{"id":25296,"date":"2023-04-20T13:10:07","date_gmt":"2023-04-20T06:10:07","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25296"},"modified":"2023-04-21T13:09:21","modified_gmt":"2023-04-21T06:09:21","slug":"ky-thuat-sinh-thiet-qua-noi-soi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/20\/ky-thuat-sinh-thiet-qua-noi-soi\/","title":{"rendered":"K\u1ef9 thu\u1eadt sinh thi\u1ebft qua n\u1ed9i soi"},"content":{"rendered":"<p><strong>Sinh thi\u1ebft qua n\u1ed9i soi l\u00e0 m\u1ed9t \u01b0u \u0111i\u1ec3m v\u01b0\u1ee3t tr\u1ed9i c\u1ee7a n\u1ed9i soi ti\u00eau h\u00f3a v\u1edbi kh\u1ea3 n\u0103ng h\u01b0\u1edbng d\u1eabn sinh thi\u1ebft ni\u00eam m\u1ea1c \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m v\u1ec1 m\u00f4 b\u1ec7nh h\u1ecdc, g\u00f3p ph\u1ea7n ch\u1ea9n \u0111o\u00e1n m\u1ed9t c\u00e1ch ch\u00ednh x\u00e1c th\u01b0\u01a1ng t\u1ed5n. C\u00f9ng v\u1edbi s\u1ef1 ti\u1ebfn b\u1ed9 c\u1ee7a khoa h\u1ecdc c\u00f4ng ngh\u1ec7, sinh thi\u1ebft qua n\u1ed9i soi c\u00f2n gi\u00fap \u00edch cho vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c ung th\u01b0 s\u1edbm \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u1edbi k\u1ef9 thu\u1eadt c\u1eaft\u00a0 ni\u00eam m\u1ea1c (EMR) v\u00e0 d\u01b0\u1edbi ni\u00eam m\u1ea1c (ESD).<\/strong><\/p>\n<h2>1. Sinh thi\u1ebft ni\u00eam m\u1ea1c trong n\u1ed9i soi ti\u00eau ho\u00e1<\/h2>\n<h3>1.1. Ch\u1ec9 \u0111\u1ecbnh<\/h3>\n<h4>1.1.1. Ch\u1ec9 \u0111\u1ecbnh chung<\/h4>\n<p>Sinh thi\u1ebft \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi t\u00ecm th\u1ea5y m\u1ed9t kh\u1ed1i u, d\u00f9 l\u00e0 l\u1edbn hay nh\u1ecf, l\u00e0 \u00e1c t\u00ednh hay l\u00e0nh t\u00ednh. V\u1ecb tr\u00ed sinh thi\u1ebft n\u00ean \u1edf:<\/p>\n<ul>\n<li>T\u1ea1i ch\u1ed7 t\u1ed5n th\u01b0\u01a1ng: 4-6 m\u1eabu.\n<ul>\n<li>T\u1ea1i c\u00e1c th\u01b0\u01a1ng t\u1ed5n d\u1ea1ng kh\u1ed1i ho\u1eb7c d\u1ea1ng n\u1ed1t nh\u1ecf.<\/li>\n<li>T\u1ea1i c\u00e1c v\u1ecb tr\u00ed ni\u00eam m\u1ea1c b\u1ea5t th\u01b0\u1eddng.<\/li>\n<li>T\u1ea1i c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c nhi\u1ec5m c\u1ee9ng chung quanh t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<\/ul>\n<\/li>\n<li>C\u1ea1nh t\u1ed5n th\u01b0\u01a1ng: 1-2 m\u1eabu\n<ul>\n<li>1-2 cm c\u00e1ch b\u1edd t\u1ed5n th\u01b0\u01a1ng, t\u1ea1i v\u1ecb tr\u00ed ni\u00eam m\u1ea1c tr\u00f4ng c\u00f3 v\u1ebb b\u00ecnh th\u01b0\u1eddng.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h4><strong><em>1.1.2. C\u00e1c ch\u1ec9 \u0111\u1ecbnh c\u1ee5 th\u1ec3 \u1edf c\u00e1c c\u01a1 quan <\/em><\/strong><\/h4>\n<p><strong>&#8211;\u00a0 Th\u1ef1c qu\u1ea3n:\u00a0 <\/strong><\/p>\n<p>+ Khi c\u1ea7n lo\u1ea1i tr\u1eeb ung th\u01b0 \u1edf c\u00e1c ch\u1ed7 h\u1eb9p v\u00e0 lo\u00e9t, n\u00ean sinh thi\u1ebft s\u00e2u \u1edf ngay d\u01b0\u1edbi t\u1ed5n th\u01b0\u01a1ng, \u1edf nhi\u1ec1u v\u1ecb tr\u00ed.