{"id":24578,"date":"2023-04-19T13:38:37","date_gmt":"2023-04-19T06:38:37","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24578"},"modified":"2023-04-19T14:28:13","modified_gmt":"2023-04-19T07:28:13","slug":"phau-thuat-noi-soi-dieu-tri-thung-o-loet-hanh-ta-trang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/phau-thuat-noi-soi-dieu-tri-thung-o-loet-hanh-ta-trang\/","title":{"rendered":"Ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111i\u1ec1u tr\u1ecb th\u1ee7ng \u1ed5 lo\u00e9t h\u00e0nh t\u00e1 tr\u00e0ng"},"content":{"rendered":"

Th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng c\u1ea5p t\u00ednh th\u01b0\u1eddng g\u1eb7p c\u1ee7a b\u1ec7nh lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng. Th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb<\/a> c\u1ea5p c\u1ee9u. Ph\u1eabu thu\u1eadt n\u1ed9i soi l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt ti\u00ean ti\u1ebfn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb th\u1ee7ng \u1ed5 lo\u00e9t h\u00e0nh t\u00e1 tr\u00e0ng.\u00a0<\/strong><\/p>\n

\"Th\u1ee7ng
Th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb c\u1ea5p c\u1ee9u<\/figcaption><\/figure>\n

1. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb th\u1ee7ng \u1ed5 lo\u00e9t h\u00e0nh t\u00e1 tr\u00e0ng<\/h2>\n

Tr\u01b0\u1edbc \u0111\u00e2y, n\u0103m 1944 Taylor \u0111\u00e3 \u0111\u1ec1 x\u01b0\u1edbng ph\u01b0\u01a1ng ph\u00e1p h\u00fat li\u00ean t\u1ee5c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng v\u00e0 ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u00e3 t\u1eebng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng trong nh\u1eefng n\u0103m 1970 – 1980. Nay ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u00e3 kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng do t\u1ef7 l\u1ec7 th\u1ea5t b\u1ea1i v\u00e0 bi\u1ebfn ch\u1ee9ng cao, m\u00e0 ch\u1ec9 l\u00e0 s\u1ef1 chu\u1ea9n b\u1ecb tr\u01b0\u1edbc m\u1ed5.<\/p>\n

Ng\u00e0y nay, ph\u1eabu thu\u1eadt l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ch\u1ee7 y\u1ebfu nh\u1ea5t \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng n\u00e0y \u0111\u01b0\u1ee3c h\u1ea7u h\u1ebft c\u00e1c t\u00e1c gi\u1ea3 trong n\u01b0\u1edbc v\u00e0 tr\u00ean th\u1ebf gi\u1edbi s\u1eed d\u1ee5ng. C\u00f3 hai th\u00e1i \u0111\u1ed9 x\u1eed tr\u00ed \u0111\u1ed1i v\u1edbi th\u1ee7ng \u1ed5 lo\u00e9t trong c\u1ea5p c\u1ee9u l\u00e0:<\/p>\n

– Kh\u00e2u l\u1ed7 th\u1ee7ng \u0111\u01a1n thu\u1ea7n: M\u1ee5c \u0111\u00edch ch\u00ednh l\u00e0 x\u1eed tr\u00ed bi\u1ebfn ch\u1ee9ng th\u1ee7ng. Kh\u00e2u l\u1ed7 th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c Mikulicz th\u1eed nghi\u1ec7m th\u1ef1c hi\u1ec7n l\u1ea7n \u0111\u1ea7u ti\u00ean n\u0103m 1884 v\u00e0 Heusner th\u1ef1c hi\u1ec7n th\u00e0nh c\u00f4ng n\u0103m 1891. Trong su\u1ed1t h\u01a1n 100 n\u0103m qua kh\u00e2u l\u1ed7 th\u1ee7ng l\u00e0 m\u1ed9t bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb ch\u00ednh c\u1ee7a bi\u1ebfn ch\u1ee9ng th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y- t\u00e1 tr\u00e0ng. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 \u01b0u \u0111i\u1ec3m l\u00e0 \u0111\u01a1n gi\u1ea3n, d\u1ec5 th\u1ef1c hi\u1ec7n nh\u01b0ng nh\u01b0\u1ee3c \u0111i\u1ec3m l\u00e0 \u1ed5 lo\u00e9t v\u1eabn c\u00f2n, b\u1ec7nh v\u1eabn ti\u1ebfp t\u1ee5c ti\u1ebfp di\u1ec5n v\u1eabn c\u00f2n nguy c\u01a1 bi\u1ebfn ch\u1ee9ng th\u1ee7ng, ch\u1ea3y m\u00e1u, h\u1eb9p m\u00f4n v\u1ecb.<\/p>\n

