{"id":17906,"date":"2023-04-11T10:25:15","date_gmt":"2023-04-11T03:25:15","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=17906"},"modified":"2023-05-13T12:56:33","modified_gmt":"2023-05-13T05:56:33","slug":"thay-khop-goi-toan-phan-voi-ky-thuat-phoi-hop","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/11\/thay-khop-goi-toan-phan-voi-ky-thuat-phoi-hop\/","title":{"rendered":"Thay kh\u1edbp g\u1ed1i to\u00e0n ph\u1ea7n v\u1edbi k\u1ef9 thu\u1eadt ph\u1ed1i h\u1ee3p"},"content":{"rendered":"<p><strong>Xu\u1ea5t ph\u00e1t t\u1eeb y\u00eau c\u1ea7u c\u1ea3i thi\u1ec7n \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a k\u1ef9 thu\u1eadt c\u1eaft x\u01b0\u01a1ng \u0111\u1ed9c l\u1eadp, c\u0169ng nh\u01b0 nh\u1eefng h\u1ea1n ch\u1ebf c\u1ee7a k\u1ef9 thu\u1eadt c\u00e2n b\u1eb1ng kho\u1ea3ng. <\/strong><strong>Ch\u00fang t\u00f4i ti\u1ebfn h\u00e0nh ph\u1eabu thu\u1eadt Thay kh\u1edbp g\u1ed1i to\u00e0n ph\u1ea7n s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt ph\u1ed1i h\u1ee3p c\u1eaft x\u01b0\u01a1ng chu\u1ea9n v\u00e0 c\u00e2n b\u1eb1ng kho\u1ea3ng c\u00f3 \u1ee9ng d\u1ee5ng g\u00f3c nghi\u00eang v\u00e0 g\u00f3c xoay c\u1ee7a l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i, quy tr\u00ecnh \u0111\u01b0\u1ee3c nh\u00f3m t\u00e1c gi\u1ea3 v\u1edbi t\u1ea5t c\u1ea3 t\u00e2m huy\u1ebft v\u00e0 \u0111am m\u00ea c\u1ee7a m\u00ecnh xin gi\u1edbi thi\u1ec7u nh\u1eefng n\u1ed9i dung c\u0103n b\u1ea3n v\u00e0 c\u1eadp nh\u1eadt v\u1ec1 ph\u1eabu thu\u1eadt thay kh\u1edbp g\u1ed1i, trong \u0111\u00f3 c\u00f3 tr\u00ecnh b\u00e0y chi ti\u1ebft c\u1ea3 quy tr\u00ecnh ph\u1eabu thu\u1eadt thay kh\u1edbp g\u1ed1i v\u1edbi k\u1ef9 thu\u1eadt \u201cph\u1ed1i h\u1ee3p\u201d v\u00e0 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 th\u00f4ng qua b\u00e0i vi\u1ebft nh\u01b0 sau.<\/strong><\/p>\n<p>Nh\u00f3m t\u00e1c gi\u1ea3: PGS.TS Tr\u1ea7n Trung D\u0169ng, BS Nguy\u1ec5n Huy Ph\u01b0\u01a1ng<\/p>\n<p>N\u0103m ph\u00e1t h\u00e0nh: 2020<\/p>\n<p>&nbsp;<\/p>\n<h2>1. \u0110\u00e1nh gi\u00e1 c\u00e1c th\u00f4ng s\u1ed1 kh\u1edbp g\u1ed1i c\u1ee7a b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc ph\u1eabu thu\u1eadt thay kh\u1edbp g\u1ed1i<\/h2>\n<ul>\n<li><a href=\"https:\/\/vinmecdr.com\/huong-dan-chup-x-quang-toan-bo-chi-duoi-thang\/\">Ch\u1ee5p X quang to\u00e0n tr\u1ee5c chi d\u01b0\u1edbi<\/a> \u1edf t\u01b0 th\u1ebf t\u1ef3 ch\u00e2n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 v\u1eb9o c\u1ee7a g\u1ed1i. <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/chup-cong-huong-tu-mri-khop-goi-khi-nao-can-thiet\/\">Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb kh\u1edbp g\u1ed1i<\/a> \u0111\u1ebf x\u00e1c \u0111\u1ecbnh c\u00e1c g\u00f3c xoay c\u1ee7a l\u1ed3i c\u1ea7u \u0111\u00f9i.<\/li>\n<li>X\u00e1c \u0111\u1ecbnh g\u00f3c gi\u1eefa tr\u1ee5c li\u00ean m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u \u0111\u00f9i ph\u1eabu thu\u1eadt (sTEA) v\u00e0 tr\u1ee5c n\u1ed1i b\u1edd sau c\u1ee7a 2 l\u1ed3i c\u1ea7u \u0111\u00f9i (PCA) tr\u00ean phim ch\u1ee5p CHT kh\u1edbp g\u1ed1i tho\u00e1i ho\u00e1 tr\u01b0\u1edbc m\u1ed5, g\u00f3c (sTEA, PCA) l\u00e0 g\u00f3c xoay c\u1ee7a ph\u1ea7n l\u1ed3i c\u1ea7u \u0111\u00f9i. G\u00f3c n\u00e0y thay \u0111\u1ed5i tu\u1ef3 t\u1eebng b\u1ec7nh nh\u00e2n v\u00e0 m\u1ee9c \u0111\u1ed9 tho\u00e1i ho\u00e1, bi\u1ebfn d\u1ea1ng c\u1ee7a kh\u1edbp. Trong \u0111\u00f3 sTEA \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 tr\u1ee5c tham chi\u1ebfu chu\u1ea9n cho tr\u1ee5c ngang kh\u1edbp g\u1ed1i, PCA l\u00e0 tr\u1ee5c \u0111\u1ec3 \u0111\u1eb7t tr\u1ee3 c\u1ee5 c\u1eaft x\u01b0\u01a1ng.<\/li>\n<li>X\u00e1c \u0111\u1ecbnh g\u00f3c nghi\u00eang c\u1ee7a ph\u1ea7n l\u1ed3i c\u1ea7u \u0111\u00f9i l\u00e0 g\u00f3c gi\u1eefa tr\u1ee5c gi\u1ea3i ph\u1eabu (FAA) v\u00e0 tr\u1ee5c c\u01a1 h\u1ecdc x\u01b0\u01a1ng \u0111\u00f9i (FMA). G\u00f3c (FMA, FAA) n\u00e0y quy\u1ebft \u0111\u1ecbnh \u0111\u1ebfn l\u00e1t c\u1eaft \u0111\u1ea7u xa x\u01b0\u01a1ng \u0111\u00f9i, \u0111\u1ea3m b\u1ea3o l\u00e1t c\u1eaft n\u00e0y vu\u00f4ng g\u00f3c v\u1edbi tr\u1ee5c c\u01a1 h\u1ecdc c\u00f9a x\u01b0\u01a1ng \u0111\u00f9i.<\/li>\n<\/ul>\n<h2>2. Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n, \u0111\u01b0\u1eddng v\u00e0o kh\u1edbp g\u1ed1i c\u1ee7a b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc ph\u1eabu thu\u1eadt thay kh\u1edbp g\u1ed1i<\/h2>\n<h3><strong>2.1. Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n<\/strong><\/h3>\n<ul>\n<li>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c g\u00e2y <a href=\"https:\/\/www.vinmec.com\/vi\/co-the-nguoi\/tuy-song-la-gi-cau-tao-va-chuc-nang-201\/?location=all\">t\u00ea tu\u1ef7 s\u1ed1ng<\/a> ho\u1eb7c g\u00e2y <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/gay-me-noi-khi-quan-la-gi\/\">m\u00ea N\u1ed9i kh\u00ed qu\u1ea3n<\/a>; k\u1ebft h\u1ee3p v\u1edbi l\u00e0m gi\u1ea3m \u0111au sau m\u1ed5 (<a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/dat-catheter-ngoai-mang-cung-de-phau-thuat-va-giam-dau-sau-mo\/\">\u0111\u1eb7t Catheter ngo\u00e0i m\u00e0ng c\u1ee9ng<\/a>; \u1ed1ng c\u01a1 kh\u00e9p; g\u00e2y t\u00ea th\u1ea7n kinh \u0111\u00f9i; ho\u1eb7c PCA morphin).<\/li>\n<li>BN n\u1eb1m ng\u1eeda tr\u00ean b\u00e0n m\u1ed5; \u0111\u1eb7t s\u1eb5n garo b\u01a1m h\u01a1i \u1edf g\u1ed1c \u0111\u00f9i, k\u00ea t\u1ea5m ch\u1eb7n m\u1eb7t ngo\u00e0i \u0111\u00f9i v\u00e0 b\u00e0n ch\u00e2n, \u0111\u1ea3m b\u1ea3o kh\u1edbp g\u1ed1i g\u1ea5p kho\u1ea3ng 110\u00ad &#8211; 120 \u0111\u1ed9. S\u00e1t tr\u00f9ng, tr\u1ea3i kh\u0103n v\u00f4 tr\u00f9ng, garo d\u1ed3n m\u00e0u t\u1eeb b\u00e0n ch\u00e2n l\u00ean, \u00e1p l\u1ef1c kho\u1ea3ng 300mmHg.