{"id":19356,"date":"2023-04-12T19:18:09","date_gmt":"2023-04-12T12:18:09","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19356"},"modified":"2023-04-21T10:03:03","modified_gmt":"2023-04-21T03:03:03","slug":"gioi-thieu-dieu-tri-trong-trat-khop-vai-tai-dien","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/gioi-thieu-dieu-tri-trong-trat-khop-vai-tai-dien\/","title":{"rendered":"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb trong tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n"},"content":{"rendered":"<p><strong>Tr\u1eadt kh\u1edbp vai l\u00e0 s\u1ef1 m\u1ea5t ti\u1ebfp x\u00fac c\u1ee7a di\u1ec7n kh\u1edbp \u1ed5 ch\u1ea3o v\u00e0 ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay. Tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n l\u00e0 t\u00ecnh tr\u1ea1ng tr\u1eadt kh\u1edbp vai t\u1eeb l\u1ea7n 2 tr\u1edf l\u00ean (th\u01b0\u1eddng tr\u00ean 10 l\u1ea7n), sau b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u1ef1 n\u1eafn \u0111\u01b0\u1ee3c. Th\u00f4ng qua b\u00e0i vi\u1ebft, ch\u00fang t\u00f4i s\u1ebd gi\u1edbi thi\u1ec7u v\u1ec1 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb trong tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n.<\/strong><\/p>\n<p><strong>Nh\u00f3m t\u00e1c gi\u1ea3:<\/strong> PGS. TS \u0110inh Ng\u1ecdc S\u01a1n, BS CKII V\u0169 Tr\u01b0\u1eddng Th\u1ecbnh<\/p>\n<p><strong>Ng\u00e0y ph\u00e1t h\u00e0nh<\/strong>: 30\/03\/2022<\/p>\n<h2><strong>1. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t<\/strong><strong>r\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n ra tr\u01b0\u1edbc<\/strong><\/h2>\n<p><strong>1.1 \u0110i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">\u0110i\u1ec1u tr\u1ecb <\/span>kh\u00f4ng <span style=\"font-weight: 400;\">ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem x\u00e9t \u1edf c\u00e1c b\u1ec7nh nh\u00e2n sau:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">S\u1ee9c kh\u1ecfe b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u1ea3m b\u1ea3o cho qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">B\u1ec7nh nh\u00e2n ch\u01b0a \u0111i\u1ec1u tr\u1ecb g\u00ec tr\u01b0\u1edbc ch\u1ea5n th\u01b0\u01a1ng.<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n tr\u1eadt vai t\u00e1i di\u1ec5n kh\u00f4ng do ch\u1ea5n th\u01b0\u01a1ng (R\u1ed1i lo\u1ea1n th\u1ea7n kinh c\u01a1)<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">V\u1eadt l\u00fd tr\u1ecb li\u1ec7u l\u00e0 c\u01a1 s\u1edf ch\u00ednh cho ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt: t\u1eadp trung t\u0103ng c\u01b0\u1eddng s\u1ee9c m\u1ea1nh c\u1ee7a h\u1ec7 th\u1ed1ng. \u1ed4n \u0111\u1ecbnh \u0111\u1ed9ng kh\u1edbp vai bao g\u1ed3m c\u00f3 ch\u00f3p xoay, c\u01a1 Delta, c\u01a1 ng\u1ef1c l\u1edbn, c\u00e1c c\u01a1 \u0111ai vai.<\/span><\/li>\n<\/ul>\n<p><strong>1.2 \u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt<\/strong><\/p>\n<p><strong>1.2.1 Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/p>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Sau l\u1ea7n tr\u1eadt kh\u1edbp \u0111\u1ea7u ti\u00ean \u1edd nh\u00f3m b\u1ec7nh nh\u00e2n l\u00e0 nam gi\u1edbi, tr\u1ebb (d\u01b0\u1edbi 30 tu\u1ed5i) v\u00e0 tham gia ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao v\u00ec \u0111\u00e2y l\u00e0 nh\u00f3m c\u00f3 nguy c\u01a1 t\u00e1i ph\u00e1t