{"id":21281,"date":"2023-04-15T01:10:19","date_gmt":"2023-04-14T18:10:19","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21281"},"modified":"2023-05-02T15:48:06","modified_gmt":"2023-05-02T08:48:06","slug":"di-chuyen-rang-tren-lam-sang-dai-cuong-vi-the","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/di-chuyen-rang-tren-lam-sang-dai-cuong-vi-the\/","title":{"rendered":"Di chuy\u1ec3n r\u0103ng tr\u00ean l\u00e2m s\u00e0ng – \u0110\u1ea1i c\u01b0\u01a1ng vi th\u1ec3."},"content":{"rendered":"

D\u1ecbch chuy\u1ec3n r\u0103ng sinh l\u00fd k\u00edch th\u00edch qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac m\u00f4 nha chu nh\u01b0ng kh\u00f4ng l\u00e0m thay \u0111\u1ed5i v\u0129nh vi\u1ec5n v\u1ecb tr\u00ed r\u0103ng. Do \u0111\u00f3 d\u1ecbch chuy\u1ec3n r\u0103ng sinh l\u00fd c\u1ea7n \u0111\u01b0\u1ee3c ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c di chuy\u1ec3n r\u0103ng sinh l\u00fd v\u00e0 di chuy\u1ec3n r\u0103ng do ch\u1ec9nh h\u00ecnh: Di chuy\u1ec3n r\u0103ng sinh l\u00fd v\u00e0 di chuy\u1ec3n r\u0103ng do ch\u1ec9nh h\u00ecnh l\u00e0m thay \u0111\u1ed5i v\u0129nh vi\u1ec5n v\u1ecb tr\u00ed r\u0103ng v\u00e0 c\u00f3 c\u00f9ng c\u01a1 s\u1edf sinh h\u1ecdc. B\u00e0i vi\u1ebft n\u00e0y s\u1ebd \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c c\u01a1 s\u1edf sinh h\u1ecdc c\u1ee7a qu\u00e1 tr\u00ecnh di chuy\u1ec3n r\u0103ng, c\u0169ng nh\u01b0 \u1ee9ng d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng. C\u00f9ng t\u00ecm hi\u1ec3u.<\/strong><\/p>\n

\"di-chuyen-rang-lam-sang\"
Di chuy\u1ec3n r\u0103ng – B\u1ea3n ch\u1ea5t c\u1ee7a qu\u00e1 tr\u00ecnh ch\u1ec9nh nha<\/figcaption><\/figure>\n

1. B\u1ea3n ch\u1ea5t qu\u00e1 tr\u00ecnh di chuy\u1ec3n r\u0103ng<\/h2>\n

Do c\u00e1c r\u0103ng b\u00e1m v\u00e0o x\u01b0\u01a1ng \u1ed5 nh\u1edd d\u00e2y ch\u1eb1ng nha chu, n\u00ean khi th\u1ef1c hi\u1ec7n ch\u1ee9c n\u0103ng, m\u1ed9t b\u1ed9 r\u0103ng c\u00f3 kh\u1edbp c\u1eafn b\u00ecnh th\u01b0\u1eddng ch\u1ecbu nh\u1eefng d\u1ecbch chuy\u1ec3n sinh l\u00fd.<\/p>\n

Nh\u1eefng d\u1ecbch chuy\u1ec3n sinh l\u00fd c\u00f2n \u0111\u01b0\u1ee3c g\u00e2y ra do nh\u1eefng l\u1ef1c y\u1ebfu, gi\u00e1n \u0111o\u1ea1n v\u00e0 t\u1ea1m th\u1eddi hay li\u00ean t\u1ee5c c\u1ee7a c\u01a1 (h\u1ec7 th\u1ed1ng m\u00f4i, m\u00e1, l\u01b0\u1ee1i v\u00e0 c\u00e1c c\u01a1 h\u00e0m) ho\u1eb7c c\u1ee7a c\u00e1c r\u0103ng \u0111\u1ed1i kh\u00e1ng trong l\u00fac c\u1eafn, nhai, nu\u1ed1t v\u00e0 c\u00e1c l\u1ef1c c\u1eadn ch\u1ee9c n\u0103ng (nghi\u1ebfn, si\u1ebft ch\u1eb7t r\u0103ng… ). C\u00e1c l\u1ef1c n\u00e0y c\u00f3 xu h\u01b0\u1edbng tri\u1ec7t ti\u00eau l\u1eabn nhau \u0111\u1ec3 duy tr\u00ec tr\u1ea1ng th\u00e1i c\u00e2n b\u1eb1ng \u0111\u1ed9ng c\u1ee7a h\u1ec7 th\u1ed1ng nhai.<\/p>\n

– Trong di chuy\u1ec3n r\u0103ng sinh l\u00fd, v\u1ecb tr\u00ed r\u0103ng trong x\u01b0\u01a1ng \u1ed5 thay \u0111\u1ed5i ch\u1ee7 y\u1ebfu theo hai h\u01b0\u1edbng: ph\u00eda g\u1ea7n (di g\u1ea7n) v\u00e0 ph\u00eda nhai (tr\u1ed3i m\u1eb7t nhai).<\/p>\n

– Trong di chuy\u1ec3n r\u0103ng do ch\u1ec9nh h\u00ecnh, v\u1ecb tr\u00ed r\u0103ng c\u00f3 th\u1ec3 thay \u0111\u1ed5i h\u1ea7u nh\u01b0 theo b\u1ea5t k\u1ef3 h\u01b0\u1edbng n\u00e0o, \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi nh\u1eefng l\u1ef1c nh\u00e2n t\u1ea1o c\u00f3 th\u1ec3 thay \u0111\u1ed5i c\u01b0\u1eddng \u0111\u1ed9 th\u00f4ng qua c\u00e1c kh\u00ed c\u1ee5 ch\u1ec9nh h\u00ecnh.<\/p>\n

2. C\u01a1 s\u1edf sinh h\u1ecdc c\u1ee7a s\u1ef1 di chuy\u1ec3n r\u0103ng<\/h2>\n

\u0110\u1ec3 l\u00e0m thay \u0111\u1ed5i v\u1ecb tr\u00ed v\u0129nh vi\u1ec5n r\u0103ng trong x\u01b0\u01a1ng \u1ed5, to\u00e0n b\u1ed9 h\u1ec7 th\u1ed1ng r\u0103ng-m\u00f4 n\u00e2ng \u0111\u1ee1 ph\u1ea3i \u0111\u01b0\u1ee3c t\u00e1i c\u1ea5u tr\u00fac. Qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac n\u00e0y \u0111\u00f2i h\u1ecfi k\u00edch ho\u1ea1t m\u1ed9t lo\u1ea1t t\u1ebf b\u00e0o kh\u00e1c nhau, c\u00f3 ch\u1ee9c n\u0103ng t\u00e1i t\u1ea1o \u0111\u1ec3 \u0111\u01b0a \u0111\u1ebfn s\u1ef1 \u0111\u1ed5i m\u1edbi sinh l\u00fd. Nh\u1eefng m\u00f4 tham gia v\u00e0o qu\u00e1 tr\u00ecnh \u0111\u00f3 l\u00e0 x\u01b0\u01a1ng \u1ed5 (\u0111\u1eb7c bi\u1ec7t l\u00e0 x\u01b0\u01a1ng \u1ed5 ch\u00ednh danh v\u00e0 nh\u1eefng b\u00e8 x\u01b0\u01a1ng n\u00e2ng \u0111\u1ee1 trong x\u01b0\u01a1ng x\u1ed1p), d\u00e2y ch\u1eb1ng nha chu, n\u01b0\u1edbu v\u00e0 x\u00ea m\u0103ng, ngh\u0129a l\u00e0 to\u00e0n b\u1ed9 c\u00e1c c\u1ea5u tr\u00fac c\u1ee7a nha chu.<\/p>\n

C\u1ea3 di chuy\u1ec3n r\u0103ng sinh l\u00fd l\u1eabn di chuy\u1ec3n r\u0103ng do ch\u1ec9nh h\u00ecnh c\u1ea7n ph\u1ea3i c\u00f3 s\u1ef1 ph\u1ed1i h\u1ee3p \u0111\u1ed3ng b\u1ed9, ph\u1ee9c t\u1ea1p v\u00e0 \u0111i\u1ec1u h\u00f2a sinh h\u1ecdc c\u1ee7a m\u1ed9t s\u1ed1 ho\u1ea1t \u0111\u1ed9ng sau:<\/p>\n

1. S\u1ef1 \u0111\u1ed5i m\u1edbi sinh l\u00fd c\u1ee7a x\u01b0\u01a1ng:<\/strong><\/p>\n

Qu\u00e1 tr\u00ecnh n\u00e0y do nh\u1eefng t\u1ebf b\u00e0o c\u1ee7a h\u1ec7 th\u1ed1ng sinh x\u01b0\u01a1ng (t\u1ebf b\u00e0o ti\u1ec1n sinh x\u01b0\u01a1ng, t\u1ea1o c\u1ed1t b\u00e0o, t\u1ebf b\u00e0o x\u01b0\u01a1ng v\u00e0 h\u1ee7y c\u1ed1t b\u00e0o) \u0111\u1ea3m nhi\u1ec7m.<\/p>\n

