{"id":23620,"date":"2023-04-17T22:28:14","date_gmt":"2023-04-17T15:28:14","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=23620"},"modified":"2023-04-18T10:48:02","modified_gmt":"2023-04-18T03:48:02","slug":"tan-soi-duong-mat-tuy-bang-laser-voi-may-spyglass","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/tan-soi-duong-mat-tuy-bang-laser-voi-may-spyglass\/","title":{"rendered":"T\u00e1n s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt t\u1ee5y b\u1eb1ng laser v\u1edbi m\u00e1y n\u1ed9i soi SpyGlass"},"content":{"rendered":"<div class=\"sabo\"><strong><span id=\"BodyContent_ctl00_ctl01_newsContent\">Tr\u01b0\u1edbc \u0111\u00e2y, b\u1ec7nh l\u00fd s\u1ecfi \u1ed1ng m\u1eadt ch\u1ee7 (OMC) \u0111\u1ec1u ph\u1ea3i can thi\u1ec7p b\u1eb1ng ngo\u1ea1i khoa. T\u1eeb khi k\u1ef9 thu\u1eadt t\u00e1n s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt t\u1ee5y b\u1eb1ng laser\u00a0 ra \u0111\u1eddi, ng\u01b0\u1eddi ta \u0111\u00e3 c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb tri\u1ec7t \u0111\u1ec3 l\u1ea5y s\u1ecfi OMC qua n\u1ed9i soi. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y d\u1ea7n d\u1ea7n thay th\u1ebf ph\u1eabu thu\u1eadt v\u00e0 th\u1ec3 hi\u1ec7n t\u00ednh \u01b0u vi\u1ec7t c\u1ee7a n\u00f3 nh\u01b0: k\u1ef9 thu\u1eadt x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u, \u00edt \u1ea3nh h\u01b0\u1edfng t\u1edbi s\u1ee9c kh\u1ecfe v\u00e0 th\u1ea9m m\u1ef9, th\u1eddi gian n\u1eb1m vi\u1ec7n ng\u1eafn, th\u1eddi gian ph\u1ee5c h\u1ed3i s\u1ee9c kh\u1ecfe nhanh, \u00edt bi\u1ebfn ch\u1ee9ng, chi ph\u00ed th\u1ea5p. Do v\u1eady ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111i\u1ec1u tr\u1ecb kh\u00e1 h\u1eefu hi\u1ec7u v\u00e0 \u0111\u00e3 kh\u1eafc ph\u1ee5c \u0111\u01b0\u1ee3c ph\u1ea7n l\u1edbn nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n s\u1ecfi OMC.<\/span><\/strong><\/div>\n<h2><strong>1. H\u1ec7 th\u1ed1ng soi \u0111\u01b0\u1eddng m\u1eadt qua mi\u1ec7ng b\u1eb1ng SpyGlass<\/strong><\/h2>\n<h3><strong>1.1. N\u1ed9i soi m\u1eadt t\u1ee5y ng\u01b0\u1ee3c d\u00f2ng l\u00e0 g\u00ec<\/strong><\/h3>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/ky-thuat-trong-diem\/noi-soi-mat-tuy-nguoc-dong-ercp-nhung-dieu-can-biet\/\">N\u1ed9i soi m\u1eadt tu\u1ef5 ng\u01b0\u1ee3c d\u00f2ng<\/a> (NSMTND) l\u00e0 k\u1ef9 thu\u1eadt chuy\u00ean bi\u1ec7t d\u00f9ng \u0111\u1ec3 quan s\u00e1t \u1ed1ng d\u1eabn m\u1eadt, \u1ed1ng t\u1ee5y v\u00e0 t\u00fai m\u1eadt. Qua \u0111\u00f3 c\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c, \u0111\u1ed3ng th\u1eddi c\u00f3 th\u1ec3 can thi\u1ec7p \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd thu\u1ed9c \u0111\u01b0\u1eddng m\u1eadt &#8211; t\u1ee5y nh\u01b0: vi\u00eam t\u1eafc \u0111\u01b0\u1eddng m\u1eadt do s\u1ecfi m\u1eadt, giun chui \u1ed1ng m\u1eadt, ch\u00edt h\u1eb9p \u0111\u01b0\u1eddng m\u1eadt g\u00e2y t\u1eafc m\u1eadt, u \u0111\u01b0\u1eddng m\u1eadt\u2026<\/p>\n<p>C\u00f9ng v\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n khoa h\u1ecdc k\u0129 thu\u1eadt, <b>SpyGlass<\/b> (h\u1ec7 th\u1ed1ng soi \u0111\u01b0\u1eddng m\u1eadt qua mi\u1ec7ng ) ra \u0111\u1eddi \u0111\u00e3 gi\u1ea3i quy\u1ebft \u0111\u01b0\u1ee3c c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 c\u00e1c b\u1ec7nh l\u00ed s\u1ecfi m\u1eadt ph\u1ee9c t\u1ea1p, ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh c\u00e1c u n\u1eb1m s\u00e2u, kh\u00f3 l\u1ea5y m\u1eabu m\u00f4 x\u00e9t nghi\u1ec7m.<\/p>\n<div class=\"editor-img-wrapper\"><img decoding=\"async\" class=\"editor-img\" src=\"https:\/\/files.benhvien108.vn\/ecm\/source_files\/2020\/03\/09\/200309-2-2-153242-090320-48.jpg\" data-node-id=\"c68dbeaf-65ac-44f9-8a31-6d28556ed6c3\" \/><\/div>\n<p>L\u1ea5y s\u1ecfi trong \u0111\u01b0\u1eddng m\u1eadt b\u1eb1ng r\u1ecd v\u00e0 b\u00f3ng k\u00e9o s\u1ecfi qua ERCP<\/p>\n<h3>1.2. H\u1ec7 th\u1ed1ng soi \u0111\u01b0\u1eddng m\u1eadt qua mi\u1ec7ng SpyGlass<\/h3>\n<div class=\"rich-text\">\n<p>C\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 c\u1ee7a h\u1ec7 th\u1ed1ng<b>\u00a0N\u1ed9i soi \u0111\u01b0\u1eddng m\u1eadt Spyglass<\/b>\u00a0\u0111\u00e3 b\u00e1o c\u00e1o r\u1eb1ng tr\u1ef1c quan tr\u1ef1c ti\u1ebfp c\u1ea3i thi\u1ec7n t\u00ednh ch\u00ednh x\u00e1c k\u1ebft qu\u1ea3 n\u1ed9i soi \u0111\u01b0\u1eddng m\u1eadt v\u00e0 c\u00f3 gi\u00e1 tr\u1ecb ti\u00ean \u0111o\u00e1n t\u1ed1t t\u00edch c\u1ef1c trong vi\u1ec7c \u0111\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng\u00a0<a href=\"https:\/\/www.vinmec.com\/tin-tuc\/thong-tin-suc-khoe\/tieu-hoa-gan-mat\/dat-stent-duong-mat-dieu-tri-tac-nghen-ong-mat\/\"><b>t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng m\u1eadt<\/b><\/a> c\u00f3 ngu\u1ed3n g\u1ed1c kh\u00f4ng x\u00e1c \u0111\u1ecbnh. \u0110\u00e1nh gi\u00e1 v\u00e0 ch\u1ea9n \u0111o\u00e1n\u00a0<a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/tieu-hoa-gan-mat\/soi-duong-mat-co-lam-tang-men-gan\/\"><b>s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt<\/b><\/a>. N\u1ed9i soi \u0111\u01b0\u1eddng m\u1eadt h\u01b0\u1edbng d\u1eabn sinh thi\u1ebft \u1ed1ng d\u1eabn m\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n th\u00e0nh c\u00f4ng trong 89% tr\u01b0\u1eddng h\u1ee3p.