{"id":24887,"date":"2023-04-19T18:42:09","date_gmt":"2023-04-19T11:42:09","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24887"},"modified":"2023-04-20T16:20:08","modified_gmt":"2023-04-20T09:20:08","slug":"viem-thuc-quan-va-nhung-van-de-lien-quan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/viem-thuc-quan-va-nhung-van-de-lien-quan\/","title":{"rendered":"Vi\u00eam th\u1ef1c qu\u1ea3n v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 li\u00ean quan"},"content":{"rendered":"

Vi\u00eam th\u1ef1c qu\u1ea3n<\/a> c\u00f3 th\u1ec3 do r\u1ea5t nhi\u1ec1u nguy\u00ean nh\u00e2n g\u00e2y ra: do tr\u00e0o ng\u01b0\u1ee3c, vi\u00eam nhi\u1ec5m, do ho\u00e1 ch\u1ea5t, do tia x\u1ea1, do thu\u1ed1c v\u00e0 c\u00e1c nguy\u00ean nh\u00e2n kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. Trong b\u00e0i vi\u1ebft n\u00e0y \u0111\u1ec1 c\u1eadp c\u1ee5 th\u1ec3 \u0111\u1eb7c \u0111i\u1ec3m t\u1eebng lo\u1ea1i vi\u00eam th\u1ef1c qu\u1ea3n v\u00e0 h\u00ecnh \u1ea3nh qua n\u1ed9i soi.<\/b><\/p>\n

1. Vi\u00eam th\u1ef1c qu\u1ea3n do vi\u00eam nhi\u1ec5m <\/strong><\/h2>\n

1.1. Vi\u00eam th\u1ef1c qu\u1ea3n do vi khu\u1ea9n <\/strong>\u00a0 Do nhi\u1ec1u lo\u1ea1i vi khu\u1ea9n, kh\u00f3 ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n.\u00a0 \u00a0 H\u00ecnh \u1ea3nh n\u1ed9i soi: vi\u00eam xu\u1ea5t ti\u1ebft v\u00e0 sung huy\u1ebft th\u1ef1c qu\u1ea3n, t\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng n\u1eb7ng h\u01a1n 1\/3 tr\u00ean th\u1ef1c qu\u1ea3n.\u00a0 C\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi vi\u00eam th\u1ef1c qu\u1ea3n tr\u00e0o ng\u01b0\u1ee3c ho\u1eb7c vi\u00eam do h\u00f3a ch\u1ea5t.<\/p>\n

1.2. Vi\u00eam th\u1ef1c qu\u1ea3n do n\u1ea5m <\/strong>\u00a0\u00a0 Th\u1ef1c qu\u1ea3n l\u00e0 t\u1ea1ng hay b\u1ecb vi\u00eam nhi\u1ec5m n\u1ea5m Candida Albicans, th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, ung th\u01b0, d\u00f9ng thu\u1ed1c ch\u1ed1ng vi\u00eam k\u00e9o d\u00e0i ho\u1eb7c suy gi\u1ea3m mi\u1ec5n d\u1ecbch.\u00a0 \u00a0\u00a0 H\u00ecnh \u1ea3nh n\u1ed9i soi: \u0111\u00e1m gi\u1ea3 m\u1ea1c tr\u1eafng b\u00e1m ch\u1eafc, r\u1eeda kh\u00f4ng s\u1ea1ch, sung huy\u1ebft, xu\u1ea5t ti\u1ebft, th\u01b0\u1eddng th\u1ea5y r\u00f5 \u1edf 2\/3 d\u01b0\u1edbi th\u1ef1c qu\u1ea3n, x\u00e9t nghi\u1ec7m n\u1ea5m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh.<\/p>\n