cao (t\u1ef7 l\u1ec7 t\u00e1i ph\u00e1t kho\u1ea3ng 67%)<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n ra tr\u01b0\u1edbc th\u1ea5t b\u1ea1i sau \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt, bao g\u1ed3m c\u1ea3 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng. C\u00e1c tri\u1ec7u ch\u1eedng c\u01a1 h\u1ecdc, \u0111au v\u00e0 c\u1ea3m gi\u00e1c m\u1ea5t v\u1eebng ph\u00eda tr\u01b0\u1edbc, nghi\u1ec7m ph\u00e1p \u201ce s\u1ee3\u201d d\u01b0\u01a1ng t\u00ednh trong qu\u00e1 tr\u00ecnh kh\u00e1m l\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh ph\u00f9 h\u1ee3p v\u1edbi m\u1ed9t t\u1ed5n th\u01b0\u01a1ng r\u00e1ch s\u1ee5n vi\u1ec1n tr\u01b0\u1edbc d\u01b0\u1edbi v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p kh\u00e1c: Hill &#8211; Sach, HAGL,&#8230;<\/span><\/li>\n<\/ul>\n<p><strong>1.2.2 Ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">Nh\u01b0 \u0111\u00e3 n\u00eau \u1edf tr\u00ean, tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n ra tr\u01b0\u1edbc l\u00e0 ph\u1ed5 bi\u1ec3n chi\u1ebfm kho\u00e1ng 95%. C\u00f3 h\u01a1n 150 ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt v\u00e0 nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p s\u1eeda \u0111\u1ed5i \u0111\u01b0\u1ee3c ngh\u0129 ra cho \u0111i\u1ec1u tr\u1ecb ch\u1ea5n th\u01b0\u01a1ng tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n ra tr\u01b0\u1edbc. Kh\u00f4ng c\u00f3 ph\u01b0\u01a1ng ph\u00e1p n\u00e0o l\u00e0 t\u1ed1t nh\u1ea5t. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u01b0\u1ee3c nh\u1ea5n m\u1ea1nh quan tr\u1ecdng trong vi\u1ec7c \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 th\u00e0nh c\u00f4ng l\u00e0 chuy\u00ean m\u00f4n \u0111\u1ea7y \u0111\u1ee7 v\u00e0 k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt ch\u00ednh x\u00e1c. T\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd c\u1ea9n \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh, v\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p n\u00ean \u0111\u01b0\u01a1c th\u1ef1c hi\u1ec7n \u0111\u00ea s\u1eeda ch\u1eefa t\u1ed1t nh\u1ea5t t\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu. L\u00fd t\u01b0\u1edfng nh\u1ea5t, ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt l\u1ef1a ch\u1ecdn cho \u0111i\u1ec1u tr\u1ecb tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n ra tr\u01b0\u1edbc n\u00ean bao g\u1ed3m c\u00e1c y\u1ebfu sau:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ef7 l\u1ec7 t\u00e1i ph\u00e1t th\u1ea5p<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ef7 l\u1ec7 bi\u1ec3n ch\u1ee9ng th\u1ea5p<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ef7 l\u1ec7 ph\u1eabu thu\u1eadt l\u1ea1i th\u1ea5p<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u00f4ng vi\u00eam kh\u1edbp<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Duy tr\u00ec t\u1ea7m v\u1eadn \u0111\u1ed9ng<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00c1p d\u1ee5ng trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cho ph\u00e9p quan s\u00e1t to\u00e0n b\u1ed9 <\/span>kh\u1edbp<\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">M\u1ee9c \u0111\u1ed9 kh\u00f4i ph\u1ee5c t\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu b\u1ec7nh<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt kh\u00f4ng qu\u00e1 