{"id":24771,"date":"2023-04-19T18:35:05","date_gmt":"2023-04-19T11:35:05","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24771"},"modified":"2023-04-20T16:59:12","modified_gmt":"2023-04-20T09:59:12","slug":"tiep-can-va-xu-tri-polyp-dai-truc-trang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/tiep-can-va-xu-tri-polyp-dai-truc-trang\/","title":{"rendered":"Ti\u1ebfp c\u1eadn v\u00e0 x\u1eed tr\u00ed polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng"},"content":{"rendered":"

Polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng l\u00e0 u l\u1ed3i v\u00e0o trong l\u00f2ng \u0110TT, kh\u1ed1i u \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh do s\u1ef1 t\u0103ng sinh qu\u00e1 m\u1ee9c c\u1ee7a ni\u00eam m\u1ea1c \u0110TT. B\u1ec1 m\u1eb7t polyp c\u00f3 l\u1edbp ni\u00eam m\u1ea1c bao ph\u1ee7. Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y v\u1edbi s\u1ef1 ti\u1ebfn b\u1ed9 v\u1ec1 k\u1ef9 thu\u1eadt n\u1ed9i soi \u0111\u1ea1i tr\u1ef1c tr\u00e0ng<\/a> \u1ed1ng m\u1ec1m, k\u1ebft h\u1ee3p v\u1edbi nh\u1eefng ch\u01b0\u01a1ng tr\u00ecnh th\u0103m kh\u00e1m s\u00e0ng l\u1ecdc nh\u1eb1m ph\u00e1t hi\u1ec7n s\u1edbm ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng trong c\u1ed9ng \u0111\u1ed3ng n\u00ean s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n ng\u00e0y c\u00e0ng nhi\u1ec1u. Di\u1ec5n bi\u1ebfn c\u1ee7a polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng kh\u00e1 ph\u1ee9c t\u1ea1p, \u0111\u1eb7c bi\u1ec7t m\u1ed9t s\u1ed1 polyp c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n th\u00e0nh ung th\u01b0 n\u00ean polyp \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o lo\u1ea1i nh\u1eefng t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n ung th\u01b0\u00a0<\/strong><\/p>\n

1. \u0110\u1eb7c \u0111i\u1ec3m h\u00ecnh \u1ea3nh h\u1ecdc n\u1ed9i soi, m\u00f4 b\u1ec7nh h\u1ecdc \u1edf b\u1ec7nh nh\u00e2n polyp c\u00f3 cu\u1ed1ng \u0111\u1ea1i tr\u1ef1c tr\u00e0ng<\/h2>\n

1.1. H\u00ecnh \u1ea3nh h\u1ecdc n\u1ed9i soi polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng<\/h3>\n

1.1.1. H\u00ecnh d\u1ea1ng polyp<\/p>\n

Polyp \u0110TT c\u00f3 h\u00ecnh th\u00e1i r\u1ea5t \u0111a d\u1ea1ng. Ng\u01b0\u1eddi ta qui \u01b0\u1edbc ph\u1ea7n polyp d\u00ednh v\u00e0o th\u00e0nh \u0110TT g\u1ecdi l\u00e0 ch\u00e2n ho\u1eb7c cu\u1ed1ng polyp, c\u00f2n ph\u1ea7n \u1edf xa nh\u1ea5t so v\u1edbi ch\u00e2n hay cu\u1ed1ng g\u1ecdi l\u00e0 \u0111\u1ec9nh polyp, ph\u1ea7n c\u00f2n l\u1ea1i gi\u1eefa \u0111\u1ec9nh polyp v\u1edbi cu\u1ed1ng l\u00e0 \u0111\u1ea7u polyp. Cu\u1ed1ng polyp c\u00f3 th\u1ec3 ng\u1eafn hay d\u00e0i, ch\u00e2n polyp c\u00f3 th\u1ec3 nh\u1ecf ho\u1eb7c to h\u01a1n \u0111\u1ea7u polyp. Polyp c\u0169ng c\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u \u0111\u1ec9nh.<\/p>\n