1.3. Vi\u00eam th\u1ef1c qu\u1ea3n do virus<\/strong>: Herpes, cytomegalovirus.<\/p>\n

H\u00ecnh \u1ea3nh n\u1ed9i soi: giai \u0111o\u1ea1n s\u1edbm t\u1ed5n th\u01b0\u01a1ng n\u1ed1t ph\u1ecfng n\u01b0\u1edbc nh\u1ecf d\u01b0\u1edbi 5mm, ni\u00eam m\u1ea1c xung quanh \u1ed5 lo\u00e9t sung huy\u1ebft, ni\u00eam m\u1ea1c gi\u1eefa c\u00e1c v\u00f9ng t\u1ed5n th\u01b0\u01a1ng b\u00ecnh th\u01b0\u1eddng. Giai \u0111o\u1ea1n sau \u1ed5 lo\u00e9t tr\u00f2n, l\u1ed3i cao, b\u1edd r\u00f5, \u0111\u00e1y c\u00f3 gi\u1ea3 m\u1ea1c tr\u1eafng v\u00e0ng, c\u00e1c \u1ed5 lo\u00e9t c\u00f3 th\u1ec3 n\u1ed1i l\u1ea1i v\u1edbi nhau th\u00e0nh m\u1ed9t \u0111\u01b0\u1eddng ch\u1ea1y d\u1ecdc th\u1ef1c qu\u1ea3n. Ch\u00fa \u00fd n\u1ebfu c\u00f3 lo\u00e9t tr\u00ean \u0111\u01b0\u1eddng Z c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi lo\u00e9t do tr\u00e0o ng\u01b0\u1ee3c th\u1ef1c qu\u1ea3n.<\/p>\n

1.4. Vi\u00eam th\u1ef1c qu\u1ea3n do HIV<\/strong>: th\u01b0\u1eddng \u1ed5 lo\u00e9t s\u00e2u to v\u00e0 kh\u00f4ng t\u00ecm th\u1ea5y c\u00e1c nguy\u00ean nh\u00e2n nhi\u1ec5m tr\u00f9ng kh\u00e1c. Kh\u00f3 ph\u00e2n bi\u1ec7t v\u1edbi t\u1ed5n th\u01b0\u01a1ng lo\u00e9t nguy\u00ean nh\u00e2n do Cytomegalovirus.<\/p>\n

2. Vi\u00eam th\u1ef1c qu\u1ea3n do h\u00f3a ch\u1ea5t<\/h2>\n

2.1. Vi\u00eam th\u1ef1c qu\u1ea3n do acid v\u00e0 baz\u01a1<\/h3>\n

Ch\u1ea5t acid v\u00e0 baz\u01a1 th\u01b0\u1eddng l\u00e0m t\u1ed5n th\u01b0\u01a1ng ho\u1ea1i t\u1eed ch\u1ea3y m\u00e1u l\u1edbp ni\u00eam m\u1ea1c. Ch\u1ea5t Baz\u01a1 l\u00e0m t\u1ed5n th\u01b0\u01a1ng s\u00e2u v\u00e0 nhanh c\u00f3 th\u1ec3 g\u00e2y th\u1ee7ng th\u1ef1c qu\u1ea3n.<\/p>\n

N\u1ebfu tr\u00ean l\u00e2m s\u00e0ng v\u00e0 ch\u1ee5p x quang th\u1ef1c qu\u1ea3n kh\u00f4ng c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 th\u1ee7ng th\u1ef1c qu\u1ea3n, vi\u00eam trung th\u1ea5t, vi\u00eam m\u00e0ng b\u1ee5ng s\u1ebd ti\u1ebfn h\u00e0nh n\u1ed9i soi th\u1ef1c qu\u1ea3n v\u00ec tr\u00ean phim ch\u1ee5p x quang th\u1ef1c qu\u1ea3n kh\u00f4ng th\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c t\u1ed5n th\u01b0\u01a1ng \u1edf th\u1ef1c qu\u1ea3n. Khi ti\u1ebfn h\u00e0nh soi c\u1ea7n h\u1ebft s\u1ee9c nh\u1eb9 nh\u00e0ng, kh\u00f4ng b\u01a1m h\u01a1i nhi\u1ec1u. N\u1ebfu soi \u0111\u01b0\u1ee3c trong v\u00f2ng 24 gi\u1edd th\u00ec \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng th\u1ef1c qu\u1ea3n ch\u00ednh x\u00e1c h\u01a1n l\u00e0 soi sau 24 gi\u1edd.<\/p>\n

