{"id":18586,"date":"2023-04-15T22:47:05","date_gmt":"2023-04-15T15:47:05","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18586"},"modified":"2023-04-18T15:25:28","modified_gmt":"2023-04-18T08:25:28","slug":"ung-thu-phoi-tu-trieu-chung-den-chan-doan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/ung-thu-phoi-tu-trieu-chung-den-chan-doan\/","title":{"rendered":"Ung th\u01b0 ph\u1ed5i: t\u1eeb tri\u1ec7u ch\u1ee9ng \u0111\u1ebfn ch\u1ea9n \u0111o\u00e1n"},"content":{"rendered":"

Ung th\u01b0 ph\u1ed5i<\/a> l\u00e0 b\u1ec7nh l\u00fd \u00e1c t\u00ednh ph\u1ed5 bi\u1ebfn nh\u1ea5t, chi\u1ebfm kho\u1ea3ng m\u1ed9t ph\u1ea7n ba s\u1ed1 ca t\u1eed vong do ung th\u01b0 v\u00e0 \u0111\u00e2y l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y t\u1eed vong li\u00ean quan \u0111\u1ebfn ung th\u01b0 \u1edf c\u1ea3 nam l\u1eabn n\u1eef, g\u00e2y ra g\u00e1nh n\u1eb7ng l\u1edbn \u0111\u1ebfn s\u1ee9c kh\u1ecfe to\u00e0n c\u1ea7u. Do \u0111\u00f3, ph\u00e1t hi\u1ec7n s\u1edbm tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n \u0111\u00fang ung th\u01b0 ph\u1ed5i c\u00f3 vai tr\u00f2 r\u1ea5t quan tr\u1ecdng trong vi\u1ec7c \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u00e0 nhanh ch\u00f3ng.<\/p>\n

\"x-quang-cua-benh-nhan-ung-thu-phoi\"
H\u00ecnh \u1ea3nh X-quang l\u1ed3ng ng\u1ef1c c\u1ee7a b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i<\/figcaption><\/figure>\n

1. C\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 g\u1eb7p \u1edf ng\u01b0\u1eddi b\u1ecb ung th\u01b0 ph\u1ed5i<\/h2>\n

C\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng gi\u1ed1ng nhau gi\u1eefa ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf v\u00e0 ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf. \u0110i\u1ec3n h\u00ecnh l\u00e0 4 nh\u00f3m tri\u1ec7u ch\u1ee9ng sau:<\/p>\n

1.1. Nh\u00f3m tri\u1ec7u ch\u1ee9ng t\u1ea1i ch\u1ed7:<\/h3>\n

\u1ede giai \u0111o\u1ea1n s\u1edbm, kh\u1ed1i u c\u00f2n nh\u1ecf v\u00e0 ch\u1ec9 khu tr\u00fa \u1edf ph\u1ed5i n\u00ean tri\u1ec7u ch\u1ee9ng ngh\u00e8o n\u00e0n. B\u1ec7nh ph\u00e1t tri\u1ec3n \u00e2m th\u1ea7m v\u00e0 c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd qua kh\u00e1m s\u1ee9c kh\u1ecfe \u0111\u1ecbnh k\u00ec ho\u1eb7c c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1ec1 h\u00f4 h\u1ea5p nh\u01b0:<\/p>\n

    \n
  • Ho k\u00e9o d\u00e0i<\/li>\n
  • Ho \u0111\u1eddm l\u1eabn m\u00e1u<\/li>\n
  • Kh\u00f3 th\u1edf: do u ch\u00e8n \u00e9p l\u00e0m b\u00edt t\u1eafc \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p<\/li>\n<\/ul>\n

    1.2. Nh\u00f3m tri\u1ec7u ch\u1ee9ng t\u1ea1i v\u00f9ng:<\/h3>\n

    Khi kh\u1ed1i u l\u1edbn d\u1ea7n x\u00e2m l\u1ea5n v\u00f9ng l\u00e2n c\u1eadn ho\u1eb7c di c\u0103n h\u1ea1ch, ng\u01b0\u1eddi b\u1ec7nh s\u1ebd c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng do kh\u1ed1i u x\u00e2m l\u1ea5n ho\u1eb7c ch\u00e8n \u00e9p<\/p>\n