kh\u00f3<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Nh\u00ecn chung t\u1ea5t c\u1ea3 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c chia th\u00e0nh hai d\u1ea1ng ch\u00ednh hi\u1ec7n \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0 m\u1ed5 m\u1edf v\u00e0 m\u1ed5 n\u1ed9i soi, c\u1ea3 hai ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ec1u c\u00f3 th\u1ebf s\u1eeda ch\u1eefa c\u00e1c t\u1ed5n th\u01b0\u01a1ng. Nhi\u1ec1u nghi\u00ean c\u1eedu b\u00e1o c\u00e1o k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng l\u00e0 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng gi\u1eefa hai ph\u01b0\u01a1ng ph\u00e1p tr\u00ean.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Cho d\u00f9 m\u1ed9t k\u1ef9 thu\u1eadt m\u1ed5 m\u1edf hay m\u1ed5 n\u1ed9i soi \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn, m\u1ee5c ti\u00eau c\u1ee7a ph\u1eabu thu\u1eadt l\u00e0:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u00f4i ph\u1ee5c s\u1eeda ch\u1eefa l\u1ea1i c\u00e1c t\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu: t\u1ed5n th\u01b0\u01a1ng Bankart, t\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sach&#8230;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ea3o t\u1ed3n t\u1ed1i \u0111a t\u1ea7m v\u1eadn \u0111\u1ed9ng c\u1ee7a kh\u1edbp vai.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ch\u1ed1ng tr\u1eadt th\u00e0nh c\u00f4ng<\/span><\/li>\n<\/ul>\n<h2><strong>2. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt m\u1ed5 m\u1edf<\/strong><\/h2>\n<p><b>2.1 Ph\u1eabu thu\u1eadt Bankart<\/b><\/p>\n<p><strong>2.1.1 Chu\u1ea9n b\u1ecb d\u1ee5ng c\u1ee5 v\u00e0 b\u1ec7nh nh\u00e2n<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c g\u00e2y m\u00ea, chu\u1ea9n b\u1ecb m\u1ed5 \u1edf t\u01b0 th\u1ebf n\u1eeda n\u1eb1m n\u1eeda ng\u1ed3i (semisitting) ho\u1eb7c t\u01b0 th\u1ebf Beach chair, n\u1eb1m s\u00e1t m\u00e9p b\u00e0n m\u1ed5.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ed9 d\u1ee5ng c\u1ee5 m\u1edf kh\u1edbp vai ti\u00eau chu\u1ea9n<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">M\u0169i kh\u00e2u neo (anchors) \u0111\u1ec3 kh\u00e2u s\u1ee5n vi\u1ec1n ho\u1eb7c bao kh\u1edbp khi c\u1ea7n thi\u1ebft<\/span><\/li>\n<\/ul>\n<div class=\"mceTemp\"><\/div>\n<p><strong>2.1.2 \u0110\u01b0\u1eddng m\u1ed5 v\u00e0 c\u00e1ch th\u1ee9c ph\u1eabu thu\u1eadt<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">V\u1ebd c\u00e1c \u0111i\u1ec3m m\u1ed1c x\u01b0\u01a1ng tr\u00ean da ba<\/span><span style=\"font-weight: 400;\">o g\u1ed3m: m\u1ecfm c\u00f9ng vai, x\u01b0\u01a1ng \u0111\u00f2n, kh\u1edbp c\u00f9ng \u0111\u00f2n, gai vai v\u00e0 m\u1ecfm qu\u1ea1.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">R\u1ea1ch da <\/span>chi\u1ec1u <span style=\"font-weight: 400;\">d\u00e0i kho\u1ea3ng 5 &#8211; 8 cm. B\u1eaft \u0111\u1ea7u t\u1eeb v\u1ecb tr\u00ed b\u00ean d\u01b0\u1edbi m\u1ecfm qu\u1ea1 2 cm v\u00e0 m\u1edf r\u1ed9ng v\u1ebft r\u1ea1ch xu\u1ed1ng ph\u00eda d\u01b0\u1edbi d\u1ecdc theo \u0111\u01b0\u1eddng n\u00e1ch tr\u01b0\u1edbc (R\u00e0nh Delta &#8221; Ng\u1ef1c): x\u00e1c \u0111\u1ecbnh kho\u1ea3ng Delta <\/span><span style=\"font-weight: 400;\">ng\u1ef1c <\/span>v\u00e0 t\u0129nh <span style=\"font-weight: 400;\">m\u1ea1ch \u0111\u1ea7u, <\/span>th\u01b0\u1eddng <span style=\"font-weight: 400;\">l\u00e0 m\u1ed9t \u0111\u01b0\u1eddng s\u1ecdc m\u1edd gi\u1eefa c\u01a1 <\/span>Delta v\u00e0 c\u01a1 ng\u1ef1c l\u1edbn. Ph\u1eabu t\u00edch <span style=\"font-weight: 400;\">v\u00e9n t\u0129nh m\u1ea1ch ra ph\u00eda ngo\u00e0i c\u00f9ng v\u1edbi c\u01a1 Delta.