{"id":18928,"date":"2023-04-11T23:45:53","date_gmt":"2023-04-11T16:45:53","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18928"},"modified":"2023-04-12T10:16:22","modified_gmt":"2023-04-12T03:16:22","slug":"trat-khoi-xuong-tu-cot-co-tay-chan-doan-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/11\/trat-khoi-xuong-tu-cot-co-tay-chan-doan-dieu-tri\/","title":{"rendered":"Tr\u1eadt kh\u1ed1i x\u01b0\u01a1ng t\u1ee5 c\u1ed1t c\u1ed5 tay : ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

Trong c\u00e1c ho\u1ea1t \u0111\u1ed9ng , sinh ho\u1ea1t , lao \u0111\u1ed9ng v\u00e0 th\u1ec3 thao h\u1eb1ng ng\u00e0y , kh\u1edbp c\u1ed5 tay l\u00e0 m\u1ed9t trong nh\u1eefng kh\u1edbp d\u1ec5 b\u1ecb ch\u1ea5n th\u01b0\u01a1ng nh\u1ea5t . Tr\u1eadt kh\u1edbp x\u01b0\u01a1ng t\u1ee5 c\u1ed1t c\u1ed5 tay ( carpal dislocations ) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ch\u1ea5n th\u01b0\u01a1ng th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng g\u00e3y x\u01b0\u01a1ng kh\u00e1c l\u00e2n c\u1eadn , hi\u1ebfm khi x\u1ea3y ra th\u1eadt \u0111\u01a1n thu\u1ea7n , v\u00ec v\u1eady b\u1ec7nh l\u00fd n\u00e0y th\u01b0\u1eddng d\u1ec5 b\u1ecb b\u1ecf s\u00f3t v\u00e0 \u0111\u1ec3 l\u1ea1i h\u1eadu qu\u1ea3 l\u00e2u d\u00e0i cho b\u1ec7nh nh\u00e2n . c\u00e1c t\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p : tr\u1eadt thuy\u1ec1n- nguy\u1ec7t<\/a> , nguy\u1ec7t -c\u1ea3 , nguy\u1ec7t th\u00e1p , tr\u1eadt x\u01b0\u01a1ng thuy\u1ec1n \u0111\u01a1n \u0111\u1ed9c , tr\u1eadt tr\u1ee5 -c\u1ed5 tay\u00a0<\/strong><\/p>\n

Nh\u00f3m t\u00e1c gi\u1ea3 : PGS.TS Tr\u1ea7n Trung D\u0169ng , ThS Nguy\u1ec5n H\u1eefu M\u1ea1nh , Bs H\u1ed3 Minh Ng\u1ecdc\u00a0<\/span><\/p>\n

Ng\u00e0y ph\u00e1t h\u00e0nh :\u00a0<\/span><\/p>\n

1. Gi\u1ea3i ph\u1eabu<\/strong><\/h1>\n

Kh\u1ed1i x\u01b0\u01a1ng t\u1ee5 c\u1ed1t g\u1ed3m 8 x\u01b0\u01a1ng x\u1ebfp th\u00e0nh 2 h\u00e0ng tr\u00ean v\u00e0 d\u01b0\u1edbi t\u1ea1o th\u00e0nh m\u1ed9t r\u00e3nh. Ho\u1ea1t \u0111\u1ed9ng c\u1ee7a x\u01b0\u01a1ng nguy\u1ec7t \u0111\u00f3ng vai tr\u00f2 trung t\u00e2m<\/span><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 <\/span> \"\"<\/b><\/p>\n

 <\/p>\n

Gi\u1ea3i ph\u1eabu kh\u1ed1i x\u01b0\u01a1ng t\u1ee5 c\u1ed1t c\u1ed5 tay<\/span><\/p>\n

.<\/span>C\u00e1c x\u01b0\u01a1ng li\u00ean k\u1ebft ch\u1eb7t ch\u1ebd v\u1edbi nhau b\u1edfi c\u00e1c d\u00e2y ch\u1eb1ng c\u1ed5 tay nh\u01b0 d\u00e2y ch\u1eb1ng thuy\u1ec1n – nguy\u1ec7t, d\u00e2y ch\u1eb1ng nguy\u1ec7t th\u00e1p, d\u00e2y ch\u1eb1ng thuy\u1ec1n c\u1ea3…<\/span><\/p>\n

D\u00e2y ch\u1eb1ng v\u00f2ng m\u1eb7t tr\u01b0\u1edbc c\u1ed5 tay b\u00e1m v\u00e0o 2 m\u00e9p r\u00e3nh t\u1ea1o th\u00e0nh \u1ed1ng c\u1ed5 tay cho c\u00e1c g\u00e2n g\u1ea5p ng\u00f3n tay v\u00e0 TK gi\u1eefa \u0111i qua<\/span><\/p>\n

