kh nng chu b con mt t. Gia nh cn lm tng v sinh, r sch ging chiu, phi nng, nu c iu kin th di nc si, luc chn mn, qun o. C nh tm bng x phng v thay qun o hng ngy ri em luc, trong 3-4 hm lin. Kim tra xem c gn chung g hay kho cha vt vnh khng x l. Dn gian hay dng l cy mn ti (cn gi l "lan tho, hng tho) ri mt lp xung di chiu chng mt g hoc rp; cng c th lt vo trong g. Nu chu b gh (t kh nng hn) th cch tin hnh nh trn cng gip bnh nhiu hoc ht hn. Nu cch lm khng hiu qu th cho chu th phn xem c giun a khng: ty ht giun s ht hin tng nga. 287. Khng phi "cha mo" u "Em b ca chu b mc nht khp mnh, cha bng khng sinh mi khng ht. Tnh c mt ngi bn gi ca m chu ti chi, mch cho mt cch cha l lng, nhn gh gh nhng rt hu hiu: Dng nc ming ca m chu bi ln nhiu ln. B khi hn. Xin cho bit l cch cha mo hay trong nc ming c cht g tr c bnh?". Khng phi "cha mo" u, m hon ton c c s khoa hc. Hy nhn xung quanh m xem: Mt s ng vt nh ch, mo, h dng li lim cc vt thng, gip chng lnh. Mt mt, li qut sch cc cht bn, cc t bo cht, mt khc gip thm nc ming ln chng li cc vi khun. Nc ming c cht lysozyme, lm tan c cc vi khun, nht l nc ming lc ta ang ng (m c hn khi thc). Ly nc ny em bi ln nhng ch ang hay sp ln nht th rt tt (phi l ca m bi ln con trnh cc yu t l, v bi nhiu ln lin tip). Loi ngi vn minh nhiu khi qun mt nhng phng php c s ca thi n lng l tng gip h tn ti v pht trin. C mt thi thy thuc Ty y ch bai tp qun m mm cm cho con; nhng chnh trong nc bt (nc ming) li c ptyaline, lm cho cht bt d c hp thu. Chim b cu v mt s chim khc mm cho con bng thc n tiu ha d dang trong d dy (chng "i" thng vo ming chim non). 288. Bin chng do x tai "Chu gi ti sau khi x tai th b ni ln hai khi u nh bng u ngn tay t. Sau khi phu thut vi To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

thng, mt bn li ni ln khi u khc to bng u ngn tay ci. Trc y, sau khi chng u hay c vt thng, chu cng thng b ni ln mt vt tht li. Xin mt li khuyn". Rt tic! Gi my thng trc y, bc cho bit nhng hin tng c ni chu, th chc chn chng ti khuyn bc ch x tai, mt tp tc m nhiu ni trn th gii b (H eo trang sc qu gi bng cch kp vo i tai nguyn vn, n lc tho ra, i tai y trng vn tuyt vi v khng b c l). Chu nh bc mang c a so li. nhng ngi ny, h da b rch ch no l ch y s c vt so li ln, mu nu, thm ch to dn, nga ngy, l li do gi ri b nhim khun. tai c t chc sn nn so li cng phc tp. Hin nay, cc vt so li trn vt m, vt rch hp... c x l tt bng cch ct b, ri xn chch vo hai mp da (sao cho phn da nng rng hn phn da su) v khp li. Nh vy, hai mp ca lp da nng s lin li nhanh hn hai mp ca lp da su, nh m ngn nga c so li vn xut pht t lp da su ny. Cn nhng so li rng hoc rt rng (thng do b bng la, bom napan...) th phi ct b ri tin hnh ghp cc vt da (cho trt t bn cnh sang hoc ly t i, bng em ti). Trng hp so li da rt kh cha. Theo ch chng ti bit th hin cha c bin php phu thut bo tn no hu hiu. Tuy nhin, bc c cho chu i khm ti mt vi c s phu thut to hnh hoc tai mi hng c trang b laser, xem h c phng php g mi khng. V thuc th hin c: - Kem Contactubex (tup 10 g gi khong 65.000 ng): Bi nhiu ln trong ngy (xoa ln so cho n khi thuc c hp thu vo da), dng trong nhiu tun n nhiu thng. - Madcassol ca Php, c s dng d phng so li khi b bng, c dng dng trong v dng bi ngoi. Thuc ny c ch bin t rau m. V vy, bc th cho chu n tht nhiu rau m thng xuyn (n sng, nu canh, nc mt) xem sao, v rau m khng c. 289. Bo chu dng li m chnh "Hai rng ca ca con trai chng ti va thay xong, mc rt p nhng li kh xa nhau. Vy phi lm th no?". Hai bn hy nhc chu thnh thong ly u li "y" t hai pha, hng cho hai ci rng gn li. ng coi thng, ci li mm vy nhng tc dng rt ng k. Thnh thong dng ngn ci v ngn tr ko thm vo cng tt, nhng trc v sau nh ra tay. 290. Giun chui ng mt "a con gi 6 tui ca ti khong my tun nay hay m bng ku au tng chp, c lc au qun qui gn na ting ng h, au t di m c thc ln ngc nh b dao m". Rt c th con gi ca bn au bng do nhim giun a. Nhng t au thc nh dao m t m c To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ln ngc l do mt vi ch giun i ngc t rut non ln, chui vo l ng mt ch m gy ra. Bn hy kim tra xem: Khi chu ln cn au d di nh trn, hy ly mt ngn tay n nh vo di m c (im cnh c), chu s khng chu ni, ht tay bn ra ngay. Gia nh nn sm cho th phn tm trng giun a nu c iu kin. Cho ung thuc ty giun a, theo di phn bit kt qu. T nay tr i, nh cho chu thng xuyn n mt t chua (chanh, cam qut, kh, da, canh chua...) tng axt trong d dy. Nguyn nhn giun chui vo ng mt ch l do axt trong d dy chu b thp, lm cho giun a tng lm cng ging nh qu hng rut non c tnh kim ca mnh, nn i chu du ri v tnh chui vo ng mt (khi ht au l lc con giun tr lui, hoc cht ti ch, to iu kin cho vic pht sinh bnh si mt). Cng t nay, gia nh nn nhc nh chu gi v sinh n ung trnh ti nhim giun, v nh k ty giun cho chu theo ch dn ca bc s. Nu chng may au khng dt, phi cho i bnh vin. Ti mt s ni, ngi ta lun mt ng thng vo d dy - t trng bm xy (giun a rt s xy). Khi xt tht cn thit mi m ly giun, v m ri giun vn c th chui li vo dp khc. Khng r a phng bn chm dt vic dng phn bc ti mt cch ba bi v t nn phng u lung tung hay cha? Nu cn, phi bn nhau cch khc phc, t ai vng khng y ry u trng giun, gy nhng nguy c nghim trng cho c tr em ln ngi ln. 291. B b r hu mn "Em c mt chu trai 8 thng. T khi mi sinh c 17 ngy cho ti nay, chu b ni mn cnh hu mn, khi bn phi, khi bn tri, ln lt v m ri lin ming, mt thi gian sau li ti pht; dng khng sinh ch m khng khi. Liu c phi chu b r hu mn? C cch g gip chu?". Em ni ng: Chu b r hu mn. Bnh ny khng nguy him nhng ko di. n khi chu trng thnh, c th x tr bng phu thut (m gy m hoc gy t khu vc) nhm thanh ton v lp kn ng r ny. T nay n , y hc khng gip ch c g nhiu cho chu. Chnh bn thn ngi m li c vai tr quyt nh: - Pht hin sm du hiu bt u mng m cho chu dng nhng t ngn khng sinh h tr. - Khi mn v m, thay bng nhiu ln trong ngy cho chu. ng tm cch nn mn v v ch v nguy him. - Ch xem chu c b s nhim lao hay khng (ra m hi trm lin tc, bing n, xanh xao, th phn ng lao dng tnh, X-quang phi c hnh qu t tp th dc), hoc c b lao hch hay khng (thng ni hch c, di hm). Nu c pht hin sm th c hai bnh ny u d dng cha khi nu theo ng ch dn ca bc s chuyn khoa lao. - Khi chu ln, phi thng xuyn theo di phi cho chu, v trong trng hp r hu mn, chu d To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


b thm nhim lao.

L Trng Bng

- Trc mt, tht yn tm, em nn a chu i khm mt bc s chuyn khoa lao c kinh nghim. 292. Pht hin kp thi thot b bn tr nh "Con trai em t khi c thng tui thnh thong li khc tht ln chng na gi n c ting ng h. n khi chu 12 thng mi pht hin bu di to khc thng, c chn on l thot v bn v c m; nhng sau 5 thng li ti pht. Gia nh mun cho chu m li, nhng nghe ngi ta ni tr c m iu tr bnh ny sau rt d b v sinh. V vy, n nay, chu vn ch dng dy eo cho rut khi tt xung". Xin ni ngay rng khng c phu thut no gy ra chng v sinh (khng c con) nam gii, ngoi vic ct b hai tinh hon, ct dng vt, hay tht hai ng dn tinh. Trng hp ca chu l thot v bn bm sinh m l thot b kh rng nn bc l rt sm: nhng ln chu khc tht ln t khi mi c 3 thng tui l do c mt quai rut chui qua l v hi b nght nh, gy au. May m sau mi ln nh th quai rut li tr ln c bng, cho nn chu khng b nght rut hon ton gy tc rut do tht (mt bin chng ng gm ca thot v bn). Nu m mun trong tnh hung ny, quai rut nght c th b hoi t phi ct b. Nhn im ny, xin nhc mi ngi l: Khi thy mt chu b khc tht tng cn, ch vi cho l chu khc hn m hy ngh n mt cn au gh gm bng chu (do lng rut, nght rut v thot v bn, thot v rn...) kp thi a chu ti mt bc s ngoi khoa c trnh . Bnh thot v bn ca chu ti pht l do c thiu st trong khu ti to thnh bng (khu gn lin kt vo cung i ng kn l bn). V vy, em nn tm n mt khoa ngoi khc tt hn, hoc v mt bnh vin trung ng m li cho chu, chm nht l trc tui n trng, chu khi mc cm t ti. Trong khi ch i, phi dn chu mang bng eo thng xuyn, khng cho rut tt xung. Nu rut xung, phi nh tay y ht ln ngay ri p cht bng vo. V dn chu cho bit ngay nu xut hin au bng. 293. Cha ta li cho tr "Em c chu b mi 11 thng tui, thnh thong h ho st phi dng khng sinh l chu b n, li b trng gn ht. Chu b b, khng chu n, ung nc kh khn". n, cn gi l ta li, c th cha bng hai v thuc d kim sau y: - C mc (c nh ni) ti 10 g - Mt ong th thit 4 ml (1 tha c ph) C mc nh tay ra tht sch, gi nt, vt ly nc. Cho mt ong vo trn u. Dng que qun bng nhng thuc, chm ln nhng ch li b ta (tt nht l lc tr ng say, chu khng nh ra hoc nut mt ngay). To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Ch : C mc dng ngy no hi ti ngy . Theo kinh nghim dn gian, dng 3-4 hm l khi. 294. "Chim" chu b nh "Ti c mt chu trai, khi mi sinh th chim ca chu nh trng rt xinh, nay trn 5 tui vn khng thy pht trin nh nhng bn cng tui chu". Bc ng lo v ch xoa nn g vo "chim" ca chu v nh vy l "v ng" cho chu c thi quen th dm sau ny. n tui dy th, "chim" ca chu s bin chuyn khc xa lc ny, min l chu c c hai tinh hon v c ch dinh dng tt. Ngoi ra, nu bao quy u b hp (khng tut "chim" ra c trn vn) th cn ch gi v sinh ti ch, v cho chu i m ct bao quy u chm nht l trc tui dy th. ngi trng thnh, ci quyt nh khng phi l kch thc ca "chim" khi ngh ngi, m l kch thc lc hot ng (lng mu tp trung vo nhiu) cng vi sc bn b ca n (lng mu ny lu li trong "chim" c lu). 295. Tr em xem tivi nhiu d b bo ph "C mt ch bc s ti nh chi, thy chng chu mi xem tivi th da l tr em xem tivi nhiu d b bo ph. M mn nh nh th chc chn hc d ri, nhng ti sao li d b bo?". Chuyn ny c tht trm phn trm. Lu nay, phng Ty, ngi ta thy nhng tr em bo ph phn ln thuc nhng gia nh m tivi th ca. Mt cng trnh nghin cu ca M tin hnh trn 91 gia nh xc nhn nguyn nhn: tr em va n va xem tivi th xi nhiu tht, bnh snack, bnh gizza hn, ung nhiu soda hn, n t hoa qu v t rau hn so vi nhng chu khng c thi quen . nc ta, cc lp mu gio, tiu hc, ngoi ng ph, trn phim nh... gn y xut hin kh nhiu tr bo ph, khng hiu c phi do ghin tivi khng, nhng chc chn l do cha m tm b qu mc, v h khoi thy con mnh to ln hn con ngi. H khng bit rng ngi bo ph d b tiu ng, bnh tim mch, hen. Mt nghin cu ca M trn 1.000 tr t 4 n 10 tui kt lun: Nhng em bo ph b hen phi cp cu v ln cn nng nhiu hn nhng em c th trng va phi. 296. Tr em v in thoi di ng "B m chu c in thoi di ng, em chu thng hay dng ni chuyn vi nhng bn m gia nh cng c my ny. iu c tc hi g khng?". T my nm nay, cc nh khoa hc cnh bo rng vic lm dng in thoi di ng (TD) c th lm tng nguy c ung th no. Vn ang c tip tc lun bn v theo di; cc nh sn xut cng ci tin sao cho my nm cng xa u cng tt trnh tc hi. c bit, mt nghin cu ca Anh khng nh, tc hi ca TD i vi sc khe tr em cao hn ngi ln. Sau , chnh ph nc ny c quy nh tr em n tui no mi c dng TD v mi ln trong bao nhiu pht, mi ngy my ln ti a. Anh cng ku gi gim s lng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


bn my TD cho tr v thnh nin.

L Trng Bng

Thit ngh, b m chu nn coi trng nhng thng tin ni trn v thng bo cho cc gia nh c lin h ngn nga hu qu xu cho cc em.

L Trng Bng 500 gii p y hc theo yu cu bn c Chng 5: Cc bnh tai mi hng, rng hm mt, tim phi v bnh bng

297. Tai chy nc vng "Tai chng chu hay b chy nc vng, nh nhiu ln bng nc xy gi ch m khng ht. C cch g cha c khng?". Sau mi ln tm hoc gi u, cc chu hy dng que qun bng v khun (ng trong ti nh, c bn ti cc hiu thuc) thm tai cho kh, ri dng mt que qun bng khc nhng ru chm vo. Chu s thy tai hi bng bng chc lt, khng sao (bnh thng dng cch ny ly ry tai rt tt). Sau dng mt trong hai cch cha sau y: 1. Ly vi ht cau kh sch gi thnh bt mn; ly giy ba lm mt ci phu nh "rt" mt t bt ht cau vo su trong tai. Nn gi sn nhng ht cau tt, khng mc, sch, phi tht kh, ct vo l kn hay ti nylon dng dn. Nhng hm khng c iu kin tm cng thc hin nh trn, cho n khi hn th tha dn ra. 2. Hnh c kh bc b v, ra sch, gi nt, cho vo mt mu gc nh, nh tay nht su vo l tai, mt m. Ch : Lc u thy tai hi bng bng, c yn tr, lt sau s ht v ng yn. 298. Cc ry tai lu nm "T nh, chu khng ch v sinh cho nn ry tai ng cht c hai l tai. Chu ny c mt bn, cn bn kia chc qu khng ti no ny ra c, c th ny chc chu s b ic mt". Chu khng c ny kh mt cch "tn bo", cng khng nn gi gm cho cc ng th co, trnh gy tn thng tai. Hy tm mua mt l glycrine hay glycrine borat (thng dng trong chuyn khoa tai mi hng), nh vo tai cho n khi thy ry khng ht nc na, hm sau li nh tip. Sang ngy th ba hoc th t, nh ai dng kp y t li ra c cc ry lu cu bao nm nay.

To Ebook: Nguyn Kim V

Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Nu khng c glycrine, c th dng du paraffine, nhng phi nh nhiu ngy hn. Nu khng c cc th ni trn th ngay sau mi ln tm gi hoc nh nhiu nc vo tai (lm cho phn ry ngoi cng b mm ra), chu c th dng u cong ca chic cp tc nh ly dn mi ln mt t, khng c st rut mun ly ht ngay. Nu cm thy kh thc hin an ton cc phng php trn, chu nn nh bc s chuyn khoa tai mi hng ly ra h. 299. Vim tai xng chm "Chu 22 tui, t nh b vim tai gia. Gn y, bc s cho chp X-quang v pht hin vim xng chm hai bn, c ch nh m, nhng chu s. Hin nay, mc d dng khng sinh liu cao, chu vn thy au hai bn tai v nhc u nhiu. Xin cho bit: Nu m th vt so c xu khng v v gi c b ic khng?". Trong trng hp ca chu, nht thit phi phu thut no xng chm th bnh mi khi, v phi khn trng ln trnh cc tai bin cho tai v cho no. Hai vt so s c tc xa xung che kn, khng sao. Cn v gi, theo l tri t, ngi no cng b "km nghe" t nhiu, c g u m lo xu h. 300. Chy mu cam "Em l con trai, 16 tui, cch y 2 nm c chy mu cam, gn y li b. C phi em cao huyt p? C cch g cha chy mu cam?". Em nn thng xuyn dng nhng th sau y: - Cc loi rau qu "lm mt" nh rau sam (luc, xo ti), rau m (nu nc ung, n sng, nu canh, luc), mp ng (nu cc mn n)... - Cc loi qu c v chua nh cam, qut, bi, qut (qu tc)... Cc loi qu ny cung cp vitamin C, gip cho thnh mch mu c vng chc. C th dng thm vitamin C 200-500 mg/ngy, ung lc no. - Nu c iu kin, hng ngy em c th ngm 5 g tam tht (th thit, mu en, rt cng). Ly dao sc cht thnh lt mng, em t vo di li cho "tan" dn. Thuc s thm qua nim mc ming, i trc tip vo mu, khng b dch tiu ha tc ng nh khi ung. Khi chy mu cam, lp tc chm khn lnh ln trn, nm nga thoi mi, nht mt cc bng sch vo l mi. Lun lun nh ng phi u trn ra nng. Chng chy mu cam ca em khng phi do cao huyt p gy nn. 301. Tn thng dy thanh i khi m "Trc y ti b bu c, c m (1 nm trc). Sau khi m, ti ni rt kh nghe, ging nh, khn, ung nc hay b sc; ni soi thy dy thanh i tri b lit, phu sp. c mt s c s y t To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

cho cha tr, luyn ging, ti mt hn khi ni nhng ging vn khn v rt nh, kh nghe. L mt c gio, ti phi chuyn sang cng tc th vin". Bn b tn thng dy thanh i trong phu thut. trnh li ny, nhng phu thut vin lo xa v thn trng thng m gy t ti ch, nh vy, h c th hi han bnh nhn kim tra. Trong phu thut ct bu c, bnh nhn cn c nguy c b ct nhm tuyn cn gip (nh nh hai ht , nm ngay sau tuyn gip). Nu tnh hung ny xy ra, bnh nhn s thiu canxi huyt vnh vin, phi tim b sung nh k, nu khng th co qup ht tay chn. V nhng nguy c m phu thut bu c nhn qua tng d nhng s thc li rt tinh t, i hi c y kin thc gii phu hc v tay ngh vng vng. Trc y, nhng phu thut vin cn non tui ngh khng c lm phu thut ny. S d t sau khi m, cc bc s vn tip tc cha cho bn l do h hy vng dy thanh i ca b ch b ng chm hay chn p, c th hi phc phn no. By gi th r: dy thanh i tri b ct t. Do vy, hin nay cng tc th vin l hp vi bn nht. Trong th bn ao c c tr li bc ging, vy chc chn nhit tnh i vi hc sinh s c th hin trong nhng vic c th hng ngy bn cc cun sch m bn cho cc em mn, km theo nhng li khuyn b ch. Vi nhng tin b ca vi phu, phu thut thn kinh v k thut nui cy m (to thm c cc loi t bo m bn thn b thiu, trong c t bo thn kinh), bn c th hy vng vo mt ngy no , chc khng xa lm u, cc nh ngoi khoa gii giang ca nc nh c th ni li dy thanh i cho bn 302. T cha vim xoang sng c m "Ti b vim xoang sng c m nn b au u nhiu, cha thuc ty ch c mt thi gian. Xin cho bit c cch cha tr hu hiu?". Xin mch bn mt cch cha vim xoang c m ca Lng y Hong Duy Tn, c mt s b con vn dng c kt qu. Bi ny gm 3 v thuc nam (gng ti, ng sen, ht k u nga) v 1 v thuc bc (tn di). Cch dng nh sau: - Gng ti 6 g, ng sen 30 g gi nt, p ln hai bn m cnh mi (cn thn, khng gng giy vo mt); sau mt lt thy bun nn v e ra m. Mi ngy tin hnh 2 ln nh trn (vo sng v ti, nh phi dng ti) cho n khi ht m. Tip theo, cng c kt qu bng cch ly ht k u nga rang gin, tn thnh bt v tn di (trng lng bng phn na ht k) sao kh, tn thnh bt, trn ln, cho vo l kn dng dn. Mi ngy ung 2 ln (sng, ti), mi ln 2 tha c ph, chiu vi nc m. Dng khong 2 thng. 303. T cha vim hng ht mn tnh "Chu b vim hng ht mn tnh, dng nhiu loi thuc khng sinh, mt ln c t ti khoa tai To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


mi hng nhng vn khng ht, thng xuyn thy nga, vng c v b ho".

L Trng Bng

Cng vi vic thng xuyn gi v sinh rng ming (nh rng ngay sau mi ba n, thnh thong ngm nc mui long ri sc mnh...) v gi m ngc, c, chu hy th dng v thuc d kim sau y (m dn gian thng dng cha mt s bnh, trong c vim hng ht): Thn v r ti cy r qut (cn gi l cy x can, tn khoa hc Belamcanda sinensis Lem, thuc h Lay n) 30 gam, cho vo 1 lt nc, un trn la nh cho n khi cn 400 ml, chia lm 2 ln ung trong ngy, dng lin tc trong mt thng. C th tm thy cy r qut mc hoang hoc c trng lm cy cnh. 304. Ct amian c lm ht vim hng khng? "Chu l con trai, 19 tui, b vim amian, lu lu tri lnh th n li hnh, lm chu b au hng, nhc u, s mi. C cch g cha tr ngoi vic ct amian?". Amian thnh thong sng to, gy st, ho, au hng th ng. V nu vy th vic dng khng sinh liu s c cng hiu. Nhng khng phi h b st, ho, au hng l li cho amian. Khi thy nhng triu chng ni trn, chu c th t mnh kim tra amian trc gng (h to ming, li xung). Nu amian khng sng th hoc l chu b vim hng thng thng do cm lnh, do d ng vi thi tit, hoc vim hng do bnh cm (trng hp ny s c nhc u d di km theo nhc mi ton thn, chy nc mi). Nn ung vitamin C liu cao (1,0-1,5 g/ngy) trong dm by hm; ch cn gi v sinh rng ming m khng cn dng khng sinh. Ch t vn ct amian nu l amian c hc m, hay sng to, hoc c ln gy bin chng vim cu thn cp (thng gp tr em). Nh vy, c th ct amian ri m vn khng trnh c vim hng. Chu cn gi gn khng b cm lnh, v eo khu trang khi giao tip trong thi gian c dch cm ti a phng mnh. 305. Khi c d vt vo mt "Chu 27 tui, hi hc lp 5 b mt ht ct t ca s bay vo mt tri. Chu c th gii mnh, n bnh vin th mt tri b hng. Liu sau ny con chu sinh ra c vic g khng?". Hu du ca chu s khng vic g ht. Nhng hy nhc mi ngi: khi c vt g bay vo mt, tuyt i khng dng tay gii, m chp mt mnh nhiu ln lin tip lm cho d vt "tri" vo khe mt, ri nh nhng dng khn mm sch gt nh ra. Trng hp thy cay mt, ly ngay mt cc nc sch, nhng con mt vo v chp lin tc, lm r cht (c th l ha cht hoc cht tit ca cn trng). Nu vn thy vng, dng mt que bng sch gt nh xung khe mt v ly ra (soi gng t lm hoc nh ngi khc). Nu d vt trong mt vn cn, nht thit phi ti mt c s nhn khoa c x tr kp thi. Mt mo nh: Khi b bi vo mt, nhm ngay mt li, ri va chp mnh va th li ra lim lin tc vo khe mi bn i din; dng nh ng tc ny lm cho d vt tri xung khe mt. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


306. Nhn vo mt au c b ly bnh khng?

L Trng Bng

"Ti sao khi c ngi b au mt , nu ta nhn thng vo mt h th ta cng b? Bn em au mt phi ngh hc, em ti thm, nhn vo mt bn thy nh ming tit, em thng qu c nhn mi vo, ch hm sau l b ngay! C thuc g cha cho chng khi?". Mt s ngi kh ng cng ngh nh em, nhng khng phi nh vy u. Khi ta tip xc vi bnh nhn, thng tay ta b dnh d mt ca h m khng hay bit (do ngi giy ra tay ri ti bt tay, giy ra sch v ri ta gi sch v), sau khng ra tay v v gii mt, a mm bnh vo. Bnh au mt rt d ly lan, i khi pht trin thnh dch. Cha c thuc iu tr c hiu. Ch yu l nh mt bng nc mui ng trng nhiu ln trong ngy. 307. M mng tht "Chu l con trai, 19 tui. T b, trong mt tri ca chu mc ln mt ci mng tht, ti nay bng u a, rt cm, lm chu rt bi quan. Xin cho chu bit phi lm g, v chu ang lo hc hnh thi tt nghip". Chu c yn tm hc cho tt m thi tt nghip; v tha vi gia nh lin h vi Vin mt Trung ng (85 ph B Triu, H Ni) hoc Vin mt TP HCM (ng in Bin Ph, qun 3), xin hn khm v m mng tht vo dp ngh h ti, sau khi thi xong. M xong, chc chn mt chu s ht cm v nht l khng cn nguy c g i vi sc nhn v sau. M gy t ti ch, v khng phi nm vin. 308. Tt cn th "Con trai ti 15 tui, thi vo trng chuyn ton. Chu rt ham hc. Ti hn ch v ngn cn tnh ham hc ca chu v s nh hng n i mt. Ti nhn thy tui con ti, nhiu chu phi eo knh cn, c chu eo ti s 2, s 3, tt c u do qu ham hc. Xin hi c thuc g phng v chng c cn th khng? Nu b th cch x l ra sao?". Ngoi nguyn nhn di truyn t b m, phn ln trng hp cn th l do mc phi, do tr nhn mi vt qu gn. Bc th quan st xem, nhiu chu mu gio v tranh m mt gn nh dn vo t giy. Nhiu chu tp vit m ci st mt vo trang v. l cha k ni hc thiu sng, nht l ti nhng ni cha c in. Cch d phng duy nht l: Ngi ln thng xuyn nhc nh, gim st, to cho tr thi quen khng nhn mi vt qu gn. Cch cha thng thng nht: Pht hin tht sm tt cn th v eo knh ng s. Trong trng hp cn nh, ch phi eo knh khi ra ng (khi phi nhn xa), cn lp ch cn c thy c cho ngi bn trn cng nhn ln bng. Trng hp ca chu, bc nh cho n cht, lo nh sng cho chu hc hnh v nhc chu cnh gic vi tt cn th. Nu c cht nghi vn, bc cho chu i kim tra th lc; nu cn th cho eo knh To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


lun, khng xu trai i u, m li c v "bc hc" na c y!

L Trng Bng

Hin c my Laser Excimer ti mt s c s H Ni v TP H Ch Minh gip x tr cc tt khc x (cn th t -1 n -20 D; vin th t +1 n +10 D; lon th t 1 n 7 D) cho la tui 18-45. Sau ny, khi chu ln ln, nu cn, bc c th cho chu i cha bng my , ch mt 7-10 pht v lu li bnh vin 1-2 gi l m p, sau s khng cn phi dng knh. Bc ng ngn cn, tri li phi thng xuyn ng vin chu chm hc hn, v my l: - Nguyn nhn gy nn tt cn th l do thi quen nhn gn, ch khng phi do chm hc. Nhiu c cu li hc m vn b cn th do sut ngy chui vo x xnh ti tm c tiu thuyt, hoc m mn trc mn hnh vi nhng tr chi in t ng ong v b. - Nu thy b m khng khuyn khch, thm ch phn i c tnh chm hc ca mnh, dn d chu s nn ch, hoc li tht s "cho b m vui lng", hoc gi v li ri chi mi hc b ti nhng ni thiu sng, s v cng tai hi cho i mt. - C th chu sp sa hoc bc vo tui dy th, s c nhiu bin ng trong cuc sng ring t. Nu khng duy tr c c tnh qu bu ny th chu d sa vo nhng th vui v b do bn b r r. 309. Cn th n thun "Chu l con trai, hn 16 tui, mi b cn th phi mang knh -0,75 D; sau gn mt thng thy vn nhn km, chu i o li v mang knh -1,5 D; mt thng ri sau ln th vt ln -2,25 D. Chu lo lng thy mt tng s qu nhanh. Liu bnh chu c cha c khng?". Chc khng phi mt chu tng s nhanh, m nhiu kh nng trong nhng ln u, chu cm nhn khng tht chnh xc v th lc ca mnh nn kt qu o khng ng. Khng sao, t nay, nu chu eo knh u n khi phi nhn xa th s knh ca chu s n nh hoc tng chm, v mc cn cui cng khng cao. Bi v tnh trng ca chu l cn th n thun (cn gi l cn th hc ng, di - 6 D, xut hin lc 6-10 tui v tin trin trong nhng nm sau ) ch khng phi cn th bnh (t - 7 D tr ln, c th ti - 30 D, bao gi cng i km nhng tn thng trong nhn cu nh: xut huyt vng im vng, teo hc mc, thoi ha vng mc...). Trng hp ca chu trc mt ch cn eo knh, c theo di cn thn eo knh ph hp. Khi c 18 tui, nu cn, chu c th cha bng my Laser Excimer. 310. Mt lc "Em b hing mt mt t nh nn rt mc cm v xu h, nay 21 tui ri m vn ngi tip xc vi cc bn khc gii. Xin cho bit c chnh c khng v lm u, chi ph c nhiu lm khng v nh em rt ngho?". T nhiu nm nay, Vin Mt Trung ng vn tin hnh m lc (m chnh li c ca mt) cho c tr em v ngi ln. Em nn bin th lin h trc khi phi ch i tn km. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

y l c s y t ca Nh nc, phc v tn tnh, chi ph cho mi ca m khong trn di 100.000 ng; ngi ln m xong khng phi nm li. 311. Nn m c thy tinh th (cm) "B ni chu trn 60 tui, b c thy tinh th nn nhn c m dn. Nghe ni nu m s thy r, nhng b chu s. Xin cho bit b chu c nn m khng?". Rt nn. Sang th k 21 ri, chc chn tui th con ngi s ko di thm nhiu; mt b phi sng cn nhn xem con chu n nn lm ra ch. Thy tinh th ging nh chic knh lp trong sut, nu cht bn trong b vn c, nh sng i qua s b ngn cn, lm cho mt ta nhn m. Chu nn ni gn cho b cch thc m nh sau: Nh thuc t vo mt; my phaco hin i gip bc s rch 1 ng 3 mm trn mt a u my vo. Sng siu m ca my s lm cho thy tinh th c b nhuyn ra, ri c dng nc lin tc chy ca my a ra ngoi. Sau , bc s lp thy tinh th nhn to vo thay th. Thi gian m khng qu 15 pht, bnh nhn khng phi nm vin. Gia nh nn sm a b v Vin mt Trung ng hoc Vin mt TP H Ch Minh (nu pha Nam) m, khng nn mun v kt qu s khng tt. 312. B mn c rng "Chic rng hm di (ch gn st vi li) ca em c mt vng chn, cng ngy cng n lm vo, lm em rt but khi n ngt hay ung nc lnh. Xin cho bit c phi su rng khng v c cha c khng?". C nhiu kh nng em b mn c rng, ban u c th cha phm vo ty rng; nhng nu mun, ty rng s d b tn thng. Nu ty rng cn lnh ln, nha s s trm ch c rng mn bng cht composit bo v rng. Loi vt liu mi ny dnh chc, bn, chu ng c hin tng mi mn, li rt nhiu mu ph hp vi mu rng. Nu ty b tn thng, hng iu tr s ging nh i vi su rng. Nu cha bo tn ( gi c rng) th c th trm tip ch c rng bng cht composit. Vy em nn khn trng n mt c s nha khoa hin i hot ng tt xin cha mi kp. 313. Su rng "Ti sao li b su rng, con su t u ti? Em b su rng hm trn cch y mt nm nhng by gi mi but, cha bng cch no l nhanh nht?". "Su rng" l mt t dn gian quen dng ch bnh "h rng". Bnh do nhiu nguyn nhn gy ra, v ch yu l km v sinh rng ming, khin lp ngoi ca rng (men rng) b h hi, to iu kin cho vi khun tn cng rng t nh n nghim trng (p xe...). Em nn i khm rng ngay "duyt li" ton b. Nha s s la chn cch x l ty mc tn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

thng. Trng hp ca em nhiu kh nng c cha bo tn. Nu mun na, ty rng b tn cng, vic cha tr s kh hn, lu hn v kh au. Khi qu mun th c th phi nh b rng su. C th ln ny bc s s ly b cao rng cho em ( l mt cht vi bm vo chn rng v gy hi cho c li ln rng), gip cho hm rng em tr nn "d bo qun" hn trc. T nay, em nn tp thi quen chi rng sau mi khi n (nht l ba ti, v ban m vi khun c nhiu thi gian hot ng ph hoi) v lc mi ng dy. Dng thuc nh rng c cha fluor th tt, v cht ny gip bo v rng. ng dng tm cng chc qua k rng, gy tn thng li v lm cho khe li b rng ra, nh hng n rng. Dng nc mui long sc ming thng xuyn. 314. p xe rng "Chu 25 tui, b mt ci nht trong li 3 nm nay; mi ln n mng m th chu li x l i, nhng sau li tip tc sng. Thy thuc bo l vim li, chu dng khng sinh nhng khng khi. Xin cho chu bit l bnh g v cch cha tr?". Nhiu kh nng chu b p xe rng. Chu nn n mt c s nha khoa c thit b chp X-quang rng ti ch pht hin tn thng trn chic rng . Nu ng l p xe th c th phi nh b (t kh nng cha bo tn trong trng hp ny v qu lu). 315. C bc m li "Em b su mt chic rng hm di lu, hai thng nay thy ni ln mt bc m nh li, ngay bn di chic rng . Xin cho bit cch cha, v liu c phi nh rng i khng?". Em tht ng trch. Nu ngay t khi rng chm b su, em i khm rng ngay th u n ni! Khi thy ni bc m ( p xe rng) ri, em vn bnh chn nh vi th tht l "ic khng s sng". Em phi i khm ngay; nha s s c gng cha bo tn cho em (v b p xe cha lu) nhm trnh nh rng. Trc tin, ngi ta s rch m (p xe rng). Mt thi gian sau, khi vt m p xe tng i sch, s phi khoan bung ty ca rng v t thuc dit ty nhiu ln cho ti khi bung ty khng cn mi hi, v khun. Lc by gi mi tin hnh trm rng tm thi bng mt cht d ph ra khi cn. V sau, khi thy rng trm n nh, s xt thi c trm rng vnh vin. Nh vy, mun gi c chic rng phi tn kh nhiu thi gian, cng sc v c tin bc na. Cn nu st rut th nh phng i lun, nhng em u phi gi m nh chu rng rng. Vn cn li l lun gi v sinh rng ming v khng ngi i khm rng khi cn, khi phi n hn v sau. 318. Rng vng do ung thuc "Con gi ti hi nh thng c bnh vin cho ung Tetracycline. Nay chu ln, hai hm rng b vng, mi khi ci l chu li xu h a tay che ming. Xin cho bit c thuc cha khng, hay c phng php thm m no tt nht?". Nha khoa c th lm trng rng vng bng cc bin php: To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

- Bi Peroxyde carbamide ln, ri a mt n quang trng hp li gn rng, ri n trong 3 pht, c th 3 ln trong mi ln (10 pht). Cha t 3 n 8 ln l c (trc phi ly ht cao rng). - t lp ph ln men rng che khut, lm cho rng nhn trng bng nh bnh thng. - Dng kem lm rng trng sau khi nh rng i ng. Cho mt lp kem va phi ln mt mt ca ci kp rng (mt ny s p vo mt trc ca rng). t kp vo cho khp cht vi cc rng ca. Dng bn chi hoc tay dn sch ch kem giy ra xung quanh. Sng dy tho kp ra, nh rng tht k, ri dng bn chi v nc m c sch kp, lau kh, ct vo hp. Mi ng kem dng c t 3 n 6 ln; do vy phi y kn ngay sau mi ln m ra. Khng c n ung hay ht thuc khi ang mang kp. Cha xong, gia nh phi thng xuyn nhc chu khc phc thi quen a tay che ming, mt ng tc "t v" khng cn "cn thit" na v c th lm cho chu tr thnh v duyn khi ci. 317. Rng vu, mi cong "Chu 14 tui, b vu c hm trn v mi b cong. Trng hp ca chu c nn hm c khng, hay phi nh rng?". Chu nn xin b m a n khoa rng ca mt bnh vin ln, xin khm v cha cng sm cng tt. Chu cn t tui, kt qu chc chn s tt hn nhiu so vi nhng trng hp mun. Nu ngoi 20 tui s khng th cha bng phng php chnh hnh. t np xong, chu s v nh, ri nh k ti kim tra. Chi ph ton b tn khong 400 ngn ng. 318. Rng rng sm "Ba chu mi 43 tui m sao rng rng. Xin cho bit c cch g hn ch hin tng ny?". Hng ngy, ba chu nn ung: - 2 vin vitamin E (loi 400 IU). - 2 vin UPSA-C canxi. B i vin thuc, ly mt na, b vo nc cho si tan ra, thm ng, c th thm , ung nh gii kht; ngy 4 ln. Bui chiu ti ch dng v thuc c th gy mt ng. Ngoi ra, nn ung thm mi ngy 1-2 vin Theravit c 1250 IU beta-carotene (cht ng u trong vic chng li cc gc t do vn lm cho c th chng lo ha). Khi rng chc li, c th cho gim na liu mi th ni trn, v duy tr lin tc. V sinh hot, ch chi rng sau mi ba n, nht l ba ti, bng kem nh rng c cha fluor. Trong ch n, nn thm cc loi rau c nn, c mm (gi chng hn), cc th rau, c, qu c mu vng, mu . 319. Khng c rng khn "Em 26 tui, c th pht trin bnh thng nhng ch c 28 chic rng, trong khi mt s bn xp x tui em mc thm 4 chic rng khn na l 32 rng. Xin cho bit ti sao?". C hai kh nng: To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

- Em vn c 4 mm rng khn nhng chm mc. Chp X-quang s thy r hnh nh ca 4 anh chng l m kia trong xng hm. Nhng khng sao, c ngi khe mnh m ngoi 60 tui mi mc chic rng khn cui cng y! - Nu chp X-quang khng thy 4 mm rng khn nh thng l, th em thuc vo mt s trng hp t bin ca loi ngi: khng cn 4 rng khn, ch c 28 rng thi. Ngm m xem, rng khn gy bao phin toi, thm ch nguy him (rng khn mc lch hc vo rng hm, gy au but kinh khng, phi i nh gp; rng khn ch c mt chn, khng c ba chn vng chc nh rng hm, v th thng gp s c, dn n nh b), cho nn khng c rng khn c l l khn ngoan hn chng? 320. Chy mu li "Khng bit chu b bnh g m mi ln nh rng (v nhiu khi khng lm g), chn rng u b chy mu? Xin cho chu mt li khuyn". Nhiu kh nng c th chu b thiu vitamin C. Chu mua mt l Upsa C calcium (C canxi si), trong c 10 vin; b i, cho na vin vo nc chn, thuc s tan nhanh, c th thm ng hay nc . Mi ngy chu dng hai ln (ht 1 vin), khi nhiu s rt xung 1 ln (na vin). Nh thng xuyn n thm cc hoa qu nh chanh, cam, qut, xoi... v cc loi rau. Khi yn tr khi hn, c th thi ung thuc cho tn (mi l C si calcium ni gm 10 vin 1.000 mg gi khong 10 ngn ng). 321. Li b vim ty " 3-4 nm nay, vng li ca chu c ty ln, rt au. Chu li hay chy mu cam, cha tr bng nhiu loi thuc ty khng khi". Chu hy p dng cch cha n gin m ngi dn ngho thng dng (v cha chc thua thuc Ty trong vic iu tr cc bnh li): - L lt ti ra sch, gi nt, vt ly nc (c th dng ci xay sinh t). Cho thm cht mui ri dng ngm mi ngy 3-4 ln, mi ln dm by pht; khi th t ln hn, ti khi khi hn th ngm thm vi hm na. Ch : Ch bin ngy no dng ngy y, khng n hm sau. Khi ngm nu nh nut vo cng chng sao. 322. C nh b nghn "Ti 41 tui, huyt p thng xuyn 160/80. T cch y khong 9 thng ti thy trong ngc nh c cc g chn li, cm gic ging nh khi n cm b nghn hoc ang trong mt cn tc gin cao ; thng bui chiu hay b hn". Th ng thiu chi tit, a ch li khng c th hi thm, cho nn phi nu ln my hng ng lin h, qua trnh by thm vi cc bc s chuyn khoa: To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