Tr\u00ean chu\u1ed9t, chu k\u1ef3 t\u00e1i c\u1ea5u tr\u00fac g\u1ed3m 1,5 \u0111\u1ebfn 2,3 ng\u00e0y ti\u00eau x\u01b0\u01a1ng; 3,5 \u0111\u1ebfn 4 ng\u00e0y t\u00e1i t\u1ed5 h\u1ee3p t\u1ebf b\u00e0o v\u00e0 1 ng\u00e0y t\u00e1i t\u1ea1o, trong \u0111\u00f3 l\u01b0\u1ee3ng x\u01b0\u01a1ng b\u1ecb l\u1ea5y \u0111i tr\u01b0\u1edbc \u0111\u00f3 ph\u00f9 h\u1ee3p v\u1edbi l\u01b0\u1ee3ng x\u01b0\u01a1ng \u0111\u01b0\u1ee3c b\u1ed3i \u0111\u1eafp sau n\u00e0y (Tran Van. P., 1982).
\nTrong su\u1ed1t qu\u00e1 tr\u00ecnh n\u00e0y, s\u1ee3i Sharpey ho\u1eb7c b\u1ecb \u0111\u1ee9t v\u00e0 sau \u0111\u00f3 t\u00e1i t\u1ea1o v\u00e0 t\u00e1i b\u00e1m d\u00ednh, ho\u1eb7c v\u1eabn c\u00f2n nguy\u00ean trong khi x\u01b0\u01a1ng \u0111\u01b0\u1ee3c t\u00e1i c\u1ea5u tr\u00fac. S\u1ef1 h\u00ecnh th\u00e0nh s\u1ee3i Sharpey m\u1edbi ph\u00f9 h\u1ee3p v\u1edbi s\u1ef1 h\u00ecnh th\u00e0nh x\u01b0\u01a1ng m\u1edbi, khi \u0111\u00f3 nguy\u00ean b\u00e0o s\u1ee3i c\u1ee7a m\u00e0ng nha chu tho\u00e1i h\u00f3a t\u1eeb x\u01b0\u01a1ng \u0111ang h\u00ecnh th\u00e0nh tr\u01b0\u1edbc \u0111o (Garant, P.R., 1976; Kurihara, S., 1980).<\/p>\n

2. S\u1ef1 chuy\u1ec3n \u0111\u1ed5i sinh l\u00fd c\u1ee7a d\u00e2y ch\u1eb1ng nha chu:<\/strong><\/p>\n

Bao g\u1ed3m vi\u1ec7c thay th\u1ebf nh\u1eefng s\u1ee3i Sharpey b\u00e1m v\u00e0o x\u01b0\u01a1ng v\u00e0 s\u1ef1 h\u00ecnh th\u00e0nh x\u01b0\u01a1ng m\u1edbi b\u00e1m v\u00e0o x\u00ea m\u0103ng; S\u1ef1 \u0111\u1ee9t s\u1ee3i nha chu c\u0169, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf v\u1ecb tr\u00ed g\u1ea7n x\u01b0\u01a1ng \u0111ang ti\u00eau th\u00f4ng qua \u0111\u1ea1i th\u1ef1c b\u00e0o v\u00e0 ti\u00eau h\u1ee7y n\u1ed9i t\u1ebf b\u00e0o b\u1edfi nguy\u00ean b\u00e0o s\u1ee3i<\/p>\n

3. S\u1ef1 t\u00e1i c\u1ea5u tr\u00fac sinh l\u00fd c\u1ee7a m\u00f4 li\u00ean k\u1ebft n\u01b0\u1edbu:<\/strong><\/p>\n

T\u00f9y thu\u1ed9c v\u00e0o ho\u1ea1t \u0111\u1ed9ng c\u1ee7a nguy\u00ean b\u00e0o s\u1ee3i \u1edf n\u01b0\u1edbu, \u0111\u1eb7c bi\u1ec7t l\u00e0 s\u1ef1 ph\u1ed1i h\u1ee3p li\u00ean t\u1ee5c c\u1ee7a qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p v\u00e0 l\u1ea5y \u0111i c\u00e1c s\u1ee3i collagen.<\/p>\n

4. S\u1ef1 b\u1ed3i \u0111\u1eafp x\u00ea m\u0103ng:<\/strong><\/p>\n

X\u00ea m\u0103ng \u0111\u01b0\u1ee3c b\u1ed3i \u0111\u1eafp l\u00e0 x\u00ea m\u0103ng s\u1ee3i ngo\u1ea1i sinh kh\u00f4ng t\u1ebf b\u00e0o, c\u00f3 s\u1ef1 t\u0103ng chi\u1ec1u d\u00e0y do kho\u00e1ng h\u00f3a t\u1eebng l\u1edbp c\u00e1c b\u00f3 s\u1ee3i nha chu k\u1ebf c\u1eadn (b\u00f3 s\u1ee3i Sharpey).<\/p>\n

X\u00ea m\u0103ng s\u1ee3i n\u1ed9i sinh c\u00f3 t\u1ebf b\u00e0o \u0111\u01b0\u1ee3c l\u1eafng \u0111\u1ecdng theo ki\u1ec3u \u0111\u1eafp th\u00eam t\u1eebng ch\u1ed7 (sau th\u1eddi k\u1ef3 ti\u00eau x\u00ea m\u0103ng), sau \u0111\u00f3 l\u1edbp x\u00ea m\u0103ng m\u1edbi c\u00f3 s\u1ee3i ngo\u1ea1i sinh kh\u00f4ng t\u1ebf b\u00e0o ph\u1ee7 l\u00ean ch\u1ed7 \u0111\u1eafp th\u00eam n\u00e0y.<\/p>\n

Qu\u00e1 tr\u00ecnh n\u00e0y l\u00e0m d\u00e0y l\u1edbp x\u00ea m\u0103ng s\u1ee3i h\u1ed7n h\u1ee3p c\u00f3 t\u1ebf b\u00e0o. T\u1ea5t c\u1ea3 h\u1ec7 th\u1ed1ng tr\u00ean ph\u1ea3i \u0111\u01b0\u1ee3c ho\u1ea1t \u0111\u1ed9ng t\u1ef1 do, kh\u00f4ng b\u1ecb gi\u1edbi h\u1ea1n do c\u00e1c can thi\u1ec7p \u0111i\u1ec1u tr\u1ecb. N\u1ebfu d\u00f9ng l\u1ef1c qu\u00e1 m\u1ee9c trong khi ch\u1ec9nh h\u00ecnh, s\u1ebd d\u1eabn \u0111\u1ebfn ho\u1ea1i t\u1eed, m\u1ed9t s\u1ed1 th\u00e0nh ph\u1ea7n c\u1ee7a h\u1ec7 th\u1ed1ng n\u00e0y s\u1ebd ng\u1eebng ho\u1ea1t \u0111\u1ed9ng v\u00e0 qu\u00e1 tr\u00ecnh di chuy\u1ec3n r\u0103ng, c\u0169ng c\u00f3 ngh\u0129a l\u00e0 qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac s\u1ebd b\u1ecb k\u00e9o d\u00e0i v\u00e0 g\u00e2y bi\u1ebfn ch\u1ee9ng<\/p>\n

3. S\u1ef1 di chuy\u1ec3n r\u0103ng: di g\u1ea7n v\u00e0 tr\u1ed3i m\u1eb7t nhai<\/h2>\n

1. S\u1ef1 di chuy\u1ec3n r\u0103ng theo ph\u01b0\u01a1ng g\u1ea7n<\/strong><\/p>\n

\u201cDi g\u1ea7n\u201d l\u00e0 thu\u1eadt ng\u1eef do Stein v\u00e0 Weinmann \u0111\u1eb7t ra v\u00e0o n\u0103m 1925, n\u00f3 c\u00f3 ngh\u0129a l\u00e0 c\u00e1c r\u0103ng tr\u00ean m\u1ed9t cung r\u0103ng to\u00e0n v\u1eb9n, (c\u1ea3 r\u0103ng s\u1eefa v\u00e0 r\u0103ng v\u0129nh vi\u1ec5n), di v\u1ec1 ph\u00eda gi\u1eefa cung r\u0103ng, l\u00e0m cho v\u1ecb tr\u00ed c\u1ee7a c\u00e1c r\u0103ng ng\u00e0y c\u00e0ng v\u1ec1 ph\u00eda g\u1ea7n h\u01a1n c\u00f9ng v\u1edbi s\u1ef1 t\u0103ng l\u00ean c\u1ee7a tu\u1ed5i t\u00e1c.
\nNguy\u00ean nh\u00e2n c\u01a1 b\u1ea3n c\u1ee7a s\u1ef1 di g\u1ea7n l\u00e0 do m\u00f2n men r\u0103ng \u1edf c\u00e1c v\u00f9ng ti\u1ebfp x\u00fac m\u1eb7t b\u00ean. C\u00e1c \u0111i\u1ec3m ti\u1ebfp x\u00fac r\u1ed9ng ra th\u00e0nh nh\u1eefng v\u00f9ng ti\u1ebfp x\u00fac. S\u1ef1 m\u1ea5t men \u0111\u01b0\u1ee3c b\u00f9 tr\u1eeb b\u1edfi s\u1ef1 di g\u1ea7n, nh\u1edd v\u1eady, t\u1ea5t c\u1ea3 c\u00e1c r\u0103ng v\u1eabn ti\u1ebfp x\u00fac nhau, c\u00f2n chi\u1ec1u d\u00e0i c\u1ee7a cung r\u0103ng th\u00ec gi\u1ea3m.
\nM\u1ee9c \u0111\u1ed9 ng\u1eafn l\u1ea1i c\u1ee7a cung r\u0103ng kh\u00e1c nhau gi\u1eefa c\u00e1c nh\u00f3m c\u01b0 d\u00e2n v\u00e0 theo c\u00e1c giai \u0111o\u1ea1n v\u0103n minh kh\u00e1c nhau: \u1ede s\u1ecd ng\u01b0\u1eddi \u00c2u v\u00e0o th\u1eddi Trung \u0110\u1ea1i v\u00e0 th\u1ed5 d\u00e2n \u00dac, ng\u01b0\u1eddi ta \u0111o \u0111\u01b0\u1ee3c s\u1ef1 gi\u1ea3m chi\u1ec1u d\u00e0i 5-8mm, c\u00f2n \u1edf ng\u01b0\u1eddi T\u00e2y u hi\u1ec7n \u0111\u1ea1i, cung r\u0103ng ng\u1eafn \u0111i 0,3mm trong 9 n\u0103m v\u00e0 ch\u1ec9 th\u1ea5y \u1edf ph\u1ea7n r\u0103ng sau. T\u1eeb nh\u1eefng d\u1eef li\u1ec7u n\u00e0y v\u00e0 nhi\u1ec1u d\u1eef li\u1ec7u kh\u00e1c, ng\u01b0\u1eddi ta t\u00ednh \u0111\u01b0\u1ee3c trung b\u00ecnh m\u1ea5t men m\u1eb7t b\u00ean, c\u0169ng c\u00f3 ngh\u0129a l\u00e0 s\u1ef1 di g\u1ea7n, \u1edf m\u1ed7i kho\u1ea3ng k\u1ebd r\u0103ng l\u00e0 1-10 pm 1 n\u0103m (Begg, P.R., 1954; Lysell, L., 1958; Lammie, G.A., 1965; Yilmaz, R.S., 1980).<\/p>\n

Qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac th\u1ec3 hi\u1ec7n r\u00f5 nh\u1ea5t trong khi di g\u1ea7n di\u1ec5n ra \u1edf x\u01b0\u01a1ng \u1ed5 v\u00e0 c\u00e1c b\u00e8 x\u01b0\u01a1ng x\u1ed1p n\u00e2ng \u0111\u1ee1: b\u1ec1 m\u1eb7t x\u01b0\u01a1ng ph\u00eda g\u1ea7n c\u1ee7a ch\u00e2n r\u0103ng c\u00f3 d\u1ea5u hi\u1ec7u ti\u00eau x\u01b0\u01a1ng; b\u1ec1 m\u1eb7t \u1edf ph\u00eda xa c\u1ee7a r\u0103ng c\u00f3 s\u1ef1 \u0111\u1eafp x\u01b0\u01a1ng.<\/p>\n

C\u00f3 th\u1ec3 th\u1ea5y r\u00f5 v\u00f9ng ti\u00eau x\u01b0\u01a1ng do c\u00f3 nhi\u1ec1u l\u1ed7 ti\u00eau x\u01b0\u01a1ng tr\u00ean b\u1ec1 m\u1eb7t x\u01b0\u01a1ng \u1ed5, c\u00f3 s\u1ef1 hi\u1ec7n di\u1ec7n t\u1ebf b\u00e0o h\u1ee7y x\u01b0\u01a1ng v\u00e0 s\u1ef1 gi\u00e1n \u0111o\u1ea1n c\u1ee7a nh\u1eefng \u0111\u01b0\u1eddng ngh\u1ec9 ph\u00e2n c\u00e1ch c\u00e1c phi\u1ebfn x\u01b0\u01a1ng c\u0169 v\u1edbi nhau do ti\u00eau x\u01b0\u01a1ng.<\/p>\n

Nh\u1eefng v\u00f9ng \u0111\u1eafp x\u01b0\u01a1ng \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 l\u1eafng \u0111\u1ecdng c\u00e1c x\u01b0\u01a1ng b\u00f3 theo th\u1ee9 t\u1ef1. S\u1ef1 ti\u00eau x\u01b0\u01a1ng v\u00e0 l\u1eafng \u0111\u1ecdng c\u00e1c x\u01b0\u01a1ng b\u00f3 kh\u00f4ng ch\u1ec9 gi\u1edbi h\u1ea1n \u1edf b\u1ec1 m\u1eb7t x\u01b0\u01a1ng \u1ed5 k\u1ebf c\u1eadn d\u00e2y ch\u1eb1ng nha chu hay x\u01b0\u01a1ng x\u1ed1p m\u00e0 c\u00f2n x\u1ea3y ra theo h\u01b0\u1edbng xa-g\u1ea7n tr\u00ean t\u1ea5t c\u1ea3 c\u00e1c b\u00e8 x\u01b0\u01a1ng x\u1ed1p trong v\u00e1ch x\u01b0\u01a1ng gi\u1eefa c\u00e1c r\u0103ng v\u00e0 gi\u1eefa c\u00e1c ch\u00e2n r\u0103ng. X\u01b0\u01a1ng b\u00f3 c\u00f3 h\u00ecnh \u1ea3nh m\u00f4 h\u1ecdc \u0111\u1eb7c tr\u01b0ng, sau \u0111\u00f3 \u0111\u01b0\u1ee3c thay b\u1eb1ng c\u00e1c x\u01b0\u01a1ng d\u1ea1ng phi\u1ebfn trong qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac sinh l\u00fd c\u1ee7a x\u01b0\u01a1ng. S\u1ef1 thay th\u1ebf n\u00e0y x\u1ea3y ra tr\u00ean b\u1ec1 m\u1eb7t x\u01b0\u01a1ng \u1ed5 \u0111\u1ed1i di\u1ec7n v\u1edbi kho\u1ea3ng x\u01b0\u01a1ng t\u1ee7y, c\u00f2n c\u00e1c x\u01b0\u01a1ng b\u00f3 m\u1edbi th\u00ec l\u1eafng \u0111\u1ecdng \u1edf ph\u00eda d\u00e2y ch\u1eb1ng nha chu do v\u1eabn c\u00f3 s\u1ef1 di g\u1ea7n. K\u1ebft qu\u1ea3 c\u1ee7a c\u00e1c ho\u1ea1t \u0111\u1ed9ng n\u00e0y l\u00e0 h\u1ed1c x\u01b0\u01a1ng \u1ed5 v\u00e0 v\u00e1ch x\u01b0\u01a1ng \u1ed5 di v\u1ec1 ph\u00eda g\u1ea7n. C\u00f3 th\u1ec3 \u01b0\u1edbc l\u01b0\u1ee3ng kho\u1ea3ng di chuy\u1ec3n c\u1ee7a x\u01b0\u01a1ng \u1ed5 t\u1eeb chi\u1ec1u d\u00e0i c\u1ee7a c\u00e1c b\u00f3 s\u1ee3i n\u1eb1m trong x\u01b0\u01a1ng b\u00f3.<\/p>\n

C\u00f9ng v\u1edbi t\u00e1i c\u1ea5u tr\u00fac x\u01b0\u01a1ng, d\u00e2y ch\u1eb1ng nha chu v\u00e0 m\u00f4 li\u00ean k\u1ebft c\u1ee7a n\u01b0\u1edbu c\u0169ng \u0111\u01b0\u1ee3c t\u00e1i c\u1ea5u tr\u00fac v\u00e0 t\u00e1i \u0111\u1ecbnh v\u1ecb. X\u00ea m\u0103ng tr\u1edf n\u00ean d\u00e0y h\u01a1n nh\u1edd s\u1ef1 l\u1eafng \u0111\u1ecdng th\u00eam c\u00e1c l\u1edbp x\u00ea m\u0103ng c\u00f3 t\u1ebf b\u00e0o.<\/p>\n

Qu\u00e1 tr\u00ecnh t\u00e1i s\u1eafp x\u1ebfp trong m\u00f4 li\u00ean k\u1ebft c\u1ee7a d\u00e2y ch\u1eb1ng nha chu v\u00e0 n\u01b0\u1edbu kh\u00f3 quan s\u00e1t \u0111\u01b0\u1ee3c qua s\u1ef1 thay \u0111\u1ed5i v\u1ec1 c\u1ea5u tr\u00fac v\u00ec kh\u00f4ng th\u1ec3 nh\u1eadn bi\u1ebft \u0111\u01b0\u1ee3c s\u1ef1 thay \u0111\u1ed5i trong c\u00e1ch s\u1eafp x\u1ebfp c\u1ee7a c\u00e1c th\u00e0nh ph\u1ea7n c\u1ea5u tr\u00fac c\u1ee7a ch\u00fang. (C\u00f3 m\u1ed9t ngo\u1ea1i l\u1ec7 l\u00e0 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 Malassez c\u00f2n s\u00f3t l\u1ea1i, t\u1ebf b\u00e0o n\u00e0y kh\u00f4ng tham gia v\u00e0o s\u1ef1 thay \u0111\u1ed5i c\u1ea5u tr\u00fac v\u00e0 do \u0111\u00f3 th\u01b0\u1eddng v\u1eabn c\u00f2n t\u1ed3n t\u1ea1i). Tr\u00ean m\u1ed9t r\u0103ng b\u1ecb tr\u1ed3i m\u1eb7t nhai \u0111\u00e1ng k\u1ec3, v\u1eabn c\u00f3 th\u1ec3 th\u1ea5y c\u00e1c t\u1ebf b\u00e0o n\u00e0y trong kho\u1ea3ng t\u1ee7y x\u01b0\u01a1ng g\u1ea7n \u0111\u00e1y \u1ed5 x\u01b0\u01a1ng.<\/p>\n

