{"id":22232,"date":"2023-04-16T14:08:08","date_gmt":"2023-04-16T07:08:08","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22232"},"modified":"2023-04-17T12:47:20","modified_gmt":"2023-04-17T05:47:20","slug":"day-chang-dui-sun-chem-cap-mau-than-kinh-dccs","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/day-chang-dui-sun-chem-cap-mau-than-kinh-dccs\/","title":{"rendered":"D\u00e2y ch\u1eb1ng \u0111\u00f9i – s\u1ee5n ch\u00eam; C\u1ea5p m\u00e1u, th\u1ea7n kinh DCCS"},"content":{"rendered":"

D\u00e2y ch\u1eb1ng ch\u00e9o sau (DCCS) c\u00f9ng v\u1edbi d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc (DCCT) l\u00e0 th\u00e0nh ph\u1ea7n quan tr\u1ecdng trong s\u1ef1 \u0111\u1ea3m b\u1ea3o v\u1eefng ch\u1eafc v\u1ec1 m\u1eb7t \u0111\u1ed9ng h\u1ecdc theo chi\u1ec1u tr\u01b0\u1edbc sau c\u1ee7a kh\u1edbp g\u1ed1i. T\u1ed5n th\u01b0\u01a1ng DCCS \u00edt g\u1eb7p h\u01a1n nhi\u1ec1u so v\u1edbi t\u1ed5n th\u01b0\u01a1ng DCCT. T\u1ef7 l\u1ec7 \u0111\u1ee9t DCCS thay \u0111\u1ed5i t\u1eeb 1- 44% c\u00e1c tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng kh\u1edbp g\u1ed1i c\u1ea5p t\u00ednh t\u00f9y thu\u1ed9c v\u00e0o qu\u1ea7n th\u1ec3 nghi\u00ean c\u1ee9u. <\/strong>Th\u00f4ng qua b\u00e0i vi\u1ebft, ch\u00fang t\u00f4i s\u1ebd tr\u00ecnh b\u00e0y v\u1ec1 gi\u1ea3i ph\u1eabu d\u00e2y ch\u1eb1ng \u0111\u00f9i – s\u1ee5n ch\u00eam (\u0110-SC), c\u1ea5p m\u00e1u v\u00e0 chi ph\u1ed1i th\u1ea7n kinh c\u1ee7a DCCS<\/strong><\/b><\/p>\n

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

Ng\u00e0y ph\u00e1t h\u00e0nh<\/strong>: 30\/03\/2022<\/p>\n

 <\/p>\n

1.Gi\u1ea3i ph\u1eabu d\u00e2y ch\u1eb1ng \u0111\u00f9i – s\u1ee5n ch\u00eam<\/b>
\n<\/b><\/p>\n

