{"id":22248,"date":"2023-04-16T13:50:05","date_gmt":"2023-04-16T06:50:05","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22248"},"modified":"2023-04-17T16:57:53","modified_gmt":"2023-04-17T09:57:53","slug":"phau-thuat-tao-hinh-day-chang-cheo-sau-dccs","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/phau-thuat-tao-hinh-day-chang-cheo-sau-dccs\/","title":{"rendered":"Ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau (DCCS)"},"content":{"rendered":"

D\u00e2y ch\u1eb1ng ch\u00e9o sau (DCCS)<\/a> 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 vi\u1ec7c \u1ee9<\/strong><\/b>ng d\u1ee5ng gi\u1ea3i ph\u1eabu c\u1ee7a DCCS trong ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau<\/strong><\/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

1. T\u1ea1o h\u00ecnh DCCS d\u1ef1a tr\u00ean c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu<\/strong><\/h2>\n

T\u1eeb nh\u1eefng hi\u1ec3u bi\u1ebft v\u1ec1 gi\u1ea3i ph\u1eabu c\u1ee7a DCCS, c\u00e1c nh\u00e0 gi\u1ea3i ph\u1eabu h\u1ecdc c\u0169ng nh\u01b0 c\u00e1c ph\u1eabu thu\u1eadt vi\u00ean ch\u1ea5n th\u01b0\u01a1ng <\/span>ch\u1ec9nh h\u00ecnh \u0111\u1ec3u ph\u1ea3i \u0111\u1ed3ng \u00fd r\u0103ng, ph\u1eabu <\/span>thu\u1eadt t\u1ea1o h\u00ecnh DCCS gi\u1ed1ng v\u1edbi gi\u1ea3i ph\u1eabu nguy\u00ean b\u1ea3n c\u1ee7a d\u00e2y ch\u1eb1ng l\u00e0 m\u1ed9t \u0111i\u1ec1u v\u00f4 c\u00f9ng kh\u00f3 kh\u0103n n\u1ebfu kh\u00f4ng mu\u1ed1n n\u00f3i l\u00e0 kh\u00f4ng th\u1ec3 th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c, v\u1ec1 c\u0103n b\u1ea3n, m\u1ee5c \u0111\u00edch chung c\u1ee7a ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh DCCS hi\u1ec7n nay l\u00e0 t\u1ea1o di\u1ec7n b\u00e1m ch\u00e0y \u1edf m\u00e2m ch\u00e0y v\u00e0 di\u1ec7n <\/span>b\u00e1m \u0111\u00f9i \u1edd x\u01b0\u01a1ng \u0111\u00f9i t\u01b0\u01a1ng \u1ee9ng v\u1edbi <\/span>v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu di\u1ec7n b\u00e1m c\u1ee7a DCCS, sau \u0111\u00f3 \u0111\u01b0a m\u1ea3nh gh\u00e9p v\u00e0o v\u00e0 c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p \u0111\u00fang v\u1ecb tr\u00ed gi\u1ea3i phau c\u1ee7a DCCS ban \u0111\u1ea7u \u0111\u1ec3 ph\u1ee5c h\u1ed3i l\u1ea1i ch\u1ee9c n\u0103ng c\u1ee7a d\u00e2y ch\u1eb1ng.<\/span><\/p>\n