C\u01a1 s\u1edf c\u1ee7a l\u1ef1c di g\u1ea7n l\u00e0 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a h\u1ec7 th\u1ed1ng s\u1ee3i tr\u00ean x\u01b0\u01a1ng \u1ed5, \u0111\u1eb7c bi\u1ec7t l\u00e0 s\u1ef1 co l\u1ea1i c\u1ee7a c\u00e1c s\u1ee3i ngang v\u00e1ch c\u1ee7a m\u00f4 nha chu vi\u1ec1n. N\u1ebfu h\u1ec7 th\u1ed1ng s\u1ee3i gi\u1eefa c\u00e1c r\u0103ng b\u1ecb c\u1eaft \u0111\u1ee9t hay n\u1ebfu l\u1ea5y b\u1ecf \u0111i to\u00e0n b\u1ed9 m\u00f4 n\u01b0\u1edbu gi\u1eefa c\u00e1c r\u0103ng, s\u1ef1 di g\u1ea7n s\u1ebd ch\u1eadm l\u1ea1i r\u1ea5t nhi\u1ec1u. Sau khi th\u1eed nghi\u1ec7m b\u1ecf \u0111i \u0111i\u1ec3m ti\u1ebfp x\u00fac, c\u00e1c r\u0103ng k\u1ebf nhau b\u1ecb k\u00e9o l\u1ea1i g\u1ea7n nhau v\u1edbi nh\u1ecbp \u0111\u1ed9 25 micromet trong 2 gi\u1edd. Do \u0111\u00f3 c\u00e1c s\u1ee3i ngang v\u00e1ch v\u00e0 c\u00e1c t\u1ebf b\u00e0o \u0111\u00f3ng m\u1ed9t vai tr\u00f2 r\u00f5 r\u1ec7t. C\u00e1c s\u1ee3i ngang n\u01b0\u1edbu, s\u1ee3i v\u00f2ng, s\u1ee3i n\u1eeda v\u00f2ng v\u00e0 s\u1ee3i gian n\u01b0\u1edbu c\u0169ng c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n quan tr\u1ecdng. N\u1ebfu nh\u1ed5 \u0111i m\u1ed9t r\u0103ng tr\u00ean cung r\u0103ng c\u00f2n nguy\u00ean th\u00ec c\u00e1c s\u1ee3i ngang v\u00e1ch s\u1ebd n\u1ed1i l\u1ea1i qua kho\u1ea3ng m\u1ea5t r\u0103ng v\u00e0 r\u0103ng \u1edf ph\u00eda xa c\u1ee7a kho\u1ea3ng m\u1ea5t r\u0103ng s\u1ebd nghi\u00eang d\u1ea7n v\u1ec1 ph\u00eda g\u1ea7n.<\/p>\n

2. S\u1ef1 tr\u1ed3i m\u1eb7t nhai<\/strong><\/p>\n

Trong khi s\u1ef1 di g\u1ea7n cho th\u1ea5y s\u1ef1 t\u00e1i \u0111\u1ecbnh v\u1ecb sinh l\u00fd c\u1ee7a r\u0103ng theo chi\u1ec1u ngang th\u00ec s\u1ef1 tr\u1ed3i m\u1eb7t nhai b\u00f9 tr\u1eeb cho s\u1ef1 m\u1ea5t men do m\u00f2n m\u1eb7t nhai c\u1ee7a c\u00e1c r\u0103ng \u0111\u1ed1i di\u1ec7n nhau. N\u1ebfu s\u1ef1 di chuy\u1ec3n m\u1eb7t nhai di\u1ec5n ra t\u01b0\u01a1ng \u0111\u1ed1i nhanh th\u00ec s\u1ef1 \u0111i\u1ec1u ti\u1ebft v\u1ecb tr\u00ed m\u1edbi c\u1ee7a r\u0103ng \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 k\u1ebft h\u1ee3p b\u1ed3i \u0111\u1eafp x\u01b0\u01a1ng \u1edf \u0111\u00e1y \u1ed5 x\u01b0\u01a1ng v\u00e0 d\u00e0y l\u00ean c\u1ee7a x\u00ea m\u0103ng \u1edf ch\u00f3p ch\u00e2n r\u0103ng.<\/p>\n

\u1ede \u0111\u00e2y, c\u0169ng nh\u01b0 trong tr\u01b0\u1eddng h\u1ee3p di g\u1ea7n, c\u00e1c l\u1edbp x\u01b0\u01a1ng b\u00f3 hi\u1ec7n di\u1ec7n tr\u00ean b\u1ec1 m\u1eb7t x\u01b0\u01a1ng \u1ed5 ph\u00eda d\u00e2y ch\u1eb1ng nha chu. S\u1ef1 l\u1eafng \u0111\u1ecdng x\u00ea m\u0103ng s\u1ee3i h\u1ed7n h\u1ee3p c\u00f3 t\u1ebf b\u00e0o g\u00f3p ph\u1ea7n l\u00e0m d\u00e0y x\u00ea m\u0103ng \u1edf ch\u00f3p \u0111\u1ed3ng th\u1eddi k\u00e9o d\u00e0i ch\u00e2n r\u0103ng. S\u1ef1 \u0111\u1eafp th\u00eam x\u00ea m\u0103ng v\u00e0 x\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 xem l\u00e0 k\u1ebft qu\u1ea3 (h\u01a1n l\u00e0 nguy\u00ean nh\u00e2n) c\u1ee7a s\u1ef1 tr\u1ed3i m\u1eb7t nhai.<\/p>\n

4. C\u01a1 s\u1edf sinh h\u1ecdc ph\u1ea3n \u1ee9ng c\u1ee7a nha chu v\u1edbi c\u00e1c l\u1ef1c \u0111i\u1ec1u tr\u1ecb<\/h2>\n

Ng\u01b0\u1eddi ta \u0111\u00e3 nghi\u00ean c\u1ee9u ph\u1ea3n \u1ee9ng c\u1ee7a m\u00f4 nha chu v\u1edbi l\u1ef1c ch\u1ec9nh h\u00ecnh t\u1eeb \u0111\u1ea7u th\u1ebf k\u1ef7 20. V\u00ec trong kho\u1ea3ng k\u1ebd r\u0103ng, d\u00e2y ch\u1eb1ng nha chu c\u00f3 s\u1ef1 s\u1eafp x\u1ebfp \u0111\u1ed9c \u0111\u00e1o l\u00e0 n\u1eb1m gi\u1eefa hai m\u00f4 c\u1ee9ng (x\u00ea m\u0103ng v\u00e0 x\u01b0\u01a1ng \u1ed5), n\u00ean lo\u1ea1i ph\u1ea3n \u1ee9ng v\u00e0 t\u1ed1c \u0111\u1ed9 ph\u1ea3n \u1ee9ng ph\u1ee5 thu\u1ed9c ch\u1ee7 y\u1ebfu v\u00e0o c\u01b0\u1eddng \u0111\u1ed9 c\u1ee7a l\u1ef1c qua r\u0103ng \u0111\u1ebfn c\u00e1c ph\u1ea7n c\u1ee7a d\u00e2y ch\u1eb1ng nha chu. C\u01b0\u1eddng \u0111\u1ed9 c\u1ee7a l\u1ef1c \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng t\u1ed5 h\u1ee3p c\u1ee7a chi\u1ec1u d\u00e0i c\u1ee7a ph\u1ea7n t\u00e1c \u0111\u1ed9ng (kho\u1ea3ng c\u00e1ch l\u1ef1c t\u00e1c \u0111\u1ed9ng), \u0111\u1ed9 m\u1ea1nh (ti\u1ec1m l\u1ef1c ban \u0111\u1ea7u) v\u00e0 th\u1eddi gian l\u1ef1c t\u00e1c \u0111\u1ed9ng. Schwarz \u0111\u00e3 n\u00f3i v\u1ec1 c\u00e1c m\u1ee9c c\u01b0\u1eddng \u0111\u1ed9 sinh h\u1ecdc m\u00e0 m\u1ed9t l\u1ef1c ch\u1ec9nh h\u00ecnh ph\u1ea3i \u0111\u1ea1t \u0111\u1ebfn nh\u01b0ng kh\u00f4ng \u0111\u01b0\u1ee3c v\u01b0\u1ee3t qu\u00e1; \u00d4ng \u0111\u00e3 ch\u1ec9 ra l\u1ef1c t\u1ed1i \u01b0u v\u1ec1 m\u1eb7t sinh h\u1ecdc kh\u00f4ng n\u00ean v\u01b0\u1ee3t qu\u00e1 huy\u1ebft \u00e1p mao m\u1ea1ch (20-24 g\/cm2). Reitan, K., (1951, 1960, 1969) \u0111\u00e3 n\u00eau nh\u1eefng chi ti\u1ebft v\u1ec1 c\u01a1 s\u1edf \u0111\u1ec3 hi\u1ec3u bi\u1ebft ph\u1ea3n \u1ee9ng c\u1ee7a m\u00f4 v\u1edbi l\u1ef1c ch\u1ec9nh h\u00ecnh.<\/p>\n

Qu\u00e1 tr\u00ecnh t\u00e1i s\u1eafp x\u1ebfp c\u1ea7n thi\u1ebft cho s\u1ef1 di chuy\u1ec3n r\u0103ng trong ch\u1ec9nh h\u00ecnh tho\u1ea1t ti\u00ean gi\u1ed1ng nh\u01b0 qu\u00e1 tr\u00ecnh di\u1ec5n ra trong s\u1ef1 di g\u1ea7n sinh l\u00fd. Tuy nhi\u00ean, s\u1ef1 t\u00e1i s\u1eafp x\u1ebfp trong qu\u00e1 tr\u00ecnh r\u0103ng di chuy\u1ec3n trong \u0111i\u1ec1u tr\u1ecb di\u1ec5n ra nhanh h\u01a1n v\u00e0 theo nguy\u00ean t\u1eafc th\u00ec qu\u00e1 tr\u00ecnh n\u00e0y ph\u1ea3i cho ph\u00e9p r\u0103ng \u1edf m\u1ed9t v\u1ecb tr\u00ed kh\u00e1c c\u00f3 kho\u1ea3ng c\u00e1ch xa h\u01a1n l\u00e0 s\u1ef1 di r\u0103ng sinh l\u00fd. Lo\u1ea1i t\u00e1i s\u1eafp x\u1ebfp nhanh v\u00e0 m\u1ea1nh n\u00e0y c\u00f3 nhi\u1ec1u nguy c\u01a1, nh\u01b0 ho\u1ea1i t\u1eed d\u00e2y ch\u1eb1ng nha chu v\u00e0 ti\u00eau ch\u00e2n r\u0103ng. M\u1ee9c \u0111\u1ed9 c\u1ee7a c\u00e1c nguy c\u01a1 li\u00ean quan \u0111\u1ebfn lo\u1ea1i di chuy\u1ec3n (nghi\u00eang, t\u1ecbnh ti\u1ebfn, xoay), c\u00e1ch th\u1ee9c v\u00e0 th\u1eddi gian (gi\u00e1n \u0111o\u1ea1n, li\u00ean t\u1ee5c) c\u1ee7a l\u1ef1c, k\u00edch th\u01b0\u1edbc c\u1ee7a v\u00f9ng b\u00e1m d\u00ednh m\u00e0 qu\u00e1 tr\u00ecnh t\u00e1i s\u1eafp x\u1ebfp x\u1ea3y ra.<\/p>\n