<\/li>\n<\/ul>\n<figure id=\"attachment_17948\" aria-describedby=\"caption-attachment-17948\" style=\"width: 632px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17948\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goi.jpg\" alt=\"tu-the-benh-nhan-tren-ban-mo\" width=\"632\" height=\"397\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goi.jpg 632w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goi-300x188.jpg 300w\" sizes=\"(max-width: 632px) 100vw, 632px\" \/><figcaption id=\"caption-attachment-17948\" class=\"wp-caption-text\">\u1ea2nh: T\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n tr\u00ean b\u00e0n m\u1ed5 ( Ngu\u1ed3n: nh\u00f3m BN nghi\u00ean c\u1ee9u)<\/figcaption><\/figure>\n<h3><strong>2.2. \u0110\u01b0\u1eddng v\u00e0o kh\u1edbp g\u1ed1i<\/strong><\/h3>\n<ul>\n<li>\u0110\u01b0\u1eddng r\u1ea1ch da: t\u01b0 th\u1ebf g\u1ed1i g\u1ea5p, \u0111\u01b0\u1eddng gi\u1eefa g\u1ed1i, b\u1eaft \u0111\u1ea7u t\u1eeb ph\u00eda tr\u00ean c\u1ef1c tr\u00ean x\u01b0\u01a1ng b\u00e1nh ch\u00e8 kho\u1ea3ng 3cm, m\u1edf r\u1ed9ng xu\u1ed1ng d\u01b0\u1edbi t\u1edbi b\u1edd trong c\u1ee7a l\u1ed3i c\u1ee7 tr\u01b0\u1edbc x\u01b0\u01a1ng ch\u00e0y.<\/li>\n<\/ul>\n<figure id=\"attachment_17950\" aria-describedby=\"caption-attachment-17950\" style=\"width: 377px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17950\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goii.jpg\" alt=\"duong-rach-da\" width=\"377\" height=\"649\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goii.jpg 377w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goii-174x300.jpg 174w\" sizes=\"(max-width: 377px) 100vw, 377px\" \/><figcaption id=\"caption-attachment-17950\" class=\"wp-caption-text\">\u1ea2nh: \u0110\u01b0\u1eddng r\u1ea1ch da ( Ngu\u1ed3n: nh\u00f3m BN nghi\u00ean c\u1ee9u)<\/figcaption><\/figure>\n<ul>\n<li>B\u1ed9c l\u1ed9 kh\u1edbp: c\u00f3 2 \u0111\u01b0\u1eddng m\u1ed5 v\u00e0o kh\u1edbp m\u00e0 ch\u00fang t\u00f4i th\u01b0\u1eddng s\u1eed d\u1ee5ng, \u0111\u00f3 l\u00e0 \u0111\u01b0\u1eddng c\u1ea1nh x\u01b0\u01a1ng b\u00e1nh ch\u00e8 (parapatellar approach) v\u00e0 \u0111\u01b0\u1eddng d\u01b0\u1edbi c\u01a1 r\u1ed9ng trong (subvastus approach). Ngo\u00e0i ra c\u00f2n 1 s\u1ed1 \u0111\u01b0\u1eddng m\u1ed5 kh\u00e1c trong thay kh\u1edbp g\u1ed1i nh\u01b0ng \u00edt ph\u1ed5 bi\u1ebfn h\u01a1n n\u00ean ch\u00fang t\u00f4i kh\u00f4ng \u0111\u1ec1 c\u1eadp s\u00e2u \u1edb \u0111\u00e2y m\u00e0 t\u1eadp trung v\u00e0o c\u00e1c \u0111\u01b0\u1eddng rao m\u00e0 ch\u00fang t\u00f4i c\u00f3 nhi\u1ec1u kinh nghi\u1ec7m \u0111\u1ec3 chia s\u1ebb. \u0110a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p ch\u00fang t\u00f4i s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng m\u1ed5 d\u01b0\u1edbi c\u01a1 r\u1ed9ng trong, \u0111\u01b0\u1eddng m\u00f4 n\u00e0y c\u00f3 \u01b0u \u0111i\u1ebfm l\u00e0 b\u1ea3o t\u1ed3n ho\u00e0n to\u00e0n ph\u1ee9c h\u1ee3p du\u1ed7i g\u1ed1i do \u0111\u00f3 sau m\u1ed5 b\u1ec7nh nh\u00e2n \u0111au \u00edt, t\u1eadp g\u1ea5p v\u00e0 du\u1ed7i g\u1ed1i t\u01b0\u01a1ng \u0111\u1ed1i thu\u1eadn l\u1ee3i nh\u01b0ng c\u00f3 nh\u01b0\u1ee3c \u0111i\u1ec3m l\u00e0 ti\u1ebfp c\u1eadn kh\u1edbp g\u1ed1i kh\u00f4ng th\u1eadt s\u1ef1 r\u1ed9ng r\u00e3i do \u0111\u00f3 \u0111\u00f2i h\u1ecfi k\u1ef9 n\u0103ng ph\u1eabu t\u00edch c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean ph\u1ea3i r\u1ea5t t\u1ed1t v\u00e0 quen thu\u1ed9c v\u1edbi ph\u1eabu thu\u1eadt thay kh\u1edbp g\u1ed1i. \u0110\u01b0\u1eddng rao c\u1ea1nh x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u00f3 thu\u1eadn l\u1ee3i l\u00e0 ti\u1ebfp c\u1eadn r\u1ed9ng r\u00e3i kh\u1edbp g\u1ed1i \u0111\u1ec5 th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt tuy nhi\u00ean c\u00f3 h\u1ea1n ch\u1ebf l\u00e0 g\u00e2y t\u1ed3n th\u01b0\u01a1ng ph\u1ee9c h\u1ee3p du\u1ed7i g\u1ed1i do ph\u00e1i m\u1edf v\u00e0o g\u00e2n c\u01a1 t\u1ee9 \u0111\u1ea7u v\u00ec v\u1eady l\u00e0m t\u0103ng nguy c\u01a1 \u0111au, gi\u1ea3m kh\u00e1 n\u0103ng t\u1eadp v\u1eadn \u0111\u1ed9ng c\u1ee7a b\u1ec7nh nh\u00e2n do \u0111\u00f3 ch\u00fang t\u00f4i th\u01b0\u1eddng s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng m\u1ed5 n\u00e0y trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n b\u00e9o, ch\u00e2n ng\u1eafn, bi\u1ebfn d\u1ea1ng kh\u1edbp nhi\u1ec1u m\u00e0 \u0111\u01b0\u1eddng m\u1ed5 d\u01b0\u1edbi c\u01a1 r\u1ed9ng trong s\u1ebd kh\u00f3 kh\u0103n cho ti\u1ebfp c\u1eadn v\u00e0 th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt c\u1eaft x\u01b0\u01a1ng.<\/li>\n<\/ul>\n<figure id=\"attachment_17953\" aria-describedby=\"caption-attachment-17953\" style=\"width: 586px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17953\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dui.jpg\" alt=\"duong-mo-co-ban-trong-thay-khop-goi\" width=\"586\" height=\"410\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dui.jpg 586w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dui-300x210.jpg 300w\" sizes=\"(max-width: 586px) 100vw, 586px\" \/><figcaption id=\"caption-attachment-17953\" class=\"wp-caption-text\">\u1ea2nh: \u0110\u01b0\u1eddng m\u1ed5 c\u01a1 b\u1ea3n trong thay kh\u1edbp g\u1ed1i<\/figcaption><\/figure>\n<p>2.2.1. \u0110\u01b0\u1eddng m\u1ed5 c\u1ea1nh x\u01b0\u01a1ng b\u00e1nh ch\u00e8<\/p>\n<figure id=\"attachment_17956\" aria-describedby=\"caption-attachment-17956\" style=\"width: 610px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17956\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/che.jpg\" alt=\"minh-hoa-duong-mo-canh-xuong-banh-che\" width=\"610\" height=\"342\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/che.jpg 610w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/che-300x168.jpg 300w\" sizes=\"(max-width: 610px) 100vw, 610px\" \/><figcaption id=\"caption-attachment-17956\" class=\"wp-caption-text\">\u1ea2nh: Minh h\u1ecda \u0111\u01b0\u1eddng m\u1ed5 c\u1ea1nh x\u01b0\u01a1ng b\u00e1nh ch\u00e8<\/figcaption><\/figure>\n<p>+ \u0110\u01b0\u1eddng m\u1edf v\u00e0o kh\u1edbp c\u00e1ch b\u1edd trong x\u01b0\u01a1ng b\u00e1nh ch\u00e8 l\u00f5m, t\u00e1ch gi\u1eefa g\u00e2n c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i<\/p>\n<figure id=\"attachment_17961\" aria-describedby=\"caption-attachment-17961\" style=\"width: 385px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17961\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goiii.jpg\" alt=\"duong-mo-vao-khop-goi\" width=\"385\" height=\"304\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goiii.jpg 385w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goiii-300x237.jpg 300w\" sizes=\"(max-width: 385px) 100vw, 385px\" \/><figcaption id=\"caption-attachment-17961\" class=\"wp-caption-text\">\u1ea2nh: \u0110\u01b0\u1eddng m\u1ed5 v\u00e0o kh\u1edbp g\u1ed1i ( Ngu\u1ed3n: nh\u00f3m BN nghi\u00ean c\u1ee9u)<\/figcaption><\/figure>\n<p>+ B\u00f3c t\u00e1ch m\u00e0ng x\u01b0\u01a1ng, t\u00e1ch bao kh\u1edbp kh\u1ecfi 2 b\u00ean m\u00e2m ch\u00e0y, tr\u00e1nh \u0111i\u1ec3m b\u00e1m ch\u00e0y c\u1ee7a c\u00e1c d\u00e2y ch\u1eb3ng b\u00ean trong v\u00e0 ngo\u00e0i.