Hi\u1ec7n nay c\u00e1c ph\u1eabu thu\u1eadt vi\u00ean ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh c\u00f3 2 quan \u0111i\u1ec3m ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh DCCS d\u1ef1a tr\u00ean c\u1ea5u tr\u00fac gi\u1ea3i ph\u1eabu c\u1ee7a d\u00e2y ch\u1eb3ng l\u00e0 ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt m\u1ed9t b\u00f3 v\u00e0 ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt hai b\u00f3. Do c\u1ea5u t\u1ea1o gi\u1ea3i ph\u1eabu c\u1ee7a BTN to v\u00e0 ch\u1eafc kh\u1ecfe h\u01a1n r\u1ea5t nhi\u1ec1u so v\u1edbi BST, nh\u1eefng ph\u1eabu thu\u1eadt vi\u00ean \u00f9ng h\u1ed9 quan \u0111i\u1ec3m ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt m\u1ed9t b\u00f3 cho r\u1eb1ng c\u1ea7n t\u1ea1o h\u00ecnh l\u1ea1i d\u00e2y ch\u1eb3ng m\u1edbi c\u00f3 gi\u1ea3i ph\u1eabu g\u1ea7n gi\u1ed1ng nh\u1ea5t v\u1edbi gi\u1ea3i ph\u1eabu c\u1ee7a <\/span>BTN c\u1ee7a DCCS. V\u1edbi quan \u0111i\u1ec3m n\u00e0y, v\u1ecb tr\u00ed khoan \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i c\u1ee7a DCCS th\u01b0\u1eddng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh \u1edd v\u1ecb tr\u00ed 11 h \u0111\u1ed1i v\u1edbi kh\u1edbp g\u1ed1i tr\u00e1i v\u00e0 Ih \u0111\u1ed1i v\u1edbi kh\u1edbp g\u1ed1i ph\u1ea3i, n\u1eb1m gi\u1eefa t\u00e2m di\u1ec7n b\u00e1m c\u1ee7a <\/span>BTN \u01b0\u1edbc l\u01b0\u1ee3ng \u0111\u01b0\u1ee3c khi n\u1ed9i soi kh\u1edbp, c\u00e1ch b\u1eeb tr\u01b0\u1edbc c\u1ee7a s\u1ee5n kh\u1edbp l\u1ed3i c\u1ea7u \u0111\u00f9i m\u1ed9t kho\u1ea3ng c\u00e1ch kho\u1ea3ng 7-8mm. V\u1ecb tr\u00ed khoan \u0111\u01b0\u1eddng h\u1ea7m ch\u00e0y c\u1ee7a\u00a0 DCCS \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng c\u00e1ch x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS quan s\u00e1t \u0111\u01b0\u1ee3c qua n\u1ed9i soi. v\u1ec1 m\u1eb7t gi\u1ea3i ph\u1eabu v\u1ecb tr\u00ed di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a BTN n\u1eb1m \u1edb ph\u00eda tr\u01b0\u1edbc h\u01a1n so v\u1edbi BST nh\u01b0ng v\u1ecb tr\u00ed khoan \u0111\u01b0\u1eddng h\u1ea9m ch\u00e0y trong k\u1ef3 thu\u1eadt t\u1ea1o h\u00ecnh DCCS m\u1ed9t b\u00f3 c\u00f3 xu h\u01b0\u1edbng n\u1eb1m gi\u1eefa t\u00e2m di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o sau h\u01a1n l\u00e0 t\u00e2m di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a BTN. \u0110\u00e0 c\u00f3 m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u nh\u00e0m t\u00ecm ki\u1ebfm s\u1ef1 l\u00fd t\u01b0\u1edfng cho v\u1ecb tr\u00ed \u0111\u1eb7t \u0111\u01b0\u1eddng h\u00e0m ch\u00e0y trong t\u1ea1o h\u00ecnh DCCS tuy nhi\u00ean <\/span>c\u00e1c <\/b>m\u1ed1c gi\u1ea3i ph\u1eabu <\/span>x\u00e1c \u0111\u1ecbnh qua n\u1ed9i soi hay tr\u00ean X-quang <\/span>c\u0169ng ch\u01b0a th\u1ef1c s\u1ef1 th\u1ed1ng nh\u1ea5t. T\u01b0 th\u1ebf c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p trong t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt m\u1ed9t b\u00f3 l\u00e0 \u1edf t\u01b0 th\u1ebf gi\u1ea3i ph\u1eabu m\u00e0 \u1edb \u0111\u00f3 BTN c\u0103ng nh\u1ea5t t\u01b0\u01a1ng \u1ee9ng v\u1edbi t\u01b0 th\u1ebf g\u1ea5p g\u1ed1i kho\u1ea3ng 70-90 \u0111\u1ed9, c\u1eb3ng ch\u00e2n xoay ngo\u00e0i v\u00e0 th\u1ef1c hi\u1ec7n nghi\u1ec7m ph\u00e1p ng\u0103n k\u00e9o tr\u01b0\u1edbc.<\/span><\/p>\n

