{"id":2444,"date":"2023-04-10T21:01:22","date_gmt":"2023-04-10T14:01:22","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2444"},"modified":"2023-05-02T17:14:09","modified_gmt":"2023-05-02T10:14:09","slug":"gay-te-trong-nha-khoa-tre-em-luu-y-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/gay-te-trong-nha-khoa-tre-em-luu-y-lam-sang\/","title":{"rendered":"G\u00e2y t\u00ea trong nha khoa tr\u1ebb em – L\u01b0u \u00fd l\u00e2m s\u00e0ng."},"content":{"rendered":"

Vi\u1ec7c n\u1eafm v\u1eefng c\u00e1c v\u1ea5n \u0111\u1ec1 t\u1ed5ng quan trong g\u00e2y t\u00ea tr\u00ean \u0111\u1ed1i t\u01b0\u1ee3ng tr\u1ebb em t\u1ea1i ph\u00f2ng kh\u00e1m gi\u00fap qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng h\u01a1n. C\u00f9ng t\u00ecm hi\u1ec3u th\u00eam v\u1ec1 ch\u1ee7 \u0111\u1ec1 n\u00e0y, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ed1i t\u01b0\u1ee3ng b\u00e1c s\u0129 R\u0103ng H\u00e0m M\u1eb7t ti\u1ebfp c\u1eadn nhi\u1ec1u v\u1edbi \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n l\u00e0 tr\u1ebb em.<\/strong><\/p>\n

1. Nh\u1eefng \u0111i\u1ec1u c\u1ea7n l\u01b0u \u00fd v\u1ec1 gi\u1ea3i ph\u1eabu<\/h2>\n

1.1. X\u01b0\u01a1ng h\u00e0m \u0111ang trong giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n<\/h3>\n

– S\u1ef1 ph\u00e1t tri\u1ec3n m\u1eb7t x\u1ea3y ra \u0111\u1ed3ng th\u1eddi v\u1edbi hi\u1ec7n t\u01b0\u1ee3ng h\u00ecnh th\u00e0nh b\u1ed9 r\u0103ng. S\u1ef1 thay \u0111\u1ed5i v\u1ec1 gi\u1ea3i ph\u1eabu trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n l\u00e0m thay \u0111\u1ed5i c\u00e1c m\u1ed1c gi\u1ea3i ph\u1eabu trong g\u00e2y t\u00ea.<\/p>\n

– M\u00f4 x\u01b0\u01a1ng \u1edf tr\u1ebb em ch\u01b0a \u0111\u01b0\u1ee3c canxi ho\u00e1 ho\u00e0n to\u00e0n n\u00ean \u00edt \u0111\u1eb7c h\u01a1n v\u00e0 d\u1ec5 th\u1ea5m thu\u1ed1c t\u1ebf h\u01a1n.<\/p>\n

– Di\u1ec7n t\u00edch gi\u1ea3i ph\u1eabu b\u1ec1 m\u1eb7t nh\u1ecf h\u01a1n, ni\u00eam m\u1ea1c m\u1ecfng h\u01a1n, do v\u1eady n\u00ean gi\u1ea3m li\u1ec1u thu\u1ed1c v\u00e0 ti\u00eam n\u00f4ng h\u01a1n.<\/p>\n