<\/p>\n<p>+ D\u00f9ng Hohmann lu\u1ed3n ph\u00eda sau m\u00e2m ch\u00e0y qua n\u01a1i b\u00f3c t\u00e1ch, g\u1ea5p g\u1ed1i, l\u1eadt ng\u1eeda x\u01b0\u01a1ng b\u00e1nh ch\u00e8 ra ngo\u00e0i, to\u00e0n b\u1ed9 kh\u1edbp g\u1ed1i \u0111\u01b0\u1ee3c b\u1ed9c l\u1ed9.<\/p>\n<p>+ C\u1eaft b\u1ecf m\u1ed9t ph\u1ea7n l\u1edbp m\u1edd Hoffa, d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc, d\u00e0y ch\u1eb1ng ch\u00e9o sau; l\u1ea5y b\u1ecf s\u1ee5n ch\u00eam. C\u1eaft b\u1ecf m\u00e0ng ho\u1ea1t \u0111\u1ecbch b\u1ecb vi\u00eam d\u1ea7y.<\/p>\n<p>+ L\u00e0m s\u1ea1ch c\u00e1c gai x\u01b0\u01a1ng (osteophytes) \u1edb r\u00eca kh\u1edbp.<\/p>\n<figure id=\"attachment_17963\" aria-describedby=\"caption-attachment-17963\" style=\"width: 385px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17963\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/boclo.jpg\" alt=\"boc-lo-khop-goi\" width=\"385\" height=\"324\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/boclo.jpg 385w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/boclo-300x252.jpg 300w\" sizes=\"(max-width: 385px) 100vw, 385px\" \/><figcaption id=\"caption-attachment-17963\" class=\"wp-caption-text\">\u1ea2nh: B\u1ed9c l\u1ed9 kh\u1edbp g\u1ed1i<\/figcaption><\/figure>\n<p>2.2.2. \u0110\u01b0\u1eddng m\u1ed5 d\u01b0\u1edbi c\u01a1 r\u1ed9ng trong<\/p>\n<p>Sau khi r\u1ea1ch da nh\u01b0 th\u01b0\u1eddng quy, ph\u1eabu t\u00edch \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh r\u00f5 c\u01a1 r\u1ed9ng trong, g\u00e2n t\u1ee9 \u0111\u1ea7u, x\u01b0\u01a1ng b\u00e1nh ch\u00e8, g\u00e2n b\u00e1nh ch\u00e8. M\u1edd \u0111\u01b0\u1eddng\u00a0 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u0111\u01b0\u1eddng v\u00e0o c\u1ea1nh trong b\u00e1nh ch\u00e8, k\u00e9o d\u00e0i t\u1eeb canh \u0111i\u1ec3m b\u00e1m g\u00e2n b\u00e1nh ch\u00e8 v\u00e0o l\u1ed3i c\u1ee7 ch\u00e0y l\u00ean ngang m\u1ee9c x\u01b0\u01a1ng b\u00e1nh ch\u00e8.<\/p>\n<p>X\u00e1c \u0111\u1ecbnh r\u00f5 b\u1edd d\u01b0\u1edbi c\u01a1 r\u1ed9ng trong. Th\u1ef1c hi\u1ec7n \u0111\u01b0\u1eddng m\u1edf k\u00e9o d\u00e0i t\u1eeb \u0111i\u1ec3m b\u00e1m c\u01a1 r\u1ed9ng trong v\u00e0o g\u00e2n t\u1ee9 \u0111\u1ea7u v\u00e0 x\u01b0\u01a1ng b\u00e1nh ch\u00e8, b\u1eaft \u0111\u1ea7u t\u1eeb ph\u00eda x\u01b0\u01a1ng b\u00e1nh ch\u00e8 h\u01b0\u1edbng v\u1ec1 b\u1edd d\u01b0\u1edbi c\u01a1 r\u1ed9ng trong. Ph\u1eabu t\u00edch t\u00e1ch c\u01a1 r\u1ed9ng trong ra kh\u1ecfi v\u00e1ch gian c\u01a1 trong, x\u01b0\u01a1ng \u0111\u00f9i v\u00e0 c\u00e2n n\u00f4ng c\u1ee7a \u0111\u00f9i. L\u1eadt to\u00e0n b\u1ed9 c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i g\u1ed3m c\u01a1 r\u1ed9ng trong ra ngo\u00e0i. Ph\u1eabu t\u00edch \u0111\u1ea3m b\u1ea3o khi k\u00e9o x\u01b0\u01a1ng b\u00e1nh ch\u00e8 v\u00e0 c\u01a1 t\u1ee9 \u0111\u1ea7u sang b\u00ean \u0111\u1ee7 kh\u00f4ng gian \u0111\u1ebf ti\u1ebfp c\u1eadn v\u00e0o c\u1ea3 2 l\u1ed3i c\u1ea7u \u0111\u00f9i \u0111\u1ebf d\u1ec5 d\u00e0ng th\u1ef1c hi\u1ec7n l\u00e1t c\u1eaft xa l\u1ed3i c\u00e0u \u0111\u00f9i. Vi\u1ec7c l\u1eadt c\u01a1 t\u1ee9 \u0111\u1ea7u c\u00f9ng x\u01b0\u01a1ng b\u00e1nh ch\u00e8 v\u00e0o trong \u0111\u00f4i khi kh\u00f4ng d\u1ec5 d\u00e0ng, n\u1ebfu c\u1ea7n thi\u1ebft c\u1ecf th\u1ec3 h\u1ea1 b\u1edbt c\u00e2n n\u00f4ng c\u1ee7a \u0111\u00f9i.<\/p>\n<p>B\u1ed9c l\u1ed9 v\u00e0 tr\u1eadt kh\u1edbp g\u1ed1i ra tr\u01b0\u1edbc: kh\u00e1c v\u1edbi \u0111\u01b0\u1eddng m\u1ed5 c\u1ea1nh x\u01b0\u01a1ng b\u00e1nh ch\u00e8, s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng m\u1ed5 d\u01b0\u1edbi c\u01a1 r\u1ed9ng trong kh\u00f4ng th\u1ec3 l\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 ra ngo\u00e0i \u0111\u01b0\u1ee3c m\u00e0 ch\u1ec9 \u0111\u00e1nh tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 ra ngo\u00e0i, v\u00ec v\u1eady n\u1ebfu kh\u00f4ng quen thu\u1ed9c v\u1edbi \u0111\u01b0\u1eddng m\u1ed5 d\u01b0\u1edbi c\u01a1 r\u1ed9ng trong th\u00ec s\u1ebd r\u1ea5t c\u00f3 nguy c\u01a1 g\u00e2y t\u1ed5n th\u01b0\u01a1ng c\u00e1c c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu nh\u01b0 x\u01b0\u01a1ng b\u00e1nh ch\u00e8, g\u00e2n b\u00e1nh ch\u00e8, g\u00e2n t\u1ee9 \u0111\u1ea7u c\u0169ng nh\u01b0 c\u00e1c c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu kh\u00e1c do ph\u1eabu tr\u01b0\u1eddng ti\u1ebfp c\u1eadn h\u1ea1n ch\u1ebf \u0111\u00f2i h\u1ecfi kinh nghi\u1ec7m c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean.<\/p>\n<figure id=\"attachment_17965\" aria-describedby=\"caption-attachment-17965\" style=\"width: 223px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17965\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khop.jpg\" alt=\"minh-hoa-duong-mo-duoi-co-rong-trong\" width=\"223\" height=\"417\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khop.jpg 223w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khop-160x300.jpg 160w\" sizes=\"(max-width: 223px) 100vw, 223px\" \/><figcaption id=\"caption-attachment-17965\" class=\"wp-caption-text\">\u1ea2nh: Minh h\u1ecda \u0111\u01b0\u1eddng m\u1ed5 d\u01b0\u1edbi c\u01a1 r\u1ed9ng trong<\/figcaption><\/figure>\n<p>L\u1ea5y h\u1ebft t\u1ed5 ch\u1ee9c m\u1edd khoang c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u1ec3 l\u1ed9 \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng \u0111\u00f9i v\u00e0 m\u00e2m ch\u00e0y, gi\u1ea3i ph\u00f3ng s\u1ee5n ch\u00eam trong, ch\u00eam ngo\u00e0i, c\u1eaft b\u1ecf <a href=\"https:\/\/www.vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/qua-trinh-lien-day-chang-cheo-truoc\/\">d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc<\/a>, <a href=\"https:\/\/www.vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/nhan-dien-dau-hieu-dut-day-chang-cheo-sau\/\">d\u00e2y ch\u1eb1ng ch\u00e9o sau<\/a>, t\u1ed5 ch\u1ee9c ho\u1ea1t m\u1ea1c vi\u00eam, l\u1ea5y b\u1ecf c\u00e1c ch\u1ed3i x\u01b0\u01a1ng \u1edf l\u1ed3i c\u1ea7u \u0111\u00f9i, <a href=\"https:\/\/www.vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/chan-thuong-khop-goi-phau-thuat-chuc-nang-sau-vo-mam-chay\/\">m\u00e2m ch\u00e0y<\/a>, b\u00e1nh ch\u00e8. B\u1ed9c l\u1ed9 m\u1eb7t tr\u01b0\u1edbc v\u00f9ng tr\u00ean l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i b\u1eb1ng c\u00e1ch l\u1ea5y b\u00f4 bao kh\u1edbp v\u00e0 kh\u1ed1i m\u1ee1 d\u1ea7y \u1edf \u0111\u00e2y.