V\u1ec1 h\u00ecnh d\u1ea1ng, ng\u01b0\u1eddi ta chia polyp ra l\u00e0m 4 lo\u1ea1i ch\u00ednh nh\u01b0 sau:<\/p>\n

– Polyp kh\u00f4ng c\u00f3 cu\u1ed1ng: <\/em><\/strong>Khi ph\u1ea7n ch\u00e2n polyp l\u1edbn h\u01a1n ph\u1ea7n \u0111\u1ea7u.<\/p>\n

–<\/em><\/strong> Polyp c\u00f3 cu\u1ed1ng :<\/em><\/strong> Khi ph\u1ea7n \u0111\u1ea7u polyp l\u1edbn h\u01a1n ph\u1ea7n cu\u1ed1ng nhi\u1ec1u l\u1ea7n v\u00e0 c\u00f3 ranh gi\u1edbi r\u00f5 gi\u1eefa \u0111\u1ea7u v\u00e0 cu\u1ed1ng. Cu\u1ed1ng polyp c\u00f3 d\u1ea1ng nh\u01b0 cu\u1ed1ng c\u1ee7a c\u00e1c lo\u1ea1i qu\u1ea3.<\/p>\n

– Polyp n\u1eeda cu\u1ed1ng:<\/em><\/strong> Khi m\u00e0 ph\u1ea7n cu\u1ed1ng polyp ch\u1ec9 nh\u1ecf h\u01a1n ph\u1ea7n \u0111\u1ea7u m\u1ed9t ch\u00fat kh\u00f4ng r\u00f5 ranh gi\u1edbi gi\u1eefa \u0111\u1ea7u v\u00e0 cu\u1ed1ng polyp.<\/p>\n

– Polyp d\u1ea1ng d\u1eb9t:<\/em><\/strong> ph\u1ea7n \u0111\u1ec9nh polyp \u201cb\u1eb1ng ph\u1eb3ng\u201d to b\u00e8, c\u00f3 khi r\u1ed9ng g\u1ea7n nh\u01b0 ph\u1ea7n ch\u00e2n, c\u00f3 t\u00e1c gi\u1ea3 c\u00f2n g\u1ecdi d\u1ea1ng d\u1eb9t l\u00e0 polyp c\u00f3 h\u00ecnh t\u1ea5m th\u1ea3m.<\/p>\n

1.1.2. K\u00edch th\u01b0\u1edbc polyp<\/h4>\n

K\u00edch th\u01b0\u1edbc polyp th\u01b0\u1eddng \u0111\u01b0\u1ee3c t\u00ednh \u1edf ch\u1ed7 polyp to nh\u1ea5t, polyp c\u00f3 cu\u1ed1ng t\u00ednh \u0111\u01b0\u1eddng k\u00ednh (\u0110K) \u0111\u1ea7u, polyp kh\u00f4ng cu\u1ed1ng t\u00ednh \u0110K ch\u00e2n. Polyp \u0110TT c\u00f3 k\u00edch th\u01b0\u1edbc r\u1ea5t nh\u1ecf, t\u1eeb v\u00e0i milim\u00e9t \u0111\u1ebfn r\u1ea5t to (l\u1edbn h\u01a1n 50mm), c\u00f3 khi g\u00e2y n\u00ean b\u00e1n t\u1eafc ho\u1eb7c l\u00e0m t\u1eafc h\u1eb3n l\u00f2ng \u0110TT :<\/p>\n