<\/p>\n<\/div>\n<h3>1.3. T\u00e1n s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt t\u1ee5y b\u1eb1ng laser v\u1edbi m\u00e1y n\u1ed9i soi SpyGlass<\/h3>\n<ul>\n<li>V\u1ec1 m\u1eb7t k\u1ef9 thu\u1eadt, s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt \u0111\u01b0\u1ee3c l\u1ea5y ra kh\u1ecfi \u0111\u01b0\u1eddng m\u1eadt b\u1eb1ng r\u1ecd ho\u1eb7c b\u00f3ng sau khi c\u1eaft c\u01a1 v\u00f2ng Oddi ho\u1eb7c sau khi nong c\u01a1 v\u00f2ng b\u1eb1ng b\u00f3ng. Nh\u1eefng s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt c\u00f3 th\u1ec3 k\u00e9o \u0111\u01b0\u1ee3c ra ngo\u00e0i \u0111\u01b0\u1eddng m\u1eadt v\u00e0o l\u00f2ng \u0111\u01b0\u1eddng ti\u00eau ho\u00e1 th\u01b0\u1eddng c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf h\u01a1n 15mm.<\/li>\n<li>Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt trong gan nguy\u00ean ph\u00e1t v\u00e0 th\u1ee9 ph\u00e1t ph\u1ee9c t\u1ea1p, \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 kh\u00f4ng th\u1ec3 l\u1ea5y s\u1ecfi \u0111\u01b0\u1ee3c d\u00f9 \u0111\u00e3 c\u00f3 nh\u1eefng c\u1ed1 g\u1eafng, vi\u1ec7c l\u1ea5y s\u1ecfi \u0111i\u1ec1u tr\u1ecb \u0111\u00f2i h\u1ecfi ph\u1ea3i c\u00f3 th\u00eam nh\u1eefng k\u1ef9 thu\u1eadt h\u1ed7 tr\u1ee3 nh\u01b0 c\u00e1c h\u00ecnh th\u1ee9c t\u00e1n s\u1ecfi.<\/li>\n<li>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p t\u00e1n s\u1ecfi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong n\u1ed9i soi m\u1eadt t\u1ee5y ng\u01b0\u1ee3c d\u00f2ng bao g\u1ed3m <strong>t\u00e1n s\u1ecfi trong c\u01a1 th\u1ec3<\/strong> v\u00e0 t\u00e1n s\u1ecfi ngo\u00e0i c\u01a1 th\u1ec3. T\u00e1n s\u1ecfi trong c\u01a1 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng ng\u00e0y nay bao g\u1ed3m: t\u00e1n s\u1ecfi c\u01a1 h\u1ecdc, t\u00e1n s\u1ecfi \u0111i\u1ec7n th\u1ee7y l\u1ef1c v\u00e0 <strong>t\u00e1n s\u1ecfi laser<\/strong>. C\u00e1c k\u1ef9 thu\u1eadt t\u00e1n s\u1ecfi n\u00e0y \u0111\u00f2i h\u1ecfi ph\u1ea3i c\u00f3 h\u1ec7 th\u1ed1ng \u1ed1ng soi m\u1eb9 &#8211; con bao g\u1ed3m: \u1ed1ng soi m\u1eb9 \u0111\u1ec3 th\u1ef1c hi\u1ec7n n\u1ed9i soi \u0111\u01b0\u1eddng m\u1eadt ng\u01b0\u1ee3c d\u00f2ng v\u00e0 m\u1ed9t \u1ed1ng soi con \u0111\u01b0a qua k\u00eanh thao t\u00e1c c\u1ee7a \u1ed1ng soi m\u1eb9 v\u00e0 soi v\u00e0o \u0111\u01b0\u1eddng m\u1eadt \u0111\u1ec3 ti\u1ebfp c\u1eadn s\u1ecfi trong \u0111\u01b0\u1eddng m\u1eadt c\u1ea3 trong v\u00e0 ngo\u00e0i gan. Ti\u1ebfp theo, m\u1ed9t\u00a0<strong>thi\u1ebft b\u1ecb t\u00e1n s\u1ecfi laser <\/strong>ho\u1eb7c thi\u1ebft b\u1ecb t\u00e1n s\u1ecfi \u0111i\u1ec7n th\u1ee7y l\u1ef1c\u00a0\u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o k\u00eanh thao t\u00e1c c\u1ee7a \u1ed1ng soi \u0111\u01b0\u1eddng m\u1eadt \u0111\u1ec3 t\u00e1n s\u1ecfi trong l\u00f2ng \u1ed1ng m\u1eadt d\u01b0\u1edbi s\u1ef1 quan s\u00e1t tr\u1ef1c ti\u1ebfp c\u1ee7a \u1ed1ng soi \u0111\u01b0\u1eddng m\u1eadt.