2. Nguy\u00ean nh\u00e2n v\u00e0 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng<\/b><\/h1>\n

C\u00f3 hai c\u01a1 ch\u1ebf’ ch\u1ea5n th\u01b0\u01a1ng d\u1eabn \u0111\u1ebfn tr\u1eadt kh\u1ed1i t\u1ee5 c\u1ed1t l\u00e0 c\u01a1 ch\u1ebf tr\u1ef1c ti\u1ebfp v\u00e0 c\u01a1 ch\u1ebf gi\u00e1n ti\u1ebfp. Trong c\u01a1 ch\u1ebf tr\u1ef1c ti\u1ebfp l\u1ef1c t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp v\u00e0o kh\u1ed1i t\u1ee5 c\u1ed1t b\u00e0n tay g\u00e2y tr\u1eadt kh\u1edbp th\u01b0\u1eddng g\u1eb7p !\u00e0 ng\u00e3 ch\u1ed1ng tay ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng tr\u1ef1c ti\u1ebfp t\u1ea1i v\u00f9ng c\u1ed5 tay, ngo\u00e0i ra, c\u00e1c tai n\u1ea1n lao \u0111\u1ed9ng nh\u01b0 c\u1ed5 tay b\u1ecb k\u1eb9t trong m\u00e1y v\u1eaft ho\u1eb7c m\u00e1y \u00e9p c\u0169ng c\u00f3 th\u1ec3 d\u1eabn t\u1edbi tr\u1eadt t\u1ee5 c\u1ed1t, khi \u0111\u00f3 m\u1eb7t l\u00f2ng c\u1ee7a c\u1ed5 tay b\u1ea5t ng\u1edd b\u1ecb va \u0111\u1eadp m\u1ea1nh g\u00e2y tr\u1eadt theo tr\u1ee5c c\u1ed5 tay.<\/span><\/p>\n

Trong c\u01a1 ch\u1ebf gi\u00e1n ti\u1ebfp l\u1ef1c t\u00e1c \u0111\u1ed9ng t\u1eeb xa g\u00e2y t\u1ed5n th\u01b0\u01a1ng kh\u1edbp trong \u0111\u1ea5y l\u1ef1c k\u00e9p \u0111\u01b0\u1ee3c truy\u1ec1n qua c\u00e1c d\u00e2y ch\u1eb1ng, l\u1ef1c n\u00e9n \u0111\u01b0\u1ee3c truy\u1ec1n qua c\u00e1c di\u1ec7n kh\u1edbp. C\u00e1c ch\u1ea5n th\u01b0\u01a1ng n\u1eb7ng nh\u01b0 ng\u00e3 cao ho\u1eb7c tai n\u1ea1n giao th\u00f4ng c\u00f3 th\u1ec3 d\u1eabn t\u1edbi tr\u1eadt t\u1ee5 c\u1ed1t, ngo\u00e0i ra v\u1eadn \u0111\u1ed9ng vi\u00ean \u1edf c\u00e1c m\u00f4n th\u1ec3 thao s\u1eed d\u1ee5ng b\u00f3ng th\u00f4ng qua b\u00e0n tay nh\u01b0 b\u00f3ng ch\u00e0y, b\u00f3ng r\u1ed5, b\u00f3ng b\u1ea7u d\u1ee5c… c\u0169ng l\u00e0 nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 nguy c\u01a1 cao g\u1eb7p ph\u1ea3i ch\u1ea5n th\u01b0\u01a1ng n\u00e0y.<\/span><\/p>\n

C\u00f9ng m\u1ed9t c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng, tuy nhi\u00ean t\u00f9y thu\u1ed9c v\u00e0o \u0111\u1ed9 tu\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c th\u01b0\u01a1ng t\u1ed5n kh\u00e1c nhau. Ch\u1eb3ng h\u1ea1n tai n\u1ea1n ng\u00e3 ch\u1ed1ng tay t\u01b0 th\u1ebf c\u1ed5 tay du\u1ed7i t\u1ed1i \u0111a c\u00f3 th\u1ec3 g\u00e2y g\u00e3y c\u00e0nh t\u01b0\u01a1i \u1edf tr\u1ebb nh\u1ecf\/g\u00e3y bong s\u1ee5n ti\u1ebfp h\u1ee3p \u1edf tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean\/g\u00e3y, tr\u1ec7t t\u1ee5 c\u1ed1t \u1edf ng\u01b0\u1eddi l\u1edbn tr\u1ebb tu\u1ed5i ho\u1eb7c g\u00e3y Pouteau – Colles \u1edf ng\u01b0\u1eddi cao tu\u1ed5i. V\u00ec v\u1eady, tu\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n c\u0169ng l\u00e0 m\u1ed9t g\u1ee3i \u00fd tr\u00ean l\u00e2m s\u00e0ng gi\u00fap ng\u01b0\u1eddi kh\u00e1m nh\u1eadn \u0111\u1ecbnh nh\u1eefng t\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 x\u1ea3y ra tr\u00ean b\u1ec7nh nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay.<\/span><\/p>\n

\"\"<\/p>\n

3. L\u00e2m s\u00e0ng\u00a0<\/strong><\/h1>\n

\u0110\u1eb7c \u0111i\u1ec3m chung c\u1ee7a c\u00e1c ch\u1ea5n th\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay l\u00e0 tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng ngh\u00e8o n\u00e0n v\u00e0 d\u1ec5 nh\u1ea7m l\u1eabn gi\u1eefa c\u00e1c lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng. C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p bao g\u1ed3m:<\/span><\/p>\n