1.1.3. V\u1ecb tr\u00ed polyp<\/h4>\n

Polyp c\u00f3 th\u1ec3 th\u1ea5y \u1edf b\u1ea5t c\u1ee9 v\u1ecb tr\u00ed n\u00e0o c\u1ee7a \u0110TT. \u0110\u1ec3 ti\u1ec7n cho ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb c\u0169ng nh\u01b0 nghi\u00ean c\u1ee9u, ng\u01b0\u1eddi ta chia v\u1ecb tr\u00ed polyp t\u01b0\u01a1ng \u1ee9ng theo s\u1ef1 ph\u00e2n chia v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu c\u1ee7a \u0110TT. Nh\u01b0 v\u1eady \u0110TT \u0111\u01b0\u1ee3c chia l\u00e0m 6 \u0111o\u1ea1n th\u00ec polyp c\u0169ng c\u00f3 6 v\u1ecb tr\u00ed t\u01b0\u01a1ng \u1ee9ng. \u0110\u1ee9ng tr\u00ean ph\u01b0\u01a1ng di\u1ec7n sinh l\u00fd v\u00e0 b\u1ec7nh l\u00fd th\u00ec \u0110TT l\u1ea1i \u0111\u01b0\u1ee3c chia l\u00e0m 2 \u0111o\u1ea1n: \u0110T ph\u1ea3i v\u00e0 \u0110T tr\u00e1i, do \u0111\u00f3 c\u00f3 polyp \u1edf \u0110T ph\u1ea3i v\u00e0 polyp \u1edf \u0110T tr\u00e1i.<\/p>\n

1.1.4. S\u1ed1 l\u01b0\u1ee3ng polyp<\/h4>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 V\u1ec1 s\u1ed1 l\u01b0\u1ee3ng polyp tr\u00ean m\u1ed9t b\u1ec7nh nh\u00e2n (BN), ng\u01b0\u1eddi ta chia polyp l\u00e0m 3 lo\u1ea1i:<\/h4>\n

– Polyp \u0111\u01a1n \u0111\u1ed9c <\/em><\/strong><\/p>\n

Khi trong \u0110TT c\u1ee7a BN ch\u1ec9 c\u00f3 m\u1ed9t polyp th\u00ec polyp \u0111\u00f3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 polyp \u0111\u01a1n \u0111\u1ed9c. Polyp \u0111\u01a1n \u0111\u1ed9c c\u00f3 nhi\u1ec1u lo\u1ea1i:<\/p>\n

+ Polyp \u0111\u01a1n \u0111\u1ed9c thi\u1ebfu ni\u00ean (Polyp Solitaire Juvenile):<\/em> Polyp lo\u1ea1i n\u00e0y th\u01b0\u1eddng c\u00f3 cu\u1ed1ng.<\/p>\n

+ Polyp tuy\u1ebfn \u0111\u01a1n \u0111\u1ed9c (polyp solitaire Adenomatous):<\/em> Polyp lo\u1ea1i n\u00e0y c\u00f3 th\u1ec3 c\u00f3 cu\u1ed1ng ho\u1eb7c kh\u00f4ng c\u00f3 cu\u1ed1ng.<\/p>\n

– \u0110a polyp <\/em><\/strong><\/p>\n

Khi BN c\u00f3 t\u1eeb 2 \u0111\u1ebfn 99 polyp \u1edf \u0110TT th\u00ec \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u0111a polyp.<\/p>\n

– <\/em><\/strong>B\u1ec7nh polyp<\/em><\/strong><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0<\/em><\/strong>Thu\u1ed9c nh\u00f3m b\u1ec7nh n\u00e0y khi \u0110TT c\u1ee7a BN c\u00f3 t\u1eeb 100 polyp tr\u1edf l\u00ean. Tr\u00ean 1 BN b\u1ecb \u0111a polyp ho\u1eb7c b\u1ec7nh polyp c\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u h\u00ecnh d\u1ea1ng, k\u00edch th\u01b0\u1edbc polyp kh\u00e1c nhau.<\/p>\n

\"Polyp
Ph\u00e2n lo\u1ea1i Polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng<\/figcaption><\/figure>\n

1.2.\u00a0\u00a0\u00a0 \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 lo\u1ea1n s\u1ea3n c\u1ee7a polyp<\/h3>\n

\u0110\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 lo\u1ea1n s\u1ea3n trong polyp\/ u tuy\u1ebfn c\u1ee7a \u0111\u1ea1i \u2013 tr\u1ef1c tr\u00e0ng, ch\u00fang t\u00f4i s\u1eed d\u1ee5ng c\u00e1c ti\u00eau chu\u1ea9n c\u1ee7a Odze R. D. (2009):<\/p>\n

