{"id":25028,"date":"2023-04-20T22:15:19","date_gmt":"2023-04-20T15:15:19","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25028"},"modified":"2023-04-21T10:43:11","modified_gmt":"2023-04-21T03:43:11","slug":"dai-cuong-ve-noi-soi-da-day","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/20\/dai-cuong-ve-noi-soi-da-day\/","title":{"rendered":"\u0110\u1ea1i c\u01b0\u01a1ng v\u1ec1 n\u1ed9i soi d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng"},"content":{"rendered":"

N\u1ed9i soi d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng<\/a> l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a t\u1eeb th\u1ef1c qu\u1ea3n \u0111\u1ebfn DII c\u1ee7a t\u00e1 tr\u00e0ng b\u1eb1ng m\u00e1y n\u1ed9i soi \u1ed1ng m\u1ec1m. V\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a khoa h\u1ecdc k\u1ef9 thu\u1eadt, m\u00e1y soi c\u0169ng c\u00f3 c\u1ea3i ti\u1ebfn v\u01b0\u1ee3t b\u1eadc nh\u1eb1m ph\u1ee5c v\u1ee5 cho vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb.<\/strong><\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng<\/h2>\n

T\u1eeb th\u1eadp k\u1ef7 60 c\u1ee7a th\u1ebf k\u1ef7 XX, m\u00e1y n\u1ed9i soi \u1ed1ng m\u1ec1m ra \u0111\u1eddi \u0111\u00e3 m\u1edf ra m\u1ed9t k\u1ef7 nguy\u00ean m\u1edbi cho chuy\u00ean ng\u00e0nh n\u1ed9i soi ti\u00eau h\u00f3a v\u00e0 t\u1eeb th\u1eadp k\u1ef7 90, khi m\u00e1y n\u1ed9i soi \u1ed1ng m\u1ec1m c\u00f3 video ra \u0111\u1eddi \u0111\u00e3 t\u1ea1o ra m\u1ed9t b\u01b0\u1edbc chuy\u1ec3n bi\u1ebfn l\u1edbn lao cho ng\u00e0nh n\u1ed9i soi v\u00e0 m\u00e1y n\u1ed9i soi ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u00e1p d\u1ee5ng c\u00e1c ti\u1ebfn b\u1ed9 m\u1edbi c\u1ea3i ti\u1ebfn k\u00edch th\u01b0\u1edbc, t\u00ednh n\u0103ng k\u1ef9 thu\u1eadt nh\u1eb1m ph\u1ee5c v\u1ee5 cho vi\u1ec7c ch\u1ea9n \u0111o\u00e1n s\u1edbm c\u00e1c d\u1ea1ng t\u1ed5n th\u01b0\u01a1ng c\u1ee7a ni\u00eam m\u1ea1c th\u1ef1c qu\u1ea3n – d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng, nh\u1ea5t l\u00e0 vai tr\u00f2 trong ch\u1ea9n \u0111o\u00e1n s\u1edbm ung th\u01b0 c\u0169ng nh\u01b0 gi\u00fap cho n\u1ed9i soi \u0111i\u1ec1u tr\u1ecb (n\u1ed9i soi can thi\u1ec7p), v\u1edbi m\u1ee5c \u0111\u00edch l\u00e0 gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh nh\u00e2n ph\u1ea3i ch\u1ecbu ph\u1eabu thu\u1eadt.<\/p>\n

\u00a0<\/strong>Trong th\u1eadp k\u1ef7 60 \u2013 90 c\u1ee7a th\u1ebf k\u1ef7 XX c\u00f3 2 ti\u1ebfn b\u1ed9 r\u1ea5t quan tr\u1ecdng c\u1ee7a n\u1ed9i soi ti\u00eau h\u00f3a l\u00e0 n\u1ed9i soi c\u00f3 video, n\u1ed9i soi si\u00eau \u00e2m. S\u1ef1 ra \u0111\u1eddi c\u1ee7a n\u1ed9i soi c\u00f3 video v\u1edbi \u0111\u1ed9 ph\u00e2n gi\u1ea3i cao do \u0111\u01b0\u1ee3c g\u1eafn m\u1ed9t camera nh\u1ecf \u1edf \u0111\u1ea7u m\u00e1y soi k\u1ebft h\u1ee3p v\u1edbi k\u1ef9 thu\u1eadt s\u1ed1 v\u00e0 m\u00e1y t\u00ednh n\u00ean cho h\u00ecnh \u1ea3nh r\u00f5 n\u00e9t c\u00f3 th\u1ec3 quan s\u00e1t \u0111\u01b0\u1ee3c nh\u1eefng t\u1ed5n th\u01b0\u01a1ng nh\u1ecf, n\u1ed9i soi si\u00eau \u00e2m c\u00f3 g\u1eafn \u0111\u1ea7u d\u00f2 si\u00eau \u00e2m n\u00ean c\u00f3 th\u1ec3 quan s\u00e1t \u0111\u01b0\u1ee3c nh\u1eefng t\u1ed5n th\u01b0\u01a1ng \u1edf d\u01b0\u1edbi ni\u00eam m\u1ea1c.<\/p>\n