    \n
  • S\u01b0ng n\u1ec1 nh\u1eb9, b\u1ea7m t\u00edm v\u00e0 \u0111au \u1edf v\u00f9ng mu b\u00e0n tay.<\/span><\/li>\n
  • \u0110au khi n\u1eafm tay, gi\u1ea3m s\u1ee9c c\u01a1 khi l\u1eb7p \u0111i l\u1eb7p l\u1ea1i.<\/span><\/li>\n
  • \u0110au t\u0103ng khi th\u1ef1c hi\u1ec7n \u0111\u1ed9ng t\u00e1c g\u1eadp, ng\u1eeda c\u1ed5 tay.<\/span><\/li>\n<\/ul>\n

    T\u00f9y v\u00e0o t\u1eebng lo\u1ea1i tr\u1eadt t\u1ee5 c\u1ed1t c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n th\u00f4ng qua c\u00e1c nghi\u1ec7m ph\u00e1p l\u00e2m s\u00e0ng ri\u00eang s\u00ea \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y d\u01b0\u1edbi \u0111\u00e2y.<\/span><\/p>\n

    4. ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00e2n lo\u1ea1i\u00a0<\/strong><\/h1>\n

    Tr\u1eadt tr\u1ee5 c\u1ed1t ph\u00e2n lo\u1ea1i theo Mayfield (1980) \u0111\u01b0\u1ee3c chia th\u00e0nh 4 lo\u1ea1i, ch\u1ee7 y\u1ebfu d\u1ef1a v\u00e0o t\u1ed5n th\u01b0\u01a1ng <\/span>quan s\u00e1t \u0111\u01b0\u1ee3c tr\u00ean ph\u01b0\u01a1ng ti\u1ec7n ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh X-quang, CT scan ho\u1eb7c MRI.<\/span><\/p>\n

    4.1 Tr\u1eadt kh\u1edbp thuy\u1ec1n – nguy\u1ec7t (xoay v\u00e0 b\u00e1n tr\u1eadt x\u01b0\u01a1ng thuy\u1ec1n)<\/b><\/h2>\n
      \n
    • L\u00e0 lo\u1ea1i tr\u1eadt ph\u1ed5 bi\u1ebfn v\u00e0 quan tr\u1ecdng nh\u1ea5t, g\u00e2y ra do t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng thuy\u1ec1n nguy\u1ec7t v\u00e0 d\u00e2y ch\u1eb1ng quay thuy\u1ec1n nguy\u1ec7t, d\u1eabn t\u1edbi 2 x\u01b0\u01a1ng thuy\u1ec3n v\u00e0 nguy\u1ec7t t\u00e1ch xa nhau.<\/span><\/li>\n
    • D\u00e2y ch\u1eb1ng thuy\u1ec1n nguy\u1ec7t c\u00f3 h\u00ecnh ch\u1eef <\/span>u <\/b>g\u1ed3m 3 ph\u1ea7n: ph\u1ea9n tr\u01b0\u1edbc, gi\u1eefa, sau.Trong \u0111\u00f3 ph\u1ea9n sau d\u00e0y nh\u1ea5t (3mm), ng\u1eafn c\u00f3 vai tr\u00f2 c\u1ed1 \u0111\u1ecbnh x\u01b0\u01a1ng thuy\u1ec1n. T\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng thuy\u1ec1n nguy\u1ec7t (r\u00e1ch ho\u00e0n to\u00e0n ph\u1ea7n sau) <\/span>\u0111\u1ee9t d\u00e2y ch\u1eb1ng quay nguy\u1ec7t m\u1edbi g\u00e2y tr\u1eadt thuy\u1ec1n nguy\u1ec7t.<\/span><\/li>\n<\/ul>\n
        \n
      • Tri\u1ec7u <\/span>ch\u1ee9ng k\u00edn \u0111\u00e1o, th\u01b0\u1eddng b\u1ecf s\u00f3t, l\u00e2u d\u00e0i d\u1eabn \u0111\u1ebfn Vi\u00eam tho\u00e1i h\u00f3a kh\u1edbp c\u1ed5 tay.<\/span><\/li>\n<\/ul>\n

        \"\"\"\"\"\"\"\"<\/p>\n

        \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\u00a0Watson test\u00a0<\/span><\/p>\n

          \n
        • Tr\u00ean X-quang; t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng thuy\u1ec1n – nguy\u1ec7t v\u1edbi d\u1ea5u hi\u1ec7u Terry Thomas \u0111\u1eb7c tr\u01b0ng (x\u01b0\u01a1ng thuy\u1ec1n v\u00e0 x\u01b0\u01a1ng nguy\u1ec7t t\u00e1ch nhau > 3mm tr\u00ean phim th\u1eb3ng – b\u00ecnh th\u01b0\u1eddng d\u01b0\u1edbi 2mm)<\/span><\/li>\n<\/ul>\n