<\/span><\/li>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Ti\u1ebfn h\u00e0nh m\u1edf kho\u1ea3ng Delta &#8211; ng\u1ef1c t\u1ea1i v\u1ecb tr\u00ed c\u00e1ch m\u1ecfm qu\u1ea1 kho\u1ea3ng 1 cm (ph\u00eda ngo\u00e0i m\u1ecfm qu\u1ea1) xu\u1ed1ng ph\u00eda d\u01b0\u1edbi, d\u00f9ng Retractor t\u1ef1 \u0111\u1ed9ng \u0111\u1ec3 v\u00e9n c\u01a1 Delta v\u00e0 c\u01a1 ng\u1ef1c l\u1edbn <\/span>sang hai b\u00ean (c\u00f3 th\u1ec3 gi\u1ea3i ph\u00f3ng <span style=\"font-weight: 400;\">th\u00eam ph\u1ea7n tr\u00ean c\u1ee7a c\u01a1 ng\u1ef1c <\/span><em>l\u1edbn)<\/em>. <span style=\"font-weight: 400;\">M\u1edf m\u1ea1c \u0111\u00f2n &#8211; ng\u1ef1c, x\u00e1c \u0111\u1ecbnh g\u00e2n c\u01a1 d\u01b0\u1edbi vai, <\/span>\u0111\u1ea7u d\u00e0i <span style=\"font-weight: 400;\">g\u00e2n c\u01a1 nh\u1ecb \u0111\u1ea7u v\u00e0 m\u1ea5u \u0111\u1ed9ng b\u00e9 (xoay ngo\u00e0i v\u00e0 xoay trong gi\u00fap x\u00e1c \u0111\u1ecbnh g\u00e2n c\u01a1 d\u01b0\u1edbi vai)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">S\u1edd \u0111\u1ec3 nh\u1eadn bi\u1ebft th\u1ea7n kinh n\u00e1ch b\u1eb1ng c\u00e1ch tr\u01b0\u1ee3t ng\u00f3n tay c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean xu\u1ed1ng g\u00e2n c\u01a1 d\u01b0\u1edbi vai v\u00e0 xoay trong c\u00e1nh tay khi ng\u00f3n tay \u0111\u1ebfn ranh gi\u1edbi ph\u00eda d\u01b0\u1edbi c\u1ee7a c\u01a1 d\u01b0\u1edbi vai, \u0111\u00e2y l\u00e0 nghi\u1ec7m ph\u00e1p \u201ctug test\u201d. \u0110\u1eb7t Retractor b\u1ea3o v\u1ec7 th\u1ea7n kinh n\u00e1ch.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u1ede tr\u00ean c\u1ee7a c\u01a1 d\u01b0\u1edbi vai l\u00e0 <\/span><span style=\"font-weight: 400;\">kho\u00e1ng tr\u1ed1ng ch\u00f3p xoay. B\u1edd d\u1ef1\u1edbi c\u1ee7a c\u01a1 d\u01b0\u1edbi vai th\u01b0\u1eddng c\u00f3 kho\u1ea3ng 3 \u0111\u1ed9ng m\u1ea1ch m\u0169 c\u00e1nh tay tr\u01b0\u1edbc, t\u00ecm v\u00e0 \u0111\u1ed1t c\u1ea7m m\u00e1u c\u00e1c m\u1ea1ch n\u00e0y.<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">V\u1edbi c\u00e1nh tay xoay ngo\u00e0i, ti\u1ebfn h\u00e0nh c\u1eaft g\u00e2n c\u01a1 d\u01b0\u1edbi vai t\u1ea1i \u0111i\u1ec3m b\u00e1m t\u1eadn. Th\u00f4ng th\u01b0\u1eddng v\u1ecb tr\u00ed c\u1eaft l\u00e0 ph\u00eda trong m\u1ea5u \u0111\u1ed9ng b\u00e9 kho\u1ea3ng 1 \u0111\u1ebfn 1,5 cm. C\u1eaft d\u1ecdc xu\u1ed1ng d\u01b0\u1edbi nh\u01b0ng ch\u00fa \u00fd kh\u00f4ng l\u00e0m t\u1ed5n th\u01b0\u01a1ng bao <\/span>kh\u1edbp b\u00ean d\u01b0\u1edbi, c\u00f3 th\u1ec3 c\u1eaft g\u00e2n c\u01a1 d\u01b0\u1edbi vai to\u00e0n ph\u1ea7n ho\u1eb7c m\u1ed9t ph\u1ea7n. \u0110\u1eb7t ch\u1ec9 kh\u00e2u ch\u1edd d\u1ecdc theo hai m\u00e9p g\u00e2n \u0111\u00e3 c\u1eaft.