{"id":20872,"date":"2023-04-16T16:45:50","date_gmt":"2023-04-16T09:45:50","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20872"},"modified":"2023-04-17T12:37:11","modified_gmt":"2023-04-17T05:37:11","slug":"dau-la-gi-phan-loai-va-chan-doan-lam-sang-nhu-the-nao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/dau-la-gi-phan-loai-va-chan-doan-lam-sang-nhu-the-nao\/","title":{"rendered":"\u0110au l\u00e0 g\u00ec: ph\u00e2n lo\u1ea1i v\u00e0 ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng nh\u01b0 th\u1ebf n\u00e0o?"},"content":{"rendered":"<p><strong>\u0110au l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p tr\u00ean l\u00e2m s\u00e0ng. Nhi\u1ec7m v\u1ee5 h\u00e0ng ng\u00e0y c\u1ee7a nh\u00e2n vi\u00ean y t\u1ebf l\u00e0 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 \u0111au c\u1ee7a b\u1ec7nh nh\u00e2n nh\u1eb1m \u0111\u01b0a ra h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb tho\u1ea3 \u0111\u00e1ng cho t\u1eebng c\u00e1 th\u1ec3.<\/strong><strong> B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y gi\u00fap tr\u1ea3 l\u1eddi cho c\u00e2u h\u1ecfi \u0111au l\u00e0 g\u00ec, ph\u00e2n lo\u1ea1i v\u00e0 ch\u1ea9n \u0111o\u00e1n \u0111au tr\u00ean l\u00e2m s\u00e0ng<\/strong><\/p>\n<h2>1. \u0110au l\u00e0 g\u00ec?<\/h2>\n<p>\u0110\u1ecbnh ngh\u0129a \u0111au c\u1ee7a Hi\u1ec7p h\u1ed9i nghi\u00ean c\u1ee9u \u0111au qu\u1ed1c t\u1ebf (International Association for the Study of Pain \u2013 IASP) n\u0103m 1994: \u201c<em>\u0110au l\u00e0 m\u1ed9t c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu v\u00e0 s\u1ef1 ch\u1ecbu \u0111\u1ef1ng v\u1ec1 c\u1ea3m x\u00fac, ch\u1ee7 y\u1ebfu \u0111i k\u00e8m theo t\u1ed5n th\u01b0\u01a1ng t\u1ed5 ch\u1ee9c ho\u1eb7c m\u00f4 t\u1ea3 nh\u01b0 l\u00e0 m\u1ed9t t\u1ed5n th\u01b0\u01a1ng t\u1ed5 ch\u1ee9c, ho\u1eb7c c\u1ea3 hai<\/em>\u201d.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_21737\" aria-describedby=\"caption-attachment-21737\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-21737\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Dau-la-cam-giac-khach-quan-cua-nguoi-benh-300x300.jpeg\" alt=\"\u0110au l\u00e0 m\u1ed9t c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu v\u00e0 s\u1ef1 ch\u1ecbu \u0111\u1ef1ng v\u1ec1 c\u1ea3m x\u00fac\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Dau-la-cam-giac-khach-quan-cua-nguoi-benh-300x300.jpeg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Dau-la-cam-giac-khach-quan-cua-nguoi-benh-150x150.jpeg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Dau-la-cam-giac-khach-quan-cua-nguoi-benh.jpeg 