– Lo\u1ea1n s\u1ea3n \u0111\u1ed9 th\u1ea5p<\/em>: C\u1ea5u tr\u00fac khe tuy\u1ebfn kh\u00f4ng ph\u1ee9c t\u1ea1p v\u1edbi c\u00e1c nh\u00e2n t\u1ebf b\u00e0o x\u1ebfp gi\u1ea3 t\u1ea7ng ho\u1eb7c x\u1ebfp t\u1ea7ng ch\u1ec9 t\u1edbi n\u1eeda d\u01b0\u1edbi chi\u1ec1u d\u00e0y c\u1ee7a b\u00e0o t\u01b0\u01a1ng t\u1ebf b\u00e0o v\u00e1ch khe tuy\u1ebfn. C\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u nh\u00e2n chia nh\u01b0ng kh\u00f3 g\u1eb7p c\u00e1c d\u1ea5u hi\u1ec7u nh\u01b0 nh\u00e2n chia kh\u00f4ng \u0111i\u1ec3n h\u00ecnh, t\u00ednh \u0111a h\u00ecnh c\u1ee7a nh\u00e2n t\u1ebf b\u00e0o, ho\u1eb7c m\u1ea5t c\u1ef1c t\u00ednh t\u1ebf b\u00e0o. C\u00e1c khe tuy\u1ebfn th\u01b0\u1eddng s\u1eafp x\u1ebfp song song. Hi\u1ebfm g\u1eb7p c\u1ea5u tr\u00fac tuy\u1ebfn d\u1ea1ng s\u00e0ng, x\u1ebfp li\u1ec1n k\u1ec1 nhau ho\u1eb7c m\u1ecdc ch\u1ed3i ph\u1ee9c t\u1ea1p.<\/p>\n

– Lo\u1ea1n s\u1ea3n \u0111\u1ed9 cao<\/em>: T\u1ed5n th\u01b0\u01a1ng c\u00f3 d\u1ea1ng gi\u1ea3 t\u1ea7ng ho\u1eb7c x\u1ebfp t\u1ea7ng r\u00f5 r\u1ec7t. Nh\u00e2n t\u1ebf b\u00e0o th\u01b0\u1eddng lan t\u1ecfa \u0111\u1ebfn n\u1eeda tr\u00ean (ph\u00eda l\u00f2ng \u1ed1ng) chi\u1ec1u d\u00e0y c\u1ee7a b\u00e0o t\u01b0\u01a1ng v\u00e1ch khe tuy\u1ebfn. Nh\u00e2n t\u1ebf b\u00e0o th\u01b0\u1eddng \u0111a h\u00ecnh r\u00f5, t\u0103ng t\u1ef7 l\u1ec7 nh\u00e2n chia v\u1edbi c\u00e1c nh\u00e2n chia kh\u00f4ng \u0111i\u1ec3n h\u00ecnh r\u00f5 k\u00e8m m\u1ea5t c\u1ef1c t\u00ednh c\u1ee7a nh\u00e2n. C\u00e1c thay \u0111\u1ed5i c\u1ea5u tr\u00fac ni\u00eam m\u1ea1c r\u1ea5t r\u00f5 r\u00e0ng nh\u01b0 c\u00e1c khe tuy\u1ebfn n\u1eb1m k\u1ec1 nhau, c\u1ea5u tr\u00fac d\u1ea1ng s\u00e0ng. Khi qu\u00e1 tr\u00ecnh ti\u1ebfn tri\u1ec3n c\u00e0ng g\u1ea7n v\u1edbi ung th\u01b0 th\u00ec tr\u1eadt t\u1ef1 khe tuy\u1ebfn c\u00e0ng h\u1ed7n lo\u1ea1n, c\u1ea5u tr\u00fac c\u00e0ng kh\u00f4ng \u0111\u1ec1u v\u00e0 ph\u1ee9c t\u1ea1p h\u01a1n. Nh\u00e2n t\u1ebf b\u00e0o v\u1edbi nhi\u1ec1u h\u1ed1c s\u00e1ng k\u00e8m h\u1ea1t nh\u00e2n l\u1edbn. T\u1ef7 l\u00ean nh\u00e2n\/b\u00e0o t\u01b0\u01a1ng cao v\u00e0 t\u1ebf b\u00e0o m\u1ea5t c\u1ef1c t\u00ednh r\u00f5.<\/p>\n