          \"\"<\/p>\n

          D\u1ea5u hi\u1ec7u Terry Tilomas \u0111\u1eb7c tr\u01b0ng<\/p>\n

          4.2 Tr\u1eadt kh\u1edbp nguy\u1ec7t – c\u1ea3<\/b><\/h2>\n
            \n
          • L\u00e0 b\u1ec7nh l\u00fd chi\u1ebfm d\u01b0\u1edbi 10% c\u00e1c ch\u1ea5n th\u01b0\u01a1ng \u1edf v\u00f9ng c\u1ed5 tay.60% lo\u1ea1i tr\u1eadt n\u00e0y c\u00f3 k\u00e8m g\u00e3y x\u01b0\u01a1ng thuy\u1ec1n.<\/span><\/li>\n
          • Trong ch\u1ea5n th\u01b0\u01a1ng n\u00e0y, x\u01b0\u01a1ng thuy\u1ec1n \u1edf v\u1ecb tr\u00ed b\u00ecnh th\u01b0\u1eddng so v\u1edbi x\u01b0\u01a1ng quay, c\u00e1c x\u01b0\u01a1ng c\u00f2n l\u1ea1i c\u1ee7a kh\u1ed1i t\u1ee5 c\u1ed1t tr\u1eadt kh\u1ecfi v\u1ecb tr\u00ed ban \u0111\u1ea7u (ph\u1ea7n l\u1edbn l\u00e0 tr\u1eadt v\u1ec1 ph\u00eda m\u1eb7t mu tay), x\u01b0\u01a1ng nguy\u1ec7t khi \u0111\u00f3 b\u1ecb \u0111\u1ea9y v\u00e0o khe Poirier.<\/span><\/li>\n<\/ul>\n

            \"\"<\/p>\n

             <\/p>\n

            Khe Poirier<\/p>\n

            Tri\u1ec7u ch\u1ee9ng:<\/span><\/p>\n

              \n
            • Bi\u1ebfn d\u1ea1ng v\u00f9ng c\u1ed5 tay c\u00f3 th\u1ec3 r\u00f5 r\u00e0ng ho\u1eb7c k\u00edn \u0111\u00e1o.<\/span><\/li>\n
            • T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh gi\u1eefa d\u1eabn \u0111\u1ebfn h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay c\u1ea5p t\u00ednh.<\/span><\/li>\n<\/ul>\n

              H\u00ecnh \u1ea3nh X-quang quan s\u00e1t \u0111\u01b0\u1ee3c s\u1ef1 thay \u0111\u1ed5i v\u1ecb tr\u00ed c\u1ee7a c\u00e1c x\u01b0\u01a1ng t\u1ee5 c\u1ed1t, \u0111\u1eb7c bi\u1ec7t l\u00e0 h\u00e0ng x\u01b0\u01a1ng ph\u00eda tr\u00ean, x\u01b0\u01a1ng nguy\u1ec7t v\u1eabn \u1edf v\u1ecb tr\u00ed ban \u0111\u1ea7u, th\u1eb3ng tr\u1ee5c v\u1edbi x\u01b0\u01a1ng quay. C\u00f3 th\u1ec3 ch\u1ee5p th\u00eam c\u1eaft l\u1edbp vi t\u00ednh n\u1ebfu nghi ng\u1edd.<\/span>
              \n\"\"
              \n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/p>\n

              4.3 Tr\u1eadt kh\u1edbp nguy\u1ec7t – th\u00e1p<\/b><\/h2>\n

              Do t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng nguy\u1ec7t th\u00e1p, quay nguy\u1ec7t th\u00e1p tr\u01b0\u1edbc, quay nguy\u1ec7t th\u00e1p sau. <\/span>Nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 do ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c do qu\u00e1 tr\u00ecnh vi\u00eam, tho\u00e1i h\u00f3a.; ch\u1ec9 c\u1ea7n m\u1ed9t <\/span>t\u1ed5n th\u01b0\u01a1ng nh\u1ecf \u1edf d\u00e2y ch\u1eb1ng nguy\u1ec7t th\u00e1p c\u0169ng \u0111\u1ee7 \u0111\u1ec3 g\u00e2y ra tri\u1ec7u ch\u1ee9ng.<\/span><\/p>\n

              Tri\u1ec7u ch\u1ee9ng:<\/span><\/p>\n

                \n
              • s\u01b0ng n\u1ec1 v\u00f9ng quanh x\u01b0\u01a1ng th\u00e1p, s\u1edd m\u1eb7t mu m\u1ec1m.<\/span><\/li>\n
              • \u0110\u1eb7c tr\u01b0ng s\u1ef1 r\u1ed9ng ra \u1edf \u0111\u1ea7u xa x\u01b0\u01a1ng tr\u1ee5.<\/span><\/li>\n
              • T\u1ed5n th\u01b0\u01a1ng m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 g\u00e2y \u0111au v\u00f9ng c\u1ed5 tay v\u1ec1 ph\u00eda tr\u1ee5 kh\u00f4ng r\u00f5 r\u00e0ng.<\/span><\/li>\n
              • Ballottement test (shear test): khi di chuy\u1ec3n x\u01b0\u01a1ng th\u00e1p qua l\u1ea1i ph\u00eda mu – gan tay th\u00ec bi\u00ean \u0111\u1ed9 t\u0103ng h\u01a1n so v\u1edbi b\u00ecnh th\u01b0\u1eddng k\u00e8m ti\u1ebfng l\u1ee5c c\u1ee5c khi di \u0111\u1ed9ng.<\/span><\/li>\n<\/ul>\n

                \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><\/p>\n

                 <\/p>\n

                \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0C\u00e1ch kh\u00e1m Ballottement test<\/b><\/p>\n

                Trong tr\u1eadt nguy\u1ec7t – th\u00e1p, X-quang th\u1eb3ng \u00edt c\u00f3 gi\u00e1 tr\u1ecb (c\u00f3 th\u1ec3 th\u1ea5y s\u1ef1 m\u1ea5t li\u00ean t\u1ee5c c\u1ee7a h\u00e0ng x\u01b0\u01a1ng c\u1ed5 tay g\u1ea9n). Tr\u00ean X-quang nghi\u00eang, x\u01b0\u01a1ng th\u00e1p l\u1ec7ch v\u1ec1 ph\u00eda mu, ph\u1ee9c h\u1ee3p thuy\u1ec1n nguy\u1ec7t l\u1ec7ch v\u1ec1 ph\u00eda gan, g\u00f3c thuy\u1ec1n nguy\u1ec7t < 30\u00b0.<\/span><\/p>\n