<\/p>\n<p>+ Ni\u00eam m\u1ea1c Barrett: Ngay d\u01b0\u1edbi c\u01a1 th\u1eaft th\u1ef1c qu\u1ea3n d\u01b0\u1edbi \u1edf 4 g\u00f3c v\u00e0 sau \u0111\u00f3 m\u1ed7i 2cm cho \u0111\u1ebfn v\u1ecb tr\u00ed m\u1edbi c\u1ee7a \u0111\u01b0\u1eddng Z. B\u1ea5t k\u1ef3 t\u1ed5n th\u01b0\u01a1ng lo\u00e9t hay kh\u00f4ng\u00a0 \u0111\u1ec1u c\u1ee7a ni\u00eam m\u1ea1c.<\/p>\n<figure id=\"attachment_25340\" aria-describedby=\"caption-attachment-25340\" style=\"width: 1544px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-25340\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tq-barrett-va-emr.jpg\" alt=\"sinh thi\u1ebft qua n\u1ed9i soi\" width=\"1544\" height=\"1247\" data-wp-editing=\"1\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tq-barrett-va-emr.jpg 1544w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tq-barrett-va-emr-300x242.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tq-barrett-va-emr-1024x827.jpg 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tq-barrett-va-emr-768x620.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/tq-barrett-va-emr-1536x1241.jpg 1536w\" sizes=\"(max-width: 1544px) 100vw, 1544px\" \/><figcaption id=\"caption-attachment-25340\" class=\"wp-caption-text\">H\u00ecnh \u1ea3nh th\u1ef1c qu\u1ea3n Barrett v\u00e0 sau khi EMR<\/figcaption><\/figure>\n<p><strong>&#8211;\u00a0 D\u1ea1 d\u00e0y:<\/strong><\/p>\n<p>+ Lo\u00e9t: sinh thi\u1ebft \u1edf r\u00eca \u1ed5 lo\u00e9t, kh\u00f4ng \u0111\u01b0\u01a1c sinh thi\u1ebft \u1edf \u0111\u00e1y \u1ed5 lo\u00e9t v\u00ec th\u01b0\u1eddng kh\u00f4ng c\u00f3 k\u1ebft qu\u1ea3 nh\u01b0ng l\u1ea1i d\u1ec5 th\u1ee7ng.<\/p>\n<p>+ Khi c\u00f3 n\u1ebfp ni\u00eam m\u1ea1c d\u00e0y b\u1ea5t th\u01b0\u1eddng: C\u00f3 th\u1ec3 d\u00f9ng lo\u1ea1i k\u00ecm c\u00f3 mi\u1ec7ng to v\u00e0 l\u1ea5y m\u1eabu tr\u00ean b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c.<\/p>\n<p>+ T\u00ecm Helicobacter pylori: L\u1ea5y m\u1ed9t m\u1eabu \u1edf hang v\u1ecb (c\u00e1ch m\u00f4n v\u1ecb trong v\u00f2ng 2cm) v\u00e0 m\u1ed9t m\u1eabu \u1edf th\u00e2n v\u1ecb.<\/p>\n<p>+ C\u00e1c t\u1ed5n th\u01b0\u01a1ng nghi l\u00e0 u tuy\u1ebfn: Sinh thi\u1ebft \u1edf 4 g\u00f3c t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<p>+ Vi\u00eam d\u1ea1 d\u00e0y: Sinh thi\u1ebft \u1edf v\u00f9ng ni\u00eam m\u1ea1c b\u1ea5t th\u01b0\u1eddng.