– Polyp ung th\u01b0 h\u00f3a<\/em>: Ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ea1i ch\u1ed7 c\u0169ng \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o lo\u1ea1n s\u1ea3n \u0111\u1ed9 cao.<\/p>\n

2. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng<\/h2>\n

2.1. C\u1eaft polyp tr\u1ef1c tr\u00e0ng qua \u0111\u01b0\u1eddng h\u1eadu m\u00f4n<\/h3>\n

Tr\u01b0\u1edbc \u0111\u00e2y khi ch\u01b0a c\u00f3 n\u1ed9i soi th\u00ec t\u1ea5t c\u1ea3 c\u00e1c polyp tr\u1ef1c tr\u00e0ng \u1edf c\u00e1ch m\u00e9p h\u1eadu m\u00f4n < 7cm \u0111\u1ec1u ph\u1ea3i ph\u1eabu thu\u1eadt c\u1eaft qua \u0111\u01b0\u1eddng h\u1eadu m\u00f4n. Ng\u00e0y nay nh\u1edd c\u00f3 c\u00e1c thi\u1ebft b\u1ecb c\u1eaft polyp b\u1eb1ng n\u1ed9i soi, n\u00ean ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt c\u1eaft polyp qua \u0111\u01b0\u1eddng h\u1eadu m\u00f4n (kh\u00f4ng qua n\u1ed9i soi) \u0111\u00e3 thu h\u1eb9p l\u1ea1i. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p sau \u0111\u00e2y m\u1eb7c d\u00f9 c\u00f3 thi\u1ebft b\u1ecb c\u1eaft polyp b\u1eb1ng n\u1ed9i soi nh\u01b0ng h\u1ea7u h\u1ebft c\u00e1c t\u00e1c gi\u1ea3 v\u1eabn ch\u1ec9 \u0111\u1ecbnh c\u1eaft polyp qua \u0111\u01b0\u1eddng h\u1eadu m\u00f4n ( kh\u00f4ng qua n\u1ed9i soi) v\u00e0 \u0111i\u1ec1u ki\u1ec7n b\u1eaft bu\u1ed9c l\u00e0 c\u00e1c lo\u1ea1i polyp n\u00e0y \u0111\u1ec1u ph\u1ea3i c\u00e1ch m\u00e9p h\u1eadu m\u00f4n < 7cm:<\/p>\n

– Polyp c\u00f3 \u0111\u01b0\u1eddng k\u00ednh cu\u1ed1ng to >20 mm<\/p>\n

– Polyp kh\u00f4ng c\u00f3 cu\u1ed1ng khi \u0111\u01b0\u1eddng k\u00ednh ch\u00e2n > 20mm<\/p>\n

– Polyp \u0111\u00e3 c\u00f3 \u1ed5 ung th\u01b0 x\u00e2m l\u1ea5n v\u00e0o th\u00e0nh TT ho\u1eb7c \u0111\u00e3 di c\u0103n. T\u00f9y thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc, m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n hay di c\u0103n c\u1ee7a polyp ung th\u01b0 ho\u00e1 m\u00e0 l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt ph\u00f9 h\u1ee3p<\/p>\n

2.2. C\u1eaft polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng qua n\u1ed9i soi b\u1eb1ng \u0111i\u1ec7n cao t\u1ea7n<\/h3>\n

