{"id":147183,"date":"2023-02-20T07:34:06","date_gmt":"2023-02-20T07:34:06","guid":{"rendered":"https:\/\/labinsights.com\/acf_article\/thuyen-tac-huyet-khoi-tinh-mach-vte-o-chau-a-yeu-to-nguy-co-chan-doan-va-dieu-tri\/"},"modified":"2026-01-27T07:08:34","modified_gmt":"2026-01-27T07:08:34","slug":"venous-thromboembolism-vte-in-asia-risk-factors-diagnosis-and-treatment","status":"publish","type":"acf_article","link":"https:\/\/labinsights.com\/vi\/disease-area\/coagulation\/venous-thromboembolism-vte-in-asia-risk-factors-diagnosis-and-treatment\/","title":{"rendered":"Thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch (VTE) \u1edf ch\u00e2u \u00c1: y\u1ebfu t\u1ed1 nguy c\u01a1, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

C\u1ea3 d\u00e2n s\u1ed1 ph\u01b0\u01a1ng T\u00e2y v\u00e0 ch\u00e2u \u00c1 \u0111\u1ec1u c\u00f3 nh\u1eefng y\u1ebfu t\u1ed1 nguy c\u01a1 t\u01b0\u01a1ng t\u1ef1 \u0111\u1ed1i v\u1edbi thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch (VTE), m\u1ed9t t\u00ecnh tr\u1ea1ng th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u (DVT) ho\u1eb7c thuy\u00ean t\u1eafc ph\u1ed5i (PE). Tuy nhi\u00ean, c\u00e1c b\u1eb1ng ch\u1ee9ng cho th\u1ea5y c\u00e1c ca VTE \u1edf ch\u00e2u \u00c1 c\u00f3 th\u1ec3 b\u1ecb b\u00e1o c\u00e1o th\u1ea5p h\u01a1n \u0111\u00e1ng k\u1ec3 [1]. V\u00ec VTE l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u1edbn \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 h\u1ec7 th\u1ed1ng y t\u1ebf, kho\u1ea3ng c\u00e1ch trong vi\u1ec7c b\u00e1o c\u00e1o n\u00e0y c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft. <\/p>\n

C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y VTE<\/h2>\n

C\u00f3 hai lo\u1ea1i y\u1ebfu t\u1ed1 nguy c\u01a1 VTE \u2014 di truy\u1ec1n ho\u1eb7c m\u1eafc ph\u1ea3i. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 di truy\u1ec1n x\u1ea3y ra do nh\u1eefng b\u1ea5t th\u01b0\u1eddng v\u1ec1 gen \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn con \u0111\u01b0\u1eddng \u0111\u00f4ng m\u00e1u. C\u1ea3 d\u00e2n s\u1ed1 ch\u00e2u \u00c1 v\u00e0 ph\u01b0\u01a1ng T\u00e2y \u0111\u1ec1u ph\u1ea3i \u0111\u1ed1i m\u1eb7t v\u1edbi t\u1ef7 l\u1ec7 m\u1eafc c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 di truy\u1ec1n \u0111\u00e1ng k\u1ec3, nh\u01b0ng c\u00e1c lo\u1ea1i y\u1ebfu t\u1ed1 nguy c\u01a1 di truy\u1ec1n c\u1ee5 th\u1ec3 l\u1ea1i kh\u00e1c bi\u1ec7t r\u00f5 r\u1ec7t gi\u1eefa hai nh\u00f3m n\u00e0y [1]. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 m\u1eafc VTE c\u00f3 \u0111\u01b0\u1ee3c bao g\u1ed3m ph\u1eabu thu\u1eadt, ch\u1ea5n th\u01b0\u01a1ng, n\u1eb1m vi\u1ec7n k\u00e9o d\u00e0i, m\u1ea5t kh\u1ea3 n\u0103ng v\u1eadn \u0111\u1ed9ng, b\u00e9o ph\u00ec, s\u1eed d\u1ee5ng thu\u1ed1c tr\u00e1nh thai d\u1ea1ng u\u1ed1ng, tu\u1ed5i cao, ung th\u01b0 v\u00e0 li\u1ec7t. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c chia th\u00e0nh hai lo\u1ea1i: y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00f3 th\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c v\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 kh\u00f4ng th\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c. Kh\u00e1c v\u1edbi c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 di truy\u1ec1n \u0111\u1ed1i v\u1edbi VTE, kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 ch\u1ee7ng t\u1ed9c \u0111\u1ed1i v\u1edbi c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00f3 \u0111\u01b0\u1ee3c. M\u1ed9t s\u1ed1 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y nguy c\u01a1 VTE \u00a0l\u00e0 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng gi\u1eefa c\u00e1c d\u00e2n s\u1ed1 ch\u00e2u \u00c1 v\u00e0 ph\u01b0\u01a1ng T\u00e2y trong c\u00e1c b\u1ed1i c\u1ea3nh ch\u0103m s\u00f3c t\u00edch c\u1ef1c, h\u1eadu ph\u1eabu thu\u1eadt v\u00e0 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 [1-3]. Tuy nhi\u00ean, do thi\u1ebfu c\u00e1c nghi\u00ean c\u1ee9u l\u1edbn, c\u00f3 t\u00ednh ch\u1ea5t tri\u1ec3n v\u1ecdng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u1ef7 l\u1ec7 m\u1eafc VTE (c\u1ea3 tri\u1ec7u ch\u1ee9ng v\u00e0 kh\u00f4ng tri\u1ec7u ch\u1ee9ng) th\u1ef1c s\u1ef1 \u1edf b\u1ec7nh nh\u00e2n ch\u00e2u \u00c1, n\u00ean c\u00e1c b\u1eb1ng ch\u1ee9ng hi\u1ec7n c\u00f3 v\u1eabn c\u00f2n h\u1ea1n ch\u1ebf [2]. <\/p>\n