<\/p>\n<figure id=\"attachment_25339\" aria-describedby=\"caption-attachment-25339\" style=\"width: 607px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-25339\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ns-dd.jpg\" alt=\"sinh thi\u1ebft qua n\u1ed9i soi\" width=\"607\" height=\"204\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ns-dd.jpg 607w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/ns-dd-300x101.jpg 300w\" sizes=\"(max-width: 607px) 100vw, 607px\" \/><figcaption id=\"caption-attachment-25339\" class=\"wp-caption-text\">N\u1ed9i soi v\u1edbi NBI<\/figcaption><\/figure>\n<p>A: N\u1ed9i soi th\u01b0\u1eddng; B: N\u1ed9i soi nhu\u1ed9m m\u00e0u; C: N\u1ed9i soi v\u1edbi \u00e1nh s\u00e1ng ch\u1ecdn l\u1ecdc<\/p>\n<p><strong>&#8211;\u00a0 <a href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/noi-soi-dai-trang-dien-ra-nhu-nao\/\">\u0110\u1ea1i tr\u00e0ng<\/a>:<\/strong><\/p>\n<ul>\n<li>Vi\u00eam \u0111\u1ea1i tr\u00e0ng:<\/li>\n<\/ul>\n<p>+ N\u1ebfu ni\u00eam m\u1ea1c kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng tr\u00ean \u0111\u1ea1i th\u1ec3: l\u1ea5y m\u1eabu ng\u1eabu nhi\u00ean \u1edf nhi\u1ec1u v\u1ecb tr\u00ed t\u01b0\u01a1ng \u1ee9ng v\u1edbi c\u00e1c \u0111o\u1ea1n kh\u00e1c nhau: tr\u1ef1c tr\u00e0ng, \u0111\u1ea1i tr\u00e0ng xu\u1ed1ng, \u0111\u1ea1i tr\u00e0ng ngang, \u0111\u1ea1i tr\u00e0ng l\u00ean, manh tr\u00e0ng.<\/p>\n<p>+ N\u1ebfu ni\u00eam m\u1ea1c b\u1ea5t th\u01b0\u1eddng to\u00e0n b\u1ed9: L\u1ea5y m\u1eabu tr\u00ean v\u00f9ng ni\u00eam m\u1ea1c b\u1ea5t th\u01b0\u1eddng.<\/p>\n<p>+ N\u1ebfu ch\u1ec9 b\u1ea5t th\u01b0\u1eddng \u1edf ni\u00eam m\u1ea1c tr\u1ef1c tr\u00e0ng: l\u1ea5y m\u1eabu \u1edf v\u00f9ng ni\u00eam m\u1ea1c b\u1ea5t th\u01b0\u1eddng v\u00e0 10 cm tr\u00ean gi\u1edbi h\u1ea1n v\u00f9ng b\u1ea5t th\u01b0\u1eddng.<\/p>\n<ul>\n<li>Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng, b\u1ec7nh Crohn:<\/li>\n<\/ul>\n<p>+ Sinh thi\u1ebft nhi\u1ec1u m\u1ea3nh \u1edf khung \u0111\u1ea1i tr\u00e0ng.<\/p>\n<p>+ B\u1ea5t k\u1ef3 t\u1ed5n th\u01b0\u01a1ng n\u00e0o nghi ng\u1edd nh\u01b0 polyp, h\u1eb9p, lo\u00e9t hay v\u00f9ng nh\u00f4 cao b\u1ea5t th\u01b0\u1eddng.<\/p>\n<h3>1.2.\u00a0 Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/h3>\n<p>Th\u1ef1c t\u1ebf \u00edt khi c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, tuy nhi\u00ean c\u1ea7n th\u1eadn trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau:<\/p>\n<ul>\n<li>R\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u v\u00e0 \u0111ang d\u00f9ng thu\u1ed1c kh\u00e1ng \u0111\u00f4ng.<\/li>\n<li>U m\u1ea1ch m\u00e1u.<\/li>\n<li>Gi\u00e3n t\u0129nh m\u1ea1ch.<\/li>\n<li>Lo\u00e9t \u0111ang xu\u1ea5t huy\u1ebft.<\/li>\n<li>D\u00f9ng k\u00ecm sinh thi\u1ebft l\u1edbn \u1edf \u0111\u1ea1i tr\u00e0ng.<\/li>\n<\/ul>\n<h3><strong>1.3. Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n <\/strong><\/h3>\n<p>Gi\u1ed1ng nh\u01b0 chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n n\u1ed9i soi d\u1ea1 d\u00e0y, \u0111\u1ea1i tr\u00e0ng.