    \n
  • X\u01b0\u01a1ng h\u00e0m tr\u00ean: S\u1ef1 ph\u00e1t tri\u1ec3n x\u01b0\u01a1ng h\u00e0m x\u1ea3y ra theo b\u1ed1n h\u01b0\u1edbng\n
      \n
    • Ra tr\u01b0\u1edbc; do s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a n\u1ec1n s\u1ecd v\u00e0 x\u01b0\u01a1ng l\u00e1 m\u00eda \u0111\u1ea9y kh\u1ed1i r\u0103ng c\u1eeda \u2013 nanh ra tr\u01b0\u1edbc.<\/li>\n
    • H\u01b0\u1edbng ngang: Trong v\u00f9ng r\u0103ng h\u00e0m, ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u01b0\u1eddng kh\u1edbp kh\u1ea9u c\u1ea3i d\u1ecdc gi\u1eefa, \u0111\u01b0\u1ee3c ho\u1ea1t ho\u00e1 b\u1edfi c\u00e1c c\u01a1 m\u00e1. Kho\u1ea3ng c\u00e1ch li\u00ean r\u0103ng nanh s\u1edbm b\u1ecb c\u1ed1 \u0111\u1ecbnh v\u00e0o kho\u1ea3ng 3 tu\u1ed5i.<\/li>\n
    • Ra sau: ch\u1ee7 y\u1ebfu do hi\u1ec7n t\u01b0\u1ee3ng b\u1ed3i \u0111\u1eafp v\u00e0 ti\u00eau x\u01b0\u01a1ng \u1edf l\u1ed1i c\u1ee7 cho \u0111\u1ebfn tu\u1ed5i d\u1eady th\u00ec. C\u00f9ng v\u1edbi hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y vi\u1ec7c ph\u00e1t tri\u1ec3n c\u00e1c r\u0103ng h\u00e0m ph\u00eda sau c\u0169ng gi\u00fap cho x\u01b0\u01a1ng h\u00e0m tr\u00ean ph\u00e1t tri\u1ec3n ra ph\u00eda sau.<\/li>\n
    • H\u01b0\u1edbng \u0111\u1ee9ng: li\u00ean quan \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a r\u0103ng v\u00e0 x\u01b0\u01a1ng \u1ed5 r\u0103ng cho \u0111\u1ebfn 15 tu\u1ed5i.<\/li>\n
    • H\u01b0\u1edbng ch\u00ednh: h\u01b0\u1edbng ngang do \u0111\u01b0\u1eddng kh\u1edbp d\u1ecdc gi\u1eefa.<\/li>\n<\/ul>\n<\/li>\n
    • X\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi: X\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi ph\u00e1t tri\u1ec3n ch\u1ee7 y\u1ebfu theo ba h\u01b0\u1edbng:\n
        \n
      • H\u01b0\u1edbng tr\u01b0\u1edbc \u2013 sau: do hi\u1ec7n t\u01b0\u1ee3ng ti\u00eau v\u00e0 b\u1ed3i \u0111\u1eafp \u1edf ph\u00eda sau do t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c c\u01a1.<\/li>\n
      • H\u01b0\u1edbng ngang: do \u0111\u01b0\u1eddng kh\u1edbp c\u1eafm.<\/li>\n
      • H\u01b0\u1edbng \u0111\u1ee9ng: s\u1ef1 ph\u00e1t tri\u1ec3n theo h\u01b0\u1edbng \u0111\u1ee9ng c\u1ee7a c\u1ea3nh l\u00ean v\u00e0 \u0111\u1ea9y l\u00f9i g\u00f3c h\u00e0m ra sau l\u00e0m v\u1ecb tr\u00ed c\u1ee7a l\u1ed7 \u1ed1ng r\u0103ng d\u01b0\u1edbi thay \u0111\u1ed5i nhi\u1ec1u, l\u00fac 2 \u2013 5 tu\u1ed5i n\u1eb1m h\u01a1i d\u01b0\u1edbi m\u1eb7t ph\u1eb3ng c\u1eafn, 5 \u2013 7 tu\u1ed5i n\u1eb1m \u1edf ngang m\u1ee9c m\u1eb7t ph\u1eb3ng c\u1eafn, 9 \u2013 11 tu\u1ed5i th\u00ec n\u1eb1m h\u01a1i ph\u00eda tr\u00ean m\u1eb7t ph\u1eb3ng c\u1eafn, b\u1eaft \u0111\u1ea7u t\u1eeb 12 tu\u1ed5i th\u00ec gi\u1ed1ng nh\u01b0 \u1edf ng\u01b0\u1eddi l\u1edbn.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

        1.2. C\u1ea5u tr\u00fac c\u00e1c s\u1ee3i th\u1ea7n kinh<\/h3>\n

        S\u1ef1 phong b\u1ebf th\u1ea7n kinh ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u01b0\u1eddng kinh, chi\u1ec1u d\u00e0i c\u00e1c s\u1ee3i th\u1ea7n kinh v\u00e0 m\u1ee9c \u0111\u1ed9 myeline ho\u00e1.<\/p>\n