650w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-21737\" class=\"wp-caption-text\">\u0110au l\u00e0 m\u1ed9t c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu v\u00e0 s\u1ef1 ch\u1ecbu \u0111\u1ef1ng v\u1ec1 c\u1ea3m x\u00fac<\/figcaption><\/figure>\n<h2>2. Ph\u00e2n lo\u1ea1i<\/h2>\n<p>C\u00f3 <strong>3 c\u00e1ch ph\u00e2n lo\u1ea1i ch\u00ednh<\/strong> tr\u00ean l\u00e2m s\u00e0ng hi\u1ec7n nay<\/p>\n<h3>2.1. <strong><em>Ph\u00e2n lo\u1ea1i \u0111au theo c\u01a1 ch\u1ebf g\u00e2y \u0111au<\/em><\/strong><\/h3>\n<p>\u2013 <strong>\u0110au c\u1ea3m th\u1ee5<\/strong> <em>(nociceptive pain)<\/em>: l\u00e0 \u0111au do t\u1ed5n th\u01b0\u01a1ng t\u1ed5 ch\u1ee9c (c\u01a1, da, n\u1ed9i t\u1ea1ng\u2026) g\u00e2y k\u00edch th\u00edch v\u01b0\u1ee3t ng\u01b0\u1ee1ng \u0111au.<\/p>\n<p>\u0110au c\u1ea3m th\u1ee5 c\u00f3 2 lo\u1ea1i:<\/p>\n<ul>\n<li>\u0110au th\u00e2n th\u1ec3 (somatic pain) l\u00e0 \u0111au do t\u1ed5n th\u01b0\u01a1ng m\u00f4 da, c\u01a1, kh\u1edbp\u2026<\/li>\n<li>\u0110au n\u1ed9i t\u1ea1ng (visceral pain) l\u00e0 \u0111au do t\u1ed5n th\u01b0\u01a1ng n\u1ed9i t\u1ea1ng.<\/li>\n<\/ul>\n<p>\u2013<a href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/dau-kinh-va-ton-thuong-kinh\/#:~:text=C%C3%A1c%20c%C6%A1n%20%C4%91au%20th%E1%BA%A7n%20kinh,b%E1%BB%87nh%20c%C3%B3%20hi%E1%BB%87u%20qu%E1%BA%A3%20cao.\"><strong> \u0110au th\u1ea7n kinh<\/strong><\/a> <em>(neuropathic pain)<\/em>: L\u00e0 ch\u1ee9ng \u0111au do nh\u1eefng th\u01b0\u01a1ng t\u1ed5n nguy\u00ean ph\u00e1t ho\u1eb7c nh\u1eefng r\u1ed1i lo\u1ea1n ch\u1ee9c trong h\u1ec7 th\u1ea7n kinh g\u00e2y n\u00ean.<\/p>\n<p>\u0110au th\u1ea7n kinh chia 2 lo\u1ea1i:<\/p>\n<ul>\n<li><em>\u0110au th\u1ea7n kinh ngo\u1ea1i vi<\/em> (peripheral neuropathic pain) do t\u1ed5n th\u01b0\u01a1ng c\u00e1c d\u00e2y ho\u1eb7c r\u1ec5 th\u1ea7n kinh (V\u00ed d\u1ee5: \u0111au sau herpes,\u00a0 \u0111au d\u00e2y V, b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i vi do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i vi sau ph\u1eabu thu\u1eadt, b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i vi sau ch\u1ea5n th\u01b0\u01a1ng\u2026);<\/li>\n<li><em>\u0110au th\u1ea7n kinh trung \u01b0\u01a1ng<\/em> (central neuropathic pain) do t\u1ed5n th\u01b0\u01a1ng \u1edf n\u00e3o ho\u1eb7c t\u1ee7y s\u1ed1ng (v\u00ed d\u1ee5: \u0111au sau \u0111\u1ed9t qu\u1ef5 n\u00e3o, x\u01a1 n\u00e3o t\u1ee7y r\u1ea3i r\u00e1c, u n\u00e3o, ch\u00e8n \u00e9p t\u1ee7y\u2026)<\/li>\n<\/ul>\n<p>\u2013 <strong>\u0110au h\u1ed7n