<\/p>\n<h3>1.4. D\u1ee5ng c\u1ee5<\/h3>\n<ul>\n<li>K\u00ecm sinh thi\u1ebft v\u1edbi nhi\u1ec1u k\u00edch th\u01b0\u1edbc kh\u00e1c nhau, lo\u1ea1i d\u00e0nh cho \u0111\u1ea1i tr\u00e0ng th\u01b0\u1eddng l\u1edbn h\u01a1n lo\u1ea1i d\u00f9ng cho d\u1ea1 d\u00e0y, c\u00f3 lo\u1ea1i k\u00ecm sinh thi\u1ebft c\u00f3 kim c\u1eafm \u1edf trung t\u00e2m, c\u00f3 lo\u1ea1i k\u00ecm sinh thi\u1ebft c\u00f3 th\u1ec3 xoay quanh tr\u1ee5c gi\u1eefa gi\u00fap sinh thi\u1ebft d\u1ec5 d\u00e0ng h\u01a1n \u1edf c\u00e1c v\u1ecb tr\u00ed kh\u00f3 kh\u0103n.<\/li>\n<\/ul>\n<figure id=\"attachment_25338\" aria-describedby=\"caption-attachment-25338\" style=\"width: 1933px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-25338\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kem-st.png\" alt=\"sinh thi\u1ebft qua n\u1ed9i soi\" width=\"1933\" height=\"780\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kem-st.png 1933w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kem-st-300x121.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kem-st-1024x413.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kem-st-768x310.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/kem-st-1536x620.png 1536w\" sizes=\"(max-width: 1933px) 100vw, 1933px\" \/><figcaption id=\"caption-attachment-25338\" class=\"wp-caption-text\">C\u00e1c lo\u1ea1i k\u1ec1m sinh thi\u1ebft<\/figcaption><\/figure>\n<ul>\n<li>\u1ed0ng n\u1ed9i soi c\u00f3 k\u00eanh sinh thi\u1ebft \u0111\u1ee7 l\u1edbn.<\/li>\n<li>C\u00e1c lam k\u00ednh ho\u1eb7c c\u00e1c \u1ed1ng nh\u1ecf \u0111\u1ec3 \u0111\u1ef1ng m\u1eabu nghi\u1ec7m.<\/li>\n<li>Th\u00f2ng l\u1ecdng \u0111\u1ec3 sinh thi\u1ebft trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1eb7c bi\u1ec7t.<\/li>\n<\/ul>\n<p>&#8211; M\u1ed9t s\u1ed1 dung d\u1ecbch nhu\u1ed9m m\u00e0u \u0111\u1ec3 d\u1ec5 b\u1ed9c l\u1ed9 th\u01b0\u01a1ng t\u1ed5n, gi\u00fap sinh thi\u1ebft ch\u00ednh x\u00e1c h\u01a1n nh\u01b0 xanh methylen, indigo carmine, \u0111\u1ecf congo.<\/p>\n<h2><strong>2. Nguy\u00ean t\u1eafc <\/strong><\/h2>\n<h3><em>2.1 \u00dd ngh\u0129a <\/em><\/h3>\n<p>N\u1ed9i soi ch\u1ec9 c\u00f3 gi\u00e1 tr\u1ecb g\u1ee3i \u00fd ch\u1ea9n \u0111o\u00e1n, c\u1ea7n ph\u1ea3i sinh thi\u1ebft \u0111\u1ec3 c\u00f3 ch\u1ea9n \u0111o\u00e1n gi\u1ea3i ph\u1eabu b\u1ec7nh, m\u1ed9t ti\u00eau chu\u1ea9n quan tr\u1ecdng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh.<\/p>\n<ul>\n<li>Ni\u00eam m\u1ea1c trong c\u00f3 v\u1ebb b\u00ecnh th\u01b0\u1eddng v\u1ec1 m\u1eb7t h\u00ecnh \u1ea3nh n\u1ed9i soi v\u1eabn c\u00f3 th\u1ec3 c\u00f3 k\u1ebft lu\u1eadn b\u1ec7nh l\u00fd tr\u00ean gi\u1ea3i ph\u1eabu b\u1ec7nh.<\/li>\n<li>Khi n\u1ed9i soi c\u00f3 nh\u1eefng bi\u1ec3u hi\u1ec7n g\u1ea7n nh\u01b0 b\u1ea5t th\u01b0\u1eddng nh\u01b0ng c\u00f3 th\u1ec3 kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh l\u00fd tr\u00ean gi\u1ea3i ph\u1eabu b\u1ec7nh.