N\u0103m 1971, t\u1ea1i H\u1ed9i ngh\u1ecb c\u1ee7a H\u1ed9i Ti\u00eau ho\u00e1 Hoa K\u1ef3 h\u1ecdp \u1edf Miami, Shinya v\u00e0 Wolff l\u00e0 nh\u1eefng ng\u01b0\u1eddi \u0111\u1ea7u ti\u00ean tr\u00ecnh b\u00e0y \u1ee9ng d\u1ee5ng th\u00f2ng l\u1ecdng \u0111i\u1ec7n (diathemrmic snare) v\u00e0 k\u00ecm sinh thi\u1ebft n\u00f3ng (hot biopsy) d\u00f9ng d\u00f2ng \u0111i\u1ec7n cao t\u1ea7n (High Frequency Current) trong \u0111i\u1ec1u tr\u1ecb c\u1eaft b\u1ecf polyp \u0110TT qua n\u1ed9i soi \u1ed1ng m\u1ec1m. Do t\u00ednh ch\u1ea5t \u01b0u vi\u1ec7t\u00a0 n\u00ean ph\u01b0\u01a1ng ph\u00e1p n\u00e0y nhanh ch\u00f3ng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng r\u1ed9ng r\u00e3i.<\/p>\n

– Nguy\u00ean l\u00fd ho\u1ea1t \u0111\u1ed9ng<\/em><\/strong><\/p>\n

Khi th\u00f2ng l\u1ecdng \u0111i\u1ec7n ti\u1ebfp x\u00fac v\u1edbi polyp t\u1ea1i \u0111\u00f3 d\u00f2ng \u0111i\u1ec7n cao t\u1ea7n \u0111\u01b0\u1ee3c chuy\u1ec3n t\u1eeb \u0111i\u1ec7n n\u0103ng th\u00e0nh nhi\u1ec7t n\u0103ng. Qu\u00e1 tr\u00ecnh c\u1eaft \u0111\u1ed1t v\u00e0 c\u1ea7m m\u00e1u \u0111\u01b0\u1ee3c t\u1ea1o ra nh\u1edd s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa nhi\u1ec7t n\u0103ng v\u1edbi l\u1ef1c c\u01a1 h\u1ecdc do th\u00f2ng l\u1ecdng xi\u1ebft ch\u1eb7t.<\/p>\n

–Thi\u1ebft b\u1ecb<\/em><\/strong><\/p>\n

G\u1ed3m hai ph\u1ea7n ch\u00ednh:<\/p>\n

+ Ngu\u1ed3n c\u1eaft \u0111\u1ed1t \u0111i\u1ec7n cao t\u1ea7n<\/p>\n

+ Ph\u1ea7n th\u00f2ng l\u1ecdng \u0111i\u1ec7n<\/p>\n

Ch\u1ec9 \u0111\u1ecbnh v\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/em><\/strong><\/h4>\n

+ Ch\u1ec9 \u0111\u1ecbnh:<\/p>\n

. Polyp c\u00f3 cu\u1ed1ng ho\u1eb7c b\u00e1n cu\u1ed1ng<\/p>\n

. \u0110\u01b0\u1eddng k\u00ednh \u0111\u1ea7u polyp c\u00f3 th\u1ec3 l\u1ed3ng v\u1eeba \u0111\u01b0\u1ee3c th\u00f2ng l\u1ecdng<\/p>\n

+ Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/p>\n

. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 ch\u1ea3y m\u00e1u bi\u1ec3u hi\u1ec7n b\u1eb1ng c\u00e1c x\u00e9t nghi\u1ec7m m\u00e1u ch\u1ea3y, m\u00e1u \u0111\u00f4ng, t\u1ec9 l\u1ec7 prothrombin, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u\u2026<\/p>\n

. BN b\u1ecb b\u1ec7nh tim m\u1ea1ch nh\u01b0: suy tim n\u1eb7ng, nh\u1ed3i m\u00e1u c\u01a1 tim\u2026<\/p>\n

– BN \u0111ang b\u1ecb s\u1ed1t, nhi\u1ec5m tr\u00f9ng ho\u1eb7c c\u01a1 th\u1ec3 suy ki\u1ec7t.<\/p>\n

Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n c\u1eaft polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng<\/em><\/strong><\/h4>\n

– \u0110TT c\u1ee7a BN ph\u1ea3i chu\u1ea9n b\u1ecb s\u1ea1ch (\u0103n nh\u1eb9, th\u1ee5t th\u00e1o\u2026)<\/p>\n