1. Do tim nm pha trc thc qun nn vic tim to ln c th vo thc qun (nht l tm nh). Huyt p 160/80 ca ng khng hn l bnh thng, bi v theo s liu JNC nm 1998 ca M, huyt p ti a trn 140 hoc huyt p ti thiu trn 90 c gi l cao. C th lu nay tim ng c tng kch thch t nhiu chng? Mt tm phim chp nghing lng ngc (c barit trong thc qun) s cho bit thc qun b ln hay khng. 2. Co tht tm v: L thng thc qun v bao t (d dy) b nh li do co tht. Nghn trong trng hp ny xy ra khi n ung, v thng xut hin la tui tr hn l tui ng. Tuy nhin, mt cng i vic, tm phim chp X quang ni trn cng cho bit chc chn c vn thc qun khng. 3. U gip th chm n ng: Vic khm k v lm sng, xt nghim v siu m s gip khng nh hay ph nh iu ny. 323. Huyt p t nhin tng cao "Em rt khe, nhng my ln khm ngha v qun s u b loi v huyt p tng ln rt cao, ti 150/95, phi nm theo di kh lu vn th ( nh huyt p ch vo khong 120/80 v em khng h b au u). Xin cho bit nguyn nhn do u v c nguy him lm khng?". Thng th khi ta xc ng, mch c nhanh ln i cht v huyt p cng vy, v iu ch xy ra trong mt thi gian ngn. Ring em, huyt p tng cao t ngt v duy tr lu l do cm xc mnh v ko di (khng quen "b khm", hi hp ch i kt qu khm tuyn, s b loi...). Cc nh khoa hc Anh nghin cu trn 1.600 ngi t 25 n 75 tui, h thy rng nhng ngi d xc ng thng c hin tng huyt p tng cao khi c khm bnh, thm ch khi va nhn thy t o b-lu trng ca bc s. C l em c tng ngi ging vy, v nh chu thit thi khng c vo qun ng. Ch lo lng g. Cch khc phc duy nht l t mnh rn luyn kin tr quen dn vi mi mi trng sinh hot v lm vic. Theo cc nh nghin cu ni trn, tnh trng ca em lc u khng sao, nhng nu lu c th lm cho tim to ra. Do , em phi nhanh chn ln. Hn na, khng bit em s xoay x ra sao nu nay mai c cuc hn h vi mt c bn m em ng ? 324. Suy tim do bnh van hai l "Nm 14 tui em b bnh khp, sau ba nm b bnh tim. Mi y bc s khm v xc nh l suy tim 3 do h van hai l, hp van ng mch ch, tim to ton b. Nm nay em 22 tui, em khng mong cha khi bnh tim, ch mong sao ng tc ngc na, nhiu m phi ng ng, kh qu!". Em cn tr lm. Bnh tim ca em tuy nng nhng ng cam chu nh vy. Trnh y hc c nng cao khc xa rt nhiu; trng hp ca em c th xem xt x tr bng phu thut thay van tim. Nu gia nh c iu kin, em c th vo Vin tim TP H Ch Minh (ng Nguyn Tri To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Phng, qun 10) kim tra, iu tr v xt m thay van tim, c th mi sng tng i khe mnh lu di c. Phu thut ny an ton, bnh nhn c chm sc tn tnh. Kt qu m rt tt, nhiu ngi c m c th lao ng nh nhng v sinh hot bnh thng. Chi ph iu tr khong trn di 25 triu (gm tin mua van tim ca nc ngoi, tin thuc men, phc v...). Nu c giy chng nhn xin min gim th tr t hn. Nu gia nh khng tin th nn xin h hng, chm xm gip , hoc xin cc t chc t thin. V phi khn trng ln. Mt bin php khc l s dng cc loi thuc tr tim, li tiu, chng ng, nga bnh thp khp ti pht theo s hng dn ca chuyn gia tim mch. Nhng nu van tim vn h th khng th ht suy tim c. M cn suy tim th tim vn to v vn tip tc gy kh th. Trong lc ny, em phi trnh tt c mi hot ng th lc, ngay c i li cng phi hn ch, v ban ngy cng hot ng nhiu th n m cng kh th. 325. Hen ph qun "Chu c bc s chn on l b hen suyn. Bnh ny c di truyn hoc ly lan khng, v c cha khi hn c khng? Chu nn dng thuc g?". Bnh hen suyn, ni chnh xc l hen ph qun ( phn bit vi hen tim) khng phi do vi khun hay virus gy ra nn khng ly. N l mt bnh d ng, m tnh hay b d ng (i vi thi tit, mt vi th thc n, phn hoa...) c th di truyn, nht l khi c hai b m u b. S d ngi hen b kh th khi ln cn l v lc , phi xy ra hai hin tng tri ngc. Cc ph qun nh co tht, trong khi cc ph nang (ti kh) gin ra (ta nh cc cung qu bng th thu nh cn bn thn cc qu bng li phnh ra); khin bnh nhn ht vo kh nhng th ra cn kh hn nhiu. V vy, ngi ln cn hen phi ngi khunh hai tay, c ht sc y khng kh ra m vn thy ngt ngt. Cc ph nang b gin lu ngy khng hi phc c na, s lm cho lng ngc bin dng. Nguyn nhn ca hai hin tng trn l do mt cn bng gia h thn kinh giao cm v h thn kinh ph giao cm (cn hen thng xy ra ban m, v vo ban m, h ph giao cm hot ng mnh hn). Y hc hin cha cha c tn gc bnh hen ph qun; cc loi thuc c s dng ch cha triu chng cng nh bin chng. Chu nn i khm mt bc s c tay ngh vng c hng dn cch cha v phng nga bin chng. Chu c th dng thuc xt hng Ventolin: Nu cn va phi, xt 2 ci lin, ch 1 pht ri xt thm 2 ci na. Nu cn nng, xt ln u 2 ci lin, ri sau c 5 pht li xt 2 ci, cho ti khi ht cn th thi. Vic dng thuc nht thit phi theo ch nh ca bc s. Mt s bnh nhn hen lu nm c bc s cho tim bp tht mng thuc Kenacort (K-cort) thi tr chm (loi 80 mg), vi khong cch 1-2 tun 1 ln, khi th tha hn, c th ti 1-2 thng/ln, kt qu nga cn kh r rt. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Bnh hen ph qun nu lu ngy s gy hi cho tim (bnh tim do phi, y hc gi l tm ph mn). V ngi hen c th d b d ng vi mt s thc n. Mt s ngi b hen ph qun do d ng thi tit, sau khi chuyn vo min Nam mt thi gian th nhiu hoc khi. Chu xem c iu kin chuyn vng khng? 326. Khi b hen cha thuc khng khi "Ti gn 30 tui, b hen t hn chc nm nay, h thay i thi tit l ln cn kh th v m, dng loi thuc khng khi. Xin hi c phng cch iu tr no tt v c nn cy Filatp khng?". V thuc men, bn c th tham kho Mc 325, nhng xin nh rng cc thuc nu trong mc ny ch c tc dng chn cn hen, ch khng cha c cn nguyn ca bnh hen l hin tng d ng. Tht vy, do d ng m c th bnh nhn xy ra s mt cn bng gia h thn kinh giao cm v h thn kinh ph giao cm (v s mt cn bng ny m cc ph nang nh b co tht, trong khi cc ph nang gin ra, gy nn kh th, nht l lc th ra), mc d c ph qun ln ph nang u khng c tn thng thc th. V suy cho cng, theo quan im hin i, mt cn bng thn kinh l do mt cn bng v nng lng sinh hc trong c th. Nu nng lng sinh hc tr li lu thng bnh thng th s ht mi hin tng mt cn bng. i theo hng , t my nm nay, Trung tm nghin cu v ng dng nng lng sinh hc thuc Lin hip cc hi khoa hc v k thut Vit Nam c kt c cc phng thc hu hiu v dng sinh v cha tr mt s bnh, trong c hen ph qun. Bn c th lin h vi trung tm qua a ch 46 Bnh Vn Trn, qun Tn Bnh, TP H Ch Minh, T: 08-8652040. Trung tm s gii thiu nhng a ch gn nht gip bn luyn tp cha tr bng nng lng sinh hc. Filatp l rau thai t dm by hm trong t lnh (theo phng on l cc m ca n do chng chi vi ci lnh m sn sinh ra cht kch thch sinh hc) ri nghin ra, ch thnh thuc tim hay ung. Phng php ny mt thi r ln ng u v mt s tnh ca nc ta. Ti nay, khng cn my ai nh ti n na v khng hiu qu. 327. Sau khi b vim phi "Chu lm ngh rang xay c ph; gn y b vim phi nng, c cha lnh. Chu mun bit sau ny nu tip tc lm vic nng th c sao khng, v c cn king khem g khng?". Vim phi l mt bnh cp tnh, cha khi l xong (i vi tr nh th hy d chng v vng ny v sau c nguy c b gin ph qun). Ch cn chu sng iu , n ung tt, tp th u n gip ch tn thng c hi phc tt. Tuy nhin, nhng ngi cha khi bnh vim phi v sau vn c th b li, ti vng phi c hay mt vng khc. Do vy, chu cn trnh khng b dm ma, nhim lnh (nht l khi ang b cm), gi v sinh rng ming... Vic gi gn tt sc khe cng s gip chu ngn nga c lao phi - mt To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


cn bnh x hi ang c nguy c pht trin trong s b con ngho.

L Trng Bng

Chu khng phi king khem g ngoi thuc l v ru. Nn eo khu trang khi lm vic chng bi. 328. Khi nghi ngi gip vic b lao "V chng chng ti bn vic, phi nh mt ch khong 45 tui trng gip chu nh 2 tui, n ti nh. Gn y, sau khi b st, ch ho nhiu, ko di cho ti nay. iu ng lo nht l chu b cng b st cao, ho, nn v gy st. Chng ti lo ch gip vic b bnh lao, v dng thuc ho mi vn khng ht". Th bn ni khng chi tit, rt kh ni chc, nn xin nu ln my im bn tham kho v vn dng: 1. Nu ch gip vic ca bn ch b st my hm ri ht, th nhiu kh nng l b cm, v triu chng ho ko di l hu qu ca bnh ny, c khi vi ba thng mi khi hn. 2. Nu ch y vn st hm hp v chiu, m ng ra m hi trm, km n, km ng...th hy coi chng ch b lao phi. Nu vy, cn cho ch i khm c chp X-quang phi, xt nghim m tm trc khun lao. Nu ch y b lao phi, bn phi cho ch y thi vic ngay c cha tr theo yu cu ca bnh tt (nm vin hay dng thuc ti nh) v trnh ly nhim tip cho gia nh bn. Trong tnh hung , phi ng thi lm my vic: - Cho chu b i khm xc nh c b s nhim lao hay khng (chp X-quang phi, th phn ng lao). Nu c, chu s c bc s cho dng thuc, sau khong 6 thng l ht, khng li di chng (va qua, chu b st cao, ho, nn, gy st ch l do b cm thi, bi v s nhim lao khng "n o" nh vy). - Tng v sinh nh ca nhiu ln (khng c qut kh), phi chn mn, qun o, c ra nng trong nhiu bui lin, hoc i (l), thng xuyn nh nng vo nh (trc khun lao rt n tia nng, nht l vo bui tra). D tm ba ln lin tip vn khng thy trc khun lao trong m ca ch gip vic ("khng thy" khng c ngha l "khng c"), bn cng phi lm nh vy thanh ton nhng trc khun lao c th c. - V chng bn cng phi i chp X-quang phi xem mnh c b thm nhim lao hay khng. Nu c, vic cha tr s mang li kt qu m mn bng nhng thuc chng lao hu hiu, vi iu kin dng liu lng, thi gian, ng thi ch bi dng v gi gn sc khe. 3. Nu cn mt ngi gip vic khc, nht thit bn phi cho h chp X-quang trc loi tr cc bnh phi, c bit l lao phi. Bi v nhng chu b s nhim lao lc u th th v sau rt d b lao phi, nht l khi ngun ly bnh li tn ti lu di ngay st nch chu. C trng hp ngi gip vic b lao x hang m gia nh vn nh trng con nh sut my nm tri, chu ny ln ln b lao To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


x hang, phi m ct phi m vn khng qua c.

L Trng Bng

Mt lng trc c lng sau, nu bn lo liu trc i th u n ni phi lo lng nhiu nh vy. 329. Hy phng thm nhim lao "Cch nay 3 nm, chu phi nm vin v hm no cng st t chiu n sng; bc s bo khng phi lao, tuy kt qu th phn ng tay chu dng tnh. Sau chu khe li. Gn 5 thng nay, thy c hin tng nh trc, chu chp phi v c kt lun khng phi lao phi. Sau khi c bo, chu mi ngh n bnh r hu mn ca mnh t trc (hm no st nhiu l ch r mng m)". R hu mn c th do lao gy nn. V nhng ln chu st km theo sng ty ri v m l biu hin ca bi nhim. Nu c vy th hin tng ny s lp li nhiu ln, ng r ngy cng phc tp hn (thm ngc ngch, x dy hn, thm ch thm ng r). Tuy hin gi hai phi chu cn bnh thng nhng nguy c b lao phi vn lun rnh rp, th phn ng lao vn dng tnh. Chu nn sm n mt khoa ngoi tng qut ca bnh vin xin m. Cc bc s s lun dm by si ch vo ng r, sau c 1-2 hm tht cht mt si, gip ng r m ra v thnh so. Nu v l do c bit no cha i m c, chu phi ch gi gn sc khe, n ng tht tt. Trong tnh hnh bnh thng, t nht mi nm chu phi chp phi mt ln, nu c thm nhim lao th kp thi cha tr; v trc khun Koch hu mn ny khng yn phn b "cm t" u, n s tm c hi tn cng phi y. 330. Chng ang cha lao phi c nn sinh con? "Chng ti b thm nhim lao, c iu tr tn cng 2 thng ti bnh vin huyn, sau iu tr ti nh 3 thng na. Trong thi gian cha bnh, chng ti c nn sinh con hay khng, nu sinh con th c nh hng g khng?". Trng hp ca v chng bn phi c cn nhc k v c hai mt bnh tt v sc khe. 1. Nu trong m ca anh y vn c trc khun lao (BK +) th kh nng ly nhim cho v con rt ln, nht l nu chu b ra i vo dp ny. D c tim phng lao, chu b cng kh trnh c tnh trng s nhim lao v c ngun ly nhim thng xuyn v qu gn. Trong tnh hnh nh vy, bn thn bn v cc thnh vin khc trong gia nh cng c nguy c ly bnh. Thc ra, "khng thy BK trong m" khng c ngha l "khng c BK trong m"; cho nn mun kt lun chnh xc, phi tin hnh cc bin php tm ti cao cp (nui cy m trong mi trng, tim truyn vo mng bng ca chut th nghim...). Nh vy, vic cn lm trc nht l cho anh y i khm ti mt c s lao c trang b tt hn v chuyn gia gii hn, nhm bit r c 2 iu: tn thng lao n nh cha v trong m cn c BK khng. T , bc s s cho hai bn li khuyn chnh xc nht. 2. Trong khi cn tp trung n lc vo vic cha bnh cho chng, nu thai nghn, sinh n, nui con..., bn s khng c iu kin tinh thn v vt cht trng nom anh y nh hin nay. l cha ni To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

n chuyn anh y s lo lng, thao thc, chia s vic nh vi bn, dn n chm bnh phc hoc bnh s din bin theo chiu hng bt li. 331. Ung th phi "Em c mt ngi bn b ung th phi, nn mun bit mt s im chnh v bnh ny: nguyn nhn bnh, c my thi k, bnh c ly khng, c cch g cha tr, k c thuc dn tc c truyn?". Ung th phi l c u c tnh xut pht t ph qun. y l mt bnh mc phi (khng ly), thng gp sau tui 40, nam hay b hn n, thng gp nhng ngi khai thc qung phng x v qung c cha cobalt, ngi nghin thuc l. Nguyn nhn gy bnh cha c xc nh r. T mt im bt k trn ph qun, khi u li dn vo trong lng ph qun, tin ti lm cht hp ph qun m biu hin sm nht l xp phn phi do ph qun ny ph trch (v khng c bm khng kh vo nh trc). Nu l ph qun nh th mt u b cng gy cht hp, dn ti hin tng xp phi; nu l ph qun ln th u phi kh to mi gy ra c hu qu ni trn. Triu chng lm sng bui u ca ung th phi thng ngho nn nn d b b qua: au ngc (d b quy l do au dy thn kinh lin sn), ho hng hng, khng c m. V sau s xut hin kh th (do ph qun b cht hp hoc do u chn p trung tht), c mu ln trong m hoc khc ra mu thc s, au nhc dc xng cnh tay pha c u... Lc ny, tnh hnh kh mun. Phng tin chn on ung th phi l chp X-quang phi thng (thy mt m m to hoc nh vi c im l c nhiu "chn" cha ra); chp tomo hay chp scanner (xc nh v tr v kch thc khi u cng nh khu vc b xp phi); chp ph qun c bm cn quang (pht hin hnh nh ph qun b ct ct in hnh). Nu u nm ti mt ph qun rng, c th tin hnh soi ph qun (trc tip nhn thy khi u v vng xung quanh). Phng php iu tr ch yu l phu thut ct thy phi hay l phi, sau kt hp vi ha tr v x tr. Thng c khong 80% bnh nhn sng thm c 1-2 nm sau m, 5% sng thm c 5 nm. Cc t l ny chc chn s c ci thin cng vi s ra i ca cc cht chng ung th hu hiu. V d phng, cn khc phc cng sm cng tt thi nghin thuc l; khi s dng ha cht phi c phng tin phng h chc chn. V pht hin bnh, ngi ta khuyn nhng ngi trn 40 tui (nht l ngi nghin thuc l) nu au ngc mt vng c nh, km theo ho ko di... phi sm i chp X-quang phi, c loi tr hay pht hin mt bnh phi bt k, trong c lao v ung th. Cho n nay, cha thy c nghin cu nghim tc no cho thy c th cha ung th phi bng y hc c truyn. Tuy nhin, sau khi phu thut, c th s dng thm cc phng thuc gia truyn h tr iu tr. Lu nay, nhiu ngi ca ngi tc dng phng chng ung th ni chung ca c tam tht; em c th mch cho bn dng xem, v tam tht cng l loi thuc b tt khng km nhn sm, li r tin v d kim. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


332. Lao phi ko di

L Trng Bng

"Ti b lao phi 6 nm nay, iu tr theo phc ca trm chng lao nhng khng bt, bnh ngy mt nng thm, th trng ch cn 40 kg. Va ri, qua bo ch ti c bit c loi thuc Rifampicine tr lao hu hiu. Xin cho bit mua u, c t tin khng, s dng nh th no?". Thuc chng lao Rifampicine c mt nc ta vo khong gia thp nin 1980 do mt s ngi i nc ngoi mang v hoc b con Vit kiu gi biu thn nhn. T my nm nay, n rt ph bin cc thnh ph. Tic rng bc khng c bit nn b "oan", nhng khng sao, bc nh tin hnh ngay my vic: - Theo n ca bc s, dng thuc Rifampicine (Php) hoc Rifacin (M), c hai u cng hm lng 300 mg/vin nhng v tc dng ngang nhau. Nu t tin th nn mua Rifacin. Nhng loi thuc ny ung vo hi mt, cn ung lun 2 vin ngay sau ba n ti ri i nm. Nc tiu ca bc s c mu hng m trong sut thi gian s dng, l iu bnh thng. Trng hp ca bc c th phi dng thuc 5-6 thng hoc hn, km theo mt s thuc khc theo cc phc iu tr lao ca ngnh y t (hin c Nh nc cp min ph). - Nn dng thm vin a sinh t Theravit, mi ngy 2 vin; khi khe nhiu ch cn dng 1 vin. - C gng bi dng ti a v cht m (tht, tm c, trng, u ph...). Nu bc khng gh th xin mch bc mt cch bi dng hu hiu, t tn km v n gin nh sau: Lin h trc vi trm h sinh c c nhng nhau thai bnh thng, khng bnh, mi tun vi ba ci. Bc b ton b mng i v ct b cung rn. Dng khn sch thm bt mu. Cho vo cho du nng, ri lt qua mt kia tht nhanh ( ci nhau chc li thi, cha cn chn). Ly ra, thi ming va phi. p ti hoc gng, thm cht nc mm. Ra sch ci cho dng, cho du, bc li ln bp. Cho nhau vo, o u tay, khi cn sn st th nhc ra (kh qu s khng ngon). n ngay ti ch lc cn nng, nhm nhi vi rau thm hay gng ti chun b t trc. Bc n chng chc ci l thy sc khe kh hn ln, d ng. - Cho cc thnh vin khc trong gia nh i kim tra phi, bt u t nhng ngi tip xc nhiu vi mnh, c iu tr nu ly bnh. Vi cc chu nh, nu b s nhim lao, nn cho dng Rimifon vi thi gian khng di 6 thng. - Thng xuyn phi nng cc vt dng (qun o, chn mn, bt a...) v m ca cho nh mt tri chiu nhiu vo nh. 333. Khc ra mu dai dng "Chu c a em gi thnh thong b khc ra mu (mi ln nh vy thy nhn nhn ni c v c th o ra kh nhiu), i bnh vin nhi a phng hai ln u c chn on l vim phi thy, khc ra mu, cha tr mi khng ht. n bnh vin lao th h bo khng phi bnh lao v khng nhn cha. Hin nay em chu vn c nh vy. Xin cho bit cch x tr". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Th chu s si v nht l khng ni r em chu c c chp X-quang phi khng, kt qu c phim ra sao, do khng nm chc c tnh hnh. Ch nu my hng gia nh chu lin h: Nu l "lao phi c khc ra mu", th trn phim X-quang s thy hnh nh ca hang (mt hoc mt vi hnh trn sng, c b dy, xung quanh l mt m m khng u). Vi th lao hang c khc ra mu d di, e da tnh mng th phi cho nm vin, c th phi m. Nhng lao hang l mt th bnh rt him thy tui thiu nin. Hy vng em chu khng ri vo trng hp . Nu l "vim phi thy gy khc ra mu" th c cha ht vim phi s ht khc ra mu. E rng em chu khng b bnh ny. Cn li mt bnh c th ngh n, l gin ph qun gy chy mu, xut hin do di chng ca cc bnh mc vo lc nh nh vim ph qun, vim phi, ho g. Nhng bnh ny lm cho thnh ca cc ph qun (cung phi) b suy yu v gin mng, d chy mu (thng xuyn khc ra cht mu nn ta tng nhm l lao phi; nu ch gin nm st mch mu th lng mu khc ra s nhiu hn). iu c bit l trng hp ny, bnh nhn thy nhn ni c v c th o mu ra, ng nh trong th chu ni. Gia nh chu cn khn trng a em ti mt bnh vin no c khoa phu thut lng ngc. Nu ngoi bc th n Vin lao v bnh phi, H Ni, ni c khoa phu thut lng ngc giu kinh nghim, k c m tr em. 334. Khi bn cng lp b lao "Mt bn trai cng tui (12 tui) trong lp chng chu c ngi m b lao phi nng i nm vin. Gn y, bn y xanh xao, thnh thong li ho hng hng, chng chu s bn y cng b lao nh m. Nu vy th lp chu c b ly hay khng, nht l nhng ai ngi cng bn?". Tuy cn t tui, hai chu t ra cu hi lu nay vn lm nhc nhi nhiu nh y hc trong cc nc ngho: Lm sao ngn chn c mt cch hu hiu, khng cho bnh lao phi tip tc ly lan nh hin nay? Chc cc chu bit c thuc cha khi bnh lao. iu ny hon ton chnh xc. Mt ti liu cng b nm 1996 cho bit rng nu c cha tt th ch sau hai tun, mt ngi lao phi s khng cn ly lan sang ngi khc. Tt nhin, ngi ny phi tip tc iu tr cho n khi hon ton khng cn hnh nh tn thng lao phi; by gi, bc s mi cho ngng thuc. Tuy bnh khi nhng chp X-quang vn thy du vt c ca bnh lao, di dng x hoc nt vi phi. Nh vy, cc chu cng thy l mun bnh lao phi khi hon ton, khng cn du vt, hai phi tr li "nguyn xi" th iu quan trng hng u l cha tht sm, cng sm cng hay. By gi ni sang chuyn lp cc chu. Nu m ca bn chu b lao nh vy th nht thit phi tin hnh tun t mt s vic: - Kim tra khng ch ngi bn m tt c nhng ai v ang gn gi m bn , c bit cc To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

chu nh di 5 tui (bng th phn ng lao, chp X-quang, th m, nu cn th cy m, cng ba ln lin tip, tm vi khun lao). Nu c vn , bc s chuyn khoa lao s cho iu tr theo phc tng trng hp c th. - Nu ngi bn nh ca chu b s nhim lao (chc l b, v m con khng trnh khi quan h, chm sc, nng gic), bn phi ung thuc c tr s nhim lao. Th bnh ny khng ly, cc chu c quan h bnh thng, nhng nn t lui ti nh bn y mt cch thng xuyn (v vi khun lao ca m bn vn tn ti ni ). - Nu chng may bn y b lao phi thc s (t kh nng hn nhng cng phi d chng), phi kim tra ton th hc sinh trong lp, cc thy c trc tip dy lp chu hoc vn km ring bn , khng phi bng ng nghe (ng nghe khng khng nh c bnh lao u), m phi kim tra theo cung cch ni trn. Nu thy c gio b lao, li phi kim tra cc gio vin hoc nhn vin trong trng c quan h thng xuyn vi thy c . Tt nhin, thy c khng may ny li phi cho kim tra cc thnh vin thn cn nht ca mnh. V c th... rt phin phc, tn km, nhng v cng cn thit cho tnh mng v hnh phc ca con ngi. 335. Trn dch mng phi "Chu c mt ngi bn trai b trn dch mng phi, hin cha khi. Nhng c ngi bo l bn y mi nm vn phi n bnh vin ht dch mt ln, v ch sng c n 30-40 tui thi. Nghe vy bn chu rt bun, sc khe gim st nhiu. Xin gii thch r chu c th gip bn y". Xin biu dng tm lng nhn hu ca chu i vi bn b (mt s ngi thy bn nh vy th "cao chy xa bay" y!); v cng ni ngay chu yn tr: nhng iu on m v tng lai ca bn chu nh vy l sai trm phn trm. Trn dch mng phi ngi tr (thut ng chuyn mn: trn dch mng phi thanh t nguyn pht) xut hin do vim mng phi ring bit hoc km theo vim mng bng, mng tim (vim a mng), th phm gy bnh l trc khun lao. Do ch vim mng phi, bnh nhn ch ho khan m khng c m, v vy khng h ly nhim cho ngi khc. Cha bnh ny cng khng phc tp: dng cc thuc chng lao, kt hp vi rt dch mng phi (chc ht ht lun mt ln, hoc bng nhiu ln, trong iu kin v khun tuyt i, k thut chnh xc). Bnh nhn phi tp th nhiu, gip phi hot ng tt tr li (v bnh t nhiu u li dnh mng phi). i vi bn chu, iu v cng quan trng trong giai on ny l ung thuc d phng lao phi, t nht trong 6 thng, v c 6 thng kim tra mt ln ti mt c s lao ca ngnh y t (trong nm u), sau th 12 thng, ri tha dn nu tnh hnh tt p. Trn dch mng phi khng gy hu qu g cho tui th hoc chuyn sinh con ci. Trong mt lp To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

y khoa t hi khng chin chng Php c ba bc s b bnh ny lc cn sinh vin. Hin nay ba c gn 70 tui vn khe khng km thanh nin, v c nhiu chu ni ngoi). Chc chn bn chu s hn ba c - v hin c thuc chng lao hu hiu v mc sng t nhiu c nng ln - nu anh ta lun t nhc nh iu ny: b trn dch mng phi th phi lun ch phng lao phi. T , phi lo gi iu trong sinh hot mi mt v t bi dng ti a, t nht trong 1-2 nm u. Xin ni thm l: Nu khng theo li ch dn ca bc s, mt thi gian sau, ngi trn dch mng phi thanh t nguyn pht c th mc lao phi. Lc by gi c th b trn dch th pht (do tn thng lao phi), rt nguy him. 336. Trn dch mng phi ngi cao tui "M ti 87 tui, trc nay vn khe mnh. Gn y, b thy mt v chn n, bc s khm thy ting phi c, chp X-quang pht hin trn dch mng phi, chc ht dch (mu vng chanh), th phn ng Rivalta dng tnh, chn on l lao mng phi. M ti c chuyn v a phng iu tr khong non mt tun th li trn dch, phi ti bnh vin chc ht; trong 1 thng chc 5 ln, khong hn 5 lt, u c mu mu. Hin m ti vn chn n, ch mun ung thi. Xin cho bit y l bnh g, nguyn nhn v cch phng tr? C th truyn dch, truyn m khng?". Qua th bn, c th thy bc s chn on nh vy l ng: M bn b trn dch mng phi nguyn pht thanh t (dch mng phi nhiu, mu vng chanh, th phn ng Rivalta dng tnh), nguyn nhn do lao mng phi. Th bnh ny hay gp ngi tr tui, rt him ngi cao tui nh c. V x tr, vic chc ht dch kp thi gip bnh nhn d th, khng b suy h hp, nht l ngi gi; cn chc ht trit nhm phng nga di chng dy dnh mng phi. Cn nh rng: Sau khi chc ht dch mng phi ln u, d ly ra c ht hoc gn ht dch, cng khng th coi l lm cho mng phi ht dch. Bnh nhn phi sn sng chc tip rt sm sau v chc nhiu ln, trong khi vn phi cha nguyn nhn l bnh lao. Th bn khng ni r c nh c dng nhng thuc g. Nht thit c phi c iu tr bng cc thuc chng lao mnh cha cho khi vim lao mng phi. C nh vy phi mi c th ht dch, ngn nga c bnh lao phi (vn nng n v phin phc hn nhiu). Gia nh nn cho c i khm chuyn khoa lao ca ngnh y t c dng thuc chng lao min ph theo phc , trong th no cng c Rifamipicine v Rimifon (c bn ti hiu thuc ty). Khng nn truyn dch, cng khng nn truyn mu, phng nga bin chng n phi, rt nguy him. Nu c truyn m, phi truyn tht chm v theo di cht ch. Tt nht l cho c ung Moriamin forte, 2 vin nang/ngy); ng vin c n nhiu nc xp tht c, rau, dng trng, nc p hoa qu cc loi, ung a sinh t Theravit 2 vin/ngy. Nn nh rng tim ngi gi rt nhy cm vi tnh trng thiu xy. V vy, cn ch gi cho ng th ca c tht thng sut bng cch ng vin c c khc ht m di, gip c m nh lng; nu To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


cn th cho th xy cch qung c theo di.

L Trng Bng

Trong trn dch thanh t, dch ht ra phn ln c mu vng chanh, v mt s t c mu mu. Trng hp c nh c th thuc s t . Dch c mu cng c th do thao tc chc ht (khng sao u, chuyn ny bnh thng thi). Tuy nhin, nu thc s cht dch ht ra hon ton l mu mu thm th phi d chng c khi u phi (chc ht dch, xong cho chp X- quang ngay s thy r). Hy vng l c khng b ri vo tnh hung ny, bi v, nh ni trn, th trn dch ny t khi thy ni ngi cao tui nh c. 337. Trn kh mng phi t pht "Em 32 tui, cch nay hai nm b trn kh mng phi t pht bn tri, ton b phi tri b chn p, c Bnh vin Lt chn on v cho chuyn cp cu v Trung tm lao v bnh phi TP HCM. Cc bc s rch ngay mt vt nh ngc tri t ng dn lu kh v dch, 1 tun rt ng, sau vi hm em c ra vin. V nh 1 tun, bnh ti pht, li c x tr ging trc, c thm thuc chng dnh bm vo qua ng dn lu, sau 2 tun, em xut vin. Trong hai ln iu tr, th m u khng thy BK. T khi ra vin, em ch c ung thuc gim au, thuc ho v thuc b, v bc s ni khng c thuc g c tr trn kh. Em mun bit bnh trn kh t pht l g, nguyn nhn do u, c nguy him v kh cha lm khng?". Em may mn c chn on sm, x tr kp thi v ng nguyn tc. Trn kh mng phi t pht, ngi tr tui v c b ngoi khe mnh nh em, thng l do v mt vi kn kh (kyste arien) nm ngay bn di mng phi. Nhng kn kh ny nu qa nh s rt kh pht hin bng X-quang. Lc bnh thng th khng sao, nhng khi gng sc qa mnh hoc khi bay rt cao, kn s v ra, cho khng kh la vo khoang o nm gia mng phi v lng ngc (bnh thng th khoang ny hon ton khng c khng kh, p lc m tnh, cho php phi lun p st vo lng ngc). Khng kh ny chn p phi, lm cho phi bp xung, khng cn hot ng trao i kh. Cch x tr duy nht l ly b lng khng kh ny. L tng nht l t ng dn lu khoang mng phi (nh lm vi em) ri dng my ht nh lin tc (nh khng gy rch thm mng phi, lin tc lun lun to khoang o ni trn). Th thut dn lu ny phi c tin hnh ti mt c s chuyn ngnh, v khun tt, vi bc s c tay ngh. Nu c s khng c iu kin thc hin th thut ni trn th trong khi ch i hoc trn ng chuyn v tuyn sau, nu bnh nhn kh th nhiu, ngi ta phi chc ht mng phi ht bt kh (trng hp ny cng phi v khun tuyt i trnh nhim khun khoang mng phi). Trong khi dn lu kh, thng thy c mt lng dch khng mu km theo, nguyn nhn l do mng phi b kch thch tit ra. Hin tng ny s chm dt khi khng cn khng kh st li. Phi rt ht cht dch trnh nguy c nhim khun m mng phi. Thuc men bc s cho nh vy l . Tuy nhin, nu mun tht chc chn khng phi do lao, em nn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

xin chp li phi v lm phn ng lao; nu c vn , bc s s cho thm mt t thuc phng lao. Em nn thng xuyn tp ht th su (th vo v th ra ti a), khc phc hin tng dnh mng phi, ch sinh hot iu , v hy yn tm. 338. Bnh bi phi "T nm 20 tui, chu vo lm ti mt x nghip gch ngi, chuyn t l; t n nay da chu sm li, mi thm. Va qua, x nghip mi bc s v khm nh k, pht hin chu b ri lon nhp tim, vim ph qun v vim hng ht, nm vin mt thng khng . Hin chu b khc ra m ln mu, bc s li chn on l vim ph qun, cho cha bng khng sinh nh ln trc, v vn khng ". Th chu khng ni v iu kin lm vic c th, cng khng ni c c chp X-quang phi hay khng nn kh ni chc. Nhng c kh nng chu mc bnh bi phi (do khng eo khu trang thng xuyn trong khi lm vic, chu ht phi bi than , nhng bi ny nm li vnh vin trong phi). Bnh bi phi gy ho nhiu v khc ra mu lt nht. Nu bnh nng, lu ngy s dn n thiu nng h hp v nh hng n tim (tm ph mn). Chu nn sm i chp X-quang hai phi ly ti liu chn on. Nu gii p ny khng trng th tht may mn v chu cng yn tm thm khi bit mnh c b lao phi hay khng. D kt qu ra sao, chu cng nn ch trng hn n vic phng h lao ng, hoc chuyn sang cng tc khc. 339. Sn v u trng sn "Chu c bo thy mt bnh vin pha Bc c my chp ct lp hin i pht hin c 20 trng hp u trng sn ln nm trong no, da v c. Bi bo cng ni nguyn nhn l do n rau sng, ung nc cha si, n tht ln cha nu chn. Trc y, thy gio chu ch bo n tht ln, tht b ti th b sn ch khng thy ni l s b bnh gh gm nh vy". Sn ln sng k sinh trong rut non ca ngi, u sn c mc bm cht vo mng rut, thn c hng chc t, mi t l mt trng. Cc t cui cng l ln tui nht, trng sn y "chn". Mi ln bnh nhn i tin, tng on gm 2-3 t hoc hn theo phn ra ngoi ( sn b c khc: tng t n c t ng chui ra "v t" bt k lc no). Nu ln hoc ngi n phi nhng trng sn ny, trng s qua thnh rut, i vo c (bp tht), no... pht trin thnh u trng, nm li trong . Nh vy l trong trng hp n phi trng sn, con ngi cng b go nh ln, chng qua v khng b m tht nn khng bit l "ngi go" m thi. y ng l trng hp m nguyn nhn c tc gi bi bo nu ln: do n rau sng, ung nc cha chn. Hu qu ny rt nghim trng, v cc u trng sn nm trong no s gy chng nhc u thng xuyn v tng dn theo tui ca u trng, hoc gy bnh ng kinh. Sai mt ly i mt dm l To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


nh vy.