D\u00e2y ch\u1eb1ng \u0110-SC tr\u01b0\u1edbc (c\u00f2n g\u1ecdi l\u00e0 d\u00e2y ch\u00e0ng Humphrey) ch\u1ea1y xi\u00ean t\u1eeb b\u1edd d\u01b0\u1edbi di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a DCCS ra sau v\u00e0 xu\u1ed1ng d\u01b0\u1edbi, \u0111\u1ebfn b\u00e1m \u1edf s\u1eebng sau c\u1ee7a s\u1ee5n ch\u00eam ngo\u00e0i n\u00ean n\u00f3 c\u00f3 v\u1ecb tr\u00ed n\u00f4ng nh\u1ea5t khi nh\u00ecn v\u00e0o kh\u1edbp g\u1ed1i t\u1eeb ph\u00eda tr\u01b0\u1edbc ra sau \u1edf t\u01b0 th\u1ebf g\u1ed1i g\u1ea5p 90 \u0111\u1ed9. Di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a d\u00e2y ch\u1eb1ng \u0110-SC tr\u01b0\u1edbc n\u1eb1m ngay s\u00e1t di\u1ec7n s\u1ee5n kh\u1edbp c\u1ee7a l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i, t\u01b0\u01a1ng \u1ee9ng v\u1ecb tr\u00ed 10 gi\u1edd \u1edb g\u1ed1i tr\u00e1i v\u00e0 2 gi\u1edd <\/span>\u1edf<\/span><\/i> kh\u1edbp g\u1ed1i ph\u1ea3i, trong t\u01b0 th\u1ebf g\u1ed1i g\u1ea5p 90 \u0111\u1ed9. C\u00e1c b\u00f3 s\u1ee3i c\u1ee7a d\u00e2y ch\u1eb1ng \u0110-SC tr\u01b0\u1edbc h\u00f2a l\u1eabn v\u1edbi c\u00e1c b\u00f3 s\u1ee3i c\u1ee7a DCCS \u1edb di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a d\u00e2y ch\u1eb1ng. D\u00e2y ch\u1eb1ng \u0110-SC tr\u01b0\u1edbc \u0111\u1ebfn b\u00e1m t\u1eadn \u1edf s\u1eebng sau c\u1ee7a s\u1ee5n ch\u00eam ngo\u00e0i. \u1eda kh\u1edbp g\u1ed1i b\u00ecnh th\u01b0\u1eddng, r\u1ea5t kh\u00f3 c\u00f3 th\u1ec3 quan s\u00e1t th\u1ea5y di\u1ec7n b\u00e1m t\u1eadn c\u1ee7a d\u00e2y ch\u1eb1ng n\u00e0y. C\u00f3 th\u1ec3 quan s\u00e1t th\u1ea5y di\u1ec7n b\u00e1m t\u1eadn c\u00f9a d\u00e2y ch\u1eb1ng n\u00e0y sau khi c\u00e1t b\u00f3 DCCT v\u00e0 l\u00e0m cho m\u00e2m ch\u00e0y b\u00e1n tr\u1eadt ra tr\u01b0\u1edbc. Quan s\u00e1t kh\u1edbp g\u1ed1ii qua D\u00e2y ch\u1eb3ng \u0110-SC sau (c\u00f2n g\u1ecdi !\u00e0 d\u00e2y ch\u1eb3ng Wirsberg) tr\u1ea3i d\u00e0i t\u1eeb m\u1eb7t trong c\u1ee7a di\u1ec7n gian l\u1ed3i c\u1ea7u \u0111\u00f9i \u0111\u1ebfn s\u1eebng sau c\u1ee7a s\u1ee5n ch\u00eam ngo\u00e0i. Di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a d\u00e2y ch\u1eb1ng \u0110-SC sau b\u00e1m g\u1ea7n ph\u1ea7n tr\u00ean c\u1ee7a di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a BST c\u1ee7a DCCS n\u00ean n\u00f3 n\u1eb1m n\u00f4ng h\u01a1n so v\u1edbi DCCS n\u1ebfu nh\u00ecn v\u00e0o kh\u1edbp g\u1ed1i t\u1eeb ph\u00eda sau. Kh\u00f4ng gi\u1ed1ng nh\u01b0 d\u00e2y ch\u1eb1ng \u0110-SC tr\u01b0\u1edbc, di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a d\u00e2y ch\u1eb1ng \u0110-SC sau n\u1eb1m c\u00e1ch bi\u1ec7t v\u1edbi DCCS n\u00ean kh\u00f4ng \u00f3 s\u1ef1 h\u00f2a lan gi\u1eefa c\u00e1c b\u00f3 s\u1ee3i c\u1ee7a d\u00e2y ch\u1eb1ng n\u00e0y v\u1edbi c\u00e1c b\u00f3 s\u1ee3i c\u1ee7a DCCS. Di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a d\u00e2y ch\u1eb1ng \u0110-SC sau n\u1eb1m \u1edf ph\u00eda sau tr\u00ean b\u1edd sau c\u1ee7a di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a DCCS. \u0110i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0, di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a d\u00e2y ch\u1eb1ng \u0110- sc sau n\u1eb1m r\u1ea5t s\u00e2u trong di\u1ec7n gian l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i n\u1ebfu <\/span>n\u1ed9i soi c\u00f3 th\u1ec3 nh\u1eadn thay c\u00e1c b\u00f3 s\u1ee3i c\u1ee7a d\u00e2y ch\u1eb1ng \u0110-SC tr\u01b0\u1edbc ch\u1ea1y theo h\u01b0\u1edbng h\u01a1i nghi\u00eang, \u0111\u1ed1i l\u1eadp v\u1edbi ph\u01b0\u01a1ng th\u1eb3ng \u0111\u1ee9ng c\u1ee7a c\u00e1c b\u00f3 s\u1ee3i c\u1ee7a <\/span>DCCsT\u00a0 <\/span>nh\u00ecn t\u1eeb ng\u00f5 v\u00e0o ph\u00eda tr\u01b0\u1edbc v\u00e0 r\u1ea5t kh\u00f3 quan s\u00e1t b\u1edfi n\u00f3 b\u1ecb che khu\u1ea5t b\u1edfi DCCS. \u0110\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a d\u00e2y ch\u1eb1ng \u0110-SC sau, c\u1ea7n x\u00e1c \u0111\u1ecbnh di\u1ec7n b\u00e1m c\u1ee7a n\u00f3 tr\u1ef1c ti\u1ebfp v\u00e0o s\u1eebng sau c\u00f9a s\u1ee5n ch\u00eam ngo\u00e0i.<\/span><\/p>\n

Kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c kh\u1edbp g\u1ed1i \u0111\u1ec1u c\u00f3 \u0111\u1ea7y \u0111\u1ee7 hai d\u00e2y ch\u1eb1ng \u0110-SC. Tuy nhi\u00ean, khi c\u00f3 m\u1eb7t c\u1ee7a c\u1ea3 hai d\u00e2y ch\u1eb3ng n\u00e0y, ch\u00fang s\u1ebd \u00f4m DCCS \u1edf ph\u00eda tr\u01b0\u1edbc v\u00e0 ph\u00eda sau. B\u1edbi v\u00ec \u0111\u1ea7u d\u01b0\u1edbi c\u1ee7a d\u00e2y ch\u1eb1ng \u0110-SC \u0111\u1ebfn b\u00e1m \u1edf s\u1eebng sau c\u1ee7a s\u1ee5n ch\u00eam ngo\u00e0i n\u00ean trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p c\u00f3 t\u1ed5n th\u01b0\u01a1ng DCCS m\u00e0 d\u00e2y ch\u1eb1ng \u0110-SC v\u1ea7n c\u00f2n nguy\u00ean v\u1eb9n. C\u1ea5u tr\u00fac n\u00e0y ho\u1ea1t \u0111\u1ed9ng nh\u01b0 m\u1ed9t n\u1eb9p tr\u1ee3 \u0111\u1edd gi\u00fap DCCS \u1edf nguy\u00ean v\u1ecb tr\u00ed \u0111\u1ec3 <\/span>ph\u1ee5c h\u1ed3i sau ch\u1ea5n th\u01b0\u01a1ng v\u00e0 c\u00f3 \u00fd ngh\u0129a quan tr\u1ecdng trong vi\u1ec7c ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n trong tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng DCCS \u0111\u01a1n thu\u1ea7n.<\/span><\/p>\n

M\u1ed9t nghi\u00ean c\u1ee9u gi\u1ea3i ph\u1eabu c\u1ee7a \u0111\u00e2y ch\u1eb1ng \u0110-SC \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean 1200 kh\u1edbp g\u1ed1i ghi nh\u1eadn, kho\u1ea3ng 93% kh\u1edbp g\u1ed1i c\u00f3 \u00edt nh\u1ea5t m\u1ed9t trong hai d\u00e2y ch\u1eb1ng \u0110-SC v\u00e0 kho\u1ea3ng 50% kh\u1edbp g\u1ed1i c\u00f3 \u0111\u1ed3ng th\u1eddi c\u1ea3 hai d\u00e2y ch\u1eb1ng [27].<\/span><\/p>\n

