{"id":23862,"date":"2023-04-18T18:07:50","date_gmt":"2023-04-18T11:07:50","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=23862"},"modified":"2023-04-19T11:47:45","modified_gmt":"2023-04-19T04:47:45","slug":"nhung-kho-khan-khi-cat-tui-mat-noi-soi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/nhung-kho-khan-khi-cat-tui-mat-noi-soi\/","title":{"rendered":"Nh\u1eefng kh\u00f3 kh\u0103n khi c\u1eaft t\u00fai m\u1eadt n\u1ed9i soi"},"content":{"rendered":"

R\u1ee7i ro ph\u1eabu thu\u1eadt v\u00e0 \u0111\u1ed9 kh\u00f3 c\u1ee7a ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf t\u00fai m\u1eadt c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi nhi\u1ec1u y\u1ebfu t\u1ed1 c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn b\u1ec7nh nh\u00e2n ho\u1eb7c li\u00ean quan \u0111\u1ebfn b\u1ec7nh t\u1eadt ho\u1eb7c c\u1ea3 hai. Vi\u1ec7c x\u00e1c \u0111\u1ecbnh s\u1edbm c\u00e1c bi\u1ebfn s\u1ed1 nh\u01b0 v\u1eady v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 r\u1ee7i ro \u0111\u1ed1i v\u1edbi t\u00fai m\u1eadt kh\u00f3 v\u00e0 nh\u1eefng c\u1ea1m b\u1eaby \u0111\u1ed1i v\u1edbi vi\u1ec7c b\u00f3c t\u00e1ch an to\u00e0n l\u00e0 ch\u00eca kh\u00f3a \u0111\u1ea7u ti\u00ean \u0111\u1ec3 t\u1ed1i \u01b0u h\u00f3a k\u1ebft qu\u1ea3, tr\u00e1nh c\u00e1c bi\u1ebfn ch\u1ee9ng ph\u1eabu thu\u1eadt c\u1eaft t\u00fai m\u1eadt<\/a>.<\/strong><\/p>\n

Xem x\u00e9t tr\u01b0\u1edbc v\u00e0 hi\u1ec3u bi\u1ebft v\u1ec1 c\u00e1c \u0111i\u1ec3m nguy hi\u1ec3m trong m\u1ed9t t\u00ecnh hu\u1ed1ng kh\u00f3 l\u00e0m t\u0103ng nh\u1eadn th\u1ee9c c\u1ee7a b\u00e1c s\u0129 ph\u1eabu thu\u1eadt, cho ph\u00e9p l\u1eadp k\u1ebf ho\u1ea1ch v\u00e0 do \u0111\u00f3, t\u1ea1o ti\u1ec1n \u0111\u1ec1 cho ph\u00e1n \u0111o\u00e1n t\u1ed1t trong ph\u1eabu thu\u1eadt. Vi\u1ec7c c\u00f4ng nh\u1eadn c\u00e1c s\u1eeda \u0111\u1ed5i v\u00e0 chi\u1ebfn l\u01b0\u1ee3c k\u1ef9 thu\u1eadt m\u00e0 ng\u01b0\u1eddi ta c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nh\u01b0 v\u1eady c\u00f3 th\u1ec3 n\u00e2ng cao h\u01a1n n\u1eefa kh\u1ea3 n\u0103ng th\u00e0nh c\u00f4ng c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u.<\/p>\n

1. Ph\u1eabu thu\u1eadt an to\u00e0n<\/h2>\n

\u201cCritical View of Safety\u201d (CVS) \u0111\u01b0\u1ee3c Strasberg m\u00f4 t\u1ea3 n\u0103m 1995 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p x\u00e1c \u0111\u1ecbnh ph\u1ed5 bi\u1ebfn nh\u1ea5t li\u00ean quan \u0111\u1ebfn b\u00f3c t\u00e1ch an to\u00e0n v\u00e0 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng c\u00e1ch \u0111\u1ea1t \u0111\u01b0\u1ee3c ba ti\u00eau ch\u00ed sau:<\/p>\n

