V

^ « ^ KHOA HUYfeT HQC VA TRlIYftw MAU

B^nh vi^n Bach Mai

HUYET HOC TAP 11

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. x « A T BAN V , I I 4 M :

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MVC LVC

SHY TOY

Trang

CHrONG I

THifilJ MAli

xnifiu MAU N H U V C SAC

I — Djnh nghia. II - Sinh ly bcnh. ^

III - Cac hpi chi'rng thicfu mdu nhupc sic chinh. '? A — Thi^u mau nhupc sic do thiiu sit . ^ B - Thi^u mau nhupc sic tang sit. ^ C - 0 s i t . *

THifiU MAU HdNG CAU K U 6 N G Ld

I,— B^nh canh lim sing vi\ kuyit hoc. 10 II — ChSn doan nguycn nh^n. j2

1. H3p thu kcm. 12 2. M^t can bing cung-cilu. 14 3- f c ch^ do tku6c. !'•

16 16

I — LAm sang. II - Huyct hoc. 'y

III— Chan doan. rV — Nguyen nhan.

17 18

V - Difiu trj. IS VI - M<>t s6 thl b^nh d jie bi<Jt. 19

VII - C h a n doan phan bi?t.

THifiU M A U TieU HL'YfiT BAM S I M I

t X 'JO

I - Phunrg ph.p „gh,e„ c u . vi, cMn Join '^i' " • " • " " *"'''• 22

2. I3^nh hAng c^u hinh bSu d^c. 24 3. B«nh huy^l sic t6. ^^ „ „ h6ng cSu. -'« 4 Thilu mau t.cu huy ft b.»m Mnn vo. i.

167

THifiu MAI T i t t n t v f T MAC P H A I

T — Thi^u mau tieu huy^t trc moi Jc. II - Thi^u mau tidu huy6t do khang ihi tu dc.

i n - Thi^u mau ti^u huyct mic phai khong do khang the ti; sinh

I I - BAN X U A T HUYfiT GIAM TlEU CAU DANG KHAC

31 31

B$MI TV Mlft.N I — Nguyen nhan. |.

II—Co ch^ xu^t hi^n. ^., 111 - Cac h^nh tu mi^n chinh. |.*J IV-S inh Iv bfnh, ^^ V - D i f i u t r j . ,3

PHA\ (r,\G QVk MAN

I — Phan ung-phan vc va dj ling. • 44 H - Phin ling kiiu dpc t6 bao, 44

III — Phan ung qua man do phuc hp hoa tan khang nguyen - khang the. 45 IV — Phan ung qua man cham. 43 V - Qua min kich ihich. 15

CHCnSG II

B$NH C t A CAM M A U V A D 0 \ G M A U

BfMI c£lA CAM MAU BAN DAT

I - BAN X U A T H U Y ^ T GIAM TlEU CAU KHONG RO NGUYEN NHAN

i7 A - Lam sang. B - Huy^thpc. Y C - DiJu tra benh nguven. D - T i g n triin. ^j| E - Sinh ly b^nh. ^ G - D i t u trj.

50 50 A — Tiiu cau ngo^i vi bj pha huy qua nhiCu

B — Tuy sinh san khong du. 50 C — Thd gia dinh.

Ill - Bt-NH ML Y NHLQC T I E L C A U 50

A - Dinh n^hia. 51 B - Dkc diciii lum sing. 51 C - DH!u tri. D - Tht b^nh chinh.

i>]

\m

I V - B A N XUAT HUYfiT DO THANH MACH A — Do nhi^m khuan. B — Do viem nhit'm. C - Do thanh mach khong Win vung don thuJln D - Do g.an mach xu^t huy^t di truyen (bi^nh Rendu-Oslcr).

II - 1 3 £ N H C O A SINH TROMBOPLASTIN

A — Hemophili A. B - H e m o p h i l i B. , t , -C - Thieu hut bam sinh cac yeu to XI hay PTA _ Benh Rosenthal I D - Thi^u hut bam sinh yeu to XII hoac yeu to Hageman

52 53

v-BENH WIL;.EBRAND A — B^nh sinh. H — Lam sang. 55 C — Sinh vat. 55 D - Sinh ly b^nh. 5« E — DiSu t r i . ^^

5fi

B$NH CUA D O N G MAU

I - B$NH CUA PHUC HE P R O T R O M B I N

A — Nhung hoi chtJng 'uy giam mpt minh bam sinh 57 B — Thieu hut phoi hop nhi^u yeu to. 57

1. Hpi chung xu^t huyet cua tre moi de. 58 2. Ton thuong duong tieu hoa. 59 3 . Renh gan-mat. . ' • 59 4. Xuat huyet do thuoc chong dong ki^u Dicumarin. 59

60 62 63 63

III - CHAT CH^NG DONG LUU H A N H

A - Chong sinh tro^nboplastin. g B — Loai chong trombolapstin. , . , . 64 C - Chit uc chc cua sir hinh thanh spi huyet.