<\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ti\u1ebfp theo ti\u1ebfn h\u00e0nh t\u00e1ch c\u01a1 v\u00e0 bao kh\u1edbp ph\u00eda trong, g\u00e2n v\u00e0 bao kh\u1edbp ph\u00eda ngo\u00e0i. Ch\u00fa \u00fd \u0111\u00e1nh gi\u00e1 kho\u00e1ng tr\u1ed1ng ch\u00f3p xoay v\u00ec n\u00f3 c\u1ea9n thi\u1ebft khi \u0111\u00f3ng v\u1ebft th\u01b0\u01a1ng<\/span><span style=\"font-weight: 400;\">\u00a0(ch\u00f3p xoay c\u00f3 \u0111\u01b0\u1ee3c r\u1ea1ch r\u1ed9ng th\u00eam hay kh\u00f4ng)<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt c\u1eaft bao kh\u1edbp, \u0111\u01b0\u1eddng c\u1eaft c\u00f3 th\u1ec3 \u1edf ph\u00eda ngo\u00e0i (ph\u00eda ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay) ho\u1eb7c <\/span><i><span style=\"font-weight: 400;\">\u1edf<\/span><\/i><span style=\"font-weight: 400;\"> ph\u00eda trong (ph\u00eda \u1ed5 ch\u1ea3o).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Sau khi m\u1edd bao kh\u1edbp ph\u00eda trong, d\u00f9ng \u201cRetractor\u201d v\u00e9n ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay xu\u1ed1ng d\u01b0\u1edbi. S\u1eed d\u1ee5ng d\u1ee5ng c\u1ee5 \u201celevator\u201d v\u00e9n gi\u1eef bao kh\u1edbp ra kh\u1edfi b\u1edd tr\u01b0\u1edbc s\u1ee5n vi\u1ec1n (\u0111\u1ed5i v\u1edbi m\u1edf bao kh\u1edbp ph\u00eda ngo\u00e0i th\u1ef1c hi\u1ec7n t\u01b0\u1ee3ng t\u1ef1, theo Bigliani (1996) th\u00ec m\u1edf bao kh\u1edbp ph\u00eda ngo\u00e0i c\u00f3 nhi\u1ec1u \u01b0u \u0111i\u1ec3m h\u01a1n).<\/span><\/p>\n<figure id=\"attachment_19336\" aria-describedby=\"caption-attachment-19336\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19336\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-18.48.47-300x139.png\" alt=\"H\u00ecnh \u1ea3nh minh h\u1ecda ph\u1eabu t\u00edch c\u1eaft \u0111i\u1ec3m b\u00e1m c\u01a1 d\u01b0\u1edbi vai \" width=\"300\" height=\"139\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-18.48.47-300x139.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-18.48.47-1024x474.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-18.48.47-768x355.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-18.48.47.png 1068w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19336\" class=\"wp-caption-text\">H\u00ecnh \u1ea3nh minh h\u1ecda ph\u1eabu t\u00edch c\u1eaft \u0111i\u1ec3m b\u00e1m c\u01a1 d\u01b0\u1edbi vai<\/figcaption><\/figure>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">N\u1ebfu bao kh\u1edbp ph\u00eda d\u01b0\u1edbi b\u1ecb gi\u00e3n qu\u00e1 m\u1ee9c, c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n m\u1edf bao kh\u1edbp h\u00ecnh ch\u1eeb\u201cT\u201d. \u0110i\u1ec1u n\u00e0y cho ph\u00e9p thay \u0111\u1ed5i bao kh\u1edbp ph\u00eda d\u01b0\u1edbi m\u1ed9t c\u00e1ch t\u1ed1t nh\u1ea5t. Ch\u1eef \u201cT\u201d \u0111\u01b0\u1ee3c t\u1ea1o n\u00ean gi\u1eefa d\u00e2y chang \u00f4 ch\u1ea3o c\u00e1nh tay gi\u1eefa v\u00e0 dir\u1edbi.<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ti\u1ebfp theo \u0111\u00e1nh gi\u00e1 t\u00f4n th\u01b0\u01a1ng s\u1ee5n vi\u1ec1n, l\u00e0m nh\u00e1m (r\u00e1p) ph\u1ea7n c\u1ed1 c\u1ee7a b\u1edd \u1ed5<\/span><span style=\"font-weight: 400;\">\u00a0ch\u1ea3o b\u1eb1ng \u201ccurette\u201d<\/span><\/li>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1eb7t m\u0169i neo d\u1ecdc theo v\u00e0nh \u1ed1 ch\u1ea3o \u1edf v\u1ecb tr\u00ed 7, 9, 11 gi\u1edd cho vai tr\u00e1i v\u00e0 v\u1ecb tr\u00ed 1, 3, 5 gi\u1edd cho vai ph\u1ea3i.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ti\u1ebfn h\u00e0nh kh\u00e2u l\u1ea1i \u0111\u01a1n thu\u1ea7n s\u1ee5n vi\u1ec1n (ho\u1eb7c kh\u00e2u s\u1ee5n vi\u1ec1n cm kh\u00e2u ch\u1ed3ng ngan bao kh\u1edbp).