                \"\"<\/p>\n

                S\u1ef1 di l\u1ec7ch c\u1ee7a c\u00e1c x\u01b0\u01a1ng t\u1ee5 c\u1ed1t trong tr\u1eadt nguy\u1ec7t – th\u00e1p Trong \u0111\u00f3 c\u00e1c \u0111\u01b0\u1eddng: ss – Tr\u1ee5c x\u01b0\u01a1ng thuy\u1ec1n, LL – Tr\u1ee5c x\u01b0\u01a1ng nguy\u1ec7t, cc – Tr\u1ee5c x\u01b0\u01a1ng c\u1ea3<\/p>\n

                \u00a0 <\/b><\/p>\n

                \"\"\"\"<\/p>\n

                Tr\u1eadt nguy\u1ec7t – th\u00e1p tr\u00ean phim X-quang nghi\u00eang\u00a0
                \n<\/span><\/p>\n

                4.4 Tr\u1eadt x\u01b0\u01a1ng nguy\u1ec7t<\/b><\/h2>\n

                L\u00e0 m\u1ed9t t\u1ed5n th\u01b0\u01a1ng r\u1ea5t n\u1eb7ng v\u00e0 hi\u1ebfm g\u1eb7p. C\u00f3 t<\/span>h\u1ec3 g\u1eb7p \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh v\u1edbi c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng tr\u1ef1c ti\u1ebfp, b\u1ecb l\u1ef1c t\u00e1c \u0111\u1ed9ng m\u1ea1nh v\u00e0o v\u00f9ng c\u1ed5 tay. Khi \u0111\u00f3, x\u01b0\u01a1ng nguy\u1ec7t di l\u1ec7ch v\u1ec1 l\u00f2ng b\u00e0n tay, ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a x\u01b0\u01a1ng c\u1ed5 tay \u1edf v\u1ecb tr\u00ed b\u00ecnh th\u01b0\u1eddng so v\u1edbi x\u01b0\u01a1ng quay.<\/span><\/p>\n

                Tr\u1eadt x\u01b0\u01a1ng nguy\u1ec7t \u0111\u01a1n \u0111\u1ed9c ch\u1ec9 x\u1ea3y ra khi t\u1ed5n th\u01b0\u01a1ng t\u1ea5t c\u1ea3 c\u00e1c d\u00e2y ch\u1eb1ng quanh nguy\u1ec7t, \u0111\u00e1ng k\u1ec3 l\u00e0 d\u00e2y ch\u1eb1ng quay nguy\u1ec7t sau, v\u00ec v\u1eady m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng r\u1ea5t n\u1eb7ng n\u1ec1, \u0111\u1ed5ng th\u1eddi nguy c\u01a1 bi\u1ebfn ch\u1ee9ng l\u00e0 r\u1ea5t l\u1edbn. V\u00ec v\u1eady ch\u1ea5n th\u01b0\u01a1ng n\u00e0y \u0111\u00f2i h\u1ecfi ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt.<\/span><\/p>\n

                Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a tr\u1eadt x\u01b0\u01a1ng nguy\u1ec7t t\u01b0\u01a1ng t\u1ef1 v\u1edbi c\u00e1c lo\u1ea1i tr\u1eadt t\u1ee5 c\u1ed1t kh\u00e1c. Tuy nhi\u00ean, nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay c\u1ea5p t\u00ednh. Khi \u0111\u00f3 c\u1ea9n ngh\u0129 \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng tr\u1eadt x\u01b0\u01a1ng nguy\u1ec7t.<\/span><\/p>\n

                \"\"<\/p>\n

                Tr\u00ean X-quang, tr\u1eadt x\u01b0\u01a1ng nguy\u1ec7t \u0111\u01a1n \u0111\u1ed9c c\u00f3 t<\/span>h\u1ec3 quan s\u00e1t d\u1ec5 d\u00e0ng \u1edf t\u01b0 th\u1ec3 ch\u1ee5p nghi\u00eang, x\u01b0\u01a1ng thuy\u1ec1n b\u1eadt ra kh\u1ecfi v\u1ecb tr\u00ed th\u00f4ng th\u01b0\u1eddng, xu\u1ea5t hi\u1ec7n \u0111\u01a1n \u0111\u1ed9c \u1edf ph\u00eda gan tay, c\u00e1c x\u01b0\u01a1ng c\u00f2n l\u1ea1i c\u1ee7a kh\u1ed1i t\u1ee5 c\u1ed1t \u1edf v\u1ecb tr\u00ed b\u00ecnh th\u01b0\u1eddng.<\/span><\/p>\n

                 <\/p>\n

                \"\"<\/p>\n

                T\u1ed5n th\u01b0\u01a1ng tr\u1eadt x\u01b0\u01a1ng nguy\u1ec7t \u0111\u01a1n \u0111\u1ed9c tr\u00ean X-quang<\/p>\n