h\u1ee3p<\/strong> <em>(mixed pain):<\/em> g\u1ed3m c\u1ea3 2 c\u01a1 ch\u1ebf \u0111au c\u1ea3m th\u1ee5 v\u00e0 \u0111au th\u1ea7n kinh. V\u00ed d\u1ee5: \u0111au th\u1eaft l\u01b0ng v\u1edbi b\u1ec7nh l\u00fd r\u1ec5 th\u1ea7n kinh, b\u1ec7nh l\u00fd r\u1ec5 th\u1ea7n kinh c\u1ed5, \u0111au do ung th\u01b0, h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay\u2026<\/p>\n<p>\u2013 <strong>\u0110au do c\u0103n nguy\u00ean t\u00e2m l\u00fd<\/strong> <em>(psychogenic pain)<\/em><\/p>\n<h3><strong><em>\u00a02.2. Ph\u00e2n lo\u1ea1i \u0111au theo th\u1eddi gian<\/em><\/strong><\/h3>\n<p><strong>\u0110au c\u1ea5p t\u00ednh<\/strong> (acute pain): l\u00e0 \u0111au m\u1edbi xu\u1ea5t hi\u1ec7n, c\u00f3 c\u01b0\u1eddng \u0111\u1ed9 m\u1ea1nh m\u1ebd, c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u b\u00e1o \u0111\u1ed9ng h\u1eefu \u00edch. Th\u1eddi gian \u0111au <strong>d\u01b0\u1edbi 3 th\u00e1ng.<\/strong><\/p>\n<p><strong>\u0110au m\u1ea1n t\u00ednh<\/strong> (chronic pain) l\u00e0 ch\u1ee9ng \u0111au dai d\u1eb3ng t\u00e1i \u0111i t\u00e1i l\u1ea1i nhi\u1ec1u l\u1ea7n.<\/p>\n<p>B\u1ea3ng 1: \u0110\u1eb7c \u0111i\u1ec3m \u0111au c\u1ea5p t\u00ednh v\u00e0 \u0111au m\u1ea1n t\u00ednh<\/p>\n<table width=\"638\">\n<tbody>\n<tr>\n<td width=\"213\"><\/td>\n<td width=\"213\"><strong>\u0110au c\u1ea5p t\u00ednh<\/strong><\/td>\n<td width=\"213\"><strong>\u0110au m\u1ea1n t\u00ednh<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"213\">M\u1ee5c \u0111\u00edch sinh h\u1ecdc<\/td>\n<td width=\"213\">C\u00f3 \u00edch \u2013 B\u1ea3o v\u1ec7<\/td>\n<td width=\"213\">V\u00f4 \u00edch \u2013 Ph\u00e1 ho\u1ea1i<\/td>\n<\/tr>\n<tr>\n<td width=\"213\">C\u01a1 ch\u1ebf g\u00e2y \u0111au<\/td>\n<td width=\"213\">\u0110\u01a1n y\u1ebfu t\u1ed1<\/td>\n<td width=\"213\">\u0110a y\u1ebfu t\u1ed1<\/td>\n<\/tr>\n<tr>\n<td width=\"213\">Ph\u1ea3n \u1ee9ng c\u1ee7a c\u01a1 th\u1ec3<\/td>\n<td width=\"213\">Ph\u1ea3n \u1ee9ng l\u1ea1i<\/td>\n<td width=\"213\">Th\u00edch nghi d\u1ea7n<\/td>\n<\/tr>\n<tr>\n<td width=\"213\">Y\u1ebfu t\u1ed1 c\u1ea3m x\u00fac<\/td>\n<td width=\"213\">Lo l\u1eafng<\/td>\n<td width=\"213\">Tr\u1ea7m c\u1ea3m<\/td>\n<\/tr>\n<tr>\n<td width=\"213\">M\u1ee5c \u0111\u00edch \u0111i\u1ec1u tr\u1ecb<\/td>\n<td width=\"213\">Ch\u1eefa kh\u1ecfi<\/td>\n<td width=\"213\">T\u00e1i th\u00edch \u1ee9ng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3><strong><em>2.3. Ph\u00e2n lo\u1ea1i theo khu tr\u00fa \u0111au<\/em><\/strong><\/h3>\n<p><strong>\u0110au c\u1ee5c b\u1ed9<\/strong> (local pain): l\u00e0 c\u1ea3m