L Trng Bng

Nu con ngi n phi tht ln go nu cha k, u trng t tht ln, tht b vo rut s tr thnh con sn trng thnh (ch u trng khng chui vo cc t chc khc nh no, c, da nh trng hp trn). Nh vy, li thy gio chu ging vn khng sai. V d nhin kin cho rng "b u trng sn nm trong no, da, c... nguyn nhn do n tht ln cha nu chn" l iu khng ng. Tic rng iu ny li c ng trn bo, c th lm cho hng triu bn c ng nhn theo. Khi thy tht ln, tht b c u trng sn (b go, r nht l li), cn b th y hu trch quyt nh khng cho s dng. Nhng do mt s ngi tic r, hm li nn nhng loi tht nh vy vn c mt trn mt s quy. Chng ta cng nn nh li mt trng hp cht thm ti mt lng qu min trung trong thi bao cp: Mt n v b i m ln thy b go bn mang vt ra b sng (c s h l khng chn k). Mt s b con xo tht v nu n; mt ngi n ng lc lng n nhiu tht ny t t sau ba n, c th do d ng mnh vi cc cht l cha trong bc u trng sn (tuy u trng cht nhng nhng cht l ny vn gy hi). Hin c thuc cha sn hu hiu. Trong cc ln i tin sau khi ung thuc, nn ngm t vo nc m lc sn t lui dn xung. Cn xem xt k u ra cha (u sn nh hn t, hnh cu), v nu u cha ra l cha khi bnh, sn s tip tc sn xut ra cc t nh trc. 340. Xt nghim vim gan virus "Chng chu 33 tui, qua xt nghim c chn on l vim gan virus B: SGOT 588, SGPT 417. Xin cho bit SGOT, SGPT l g, kt qu xt nghim nh vy c nng khng?". SGOT v SGPT l nhng enzyme (men) vn nm trong t bo, c gii phng ra khi t bo hoi t v i vo mu (bnh thng c < 40 n v; khi vim gan, c th ti hng ngn n v). Trong trng hp chng chu, hai men ny tng va phi, chng t gan b vim nhng khng nng. Tuy nhin, xc nh vim gan virus B (gi tt l VGB) th phi lm thm xt nghim mu tm c tc nhn gy bnh l HBsAg. Bi v bnh vim gan virus khng ch c VGB m cn c vim gan C (cng ly qua ng mu) v vim gan A (nh nht, ly qua ng tiu ha). 341. Vim gan virus B ly nh th no? "Chng em c mt chu gi su tui. Va ri, bnh vin pht hin trong mu chng em c khng nguyn virus vim gan B dng tnh. Chng em phi lm g khi ly bnh, nht l vi chu nh; c phi cch ly khng? V liu sau ny chng em cn c th c thm mt a con khe mnh?" Vim gan virus B ch ly qua ng mu: qua vt xc da, nh rng... khin virus t ngun ly lt vo; qua tim truyn bng nhng dng c khng trit v khun (thng l do truyn mu ca nhng ngi hin b vim gan). To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Vim gan virus B khng ly qua nc bt hoc qua ng sinh dc (mt vi nh nghin cu pht hin thy virus vim gan B c mt trong cht xut tit ca b my sinh dc, nhng hin vn cha c bng c v ng ly nhim ny), cho nn khng cn cch ly v n ung hay ngng quan h v chng. V d nhin hai em vn c th c thm chu b khe mnh nu nui dng ng phng php. Trc mt, em v chu phi i xt nghim mu tm khng nguyn virus vim gan B. Nu m tnh th xin tim chng phng bnh ny (ti Vin v sinh dch t H Ni hoc Vin Pasteur TP H Ch Minh), nu dng tnh th thi. Ch bi dng c bit cho b chu v cht m (tht, c, u ph...), vitamin; khng cho ung ru hoc nhiu bia, khng ht thuc l; lm vic v ngh ngi iu . Trc khi quyt nh c thm chu, nn cho kim tra li sc khe ca b chu. Nu cn ti thuc th phi i khm bc s k n 2 th thuc sau: 1. Lamivudine, tc ng trc tip ln virus, khng cho n sinh sn. Hin c 2 loi, tnh nng nh nhau nhng mang tn bit dc, cch ng gi v gi c khc nhau; ty tnh hnh m chn loi thch hp, ung mi ngy 1 vin, trong t nht 1 nm. - Zeffix 100 mg, l 28 vin, gi khong 34 ngn ng/vin. - Lavudine 100 mg, l 30 vin, gi khong 26 ngn ng/vin. 2. Alpha-interferon (Intron A), kch hot h min dch, tim mi tun 3 ln trong 4-6 thng. Gi khong 450 ngn/l. Nhn y xin gii thiu 1 bi thuc ng y cc em c th s dng kt hp: - B cng anh, nhn trn, phc linh, si h, sn chi mi v 10-12 g, ut kim 6 g, sc ung hng ngy. 342. Li gii cn b ng "Bnh vim gan virus B ch ly qua ng mu, vy khi hai v chng chu ng chung ging cng b mt con mui t th c ly cho nhau khng?". Cu hi ca chu lm cho ngi gii p bt ci nhng li rt lng tng, v cha thy c cng trnh nghin cu no cp n tnh hung c bit ! nh b ng nh cc nh bc hc trn th gii cng nh trong nc c dp gii p gip. Trong khi ch i, nn chng chng mnh c "khng nh i" i, thc y mi ngi chng mui t (gi v sinh ngoi cnh, tch cc dit mui, nm mn...). Vic ny cng gip trnh mt s bnh nguy him khc nh st rt, vim no Nht Bn, st xut huyt, bnh giun ch... 343. C hai c thoi mi "Bc hng xm ca b chu i xt nghim mu thy vim gan B dng tnh, vy m hai c vn i li chi bi vi nhau nh khng c chuyn g xy ra. M chu th s cht khip nhng lc phi tip bc y trong nh, sau b lau chi sut lt cc th". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Hin gi th hai ng gi cha c ai sai c; bi v bnh vim gan B hoc vim gan C ch ly qua ng mu m thi (chng vim gan B nhng v khng b ly v vn sinh con khe mnh bnh thng). Nhng nu hai ngi dng chung dao co ru hoc ci ct mng tay th cc k nguy him v virus vim gan B s d ly nhim sang b chu qua vt rch da (mt s phu thut vin v bnh nhn m c th ly cho nhau theo kiu ny). Th thi. Ngoi ra, c hai c thoi mi ung tr, tm s. M chu chng phi dn dp, chi ra ph cng, mt ngi. 344. Khi nhiu ngi nh mang khng nguyn vim gan B "Cch y khong 4 nm, ch ca chu i xt nghim mu c kt qu HBsAg dng tnh; sau trong gia nh ch c chu i xt nghim (kt qu m tnh v c tim phng). Nay ch du ca chu, ang c thai khong 3 thng, thy mt vng, i xt nghim vim gan B th m tnh, nhng kt qu xt nghim ca chng ch sau li dng tnh (anh ch mi xy dng khong 4-5 thng nay). Ri chng chu i xt nghim cng thy nhim virus B. Xin cho bit ch du chu c cn xt nghim li hay tim phng khng, v phi dng thuc g? a con ca ch y c b nhim khng? Anh chu v chng chu cn cng nhng thuc g? Sau ny, con ca chu sinh ra c b nhim khng?". Chu ng qu bi quan, bi v mang khng nguyn virus vim gan B (VGB) trong mu khng c ngha l mc bnh VGB mc nguy him. V chng, ngay c khi bc pht, VGB cng c th nng hay nh ty tng tnh hung (s t bo gan b tn thng, sc khng ca c th, vic gi gn v bi dng sc khe ra sao...). Hp l nht l cho cc thnh vin cn li trong gia nh i xt nghim mu, nhng ai (-) th cho tim phng, nhng ai (+) th phi c theo di cn thn hn v sc khe. Ch du chu phi i xt nghim li, nu vn (-) th sau khi sinh phi tim phng. Trng hp ca chu, v chu khng ni r quy trnh tim trc y nn khng bit th no. Chu nn n mt chuyn gia v vn ny, ni r v vic tim phng trc y c hng dn c th. Con ca chu v ca ch du chu khng b ly nhim VGB, vi iu kin bo m v khun cc dng c v thao tc h sinh, bi v bnh ny ly lan qua ng mu. Vi cc thnh vin c kt qu xt nghim (+), cn lu : - Gi vng tinh thn lc quan khng ri vo trng thi stress, c th s lm cho tnh hnh xu i. Khi b VGB, khng phi l ton b cc t chc gan b tn thng hoc tn thng nng. Phn gan lnh mnh vn m nhim c chc nng (nhiu ngi b thng phi ct b mt phn quan trng ca gan, sau vn khe mnh bnh thng). - Tng cng bi dng c th bng n ung, ch yu l cht protid (m) v cc vitamin (c nhiu trong hoa qu, rau xanh...). C mt ngun protid rt qu, d kim, r tin, d ch bin l nhau sn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


ph.

L Trng Bng

- Trnh nhng thc n m c th "khng thch". Tuyt i king bia ru, thuc l. Th dc nh nhng u n. - V thuc iu tr VGB, xin xem Mc 341. - C th kt hp dng thm cc loi thuc trong c mt gu (gu rng hay gu nui u c) nhm gim thiu, thm ch ngn chn cc bin chng c th xy ra (x gan, ung th gan). 345. Mang thai khi ang b nhim virus vim gan B "Trc y ti b nhim virus vim gan B, xt nghim HBsAg(+), ung thuc theo n bc s, mt thi gian sau, xt nghim li vn dng tnh. Nay ti c thai 5 thng. Ti c th dng Alphainterferon v Lamivudine c khng?". Th bn khng ni r l trc khi mang bu, bn c lm xt nghim li HBsAg khng? Nu vn dng tnh th rt nhiu kh nng chu b cng b nhim, do , bn cn ch my im sau y: - Dng u n c hai loi thuc Mc 341. - Ch gi gn sc khe trong khi mang thai, n ung cht, nht l cht m v vitamin. - Bn cn c mt c s sn ph ca ngnh y t theo di v xin c sinh ti y (nh rng nu HBsAg(+) th mu bn s lm ly nhim bnh cho n h sinh nu tay h c vt rch da m khng mang gng phng h). - Chu b s sinh cn c sn sc chu o, tt nht l c mt chuyn gia giu kinh nghim trong lnh vc ny trng nom. 346. l vim gan virus A "Xin cho bit ti sao bnh vim gan B li ly lan tm lum? Bn nh hng xm quanh nm sut thng chng i u, vy m c nh thi nhau mc vim gan B, d s! Gia nh chng em k bn, liu c ly bnh khng?". Vim gan B (vim gan virus B) ch ly qua ng mu, khng ly qua ng tiu ha hoc qua quan h v chng. V vy, gia nh ngi hng xm ca em khng b vim gan B m b vim gan A (vim gan virus A). Bnh ny ch ly qua ng tiu ha, do giy phn ca ngi ang mc bnh hoc khi bnh cha c 45 ngy (cho nn trong phn vn cn mm bnh v ly cho ngi khc). Bnh nhn tip xc vi phn ca bn thn ri cm vo nm ca, cn go, sch v, chn bt... Cho nn, nu khng cch ly tt th thng trong nh ly ln cho nhau; v phc cho nhng ai lai vng gia nh m khng ch gi gn. Hai em nn mang gii p ny sang c cho h nghe, nhc gia nh qun l phn cho tt, cch ly trit , khng ly tip cho ngi nh, v khng ly lan bnh sang b con li xm. Hai em cng nh ni r h khng qu s hi, v vim gan A nh hn nhiu so vi vim gan B hay vim gan C. Nn nhc h dng nhiu ng, nht l ng t tri cy, mt ong; v tng cng n nhiu To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

tht c, tm cua, u nnh... (t nht cng trong thi gian dng bnh) gip cho gan chng hi phc. 347. Thuc cha vim gan virus C "Ti i xt nghim mu, c bc s kt lun v vim gan virus C. Trng hp ti nn cha bng loi thuc Ty no, v c nn ung cy ch ?". V thuc ty, i vi vim gan virus B (VGB), Vit Nam ang c 2 loi kh cng hiu (dng kt hp) l Lamivudine v Interferon. Cn i vi vim gan virus C (VGC) th Php c thuc Ribavirin (Rebetol) dng kt hp vi Interferon (Virafron) rt cng hiu. T thng 6/2000, thuc ny c php bn trn th trng th gii; nc ta chc phi mt thi gian na mi nhp c. V vy, trong khi ch i, bn c th cha tr nh i vi VGB, hoc nh ngi nh mua gip Ribavirin t nc ngoi (mi ngy ung 2 vin, chia lm 2 ln, trong 6-12 thng). T cui nm 2000, Php c thm loi Interferon khuch tn chm mang tn Pgyl, tim mi tun 1 ln, lin tc trong mt nm, kt hp vi Ribavirin, mang li kt qu cao hn trong iu tr VGC, nhng thuc kh t tin, phi mt hng chc ngn frng. Tuy nhin, bnh nhn vn phi "rng chu tn" v t l ung th gan do VGC tng gp ba, trong khi t l ung th do VGB v x gan vn gi mc c. V thuc nam, trong nhn dn hay dng cy ch rng ca cha bnh gan, bn cng c th dng thm. Mt s ngi gi cy ch rng ca l "cy ch ", phi cn thn ko nhm v cy hy thim, thuc h Cc, cng c tn gi "cy ch ", nhng khng dng cha bnh gan) Theo gio s Tt Li, cy ch rng ca (cn gi l dip h chu, dip he thi, lo nha chu, prak phle theo ting Khme), tn khoa hc Phyllanthus urinaria L., thuc h Thu du, hay c b con dng cha bnh gan, st... Mi ngy dng 20-40 g cy ti sc ung. 348. B x gan c ghp gan c khng? "B bnh tim th ghp tim, b bnh thn th ghp thn thay th. Cn nu b bnh gan, c th ghp gan c khng? Em c ngi thn nghin ru nng, i khm bc s ni b x gan, c thay gan khc c khng?". Khng phi c b bnh tim g cng ghp tim. Chng hn, nu b hp van tim, ch cn m nong cho van rng tr li; b h van tim thc th th m thay van; b thng lin nh, thng lin tht th m v kn; x va mch vnh th m t cu ni cho cc ng mch ny; nhiu bnh khc v tim c iu tr bng thuc... Ch cn ghp tim khi tim suy n mc khng cn m nhim c vic co bp bnh thng cho mu lu thng. Trng hp bnh thn hay bnh gan cng theo logic ni trn. Vic ghp thn c con ngi thc hin sm hn ghp gan, v chc nng gan rt a dng v khi lng ln ca gan d gy thi loi mnh ghp. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Vic ghp gan trn th gii c tin hnh kh rng ri. chu u, cho n nay c hn 2 vn trng hp; ring nm 1995 l 2.940 trng hp, trong c 60% l bnh nhn x gan (trong , 35% do nghin ru, 50% do vim gan virus B, C). Kt qa kh quan: 70% bnh nhn m sng thm c 5 nm trong trng thi tng i khe mnh. Tuy nhin, trn bnh din ton cu, vic ghp gan cn gp kh khn v khng mnh ghp cung cp cho bnh nhn (nm 1995 Php c 100 bnh nhn ch m ghp gan phi cht v thiu gan ghp). Gi thnh cuc m ghp gan cn cao, kh xa vi i vi nhng ngi c thu nhp thp v nhn dn cc nc ngho. Ngi ta ang ngh cch ci tin phng php ny bng cch ly mnh ghp hng lot t ln. Khng hiu ngi nh ca em c cm c c n ngy thnh cng trong lnh vc ny khng. Trong khi ch i, em nn khuyn anh ta b ru, hy vng x gan tin trin nhanh chng. 349. Nut phi inh "Chu l con trai, 15 tui. Cch y khong 4-5 nm, chu nut phi mt ci inh di 3 cm, nhng khng dm th l vi ai. Hin nay thnh thong thy au bng nn chu rt lo. Xin gip chu". Rt nhiu kh nng ci inh 3 cm b tng ra ngoi theo phn vo ngy hm sau ca s c; tic rng do chu khng cho b m bit cc c theo di phn (cho chu i tin vo mt ci b ri tm ci inh). Nu n vn nm li c ngha l n b nm ngang, chc thng rut, gy vim mng bng; v bc s phi m cp cu cho chu ly inh, khu rut v dn lu bng t lu ri! V vy, hin tng au bng gn y ca chu l do nguyn nhn khc, thng gp nht l giun a v ri lon tiu ha do thiu v sinh n ung. Chu nn xin gia nh i th phn, nu c trng giun th ung thuc ty. Nu chu vn cha tin hon ton vo gii p ny v vn lo lng th nn xin chp X-quang bng. 350. Thot v bn c hai bn "Chu hc lp 11. T 3-4 nm nay, chu thy bn tri bu di c mt bc m khi ly tay bp vo th thy xp i, khi bung tay ra hay rn mnh th n li phng ln nh c. T nm ngoi, chu li thy bn phi bu di cng c hin tng tng t, ch hi khc l khi ly tay bp, n khng b li nh bn kia. Xin cho chu mt li khuyn". Nhiu kh nng chu b thot v bn bm sinh c hai bn. Qua l thot v bn tri, rut non tt xung bu, cn bn phi c th l mt on mc ni ln (m chi) tt xung. S d bn tri, rut khng ln no b nght l do l thot v kh rng, cho php rut quay tr ln d dng, thm vo l nh "ng ch" hay tn mn nn bp y rut ln gip. Tuy nhin, khng nn chi vi la, v chi lu n vy! V ngh h ny, chu nn xin b m a i khm ti mt khoa ngoi tng qut hot ng tt. Nu khng c iu kin m mt lc c hai bn, cc bc s s m bn tri cho chu trc, v bn c rut non, d xy ra nguy c b nght rut, mt bin To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


chng rt nguy him. 351. "Ti dch" sau khi m thot v bn

L Trng Bng

"Chu m thot v bn mi c hai ngy th pht hin ra mt ti dch cng trn trn tinh hon tri (trc khng c). Chu xut vin vo ngy th 9 sau m, vn nguyn ti dch . V nh 1 tun, thy ti dch khng t mt i nh v bc s m bo, chu i siu m thy n c kch thc 4,9 x 3,9 cm. Tr li bnh vin, chu c chnh ng bc s m chc ht dch, nhng sau n vn cn v gy au. Chu hoang mang v chn i qu". Tnh hnh ca chu vn sng sa. Ci "ti dch" m chu ni, ban u khng phi cha cht dch. l mu r ra trong qu trnh m (v c sau m) t nhng vt rch khng c cm mu k. Nu c bng p tt, nhng ch r nay s t cm. Nhng chu, c mt iu m khng bit v bc s m c nhn ra khng: Ti thot v ca chu khng nm na chng (nh mt ngn gng tay), m n xung gn tinh hon, nh ci ng. Do c im ny m mu r tch t dn thnh mt ti mu; nu c chc ht trit ngay lc pht hin, s khng li di chng. Thi gian tri i, mu trong ti kia bin cht thnh cht dch. Lc ny, ci c chc ht khng cn l mu, v n li di chng l cc m x sinh ra trong qu trnh hp thu cht dch. Ti mu ny c th trnh c, nu phu thut vin sau khi ti to thnh bng cha thot v bn thanh ton gip "ci ng" ni trn bng cch khu ln n ra (nh kiu ta ln ngc ci v chanh vt), mt ng tc n gin ch mt 1 pht. Vn quan trng nht by gi l xem chu ht thot v cha. Nu ht, th coi nh phu thut ti to thnh bng thnh cng. Cn di chng ni trn tuy lm chu phi bn tm nhng chc chn khng nh hng g n sc khe ni chung v hot ng gii tnh ni ring, dn d s ht. 352. Nt hu mn "Mi ln i ngoi, chu rt kh v au rt hu mn v khi lau thy c rm mu. Xin cho bit cch cha". Hin cha c thuc c tr chng nt hu mn nh trng hp ca chu. Nn thng xuyn gi m cho vng hu mn bng cch bi Glycrine hoc Vaseline pure, kem chng n..., nht l khi tri hanh kh. Vo thi gian vt n lnh v cha ti li, khi tm, chu c th dng khn mm thm nc m c nh ln vng quanh hu mn, nhm lm mng bt lp sng xung quanh hn ch su ca cc vt nt. Gi cho phn lun mm bng cch n nhiu rau xanh, ung nhiu nc, nht l ma nc, khi tri hanh kh. 353. U i trng "B chu nm nay gn 70 tui, sc khe bnh thng, nhng gn y b hay b cun bng t di ln ri nn ra, bt c lc no hay lc i. Xin cho gia nh chu mt li khuyn". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Nhiu kh nng b chu b u i trng, thnh thong gy bn tc rut (au qun bng tng cn, khng trung tin c, nn khan hoc nn ra thc n, mt lc sau th mi chuyn tr li bnh thng). Gia nh nn sm cho b i khm ti mt bnh vin c trang b v k thut tt, nu ng nh vy th c th xt phu thut cho b. Bi v trong iu kin hin nay, vic m ngi cao tui bo m an ton hn trc kia. Trong khi ch i, hoc nu khng c ch nh phu thut, cn ch cho b ung nhiu nc gip cho phn mm; trnh cc thc n kh tiu; dng cc thc n nhun trng (khoai lang, u , rau xanh nu nh...). Nu ng l u i trng th b l u c tnh; nu c vy, u s pht trin nng dn. Nu cn m c, chc chn b s sng thm, c bao lu l ty thuc vo tnh hnh c th; v nht l nhng ngy cui i ca b s nh nhng hn nhiu. 354. Khi b lot b cong nh d dy "M em au bng vng di xng m c lu, nm kia c bc s cho chp X-quang d dy, chn on l lot b cong nh v khuyn vo nm vin m lun, nhng m em ngn ngi. Gn y au tng, khng n ung g c nn m em mun m, th gia nh chng em li lo lng v sc khe st km nhanh ca m". Tnh hnh khng cn n gin nh hai nm trc y, cho nn khi em nhn c th ring ca ta son hay c gii p ny trn bo, em nh gi kn ng cho m bit nh! V thut ng y hc, khi ni n bnh d dy (bao t), mt s thy thuc v k thut vin thng ni gp "d dy - t trng" (do ch phn cui d dy ni vo hnh t trng, trng ging ta nh c hnh). V ni gp "hi chng d dy t trng", "vim lot d dy t trng" nn ni dung kh m h v nht l d gy ng nhn cho bnh nhn cng nh gia nh h. Thc t th tuy cng l lot, cng gy au vng thng v, nhng lot d dy khc lot hnh t trng v triu chng lm sng, din bin v tin lng bnh. Ni chung, lot hnh t trng gy au bng lc i, n vo th , khng b ung th ha; cn lot d dy gy au khi no, nn ht ra hoc tiu ha xong th , thng c nguy c b ung th ha, nht l khi lot phn ng ca b cong nh d dy. V bc s khuyn m em "vo nm vin m lun" rt c l, tic rng chng ta b l mt c hi. Rt nhiu kh nng lot d dy ca m b ung th ha theo quy lut din tin ca n. Trc tin, phi cho m em vo vo iu tr ni tr ti mt bnh vin c cc phu thut vin vng tay ngh v giu kinh nghim. Cn trin vng c m c na hay khng s do bnh vin quyt nh sau khi c y c liu. Tuy nhin, c hai im m gia nh em cn nm r c th ch ng trong tng tnh hung: To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

- Nu lot ung th ha phn ngang ca b cong nh (iu rt may mn), cc bc s phi ct ti 3/4, thm ch 4/5 d dy (trng hp lot n thun ch ch ct 2/3). - Nu lot ung th ha phn ng ca b cong nh, phi ct rng hn, thm ch phi ct ton b d dy ri em mt on rut non ln ni vi phn cui ca thc qun; y l mt phu thut nng n v c th b bc ming ni, gy t vong sau m. - Nu bnh vin t chi m, hoc l cc bc s, sau khi trc tip s nn tn thng, thy khng cn kh nng phu thut, th iu chng t ung th lan rng. 355. Dit th phm gy lot d dy - t trng "Ti c ngi em 27 tui b lot hnh t trng, c ngi mch nn ung Helikit. Xin cho bit chi tit v tc dng ca thuc v cch s dng". Ngi ta xc nh 80-100% trng hp lot d dy - t trng l do vi khun Helicobacter pylori gy ra, v tm ra c thuc iu tr c hiu qu, trong c Helikit. Helikit c ng thnh v, mi v c 3 vin (1 vin nang Omeprazole 20 mg, 1 vin nn Tinidazole 500 mg v 1 vin nn Amoxycillin 750 mg); mi hp c 14 v dng trong 7 ngy lin, mi ngy ung 2 ln vo sng v ti, mi ln 1 v (tc c 3 vin mt lc). Sau , ung thm Omeprazole 20 mg mi ngy 2 vin (chia lm 2 ln) trong 3 tun lin. Nh vy, liu trnh hon chnh l 4 tun, ht mt hp 14 v (khong 180 ngn ng) v 42 vin Omeprazole. Omeprazole c ch mnh s tit axit ca d dy, to thun li cho tc dng chng Helicobacter pylori ca Tinidazole (can thip vo vic tng hp ADN ca vi khun) v ca Amoxycillin (khng sinh ph rng, dit c c vi khun Gram - v Gram+). Do , phi ung 3 th mt lc (c v), trong 7 ngy lin, th mi c tc dng, v sau dng thm Omeprazole trong 21 ngy lin tip tc c ch tit axit. 356. Pht hin ung th d dy "Ti b au d dy lu, c ni soi v kt lun l vim d dy, dng thuc theo n nhng khng khi. Nu mun pht hin ung th d dy th c phng php khm xt g chc chn?". Ty tng tnh hung m c phng php thch hp. 1. Nu mi b ung th d dy hoc lot c va mi ung th ha th: - Khi chp X-quang d dy, trn mt lot phim chp trong cng mt t th ( so snh) s thy b cong b co bp thiu mm mi, ti ch thy c hin tng "cng " (nh mt tm vn nm trn mt nc gn sng). - Soi d dy kim tra trc tip tnh hnh ti khu vc nghi vn, nht l lm sinh thit ti (ly mt mu m lm xt nghim gii phu bnh). Nu thy hin din nhng t bo bt thng, phi m sm ct on d dy; sau tip tc lm xt nghim trn mnh ct nhm xc nh thm v phn loi c hng theo di v cha tip sau phu thut (ha tr liu nu cn). To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

2. Nu ung th hi mun, chp X-quang d dy s thy c hnh khuyt ni b cong b; hnh khuyt ny tn ti trn mt lot phim chp trong cng mt t th. Lc ny, th thut soi d dy khng cn thit na; tt nht l bnh nhn vo vin sm xt m, sau cho xt nghim mnh ct. C th phi ct ti 3/4, thm ch 4/5 d dy (ung th cng cao cng phi ct rng); sau m phi kt hp thm ha tr liu. Trong trng hp ung th hi mun, nhiu khi bnh nhn t pht hin cc hch nm trn xng n tri. 3. Nu ung th kh mun, c th s thy mt m rn chc vng thng v (di m c), thng c hch r trn xng n tri. Lc ny, triu chng qu r, vic chp X-quang ch nhm khng nh thm m thi (s thy vng hang v b thu hp li do ung th m ly n). Trng hp ny, nu cn m c th phi ct ton b d dy (a mt phn rut non ln khu vi thc qun). y l mt phu thut nng n v nhiu nguy c bin chng. Do vy, nu b lot d dy, bnh nhn phi ht sc cnh gic phng nguy c b ung th ha, nht l khi lot phn ng ca b cong b. iu tr ni khoa tht tch cc mt thi gian, nu khng thuyn gim, nn phu thut sm trnh hu ha (tri li, lot t trng khng dn n nguy c trn). 357. Khi no phi m ct on d dy? "Anh bn ti trn 50 tui, b lot hnh t trng lu nm, my thng nay au lin min khng chu ni, hu nh khng n ung, ngi gy mn. Bn mun m nhng gia nh li can ngn. Xin cho bit khi no th phi m ct on d dy?". Bn hy chuyn n ngi thn ca anh bn mt s tnh hung phi m h tham kho: a) Ni chung, lot hnh t trng au theo chu k sau y: i au, n vo , tri lnh au hn tri m, khi u c cng thng au nhiu hn khi thanh thn... Khi au khng theo chu k na c ngha l bnh nng. Trong trng hp ny, nu cha chy tch cc mt thi gian ngn khng th phi ngh n phu thut, cho d bnh nhn cn tr, thm ch ang tui thiu nin. b) Lot hnh t trng cng c nguy c n thng vo ty, vo gan, cho nn khi thy au lin min, hy ngh n tnh hung ny v sm ti bnh vin xt m. Trng hp anh bn kia nm trong c (a) v (b). c) Khi mt lot b thng m khu cp cu, ngi ta khuyn 6 thng sau nn m ct on d dy (ch nh l tng i nu lot hnh t trng, tuyt i nu lot b cong nh). d) Nu lot chy mu nng hay ko di m cha ni khoa khng kt qu, li thot duy nht l ct on d dy. 358. Ti sao phi ct ti 2/3 d dy? "Khi m lot d dy - t trng, ti sao bc s c phi ct b ti 2/3 d dy, m khng tin hnh khot ch lot i ri khu li, c phi nh nhng hn khng?". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Nu "sng kin" ca bn mang li kt qu tt th hay bit my! Rt tic l khng th lm nh vy, bi v nu ch khot b lot i ri khu li th sau khi m, mt lot mi s xut hin ngay ti ni x tr. V sao vy? Lot d dy hay lot t trng l hu qu ca hin tng a toan (nhiu axit) ca d dy; nu khng thanh ton c nguyn nhn ny th phu thut s tht bi. Ngi ta chia d dy thnh 3 vng, tnh t di ln, nh sau: - Vng hang v: Chim non 1/3 cui ca d dy, chuyn vic tit cht kim. - Vng thn v: Chim khong gi 1/3 gia, chuyn tit cht toan (axit). - Vng phnh v, chim khong non 1/3 trn, tit hn hp kim-toan. Khi thc n xung d dy, vng hang v b kch thch u tin, tit ra cht kim; chnh cht kim ny s khi ng vic tit ra cht toan ca vng thn v. ngi b lot d dy-t trng c m ct 2/3 d dy (ngha l ct ht vng hang v v gn ht vng thn v), th mc tit toan ca d dy ch yu do vng phnh v m nhim, lun mc bnh thng. Nu bc s ct b khng 2/3 d dy (ngha l li qu nhiu t chc ca vng thn v) th v sau, ngay ti ming ni ca d dy vi rut non s sinh ra mt lot mi, gi l lot ming ni. Trng hp ny phi x tr li bng mt phu thut phc tp, thm ch nguy him. 359. Ti sao phi ct on d dy cp cu? "Con trai ti 32 tui, ku au bng vng m c khong mt nm th b thng d dy, phi i m cp cu. Chu ra vin v cho bit b thng lot b cong b, c m ct on d dy ngay trong m vo vin. Thy chu bnh phc, ti rt mng, nhng vn bn khon sao phi ct d dy sm vy, tng thng th ch khu ch thng thi?". Thng thng, khi gp thng lot t trng, bc s ch tin hnh khu l thng, lau sch bng, t ng dn lu, ri ng bng li. Trc khi ra vin, h dn bnh nhn "nu tip tc au th sau t nht 6 thng phi tr li ct on d dy". S d h lm nh vy l v: - Mt s trng hp khu xong th khi lun, bnh nhn khng au li; l trng hp lot cha lu nm, b lot cn tng i mm mi. - Thi gian 6 thng cho php bng n nh li, cc ch dnh gia quai rut bt i nhiu. Nu m sm hn, s gp nhiu t chc dnh hn, gy kh khn cho tin trnh m cng nh giai on sau m. - Khi d dy b thng, cht dch v thc n trn ngp bng, v vy ch x tr ti thiu nh trn l an ton nht. Tuy nhin, c nhng tnh hung buc bc s m phi cn nhc li hi, c th phi "mnh tay hn" th mi em li kt qu cao nht cho bnh nhn. l khi gp phi mt s tnh hung nh sau: - Va thng d dy va chy mu d dy (tn thng mch mu ngay ti ch thng). Vic cng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

nhc, ch tin hnh khu khng thi th s nguy him n tnh mng bnh nhn (nu nh mu vn tip tc chy, cha khng cm th li phi m bng ct on d dy, khin bnh nhn mt thm nhiu mu). - Thng lot b cong b: Lot b cong b thng c khuynh hng ung th ha. Nu ch khu l thng ri ch 6 thng e khng kp, bi l, nu ngm ngm c hin tng c tnh ha th cuc m y s thc cho tin trnh nhanh ln gp bi. M m li trc 6 thng s kh hn v cha tht n nh. - Ch thng lot t trng, nhng l mt lot lu nm v x chai; nu ch khu khng thi s d gy hp lm cn tr lu thng (hp mn v), ch khu c nguy c b bc. Trong nhng tnh hung ni trn, nu tnh trng bnh nhn tt, bng tng i sch..., bc s s tin hnh m ct on d dy lun. V khi m, nu xt thy c du hiu c tnh ha, bc s cn phi ct rng hn (3/4 thay v 2/3 d dy nh thng l). Nh vy, trng hp con trai bc ri vo tnh hung sau cng, v d sao chu cng may mn gp c v bc s c u c tnh to, ht lng v bnh nhn v c k thut m tt; xung quanh v c nhng bc s ph m n , kp gy m hi sc trc c trnh . Bi l m ct d dy cp cu thng khng c thun li nh m theo k hoch hng tun. 360. Nn ra mu nhng khng thy lot "Em trai ti 35 tui, ang khe mnh bng nn ra nhiu mu ti v lm rm au bng; bnh vin cho thuc cm mu v truyn mu th khi. Hn hai nm nay, n khng au bng hoc nn, khng phi dng thuc g, sc khe tt, chp X-quang d dy khng thy lot. Gia nh rt mng nhng vn lo v thy ngi ta bo chy mu d dy l do b lot d dy-t trng, phi thuc men lin tc v au, thm ch b nn ra mu ti pht". Nu ng l kt qu chiu chp X-quang cho thy nim mc d dy bnh thng, b cong b v b cong ln mm mi, khng c lot d dy hay t trng th nhiu kh nng l cch y hai nm, em trai bn b nn ra mu khng phi do mt lot ca d dy hay t trng, m l do mt vt trt nim mc d dy. Vt trt nim mc d dy (VTNMDD) l mt tn thng cp tnh, t gp, xy ra trn ngi trc khng c du hiu g ca bnh d dy-t trng, thng ngi tr. Chy mu c th d di ngay t u nhng c th cm c bng thuc men v truyn mu, sau vt trt khi hn, khng li du vt. Ngun gc ca VTNMDD cha c lm sng t (khng r thc n thc ung nht thi hay vi khun Helicobacter pylori c can d g vo y khng?) 361. Khi m vim rut tha cp "Chu l n, 18 tui, hi cn 5 tui b vim rut tha cp, m. Chu nghe ni nhng ai m rut To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

tha th sau 6-7 nm s b tc rut, nhng chu th khng. Xin cho bit t nay v sau chu c b tc rut nh h khng?". Ni chung, vim rut tha cp nu c m tht sm (trong vng 4-6 gi, tt nht l ch sau 2 gi) th m xong coi nh khng pht sinh vn g. Tuy nhin, trong trng hp c m sm, vn c nhng yu t nh hng khng tt: - tr em, vic khm xt, chn on kh khn, cho nn chng ta b chm chn m c tng cn sm. - Tuy him, nhng tr nh c th gp mt dng vim rut tha tin trin cc nhanh, ngoi s tin lng ca bc s. - K thut m x ca ngi thy thuc c th gy dnh rut nh: gy ng gip, b st d vt (dch tit do vim, mu r ra trong qu trnh m); khng khu kn hon ton mng bng ( nu cn li mt ch h nh l rut s chy ti dnh vo ; v trong trng hp ny, tc rut thng xy ra sm v nng, bi mt on rut khc c th b cht vo y). - Trong vng 36-48 gi sau khi m, ton b rut nm im bt ng, p st nhau, nn d dnh vi nhau. V vy bnh nhn phi ngi ln ri i li tht sm nhm ngn khng cho rut "m p nhau lu" trong qung thi gian ngn ngi nhng quan trng . Thi ng n nht l: Nu c mt ln b m bng trong i ri th phi cnh gic, thng bo chuyn ny ngay cho bc s khi c cn au qun bng. C trng hp ch m tht ng dn trng, mi hn 20 nm sau mi b tc rut do rut dnh vo ch m ng dn trng khng c khu vi ng quy cch. Cn ch pht hin sm vim rut tha tr nh, biu hin l khc lin min. Cu hi ca chu mang mt ni dung rng nn phi ni hi di. Chc rng c xong, chu s va yn tm va tip tc cnh gic nh hin nay. C iu mng l c th tr em c c tnh "lp li trt t mt cch nhanh chng", thng "xa sch c mi du vt trong ngi". 362. C nn m vim rut tha mn tnh? "Ti 32 tui, b au bng vng h chu phi mt ln cch y hn 2 nm, tng phi m v vim rut tha cp, nhng sau thy dn nn bc s li thi. T by n nay, thnh thong ti li lm rm au ti v tr ; i khm, chp X-quang rut tha c pht hin l vim rut tha mn tnh. Nh vy ti c cn phi m khng?". 1. C ngi b vim rut tha cp vi triu chng in hnh, nhng sau bnh du dn ri bin mt. Mt s trng hp nh vy v sau thnh thong au nh nh bn ni, v c xp vo danh mc vim rut tha mn tnh. 2. C trng hp vim rut tha cp bin chng thnh m qunh rut tha (m chi chy n m ly ch b tn thng quan trng rut tha). Dng ny khng c ch nh m m phi cha tch cc To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

bng khng sinh liu cao, chm lnh ti ch v bt ng; nu khi s c xp hng nh trn. 3. C trng hp vim rut tha cp mun, gy bin chng p xe rut tha, c rch dn lu. Ci rut tha cn li cng c xp hng tng t. C nn m ct vim rut tha mn tnh hay khng? Vi hai tnh hung (2) v (3), nn m bi v trc y c bin chng; nhng phi ch sau 6 thng cho bng n nh . Vi tnh hung (1) nh ca bn th ty tnh hnh: - Nu rt t khi au, bn c th "chung sng ha bnh" vi n, nhng phi cnh gic, phng khi n bt pht. - Nu au m thng xuyn hoc km ri lon tiu ha (d c nguy c bt pht) hoc nu bn sp i vo mt vng xa trung tm y t, th nn m. V vic m "ngui" theo k hoch s n gin v an ton tuyt i; cn khi phi m "nng" (cp cu) th s gp nhiu kh khn. 363. Khi b si mt "C phi ngi b bnh si mt nh ti phi king n cc th chin rn, du m, quy, vt quay, ngan quay, bnh rn, tht ln, pho mt, tng ng vt, s, cua...? C thuc g cha c si mt m khng cn m khng?". C hai loi si mt khc nhau v bnh sinh, din bin, tin lng cng nh cch cha tr v d phng, trong c n ung. Bc hy lin h xem mnh thuc din no: - Si ti mt: Hay gp ph n, nht l nhng ngi bo ph do n ung v . Thng l si cholesterol (cn quang t, th vo nc thy ni v c th t chy); bnh din bin lu nm, c nhng t cp, au tng v st do ti mt b vim. X tr bng cch ct ti mt nu cha tr bng thuc khng ht. Thnh ti mt vim mn tnh nn dy chc. V nguyn nhn gay bnh l dinh dng nn bnh nhn cn hn ch n cht bo bnh khng nng ln. - Si ng mt: Xut hin do giun a chui ln ng mt, gy vim nhim ri trng hay cht ti ; xc v trng giun to iu kin cho sc t mt vn dn li thnh mt hay nhiu vin, ri rc trong ng mt (si bilirubinat rt cn quang, t khng chy, v th vo nc th chm). Nu si lm tc ng mt ch, n s gy mt hon ton, k c ti mt, lm cho thnh ti mt gin mng km theo vim cp v v ra. X tr bng cch m ng mt ch ly si v dn lu; bo tn ti mt nu thy cn gi c. Cch phng bnh l trnh nhim giun. n y, chc bc cng thy danh sch king c ca mnh qu di, k c khi bnh ca bc l si ti mt. V thuc Ty cha si mt, bc c th tham kho Mc 83. Thuc Nam c Kim tin tho, dng hng ngy 10-30 g di dng thuc sc, hoc dng vin Kim tin tho ca X nghip Dc phm trung ng 26, ung theo liu ch dn. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


364. Sau khi m vim phc mc mt

L Trng Bng

"Nm ngoi, ba chu (49 tui) c m cp cu ct ti mt do b hoi t gy vim phc mc mt; mt tun sau phi m li v p xe di c honh phi. T ngy xut vin n nay, ba chu b au m vng bn phi (trc y ba c tin s lot d dy, nhng my nm gn y thy gim hn)". Chu khng ni r l km theo vim ti mt, ba chu c b si ng mt hay khng, cho nn ch nu my im chnh vi gia nh chu nh sau: - Nu vim ti mt n thun (triu chng ban u: n vo im gia ca b sn phi thy au chi, vng da, vng mt t nhiu, st...) nhng khng c chn on v x tr kp thi, ti mt b hoi t gy vim phc mc, th sau khi ct ti mt, ra sch v dn lu bng, coi nh gii quyt xong nguyn nhn v hu qu. Ba chu phi m li l v cn cht dch mt bn mt trn gan, ngay di c honh phi; pht hin ra c v m li an ton nh vy l iu rt may mn. T nay, ba chu ch cn c ch dinh dng (cht b, vitamin...) v ngh ngi tt l c. Tuy nhin, vi tnh trng au bng m nh hin nay, ba chu hy cn thn, d chng bnh lot d dy c th nng ln sau hai cuc m ln. Nu au ko di hoc tng, nht thit phi i chp X-quang d dy xc nh tnh hnh ca lot c, c cch x tr thch ng. V thuc nhun mt, xin gii thiu vi chu cy actis (tn khoa hc Cynara scolymus L.) c ghi trong sch Nhng cy thuc v v thuc Vit Nam, khng c, c bn nhiu ni. Nn thng xuyn sc l ti hay kh (thn v r cng cng dng nh l) ung, hoc ung dng cao lng, mi ln 10-40 git, mi ngy 1-3 ln. - Nu vim ti mt hoi t do si ng mt th v lu di, ba chu phi cnh gic vi chng si mt ti pht (biu hin d thy nht l vng mt, vng da) v ch ty giun a nu c. 365. L trc khun b i b li "Ti c mt chu trai 25 thng tui. Lc 18 thng, chu b tiu chy 5-6 ln/ngy, bc s chn on l kit l v cho cha, sau 5 hm th ht. Sau 4 thng chu li b, c bnh vin chn on v cha tr, cng ht sau 5 hm. Gn y nht, chu li pht bnh nhng nng hn, st 40-41 C, au bng d; bnh vin cng iu tr 5 hm l ht. Xin cho bit c thuc g phng ti pht bnh, v c cn king c g cho chu khng?". Chu lin tip b nhiu t l trc khun, v gia nh phi cm n cc bc s bnh vin cha tr kp thi, nht l ln va ri. Bc cn xem li tnh hnh v sinh trong gia nh. C th rui nhng mang trc khun l t mt ngun ly no ti cho chu; hoc trong s nhng ngi thng xuyn tip xc vi chu c t nht mt ngi mang trc khun l (tuy khng c triu chng l nhng trong phn li c trc khun l). Ngi ny v km v sinh thng qua bn tay bn ca mnh trc tip a mm bnh vo ming chu, hoc gin tip truyn bnh qua qu bnh, chi, vt dng... m h cm vo. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Cch phng duy nht l gi v sinh tht tt: nhng nc si cc dng c n ung; gi tay chu thng xuyn sch, v dy chu khng mt tay; gi sch cc chi hoc nhng vt m chu c th tip xc. Ch n ung sch, nht l qu bnh; v khng bao gi qun ra sch tay mnh trc khi bng b, vut ve chu. 366. Vim i trng "Hi b chu hay b to, hn 2 nm nay hay au bng di, phn th khi b, t, thm ch rt to, khi th lng. Nm ngoi chu i chp in, c kt lun l vim lot thnh t trng, nhng ung thuc cha li thy au hn nn chu thi. Hin ti thng hay to bn". Chu nn nh rng, i trng (rut gi) ca con ngi c mt on nm ngang vt qua trc phn di ca d dy, v nhng rc ri i trng thng d nhm ln vi d dy. chu khng thy c triu chng in hnh ca lot hnh t trng (khng phi thnh, m l hnh, v on cui ny ca d dy trng ging nh c hnh): au bng khi i, n vo au. chu cng khng thy c triu chng in hnh ca vim d dy hoc lot d dy: n vo th au, nn ra hoc i th . Triu chng au do bnh ca d dy th din ra thng xuyn, lin quan n gi gic n ung, tng ln khi chuyn thi tit... Chu b vim i trng mn th ng hn. Chu th dng tay n su vo bng di bn tri xem, s thy ni ln mt on rut i chch t ngoi vo trong, n vo thy chng chc, ln di tay; l do i trng b vim lu ngy nn thnh ca n dy ln, chuyn mn gi l "dy thng i trng". Chu nn trnh m v nhng thc n g m "n" t chi (h n th vo l b au qun bng di, phn lng, c khi thm c cm gic mt rn). n nhiu rau xanh, rau c, cc loi khoai gip nhun trng. Thng xuyn xoa bng theo chiu kim ng h: Nm nga thoi mi, a bn tay phi t bng di bn phi i thng ln ri i ngang rn sang tri, ri vng xung bng di bn tri. Gp khi phn ly nhy nh mi, phi i khm c iu tr bng khng sinh ng rut. Nn dng thm mi ngy 1 vin Theravit b sung y cc loi vitamin v cht khong ti cn cho c th m chu c th b thiu do bnh ng rut. Chu c th cha bng nn l bng. 367. To bn ko di "Chu l con gi, 26 tui, c 1 tun hay 10 ngy mi i i tin mt ln (mc du vn ch n ung cc thc mt, nhun trng), ln no cng b chy mu v chu cn b bnh tr. Xin gip chu cch g c th i ngoi hng ngy nh mi ngi". C mt s vic chu cn tin hnh ng thi v kin tr, chc chn s c kt qa: - Ung nhiu nc u n, khng thy kht cng ung (lng nc d tha s gip cho phn b "kh"). Nu ung c nc ch ti hay tr xanh cng hay, v ch cha nhiu cht chng xy ha, To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


gip phng nga mt s bnh nan y.