2. T\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau k\u1ef9 thu\u1eadt hai b\u00f3<\/strong><\/h2>\n

V\u1edbi quan \u0111i\u1ec3m t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau k\u1ef9 thu\u1eadt hai b\u00f3, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u1ec1u th\u1ed1ng nh\u1ea5t, ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh DCCS s\u1ebd t\u1ea1o h\u00ecnh \u0111\u1ed3ng th\u1eddi c\u00e1 BTN v\u00e0 BST c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o sau sao cho c\u1ea3 hai b\u00f3 c\u1ee7a d\u00e2y ch\u1eb1ng m\u1edbi t\u00e1i t\u1ea1o c\u00f3 v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu g\u1ea7n gi\u1ed1ng nh\u1ea5t v\u1edbi b\u00f3 BTN v\u00e0 BST c\u1ee7a DCCS nguy\u00ean th\u1ee7y. B\u1edfi v\u1eady, trong k\u1ef9 thu\u1eadt n\u00e0y v\u1ecb tr\u00ed khoan \u0111\u01b0\u1eddng h\u1ea7m \u0111\u00f9i c\u1ee7a BTN th\u01b0\u1eddng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh \u1edf v\u1ecb tr\u00ed 11h \u0111\u1ed1i v\u1edbi kh\u1edbp g\u1ed1i tr\u00e1i v\u00e0 !h \u0111\u1ed1i v\u1edbi kh\u1edbp g\u1ed1i ph\u1ea3i v\u00e0 c\u1ee7a BST l\u00e0 v\u1ecb tr\u00ed 10h \u0111\u1ed1i v\u1edbi kh\u1edbp g\u1ed1i tr\u00e1i v\u00e0 2h \u0111\u1ed1i v\u1edbi kh\u1edbp g\u1ed1i ph\u1ea3i, n\u1eb1m gi\u1eefa t\u00e2m di\u1ec7n b\u00e1m BTN v\u00e0 BST c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o sau quan s\u00e1t \u0111\u01b0\u1ee3c khi n\u1ed9i soi kh\u1edbp g\u1ed1i.<\/span><\/p>\n

K\u1ef3 thu\u1eadt khoan \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng ch\u00e0y c\u0169ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 k\u1ef9 thu\u1eadt khoan \u0111\u01b0\u1eddng h\u1ea9m x\u01b0\u01a1ng ch\u00e0y trong t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt m\u1ed9t b\u00f3 nh\u01b0ng l\u00fac n\u00e0y \u0111\u01b0\u1eddng h\u1ea7m c\u1ee7a BTN v\u00e0 BST \u0111\u01b0\u1ee3c \u0111\u1eb7t \u1edf \u0111\u00fang v\u1ecb tr\u00ed t\u01b0\u01a1ng \u1ee9ng v\u1edbi t\u00e2m di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a BTN v\u00e0 c\u1ee7a BST c\u1ee7a d\u00e2y ch\u1eb1ng nguy\u00ean th\u1ee7y. V\u00ec nh\u1eefng nghi\u00ean c\u1ee9u gi\u1ea3i ph\u1eabu \u0111\u1ec1u nh\u1eadn th\u1ea5y di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS t\u01b0\u01a1ng \u0111\u1ed5i g\u1ecdn n\u00ean m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 ch\u1ee7 \u0111\u1ed9ng \u0111\u1ec1 xu\u1ea5t k\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS hai b\u00f3 v\u1edbi m\u1ed9t \u0111\u01b0\u1eddng h\u1ea7m ch\u00e0y n\u1ea7m gi\u1eefa t\u00e2m di\u1ec7n b\u00e1m ch\u00e0y c\u1ee7a DCCS v\u00e0 hai \u0111\u01b0\u1eddng h\u1ea7m \u0111\u00f9i nh\u01b0 m\u00f4 t\u1ea3.<\/span><\/p>\n

\"V\u1ecb
V\u1ecb tr\u00ed \u0111\u01b0\u1eddng h\u1ea7m ch\u00e0y (A) v\u00e0 \u0111\u01b0\u1eddng h\u1ea7m \u0111\u00f9i (B) trong t\u1ea1o h\u00ecnh DCCS k\u1ef9 thu\u1eadt m\u1ed9t b\u00f3 so v\u1edbi di\u1ec7n b\u00e1m c\u1ee7a DCCS nguy\u00ean thu\u1ef7<\/figcaption><\/figure>\n