I V - B t N H C U A SOI HUYET

A - Bit binh thuong cGa h^ th6ng tong hop. 65 B - Ti5n soi huvet bj pha hOy qua nhi^u. CO

1. Hoaa cJnh xu5t hicn. 67 2. Lam sang. 3. Chan doan sinh vat. 4. Di^u tri.

67 68

ley

V - THEO D O I DlfeU TRI B A N G C A C T H U O C C H 6 N G D O N G

A — D^i cuong. B — Di$u tri ch5t ch6ng dong. C — Xet nghiem cdn lam

1, Truoc di^u tri. 2, Theo doi di^u trj b^ng Heparin 3. Theo doi digu trj voi cac chit chong sinh to K. 4. Di^u tri Heparin va thay th^ b^ng chSt chong sinh to K

D — Tai bi^n va tai nan. E — Yeu to nhay cam ho^c khang voi chit ch6ng dong.

71 71 71 72 72 73 73 73 74

CHrONG III

B$NH M A L A C TfNH

LaxfiMi C A P

I - THE L A M S A N G

I I - C H A N D O A N

I I I - D i f e U TRI

A - The trieu chung. B —The huyet hpc. C - The tien trien. D — ThS tiiy theo co dja.

1. Chan doan lam sang 2. Chan doan phan bi?t

A — Phuong ti^n. B - C h i djnh. C - K6t qua.

I V - P H A C D 6 DI£U TRJ LOXEMI C A P

A - CIp cuu, B - Di^u tri the tang bach c^u.

1. Didu trj tin cong. 2. DiSu tri cung c6. 3. DiSu tri tai tin c6ng.

C - Cac the giam bach cSu ngoai vi va suy tiiy. ^ D - Ket luan.

HOl CHfTNC TANG SINH T C Y AC XiNH

1 _ LOXEMI HAT K I N H

A — Lam sang. B - TriC'U chirng sinh v;it.

75 77 78 78

79 7I>

80 80

K2 81i 82 S3 S3 S3

8:i

85 H5

170

5 . 1 U4 X^ .

6. edit lich.

LaXEMl MMPHOMT M>H

H

9«

C — Tife triift^

c) H M koc 1«^ « I M ^ d) Oil JidL »

I ! - - H O l C H C ^ . I>A H C ^ N G C \ U

A — Lfcn 5J2ig,

1, O t 1I5A$ c iv klME« t int A* licit kk6i h J ^ ,^ i Dft k ^ c iv OS l ing :h^ t id; khvM k^«s dtv ^

a) f>t kJ>«f d u hiu phi: trjcu cktn^. ^ h) On kdiig ciu ngayen pkat ki:^ k ^ V«^ie& ^

D - Di^u tri. ^^

III - H O I CHl^NO ! A m TO STNH T t V

A - l . r " <- - IM

^. \\ ^ in j kKac« l iJi

B — O i i n d.\aa ! « !• Xac dinh vi tru 1 ^ 2, Cic the hiu phit hi*m jri | \ W> >. T ieu chuan c h i n dcvan, ^ W

C - Di^u tri *•* 1. Truyen niau^ f^ 2, .\ndrogen. k Coctiooiu

x^

to" A — L4m sang lOT

1. Thi dien hinh, jOH 2 . The khong d;dn hinh. I(l.i 3. ThJ tien triin. „>i)

B _ Chin doan phan bi^t. u . j r i i n t f c j o '** 1, Trvaing hvip t.^ng b;^ch cJu limphox.t Ung . ao . j , , , 2. B^nh WaldcstrOm, rn» 3 Saccom l in\pho\ i t .

171

II — B^nh day nang hay u tuy Bence Jones III — Benh day nang gama hay benh Franklin IV — B^nh day anpha V - Hoi chung r6i loan protein lanh tinh khong phai d^ng u tyV

VI — Khong CO gamma globulin - mau

no III) 110

C - Tiiti tri^n.

!• Bi<fn chiimg midn Jjch. 2. SuT tuy. I Kfx hop voi bvnh khac.

D - Cach k^t thuc. Mo 1. ChuvJn bi^n thanh loxcmi d p . "» 2. Ufi'i chung Richtcr. Hi

^ - Diiu tri, ' "

1. Kiim t n truoc khi chua, "'-2, l4iuong phap. wi 3* Chi dinh, ' llj

tu

B tMl KAIILER

A — Lam sang.