L Trng Bng

- n tht nhiu rau xanh trong cc ba n. Tip tc n u u chn. Trnh cc cht cht (chui xanh, sung...) v nhng th cho b rn (chui ht, i, du da...). Nu c iu kin, nn n cm go lt (khng gi), rt tt v c nhiu cm lm nhun trng. - Tp vn ng nhm c bng bng ng tc nm nga, hai chn dang v dui thng, ri ngi ln, a ngn tay bn n chm vo ngn chn bn kia; s ln tng dn. - Xoa nn vng bng theo chiu kim ng h: Nm nga, hai bn tay chng ln nhau, p vo h chu phi ri vut ngc ln, vut tip sang ngang rn, vng xung h chu tri th kt thc. Lm lin tip nhiu ln khi c iu kin. ng tc ny gip rut gi tng cng co bp, y phn i xung. C th tranh th mi lc h tr cho ng tc trn bng cch: Chm cc ngn tay phi xung quanh rn, ri "xoay rn" cng theo chiu kim ng h. - Vo mt gi nht nh no thun tin trong ngy, tt nht l bui sng, sau khi ung mt cc nc un si ngui, chu vo toa lt, rn nh nhng trong 15-20 pht; nu cha i tin c, th hm sau li "th" mt ln na, nu vn cha cng khng sao. Ch : Nu thy phn ra, phi nn li, ch cho php cc phn nhch dn tht chm, phng chy mu bi tr. - Nu cn thit, chu c th ung gi thuc bt nhun trng Forlax (hot cht l Macrogol 4.000 trong mi gi, lm tng lng nc trong rut khi ung vo, nc trong rut khng b i trng hp thu nh trc). Mi ngy ung 1 gi 10 g ha vo cc nc (ti a 2 gi); khi thy kt qa kh th ngng ngay v thuc c th gy i lng. Chu mua loi hp 10 gi cho ph. Nu c 2 ngy i tin 1 ln phn mm cng sung sng lm ri, ch cu ton. Nh trong vng 2 gi sau khi ung Forlax, chu khng nn dng bt k thuc g v cc thuc s t c hp thu. V bnh tr th nu cn, sau khi cha khi to bn, chu c th ung vin nang Ginkor fort mi ngy 3 vin trong mt tun lin. Ngoi ra, hng ngy chu c th n thm rau dip c (theo kinh nghim dn gian th dip c c th lm tr). C th dng hoa ho di dng nc sc ung thay nc ch (gip cho s vng chc ca thnh mch). Khi cn, nn i khm ti khoa ngoi bng ca ngnh y t, bc s xt c ch nh m hay khng. Nn duy tr mt cuc sng thanh thnh v ci m, vn ng u n gip thanh ton tnh trng tr ca ng tiu ha. Nu nh chng to bn c t nh v ko di cho n nay, chu hy i chp X-quang xem i trng c b di hay khng. 368. To bn thng xuyn do i trng di "B chu b to bn thng xuyn, cha mi khng khi; va qua i chp X-quang khung i trng, thy bc s ni l c hin tng i trng di. Xin cho b chu mt li khuyn". Khung i trng di cng l mt nguyn nhn gy to bn. Nh bit, thc n tiu ha xong trong To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

rut non vn cn rt lng; khi qua i trng n s b ht bt nc, do mm, nho m khng lng nh khi va mi ra khi rut non. Nhng nu v mt l do no , phn lu li qu lu trong i trng (qun hoc nhn i tin do bn rn), phn cng b ht mt nc, do tr nn rn, gy to bn. i trng ca b chu rt di, phn phi mt mt thi gian di hn bnh thng vt qua, v vy ri vo tnh trng b kh, gy to bn. C th khc phc bng cc bin php tp luyn, dinh dng, sng th gin. Nn trnh lm dng thuc nhun trng (chng l li dng sut i?). 372. Co tht tm v "Chu 18 tui, b mc mt chng bnh him ngho t nh, i khm nhiu ni nhng khng chn on c l bnh g: n cm, ung nc hay n ung bt c ci g cng b nghn; khi n vo cm thy rt au vng ngc, khi nghn khng chu c, nh phi nn ra, n lc tip tc n li b nghn rt nhiu ln. Xin cho bit l bnh g v cch iu tr". Cha c kt qa X-quang, nhng nhiu kh nng chu b chng co tht tm v (ch thc qun ni vi d dy), lm cho thc n tri xung kh khn. Nu ng l bnh ny th khi chp X-quang c ung baryte s thy r hnh nh ch hp; trng hp mun, s thy thc qun pha trn ch co tht b rng ra. Chu nn sm v mt bnh vin ln ti H Ni hay TP H Ch Minh; cc chuyn gia s chn on v x l cho chu. Gp chng co tht tm v, ngi ta lm phu thut Heller nh sau: rch dc ch co tht cho n khi gn ti nim mc ca thc qun (khng lm thng nim mc), gip nim mc c tri rng ra. Sau khi m, vt rch trn lp c ca vng tm v - thc qun h rng ming, dn d s y ln v lin li, che kn nim mc, lm cho l tm v tr nn rng hn, gip cho lu thng thc n bnh thng. 373. Khi u thc qun "ng chu 75 tui, thnh thong n cm b nghn c, khng nut c na; khi nghn, ng chu thng ku au tc khp ngc. Hin tng ny ng chu b t hi cn tr, sau thi gian b gic bt giam ri tra tn bng cch gim ln ngc v vng m c. C cch g cha c cho ng chu khng?". Chu ni thiu chi tit, nhng v khng c a ch c th trao i thm, nh nu hai hng chn on. ng chu c th b: - Co tht thc qun do hu qa ca chn thng vng (nu ng th th may mn, v c th cha bng thuc men, chm cu..., nhng t kh nng). - Hp thc qun do khi u (kh nng ny nhiu hn). Nu ng c khi u th bnh s ngy cng nng v khi u c ngy cng ln. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Gia nh chu nn sm a c v mt bnh vin trung ng khm xt, ch yu bng X-quang (chp thc qun c ung baryte). Nu l u thc qun, thng l u c tnh, cc bc s s nh liu phng php x tr: - M to mt cu ni vt qua ch hp, gip bnh nhn n ung c (t kh nng, v ng chu gi, hoc khi u ny lan rng). - Chiu x ln vng ngc (x tr liu), hay dng ha cht (ha tr liu), hoc kt hp c hai, nhm mc ch dit cc t bo c tnh; kt qa ty thuc vo mc ln ca khi u v sc chu ng ca ng chu. 374. m thot v "Chu 17 tui, lc 16 tui i m thot v; khi c ra vin v nh th nhng ngi thn bo l my nm na chu li phi i m tip, nu khng s b ung th, nn chu rt lo s. Xin cho chu mt li khuyn". Chu khng ni r l thot v g (thot v bn, thot v rn...), nhng chc y l thot v bn (c mt l thng lm cho rut chui c ra khi bng, thm ch xung tn thp trong bu di). Chu c an tm v vui v hc hnh, bi v nu phu thut m thot v c tin hnh ng quy tc ngoi khoa, m bo khng ti pht, th chu khng cn phi i bnh vin mt ln no na (nu b ti li l do li ca bc s m, ch khng phi do chu)! Bnh ung th khng dnh dng g y. 375. Thot v bn m ri nay ti pht Em l con trai, 19 tui. Nm ngoi, em c m thot v bn, sau em vn king khng dm bng hoc mang vc, nhng gn y li ti pht. Xin cho bit nguyn nhn, v liu em c nn i m li khng? C hai loi thot v bn (TVB): TVB bm sinh v TVB mc phi (cn gi l TVB trc tip). TVB bm sinh c th xut hin rt sm, nhng cng c th xut hin kh mun, khi ta trng thnh, thm ch khi c tui. Nguyn nhn l do l bn khng c ng kn li khi cn trong bng m; do c ci l ny m rut c th chui ra khi bng, c khi xung nm trong bu di, l cng to th rut xung cng d, bnh bc l cng sm. TVB mc phi l do thnh bng b suy yu (do mang vc nng v rng sc qa nhiu, do thiu dinh dng, do mt s bnh lm cho cc bp tht ti y b nho), ch thy ngi ln sng trong nhng hon cnh k trn. Bin chng ca TVB l nght rut (khc rut tt xung khng tr ln c na) l mt trng hp cp cu ngoi khoa, nu mun, on rut nght c th b h hi (hoi t) phi ct b; trong tnh hung ny, tnh mng c th b e do. Trng hp ca em th, nu cha c iu kin i m li, em nn dng mt mnh vi nh bng lng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

bn tay, bn gc c bn si dy, gia khu nh mt ni vi vn bng u ngn tay ci, em p ln ch l thot v v buc li, nhm ngn khng cho rut tt xung. Nu trong khi tm ra, rut tt xung, th sau em nh nhng la th y n tr ln, ri bng li nh trn. Khi c iu kin, em nn n mt c s ngoi khoa tt hn xin m li, ng tm n ni c lm g! Bi l m TVB mc phi m ti pht, thm ch ti pht nhiu ln, th nhiu kh nng l do thnh bng qa yu. Cn m TVB bm sinh m ti pht th chc chn do thiu st k thut ca bc s m. Phu thut tuy n gin nhng khng phi bt c ai thc hin cng thnh cng, v c nhng chi tit rt nh m ngi c tay ngh vng mi quan tm ng mc. 376. Tc rut ti pht nhiu ln Nm 1990, ti c m vim rut tha, nm vin 7 ngy th c cho v nh. Ngy th 8, phi tr li bnh vin m ln th 2 v tc rut; sau 2 nm, m ln th 3; sau 1 nm m ln th 4. Nh vy l sau khi m vim rut tha, ti b m tc rut ti 4 ln. Xin cho bit u c th m c khi hn v l do ti sao b tc rut nhiu ln nh vy? Bn ni "m vim rut tha" e rng cha y , bi v vim rut tha cp (VRTC) c m sm trong vng 2 gi u hu nh khng c bin chng g v sau. Trng hp ca bn trc y c th nm vo mt trong hai tnh hung sau y: a) VRTC mun c vim mng bng cc b. b) Vim mng bng ton th (VMBTT) do VRTC mun. Nu theo tnh hung (a), th khi b tc rut ln 1, rut dnh khng rng, ch yu l h chu phi; v sau , mi ln m li lm tng nguy c dnh tip. Nu theo tnh hung (b), th nguy c dnh rut ngay sau khi m VMBTT rt cao, thm ch phi m x tr tc rut ngay trong tun l u tin, khi ang nm vin; v nguy c , bao gi phu thut vin cng cnh bo cho thn nhn, sau khi m xong VMBTT. V iu tr tc rut ti pht, c hai thi tri ngc nhau: 1. X tr ti thiu: G dnh n thun (c th bm mt dung dch no vo bng vi hy vng hn ch dnh). Nu tc li: m! Tc li na: m na! 2. X l trit : G dnh, xong xp ton b cc quai rut non vo mt t th sinh l, ri c nh chng li. Th l ch no dnh tip c dnh, nhng khng cn gy ra tc rut na. Th thut ny do T.B. Noble, phu thut vin ngi M, cng b nm 1937, n nm 1960 c W.A Childs v R.B. Phillips ci tin bng cch xuyn ch c nh cc np gp mc treo (thay v khu trn thnh rut), thi gian th thut c rt ngn hn nhiu. nc ta, Gio s Nguyn Trinh C, Bnh vin Vit-c, H Ni, l ngi i tin phong trong vic ng dng th thut ny t nm 1965, nhng gio s khng c nhng ngi ph trch ng h, nn ch thc hin c trn di 15 trng hp ri thi. Trong khi , ti mt bnh vin khc, t 1966 To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

n 1976, mt bc s thuc lp n em c iu kin thc hin th thut ny cho 70 bnh nhn tc rut, ch yu l tc rut do dnh ti pht nhiu ln, theo di lin tc kt qa sau 6-17 nm, thy kt qa tt (lun n tin s y hc trong nc nm 1984). Ti nay, th thut n gin v an ton ny t c lp tr bit n c th vn dng khi cn thit. 377. Hi b m rn "Chu 17 tui, khe mnh. Nhng lc cn b chu phi m khu rn, liu vic ny c nh hng g n sinh khng?" Trc y, chu m rn l lm phu thut x tr thot v rn (do mng cn nm gia bng lng lo, yu, nguyn nhn bm sinh hoc nhim khun ti ch, lm cho rut c li ra trc bng). Nu m khng tt th chu b thot v tr li t lu ri; hn na, khi m, thng bc s c gng khng lm ng gip rut, nn chu cng khng b tc rut do dnh. Chu c yn tm, n tui kt hn c tin hnh, v n tui lm m cng xin c vic! Ch c iu ci rn khu ri n khng c xinh xo nh ca ngi ta, nhng lo g, nu bi li th dng o tm mt mnh che i, ai m bit c! 378. D tt khng hu mn m "Khi cn s sinh, em c m to hu mn. Nm 12 tui, do n nhiu tri cy xanh, trong khong 2 tun em khng i cu c, phi a n bnh vin tht tho; siu m cho bit c mt on 20 cm rut pha trn hu mn b hp. Em lo cho cn bnh ca mnh, khng bit sau ny xy dng gia nh ri sanh con c d dng khng?". D tt trc y ca em (khng hu mn) c x tr vi kt qu m mn; hin tng cn li mt on trc trng b hp l iu khng trnh khi. Ch cn em ch : khng nut cc ht du da, ba, mng ct, khng n nhng tri cy c nhiu ht nh i, chui ht hoc tri cy xanh nh sung, v, chui xanh... Nhng thc n ny cha nhiu cht tanin, d gy to bn. Nn n nhiu rau, c. Khi n nh nhai tht k. Ung nhiu nc cho phn lun mm. Sau ny, khi c bu cng phi ch trng ch n ung. Em c yn tm: D tt c cha khi ny khng nh hng cht no n kh nng th thai cng nh vic chuyn d sanh con, do khng h c chng ch nh yu v lp gia nh. 379. m u nang bung trng "Ti 25 tui; 10 thng trc y c bnh vin m u nang bung trng, nhng khng bit l ct mt bn hay hai bn. Hin ti vn c kinh nguyt, v thnh thong au bn phi. Ti c cn sinh c na khng?". Trong phu thut bung trng, bc s bao gi cng tn trng v tit kim i. Nu u nang c cung, khng dnh cht vo bung trng th ch ct b u v gi bung trng nguyn vn. Trng hp m u nang hai bn cng phi tn trng v tit kim hn, bi v ngi ph n b ct ht bung trng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

s xy ra hin tng nam tnh ha (mc ru, ging ni , thay i vc dng...) v d nhin khng cn kinh nguyt, khng sinh . Nu sau khi c m ct u nang bung trng m vn c kinh nguyt th chc chn bn vn cn t nht mt bung trng; nh vy, bn khng thua em km ch v phng din sinh sn. Hin tng thnh thong au nh vng m s dn v ht. Tuy nhin, cng ging nh bt c ai c m vng bng, bn hy ch : nu chng may thy au qun bng tng cn km theo b trung tin, i ma..., phi ti ngay mt c s ngoi khoa tt c theo di st v x tr nu cn. Ngoi ra, bn nn thu xp nh k ti khm mt bc s gii v ph khoa. Ngi ny, do nm vng "l lch" ca bn, chc chn s gip ch c nhiu iu. Cn nu mun tht chc chn v tnh hnh ca hai ng dn trng (nguyn vn c hai, nguyn vn mt bn, hay c hai bn u c tht do yu cu ca tnh hung phu thut), bn nn bin th hi c s m cho bn trc y, bi v th no phu thut vin cng ghi chp chi tit vo bin bn m. Nu c hai ng dn trng u c tht, mun c con, bn phi xin lm k thut th thai trong ng nghim ti Bnh vin ph sn T D, TP H Ch Minh, l c s u tin ca nc ta thc hin thnh cng k thut ny. Trng hp ca bn thun li v nhiu kh nng ngi ta s cy phi vo d con ca bn, khng phi nh ngi mang thai gip, v bn ang tui sinh sn. 380. U nang bung trng xon "Chng chu ci nhau gn hai nm v cn ang k hoch nn cha c con. Khong nm su thng nay, v chu thnh thong b au bng di. m gn y c y au bng rt d, n bnh vin khm v siu m th bc s cho bit b u nang bung trng bn phi, k n v hn ti khm. Chng chu khng hiu bnh ny c nguy him lm khng, c phi phu thut khng, v c nh hng g n ng con ci?". V hnh th, u nang bung trng c hai loi: c cung v khng cung. Trng hp khng cung, u nang pht trin m khng gy au, ch khi no ln th ngi bnh mi cm thy tng tc ti ch, bng pha bn hi to ra... Thm ch c ngi mang mt u nang cha gn hai chc lt dch mi chu i m. Trng hp c cung th tri li, triu chng au xut hin rt sm, v u nang d b xon nh (cung cng di cng d xon) v sau li tr v v tr c nn ngi bnh au hoc ht au. Nu xon mnh hn, u nang s khng th tr v v tr ban u, v do khng c mu ti nui dng nn nu khng c m kp thi, n s b hoi t v v, gy vim mng bng. Do , khi thy u nang bung trng gy au, bc s ngh ngay n loi c cung v khuyn nn m sm. Nhng khng phi bnh nhn no cng ng ngay, bi v h cn rt tr, nhiu trng hp cha xy dng gia nh, nn rt ngi ngng, lo s cho hnh phc la i, cho vic sinh sn v sau. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

M ct b u nang bung trng c cung trong iu kin bnh thng kh n gin, ngi bnh nhanh chng hi phc sc khe. Nu phi xn mt phn hoc ct i mt bung trng, phn cn li vn tip tc hot ng bnh thng v m bo chc nng sinh sn. Cn m cp cu (khi c bin chng) s phc tp, thm ch nguy him trc mt (nhim khun bng tin trin sau m) v lu di v sau (dnh rut gy tc rut). V chu cn c theo di st c th ti bc s kp thi. Nn n ti khm ng hn bc s c th c quyt nh cn thit. Trong thi gian ny, khng nn v chu i v nhng vng thiu giao thng thun li, s kh n bnh vin ng lc. 381. Lao mng bng "Em trai ti 28 tui, c bnh vin chn on l lao mng bng, cho cha theo n, mi thng ti khm mt ln. 2 thng ri m bng em vn cn ln. Xin cho bit bnh ca em ti nh th no, sau 7 thng na c khi khng, n bao gi c th ci v, v lc ny c nn cho ung thm thuc ta khng?". Lao mng bng (c th ring r hoc xut hin cng lc vi lao mng phi v lao mng tim, gi l vim a mng) c c im: mng bng, di tc ng ca trc khun Koch, tit ra mt cht dch thanh t, mu vng chanh (khi xt nghim dch thy phn ng Rivalta dng tnh). Nu c iu tr tt, ch yu bng thuc chng lao v nng cao khng, th trong trng hp thun li, bnh s thot lui, dch tit ra c hp thu ht, bng tr li "kh ro" bnh thng sau mt thi gian chng 2-3 thng. Nu sau thi gian m dch trong bng bt t hoc vn nh c, thm ch nhiu thm, th tt nht l phu thut m bng vi mc ch dn lu cht dch. Cuc m chng vnh v khng phc tp. Ngy hm sau, bnh nhn c th i li; sau 7 hm, vt m khi, bng tr nn bnh thng, bnh nhn ra vin, dng tip thuc chng lao theo n v nh k ti khm, ch yu l kim tra phi. Trng hp em bn, nu chp phim trong t th ng thy tim phi bnh thng th l trng hp lao mng bng n thun nhng chm thoi lui, c ch nh can thip bng phu thut h tr. Trong thi gian chun b cho em i cha, c th gip em ng tt hn bng cch cho n thm ng sen, c sen, ht sen, tm sen, tri du tm... (trnh lm dng thuc ng); tng cng tri cy, rau xanh... gip em n ngon ming hn. Lao mng bng khng ly, cho nn ngi nh c th yn tm chm sc hoc gn gi, ng vin em. Thi gian "7 thng khi" m bn ao c xem ra c th t c nu ta chn phng php ngoi khoa ni trn v cng rng sc, nht l bnh nhn phi tht tin tng, lc quan. Cn bao gi em bn c th ci v th xin nhng li cho ch r ng vo thi im tuyt vi .

To Ebook: Nguyn Kim V

Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


L Trng Bng 500 gii p y hc theo yu cu bn c

L Trng Bng

Chng 6: Bnh t chi, xng khp, h tit niu v h sinh dc

382. Hu qu ca vic khng cha tr chn m "Ti c a con trai 10 tui, cch y 4-5 thng b mng m u ngn chn ci, ko di chng 10 hm, sau t v m ri lin ming (gia nh khng c iu kin cho chu cha tr). Sau mt thi gian, ch y li mng ln, ri v m, thi nh mi bc m, c khi r khi lnh cho ti nay, mc d chu vn rng chu au i hc u". Bn hy coi chng chu b vim ct ty t cui ca ngn chn ci. Hy cho chu chp X-quang ngn chn ci, bn s thy hnh nh t ny b "gm mn", phn cn li c hin tng dy ln v c th thy nhng mu nh xng cht bn cnh (ci mi "bc m" l t nhng mu xng cht ny m ra). Nhiu kh nng y l bin chng ca bnh chn m u ngn chn ci m bn b qua. Chn m nu c pht hin sm v iu tr bng khng sinh, chm lnh th c th khi m khng mng m. Nu pht hin hi mun, nn cho dng khng sinh vi liu cao, ng thi chm nng lin tc, m s nh, sau khi c rch tho m s nhanh khi, khng c di chng hoc bin chng. Nu ng l vim ct ty, trong trng hp con bn c 2 mc x tr phu thut. Nu phn xng tt cn nhiu, n gin nht l tin hnh no vim, ly ht xng cht, ch cho xng t lnh (khng cn r m, chp X-quang kim tra thy hnh nh xng tr li bnh thng). Nu phn xng cn li khng nhiu, c th phi tho khp t cui ngn chn ci (sau ny ngn chn s ngn i mt cht v ch hy vng c mt cht mng chn). 383. Khng nn lm nh th "Chu c ngi ch gi 21 tui, b dnh bm sinh ngn tay eo nhn v ngn gia ca tay tri. Ch c mt bnh vin t m tch ra cch y 2 nm, nhng vn cn b dnh khong 2 cm phn di ngn; v do thiu da khi m nn t tay ch b cong li rt xu v kh hot ng, lm vic mnh th au. Xin cho ch chu mt li khuyn". p: Khng r "phn di" chu ni l "di" (cui ngn tay, t th 3), hay l "trn" (t th nht, ngay khe ngn tay); v theo quy nh trong gii phu hc, "ci g cui l di, cho d ta c gi ngc n ln". Nhng chc ch vn dnh ny l phn trn, ngha gn khe ngn, gia cc t 1 ca hai ngn tay. Nh vy l trong cuc m cch y 2 nm, ngi ch tr phu thut : - Khng nh gi trc c mc dnh phn ny (khng ch dnh da m dnh c m di da, To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

thm ch c bp tht ca ngn tay), tng l n gin nn nhn lm phu thut ny ti mt c s khng chuyn khoa. - Khng bit n k thut chuyn vt da (xoay hai vt da nh bn cnh n khu ph ln ch s tch ra trn hai ngn tay), cng khng bit n k thut v da ri (lng hai mnh da mng i "p" ln), nn khi gp tnh hung thiu da phi rt lui. - Sau , khng gii thiu tip ch chu cho mt c s gii hn h v trnh v trang b, v iu ny l quan trng hng u. Tic rng gia nh do thiu hiu bit nn ko di qu lu. Tuy nhin, sau mt vi ca phu thut s c tin hnh ng n, chnh xc v theo di st sao, sau khi c hng dn tp luyn, ch chu c th khc phc dn mi rc ri. Gia nh chu nn lin h ngay vi Vin bng quc gia, ni giu kinh nghim trong ghp da c m sm. 384. B tht chn t b "Chu 20 tui, b tht chn t b, nghe ni l do vim no. Hin c phng php g cha c bnh ny? Nu vy c nh hng g trong tng lai khng?". Do di chng ca st bi lit, chu b tht chn, teo c v xng khp c mt chn. Bnh ny khng cha c bng nhng phu thut chnh hnh khu vc. Hin trn th gii hiu chnh c cc chn gi in t gip cho c nng vn ng ca chn. Tic rng k thut ny cha c kh nng dng rng ri cho mi ngi, nht l ngi ngho. Tuy nhin, vi tc pht trin nhanh ca khoa hc, chu c th hy vng. Trong khi ch i, chu ch c th dng nng hoc xe ln (hay xe my ba bnh nu c iu kin). Mi dng thy hi ngi nhng ri cng quen dn, ch sao. Nu khng cha cng chng phi lo lng g nhiu. Do i lch, khung chu ca chu khng cn i, kh c th thng; nhng chu vn cho th sinh con nh phu thut ly thai qua ng di, rt an ton cho c m ln con. C iu, vi ngi no sau ny yu thng chu, chu phi ni r t u v kh nng ny, xem h c "chu" khng? Chc chu c c ngh lc v lng tin khng ngng vn ln. Bit u mt ngy no , mi ngi s c hoan h chu trong on vn ng vin i xe ln ca c nc! 385. Lit hai chn do chn thng "Chu l con gi, 20 tui, cch y gn 4 nm b tai nn chn thng ct sng, mt cm gic t t sng lng th 5 tr xung, khng t iu khin c hai chn (cc chc nng khc vn bnh thng). n nay, chu thy c mt s tin b, chng hn nh c cm gic thp hn trc 2 t ngn tay. Xin cho bit chu cn phi lm g, v c th hy vng hi phc hon ton khng?". Trng hp ca chu may mn hn nhiu so vi nhng ngi b chn thng ct sng v tr cao To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

hn (h cn b thm nhng ri lon ca rut gi, bng quang...). Ngnh phu thut thn kinh xut v ang th nghim mt s k thut iu tr tin tin, k c vic ghp ty sng. Ngay c vi trng hp khng th hi phc, ngi ta cng sng to ra nhng thit b vi in t c kh nng gip h khc phc v vn ng. Qu 2 nm 2001, cc nh nghin cu Php v Italy cng nhau hiu chnh thnh cng v ch to mt thit b gip ngi lit hai chn do tai nn ng dy i li c. Thit b ny s dng mt s in cc c cy ghp vo cc bp tht v dy thn kinh, kch thch hot ng ca hai chn qua mt b vi x l (iu khin bng cch n nt). D nhin, loi k thut v thit b nh vy hin cha th ph bin rng, nhng s l iu kin thc trong tng lai khng xa. Trong khi ch i, chu nn thc hin v nh ngi nh gip lm cc ng tc: co dui chn, k c c chn v ngn chn, vn ng phn trn ca c th, nhm mc ch gip h c xng khp pht trin bnh thng, trnh nguy c b yu hay teo nho. Xoa bp thng xuyn vng lng, vn ng cc c bng v ngc, tp th su thng xuyn. Nu xut hin cm gic nong nng hay rn rn nh kin b vng pha di tn thng l biu hin tt y. Ngoi ra, nu c xe ln, chu nn duy tr v m rng quan h bn b, ra ngoi tri nhiu hn cho khe ngi, c sch di bng cy, thm ch tham gia thi u mt vi mn no dnh cho ngi i xe ln. Nhng hot ng ny s gip chu c thm ngh lc trc cuc sng. Khng cn thuc men, nn ch n ung tt v trnh cm lnh. 386. Di chng st bi lit "Chu b mt chn b, mt chn to t nh, nhng vn i li c. Liu sau ny chu c b lit khng?". C nhiu kh nng hi cn nh chu b st bi lit, v chn b kia l hu qu di chng ca bnh. Chu c yn tm hc hnh v vui chi v di chng ny khng pht trin thm gy lit. Sau ny, khi chu trng thnh, c th lm mt s phu thut chnh hnh ti ch ci thin tnh hnh, gip cho vic i li d dng v duyn dng hn. Trong khi ch i, chu nn tng cng vic xoa nn v vn ng nhng bp tht b nho, cc khp c chn, u gi, ngn chn, gip chng khe ln. 387. Lao khp gi " hn mt nm nay, u gi phi ca em b sng v nng ran, au khng i c; chp Xquang th c chn on l vim khp. Em c bc s k cho nhiu thuc, nhng khng khi; em cng dng c thuc nam cng chng n thua. Xin cho em mt li khuyn (Xin ni thm l ch sng u gi phi thi, khng h di chuyn sang ni khc)". Th em vit cha tht chi tit, kh ni chc. Nhng c kh nng em b lao khp gi phi, tuy bnh ny thng him gp. Nu ng vy th ch cn b bt gi yn khp gi mt thi gian v dng thuc c tr bnh lao, km theo cc thuc chng bi nhim... To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Em nn sm v Vin Lao v Bnh phi (463 Hong Hoa Thm, Ba nh, H Ni) hoc Trung tm Lao v Bnh phi Phm Ngc Thch(qun 5, TP H Ch Minh) xin khm. Cc bc s s tin hnh xt nghim c mt chn on chnh xc (nh bnh hoc loi tr "lao khp gi"). Em phi xut trnh y b, cc n thuc v ni r din bin ca cn bnh trong nm qua, ngi khm khng c nh kin ngay t u l ch c "thp khp". Nu gi thit ny khng sai th em tht may mn, bi v ngnh y t c thuc chng lao rt cng hiu; sau mt thi gian khng lu, u gi phi ca em s hi phc hon ton 388. U x vai "Chu ang trong qun ng, b u hai vai, cng ngy cng to, c phi do chu chi x n x kp khng?". X n x kp c ti tnh g y? Chu b u x ni khi c vai, trng hi xu mt cht nhng lnh tnh. Nu u g ln r, eo qun hm b lch, chu nn ti bnh vin xin phu thut ct b. Phu thut c gy t ti ch, m khng kh nhng tn thi gian v phi xo dn tng phn do ranh gii khng r rt. Bc s s rch da theo hnh vng cung nhm khng li so chnh gia vai, gy tr ngi khi mang vc sau ny. 389. Khi b gy xng, sai khp "Trong dn gian c mt s thy lang qung co l cha c gy xng, sai khp. Nu chng may b th c nn nh h khng?". Nhng ngi ny c mt s kinh nghim nht nh, nhng v h thiu kin thc v gii phu v sinh l hc, thiu phng php chn on chnh xc... nn kh nh gi c y v tin lng mt cch ng n, d dn ti x tr theo phng cch khng ph hp, thm ch nguy him. Thc t cho thy, nhiu trng hp c tn thng kn o phi chp X-quang my t th khc nhau mi pht hin c. Ngoi ra, ch cc c s y t mi c nhng phng tin hu hiu phng nga v cha tr cc bin chng do chn thng, cng nh kim tra ngay ti ch kt qu x tr lc by gi ca bc s, pht hin c nhng sai st b cu kp thi. 390. Khi c ti 6 t sng lng "Xin gii p cho mt chuyn rt l: Thm chu nm nay trn 40 tui, thng hay au m lng, i chp X-quang thy c ti 6 t sng lng (chu tng ai cng ch c 5 thi). Gia nh chu lo qu, khng bit nh vy c vic g khng?". Chu ni ng y, bnh thng con ngi ch c 5 t sng lng, c nh s (trn xung) t L1 n L5. Nhng c ti 6 t sng lng cng khng phi chuyn qu k l, ch him thi, v l do nhng bt thng v gii phu hc. Mt s ngi mang 6 t sng lng nh thm chu m khng hay bit v khng thy nh hng g, ch pht hin do tnh c chp X-quang. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Tuy nhin, ngi ta thy hin tng 6 t sng lng c th km theo mt bnh bm sinh l thn a nang: xen k gia cc m ca hai qu thn l nhng nang nc, lc mi ch nh li ti, v sau c th vn gi nguyn trng m khng gy hu qu g. Nhng cng c th mt hay rt nhiu nang c to dn, tin ti chn p m thn, ti mc lm cho m thn tr thnh mt lp mng khng cn lc c nc tiu nh trc. Do vy, thm chu nn sm ti mt bnh vin trung ng c chn on v nh gi ng thc trng. Qua hnh nh chp thn thuc, bc s s loi tr, nghi ng hay khng nh bnh thn a nang. Qua xt nghim mu, h s bit ur huyt c bnh thng hay khng. 391. T cha g lng do t th "Chu 16 tui, ang hc lp 11. C l do ngi hc t th khng ng nn t mt nm nay, lng chu c g dn. Chu lo qu. Liu c cch g lm ht g khng?". Lm ht g hon ton th kh, nhng lm cho g, thm ch hn, th c th c (nu g khng phi do bnh v xng khp m ch l do ngi sai t th): - Nh gia nh to cho mt ci x ngang chc chn, va tay nm, tm cao hn ngi khi chu gi cao tay chng 15-20 cm, ti mt ch kn o, khng b nng ma, ngay trong nh cng tt. Hng ngy, chu u mnh ln, hai tay nm x v bung thng ngi, nhm mc ch dng sc nng c th ko thng ct sng (cng nh gip cho ngi c th cao thm). Khi treo mnh, chu hy ht th u n v thoi mi, hai tay vn gi thng, khng ln gn. Nhn ng h, bui u ch gi mt lc, thy hi mi th ngng; cc bui sau tng dn thi gian v s ln thc hin. Tt nht l xen k gia gi hc nh, cng nhiu cng tt, nhng khng nhc mi, d nn lng. - Khi nm, chu k mt chic gi n di hai vai, lm cho c n ra; ban u thy hi kh chu nhng s quen dn. - Ngi hc ti lp hay nh u gi ng t th, khng c khom ngi. Hy kin tr, chu s thnh cng. 392. Vo ct sng "Chu 23 tui. Nm 17 tui, khi i o qun o, gia nh mi pht hin ra chu b vo ct sng. Chp X-quang thy ct sng hnh ch S, hai b vai lch, ngc khng u... C phi do chu khng ch gi ng t th khi ngi hc? Xin hi c cch g chnh li khng?". Bnh ca chu c t b, d b m c pht hin sm cng khng lm c g nhiu. Bnh ny vn gy au u cho cc nh nghin cu y hc. Hy vng rng sau khi xc lp c bn gene ca con ngi, khoa hc s pht hin ra nhng gene chu trch nhim v bnh ny c th phng nga cho tr. Tnh hnh vo coi nh c nh v n nh (ch cn vi nm na l cc xng ca chu ht ln). C l iu chu cn quan tm hin nay l lm sao gi vng c tinh thn, bt mc cm v hnh To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

thc, c bit chm cht v ni dung (hc tp, o c) cho vt tri ln b tr mt cch xng ng. Hy th bt u i, no! 393. Kim gy li trong bp chn "Chu 23 tui, hi cn b b mt na ci kim khu gy m vo bp chn tri. Chu giu b m, nhng hai nm tr li y nghe ngi ta ni n c th chy ln tim, ln c, v chu s cht... Xin cho bit c ng khng?". ng l nhng vt nhn nh khi mi m vo bp tht c th theo c ng ca c th m trt dc th c, di chuyn ti mt vng khc, c khi kh xa. Nhng lu dn, n s b bao bc bi mt lp t chc x, do vy kh nng di ng cng gim nhiu theo nm thng. Na ci kim khu ca chu chc "yn v" ti mt ni no ri. Nu chu mun tht "yn tr", c th xin chp mt phim X-quang vng bp chn tri xem n ang nm ti u. Nu khng thy, chp thm pha di hoc pha trn. Trng hp ca chu khng c ch nh m tuyt i, bi l d vt khng gy hi v s khng gy hi; qu trnh m li phi tin hnh di tia X-quang (do vy, c kp m ln bnh nhn u phi "n tia"). 394. khng phi l gn "Lc cn con gi, tay ti ni nhiu ng gn xanh, sau khi sinh chu u lng li cng ni r. C cch g lm ht?". khng phi l "gn" m l nhng tnh mch di da; ngi no c lp m di da mng s thy rt r. Hin tng ny hon ton bnh thng. Nu c th bt gy (bt m) th s thy bt r hn. 395. Ngn tay tha "Em l con trai, 18 tui, t khi sinh ra c mt ngn tha cnh ngn tay phi, cng c c xng v mng. N lm em vng vu nn em ch thun tay tri v vit tay tri. Do b bn b tru chc nn em rt mun m b i, nhng b m s s b thn kinh. Xin cho bit phi m u v c tn nhiu tin khng?". Trng hp nh ca em ng ra phi m tht sm, khi em bit ngoan ngon chu ng mt cuc m nh v gy t ti ch, ngha l vo khong 5-7 tui (nu m khi a tr cn qu nh th phi gy m, khng li cho s pht trin tr tu). Vic ny s gip tr trnh mc cm t ti do b tru chc, v khng nh hng n s kho lo ca bn tay. M xong, chc chn thn kinh em chng nhng khng vic g m cn khong t hn v khng cn b nhng bn xu quy ry. Vo mt dp thun tin no , em hy xin gia nh cho n khoa chn thng chnh hnh ca mt bnh vin khu vc hoc trung ng. M xong chc em khng phi nm vin nn khng tn km my, em ng qu lo lng. 396. Sai khp vai ti pht v v thut To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

"Nm ngoi, trong mt bui tp v thut chun b thi u, em b trt khp b vai, c thy ca em nn li, nhng t n nay hay trt i trt li ti 4-5 ln. C cch g lm cho khp vai ca em tr li phong ban u khng?". Tht ng tic, cc dy chng ca khp vai em b suy yu do tn thng ban u, th hin bng nhng ln trt khp ti pht v sau. T nay, chng nhng em khng th tip tc mn v thut m trong sinh hot cn phi nng nh ci khp vai khng may ny n khng "tr chng". ng bun nhiu, bit bao danh th ni danh nh cn phi ri b sn c, bi u, trng ua... ch v tai nn y thi! 397. Sng mt c sau chn thng cng chn "Em 25 tui, c v. Va qua em b tai nn giao thng, chn thng cng chn (c chp X-quang nhng bc s ni l khng nh hng n xng). Mt tun sau, thy mt c sng ln, em i khm th bc s ni l do i li nhiu. T khi b tai nn, v chng em tm cch ly; c mt thng, thy ht au, chng em mi quan h bnh thng. Hin em rt khng hong v nghe ni ngi b chn thng nh vy m quan h tnh dc s b ci, thm ch phi ca chn. Hy cho em li khuyn". Bnh phong (b gi mt cch thnh kin l "ci", "hi") do vi khun gy ra. Phi gn gi lin tc vi ngi bnh trong nhiu nm m khng ch gi gn th mi ly. Ngi ta ch ca chn khi: - Chn b hoi th sinh hi do b nhim vi khun ym kh. Gp trng hp ny th nhiu khi m m vn khng cu c tnh mng. - Chn b mt qu nhiu da tht lm l xng ra m khng th che ph. - Ung th xng; vim a khp bin dng gy au nhc n mc chu khng ni. D b chn thng cng khng phi king khem quan h v chng. Tri li, vic ny cn c tc ng tch cc v c tinh thn ln th cht, vi iu kin l v chng phi thun tnh v ng mc. V mt c chn ca em, c hai kh nng: - Sng sau chn thng: Ch cn hn ch i li, ngi ti ging v k chn ln gi, mt thi gian s ht. - C tn thng xng ni mt c m trc y khng pht hin c (rn xng hoc bong mt cht v xng...): Nu c c nh ngay (thng dng np bt) th an ton hn. Tuy nhin, khi em c gii p ny th chn thng xy ra chng hai thng, nu c rn xng th cng lin ri. 398. Ct ty vim ng mu "Chu l con trai, 18 tui. Nm 1993, chu b st cao, c my ngy th bp chn phi sng to, , bc s chn on l vim c, cho dng khng sinh tim v ung, ch m khng khi. Mt thi gian sau, bp chn li sng, nn ra m (khng thy c ngi nh mn nht), sau th xp, li mt vt so bng ngn tay ci lm xung. Nm 1994, bnh ti pht nhng l m chy ra pha di l trc To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