– B\u1ec7nh nh\u00e2n c\u1ea7n x\u00e1c \u0111\u1ecbnh nh\u00f3m m\u00e1u v\u00e0 c\u00f3 c\u00e1c x\u00e9t nghi\u1ec7m: m\u00e1u ch\u1ea3y, m\u00e1u \u0111\u00f4ng, t\u1ec9 l\u1ec7 prothrombin, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u\u2026 b\u00ecnh th\u01b0\u1eddng.<\/p>\n

– C\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c gi\u1ea3m co th\u1eaft: spasfon ho\u1eb7c buscopan\u2026 Tu\u1ef3 theo t\u00ecnh tr\u1ea1ng BN c\u00f3 th\u1ec3 d\u00f9ng ti\u1ec1n m\u00ea ho\u1eb7c kh\u00f4ng. \u0110\u1ed1i v\u1edbi tr\u1ebb nh\u1ecf n\u1ebfu s\u1ee3 h\u00e3i kh\u00f4ng ph\u1ed1i h\u1ee3p \u0111\u01b0\u1ee3c v\u1edbi th\u1ea7y thu\u1ed1c th\u00ec ph\u1ea3i g\u00e2y m\u00ea.<\/p>\n

* Chu\u1ea9n b\u1ecb d\u1ee5ng c\u1ee5<\/em><\/strong><\/h4>\n

– Ki\u1ec3m tra d\u1ee5ng c\u1ee5: th\u00f2ng l\u1ecdng ph\u1ea3i \u0111\u00f3ng m\u1edf d\u1ec5 d\u00e0ng; ki\u1ec3m tra ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ngu\u1ed3n c\u1eaft \u0111\u1ed1t; \u0111i\u1ec1u ch\u1ec9nh m\u1ee9c c\u00f4ng su\u1ea5t \u0111\u1ec3 ph\u00f9 h\u1ee3p v\u1edbi polyp \u0111\u1ecbnh c\u1eaft; ki\u1ec3m tra d\u00e2y n\u1ed1i \u0111\u1ea5t c\u1ee7a ngu\u1ed3n c\u1eaft \u0111\u1ed1t v\u00e0 ngu\u1ed3n s\u00e1ng m\u00e1y n\u1ed9i soi; ki\u1ec3m tra b\u1ea3ng \u0111i\u1ec7n c\u1ef1c n\u1ed1i v\u1edbi BN xem \u0111\u00e3 ti\u1ebfp x\u00fac ch\u01b0a (v\u1ecb tr\u00ed \u0111i\u1ec7n c\u1ef1c ti\u1ebfp x\u00fac v\u1edbi BN t\u1ed1t nh\u1ea5t l\u00e0 \u1edf c\u1eb3ng ch\u00e2n, n\u01a1i m\u00e0 d\u00f2ng \u0111i\u1ec7n kh\u00f4ng g\u00e2y t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim). Di\u1ec7n ti\u1ebfp x\u00fac c\u1ee7a b\u1ea3ng \u0111i\u1ec7n c\u1ef1c v\u1edbi da BN ph\u1ea3i \u0111\u1ee7 r\u1ed9ng \u0111\u1ec3 tr\u00e1nh nguy c\u01a1 g\u00e2y b\u1ecfng v\u00ec nhi\u1ec7t \u0111\u1ed9 t\u1ec9 l\u1ec7 ngh\u1ecbch v\u1edbi di\u1ec7n ti\u1ebfp x\u00fac<\/p>\n