          \n
        • T\u1ed1c \u0111\u1ed9 d\u1eabn truy\u1ec1n c\u1ee7a c\u00e1c s\u1ee3i th\u1ea7n kinh kh\u00f4ng c\u00f3 v\u1ecf myeline th\u00ec gi\u1ed1ng nhau \u1edf ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em, tuy nhi\u00ean t\u1ed1c \u0111\u1ed9 d\u1eabn truy\u1ec1n c\u1ee7a s\u1ee3i th\u1ea7n kinh c\u00f3 v\u1ecf myeline th\u00ec kh\u00e1c nhau.<\/li>\n
        • C\u1ea5u t\u1ea1o s\u1ee3i th\u1ea7n kinh m\u1ea3nh h\u01a1n, l\u1edbp v\u1ecf myeline it d\u00e0y h\u01a1n v\u00e0 kho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c n\u00fat Ranvier ng\u1eafn h\u01a1n n\u00ean l\u01b0\u1ee3ng thu\u1ed1c t\u00ea t\u1ed1i thi\u1ec3u \u0111\u1ec3 \u0111\u1ea1t hi\u1ec7u qu\u1ea3 t\u1ebf tr\u00ean tr\u1ebb em s\u1ebd \u00edt h\u01a1n \u1edf ng\u01b0\u1eddi l\u1edbn.<\/li>\n<\/ul>\n

          2. Chu\u1ea9n b\u1ecb b\u1ec7nh nhi tr\u01b0\u1edbc khi g\u00e2y t\u00ea<\/h2>\n

          \u0110\u00e2y l\u00e0 m\u1ed9t trong nh\u1eefng b\u01b0\u1edbc v\u00f4 c\u00f9ng quan tr\u1ecdng, quy\u1ebft \u0111\u1ecbnh s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a qu\u00e1 tr\u00ecnh g\u00e2y t\u00ea.<\/p>\n

            \n
          • B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb t\u00e2m l\u00fd s\u1eb5n s\u00e0ng b\u1eb1ng c\u00e1ch b\u00e1c s\u0129 h\u01b0\u1edbng d\u1eabn b\u1ed1 m\u1eb9 n\u00f3i chuy\u1ec7n v\u1edbi tr\u1ebb v\u1ec1 bu\u1ed5i \u0111i\u1ec1u tr\u1ecb ng\u00e0y h\u00f4m \u0111\u00f3, gi\u1ea3i th\u00edch theo c\u00e1ch hi\u1ec3u v\u00e0 tr\u00ed t\u01b0\u1edfng t\u01b0\u1ee3ng c\u1ee7a tr\u1ebb, khuy\u1ebfn kh\u00edch tr\u1ebb mang theo nh\u1eefng \u0111\u1ed5 ch\u01a1i y\u00eau th\u00edch \u0111\u1ebfn c\u0169ng khi \u0111i ch\u1eefa r\u0103ng, b\u1ed1 m\u1eb9 c\u00f3 th\u1ec3 chu\u1ea9n b\u1ecb th\u00eam nh\u1ea1c ho\u1eb7c video tr\u1ebb th\u00edch \u0111\u1ec3 nghe v\u00e0 xem trong qu\u00e1 tr\u00ecnh l\u00e0m.<\/li>\n
          • Kh\u00f4ng n\u00ean cho tr\u1ebb \u0103n qu\u00e1 no v\u00e0 ph\u1ea3i \u0103n tr\u01b0\u1edbc \u0111\u00f3 \u00edt nh\u1ea5t 1 \u2013 1,5 gi\u1edd.<\/li>\n
          • Tr\u1ebb m\u1eb7c \u0111\u1ed3 tho\u00e1ng m\u00e1t, kh\u00f4ng c\u1ea7n m\u1eb7c qu\u00e1 nhi\u1ec1u qu\u1ea7n \u00e1o n\u1ebfu trong ph\u00f2ng \u1ea9m. – Tr\u1ebb n\u1eb1m t\u01b0 th\u1ec3 tho\u1ea3i m\u00e1i tr\u00ean gh\u1ebf, n\u1ebfu c\u1ea7n c\u00f3 th\u1ec3 \u0111\u1ec3 b\u1ed1 m\u1eb9 \u00f4m n\u1eb1m tr\u00ean ng\u01b0\u1eddi.<\/li>\n
          • \u0110\u1ea7u tr\u1ebb c\u1ea7n \u0111\u01b0\u1ee3c gi\u1eef c\u1ed1 \u0111\u1ecbnh, \u0111\u1eb7c bi\u1ec7t khi tr\u1ebb kh\u00f4ng h\u1ee3p t\u00e1c. C\u00e1ch c\u1ed1 \u0111\u1ecbnh \u0111\u1ea7u tr\u1ebb nh\u01b0 sau: Tr\u1ee3 th\u1ee7 \u0111\u1ee9ng \u1edf v\u1ecb tr\u00ed 2 gi\u1edd, tay tr\u00e1i \u0111\u1eb7t d\u01b0\u1edbi g\u00e1y tr\u1ebb, tay ph\u1ea3i gi\u1eef tr\u00e1n.<\/li>\n
          • Gi\u1ea3i th\u00edch v\u1edbi tr\u1ebb c\u00e1c v\u1ea5n \u0111\u1ec1 c\u00f3 th\u1ec3 x\u1ea3y ra trong qu\u00e1 tr\u00ecnh g\u00e2y t\u00ea nh\u01b0 c\u1ea3m gi\u00e1c s\u01b0ng ph\u1ed3ng, t\u00ea t\u00ea, bu\u1ed3n bu\u1ed3n t\u1ea1i v\u1ecb tr\u00ed ti\u00eam, v\u1ecb \u0111\u1eafng c\u1ee7a thu\u1ed1c,…<\/li>\n
          • Tr\u1ebb c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng thu\u1ed1c an th\u1ea7n tr\u01b0\u1edbc khi can thi\u1ec7p nh\u01b0ng ch\u1ec9 \u00e1p d\u1ee5ng v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n qu\u00e1 lo l\u1eafng, s\u1ee3 h\u00e3i. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1eb7c bi\u1ec7t nh\u01b0 tr\u1ebb qu\u00e1 lo l\u1eafng, s\u1ee3 h\u00e3i th\u00ec c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng thu\u1ed1c an th\u1ea7n tr\u01b0\u1edbc khi can thi\u1ec7p.<\/li>\n<\/ul>\n