Trong di chuy\u1ec3n r\u0103ng do ch\u1ec9nh h\u00ecnh, nh\u1eefng v\u00f9ng \u00e9p v\u00e0 v\u00f9ng c\u0103ng \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh trong d\u00e2y ch\u1eb1ng nha chu. Nh\u1eefng v\u00f9ng n\u00e0y c\u00f3 v\u1ecb tr\u00ed v\u00e0 k\u00edch th\u01b0\u1edbc thay \u0111\u1ed5i t\u00f9y theo lo\u1ea1i di chuy\u1ec3n.<\/p>\n

1. Di chuy\u1ec3n nghi\u00eang v\u00e0 di chuy\u1ec3n t\u1ecbnh ti\u1ebfn <\/strong><\/p>\n

– Trong di chuy\u1ec3n nghi\u00eang, v\u00f9ng \u00e9p v\u00e0 v\u00f9ng c\u0103ng n\u1eb1m song song v\u1edbi tr\u1ee5c ch\u00e2n r\u0103ng, v\u1edbi l\u1ef1c t\u1ed1i \u0111a \u1edf m\u00e0o x\u01b0\u01a1ng \u1ed5 v\u00e0 g\u1ea7n ch\u00f3p ch\u00e2n r\u0103ng, l\u1ef1c t\u1ed1i thi\u1ec3u g\u1ea7n v\u00f9ng t\u00e2m xoay c\u1ee7a tr\u1ee5c r\u0103ng.<\/p>\n

– Trong di chuy\u1ec3n r\u0103ng t\u1ecbnh ti\u1ebfn, c\u00f3 nh\u1eefng v\u00f9ng \u00e9p v\u00e0 v\u00f9ng c\u0103ng v\u1edbi c\u01b0\u1eddng \u0111\u1ed9 \u00edt nhi\u1ec1u b\u1eb1ng nhau d\u1ecdc su\u1ed1t b\u1ec1 m\u1eb7t ch\u00e2n r\u0103ng.
\nTrong v\u00f9ng \u00e9p c\u00f3 s\u1ef1 ti\u00eau x\u01b0\u01a1ng c\u00f2n v\u00f9ng c\u0103ng c\u00f3 s\u1ef1 \u0111\u1eafp x\u01b0\u01a1ng; c\u1ea7n ph\u00e2n bi\u1ec7t qu\u00e1 tr\u00ecnh ti\u00eau x\u01b0\u01a1ng tr\u1ef1c ti\u1ebfp v\u00e0 gi\u00e1n ti\u1ebfp:<\/p>\n