<\/p>\n<figure id=\"attachment_18255\" aria-describedby=\"caption-attachment-18255\" style=\"width: 385px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-18255 size-full\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/boclo-1.jpg\" alt=\"boc-lo-khop-goi\" width=\"385\" height=\"324\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/boclo-1.jpg 385w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/boclo-1-300x252.jpg 300w\" sizes=\"(max-width: 385px) 100vw, 385px\" \/><figcaption id=\"caption-attachment-18255\" class=\"wp-caption-text\">\u1ea2nh: B\u1ed9c l\u1ed9 kh\u1edbp g\u1ed1i<\/figcaption><\/figure>\n<h3><strong><em>2.3. L\u00e1t c\u1eaft \u0111\u1ea7u xa x\u01b0\u01a1ng \u0111\u00f9i<\/em><\/strong><\/h3>\n<p>C\u1eaft x\u01b0\u01a1ng \u1edf \u0111\u1ea7u xa x\u01b0\u01a1ng \u0111\u00f9i<\/p>\n<p>+ Khoan \u1ed1ng t\u1ee7y x\u01b0\u01a1ng \u0111\u00f9i v\u00e0 \u0111\u1eb7t n\u00f2ng n\u1ed9i t\u1ee7y t\u01b0\u01a1ng \u1ee9ng v\u1edbi tr\u1ee5c gi\u1ea3i ph\u1eabu c\u1ee7a x\u01b0\u01a1ng \u0111\u00f9i.<\/p>\n<p>+ G\u1eafn gi\u00e1 \u0111\u1ee1 v\u00e0o n\u00f2ng n\u1ed9i tu\u1ef7, tu\u1ef3 ch\u1ec9nh g\u00f3c c\u1eaft tr\u00ean gi\u00e1 \u0111\u1ee1 theo ch\u1ec9 s\u1ed1 \u0111o g\u00f3c (FAA, FMA) tr\u01b0\u1edbc m\u1ed5.<\/p>\n<figure id=\"attachment_17971\" aria-describedby=\"caption-attachment-17971\" style=\"width: 447px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17971\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/gann.jpg\" alt=\"tuy-chinh-goc-nghieng-theo-chi-so-do-goc ( FMA,FAA)\" width=\"447\" height=\"455\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/gann.jpg 447w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/gann-295x300.jpg 295w\" sizes=\"(max-width: 447px) 100vw, 447px\" \/><figcaption id=\"caption-attachment-17971\" class=\"wp-caption-text\">\u1ea2nh: T\u00f9y ch\u1ec9nh g\u00f3c nghi\u00eang theo ch\u1ec9 s\u1ed1 \u0111o g\u00f3c ( FMA,FAA)<\/figcaption><\/figure>\n<p>+ G\u1eafn khu\u00f4n c\u1eaft v\u00e0o gi\u00e1 \u0111\u1edd, t\u1ea1i v\u1ecb tr\u00ed mu\u1ed1n c\u1eaft 8, 10 ho\u1eb7c 12mm. V\u1edbi nh\u1eefng nghi\u00ean c\u1ee9u v\u1ec1 gi\u1ea3i ph\u1eabu c\u1ee7a ch\u00fang t\u00f4i, \u0111\u1ed9 d\u1ea7y l\u00e1t c\u1eaft \u0111\u1ea7u xa x\u01b0\u01a1ng \u0111\u00f9i c\u00f3 s\u1ef1 thay \u0111\u1ed5i \u1edb nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00e1c nhau, tuy nhi\u00ean ph\u1ea3i \u0111\u1ea3m b\u1ea3o l\u00e1t c\u1eaft \u0111i qua \u0111i\u1ec3m th\u1ea5p nh\u1ea5t c\u1ee7a khe li\u00ean l\u1ed3i c\u1ea7u, kh\u00f4ng \u00edt h\u01a1n v\u00e0 c\u0169ng kh\u00f4ng nhi\u1ec1u h\u01a1n. Neu c\u1eaft \u00edt h\u01a1n c\u00f3 nguy c\u01a1 h\u1ea1 th\u1ea5p Joint line, l\u00e0m h\u1eb9p kho\u1ea3ng du\u1ed7i, n\u1ebfu c\u1eaft nhi\u1ec1u h\u01a1n s\u1ebd g\u00e2y t\u1ed5n th\u01b0\u01a1ng \u0111i\u1ec3m b\u00e1m c\u1ee7a g\u00e2n c\u01a1 khoeo \u1edd ph\u00eda sau. Do \u0111\u00f3 trong k\u1ef9 thu\u1eadt c\u1ee7a ch\u00fang t\u00f4i lu\u00f4n c\u1eaft c\u1ed1 \u0111\u1ecbnh l\u00e1t c\u1eaft xa x\u01b0\u01a1ng \u0111\u00f9i. C\u1ed1 \u0111\u1ecbnh khu\u00f4n c\u1eaft b\u1eb1ng 2 \u0111inh nh\u1ecf sau khi x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed ch\u00ednh x\u00e1c c\u1ee7a khay c\u1eaft v\u00e0 sau \u0111\u00f3 l\u00e0 2 \u0111inh ch\u00e9o (xpin) \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o c\u1ed1 \u0111\u1ecbnh ch\u1eafc ch\u1eafn, tr\u00e1nh b\u1ecb thay \u0111\u1ed5i khi th\u1ef1c hi\u1ec7n l\u00e1t c\u1eaft.<\/p>\n<figure id=\"attachment_17976\" aria-describedby=\"caption-attachment-17976\" style=\"width: 498px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17976\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dungcu.jpg\" alt=\"dat-tro-cu-cat-dau-xa-xuong-dui\" width=\"498\" height=\"507\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dungcu.jpg 498w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dungcu-295x300.jpg 295w\" sizes=\"(max-width: 498px) 100vw, 498px\" \/><figcaption id=\"caption-attachment-17976\" class=\"wp-caption-text\">\u1ea2nh: \u0110\u1eb7t tr\u1ee3 c\u1ee5 c\u1eaft \u0111\u1ea7u xa x\u01b0\u01a1ng \u0111\u00f9i<\/figcaption><\/figure>\n<p>+ L\u1ea5y h\u1ebft n\u00f2ng v\u00e0 gi\u00e1 \u0111\u1ee1 ch\u1ec9 \u0111\u1ec3\u00a0 l\u1ea1i khu\u00f4n c\u1eaft, ti\u1ebfn h\u00e0nh c\u1eaft \u0111\u1ea7u xa c\u1ee7a x\u01b0\u01a1ng \u0111\u00f9i.<\/p>\n<figure id=\"attachment_17981\" aria-describedby=\"caption-attachment-17981\" style=\"width: 498px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17981\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dauxa.jpg\" alt=\"cat-dau-xa-xuong-dui\" width=\"498\" height=\"376\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dauxa.jpg 498w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/dauxa-300x227.jpg 300w\" sizes=\"(max-width: 498px) 100vw, 498px\" \/><figcaption id=\"caption-attachment-17981\" class=\"wp-caption-text\">\u1ea2nh: C\u1eaft \u0111\u1ea7u xa x\u01b0\u01a1ng \u0111\u00f9i<\/figcaption><\/figure>\n<p>+ Th\u00e1o b\u1ed9 tr\u1ee3 c\u1ee5 c\u1eaft \u0111\u1ea7u xa x\u01b0\u01a1ng \u0111\u00f9i, ki\u1ec3m tra v\u00e0 c\u1eaft b\u1ecf th\u00eam c\u00e1c ch\u1ed3i x\u01b0\u01a1ng \u1edf 2 b\u00ean c\u1ee7a l\u1ed3i c\u1ea7u \u0111\u00f9i v\u00e0 m\u00e2m ch\u00e0y n\u1ebfu c\u00f2n, du\u1ed7i g\u1ed1i th\u1eb3ng t\u1ed1i \u0111a, k\u00e9o ch\u00e2n th\u1eb3ng tr\u1ee5c, \u0111\u1eb7t mi\u1ebfng \u201cGap\u201d \u0111\u1ec3 t\u00ednh kho\u1ea3ng du\u1ed7i, \u0111\u00e1nh d\u1ea5u m\u1ee9c c\u1eaft c\u1ee7a m\u00e2m ch\u00e0y. \u0110\u1ed9ng t\u00e1c n\u00e0y r\u1ea5t quan tr\u1ecdng v\u00e0 l\u00e0 1 trong nh\u1eefng y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o c\u00e2n b\u1eb1ng kho\u1ea3ng ch\u00ednh x\u00e1c.