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  • N\u1ed9i soi nhu\u1ed9m m\u00e0u: l\u00e0 ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i soi c\u00f3 k\u1ebft h\u1ee3p v\u1edbi c\u00e1c ch\u1ea5t nhu\u1ed9m m\u00e0u nh\u01b0: lygol, xanh methylen, indigo carmine, \u0111\u1ecf congo v\u00e0 \u0111\u1ecf phenol, d\u1ef1a tr\u00ean c\u00e1c c\u01a1 ch\u1ebf h\u1ea5p thu ch\u1ea5t nhu\u1ed9m m\u00e0u, c\u01a1 ch\u1ebf t\u01b0\u01a1ng ph\u1ea3n v\u00e0 c\u01a1 ch\u1ebf ph\u1ea3n \u1ee9ng. V\u1edbi ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i soi nhu\u1ed9m m\u00e0u s\u1ebd x\u00e1c \u0111\u1ecbnh r\u00f5 v\u00f9ng t\u1ed5n th\u01b0\u01a1ng, gi\u00fap cho sinh thi\u1ebft \u0111\u00fang v\u1ecb tr\u00ed ph\u1ee5c v\u1ee5 cho ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c nh\u1ea5t l\u00e0 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 s\u1edbm.<\/li>\n
  • N\u1ed9i soi khu\u1ebfch \u0111\u1ea1i: m\u00e1y n\u1ed9i soi \u0111\u01b0\u1ee3c trang b\u1ecb th\u00eam b\u1ed9 ph\u1eadn ph\u00f3ng \u0111\u1ea1i h\u00ecnh \u1ea3nh l\u00ean t\u1edbi 80 \u2013 120 l\u1ea7n, gi\u00fap cho b\u00e1c s\u0129 quan s\u00e1t \u0111\u01b0\u1ee3c chi ti\u1ebft c\u00e1c thay \u0111\u1ed5i nh\u1ecf c\u1ee7a ni\u00eam m\u1ea1c \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. N\u1ed9i soi khu\u1ebfch \u0111\u1ea1i k\u1ebft h\u1ee3p v\u1edbi n\u1ed9i soi nhu\u1ed9m m\u00e0u c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<\/ul>\n

    T\u1eeb \u0111\u1ea7u th\u1ebf k\u1ef7 XXI \u0111\u00e3 c\u00f3 m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i soi \u0111\u1eb7c bi\u1ec7t \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng, kh\u00f4ng nh\u1eefng ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c t\u1ed5n th\u01b0\u01a1ng tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a ni\u00eam m\u1ea1c m\u00e0 c\u00f2n c\u1ea3 nh\u1eefng t\u1ed5n th\u01b0\u01a1ng d\u01b0\u1edbi l\u1edbp ni\u00eam m\u1ea1c nh\u01b0 lo\u1ea1n s\u1ea3n, ph\u00e1t hi\u1ec7n Helicobacter pylori<\/em>:<\/p>\n

