{"id":24528,"date":"2023-04-19T13:40:56","date_gmt":"2023-04-19T06:40:56","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24528"},"modified":"2023-04-19T14:47:02","modified_gmt":"2023-04-19T07:47:02","slug":"dieu-tri-loet-da-day-ta-trang-man-bang-phau-thuat-noi-soi-cat-da-day","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/dieu-tri-loet-da-day-ta-trang-man-bang-phau-thuat-noi-soi-cat-da-day\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng m\u1ea1n b\u1eb1ng ph\u1eabu thu\u1eadt n\u1ed9i soi c\u1eaft d\u1ea1 d\u00e0y"},"content":{"rendered":"

Lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng m\u1ea1n l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn d\u1ea1 d\u00e0y v\u00e0 t\u00e1 tr\u00e0ng, g\u00e2y ra c\u00e1c v\u1ebft lo\u00e9t ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng tr\u00ean b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c. \u0110i\u1ec1u tr\u1ecb<\/a> lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng m\u1ea1n c\u00f3 th\u1ec3 bao g\u1ed3m s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng vi\u00eam, kh\u00e1ng sinh v\u00e0 thu\u1ed1c gi\u1ea3m ti\u1ebft acid d\u1ea1 d\u00e0y; tuy nhi\u00ean, trong tr\u01b0\u1eddng h\u1ee3p nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 c\u1ea7n \u0111\u1ebfn ph\u1eabu thu\u1eadt. Ph\u1eabu thu\u1eadt n\u1ed9i soi c\u1eaft d\u1ea1 d\u00e0y l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng m\u1ea1n b\u1eb1ng c\u00e1ch c\u1eaft b\u1ecf m\u1ed9t ph\u1ea7n c\u1ee7a d\u1ea1 d\u00e0y b\u1ecb t\u1ed5n th\u01b0\u01a1ng.\u00a0<\/strong><\/p>\n

\"H\u00ecnh
H\u00ecnh \u1ea3nh lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng<\/figcaption><\/figure>\n

1. Nguy\u00ean l\u00fd c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p<\/span><\/b><\/h2>\n

C\u1eaft b\u1ecf v\u00f9ng ph\u1ea3n x\u1ea1 ti\u1ebft axit c\u1ee7a d\u1ea1 d\u00e0y, v\u00f9ng hang m\u00f4n v\u1ecb, v\u00f9ng th\u00e2n v\u1ecb b\u1eb1ng ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111\u1ea3m b\u1ea3o 2 y\u00eau c\u1ea7u:<\/span><\/p>\n

– Lo\u1ea1i b\u1ecf \u1ed5 lo\u00e9t v\u00e0 c\u1eaft ph\u1ea7n d\u1ea1 d\u00e0y sinh b\u1ec7nh lo\u00e9t.<\/span><\/p>\n

– L\u1eadp l\u1ea1i l\u01b0u th\u00f4ng ti\u00eau h\u00f3a b\u1eb1ng mi\u1ec7ng n\u1ed1i gi\u1eefa \u0111o\u1ea1n d\u1ea1 d\u00e0y c\u00f2n l\u1ea1i v\u1edbi quai \u0111\u1ea7u ti\u00ean c\u1ee7a h\u1ed7ng tr\u00e0ng, ki\u1ec3u Polya ho\u1eb7c Finsterer.<\/span><\/p>\n

M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p do \u1ed5 lo\u00e9t s\u00e2u \u1edf D2 ho\u1eb7c D3, c\u00f3 th\u1ec3 c\u1eaft 2\/3 d\u1ea1 d\u00e0y \u0111\u1ec3 l\u1ea1i \u1ed5 lo\u00e9t.<\/span><\/p>\n

2. Ch\u1ec9 \u0111\u1ecbnh<\/span><\/b><\/h2>\n

– Lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng m\u1ea1n t\u00ednh g\u00e2y bi\u1ebfn ch\u1ee9ng: h\u1eb9p m\u00f4n v\u1ecb, ch\u1ea3y m\u00e1u ti\u00eau h\u00f3a nhi\u1ec1u l\u1ea7n, th\u1ee7ng \u1ed5 lo\u00e9t.<\/span><\/p>\n

– Lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng m\u1ea1n \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa kh\u00f4ng \u0111\u1ee1.<\/span><\/p>\n

3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/span><\/b><\/h2>\n

3.1. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a m\u1ed5 c\u1eaft d\u1ea1 d\u00e0y:<\/span><\/b><\/h3>\n

– Lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng nh\u01b0ng ch\u01b0a \u0111i\u1ec1u tr\u1ecb n\u1ed9i \u0111\u00fang k\u1ebf ho\u1ea1ch, ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng h\u1eb9p, xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a, ch\u01b0a th\u1ee7ng.<\/span><\/p>\n