V\u00ec c\u01a1 sinh h\u1ecdc c\u1ee7a BTN v\u00e0 BST c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o sau c\u0103ng ch\u00f9ng kh\u00e1c nhau trong qu\u00e1 tr\u00ecnh g\u1ea5p du\u1ed7i kh\u1edbp g\u1ed1i n\u00ean v\u1ecb tr\u00ed c\u1ed1 \u0111\u1ecbnh c\u00f9a BTN v\u00e0 BST trong k\u1ef9 thu\u1eadt t\u1ea1o h\u00ecnh DCCS hai b\u00f3 kh\u00f4ng gi\u1ed1ng nhau. V\u1edbi BTN, m\u1ea3nh gh\u00e9p \u0111\u01b0\u1ee3c c\u1ed5 \u0111\u1ecbnh t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u0111\u00e3 m\u00f4 t\u1ea3 \u1edf k\u1ef3 thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o saum\u1ed9t b\u00f3. V\u1edbi BST, m\u1ea3nh gh\u00e9p \u0111\u01b0\u1edbc c\u1ed1 \u0111\u1ecbnh \u1edd t\u01b0 th\u1ec3 du\u1ed7i g\u1ed1i v\u00e0 duy tr\u00ec m\u1ed9t l\u1ef1c k\u1ebbo m\u00e2m ch\u00e0y ra tr\u01b0\u1edbc trong su\u1ed1t qu\u00e1 tr\u00ecnh c\u1ed1 \u0111\u1ecbnh m\u1ea3nh gh\u00e9p.<\/span><\/p>\n

D\u1ef1a tr\u00ean hi\u1ec3u bi\u1ebft gi\u1ea3i ph\u1eabu d\u00e2y ch\u1eb1ng ch\u00e9o sau v\u00e0 ph\u1ee9c h\u1ee3p d\u00e2y ch\u1eb3ng \u0110-SC tr\u01b0\u1edbc v\u00e0 sau c\u0169ng nh\u01b0 vai tr\u00f2 c\u1ee7a ho\u1ea1t d\u1ecbch kh\u1edbp g\u1ed1i trong vi\u1ec7c t\u00e1i t\u01b0\u1edbi m\u00e1u cho m\u1ea3nh gh\u00e9p c\u0169ng nh\u01b0 ph\u00e2n ph\u1ed1i c\u1ee7a c\u00e1c th\u1ee5 th\u1ec3 than kinh, m\u1ed9t s\u1ed1 ph\u1eabu thu\u1eadt vi\u00ean cho r\u1eb1ng, trong ph\u1eabu thu\u1eadt t\u1ea1o h\u1ec9nh d\u00e2y ch\u1eb1ng ch\u00e9o sau, <\/span>vi\u1ec7c b\u1ea3o t\u1ed3n ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o sau nguy\u00ean th\u1ee7y c\u00f9ng nh\u01b0 b\u1ea3o t\u1ed3n d\u00e2y ch\u1eb1ng \u0110-SC l\u00e0 r\u1ea5t quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh li\u1ec1n m\u1ea3nh gh\u00e9p c\u0169ng nh\u01b0 ph\u1ee5c h\u1ed3i c\u00e1c th\u1ee5 c\u00e1m th\u1ea7n kinh cho d\u00e2y ch\u1eb1ng m\u1edbi [22].<\/span><\/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":"\nPh\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau (DCCS) - Vinmec<\/title>\n<meta name=\"description\" content=\"T\u1eeb nh\u1eefng hi\u1ec3u bi\u1ebft v\u1ec1 gi\u1ea3i ph\u1eabu c\u1ee7a DCCS, \u0111\u1ed3ng \u00fd ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau gi\u1ed1ng v\u1edbi gi\u1ea3i ph\u1eabu nguy\u00ean b\u1ea3n c\u1ee7a d\u00e2y ch\u1eb1ng\" \/>\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=\"Ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng ch\u00e9o sau (DCCS) - 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