<\/p>\n<figure id=\"attachment_17984\" aria-describedby=\"caption-attachment-17984\" style=\"width: 659px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17984\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khoang.jpg\" alt=\"tinh-khoang-duoi-va-danh-dau-muc-cat-mam-chay\" width=\"659\" height=\"442\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khoang.jpg 659w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khoang-300x201.jpg 300w\" sizes=\"(max-width: 659px) 100vw, 659px\" \/><figcaption id=\"caption-attachment-17984\" class=\"wp-caption-text\">\u1ea2nh: T\u00ednh kho\u1ea3ng du\u1ed7i v\u00e0 \u0111\u00e1nh d\u1ea5u m\u1ee9c c\u1eaft m\u00e2m ch\u00e0y<\/figcaption><\/figure>\n<p><strong>2.4. C\u1eaft l\u00e1t c\u1eaft g\u1ea7n m\u00e2m ch\u00e0y<\/strong><\/p>\n<p>+ \u0110\u1eb7t b\u1ed9 \u0111\u1ecbnh v\u1ecb \u0111\u1ec3 c\u1eaft m\u00e2m ch\u00e0y, v\u1edbi thanh gi\u00f3ng tr\u1ee5c n\u1ed1i t\u1eeb t\u00e2m kh\u1edbp g\u1ed1i (gi\u1eefa 2 gai ch\u00e0y) \u0111\u1ebfn t\u00e2m kh\u1edbp c\u1ed5 ch\u00e2n ( gi\u1eefa 2 m\u1eaft c\u00e1 ch\u00e2n).<\/p>\n<p>+ Thanh gi\u00f3ng tr\u1ee5c c\u00f3 th\u1ec3 ch\u1ec9nh tr\u01b0\u1edbc<\/p>\n<ul>\n<li>Sau theo m\u1eb7t ph\u1eb3ng \u0111\u1ee9ng d\u1ecdc \u0111\u1ec3 ch\u1ec9nh \u0111\u1ed9 nghi\u00eang sau c\u1ee7a m\u00e2m ch\u00e0y (g\u00f3c slope) kho\u00e1ng t\u1eeb 3\u00b0- 5\u00b0. Ch\u1ec9nh khay c\u1eaft l\u00ean tr\u00ean &#8211; xu\u1ed1ng d\u01b0\u1edbi d\u1ef1a theo b\u00ean m\u00e2m ch\u00e0y b\u1ecb t\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u h\u01a1n \u0111\u1ec3 t\u00ednh \u0111\u1ed9 d\u00e0y c\u1ee7a l\u00e1t c\u1eaft, th\u01b0\u1eddng c\u1eaft d\u01b0\u1edbi m\u1ee9c t\u1ed5n th\u01b0\u01a1ng kho\u1ea3ng 2mm, \u0111\u1ed3ng th\u1eddi so s\u00e1nh v\u1edbi v\u1ecb tr\u00ed \u0111\u00e1nh d\u1ea5u c\u1ee7a kho\u00e1ng du\u1ed7i tr\u01b0\u1edbc \u0111\u00f3. Tr\u01b0\u1eddng h\u1ee3p m\u00e2m ch\u00e0y b\u1ecb l\u00fan x\u01b0\u01a1ng nhi\u1ec1u th\u00ec s\u1eed d\u1ee5ng \u0111o \u0111\u1ea1c l\u00e1t c\u1eaft x\u01b0\u01a1ng ti\u00eau chu\u1ea9n khi \u0111o v\u1edbi ph\u1ea7n m\u00e2m ch\u00e0y \u00edt b\u1ecb t\u1ed5n th\u01b0\u01a1ng h\u01a1n \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o l\u00e1t c\u1eaft x\u01b0\u01a1ng m\u00e2m ch\u1ea7y kh\u00f4ng \u0111i qu\u00e1 lOmm t\u00ednh t\u1eeb m\u1eb7t kh\u1edbp \u0111\u1ec3 tr\u00e1nh t\u1ed1n th\u01b0\u01a1ng c\u00e1c d\u00e2y ch\u1eb1ng b\u00ean c\u1ee7a kh\u1edbp g\u1ed1i. N\u1ebfu 2 l\u00e1t c\u00e1t n\u00e0y tr\u00f9ng nhau th\u00ec kh\u00f4ng c\u00f3 g\u00ec ph\u1ea3i b\u00e0n c\u00e3i, khi kh\u00f4ng tr\u00f9ng nhau, c\u00f3 2 kh\u1ea3 n\u0103ng x\u1ea3y ra: 1 l\u00e0 l\u00e1t c\u1eaft khi x\u00e1c \u0111\u1ecbnh b\u1eb1ng th\u01b0\u1edbc (l\u1ea5y v\u00ed d\u1ee5 \u0111\u1ec3 c\u1eaft x\u01b0\u01a1ng d\u01b0\u1edbi th\u01b0\u01a1ng t\u1ed5n 2mm) cao h\u01a1n l\u00e1t c\u1eaft x\u00e1c \u0111\u1ecbnh b\u1eb1ng \u201cGap\u201d th\u00ec th\u01b0\u1eddng ch\u00fang t\u00f4i s\u1ebd t\u1ea1o l\u00e1t c\u1eaft trung gian \u1edf gi\u1eefa \u0111\u1ebf c\u1eaft x\u01b0\u01a1ng sau \u0111\u00f3 \u0111o l\u1ea1i \u201cGap\u201d, n\u1ebfn \u201cgap\u201d \u1ed5n th\u00ec t\u1ed1t, n\u1ebfu kh\u00f4ng th\u00ec s\u1ebd c\u1eaft ti\u1ebfp theo l\u00e1t c\u1eaft \u0111\u1ecbnh v\u1ecb b\u1eb1ng \u201cgap\u201d; 2 l\u00e0 l\u00e1t c\u1eaft khi x\u00e1c \u0111\u1ecbnh b\u1eb1ng th\u01b0\u1edbc th\u1ea5p h\u01a1n l\u00e1t c\u00e1t x\u00e1c \u0111\u1ecbnh b\u1eb1ng \u201cgap\u201d, th\u01b0\u1eddng do c\u00f3 th\u1ec3 m\u1ea5t x\u01b0\u01a1ng nhi\u1ec1u, ch\u00fang t\u00f4i s\u1ebd c\u1eaft theo l\u00e1t c\u1eaft x\u00e1c \u0111\u1ecbnh b\u1eb1ng \u201cgap\u201d. Sau khi \u0111\u1eb7t \u0111\u00fang v\u1ecb tr\u00ed, d\u00f9ng \u0111inh c\u1ed1 \u0111\u1ecbnh, th\u00e1o b\u1ed9 \u0111\u1ecbnh v\u1ecb, \u0111\u1ec3 l\u1ea1i khay c\u1eaft.<\/li>\n<li>\n<div class=\"mceTemp\">\n<ul id=\"attachment_17988\" class=\"wp-caption aligncenter\" style=\"width: 533px;\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17988\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/catt.jpg\" alt=\"dat-bo-tro-cu-cat-mam-chay\" width=\"533\" height=\"706\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/catt.jpg 533w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/catt-226x300.jpg 226w\" sizes=\"(max-width: 533px) 100vw, 533px\" \/>\u1ea2nh: \u0110\u1eb7t b\u1ed9 tr\u1ee3 c\u1ee5 c\u1eaft m\u00e2m ch\u00e0y.\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0+ <span style=\"font-size: 16px;\">\u00a0C\u1eaft m\u00e2m ch\u00e0y d\u1ee9t kho\u00e1t v\u00e0 ph\u1eb3ng, \u0111\u1ea3m b\u1ea3o l\u00e1t c\u1eaft vu\u00f4ng g\u00f3c v\u1edbi tr\u1ee5c x\u01b0\u01a1ng ch\u00e0y.<\/span><\/ul>\n<\/div>\n<\/li>\n<\/ul>\n<figure id=\"attachment_17991\" aria-describedby=\"caption-attachment-17991\" style=\"width: 434px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17991\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mamchay.jpg\" alt=\"mam-chay-sau-khi-cat\" width=\"434\" height=\"438\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mamchay.jpg 434w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mamchay-297x300.jpg 297w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mamchay-150x150.jpg 150w\" sizes=\"(max-width: 434px) 100vw, 434px\" \/><figcaption id=\"caption-attachment-17991\" class=\"wp-caption-text\">\u1ea2nh: M\u00e2m ch\u00e0y sau khi c\u1eaft<\/figcaption><\/figure>\n<p>+ Ki\u1ec3m tra kho\u1ea3ng du\u1ed7i sau khi c\u1eaft x\u01b0\u01a1ng \u0111\u1ea7u xa x\u01b0\u01a1ng \u0111\u00f9i v\u00e0 \u0111\u1ea7u tr\u00ean xu\u01a1ng ch\u00e0y. \u0110\u1ea3m b\u1ea3o g\u1ed1i du\u1ed7i th\u1eb3ng t\u1ed1i \u0111a, c\u00e2n x\u1ee9ng trong &#8211; ngo\u00e0i v\u00e0 th\u1eb3ng tr\u1ee5c c\u01a1 h\u1ecdc.