– Ng\u01b0\u1eddi b\u1ec7nh th\u1ec3 tr\u1ea1ng y\u1ebfu hay k\u00e8m b\u1ec7nh n\u1eb7ng c\u1ea5p.<\/span><\/p>\n

3.2. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a ph\u1eabu thu\u1eadt n\u1ed9i soi:<\/span><\/b><\/h3>\n

– Ti\u1ec1n s\u1eed m\u1ed5 vi\u00eam ph\u00fac m\u1ea1c, t\u1eafc ru\u1ed9t.<\/span><\/p>\n

– C\u1ed5 tr\u01b0\u1edbng t\u1ef1 do ho\u1eb7c c\u1ed5 tr\u01b0\u1edbng khu tr\u00fa.<\/span><\/p>\n

– Tho\u00e1t v\u1ecb th\u00e0nh b\u1ee5ng, tho\u00e1t v\u1ecb r\u1ed1n.<\/span><\/p>\n

– Nhi\u1ec5m khu\u1ea9n t\u1ea1i ch\u1ed7 th\u00e0nh b\u1ee5ng.<\/span><\/p>\n

– B\u1ec7nh l\u00fd r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u.<\/span><\/p>\n

4. Chu\u1ea9n b\u1ecb<\/span><\/b><\/h2>\n

4.1. Ng\u01b0\u1eddi b\u1ec7nh<\/span><\/b><\/h3>\n

– L\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m c\u01a1 b\u1ea3n m\u00e1u v\u00e0 n\u01b0\u1edbc ti\u1ec3u, ch\u1ee5p v\u00e0 soi th\u1ef1c qu\u1ea3n d\u1ea1 d\u00e0y, t\u00e1 tr\u00e0ng.<\/span><\/p>\n

– B\u00f9 d\u1ecbch, \u0111i\u1ec7n gi\u1ea3i, protit, s\u1ed1 l\u01b0\u1ee3ng h\u1ed3ng c\u1ea7u thi\u1ebfu. Chu\u1ea9n b\u1ecb m\u1ed5:<\/span><\/p>\n

– R\u1eeda d\u1ea1 d\u00e0y n\u1ebfu c\u00f3 h\u1eb9p m\u00f4n v\u1ecb. V\u1ec7 sinh r\u0103ng mi\u1ec7ng, l\u00e0m h\u00e0m gi\u1ea3 n\u1ebfu kh\u00f4ng c\u00f2n r\u0103ng. Th\u1ee5t th\u00e1o tr\u01b0\u1edbc ph\u1eabu thu\u1eadt v\u00e0 kh\u00e1ng sinh d\u1ef1 ph\u00f2ng.<\/span><\/p>\n

4.2. Ph\u01b0\u01a1ng ph\u00e1p g\u00e2y m\u00ea: m\u00ea n\u1ed9i kh\u00ed qu\u1ea3n<\/span><\/b><\/h3>\n

4.3. Ph\u01b0\u01a1ng ti\u1ec7n, d\u1ee5ng c\u1ee5<\/span><\/b><\/h3>\n

– B\u1ed9 trang thi\u1ebft b\u1ecb \u0111\u1ed3ng b\u1ed9 m\u1ed5 n\u1ed9i soi.<\/span><\/p>\n

– M\u00e1y c\u1eaft, n\u1ed1i trong m\u1ed5 n\u1ed9i soi d\u00f9ng 1 l\u1ea7n.<\/span><\/p>\n

5. C\u00e1c b\u01b0\u1edbc ti\u1ebfn h\u00e0nh<\/span><\/b><\/h2>\n

5.1. T\u01b0 th\u1ebf ng\u01b0\u1eddi b\u1ec7nh<\/span><\/b><\/h3>\n

Ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m ng\u1eeda, \u0111\u1eb7t \u1ed1ng sonde d\u1ea1 d\u00e0y tr\u01b0\u1edbc m\u1ed5. Ng\u01b0\u1eddi b\u1ec7nh n\u0103m \u1edf t\u01b0 th\u1ebf \u0111\u1ea7u cao ch\u00e2n th\u1ea5p m\u1ed9t g\u00f3c 30 \u0111\u1ed9 so v\u1edbi m\u1eb7t ph\u1eb3ng n\u1eb1m ngang. Hai ch\u00e2n d\u1ea1ng m\u1ed9t g\u00f3c 90 \u0111\u1ed9.<\/span><\/p>\n