1. Th^d i^nhbh , ^" 2. Cac the lam sang.

a) ThS xuung. b) The mau. c) The protit. d) The u tiiy tang lipir. e) The ti^m tang,

B — Chan doan phan biet. 1. Giai doan lam sang. 2. Giai do^n x quang, 120 3- Giai doan huyet hoc. 120 4. Giai do^n sinh vat. I20

C — Chan doan duong tinh. I2i D — Dieu tri. 121

1. Co so. V2\ 2. Phuong ti?n. 121

a) Hoa h e lieu phap. l-I b) Phuong phap di^u tri khac. ^--c) Chi dinh. V22 d) Ket qua. 122

116 119 111) 119 119 119 120

120 120

HOI CHCNG R 6 I LO^N P R O T £ I N —MAU

I - Benh Waldenstrom ^f^

121

125

172

m ^. B^nh Bruton. 2. B^nh Di George va Nezcloff. 3. Khong CO gama kiSu Thvy Si. ' 127 4. Thit di$u-gian mao mach. ^'^'^ 5. Cac hOi chung ton thuong mQt ho|c hai nhom Ig. ^ 7

127

CHUOXG IV

U VA c A c T t N H T R ^ N G G I 6 N G U CUA CAc T 6 CHtrC SINH M A U

B$NH nODGKIN

I — Lich su. m II — Phan loai. 128

III — Nguyen nhan. IV -r Benh sinh.

V — Trieu chung.

A — Trieu chting lam sang va thuc the.

1. H^ch. \^ 2. Lach. .oo 3. Tuyen giap trang. 133 4. H6 hip. J33 5. Tieu hoa. j34 6. Tu^n hoan. 134 7. Tiet ni6u, sinh due j34 8. Xuong. 134 9. Da. 134

10. Than kinh. ^ 135 11. Cac bieu hicn toan the. ^ ^

B — Tri§u chung sinh vat. 135

1. Mau. 2. Tuy xuong. ^ , , 3. Mot s6 trieu chung xet nghiem khac.

VI — Chan doan. A - Chan doan quyct dinh. B - Chan doan the c6 diSn. 137

1. The g^n hat. 37 2. Thi hat. 3. The saccora ^^^

129 130 132

132

136

137 137 137

C — Ch5n doan phan bi t. L Lao hach. l-i7 2. Saccoidodo Bacek. 17 3. Luput ban do rai rac. 137

D - Phan bi^t lam sang giua cac benh cua hach. ^ ^

VII - Ti^n trien. '' VIII - Tien luong. -'

IX - Di5u t r i . '''9 1. Quang tuyen^ 2. Thu6c hoa hpc.

a) Da hoa hoc lieu phap. b) Don hoa hoc lieu phap,

3. Di&u tri truong hop benh Ian a tren va o duoi co hoanh 4. Ket luyn.

B$NH L I £ N VONG AC T I N H

I — B?nh Gaucher. II - B^nh Niemann Pich,

III - Benh to chtic bao X. 1. Benh Letterer — Siwe 2. Benh Hand Schulier Christian 3- Benh u hat ua axit

CHUO'NG V

N H O N G H O I CHtTNG B$NH L t K H A C C 6 LifiN QUAN DtlS MAU

CHAN DOAN LACH T O

LACH T O MOT MiNH

Ml)

MO MI Ml M:i M;i in

MI

M7

MS

MS

M!*

W

151 I — ChSn doan duong tiph. II — Chan doan phan biet. '' '*

III — ChSn doan nguyen nhan. . ' IV — Lach to la mot trieu chung co ve don doc. ""

I.\> I - Lach to do u dpng, ' I I — Lach to do u va nang. ^l,. I l l — Lach to do ky sinh trung. VI — Lao lach. V — Lach to 6 trc cm.

150 I5f> 156

174

N H C N G H O I C D O N C H L Y £ T H Q C DO V I ^ M , NlufeM KHlA?j, Ki SI>H TRtNG VA LNC THU

T _ Benh nhiJm khuan bach cSu mot nhan. H — HOi chung bach cSu mOt nhan voi phan ung Paul Bunnell — Davidsohn

156

am tinh 160 III - M6t so b^nh viem khac. l^l IV — Lao CO quan limpho va tao mau. 1 1 V — Saccoidozo - B ^ h Besnier Boeck Schaumann. 162

VI — MOt truong hop rieng : luput ban do rai rac. 1^ VII - Benh ky sinh trung. 164

VIII — Tang bach cSu ua axit khong do ky sinh triing. ins IX - Benh ung thu. ^

175