nh\u1eadn v\u1ecb tr\u00ed \u0111au tr\u00f9ng v\u1edbi v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<p><strong>\u0110au xu\u1ea5t chi\u1ebfu<\/strong> (referred pain): l\u00e0 c\u1ea3m nh\u1eadn v\u1ecb tr\u00ed \u0111au \u1edf v\u1ecb tr\u00ed kh\u00e1c v\u1edbi v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng. T\u1ea1i l\u1edbp V s\u1eebng sau t\u1ee7y s\u1ed1ng, c\u00f3 nh\u1eefng neuron \u0111au kh\u00f4ng \u0111\u1eb7c hi\u1ec7u g\u1ecdi l\u00e0 neuron h\u1ed9i t\u1ee5, t\u1ea1i \u0111\u00e2y s\u1ebd h\u1ed9i t\u1ee5 nh\u1eefng \u0111\u01b0\u1eddng c\u1ea3m gi\u00e1c \u0111au h\u01b0\u1edbng t\u00e2m xu\u1ea5t ph\u00e1t t\u1eeb da, c\u01a1 x\u01b0\u01a1ng v\u00e0 v\u00f9ng n\u1ed9i t\u1ea1ng, l\u00e0m cho n\u00e3o khi ti\u1ebfp nh\u1eadn th\u00f4ng tin t\u1eeb d\u01b0\u1edbi l\u00ean s\u1ebd kh\u00f4ng ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c \u0111au c\u00f3 ngu\u1ed3n g\u1ed1c \u1edf \u0111\u00e2u, v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c hi\u1ec3u nh\u1ea7m l\u00e0 \u0111au xu\u1ea5t ph\u00e1t t\u1eeb v\u00f9ng da t\u01b0\u01a1ng \u1ee9ng.<\/p>\n<p><strong>\u0110au lan xi\u00ean<\/strong>: l\u00e0 c\u1ea3m gi\u00e1c \u0111au g\u00e2y ra do s\u1ef1 lan t\u1ecfa t\u1eeb m\u1ed9t nh\u00e1nh d\u00e2y th\u1ea7n kinh n\u00e0y sang m\u1ed9t nh\u00e1nh th\u1ea7n kinh kh\u00e1c. V\u00ed d\u1ee5 khi k\u00edch th\u00edch \u0111au \u1edf m\u1ed9t trong ba nh\u00e1nh c\u1ee7a d\u00e2y th\u1ea7n kinh sinh ba (d\u00e2y V) c\u00f3 th\u1ec3 \u0111au lan sang v\u00f9ng ph\u00e2n b\u1ed1 c\u1ee7a hai nh\u00e1nh kia.<\/p>\n<h2>3. L\u00e2m s\u00e0ng<\/h2>\n<div class=\"para\">\n<h3><em><strong>3.1. \u0110\u00e1nh gi\u00e1 \u0111au c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t th\u00f4ng qua c\u00e1c th\u00f4ng tin c\u01a1 b\u1ea3n sau<\/strong><\/em><\/h3>\n<ul>\n<li>Bi\u1ec3u hi\u1ec7n khu tr\u00fa \u0111au? (khu\u1ebfch t\u00e1n hay lan truy\u1ec1n).<\/li>\n<li>T\u00ednh ch\u1ea5t \u0111au? (Nh\u01b0 kim ch\u00e2m, \u1ea9m \u01b0\u1edbt, b\u1ecfng r\u00e1t).<\/li>\n<li>M\u1ee9c \u0111\u1ed9 \u0111au? (ch\u1ecbu \u0111\u01b0\u1ee3c, kh\u00f4ng ch\u1ecbu \u0111\u01b0\u1ee3c).<\/li>\n<li>Th\u1eddi gian xu\u1ea5t hi\u1ec7n v\u00e0 t\u1ed3n t\u1ea1i c\u01a1n \u0111au? (c\u1ea5p t\u00ednh, t\u1ea3n m\u1ea1n, t\u00e1i ph\u00e1t, k\u00e9o d\u00e0i, m\u1ea1n t\u00ednh).<\/li>\n<li>T\u00ecnh tr\u1ea1ng \u0111au? (y\u00ean l\u1eb7ng, c\u0103ng th\u1eb3ng, khi n\u1eb1m, khi ng\u1ed3i, khi \u0111\u1ee9ng, khi \u0111i).<\/li>\n<li>Tri\u1ec7u ch\u1ee9ng \u0111i k\u00e8m v\u1edbi \u0111au? (ch\u00f3ng m\u1eb7t, nh\u1ecbp tim nhanh).