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  • Ti\u00eau x\u01b0\u01a1ng \u1ed5 tr\u1ef1c ti\u1ebfp:\n
      \n
    • X\u1ea3y ra \u1edf v\u00f9ng nha chu d\u01b0\u1edbi l\u1ef1c nh\u1eb9, khi \u0111\u00f3 tu\u1ea7n ho\u00e0n m\u00e1u kh\u00f4ng b\u1ecb gi\u1edbi h\u1ea1n hay gi\u00e1n \u0111o\u1ea1n v\u00e0 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a t\u1ebf b\u00e0o v\u1eabn duy tr\u00ec. Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y th\u1ea5y t\u0103ng ho\u1ea1t \u0111\u1ed9ng t\u1ebf b\u00e0o \u1edf v\u00f9ng \u00e9p v\u00e0 v\u00f9ng c\u0103ng ch\u1ec9 sau 12 gi\u1edd t\u1eeb khi b\u1eaft \u0111\u1ea7u t\u00e1c d\u1ee5ng l\u1ef1c.<\/li>\n
    • T\u00f9y theo lo\u1ea1i k\u00edch th\u00edch (ch\u1ea5n th\u01b0\u01a1ng, l\u1ef1c ch\u1ec9nh h\u00ecnh) m\u00e0 nguy\u00ean b\u00e0o s\u1ee3i hay nguy\u00ean b\u00e0o s\u1ee3i v\u00e0 nguy\u00ean b\u00e0o x\u01b0\u01a1ng s\u1ebd chi\u1ebfm \u0111a s\u1ed1. Trong v\u00f2ng 24 gi\u01a1, t\u1ebf b\u00e0o h\u1ee7y x\u01b0\u01a1ng xu\u1ea5t hi\u1ec7n \u1edf b\u1ec1 m\u1eb7t x\u01b0\u01a1ng \u1ed5 ph\u00eda d\u00e2y ch\u1eb1ng nha chu \u1edf v\u00f9ng \u00e9p; trong 36 gi\u1edd m\u1ed9t d\u00e3y nguy\u00ean b\u00e0o x\u01b0\u01a1ng xu\u1ea5t hi\u1ec7n \u1edf b\u1ec1 m\u1eb7t x\u01b0\u01a1ng \u1ed5 \u1edf v\u00f9ng c\u0103ng. M\u1eadt \u0111\u1ed9 c\u1ee7a nguy\u00ean b\u00e0o x\u01b0\u01a1ng m\u1edbi \u0111\u1ea1t t\u1ed1i \u0111a trong 70 gi\u1edd (Yee, J.A., 1976). Sau 2-4 ng\u00e0y xu\u1ea5t hi\u1ec7n m\u1ed9t vi\u1ec1n d\u1ea1ng x\u01b0\u01a1ng \u1edf v\u00f9ng c\u0103ng, ngh\u0129a l\u00e0 s\u1ef1 \u0111\u1eafp x\u01b0\u01a1ng \u0111\u00e3 b\u1eaft \u0111\u1ea7u. Trong v\u00f9ng c\u0103ng, m\u1ed9t ph\u1ea7n c\u1ee7a c\u00e1c s\u1ee3i d\u00e2y ch\u1eb1ng nha chu n\u1eb1m trong nh\u1eefng l\u1edbp x\u01b0\u01a1ng m\u1edbi t\u1ea1o th\u00e0nh x\u01b0\u01a1ng b\u00f3. Khi l\u00e0m t\u0103ng t\u1ed1c \u0111\u1ed9 di chuy\u1ec3n r\u0103ng trong ch\u1ec9nh h\u00ecnh (g\u1ea7n g\u1ea5p \u0111\u00f4i) b\u1eb1ng c\u00e1ch ti\u00eam prostaglandin E1 t\u1ea1i ch\u1ed7, s\u1ef1 m\u1ea5t x\u01b0\u01a1ng \u0111\u1ea1t \u0111\u1ebfn t\u1ed1c \u0111\u1ed9 t\u1ed1i \u0111a, c\u00f3 th\u1ec3 v\u01b0\u1ee3t qu\u00e1 t\u1ed1c \u0111\u1ed9 t\u1ea1o x\u01b0\u01a1ng (Yamasaki, K., 1984). \u1ede chu\u1ed9t, qu\u00e1 tr\u00ecnh n\u00e0y \u0111\u1ea1t t\u1ed1i \u0111a sau 22 gi\u1edd.<\/li>\n<\/ul>\n<\/li>\n
    • Ti\u00eau x\u01b0\u01a1ng \u1ed5 gi\u00e1n ti\u1ebfp:\n
        \n
      • L\u1ef1c qu\u00e1 m\u1ee9c kh\u00f4ng sinh l\u00fd t\u1ea1o ra nh\u1eefng v\u00f9ng ho\u1ea1i t\u1eed (tr\u01b0\u1edbc \u0111\u00e2y g\u1ecdi l\u00e0 v\u00f9ng hyalin h\u00f3a) trong d\u00e2y ch\u1eb1ng nha chu \u1edf nh\u1eefng v\u00f9ng ch\u1ecbu l\u1ef1c \u00e9p t\u1ed1i \u0111a. Nh\u1eefng v\u00f9ng ho\u1ea1i t\u1eed trong d\u00e2y ch\u1eb1ng nha chu \u0111a s\u1ed1 x\u1ea3y ra khi r\u0103ng di chuy\u1ec3n nghi\u00eang, v\u00e0 c\u00f3 th\u1ec3 do l\u1ef1c li\u00ean t\u1ee5c kh\u00f4ng l\u1edbn h\u01a1n 25g g\u00e2y ra.<\/li>\n
      • Ho\u1ea1i t\u1eed b\u1eaft \u0111\u1ea7u trong 2 gi\u1edd \u0111\u1ea7u sau khi \u00e1p d\u1ee5ng l\u1ef1c v\u00e0 ti\u1ebfp sau \u0111\u00f3 l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh kh\u00f4ng ho\u00e0n nguy\u00ean:<\/li>\n
      • Ch\u1ec9 30 ph\u00fat sau khi d\u00f9ng l\u1ef1c \u0111\u00e3 th\u1ea5y nh\u1eefng thay \u0111\u1ed5i trong b\u00e0o t\u01b0\u01a1ng (ty th\u1ec3 ph\u00f9 n\u1ec1, m\u1ea1ng l\u01b0\u1edbi n\u1ed9i b\u00e0o m\u1edf r\u1ed9ng ch\u1ed7 ch\u1ee9a) trong nh\u1eefng t\u1ebf b\u00e0o c\u1ee7a d\u00e2y ch\u1eb1ng nha chu (nguy\u00ean b\u00e0o s\u1ee3i v\u00e0 t\u1ebf b\u00e0o bi\u1ec3u m\u00f4); tu\u1ea7n ho\u00e0n m\u00e1u \u1ee9 \u0111\u1ecdng.<\/li>\n
      • Kho\u1ea3ng 2 gi\u1edd sau, m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng c\u1ee7a nh\u1eefng thay \u0111\u1ed5i n\u00e0y t\u0103ng l\u00ean: Xu\u1ea5t hi\u1ec7n nh\u1eefng kh\u00f4ng b\u00e0o l\u1edbn trong b\u00e0o t\u01b0\u01a1ng, m\u00e0ng t\u1ebf b\u00e0o b\u1ecb \u0111\u1ee9t \u0111o\u1ea1n v\u00e0 nh\u00e2n t\u1ebf b\u00e0o tho\u00e1i h\u00f3a hay b\u1ecb ph\u00e2n h\u1ee7y. N\u1ebfu l\u1ef1c n\u00e0y kh\u00f4ng ng\u1eebng l\u1ea1i sau 2 gi\u1edd, t\u1ea5t c\u1ea3 t\u1ebf b\u00e0o \u1edf v\u00f9ng n\u00e0y, k\u1ec3 c\u1ea3 t\u1ebf b\u00e0o th\u00e0nh m\u1ea1ch m\u00e1u s\u1ebd ch\u1ebft.<\/li>\n
      • Nh\u1eefng \u0111i\u1ec1u tr\u00ean th\u1ea5y \u0111\u01b0\u1ee3c t\u1eeb nh\u1eefng nghi\u00ean c\u1ee9u \u1edf chu\u1ed9t, b\u1ed5 sung cho nh\u1eefng quan s\u00e1t th\u1ef1c nghi\u1ec7m \u1edf r\u0103ng ng\u01b0\u1eddi ch\u1ecbu l\u1ef1c 70-100g t\u1eeb 2-50 ng\u00e0y:<\/li>\n
      • 2 ng\u00e0y sau khi b\u1eaft \u0111\u1ea7u t\u00e1c \u0111\u1ed9ng, ho\u1ea1i t\u1eed \u0111\u00e3 v\u01b0\u1ee3t qu\u00e1 giai \u0111o\u1ea1n ban \u0111\u1ea7u, c\u00f3 ngh\u0129a l\u00e0 kh\u00f4ng th\u1ec3 ho\u00e0n nguy\u00ean \u0111\u01b0\u1ee3c. V\u00f9ng \u00e9p b\u1ecb ho\u1ea1i t\u1eed ch\u1ee9a di t\u00edch c\u1ee7a nh\u00e2n t\u1ebf b\u00e0o b\u1ecb t\u00e1ch kh\u1ecfi b\u00e0o t\u01b0\u01a1ng c\u1ee7a ch\u00fang v\u00e0 \u0111\u00e3 b\u1ecb ph\u00e2n h\u1ee7y m\u1ed9t ph\u1ea7n. C\u00e1c th\u00e0nh m\u1ea1ch m\u00e1u c\u0169ng b\u1ecb ph\u00e1 h\u1ee7y. C\u00e1c s\u1ee3i collagen c\u1ee7a d\u00e2y ch\u1eb1ng nha chu v\u1eabn c\u00f2n d\u00e0i nguy\u00ean v\u1eb9n. (V\u1eabn c\u00f3 th\u1ec3 th\u1ea5y r\u00f5 h\u1ea7u h\u1ebft c\u00e1c \u0111o\u1ea1n ngang 50-80 nm v\u00e0 c\u00e1c v\u00e2n ngang c\u1ee7a ch\u00fang \u1edf kho\u1ea3ng c\u00e1ch 64 nm 20 ng\u00e0y sau khi b\u1eaft \u0111\u1ea7u d\u00f9ng l\u1ef1c). 10 ng\u00e0y sau khi b\u1eaft \u0111\u1ea7u d\u00f9ng l\u1ef1c, c\u00e1c b\u00f3 s\u1ee3i \u0111\u00e3 b\u1ecb \u0111\u1ee9t th\u00e0nh nh\u1eefng \u0111o\u1ea1n ri\u00eang r\u1ebd, nh\u01b0ng ch\u1ec9 sau \u0111\u00f3 c\u00e1c s\u1ee3i collagen m\u1edbi t\u1eeb t\u1eeb b\u1ecb t\u00e1ch ra theo tr\u1ee5c d\u1ecdc c\u1ee7a ch\u00fang v\u00e0 m\u1ea5t \u0111i.<\/li>\n
      • \u1ede v\u00f9ng b\u1ecb \u00e9p trong th\u1eed nghi\u1ec7m tr\u00ean d\u00e2y ch\u1eb1ng nha chu c\u1ee7a ng\u01b0\u1eddi, m\u00f4 s\u1ebd ch\u1ebft sau 2 ng\u00e0y d\u00f9ng l\u1ef1c (Rygh, P., 1972, 1973; Roberts, W.E., 1981).<\/li>\n
      • X\u01b0\u01a1ng \u1ed5 k\u1ebf c\u1eadn v\u1edbi v\u00f9ng d\u00e2y ch\u1eb1ng nha chu ho\u1ea1i t\u1eed kh\u00f4ng th\u1ec3 ti\u00eau \u0111i m\u1ed9t c\u00e1ch tr\u1ef1c ti\u1ebfp m\u00e0 ph\u1ea3i ti\u00eau gi\u00e1n ti\u1ebfp d\u1ea7n d\u1ea7n. S\u1ef1 ti\u00eau x\u01b0\u01a1ng n\u00e0y x\u1ea3y ra t\u1eeb v\u00f9ng t\u1ee7y x\u01b0\u01a1ng c\u1ee7a x\u01b0\u01a1ng x\u1ed1p k\u1ebf c\u1eadn (\u1edf \u0111\u00f3 v\u1eabn c\u00f3 ho\u1ea1t \u0111\u1ed9ng t\u1ebf b\u00e0o). Do \u0111\u00f3 x\u01b0\u01a1ng \u1ed5 n\u1eb1m g\u1ea7n v\u00f9ng \u00e9p ho\u1ea1i t\u1eed b\u1ecb ti\u00eau theo chi\u1ec1u ng\u01b0\u1ee3c l\u1ea1i. T\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 ho\u1ea1i t\u1eed m\u00e0 c\u1ea7n kho\u1ea3ng 1-2 tu\u1ea7n \u0111\u1ec3 ph\u1ea7n x\u01b0\u01a1ng \u1ed5 ti\u00eau \u0111i v\u00e0 ph\u1ea7n m\u00f4 d\u00e2y ch\u1eb1ng nha chu ho\u1ea1i t\u1eed m\u1ea5t \u0111i. Trong th\u1eddi gian n\u00e0y, s\u1ef1 di chuy\u1ec3n do ch\u1ec9nh h\u00ecnh ng\u1eebng l\u1ea1i. Khi x\u01b0\u01a1ng \u1ed5 \u0111\u00e3 m\u1ea5t \u0111i, c\u00f3 s\u1ef1 di chuy\u1ec3n th\u00ecnh l\u00ecnh, sau \u0111\u00f3 l\u00e0 ti\u1ebfp t\u1ee5c di chuy\u1ec3n ch\u1eadm v\u00e0 li\u00ean t\u1ee5c. H\u1ea7u h\u1ebft ph\u1ea7n m\u00f4 b\u1ecb ho\u1ea1i t\u1eed trong giai \u0111o\u1ea1n d\u00f9ng l\u1ef1c ban \u0111\u1ea7u s\u1ebd m\u1ea5t \u0111i ho\u00e0n to\u00e0n trong v\u00f2ng 3 tu\u1ea7n sau khi d\u00f9ng l\u1ef1c. Cho \u0111\u1ebfn l\u00fac n\u00e0y, d\u00e2y ch\u1eb1ng nha chu m\u1edbi v\u00e0 x\u01b0\u01a1ng \u1ed5 m\u1edbi s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh.<\/li>\n
      • Trong ti\u00eau x\u01b0\u01a1ng gi\u00e1n ti\u1ebfp, ph\u1ea7n t\u1ee7y x\u01b0\u01a1ng x\u1ed1p t\u1ea1m th\u1eddi chuy\u1ec3n th\u00e0nh m\u00f4 li\u00ean k\u1ebft, c\u00e1c b\u00e8 x\u01b0\u01a1ng \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh v\u00e0 m\u1ea5t \u0111i d\u1ecdc theo \u0111\u01b0\u1eddng \u00e1p l\u1ef1c \u1edf trong v\u00e1ch x\u01b0\u01a1ng gi\u1eefa c\u00e1c r\u0103ng v\u00e0 gi\u1eefa c\u00e1c ch\u00e2n r\u0103ng, \u00edt khi th\u1ea5y d\u00e2y ch\u1eb1ng nha chu b\u1ecb ho\u1ea1i t\u1eed \u1edf v\u00f9ng c\u0103ng: \u0110\u1ea7u ti\u00ean h\u00ecnh th\u00e0nh nh\u1eefng khoang l\u1edbn trong m\u00f4 v\u00e0 nguy\u00ean b\u00e0o s\u1ee3i s\u1eafp x\u1ebfp d\u1ecdc theo \u0111\u01b0\u1eddng c\u0103ng. Kho\u1ea3ng 30-50 gi\u1edd sau khi \u00e1p d\u1ee5ng l\u1ef1c, m\u1eadt \u0111\u1ed9 t\u1ebf b\u00e0o trong d\u00e2y ch\u1eb1ng nha chu \u0111\u00e3 t\u0103ng \u0111\u00e1ng k\u1ec3 do s\u1ef1 sinh s\u1ea3n c\u1ee7a nguy\u00ean b\u00e0o s\u1ee3i v\u00e0 c\u00e1c t\u1ebf b\u00e0o ti\u1ec1n sinh x\u01b0\u01a1ng. Sau v\u00e0i ng\u00e0y, xu\u1ea5t hi\u1ec7n m\u1ed9t vi\u1ec1n d\u1ea1ng x\u01b0\u01a1ng, tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a n\u00f3 c\u00f3 m\u1ed9t h\u00e0ng nguy\u00ean b\u00e0o x\u01b0\u01a1ng. C\u00e1c s\u1ee3i d\u00e2y ch\u1eb1ng nha chu \u0111i qua gi\u1eefa nh\u1eefng t\u1ebf b\u00e0o n\u00e0y v\u00e0 s\u1ebd ch\u00f4n trong x\u01b0\u01a1ng m\u1edbi t\u1ea1o. Nh\u1eefng l\u1edbp x\u01b0\u01a1ng m\u1edbi \u0111\u01b0\u1ee3c t\u1ea1o song song v\u1edbi b\u1ec1 m\u1eb7t x\u01b0\u01a1ng \u1ed5 c\u0169. C\u00e1c l\u1ef1c gi\u00e1n \u0111o\u1ea1n l\u00e0m ch\u1eadm qu\u00e1 tr\u00ecnh t\u00e1i s\u1eafp x\u1ebfp, do \u0111\u00f3 t\u1ed1c \u0111\u1ed9 b\u1ed3i \u0111\u1eafp x\u01b0\u01a1ng ch\u1eadm h\u01a1n khi d\u00f9ng l\u1ef1c li\u00ean t\u1ee5c.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