Tai bi\u1ebfn<\/em><\/strong><\/h4>\n

Trong qu\u00e1 tr\u00ecnh n\u1ed9i soi c\u1eaft polyp \u0110TT c\u00f3 th\u1ec3 x\u1ea3y ra m\u1ed9t s\u1ed1 tai bi\u1ebfn nh\u01b0: ch\u1ea3y m\u00e1u; th\u1ee7ng \u0110TT; b\u1ecfng; \u0111i\u1ec7n gi\u1eadt; nhi\u1ec5m tr\u00f9ng ho\u1ea1i t\u1eed n\u01a1i c\u1eaft v\u00e0 h\u1ed9i ch\u1ee9ng sau c\u1eaft polyp: bi\u1ec3u hi\u1ec7n b\u1eb1ng c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au b\u1ee5ng, s\u1ed1t nh\u01b0ng kh\u00f4ng c\u00f3 h\u01a1i trong \u1ed5 b\u1ee5ng\u2026 trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y ph\u1ea3i theo d\u00f5i s\u00e1t \u0111\u1ec3 tr\u00e1nh nh\u1ea7m l\u1eabn v\u1edbi bi\u1ebfn ch\u1ee9ng th\u1ee7ng \u0110TT v\u00e0 ch\u1ec9 c\u1ea7n x\u1eed tr\u00ed b\u1eb1ng n\u1ed9i khoa h\u1ed9i ch\u1ee9ng n\u00e0y c\u0169ng h\u1ebft<\/p>\n

2.3. C\u1eaft polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng v\u1edbi h\u1ed7 tr\u1ee3 Endoloop v\u00e0 Endoclips<\/h3>\n

V\u1ec1 k\u1ef9 thu\u1eadt gi\u1ed1ng nh\u01b0 tr\u00ean, nh\u01b0ng v\u1edbi s\u1ef1 h\u1ed7 tr\u1ee3 c\u1ee7a Endoloop v\u00e0 Endoclips.<\/p>\n

\"polyp
Ti\u1ebfp c\u1eadn x\u1eed tr\u00ed polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng (Ngu\u1ed3n: Hi\u1ec7p h\u1ed9i n\u1ed9i soi \u0111\u01b0\u1eddng ti\u00eau h\u00f3a Hoa K\u1ef3 n\u0103m 2020 )<\/figcaption><\/figure>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/p>\n

    \n
  1. Hi\u1ec7p h\u1ed9i n\u1ed9i soi \u0111\u01b0\u1eddng ti\u00eau h\u00f3a Hoa K\u1ef3 n\u0103m 2020<\/li>\n
  2. \n

    Classification\u00a0of\u00a0colorectal polyps, WHO<\/p>\n<\/li>\n<\/ol>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    Polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng l\u00e0 u l\u1ed3i v\u00e0o trong l\u00f2ng \u0110TT, kh\u1ed1i u \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh do s\u1ef1 t\u0103ng sinh qu\u00e1 m\u1ee9c c\u1ee7a ni\u00eam m\u1ea1c \u0110TT. B\u1ec1 m\u1eb7t polyp c\u00f3 l\u1edbp ni\u00eam m\u1ea1c bao ph\u1ee7. Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y v\u1edbi s\u1ef1 ti\u1ebfn b\u1ed9 v\u1ec1 k\u1ef9 thu\u1eadt n\u1ed9i soi \u0111\u1ea1i tr\u1ef1c tr\u00e0ng \u1ed1ng m\u1ec1m, k\u1ebft […]<\/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":"\nTi\u1ebfp c\u1eadn v\u00e0 x\u1eed tr\u00ed polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"Polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng l\u00e0 u l\u1ed3i v\u00e0o trong l\u00f2ng \u0110TT, kh\u1ed1i u \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh do s\u1ef1 t\u0103ng sinh qu\u00e1 m\u1ee9c c\u1ee7a ni\u00eam m\u1ea1c \u0110TT. N\u1ed9i soi \u0111\u1ea1i tr\u1ef1c tr\u00e0ng c\u1eaft polyp gi\u1ea3m t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh v\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong do ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng\" \/>\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=\"Ti\u1ebfp c\u1eadn v\u00e0 x\u1eed tr\u00ed polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Polyp \u0111\u1ea1i tr\u1ef1c tr\u00e0ng l\u00e0 u l\u1ed3i v\u00e0o trong l\u00f2ng \u0110TT, kh\u1ed1i u \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh do s\u1ef1 t\u0103ng sinh qu\u00e1 m\u1ee9c c\u1ee7a ni\u00eam m\u1ea1c \u0110TT. 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