<\/li>\n<\/ul>\n<p>Theo s\u1ed1 li\u1ec7u t\u1eeb m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u, t\u1ec9 l\u1ec7 l\u00e0m v\u1ee1 s\u1ecfi c\u00f3 th\u1ec3 l\u00ean \u0111\u1ebfn 95%. Nh\u1edd \u0111\u00f3, t\u1ec9 l\u1ec7 l\u00e0m s\u1ea1ch s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt sau khi l\u00e0m n\u1ed9i soi m\u1eadt t\u1ee5y ng\u01b0\u1ee3c d\u00f2ng l\u1ea5y s\u1ecfi \u0111\u1ea1t kho\u1ea3ng 70% \u0111\u1ebfn 90% c\u00e1c tr\u01b0\u1eddng h\u1ee3p s\u1ecfi OMC. C\u00e1c bi\u1ebfn ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p l\u00e0 vi\u00eam \u0111\u01b0\u1eddng m\u1eadt c\u1ea5p, ch\u1ea3y m\u00e1u \u0111\u01b0\u1eddng m\u1eadt, ti\u1ec3u m\u00e1u, lo\u1ea1n nh\u1ecbp tim tho\u00e1ng qua&#8230;<\/p>\n<h2><strong>2. C\u00e1c b\u01b0\u1edbc chu\u1ea9n b\u1ecb v\u00e0 ti\u1ebfn h\u00e0nh<\/strong><\/h2>\n<h3><strong>2.1. Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc th\u1ee7 thu\u1eadt<\/strong><\/h3>\n<p>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ho\u1eb7c nghi ng\u1edd s\u1ecfi OMC b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh v\u00e0 x\u00e9t nghi\u1ec7m, tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n th\u1ee7 thu\u1eadt c\u1ea7n:<\/p>\n<ul>\n<li>Ph\u1ea3i nh\u1ecbn \u0103n u\u1ed1ng \u00edt nh\u1ea5t 6h tr\u01b0\u1edbc khi n\u1ed9i soi.<\/li>\n<li>N\u1ebfu \u0111ang d\u00f9ng thu\u1ed1c tim m\u1ea1ch ho\u1eb7c thu\u1ed1c ch\u1ed1ng co gi\u1eadt th\u00ec d\u00f9ng n\u00f3 nh\u01b0 b\u00ecnh th\u01b0\u1eddng v\u00e0o ng\u00e0y ch\u1ec9 \u0111\u1ecbnh.<\/li>\n<li>N\u1ebfu b\u1ecb ti\u1ec3u \u0111\u01b0\u1eddng: kh\u00f4ng u\u1ed1ng thu\u1ed1c bu\u1ed5i s\u00e1ng cho \u0111\u1ebfn sau khi l\u00e0m ERCP.<\/li>\n<li>Li\u00ean h\u1ec7 v\u1edbi b\u00e1c s\u0129 \u00edt nh\u1ea5t 10 ng\u00e0y tr\u01b0\u1edbc khi l\u00e0m th\u1ee7 thu\u1eadt n\u1ebfu b\u1ea1n b\u1ecb ti\u1ec3u \u0111\u01b0\u1eddng ho\u1eb7c \u0111ang u\u1ed1ng ch\u1ed1ng \u0111\u00f4ng nh\u01b0: Aspirin, Warfarin, Clopidogrel&#8230;.<\/li>\n<li>B\u1ec7nh nh\u00e2n v\u00e0 gia \u0111\u00ecnh \u0111\u1ed3ng \u00fd th\u1ef1c hi\u1ec7n th\u1ee7 thu\u1eadt sau khi \u0111\u01b0\u1ee3c b\u00e1c s\u0129 gi\u1ea3i th\u00edch k\u1ef9 l\u01b0\u1ee1ng.<\/li>\n<\/ul>\n<h3>2.2. Thi\u1ebft b\u1ecb<\/h3>\n<p>Hai h\u1ec7 th\u1ed1ng \u0111i\u1ec1u h\u00e0nh: \u1ed0ng n\u1ed9i soi m\u1eb9 &#8211; con v\u00e0 \u1ed1ng n\u1ed9i soi mini<\/p>\n<p>C\u00e1c th\u00e0nh ph\u1ea7n c\u1ee7a h\u1ec7 th\u1ed1ng bao g\u1ed3m:<\/p>\n<ul>\n<li>Ngu\u1ed3n s\u00e1ng v\u00e0 c\u00e1p \u0111i\u1ec7n (300-W \u00e1nh s\u00e1ng tr\u1eafng c\u01b0\u1eddng \u0111\u1ed9 cao)<\/li>\n<li>M\u00e1y \u1ea3nh v\u00e0 v\u00e0 h\u1ec7 th\u1ed1ng x\u1eed l\u00ed \u1ea3nh (autoshutter m\u00e1y \u1ea3nh