– Ph\u1eabu thu\u1eadt tri\u1ec7t c\u0103n ngay th\u00ec \u0111\u1ea7u: x\u1eed tr\u00ed bi\u1ebfn ch\u1ee9ng th\u1ee7ng v\u00e0 \u0111i\u1ec1u tr\u1ecb lo\u00e9t.<\/p>\n

– Ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt kh\u00e2u l\u1ed7 th\u1ee7ng \u0111\u01a1n thu\u1ea7n ph\u1ed1i h\u1ee3p v\u1edbi c\u1eaft d\u00e2y th\u1ea7n kinh X nh\u1eb1m m\u1ee5c \u0111\u00edch \u0111i\u1ec1u tr\u1ecb tri\u1ec7t c\u0103n b\u1ec7nh lo\u00e9t nh\u01b0ng k\u1ebft qu\u1ea3 v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c t\u1ed1t nh\u01b0 l\u00fd thuy\u1ebft.<\/p>\n

Ngay sau khi ph\u1eabu thu\u1eadt n\u1ed9i soi ra \u0111\u1eddi v\u1edbi tr\u01b0\u1eddng h\u1ee3p c\u1eaft t\u00fai m\u1eadt qua n\u1ed9i soi \u0111\u1ea7u ti\u00ean n\u0103m 1987, c\u00e1c Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n \u0111\u00e3 ngh\u0129 t\u1edbi vi\u1ec7c \u00e1p d\u1ee5ng k\u1ef9 thu\u1eadt n\u00e0y trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng. N\u0103m 1989, P.Mouret \u0111\u00e3 th\u00f4ng b\u00e1o tr\u01b0\u1eddng h\u1ee3p kh\u00e2u th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y \u0111\u1ea7u ti\u00ean qua n\u1ed9i soi \u1ed5 b\u1ee5ng v\u00e0 t\u1eeb \u0111\u00f3 ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng c\u00f3 hi\u1ec7u qu\u1ea3 v\u00e0 lan r\u1ed9ng t\u1ea1i m\u1ed9t s\u1ed1 trung t\u00e2m ph\u1eabu thu\u1eadt n\u1ed9i soi tr\u00ean th\u1ebf gi\u1edbi.<\/p>\n

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

– Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 ch\u1ea9n \u0111o\u00e1n th\u1ee7ng \u1ed5 lo\u00e9t h\u00e0nh t\u00e1 tr\u00e0ng \u0111\u01a1n thu\u1ea7n.<\/p>\n

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

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

– Th\u1ec3 tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh qu\u00e1 y\u1ebfu v\u00e0 c\u00f3 nhi\u1ec1u b\u1ec7nh ph\u1ed1i h\u1ee3p<\/p>\n

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

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

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

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

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

3.2. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh b\u01a1m h\u01a1i \u1ed5 b\u1ee5ng:<\/h3>\n

– B\u1ec7nh m\u1ea1ch v\u00e0nh.<\/p>\n

– B\u1ec7nh van tim.<\/p>\n

– B\u1ec7nh t\u00e2m ph\u1ebf m\u00e3n.<\/p>\n

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

4.1. Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n:<\/b><\/h3>\n

Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n chuy\u00ean khoa ti\u00eau h\u00f3a v\u00e0 n\u1ed9i soi v\u00e0 g\u00e2y m\u00ea h\u1ed3i s\u1ee9c c\u00f3 kinh nghi\u1ec7m.<\/p>\n

4.2. Ph\u01b0\u01a1ng ti\u1ec7n:<\/b><\/h3>\n

B\u1ed9 ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111\u1ed3ng b\u1ed9.<\/p>\n