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    • Ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i soi s\u1eed d\u1ee5ng \u00e1nh s\u00e1ng ch\u1ecdn l\u1ecdc: m\u00e1y n\u1ed9i soi \u0111\u01b0\u1ee3c trang b\u1ecb th\u00eam thi\u1ebft b\u1ecb c\u00f3 ch\u1ee9c n\u0103ng l\u1ecdc \u00e1nh s\u00e1ng tr\u1eafng, \u01b0u ti\u00ean s\u1eed d\u1ee5ng lo\u1ea1i \u00e1nh s\u00e1ng xanh c\u00f3 b\u01b0\u1edbc s\u00f3ng ng\u1eafn, kh\u1ea3 n\u0103ng \u0111\u00e2m xuy\u00ean trong m\u00f4 k\u00e9m, do \u0111\u00f3 c\u00f3 th\u1ec3 quan s\u00e1t r\u00f5 c\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u00f4ng tr\u00ean b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c v\u00e0 nh\u1eefng c\u1ea5u tr\u00fac m\u1ea1ch ngay d\u01b0\u1edbi ni\u00eam m\u1ea1c. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 t\u00e1c d\u1ee5ng g\u1ea7n gi\u1ed1ng nh\u01b0 ph\u01b0\u01a1ng ph\u00e1p nhu\u1ed9m m\u00e0u, nh\u01b0ng c\u00f3 \u01b0u \u0111i\u1ec3m h\u01a1n l\u00e0 kh\u00f4ng ch\u1ecbu \u1ea3nh h\u01b0\u1edfng c\u1ee7a c\u00e1c ch\u1ea5t nh\u1ea7y b\u00e1m tr\u00ean b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c.<\/li>\n
    • Ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i soi c\u00f3 k\u1ebft h\u1ee3p v\u1edbi laser: m\u00e1y n\u1ed9i soi \u0111\u01b0\u1ee3c g\u1eafn th\u00eam m\u1ed9t b\u1ed9 ph\u1eadn ph\u00e1t v\u00e0 thu laser, ngo\u00e0i quan s\u00e1t \u0111\u01b0\u1ee3c ni\u00eam m\u1ea1c nh\u01b0 m\u00e1y n\u1ed9i soi b\u00ecnh th\u01b0\u1eddng, m\u00e1y n\u1ed9i soi n\u00e0y c\u00f2n cho ph\u00e9p h\u00ecnh \u1ea3nh vi th\u1ec3 ph\u00f3ng \u0111\u1ea1i t\u1edbi h\u00e0ng ngh\u00ecn l\u1ea7n, n\u00ean c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng lo\u1ea1n s\u1ea3n, d\u1ecb s\u1ea3n, h\u00ecnh \u1ea3nh ung th\u01b0 s\u1edbm gi\u00fap cho sinh thi\u1ebft \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f2n c\u00f3 kh\u1ea3 n\u0103ng ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c Helicobacter pylori.<\/em><\/li>\n<\/ul>\n

      2. H\u00ecnh \u1ea3nh n\u1ed9i soi d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng b\u00ecnh th\u01b0\u1eddng<\/h2>\n

      2.1. Trong khi soi c\u1ea7n quan s\u00e1t \u0111\u1ea7y \u0111\u1ee7 nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m sau <\/strong><\/h3>\n
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      • Th\u1ec3 t\u00edch d\u1ea1 d\u00e0y: h\u1eb9p, gi\u00e3n, b\u00ecnh th\u01b0\u1eddng.<\/li>\n
      • C\u00e1c ch\u1ea5t ch\u1ee9a trong d\u1ea1 d\u00e0y: d\u1ecbch d\u1ea1 d\u00e0y trong hay c\u00f2n th\u1ee9c \u0103n.<\/li>\n
      • D\u1ecbch m\u00e1u: m\u00e1u \u0111\u1ecf m\u1edbi ch\u1ea3y hay m\u00e1u \u0111en c\u1ee5c.<\/li>\n
      • D\u1ecbch m\u1eadt m\u00e0u xanh khi c\u00f3 tr\u00e0o ng\u01b0\u1ee3c d\u1ecbch m\u1eadt t\u1eeb t\u00e1 tr\u00e0ng v\u00e0o d\u1ea1 d\u00e0y.<\/li>\n
      • D\u1ecb v\u1eadt, giun s\u00e1n, ch\u1ec9 kh\u00e2u c\u00f2n s\u00f3t l\u1ea1i…<\/li>\n
      • Nhu \u0111\u1ed9ng d\u1ea1 d\u00e0y.<\/li>\n
      • Th\u00e0nh d\u1ea1 d\u00e0y: m\u1ec1m hay c\u1ee9ng, c\u00f3 gi\u00e3n khi b\u01a1m h\u01a1i hay kh\u00f4ng.<\/li>\n
      • M\u00e0u s\u1eafc ni\u00eam m\u1ea1c: h\u1ed3ng hay nh\u1ea1t.<\/li>\n
      • H\u1ec7 th\u1ed1ng mao m\u1ea1ch c\u1ee7a ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y.<\/li>\n<\/ul>\n