N\u1ed9i soi \u0111\u00e1nh gi\u00e1 theo \u0111\u1ed9 nh\u01b0 sau:<\/p>\n

    \n
  • \u0110\u1ed9 1: sung huy\u1ebft \u0111\u1ecf, ph\u00f9 n\u1ec1, kh\u00f4ng c\u00f3 d\u1ecbch xu\u1ea5t ti\u1ebft v\u00e0 lo\u00e9t, kh\u00f4ng c\u00f3 ch\u1ea3y m\u00e1u, t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9 1 kh\u00f4ng g\u00e2y bi\u1ebfn ch\u1ee9ng h\u1eb9p.<\/li>\n
  • \u0110\u1ed9 2: Vi\u00eam sung huy\u1ebft c\u00f3 nhi\u1ec1u tr\u1ee3t v\u00e0 d\u1ecbch xu\u1ea5t ti\u1ebft, d\u1ec5 ch\u1ea3y m\u00e1u khi ch\u1ea1m m\u00e1y v\u00e0o.<\/li>\n
  • \u0110\u1ed9 3: lo\u00e9t, xu\u1ea5t ti\u1ebft nhi\u1ec1u m\u00e0 ch\u1ea3y m\u00e1u ho\u1ea1i t\u1eed ni\u00eam m\u1ea1c, c\u00f3 nguy c\u01a1 bong l\u1edbp ni\u00eam m\u1ea1c bi\u1ebfn ch\u1ee9ng vi\u00eam trung th\u1ea5t, vi\u00eam m\u00e0ng b\u1ee5ng, vi\u00eam ph\u1ed5i, tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i, r\u00f2 th\u1ef1c qu\u1ea3n \u2013 ph\u1ebf qu\u1ea3n.<\/li>\n<\/ul>\n

    Khi soi c\u1ea7n ch\u00fa \u00fd b\u01a1m \u00edt h\u01a1i, thao t\u00e1c nh\u1eb9 nh\u00e0ng c\u00f3 th\u1ec3 ch\u1ee5p x quang th\u1ef1c qu\u1ea3n sau v\u00e0i ng\u00e0y.<\/p>\n

    N\u1ebfu c\u00f3 h\u1eb9p th\u1ef1c qu\u1ea3n s\u1ebd ti\u1ebfn h\u00e0nh nong th\u1ef1c qu\u1ea3n qua n\u1ed9i soi sau 2 tu\u1ea7n ho\u1eb7c \u0111\u1eb7t stent \u0111\u1ec3 ph\u00f2ng h\u1eb9p th\u1ef1c qu\u1ea3n.<\/p>\n

    \"Vi\u00eam
    Vi\u00eam th\u1ef1c qu\u1ea3n do ho\u00e1 ch\u1ea5t<\/figcaption><\/figure>\n

    2.2. Vi\u00eam th\u1ef1c qu\u1ea3n do thu\u1ed1c<\/h3>\n

    C\u00f3 kho\u1ea3ng 25 lo\u1ea1i thu\u1ed1c g\u00e2y vi\u00eam th\u1ef1c qu\u1ea3n, nh\u1eefng lo\u1ea1i thu\u1ed1c hay g\u00e2y vi\u00eam l\u00e0: tetracyclin, doxycylin, bromma, quinidin, acid ascorbic. Th\u01b0\u1eddng l\u00e0 thu\u1ed1c d\u01b0\u1edbi d\u1ea1ng vi\u00ean n\u00e9n, vi\u00ean nang \u0111i qua th\u1ef1c qu\u1ea3n ch\u1eadm do t\u01b0 th\u1ebf n\u1eb1m, do u\u1ed1ng \u00edt n\u01b0\u1edbc tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd h\u1eb9p, t\u1eafc ho\u1eb7c r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng th\u1ef1c qu\u1ea3n, thu\u1ed1c th\u01b0\u1eddng m\u1eafc \u1edf \u0111o\u1ea1n gi\u1eefa n\u01a1i c\u00f3 cung \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u00e8 v\u00e0o.<\/p>\n