v\u1edbi b\u1ed9 c\u1ea3m bi\u1ebfn h\u00ecnh \u1ea3nh m\u00e0u s\u1eafc)<\/li>\n<li>M\u1eaft quang coupler giao di\u1ec7n v\u1edbi \u0111\u1ea7u d\u00f2 v\u00e0 m\u00e1y \u1ea3nh<\/li>\n<li>H\u1ec7 th\u1ed1ng b\u01a1m r\u1eeda<\/li>\n<li>M\u00e0n h\u00ecnh Video<\/li>\n<\/ul>\n<div class=\"rich-text\">\n<p>V\u1ec1 h\u1ec7 th\u1ed1ng th\u1ee7 thu\u1eadt, h\u1ec7 th\u1ed1ng d\u00e2y soi ERCP ti\u00eau chu\u1ea9n c\u00f3 k\u00eanh th\u1ee7 thu\u1eadt 10-F \u0111\u01b0\u1eddng k\u00ednh ngo\u00e0i, m\u1ed9t d\u00e2y Spyscope c\u00f3 chi\u1ec1u d\u00e0i 230 cm v\u00e0 \u0111\u01b0\u1eddng k\u00ednh ngo\u00e0i c\u1ee7a 10 F-bao g\u1ed3m 4 k\u00eanh nh\u1ecf: m\u1ed9t cho c\u00e1c d\u1ee5ng c\u1ee5 th\u0103m d\u00f2 Spyglass, m\u1ed9t l\u00f2ng cho k\u1eb9p sinh thi\u1ebft Spybite, v\u00e0 h\u1ec7 th\u1ed1ng t\u00e1n s\u1ecfi thu\u1ef7 \u0111i\u1ec7n l\u1ef1c ho\u1eb7c \u0111\u1ea7u d\u00f2 laser. Hai k\u00eanh b\u01a1m n\u01b0\u1edbc tho\u00e1t ra \u1edf ph\u1ea7n cu\u1ed1i c\u1ee7a k\u00eanh n\u01b0\u1edbc c\u1ee7a \u1ed1ng d\u1eabn.<\/p>\n<h3>2.3. Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n<\/h3>\n<p><b>G\u00e2y t\u00ea<\/b><br \/>\nN\u1ed9i soi \u0111\u01b0\u1eddng m\u1eadt l\u00e0 m\u1ed9t th\u1ee7 thu\u1eadt t\u1ed1n th\u1eddi gian v\u00e0 nh\u00e2n l\u1ef1c. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c m\u00ea s\u00e2u v\u1edbi midazolam\/ fentanyl b\u1edfi m\u1ed9t b\u00e1c s\u0129 g\u00e2y m\u00ea trong su\u1ed1t qu\u00e1 tr\u00ecnh th\u1ee7 thu\u1eadt th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i. Trong v\u00e0i tr\u01b0\u1eddng h\u1ee3p, <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/nhung-dieu-can-biet-ve-gay-me-toan\/\"><b>g\u00e2y m\u00ea to\u00e0n th\u00e2n<\/b><\/a>\u00a0c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u \u0111\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c th\u1ee7 thu\u1eadt. B\u1ea3o v\u1ec7 \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p l\u00e0 m\u1ed9t m\u1ed1i quan t\u00e2m quan tr\u1ecdng trong m\u1ed9t th\u1ee7 thu\u1eadt k\u00e9o d\u00e0i nh\u01b0 n\u1ed9i soi \u0111\u01b0\u1eddng m\u1eadt, trong \u0111\u00f3 ti\u1ebfp t\u1ee5c nh\u1ea5n m\u1ea1nh s\u1ef1 c\u1ea7n thi\u1ebft ph\u1ea3i cho b\u00e1c s\u0129 g\u00e2y m\u00ea.<br \/>\nB\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i li\u00ean t\u1ee5c c\u1ee7a huy\u1ebft \u00e1p, nh\u1ecbp tim, nh\u1ecbp tim, t\u1ef7 l\u1ec7 h\u00f4 h\u1ea5p, v\u00e0 oxy trong su\u1ed1t qu\u00e1 tr\u00ecnh.<\/p>\n<\/div>\n<h3><strong>2.4. C\u00e1ch th\u1ee9c ti\u1ebfn h\u00e0nh NSMTND l\u1ea5y s\u1ecfi OMC<\/strong><\/h3>\n<ul>\n<li>B\u1ec7nh nh\u00e2n n\u1eb1m nghi\u00eang tr\u00e1i tr\u00ean b\u00e0n th\u1ee7 thu\u1eadt. B\u00e1c s\u0129 d\u00f9ng \u1ed1ng n\u1ed9i soi t\u00e1 tr\u00e0ng c\u00f9ng v\u1edbi h\u1ec7 th\u1ed1ng\u00a0<b>N\u1ed9i soi \u0111\u01b0\u1eddng m\u1eadt Spyglass<\/b>.