            3. Li\u1ec1u l\u01b0\u1ee3ng thu\u1ed1c g\u00e2y t\u00ea d\u00f9ng \u1edf tr\u1ebb<\/h2>\n
              \n
            • Thu\u1ed1c t\u00ea sau khi \u0111\u01b0\u1ee3c ti\u00eam s\u1ebd \u0111i v\u00e0o m\u00e1u v\u00e0 v\u00f2ng tu\u1ea7n ho\u00e0n c\u1ee7a c\u01a1 th\u1ec3 n\u00ean s\u1ebd c\u00f3 nh\u1eefng \u1ea3nh h\u01b0\u1edfng mang t\u00ednh h\u1ec7 th\u1ed1ng. Thu\u1ed1c co m\u1ea1ch (epinephrine hay adrenaline, levonordefrin, norepinephrine…) \u0111\u01b0\u1ee3c th\u00eam v\u00e0o trong th\u00e0nh ph\u1ea7n c\u1ee7a thu\u1ed1c t\u00ea nh\u1eb1m t\u00e1c d\u1ee5ng co c\u00e1c m\u1ea1ch m\u00e1u t\u1ea1i v\u1ecb tr\u00ed ti\u00eam gi\u00fap h\u1ea1n ch\u1ebf vi\u1ec7c th\u1ea9m th\u1ea5u c\u1ee7a thu\u1ed1c v\u00e0o m\u00e1u, gi\u1ea3m nguy c\u01a1 nhi\u1ec5m \u0111\u1ed9c, gi\u1ea3m ch\u1ea3y m\u00e1u v\u00e0 s\u1ebd k\u00e9o d\u00e0i t\u00e1c d\u1ee5ng t\u1ebf t\u1ea1i v\u1ecb tr\u00ed \u0111\u00f3. Khi s\u1eed d\u1ee5ng thu\u1ed1c t\u00ea kh\u00f4ng c\u00f3 ch\u1ea5t co m\u1ea1ch c\u1ea7n l\u01b0u \u00fd v\u00ec vi\u1ec7c thu\u1ed1c \u0111i v\u00e0o m\u00e1u s\u1ebd r\u1ea5t nhanh, d\u1ec5 g\u00e2y qu\u00e1 li\u1ec1u.<\/li>\n
            • N\u1ebfu g\u00e2y t\u00ea v\u00e0o v\u1ecb tr\u00ed v\u00f9ng \u0111ang c\u00f3 vi\u00eam nhi\u1ec5m th\u00ec s\u1ef1 kh\u1edfi ph\u00e1t c\u1ee7a thu\u1ed1c t\u00ea s\u1ebd b\u1ecb tr\u00ec ho\u00e3n ho\u1eb7c th\u1eadm ch\u00ed d\u1eebng l\u1ea1i, do t\u1ea1i \u0111\u00e2y qu\u00e1 tr\u00ecnh vi\u00eam khi\u1ebfn pH c\u1ee7a m\u00f4 ngo\u1ea1i b\u1ea3o s\u1ebd b\u1ecb gi\u00e1m t\u1eed gi\u00e1 tr\u1ecb trung t\u00ednh 7,4 xu\u1ed1ng 6 ho\u1eb7c th\u1ea5p h\u01a1n. pH th\u1ea5p g\u00e2y \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a thu\u1ed1c t\u00ea v\u00ec r\u1ea5t \u00edt c\u00e1c ph\u00e2n t\u1eed t\u1ef1 do c\u1ee7a thu\u1ed1c t\u00ea \u0111\u01b0\u1ee3c ph\u00e9p \u0111i qua v\u1ecf b\u1ecdc th\u1ea7n kinh \u0111\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 d\u1eabn truy\u1ec1n xung th\u1ea7n kinh.<\/li>\n
            • Trong \u0111i\u1ec1u tr\u1ecb nha khoa tr\u1ebb em, vi\u1ec7c ki\u1ec3m so\u00e1t li\u1ec1u l\u01b0\u1ee3ng d\u1ef1a tr\u00ean c\u00e2n n\u1eb7ng c\u1ee7a tr\u1ebb l\u00e0 h\u1ebft s\u1ee9c c\u1ea7n thi\u1ebft \u0111\u1ec3 l\u00e0m gi\u1ea3m thi\u1ec3u nguy c\u01a1 nhi\u1ec5m \u0111\u1ed9c c\u0169ng nh\u01b0 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i c\u1ee7a thu\u1ed1c t\u00ea c\u00f3 th\u1ec3 d\u1eabn t\u1edbi t\u1ed5n th\u01b0\u01a1ng c\u00e1c v\u00f9ng m\u00f4 m\u1ec1m xung quanh (m\u00e1, l\u01b0\u1ee1i, m\u00f4i) do b\u1ec7nh nh\u00e2n c\u1eafn ph\u1ea3i.<\/li>\n<\/ul>\n