                4.5 Tr\u1eadt tr\u1ee5<\/b>-C\u1ed5 <\/b>tay<\/b><\/h2>\n

                Kh\u00f4ng n\u1eb1m trong ph\u00e2n lo\u1ea1i c\u1ee7a Mayfield, tuy nhi\u00ean tr\u1eadt – tr\u1ee5 c\u1ed5 tay c\u0169ng l\u00e0 m\u1ed9t t\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 g\u1eb7p trong ch\u1ea5n th\u01b0\u01a1ng c\u1ed5 tay v\u1edbi c\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u1ef1 c\u00e1c lo\u1ea1i tr\u1eadt t\u1ee5 c\u1ed1t.<\/span><\/p>\n

                Trong lo\u1ea1i tr\u1eadt n\u00e0y, th\u00e0nh ph\u1ea7n\u00a0 b\u1ecb t\u1ed5n th\u01b0\u01a1ng l\u00e0 ph\u1ee9c h\u1ee3p s\u1ee5n s\u1ee3i tam gi\u00e1c TFCC (Triangular Fibrocartilage Complex ). Ph\u1ee9c h\u1ee3p n\u00e0y c\u00f3 nhi\u1ec7m v\u1ee5 k\u1ebft n\u1ed1i x\u01b0\u01a1ng tr\u1ee5 v\u1edbi x\u01b0\u01a1ng nguy\u1ec7t n\u00f3i ri\u00eang hay c\u1ea3 kh\u1ed1i t\u1ee5 c\u1ed1t n\u00f3i chung. T\u1ed5n th\u01b0\u01a1ng ph\u1ee9c h\u1ee3p n\u00e0y khi\u1ebfn m\u1ea5t s\u1ef1 li\u00ean quan gi\u1eefa x\u01b0\u01a1ng tr\u1ee5 v\u00e0 kh\u1ed1i t\u1ee5 c\u1ed1t, d\u1eabn \u0111\u1ebfn h\u1ea1n ch\u1ebf g\u1ea5p du\u1ed7i c\u1ed5 tay.<\/span><\/p>\n

                 <\/p>\n

                \"\"\"\"<\/p>\n

                 <\/p>\n

                \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0V\u1ecb tr\u00ed c\u1ee7a ph\u1ee9c h<\/b>\u1ee3p s<\/b>\u1ee5n s\u1ee3i tam gi\u00e1c\u00a0\u00a0<\/b><\/p>\n

                B\u1ec7nh nh\u00e2n th\u01b0\u1eddng v\u00e0o vi\u1ec7n v\u1edbi tri\u1ec7u ch\u1ee9ng \u0111au c\u1ed5 tay ph\u00eda tr\u1ee5 (t\u0103ng khi ng\u1eeda c\u1ed5 tay), nghe th\u1ea5y ti\u1ebfng l\u1ee5c c\u1ee5c khi xoay c\u1ed5 tay. D\u1ea5u hi\u1ec7u piano (b\u1eadp b\u1ec1nh khi \u1ea5n \u0111au d\u01b0\u1edbi x\u01b0\u01a1ng quay v\u00e0 x\u01b0\u01a1ng tr\u1ee5) l\u00e0 d\u1ea5u hi\u1ec7u s\u1eed d\u1ee5ng \u0111\u1ec3 nh\u1eadn bi\u1ebft t\u1ed5n th\u01b0\u01a1ng n\u00e0y.<\/span><\/p>\n

                Tr\u00ean X-quang, d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng l\u00e0 s\u1ef1 t\u00e1ch xa \u0111\u1ea7u d\u01b0\u1edbi 2 x\u01b0\u01a1ng quay v\u00e0 tr\u1ee5, \u0111\u00f4ng th\u1eddi kh\u00f4ng c\u00f3 g\u00e3y m\u1ecfm tr\u00e2m tr\u1ee5 k\u00e8m theo.<\/span><\/p>\n

                 <\/p>\n

                \"\"<\/p>\n

                D\u1ea5u hi\u1ec7u g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng TFCC tr\u00ean X-quang (ph\u1ea3i), h\u00ecnh \u1ea3nh b\u00ecnh th\u01b0\u1eddng (tr\u00e1i)<\/p>\n

                N\u1ebfu tr\u00ean l\u00e2m s\u00e0ng ng\u01b0\u1eddi kh\u00e1m ngh\u0129 t\u1edbi t\u1ed5n th\u01b0\u01a1ng tr\u1eadt tr\u1ee5 – c\u1ed5 tay nh\u01b0ng kh\u00f4ng th\u1ea5y d\u1ea5u hi\u1ec7u t\u00e1ch xa \u0111\u00e1u d\u01b0\u1edbi 2 x\u01b0\u01a1ng quay tr\u1ee5 tr\u00ean X-quang, ch\u1ee5p MRI c\u00f3 th\u1ec3 gi\u00fap \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y.<\/span><\/p>\n

                 <\/p>\n

                \"\"<\/p>\n

                \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\u00a0H\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng ph\u1ee9c h\u1ee3p s\u1ee3i tam gi\u00e1c tr\u00ean phim MRI<\/b><\/p>\n