<\/p>\n<figure id=\"attachment_17992\" aria-describedby=\"caption-attachment-17992\" style=\"width: 619px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17992\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kiemtra.jpg\" alt=\"kiem-tra-khoang-duoi-va-truc-chi\" width=\"619\" height=\"346\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kiemtra.jpg 619w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kiemtra-300x168.jpg 300w\" sizes=\"(max-width: 619px) 100vw, 619px\" \/><figcaption id=\"caption-attachment-17992\" class=\"wp-caption-text\">\u1ea2nh: Ki\u1ec3m tra kho\u1ea3ng du\u1ed7i v\u00e0 tr\u1ee5c chi<\/figcaption><\/figure>\n<p><strong>2.5. C\u1eaft c\u00e1c l\u00e1t c\u1eaft tr\u01b0\u1edbc sau v\u00e0 c\u00e1c l\u00e1t c\u1eaft c\u00f2n l\u1ea1i c\u1ee7a x\u01b0\u01a1ng \u0111\u00f9i. Sau khi \u0111\u00e3 c\u1eaft xong l\u00e1t \u0111\u1ea7u xa l\u1ed3i c\u00e2u \u0111\u00f9i v\u00e0 m\u00e2m ch\u00e0y \u0111\u1ec3 t\u1ea1o kho\u1ea3ng du\u1ed7i, ti\u1ebfn h\u00e0nh \u0111o \u0111\u1ea1c v\u00e0 c\u1eaft c\u00e1c l\u00e1t b\u1edd tr\u01b0\u1edbc v\u00e0 sau c\u1ee7a l\u1ed3i c\u1ea7u \u0111\u00f9i.<\/strong><\/p>\n<p>+ X\u00e1c \u0111\u1ecbnh c\u00e1c \u0111\u01b0\u1eddng li\u00ean quan: \u0111\u01b0\u1eddng Whiteside, tr\u1ee5c li\u00ean l\u1ed3i c\u1ea7u TEA<\/p>\n<p>+ D\u00f9ng tr\u1ee3 c\u1ee5 t\u1ef3 v\u00e0o b\u1edd sau c\u1ee7a 2 l\u1ed3i c\u1ea7u \u0111\u00f9i, ch\u1ec9nh \u0111\u1ed9 xoay ngo\u00e0i c\u1ee7a c\u00e1c l\u00e1t b\u1edd tr\u01b0\u1edbc &#8211; sau l\u1ed3i c\u1ea7u \u0111\u00f9i d\u1ef1a v\u00e0o ch\u1ec9 s\u1ed1 g\u00f3c xoay ngo\u00e0i (sTEA,PCA) \u0111o tr\u00ean phim MRI tr\u01b0\u1edbc m\u1ed5, khoan 2 \u0111inh d\u1ea5u v\u00e0 c\u1ed1 \u0111\u1ecbnh khu\u00f4n c\u1eaft. X\u00e1c \u0111\u1ecbnh g\u00f3c nghi\u00eang c\u1ee7a l\u1ed3i c\u1ea7u so v\u1edbi \u0111\u01b0\u1eddng PCA d\u1ef1a tr\u00ean 2 y\u1ebfu t\u1ed1: 1 l\u00e0 gi\u00e1 tr\u1ecb \u0111o \u0111\u1ea1c tr\u00ean phim MRI tr\u01b0\u1edbc m\u1ed5; 2 l\u00e0 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng c\u1ee7a kh\u1edbp b\u00e1nh ch\u00e8 l\u1ed3i c\u1ea7u, n\u1ebfu kh\u1edbp b\u00e1nh ch\u00e8 t\u1ed3i c\u1ea7u t\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u ngh\u0129a l\u00e0 c\u00f3 t\u00ecnh tr\u1ea1ng t\u0103ng \u00e1p l\u1ef1c c\u1ee7a kh\u1edbp b\u00e1nh ch\u00e8 l\u1ed3i c\u1ea7u khi g\u1ed1i g\u1ea5p, th\u01b0\u1eddng do co r\u00fat c\u1ee7a c\u00e1nh ngo\u00e0i b\u00e1nh ch\u00e8, do \u0111\u00f3 c\u00f3 th\u1ec3 t\u0103ng g\u00f3c xoay ngo\u00e0i c\u1ee7a l\u1ed3i c\u1ea7u l\u00ean 5 \u0111\u1ed9 ho\u1eb7c h\u01a1n tu\u1ef3 theo \u0111\u00e1nh gi\u00e1 tr\u1ef1c ti\u1ebfp trong ph\u1eabu thu\u1eadt. Vi\u1ec7c x\u00e1c \u0111\u1ecbnh c\u1ee1 kh\u1edbp d\u1ef1a tr\u00ean 2 m\u1ed1c: I l\u00e0 \u0111\u01b0\u1eddng k\u00ednh tr\u01b0\u1edbc sau th\u00f4ng qua vi\u1ec7c \u0111o \u0111\u1ea1c b\u1eb1ng tr\u1ee3 c\u1ee5; 2 l\u00e0 \u0111\u01b0\u1eddng k\u00ednh trong ngo\u00e0i d\u1ef1a tr\u00ean \u0111o \u0111\u1ea1c tr\u1ef1c ti\u1ebfp. Kinh nghi\u1ec7m l\u00e2m s\u00e0ng cho th\u1ea5y, t\u1ef7 l\u1ec7 \u0111\u01b0\u1eddng k\u00ednh tr\u01b0\u1edbc sau c\u1ee7a b\u1ec7nh nh\u00e2n Vi\u1ec7t Nam th\u01b0\u1eddng l\u1edbn h\u01a1n \u0111\u01b0\u1eddng k\u00ednh trong ngo\u00e0i, do \u0111\u00f3 n\u1ebfu s\u1eed d\u1ee5ng c\u1ee1 kh\u1edbp theo \u0111\u01b0\u1eddng k\u00ednh tr\u01b0\u1edbc sau th\u00ec c\u00f3 th\u1ec3 s\u1ebd b\u1ecb l\u1edbn h\u01a1n \u0111\u01b0\u1eddng k\u00ednh trong ngo\u00e0i c\u1ee7a l\u1ed3i c\u1ea7u g\u00e2y hi\u1ec7n t\u01b0\u1ee3ng \u201coverhang\u201d l\u00e0m cho kh\u1edbp nh\u00e2n t\u1ea1o c\u1ecd x\u00e1t v\u1edbi d\u00e2y ch\u00e0ng b\u00ean trong v\u00e0 b\u00ean ngo\u00e0i, g\u00e2y \u0111au v\u00e0 h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng. V\u00ec v\u1eady trong tr\u01b0\u1eddng h\u1ee3p \u0111\u01b0\u1eddng k\u00ednh tr\u01b0\u1edbc sau l\u1edbn h\u01a1n \u0111\u01b0\u1eddng k\u00ednh trong ngo\u00e0i c\u1ee7a l\u1ed3i c\u1ea7u, ch\u00fang t\u00f4i l\u1ef1a ch\u1ecdn gi\u1ea3i ph\u00e1p gi\u1ea3m c\u1ee1 kh\u1edbp (downsize) theo c\u1ee1 kh\u1edbp x\u00e1c \u0111\u1ecbnh theo \u0111\u01b0\u1eddng k\u00ednh trong ngo\u00e0i \u0111\u1ec3 tr\u00e1nh t\u00ecnh tr\u1ea1ng \u201coverhang\u201d. Vi\u1ec7c n\u00e0y s\u1ebd d\u1eabn \u0111\u1ebfn nguy c\u01a1 c\u1ee7a hi\u1ec7n t\u01b0\u1ee3ng downsize l\u00e0 t\u0103ng kho\u1ea3ng g\u1ea5p v\u00e0 nguy c\u01a1 l\u00e1t c\u1eaft tr\u01b0\u1edbc s\u1ebd b\u1ecb \u201c\u0103n s\u00e2u\u201d v\u00e0o th\u00e0nh tr\u01b0\u1edbc x\u01b0\u01a1ng \u0111\u00f9i d\u1ea7n \u0111\u1ebfn y\u1ebfu x\u01b0\u01a1ng v\u00e0 nguy c\u01a1 g\u00e3y x\u01b0\u01a1ng, Vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh v\u1ecb tr\u00ed c\u1ee7a khay c\u1eaft \u0111\u1ec3 gi\u1ea3m thi\u1ec3u 2 \u0111i\u1ec1u tr\u00ean ph\u1ee5 thu\u1ed9c r\u1ea5t nhi\u1ec1u v\u00e0o kinh nghi\u1ec7m c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean.<\/p>\n<p>+ \u0110\u1ec3 g\u1ed1i \u1edf t\u01b0 th\u1ebf g\u1ea5p 90 \u0111\u1ed9, c\u1ed1 \u0111\u1ecbnh c\u1ed5 ch\u00e2n v\u00e0 n\u00e2ng \u0111\u00f9i t\u1ed1i \u0111a, d\u00f9ng mi\u1ebfng \u201cGap\u201d c\u1ee7a kho\u1ea3ng du\u1ed7i \u0111\u1ec3 t\u00ednh to\u00e1n l\u00e1t c\u1eaft b\u1edd sau l\u1ed3i c\u1ea7u \u0111\u00f9i \u0111\u1ec3 t\u1ea1o Kho\u1ea3ng g\u1ea5p b\u1eb1ng v\u1edbi Kho\u1ea3ng du\u1ed7i. \u0110\u00e1nh d\u1ea5u m\u1ee9c c\u1eaft n\u00e0y.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_17994\" aria-describedby=\"caption-attachment-17994\" style=\"width: 797px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17994\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/xoay.jpg\" alt=\"gan-tro-cu-theo-xoay-ngoai\" width=\"797\" height=\"351\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/xoay.jpg 797w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/xoay-300x132.