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1ed1i v\u1edbi c\u1eaft bao kh\u1edbp h\u00ecnh ch\u1eef \u201cT\u201d, v\u1ea1t ph\u00eda tr\u00ean \u0111\u01b0\u1ee3c d\u1ecbch <\/span>chuy\u1ebfn xu\u1ed1ng d\u01b0\u1edbi \u0111\u00ea ch\u1ed3ng l\u00ean ch\u00e9o l\u00ean v\u1edbi v\u1ea1t ph\u00eda d\u01b0\u1edbi \u0111\u01b0\u1ee3c d\u1ecbch chuy\u1ec3n l\u00ean tr\u00ean v\u00e0 ti\u1ebfn h\u00e0nh kh\u00e2u l\u1ea1i s\u1ee5n vi\u1ec1n bao kh\u1edbp qua m\u0169i neo \u1edf c\u00e1c v\u1ecb tr\u00ed n\u00eau tr\u00ean.<\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u0110\u00f3ng v\u1ebft m\u1ed5, kh\u00e2u ph\u1ee5c h\u1ed3i c\u00e1c l\u1edbp theo gi\u1ea3i ph\u1eabu. Mang \u00e1o c\u1ed5 \u0111\u1ecbnh vai (\u0111\u1eb7t c\u00e1nh tay kho\u1ea3ng 20<\/span> <span style=\"font-weight: 400;\">\u0111\u1ed9 xoay ngo\u00e0i v\u00e0 d\u1ea1ng, kho\u1ea3ng 10 \u0111\u1ed9 g\u1ea5p v\u1ec1 ph\u00eda tr\u01b0\u1edbc)<\/span><\/p>\n<h2><strong>3. Ph\u1eabu thu\u1eadt Latarjet<\/strong><\/h2>\n<p><span style=\"font-weight: 400;\">Ph\u1eabu thu\u1eadt chuy\u1ec3n m\u1ecfm qu\u1ea1 c\u00f9ng v\u1edbi g\u00e2n c\u01a1 qu\u1ea1 c\u00e1nh tay v\u00e0 \u0111\u1ea7u ng\u1eafn g\u00e2n c\u01a1 nh\u1ecb \u0111\u1ea7u b\u00e1m v\u00e0o n\u00f3 xu\u1ed1ng g\u1eafn v\u00e0o b\u1edd tr\u01b0\u1edbc d\u01b0\u1edbi c\u1ee7a \u1ed5 ch\u00e0o nh\u1eb1m gh\u00e9p m\u1ea3nh x\u01b0\u01a1ng v\u00e0o <\/span><span style=\"font-weight: 400;\">ch\u1ed7 khuy\u1ebft h\u1ed5ng b\u1edd tr\u01b0\u1edbc d\u01b0\u1edbi \u1ed5 <\/span><span style=\"font-weight: 400;\">ch\u1ea3o.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><strong>3.1 Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Khuy\u1ebft x\u01b0\u01a1ng b\u1edd tr\u01b0\u1edbc d\u01b0\u1edbi \u1ed5 ch\u1ea3o l\u1edfn h\u01a1n 21 \u0111\u1ebfn 30% di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t \u1ed1 ch\u1ea3o.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sach &gt; 25% so v\u1edbi di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t ch\u1ecfm x\u01b0\u01a1ng <\/span>c\u00e1nh <span style=\"font-weight: 400;\">tay<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hi\u1ec7n t\u01b0\u1ee3ng \u201cEngaging\u201d trong t\u1ed5n th\u01b0\u01a1ng Hill &#8211; Sach <\/span><\/li>\n<\/ul>\n<p><strong>3.2 Chu\u1ea9n b\u1ecb d\u1ee5ng c\u1ee5 v\u00e0 b\u1ec7nh nh\u00e2n<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u01b0\u01a1ng t\u1ef1 ph\u1eabu thu\u1eadt Bankart<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u01b0a x\u01b0\u01a1ng<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">V\u00edt x\u01b0\u01a1ng x\u1ed1p \u0111\u01b0\u1eddng k\u00ednh 3,5 ho\u1eb7c 4 mm<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><strong>3.3 \u0110\u01b0\u1eddng m\u1ed5<\/strong><\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">R\u00e3nh Delta &#8211; ng\u1ef1c (B\u1ed9c l\u1ed9 c\u00e1c l\u1edbp gi\u1ea3i ph\u1eabu t\u01b0\u01a1ng t\u1ef1 ph\u1eabu thu\u1eadt Bankart)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><strong>3.4 C\u00e1ch th\u1ee9c ph\u1eabu thu\u1eadt<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Tr\u01b0\u1edbc khi v\u00e0o kh\u1edbp c\u1ea7n ph\u00e1i ti\u1ebfn h\u00e0nh c\u1eaft m\u1ecfm qu\u1ea1. K\u1ef9\u00a0<\/span><span style=\"font-weight: 400;\">thu\u1eadt: <\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">+ C\u01a1 ng\u1ef1c nh\u1ecf \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng t\u1eeb c\u1ea1nh trong c\u1ee7a m\u1ecfm qu\u1ea1<\/span><\/p>\n<p><span style=\"font-weight: 400;\">+ C\u1eaft m\u1ecfm qu\u1ea1 g\u1ea7n n\u1ec1n c\u1ee7a n\u00f3 (s\u00e1t ph\u00eda d\u01b0\u1edbi d\u00e2y ch\u1eb1ng qu\u1ea1 \u0111\u00f2n)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">+ Gi\u1ea3i ph\u00f3ng d\u00e2y ch\u1eb1ng c\u00f9ng &#8211; qu\u1ea1, ch\u00fa \u00fd \u0111\u1ebf l\u1ea1i 1<\/span><b>\u00a0<\/b><span style=\"font-weight: 400;\">cm g\u1ed1c d\u00e2y ch\u1eb1ng g\u1eafn li\u1ec1n m\u1ecfm qu\u1ea1<\/span><\/p>\n<p>+ Gi\u1eef l\u1ea1i g\u00e2n c\u01a1 qu\u1ea1 c\u00e1nh tay v\u00e0 g\u00e2n \u0111\u1ea7u ng\u1eafn c\u01a1 nh\u1ecb \u0111\u1ea7u.<\/p>\n<p><span style=\"font-weight: 400;\">+ Tr\u00e1nh l\u00e0m t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh c\u01a1 b\u00ec khi \u0111\u01b0a m\u1ecfm qu\u1ea1 xu\u1ed1ng v\u1ecb tr\u00ed d\u1ecdc theo b\u1edd tr\u01b0\u1edbc d\u01b0\u1edbi \u1ed5 ch\u1ea3o.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00e1c b\u01b0\u1edbc ti\u1ebfp c\u1eadn kh\u1edbp vai t\u01b0\u01a1ng t\u1ef1 ph\u1eabu thu\u1eadt Bankart<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">L\u00e0m s\u1ea1ch t\u1ed5 ch\u1ee9c m\u00f4 m\u1ec1m x\u01a1 d\u00ednh c\u1ee7a v\u00e0nh v\u00e0 c\u1ed5 \u1ed5 ch\u1ea3o t\u1ea1i v\u00f9ng khuy\u1ebft x\u01b0\u01a1ng. Ti\u1ebfn h\u00e0nh m\u00e0i nh\u1eb9 nh\u00e0ng m\u00e0ng x\u01b0\u01a1ng v\u00f9ng n\u00e0y \u0111\u1ebfn khi th\u1ea5y ch\u1ea3y m\u00e1u t\u1eeb x\u01b0\u01a1ng. L\u00e0m t\u01b0\u01a1ng t\u1ef1 v\u1edbi b\u1ec1 m\u1eb7t cua m\u1ecfm qu\u1ea1 \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o v\u1ecb tr\u00ed gh\u00e9p x\u01b0\u01a1ng.<\/span><\/span>\n<p><figure id=\"attachment_19359\" aria-describedby=\"caption-attachment-19359\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19359\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-19.13.39-300x300.png\" alt=\"H\u00ecnh \u1ea3nh minh h\u1ecda k\u1ef3 thu\u1eadt c\u1eaft m\u1ecfm qu\u1ea1 \" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-19.13.39-300x300.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-19.13.39-150x150.png 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-12-luc-19.13.39.png 604w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19359\" class=\"wp-caption-text\">H\u00ecnh \u1ea3nh minh h\u1ecda k\u1ef3 thu\u1eadt c\u1eaft m\u1ecfm qu\u1ea1<\/figcaption><\/figure><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Ti\u1ebfn h\u00e0nh gh\u00e9p x\u01b0\u01a1ng. K\u1ef9 thu\u1eadt:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ti\u1ebfn h\u00e0nh khoan m\u1ecfm qu\u1ea1 t\u1ea1o\u00a0<\/span><span style=\"font-weight: 400;\">ra c\u00e1c l\u1ed7 tr\u00ean v\u00e0 d\u01b0\u1edbi \u0111\u1ec3 c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p n\u00e0y v\u00e0o v\u00f9ng khuy\u1ebft x\u01b0\u01a1ng <\/span><span style=\"font-weight: 400;\">0<\/span><span style=\"font-weight: 400;\"> ch\u1ea3o bang v\u00edt x\u1ed1p.