    Tri\u1ec7u ch\u1ee9ng \u0111au sau \u1ee9c, nu\u1ed1t kh\u00f3.<\/p>\n

    Nh\u1eefng h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng qua n\u1ed9i soi: sung huy\u1ebft, xu\u1ea5t ti\u1ebft, tr\u1ee3t, lo\u00e9t. Nh\u1eefng t\u1ed5n th\u01b0\u01a1ng n\u00e0y kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. D\u1ea5u hi\u1ec7u quan tr\u1ecdng l\u00e0 th\u1ea5y vi\u00ean thu\u1ed1c c\u00f2n m\u1eafc l\u1ea1i tr\u00ean ch\u1ed5 h\u1eb9p ho\u1eb7c tr\u1ee3t, lo\u00e9t ngay tr\u00ean ch\u1ed5 h\u1eb9p. Th\u00e0nh ph\u1ea7n c\u1ee7a thu\u1ed1c v\u00e0 th\u1eddi gian ti\u1ebfp x\u00fac c\u1ee7a thu\u1ed1c v\u1edbi ni\u00eam m\u1ea1c th\u1ef1c qu\u1ea3n \u1ea3nh h\u01b0\u1edfng t\u1edbi m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng c\u1ee7a ni\u00eam m\u1ea1c.<\/p>\n

    Nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 h\u1eb9p th\u1ef1c qu\u1ea3n v\u00e0 c\u00f3 r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng th\u1ef1c qu\u1ea3n n\u00ean u\u1ed1ng thu\u1ed1c d\u1ea1ng n\u01b0\u1edbc, ho\u1eb7c u\u1ed1ng nhi\u1ec1u n\u01b0\u1edbc \u1edf t\u01b0 th\u1ebf ng\u1ed3i khi u\u1ed1ng thu\u1ed1c \u0111\u1ec3 tr\u00e1nh thu\u1ed1c m\u1eafc \u1edf th\u1ef1c qu\u1ea3n<\/p>\n

    C\u1ea7n ph\u00e1t hi\u1ec7n h\u1eb9p th\u1ef1c qu\u1ea3n do kh\u1ed1i u \u00e1c t\u00ednh b\u1eb1ng sinh thi\u1ebft qua n\u1ed9i soi.<\/p>\n

    2.3. Vi\u00eam th\u1ef1c qu\u1ea3n do tia x\u1ea1<\/h3>\n

    Do \u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ebf qu\u1ea3n, ung th\u01b0 v\u00fa, ung th\u01b0 th\u1ef1c qu\u1ea3n, ung th\u01b0 tuy\u1ebfn ti\u1ec1n li\u1ec7t b\u1eb1ng tia x\u1ea1.<\/p>\n

    Tri\u1ec7u ch\u1ee9ng: nu\u1ed1t kh\u00f3, nu\u1ed1t \u0111au, \u0111au ng\u1ef1c.<\/p>\n

    T\u1ed5n th\u01b0\u01a1ng qua n\u1ed9i soi: vi\u00eam th\u1ef1c qu\u1ea3n do n\u1ea5m, do Virus Herpes ho\u1eb7c c\u1ea3 2 nguy\u00ean nh\u00e2n, ni\u00eam m\u1ea1c sung huy\u1ebft, xu\u1ea5t ti\u1ebft, tr\u1ee3t. Sau v\u00e0i n\u0103m c\u00f3 th\u1ec3 th\u1ea5y gi\u00e3n m\u1ea1ch tr\u00ean v\u00f9ng chi\u1ebfu tia.<\/p>\n

    N\u1ebfu t\u1ed5n th\u01b0\u01a1ng \u0111ang \u1edf giai \u0111o\u1ea1n c\u1ea5p t\u00ednh th\u00ec ph\u1ea3i gi\u1ea3m li\u1ec1u tia x\u1ea1, thay \u0111\u1ed5i ch\u1ebf \u0111\u1ed9 \u0103n, d\u00f9ng thu\u1ed1c gi\u1ea3m \u0111au.<\/p>\n