        2. Xoay r\u0103ng<\/strong><\/p>\n

        Khi xoay m\u1ed9t r\u0103ng, h\u00ecnh d\u1ea1ng ch\u00e2n r\u0103ng s\u1ebd quy\u1ebft \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 v\u00e0 v\u1ecb tr\u00ed v\u00f9ng c\u0103ng v\u00e0 v\u00f9ng \u00e9p. Lo\u1ea1i di chuy\u1ec3n n\u00e0y c\u00f3 s\u1ef1 t\u00e1i s\u1eafp x\u1ebfp r\u1ea5t nhi\u1ec1u. Th\u01b0\u1eddng th\u1ea5y c\u00f3 s\u1ef1 h\u00ecnh th\u00e0nh t\u1ea1m th\u1eddi c\u1ee7a c\u00e1c gai x\u01b0\u01a1ng d\u1ecdc theo c\u00e1c s\u1ee3i d\u00e2y ch\u1eb1ng nha chu b\u1ecb k\u00e9o d\u00e0i. Sau khi s\u1ef1 xoay ho\u00e0n t\u1ea5t, c\u00e1c gai x\u01b0\u01a1ng \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng x\u01b0\u01a1ng d\u1ea1ng phi\u1ebfn. Di chuy\u1ec3n xoay c\u1ea7n c\u00f3 s\u1ef1 t\u00e1i s\u1eafp x\u1ebfp r\u1ea5t nhi\u1ec1u c\u00e1c s\u1ee3i collagen trong d\u00e2y ch\u1eb1ng nha chu v\u00e0 n\u01b0\u1edbu. \u0110\u1ea7u ti\u00ean c\u00e1c s\u1ee3i c\u0169 b\u1ecb di chuy\u1ec3n trong khi xoay ph\u1ea3i b\u1ecb ph\u00e2n h\u1ee7y v\u00e0 thay th\u1ebf b\u1eb1ng nh\u1eefng s\u1ee3i m\u1edbi \u0111i t\u1eeb x\u00ea m\u0103ng \u0111\u1ebfn x\u01b0\u01a1ng \u1ed5. S\u1ef1 thay th\u1ebf n\u00e0y c\u1ea7n nhi\u1ec1u th\u1eddi gian h\u01a1n l\u00e0 s\u1ef1 t\u00e1i c\u1ea5u tr\u00fac x\u01b0\u01a1ng \u1ed5 v\u00e0 x\u01b0\u01a1ng x\u1ed1p.<\/p>\n

        Quan s\u00e1t th\u1ef1c nghi\u1ec7m cho th\u1ea5y c\u00e1c s\u1ee3i d\u00e2y ch\u1eb1ng nha chu \u0111\u01b0\u1ee3c thay th\u1ebf ho\u00e0n to\u00e0n sau khi \u0111\u00e3 ho\u00e0n t\u1ea5t di chuy\u1ec3n xoay kho\u1ea3ng 1-3 th\u00e1ng. C\u00e1c s\u1ee3i \u1edf n\u01b0\u1edbu c\u1ea7n th\u1eddi gian t\u00e1i s\u1eafp x\u1ebfp kho\u1ea3ng m\u1ed9t hay nhi\u1ec1u n\u0103m. Do \u0111\u00f3 r\u0103ng \u0111\u00e3 xoay c\u1ea7n \u0111\u01b0\u1ee3c duy tr\u00ec l\u00e2u d\u00e0i \u1edf v\u1ecb tr\u00ed m\u1edbi. N\u1ebfu s\u1ef1 t\u00e1i s\u1eafp x\u1ebfp c\u00e1c s\u1ee3i n\u01b0\u1edbu ch\u01b0a ho\u00e0n t\u1ea5t, r\u0103ng s\u1ebd t\u1eeb t\u1eeb xoay v\u1ec1 v\u1ecb tr\u00ed c\u0169 sau khi \u0111\u00e3 b\u1ecf kh\u00ed c\u1ee5 duy tr\u00ec. Trong t\u1ea5t c\u1ea3 c\u00e1c qu\u00e1 tr\u00ecnh t\u00e1i s\u1eafp x\u1ebfp do ch\u1ec9nh h\u00ecnh, h\u1ec7 th\u1ed1ng s\u1ee3i oxytalan v\u1eabn duy tr\u00ec v\u00e0 t\u01b0\u01a1ng \u1ee9ng v\u1edbi h\u00ecnh d\u1ea1ng thay \u0111\u1ed5i, \u1edf v\u00f9ng \u00e9p c\u0169ng nh\u01b0 v\u00f9ng c\u0103ng, b\u1eb1ng c\u00e1ch t\u00e1i s\u1eafp x\u1ebfp li\u00ean t\u1ee5c.<\/p>\n

        3. S\u1ef1 ti\u00eau ch\u00e2n r\u0103ng trong ch\u1ec9nh h\u00ecnh<\/strong><\/p>\n

        Th\u00f4ng th\u01b0\u1eddng, trong di chuy\u1ec3n r\u0103ng v\u00e0 t\u00e1i s\u1eafp x\u1ebfp do ch\u1ec9nh h\u00ecnh, ch\u00e2n r\u0103ng c\u0169ng b\u1ecb ti\u00eau ng\u00f3t, khi \u0111\u00f3 c\u1ea3 x\u00ea m\u0103ng v\u00e0 v\u00f9ng ng\u00e0 n\u00f4ng b\u1ecb m\u1ea5t \u0111i do ho\u1ea1t \u0111\u1ed9ng c\u1ee7a t\u1ebf b\u00e0o h\u1ee7y ng\u00e0. C\u00f3 hai d\u1ea1ng ti\u00eau ch\u00e2n r\u0103ng:<\/p>\n

        3.1. Ti\u00eau ng\u00f3t m\u1eb7t b\u00ean<\/em><\/span><\/p>\n

        \u1ede m\u1eb7t b\u00ean c\u1ee7a ch\u00e2n r\u0103ng, nh\u1ea5t l\u00e0 xung quanh v\u00f9ng ho\u1ea1i t\u1eed c\u1ee7a d\u00e2y ch\u1eb1ng nha chu, c\u00f3 s\u1ef1 ti\u00eau ng\u00f3t d\u1ea1ng h\u1ed1c t\u1ed5 ong v\u1edbi nhi\u1ec1u k\u00edch th\u01b0\u1edbc kh\u00e1c nhau. \u0110\u1ea7u ti\u00ean, nh\u1eefng h\u1ed1c n\u00e0y c\u00f3 \u0111\u01b0\u1eddng k\u00ednh kho\u1ea3ng 6 km, sau \u0111\u00f3 c\u00e1c h\u1ed1c h\u1ee3p l\u1ea1i t\u1ea1o th\u00e0nh h\u1ed1c r\u1ed9ng v\u00e0i mm. (\u0110\u1eb7c bi\u1ec7t, khi ch\u1ec9nh h\u00ecnh n\u1edbi r\u1ed9ng nhanh h\u00e0m tr\u00ean, xu\u1ea5t hi\u1ec7n nh\u1eefng h\u1ed1c ti\u00eau x\u01b0\u01a1ng r\u1ea5t r\u1ed9ng). Trong v\u00e0i th\u00e1ng sau khi ho\u00e0n t\u1ea5t ch\u1ec9nh h\u00ecnh, c\u00e1c h\u1ed1c ti\u00eau ng\u00f3t n\u00e0y \u0111\u01b0\u1ee3c l\u1ea5p \u0111\u1ea7y b\u1eb1ng ch\u1ea5t d\u1ea1ng x\u01b0\u01a1ng (t\u1eeb x\u00ea m\u0103ng s\u1ee3i n\u1ed9i sinh c\u00f3 t\u1ebf b\u00e0o), sau \u0111\u00f3 \u0111\u01b0\u1ee3c bao ph\u1ee7 b\u1edfi x\u00ea m\u0103ng s\u1ee3i ngo\u1ea1i sinh kh\u00f4ng t\u1ebf b\u00e0o. V\u1ec1 m\u00f4 h\u1ecdc, pha ho\u1ea1t \u0111\u1ed9ng ti\u00eau ng\u00f3t \u0111\u1eb7c tr\u01b0ng b\u1edfi nhi\u1ec1u t\u1ebf b\u00e0o h\u1ee7y ng\u00e0 n\u1eb1m trong h\u1ed1c Howship.<\/p>\n