    \n
  • B\u00f3c t\u00e1ch ho\u00e0n to\u00e0n tam gi\u00e1c gan m\u1eadt. v\u1edbi vi\u1ec7c l\u00e0m s\u1ea1ch t\u1ea5t c\u1ea3 m\u1ee1 v\u00e0 b\u00f3c t\u00e1ch m\u00f4 li\u00ean k\u1ebft x\u01a1<\/li>\n
  • T\u00e1ch 1\/3 d\u01b0\u1edbi c\u1ee7a t\u00fai m\u1eadt ra kh\u1ecfi gi\u01b0\u1eddng t\u00fai m\u1eadt<\/li>\n
  • B\u1ed9c l\u1ed9 hai c\u1ea5u tr\u00fac ( \u0111\u1ed9ng m\u1ea1ch t\u00fai m\u1eadt v\u00e0 \u1ed1ng t\u00fai m\u1eadt) \u0111i v\u00e0o t\u00fai m\u1eadt \u1edf c\u1ea3 hai g\u00f3c nh\u00ecn tr\u01b0\u1edbc v\u00e0 sau.\n

    \"C\u1eaft
    CVS m\u1eb7t tr\u01b0\u1edbc<\/figcaption><\/figure><\/li>\n<\/ul>\n
    \"C\u1eaft
    CVS m\u1eb7t sau<\/figcaption><\/figure>\n

    Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y d\u1ef1a tr\u00ean c\u00e1c nguy\u00ean t\u1eafc c\u1ee7a ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf t\u00fai m\u1eadt m\u1edf, trong \u0111\u00f3 \u1ed1ng t\u00fai m\u1eadt v\u00e0 \u0111\u1ed9ng m\u1ea1ch \u0111\u01b0\u1ee3c c\u00f4 l\u1eadp \u0111\u1ea7u ti\u00ean v\u00e0 sau \u0111\u00f3 t\u00fai m\u1eadt \u0111\u01b0\u1ee3c l\u1ea5y ho\u00e0n to\u00e0n ra kh\u1ecfi gi\u01b0\u1eddng t\u00fai m\u1eadt \u0111\u1ebfn khi t\u00fai m\u1eadt \u0111\u01b0\u1ee3c n\u1ed1i b\u1edfi 2 c\u1ea5u tr\u00fac d\u1ea1ng \u1ed1ng. B\u1edfi v\u00ec kh\u00f3 \u0111\u1ec3 ho\u00e0n to\u00e0n t\u00e1ch t\u00fai m\u1eadt kh\u1ecfi gi\u01b0\u1eddng, vi\u1ec7c b\u00f3c t\u00e1ch 1\/3 d\u01b0\u1edbi c\u1ee7a t\u00fai m\u1eadt \u0111\u1ebfn gi\u01b0\u1eddng t\u00fai m\u1eadt \u0111\u1ea3m b\u1ea3o di\u1ec7n c\u1eaft. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 c\u00f3 \u0111\u1ed9ng m\u1ea1ch t\u00fai m\u1eadt k\u00e9p ho\u1eb7c \u0111\u1ed9ng m\u1ea1ch t\u00fai m\u1eadt chia \u0111\u00f4i v\u1edbi hai nh\u00e1nh \u0111i v\u00e0o t\u00fai m\u1eadt.<\/p>\n