4.3. Ng\u01b0\u1eddi b\u1ec7nh:<\/b><\/h3>\n

– C\u00e1c x\u00e9t nghi\u1ec7m c\u01a1 b\u1ea3n.<\/p>\n

– Xquang b\u1ee5ng kh\u00f4ng ch\u1ea9n b\u1ecb.<\/p>\n

– Kh\u00e1ng sinh d\u1ef1 ph\u00f2ng tr\u01b0\u1edbc m\u1ed5.<\/p>\n

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

3.1. T\u01b0 th\u1ebf:<\/b><\/h3>\n

Ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m t\u01b0 th\u1ebf \u0111\u1ea7u cao, ch\u00e2n th\u1ea5p m\u1ed9t g\u00f3c 15 – 30 \u0111\u1ed9 (t\u01b0 th\u1ebf Trendenburg), hai ch\u00e2n d\u1ea1ng m\u1ed9t g\u00f3c 90 \u0111\u1ed9. M\u00e0n h\u00ecnh ch\u00ednh v\u00e0 c\u00e1c thi\u1ebft b\u1ecb \u0111\u01b0\u1ee3c \u0111\u1eb7t ngang v\u1ecb tr\u00ed vai ph\u1ea3i ng\u01b0\u1eddi b\u1ec7nh, Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n \u0111\u1ee9ng gi\u1eefa 2 ch\u00e2n ng\u01b0\u1eddi b\u1ec7nh, ho\u1eb7c \u0111\u1ee9ng ph\u00eda b\u00ean tr\u00e1i ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

5.2. V\u00f4 c\u1ea3m:<\/b><\/h3>\n

Ng\u01b0\u1eddi b\u1ec7nh g\u00e2y m\u00ea n\u1ed9i kh\u00ed qu\u1ea3n<\/p>\n

5.3. K\u1ef9 thu\u1eadt:<\/b><\/h3>\n

K\u1ef9 thu\u1eadt b\u01a1m h\u01a1i m\u1edf ki\u1ec3u Hasson v\u1edbi \u00e1p l\u1ef1c 12mm Hg, l\u01b0u l\u01b0\u1ee3ng 2,5 l\/h.<\/p>\n

Qua \u0111\u01b0\u1eddng r\u1ea1ch d\u01b0\u1edbi r\u1ed1n ho\u1eb7c tr\u00ean r\u1ed1n (chi\u1ec1u d\u00e0i \u0111\u01b0\u1eddng r\u1ea1ch ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u01b0\u1eddng k\u00ednh c\u1ee7a trocar \u0111\u1ecbnh d\u00f9ng) d\u00f9ng kim Veress b\u01a1m kh\u00ed CO2<\/sub>\u00a0v\u00e0o m\u00e0ng b\u1ee5ng v\u1edbi \u00e1p l\u1ef1c t\u1eeb 9 t\u1edbi 12mmHg). Canule Hasson l\u00e0 m\u1ed9t c\u00e1ch thay th\u1ebf cho kim Verres. Th\u00f4ng th\u01b0\u1eddng d\u00f9ng 4 trocar, 3 trocar 10mm v\u00e0 1 trocar 5mm. Trocar \u0111\u1ea7u ti\u00ean 10mm d\u00f9ng cho \u1ed1ng soi \u0111\u1eb7t \u1edf c\u1ea1nh r\u1ed1n, \u1ed1ng soi 10mm nghi\u00eang 30 \u0111\u1ed9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. Sau khi \u0111\u1eb7t trocar \u0111\u1ea7u ti\u00ean, ti\u1ebfn h\u00e0nh quan s\u00e1t to\u00e0n b\u1ed9 \u1ed5 b\u1ee5ng, b\u1ea3n th\u00e2n vi\u1ec7c soi \u1ed5 b\u1ee5ng l\u00e0 m\u1ed9t c\u00f4ng c\u1ee5 ch\u1ea9n \u0111o\u00e1n c\u00f3 gi\u00e1 tr\u1ecb, v\u00ec v\u1eady c\u1ea7n kh\u1ea3o s\u00e1t k\u1ef9 l\u01b0\u1ee1ng to\u00e0n b\u1ed9 \u1ed5 b\u1ee5ng. C\u00e1c trocar kh\u00e1c \u0111\u01b0\u1ee3c \u0111\u1eb7t d\u01b0\u1edbi s\u1ef1 h\u01b0\u1edbng d\u1eabn c\u1ee7a n\u1ed9i soi, bao g\u1ed3m m\u1ed9t trocar 10mm \u1edf v\u00f9ng th\u01b0\u1ee3ng v\u1ecb d\u00f9ng que g\u1ea1t v\u00e9n gan v\u00e0 d\u00e2y ch\u1eb1ng tr\u00f2n \u0111\u1ec3 b\u1ed9c l\u1ed9 m\u1eb7t tr\u01b0\u1edbc d\u1ea1 d\u00e0y, m\u00f4n v\u1ecb v\u00e0 h\u00e0nh t\u00e1 tr\u00e0ng. \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng l\u1ed1 th\u1ee7ng bao g\u1ed3m v\u1ecb tr\u00ed, \u0111\u01b0\u1eddng k\u00ednh, \u0111\u1ed9 x\u01a1 chai \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c c\u01a1 quan xung quanh, v\u1edbi l\u1ed7 th\u1ee7ng d\u1ea1 d\u00e0y \u0111\u00e1nh gi\u00e1 xem c\u00f3 bi\u1ec3u hi\u1ec7n \u00e1c t\u00ednh kh\u00f4ng. \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng \u1ed5 b\u1ee5ng, m\u1ee9c \u0111\u1ed9 b\u1ea9n, gi\u1ea3 m\u1ea1c.<\/p>\n