        Trong giai \u0111o\u1ea1n ng\u1eebng ti\u00eau ng\u00f3t, kh\u00f4ng th\u1ea5y t\u1ebf b\u00e0o h\u1ee7y ng\u00e0, b\u1edd d\u1ea1ng x\u00ea m\u0103ng, c\u0169ng nh\u01b0 nguy\u00ean b\u00e0o x\u00ea m\u0103ng. B\u1ec1 m\u1eb7t d\u1ea1ng t\u1ed5 ong c\u1ee7a c\u00e1c h\u1ed1c ti\u00eau ng\u00f3t \u0111\u01b0\u1ee3c \u0111\u01b0\u1ee3c l\u1ea5p \u0111\u1ea7y b\u1eb1ng ch\u1ea5t d\u1ea1ng x\u01b0\u01a1ng (t\u1eeb x\u00ea m\u0103ng s\u1ee3i n\u1ed9i sinh c\u00f3 t\u1ebf b\u00e0o), sau \u0111\u00f3 \u0111\u01b0\u1ee3c bao ph\u1ee7 b\u1edfi x\u00ea m\u0103ng s\u1ee3i ngo\u1ea1i sinh kh\u00f4ng t\u1ebf b\u00e0o. V\u1ec1 m\u00f4 h\u1ecdc, pha ho\u1ea1t \u0111\u1ed9ng ti\u00eau ng\u00f3t \u0111\u1eb7c tr\u01b0ng b\u1edfi nhi\u1ec1u t\u1ebf b\u00e0o h\u1ee7y ng\u00e0 n\u1eb1m trong h\u1ed1c Howship.<\/p>\n

        Trong giai \u0111o\u1ea1n ng\u1eebng ti\u00eau ng\u00f3t, kh\u00f4ng th\u1ea5y t\u1ebf b\u00e0o h\u1ee7y ng\u00e0, b\u1edd d\u1ea1ng x\u00ea m\u0103ng, c\u0169ng nh\u01b0 nguy\u00ean b\u00e0o x\u00ea m\u0103ng. B\u1ec1 m\u1eb7t d\u1ea1ng t\u1ed5 ong c\u1ee7a c\u00e1c h\u1ed1c ti\u00eau ng\u00f3t \u0111\u01b0\u1ee3c bao ph\u1ee7 b\u1edfi m\u00f4 d\u00e2y ch\u1eb1ng nha chu nh\u01b0ng kh\u00f4ng c\u00f3 s\u1ef1 b\u00e1m d\u00ednh c\u1ee7a c\u00e1c s\u1ee3i Sharpey. Trong giai \u0111o\u1ea1n s\u1eeda ch\u1eefa c\u00f3 th\u1ec3 th\u1ea5y m\u1ed9t b\u1edd vi\u1ec1n ch\u1ea5t d\u1ea1ng x\u00ea m\u0103ng, nguy\u00ean b\u00e0o x\u00ea m\u0103ng \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp \u1edf b\u1ec1 m\u1eb7t c\u1ee7a c\u00e1c h\u1ed1c ti\u00eau ng\u00f3t v\u00e0 x\u00ea m\u0103ng s\u1ee3i n\u1ed9i sinh s\u1eeda ch\u1eefa m\u1edbi t\u1ea1o. \u0110\u1ea7u ti\u00ean c\u00e1c s\u1ee3i d\u00e2y ch\u1eb1ng nha chu kh\u00f4ng n\u1eb1m ch\u00f4n trong x\u00ea m\u0103ng s\u1eeda ch\u1eefa. Ch\u1ec9 \u1edf giai \u0111o\u1ea1n sau n\u00e0y, khi b\u1ec1 m\u1eb7t c\u1ee7a x\u00ea m\u0103ng s\u1ee3i n\u1ed9i sinh s\u1eeda ch\u1eefa \u0111\u01b0\u1ee3c bao ph\u1ee7 b\u1edfi x\u00ea m\u0103ng s\u1ee3i ngo\u1ea1i sinh kh\u00f4ng t\u1ebf b\u00e0o th\u00ec m\u1edbi c\u00f3 s\u1ef1 t\u00e1i b\u00e1m d\u00ednh c\u1ee7a c\u00e1c s\u1ee3i m\u1edbi.<\/p>\n

        Nh\u01b0 v\u1eady, vi\u1ec7c s\u1eeda ch\u1eefa b\u1ec1 m\u1eb7t ch\u00e2n r\u0103ng d\u1eabn t\u1edbi c\u00e1c k\u1ebft qu\u1ea3 sau: – C\u00e1c h\u1ed1c ti\u00eau x\u01b0\u01a1ng \u0111\u01b0\u1ee3c l\u1ea5p \u0111\u1ea7y ho\u00e0n to\u00e0n,<\/p>\n

        – B\u1ec1 m\u1eb7t ch\u00e2n r\u0103ng t\u00e1i l\u1eadp s\u1ef1 li\u00ean t\u1ee5c.<\/p>\n

        – H\u1ec7 th\u1ed1ng s\u1ee3i c\u1ee7a d\u00e2y ch\u1eb1ng nha chu t\u00e1i b\u00e1m d\u00ednh.<\/p>\n

        Lo\u1ea1i l\u00e0nh th\u01b0\u01a1ng n\u00e0y g\u1ecdi l\u00e0 s\u1eeda ch\u1eefa gi\u1ea3i ph\u1eabu, kh\u00e1c v\u1edbi s\u1eeda ch\u1eefa ch\u1ee9c n\u0103ng, trong \u0111\u00f3 c\u00e1c h\u1ed1c ti\u00eau ng\u00f3t ch\u1ec9 \u0111\u01b0\u1ee3c l\u1ea5p \u0111\u1ea7y m\u1ed9t ph\u1ea7n, c\u00e1c s\u1ee3i d\u00e2y ch\u1eb1ng nha chu b\u00e1m v\u00e0o b\u1ec1 m\u1eb7t c\u1ee7a c\u00e1c ch\u1ed7 l\u00f5m n\u00f4ng, v\u00e0 x\u01b0\u01a1ng \u1ed5 \u0111\u01b0\u1ee3c b\u1ed3i \u0111\u1eafp d\u00e0y h\u01a1n \u0111\u1ec3 t\u00e1i l\u1eadp \u0111\u1ed9 r\u1ed9ng sinh l\u00fd c\u1ee7a kho\u1ea3ng d\u00e2y ch\u1eb1ng nha chu.<\/p>\n

        3.2. Ti\u00eau ng\u00f3t v\u00f9ng ch\u00f3p<\/em><\/span><\/p>\n

        D\u1ea1ng th\u1ee9 hai c\u1ee7a ti\u00eau ch\u00e2n r\u0103ng l\u00e0 \u1edf ch\u00f3p ch\u00e2n r\u0103ng, l\u00e0m cho ch\u00e2n r\u0103ng ng\u1eafn \u0111i v\u0129nh vi\u1ec5n th\u1ea5y \u0111\u01b0\u1ee3c tr\u00ean phim X quang. Ch\u00e2n r\u0103ng ng\u1eafn \u0111i kh\u00f4ng ho\u00e0n nguy\u00ean c\u0169ng c\u00f3 th\u1ec3 th\u1ea5y \u1edf ng\u01b0\u1eddi ch\u01b0a bao gi\u1edd \u0111i\u1ec1u tr\u1ecb ch\u1ec9nh h\u00ecnh. S\u1ef1 ti\u00eau ch\u00e2n r\u0103ng kh\u00f4ng do \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 th\u1ea5y \u1edf 22% ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh \u1edf 70-80% r\u0103ng c\u1ee7a h\u1ecd v\u00e0 ng\u00e0y c\u00e0ng t\u0103ng c\u00f9ng v\u1edbi tu\u1ed5i, l\u00e0m cho ch\u00e2n r\u0103ng ng\u00e0y c\u00e0ng ng\u1eafn \u0111i v\u00e0 tr\u1edf n\u00ean tr\u00f2n ra. C\u00e1c r\u0103ng h\u00e0m tr\u00ean, \u0111\u1eb7c bi\u1ec7t l\u00e0 r\u0103ng c\u1eeda gi\u1eefa v\u00e0 c\u1eeda b\u00ean, r\u0103ng c\u1ed1i nh\u1ecf th\u1ee9 2 v\u00e0 c\u1ed1i l\u1edbn th\u1ee9 nh\u1ea5t, b\u1ecb \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u h\u01a1n c\u00e1c r\u0103ng h\u00e0m d\u01b0\u1edbi (Massler, M., 1954; Hotz, R., 1967). M\u1ee9c \u0111\u1ed9 ti\u00eau ch\u00f3p ch\u00e2n r\u0103ng r\u1ea5t kh\u00e1c nhau \u1edf m\u1ed7i ng\u01b0\u1eddi, cho th\u1ea5y khuynh h\u01b0\u1edbng kh\u00e1c nhau \u1edf m\u1ed7i ng\u01b0\u1eddi \u0111\u1ed1i v\u1edbi t\u00ecnh tr\u1ea1ng n\u00e0y<\/p>\n

        Ngu\u1ed3n: T\u1ed5ng h\u1ee3p<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

        D\u1ecbch chuy\u1ec3n r\u0103ng sinh l\u00fd k\u00edch th\u00edch qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac m\u00f4 nha chu nh\u01b0ng kh\u00f4ng l\u00e0m thay \u0111\u1ed5i v\u0129nh vi\u1ec5n v\u1ecb tr\u00ed r\u0103ng. Do \u0111\u00f3 d\u1ecbch chuy\u1ec3n r\u0103ng sinh l\u00fd c\u1ea7n \u0111\u01b0\u1ee3c ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c di chuy\u1ec3n r\u0103ng sinh l\u00fd v\u00e0 di chuy\u1ec3n r\u0103ng do ch\u1ec9nh h\u00ecnh: Di chuy\u1ec3n r\u0103ng sinh l\u00fd […]<\/p>\n","protected":false},"author":21,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[28,33],"tags":[3],"yoast_head":"\nDi chuy\u1ec3n r\u0103ng tr\u00ean l\u00e2m s\u00e0ng - \u0110\u1ea1i c\u01b0\u01a1ng vi th\u1ec3. - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft n\u00e0y s\u1ebd \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c c\u01a1 s\u1edf sinh h\u1ecdc c\u1ee7a qu\u00e1 tr\u00ecnh di chuy\u1ec3n r\u0103ng, c\u0169ng nh\u01b0 \u1ee9ng d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng. 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