              3.1. Thu\u1ed1c g\u00e2y t\u00ea b\u1ec1 m\u1eb7t<\/h3>\n
                \n
              • Thu\u1ed1c t\u00ea t\u1ea1i ch\u1ed7 c\u00f3 nhi\u1ec1u d\u1ea1ng kh\u00e1c nhau: gel, ch\u1ea5t l\u1ecfng, d\u1ea7u, patch ho\u1eb7c x\u1ecbt. FDA \u0111\u00e3 \u0111\u01b0a ra khuy\u1ebfn c\u00e1o v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c t\u00ea t\u1ea1i ch\u1ed7 v\u00e0 nguy c\u01a1 t\u0103ng methemoglobin huy\u1ebft. \u0110\u00e2y l\u00e0 t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd m\u1eafc ph\u1ea3i khi s\u1eed d\u1ee5ng hai lo\u1ea1i t\u00ea t\u1ea1i ch\u1ed7 c\u00f3 th\u00e0nh ph\u1ea7n l\u00e0 prilocaine v\u00e0 benzocaine. Khi n\u00e0y n\u1ed3ng \u0111\u1ed9 methemoglobin trong m\u00e1u t\u0103ng cao kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng g\u1eafn v\u1edbi oxy \u0111\u1ec3 v\u1eadn chuy\u1ec3n trong m\u00e1u g\u00e2y thi\u1ebfu oxy t\u1edbi c\u00e1c m\u00f4.<\/li>\n
              • Trong nha khoa, benzocaine 20% c\u00f3 d\u1ea1ng gel, x\u1ecbt ho\u1eb7c l\u1ecfng \u0111\u01b0\u1ee3c d\u00f9ng kh\u00e1 ph\u1ed5 bi\u1ebfn. Th\u1eddi gian t\u00e1c d\u1ee5ng nhanh sau 30s, k\u00e9o d\u00e0i t\u1eeb 5 \u0111\u1ebfn 15 ph\u00fat. B\u00e1o c\u00e1o li\u00ean quan \u0111\u1ebfn nhi\u1ec5m \u0111\u1ed9c do qu\u00e1 li\u1ec1u benzocaine tr\u00ean l\u00e2m s\u00e0ng r\u1ea5t hi\u1ebfm. Tuy nhi\u00ean, khi s\u1eed d\u1ee5ng thu\u1ed1c t\u00ea t\u1ea1i ch\u1ed7 c\u00f3 th\u00e0nh ph\u1ea7n benzocaine c\u1ea7n \u0111\u1eb7c bi\u1ec7t l\u01b0u \u00fd \u0111\u1ebfn li\u1ec1u l\u01b0\u1ee3ng tr\u00ean b\u1ec7nh nh\u00e2n tr\u1ebb em.<\/li>\n
              • Lidocaine (hay lignocaine) c\u0169ng \u0111\u01b0\u1ee3c d\u00f9ng t\u1ea1i ch\u1ed7 d\u01b0\u1edbi d\u1ea1ng l\u1ecfng, d\u1ea7u 5%, x\u1ecbt 10% v\u1edbi t\u1ef7 l\u1ec7 ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng r\u1ea5t th\u1ea5p tuy nhi\u00ean n\u00f3 s\u1ebd h\u1ea5p thu theo \u0111\u01b0\u1eddng to\u00e0n th\u00e2n v\u00e0 c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi l\u01b0\u1ee3ng thu\u1ed1c t\u1ebf \u0111i theo \u0111\u01b0\u1eddng to\u00e0n th\u00e2n g\u00e2y qu\u00e1 li\u1ec1u n\u00ean c\u0169ng c\u1ea7n l\u01b0u \u00fd khi t\u00ednh li\u1ec1u l\u01b0\u1ee3ng s\u1eed d\u1ee5ng tr\u00ean b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n