<\/li>\n<\/ul>\n<p>Trong c\u00e1c b\u1ec7nh l\u00fd \u0111\u1ea1i tr\u00e0ng nghi h\u1ed9i ch\u1ee9ng k\u00e9m h\u1ea5p thu ho\u1eb7c nghi u lympho, khi ni\u00eam m\u1ea1c c\u00f3 v\u1ebb b\u00ecnh th\u01b0\u1eddng v\u1eabn n\u00ean sinh thi\u1ebft nhi\u1ec1u m\u1ea3nh.<\/p>\n<p>S\u1ed1 l\u01b0\u1ee3ng m\u1eabu sinh thi\u1ebft t\u00f9y thu\u1ed9c lo\u1ea1i b\u1ec7nh l\u00fd, nh\u1ea5t l\u00e0 trong ung th\u01b0 c\u1ea7n l\u1ea5y nhi\u1ec1u m\u1eabu. Ngo\u00e0i ra, y\u1ebfu t\u1ed1 quan tr\u1ecdng h\u01a1n l\u00e0 ph\u1ea9m ch\u1ea5t v\u00e0 k\u00edch th\u01b0\u1edbc c\u1ee7a t\u1eebng m\u1eabu (n\u00ean l\u1ea5y c\u1ea1nh t\u1ed5n th\u01b0\u01a1ng). V\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng khu tr\u00fa, ph\u1ea3i l\u1ea5y th\u00eam m\u1eabu \u1edf ni\u00eam m\u1ea1ch g\u1ea7n t\u1ed5n th\u01b0\u01a1ng tr\u00f4ng c\u00f3 v\u1ebb b\u00ecnh th\u01b0\u1eddng (v\u00ec c\u00f3 th\u1ec3 b\u1ea5t th\u01b0\u1eddng v\u00e0 \u0111\u1ec3 bi\u1ebft gi\u1edbi h\u1ea1n t\u1ed5n th\u01b0\u01a1ng).<\/p>\n<h3><strong><em>2.2. M\u1ed9t s\u1ed1 nguy\u00ean t\u1eafc chung <\/em><\/strong><\/h3>\n<p>Tr\u01b0\u1edbc khi sinh thi\u1ebft:<\/p>\n<ul>\n<li>\u00a0C\u1ea7n ki\u1ec3m tra xem s\u1ef1 \u0111\u00f3ng m\u1edf nh\u1ecbp nh\u00e0ng c\u1ee7a k\u00ecm sinh thi\u1ebft.<\/li>\n<li>\u00a0C\u1ea7m s\u00e1t ch\u1ed7 v\u00e0o k\u00eanh sinh thi\u1ebft, \u0111\u01b0a k\u00ecm v\u00e0o t\u1eebng ch\u00fat m\u1ed9t. Khi \u1ed1ng soi qu\u00e1 g\u1eadp, c\u00f3 th\u1ec3 c\u1ea7n nh\u1ea3 b\u1edbt \u0111\u1ed9 g\u1eadp m\u1ed9t \u00edt khi \u0111\u01b0a k\u00ecm qua \u0111\u1ec3 tr\u00e1nh l\u00e0m h\u01b0 \u1ed1ng n\u1ed9i soi do t\u1ed5n th\u01b0\u01a1ng k\u00eanh sinh thi\u1ebft. &#8211; Trong khi sinh thi\u1ebft:<\/li>\n<li>\u00a0Ch\u1ecdn v\u1ecb tr\u00ed tr\u01b0\u1edbc khi sinh thi\u1ebft: \u0110\u1ebfn g\u1ea7n t\u1ed5n th\u01b0\u01a1ng, \u0111\u1ecbnh h\u01b0\u1edbng ch\u1ed7 \u0111\u1ecbnh sinh thi\u1ebft \u1edf ngay v\u1ecb tr\u00ed \u0111i qua c\u1ee7a kim.<\/li>\n<li>\u00a0N\u00ean \u1ea5n nh\u1eb9 k\u00ecm v\u00e0o ni\u00eam m\u1ea1c, \u0111\u00f3ng v\u00e0o t\u1eeb t\u1eeb v\u00e0 r\u00fat ra nhanh.<\/li>\n<li>\u00a0M\u1eabu \u0111\u1ea7u ti\u00ean l\u00e0 quan tr\u1ecdng nh\u1ea5t, th\u01b0\u1eddng cho k\u1ebft qu\u1ea3 nh\u1ea5t, c\u00e1c v\u1ecb tr\u00ed sinh thi\u1ebft c\u00e1c l\u1ea7n ti\u1ebfp theo c\u00f3 th\u1ec3 g\u1eb7p kh\u00f3 kh\u0103n do m\u00e1u che l\u1ea5p.<\/li>\n<li>\u0110\u00f4i khi c\u1ea7n ph\u1ea3i r\u00fat x\u1eb9p b\u1edbt h\u01a1i, sinh thi\u1ebft s\u1ebd d\u1ec5 h\u01a1n. &#8211;\u00a0 Sau khi sinh thi\u1ebft:<\/li>\n<li>\u0110\u00e1nh gi\u00e1: m\u1eabu t\u1ed1t ph\u1ea3i \u0111\u1ea3m b\u1ea3o ba y\u1ebfu t\u1ed1 l\u00e0 k\u00edch th\u01b0\u1edbc (2-3mm), v\u1ecb tr\u00ed,\u00a0 ph\u1ea3i l\u00e0 t\u1ed5 ch\u1ee9c thay v\u00ec ch\u1ea5t nh\u1ea7y hay m\u00e1u.