6 cm. Nm 1995 cng vy nhng cn ra thm nhng mu trng nh g gh nh xng, bc s cho tim thuc vo bp chn th xp; nm 1997 ti pht. Xin cho chu bit l bnh g v cch cha tr ra sao?". Nhiu kh nng l ngay t u, chu b ct ty vim ng mu (ni nm na l xng b vim do vi khun xm nhp qua ng mu, m khng phi qua vt thng). Cha bng khng sinh liu cao l ng, nhng sau ngi ta qun mt mt ng tc n gin nhng rt quan trng l chp Xquang cng chn! Trn phim X-quang, bc s s d dng nhn thy tn thng ca xng v v xng. Nu ng l ct ty vim ng mu, ngi ta s cho thm mt t khng sinh mnh ri m rng, ly cc mnh xng cht, no sch vim xng v dn lu. Qu trnh lin vt m s din ra t trong ra ngoi, v coi nh khi hon ton. Chu hy xin gia nh cho ti mt c s chn thng chnh hnh c trnh . , ngoi vic chp X-quang thng pht hin cc mnh xng cht, c th ngi ta cn cho bm thuc cn quang vo l r chp kim tra xem cc ngc ngch ng r ra sao. Cn c vo tnh hnh c th, bc s s ly xng cht v no sch ri dn lu, hoc phi hp th thut trn vi vic trm c ti ch (tch mt di bp tht gn xem nht vo ch xng no gip n chng lin). Tuy bnh c c iu tr mun mt cht nhng khng sao. Chu cn tr; sau "v" ny, xng ca chu vn pht trin p , ng lo! 399. Chn b b, trng bch "Hai bn chn ca b chu c mu trng bch v b b, dng ko ct ch khng thy au. Xin cho bit l bnh g?". Nn thu xp a b chu i khm mt khoa da liu c kinh nghim xem c phi l triu chng sm ca bnh phong khng. Ngi ta ngh ti bnh phong khi thy xut hin mt vng da bc mu, teo, kh, rng lng v mt cc cm gic nng lnh, s vo thy t di. Nu khm xt xc nh v cha tr vo lc ny th kt qu nhanh nht, hon ho nht. mun na, bnh nhn s c nhng u sn si mt, vnh tai, hoc bn tay teo tp, ngn tay t v ngn eo nhn kho rt; hoc thng lot lng bn chn. Vo thi im ny, vic cha tr s kh khn hn nhiu, v thng li di chng; c khi phi dng phu thut to hnh v thm m khc phc. 400. C phi l bnh phong? "Chu c quen vi mt ngi bn trai. B ngoi bn y gn y ni nhiu nht g k lm. c phi bnh ci khng? Bnh ly qua ng no, n ung cng mt mm c ly khng? Ngy nay y hc tr c khi hn bnh phong cha hay ch ngn khng cho bnh pht ra ngoi?". Bnh phong ly qua ng mu; thi gian nung bnh thng rt lu, c khi c chc nm hoc hn. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Do , nu ch n cng mm hoc tip xc trong mt thi gian ngn th khng sao. Y hc cha khi hn bnh phong, khng li di chng nu pht hin, iu tr sm v liu. Trng hp mun cng cha c khi hn bnh (ht vi khun) nhng khng th phc hi cc di chng (ct u chi, tai, mi...). B ca bn chu c cc triu chng nh trong Mc 399 hay khng? Khng tc l khng b bnh phong. Nhn y, xin k vi chu mt s trng hp: C mt ng nh vn b my nt bch tng trn, vy m con ci la hong ln l "B mc bnh phong, chng mnh lm sao ly v ly chng!", khin ng gi qu bi quan ch mun cht! C b b bch tng loang l c mt my, ta c cm gic gh gh; nu b ta i hi v cho con th kh c chp nhn lm; nhng bnh bch tng u c ly! 401. Mn cm u cc ngn tay "Chu b mc nhiu mn cm u cc ngn tay, cha cch no cng khng khi, v chng c to dn. C cch g cha khng?". Khng cha trn lan c, m phi tm ng tn "u tu" tr, bn "n em" s bin dn. Chu hy nh li ng ci mn cm xut hin u tin, ri nh bc s t bng dao in (phi gy t tt, khng au, phi t cho c "chn" ca n). Nu khng c iu kin n bnh vin, chu c th t cha bng mt trong cc cch sau: - Chm thuc tiu mn cm Collomark (l 10 ml dung dch, cha 2 g acid salicylic, 0,5 g acid lactic v 0,2 g polidocanol): Ch nh mt git va khp vi din tch ca ci mn cm ny, ch 5-7 pht th thm kh thuc (mi ngy lm 2 ln sng v chiu). n khi n vo thy mm mi l c; nu cha th tip tc thm vi hm na. Cc mn "v tinh" s t ht. Nu sau t lu bn ny cha ht hn th chm thm mt thi gian cho n khi ht hon ton. Nh khng thuc giy rng ra s hi da, khng giy thm ln mt (nu b, phi cho ngay mt vo nc sch m chp mnh nhiu ln), v d nhin khng cho tr s vo l thuc. Nh nt k ngay sau khi ly thuc ra. - Ly mt cht x phng git (x phng git, khng phi bt git) trn vi cht vi n tru, lm thnh mt ht ng c ci mn cm(khng c to hn) ri em t ln. Ht ny s lm mn lot dn, cho n khi cn li mt l nh (ng vi ly ra qu sm v s st "chn"). Chm thuc v gi kh sch, trnh nhim khun. - Ly mt chic kim, cho cn vo t kim dit khun, ri cm vo mn cm sau khi xoa cn ln n. H u kim ln ngn la khng khi (bt la ga hoc n cn ca y t). Kim nung s git cht mn. Cui cng, xoy nh kim ly ton b ra. Chm thuc v gi kh sch. 402. Bong gn "Chu b tro chn, xng khng vic g nhng b bong gn. C ngi mch phi xoa cn, ngi ni bi du chi, du c l. Mt ng bc s qun y li bo chu ngm nc lnh; chu theo ng ta, thy To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

nhanh bt, nhng vn thc mc khng hiu xoa cc th kia vo th c nhanh hn khng?". Khi b bong gn, chm lnh hoc ngm vo nc lnh l tt nht. Ci lnh lm gim lng mu i vo ch tn thng, gip nn nhn cng tc, au. Nhng phi cho cht mui vo nc lm cho nc khng cn nhc trng so vi c th, nh khng gy n thm. Khng c bi cc th du gy nng, khng nn chm nng, v chng s gy tc dng ngc li. 403. Bo v chn v cha n "Chu 16 tui, nng thn, thng phi li ng. My nm nay, t bp chn tr xung b n tng vy nh, lu lu li bong ra. Xin cho chu mt li khuyn". Do sau mi ln li ng, chu khng ra tht k nn bn t cn li trn da dn d lm cho lp sng ca da dy ln, khin da chu d n khi gp khng kh kh. nng thn, nhiu ch em c thi quen tt bo v i chn: khi lm vic di nc, h mang ng vi t to, v nh li ra ry k cng. Trc khi i ng, hy thng xuyn dng khn mt c nh ln bp chn (khng c gy rt hoc au). Nh vy, lp sng ny s mng dn, mt ngy no s tr li bnh thng. Mi ln c xong, c th bi mt lp mng kem bi mt. ng st rut, bi qu trnh phc hi din ra kh chm. Nu c iu kin, nn ngh li ng mt thi gian. Nu phi li ng th nh mang bt cao su hoc ng vi t to. 404. Chai chn "Chu b chai c hai bn chn, i li rt kh chu v cn au na. C ngi khuyn chu nn i m. Xin cho bit nguyn nhn gy bnh v c cch cha no khc khng?". Do lc ca ton thn ln mt s im chn trong khi bn di khng c m lt (tt, giu mm...), thm ch ngay c khi c m lt, rt nhiu ngi b chai chn mc khc nhau. Khi b au ngha l c mt nhn rn bn trong; phi loi b c ci nhn ny th mi ht au. Mi nhn, tng nh ch cn m ct b chai chn l bnh khi. Nhng cuc m thng li so (tho) v chnh t chc ny li c th lm xut hin mt cc chai mi. Cch cha n gin sau y c th gip ch cho chu vi iu kin tht kin tr: Dng nc m ngm chn. Sau chng 10-15 pht, khi da chn mm ra, dng mt con dao cn co ln ch chai, c gng lm mng n tng cht mt. Sau mt thi gian, chu s nhn thy ci nhn ca n; lc by gi hy dng mt mi dao cn khu n t chnh gia (khng au v khng chy mu, v dao ch tc ng ln cht sng thi). Nhng ln sau s ly thm, cng t trong ra ngoi, cho n khi ht hn. Ht ri vn phi chm nom phng ti pht. Xem loi giy dp no gy cm th thay loi khc; c khi phi b guc. 405. N gt chn "C n ma hanh kh l m chu n c hai gt chn, trng c nh qu da b, rt au (n ni phi ngh vic ng ng). Nay li n chu: sau mt t o vt ao cng b, gt chn chu cng n! To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Chng n gt chn c di truyn khng? Hy cho chu bit cch cha cho c hai m con?". Gt chn ca nhng ngi thng xuyn tip xc vi t (nht l vi bn) nhng khng c ra k cng thng hay b n, c khi rm mu v n kh su. l do lp sng vng da ny tr nn dy cng; gp khi tri lnh, hanh kh ( m khng kh gim), n n ra, ko theo phn tht b x rch. Cch cha n gin, nhng phi tht t m, kin tr: - Khi cha b n: Sau mi ln tip xc vi bn t, nht thit phi c ra tht k. Dng bn chi hoc mt thanh tre ct un cong no k da chn cho k ht cht bm, lm da mm mi tr li. Tranh th mi lc tin hnh thm vic ny, chng hn khi tm. - Khi da n: Dng nc m gi pha cht mui, ngm chn hng ngy vi ba ln, mi ln chng na gi, dng mt li dao cn hoc ct tre sc no dc mp cc vt n (chu kh nhn au, cng v sau cng t au). Thay nc nu cn. Mc ch: Lm cho da chn mng dn tng t mt. Sau mi ln nh vy, chu c th bi mt cht Vaseline pure (c bn ti hiu thuc ty) hay kem thoa mt cho da c m. Nh gi chn sch s trnh nhim khun. Chc by gi chu hiu rng n chn khng di truyn. Chu b n l do trong khi o vt ao bn bm mi vo, khin cho lp sng ca da chn dy cp ln. Hy t cha ngay cho mnh v gip m cha. Khi khi, nh ph bin kinh nghim cho b con. 406. Thp khp "Em 21 tui, 7 nm trc t nhin khp mt c sng ln, au nhc khng i c, bc s cho ung Voltarne kt hp vi xoa bp th gim hn; mt thi gian sau au nhc tr li nhng khng ng k. Hai thng nay, t khi ln Lt, hai gi v khp c chn em rt nhc... Xin cho em mt li khuyn". Nhiu kh nng em b bnh thp khp cp t trc nhng khng c cha dt im (bng khng sinh liu cao, thuc chng vim, sau tip tc tim khng sinh thi tr chm cng c, theo nh k hng thng, trong thi gian di); v bnh ca em ti pht theo quy lut ca n. Hu qu ch yu ca bnh thp khp cp l tim (ngoi di chng n li mng phi v mng bng). Bnh cng lu, cng ti pht nhiu ln th tim cng c nhiu nguy c b thng tn nng, nht l ti cc van tim. Em cn tm n mt c s chuyn khoa v khp c hng dn cha tr chu o c theo di lu di, ng thi kim tra k tim. Khng nn qu lo lng, nhng phi ht sc cnh gic. 407. ng ngh l ht hn bnh "Chu b thp khp (chm vo tim), nm cha ti bnh vin hai tun th khi. Khi xut vin, bc s k n cho ung khng sinh lin tc di ngy nga ti pht. Chu vn thc hin u, nhng gn y mt ng lang ni c th cha tit nc bnh thp khp ca chu m khng cn dng thuc Ty. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


Xin cho chu mt li khuyn".

L Trng Bng

Trong dn gian c mt s bi thuc cha thp khp, nhng hin cha c cng trnh nghin cu no ng tin cy cho php khng nh chng cha khi c bnh. Cn y hc hin i th c thuc cha thp khp mt cch hu hiu. Thuc trong n m bc s k cho chu thuc quy trnh iu tr v ngn nga ti pht bnh ny; chu cn tip tc thc hin tht nghim tc, ng liu lng v thi gian. Nu khng, bnh thp khp c th ti pht; v c mi ln nh vy, tim li b tn thng thm, nht l cc van tim, dn n nhng hu qu tai hi. Chu cng phi theo ng lch hn ti khm thp khp v kim tra tim. Ngoi ra, nu cha n hn m thy c du hiu c bit (khp sng nng, tc ngc kh th...) l phi n bnh vin xin khm ngay. Ngoi ra, chu nn ch gi sc khe, trnh lao ng nng, trnh chy nhy nhiu tim mt do gng sc. ng v thy khi khp m cho rng ht hn bnh, bi v thp khp "lim" khp, "p" tim! 408. Gai xng t sng lng "C phi n hay b gai ct sng hn nam? Ti hay au lng, chp X-quang thy c gai xng cc t sng lng. Xin cho bit c cch g cha c". Cha thy c thng k ln no kt lun l gai xng n nhiu hn nam. Cho n nay, y hc vn cha tm ra nguyn nhn ca hin tng mc gai xng (thng l cc t sng lng) nn cha c phng cch g iu tr ht c; ch c th dng thuc gim au, chm cu, xoa nn... Trong tnh hung kh khn ny, xin gii thiu mt cch cha ca Lng y Hong Duy Tn bn tham kho v vn dng nu c iu kin: - B mt qu u c va hi chn, ly ht cho vo r, xt mnh ri ra cho sch mng bc ngoi, ch ly phn li. Gi nt, cho vo mt ming vi mng. t ln vng c hoc nghi c gai xng trong na gi (khng lu hn v c th gy rp da). Mi ngy 1 ln, lin tc trong 20-30 ngy. - Khi t c 2 tun th dng ng tc xoa nn nh sau: ng da lng vo st tng, t mt qu bng tennis (hoc bng nha cng c) vo gia tng v vng au, ri t t y mnh ln xung nhm lm cho qu bng ln ln ch au, lm khong 20-30 lt, mi ngy 1-2 ln. Cui t cha, kim tra li bng X-quang, nu cha ht hn th tin hnh thm mt t na. 409. T cha m hi nhiu tay chn "Chu ra rt nhiu m hi tay, khi vit b t c v... Ngi em cng rt nhiu m hi, c lm vic g l t m qun o. Xin cho bit cch cha". Xin gii thiu bi thuc c lng y Hong Duy Tn ci bin t mt phng thang c, gm 5 v To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


nh sau:

L Trng Bng

Hong k 12 g, phng phong 6 g, bch trut 8 g, mch mn 8 g, ng v t 4 g. Cho vo 1,5 lt nc, un nh la, ly 0,5 lt. Ung hng ngy, chia lm 2 ln. Dng trong 1 thng lin. 410. Di chng chn thng u gi "Cch y 6 nm, chu chy b ng, u gi sng v bm tm, khong 10 ngy sau mi bt c phn no, i li hi kh chu mt cht. V sau, mi ln i, chy, nhy, chn chu qu xung au but, nht l lc b vp, d nh. Chn chu nh yu i, co dui kh khn, phi ly tay . Mi y chu pht hin chn mnh b teo phn st u gi, i chp X-quang nhng bc s ni khng c vn g v xng khp. Liu chn chu c cha c khng? Chu s mnh b tn ph". Theo m t th c nhiu kh nng trc y chu b chn thng rt mnh vo u gi, c tn thng dy chng ca khp, thm ch c mu t trong khp, nhng khng c x tr ng phng php (bt ng tuyt i, chc ht mu nu c mu t, khu ni dy chng b tn thng...). Hin X-quang khng cho thy hnh nh tn thng xng khp nhng iu khng loi tr di chng ca chn thng c trc y. Chu nn n mt trung tm chn thng - chnh hnh c nh gi ng cc di chng v c hng iu tr hu hiu. Sau khi cha, chu cn phi luyn tp mt thi gian di di y; nhng chc chn chu s kh dn v d nhin khng tn ph nu kin tr. T nay, nu thy bn no b chn thng u gi th chu hy khuyn bn ch coi thng. Tri li, phi ti ngay mt c s chn thng chnh hnh c kinh nghim trnh di chng rc ri v sau. 411. Trc y b chn thng ct sng "Em b chn thng ct sng do tai nn nm 1989, khi. n nm 1993, do lao ng nng nn bnh ti pht, i bnh vin c chn on l vim dnh ct sng, cha bng vt l tr liu khng khi. Xin hi bnh ca em c m c khng? Nghe ni nu lu c th b lit ton thn, c ng khng?". Trng hp ca em khng phi l bnh, m l di chng ca mt chn thng vng lng, khng gy tn thng ty sng. Nu nh trc y c tn thng ty sng th em b lit hai chi di t do y, km theo nhng ri lon vn hnh ca cc c quan pha di (rut, bng quang, b my sinh dc). iu phin toi thng thy do chn thng vng lng li l: hay b au lng, lng km mm mi. C th khc phc phn no bng xoa bp, bm huyt, kh cng dng sinh, nhn in, hoc luyn tp nhng ng tc mm do vi mc tng dn; trnh ci nhiu, trnh ngi xm. Nu chp X-quang, c th thy nhng ch v xng dy ln, thm ch c mt vi gai xng nh (do nhng tn thng nh c nay lnh), khng phi do vim nhim. Em ng hong ht, v l chuyn d nhin, bnh thng. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

V nu n tui kt hn, em hy c mnh dn ci v, bi chn thng c s khng lm em b lit bt c b phn no. 412. Khi b chn thng gy xng sn "Va qua, chu b tai nn giao thng, gy ba xng sn lin, c bc s dn bng dnh v tim gim au. Chu khng thch nm vin, nhng bc s bt li theo di. Chu thy bnh chng c g nng, khng hiu bnh vin gi li lm g?". theo di ch lm g na! V bc s ni ng y, v v c trch nhim cao i vi sinh mng chu nn ng mi "bt" nh vy. Chu phi nm vin v nhng l do sau: - Tai nn giao thng thng gy nhng tn thng phc tp nhng nhiu khi li kn o, kh pht hin, v chuyn bin mt cch m thm nn rt d b b qua. Thc t cho thy, c nhng ngi lc b nn vn tnh to, ng hong ra v, nhng ch my gi sau l c biu hin ca mt mu t trong hp s, phi m cp cu mi cu sng c. - Cc xng sn pha trc c nhng on sn cho php chng n hi khi b nn p. Khi xng sn gy c ngha l lc tc ng ln n kh mnh, c trng hp lm rn gan, rn lch, gy nn mu t di bao, sm mun s v ra, rt nng. Nu sc p tp trung vo vng sn gy th c th mng phi ngay bn di cng b tn thng, gy trn kh mng phi, trn mu mng phi... C trng hp do au n, phi s lm vic km, khng tng ht c nhng cht dch xut tit ra nhiu sau chn thng, gy n tc ng th, thm ch xp phi. 413. Sau mt chn thng vng chu "u nm nay, chu b tai nn xe my, chp X-quang pht hin rn xng chu; sau 2 ngy nm vin thy mu chy t hu mn ra. T khi ra vin, thnh thong c ra mt cht nht mu hi trng, i khi ln mu. Vy rut chu c sao khng?". Chn thng mnh vng chu gy bm dp mt vi ni trn nim mc rut (mng nhy nm trong cng). Sau , ch mu t c o thi ra ngoi, vt thng tip tc y nt nhng g cn st li ri dn d lin so. Chu khng ni r lng mu chy ra, nhng chc khng nhiu, chng t phm vi b ng dp khng ln (v cng khng su, v nu thnh rut b tn thng th c th chu b thng rut, phi m cp cu). B chn thng m c rn xng chu th phi nm theo di st ti bnh vin t nht 48 gi mi an ton. C yn tm, trng hp ca chu nh vy l khng c di chng g v rut. 414. Lch vo khuu tay do gy xng "Nm ln 10 tui, chu nghch ngm ly xe p ca khch i nn b ng gy tay (khuu tay b te ra lm ba), c bnh vin m xp li xng. Nay chu 16 tui, tay vn khng c thng, nhng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

khi i tp qun s thng b bn b tru chc. Xin cho bit c cch g lm cho tay thng tr li?". Rt tic, i vi trng hp ca chu, trc mt cha c cch g lm cho tay thng tr li bnh thng, k c phu thut chnh hnh. Gy xng thnh nhiu mnh ni khuu tay thuc loi phc tp, xng vng ny l ch bm ca cc c c chc nng quan trng i vi s kho lo ca tay. Bn cnh chng li c cc dy thn kinh v mch mu ln. Chu vn i tp qun s c l iu may mn y, ch mt s ngi cn b cc bin chng nh: hn ch c ng khp khuu, khp gi khuu tay, hi chng co qup bn-ngn tay do chn p mch mu, teo c, t but do tn thng thn kinh..., au kh hn nhiu. Chu nn lu vn ng cnh tay khng may ny nhiu hn, n khi thua km nhiu do t c c hi c ch giao vic. 415. Ch tim thuc trc y "Cch y 6 nm, chu b st rt, c y t tim thuc vo mng. Sau ch ny tr nn chc v to dn, n nay bng qu trng g nh, khng au, khng vng. C ngi khuyn chu i m ly ra, c ngi li can. Xin cho chu mt li khuyn". Chc ln chu c tim thuc quinine vo mng, nhng thuc khng khuch tn v hp thu ht, phn cn li c v bc bao quanh. C hai thi khc nhau: - Nu thy n "khng vic g" v khng bn khon nhiu v n th c yn, nhng trnh ng ty my kch thch n. - Nu c mun "dt im" th n mt c s ngoi khoa tt xin khm cha. Bc s s chc thm d, nu thy c cht dch th s ht ht ra (mt ln hay vi ba ln), hoc rch dn lu. Khi khng cn cht dch bn trong, ci bc t n s tiu dn. Mt thi dung ha l n c s y t xin cha bng l liu php. 416. i dm "Nm nay chu 16 tui nhng thnh thong vn b i dm. Chu rt xu h. Xin cho bit cch cha". T nay, c sau 4 gi chiu, chu nn hn ch ung nc v khng n tri cy loi chua, sa chua... Ba ti khng n canh, khng n rau ci xanh, ci bp (nhng sng sm phi lo ung b, khng cho c th b thiu nc). Xem li gi hay "b", d phng. V d: Nu hay i dm vo 2 gi sng th ng h bo thc lc 1 gi v tr dy i tiu; hm sau, bo thc lc 1 gi 15, hm sau na lc 1 gi 30. C kin nhn tng tng 15 pht mt, ng st rut, cui cng im thc dy s l vo lc tri sng v th l chu thng li. Tip tc vi ba quy trnh nh trn. Khi kt qu tht bn vng mi c th tnh chuyn th tng dn cht t nc ung v tri cy, To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


canh... trong ba chiu. 417. c vacxin nga vim ng tit niu

L Trng Bng

"Ti v bn b ti hay b vim ng tiu, phi i khm bc s hoi v phi ung thuc qu nhiu khng sinh. Xin cho bit c phng php g cha dt bnh c khng?". 40% ph n b vim ng tit niu (ng tiu) t nht mt ln trong i, v 20% b ti pht nhiu ln. Triu chng bnh rt kh chu, bnh nhn phi dng khng sinh, phi king c th. Thng 5 nm 2001, mt tin vui n t bang Maryland ca M: cc nh khoa hc y ch to thnh cng mt loi vacxin chng vim nhim ng tit niu do vi khun Escherichia coli gy ra. N c tim cho 300 ph n M u tin theo di kt qu. D kin hai nm na, vacxin ny s c mt trn th trng chu u. Trong khi ch i, cc bn c th phng nga bng cch u n ung nhiu nc, n thm rau xanh cc loi, nht l rau "lm mt" nh rau m, rau sam. 418. Mt tiu (mc tiu) "My thng gn y, em hay b mc tiu, c 5-10 pht phi i mt ln; i khm th bc s ni thn em hot ng bnh thng. Xin gip em cch cha". Em ni cha k cng cho nn phi nu ln my hng em lin h: - Nu trc c quan h tnh dc vi bt c ai, k c vi v, th l vim niu o - bng quang, cn i khm bnh hoa liu ngay. - Nu khng, c th do hai kh nng: 1. Vim bng quang do khun Escherichia coli (t ng rut xm nhp vo v ta s h lc ra ry sau khi i tin); n hay b hn nam. Trng hp ny, em nn dng mt t khng sinh chng 7-10 hm, kt hp cc thc ung li tiu (ru bp, cy m , rau ci, rau m...). 2. Do em thng xuyn ung qu t nc, khin nc tiu tr nn m c, lin tc kch thch bng quang. Nu ng vy, ch cn ung nc u n v t tn, lng cng nhiu cng tt, bt k vo ma no. Em c th dng bi thuc nam gm hai v Bin sc (cn c tn l rau ng, cy cng tm, cy xng c, tn khoa hc Polygonum aviculare L.) v u nh (cn gi l xch tiu u, mao si xch, m xch, tn khoa hc Phaseolus angulari Wight). Mi ngy dng 100 g bin sc v 40 g u nh sc vi nc ung; thuc khng c nn c th dng di ngy. 419. T khi ly chng b vim bng quang "Trc khi ly chng, chu vn khe, nhng t sau ngy ci chu thng b i rt, c ln nc tiu , xt nghim c hng cu. Bc s cho cha vim bng quang, dng nhiu loi thuc khng khi". Chu hy kim tra li v x tr theo Mc 418. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Nu khng , hy d chng b vim bng quang do sinh hot v chng qu nhiu. Trng hp ny ch cn nhc chng chu cho quan h tha ra, s khi m khng cn thuc men g. 420. Vim niu o do tp khun "Chu 20 tui, cha quan h nam n bao gi. My hm nay chu thy ming so ca dng vt sng ln, ty , hi au. Xin cho chu mt li khuyn". Chu b vim nhim niu o do tp khun. Hy dng nc sch pha thuc tm tht long, t l 1/4000 (mu hi hng hng), cho vo mt ci bt hoc ci ly sch, ngm cho ngp dng vt. Lm mi ngy 3-4 ln, mi ln na gi; mi ln nh vy, dng ngn tay p nh ln, cho nc thuc tm vo ra qua ming so. Xem xt li ngun nc, v sinh chn chiu, luc qun o; nu c iu kin, nn l (i) qun o trc khi mc. 421. Nc tiu nh nc vo go "Em 25 tui, tng b mt ln nc tiu nh nc vo go; n 1994 b li, lc u nc tiu l l, v sau cng c. Em xu h nn khng i khm. Xin cho bit l bnh g, c phi l em i ra tinh trng khng? Bnh c nh hng g v ng con ci, cch cha ra sao?". Triu chng em k lm ti ngh n hai kh nng: - Em b bnh giun ch: Loi giun ny sng trong h bch huyt, gy nn nhng l thng li ti gia ng bch huyt v ng tit niu, lm cho nc tiu c bch huyt nn ging mu nc vo go. Bnh c thuc cha tr cho nhng ca va phi. Nu khng iu tr c, tin hnh phu thut nhm ct t nhng l thng thng ni trn (phu thut bc h thng mch bch huyt quanh thn) pha c tn thng, kt qu kh quan. - Em b bnh i ra phosphate: Trong trng hp ny, b ng nc tiu ng cn mu trng. Em phi coi sc khe lm trng, khn trng ti mt bnh vin ln xin khm c hng x tr thch hp. Cn tinh dch, tinh trng ca em th khng can d g vo y. 422. Gin tnh mch thng tinh "Em l con trai, 18 tui, t nh b phn sinh dc pht trin u nhng hai nm nay tinh hon tri sa xung thp, thnh thong hi au, kch thc bnh thng. Em i khm huyn th bc s bo cc tnh mch bn b t. Xin cho bit cch cha". Nhiu kh nng em b gin tnh mch thng tinh bn tri: khi s nn nh vo s c cm gic hi ln nhn, n hi tc. Nh vy c ngha l, v mt nguyn nhn cha r, thnh ca nhng tnh mch thng tinh tri tr nn km vng chc hn bn phi v b gin (ch khng phi b t nh em nghe nhm). Ban ngy, em hy eo x lp thng xuyn, v hn ch chy nhy. V thuc, em hy dng th bi ny trong 10-15 hm: Ht qut kh (ng y gi l qut hch) 6-12 g To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

rang vng (khng chy), un si vi 2 bt nc, ly 1/2 bt, chia ung 2 ln trong ngy (c th pha cht ng cho d ung). 423. X tr trn dch mng tinh hon "Ti c a con trai 5 tui, mt na bu di sng to, c bnh vin chn on l trn dch mng tinh hon, nm vin cha bng khng sinh trong 1 tun khng . Sau , bc s dng x-ranh chc ht ra nc vng (n x-ranh th 3 th c mu hng ca mu), v c xut vin; nhng ngay hm sau li thy cng ln nh c". mt s tr s sinh nam, thng sau 2-3 tun c biu hin trn dch mng tinh hon r (hin tng sinh l bnh thng), sau gim dn v ht ( tr s sinh n th c ra huyt kiu nh "hnh kinh", ri cng ht). Mt s trng hp vn khng ht trn dch mc khc nhau. Cho n nay, vn cha c thuc g lm mt c hin tng trn dch mng tinh hon, k c khng sinh. Khng c chc ht dch, v vic ny d gy tn thng cho tinh hon ( x-ranh th 3, dch ca chu c mu hng l do chm phi mch mu, nhng khng r mc n u). Chc ht l v ch v chc chn dch s c ti lp. Trn dch mng tinh hon phi c iu tr bng phu thut ln mng tinh hon (rch ti ra cho thot ht dch, ri khu ln tri nh ln na ci v chanh vt kit). Cuc m thng khng qu mi lm pht, sau tinh hon vn bnh yn v s. Thng ngi ta hay ch cho chu "hi khn khn, d bo", c th ch gy t ti ch, trnh phi gy m, ngha l vo khong 6-8 tui; khng mun hn. C khi phi m sm hn nu chu b cc bn tru chc l "thng chim to", sinh mc cm t ty. Trng hp con bn, ti thy c mt im ng ng l dch ti hin qu nhanh. Nn sm cho chu n chuyn khoa tit niu sinh dc nam ca mt bnh vin ln m. Nu ln chc c gy chy mu th mu c cm, bin thnh mt th dch snh. Vic ln mng tinh hon s gip khi bnh (nu mng dy cp ln sau khi b chy mu, c th phi xn bt t nhiu trc khi khu ln). 424. Cn au qun thn "Ti lm ngh nng, b au qun bng phi d di km theo i but, ln sau cch ln u chng mt tun, siu m cho bit b gin i b thn bn phi. Xin cho bit nguyn nhn; chuyn phng the c lin quan g n bnh khng? C cn xt nghim g thm khng v cch cha ra sao?". Nu kt qu siu m ni trn l chnh xc th bc hai ln b cn au qun thn bn phi do si ng tit niu di chuyn xung dc theo niu qun. d hnh dung, bc coi b thn nh mt thng cha nc t bn trn, v niu qun l ci ng dn nc xung. By lu nay trong thng cha ca bc xut hin mt hay nhiu vin si nh hoc to, nhng v chng nm yn ti ch nn bc thy "bnh yn v s". Nay t nhin mt vin si tt vo To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ng dn nc v di chuyn xung di, gy au d di v ng dn phi co bp mnh tng ci vt l i. Nu vin si nh, n c th i xung bng quang; t c th tt vo niu o, gy au but dc dng vt trc khi lt c ra ngoi. Nu si to hoc sn si, n s mc kt trong niu qun, gy tc nc tiu t thn xung, lm cho b thn b gin ra; nu mun s gy gin i thn (ni cha cc ng li ti dn nc tiu ra b thn). mun thm na th c qu thn s b gin, nhu m thn b hy hoi, tr thnh mt ti nc va v dng, va nguy him v d b nhim khun thnh mt ti m. Trng hp ca bc phi c cc bc s chuyn khoa tit niu khm xt v gii quyt. Ti y, bc s c th chp X-quang thng bng (sau khi tht tho phn k cng hai ln lin tip khng nhm vin phn vi vin si) nhm xc nh c si ti nhng v tr no (thn, niu qun), kch thc v hnh th vin si. - Nu vin si niu qun to, sn si, nm ni kh vt qua..., bc s s ch nh m. Bc s phi chp thm thn thuc ( nh gi chc nng bi tit ca c hai thn v tnh hnh i b thn). - Nu vin si nh, hy vng c th t tt xung thm ra bng quang, bc s chuyn khoa s cho iu tr bo tn mt thi gian ngn (ch yu l cho chy nhiu bn trong ngy sau nhng ln ung nhiu nc; nu cn th dng thm thuc gim au bnh nhn chy c thun li). Nu khng bin chuyn, nht thit phi phu thut. - Nu si xung bng quang, trng hp khng t i ra c s c cha bng k thut tn si, khng nht thit phi m nh trc y. Si bng quang lu s ln dn do c bc thm cc lp vi xung quanh, d gy chy mu v vim nhim bng quang. - Nu c si i b thn, bc s tit niu s cho ch nh c th ty tng tnh hung. - Nu chp X-quang khng thy si th hoc vin si khng cn quang (him gp), hoc khng c si (nu vy th kt qu siu m va qua l khng chnh xc, v nhng ht si li ti tuy gy au khi di chuyn nhng khng th gy gin i b thn). Bc cn khn trng ln. Bi l trong iu tr si niu qun, yu t quan trng hng u l thi gian: - Khi cn cn au qun thn l cn sm; nu thanh ton c vin si th mi chuyn s tr li gn bnh thng hoc nh c. - Khi khng cn cn au l mun hay qu mun. Lc by gi, nu c m ly v vin si th chc nng thn kh phc hi hoc mt hn. Chuyn phng the khng phi l nguyn nhn gy bnh si tit niu. Nhng khi quan h v chng, nhng ng tc t ngt v mnh m vng lng c th lm cho vin si ang nm yn trong b thn lt vo niu qun (cng nh khi ta chy nhy hay i li nhiu). D c m ly si hay khng, t nay tr i bc cn ch thng xuyn dng mt cht cht chua v To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ung nhiu nc (nc chanh, cam, nc p hoa qu chua nh kh, mum...) gip cho nc tiu bt kim, hn ch hin tng sinh si. 425. i tiu ra mu sau chn thng vng lng "Ti 42 tui. Cch y chng 10 nm, ti chi x ngang b ng p mnh lng xung t, m y i tiu nh mu, t hm sau nht dn ri ht, khng phi thuc men g. Hai 2 nm nay, ti hay au lng v thnh thong thy nc tiu mu nht, vi ba ba th ht, nhng vn khe, lao ng nh nng rt tt". Mi nm trc, khi lng p xung t, thn ca bc b ng gip, gy tiu tin ra mu; cng may sau khng h hn g. Ni "may" l v khi gp chn thng thn c i ra mu, ta khng bit chc l b mt hay hai bn, mc tn thng nh hay nng, chy mu c th t cm hay buc phi m x tr, v nu m th vn gi c thn (khu cm mu...) hay phi ct thn (ct mt phn hay ct c thn). l cha k b thn hoc niu qun c th b rch, b t lm cho nc tiu r vo bng... Gp trng hp nh vy, nht thit bc s phi chp thn thuc (ngha l tim thuc cn quang c it vo tnh mch ri chp X-quang vng thn, gi tt l UIV) nh gi tnh hnh. Thuc cn quang trong nc tiu s gip gii p cc cu hi hc ba . C chuyn rc ri xy ra sau chn thng thn l: Canxi trong nc tiu c nguy c ng li trn vt so ca thn, hnh thnh si thn, thm ch si rt to, trng c nh mt c gng. Qu trnh ny chm hay nhanh, lng l (si "dnh" vo i thn) hay n o (si "ri" xung niu qun, gy cn au qun thn) ty tng trng hp. Ln tiu ra mu cch y 2 nm ca bc l du hiu cnh bo u tin, sau ti i ti li m bc b qua, chng t chc chn l bc b si thn mt hay c hai bn. Nht thit bc phi c chp mt phim X-quang vng lng xc nh. Ch phim t tiu chun mi pht hin c nhng vt ng vi cn mng trn thn. T nay (v ng l ngay t do ), bc nn thng xuyn dng thc ung hi chua (nc chanh qu, nc cam qut...) v ung nhiu nc hn ch vic sinh si. Cng trnh c lao ng nng cng tt, v nhng ng tc mnh hoc vic i li nhiu d gy tiu ra mu do si c xt ln nhu m thn. Nu ng c si thn th trng hp ca bc chc khng c ch nh phu thut tuyt i, t nht l trong thi gian ny, v si thn khng cn phi x tr ngay nh si niu qun. 426. Vi v thuc dn gian cha si thn "B chu b si thn hai bn; m chu vay mn a b i tn si ti Vin qun y 108, nhng v thiu tin nn ch tn c si thn phi, cn vin si 1 cm thn tri vn nguyn y. Xin cho bit c loi thuc g lm cho si ra m khng phi tn khng (v m chu khng vay c thm na)?". B chu c th ung Kim tin tho do X nghip Dc phm Trung ng 26 sn xut di dng cao To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


vin (l 100 vin gi khong 38 ngn ng).