5.2. V\u1ecb tr\u00ed v\u00e0 ph\u01b0\u01a1ng ti\u1ec7n c\u1ee7a nh\u00f3m m\u1ed5:<\/span><\/b><\/h3>\n

– M\u00e0n h\u00ecnh ch\u00ednh v\u00e0 c\u00e1c thi\u1ebft b\u1ecb tr\u00ean xe \u0111\u1ea9y ngang v\u1ecb tr\u00ed vai tr\u00e1i c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, m\u00e0n h\u00ecnh ph\u1ee5 \u0111\u1eb7t b\u00ean ph\u1ea3i.<\/span><\/p>\n

– Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n \u0111\u1ee9ng gi\u1eefa 2 ch\u00e2n ng\u01b0\u1eddi b\u1ec7nh, ng\u01b0\u1eddi c\u1ea7m camera \u0111\u1ee9ng b\u00ean tr\u00e1i ng\u01b0\u1eddi b\u1ec7nh, ng\u01b0\u1eddi ph\u1ee5 v\u00e0 \u0111\u01b0a d\u1ee5ng c\u1ee5 \u0111\u1ee9ng b\u00ean ph\u1ea3i ng\u01b0\u1eddi b\u1ec7nh.<\/span><\/p>\n

5.3. V\u1ecb tr\u00ed trocar:<\/span><\/b><\/h3>\n

– B\u01a1m h\u01a1i v\u00e0o \u1ed5 b\u1ee5ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p b\u01a1m h\u01a1i m\u1edf ki\u1ec3u Hasson, \u00e1p l\u1ef1c kh\u00ed trong \u1ed5 b\u1ee5ng duy tr\u00ec 12mmHg.<\/span><\/p>\n

– Th\u00f4ng th\u01b0\u1eddng \u0111\u1eb7t 4 trocar, trocar \u0111\u1ea7u d\u00e0nh cho \u1ed1ng soi \u0111\u1eb7t c\u1ea1nh r\u1ed1n, \u1ed1ng soi 10mm, nghi\u00eang 30 \u0111\u1ed9 th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. Trocar 10mm \u0111\u1eb7t b\u00ean ph\u1ea3i m\u0169i \u1ee9c d\u00e0nh cho que g\u1ea1t \u0111\u1ec3 v\u00e9n gan tr\u00e1i l\u00ean b\u1ed9c l\u1ed9 m\u1eb7t tr\u01b0\u1edbc d\u1ea1 d\u00e0y. Hai trocar thao t\u00e1c \u0111\u1eb7t \u1edf tr\u00ean \u0111\u01b0\u1eddng v\u00fa b\u00ean ph\u1ea3i d\u01b0\u1edbi b\u1edd s\u01b0\u1eddn 5 cm v\u00e0 \u1edf \u0111\u01b0\u1eddng n\u00e1ch tr\u01b0\u1edbc tr\u00e1i ngang r\u1ed1n.<\/span><\/p>\n

5.4. Ph\u1eabu thu\u1eadt:<\/span><\/b><\/h3>\n

– Th\u00ec I: Th\u0103m d\u00f2,\u0111\u00e1nh gi\u00e1 th\u01b0\u01a1ng t\u1ed5n. Th\u0103m d\u00f2 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng \u1ed5 lo\u00e9t, ki\u1ec3m tra c\u00e1c t\u1ea1ng kh\u00e1c trong \u1ed5 b\u1ee5ng.<\/span><\/p>\n

– Th\u00ec II: Gi\u1ea3i ph\u00f3ng b\u1edd cong l\u1edbn d\u1ea1 d\u00e0y c\u1eaft b\u1ecf v\u00e0 ph\u1eabu t\u00edch b\u1edd cong nh\u1ecf c\u1ee7a d\u1ea1 d\u00e0y.<\/span><\/p>\n

– Th\u00ec III: ph\u1eabu t\u00edch b\u00f3 m\u1ea1ch m\u00f4n v\u1ecb, c\u1eb7p b\u1eb1ng clip hay th\u1eaft ch\u1ec9.<\/span><\/p>\n

– Th\u00ec IV: C\u1eaft v\u00e0 \u0111\u00f3ng m\u1ecfm t\u00e1 tr\u00e0ng b\u1eb1ng m\u00e1y c\u1eaft v\u1edbi \u0111\u1ea1n d\u00f9ng cho \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/span><\/p>\n

– Th\u00ec V: Ph\u1eabu t\u00edch, c\u1eb7p clip, c\u1eaft, ho\u1eb7c bu\u1ed9c ch\u1ec9 ch\u1eafc \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u1ecb.<\/span><\/p>\n

– Th\u00ec V: C\u1eaft ph\u1ea7n d\u1ea1 d\u00e0y b\u1eb1ng m\u00e1y c\u1eaft, d\u00f9ng kho\u1ea3ng 2 \u0111\u1ea1n cho \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/span><\/p>\n