<\/li>\n<li>\u1ed0ng soi \u0111\u01b0\u1ee3c \u0111\u01b0a t\u1eeb t\u1eeb qua mi\u1ec7ng b\u1ec7nh nh\u00e2n xu\u1ed1ng th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y v\u00e0 \u0111o\u1ea1n th\u1ee9 hai c\u1ee7a t\u00e1 tr\u00e0ng \u0111\u1ec3 th\u1ea5y b\u00f3ng Vater v\u00e0 nh\u00fa.<\/li>\n<li>Th\u00f4ng qua l\u1ed7 n\u00e0y b\u00e1c s\u0129 \u0111\u01b0a c\u00e1c d\u1ee5ng c\u1ee5 chuy\u00ean d\u1ee5ng v\u00e0o \u0111\u01b0\u1eddng m\u1eadt v\u00e0 b\u01a1m thu\u1ed1c c\u1ea3n quang, ch\u1ee5p h\u00ecnh \u0111\u01b0\u1eddng m\u1eadt &#8211; t\u1ee5y b\u1eb1ng m\u00e1y C-arm.<\/li>\n<li>M\u1ed9t d\u00e2y d\u1eabn sau \u0111\u00f3 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o c\u00e1c \u1ed1ng d\u1eabn m\u1eadt d\u01b0\u1edbi m\u00e0n h\u00ecnh hu\u1ef3nh quang, sau \u0111\u00f3, \u1ed1ng n\u1ed9i soi t\u00e1 tr\u00e0ng \u0111\u01b0\u1ee3c l\u1ea5y ra, \u0111\u1ec3 l\u1ea1i c\u00e1c d\u00e2y d\u1eabn trong \u1ed1ng d\u1eabn m\u1eadt.<br \/>\nM\u1ed9t \u1ed1ng n\u1ed9i soi si\u00eau m\u1ecfng sau \u0111\u00f3 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o \u0111\u01b0\u1eddng m\u1eadt theo d\u00e2y d\u1eabn v\u00e0 h\u01b0\u1edbng d\u1eabn c\u1ee7a m\u00e0n hu\u1ef3nh quang. N\u1ebfu m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p c\u00f3 b\u00f3ng h\u1ed7 tr\u1ee3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, m\u1ed9t qu\u1ea3 b\u00f3ng \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o v\u00e0 th\u1ed5i ph\u1ed3ng trong \u1ed1ng gan chung. \u0110i\u1ec1u n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t neo \u0111\u1ec3 ti\u1ebfn \u0111\u1ebfn \u0111\u01b0a \u1ed1ng n\u1ed9i soi si\u00eau m\u1ecfng v\u00e0o \u1ed1ng d\u1eabn m\u1eadt.<\/li>\n<li>D\u00e2y soi Spyscope, c\u00f9ng v\u1edbi \u0111\u1ea7u d\u00f2 quang h\u1ecdc, ti\u1ebfn v\u00e0o \u1ed1ng d\u1eabn m\u1eadt \u0111\u1ec3 hi\u1ec3n th\u1ecb tr\u1ef1c ti\u1ebfp h\u00ecnh \u1ea3nh b\u00ean trong \u0111\u01b0\u1eddng m\u1eadt tu\u1ef5. M\u1ed9t khi b\u00ean trong c\u00e1c \u1ed1ng m\u1eadt ch\u1ee7, \u0111\u01b0\u1eddng \u0111i c\u1ee7a Spyglass \u0111\u01b0\u1ee3c ki\u1ec3m tra d\u01b0\u1edbi m\u00e0n hu\u1ef3nh quang (X-quang).<\/li>\n<li>Th\u1ef1c hi\u1ec7n c\u1eaft c\u01a1 v\u00f2ng Oddi Sphincterotomy ( trong tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thi\u1ebft)<\/li>\n<li><strong>T\u00e1n s\u1ecfi b\u1eb1ng laser<\/strong> \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n th\u00f4ng qua c\u00e1c k\u00eanh l\u00e0m vi\u1ec7c c\u1ee7a \u1ed1ng n\u1ed9i soi \u0111\u01b0\u1eddng m\u1eadt.