    V\u00e0o n\u0103m 2014, SAGES \u0111\u00e3 th\u00e0nh l\u1eadp ch\u01b0\u01a1ng tr\u00ecnh C\u1eaft t\u00fai m\u1eadt an to\u00e0n \u0111\u1ec3 n\u00e2ng cao an to\u00e0n cho ph\u1eabu thu\u1eadt c\u1eaft t\u00fai m\u1eadt. Ch\u01b0\u01a1ng tr\u00ecnh n\u00e0y \u0111\u00e3 li\u1ec7t k\u00ea s\u00e1u b\u01b0\u1edbc ho\u1eb7c chi\u1ebfn l\u01b0\u1ee3c m\u00e0 b\u00e1c s\u0129 ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng, \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p kh\u00f3, \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng \u0111\u01b0\u1eddng m\u1eadt v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00e1c c\u1ee7a quy tr\u00ecnh n\u00e0y. Nh\u1eefng nguy\u00ean t\u1eafc n\u00e0y \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n t\u1eeb quy tr\u00ecnh \u0111\u1ed3ng thu\u1eadn Delphi \u0111\u00e3 x\u00e1c \u0111\u1ecbnh c\u00e1c y\u1ebfu t\u1ed1 quan tr\u1ecdng \u0111\u1ec3 m\u1ed5 x\u1ebb an to\u00e0n trong cu\u1ed9c kh\u1ea3o s\u00e1t 160 th\u00e0nh vi\u00ean \u1ee7y ban SAGES.<\/p>\n

      \n
    • B\u01b0\u1edbc 1: Hi\u1ec3u CVS v\u00e0 s\u1eed d\u1ee5ng\u00a0 trong m\u1ecdi tr\u01b0\u1eddng h\u1ee3p<\/li>\n
    • B\u01b0\u1edbc 2: Hi\u1ec3u b\u00ecnh th\u01b0\u1eddng v\u00e0 c\u00e1c bi\u1ebfn th\u1ec3 trong gi\u1ea3i ph\u1eabu \u0111\u01b0\u1eddng m\u1eadt<\/li>\n
    • B\u01b0\u1edbc 3: K\u1ebft h\u1ee3p s\u1eed d\u1ee5ng h\u00ecnh \u1ea3nh trong ph\u1eabu thu\u1eadt (V\u00ed d\u1ee5: Ch\u1ee5p \u0111\u01b0\u1eddng m\u1eadt)<\/li>\n
    • B\u01b0\u1edbc 4: Th\u1ef1c hi\u1ec7n b\u01b0\u1edbc ki\u1ec3m tra c\u00e1c c\u1ea5u tr\u00fac \u1ed1ng tr\u01b0\u1edbc khi c\u1eaft<\/li>\n
    • B\u01b0\u1edbc 5: Nh\u1eadn bi\u1ebft khi v\u00e0o v\u00f9ng ph\u1eabu thu\u1eadt kh\u00f3, c\u00f3 th\u1ec3 chuy\u1ec3n m\u1ed5 h\u1edf n\u1ebfu qu\u00e1 tr\u00ecnh c\u1eaft t\u00fai m\u1eadt qu\u00e1 kh\u00f3 kh\u0103n v\u00e0 kh\u00f4ng th\u1ec3 b\u1ed9 l\u1ed9 CVS<\/li>\n
    • B\u01b0\u1edbc 6: Nh\u1eadn s\u1ef1 tr\u1ee3 gi\u00fap t\u1eeb ph\u1eabu thu\u1eadt vi\u00ean kh\u00e1c khi qu\u00e1 tr\u00ecnh b\u00f3c t\u00e1ch qu\u00e1 kh\u00f3 kh\u0103n<\/li>\n<\/ul>\n