L Trng Bng

Nu thy au qun thn, au lm y, th c nh hy vui mng, v l biu hin vin si nh bt v lt c xung niu qun. Lc , b chu phi ung tht nhiu nc ri chy ti ch, gip si tt nhanh xung bng quang ri i ra. Bn cnh , b chu c th theo kinh nghim dn gian, dng mt trong hai cch sau: - Qu chui ht (cng gi cng tt) c v, thi lt mng, rang cho kh gin (khng chy), h th, tn thnh bt, ng vo l kn hoc ti ni lng dng dn. Mi ngy ung 3 ln, mi ln 15 g. - Qu da chn va c v, khot xoy mt l nh, nht vo mt cc phn chua c bng u ngn tay tr, y np li, em nung mt lc trn la. Ly ra gt v v vt nc ung. Cch 1-2 hm dng mt qu, chng 5 ln. V n ung, b chu tham kho Mc 424. 427. c chn on si thn cch y 3 nm. "Khi chu 17 tui, cc bc s khm v cho siu m, kt lun l b si thn v k n thuc. Nay chu 20 tui, thy bnh c gim cht t, vn i gii nhiu ln, nc tiu v t. Xin cho chu mt li khuyn". Trc ht, chu nn sm ti khoa tit niu ca bnh vin : - Xin th nc tiu: Nu trong nc tiu c hng cu th nhiu kh nng vn cn si (do vin si c st gy xut huyt). Chu hy xin chp X-quang ton b vng bng xem c si hay khng v si pha no (phim phi tht r; mun vy, trc khi chp X-quang, chu phi c tht tho hai ln lin tip loi tr ht cc hn phn c th nh la bc s). Chu ng mt th gi siu m v s rt kh pht hin nu si nh hoc ln vi bng phn. Nu c si v thy cn thit, bc s s cho chp thm thn thuc (UIV) nh gi tnh hnh ca h tit niu ni chung, t ra phng n cha tr thch hp. Nu cha c iu kin i khm nh trn v nghi ng vn cn si thn, chu c th dng thuc nam v ung cc loi nc nh nu trong Mc 426 v Mc 424. Cn lu iu quan trng sau y: Nu xt nghim thy trong nc tiu c cc tr hnh ht th trc y chu b vim cu thn cp, nay thnh vim cu thn mn. Nu vy th phng hng iu tr s khc hn. 428. Si thn khi no phi m? "Ti nm nay gn 40 tui, vn khe mnh v cng tc bnh thng. Gn y, do au m lng nn ti c chp in vng lng, tnh c pht hin ra mt vin si bng ngn tay t b thn phi. Xin cho bit liu ti c phi m ly vin si ra khng?". Nh vy l vin si b thn phi ca bc c t lu nhng din bin m thm nn b b qua. ng s nht l khi n cn nh bng u a, nu lt xung niu qun (tip ni ngay vi b thn) s To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

gy tc nc tiu do thn bi tit ra, khin bnh nhn au d di (cn au qun thn). Nu n mc li ti niu qun th dn d s gy gin thn. n khi si to dn ti kch thc hin nay th nguy c ni trn khng cn na, v n ln hn lng ca niu qun rt nhiu. V lu di, vin si ny c th s ln thm dn, tuy nhin khng th tin lng c l nhanh hay chm. N c th gy chy mu t nhiu do c xt khi bc vn ng (trong trng hp ny s thy nc tiu c mu t u n cui bi, hoc xt nghim nc tiu thy c nhiu hng cu); cng c th gy vim nhim ng tit niu phi (t thy hn). Ngoi ra, nu vin si ca bc hnh m vt th ch m vt s khp vi ch tip ni gia b thn v niu qun. Trong trng hp ny, v lu di, n c th lm gin b thn mc nht nh, v bnh nhn phi c m cng sm cng tt. V vy, tht chc chn, bc nn sm v khm ti khoa tit niu ca mt bnh vin trung ng. Bc s s cho chp X-quang li ton b ng tit niu, chp thn thuc (UIV) nh gi chc nng thn cng nh tnh hnh ca i b thn, t s quyt nh phi x l sm hay khng (tn si hay m ly si). Nu cha c du hiu bo ng hoc gia nh cha c iu kin n bnh vin, bc c th tm thi "chung sng ha bnh" vi vin si ny, ng thi cnh gic sm pht hin cc bin chng nu trn. Bc khng nn vn ng nhiu trnh b xut huyt do vin si c st. Thng xuyn dng thc ung hi chua (nu khng c hi chng vim lot d dy - t trng) nhm hn ch si c ln thm v si mi hnh thnh. Trong khi ch i, bc c th vn ng v ung mt vi v thuc nam d kim (xem Mc 426). 429. Ph i v si tuyn tin lit "Ti 78 tui, va qua i siu m, c pht hin l ph i tuyn tin lit, c si. Hin nay ti vn tiu tin bnh thng, khng gp g rc ri. Liu c phi m khng?". Ph i tuyn tin lit c ch nh x tr ngoi khoa khi n gy tr ngi lu thng nc tiu, cha tr ni khoa khng . Trng hp ca bc trc mt khng c g ng lo ngi. Si tuyn tin lit thng c nhiu vin nm cnh nhau, khc hn si thn, si niu qun hay bng quang v khng gy hu qu g cho b my tit niu. Bc c th dng thm Theravit ca Hoa K, mi ngy 1-2 vin, v n cha selen, cht c tc dng bo v tuyn tin lit. Nu xut hin rc ri, bc th dng Prostati-Dauss, mt loi thuc nc ca Php mang cht chit xut t tinh hon ng vt, mi ngy ung 2 ng (chia lm hai ln, lc no) trong ba tun lin ri tm ngng, sau nu cn li dng tip t khc. V cha tr vim nhim ng tit niu ni chung v bng quang ni ring (thng xy ra ngi To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

c u tuyn tin lit), c th ung thm hng ngy 1-2 vin Mictasol blcu ca Php (vo cc ba n, chiu vi nc). Thuc lm gim vim nhim, khin vic tiu tin khng cn gp tr ngi. Tuy nhin, phi nh rng Mictasol bleu khng c dng cho ngi b suy thn. Cn v x tr ngoi khoa, hin nay ngi ta dng ni soi bng quang "ct" tuyn tin lit thnh tng mnh nh ri cho chy ra ngay theo dng nc. Th thut ny n gin, nh nhng. Thng 4/1999, cc nh khoa hc Php sng to c mt phng php mi cn n gin v nh nhng hn nhiu: lun qua hu mn vo trc trng mt u d c siu m cng cao lm tiu tan tuyn tin lit b bnh. Trong s 50 bnh nhn u tin c cha tr, c 40 ngi thu c kt qu tt. Trng hp ca bc hy vng s khng phi dng n cc th thut ngoi khoa ni trn. 430. Khng tinh hon sao vn c con? "Cc gii p y hc ni rng tinh hon lc ch nu khng m s b v sinh. Nhng sao trong xm chng ti li c mt ngi n ng t khi sinh ra vn khng c tinh hon m nay vn c con?". Nu tinh hon nm l trong bng th n tui dy th, n khng pht trin tr nn thnh thc, b x ha, v th s gy v sinh. Ngoi ra, nhng bnh nhn ny cn d b c tnh ha thnh ung th tinh hon. Trng hp cc bn gp chc chn l nm vo mt trong hai tnh hung sau: - Tinh hon ca ngi tuy khng hin din bu nhng vn thp th l bn (ngha l vn c nhng dp "ra hng mt" bn ngoi bng), c hai bn hay ch mt bn. V chng vn pht trin c bnh thng. - C hai tinh hon u nm hn trong bng: Chng b x ha v gy v sinh. Do , ngi ny khng phi l cha sinh hc ca a b. Chng ta khng nn t m i vo i t ca ngi khc. Nhng gip ngn nga ung th tinh hon, cc bn nn n ni bng cch no gip anh ta hiu ra vn v i khm xin m ct b mt (hoc c hai) tinh hon nu n vn nm su trong bng. 431. Sa d con "M chu hn 50 tui, lu nay mi ln i tin li thy thi ra mt cc g ni ca mnh. Chu lo qu. Xin cho bit l bnh g, liu c phi ung th khng?". Chu hy bnh tm. M chu b sa d con, v ci khi th ra ngoi l c t cung y. Chc chn khng phi ung th. Nu m chu khng thy vng vu lm, c th chu ng c, th ch cn gi v sinh tt, trnh vn ng nhiu hay mang vc khng lm cho bnh nng thm. Nu n sa xung qu thp, c nguy c nhim khun th nn phu thut treo hoc ct d con. Tt nht l m chu ti mt c s ph sn tt xin khm c hng x tr thch hp. Nu m cng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

khng nng n nh m d dy hay m gan mt, ni m ng s, ch sau my hm l xut vin thi. 432. T cung nhi tnh "Ti c mt a chu gi hn 20 tui. Nm 18 tui, chu hnh kinh ln u, sau ti nay khng c, lng nch v lng mu khng mc. Va qua, chu c Bnh vin ph sn T D khm v chn on l t cung nhi tnh, c ung thuc to vng kinh. Xin gii thch r v hin tng ny, nh hng ca n i vi sc khe v hnh phc sau ny ca chu". T sau tui dy th, bung trng thnh thc s tit ra hoc mn n mt cch thng xuyn, hnh thnh chu k kinh nguyt hng thng, km theo hin tng phng non (rng trng) ch th tinh. Nu c trc trc ca bung trng hoc ca tuyn yn (nm ngay di no), s khng c kinh nguyt v d nhin khng th th thai; b phn sinh dc cng khng pht trin y (d con nh nh ca tr em, khng c lng mu...). Trong trng hp ny, phi dng thuc to vng kinh nhn to, nhng vn khng c phng non. Tuy vy, vn phi cho chu s dng lin tc, khng c cch qung, chu c thoi mi v hy vng. Hin ti, cha c thuc g cha c "t cung nhi tnh". Nhng sau khi k thut th thai trong ng nghim c tin hnh rng ri cho la tui ang sinh sn, ngi ta thc hin c k thut c kt qu cho mt b gi trn 62 tui, to nim hy vng cho nhng ch em mn kinh m cha c con. u nm 1999, Italy cng b mt phng php mi thc hin trn nam gii v sinh (do "tinh hon nhi tnh"), cho ra i 5 chu khe mnh bnh thng. Trc nhng tin vui nh vy, chng ta c th hy vng cho hnh phc tng lai ca chu.

L Trng Bng 500 gii p y hc theo yu cu bn c Chng 7: Bnh da, tc, lng, bnh ly qua ng tnh dc v mt s bnh khc

433. Cha tn nhang (tn hng, nm) "Chu 20 tui, t 4 nm nay trn mt c nhiu nt tn hng. Xin cho bit cch cha". Chu c th dng mt trong hai loi kem bi sau y: - Leucodinine B (cha 10% hot cht mequinol), can thip vo qu trnh to melanin nhng khng gy hi cho t bo sc t. V vy, sau khi iu tr, vng da b "lt" vn c mu bnh thng. Cch dng: Bi ti ch 2 ln/ngy; thy t hiu qu th bi 1-2 ln/tun. Ch trnh nh nng mt tri; nu thy xut hin mt vi m trng (ti vng bi hoc khng bi) th phi ngng ngay thuc.

To Ebook: Nguyn Kim V

Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Kem ny khng nhn, d ra sch bng nc l, khng lm bn qun o. Gi khong 54 ngn ng/tup. - Renova, mi ti thoa 1 ln vi lng bng ht bp, sau khng c bi bt c th g ln. Ban ngy thoa mt loi kem lm m da (v d Johnson s Baby Cream) t 2 n 3 ln, nht l trong thng u, khi da d b kh, , b lt do tc dng ca kem Renova. Chu nn thng xuyn dng thm vitamin C (c nhiu trong hoa qu chua, nht l cam qut), c tc dng tt i vi da. Nu ra nng t 10 gi sng n 4 gi chiu, phi i nn, m rng vnh hay trm khn che mt (v nh nng lm cho tn nhang nng thm, hoc nhng ch cha khi tr nn nm li). 434. Kem bi cha so li "Xin cho bit kem bi ngoi da Contractubex c cht g m c dng cha bng?". Chc bn nghe nhm thi. Kem bi Contractubex khng dng cha bng m ch dng cha so xu hay so li sau khi b bng (nht l bng la) hoc sau phu thut (trn ngi c c a so li). C 100 g Contractubex c 3 cht chnh sau y: - Allantoin 1 g, lm tng cc t bo lnh ca m da, tiu cht sng, lm mm so. - Heparin 5.000 UI (n v quc t), lm tng c tnh tan x ca m da, c ch s tng sinh ca cc nguyn bo si, ci thin vic ti mu cho da. - Dch chit c hnh ty 10 g, cung cp cc protein, vitamin, yu t vi lng, gi vai tr cht nn cho qu trnh ti to t bo. Thuc bi ny c ng thnh tup 20 g, 50 g v 100 g. Cch dng: Bi kem ln so li ri xoa bp k lng lin tc cho thuc ngm vo. Lm nhiu ln trong ngy; trc khi ng nn lm 1 ln, sau bi thm cht kem ri bng li, qua m. 435. B l sn "Chng em cng nhau vo chi trong rng, khi v th my a b sng v mt, rt nga, lng, rt, ni mn nc li ti mt v c, ngi ln bo l l sn. Trong khi , my bn khc li khng vic g. Xin cho bit ti sao?". Cy sn (tn khoa hc Rhussuccedanea anacar-diaceae) tit ra mt cht nha, t ngn xa c nhn dn ta dng ch ra "sn ta" sn mi th g. Nha cy sn cha cht laccol, kch thch gy d ng mnh i vi da. C khi ch m mt hp sn ta qua ch bin, ngm mt tc phm mi sn xong, tnh c i qua cnh cy sn, un ci c ln cnh cy sn... m cng b l sn. Hin ti ngi ta vn cha bit loi da no hay b, loi da no khng. Dng nh dn c nhng vng trng cy sn hoc ch bin s dng sn ta (lm sn mi chng hn) th t b l sn; v nhng ngi mang th a d ng (hen ph qun, my ay, eczema...) d b v b nng hn. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Chc l trong khi len li trong rng, cc em "chm trn hung thn" m khng bit, v nhng bn khng b thuc din "c min tr". T nay, trc khi vo chi trong rng, nn tm hiu qua "tnh hnh ch": nm c, qu c, cy gai, l han, rn c... c phng cch i ph. V cha tr l sn, c th p l kh ti gi nh, chm nc ch ti, l bng, hoc nc mui 9/1.000; nu nghi c nhim khun th chm thuc tm pha tht long 1/4.000. 436. R ch sau m hay so li? "Cch y khong 2 nm, m chu c m u nang bung trng, sau mt thi gian, ti vt m ni ln mt cc tht rt nga ngy. Xin cho m chu bit cch cha". Th chu m t s si qu. Trng hp ca m chu c th thuc mt trong hai kh nng sau y: - B "r ch" (ni "ch khu thnh bng b o thi" th ng hn). Khi ng thnh bng, ngi ta dng ch khng tiu khu cn c. Thng nhng vng ch c tht nt ny "chung sng ha bnh", nhng mt s t bnh nhn, v sau c hin tng o thi. V khng phi do vim nhim (hoc vim nhim khng ng k) nn khng c nh hng g quan trng; ch thy ni g ln mt hay nhiu ch dc vt m, hi nga, n nh ln thy lng nhng t cht bn trong, c trng hp thnh thong r ra mt t dch ri li lin ming nh c. Nu ng vy th bc s, thm ch y t c kin thc, sau khi bi thuc dit khun s dng kp (c mng, v khun) thc vo ch lng nhng , tm nt ch kp cht v nng vng ch ln, ri dng ko ct mt pha, bin ci vng thnh mt si v rt ra (khng ct c hai phn, v s st mt na vng, khng khi). Bng sch, dm hm l khi hon ton. Nu sau mt thi gian thy xut hin tng t ti mt ch khc th cng tin hnh nh vy, chng cn thuc men g. - B so li. 437. Trng c " mi chu my thng nay b nhng nt ng ni ln, c chiu hng lan dn ra. Xin cho bit c thuc cha khng?". Chu b trng c . C th dng kem Erythrogel theo cch sau: - Nh nhng ra sch vng nh bi. - Bp vo tup cho ra mt git nh, em bi ln cc nt trng c, ly tay mit nh nhiu ln lin tip cho thuc ngm vo. - Mi ngy bi hai ln; tt nht l vo nhng lc t ra m hi. 438. Nm k chn "Chu c em trai hc lp 10, lu nay chn c mi rt thi, ngi bn cnh cm thy rt r. Em chu thng xuyn i chn t, thnh thong mi x dp. Xin bc s cho mt li khuyn". Th chu s si qu nn ti ch dm "on" thi. Chu th em nhng iu sau y hi k v kim tra em chu xem: C l em chu b nm k chn lu khng c cha tr, t bui ban u To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ch b gia ngn 4 v ngn 5 (k chn th t), nay lan rng sang cc khe khc v c hai bn. Nm k chn gy nga nhiu, phi gi mnh nn d nhim khun, mng m. Lc ny bnh nhn va nga va au nn ngi lm v sinh ti ch, khin bnh ngy cng nng thm; mi ln bi nhim c th b st, ni hch bn. Nu ng bnh, chu hy by cho em cha theo cch sau: - Ngm chn mi ngy 1-2 ln vo thuc tm pha tht long 1/4.000 (mu hi hng hng), nc m gi cng tt, mi ln chng 20-30 pht (nhng ln u, nn thay nc 1-2 ln c sch). Dng ngn tay c mnh ln, nu thy c lp da nht nht th nh tay "lt" i (khng c gy chy mu), ri tip tc c. ng tc ny ngoi vic lm sch cht bn cn c tc dng thanh ton bt lng nm, gip thuc tc ng tt hn. Nn tranh th thi c ny k c c bn chn lun. - Di nc thuc tm sch ri dng khn sch lau kh (khn ny dng ring cho em, v sau phi luc). - Bi ln ton b k chn v mt di ngn mt lt kem SILKRON (tup 10 g gi khong 8.000 ng, dng c nhiu ln), dng ngn tay mit mnh cho thuc thm u ln mt da vng ny. Ch no thy t thuc th b sung, nhng khng bi qu m. - Sau khi bi thuc, khng c nhng chn vo nc. Do , tt nht l bi trc ba n tra v trc khi ng ti. - Bi lin tc trnh ti pht. - Khi thy khi hn, c th ngng thuc, nhng mi ngy phi ra ry k c cc k chn v mt di ngn, khng c l l. Nu thy c ch hi nga, phi bi thuc ngay trong dm hm. - T nay phi chm dt vic i chn t. Khi khi nm v chn lun sch th ma no em chu i tt, chn cng vn thm tho. 439. Lang ben "Hai a chng em b lang ben mt v vai. Bnh c th loang dn, bi mi kem Nizoral khng ht. Liu vic i tm bin ri phi nng thng xuyn c lm ht c lang ben khng?". Hai em hy i sang thuc khc. - Thuc nc Selsun 25% cha hot cht selenium sulfide: C tc dng chng nm v chng tit b nhn; gi khong 60 ngn ng/chai. Sau khi tm, bi Selsun ln nhng ch c hoc nghi ng b lang ben, bi rng thm mt cht cho chc n (ch khng giy vo mt v b phn sinh dc v s gy bng rt, nu b th ra sch ngay), gi nguyn trong 10 pht, sau tm cho tht sch thuc. Mi ngy tin hnh 1 ln, trong 1 tun lin. - Kem Canesten cha 1% hot cht clotrimazole, gi chng 13 ngn ng/tup. Sau khi ht triu chng phi dng thm khong 2 tun na (thi gian cha trung bnh 1-3 tun). C th dng bi thuc ca Lng y Hong Duy Tn m mt s ngi p dng thy c cng hiu: To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ring ti mt dnh ra tht sch, bc v, ct khc ri gi nt, cho vo xoong con. gim vo hi ngp ring, y vung ri un si nh la mt lc. Dng kp nhng mt cc bng vo cht thuc ang nng, em bi trn nhng vng b lang ben (thot u hi rt cht xu, hy rng chu, s nh nhm ngay). Mi ngy bi 1-2 ln ty theo tnh hnh, trong 1-2 tun l khi, da d tr li bnh thng. Lang ben l do nm Pityrosporum furfur gy ra, khng th dng nh nng mt tri dit n c. Hn na, vic phi nng qu mc s gy nguy hi cho da ni ring v cho cc t bo c th ni chung. 440. Bnh zona "Chu b gii leo mt bn mng sn, au pht st. Liu n cn leo sang ngi khc khng? B m chu gi tung chn chiu tm dit tn hang nhng khng thy; trn tng, trn trn nh cng khng. Xin cho gia nh chu mt li khuyn". Chu thy con gii leo bao gi cha? N cng c nhiu chn nh con rt, c bit c th cha phospho. Khi ta p gip, cht vung vi trn da, khin da b rt bng. Tm mi khng thy n, vy n chy i u? Nu qu ng c con gii leo "chi khm" chu th n b chu nh cht, c th cht phospho mi c gii phng ra m gy bnh. Tm "gia nh" n trong nh xy l v ch, v con gii ch thch sng trong mi r, mi tranh. Con vt kia v ti, v bnh ca chu khng phi do gii leo. Chu b zona, mt bnh cp tnh do virus vi cc biu hin: ni nhng mn m au rt theo ng i ca mt dy thn kinh, km theo st v ni cc hch au trong khu vc. Nhng ni b bnh l: mng sn, hng, tht lng, ngc, cnh tay... Him khi b c hai bn. V cha tr, cm bi m corticoid (Flucinar, Xinala). Cn nng cao sc khng ton thn v ti ch. Dng khng sinh chng bi nhim, chng gim au khi cn. Sau 10-15 ngy, bnh s t khi, li mt vt so lm xung; thng khng ti pht do c min dch vi virus . Ngi c tui mc zona d b au dai dng ti vng tn thng c. 441. Bin php cha hi u "Ti cha nhiu tui lm m sao u b hi d qu, dng my th thuc ngi ta mch cho u khng bt. Xin cho bit khoa hc c bin php g cha? Ti c gia nh sng nc ngoi nn c iu kin cha tr". V cha tr hi u, trn th gii mi c hai phng php hay, mt bng thuc v mt bng ngoi khoa. 1. Finastride ung, do bc s k n, ngn khng cho testosterone (hoc mn sinh dc nam) bin thnh dihydrotestosterone gy rng tc. Nhiu nghin cu ng dng trn nam gii 18-41 tui cho thy, nhm nhng ngi hi nh u, To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

sau 1 nm ung thuc, 86% trng hp tc thi rng v 48% tc mc li, sau 2 nm c 83% tc thi rng v 66% tc mc li. ngi hi trn, sau 1 nm ung thuc, mt tc tng ln. Ph n c thai khng c s dng Finastride v thuc c th gy d tt cho c quan sinh dc ca cc chu trai). 2. V ngoi khoa, c k thut cy tc mnh danh l "dense packing": Ly cc nang lng ca tc t vng lnh em cy ln vng hi, mi ln c th "trng mi" c 3.000 chic trn mt din tch bng lng bn tay. Thng 3 nm 2001, mt nhm nghin cu Php pht hin ra cc t bo gc nm ch phnh ca lng c tnh "a nng", ngha l c th ti to c biu b, tuyn b nhn v nang lng. c tnh ny s c khai thc phc hi nhng phn da b h hi (nht l khi b bng rng), sn xut thuc cha chng rng tc... 442. Ci sy ny ci ung "a em nh ca chu b mt ci nht to i, sng nhc. Chu thng qu, ang nh ly bng gi trong giy bo ra nn m th bc qun y s gi v hu trong xm ti chi. Bc y mng chu ri i mua khng sinh cho em chu ung, ming c lm bm: Nguy him, nguy him cht ngi! . Ba hm sau bc dn em ln trm x, dng dao m hp chch m ra v bng li. Chu khng hiu v sao m nn nht li nguy him cht ngi, nhng v s bc y mng na ln khng dm hi". Chu vn cn m c chng? Chu b mng khng oan u, v my l: - Tay chu v bng m chu nh dng khng m bo v khun (ngha l cn mang nhiu mm bnh c th nhim thm cho em chu). - Vic nn nht rt nguy him ch dng sc mnh ph v hng ro bo v c th ti ch tn thng (nh hng ro ny, vi khun b ngn chn v khu tr li, khng th tin xa hn hay trn vo mu). Thnh ly phng th b v th k th d bng lt qua. - Vic nn nht cho em chu vo thi im c th gy cht ngi bi v lc by gi ang c s tranh chp gia c th v mm bnh (tc gia bch cu phng v v vi khun tn cng). Hng ro bo v cha hnh thnh hoc cha hon chnh; ng tc nn nht s tip sc cho vi khun nh bi s phng v ca bch cu v lan trn vo mu, gy nhim khun cc c quan khc (thng l p xe phi) hoc nhim trng huyt. Cu hi ca chu gi li mt chuyn au thng xy ra kh lu cho mt sinh vin nc mnh: Anh ta b mc nht i, t mnh nn non ra, b p xe phi, phi nm vin. Do m ra nhiu, cn tr h hp nn phi m kh qun ht m v cho th xy. V sau, bnh un vn xut hin. Cui cng anh qua i. Bc qun y s gi tht khn ngoan. Bc y bit ci nht ca em chu cha chn (cn cng nhc, cha mm), phi cho thm khng sinh gip c th xc lp hng ro bo v chc chn , sau mi To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

dng dao v khun rch m khng nn nht, ri dng bng v khun bng li. T gi pht , c th em chu s tng dn m ra qua vt rch. Nn qun i hai ch "nn nht" trong ngn ng thng thng cng nh trong ngn ng y hc, trnh nhng ng nhn c th gy nguy him cht ngi v "ci sy ny ci ung". 443. Lng nch v hi nch "C phi con gi thng khng hay mc lng nch? Cn nch em th li mc mt t lng, v em cho rng v th m b hi nch, c ng khng, tha bc s? Em mun nh ht lng i, nhng nghe ngi ta ni nh lng nch c hi cho tim nn em s qu. Xin cho em cch gii quyt". Lng nch v hi nch khng lin quan g n nhau. Tri cho lng nch ta thi bt nhit khi tri nng bc (m hi tot ra t nch, c gi thi vo lm cho mt m), v c m p hn khi khi khng kh lnh t h Baican ca nc Nga trn v, gy nn gi ma ng bc. Th th ti sao li em nh hoc co i "cho p mt"? V vn ny, chu cn bit thm hai iu. Th nht, vic nh tc su, nh ru v lng nch ca ta rt chi l khng khip i vi cc bn quc t, k c ngi chu Phi. Th hai, nu thy n "nch khng lng", n ng c cht kin thc s nh gi oan l "bn mnh ni chung khng c si lng no mi v tr" (hin tng v mao, vn lm cho mt s ch em au u v thit thi trong chuyn n i, nhng y hc cha c cch khc phc). Vic nh lng nch khng c hi cho tim; nu khoi nh, xin c vic! Cn nu mun "vt lng" nhanh v khng au, xin xem Mc 128. V hi nch, c cch kh mi hu hiu v n gin sau: Mua mt t phn chua ti cc hng kh, hng xn hay hiu thuc ng y, em ngm vo l cho tht ngp nc, nt kn, lc mnh n khi khng cn tan thm. Ra sch v lau kh nch ri dng gc thm bi (nu l c l nh th r thng vo), kp nch li dm ba pht. Dng thng xuyn, mi ngy 1-3 ln hoc hn ty theo tnh hnh (nn thc hin trc khi ng ti chn gi khi c mi). i u xa nh mang theo. Khng qun l phn v s dng kn o th s khng ai pht hin ra, k c ngi thn gn gi nht. L phi nt kn, phn phi lun ngp nc; nu v cn, phi vt i v khng cn tc dng. 444. Chuyn nt rui "Hai chng em ging nhau ch u c tri ban cho mt ci nt rui kh to ni khe mt, chng p g m li vng vu khi ra mt. C nn ty i khng v ty u?". Mt c tnh chung ca cc khi u l d pht trin nhanh, thm ch thnh c tnh, nu b va chm lin tc. Nt rui nm khe mt, thi dng rt d b khn mt va chm nhiu ln trong ngy nn nguy c cng ln, nht l ngi ln tui. Phng nga trc vn hn, v li ci nt rui y cng chng gip mnh xinh thm. Hai em nn n To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Trung tm Vt l Y sinh hc TP H Ch Minh (109 A Pasteur, qun 1) hoc khoa Phu thut To hnh Vin qun y 108 (Trn Hng o, H Ni). Cc bc s s dng laser ty nh nhng, khng so. Nt rui en thng c din bin kh lng trc. V vy, khi n c khuynh hng to ln hoc gy nga ngy ra xung quanh, khi n nm nhng v tr d b va chm nhiu... th nn thanh ton cng sm cng tt ngn nga nguy c tr thnh c tnh. Ngoi ra, ngi c nhiu nt rui en thng c bit nhy cm vi tc ng ca tia t ngoi. Do , ngay c khi ty, cc chu vn nn trnh ra nng (trong khong t 10 gi sng n 4 gi chiu). V d nhin khng nn bi kem chng nng ri i phi nng (v tt c cc loi kem chng nng hin nay khng c tc dng tt nh qung co). 445. Khi mt c vt so en ln "Chu l con gi; da mt trng hng nhng li c mt vt so rt to mu en bn m phi, lm chu rt bun v ngi tip xc. Xin hi c cch g lm cho so trng tr li m khng phi m?". Hin cha c cch g lm ht so c ngoi vic m to hnh: ly b so ri dng mt vt da lnh ln v ln. Kt qu s l tng nu tnh hnh cho php xoay mt vt da lin bn cnh ti, bi cng l da mt nn n s lun cng mu vi da xung quanh. Nu khng, s phi dng mt vt da ri ly t vng khc v; trong trng hp ny, v sau mnh v s "bt nng", mu thm hn, i hi phi dng m phm thng xuyn (nhng vn tt hn l c gi vt so xu m khng c cch g che giu c). Nu pha Bc, chu nn lin h trc vi Vin Bng Quc gia (H ng) hoc khoa Phu thut To hnh Vin qun y 108 (Trn Hng o, H Ni); pha Nam th lin h vi khoa Bng Bnh vin Ch Ry (qun 5, TP H Ch Minh)... xin khm cha. Gi km theo 2 nh chp mt thng v nghing, 1 phong b dn sn tem ghi a ch gia nh tin lin lc). Nhn y, xin nhc mi ngi ch : - Khi c vt thng trn u, c bit l trn mt, d l mt ch rch nh, cng phi n cho bc s khu li trnh nhng vt so xu v sau. - Khi c mn nht mt, phi nh bc s gip, khng c rch tho m mt cch ty tin, gy nn nhng vt so ln lm xu gng mt. - Trong qu trnh ln da non, nh gi c ngh ti bi ln thng xuyn trong vi ba tun, gip cho so bt "bt nng", khng thm mu mt cch qu ng. 446. So li "Nm 1998, em c m chuyn gn tay, sau xut hin nhiu so li ni vt m, c ci di 5-7 cm, rng 1 cm, v ngy cng li ln. Xin cho bit nguyn nhn (trong thi gian sau m, em khng h n cc th nh cua, cc, rau mung, tht b) v cch cha tr". To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Em l ngi mang th a so li. nhng ngi nh vy, ch cn mt vt thng rt nh do t tay cng b so, khng trnh c, d nhn th thc n vn vy. c im ca so li l nga ngy, c mu sm, c ln dn v d nhim khun. Em hy cha th mt t bng kem bi Contractubex; nu thy th kin nhn tip tc. Nu khng, em phi c x tr ti cc c s nh: khoa Phu thut To hnh Vin qun y 108, Vin Bng Quc gia, khoa Bng Bnh vin Ch Ry. Ti cc c s , bc s s m ct b so li ri khu kn da theo cch sau: Khng hai mp vt m thng tp t ngoi vo trong nh mi phu thut khc m ht cho da, lm cho lp su ht i so vi lp nng. Nh vy, sau khi vt m c khu kn, lp da nng s lin so trc lp da su, khng cho lp da su vt ra ngoi gy so li nh c (nu lm khng ng k thut th so li li ti din ngay ti ch m mi). Sau phu thut, em nn dng tip kem bi Contractubex hay Madcassol (kem bi, thuc ng ung mi ngy 1-2 ng) gip lin so bnh thng, gim kh nng gy so li ca lp da su nh ni trn. Madcassol l bit dc ca Php chit xut t cy rau m, cho nn em c th n tht nhiu rau m. Ngoi ra, c th n thm hnh ty h tr qu trnh ti to t bo. 447. Ty vt xm "Hi b chu di dt xm tay, vit ln nhng ch tht v vn. Nay chu mun ty, nhng khng bit c ch no ty m khng li so?". Chu hy n Trung tm Vt l Y sinh hc TP H Ch Minh (109 A ng Pasteur, qun 1) hoc khoa Phu thut To hnh Vin qun y 108 (1 Trn Hng o, H Ni) xin ty. Ti y, cc bc s s dng tia laser ty vt xm, tin hnh lm nhiu t. Cc vt so ch thong qua, kh nhn bit, v nht l khng gp nguy c b so li nh cch t bng dao in trc y. 448. Nang b u "Ti 42 tui, c mt cc u sau vnh tai bn phi cch y 20 nm, lc u nh nh ht u, nay pht trin to bng qu trng. Ti mun m n i, c c khng? Nu m th m u v chi ph khong bao nhiu?". Bc tnh chuyn m l rt ng, bi v khng bao gi nn coi thng bt c cc g xut hin trn ngi mnh c, nht l khi lung tui. C th ch l u lnh, nhng bit u mt lc no y li tin trin thnh u c. Trng hp ca bc c th l nang b u hoc u m. M s khi hn vi iu kin khng st li mt cht no (m nang b u d b st v bao nang b rch v mt vi mu nh s nm li trong ). Cuc m ch l mt tiu phu thut; bnh nhn c gy t ti ch v khng cn nm vin, ct ch sau 1 tun, chc l chi ph khng my u. Bc s phu thut ca mt bnh vin tnh c th x l tt. Tuy nhin, v u ca bc sau vnh tai nn phi cn thn khng b so xu lm mt thm m. 449. Bnh bch bin To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

"Chu b bnh bch bin gn hai nm, cha nhiu cch v nhiu loi thuc ngi ta ch dn nhng khng khi. Xin cho bit nguyn nhn v cch cha c hiu qu ". Bnh bch bin xut hin do cc t bo da vng tn thng khng sn xut ra melanin (hc t) nh thng l, nn da chuyn sang mu trng. Hin cha c cch cha bnh bch bin. Nhng gia nm 2001, cc nh khoa hc M a c vo c th chut th nghim mt cp gene c tc ng ngc nhau i vi vic to melanin ca con vt: khi gene ny u th th chut c lng en, khi gene kia u th th lng chut dn tr li mu trng; hn na, h c th dng thc n kch hot hay c ch cc gene . Thnh tu ny m ra nhiu trin vng cha mt s bnh nan y, trong c bnh bch bin. 450. U huyt qun mi "T khi mi ln ln, em thy mi di ca mnh b thm thnh nhiu qung nh gia. Bc s u tin khm ni l u mu, ch cn m bc i l khi, nhng em khng i. Sau c ngi ni do thiu vitamin, nhng ung mi khng chuyn. Xin cho em mt li khuyn". Em t khng c th nn rt kh ni chc, nhng nhiu kh nng y l mt trng hp u huyt qun, khng nguy him nhng lm cho gng mt km p, thm ch d s, v n vn tip tc pht trin mt cch m . Ngi ta thng dng tc ng ca tia x km hm ri tiu dit nhng t chc bt thng , hoc m bc b ton b nu tnh hnh cho php. Em ng chn ch na, hy v khm ti mt khoa phu thut to hnh c kinh nghim c chn on v c hng iu tr thch hp. 451. Tc bc sm "Em c mi tc rt di, gn y mt na u b bc nhiu t chn tc tr i. V xu h vi cc bn nn em mun b hc. Xin cho em mt li khuyn". Hin khoa hc cha c cch g hu hiu cha chng bc tc sm. Em nn cng thuc nhum tc, c 7-10 ngy chm thuc vo chn tc mt ln; cc bn s cho l em iu tr khi bc tc. Thuc nhum tc ca Vit Nam (lin doanh vi nc ngoi) nhn hiu Mekelong c gi 7.000 ng/hp, gm 1 l thuc bt v 1 l nc xy gi; dng rt tt, li t tn km. Mi hp nh vy dng c nhiu ln vi iu kin nt tht kn. Khi ht xy gi, c th mua thm ti hiu thuc, gi 500 ng/l. Thuc ca Nht (Bigel) t tin hn nhiu, nhng tin li hn ch: ch pha vi nc, khng giy mu en ra da v gi nhanh sch hn. Ch khng mua thuc dm, s lm rng tc. Cch nhum: Dng u a c qun cht vi chm thuc pha, chm u ln nhng ch chn tc bc (ch cn thm t, mt lc sau tc mi c mu en). Ch 30-40 pht ri gi tht sch. Vic ny c th nh m, ch em trong nh hoc bn thn lm, v nh nhc mi ngi gi b mt y. Cn v lu v di, em c th hy vng v cc nh nghin cu thuc i hc tng hp Bradford (Anh) To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

nh thc c cc t bo hc t "ng qun" ti chn tc bc hot ng tr li (nhng t bo ny ng l tip tc chc nng sn xut ra cht en lm p tc th khng hiu v sao li ra khng chu hot ng, lm cho tc bc). D nhin cha th c ngay thuc bi tc mc en tr li, nhng mt khi tm ra nguyn c ri th chc chn trong tng lai khng xa, khoa hc s tm ra c cch khc phc hin tng bc tc sm nh trng hp ca em. Ch c di dt b hc ri phi hi tic. 452. Ung th da "Ti c mt ngi bn gi 31 tui, c mt khi u bng u ngn tay t, s thy cng, t nm 1995 n 1997 c mt bnh vin tnh lin tip m ct b 2 ln vi chn on l nang b u. Sau u li ti pht, c Bnh vin K H Ni chn on l ung th da u, ung th biu m gai sng ha di cn vo hch c (sau khi phu thut ct b u v ly mt hch thng n em xt nghim gii phu bnh). Trng hp bn ti c cch g cha khi khng? n ung c nn king khem g khng? Phi chng v bnh ny m bn ti ly chng 4 nm ri vn cha c chu? Nu sinh n th con ci c b nh hng khng?". Ung th da l loi nh nht trong cc bnh ung th; nu pht hin c sm (bng cch lm sinh thit, em xt nghim gii phu bnh) khi cha c di cn, vic phu thut ct b u s em li kt qu tt p, t khi cn n ha tr hay x tr. Bn gi ca bn b ung th ch khng phi nang b u (nang b u ch cng cng, lng nhng thi, ch khng h cng). Do s nn c y hai ln b l c hi lm xt nghim gii phu bnh, do chm chn. Tuy nhin, hin y hc c cc thuc ung chng ung th hu hiu, phng php x tr cng mnh hn v an ton hn; nu cn thit, cc bc s chuyn ngnh s k n. C iu l bnh nhn phi ti khm ng hn hoc kp thi tr li Bnh vin K khi thy c du hiu bt thng. V n ung, khng phi king khem g ht. Khi u khng lin quan g n chuyn th thai. Gi d c y c con th cng t kh nng nh hng n cc chu (khng ging nh trng hp ung th cc b phn khc c th gy nn hin tng "c a d mc ung th" cho th h sau). 453. Ngi hom hem qu "Chu l con gi 23 tui m gy n ni ai cng bo l hom hem, tm b bao nhiu cng vn th. Sc khe ca chu rt km, lc no cng vng vt kh chu, c ln b ng bt tnh. Bc s k n cha bng thuc khng . Xin cho chu mt li khuyn". C th chu b suy nhc, c th l do hi b chu b s nhim lao nhng khng c cha tr, dn n tnh trng gy g ngy nay. Thm vo , chu ri vo mt trng thi tm l bi quan, xu h v ngoi hnh ca mnh nn tnh trng thng xuyn b stress (cng p thn kinh). Ch c chu mi gii ta c tnh hung bt li . To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


Xin nu ra my hng m chu c th vn dng:

L Trng Bng

- Xin bc s cho chp X-quang phi hoc yn tm khng c vn g, hoc c bc s hng dn phng cch x tr thch hp. Nhn dp ny, nn kim tra c tim xem (khm lm sng, lm in tim). - T to cho mnh nim lc quan, yu i. Gip gia nh mt s vic cho bn thn c c nim vui mi khi hon tt. Tm c nhng tc phm hay, b ch ri trao i vi cc bn cng trang la. - Hot ng th lc vi k hoch tng dn t mt (do bc trong sn vn hay trong phng tp th dc tay khng, lc vng cho ngi mm mi...). - n tt trong c ba ba; nu c iu kin th n thm mt ba m, trc khi i ng. Bn cnh thc n b dng, cn thm nhiu rau xanh v hoa qu chn, ung thm a sinh t. - Ng t nht 8 ting mi ngy; ng tra tht u nhng khng qu 1 gi bui chiu khi u oi. Trc khi thc hin nhng iu trn, chu cn li th trng, o vng ngc, vng eo, vng i..., ghi chp vo s tay so snh tng thng mt. Khi thy kh ln nhanh, phi kp thi iu chnh "thu chi" ngn nga chng bo ph. 454. C trnh c bo ph khng? "Bnh bo ph c di truyn khng m em thy bn h ngoi nh em, cc d u mp ; mt s con gi ca h cng vy. M em cng mp, cn em th tri thng hay sao y (con mt m), nn khng mp; nhng em vn lo..." Cu hi ca em va d va kh tr li; nhng cng xin c gng, bi em khng ghi a ch c th, nn khng th tm hiu thm. Ni chuyn d trc nh: V danh t th bo ph c tnh cht bnh l c gi l bnh bo ph; cn bo ph do sai lm trong n ung v ngh ngi c gi l chng bo ph. Bnh bo ph thng di truyn. Trn thc t, ngi ta thy trong mt s dng h c nhng ngi bo ph qua cc th h (ni vy khng c ngha l mi ngi u bo ph). Nghin cu trn chut th nghim, nhng nm gn y, cc nh khoa hc ln lt tm ra nhiu gene gy bnh ny. u nm 1999, h li tm c thm gene ob 1 hin hu trong 1/3 s ngi bo ph trong cng dng h. Tt nhin, vi nhng bc tin ln ca di truyn hc, con ngi s c bin php ch ng tc ng ca nhng gene bnh hon . Nhng v khng phi ch c mt gene cho nn cng chuyn s khng n gin v chng vnh. Chng bo ph, tri li, c th khc phc c bng s cn bng trong n ung v ngh ngi: khng n ung th ca v khng lm bing trong sinh hot. Nu khng th, qua mt s th h, bo ph s khng cn l chng m tr thnh bnh. Lc th nh m ci bng ph nm ch thnh tu trong tng li ca cc "Hoa hin i"! Chuyn h hng bn ngoi nh em tht kh khng nh. Tuy nhin, em th lin h chuyn gia nh To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

vi cc iu k trn xem thuc din no. Em thy kh chng? Chng ta cng lp lun nh: - Nu bo ph do thng xuyn n nhiu ko bnh, mt, m, b... v ung nhiu bia, nhng hot ng th lc li rt t v ng nhiu, th hy vng l chng. - Nu t nh n nay vn theo mt ch n ung v ngh ngi hp l m vn bo ph th c kh nng l bnh. - Cng c th do c hai yu t kt hp. Do vy, nu ai mun em cho h mt li khuyn, em hy nhc li nhn xt lu nay ca cc nh nghin cu: Ngi thon th, hi gy cng c, sng thoi mi yu i, khng nghin ru, khng ht thuc l l ngi sng lu nht. V vi nhng bn bo ph no cha phn u tt gim cn, em c th nhc h rng, theo mt nghin cu cng b M, nhng ch em trn 18 tui b tha 20-25 kg th trng th n thi k mn kinh s gp nguy c ung th v cao gp i so vi nhng ch em ch tha mt vi kg. Ring em th tri thng, ban cho mt ngi m sm bit cng b gi gn khng cho sa vo thi xu n ung tha ma, li bing v ng nhiu. Tuy nhin, em phi lun cnh gic, nht l khi n lt mnh c trao chc nng lm m. 455. Nm ng b bng Khi ng, nht l ng tra, ti hay b bng , phi ly ht sc dy, mi ln nh vy rt mt. V th ti phi dng thuc thn kinh hu nh thng xuyn. Xin cho ti mt li khuyn. Trc khi ng, k c ng tra, bn phi ni lng hoc b hn nt ngc v o lt qa cht, ri nm xung ngay theo t th nghing phi; nu tr mnh th nm sang nghing tri hi sp ( cho tim c thoi mi), ch khng nm nga. Hai tay lun th t do dc theo thn mnh, khng chp li, khng t ln ngc hay ln bng, khng m c; hai chn khng gc ln nhau. Bi v nhng t th g b khi ng s gy cho bn cm gic b tri cht hoc b ln ngi, do vy bn c mun chng c li, mun t g ra, rt mt. Nu ng tra, phi che cn phng cho cng ti cng tt; nu l m, n ng phi tht m, hay nht l khng n. Bi v nu khi ng m vn c nh sng, mt bn s b kch thch nn vn m, v nhng hnh nh tht t bn ngoi lc by gi s b mo m v tc ng ln bn nh mt sc nng kinh khng ca mt tn khng l no ln ngi. Ngoi ra, trc gi ng bn nn tm hay gi u bng nc nng ri hong kh tc, hoc ngm chn vo nc nng chng mi pht ri lau kh. Hng ngy, nn n thm canh nu vi l du tm non, hoc l vng, lc tin, n ng sen, ung tm sen, n mt ht sen..., tm li l nhng cy c gip cho gic ng c su v lng du. Khng nn lm dng thuc ng. Khi tnh hnh c ci thin, nu cn, bn c th tr li dn dn vi t th nm nga, v nh vn To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


theo cch thc ni trn. 456. Vim nim mc ming

L Trng Bng

Em 30 tui. Em b l ming mt nm nay ri, mi ln b trong 1-2 tun, dng cc loi vitamin kt hp vi Penicilline, nhng khng . Xin cho em mt li khuyn. Em th cha theo cch sau xem, gm 3 vic: 1. Trong cc ba n, thng xuyn c tht nhiu rau xanh, trong c ci xoong (cresson) chn ti hay n sng rt tt. 2. Ly vi ba ci mng trong ca m g (k ni kim), di nh cho sch, t vo mt hp kim loi kn, em t (s chy en nhng khng thnh tro do khng tip xc vi khng kh, ng y gi l t tn tnh), gim vn, cho vo mt l mt ong th thit, chm nhiu ln vo cc vt l. Nu c nhiu mt ong th ngm nhiu m g ri ngm lu lu, cng tt. 3. Ung Theravit (a sinh t + cc cht khang ca Hoa K), ngy 2 vin, chia lm hai ln. Khi khi, thng xuyn dng 1 vin/ngy (gi mi vin khong 400 ). 457. Ti sao vn hi ming Em c c bo, cng bit hi ming do cc nguyn nhn nh su rng, vim xoang, do hi bao t a ln, v.v. Em tuy b su rng lu, ci rng vng sm m cha c iu kin i cha, em vn rng nh rng sc ming nhiu ln, thy khng nng ln, nhng khng hiu sao cc bn vn bo l em hi ming. Rng ca em b su m em qa mun, phi c gng v kin tr cha bo tn may ra mi gi c. Em tha vi gia nh sm n mt c s nha khoa tt ca y t xin iu tr. Th no nha s cng s khoan bung ty ni rng em; lc by gi em s ngi thy mt mi thi khng khip, nh mi xng cht, v phi t thuc rt nhiu ln mi ht mi, mi sch s v v khun, cho php trm li c chic rng; cn nu phi nh b th n tri, em s ht hi ming ngay lp tc. 458. ming bt hi Chu trng thnh, nhng b hi ming t hn mt nm nay, tuy ngy no cng nh rng u 3 ln. Chu mc cm qa. p: Hi ming do nhiu nguyn nhn: su rng, vim amian, vim mi, vim xoang, lot nim mc ming...; nu cha khi cc bnh ny th hi th s ht hi. C mt nguyn nhn na l do hi t d dy (bao t) a ngc ln do l tm v (gia thc qun v d dy) ng khng kn; ngoi ra, mt s ngi, nc bt (nc ming) nng mi hn ca ngi khc. Cha c phng cch iu tr tn gc. Ch c mt s bin php khc phc mi hi, v phi s dng thng xuyn. a) Nu c iu kin, chu mua thuc xt hng Sweet Breath, vn dng kinh nghim ca th dn da To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

: Mi bui sng nh rng xong, ly mt cc nh nc chn, pha vo 1 tha con mt ong th thit + cht xu bt qu (hoc nhc qu mi vo nc), dng ngm trong 5-7 pht; ming c th thm mt c c ngy. c) V thuc cha, xin gii thiu mt bi thuc ca Lng y Hong Duy Tn gm: Gi u nnh 100 g; Lch b: 60 g. Hai th cho vo 1 lt nc, y kn vung, un trn la nh cn 1/2 lt, ung dn cho ht trong ngy. Dng trong mt thng lin. 459. Mn nga khp ngi Chu 24 tui, t 6 nm nay, v ma ng, khi c cn gi lnh l chu b bng mt ri ni mn nga, trng rt s. Chu c bc s cho bit l d ng do thi tit, v cho ung thuc nhng khng thy khi. Bc s chn on ng: Chu b mn nga (ni my ay) do d ng vi thi tit. C th ngi bnh thng khi gp gi lnh th co mch mu ngoi vi li bt ta nhit, tit kim c nng lng. Cn c th chu, do b mn cm, li phn ng mt cch d thng (d ng) bng hin tng gin mch, lm cho mt nh gc v ngi n lnh v hao tn nhiu "sc nng"; ngay sau , cht huyt tng ca mu trn qua thnh mch m xm nhp cc m, lm nga ngy v sng n. Nu tip tc ra gi hay dm nc, c th ni mm nhiu ch, thm ch ton thn, km theo au bng: trng hp c bit c th n thanh qun gy kh th. Nguyn nhn do c th b d ng sn xut ra cht histamin gy nn mt lot hin tng ni trn. V vy, ty y ch ra cc loi thuc chng histamin tng hp i ph; tic rng nhng loi thuc ny lm cho bnh nhn va ng li b va d git tht ngi rt kh chu, gy tr ngi trong sinh hot bnh thng; v chng y ch l cha triu chng, khng cha c tn gc (Ty y cng c gng cha tn gc bng cch pht hin ra nhng nguyn nhn gy d ng: thc n, ung, phn hoa, lng sc vt, bi bm, ha cht... ri to cho c th c kh nng chng chi; ring d ng vi thi tit cha thy c cng trnh nghin cu no cp ti). Trong khi ch i cc nh nghin cu nc ta tm c cch cha tn gc bnh d ng vi thi tit nh mn nga, hen suyn... (m tc nhn ch yu c l l s thay i t ngt p sut ca kh quyn), mt s bnh nhn mn nga lu nay vn dng: Kim ngn hoa 12 g cho vo 200 ml nc, un si trn la nh cn 20 ml, ung lm 2 ln trong ngy (c th dng liu tng dn cho ti 24 g/ngy); dng thng xuyn, k c nhng hm khng ni mn, trong thi gian di, s c tc dng gii mn cm, do s bt hoc cht hn d ng. Chu nh mi khi b mn nga phi lp tc vo ch kn gi, si m hoc trm chn ngay, ung nc nng, trnh tip xc vi lnh. C th dng khn h nng xt nh ln ch ni mn (dn gian thng dng ci bi nhi thu c khi m t, em rang trn cho nng chm). Nu au qun bng th dng ti nc nng hay vin gch nng chm ln, s ht, khng cn dng thuc. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


460. B bng (phng) phi lm g ngay

L Trng Bng

Qu chng ti thnh thong c cc em nh b phng nc si, phng la do nghch ngm hoc do cha m s , v thng khi nh vy ngi ta bi ngay nc mm vo, ni l lm cho t li, mau khi. C ng vy khng? Cc bn c thy khi ta cm vo vt g nng, ta thng a vi tay ln nm vo di tai, v thy nh vy s d chu? ng tc ny chc hnh thnh ni con ngi c xa, nhng li rt ph hp vi nhng kt qa nghin cu ca con ngi hin i. Di tai t mu lu thng, li c khng kh qut mt thng xuyn, nn nhit thp hn v n s thu ngay nhit t ni tay ta ang b nng. Sau khi b bng (phng), sc nng ti ch cn lan rng v i su hn, tip tc tc hi nhng phn xung quanh, lm cho tn thng ban u nng thm rt nhiu. V vy, iu quan trng bc nht cn thc hin ngay l lm lnh vng b bng cng nhanh cng tt trong vng 15 pht u, nhm hn ch phm vi v mc ca tn thng do bng. C th l, khng chm tr, cho ngay vng b bng vo nc lnh, hoc lin tip di nc lnh ln tn thng bng trong 5 n 10 pht (Nu dng vi nc th cch mt da 10-15 cm cho an ton, v trnh khng di t cc vng khc lm cho nn nhn d b cm). Nc lnh s thu ngay s nhit hin hu trong tn thng, ngn khng cho n lan rng ra tc hi; ngoi ra, nc lnh lm cho nn nhn d chu, cm gic rt but c th gy chang. Nhng, nh ni trn, vic lm lnh ch b bng ch c gi tr trong vng 15 pht u; nu mun hn th "s ri", ngha l nhit hon thnh vic gy hi ca n. (C mt phng php lm lnh hin i c s dng ti Php l dng loi mn c tm sn cht lm lnh, t c nh 5-60 cm n c va hoc ln trm ln c ton thn). Nh vy, chc cc bn thy rng bi nc mm vo vt bng va v ch va c hi: Nc mm s lm cho vt bng v sau d nhim khun, v nht l lm cho tn thng ban u nng thm do khng c lm lnh ngay theo phng php khoa hc. Tt nhin ng tc ni trn ch l mt trong nhng ng tc x tr bng; ngay sau nn nhn cn c bc s khm xt v iu tr ti ch hoc a i bnh vin ty trng hp. Ti nh, cc bn c th tin hnh nh sau: a) Sau khi ngm vt bng vo nc lnh, nu thy c nt phng (bng 2), th lt b ngay ht ch b phng v thm kh cht dch: Dng nc mui nht (nu c thanh huyt mn ng trng th tt) di nh ln cho sch, ri dng kp (pince) c dit khun ln lt lt ht ch da b phng, cng trit cng tt. Xong ly gc v khun, em qut Vaseline pure vo (nhng th ny u c bn cc nh thuc), em t ln v bng li. S d phi qut Vaseline l sau ny thay bng g ra khi au (Tt nht l sau khi lt b nhng ch da b phng, dng Btadine bi ln ri t gc, khng dng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Vaseline, mt tun sau s khi, gc t bong ra). Nu dng m penicilline, phi tht chc chn l nn nhn khng c phn ng i vi loi khng sinh ny; cho nn an ton nht l dng Vaseline pure. Nn nh: Nu gi nguyn cc ch phng, s d b nhim khun (do vi khun thm nhp vo cht dch bng v pht trin); ngoi ra, lp da b bng nm s gy tr ngi cho vic lin so. b) Nu nghi ng vt bng nhim bn (v d nc ngm lnh khng c sch), hoc mun tht chc chn, th ti y t xin chch nga un vn, v ung khng sinh khong 5-7 hm. c) Nu din bng rng, nht l bng la, phi kp thi a n bnh vin. Nhng xin nhc li: bt c tnh hung no cng khng c qun khu u tin ht sc quan trng l ngm ngay vo nc lnh. 461. Bu c n thun Chu c chn on l bu c n thun (T3, T4 v TSH u bnh thng). Xin cho bit c thuc g cha c? Phi xc nh l bu c lan ta hay bu c th nhn (Xem thm Mc 462). Nu ng l bu c lan ta, th ngoi vic thng xuyn dng mui it trong thc n, dng thm sn phm bin (rau cu, tm, mc, c bin), ung nc khng c cht vi (nc my hoc nc ng chai), chu nn ung v thuc d kim sau y: K u nga (dn gian gi tt l k nga, qa c gai nhn lm chm thng c tr em dng nm vo tc nhau, tn khoa hc Xanthiu, strumarium L., thuc h Cc): u n ung mi ngy 4-5 gam qa hay cy l kh (thuc sc, un si 15-20 pht); trong khi dng k u nga nn king tht ln trnh b ni qung khp mnh. K u nga c bn trn th trng di dng qa kh, cy l kh hay c bo ch thnh vin cao. 462. Cng tuyn gip Em nm nay 18 tui. Bnh vin a khoa chn on em b Baz (cng tuyn gip) v bu c, ang c bc s cho dng MTU v PTU. Nghe ni b Baz th ngi gy dn, nhng em li thy ln cn, liu c phi ng bnh khng? Em c th m bu c c khng, v liu sau ny c nh hng g n ng con ci? Cu hi v bnh ca em cha c chi tit. Em hy xem c cc triu chng sau y khng: run tay, mt hi li, mch nhanh, hay cu gt, v nht l xt nghim thy T3 v T4 tng cao, ng thi TSH h thp. Nu c, l bnh Baz (cng tuyn gip). - Nu trc y em b bu c, sau mi c du hiu Baz, th l bu c Baz ha; trng hp ny c ch nh dng thuc c tr; khi bnh Baz n nh, c th m bu c. - Nu nh khng c cc du hiu ca Baz, th l bu c n thun: a) Trng hp bu c th nhn (ban u khng to nhng gii hn r rt, ln tng i nhanh, s vo hi chc tay) th cn c m tht sm trnh bin chng n b Baz ha hoc chuyn thnh c tnh. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

b) Trng hp bu c lan ta (gii hn khng r, pht trin chm, s khng thy nhn), th ch nh m l tng i, nhm mc ch thm m nhiu hn, v bu c lan ta thng lnh tnh. S dng mui c it gip phng nga bnh bu c; cn khi b bnh th it khng gip cho bu c nh li c. B Baz m c cha tt, thm ch phu thut, bnh nhn khng b nh hng g v ng con ci. Em hy i kim tra ngay cc xt nghim ni trn v xin khm chuyn khoa ni tit. 463. Bu c c th chm Em l con gi, nm nay 20 tui. Em c pht hin c bu c nm 17 tui v ung thuc phng chng bu c trong 6 thng; sau , bc s cho bit bu ngng hot ng, khng cn ung thuc na. K t n nay, ngi em gy dn, lc no cng cm thy c mt vt g mnh ln ngc, thy hi th rt kh khn, mi khi th phi ht mnh mi ly hi... 1. Em k bnh cha tht chi tit, tuy nhin c th thy nhiu kh nng l: a) Cch y 3 nm, em b bu gip th chm (loi bu ny khng pht trin ra bn ngoi, m lun su xung lng ngc), cho nn c nh gi nhm l "bu khng cn hot ng" v cho ngng iu tr. Hin nay n ln ln thm, t nhiu c chn vo kh qun (ng th), lm cho em ht th kh khn. b) Sau 6 thng u tin , bu ca em chuyn thnh bu c (chuyn mn gi l bnh Baz, ngha l bu c + cng tuyn gip); tic rng khng c ai gip em pht hin cha tht sm (nhng biu hin sm ca bnh ny l: gy st, ngi lun thy bng bng, hay ni nng v c, run tay, mnh nhanh...). 2. Em nn xin gia nh sm cho i khm ti mt bnh vin trung ng; cc bc s s cn c vo cc kt qa khm xt (th mu tm T3, T4 v TSH xc nh bu c hay khng; siu m, chp X quang... xc nh v tr ca bu chm trong lng ngc; kim tra tim mch, v.v.), t s c phng php iu tr thch hp. 464. Cn h ng huyt Cch y 7 nm, em i tiu th t nhin mt hoa chng mt ri ng ra bt tnh; mt lt sau em li bnh thng. Thng 4 va ri, em ang ngi chi, khi ng dy ra ngoi li b nh do trc. Xin cho em mt li khuyn. Nhiu kh nng hai ln em b ngt do cn h ng huyt, hoc va h ng huyt va b huyt p thp. Nu c iu kin, em nn i khm bc s kim tra xem c phi ng nh vy khng. Trong khi ch i, cch d phng n gin nht l lun c sn trong nh hoc trong ti xch (khi i xa) mt mu bnh ngt hoc mt cht ng..., nu thy hi i l nhm nhp ngay nhm cung To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

cp ng kp thi cho c th; ngoi ra, trnh phi nng nhiu, v ch ung b sung nc khi lao ng hoc khi tri nng nc. 465. Hc tip thu chm Em 22 tui, t b hc tip thu rt nhanh, hc gii, nhng t khi em b xe thy hc tip thu chm, i khi hc trc qun sau. Liu c cch g khc phc? Em cng mun bit u c my chp no chnh xc nht i n chp. Khng tht chc chn l do b xe m tr lc ca em gim st. C nhng trng hp lc cn nh hc gii m ln ln li hc khng gii bng, thm ch km hn; ngc li, c ngi thu nh hc trung bnh nhng cng ln ln cng hc gii. Nhiu yu t tc ng ln qa trnh ny, ngoi yu t di truyn: dinh dng, rn luyn, sc khe, tc ng ca hon cnh xung quanh... Trng hp ca em, hy n vi m nhc xem, v nhiu cng trnh trn th gii cho bit: m nhc c tc ng lm pht trin tr tu mt cch ton din, thm ch ci to c c bn cht con ngi. Mc thp, em nghe v nhm thuc dn ca, cc ln iu hay trong nc v quc t. Mc va, em hc k xng m ri tp ht hoc tp chi mt nhc c n gin. Mc cao, em hc organ hoc piano. Ri em s ngc nhin cho m xem. V my chp qut no (scanner) th hu ht cc c s y t ln ca TP H Ch Minh hay H Ni u c, gip bit c tnh trng ca h thng mch mu trong no, cc no tht, pht hin c khi u, v tr v kch thc ni xut huyt, v.v.; cn trng hp ca em c chp chc cng chng pht hin c g. 466. Nn hc ngoi ng lc no trong ngy Trong ngy nn hc ngoi ng vo lc no th tt? Qua nghin cu trn mt vi loi chim nh bit ht, cc nh khoa hc thy rng: Ban m, trong gic ng, cc ch chim non hi tng li nhng giai iu m b m chng va ht hm trc; bng chng l nng cht norepinephrin (cht dn truyn thn kinh tc ng ln vng no c lin quan n ting ht) tng cao ni nhng ch chim con ang ng sau. V cng thy rng, i vi loi chim, gic ng ng vai tr quan trng trong vic hc ht. Dng nh cng vy i vi con ngi. Mt s hc sinh hc ngoi ng m my cho pht m chun cc t hc trong ngy, ri ln ging nm ng hn hoi, trong lc bng vn chy cho n ht th my t tt; s ny thy d nh t hn. Em vn dng th xem, chng tn km v cng khng gy hi. iu cn bit thm l: Qua chp qut no, ngi ta thy rng hc ngoi ng vo tui cng th u th kt qa cng tuyt vi. V vy cc em nn tranh th thi gian "va chi va hc" kiu cc ch chim non ni trn. 467. Khong 8 gi ti l bun ng To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Chu nm nay 16 tui. H n khong 8 gi ti l chu bun ng khng chu c. Xin cho bit cch khc phc. 1. C thi im ta hay bun ng l khi va n xong, nht l n no (n sng cng bng cng vy). Cho nn chu hy xem li gi gic n ti ca gia nh t iu chnh. - Nu c nh n vo lc 7 gi ti, th chu rng hc hnh hay lm xong vic ri s n sau, vo lc 8 gi tr i, sau ng lun (bng i kh ng hn nhiu); hoc c nh thng cm v cng n ung sau 8 gi. - Nu gia nh n ti rt sm v khng th mun hn c, th chu nn dng ba cng sm cng tt; xong ng chp ngay 15-30 pht (nh ngi gi hoc ng h bo thc), sau s c tnh to; khi thy u oi, chu hy vn ng thn th mt lc ri tm nc lnh nu chu ng c (tm nng s d bun ng). 2. Mt thi im bun ng na l bui tra (thc ra cng l sau ba n tra), by gi b no phi hot ng lin tc my ting lin nn cn c ngh ngi (y l phn x c ch t bo v ca v no). Nu chu khng ng tra th nguyn nhn chnh l y; t nay chu hy tp ng tra u n 15-30 pht. 3. Chu xem c nguy c mp ph khng; nu c, chu khng nn ng qa 7 gi mi ngy (nhng vn bo m ng tra). 4. Chu cn t tui, khng nn dng tr c hoc c ph v nhng mt tri ca thi quen ny. 468. Mt ng ko di Chu l n sinh vin sng trong k tc x. Chu b bnh mt ng lu, cng ngy cng nng, n mc c lc nh pht in ln, c cc bc s k toa cho dng thuc an thn, thuc ng, vn khng bt. Xin nu ln 7 hng khc phc chu vn dng trong iu kin sng tp th: 1. Trc ht, chu hy suy ngm v li khuyn sau y ca mt nh tm l tr liu: "Gic ng ta nh chim b cu, nu ta pht l th chim u ln tay, nu ta nh bt th chim bay mt". T nay, c ngy ln m, chu hy dng dc tuyn b vi chnh mnh: "Ta khng cn ng. Khng ng cht ai m s!", c thanh thn mi khi ln ging. 2. Gn gi nhng bn yu i, hi hc, cng gp ting ci thoi mi ca mnh. 3. Tranh th v ng qu, leo ni, tm bin khi c iu kin. 4. Tm thi ngh xem truyn hnh, trnh nhng cm xc bt li cho gic ng. 5. Gn ti gi ng ban m, chu tm nc nng (sau hong kh tc lin), hoc ngm hai chn vo nc nng chng 15-20 pht ri lau kh chn ngay. 6. Nm t th nga, t chi dui thng, dng gi mm thp. Chn mt hnh nh p quen thuc hnh dung ra trong u "sng" vi hnh nh m khng ri xa (ngi hoc cnh vt). Nu chu To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


thch, c th m bng nhc dn tc khng li (so trc, n bu...).

L Trng Bng

7. Thi dng thuc ng. Hng ngy, n thm nhiu ng sen, c sen, mt sen, tm sen, cnh l vng nem, l du tm, l lc tin. Tuyt i khng ung c ph, tr hoc nc ch xanh. 469. Bnh bch cu a sinh Bnh mu trng l bnh g m mt em b gi qu chu b, hng thng gia nh phi a i truyn mu ti bnh vin? "Bnh mu trng" hay "bnh ung th mu" l nhng tn gi thng thng ca bnh bch cu a sinh (BCS, a sinh = sinh sn mnh). Khng phi c sinh sn mnh l tt. Trng hp ny cng vy. d hiu, ta ly con s trung bnh ca bch cu l 8.000 con trong 1 mililt mu; nu con ngi b vim nhim (mn nht, vim rut tha, v.v.), bch cu s tng cao, v d ti 12.000; lc bnh lui th s lng bch cu dn d tr li bnh thng. Trong trng hp chung nht, cc bch cu u thuc loi trng thnh, cng ging nh cc chin binh 18 tui qua hun luyn. Trong bnh bch cu a sinh (BCS), c hin tng bch cu tng cng sinh sn mt cch v t chc, chng nhng s lng bch cu trong mu tng rt cao, m iu quan trng na l nhng bch cu ny "non thng", khng sc chng li tc nhn gy bnh, cng ging nh mt i qun ch gm ton l lnh tr con ang b m. Trong bnh BCS, vic truyn mu c tc dng b sung phn no vo thiu ht "lc lng chin u", vi iu kin dng mu mi ly (vn cn nguyn vn cc yu t hu hnh, trong c bch cu), khng dng mu bo qun mt thi gian ri, tuy vn cha qa hn v vn tt. Bn cnh , truyn mu cn bi b thm cho c th. Bnh BCS c cp v mn; cp nng hn mn nhiu. Nguyn nhn thng thy nht l do b nhim x (mt s k thut vin X quang ch quan khng ch t bo v cht v bnh BCS; t sau s c ti Nh my in nguyn t Trcnbn ca Lin X, t l bnh BCS trong khu vc xung quanh tng rt cao). 470. Ng p u xung t Cch y 5 nm, hi cn hc lp 7, trong khi bng, chu b t nga p u xung nn xi mng, khng chy mu, khng sng, au khong 10 pht th ht, v chu giu c b m. Gn y, trong xm chu c mt ng cht v t nhin b co git, nc bt tro ra; nghe b con ni l do trc y ng b t p u xung t m khng lo cha chy nn mi nh vy. T hm , chu khng cn tinh thn u m hc hnh na. Khng bn chuyn ng g chng may t vong nh chu ni, v khng c liu chn on. V chuyn ca chu, th sau y l nhng kin thc chu cn nm vng, phng khi b t ln na th bit cch ng x: Chn thng vo u c th gy chu mu bn trong hp s, m nguy kch nht l hnh thnh To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

mu t ngoi mng cng gy chn p no; mu t ny c th xut hin sm trong trng hp va chm mnh, lng mu kh ln, nhng cng c th xut hin mun, thm ch rt mun (c khi mi 1-2 ngy sau) nu va chm nh hn, nhiu khi "khng ng k". V vy, nu khng gi nn nhn li bnh vin theo di, bc s bao gi cng dn ngi nh trng nom cn thn sm pht hin nhng triu chng u tin (lit na mt bn pha c mu t; gim, mt cm gic hoc lit na ngi bn pha i din); c m kp thi (khoan hp s, thanh ton mu t, cm mu...), nn nhn s khi hon ton, thng khng c di chng. Tri li, nu mun, c m tt chng na cng kh thot khi bin chng n no dn n "mt no" (ch c i sng thc vt, mt tri gic), hoc t vong. Theo , ng l hi y chu phi bo cho gia nh bit, nu thy chu hi b "mo mm" l ch i bnh vin m lin. Cn by gi th sao? C yn tr hc hnh, b li mt thi gian ht hong v c v v ch, bi v chng qua cng nh mt c nh u ca siu cu th m thi. 471. Chn thng vng v Chu l n hc sinh cp 3, c ngi bn thn ln lt b chn thng vo v tri v v phi (ln u do ng, ln sau gh p vo), gy au nhc khng chu ni, nhng bn y ngi i khm bc s. Xin cho bit c nh hng g khng v c dn ti u v khng? Khi chu c gii p ny th chc chn rng bn chu hoc ht au (nu chn thng khng lm ng gip cc m v), hoc ang b au nhc nhiu hn km theo st (nu cc m v b ng gip nhiu, c mu t nay ang nhim khun v khng c x tr tt ngay t u). a) Trng hp b va p nh vy, tt nht l chm lnh lin tc ti ch: Dng khn mt hoc ti nc lnh t ln vng chn thng (nu tri rt, phi nm ni kn gi) cho ti khi thy hn au (thng sau 1 ting l c); nu cn th tip tc lm vi ln sau . Ni chung, khng cn thuc men g. Nu thy ch b chn thng sng dn ln, phi d chng c mu t: Bc s s cho chc ht v khun, sau bng p trnh ti pht; trng hp ny nn ung thm khng sinh trong dm hm, nga vim nhim ti ch. b) Chn thng ny khng c vai tr g trong vic hnh thnh cc bnh v. 472. Hy xem li tht cn thn Chu c mt ngi bn trai khi bng b tri banh p vo ngc gy ho ra mu, sau c dng thuc, c gim s s, gn y li ti pht, sc khe yu, nhng bn chu vn giu gia nh... Xin cho chu mt li khuyn. p: Th chu kh m h, chc l v chu cng nghe ni mt cch m h nh th. 1. Trc ht, chu cn nm mt vi kin thc chung v chuyn ho ra mu do chn thng: To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

a) Lng ngc c khung xng sn kh vng chc. Nu b va p vo thnh ngc th phi tht mnh, thng lm gy xng sn, lm ng gip t nhiu m phi, t m chy mu ri nn nhn ho khc ra. Mu ny thm ch c th r vo khoang mng phi gy trn mu mng phi. b) Nu b sc p ca bom, mn n gn, th tuy b ngoi nhn lng ngc bnh thng, nhng do p lc khng kh rt cao nn m phi b tn thng (bm gip, rch...) v chy mu, lm ta khc ra mu ty mc . 2. em i chiu kin thc trn vi trng hp bn chu, thy khng ph hp. Bi v d l c banh ca siu cu th i na cng kh lng lm cho anh ta ho ra mu ri "sc khe b yu". Do , c th bn chu c sn mt bnh phi (thm nhim lao, thm ch hang lao, gin ph qun...), v c banh kia ch tc ng thm v "cnh bo" cho ta m thi. (Ni th hi v on, nhng cng d chng chuyn "c banh" l khng h c). Vy tt nht v m bo nht l bn chu sm i chp X quang hai phi ri i khm ti mt c s lao ca ngnh y t; cc chuyn vin s c kin chnh xc. Nu chng may b lao th hin gi c thuc chng lao hu hiu, c yn tr; nhng trong trng hp ny chu phi ch khng b ly bnh. 473. Nhng th cn c trong nh Hm kia, chu c ngi ln giao vic cho co ra ci th (u) ca mt con ln cht bnh, chu v b mt u xng m thng ngn tay, chu ly nc ra chn ra sch; sang ngy hm qua thy nhc nhi, chu nn ra c mt t t ct ri ra sch bng nc mui, nhng vn s v sau vn nhc. Xin cho chu ngay mt li khuyn bng th ring. Khng bin th ring cho chu lm g, v qa tr (trong trng hp cn x tr tht nhanh nh vy, khng th ngi ch "th i t qu ti to son ri i ngc chiu tr li", ch t cng mt 7,8 hm). Nhn y ch mun nhc cc chu mt s vic, tng chng nh nhoi, nhng li cn thit: 1. Mi gia nh nn c mt l cn 70 , hoc cn it; mt gi bng, mt gi gc nh dit khun; tt nht l c thm loi bng dnh c dn sn gc nh. Chi ph cho khon ny khng qa 15 ngn ng, dng c quanh nm. Ct tt c vo mt chic hp sch v ni d tm thy khi cn. 2. Khi b thng tch da tht, phi: - R cn ngay vo vt thng (nu qa bn, c th dng nc sch di nhiu ln trc khi thm kh v r cn); - Xem k, nu cn d vt th dng kim xoa cn khu nh ly ra; - Va bp mnh xung quanh vt thng va r cn, cho mu y ht t ct ra; nu vt m c dnh ha cht th lm k cng hn; - Bi cn ln cui ri bng li. - Nn tim phng un vn (ti cc trm y t) nu vt m bn (g, bn...). To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


- Nu thy vt m bn, hoc vt m su, nn ung khng sinh 3 n 5 hm.

L Trng Bng

c) Nu v x tr k u khng tt, sang ngy th hai thy nhc nhi, thn nhit tng, tc l c hin tng nhim khun; lc by gi tuyt i khng c bp nn vo vt thng. Ti sao? Bi v vo giai on ny hnh thnh hng ro bo v chng vi vi khun hin din trong vt thng, nu bp mnh s ph v hng ro , to iu kin cho vi khun tn cng t, thm ch thm nhp ngay vo mu. Phi c khm bc s kp thi c bin php iu tr thch hp. 474. M bn to bn nh Ti c mt con trai 4 tui, hai m pht trin khng u, bn to bn nh. Xin hi c th cha bng thuc hay chm cu khng? Khng nn chm cu v dng thuc. Bn tp cho chu nhai nhiu v pha nh (thnh mt thi quen) gip cho nhm c nhai bn pht trin. Hng ngy gia nh xoa nn thm bn tng cng. Thi gian lu di y, cn kin tr. Ngoi ra, tuyt i khng mt ai c tru trc chu, khi gy tm l t ty, mc cm. 475. B mo hoang cn Cch y hn 2 thng, em b mt con mo hoang cn ngn tay, trong khi em bt n v nui (hin n vn trong nh em, v vt thng lnh). Em mun bit b mo hoang cn c phi chch nga khng? Mt s ngi bo l nu khng chch nga th sau 3 thng s b cht c hnh h. Trong iu kin nghi vn th khi b ch hay th hoang cn, phi tim phng di, theo ch quy nh ca y t, c bit vi vt cn cao, tc l gn no (mt, c, ngc, tay) phi tim phng cng sm cng an ton. May mn con mo cn em l mo lnh, v rng ming n cng "sch", nn vt cn khng nhim khun (c l ch miu ny va mi "bi i" thi, cha thuc loi n bn kinh khng n mc vt cn gy nhim khun nng, phi tn nhiu thuc mi khi). Chng c cht c g hnh h sau nhng ba thng. Bi ni "khng" mt cht nh, nu l mo di th chc chn em b cc cn di hnh h (au n kinh khng, s nh sng, s nc, s gi, tru ln tng cn...), l cha k mt s ngi na cng b v ly do "v bt mo" ca em. Thch chi mo cng c thi, nhng hy d chng hin tng d ng do lng mo! 476. S th nh gi tay lun sch Va ri em ca b chu ra chi, n ti nh chu my ngy. Nghe ch y ni l ang b vim gan C, chu s qa, nn mun bit l gia nh chu c b ly khng v phi lm g trnh mc bnh? a) Chng phi lm g c nu ng l ng y b vim gan C. Bi v vim gan B v vim gan C ch ly nhim qua ng mu (khi tim chch, nh rng, truyn mu, qua vt m khi phu thut, qua vt xc tay khi thao tc trn mi trng c virus). Gi th trong thi gian ng ch lu li nh, nu gia nh chu c ai t tay, cn ng y khng rch To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


da rch tht, th cng khng th ly bnh c.

L Trng Bng

b) Nu ng y b vim gan A cha c trn di 2 thng, th gia nh phi lm tng v sinh chn chiu, toa lt (ch bn cu, nm m ca)..., tm li l nhng g ng c th giy phn vo. Bi v vim gan A ch ly qua ng tiu ha nn rt d nhim cho nhau, c trng hp c mt khu vc dn b mc thnh mt bnh a phng. Cng may vim gan A ni chung nh hn v virus b thi tr sau 45-50 ngy. Nhng gia nh c thi quen ra tay trc khi n, ra sch bt c hoa qa g trc khi n (k c da, da, nhn, v.v.), dng dao sch gt v, di bt a bng nc si trc khi dn mm... th cc thnh vin khng gp nguy c b vim gan A. 477. Lm g khi d ng vi bia ru Em l con trai nhng khng th no ung c bia ru (1 lon bia l mt ta tai, 3-4 lon th ni mn nga khp ngi, ko di khong 5-7 ngy). Nhng em li mun bit ung c thun li trong giao tip, hay ngay trong m ci ca mnh khi mi ngi h "zd, zd" bt ch r ung. Xin cho bit c cch g lm cho ht d ng i vi bia ru khng? 1. Con ngi c xa rt khoi cht "tu", nht l cc qy ng (nam v tu nh k v phong = trai khng ru nh c khng gi), nhng cui cng git mnh v n hy hoi dn cc t bo gan, cha ni chuyn con ci sinh ra thng km pht trin tr tu, thm ch hay mc bnh tm thn... Khi cc danh y ln ting cnh bo v hu ho th mun: thi quen ung ru lan trn, n ni trc y c ln chnh quyn Hoa K cng b bnh cm ru, tn bao cng sc dp b thi ung ru, m cui cng nh thc th. iu kh hiu l: Mt ngi ung nhiu bia ru gay chng p g, ming h sc mi cn khng thm tho cht no, ging ni thiu t nhin ca h chng c g ng tin cy, bn thn h c th khng bit nhng iu , nhng ti sao chng ta tuy thy chng m vn khng sm ni cho h hay? Phi chng v chng ta ang phi sng trong mt bu khng kh nhu nht trn lan, n ni mt sinh vin y dc chng chc nh em cng mun "c ti nhu nht", d tri cm? 2. Em s c cc thy ging v d ng (= phn ng d thng) cng cc phng php gii ta mn cm cha cc bnh ho d ng. Chng hn dng phn hoa cho ngi nghi b d ng do phn hoa, dng cc ht bi cho ngi nghi d ng do bi, v.v. Vic ny phi thn trng vi liu ban u rt nh, tng dn v theo di st sao. Cc phn hoa, cht bi ny (gi l d ng nguyn) s tp dn cho c th quen vi chng, n mc khng cn d ng, ngha l ht mn cm i vi d ng nguyn v khi bnh. Nu v a vo mt lc mt lng ln d ng nguyn, th tc dng s ngc li: khng phi gii ta mn cm, m li gy ra phn ng qa mn cm nguy him n tnh mng (sc phn v). C th em ngh s dng bia ru cha d ng ca mnh? Ch, bi v gii hn gia "liu lng gii To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

tan mn cm" v "liu lng gy chang phn v" kh mong manh, nn c th sai mt ly i mt dm. "Liu mng" nh vy ch nhm tr thnh "siu nhu" l chuyn khng nn. i cc em cn bao nhiu vic hay, vic tt, vic tuyt vi ng lm v cn lm. 3. Khi ai mi ung bia ru, em c h hi cng ly nc ngt ca mnh vi h v ni: "Xin li, ti khng bit ung". Lc , nu bn cnh c "nng", em s thy nng sung sng bit bao, bi nu khng, n hn ca em s sc mi cn trc khi em ng li b ri c th gi sn st khp ngi sut c tun nh th em ni. V chng, cu xin li khng c li ca em c th lm cho ngi mi nhp ngh li phn no. 4. Nu c dp ra nc ngoi, th mi ln bi bn a thc ung, em phi ni r l em b d ng bia ru, thm ch phi vit ra giy nh c ngi phng Ty b d ng u phng (lc) lm khi sang thm nc ta. 478. Ung th v c di truyn khng Ngi c h ca em b ung th v m c ba nm nay, sc khe vn tng i tt. Mi y, con gi ln ca c em c bc s cho chp X quang v v chn on l ung th v. Nh vy l ung th v di truyn t m sang con? 1. T lu, qua thng k ngi ta thy hin tng bnh ung th xy ra trong dng h; ngy nay hin tng ny c gii thch bng s t bin gene, v cc nh khoa hc ang n lc sm c phng cch x l n. Ring i vi ung th v (UTV), khoa hc xc nh c l do t bin ca cc gene BRCA1 v BRCA2. D nhin nhn dng c k th ri th sm mun s c phng cch hu hiu tiu dit. 2. Trong khi ch i mt bin php "tn gc" nh vy, chi em ta cn: - Quan tm hn pht hin "cc g" v, nht l cc khng gy au, c khm v chn on kp thi, ch yu bng chp X quang v v phng php hin i nht hin nay; nu nghi ng th phu thut ly u lc ny nh nhng v an ton tuyt i. Ch em no cha quan tm, xin hy tham kho mt s liu nhc nh sau y: Ti Hoa K, c 8 n sng ti 80 tui th c 1 b UTV. - Khng qa lo lng l "khi thn nhn b UTV th chc chn bn thn mnh cng s b". V theo cc thng k ln trn th gii, ch c 10 n 20% trng hp UTV do di truyn m thi; cn li 80 n 90% UTV cha bit nguyn nhn do u. 3. Trng hp ngi ch em h ca em nm trong t l 10-20% ni trn, nhng cng cn thy ngay rng cha chc con gi ca ch y s b UTV nh m; y khng phi l li an i sung m l mt thc t khoa hc. Em nn thng bo vi ch v kt qa nghin cu ca nc ngoi cho bit cc loi nm nh: nm hng nu, nm s ta, nm mo (mc nh), nm linh chi... cha hot cht taxol c tc dng cha ung To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

th v v ung th bung trng; v khuyn ch nn thng xuyn n cc loi nm ny. 479. Sau khi b tai bin mch no M chu nm nay 43 tui, b tai bin mch mu no, lit chn tri v tay tri, ni ngng. Gia nh chu c gng ht sc, nhng bnh ca m chu vn th. Xin cho chng chu mt li khuyn. Th chu s si qa nn ch nu ln my im chnh gia nh i chiu m vn dng. 1. Nu xut huyt do tn thng ca thnh mch mu no, th trng hp m chu lng mu ra khng ln v ngng chy. Tuy nhin, mu t (nm bn phi), gy chn p, gy lit na ngi tri. Trng hp ny, hin tng lit t kh nng hi phc. Nu ch do co tht mch mu no (thnh mch mu khng b tn thng) th hu qa cng tng t nh trn, nhng hy vng tin lng s tt hn v c kh nng hi phc khi ht co tht mch no. 2. Do mu t, nguyn nhn gy lit ni m chu, nm bn phi ca no, cho nn nhiu kh nng cc trung khu ngn ng (vn nm bn tri) t b tn thng; tuy ban u b ngng nhng dn d c th s ni c kh ln. 3. V iu tr nguyn nhn, phi dng thuc cha cao huyt p, co tht mch no, nhm ngn nga xut huyt ti pht. V ton thn, ch yu l cho tr mnh thng xuyn, gi cho da d kh sch phng b lot mng, vai; xoa bp v vn ng nh nhng tay chn, phng teo c; cho ung nc, rau xanh phng to bn; cho king cht m, thc n qa mn; luyn tp cch pht m, v.v. 4. Chc do gp kh khn nn gia nh chu khng a m i bnh vin c. Tuy nhin, vn cn mt bc s giu kinh nghim ti chm nom, m c cha bnh theo khoa hc. ng c t tng bung xui; mi c gng ca ngi thn s c n b. 480. Bnh nhn lit na ngi c th hy vng Hin c cch g cha cho nhng bnh nhn lit na ngi do tai bin mch no? Theo mt nghin cu M tin hnh trn chut, cng b trong qy 2 nm 2001, th: 24 gi sau khi chut b tai bin mch no lm cho lit na ngi, khi ly cc t bo gc chit xut t mu cung rn em tim tnh mch cho chng, ngi ta thy chut bnh c hin tng phc hi vn ng v t 50% hiu nng so vi khi tin hnh cc th nghim thn kinh trn nhng chut lnh mnh. Cc nh nghin cu cho rng cc t bo gc m h dng ha cht hng cho chng bit ha thnh t bo thn kinh, khi c tim vo c th chut, dng nh tm thy v tr tn thng no v ti b p cho phn m b h hi do tai bin mch no. 481. Chng nhc c Con gi chng ti nm nay 17 tui, gn y xut hin mt bnh rt l: Chu c i b khong dm chc mt l ku mi r c hai chn, phi ngi ngh mt lc lu mi i tip c. Chu cho bit chuyn ny bt u xy ra cch y my thng ri nhng mi u chu i c xa hn by gi. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