<\/li>\n<li>Sau th\u1ee7 thu\u1eadt, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea7n n\u1eb1m vi\u1ec7n \u0111\u1ec3 theo d\u00f5i v\u00e0 d\u00f9ng thu\u1ed1c kho\u1ea3ng t\u1eeb 1-5 ng\u00e0y t\u00f9y t\u1eebng tr\u01b0\u1eddng h\u1ee3p.<\/li>\n<\/ul>\n<p><strong>K\u1ebft lu\u1eadn:<\/strong> K\u1ef9 thu\u1eadt t\u00e1n s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt t\u1ee5y b\u1eb1ng laser v\u1edbi m\u00e1y n\u1ed9i soi SpyGlass l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt kh\u00f3. H\u1ec7 th\u1ed1ng B\u1ec7nh vi\u1ec7n \u0111a khoa Qu\u1ed1c t\u1ebf Vinmec v\u1edbi \u0111\u1ed9i ng\u0169 b\u00e1c s\u0129 c\u00f3 kinh nghi\u1ec7m v\u00e0 tay ngh\u1ec1 t\u1ed1t, c\u00f9ng <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/tieu-hoa-gan-mat\/spyglass-trien-vong-moi-trong-dieu-tri-benh-ly-mat-tuy\/\"><b>h\u1ec7 th\u1ed1ng SpyGlass<\/b><\/a> \u0111\u00e3 m\u1edf ra tri\u1ec3n v\u1ecdng \u0111i\u1ec1u tr\u1ecb m\u1edbi cho c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh l\u00fd m\u1eadt tu\u1ef5, gi\u1ea3m c\u00e1c bi\u1ec7n ph\u00e1p can thi\u1ec7p x\u00e2m l\u1ea5n, \u0111em l\u1ea1i ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng t\u1ed1t h\u01a1n cho b\u1ec7nh nh\u00e2n.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tr\u01b0\u1edbc \u0111\u00e2y, b\u1ec7nh l\u00fd s\u1ecfi \u1ed1ng m\u1eadt ch\u1ee7 (OMC) \u0111\u1ec1u ph\u1ea3i can thi\u1ec7p b\u1eb1ng ngo\u1ea1i khoa. T\u1eeb khi k\u1ef9 thu\u1eadt t\u00e1n s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt t\u1ee5y b\u1eb1ng laser\u00a0 ra \u0111\u1eddi, ng\u01b0\u1eddi ta \u0111\u00e3 c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb tri\u1ec7t \u0111\u1ec3 l\u1ea5y s\u1ecfi OMC qua n\u1ed9i soi. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y d\u1ea7n d\u1ea7n thay th\u1ebf ph\u1eabu thu\u1eadt v\u00e0 th\u1ec3 [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":23655,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>T\u00e1n s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt t\u1ee5y b\u1eb1ng laser v\u1edbi m\u00e1y n\u1ed9i soi SpyGlass - Vinmec<\/title>\n<meta name=\"description\" content=\"K\u1ef9 thu\u1eadt t\u00e1n s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt tu\u1ef5 b\u1eb1ng laser v\u1edbi m\u00e1y n\u1ed9i soi SpyGlass l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt kh\u00f3, \u0111\u00f2i h\u1ecfi tay ngh\u1ec1 cao, trang thi\u1ebft b\u1ecb hi\u1ec7n \u0111\u1ea1i.\" \/>\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=\"T\u00e1n s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt t\u1ee5y b\u1eb1ng laser v\u1edbi m\u00e1y n\u1ed9i soi SpyGlass - 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