      2. C\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u1eaft t\u00fai m\u1eadt kh\u00f3<\/h2>\n

      C\u00e1c \u0111i\u1ec1u ki\u1ec7n li\u00ean quan \u0111\u1ebfn ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf t\u00fai m\u1eadt kh\u00f3 kh\u0103n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c chia th\u00e0nh c\u00e1c lo\u1ea1i li\u00ean quan \u0111\u1ebfn b\u1ec7nh nh\u00e2n v\u00e0 li\u00ean quan \u0111\u1ebfn b\u1ec7nh t\u1eadt. Tu\u1ed5i cao h\u01a1n v\u00e0 gi\u1edbi t\u00ednh nam l\u00e0 nh\u1eefng bi\u1ebfn s\u1ed1 tr\u01b0\u1edbc khi ph\u1eabu thu\u1eadt c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c t\u0103ng \u0111\u1ed9 kh\u00f3 v\u00ec nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u00f3 xu h\u01b0\u1edbng bi\u1ec3u hi\u1ec7n b\u1ec7nh s\u1ecfi m\u1eadt ph\u1ee9c t\u1ea1p h\u01a1n. Ph\u1eabu thu\u1eadt v\u00f9ng b\u1ee5ng tr\u00ean tr\u01b0\u1edbc \u0111\u00f3 c\u00f3 th\u1ec3 g\u00e2y kh\u00f3 kh\u0103n cho vi\u1ec7c ti\u1ebfp c\u1eadn v\u00e0 b\u1ed9c l\u1ed9 ph\u1ea7n t\u01b0 ph\u00eda tr\u00ean b\u00ean ph\u1ea3i, v\u00e0 b\u00e9o ph\u00ec l\u00e0m ph\u1ee9c t\u1ea1p vi\u1ec7c ti\u1ebfp c\u1eadn, co r\u00fat v\u00e0 b\u1ed9c l\u1ed9 c\u1ed5 t\u00fai m\u1eadt. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam t\u00fai m\u1eadt c\u1ea5p t\u00ednh, th\u00e0nh t\u00fai m\u1eadt d\u00e0y l\u00ean tr\u00ean si\u00eau \u00e2m, s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u t\u0103ng cao (>18.000\/mm3 ), s\u1edd th\u1ea5y t\u00fai m\u1eadt, v\u00e0 nghi ng\u1edd vi\u00eam t\u00fai m\u1eadt ho\u1ea1i t\u1eed ho\u1eb7c t\u00fai m\u1eadt sinh h\u01a1i.<\/p>\n\n\n\n\n
      T\u00ecnh tr\u1ea1ng li\u00ean quan c\u1eaft t\u00fai m\u1eadt kh\u00f3<\/td>\n<\/tr>\n
      Li\u00ean quan \u0111\u1ebfn b\u1ec7nh nh\u00e2n<\/p>\n
        \n
      • Tu\u1ed5i gi\u00e0 h\u01a1n<\/li>\n
      • Gi\u1edbi nam<\/li>\n
      • B\u00e9o ph\u00ec<\/li>\n
      • C\u00f3 ph\u1eabu thu\u1eadt v\u00f9ng b\u1ee5ng tr\u01b0\u1edbc \u0111\u00f3<\/li>\n<\/ul>\n

        Li\u00ean quan \u0111\u1ebfn b\u1ec7nh t\u1eadt<\/p>\n

          \n
        • Vi\u00eam t\u00fai m\u1eadt c\u1ea5p\n
            \n
          • D\u1ea5u hi\u1ec7u \u0111\u1ec1 kh\u00e1ng<\/li>\n
          • WBC >18000\/mm3<\/sup><\/li>\n
          • D\u00e0y th\u00e0nh t\u00fai m\u1eadt tr\u00ean si\u00eau \u00e2m<\/li>\n
          • Vi\u00eam t\u00fai m\u1eadt ho\u1ea1i t\u1eed ho\u1eb7c sinh h\u01a1i<\/li>\n<\/ul>\n<\/li>\n
          • Vi\u00eam t\u00fai m\u1eadt m\u1ea1n t\u00ednh v\u00e0 nhi\u1ec1u c\u01a1n \u0111au qu\u1eb7n m\u1eadt tr\u01b0\u1edbc \u0111\u00f3\n
              \n
            • H\u1ed9i ch\u1ee9ng Mirizzi<\/li>\n
            • X\u01a1 gan\/ T\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1eeda<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