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/xoay-768x338.jpg 768w\" sizes=\"(max-width: 797px) 100vw, 797px\" \/><figcaption id=\"caption-attachment-17994\" class=\"wp-caption-text\">\u1ea2nh: G\u1eafn tr\u1ee3 c\u1ee5 theo xoay ngo\u00e0i<\/figcaption><\/figure>\n<figure id=\"attachment_17998\" aria-describedby=\"caption-attachment-17998\" style=\"width: 790px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-17998\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/danhdau.jpg\" alt=\"danh-dau-muc-cat-xuong-theo-khoang-gap\" width=\"790\" height=\"294\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/danhdau.jpg 790w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/danhdau-300x112.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/danhdau-768x286.jpg 768w\" sizes=\"(max-width: 790px) 100vw, 790px\" \/><figcaption id=\"caption-attachment-17998\" class=\"wp-caption-text\">\u1ea2nh: \u0110\u00e1nh d\u1ea5u m\u1ee9c c\u1eaft x\u01b0\u01a1ng theo kho\u1ea3ng g\u1ea5p<\/figcaption><\/figure>\n<p>+ L\u1eafp khay c\u1eaft l\u1ed3i c\u1ea7u \u0111\u00f9i theo c\u1ee1 kh\u1edbp v\u1eeba \u0111o v\u00e0 theo v\u1ecb tr\u00ed \u0111\u00e1nh d\u1ea5u c\u1ee7a 2 ch\u00e2n \u0111inh tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n<figure id=\"attachment_18000\" aria-describedby=\"caption-attachment-18000\" style=\"width: 534px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18000\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khay.jpg\" alt=\"gan-khay-cat\" width=\"534\" height=\"436\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khay.jpg 534w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/khay-300x245.jpg 300w\" sizes=\"(max-width: 534px) 100vw, 534px\" \/><figcaption id=\"caption-attachment-18000\" class=\"wp-caption-text\">\u1ea2nh: G\u1eafn khay c\u1eaft<\/figcaption><\/figure>\n<p>+ C\u1eaft \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng \u0111\u00f9i v\u1edbi c\u00e1c l\u00e1t c\u1eaft tr\u01b0\u1edbc-sau v\u00e0 c\u1eaft ch\u00e9o.<\/p>\n<figure id=\"attachment_18001\" aria-describedby=\"caption-attachment-18001\" style=\"width: 789px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18001\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/loicau.jpg\" alt=\"cat-xuong-loi-cau-dui\" width=\"789\" height=\"277\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/loicau.jpg 789w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/loicau-300x105.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/loicau-768x270.jpg 768w\" sizes=\"(max-width: 789px) 100vw, 789px\" \/><figcaption id=\"caption-attachment-18001\" class=\"wp-caption-text\">\u1ea2nh: C\u1eaft x\u01b0\u01a1ng l\u1ed3i c\u1ea7u \u0111\u00f9i<\/figcaption><\/figure>\n<p>+ Ki\u1ec3m tra l\u1ea1i Kho\u1ea3ng g\u1ea5p sau khi c\u1eaft b\u1edd tnr\u01a1c &#8211; sau l\u1ed3i c\u1ea7u \u0111\u00f9i<\/p>\n<figure id=\"attachment_18002\" aria-describedby=\"caption-attachment-18002\" style=\"width: 790px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18002\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kt.jpg\" alt=\"kiem-tra-lai-khoang-gap-sau-khi-cat-bo-truoc-sau-loi-cau-dui\" width=\"790\" height=\"250\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kt.jpg 790w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kt-300x95.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kt-768x243.jpg 768w\" sizes=\"(max-width: 790px) 100vw, 790px\" \/><figcaption id=\"caption-attachment-18002\" class=\"wp-caption-text\">\u1ea2nh: Ki\u1ec3m tra l\u1ea1i kho\u1ea3ng g\u1ea5p<\/figcaption><\/figure>\n<p>+ C\u1eaft khuy\u1ebft cho l\u1ed3i c\u1ea7u \u0111\u00f9i<\/p>\n<figure id=\"attachment_18007\" aria-describedby=\"caption-attachment-18007\" style=\"width: 790px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18007\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/1990.jpg\" alt=\"cat-tao-ranh-cho-xuong-chay\" width=\"790\" height=\"252\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/1990.jpg 790w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/1990-300x96.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/1990-768x245.jpg 768w\" sizes=\"(max-width: 790px) 100vw, 790px\" \/><figcaption id=\"caption-attachment-18007\" class=\"wp-caption-text\">\u1ea2nh: C\u1eaft t\u1ea1o r\u00e3nh cho m\u00e2m ch\u00e0y<\/figcaption><\/figure>\n<p>+ \u0110\u1eb7t th\u1eed kh\u1edbp nh\u00e2n t\u1ea1o, ki\u1ec3m tra tr\u1ee5c chi, \u0111\u1ed9 v\u1eefng trong &#8211; ngo\u00e0i, tr\u01b0\u1edbc &#8211; sau; s\u1ef1 tr\u01b0\u1ee3t c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8 tr\u00ean r\u00e3nh l\u1ed3i c\u1ea7u nh\u00e2n t\u1ea1o. Sau \u0111\u00f3 \u0111\u00e1nh d\u1ea5u v\u1ecb tr\u00ed c\u1ee7a ph\u1ea7n ch\u00e0y nh\u00e2n t\u1ea1o.<\/p>\n<figure id=\"attachment_18009\" aria-describedby=\"caption-attachment-18009\" style=\"width: 790px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18009\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/nhantao.jpg\" alt=\"dat-thu-khop-nhan-tao\" width=\"790\" height=\"266\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/nhantao.jpg 790w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/nhantao-300x101.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/nhantao-768x259.jpg 768w\" sizes=\"(max-width: 790px) 100vw, 790px\" \/><figcaption id=\"caption-attachment-18009\" class=\"wp-caption-text\">\u1ea2nh: \u0110\u1eb7t th\u1eed kh\u1edbp nh\u00e2n t\u1ea1o<\/figcaption><\/figure>\n<p><strong><em>2.6. C\u1eaft t\u1ea1o r\u00e3nh khay c\u1eaft m\u00e2m ch\u00e0y + C\u1eaft t\u1ea1o r\u00e3nh c\u1ee7a khay m\u00e2m ch\u00e0y<\/em><\/strong><\/p>\n<ul>\n<li>Ch\u1ecdn khay th\u1eed ph\u00f9 h\u1ee3p v\u1edbi m\u00e2m ch\u00e0y c\u1ee7a BN.<\/li>\n<li>\u0110\u1eb7t khay th\u1eed \u0111\u00fang h\u01b0\u1edbng, c\u1ed1 \u0111\u1ecbnh b\u1eb1ng 2 \u0111inh.<\/li>\n<li>\u0110\u1eb7t kh\u1ed1i d\u1eabn khoan.<\/li>\n<li>Khoan s\u00e2u 10-15mm, d\u00f9ng x\u01b0\u01a1ng x\u1ed1p<\/li>\n<li>B\u00edt l\u1ea1i kh\u00f4ng \u0111\u1ec3 xi m\u0103ng v\u00e0o \u1ed1ng t\u1ee7y x\u01b0\u01a1ng ch\u00e0y.