Trocar 10mm d\u1ec3 thao t\u00e1c \u0111\u1eb7t \u1edf tr\u00ean \u0111\u01b0\u1eddng v\u00fa tr\u00e1i, d\u01b0\u1edbi b\u1edd s\u01b0\u1eddn 5 cm. Trocar tr\u1ee3 gi\u00fap \u0111\u1eb7t \u1edf \u0111\u01b0\u1eddng n\u00e1ch tr\u01b0\u1edbc ph\u1ea3i ngang r\u1ed1n.<\/p>\n

– Th\u00ec I:<\/i>\u00a0H\u00fat s\u1ea1ch th\u1ee9c \u0103n, ch\u1ea5t b\u1ea9n, gi\u1ea3 m\u1ea1c trong \u1ed5 b\u1ee5ng.<\/p>\n

– Th\u00ec II:<\/i>\u00a0V\u1edbi l\u1ed7 th\u1ee7ng d\u1ea1 d\u00e0y, c\u1ea7n x\u00e9n m\u00e9p l\u1ed7 th\u1ee7ng \u0111\u1ec3 l\u00e0m sinh thi\u1ebft h\u1ec7 th\u1ed1ng.<\/p>\n

Nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p m\u1ed5 n\u1ed9i soi \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3. M\u1ed9t l\u00e0 ph\u01b0\u01a1ng ph\u00e1p Walsh v\u00e0 cs. Sau khi \u0111\u00e3 x\u00e1c nh\u1eadn \u0111\u00f3ng k\u00edn l\u1ed7 th\u1ee7ng, n\u00f3 \u0111\u01b0\u1ee3c \u0111\u1ec3 nguy\u00ean; ti\u1ebfn h\u00e0nh r\u1eeda v\u00e0 d\u1eabn l\u01b0u ph\u00fac m\u1ea1c. Trong tr\u01b0\u1eddng h\u1ee3p l\u1ed7 th\u1ee7ng ch\u01b0a \u0111\u01b0\u1ee3c m\u1ea1c n\u1ed1i l\u1ea5p k\u00edn, ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c chuy\u1ec3n sang m\u1ed5 m\u1edf, v\u00e0 ti\u1ebfn h\u00e0nh \u0111\u00f3ng m\u1ea1c n\u1ed1i \u0111\u01a1n gi\u1ea3n. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y sau \u0111\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c c\u00e1c Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n kh\u00e1c ch\u1ea5p nh\u1eadn..<\/p>\n

Khi ti\u1ebfn h\u00e0nh kh\u00e2u k\u00e8m t\u0103ng c\u01b0\u1eddng b\u1eb1ng mi\u1ebfng v\u00e1 m\u1ea1c n\u1ed1i, kh\u00e2u 3 m\u0169i qua ph\u1ea7n t\u00e1 tr\u00e0ng nh\u00ecn th\u1ea5y \u1edf 2 b\u00ean l\u1ed7 th\u1ee7ng v\u00e0 th\u1eaft ch\u1eb7t \u0111\u1ec3 \u0111\u00f3ng k\u00edn l\u1ed7 th\u1ee7ng. Kh\u00e2u qua n\u1ed9i soi cu\u1ed1ng m\u1ea1c n\u1ed1i v\u1eaft qua l\u1ed7 th\u1ee7ng s\u1ebd ho\u00e0n t\u1ea5t vi\u1ec7c \u0111\u00f3ng. Khi m\u1ea1c n\u1ed1i nh\u1ecf, c\u00f3 th\u1ec3 d\u00f9ng d\u00e2y ch\u1eb1ng li\u1ec1m thay th\u1ebf.<\/p>\n