              2.1. Kh\u00f3 ti\u1ebfp c\u1eadn v\u00e0 kh\u00f3 b\u1ed9c l\u1ed9<\/h3>\n

              Ti\u1ec1n c\u0103n ph\u1eabu thu\u1eadt b\u1ee5ng tr\u01b0\u1edbc \u0111\u00f3:<\/strong> Nh\u1eefng th\u00e1ch th\u1ee9c khi ti\u1ebfp c\u1eadn \u1ed5 b\u1ee5ng ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh nh\u00e2n kh\u00e1c kh\u00f4ng li\u00ean quan \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh l\u00fd t\u00fai m\u1eadt c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u1ed9 kh\u00f3 c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i soi. Ph\u1eabu thu\u1eadt v\u00f9ng b\u1ee5ng tr\u00ean tr\u01b0\u1edbc \u0111\u00e2y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nh\u1eefng th\u00e1ch th\u1ee9c khi ti\u1ebfp c\u1eadn v\u00e0 b\u1ed9c l\u1ed9. \u1ede b\u1ec7nh nh\u00e2n \u0111\u00e3 t\u1eebng ph\u1eabu thu\u1eadt \u0111\u01b0\u1eddng gi\u1eefa quanh r\u1ed1n ho\u1eb7c v\u00f9ng b\u1ee5ng tr\u00ean, khoang trong \u1ed5 b\u1ee5ng n\u00ean \u0111\u01b0\u1ee3c ti\u1ebfp c\u1eadn c\u00e1ch xa b\u1ea5t k\u1ef3 v\u1ebft r\u1ea1ch n\u00e0o tr\u01b0\u1edbc \u0111\u00f3.
              \nN\u00ean ch\u1ecdn m\u1ed9t g\u00f3c ph\u1ea7n t\u01b0 c\u1ee7a b\u1ee5ng \u0111\u1ec3 kh\u00f4ng b\u1ecb d\u00ednh; c\u00e1c t\u00f9y ch\u1ecdn c\u00f3 th\u1ec3 bao g\u1ed3m ti\u1ebfp c\u1eadn kim Veress k\u00edn \u1edf g\u00f3c ph\u1ea7n t\u01b0 ph\u00eda tr\u00ean b\u00ean ph\u1ea3i ho\u1eb7c b\u00ean tr\u00e1i, v\u1ecb tr\u00ed c\u1ee7a c\u1ed5ng b\u01a1m kh\u00ed quang ho\u1eb7c ti\u1ebfp c\u1eadn m\u1edf \u1edf v\u00f9ng th\u01b0\u1ee3ng v\u1ecb ho\u1eb7c v\u00e0o Trocar h\u1edf. Ngay c\u1ea3 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt l\u1edbn v\u00f9ng b\u1ee5ng tr\u00ean tr\u01b0\u1edbc \u0111\u00f3, n\u1ebfu c\u00f3 th\u1ec3 ti\u1ebfp c\u1eadn ban \u0111\u1ea7u m\u1ed9t c\u00e1ch an to\u00e0n v\u00e0 \u0111\u1eb7t \u0111\u01b0\u1ee3c l\u1ed7 th\u00f4ng th\u1ee9 hai, th\u00ec th\u01b0\u1eddng c\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh t\u00e1ch d\u00ednh c\u1ea9n th\u1eadn \u0111\u1ec3 ti\u1ebfp c\u1eadn t\u00fai m\u1eadt. C\u00f3 th\u1ec3 c\u1ea7n th\u00eam c\u00e1c l\u1ed7 th\u00f4ng \u0111\u1ec3 t\u00e1ch d\u00ednh v\u00e0 gi\u1ea3i ph\u00f3ng v\u00f9ng b\u1ee5ng tr\u00ean b\u00ean ph\u1ea3i.<\/p>\n