      \n
    • \u0110au ng\u1ef1c <\/strong>hay g\u1eb7p khi u \u1edf ngo\u1ea1i vi<\/li>\n
    • Kh\u00f3 nu\u1ed1t, nu\u1ed1t ngh\u1eb9n <\/strong>do u ch\u00e8n \u00e9p v\u00e0o th\u1ef1c qu\u1ea3n<\/li>\n
    • Kh\u00e0n ti\u1ebfng, gi\u1ecdng \u0111\u00f4i <\/strong>do u ch\u00e8n \u00e9p v\u00e0o d\u00e2y th\u1ea7n kinh thanh qu\u1ea3n qu\u1eb7t ng\u01b0\u1ee3c<\/li>\n
    • Kh\u00f3 th\u1edf, n\u1ea5c <\/strong>do u ch\u00e8n \u00e9p v\u00e0o th\u1ea7n kinh ho\u00e0nh<\/li>\n
    • H\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean <\/strong>g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng ph\u00f9 \u00e1o kho\u00e1c, tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7, kh\u00f3 th\u1edf<\/li>\n
    • H\u1ed9i ch\u1ee9ng Pancoast \u2013 Tobias <\/strong>do kh\u1ed1i u \u1edf \u0111\u1ec9nh ph\u1ed5i ch\u00e8n \u00e9p v\u00e0o \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay<\/li>\n
    • H\u1ed9i ch\u1ee9ng Claude \u2013 Bernard \u2013 Horner <\/strong>do kh\u1ed1i u ch\u00e8n \u00e9p th\u1ea7n kinh giao c\u1ea3m c\u1ed5<\/li>\n
    • H\u1ed9i ch\u1ee9ng 3 gi\u1ea3m<\/strong> do tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i<\/li>\n
    • Kh\u1ed1i u x\u00e2m l\u1ea5n th\u00e0nh ng\u1ef1c <\/strong>g\u00e2y \u0111au ng\u1ef1c, g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd<\/li>\n<\/ul>\n

      1.3. Nh\u00f3m tri\u1ec7u ch\u1ee9ng c\u1eadn u:<\/h3>\n

      Nh\u00f3m tri\u1ec7u ch\u1ee9ng n\u00e0y hay g\u1eb7p trong ung th\u01b0 ph\u1ed5i, \u0111\u1eb7c bi\u1ec7t l\u00e0 ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf. Tri\u1ec7u ch\u1ee9ng r\u1ea5t \u0111a d\u1ea1ng nh\u01b0:<\/p>\n

        \n
      • V\u00fa to 2 b\u00ean \u1edf nam gi\u1edbi<\/li>\n
      • To \u0111\u1ea7u chi (ng\u00f3n tay d\u00f9i tr\u1ed1ng)<\/li>\n
      • \u0110au nh\u1ee9c x\u01b0\u01a1ng kh\u1edbp<\/li>\n
      • Ph\u00ec \u0111\u1ea1i kh\u1edbp<\/li>\n
      • \u0110\u00e1i th\u00e1o nh\u1ea1t<\/li>\n<\/ul>\n

        1.4. Nh\u00f3m tri\u1ec7u ch\u1ee9ng di c\u0103n<\/h3>\n

        U \u1edf ph\u1ed5i di c\u0103n sang c\u00e1c c\u01a1 quan kh\u00e1c v\u00e0 g\u00e2y ra m\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng nh\u01b0:<\/p>\n

          \n
        • Di c\u0103n h\u1ea1ch: h\u1ea1ch th\u01b0\u1ee3ng \u0111\u00f2n, h\u1ea1ch c\u1ea3nh<\/li>\n
        • N\u1ed1t di c\u0103n d\u01b0\u1edbi da<\/li>\n
        • Di c\u0103n xa hay g\u1eb7p trong:\n
            \n
          • Di c\u0103n n\u00e3o: h\u1ed9i ch\u1ee9ng t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd<\/li>\n
          • Di c\u0103n x\u01b0\u01a1ng: \u0111au x\u01b0\u01a1ng<\/li>\n
          • Di c\u0103n gan: \u0111au h\u1ea1 s\u01b0\u1eddn ph\u1ea3i<\/li>\n
          • Di c\u0103n ph\u1ed5i \u0111\u1ed1i b\u00ean<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

            2. C\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ung th\u01b0 ph\u1ed5i<\/h2>\n

            2.1. X-quang l\u1ed3ng ng\u1ef1c:<\/h3>\n
              \n
            • \u0110\u00e1nh gi\u00e1 \u0111\u1eb7c \u0111i\u1ec3m u v\u00e0 h\u1ea1ch v\u1ec1 v\u1ecb tr\u00ed, k\u00edch th\u01b0\u1edbc v\u00e0 h\u00ecnh th\u00e1i<\/li>\n
            • \u0110\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng ph\u1eabu thu\u1eadt<\/li>\n
            • M\u1ed9t s\u1ed1 h\u00ecnh \u1ea3nh: \u0111\u00e1m m\u1edd r\u1ed1n ph\u1ed5i, x\u1eb9p ph\u1ed5i, h\u00ecnh \u1ea3nh th\u1ea3 b\u00f3ng (g\u1eb7p trong di c\u0103n ph\u1ed5i)<\/li>\n<\/ul>\n