<\/li>\n<li>\u0110\u00e1nh s\u1ed1: sau khi \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn l\u00e0 \u0111\u1ee7 ph\u1ea9m ch\u1ea5t, m\u1eabu \u0111\u01b0\u1ee3c l\u1ea5y kh\u1ecfi k\u00ecm lo\u1ea1i b\u1ecf m\u00e1u d\u00ednh theo (\u0111\u1ec3 tr\u00e1nh che l\u1ea5p c\u00e1c chi ti\u1ebft c\u1ee7a c\u00e1c l\u00e1t c\u1eaft), r\u1ed3i \u0111\u1eb7t l\u00ean m\u00f4i tr\u01b0\u1eddng n\u00e2ng \u0111\u1ee1. Ng\u01b0\u1eddi soi ph\u1ea3i nh\u1edb v\u1ecb tr\u00ed c\u1ee7a t\u1eebng m\u1eabu.<\/li>\n<li>Ghi nh\u1eadn: trong phi\u1ebfu n\u1ed9i soi v\u00e0 gi\u1ea5y x\u00e9t nghi\u1ec7m m\u00f4 h\u1ecdc, n\u00ean v\u1ebd h\u00ecnh \u1ea3nh minh h\u1ecda \u0111\u1ec3 th\u00f4ng b\u00e1o v\u00e0i th\u00f4ng tin c\u01a1 b\u1ea3n v\u1ec1 t\u1ed5n th\u01b0\u01a1ng \u0111\u1ea1i th\u1ec3.<\/li>\n<li>\u00a0B\u1ea3o qu\u1ea3n: R\u1eeda s\u1ea1ch k\u00ecm sinh thi\u1ebft b\u1eb1ng n\u01b0\u1edbc. Di\u1ec7t khu\u1ea9n b\u1eb1ng dung d\u1ecbch s\u00e1t khu\u1ea9n nh\u01b0 Glutaraldehyd (Cidex), formaline. B\u00f4i tr\u01a1n b\u1eb1ng d\u1ea7u silicone.<\/li>\n<li>\u00a0Ch\u00fa \u00fd: Khi \u0111\u00f3ng, kh\u00f4ng n\u00ean b\u00f3p qu\u00e1 m\u1ea1nh kim h\u01b0 v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c m\u1edf k\u00ecm l\u00fac \u0111\u1ea7u k\u00ecm \u1edf trong k\u00eanh thao t\u00e1c c\u00f3 th\u1ec3 l\u00e0m h\u01b0 \u1ed1ng n\u1ed9i soi. N\u1ebfu \u0111\u1ea9y m\u1ea1nh k\u00ecm qua \u0111o\u1ea1n \u1ed1ng soi \u0111ang g\u1ea5p kh\u00fac cao \u0111\u1ed9 s\u1ebd l\u00e0m h\u01b0 k\u00eanh sinh thi\u1ebft v\u00e0 h\u01b0 \u1ed1ng soi.<\/li>\n<\/ul>\n<h2>3. C\u00e1c k\u0129 thu\u1eadt sinh thi\u1ebft<\/h2>\n<h3>3.1. Sinh thi\u1ebft k\u1eb9p<\/h3>\n<p>L\u00e0 lo\u1ea1i sinh thi\u1ebft ph\u1ed5 bi\u1ebfn v\u00e0 d\u1ec5 th\u1ef1c hi\u1ec7n nh\u1ea5t. M\u1eabu nghi\u1ec7m thu \u0111\u01b0\u1ee3c th\u01b0\u1eddng ch\u1ec9 l\u00e0 l\u1edbp ni\u00eam m\u1ea1c, c\u00f3 th\u1ec3 c\u00f3 th\u00eam m\u1ed9t \u00edt t\u1ed5 ch\u1ee9c d\u01b0\u1edbi ni\u00eam m\u1ea1c. K\u1ef9 thu\u1eadt n\u00e0y h\u1ea7u nh\u01b0 kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng. C\u00f3 nhi\u1ec1u lo\u1ea1i k\u00ecm sinh thi\u1ebft kh\u00e1c nhau v\u1ec1 k\u00edch th\u01b0\u1edbc, c\u1ea5u tr\u00fac \u2026 C\u00e1c lo\u1ea1i k\u00ecm sinh thi\u1ebft c\u00f3 kim nh\u1ecdn \u1edf gi\u1eefa ho\u1eb7c k\u00ecm sinh thi\u1ebft c\u00f3 th\u1ec3 xoay quanh tr\u1ee5c th\u00ec gi\u00fap cho thao\u00a0 t\u00e1c sinh thi\u1ebft \u0111\u01b0\u1ee3c d\u1ec5 d\u00e0ng h\u01a1n, nh\u1ea5t l\u00e0 \u1edf nh\u1eefng v\u1ecb tr\u00ed kh\u00f3 quan s\u00e1t, kh\u00f3 b\u1ea5m, lo\u1ea1i c\u00f3 kim c\u00f2n gi\u00fap cho m\u1ea3nh sinh thi\u1ebft to h\u01a1n do c\u00f3 th\u1ec3 c\u1eafm s\u00e2u v\u00e0o ni\u00eam m\u1ea1c.