– Th\u00ec VI: L\u1eadp l\u1ea1i l\u01b0u th\u00f4ng ti\u00eau h\u00f3a b\u1eb1ng c\u00e1ch n\u1ed1i m\u1ed5 d\u1ea1 d\u00e0y d\u1ea1 d\u00e0y h\u1ed7ng tr\u00e0ng ki\u1ec3u finsterer b\u1eb1ng m\u00e1y ho\u1eb7c kh\u00e2u tay qua n\u1ed9i soi.<\/span><\/p>\n

– Th\u00ec VII: Ki\u1ec3m tra, l\u1ea5y b\u1ec7nh ph\u1ea9m v\u00e0 \u0111\u00f3ng c\u00e1c l\u1ed7 trocar.<\/span><\/p>\n

6. Theo d\u00f5i v\u00e0 ch\u0103m s\u00f3c sau ph\u1eabu thu\u1eadt<\/span><\/b><\/h2>\n

– Truy\u1ec1n d\u1ecbch ng\u00e0y \u0111\u1ea7u sau ph\u1eabu thu\u1eadt.<\/span><\/p>\n

– C\u00f3 th\u1ec3 u\u1ed1ng n\u01b0\u1edbc sau 24 gi\u1edd.<\/span><\/p>\n

– \u0110i\u1ec1u tr\u1ecb kh\u00e1ng sinh theo ph\u00e1c \u0111\u1ed3.<\/span><\/p>\n

– R\u00fat d\u1eabn l\u01b0u theo t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3.<\/span><\/p>\n

7. X\u1eed l\u00fd tai bi\u1ebfn<\/span><\/b><\/h2>\n

– Ch\u1ea3y m\u00e1u l\u00e1ch: C\u1ea7m m\u00e1u b\u1ea3o t\u1ed3n. N\u1ebfu c\u1ea7m m\u00e1u b\u1ea3o t\u1ed3n kh\u00f4ng th\u00e0nh c\u00f4ng, vi\u1ec7c c\u1eaft l\u00e1ch c\u00f3 th\u1ec3 l\u00e0 c\u00e1ch duy nh\u1ea5t \u0111\u1ec3 ki\u1ec3m so\u00e1t ch\u1ea3y m\u00e1u l\u00e1ch. C\u1eaft l\u00e1ch l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt \u0111\u1ec3 c\u1eaft b\u1ecf m\u1ed9t ph\u1ea7n ho\u1eb7c to\u00e0n b\u1ed9 c\u1ee7a l\u00e1ch.<\/span><\/p>\n

– T\u1ed5n th\u01b0\u01a1ng \u0111\u01b0\u1eddng m\u1eadt: Kh\u00e2u ph\u1ee5c h\u1ed3i, d\u1eabn l\u01b0u \u1ed1ng Kehr.<\/span><\/p>\n

– L\u1ed9 b\u00f3ng Vater, c\u1eaft ph\u1ea3i b\u00f3ng Vater: T\u1ea1o h\u00ecnh<\/span><\/p>\n

– C\u1eaft ph\u1ea3i cu\u1ed1ng gan: Ph\u1ee5c h\u1ed3i t\u0129nh m\u1ea1ch c\u1ee7a tr\u01b0\u1edbc, \u0111\u1ed9ng m\u1ea1ch gan (c\u00f3 th\u1ec3 th\u1eaft) v\u00e0 ph\u1ee5c h\u1ed3i \u0111\u01b0\u1eddng m\u1eadt sau c\u00f9ng.<\/span><\/p>\n

T\u00f3m l\u1ea1i, ph\u1eabu thu\u1eadt n\u1ed9i soi c\u1eaft d\u1ea1 d\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng m\u1ea1n nghi\u00eam tr\u1ecdng, kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c ho\u1eb7c c\u00f3 nguy c\u01a1 g\u00e2y ra bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng nh\u01b0 ch\u1ea3y m\u00e1u ti\u00eau h\u00f3a ho\u1eb7c th\u1ee7ng d\u1ea1 d\u00e0y. Quy\u1ebft \u0111\u1ecbnh ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0o ph\u00f9 h\u1ee3p nh\u1ea5t cho m\u1ed7i b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u01b0a ra sau khi tham kh\u1ea3o \u00fd ki\u1ebfn c\u1ee7a b\u00e1c s\u0129 chuy\u00ean khoa ti\u00eau h\u00f3a v\u00e0 x\u00e1c \u0111\u1ecbnh c\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan nh\u01b0 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe chung, l\u1ecbch s\u1eed b\u1ec7nh v\u00e0 kh\u1ea3 n\u0103ng ch\u1ecbu \u0111\u1ef1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

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