Ph\u01b0\u01a1ng ph\u00e1p kh\u00e2u th\u1ee7ng: d\u00f9ng ch\u1ec9 li\u1ec1n kim lo\u1ea1i ti\u00eau ch\u1eadm Vicryl 2.0 ho\u1eb7c 3.0 d\u00e0i kho\u1ea3ng 18 – 20 cm l\u00e0 v\u1eeba. D\u00f9ng v\u00e9n gan n\u00e2ng m\u1eb7t d\u01b0\u1edbi gan b\u1ed9c l\u1ed9 l\u1ed7 th\u1ee7ng, ti\u1ebfn h\u00e0nh kh\u00e2u th\u1ee7ng. N\u1ebfu l\u1ed7 th\u1ee7ng < 0,5 cm kh\u00e2u m\u1ed9t m\u0169i ch\u1eef X, h\u01b0\u1edbng kh\u00e2u \u0111i theo tr\u1ee5c c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a, sau \u0111\u00f3 th\u1eaft ch\u1ec9 kh\u00e9p k\u00edn l\u1ed7 th\u1ee7ng. N\u1ebfu l\u1ed7 th\u1ee7ng l\u1edbn h\u01a1n th\u01b0\u1eddng ph\u1ea3i kh\u00e2u 2 – 3 m\u0169i r\u1eddi, kh\u00e2u theo chi\u1ec1u c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a \u0111\u1ec3 khi th\u1eaft ch\u1ec9 \u0111\u01b0\u1eddng kh\u00e2u n\u1eb1m ngang kh\u00f4ng g\u00e2y h\u1eb9p t\u00e1 tr\u00e0ng. Sau khi kh\u00e2u ph\u1ee7 m\u1ea1c n\u1ed1i l\u1edbn l\u00ean \u0111\u01b0\u1eddng kh\u00e2u v\u00e0 d\u00f9ng ch\u1ec9 c\u1ed1 \u0111\u1ecbnh v\u00e0o \u0111\u01b0\u1eddng kh\u00e2u.<\/p>\n

– Th\u00ec III:<\/i>\u00a0R\u1eeda \u1ed5 b\u1ee5ng<\/p>\n

R\u1eeda khoang ph\u00fac m\u1ea1c l\u00e0 m\u1ed9t trong nh\u1eefng ph\u1ea7n quan tr\u1ecdng nh\u1ea5t c\u1ee7a ph\u1eabu thu\u1eadt, chi\u1ebfm m\u1ed9t ph\u1ea7n \u0111\u00e1ng k\u1ec3 c\u1ee7a ph\u1eabu thu\u1eadt. R\u1eeda \u0111\u1ea3m b\u1ea3o s\u1ea1ch to\u00e0n b\u1ed9 c\u00e1c ch\u1ea5t b\u1ea9n v\u00e0 gi\u1ea3 m\u1ea1c trong b\u1ee5ng. R\u1eeda t\u1eebng khoang trong \u1ed5 b\u1ee5ng k\u1ebft h\u1ee3p v\u1edbi thay \u0111\u1ed5i t\u01b0 th\u1ebf ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ec3 r\u1eeda s\u1ea1ch c\u00e1c khoang. C\u1ea7n ch\u00fa \u00fd \u0111\u1eb7c bi\u1ec7t \u0111\u1ebfn vi\u1ec7c r\u1eeda khoang tr\u00ean gan v\u00e0 d\u01b0\u1edbi gan, r\u00e3nh b\u00ean, khoang d\u01b0\u1edbi c\u01a1 ho\u00e0nh tr\u00e1i v\u00e0 h\u1ed1 ch\u1eadu ph\u1ea3i. N\u1ebfu \u1ed5 b\u1ee5ng s\u1ea1ch kh\u00f4ng c\u1ea7n \u0111\u1eb7t d\u1eabn l\u01b0u, n\u1ebfu b\u1ecb vi\u00eam ph\u00fac m\u1ea1c mu\u1ed9n, \u0111\u1eb7t d\u1eabn l\u01b0u d\u01b0\u1edbi gan ph\u1ea3i. Khoang ph\u00fac m\u1ea1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u1eabn l\u01b0u. M\u1eb7c kh\u00e1c, m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 kh\u00f4ng ch\u1ee7 tr\u01b0\u01a1ng d\u1eabn l\u01b0u khoang ph\u00fac m\u1ea1c.<\/p>\n