    N\u1ebfu c\u00f3 h\u1eb9p th\u1ef1c qu\u1ea3n ti\u1ebfn h\u00e0nh nong th\u1ef1c qu\u1ea3n qua n\u1ed9i soi.<\/p>\n

    2.4. Vi\u00eam th\u1ef1c qu\u1ea3n do \u1ee9 tr\u1ec7 th\u1ee9c \u0103n<\/h3>\n

    Do h\u1eb9p th\u1ef1c qu\u1ea3n n\u00ean th\u1ee9c \u0103n \u1ee9 \u0111\u1ecdng g\u00e2y vi\u00eam sung huy\u1ebft, tr\u1ee3t, lo\u00e9t. T\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng th\u1ea5y 1\/3 d\u01b0\u1edbi th\u1ef1c qu\u1ea3n v\u00ec th\u1ee9c \u0103n \u0111\u1ecdng \u1edf \u0111\u00e2y l\u00e2u nh\u1ea5t<\/p>\n

    3. Vi\u00eam th\u1ef1c qu\u1ea3n tr\u00e0o ng\u01b0\u1ee3c<\/h2>\n

    3.1. H\u1ed9i ch\u1ee9ng tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y \u2013 th\u1ef1c qu\u1ea3n<\/h3>\n

    L\u00e0 hi\u1ec7n t\u01b0\u1ee3ng c\u00e1c ch\u1ea5t d\u1ecbch ch\u1ee9a trong d\u1ea1 d\u00e0y tho\u00e1t qua t\u00e2m v\u1ecb l\u00ean th\u1ef1c qu\u1ea3n. n\u1ebfu hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y x\u1ea3y ra th\u01b0\u1eddng xuy\u00ean v\u00e0 k\u00e9o d\u00e0i s\u1ebd g\u00e2y ra b\u1ec7nh v\u00e0 g\u1ecdi l\u00e0 b\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c th\u1ef1c qu\u1ea3n \u2013 d\u1ea1 d\u00e0y.<\/p>\n

    Ch\u1ea9n \u0111o\u00e1n b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i soi: \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng, l\u00e0m sinh thi\u1ebft khi c\u00f3 nghi ng\u1edd v\u00e0 ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh kh\u00e1c \u1edf th\u1ef1c qu\u1ea3n.<\/p>\n

    Ph\u00e2n lo\u1ea1i c\u1ee7a LOS ANGELES<\/strong><\/p>\n

      \n
    • \u0110\u1ed9 A: t\u1ed5n th\u01b0\u01a1ng m\u1ed9t hay nhi\u1ec1u v\u1ebft tr\u1ee3t nh\u01b0ng kh\u00f4ng k\u1ebft n\u1ed1i v\u1edbi nhau, t\u1ed5n th\u01b0\u01a1ng n\u1eb1m tr\u00ean \u0111\u01b0\u1eddng Z.<\/li>\n
    • \u0110\u1ed9 B: t\u1ed5n th\u01b0\u01a1ng tr\u1ee3t hay lo\u00e9t tr\u1ee3t chi\u1ebfm 10% b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c, t\u1ed5n th\u01b0\u01a1ng n\u1eb1m tr\u00ean \u0111\u01b0\u1eddng Z.<\/li>\n
    • \u0110\u1ed9 C: t\u1ed5n th\u01b0\u01a1ng tr\u1ee3t hay lo\u00e9t tr\u1ee3t chi\u1ebfm 10 \u2013 50 % b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c v\u00e0 l\u00ean cao tr\u00ean \u0111\u01b0\u1eddng Z kho\u1ea3ng 5 cm, ho\u1eb7c c\u00f3 t\u1ed5n th\u01b0\u01a1ng lo\u00e9t \u0111\u01b0\u1eddng k\u00ednh 3 \u2013 5 mm.<\/li>\n
    • \u0110\u1ed9 D: lo\u00e9t tr\u1ee3t n\u00f4ng chi\u1ebfm h\u01a1n 50% b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c ho\u1eb7c c\u00f3 lo\u00e9t \u0111\u01b0\u1eddng k\u00ednh tr\u00ean 5 mm, c\u00f3 vi\u00eam gi\u1ea3 polyp, c\u1ea7n sinh thi\u1ebft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t t\u1ed5n th\u01b0\u01a1ng l\u00e0nh hay \u00e1c t\u00ednh.<\/li>\n<\/ul>\n
      \"Vi\u00eam
      Ph\u00e2n \u0111\u1ed9 LA<\/figcaption><\/figure>\n