        2.2. H\u00ecnh \u1ea3nh soi d\u1ea1 d\u00e0y b\u00ecnh th\u01b0\u1eddng<\/h3>\n

        B\u00ecnh th\u01b0\u1eddng: khi nh\u1ecbn \u0111\u00f3i, trong d\u1ea1 d\u00e0y ch\u1ec9 c\u00f3 \u00edt d\u1ecbch trong v\u00e0 n\u01b0\u1edbc b\u1ecdt, ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y \u0111\u1ecf h\u01a1n v\u00e0 b\u00f3ng h\u01a1n ni\u00eam m\u1ea1c th\u1ef1c qu\u1ea3n. T\u00f9y theo t\u1eebng v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu m\u00e0 h\u00ecnh \u1ea3nh ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y kh\u00e1c nhau v\u00e0 c\u00f3 c\u1ea5u t\u1ea1o m\u00f4 h\u1ecdc kh\u00e1c nhau.<\/p>\n

          \n
        • Th\u1ef1c qu\u1ea3n: t\u1eeb cung r\u0103ng tr\u00ean t\u1edbi l\u1ed5 t\u00e2m v\u1ecb d\u00e0i kho\u1ea3ng 35 \u2013 40 cm, l\u1ed5 tr\u00ean th\u1ef1c qu\u1ea3n c\u00e1ch cung r\u0103ng tr\u00ean 15 cm, ni\u00eam m\u1ea1c b\u00ecnh th\u01b0\u1eddng m\u1ec1m m\u1ea1i, nh\u1eb5n b\u00f3ng, m\u00e0u h\u1ed3ng nh\u1ea1t. \u0110\u01b0\u1eddng Z l\u00e0 \u0111\u01b0\u1eddng ranh gi\u1edbi chuy\u1ec3n ti\u1ebfp gi\u1eefa ni\u00eam m\u1ea1c th\u1ef1c qu\u1ea3n m\u00e0u h\u1ed3ng nh\u1ea1t sang ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y m\u00e0u h\u1ed3ng s\u1eabm h\u01a1n, ch\u00fa \u00fd d\u1ec5 nh\u1ea7m v\u1edbi h\u00ecnh \u1ea3nh vi\u00eam th\u1ef1c qu\u1ea3n.<\/li>\n
        • T\u00e2m v\u1ecb: ph\u1ea7n s\u00e1t th\u1ef1c qu\u1ea3n d\u00e0i kho\u1ea3ng 2-3cm, ni\u00eam m\u1ea1c nh\u1eb5n b\u00f3ng, t\u00e2m v\u1ecb v\u1ec1 ph\u00eda t\u00fai h\u01a1i c\u00f3 m\u1ed9t n\u1ebfp g\u1ea5p t\u1ea1o th\u00e0nh m\u1ed9t g\u00f3c, \u1edf g\u00f3c \u0111\u00f3 c\u00f3 m\u1ed9t van khi b\u01a1m h\u01a1i v\u00e0o d\u1ea1 d\u00e0y l\u00e0m cho van r\u00f5 n\u00e9t, khi d\u1ea1 d\u00e0y x\u1eb9p g\u00f3c \u0111\u00f3 t\u00f9, khi d\u1ea1 d\u00e0y c\u0103ng l\u00e0m cho g\u00f3c \u0111\u00f3 tr\u1edf n\u00ean nh\u1ecdn g\u00e2y c\u1ea3n tr\u1edf quan s\u00e1t t\u1ea1o th\u00e0nh m\u1ed9t v\u00f9ng g\u1ecdi l\u00e0 “v\u00f9ng m\u00f9”.<\/li>\n<\/ul>\n

          Ngay d\u01b0\u1edbi t\u00e2m v\u1ecb c\u00f3 m\u1ed9t h\u00f5m l\u00e0 n\u01a1i ch\u1ee9a d\u1ecbch c\u1ee7a th\u1ef1c qu\u1ea3n ch\u1ea3y v\u00e0o d\u1ea1 d\u00e0y, d\u1ecbch t\u1eeb th\u1ef1c qu\u1ea3n ch\u1ee9a v\u00e0o h\u00f5m n\u00e0y sau \u0111\u00f3 m\u1edbi ch\u1ea3y v\u00e0o d\u1ea1 d\u00e0y t\u1ea1o th\u00e0nh h\u00ecnh \u1ea3nh “th\u00e1c \u0111\u1ed5”. Ch\u1ed5 h\u00f5m n\u00e0y c\u00f3 th\u1ec3 thay \u0111\u1ed5i h\u00ecnh d\u1ea1ng l\u00fac c\u00f3 l\u00fac kh\u00f4ng, l\u00fac to, l\u00fac nh\u1ecf. Khi soi m\u00e1y soi hay b\u1ecb cu\u1ed9n \u1edf h\u00f5m n\u00e0y.<\/p>\n