              2.2. C\u1eaft l\u1edbp vi t\u00ednh l\u1ed3ng ng\u1ef1c:<\/h3>\n
                \n
              • \u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p c\u00f3 gi\u00e1 tr\u1ecb nh\u1ea5t<\/li>\n
              • Ph\u00e1t hi\u1ec7n ngay c\u1ea3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng nh\u1ecf, u kh\u00f3 ph\u00e1t hi\u1ec7n tr\u00ean X-quang<\/li>\n
              • \u0110\u00e1nh gi\u00e1 \u0111\u1eb7c \u0111i\u1ec3m t\u1ed5n th\u01b0\u01a1ng u v\u00e0 h\u1ea1ch:\n
                  \n
                • Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh u l\u00e0nh hay u \u00e1c<\/li>\n
                • \u0110\u00e1nh gi\u00e1 giai \u0111o\u1ea1n b\u1ec7nh: \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c giai \u0111o\u1ea1n T v\u00e0 N theo h\u1ec7 th\u1ed1ng TNM<\/li>\n<\/ul>\n<\/li>\n
                • Ti\u00ean l\u01b0\u1ee3ng cu\u1ed9c ph\u1eabu thu\u1eadt<\/li>\n<\/ul>\n

                  2.3. Sinh thi\u1ebft<\/h3>\n

                  C\u00f3 6 ph\u01b0\u01a1ng ph\u00e1p th\u01b0\u1eddng d\u00f9ng trong sinh thi\u1ebft m\u00f4 b\u1ec7nh h\u1ecdc \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 ph\u1ed5i:<\/p>\n

                    \n
                  • Sinh thi\u1ebft qua n\u1ed9i soi ph\u1ebf qu\u1ea3n:<\/strong> Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y ch\u1ec9 soi \u0111\u01b0\u1ee3c \u1edf nh\u1eefng ph\u1ebf qu\u1ea3n l\u1edbn, n\u00ean th\u1ef1c hi\u1ec7n \u1edf c\u00e1c u \u1edf v\u1ecb tr\u00ed trung t\u00e2m, kh\u00f4ng n\u00ean th\u1ef1c hi\u1ec7n khi kh\u1ed1i u \u1edf v\u00f9ng ngo\u1ea1i vi<\/li>\n
                  • Sinh thi\u1ebft qua th\u00e0nh ng\u1ef1c:<\/strong> Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y th\u00edch h\u1ee3p \u0111\u1ed1i v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u1edf ngo\u1ea1i vi<\/li>\n
                  • Sinh thi\u1ebft h\u1ea1ch trung th\u1ea5t qua n\u1ed9i soi trung th\u1ea5t:<\/strong> Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u01b0\u1ee3c d\u00f9ng khi ph\u00e1t hi\u1ec7n c\u00f3 h\u1ea1ch trung th\u1ea5t v\u00e0 c\u00e1c kh\u1ed1i u \u1edf ph\u1ed5i kh\u00f3 ti\u1ebfp c\u1eadn<\/li>\n
                  • Sinh thi\u1ebft m\u00e0ng ph\u1ed5i qua n\u1ed9i soi:<\/strong> Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u01b0\u1ee3c d\u00f9ng khi ph\u00e1t hi\u1ec7n tr\u00ean CT-scan c\u00f3 di c\u0103n m\u00e0ng ph\u1ed5i<\/li>\n
                  • Cell block d\u1ecbch m\u00e0ng ph\u1ed5i<\/strong><\/li>\n
                  • Sinh thi\u1ebft h\u1ea1ch c\u1ed5 ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng di c\u0103n<\/strong><\/li>\n<\/ul>\n

                    2.4. C\u00e1c ch\u1ea5t ch\u1ec9 \u0111i\u1ec3m ung th\u01b0 trong ung th\u01b0 ph\u1ed5i<\/h3>\n

                    Ngo\u00e0i 3 ph\u01b0\u01a1ng ph\u00e1p th\u01b0\u1eddng d\u00f9ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 ph\u1ed5i tr\u00ean, hi\u1ec7n nay ng\u01b0\u1eddi ta c\u00f2n x\u00e9t nghi\u1ec7m c\u00e1c marker sinh h\u1ecdc trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 theo d\u00f5i t\u00e1i ph\u00e1t, di c\u0103n hay \u0111\u00e1nh gi\u00e1 \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb.<\/p>\n