– Th\u00ec IV:<\/i>\u00a0R\u00fat trocar, th\u00e1o h\u01a1i \u0111\u00f3ng c\u00e1c l\u1ed7.<\/p>\n

6. Theo d\u00f5i<\/b><\/h2>\n

Ch\u0103m s\u00f3c sau m\u1ed5: \u1ed0ng th\u00f4ng d\u1ea1 d\u00e0y \u0111\u01b0\u1ee3c gi\u1eef cho \u0111\u1ebfn khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nhu \u0111\u1ed9ng ru\u1ed9t, th\u1eddi gian \u0111\u1eb7t x\u00f4ng d\u1ea1 d\u00e0y \u00edt nh\u1ea5t l\u00e0 48 gi\u1edd. Cho \u0103n tr\u1edf l\u1ea1i sau khi r\u00fat \u1ed1ng th\u00f4ng d\u1ea1 d\u00e0y. D\u1eabn l\u01b0u \u1ed5 b\u1ee5ng n\u1ebfu c\u00f3 s\u1ebd \u0111\u01b0\u1ee3c r\u00fat khi kh\u00f4ng c\u00f2n ch\u1ea3y d\u1ecbch, th\u01b0\u1eddng sau 24 gi\u1edd. Kh\u00e1ng sinh d\u00f9ng theo ch\u1ebf \u0111\u1ed9 kh\u00e1ng sinh \u0111i\u1ec1u tr\u1ecb, \u0111\u01b0\u1ee3c d\u00f9ng t\u1edbi 5 ng\u00e0y ho\u1eb7c \u0111\u1ebfn khi h\u1ebft s\u1ed1t. D\u00f9ng c\u00e1c thu\u1ed1c gi\u1ea3m ti\u1ebft d\u1ecbch d\u1ea1 d\u00e0y. Ch\u1ea5t \u1ee9c ch\u1ebf b\u01a1m proton ho\u1eb7c ch\u1ea5t ch\u1eb9n th\u1ee5 th\u1ec3 H2 \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u ngay sau m\u1ed5. Ng\u01b0\u1eddi b\u1ec7nh d\u1eady v\u1eadn \u0111\u1ed9ng sau m\u1ed5 24 gi\u1edd.<\/p>\n

7. X\u1eed tr\u00ed tai bi\u1ebfn<\/b><\/h2>\n

– Ch\u1ea3y m\u00e1u: ph\u1ea3i m\u1ed5 l\u1ea1i ngay c\u1ea7m m\u00e1u.<\/p>\n

– B\u1ee5c ch\u1ed7 kh\u00e2u: kh\u00e2u l\u1ea1i ch\u1ed7 b\u1ee5ng ho\u1eb7c d\u1eabn l\u01b0u.<\/p>\n

– \u00c1p xe t\u1ed3n d\u01b0: c\u00f3 th\u1ec3 m\u1ed5 l\u1ea1i ho\u1eb7c \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh, ho\u1eb7c ch\u1ecdc h\u00fat.<\/p>\n

Ph\u1eabu thu\u1eadt n\u1ed9i soi l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt ti\u00ean ti\u1ebfn v\u00e0 an to\u00e0n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb th\u1ee7ng \u1ed5 lo\u00e9t h\u00e0nh t\u00e1 tr\u00e0ng. Tuy nhi\u00ean, quy\u1ebft \u0111\u1ecbnh ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb 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 c\u00e1c chuy\u00ean gia y t\u1ebf 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":"

Th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng c\u1ea5p t\u00ednh th\u01b0\u1eddng g\u1eb7p c\u1ee7a b\u1ec7nh lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng. Th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb c\u1ea5p c\u1ee9u. Ph\u1eabu thu\u1eadt n\u1ed9i soi l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt ti\u00ean ti\u1ebfn \u0111\u01b0\u1ee3c s\u1eed […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"\nPh\u1eabu thu\u1eadt n\u1ed9i soi \u0111i\u1ec1u tr\u1ecb th\u1ee7ng \u1ed5 lo\u00e9t h\u00e0nh t\u00e1 tr\u00e0ng<\/title>\n<meta name=\"description\" content=\"Th\u1ee7ng \u1ed5 lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng c\u1ea5p t\u00ednh th\u01b0\u1eddng g\u1eb7p c\u1ee7a b\u1ec7nh lo\u00e9t d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng. 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