          Ni\u00eam m\u1ea1c c\u1ee7a v\u00f9ng t\u00e2m v\u1ecb m\u00e0u h\u1ed3ng, n\u1ebfp nh\u0103n ch\u1ea1y theo chi\u1ec1u d\u1ecdc, k\u00edch th\u01b0\u1edbc c\u1ee7a c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c b\u00ecnh th\u01b0\u1eddng, c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y m\u1ed9t s\u1ed1 mao m\u1ea1ch.<\/p>\n

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          • Ph\u00ecnh v\u1ecb: \u0111\u00e1y d\u1ea1 d\u00e0y (t\u00fai h\u01a1i) nh\u00ecn r\u00f5 m\u1ea1ch m\u00e1u, c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c v\u00f9ng n\u00e0y th\u01b0\u1eddng ch\u1ea1y kh\u00f4ng theo m\u1ed9t h\u01b0\u1edbng.<\/li>\n
          • Th\u00e2n d\u1ea1 d\u00e0y: l\u00e0 ph\u1ea7n \u0111\u1ee9ng c\u1ee7a d\u1ea1 d\u00e0y, c\u00f3 n\u1ebfp ni\u00eam m\u1ea1c ch\u1ea1y song song \u1edf ph\u00eda b\u1edd cong l\u1edbn. \u0110\u1ec3 d\u1ec5 m\u00f4 t\u1ea3 v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng, th\u00e2n v\u1ecb \u0111\u01b0\u1ee3c chia th\u00e0nh c\u00e1c ph\u1ea7n (chia m\u1ed9t c\u00e1ch t\u01b0\u01a1ng \u0111\u1ed1i theo t\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n n\u1eb1m nghi\u00eang tr\u00e1i):<\/li>\n<\/ul>\n

            T\u01b0\u01a1ng \u1ee9ng v\u1edbi b\u1edd cong l\u1edbn, \u1edf v\u1ecb tr\u00ed th\u1ea5p l\u00e0 n\u01a1i d\u1ecbch d\u1ea1 d\u00e0y \u0111\u1ecdng. Ph\u1ea3i h\u00fat d\u1ecbch \u0111\u1ec3 quan s\u00e1t. Khi d\u1ea1 d\u00e0y co b\u00f3p, nhu \u0111\u1ed9ng s\u1ebd ch\u1ea1y d\u1ecdc th\u00e2n d\u1ea1 d\u00e0y v\u1ec1 ph\u00eda hang v\u1ecb v\u00e0 k\u1ebft th\u00fac \u1edf m\u00f4n v\u1ecb, nhu \u0111\u1ed9ng \u1edf th\u00e2n d\u1ea1 d\u00e0y y\u1ebfu.<\/p>\n

            + B\u1edd cong nh\u1ecf<\/h4>\n

            Ph\u1ea7n \u0111\u1ee9ng l\u00e0 m\u1ed9t d\u1ea3i d\u1ecdc ph\u1eb3ng, nh\u1eb5n, co b\u00f3p \u00edt, n\u1ebfp nh\u0103n nh\u1ecf v\u00e0 \u00edt. Ph\u00eda 12 gi\u1edd, nh\u1eb5n, kh\u00f4ng c\u00f3 c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c<\/p>\n

            + B\u1edd cong l\u1edbn<\/h4>\n

            C\u00e1c n\u1ebfp ni\u00eam m\u1ea1c ch\u1ea1y d\u1ecdc, th\u00f4, to, khi b\u01a1m h\u01a1i c\u0103ng c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c kh\u00f4ng gi\u00e3n h\u1ebft \u0111\u01b0\u1ee3c. Ph\u00eda 6 gi\u1edd c\u00f3 c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c ch\u1ea1y song song.<\/p>\n

            M\u1eb7t tr\u01b0\u1edbc th\u00e2n v\u1ecb: b\u00ean tay tr\u00e1i c\u1ee7a b\u00e1c s\u0129 n\u1ed9i soi.<\/p>\n