<\/p>\n<p>V\u1ec1 k\u00edch th\u01b0\u1edbc, lo\u1ea1i k\u00ecm sinh thi\u1ebft l\u1edbn c\u00f3 th\u1ec3 gi\u00fap\u00a0 l\u1ea5y m\u1eabu to h\u01a1n b\u00ecnh th\u01b0\u1eddng, c\u00f3 khi g\u1ea5p 2 m\u1eabu th\u00f4ng th\u01b0\u1eddng, nh\u01b0ng ph\u1ea3i d\u00f9ng \u1ed1ng n\u1ed9i soi c\u00f3 k\u00eanh sinh thi\u1ebft \u0111\u1ee7 l\u1edbn, tr\u00ean 3,5 mm.<\/p>\n<p>C\u00f3 c\u00e1c lo\u1ea1i k\u1ef9 thu\u1eadt sinh thi\u1ebft k\u1eb9p nh\u01b0 sau:<\/p>\n<p>&#8211;\u00a0 K\u1ef9 thu\u1eadt sinh thi\u1ebft \u0111\u1ea9y: M\u1edf k\u00ecm sinh thi\u1ebft, \u1ea5n nhe nh\u00e0ng l\u00ean b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c v\u1edbi l\u1ef1c v\u1eeba \u0111\u1ee7 \u0111\u1ec3 l\u00e0m k\u00ecm sinh thi\u1ebft h\u01a1i cong, \u0111\u00f3ng k\u00ecm l\u1ea1i t\u1eeb t\u1eeb r\u1ed3i r\u00fat k\u00ecm sinh thi\u1ebft ra nhanh \u0111\u1ec3 \u0111\u1ee1 b\u1ecb ch\u1ea3y m\u00e1u v\u00e0 d\u1eadp m\u00f4. N\u00f3i chung \u0111\u00e2y l\u00e0 k\u1ef9 thu\u1eadt d\u1ec5 th\u1ef1c hi\u1ec7n nh\u1ea5t.<\/p>\n<p>L\u01b0u \u00fd quan s\u00e1t nhu \u0111\u1ed9ng \u1ed1ng ti\u00eau h\u00f3a, ch\u1edd l\u00fac co th\u1eaft l\u1ea1i \u0111\u1ec3 c\u00e1c n\u1ebfp ni\u00eam m\u1ea1c n\u1ed5i r\u00f5 h\u01a1n v\u00e0 d\u1ec5 sinh thi\u1ebft h\u01a1n.<\/p>\n<ul>\n<li>K\u1ef9 thu\u1eadt sinh thi\u1ebft k\u00e9o: Sau khi m\u1edf k\u00ecm sinh thi\u1ebft, k\u00e9o k\u00ecm lui cho t\u1edbi khi ch\u1ea1m v\u00e0o \u1ed1ng n\u1ed9i soi, xoay \u1ed1ng n\u1ed9i soi cho g\u1ea7n vu\u00f4ng g\u00f3c v\u1edbi th\u00e0nh ni\u00eam m\u1ea1c, \u0111\u1ea9y kim v\u00e0o t\u1eebng \u0111o\u1ea1n ng\u1eafn ho\u1eb7c \u0111\u1ea9y \u1ed1ng n\u1ed9i soi cho \u0111\u1ebfn khi g\u1eb7p ni\u00eam m\u1ea1c. C\u00f3 th\u1ec3 h\u00fat x\u1eb9p l\u00f2ng \u1ed1ng ti\u00eau h\u00f3a tr\u01b0\u1edbc khi \u0111\u00f3ng k\u00ecm.<\/li>\n<\/ul>\n<p>K\u1ef9 thu\u1eadt n\u00e0y c\u00f3 \u01b0u \u0111i\u1ec3m l\u1edbn l\u00e0 l\u1ea5y \u0111\u01b0\u1ee3c m\u1eabu v\u1edbi k\u00edch th\u01b0\u1edbc l\u1edbn v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng t\u1ed1t h\u01a1n, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf ni\u00eam m\u1ea1c th\u1ef1c qu\u1ea3n. Tuy nhi\u00ean, v\u1ec1 k\u1ef9 thu\u1eadt c\u00f3 ph\u1ea7n kh\u00f3 kh\u0103n h\u01a1n.<\/p>\n<ul>\n<li>K\u1ef9 thu\u1eadt sinh thi\u1ebft 2 l\u1ea7n: \u0110\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 l\u1ea5y m\u00f4 d\u01b0\u1edbi ni\u00eam m\u1ea1c. Ch\u1ec9 c\u1ea7n sinh thi\u1ebft l\u1eb7p l\u1ea1i \u1edf ngay t\u1ea1i n\u01a1i m\u1edbi sinh thi\u1ebft.<\/li>\n<\/ul>\n<h3><em>3.2. K\u1ef9 thu\u1eadt sinh thi\u1ebft b\u1eb1ng th\u00f2ng l\u1ecdng <\/em><\/h3>\n<p>L\u00e0 k\u1ef9 thu\u1eadt th\u01b0\u1eddng d\u00f9ng sau sinh thi\u1ebft k\u1eb9p. K\u1ef9 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t \u0111\u1ec3 c\u1eaft b\u1ecf polyp c\u00f3 cu\u1ed1ng hay kh\u00f4ng cu\u1ed1ng qua n\u1ed9i soi. Bi\u1ebfn ch\u1ee9ng g\u1eb7p nhi\u1ec1u h\u01a1n sinh thi\u1ebft k\u1eb9p.