D\u00e2y ch\u00e0ng \u0110-SC’ l\u00e0 m\u1ed9t c\u1ea5u tr\u00fac c\u00f3 nhi\u1ec1u t\u00f9y bi\u1ebfn v\u00e0 khi c\u1ecf m\u1eb7t, k\u00edch <\/span>th\u01b0\u1edbc c\u1ee7a d\u00e2y ch\u1eb1ng c\u0169ng r\u1ea5t thay \u0111\u1ed1i. D\u00e2y ch\u1eb1ng \u0110-SC ch\u1ecbu \u0111\u01b0\u1ee3c s\u1ee9c c\u0103ng trung b\u00ecnh kho\u1ea3ng 300 N, t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi s\u1ee9c c\u00e1ng trung b\u00ecnh c\u1ee7a BST c\u1ee7a DCCS. Do d\u00e2y ch\u1eb1ng \u0110-SC c\u00f3 h\u01b0\u1edbng xi\u00ean t\u1eeb s\u1eebng sau s\u1ee5n ch\u00eam ngo\u00e0i \u0111\u1ebfn m\u00e1i c\u1ee7a di\u1ec7n gian l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i n\u00ean n\u00f3 c\u00f3 vai tr\u00f2 ch\u1ed1ng l\u1ea1i s\u1ef1 di l\u1ec7ch ra sau c\u1ee7a m\u00e2m ch\u00e0y so v\u1edbi x\u01b0\u01a1ng \u0111\u00f9i. Ch\u1ee9c n\u0103ng n\u00e0y c\u1ee7a d\u00e2y ch\u1eb3ng \u0110-SC ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c ch\u1ee9ng minh r\u00f5 r\u00e0ng trong nh\u1eefng nghi\u00ean c\u1ee9u c\u01a1 sinh h\u1ecdc g\u1ea7n \u0111\u00e2y [2].<\/span><\/p>\n

2. C\u1ea5p m\u00e1u v\u00e0 chi ph\u1ed1i th\u1ea7n kinh c\u1ee7a DCCS<\/b><\/p>\n

\u0110\u1ed9ng m\u1ea1ch kheo cho 5 nh\u00e1nh b\u00ean \u0111en c\u1ea5p m\u00e1u cho kh\u1edbp g\u1ed1i: \u0111\u1ed9ng m\u1ea1ch g\u1ed1i tr\u00ean trong, \u0111\u1ed9ng m\u1ea1ch g\u1ed1i tr\u1ee9\u01a1c ngo\u00e0i, \u0111\u1ed9ng m\u1ea1ch g\u1ed1i d\u01b0\u1edbi trong, \u0111\u1ed9ng m\u1ea1ch g\u1ed1i d\u01b0\u1edbi ngo\u00e0i v\u00e0 \u0111\u1ed9ng m\u1ea1ch g\u1ed1i gi\u1eefa. \u0110\u1ed9ng m\u1ea1ch g\u1ed1i gi\u1eefa ch\u1ea1y xuy\u00ean qua bao kh\u1edbp ph\u00eda sau c\u1ee7a kh\u1edbp g\u1ed1i \u0111\u1ebfn c\u1ea5p m\u00e1u cho c\u00e1c d\u00e2y ch\u1eb1ng ch\u00e9o, bao ho\u1ea1t d\u1ecbch v\u00e0 bao kh\u1edbp ph\u00eda sau. M\u00e0ng ho\u1ea1t d\u1ecbch kh\u1edbp g\u1ed1i \u0111\u1ebfn bao ph\u00fa DCCS l\u00e0 ngu\u1ed3n c\u1ea5p m\u00e1u ch\u00ednh cho DCCS. Ngo\u00e0i ra ph\u1ea7n ba d\u01b0\u1edbi c\u1ee7a DCCS c\u00f2n nh\u1eadn c\u1ea5p m\u00e1u t\u1eeb c\u00e1c nh\u00e1nh bao kh\u1edbp c\u1ee7a \u0111\u1ed9ng m\u1ea1ch g\u1ed1i d\u01b0\u1edbi v\u00e0 c\u1ee7a \u0111\u1ed9ng m\u1ea1ch khoeo.<\/span><\/p>\n