      Khi tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y \u2013 th\u1ef1c qu\u1ea3n k\u00e9o d\u00e0i s\u1ebd c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng d\u1ecb s\u1ea3n \u1edf \u0111o\u1ea1n cu\u1ed1i c\u1ee7a th\u1ef1c qu\u1ea3n g\u1ecdi l\u00e0 th\u1ef1c qu\u1ea3n Barrett, l\u1edbp bi\u1ec3u m\u00f4 v\u1ea9y c\u1ee7a th\u1ef1c qu\u1ea3n \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng l\u1edbp bi\u1ec3u m\u00f4 c\u1ee7a d\u1ea1 d\u00e0y ho\u1eb7c \u0111\u00f4i khi l\u00e0 l\u1edbp bi\u1ec3u m\u00f4 c\u1ee7a ru\u1ed9t.<\/p>\n

      Tr\u00ean n\u1ed9i soi th\u1ea5y ni\u00eam m\u1ea1c \u0111\u1ecf r\u1ef1c lan l\u00ean ph\u00eda tr\u00ean c\u1ee7a \u0111\u01b0\u1eddng Z, x\u00e2m l\u1ea5n l\u00ean th\u1ef1c qu\u1ea3n, tr\u00f4ng nh\u01b0 m\u1ed9t c\u00e1i l\u01b0\u1ee1i \u0111\u1ecf. Tr\u00ean \u0111\u00e1m lo\u1ea1n s\u1ea3n c\u1ee7a th\u1ef1c qu\u1ea3n Barrett c\u00f3 th\u1ec3 c\u00f3 lo\u00e9t. Bi\u1ebfn ch\u1ee9ng c\u1ee7a th\u1ef1c qu\u1ea3n Barrett l\u00e0 ung th\u01b0 h\u00f3a.<\/p>\n

      Vi\u00eam th\u1ef1c qu\u1ea3n tr\u00e0o ng\u01b0\u1ee3c c\u00f3 th\u1ec3 l\u00e0m h\u1eb9p th\u1ef1c qu\u1ea3n do vi\u00eam, s\u1eb9o, x\u01a1. Ch\u00edt h\u1eb9p ho\u00e0n to\u00e0n m\u00e1y kh\u00f4ng qua \u0111\u01b0\u1ee3c ho\u1eb7c ch\u00edt h\u1eb9p kh\u00f4ng ho\u00e0n to\u00e0n m\u00e1y c\u00f2n qua \u0111\u01b0\u1ee3c nh\u01b0ng kh\u00f3 kh\u0103n. C\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi m\u00e0ng ng\u0103n Schatzki, v\u00f2ng n\u00e0y do l\u1edbp bi\u1ec3u m\u00f4 v\u1ea9y c\u1ee7a th\u1ef1c qu\u1ea3n t\u1ea1o ra ngay tr\u00ean \u0111\u01b0\u1eddng Z, \u0111\u1eb7c bi\u1ec7t khi b\u1ec7nh n\u00e0y c\u00f3 ph\u1ed1i h\u1ee3p v\u1edbi b\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n, m\u00e0ng n\u00e0y c\u00f3 b\u1ec1 d\u00e0y kh\u00f4ng qu\u00e1 4mm.<\/p>\n