            M\u1eb7t sau th\u00e2n v\u1ecb: b\u00ean tay ph\u1ea3i c\u1ee7a b\u00e1c s\u0129 n\u1ed9i soi.<\/p>\n

            + M\u1eb7t tr\u01b0\u1edbc d\u1ea1 d\u00e0y<\/h4>\n

            D\u1ec5 quan s\u00e1t v\u00ec d\u1ec5 ph\u1ed3ng l\u00ean khi b\u01a1m h\u01a1i, c\u00e1c n\u1ebfp nh\u0103n d\u00e0y, khi b\u01a1m h\u01a1i c\u00e1c n\u1ebfp nh\u0103n th\u01b0a h\u01a1n. M\u1ed9t ph\u1ea7n gan \u0111\u00e8 v\u00e0o m\u1eb7t tr\u01b0\u1edbc l\u00e0m cho v\u00f9ng n\u00e0y l\u1ed3i v\u00e0o trong l\u00f2ng d\u1ea1 d\u00e0y.<\/p>\n

            + M\u1eb7t sau d\u1ea1 d\u00e0y v\u00f9ng th\u00e2n v\u1ecb<\/h4>\n

            N\u1ebfp ni\u00eam m\u1ea1c th\u00f4, c\u00e1c n\u1ebfp nh\u0103n tr\u00f4ng gi\u1ed1ng nh\u01b0 t\u1ed5 ch\u1ee9c n\u00e3o, khi b\u01a1m h\u01a1i c\u0103ng c\u00e1c n\u1ebfp nh\u0103n kh\u00f4ng thay \u0111\u1ed5i, c\u00f3 th\u1ec3 th\u1ea5y nh\u1ecbp \u0111\u1eadp c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/p>\n

            – Hang v\u1ecb<\/h4>\n

            C\u00f3 h\u00ecnh ch\u00f3p \u0111\u1ec9nh l\u00e0 l\u1ed7 m\u00f4n v\u1ecb, khi b\u01a1m h\u01a1i c\u0103ng kh\u00f4ng c\u00f2n th\u1ea5y c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c, hang v\u1ecb co b\u00f3p m\u1ea1nh, khi co b\u00f3p qu\u00e1 m\u1ea1nh th\u1eaft l\u1ea1i d\u1ec5 nh\u1ea7m v\u1edbi l\u1ed5 m\u00f4n v\u1ecb. l\u00e0 ph\u1ea7n ngang c\u1ee7a c\u1ee7a d\u1ea1 d\u00e0y, n\u1eb1m gi\u1eefa m\u00f4n v\u1ecb v\u00e0 th\u00e2n v\u1ecb. \u0111\u1ec3 d\u1ec5 m\u00f4 t\u1ea3 v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng, hang v\u1ecb \u0111\u01b0\u1ee3c chia th\u00e0nh c\u00e1c ph\u1ea7n (chia m\u1ed9t c\u00e1ch t\u01b0\u01a1ng \u0111\u1ed1i theo t\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n n\u1eb1m nghi\u00eang tr\u00e1i):<\/p>\n

            B\u1edd cong l\u1edbn c\u1ee7a hang v\u1ecb ph\u00eda 6 gi\u1edd.<\/p>\n

            B\u1edd cong nh\u1ecf c\u1ee7a hang v\u1ecb ph\u00eda 12 gi\u1edd.<\/p>\n

            M\u1eb7t tr\u01b0\u1edbc hang v\u1ecb b\u00ean tr\u00e1i c\u1ee7a b\u00e1c s\u0129 n\u1ed9i soi.<\/p>\n

            M\u1eb7t sau hang v\u1ecb b\u00ean ph\u1ea3i c\u1ee7a b\u00e1c s\u0129 n\u1ed9i soi.<\/p>\n

            – L\u1ed7 m\u00f4n v\u1ecb<\/h4>\n

            Tr\u00f2n, lu\u00f4n lu\u00f4n co b\u00f3p, ni\u00eam m\u1ea1c \u0111\u1ecf, n\u1ebfu m\u00e9o m\u00f3 l\u00e0 d\u1ea5u hi\u1ec7u gi\u00e1n ti\u1ebfp c\u1ee7a b\u1ec7nh l\u00fd \u1edf h\u00e0nh t\u00e1 tr\u00e0ng. L\u00e0 ph\u1ea7n n\u1ed1i d\u1ea1 d\u00e0y v\u1edbi h\u00e0nh t\u00e1 tr\u00e0ng, d\u00e0i kho\u1ea3ng 0,5 cm.<\/p>\n