<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1eb7t m\u1ea3nh gh\u00e9p m\u1ecfm qu\u1ea1 v\u00e0o v\u00f9ng khuy\u1ebft x\u01b0\u01a1ng \u1ed5 ch\u1ea3o s\u00e1t v\u1edbi v\u00e0nh \u1ed5<\/span><span style=\"font-weight: 400;\"> ch\u1ea3o (th\u00f4ng th\u01b0\u1eddng m\u1ea3nh gh\u00e9p \u0111\u1eb7t ph\u00e1i m\u1ea5p m\u00e9 s\u1ee5n \u1ed5 ch\u1ea3o kh\u00f4ng \u0111u\u1ee3c qu\u00e1, ph\u1ea3i \u0111\u1eb7t theo chi\u1ec1u c\u1ef1c tr\u00ean c\u1ef1c d\u01b0\u1edbi, v\u1ecb tr\u00ed \u0111\u1eb7t th\u01b0\u1eddng n\u1eb1m d\u01b0\u1edbi \u0111\u01b0\u1eddng x\u00edch \u0111\u1ea1o \u1ed5 ch\u1ea3o cho m\u1ed9t t\u1ed5n th\u01b0\u01a1ng b\u1edd tr\u01b0\u1edbc d\u01b0\u1edbi, g\u1ed1c c\u1ee7a d\u00e2y ch\u1eb1ng c\u00f9ng &#8211; qu\u1ea1 h\u01b0\u1edbng ra b\u00ean <\/span>ngo\u00e0i), c\u00f3 th\u1ec3 c\u1ed1 \u0111\u1ecbnh t\u1ea1m th\u1eddi m\u00e0nh gh\u00e9p b\u1eb1ng \u0111inh Kirschner.<\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u00e2u l\u1ea1i bao kh\u1edbp: v\u1ea1t ph\u00eda ngo\u00e0i c\u1ee7a bao kh\u1edbp \u0111\u01b0\u1ee3c s\u1eeda ch\u1eefa \u0111\u1ebf kh\u00e2u ph\u1ee5c h\u1ed3i l\u1ea1i v\u1edbi g\u1ed1c d\u00e2y ch\u1eb1ng c\u00f9ng &#8211; qu\u1ea1, \u0111\u00ea m\u1ea3nh gh\u00e9p n\u1eb1m trong<\/span> kh\u1edbp. \u0110\u00f3ng v\u1ebft m\u1ed5 theo c\u00e1c l\u1edbp gi\u1ea3i ph\u1eabu.<\/li>\n<li aria-level=\"1\"><span style=\"font-weight: 400;\">Khoan xuy\u00ean qua 2 th\u00e0nh x\u01b0\u01a1ng \u1ed5 ch\u1ea3o th\u00f4ng qua c\u00e1c l\u1ed3 khoan tr\u00ean v\u00e0 d\u01b0\u1edbi c\u1ee7a m\u00f3m qu\u1ea1, b\u1eaft 02 v\u00edt x\u01b0\u01a1ng x\u1ed1p 35 -40 mm c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p m\u1ecfm qu\u1ea1.<\/span><\/li>\n<\/ul>\n<p>\u0110\u1ec3 \u0111\u0103ng k\u00fd kh\u00e1m v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ea1i B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c t\u1ebf Vinmec, Qu\u00fd Kh\u00e1ch c\u00f3 th\u1ec3 li\u00ean h\u1ec7 \u0111\u1ebfn\u00a0<b class=\"link-in-body\">Hotline<\/b>\u00a0H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec tr\u00ean to\u00e0n qu\u1ed1c, ho\u1eb7c \u0111\u0103ng k\u00fd kh\u00e1m tr\u1ef1c tuy\u1ebfn\u00a0<a class=\"link-in-body\" href=\"https:\/\/www.vinmec.com\/vi\/dat-kham\/\"><b class=\"link-in-body\">T\u1ea0I \u0110\u00c2Y<\/b><\/a><b>.<\/b><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tr\u1eadt kh\u1edbp vai l\u00e0 s\u1ef1 m\u1ea5t ti\u1ebfp x\u00fac c\u1ee7a di\u1ec7n kh\u1edbp \u1ed5 ch\u1ea3o v\u00e0 ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay. Tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n l\u00e0 t\u00ecnh tr\u1ea1ng tr\u1eadt kh\u1edbp vai t\u1eeb l\u1ea7n 2 tr\u1edf l\u00ean (th\u01b0\u1eddng tr\u00ean 10 l\u1ea7n), sau b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u1ef1 n\u1eafn \u0111\u01b0\u1ee3c. Th\u00f4ng qua b\u00e0i vi\u1ebft, ch\u00fang t\u00f4i s\u1ebd gi\u1edbi thi\u1ec7u [&hellip;]<\/p>\n","protected":false},"author":49,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[75,40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb trong tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n - Vinmec<\/title>\n<meta name=\"description\" content=\"Gi\u1edbi thi\u1ec7u \u0111i\u1ec1u tr\u1ecb trong tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n bao g\u1ed3m: \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt v\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt\" \/>\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=\"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb trong tr\u1eadt kh\u1edbp vai t\u00e1i di\u1ec5n - 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