\"C\u1ea5p
C\u1ea5p m\u00e1u cho DCCS<\/figcaption><\/figure>\n

DCCS v\u00e0 bao ho\u1ea1t d\u1ecbch c\u1ee7a n\u00f3 nh\u1eadn chi ph\u1ed1i th\u1ea7n kinh t\u1eeb \u0111\u00e1m r\u1ed1i khoeo. \u0110\u00e1m r\u1ed1i n\u00e0y \u0111\u01b0\u1ee3c c\u1ea5u th\u00e0nh t\u1eeb <\/span>th\u1ea7n kinh kh\u1edbp g\u1ed1i sau (l\u00e0 m\u1ed9t nh\u00e1nh c\u1ee7a th\u1ea7n kinh ch\u00e0y sau) v\u00e0 nh\u00e1nh t\u1eadn c\u1ee7a th\u1ea7n kinh b\u1ecbt. c\u1ea5u tr\u00fac gi\u1ed1ng th\u1ec3 Golgi quan s\u00e1t th\u1ea5y \u1edd g\u1ea7n \u0111i\u1ec3m b\u00e1m c\u1ee7a d\u00e2y ch\u1eb1ng, d\u01b0\u1edbi bao ho\u1ea1t d\u1ecbch, \u0111u\u1ee3c cho r\u1eb1ng l\u00e0 c\u00e1c th\u1ee5 th\u1ec3 c\u1ea3m nh\u1eadn ch\u1ee9c n\u0103ng c\u1ee7a kh\u1edbp g\u1ed1i. C\u00e1c nghi\u00ean c\u1ee9u c\u1ee7a Hirasawa v\u00e0 cs, Katonis v\u00e0 cs, v\u00e0 Kennedy v\u00e0 cs ghi nh\u1eadn c\u00e1c h\u1ea1t Ruff\u00edni (th\u1ee5 th\u1ebf c\u1ea3m nh\u1eadn \u00e1p l\u1ef1c), h\u1ea1t <\/span>DCCS kh\u00f4ng chi \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u01a1 sinh h\u1ecdc c\u1ee7a kh\u1edbp g\u1ed1i m\u00e0 c\u00f2n g\u1eedi nh\u1eefng t\u00edn hi\u1ec7u h\u01b0\u1edbng t\u00e2m t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh [29], <\/span>\u01b0\u1edbc \u0111o\u00e1n. H\u01a1n n\u1eefa, tu\u1ed5i t\u00e1c c\u0169ng l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 c\u00f3 vai tr\u00f2 quan tr\u1ecdng \u1ea3nh h\u01b0\u1eddng \u0111\u1ebfn s\u1ee9c c\u0103ng c\u1ee7a d\u00e2y ch\u1eb1ng.<\/span><\/p>\n

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

D\u00e2y ch\u1eb1ng ch\u00e9o sau (DCCS) c\u00f9ng v\u1edbi d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc (DCCT) l\u00e0 th\u00e0nh ph\u1ea7n quan tr\u1ecdng trong s\u1ef1 \u0111\u1ea3m b\u1ea3o v\u1eefng ch\u1eafc v\u1ec1 m\u1eb7t \u0111\u1ed9ng h\u1ecdc theo chi\u1ec1u tr\u01b0\u1edbc sau c\u1ee7a kh\u1edbp g\u1ed1i. T\u1ed5n th\u01b0\u01a1ng DCCS \u00edt g\u1eb7p h\u01a1n nhi\u1ec1u so v\u1edbi t\u1ed5n th\u01b0\u01a1ng DCCT. T\u1ef7 l\u1ec7 \u0111\u1ee9t DCCS thay \u0111\u1ed5i t\u1eeb 1- 44% […]<\/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":"\nD\u00e2y ch\u1eb1ng \u0111\u00f9i - s\u1ee5n ch\u00eam; C\u1ea5p m\u00e1u, th\u1ea7n kinh DCCS - Vinmec<\/title>\n<meta name=\"description\" content=\"Gi\u1ea3i ph\u1eabu d\u00e2y ch\u1eb1ng \u0111\u00f9i - s\u1ee5n ch\u00eam: D\u00e2y ch\u1eb1ng \u0110-SC tr\u01b0\u1edbc (c\u00f2n g\u1ecdi l\u00e0 d\u00e2y ch\u00e0ng Humphrey) ch\u1ea1y xi\u00ean t\u1eeb b\u1edd d\u01b0\u1edbi di\u1ec7n b\u00e1m \u0111\u00f9i c\u1ee7a DCCS ra sau\" \/>\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=\"D\u00e2y ch\u1eb1ng \u0111\u00f9i - s\u1ee5n ch\u00eam; 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