                    M\u1ed9t s\u1ed1 tumor marker c\u00f3 \u00fd ngh\u0129a tr\u00ean l\u00e2m s\u00e0ng nh\u01b0:<\/p>\n

                      \n
                    • CEA: t\u0103ng trong K bi\u1ec3u m\u00f4 tuy\u1ebfn<\/li>\n
                    • SCC: t\u0103ng trong K bi\u1ec3u m\u00f4 v\u1ea3y<\/li>\n
                    • CYFRA 21-1: type t\u1ebf b\u00e0o v\u1ea3y v\u00e0 bi\u1ec3u m\u00f4 tuy\u1ebfn<\/li>\n
                    • NSE, pro-GRP: t\u0103ng r\u1ea5t cao trong ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf<\/li>\n<\/ul>\n

                      2.5. C\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n<\/h3>\n

                      Sau khi \u0111\u00e3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c ung th\u01b0 ph\u1ed5i, \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n b\u1ec7nh, ta c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng c\u00e1c c\u1eadn l\u00e2m s\u00e0ng nh\u01b0:<\/p>\n

                        \n
                      • CT scan l\u1ed3ng ng\u1ef1c<\/li>\n
                      • Si\u00eau \u00e2m \u2013 CT \u1ed5 b\u1ee5ng<\/li>\n
                      • X\u1ea1 h\u00ecnh x\u01b0\u01a1ng<\/li>\n
                      • MRI s\u1ecd n\u00e3o<\/li>\n
                      • PET-CT<\/li>\n<\/ul>\n

                        D\u1ef1a v\u00e0o k\u1ebft qu\u1ea3 c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p tr\u00ean, b\u00e1c s\u0129 s\u1ebd \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n ung th\u01b0 ph\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n. Vi\u1ec7c \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n ung th\u01b0 ph\u1ed5i l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u00e0 ti\u00ean l\u01b0\u1ee3ng k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n

                        K\u1ebft lu\u1eadn<\/h2>\n

                        Vi\u1ec7c ph\u00e1t hi\u1ec7n tri\u1ec7u ch\u1ee9ng v\u00e0 ti\u1ebfn h\u00e0nh c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ung th\u01b0 ph\u1ed5i c\u00f3 \u00fd ngh\u0129a quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 ph\u00f2ng bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng g\u00e2y ra b\u1edfi c\u0103n b\u1ec7nh n\u00e0y. C\u00f9ng v\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a y h\u1ecdc hi\u1ec7n \u0111\u1ea1i, ch\u00fang ta c\u00f3 nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n v\u1edbi \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u cao gi\u00fap ph\u00e1t hi\u1ec7n ung th\u01b0 ph\u1ed5i khi ch\u00fang c\u00f2n \u1edf giai \u0111o\u1ea1n s\u1edbm.<\/p>\n","protected":false},"excerpt":{"rendered":"

                        Ung th\u01b0 ph\u1ed5i l\u00e0 b\u1ec7nh l\u00fd \u00e1c t\u00ednh ph\u1ed5 bi\u1ebfn nh\u1ea5t, chi\u1ebfm kho\u1ea3ng m\u1ed9t ph\u1ea7n ba s\u1ed1 ca t\u1eed vong do ung th\u01b0 v\u00e0 \u0111\u00e2y l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y t\u1eed vong li\u00ean quan \u0111\u1ebfn ung th\u01b0 \u1edf c\u1ea3 nam l\u1eabn n\u1eef, g\u00e2y ra g\u00e1nh n\u1eb7ng l\u1edbn \u0111\u1ebfn s\u1ee9c kh\u1ecfe to\u00e0n c\u1ea7u. Do \u0111\u00f3, ph\u00e1t hi\u1ec7n […]<\/p>\n","protected":false},"author":61,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[3],"yoast_head":"\nUng th\u01b0 ph\u1ed5i: t\u1eeb tri\u1ec7u ch\u1ee9ng \u0111\u1ebfn ch\u1ea9n \u0111o\u00e1n - Vinmec<\/title>\n<meta name=\"description\" content=\"Ph\u00e1t hi\u1ec7n s\u1edbm tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n \u0111\u00fang ung th\u01b0 ph\u1ed5i r\u1ea5t quan tr\u1ecdng trong vi\u1ec7c \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u00e0 nhanh ch\u00f3ng.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ung th\u01b0 ph\u1ed5i: t\u1eeb tri\u1ec7u ch\u1ee9ng \u0111\u1ebfn ch\u1ea9n \u0111o\u00e1n - 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