      N\u1ebfu c\u00f3 bi\u1ebfn ch\u1ee9ng h\u1eb9p th\u1ef1c qu\u1ea3n g\u00e2y nu\u1ed1t kh\u00f3 ho\u1eb7c nu\u1ed1t ngh\u1eb9n c\u1ea7n nong th\u1ef1c qu\u1ea3n qua n\u1ed9i soi. Vi\u00eam th\u1ef1c qu\u1ea3n tr\u00e0o ng\u01b0\u1ee3c c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p v\u1edbi tho\u00e1t v\u1ecb ho\u00e0nh.<\/p>\n

      3.2. Vi\u00eam th\u1ef1c qu\u1ea3n tr\u00e0o ng\u01b0\u1ee3c do d\u1ecbch ki\u1ec1m<\/h3>\n

      Do tr\u00e0o ng\u01b0\u1ee3c d\u1ecbch t\u00e1 tr\u00e0ng v\u00e0o th\u1ef1c qu\u1ea3n sau m\u1ed5 n\u1ed1i th\u1ef1c qu\u1ea3n \u2013 t\u00e1 tr\u00e0ng, th\u1ef1c qu\u1ea3n \u2013 h\u1ed7ng tr\u00e0ng ho\u1eb7c tr\u00ean b\u1ec7nh nh\u00e2n b\u1ecb thi\u1ec3u toan, v\u00f4 toan.<\/p>\n

        \n
      • N\u1ebfu sau c\u1eaft d\u1ea1 d\u00e0y vi\u00eam tr\u00e0o ng\u01b0\u1ee3c th\u1ef1c qu\u1ea3n do d\u1ecbch ki\u1ec1m th\u01b0\u1eddng k\u1ebft h\u1ee3p v\u1edbi tr\u00e0o ng\u01b0\u1ee3c do acid.<\/li>\n
      • H\u00ecnh \u1ea3nh n\u1ed9i soi: tr\u1ee3t, sung huy\u1ebft, d\u1ec5 ch\u1ea3y m\u00e1u khi ch\u1ea1m v\u00e0o, xu\u1ea5t ti\u1ebft v\u00e0 c\u00f3 th\u1ec3 h\u1eb9p. T\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng \u1edf ch\u1ed5 n\u1ed1i th\u1ef1c qu\u1ea3n \u2013 t\u00e1 tr\u00e0ng hay th\u1ef1c qu\u1ea3n \u2013 h\u1ed7ng tr\u00e0ng.<\/li>\n
      • \u0110i\u1ec1u tr\u1ecb: thu\u1ed1c trung h\u00f2a acid m\u1eadt, cholestyramin, thu\u1ed1c b\u1ea3o v\u1ec7 ni\u00eam m\u1ea1c.<\/li>\n
      • Ch\u1ec9 \u0111\u1ecbnh ngo\u1ea1i khoa khi \u0111i\u1ec1u tr\u1ecb n\u1ed9i th\u1ea5t b\u1ea1i b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p n\u1ed1i m\u1eadt ru\u1ed9t ki\u1ec3u Roux-en-Y.<\/li>\n<\/ul>\n

        4. Vi\u00eam th\u1ef1c qu\u1ea3n kh\u00f4ng \u0111\u1eb7c hi\u1ec7u<\/h2>\n

        4.1. Vi\u00eam th\u1ef1c qu\u1ea3n th\u00e2m nhi\u1ec5m t\u1ebf b\u00e0o \u00e1i toan<\/strong>: th\u01b0\u1eddng 50% b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng v\u1edbi th\u1ee9c \u0103n.<\/p>\n

        Tri\u1ec7u ch\u1ee9ng nu\u1ed1t kh\u00f3 do r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng th\u1ef1c qu\u1ea3n hay do h\u1eb9p th\u1ef1c qu\u1ea3n. K\u00e8m theo c\u00e1c tri\u1ec7u ch\u1ee9ng \u1edf ru\u1ed9t nh\u01b0 ch\u1ea3y m\u00e1u, k\u00e9m h\u1ea5p thu. H\u00ecnh \u1ea3nh n\u1ed9i soi: lo\u00e9t th\u1ef1c qu\u1ea3n, h\u1eb9p th\u1ef1c qu\u1ea3n c\u00f3 nhi\u1ec5m t\u1ebf b\u00e0o \u01b0a acid x\u00e2m nh\u1eadp v\u00e0o l\u1edbp ni\u00eam m\u1ea1c v\u00e0 l\u1edbp d\u01b0\u1edbi ni\u00eam m\u1ea1c.<\/p>\n