Nhiu kh nng chu b chng nhc c (myasthenia) nguyn nhn do ph i tuyn c. Bc tm mua ngay 1 ng thuc Prostigmine v 1 bm tim hp sn, ch ch y t no cn thn, cng i b vi chu; khi chu ku mi chn khng bc c na th tim thuc; nu chu ngay, tip tc ct bc v i xa hn, c ngha l chu b chng nhc c. Nu ng vy, gia nh nn sm cho chu ti khoa phu thut lng ngc ca mt bnh vin trung ng xin khm cha. Ti y, chu s c chp X quang, chp scanner vng ngc..., xc nh kch thc ca tuyn c (siu m kh xc nh v xng m c che khut tuyn c). Khi xc nh c bnh, trc mt, cc bc s c th s k toa cho chu mt t loi thuc ni trn th cha bng ni khoa; nu dng mt thi gian km hiu qa s phi m lng ngc ct tuyn c. y l mt i phu thut, phi x dc v banh rng xng m c tip cn tuyn c, nhng khng ng chm n phi v tim, nn rt an ton; gia nh c yn tr, m xong s khi bnh. 482. Bnh ng kinh Ti c mt chu gi ang hc lp 2, thnh thong c biu hin mt ht cm gic (chu khng b ng), do u ch ko di 5-7 giy, sau ny ln n 1 pht; mi ln nh vy ngi nh gi to th chu mi tnh. Xin cho ti mt li khuyn. Ngoi ra, cng mun hi thm: Thy gio ca chu thng xuyn beo tai, bm tai tht au pht hc sinh, trong c chu; c phi v nh vy m nh hng n bnh khng? 1. Bn hy d chng chu b bnh ng kinh giai on khi pht. Cn sm cho chu i khm ti mt chuyn khoa thn kinh gii ca bnh vin; c th chu phi lm xt nghim in no th mi xc chn c, qua bc s s c phng php iu tr thch hp. Trng hp ca chu, nu ng l ng kinh, th pht hin v cha tr nh vy l sm, s c kt qa tt, nhng thi gian cha tr khng ngn u, gia nh phi kin tr. Ngoi ra, t nay gia nh cn nhc nh v kim tra chu: - Khng c gn ni c vt nhn, la, nc si (ngi ln cn bt tnh p mt vo mt chu nc l cng c th "cht ui"). - Khng c tm sng hay tp bi (d c theo di nhng c khi b st, khng kp cu). - Cn thn khi qua ng (tt nht l c ngi dn). 2. Vic trng pht hc sinh bng mng chi qa ng lm ri (nh trong th bn ni, thy bo trc lp l "phi b u ra m vt ht no i"), cn chuyn beo tai, bm tai l vic xm phm n thn th ca hc sinh; nn chng cc bc ph huynh gp thng thn vi thy gio ; nu cn th bo co vi c quan gio dc v o to cp trn. Nu thy khng chu sa th thit ngh thy nn chn cng vic khc ngoi vic dy hc. Tuy vic beo tai, bm tai khng phi l nguyn nhn bnh, nhng l nhng kch thch c hi i vi chu, cha k vic s lm cho chu mc cm thm. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


483. C th phi m mi khi

L Trng Bng

Anh trai ti 34 tui; cch y 8 nm, anh b chn thng s no, sau , tuy lnh vt thng u, mi ln tr tri l anh ti li tht to, ln cn co git, chn tay co qup, si bt mp. Gia nh cng lo lng khi s thy ni c vt thng c mm v lm xung 1 cm. Xin cho chng ti mt li khuyn. Bn khng ni r 8 nm v trc anh ca bn c c phu thut g hp s no khng, nhng theo m t hin gi (vt thng c mm v lm xung 1 cm), 3 rng do : - hoc khng pht hin ra ch xng s b ln xung nn khng ngh n chuyn m nng ch ln ln nh c; - hoc m ly b mnh xng s v vn ti vt thng (v n mc khng th t n tr li vo v tr c). Nu tnh hung th nht, ch xng s ln lc by gi c chy mu t nhiu v dn d ch mu t tiu i, to thnh nhng ch dnh gia no v mng no (nhiu kh nng anh ca bn nm trong trng hp ny). Nu tnh hung th hai, v thiu hng xng, nn ti ch c dnh thm c vo da u; ngoi ra, khng bit cc bc s m c gii quyt tn thng g cht no khng. S d ngi anh ca bn b ng kinh l do nhng ch dnh ni trn; nu cha thanh ton c dnh th coi nh cha gii quyt nguyn nhn gy bnh; tri li, nu gii quyt c trit bng phu thut g dnh, v li ch thiu hng xng s bng mt tm cht do chc, th nhiu hy vng anh ca bn s khi bnh. V vy, gia nh nn sm thu xp a anh v mt khoa phu thut thn kinh trung ng, c khm xt v phu thut nu cc bc s xt thy c ch nh. Trong khi ch i, cn theo di st bnh nhn (xem Mc 482), khng cho tip xc vi cc vt st nhn, khng li gn la, gn nc. y s l mt phu thut ln, chc s gian kh, nhng anh ca bn cn tr, nhiu kh nng chu ng, nn rt c trin vng thnh cng. 484. Khi cha bnh tm thn phn lit B chu c chn on l b bnh tm thn phn lit, bc s bnh vin tm thn ca tnh k n cho ung Aminazin liu cao, sau gim dn, n khi b chu nhiu (co th ni l bnh phc), th mi ngy ung 8 vin chia lm 2 ln. Nay nghe vi ngi trong ngnh y ni "dng Aminazin lu ngy s b t lit thn kinh v dn n mt tr hn", chu lo qa nn t ng gim dn xung cn 4 vin mi ngy. Xin cho gia nh chu mt li khuyn. ng nghe li gii thch ca nhng ngi khng phi chuyn gia v tm thn, v phi thc hin nghim chnh n thuc ca bnh vin cng nh tr li ti khm ng hn; cn khi no gim liu, To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

gim xung cn bao nhiu, trong bao lu, khi no th thi dng thuc, v.v. l do bc s ph trch quyt nh. Chu tht liu lnh, may m cha gy ra chuyn g ng tic! Gia nh nn thu xp sm a b chu tr li ti khm, v tha r chuyn t ng gim thuc ca chu; bc s s cn c vo kt qa khm xt m cho kin c th. 485. T k m th Em l con trai, 29 tui. Nm 15 tui, em nh v chic nhit k ca mt bc s; v qa s hi, em ly giy ht thy ngn vo hp ri em vo ngn ko ca ng ta. T nm 17 tui n gi em rt lo lng v nghe ngi ta ni rng "ht phi cht thy ngn l khng c con", em nhiu lc nh ngi mt tr, hay gy g, ru, v h nhn thy ci nhit k l ngi em c ni gai c. H ni to lao thi, nhng em b m nh bi cu ni y n mc tr nn bnh hon, t k m th to thnh mt ni lo lng bi quan cho tng lai ca mnh. Trong lc ny, iu quyt nh sc khe ca em - v quyt nh c cuc i ca em na - l phi b ngay thi xu ru ch. Ru s hy hoi dn cc t bo gan, dn ti x gan; trc mt th "ru v, di ra", em c th chuc ly nhng phin toi, thm ch nhng tai ho khng ng c. Cn iu em lo s th khoa hc khng nh l khng c. Em u phi l mt cng nhn ngy xa lm vic lin tc trong mt mi trng sc sa hi thy ngn (khi khoa hc cha pht hin, phng bnh km). ng v chic nhit k v m lm hng c cuc i. 486. U sn thnh ngc Chu l con gi, 21 tui, sm c m mt u khng au, cng, di ng c, ra v, bng u ngn tay tr. Nay chu thy xut hin mt cc nh, cng bng ht go. Mt vi ch cng b nh chu. Nghe ngi ta ni l u m xong cng khng khi, nn chng chu rt lo. U v m kp thi th t kt qa m mn v lu di. Trng hp ca chu c m rt sm (u di ng c, khng dnh ra xung quanh nn ly c gn); nhng v chu khng cho bit kt qa xt nghim gii phu bnh, nn khng bit u thuc loi no. Tuy nhin, trng hp ca chu v ca vi chu khc nhiu kh nng l mt u sn; loi ny thng gp nht vng ngc v khng ch n mi b; loi u ny rt lnh, cng lnh nh u m hay u x m. Ch thy n qa cng m lo (Ung th v thc s th khng "cng ngc" u, n vo ch thy "chc tay" thi). Nhng ch u nh v tr khc c th cng xut hin nhng cc chu khng t trc v qa nh. Cc chu c yn tm, v ch nn m nhiu lm n to ra do b kch thch; nu n v th nn m sm cho yn tr v yu cu c lm xt nghim gii phu bnh. 487. Bnh vim no B Nht Bn qu em, ngi ta ni n ma h, h nghe chim tu h ku l hay mc bnh vim no B Nht Bn. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


l bnh g, v ti sao li lin quan n chuyn tu h ku?

L Trng Bng

Vim no B Nht Bn l mt bnh vim no do virus Arbor thuc nhm B gy ra, trc y c pht hin u tin ti Nht Bn. Tuyt i a s bnh nhn l tr em, la tui b nhiu nht l 1 n 7 tui (ngi ln him khi b, c th do min dch t nhin). Bnh nhi st cao trn 40 C, m sng, cng gy, co git tng cn, co cng chn tay...; tnh trng trn ko di 5-7 ngy, hoc gy t vong (c th ln ti 50%), hoc thoi lui, nhng c thay, bnh li nhng di chng nghim trng gy tn ph sut i nh: mt kh nng phi hp cc ng tc ca t chi, lit tay chn, tr n, ng kinh lin tc, thm ch sng m khng cn tri gic. Vt trung gian truyn bnh ch yu l mt loi mui vn c tn khoa hc l Culex tritaeniorhynous, thng sng khp ni, nht l ti nhng khu vc nhiu ao h, rm rp, c nui nhiu gia sc... Trong thin nhin, virus ca bnh vim no B Nht Bn hin hu v sinh si trong c th mt s gia sc, gia cm v chim mung, m khng gy ra cc triu chng bnh nh ngi, v chnh v vy m chng cng nguy him v lm cho con ngi mt cnh gic. Loi mui vn ni trn, sau khi chch ht mu ca cc vt ch , ti t ngi v truyn bnh. Y hc vn cha c thuc c tr bnh vim no B Nht Bn. Cho nn ch yu vn l phng bnh bng cch dit mui v chng mui t, k c ban ngy. Hin c vacxin nga vim no B Nht Bn, tim phng cho tr < 15 tui sng ti nhng vng c bnh ny lu hnh. Tim tt c 3 mi; 2 mi u cch nhau 7-15 ngy; mi th ba sau 1 nm. Phi chng ting tu h ku ni qu em l li cnh bo: "n chim hoang d li c mt. Loi ngi hy coi chng!", bi v by gi l ma nc, khong t thng ba n thng tm m lch, l ma nhng loi chim di c t nhiu ni trn th gii ti nc ta, mang theo loi virus kinh khng ny, cng l ma hay xy ra nhng t r bnh vim no B Nht Bn ti mt s a phng. 488. V bnh b in Xin cho chng em bit: tru b nc ta c nguy c b bnh b in nh Anh khng, bnh c d ly sang ngi khng, pht hin bnh nh th no, v c thuc cha cha? Vn cc em hi rt rng, xin nu gn my im chnh cc em d nm c: 1. Bnh b in (vim no b th xp) c pht hin ca u tin ti Anh vo thng 2-1985, v trong nhng thp nin 90, ring nc ny c hn 176.000 b b. Php, pht hin thng 2-1991, v t u nm 2000 n nay c khong 30 con b. Trc , Php vn nhp bt tht chn nui ca Anh (no, rut b, cu... xay nhuyn), v n lm cho gia sc tng trng nhanh, tht c nhiu nc. Thng 7-1988, Anh cm dng thc n ny cho ng vt nhai li. Thng 12-1989, Php cm nhp khu v thng 7-1990 cm cho b n. 2. ngi, trc y y hc pht hin bnh Creutzfeldt-Jakob (vit tt C-J: vim no, gy lit nhiu b phn, sa st tr tu... din bin rt nhanh). Thng 3-1996, ln u tin Anh pht hin 10 To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

trng hp mc mt bin th ca bnh C-J (bt C-J) xut pht t bnh b in. Ngay sau chu u cm dng tht b Anh. Thng 7 v thng 8-2000, Anh c thm 83 ngi b bt C-J, trong c 74 t vong; Php c 3 t vong v 2 do bt C-J v 1 cn nghi vn. Ngi ta d tnh t nay n nm 2020, trong tnh hung xu nht, Anh s c khong 136 ngn ngi b. 3. V chn on, trong bnh C-J xt nghim cho thy nhiu protein 14-33 trong dch no ty. Cn trong bt C-J th khng, v iu ny l tr ngi ln cho vic chn on, phi m t thi mi kt lun c (thy nhng ch no b xp). Hin cha c thuc c hiu, nn hu qa cn nng n, ging nh bnh vim no ni chung, v cha c thuc chng nga. 4. Tc nhn gy bnh b in (ESB) l prion. Prion khng t phn chia trong mi trng cy ti phng th nghim nh vi khun; khng t nhn bn trong t bo sng nh virus. Protein gy bnh cu prion (PrPsc) khi vo no s lm cho protein bnh thng ca no (PrPc) "bt chc" n t hnh xon c bin dng thnh hnh"l bta" xp chng cht ln nhau trong cc t bo siu m ca no n mc gy t vong. Protein ca prion b ging ht ca ngi, ch khc nhau v s phn b in tch trn b mt phn t. Kh nng ly nhim ca prion b in s gim nu n gp nhit 1330C mi trng m trong 20 pht, vi p sut 3 atmosphe. Nhng prion li chu ng c formol, tia x cng nh cc phng php kh khun c in, v y chnh l iu kh khn cho vic tiu dit mm bnh. Giai on bnh ca bnh b in kh di, bt u t thng th 4 hoc th 8 v kt thc vo thng th 34 k t khi nhim bnh (lc ny prion tp trung trong rut). Tip theo l giai on ton pht (prion xm nhp no, tuyn c, mt hay ty sng...). V ly nhim sang loi khc, thy cu c nguy c ln nht. C th do trc y n phi bt xng cu b vim no cu th xp (pht hin t th k XVIII, gi l bnh nga rung) m b b nhim bnh ny. Cha thy c ly cho sang cc loi vt khc. 5. C l v nc ta may mn qa xa cha t nhp bt tht chn nui cng tht b ca Anh nh mt s nc chu u, nn khng b "in u" nh h. Tuy nhin, quan tm lo lng nh cc em l iu ng khen v ng cc c quan hu trch lu ng "mt b mi lo lm chung". 489. Bnh lu Xin cho bit nhng du hiu ca bnh lu? Bnh lu do song cu khun lu Gonococcus neisseiria gy ra qua quan h tnh dc, hoc qua tip xc vi mm bnh (b gi dng ln khn tm, chu git vi m chng hn). Sau t 2 n 5 ngy, thm ch sm hn, thy xut hin cc triu chng: i but, i au nh x, c To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

m mu vng xanh ming so hay l i, ni hch au bn, c th c st nh. Bnh gim dn sau khong 1-2 thng d khng iu tr hoc iu tr d dang, do bnh nhn tng nhm khi. S thc l bnh tin trin sang giai on mn tnh, rt nguy him, tuy ch thy i hi but sng ra c vi git cht nhn mu trng ming so hay l i: nam, cu khun lu tn cng vo ti tinh, tuyn tinh, ng dn tinh, tinh hon, gy vim ri x ha, s dn n v sinh nu khng cha tr tt; v ng s rt d ly bnh cho ngi khc. n, vim lan ln c t cung, t cung, bung trng, ng dn trng, gy ri lon kinh nguyt, kh h, cng s dn n v sinh v l ngun ly bnh. c hai gii, bnh lu c th gy tn thng khp, hu mn, hng... Nu b giy m lu vo mt, c th b vim kt mc, vim gic mc cp, k c tr s sinh. 490. Bnh giang mai Chu nghe ni v bnh kim la m khng bit l bnh g? Xin cho bit thm bnh ly qua nhng ng no v c cha c khng? 1. Chc chu nghe nhm. Khng c bnh g gi l "kim la". Dn gian dng t "tim la", "tim la", "dng mai" ch bnh giang mai (syphilis), mt bnh rt nguy him ly qua ng tnh dc v ng mu, do xon khun Treponema pallidum gy nn. Triu chng bnh khc nhau ty giai on. - Giang mai I xut hin 20-25 ngy n 2-3 thng sau khi quan h vi ngi c bnh. Ch c mt vt trt vng sinh dc, hnh trn hay bu dc, khng au, nn thy nn cm cng; km theo mt chm hch cng khng au. Thi k ny bnh nhn vn hot ng gii tnh c, cho nn rt d ly cho ngi khc. - Giang mai II xut hin t 2-3 thng n 2-3 nm sau khi quan h. Tn thng a dng: ban ging nh si, sn ht c vin da xung quanh, si hu mn hoc vng sinh dc, mng lot trt li, km theo hch ri rc bn, nch, c; ti nhng tn thng ny c nhiu xon khun nn rt d ly bnh c khi ch tip xc ln quan h gii tnh. - Giang mai III xut hin t 2-3 nm n 20-30 nm sau khi quan h. Thi k ny t hoc khng cn ly bnh, nhng bn thn c th b tn ph hoc t vong v tn thng thn kinh, tim mch. Trn da cn mt s tn thng nh gm, c, mng bch sn... - Giang mai bm sinh do thai ph truyn cho thai nhi. Tr s sinh c nhng phng nc lng bn tay, lng bn chn, vim mi chy dch ln mu, nn rt d ly khi tip xc. Khi c 2-3 tui n 20-30 tui, c th c nhng biu hin mun nh trong giang mai III, hoc b trn d + mi tt + xng chy hnh li mc rt d nhn ra. 2. V iu tr, hin c cc thuc hu hiu, cha tn gc, vi iu kin cha tht sm, liu, thi gian, di s theo di cht ch ca thy thuc chuyn khoa. Khng nn t cha ly, v chc To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


chn s tin mt tt mang. 491. V xut x ca virus HIV

L Trng Bng

C phi ngun gc ca bnh AIDS xut pht t mt loi tinh tinh ca Ty Phi khng? Bng cch no n ly c sang ngi? 1. Vo thp nin 1950, nh nghin cu H. Koprowski s dng t bo thn ca kh lm mi trng nui cy virus ca bnh st bi lit (polio) trong sn xut vacxin nga bnh ny cho nhn dn chu Phi, gp phn ng k vo vic tiu dit bnh polio trn th gii. 2. Cui nm 1999, nh bo Anh tn E. Hooper tung ra mt tc phm nhan The River t gi thuyt: H. Koprowski dng t bo thn ca tinh tinh sn xut vacxin, do virus SIV (gy hi chng suy gim min dch tinh tinh) truyn sang ngi, sau bin th thnh virus HIV-1 gy bnh cho ngi! Cun sch ta nh mt qa bom ln nh vo lng tin ca nhn loi i vi khoa hc. Cc phng th nghim trn th gii lin ra sc truy tm "th phm gi nh" ca tc gi cun sch trong cc mu lu tr vacxin do Koporowki sn xut vo thi k . V gia nm 2001, t mu lu tr cui cng ca vacxin polio, c gi 40 nm nay trong t lnh ti Vin Wistar Philadelphia, Hoa K, cc nh khoa hc giao cho 3 phng th nghim trn th gii xem xt, v c ba c s ny u khng thy du vt g ca HIV hay SIV; v h cng khng h thy ADN ca tinh tinh nh Hooper nu, m ch thy ADN ca kh. Ngoi ra, mt cng trnh khc cng gp phn nh bi hon ton gi thuyt ca nh bo ngi Anh n. Nhm nghin cu th t, do GS Edward Holmes thuc i hc Oxford ca Anh Quc ch tr, va cho cng b cy tin ha ca HIV trn ngi: Kt qa phn tch 197 ging gc HIV-1 hin hu ti Congo cho thy nhiu ngi ti y mang sn virus HIV-1 nhiu nm trc khi vacxin nga st bi lit c s dng rng ri. 492. Ly nhim HIV c bo ch thy ni l khi hn mi cng c kh nng ly nhim HIV nu c vt xc nim mc ming hoc li. Nhng chu nghe trn tivi l HIV ch ly qua ng tnh dc v ng mu. Vy iu no ng? Xin hi thm: Nhng triu chng u tin cho bit ngi b nhim HIV? Sng nu rng c b nhim khng? u ng c. Ly nhim HIV ch yu qua ng tnh dc th r ri. Ly qua ng mu, c ngha l: do truyn mu, do vt thng hay vt sy st da (nguy c cho nhng ngi tip xc vi HIV trong phng th nghim; nguy c cho nhng bnh nhn c m bi bc s c HIV dng tnh...), do tim chch ma tu... Hn mi (trong khi hn mi, i bn ng s thng hay mt li ca nhau), nu c hai u c vt xc nim mch ming, li, th l li vo ra ca HIV. Trng hp sng nu (vim li, nha To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


chu vim) m c vt lot cng c th gp nguy c ni trn.

L Trng Bng

Nh rng, gia thi bui ny, vic cha rng, nh rng, tim chch, v.v phi m bo tuyt i v khun v dng c cng nh trong thao tc hnh ngh; ai vi phm s b x pht rt nng. Du hiu sm nht ca ly nhim HIV l kt qa xt nghim mu cho thy s hin din ca con virus khng khip ny. Tic thay, v xu h hoc v v trch nhim, nhiu bnh nhn khng i xt nghim; n khi xut hin nhng triu chng lm sng ca bnh AIDS th mun, sau khi gy hu qa truyn bnh cho bao ngi. Nhn y, xin cung cp mt tin mi nht c lin quan n i mi. Thng 4-1999, mt nghin cu lin quc gia cho thy nguy c ly nhim virus HIV t ngi m sang a con ang b gia tng theo thi gian b: Tnh chung, c 1.000 tr b m 1 thng c 2,7 em b, v c 100 tr b m 1 nm c 3,2 em b; v kt lun rng nhng sn ph HIV dng tnh khng nn cho con b, iu khng d dng g i vi cc nc ngho. 493. Ba du cng g vy? Chu l n hc sinh, cng mt bn gi n bnh vin hin mu nhn o; khi th mu xong, bn chu khc v trong phiu bc s ghi +++, bn chu bo phi giu kn chuyn ny. Mt hm tm xong, chu thy lng bn ni nhiu nt nh l mn lm chu s qa. Xin cho bit 3 du cng kia l g m bn chu s v bun kh n th? Tr li chc chn th kh y, v thiu c liu khoa hc, chu khng ghi tn v a ch nn khng th hi. Nhng xt thy vn tuy m h nhng c v nghim trng, nn nh liu "phn" t xa cc chu d chng. 1. Ba ci du cng kia ch ni ln mc mnh nht ca mt phn ng xt nghim no . a) Chc hn khng phi kt qa xt nghim vim gan virus, bi nu phn ng mnh nh vy th bnh vim gan ang thi k ton pht, bn chu khng th khe mnh bnh thng i hin mu, gan c th to, tc, mt vng, v.v. b) Cng khng phi kt qa xt nghim bnh giang mai, v nu vy, bn chu phi c nhng hin tng bnh l ring ca bnh ny ni b phn sinh dc; nu c bnh ny th y t s cho mi kim tra ngay c iu tr kp thi. c) Ch cn li kt qa xt nghim tm HIV m thi. iu ny dng nh ph hp vi tnh hung lc : - V m bo b mt ring t cho ng s, bc s khng ghi tn xt nghim (cng nh khi ghi tn xt nghim th bc s li khng ghi tn ngi, m ch ghi k hiu m s). - Bn chu au bun v mnh b HIV dng tnh, li dng tnh rt mnh, c kh nng bn y ngh n mt s ln quan h gii tnh no . - Bn chu s xu h nn mun chu giu h. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

2. Nhng nt lng ch nguy him cho bn nu ri vo tnh trng suy gim min dch nghim trng (cc nhim khun nh v ngha ny lc s vung ra ton thn m khng chng ni), cn hin ti th hy vng l cha n ni nh vy. 3. Nu ng l HIV dng tnh, th mu ca bn chu s ly nhim c sang ngi khc nu ngi b sy da, t tay...; d nhin l ly nhim d dng nu quan h gii tnh. Ngoi ra, khng ly theo ng th hay ng tiu ha. 4. V thi ca chu, th nn chng khuyn bn y tha tht vi gia nh xin cha tr ngay mi kp, v ch gi gn ng ly sang ngi khc. 494. Tc ng ca HIV v tnh hnh cha tr Khi nhim HIV th bao nhiu lu sau s c triu chng lm sng ca bnh AIDS? Y hc th gii c thuc hu hiu cha tr bnh AIDS? Sau khi vo ngi - qua ng tnh dc hoc ng mu -, virus HIV thm nhp cc bch cu CD4 gi trng trch trong h thng min dch ca c th, v lin tip t nhn ln ngy cng ng trong loi bch cu ny. Ban u, c th phn ng li bng cch tng cng sn xut bch cu CD4 nhm b vo s lng b HIV hy hoi, v th lc ny HIV vn cha lm nn cng chuyn, bnh AIDS cha bc l, s lng bch cu CD4 vn nh trc hoc gn nh trc, ch c th mu thy HIV dng tnh m thi. C th, trong cuc chin u khng cn sc , c th dn d suy yu, mt kh nng sn xut tip cc bch cu CD4 b p vo s bch cu CD4 b vurus tiu dit (ngi ta thy lc trong mi 3 ml mu ch cn 200 bch cu CD4, th ch cn 1 vi khun xm nhp, c th s c nguy c b nhim khun c hi), by gi hin tng suy gim min dch ca c th mi biu hin ra ngoi, l lc bnh AIDS c nhng triu chng lm sng u tin: i i vi tnh trng ngy cng suy yu, c th d dng b tn cng bi bt c mm bnh g (vi khun, virus, nm) ti bt c b phn no, v khng thuc khng sinh no c th tr gip thanh ton ht c, cui cng dn n ci cht. Thi gian im lng ni trn ca HIV ty thuc vo mc ly nhim, sc khng ca tng ngi, vo thi c s dng thuc v cng hiu ca thuc dng, vo c tinh thn ca bnh nhn, c th t 1-5 nm n 10-15 nm, v trong mt s trng hp hy hu c th di hn hoc thot khi bnh AIDS bc pht, HIV tr li m tnh trong mu. V iu tr th cho ti nay cha c loi thuc no cha dt c bnh, m ch c tnh cht h tr c th chng li cuc tn cng ca virus HIV; gi thnh ca thuc cn rt cao, ngoi tm vi ca ngi ngho. u nm 1999, mt cng trnh nghin cu ca Trng i hc tng hp Washington ti Saint Louis, Hoa K, thu c kt qa khi s dng mt loi protein c tc dng ch tiu dit cc t bo b nhim HIV (lm cho HIV khng cn ch sinh si); protein ny ch tc ng khi c mt cht To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

protease ca HIV l enzyme chu trch nhim v vic to ra cc HIV mi. Nhng cc tc gi ca cng trnh ny cha c iu kin thc hin trn c th sng (in vivo), m ch mi trong ng nghim (in vitro). Cng vo u nm 1999, Vin hn lm khoa hc quc gia M cng b kt qa nghin cu cho bit cht lysozyme trong nc tiu ca ph n mang thai c kh nng ngn chn mt cch hu hiu s pht trin ca virus HIV (t lu ngi ta bit lysozyme l mt protein hin hu trng nc bt (nc ming) v nc mt, c kh nng lm tan mt s tp khun). Pht hin ny rt quan trng, m ra trin vng mi trong vic ch to thuc chng virus HIV. Tuy nhin c mt tnh hnh ng lo ngi l: Ti cc nc Ucraina, Belaruxia, mnh danh l HIV-0, gy cht nhanh gp i cc dng HIV khc, lm ngi bnh cht ch sau 3-5 thng, lu nht l 1 nm. Cc nh khoa hc khng nh hin tng t bin ny ca HIV l do ba nc ni trn b nhim x sau v n nh my in nguyn t Trcnbn nm 1986. 495. Ch vi mng qa sm D rut ca chu c ngi chng nghin ma tu ri b bnh AIDS giai on cui, nhng bn thn d chu khi th mu li thy HIV m tnh. Chu thc mc hi mt bc s th ng ny ni l HIV khng ly qua ng tnh dc, m ch ly qua ng mu, ngha l b phn sinh dc c sy st lc quan h; chu hoang mang qa. Nu qa c mt bc s bo chu nh vy, th ng l ng y khng hiu mt t g v cn bnh kinh khng ny ca nhn loi; chu th tm gp li v hi ln na xem. Nu xt nghim ni d chu l hon ton chnh xc (nn nh l c nhiu trng hp cho kt qa m tnh mt cch nhm ln), th l iu hy hu v ht sc may mn: Theo c tnh, khong 20% dn s th gii mang gene t bin CCR5 c tc dng ngn cn s thm nhp ca virus; v d chu may mn thuc din ny. Tuy nhin, ch vi mng qa sm, bi l: - Xt nghim ch dng tnh sau khi ly nhim t 20 n 30 ngy l thi gian cho cc khng th chng HIV hin din trong mu; nu xt nghim sm hn s khng thy (Mt phng php mi, tm khng nguyn p24, mt protein ca HIV, th c th lm sm hn, ch sau 10-15 ngy). - C trng hp do thiu st k thut nn kt qa khng chnh xc. V vy, chu hy khuyn d i th li mt, thm ch vi ln na, ti nhng c s c trnh cao hn. Trong khi ch i, hy khuyn d chu yu cu chng b s dng bao cao su 100%. 496. Khi c ngi bn b AIDS cht Chu c anh bn do v tnh p chung chn vi ngi b bnh AIDS, nm gc chn ln nhau, cng ngi n mt mm; nay rt lo s v ngi y cht. 1. Th chu khng ni r ngi b AIDS ri hay ch mi HIV dng tnh. Bi v khi cha pht To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

hin bnh AIDS, thng ngi bnh ch thy mt mi, cha c biu hin g c bit, chnh v vy m khng i th mu lo cha chy. Cn khi l AIDS th c hin tng nhim khun khng th cha khi ti mt s c quan, r rng nht l da; trong trng hp ny e kh m thoi mi "gc chn gc cng". 2. Th chu cng khng cho bit ngi cht v bnh g. Ngi HIV dng tnh c th cha kp cht v AIDS, m cht v mt bnh no khng lin quan g n AIDS. 3. D trong tnh hung no, bn chu cng c yn tr, v bnh AIDS (hay trong giai on HIV dng tnh, bnh cha pht) ch ly qua ng tnh dc v ng mu, khng ly truyn qua ng h hp hay tiu ha. Mi chng ta ch cn khng quan h gii tnh ba bi l c an ton trong hu ht trng hp. Bi v ngnh y t p dng cc bin php nghim ngt (khng ly nhm phi mu ca ngi HIV dng tnh; kh khun tt cc dng c y khoa; thao tc k thut ngoi khoa ng quy tc khi m x, , nh rng, v.v); ch cn li mt ng ly do bn thn ta t to ra: chch ma tu bng kim bn, dng chung dao co vi ngi HIV dng tnh ri mnh l b rch da. 497. AIDS v quan h thy thuc - bnh nhn Mt s bn c bn khon v nguy c ly nhim t bnh nhn b HIV dng tnh sang nhn vin y t, v ngc li t nhn vin y t b HIV dng tnh sang bnh nhn. Ri ro ly truyn bnh AIDS do hnh ngh y t c cc trung tm kim sot bnh tt (CDC) ca Hoa K xem xt nh gi da trn 214.686 trng hp AIDS thng k c ti Hoa K ngy 31-31993; trong s ny, c 10.122 trng hp (4,7%) l nhn vin lm vic ti cc c s y t. Trong s 10.122 nhn vin y t mc bnh AIDS, 94% khai khng phi b ly nhim do hnh ngh; 6% cn li l nhng trng hp "c bn ci" v xem xt k lng. Ly t bnh nhn sang nhn vin y t H thng quc gia theo di bnh AIDS ca CDC thng k c 115 trng hp "c kh nng ly nhim" do hnh ngh. Trong s ny c 37 ngi ghi chp y v hon cnh ly nhim ca h: phn ng do s h khi tip xc vi mu ca bnh nhn AIDS, v 1 trng hp do tic xc vi mi trng nui cy HIV trong phng th nghim. 33 trng hp b rch da, 4 b rch nim mc khi tip xc. C 8 trng hp bc pht bnh AIDS. Nhng nhn vin y t d b ly truyn nht l: k thut vin phng xt nghim (14), bc s ni tng qat (13), phu thut vin (4), 78 trng hp khc "c s h" khi tip xc vi virus HIV cng c thng k, nhng tt c u c huyt thanh m tnh. Trn y l nhng s liu thng k da trn vic khai bo chnh thc v tai nn lao ng ca nhn vin y t v do vy t c coi trng. Bi v, theo CDC, ch c t 10 n 60% cc vt thng ti c s y t l c khai bo, lm hn ch rt nhiu nhng thng k ln c gi tr khoa hc hn. To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


Ly t nhn vin y t sang bnh nhn

L Trng Bng

Ti ngy 1-1-1995, mt cuc iu tra trn 22.171 bnh nhn thng thng ti khm ni 64 nhn vin y t - vn b HIV dng tnh - cho thy: - Trong s bnh nhn n khm ni 37 nhn vin y t loi ny, khng mt ngi no b ly nhim. - Trong s 9.108 bnh nhn ti khm ni 14 nhn vin y t khc thuc loi ny, c 113 ngi b HIV dng tnh. Tuy nhin, sau cc cuc iu tra v dch t hc v huyt thanh vn cha c lun c khoa hc khng nh l do nguyn nhn hnh ngh. Ngoi ra, hai cuc iu tra ca CDC ti cc c s y t cho thy s ly truyn t cc nhn vin y t b HIV dng tnh sang bnh nhn l khng ng k, do vy khng bt buc phi kim tra huyt thanh ca nhn vin y t. 498. Bnh AIDS v loi vt Gi s ly mu ca ngi mc bnh AIDS c HIV dng tnh, em truyn cho b, ch, tru, heo..., th chng c mc bnh ny khng? V nu chng b, ta n tht c vic g khng? Khng phi bt c bnh g ca ngi cng truyn c cho loi vt, v ngc li. i vi bnh AIDS, ngi ta nghi ng l xut pht t mt loi kh ti chu Phi (Xem Mc 490). Hin cha thy c ti liu no ni v bnh ny cc ng vt khc. C iu chc chn l AIDS khng ly nhim qua n ung. 499. Gn c c thuc chng nga AIDS Vi mt s bnh do virus, y hc c thuc chng hu hiu. Ti sao vi HIV ca bnh AIDS vn cha c, l no nhn loi cui cng s b tiu dit v cn bnh ly theo ng tnh dc ny sao? Cha tm ra thuc chng nga th ng ri. Nhng chuyn "nhn loi s b tiu dit v bnh AIDS", th cha hn; c xy ra hay khng l do mi ngi chp nhn hay khng chp nhn ch "mt v mt chng", "ch mt ngi tnh duy nht", hoc "s dng bao cao su 100%)! Khoa hc vn ang ro rit tm mt vacxin chng nga. - u thng 11-1998, cc nh nghin cu ca c cho bit l, ln u tin trn th gii, h hiu chnh c mt loi vacxin nga HIV/AIDS, sau khi thnh cng trn kh th nghim, s c dng th cho 25 ngi nhim HIV tnh nguyn vo cui 1998 - u 1999, vi s ti tr ca Chnh ph c. Nguyn tc ca vacxin ni trn l lm cho c th sn xut hng lot loi bch cu T c c tnh gy nguy hi cho nhng bch cu CD4 nhim virus (do ph hy c ni c tr v t nhn ln ca virus HIV, lm cho chng mt "t" hot ng v sinh si). Nu vacxin ny thnh cng, gi thnh ca mi mi chng nga ch khong 0,02 - 0,03 la M; c th th tht hng phc ln cho nhn loi! - phng Ty, s d cha ch to c thuc chng nga AIDS l v l do sau y: Mun thm nhp vo t bo ngi, virus HIV s dng mt th v kh li hi l protein gp 120 - nm trn b mt To Ebook: Nguyn Kim V Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c

L Trng Bng

ca virus, gip n gn dnh vo cc t bo b nhim - c c tnh bin d rt cao, ngha l lun thay i, lm cho cc nh khoa hc nh b ri vo mt trn bt qai, cha tm c cch i ph. Nm 1998, mt nhm nghin cu ca Trng i hc tng hp Harvard, Massachusetts, Hoa K, do nh khoa hc J.Sodroski ch tr, pht hin ra rng gp 120 c mt mu hng nh, ngha l khng my may thay i trong bt c hon cnh no; nu v hiu ha c mu ny th c th "cm ca" HIV, khng cho n thm nhp t bo. Nhng iu gay cn l mu ny ch bc l trong nhy mt, vo lc t bo b nhim; cho nn trong tng lai gn, liu cc nh khoa hc c nhm c ng thi c v hiu ha n khng? u nm 1999, xut pht t nim cho rng "gp 120 thay hnh i dng nhiu ln trong qa trnh gn dnh vo cc b phn cm ca t bo b nhim, vy th c l lc n pht hin ra nhiu v tr gy min dch", nhm nghin cu ca J. Nunber, Trng i hc tng hp Montana, Hoa K, ch to ra nhng t bo mang phc hp gp 120 - b nhn cm (m h nm bt c ht trong qa trnh gn dnh), ri tim cc t bo cho chut ht trong qa trnh gn dnh), ri tim cc t bo cho chut chuyn gene nay mang b cm th ca ngi. Kt qa thu c tht rc r: Chut c bo v hon ton, khng h hn g trc s tn cng ca loi HIV. D nhin cc t bo ny cha th dng cho ngi v cha an ton, nhng nu tinh khit ha c phc hp gp 120 - b nhn cm, chc chn y s l phng cch hu hiu phng chng HIV. 500. Nhng thnh tu mi nht Xin cho bit nhn loi c thm nhng thnh tu g mi trong trn chin chng HIV/AIDS? M s dng rng ri loi thuc mi mang tn Trizivir (gm 3 phn t hot tnh l Lamivudine, Abacavir v Zidovudine), mi ngy ung 2 vin chia lm 2 ln, cng hiu hn rt nhiu. - Cc nh khoa hc trn th gii tm ra c mt s cht c tc dng ngn cn virus HIV khng cho n ha ln vo mng t bo ca cc bch cu CD4 (do khng thm nhp c vo bch cu gy hi), c cht ang c dng th nghim trn ngi, nhng gp kh khn v phi s dng vi liu lng ln. - Vo qy 1 nm 2001, cc nh nghin cu Hoa K pht hin ra mt protein mang tn 5-Helix ngn chn c HIV, c c tnh l rt bn vng, t b h hi khi gp cc enzyme (men) ca c th, v ch cn mt lng rt nh t hiu qa cao. - Vin ung th quc gia Hoa K pht hin ra tc dng cha bnh AIDS v bnh lao ca cht Calanolide A, chit xut t cy bintangor ca Malaysia, tn khoa hc Calophyllum lanigerum, thuc h Mng ct (b con vi cy m u ca Vit Nam); u nm 2001, thuc c th nghim trn lm sng ti M, kt qa bc u y ha hn.

To Ebook: Nguyn Kim V

Ngun truyn: vnthuquan.net

500 gii p y hc theo yu cu bn c


Li cui: Cm n bn theo di ht cun truyn. Ngun: http://vnthuquan.net Pht hnh: Nguyn Kim V. Ngun: VnExpress c bn: NHK1978 a ln vo ngy: 4 thng 6 nm 2004

L Trng Bng

To Ebook: Nguyn Kim V

Ngun truyn: vnthuquan.net

You might also like