                5. \u0111i\u1ec1u tr\u1ecb\u00a0<\/strong><\/h1>\n

                Nh\u00ecn chung, \u0111i\u1ec1u tr\u1ecb cho c\u00e1c lo\u1ea1i tr\u1eadt kh\u1edbp t\u1ee5 c\u1ed1t t\u01b0\u01a1ng \u0111\u1ed1i kh\u00f3 kh\u0103n, \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n \u00edt c\u00f3 k\u1ebft qu\u1ea3, \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt c\u0169ng ch\u1ec9 \u0111\u01b0\u1ee3c \u0111\u1eb7t ra v\u1edbi 1 s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3, \u0111\u1ed3ng th\u1eddi, c\u00f3 nguy c\u01a1 t\u00e1i ph\u00e1t v\u00e0 bi\u1ebfn ch\u1ee9ng cao.<\/span><\/p>\n

                Tr\u1eadt thuy\u1ec1n nguy\u1ec7t<\/b><\/p>\n

                  \n
                • C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n kh\u00f4ng l\u00e0m gi\u1ea3m \u0111\u01b0\u1ee3c kho\u1ea3ng c\u00e1ch 2 x\u01b0\u01a1ng.<\/span><\/li>\n
                • Ph\u1eabu thu\u1eadt:<\/span><\/li>\n<\/ul>\n

                  + K\u1ebft h\u1ee3p s\u1eed d\u1ee5ng ghim \u0111inh Kirschner v\u00e0 bu\u1ed9c ch\u1ec9 th\u00e9p xuy\u00ean x\u01b0\u01a1ng \u0111\u1ec3 \u0111\u01b0a 2 x\u01b0\u01a1ng thuy\u1ec1n nguy\u1ec7t v\u1ec1 v\u1ecb tr\u00ed ban \u0111\u1ea7u.<\/span><\/p>\n

                  + Trong tr\u01b0\u1eddng h\u1ee3p tr\u1eadt m\u1ea1n t\u00ednh, chuy\u1ec3n \u0111i\u1ec3m b\u00e1m d\u00e2y ch\u1eb1ng, t\u00e1i t\u1ea1o x\u01b0\u01a1ng – g\u00e2n – x\u01b0\u01a1ng.<\/span><\/p>\n

                  \"\" \"\"<\/p>\n

                  Ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb tr\u1eadt thuy\u1ec1n – nguy\u1ec7t c\u1ea5p v\u00e0 m\u1ea1n t\u00ednh<\/span><\/p>\n

                  Tr\u1eadt nguy\u1ec7t – c\u1ea3<\/b><\/p>\n

                  H\u00ecnh th\u00e1i tr\u1eadt n\u00e0y d\u1eabn t\u1edbi nguy c\u01a1 cao t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh gi\u1eefa, ch\u00e8n \u00e9p d\u1eabn t\u1edbi h\u1ed9i ch\u1ee9ng khoang v\u00e0 h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay m\u00e3n t\u00ednh. C\u1ea7n thi\u1ebft ph\u1eabu thu\u1eadt m\u1edf \u0111\u1eb7t l\u1ea1i v\u1ecb tr\u00ed c\u00e1c x\u01b0\u01a1ng v\u00e0 s\u1eeda l\u1ea1i d\u00e2y ch\u1eb1ng.<\/span><\/p>\n

                  M\u1eb7c d\u00f9 \u0111i\u1ec1u tr\u1ecb, nguy c\u01a1 tho\u00e1i h\u00f3a kh\u1edbp sau n\u00e0y v\u1eabn l\u00e0 r\u1ea5t cao – x\u1ea5p x\u1ec9 60%, c\u0169ng nh\u01b0 bi\u1ebfn ch\u1ee9ng DISI ho\u1eb7c VIS1. Ngo\u00e0i ra, khi g\u00e3y x\u01b0\u01a1ng thuy\u1ec1n k\u00e8m theo tr\u1eadt nguy\u1ec7t c\u1ea3 th\u00ec t\u1ec9 l\u1ec7 kh\u00f4ng li\u1ec1n x\u01b0\u01a1ng c\u0169ng s\u1ebd t\u0103ng l\u00ean r\u1ea5t cao.<\/span><\/p>\n

                  Tr\u1eadt nguy\u1ec7t – th\u00e1p<\/b><\/p>\n

                  \u0110i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n c\u00f3 th\u1ec3 \u0111\u1eb7t ra, tuy nhi\u00ean ch\u1ec9 \u00e1p d\u1ee5ng v\u1edbi t\u1ed5n th\u01b0\u01a1ng m\u1ee9c \u0111\u1ed9 nh\u1eb9. Ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt ghim \u0111inh Kirschner d\u01b0\u1edbi m\u00e0n t\u0103ng s\u00e1ng \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng, N\u1ebfu th\u1ea5t b\u1ea1i, chuy\u1ec3n m\u1ed5 m\u1edf k\u1ebft h\u1ee3p x\u01b0\u01a1ng.<\/span><\/p>\n

                  Tr\u1eadt x\u01b0\u01a1ng nguy\u1ec7t<\/b><\/p>\n

                  T\u01b0\u01a1ng t\u1ef1 nh\u01b0 tr\u1eadt nguy\u1ec7t – c\u1ea3, tr\u1eadt x\u01b0\u01a1ng nguy\u1ec7t \u0111\u01a1n \u0111\u1ed9c c\u0169ng d\u1eabn t\u1edbi nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh gi\u1eefa, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay. V\u00ec v\u1eady, ph\u1eabu thu\u1eadt m\u1edf l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng.<\/span><\/p>\n