<\/li>\n<li>L\u1ea5y kh\u1ed1i d\u1eabn khoan ra, d\u00f9ng \u0111\u1ee5c n\u1ec7n t\u1ea1o c\u00e1c r\u00e3nh khuy\u1ebft cho ph\u1ea7n ch\u00e0y.<\/li>\n<\/ul>\n<figure id=\"attachment_18011\" aria-describedby=\"caption-attachment-18011\" style=\"width: 789px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18011\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/cattt.jpg\" alt=\"cat-khuyet-cho-loi-cau\" width=\"789\" height=\"267\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/cattt.jpg 789w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/cattt-300x102.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/cattt-768x260.jpg 768w\" sizes=\"(max-width: 789px) 100vw, 789px\" \/><figcaption id=\"caption-attachment-18011\" class=\"wp-caption-text\">\u1ea2nh: C\u1eaft khuy\u1ebft cho l\u1ed3i c\u1ea7u<\/figcaption><\/figure>\n<p><strong>2.7. S\u1eeda so\u1ea1n x\u01b0\u01a1ng b\u00e1nh ch\u00e8, \u0111\u1eb7t kh\u1edbp nh\u00e2n t\u1ea1o, d\u1ecdn d\u1eb9p v\u00e0 \u0111\u00f3ng v\u1ebft m\u1ed5 cho b\u1ec7nh nh\u00e2n thay kh\u1edbp g\u1ed1i<\/strong><\/p>\n<ul>\n<li>Chu\u1ea9n b\u1ecb x\u01b0\u01a1ng b\u00e1nh ch\u00e8: l\u00e0m s\u1ea1ch c\u00e1c gai x\u01b0\u01a1ng v\u00e0 m\u00e0i ph\u1eb3ng c\u00e1c ch\u1ed3i x\u01b0\u01a1ng, d\u00f9ng dao \u0111i\u1ec7n \u0111\u1ed1t quanh chu vi x\u01b0\u01a1ng b\u00e1nh ch\u00e8.<\/li>\n<li>\u0110\u1eb7t kh\u1edbp nh\u00e2n t\u1ea1o<\/li>\n<\/ul>\n<p>+ R\u1eeda s\u1ea1ch tr\u01b0\u1eddng m\u1ed5 tr\u01b0\u1edbc khi \u0111\u1eb7t kh\u1edbp<\/p>\n<p>+ \u0110\u1eb7t<a href=\"https:\/\/www.vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/cac-co-va-trong-luong-cua-khop-goi-nhan-tao\/\"> kh\u1edbp nh\u00e2n t\u1ea1o<\/a> c\u00f3\u00a0 xi m\u0103ng, \u0111\u1eb7t ph\u1ea7n \u0111\u00f9i tr\u1ee9\u1edbc sau \u0111\u00f3 \u0111\u1eb7t ph\u1ea7n khay m\u00e2m ch\u00e0y v\u00e0 mi\u1ebfng \u0111\u1ec7m th\u1eed c\u1ee7a m\u00e2m ch\u00e0y.<\/p>\n<p>+ G\u1ed1i gi\u1eef \u1edf t\u01b0 th\u1ebf du\u1ed7i ho\u00e0n to\u00e0n trong khi ch\u1edd xi m\u0103ng c\u1ee9ng h\u1eb3n, v\u1edbi t\u01b0 th\u1ebf n\u00e0y kh\u1edbp nh\u00e2n t\u1ea1o \u0111\u01b0\u1ee3c \u00e9p ch\u1eb7t v\u00e0o x\u01b0\u01a1ng + D\u1ecdn s\u1ea1ch xi m\u0103ng th\u1eeba, b\u01a1m r\u1eefa s\u1ea1ch kh\u1edbp.<\/p>\n<p>+ Ch\u1edd xi m\u0103ng c\u1ee9ng h\u1eb3n, ki\u1ec3m tra \u0111\u1ed9 ch\u1eadt\/l\u1ecfng c\u1ee7a kh\u1edbp g\u1ed1i \u0111\u1ebf t\u00ednh \u0111\u1ed9 d\u00e0y c\u1ee7a mi\u1ebfng \u0111\u1ec7m m\u00e2m ch\u00e0y. Thay mi\u1ebfng \u0111\u1ec7m th\u1eed b\u1eb1ng mi\u1ebfng \u0111\u1ec7m Polyethylen ph\u00f9 h\u1ee3p.<\/p>\n<figure id=\"attachment_18014\" aria-describedby=\"caption-attachment-18014\" style=\"width: 796px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18014\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/nhann.jpg\" alt=\"dat-khop-nhan-tao\" width=\"796\" height=\"267\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/nhann.jpg 796w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/nhann-300x101.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/nhann-768x258.jpg 768w\" sizes=\"(max-width: 796px) 100vw, 796px\" \/><figcaption id=\"caption-attachment-18014\" class=\"wp-caption-text\">\u1ea2nh: \u0110\u1eb7t kh\u1edbp nh\u00e2n t\u1ea1o<\/figcaption><\/figure>\n<p>\u0110\u1eb7t d\u1eabn l\u01b0u v\u00e0 \u0111\u00f3ng v\u1ebft m\u1ed5 + \u0110\u1eb7t d\u1eabn l\u01b0u h\u00fat \u00e1p l\u1ef1c \u00e2m c\u1ee7a \u1ed5 kh\u1edbp nh\u00e2n t\u1ea1o.<\/p>\n<p>+ Kh\u00e2u l\u1ea1i bao kh\u1edbp, kh\u00e2u l\u1edbp c\u00e2n, t\u1ed5 ch\u1ee9c d\u01b0\u1edbi da v\u00e0 kh\u00e2u da \u1edb t\u01b0 th\u1ebf g\u1ea5p g\u1ed1i 30&#8243;.<\/p>\n<p>+ B\u0103ng \u00e9p v\u1ebft m\u1ed5, th\u00e1o garo, c\u1ed1 \u0111\u1ecbnh t\u1ea1m th\u1eddi kh\u1edbp g\u1ed1i b\u1eb1ng n\u1eb9p g\u1ed1i \u1edf t\u01b0 th\u1ebf du\u1ed7i.<\/p>\n<figure id=\"attachment_18015\" aria-describedby=\"caption-attachment-18015\" style=\"width: 789px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-18015\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/vetmo.jpg\" alt=\"dong-vet-mo\" width=\"789\" height=\"265\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/vetmo.jpg 789w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/vetmo-300x101.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/vetmo-768x258.jpg 768w\" sizes=\"(max-width: 789px) 100vw, 789px\" \/><figcaption id=\"caption-attachment-18015\" class=\"wp-caption-text\">\u1ea2nh: \u0110\u00f3ng v\u1ebft m\u1ed5<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Xu\u1ea5t ph\u00e1t t\u1eeb y\u00eau c\u1ea7u c\u1ea3i thi\u1ec7n \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a k\u1ef9 thu\u1eadt c\u1eaft x\u01b0\u01a1ng \u0111\u1ed9c l\u1eadp, c\u0169ng nh\u01b0 nh\u1eefng h\u1ea1n ch\u1ebf c\u1ee7a k\u1ef9 thu\u1eadt c\u00e2n b\u1eb1ng kho\u1ea3ng. Ch\u00fang t\u00f4i ti\u1ebfn h\u00e0nh ph\u1eabu thu\u1eadt Thay kh\u1edbp g\u1ed1i to\u00e0n ph\u1ea7n s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt ph\u1ed1i h\u1ee3p c\u1eaft x\u01b0\u01a1ng chu\u1ea9n v\u00e0 c\u00e2n b\u1eb1ng kho\u1ea3ng c\u00f3 \u1ee9ng d\u1ee5ng [&hellip;]<\/p>\n","protected":false},"author":17,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Thay kh\u1edbp g\u1ed1i to\u00e0n ph\u1ea7n v\u1edbi k\u1ef9 thu\u1eadt ph\u1ed1i h\u1ee3p<\/title>\n<meta name=\"description\" content=\"Nh\u1eefng ph\u1ee9c t\u1ea1p v\u1ec1 m\u1eb7t gi\u1ea3i ph\u1eabu, ch\u1ee9c n\u0103ng, y\u1ebfu t\u1ed1 gi\u1edbi, nh\u00e2n ch\u1ee7ng h\u1ecdc l\u00e0m cho ph\u1eabu thu\u1eadt thay kh\u1edbp g\u1ed1i ch\u00ednh x\u00e1c ch\u01b0a \u0111\u1ea1t \u0111\u1ebfn 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content=\"2023-04-11T03:25:15+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-05-13T05:56:33+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/goi.jpg\" \/>\n<meta name=\"author\" content=\"An Huynh Phan Ngoc\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"An Huynh Phan Ngoc\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"19 minutes\" \/>\n<script type=\"application\/ld+json\" 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