<\/li>\n<li>Th\u00f4ng tin kh\u00e1c? (tu\u1ed5i, ngh\u1ec1 nghi\u1ec7p, th\u00f3i quen trong sinh ho\u1ea1t\u2026)<\/li>\n<\/ul>\n<h3><strong><em>3.2. Tri\u1ec7u ch\u1ee9ng \u0111au th\u00e2n th\u1ec3<\/em><\/strong><\/h3>\n<p>\u0110au th\u00e2n th\u1ec3 th\u01b0\u1eddng c\u00f3 vai tr\u00f2 nh\u1eadn c\u1ea3m th\u1ee5 c\u1ee7a c\u00e1c th\u1ee5 c\u1ea3m th\u1ec3, l\u00e0 <strong>c\u01a1 ch\u1ebf th\u01b0\u1eddng g\u1eb7p nh\u1ea5t<\/strong> trong ph\u1ea7n l\u1edbn c\u00e1c ch\u1ee9ng \u0111au c\u1ea5p t\u00ednh v\u00e0 m\u1ea1n t\u00ednh.<\/p>\n<ul>\n<li>K\u00edch th\u00edch g\u00e2y c\u1ea3m gi\u00e1c \u0111au r\u00f5 r\u00e0ng.<\/li>\n<li>\u0110au khu tr\u00fa \u1edf m\u1ed9t v\u1ecb tr\u00ed r\u00f5 r\u1ec7t ph\u00f9 h\u1ee3p v\u1edbi v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng<\/li>\n<li>C\u01a1n \u0111au gi\u1ea3m n\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c d\u00f9ng thu\u1ed1c gi\u1ea3m \u0111au ngo\u1ea1i vi v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p phong b\u1ebf v\u00f4 c\u1ea3m.<\/li>\n<\/ul>\n<h3><strong><em>3.3. Tri\u1ec7u ch\u1ee9ng \u0111au n\u1ed9i t\u1ea1ng<\/em><\/strong><\/h3>\n<p>\u0110au li\u00ean quan t\u1edbi t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan n\u1ed9i t\u1ea1ng (d\u1ea1 d\u00e0y, ph\u1ed5i, gan\u2026). V\u1ecb tr\u00ed khu tr\u00fa kh\u00f4ng r\u00f5 r\u00e0ng nh\u01b0 \u0111au th\u00e2n th\u1ec3. C\u00f3 th\u1ec3 g\u00e2y \u0111au xu\u1ea5t ra v\u00f9ng da t\u01b0\u01a1ng \u1ee9ng.<\/p>\n<figure id=\"attachment_21745\" aria-describedby=\"caption-attachment-21745\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-21745\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screen-Shot-2023-04-15-at-21.54.48-300x218.png\" alt=\"dau-noi-tang-thuong-co-vi-tri-khu-tru-khong-ro-rang\" width=\"300\" height=\"218\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screen-Shot-2023-04-15-at-21.54.48-300x218.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screen-Shot-2023-04-15-at-21.54.48-768x558.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screen-Shot-2023-04-15-at-21.54.48.png 840w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-21745\" class=\"wp-caption-text\">\u0110au n\u1ed9i t\u1ea1ng th\u01b0\u1eddng c\u00f3 v\u1ecb tr\u00ed khu tr\u00fa kh\u00f4ng r\u00f5 r\u00e0ng<\/figcaption><\/figure>\n<h3><strong><em>3.4. Tri\u1ec7u ch\u1ee9ng \u0111au th\u1ea7n kinh<\/em><\/strong><\/h3>\n<p>\u0110au th\u1ea7n kinh <strong>th\u01b0\u1eddng g\u00e2y \u0111au m\u1ea1n