            – H\u00e0nh t\u00e1 tr\u00e0ng<\/strong>:<\/h4>\n

            T\u1eeb m\u00f4n v\u1ecb \u0111\u1ebfn g\u1ed1i tr\u00ean D1, h\u00e0nh t\u00e1 tr\u00e0ng l\u00e0 v\u00f9ng r\u1ed9ng tr\u00f2n ni\u00eam m\u1ea1c nh\u1eb3n m\u00e0u h\u1ed3ng nh\u1ea1t, kh\u00f4ng c\u00f3 c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c ch\u1ea1y v\u00f2ng.<\/p>\n

            Ni\u00eam m\u1ea1c m\u1ecfng, khi b\u01a1m h\u01a1i kh\u00f4ng c\u00f2n n\u1ebfp nh\u0103n. \u0110\u1ec9nh n\u1ec1n h\u00e0nh t\u00e1 tr\u00e0ng l\u00e0 nh\u1eefng v\u00f9ng kh\u00f3 quan s\u00e1t.<\/p>\n

            M\u1eb7t tr\u01b0\u1edbc c\u1ee7a h\u00e0nh t\u00e1 tr\u00e0ng: b\u00ean tay tr\u00e1i c\u1ee7a b\u00e1c s\u0129 n\u1ed9i soi, v\u00f9ng n\u00e0y d\u1ec5 quan s\u00e1t.<\/p>\n

            M\u1eb7t sau c\u1ee7a h\u00e0nh t\u00e1 tr\u00e0ng: b\u00ean tay ph\u1ea3i c\u1ee7a b\u00e1c s\u0129 n\u1ed9i soi, v\u00f9ng n\u00e0y kh\u00f3 quan s\u00e1t v\u00ec \u0111\u00e8n soi d\u1ec5 b\u1ecb tu\u1ed9t ra d\u1ea1 d\u00e0y do \u0111\u00f3 ph\u1ea3i c\u1ed1 \u0111\u1ecbnh \u0111\u00e8n soi \u0111\u1ec3 quan s\u00e1t k\u1ef9 v\u00f9ng n\u00e0y.<\/p>\n

            \u0110\u1ec9nh h\u00e0nh t\u00e1 tr\u00e0ng: \u0111o\u1ea1n chuy\u1ec3n ti\u1ebfp t\u1eeb h\u00e0nh t\u00e1 tr\u00e0ng sang \u0111o\u1ea1n D1 c\u1ee7a t\u00e1 tr\u00e0ng<\/p>\n

            \u0110o\u1ea1n DI: \u0111o\u1ea1n n\u1ed1i h\u00e0nh t\u00e1 tr\u00e0ng v\u1edbi D2 t\u00e1 tr\u00e0ng, kh\u00f4ng c\u00f3 c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c ch\u1ea1y v\u00f2ng.<\/p>\n

            \u0110o\u1ea1n D2: \u0111o\u1ea1n n\u1ed1i D1 v\u00e0 D3 t\u00e1 tr\u00e0ng: c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c ch\u1ea1y v\u00f2ng \u0111\u1ec1u nhau. \u1ede \u0111o\u1ea1n D2 c\u00f3 b\u00f3ng Vater.<\/p>\n

            2.3. H\u00ecnh \u1ea3nh d\u1ea1 d\u00e0y sau ph\u1eabu thu\u1eadt<\/h3>\n
              \n
            • Sau c\u1eaft d\u00e2y th\u1ea7n kinh X: h\u00ecnh \u1ea3nh d\u1ea1 d\u00e0y b\u00ecnh th\u01b0\u1eddng c\u00f3 th\u1ec3 h\u01a1i gi\u00e3n v\u00e0 nhu \u0111\u1ed9ng k\u00e9m.<\/li>\n
            • Sau ph\u1eabu thu\u1eadt n\u1ed1i d\u1ea1 d\u00e0y \u2013 h\u1ed7ng tr\u00e0ng, n\u1ebfu soi theo ki\u1ec3u Bilolroth II c\u00f3 2 mi\u1ec7ng n\u1ed1i, th\u00e0nh c\u1ee7a h\u1ed7ng tr\u00e0ng t\u1ea1o th\u00e0nh n\u1ebfp ni\u00eam m\u1ea1c gi\u1eefa quai \u0111i v\u00e0 quai \u0111\u1ebfn, n\u1ebfu soi theo ki\u1ec3u Bibilroth I c\u00f3 1 mi\u1ec7ng n\u1ed1i.<\/li>\n
            • Sau m\u1ed5 c\u1eaft d\u1ea1 d\u00e0y: n\u1ebfu c\u1eaft 2\/3 d\u1ea1 d\u00e0y c\u00f2n quan s\u00e1t th\u1ea5y th\u00e2n v\u1ecb, n\u1ebfu c\u1eaft \u00be d\u1ea1 d\u00e0y ch\u1ec9 quan s\u00e1t th\u1ea5y ph\u1ea7n t\u00e2m v\u1ecb v\u00e0 ph\u00ecnh v\u1ecb.<\/li>\n<\/ul>\n