        \u0110i\u1ec1u tr\u1ecb b\u1eb1ng corticoides, n\u1ebfu c\u00f3 h\u1eb9p th\u1ef1c qu\u1ea3n \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p nong th\u1ef1c qu\u1ea3n qua n\u1ed9i soi.<\/p>\n

        4.2. Bong bi\u1ec3u b\u00ec b\u1ecdng n\u01b0\u1edbc:<\/strong> l\u00e0 b\u1ec7nh di truy\u1ec1n, c\u00f3 nh\u1eefng b\u1ecdng n\u01b0\u1edbc d\u01b0\u1edbi bi\u1ec3u m\u00f4, t\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 th\u1ea5y \u1edf b\u1ea5t c\u1ee9 t\u1ea1ng n\u00e0o trong c\u01a1 th\u1ec3 trong \u0111\u00f3 c\u00f3 th\u1ef1c qu\u1ea3n.<\/p>\n

        Ch\u1ee5p th\u1ef1c qu\u1ea3n c\u00f3 u\u1ed1ng baryte th\u1ea5y: r\u1ed1i lo\u1ea1n co b\u00f3p, b\u1ecdng n\u01b0\u1edbc, lo\u00e9t ho\u1eb7c h\u1eb9p.<\/p>\n

        Bi\u1ebfn ch\u1ee9ng th\u1ee7ng, ch\u1ea3y m\u00e1u v\u00e0 ung th\u01b0. N\u1ebfu g\u1eb7p \u1edf tr\u1ebb s\u01a1 sinh g\u00e2y suy dinh d\u01b0\u1ee1ng. N\u1ed9i soi th\u1ef1c qu\u1ea3n khi b\u1ec7nh \u1ed5 \u0111\u1ecbnh.<\/p>\n

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

          \n
        1. N\u1ed9i soi ti\u00eau ho\u00e1. B\u1ec7nh vi\u1ec7n B\u1ea1ch Mai.<\/li>\n
        2. Jean Macr Canard (2011), Gastrointestinal Endoscopy in practice. Elsevier Churchill Livingstone.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

          Vi\u00eam th\u1ef1c qu\u1ea3n c\u00f3 th\u1ec3 do r\u1ea5t nhi\u1ec1u nguy\u00ean nh\u00e2n g\u00e2y ra: do tr\u00e0o ng\u01b0\u1ee3c, vi\u00eam nhi\u1ec5m, do ho\u00e1 ch\u1ea5t, do tia x\u1ea1, do thu\u1ed1c v\u00e0 c\u00e1c nguy\u00ean nh\u00e2n kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. Trong b\u00e0i vi\u1ebft n\u00e0y \u0111\u1ec1 c\u1eadp c\u1ee5 th\u1ec3 \u0111\u1eb7c \u0111i\u1ec3m t\u1eebng lo\u1ea1i vi\u00eam th\u1ef1c qu\u1ea3n v\u00e0 h\u00ecnh \u1ea3nh qua n\u1ed9i soi. 1. Vi\u00eam […]<\/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":"\nVi\u00eam th\u1ef1c qu\u1ea3n v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 li\u00ean quan - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam th\u1ef1c qu\u1ea3n c\u00f3 th\u1ec3 do r\u1ea5t nhi\u1ec1u nguy\u00ean nh\u00e2n g\u00e2y ra: do tr\u00e0o ng\u01b0\u1ee3c, vi\u00eam nhi\u1ec5m, do ho\u00e1 ch\u1ea5t, do tia x\u1ea1, do thu\u1ed1c v\u00e0 c\u00e1c nguy\u00ean nh\u00e2n kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. 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