t\u00ednh<\/strong><\/p>\n<p>V\u1ecb tr\u00ed khu tr\u00fa \u0111au kh\u00f4ng r\u00f5 r\u00e0ng<\/p>\n<p>\u0110an xen gi\u1eefa c\u00e1c tri\u1ec7u ch\u1ee9ng \u00e2m t\u00ednh (gi\u1ea3m c\u1ea3m gi\u00e1c), tri\u1ec7u ch\u1ee9ng d\u01b0\u01a1ng t\u00ednh (t\u0103ng c\u1ea3m \u0111au, lo\u1ea1n c\u1ea3m \u0111au) v\u00e0 bi\u1ec3u hi\u1ec7n r\u1ed1i lo\u1ea1n th\u1ea7n kinh th\u1ef1c v\u1eadt (thay \u0111\u1ed5i m\u00e0u da, d\u00e0y m\u00f3ng, ra m\u1ed3 h\u00f4i l\u1ea1nh, ph\u00f9\u2026) tr\u00ean c\u00f9ng m\u1ed9t v\u00f9ng chi ph\u1ed1i th\u1ea7n kinh.<\/p>\n<p>T\u00ednh ch\u1ea5t v\u00e0 c\u01b0\u1eddng \u0111\u1ed9 \u0111au: th\u01b0\u1eddng \u0111au r\u1ea5t d\u1eef d\u1ed9i. C\u1ea3m gi\u00e1c \u0111au b\u1ecfng ch\u00e1y, \u0111au nh\u01b0 dao \u0111\u00e2m, \u0111au nh\u01b0 \u0111i\u1ec7n gi\u1eadt, \u0111au gi\u1eb1ng x\u00e9\u2026<\/p>\n<p>C\u00f3 th\u1ec3 <strong>\u0111au t\u1ef1 ph\u00e1t<\/strong> (stimulus \u2013 independent pain) ho\u1eb7c <strong>\u0111au do k\u00edch th\u00edch<\/strong> (stimulus evoked pain). C\u00e1c k\u00edch th\u00edch th\u00f4ng th\u01b0\u1eddng kh\u00f4ng g\u00e2y \u0111au \u1edf ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng l\u1ea1i c\u00f3 th\u1ec3 g\u00e2y b\u00f9ng ph\u00e1t \u0111au \u1edf b\u1ec7nh nh\u00e2n \u0111au th\u1ea7n kinh.<\/p>\n<p><strong>C\u00e1c lo\u1ea1i thu\u1ed1c gi\u1ea3m \u0111au truy\u1ec1n th\u1ed1ng (thu\u1ed1c gi\u1ea3m \u0111au kh\u00f4ng steroid, corticoid\u2026) kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au<\/strong><\/p>\n<p>C\u00e1ch kh\u00e1m ch\u1ee9c n\u0103ng t\u1eebng s\u1ee3i th\u1ea7n kinh c\u1ea3m gi\u00e1c<\/p>\n<table width=\"609\">\n<tbody>\n<tr>\n<td>Lo\u1ea1i s\u1ee3i<\/td>\n<td>C\u1ea3m gi\u00e1c<\/td>\n<td>Ph\u01b0\u01a1ng ti\u1ec7n kh\u00e1m<\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center;\">A\u03b2<\/td>\n<td style=\"text-align: left;\">X\u00fac gi\u00e1c<\/td>\n<td style=\"text-align: left;\">Mi\u1ebfng b\u00f4ng, gi\u1ebb m\u1ec1m<\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center;\">Ad<\/td>\n<td>\n<p style=\"text-align: left;\">Kim ch\u00e2m, v\u1eadt s\u1eafc nh\u1ecdn<\/p>\n<p style=\"text-align: left;\">L\u1ea1nh<\/p>\n<\/td>\n<td>\u00c2m thoa (4-128Hz), kim nh\u1ecdn<\/p>\n<p>V\u1eadt l\u1ea1nh (20<sup>o<\/sup>C)<\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center;\">C<\/td>\n<td>\u1ea4m<\/td>\n<td>V\u1eadt \u1ea5m (40<sup>o<\/sup>C)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong style=\"text-align: center;\">T\u0103ng c\u1ea3m \u0111au (Hyperalgesia)<\/strong><span