                3.2. Thu\u1ed1c g\u00e2y t\u00ea ti\u00eam<\/h3>\n

                C\u00e1c lo\u1ea1i thu\u1ed1c t\u00ea ti\u00eam nh\u00f3m amide th\u01b0\u1eddng s\u1eed d\u1ee5ng trong nha khoa bao g\u1ed3m lidocaine, mepivacaine, articaine, prilocaine v\u00e0 bupivacaine. Li\u1ec1u l\u01b0\u1ee3ng c\u1ee5 th\u1ec3 c\u1ee7a t\u1eebng lo\u1ea1i \u1edf trong b\u1ea3ng sau:<\/p>\n

                \"thuoc-gay-te-tre-em-lieu\"<\/p>\n

                Tr\u00ean tr\u1ebb em, articaine l\u00e0 m\u1ed9t thu\u1ed1c t\u00ea kh\u00e1 hi\u1ec7u qu\u1ea3 v\u1edbi \u0111\u1ed9c t\u00ednh \u00edt, th\u1eddi gian t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i v\u00e0 kh\u1ea3 n\u0103ng t\u00ea nhanh. Tr\u1ebb tr\u00ean 6 th\u00e1ng tu\u1ed5i, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng thu\u1ed1c t\u00ea c\u00f3 ch\u1ea5t co m\u1ea1ch v\u1edbi n\u1ed3ng \u0111\u1ed9 khuy\u1ebfn c\u00e1o 1\/200.000 v\u1edbi c\u00e1c k\u1ef9 thu\u1eadt g\u00e2y t\u00ea th\u00f4ng th\u01b0\u1eddng. N\u1ebfu d\u00f9ng b\u01a1m ti\u00eam \u0111i\u1ec7n th\u00ec n\u1ed3ng \u0111\u1ed9 c\u00f3 th\u1ec3 cao h\u01a1n t\u1edbi 1\/80.000.<\/p>\n

                Ngu\u1ed3n: S\u00e1ch R\u0103ng tr\u1ebb em – NXB Gi\u00e1o d\u1ee5c Vi\u1ec7t Nam<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

                Vi\u1ec7c n\u1eafm v\u1eefng c\u00e1c v\u1ea5n \u0111\u1ec1 t\u1ed5ng quan trong g\u00e2y t\u00ea tr\u00ean \u0111\u1ed1i t\u01b0\u1ee3ng tr\u1ebb em t\u1ea1i ph\u00f2ng kh\u00e1m gi\u00fap qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng h\u01a1n. C\u00f9ng t\u00ecm hi\u1ec3u th\u00eam v\u1ec1 ch\u1ee7 \u0111\u1ec1 n\u00e0y, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ed1i t\u01b0\u1ee3ng b\u00e1c s\u0129 R\u0103ng H\u00e0m M\u1eb7t ti\u1ebfp c\u1eadn nhi\u1ec1u v\u1edbi \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n l\u00e0 tr\u1ebb […]<\/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":"\nG\u00e2y t\u00ea trong nha khoa tr\u1ebb em - L\u01b0u \u00fd l\u00e2m s\u00e0ng. - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u1ec7c n\u1eafm v\u1eefng c\u00e1c v\u1ea5n \u0111\u1ec1 t\u1ed5ng quan trong g\u00e2y t\u00ea tr\u00ean \u0111\u1ed1i t\u01b0\u1ee3ng tr\u1ebb em t\u1ea1i ph\u00f2ng kh\u00e1m gi\u00fap qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng h\u01a1n. 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