G\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt c\u1ee7a VTE<\/h2>\n

G\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt c\u1ee7a VTE ph\u1ee5 thu\u1ed9c v\u00e0o t\u1ef7 l\u1ec7 t\u1eed vong, nguy c\u01a1 t\u00e1i ph\u00e1t v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng n\u1eb7ng l\u00e2u d\u00e0i c\u1ee7a n\u00f3, ch\u1eb3ng h\u1ea1n nh\u01b0 t\u0103ng huy\u1ebft \u00e1p ph\u1ed5i m\u1ea1n t\u00ednh v\u00e0 h\u1ed9i ch\u1ee9ng sau huy\u1ebft kh\u1ed1i. T\u0103ng huy\u1ebft \u00e1p ph\u1ed5i m\u1ea1n t\u00ednh th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng tim ph\u1ed5i, nh\u01b0 kh\u00f3 th\u1edf, \u0111au ng\u1ef1c v\u00e0 m\u1ec7t m\u1ecfi. H\u1ed9i ch\u1ee9ng h\u1eadu huy\u1ebft kh\u1ed1i bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng \u0111au ch\u00e2n m\u1ea1n t\u00ednh, ph\u00f9 n\u1ec1 kh\u00f3 ch\u1eefa, v\u00e0 n\u1ebfu n\u1eb7ng th\u00ec lo\u00e9t t\u0129nh m\u1ea1ch [4,5]. Ch\u00fang \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn b\u1ec7nh nh\u00e2n v\u1ec1 th\u1ec3 ch\u1ea5t v\u00e0 t\u00e2m l\u00fd x\u00e3 h\u1ed9i v\u00e0 h\u1ea1n ch\u1ebf c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y c\u1ee7a h\u1ecd, bao g\u1ed3m c\u1ea3 n\u0103ng su\u1ea5t l\u00e0m vi\u1ec7c [4,5]. <\/p>\n