style=\"text-align: center;\">: l\u00e0 t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u00e1p \u1ee9ng k\u00edch th\u00edch \u0111au\u00a0 v\u1edbi nh\u1eefng k\u00edch th\u00edch d\u01b0\u1edbi ng\u01b0\u1ee1ng g\u00e2y \u0111au. \u00a0Theo lo\u1ea1i k\u00edch th\u00edch, c\u00f3 th\u1ec3 chia t\u0103ng c\u1ea3m \u0111au th\u00e0nh c\u00e1c lo\u1ea1i <\/span><em style=\"text-align: center;\">t\u0103ng c\u1ea3m \u0111au c\u01a1 h\u1ecdc<\/em><span style=\"text-align: center;\"> (mechanical hyperalgesia), <\/span><em style=\"text-align: center;\">t\u0103ng c\u1ea3m \u0111au h\u00f3a h\u1ecdc<\/em><span style=\"text-align: center;\"> (chemical hyperalgesia)\u00a0 v\u00e0 <\/span><em style=\"text-align: center;\">t\u0103ng c\u1ea3m \u0111au nhi\u1ec7t \u0111\u1ed9<\/em><span style=\"text-align: center;\"> (thermal hyperalgesia).<\/span><strong>Lo\u1ea1n c\u1ea3m \u0111au<\/strong> (Allodynia): l\u00e0 t\u00ecnh tr\u1ea1ng xu\u1ea5t hi\u1ec7n \u0111au v\u1edbi ngay c\u00e1c k\u00edch th\u00edch v\u00f4 h\u1ea1i (non-noxious stimulus).\u00a0 Lo\u1ea1n c\u1ea3m \u0111au l\u00e0 m\u1ed9t d\u1ea1ng \u0111\u1eb7c bi\u1ec7t c\u1ee7a t\u0103ng c\u1ea3m \u0111au.<\/p>\n<p><strong>D\u1ecb c\u1ea3m<\/strong> (Paresthesia): xu\u1ea5t hi\u1ec7n c\u00e1c c\u1ea3m gi\u00e1c b\u1ea5t th\u01b0\u1eddng kh\u00f4ng do k\u00edch th\u00edch t\u1eeb b\u00ean ngo\u00e0i: v\u00ed d\u1ee5 c\u1ea3m gi\u00e1c ki\u1ebfn b\u00f2, kim ch\u00e2m, t\u00ea bu\u1ed3n\u2026<\/p>\n<p><strong>\u0110au t\u1ef1 ph\u00e1t\/ \u0111au kh\u00f4ng ph\u1ee5 thu\u1ed9c k\u00edch th\u00edch<\/strong> (stimulus \u2013 independent pain): c\u01a1n \u0111au b\u00f9ng ph\u00e1t t\u1ef1 nhi\u00ean, kh\u00f4ng c\u1ea7n k\u00edch th\u00edch t\u1eeb b\u00ean ngo\u00e0i.<\/p>\n<p><strong>\u0110au do k\u00edch th\u00edch<\/strong> (stimulus \u2013 evoked pain): \u0111au khi c\u00f3 k\u00edch th\u00edch t\u1eeb b\u00ean ngo\u00e0i (c\u01a1 h\u1ecdc, nhi\u1ec7t, h\u00f3a h\u1ecdc).<\/p>\n<h3><strong><em>3.5. \u0110au do c\u0103n nguy\u00ean t\u00e2m l\u00fd<\/em><\/strong><\/h3>\n<p>\u0110au do nh\u1eefng c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3 hay n\u1ed9i t\u1ea1i, \u0111au do b\u1ecb \u00e1m \u1ea3nh nhi\u1ec1u h\u01a1n l\u00e0 \u0111au th\u00e2n th\u1ec3.<\/p>\n<p>\u0110au kh\u00f4ng \u0111i\u1ec3n h\u00ecnh, kh\u00f4ng c\u00f3 v\u00ed tr\u00ed r\u00f5 r\u1ec7t, th\u01b0\u1eddng \u0111au lan to\u1ea3.<\/p>\n<p>\u0110au th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb tr\u1ea7m c\u1ea3m, t\u1ef1 k\u1ef7 \u00e1m th\u1ecb v\u1ec1 b\u1ec7nh t\u1eadt, t\u00e2m th\u1ea7n ph\u00e2n li\u1ec7t.