                  6. Bi\u1ebfn ch\u1ee9ng\u00a0<\/strong><\/h1>\n

                  \u0110a ph\u1ea7n c\u00e1c tr\u1eadt kh\u1edbp t\u1ee5 c\u1ed1t cho d\u00f9 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb s\u1edbm v\u00e0 t\u00edch c\u1ef1c v\u1eabn c\u00f3 nguy c\u01a1 cao \u0111\u1ec3 l\u1ea1i di ch\u1ee9ng h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay, \u0111au m\u1ea1n t\u00ednh v\u00e0 tho\u00e1i h\u00f3a kh\u1edbp c\u1ed5 tay sau n\u00e0y.<\/span><\/p>\n

                  B\u00ean c\u1ea1nh \u0111\u00f3, \u0111a ph\u1ea7n c\u00e1c lo\u1ea1i tr\u1eadt kh\u1edbp n\u00e0y n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi s\u1ebd d\u1eabn \u0111\u1ebfn 2 lo\u1ea1i bi\u1ebfn d\u1ea1ng: g\u1ea5p kh\u00fac c\u1ed5 tay m\u1eadt mu (DISI – Dorsal Intercalated Segment Instability) v\u00e0 g\u1ea5p kh\u00fac c\u1ed5 tay m\u1eb7t gan (VI5I \u2014 Volar Intercalated Segment Instability).<\/span><\/p>\n

                    \n
                  • DISI; t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng thuy\u1ec1n nguy\u1ec7t, g\u00f3c thuy\u1ec1n nguy\u1ec7t >60\u00b0, g\u00f3c c\u1ea3 – nguy\u1ec7t >30\u00b0<\/span><\/li>\n
                  • VISI: g\u00f3c thuy\u1ec1n nguy\u1ec7t <30\u00b0, g\u00f3c c\u1ea3 – nguy\u1ec7t >30\u00b0<\/span><\/li>\n<\/ul>\n

                    7.K\u1ebft lu\u1eadn\u00a0<\/strong><\/h1>\n

                    Tr\u1eadt kh\u1ed1i x\u01b0\u01a1ng t\u1ee5 c\u1ed1t c\u1ed5 tay l\u00e0 m\u1ed9t t\u1ed5n th\u01b0\u01a1ng kh\u00f3 ph\u00e1t hi\u1ec7n, d\u00ea b\u1ecb b\u1ecf qua khi th\u0103m kh\u00e1m, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi kh\u00f4ng c\u00f3 m\u1ed9t t\u1ed5n th\u01b0\u01a1ng g\u00e3y x\u01b0\u01a1ng \u0111i k\u00e8m. \u0110\u1ed3ng th\u1eddi, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u00f2n h\u1ea1n ch\u1ebf, t\u1ec9 l\u1ec7 \u0111\u1ec3 l\u1ea1i di ch\u1ee9ng cao.<\/span><\/p>\n

                    \u0110\u1ec3 tr\u00e1nh b\u1ecf s\u00f3t t\u1ed5n th\u01b0\u01a1ng n\u00e0y, tr\u00ean l\u00e2m s\u00e0ng c\u1ea7n ch\u00fa \u00fd \u0111\u1ebfn c\u01a1 ch\u1ebf tai n\u1ea1n, \u0111\u1ed9 tu\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n, s\u1eed d\u1ee5ng c\u00e1c test th\u0103m kh\u00e1m, ch\u00fa \u00fd c\u00e1c d\u1ea5u hi\u1ec7u \u0111\u1eb7c bi\u1ec7t tr\u00ean X-quang, s\u1eed d\u1ee5ng th\u00eam c\u00e1c c\u00f4ng c\u1ee5 ch\u1ea9n \u0111o\u00e1n\u00a0<\/span><\/p>\n

                     <\/p>\n","protected":false},"excerpt":{"rendered":"

                    Trong c\u00e1c ho\u1ea1t \u0111\u1ed9ng , sinh ho\u1ea1t , lao \u0111\u1ed9ng v\u00e0 th\u1ec3 thao h\u1eb1ng ng\u00e0y , kh\u1edbp c\u1ed5 tay l\u00e0 m\u1ed9t trong nh\u1eefng kh\u1edbp d\u1ec5 b\u1ecb ch\u1ea5n th\u01b0\u01a1ng nh\u1ea5t . Tr\u1eadt kh\u1edbp x\u01b0\u01a1ng t\u1ee5 c\u1ed1t c\u1ed5 tay ( carpal dislocations ) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ch\u1ea5n th\u01b0\u01a1ng th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng g\u00e3y […]<\/p>\n","protected":false},"author":9,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[40],"tags":[3],"yoast_head":"\nTr\u1eadt kh\u1ed1i x\u01b0\u01a1ng t\u1ee5 c\u1ed1t c\u1ed5 tay : ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"t\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p : tr\u1eadt thuy\u1ec1n- nguy\u1ec7t , nguy\u1ec7t -c\u1ea3 , nguy\u1ec7t th\u00e1p , tr\u1eadt x\u01b0\u01a1ng thuy\u1ec1n \u0111\u01a1n \u0111\u1ed9c , tr\u1eadt tr\u1ee5 -c\u1ed5 tay\u00a0\" \/>\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=\"Tr\u1eadt kh\u1ed1i x\u01b0\u01a1ng t\u1ee5 c\u1ed1t c\u1ed5 tay : ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb - 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