              2.4. S\u1ef1 li\u00ean quan c\u1ee7a d\u1ea1 d\u00e0y v\u1edbi c\u00e1c t\u1ea1ng trong \u1ed5 b\u1ee5ng <\/strong><\/h3>\n
                \n
              • D\u1ea1 d\u00e0y c\u00f3 li\u00ean quan t\u1edbi tim, gan, t\u1ee5y v\u00e0 l\u00e1ch.<\/li>\n
              • Li\u00ean quan \u0111\u1ebfn t\u1ee5y: t\u1ee5y \u0111\u00e8 v\u00e0o th\u00e0nh sau c\u1ee7a d\u1ea1 d\u00e0y ch\u1ed5 n\u1ed1i gi\u1eefa th\u00e2n d\u1ea1 d\u00e0y v\u00e0 hang v\u1ecb l\u00e0m cho v\u00f9ng n\u00e0y l\u1ed3i v\u00e0o trong l\u00f2ng d\u1ea1 d\u00e0y.<\/li>\n
              • Li\u00ean quan \u0111\u1ebfn gan: gan \u0111\u00e8 g\u00f3c b\u1edd cong nh\u1ecf v\u1ecb tr\u00ed 7 \u2013 9 gi\u1edd l\u00e0m cho v\u00f9ng n\u00e0y h\u01a1i l\u1ed3i v\u00e0o trong l\u00f2ng d\u1ea1 d\u00e0y.<\/li>\n
              • Li\u00ean quan t\u1edbi tim: tim \u0111\u00e8 v\u00e0o v\u00f9ng tr\u00ean tr\u01b0\u1edbc ph\u00ecnh v\u1ecb v\u00e0 t\u00e2m v\u1ecb, khi tim \u0111\u1eadp s\u1ebd th\u1ea5y \u0111\u01b0\u1ee3c gi\u00e1n ti\u1ebfp qua v\u00f9ng t\u00e2m v\u1ecb v\u00e0 ph\u00ecnh v\u1ecb.<\/li>\n
              • Li\u00ean quan \u0111\u1ebfn l\u00e1ch: l\u00e1ch ti\u1ebfp x\u00fac v\u1edbi d\u1ea1 d\u00e0y \u1edf v\u00f9ng tr\u00ean sau v\u00e0 hai b\u00ean d\u1ea1 d\u00e0y.<\/li>\n<\/ul>\n

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

                  \n
                1. \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\u00a0 Churchill Livingstone.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

                    N\u1ed9i soi d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a t\u1eeb th\u1ef1c qu\u1ea3n \u0111\u1ebfn DII c\u1ee7a t\u00e1 tr\u00e0ng b\u1eb1ng m\u00e1y n\u1ed9i soi \u1ed1ng m\u1ec1m. V\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a khoa h\u1ecdc k\u1ef9 thu\u1eadt, m\u00e1y soi c\u0169ng c\u00f3 c\u1ea3i ti\u1ebfn v\u01b0\u1ee3t b\u1eadc nh\u1eb1m ph\u1ee5c […]<\/p>\n","protected":false},"author":15,"featured_media":25220,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"\n\u0110\u1ea1i c\u01b0\u01a1ng v\u1ec1 n\u1ed9i soi d\u1ea1 d\u00e0y - t\u00e1 tr\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"N\u1ed9i soi d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a t\u1eeb th\u1ef1c qu\u1ea3n \u0111\u1ebfn DII c\u1ee7a t\u00e1 tr\u00e0ng b\u1eb1ng m\u00e1y n\u1ed9i soi \u1ed1ng m\u1ec1m. 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