<\/p>\n<p><strong>\u0110i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1c lo\u1ea1i thu\u1ed1c an th\u1ea7n, tr\u1ecb li\u1ec7u t\u00e2m l\u00fd th\u01b0\u1eddng c\u00f3 hi\u1ec7u qu\u1ea3.<\/strong><\/p>\n<figure style=\"width: 230px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/www.innerjoy.app\/wp-content\/uploads\/2022\/11\/18915859-1024x1024.jpg\" alt=\"\u0110au do c\u0103n nguy\u00ean t\u00e2m l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb tr\u1ea7m c\u1ea3m, t\u1ef1 k\u1ef7 \u00e1m th\u1ecb v\u1ec1 b\u1ec7nh t\u1eadt, t\u00e2m th\u1ea7n ph\u00e2n li\u1ec7t.\" width=\"230\" height=\"230\" \/><figcaption class=\"wp-caption-text\">\u0110au do c\u0103n nguy\u00ean t\u00e2m l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb tr\u1ea7m c\u1ea3m, t\u1ef1 k\u1ef7 \u00e1m th\u1ecb v\u1ec1 b\u1ec7nh t\u1eadt, t\u00e2m th\u1ea7n ph\u00e2n li\u1ec7t.<\/figcaption><\/figure>\n<h3><em><strong>3.6. C\u00e1c h\u1eadu qu\u1ea3 th\u1ee9 ph\u00e1t<\/strong><\/em><\/h3>\n<p>C\u00e1c \u1ea3nh h\u01b0\u1edfng l\u00ean ch\u1ee9c n\u0103ng th\u1ea7n kinh g\u00e2y ra c\u00e1c r\u1ed1i lo\u1ea1n n\u1ed9i ti\u1ebft, chuy\u1ec3n ho\u00e1. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng lo l\u1eafng, tr\u1ea7m c\u1ea3m, m\u1ea5t ng\u1ee7.<\/p>\n<\/div>\n<section id=\"v1032717_vi\" class=\"topic__section GHead\">\n<p class=\"topic__header--section\"><em>Ngu\u1ed3n: H\u1ed9i th\u1ea7n kinh h\u1ecdc Vi\u1ec7t Nam<\/em><\/p>\n<p>&nbsp;<\/p>\n<\/section>\n","protected":false},"excerpt":{"rendered":"<p>\u0110au l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p tr\u00ean l\u00e2m s\u00e0ng. Nhi\u1ec7m v\u1ee5 h\u00e0ng ng\u00e0y c\u1ee7a nh\u00e2n vi\u00ean y t\u1ebf l\u00e0 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 \u0111au c\u1ee7a b\u1ec7nh nh\u00e2n nh\u1eb1m \u0111\u01b0a ra h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb tho\u1ea3 \u0111\u00e1ng cho t\u1eebng c\u00e1 th\u1ec3. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y gi\u00fap tr\u1ea3 l\u1eddi cho c\u00e2u h\u1ecfi \u0111au l\u00e0 g\u00ec, ph\u00e2n [&hellip;]<\/p>\n","protected":false},"author":10,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u0110au l\u00e0 g\u00ec: ph\u00e2n lo\u1ea1i v\u00e0 ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng nh\u01b0 th\u1ebf n\u00e0o? - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110au l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p tr\u00ean l\u00e2m s\u00e0ng. 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