Ch\u1ea9n \u0111o\u00e1n VTE<\/h2>\n

Ch\u1ea9n \u0111o\u00e1n VTE l\u00e0 nh\u01b0 nhau, b\u1ea5t k\u1ec3 d\u00e2n t\u1ed9c, v\u00e0 d\u1ef1a tr\u00ean \u0111\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng v\u00e0 x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n [1]. \u0110\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng s\u1ebd xem x\u00e9t c\u00e1c d\u1ea5u hi\u1ec7u, tri\u1ec7u ch\u1ee9ng v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 li\u00ean quan \u0111\u1ebfn VTE, lo\u1ea1i tr\u1eeb c\u00e1c t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd kh\u00e1c. D-dimer \u0111\u01b0\u1ee3c t\u1ea1o ra t\u1eeb s\u1ef1 tho\u00e1i h\u00f3a fibrin v\u00e0 th\u01b0\u1eddng t\u0103ng trong VTE. Tuy nhi\u00ean, n\u00f3 c\u0169ng t\u0103ng l\u00ean trong c\u00e1c \u0111i\u1ec1u ki\u1ec7n kh\u00e1c, ch\u1eb3ng h\u1ea1n nh\u01b0 nhi\u1ec5m tr\u00f9ng v\u00e0 \u0111\u1ed9t qu\u1ef5. Do \u0111\u00f3, kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u D-dimer t\u0103ng cao cho ph\u00e9p b\u00e1c s\u0129 l\u00e2m s\u00e0ng lo\u1ea1i tr\u1eeb VTE khi s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p v\u1edbi x\u00e1c su\u1ea5t ti\u1ec1n x\u00e9t nghi\u1ec7m l\u00e2m s\u00e0ng \u1edf c\u1ea3 hai nh\u00f3m d\u00e2n s\u1ed1 ch\u00e2u \u00c1 v\u00e0 ph\u01b0\u01a1ng T\u00e2y. \u0110\u1ed1i v\u1edbi ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh, si\u00eau \u00e2m n\u00e9n (cho DVT) v\u00e0 ch\u1ee5p \u0111\u1ed9ng m\u1ea1ch b\u1eb1ng CT \u0111a l\u00e1t c\u1eaft (cho PE) l\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m \u0111\u01b0\u1ee3c \u01b0u ti\u00ean [1]. <\/p>\n

Ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb VTE<\/h2>\n

\u2014 Ph\u00f2ng ng\u1eeba VTE \u0111\u00f2i h\u1ecfi b\u1ec7nh nh\u00e2n ph\u1ea3i \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i d\u1ef1a tr\u00ean c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 m\u1eafc ph\u1ea3i. V\u00ec c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 n\u00e0y trong d\u00e2n s\u1ed1 ch\u00e2u \u00c1 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 d\u00e2n s\u1ed1 ph\u01b0\u01a1ng T\u00e2y n\u00ean c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng c\u00e1c c\u00f4ng c\u1ee5 \u0111\u00e1nh gi\u00e1 nguy c\u01a1 t\u01b0\u01a1ng t\u1ef1, ch\u1eb3ng h\u1ea1n nh\u01b0 m\u00f4 h\u00ecnh \u0111\u00e1nh gi\u00e1 nguy c\u01a1 CAPRINI [3]. B\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 m\u1eafc VTE th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng d\u01b0\u1ee3c l\u00fd nh\u01b0 thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c heparin tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p (LMWH) [3].\u00a0Tuy nhi\u00ean, vi\u1ec7c d\u1ef1 ph\u00f2ng VTE \u00edt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u1edf ch\u00e2u \u00c1 do lo ng\u1ea1i v\u1ec1 ch\u1ea3y m\u00e1u, s\u1ef1 thi\u1ebfu h\u1ee5t c\u00e1c nghi\u00ean c\u1ee9u \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nguy c\u01a1 ch\u1ea3y m\u00e1u \u1edf b\u1ec7nh nh\u00e2n ch\u00e2u \u00c1 khi s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c d\u1ef1 ph\u00f2ng n\u00e0y [3], v\u00e0 quan ni\u1ec7m r\u1eb1ng VTE kh\u00f4ng ph\u1ed5 bi\u1ebfn \u1edf qu\u1ea7n th\u1ec3 ch\u00e2u \u00c1 nh\u01b0 \u1edf d\u00e2n s\u1ed1 ph\u01b0\u01a1ng T\u00e2y. C\u00e1c h\u01b0\u1edbng d\u1eabn ch\u00e2u \u00c1 v\u1ec1 ph\u00f2ng ng\u1eeba VTE khuy\u1ebfn c\u00e1o r\u1eb1ng [3]: <\/p>\n