              B\u00e9o ph\u00ec:\u00a0<\/strong>B\u00e9o ph\u00ec th\u01b0\u1eddng g\u00e2y kh\u00f3 kh\u0103n khi l\u1ed9 v\u00e0 trong qu\u00e1 tr\u00ecnh c\u1eaft b\u1ecf t\u00fai m\u1eadt n\u1ed9i soi. B\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n gia t\u0103ng t\u1ec9 l\u1ec7 m\u1ed5 m\u1edf do vi\u00eam t\u00fai m\u1eadt c\u1ea5p. Nguy c\u01a1 t\u0103ng h\u01a1n n\u1eefa \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n BMI >50(9.6% so 3.5%).<\/p>\n

              \u1ede b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec, r\u1ed1n n\u1eb1m th\u1ea5p l\u00e0m cho ph\u1eabu tr\u01b0\u1eddng c\u00e0ng xa h\u01a1n. B\u00e9o ph\u00ec c\u0169ng t\u1ea1o ra nh\u1eefng th\u00e1ch th\u1ee9c \u0111\u1ed1i v\u1edbi vi\u1ec7c ti\u1ebfp c\u1eadn ph\u1eabu thu\u1eadt theo hai c\u00e1ch. \u0110\u1ea7u ti\u00ean, m\u1ee1 n\u1ed9i t\u1ea1ng t\u0103ng l\u00ean che khu\u1ea5t tam gi\u00e1c gan m\u1eadt. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nh\u01b0 v\u1eady n\u1ebfu s\u1ef1 b\u1ed9c l\u1ed9 kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7, c\u00f3 th\u1ec3 v\u00e0o th\u00eam Trocar \u0111\u1ec3 b\u1ed9c l\u1ed9. Th\u00e1ch th\u1ee9c th\u1ee9 hai \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec l\u00e0 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a gan nhi\u1ec5m m\u1ee1, khi\u1ebfn cho vi\u1ec7c b\u1ed9c l\u1ed9 tam gi\u00e1c gan m\u1eadt kh\u00f3 kh\u0103n h\u01a1n.<\/p>\n

              Ngu\u1ed3n: The Difficult Cholecystectomy, The SAGES Manual of Biliary Surgery 2020<\/p>\n","protected":false},"excerpt":{"rendered":"

              R\u1ee7i ro ph\u1eabu thu\u1eadt v\u00e0 \u0111\u1ed9 kh\u00f3 c\u1ee7a ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf t\u00fai m\u1eadt c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi nhi\u1ec1u y\u1ebfu t\u1ed1 c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn b\u1ec7nh nh\u00e2n ho\u1eb7c li\u00ean quan \u0111\u1ebfn b\u1ec7nh t\u1eadt ho\u1eb7c c\u1ea3 hai. Vi\u1ec7c x\u00e1c \u0111\u1ecbnh s\u1edbm c\u00e1c bi\u1ebfn s\u1ed1 nh\u01b0 v\u1eady v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 r\u1ee7i ro \u0111\u1ed1i […]<\/p>\n","protected":false},"author":15,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"\nNh\u1eefng kh\u00f3 kh\u0103n khi c\u1eaft t\u00fai m\u1eadt n\u1ed9i soi - Vinmec<\/title>\n<meta name=\"description\" content=\"Ph\u1eabu thu\u1eadt n\u1ed9i soi c\u1eaft t\u00fai m\u1eadt l\u00e0 m\u1ed9t ph\u1eabu thu\u1eadt th\u01b0\u1eddng g\u1eb7p, tuy nhi\u00ean c\u00f3 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u1eaft t\u00fai m\u1eadt kh\u00f3 \u0111\u00f2i h\u1ecfi kinh nghi\u1ec7m v\u00e0 s\u1ef1 chu\u1ea9n b\u1ecb c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean.\" \/>\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=\"Nh\u1eefng kh\u00f3 kh\u0103n khi c\u1eaft t\u00fai m\u1eadt n\u1ed9i soi - 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