<\/p>\n<div class=\"mceTemp\"><\/div>\n<figure id=\"attachment_25337\" aria-describedby=\"caption-attachment-25337\" style=\"width: 409px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-25337\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/st-tl.jpg\" alt=\"sinh thi\u1ebft qua n\u1ed9i soi\" width=\"409\" height=\"126\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/st-tl.jpg 409w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/st-tl-300x92.jpg 300w\" sizes=\"(max-width: 409px) 100vw, 409px\" \/><figcaption id=\"caption-attachment-25337\" class=\"wp-caption-text\">H\u00ecnh \u1ea3nh minh ho\u1ea1 c\u1eaft polyp v\u1edbi th\u00f2ng l\u1ecdng<\/figcaption><\/figure>\n<figure id=\"attachment_25336\" aria-describedby=\"caption-attachment-25336\" style=\"width: 1950px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-25336\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sttl-cp.jpg\" alt=\"sinh thi\u1ebft qua n\u1ed9i soi\" width=\"1950\" height=\"578\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sttl-cp.jpg 1950w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sttl-cp-300x89.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sttl-cp-1024x304.jpg 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sttl-cp-768x228.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sttl-cp-1536x455.jpg 1536w\" sizes=\"(max-width: 1950px) 100vw, 1950px\" \/><figcaption id=\"caption-attachment-25336\" class=\"wp-caption-text\">C\u1eaft polyp v\u1edbi th\u00f2ng l\u1ecdng<\/figcaption><\/figure>\n<h3>3.3. K\u1ef9 thu\u1eadt c\u1eaft h\u1edbt ni\u00eam m\u1ea1c v\u00e0 ph\u1eabu t\u00edch d\u01b0\u1edbi ni\u00eam m\u1ea1c (EMR v\u00e0 ESD)<\/h3>\n<p>\u0110\u00e2y l\u00e0 hai ph\u01b0\u01a1ng ph\u00e1p v\u1eeb l\u1ea5y m\u1eabu l\u00e0m m\u00f4 b\u1ec7nh h\u1ecdc ch\u1ea9n \u0111o\u00e1n s\u1edbm ung th\u01b0 \u0111\u01b0\u1eddng ti\u00eau h\u00f3a \u0111\u1ed3ng th\u1eddi c\u00f2n mang t\u00ednh ch\u1ea5t \u0111i\u1ec1u tr\u1ecb kh\u1ecfi ung th\u01b0 s\u1edbm n\u00e0y.<\/p>\n<figure id=\"attachment_25335\" aria-describedby=\"caption-attachment-25335\" style=\"width: 1929px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-25335\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/emr.png\" alt=\"sinh thi\u1ebft qua n\u1ed9i soi\" width=\"1929\" height=\"1268\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/emr.png 1929w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/emr-300x197.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/emr-1024x673.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/emr-768x505.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/emr-1536x1010.png 1536w\" sizes=\"(max-width: 1929px) 100vw, 1929px\" \/><figcaption id=\"caption-attachment-25335\" class=\"wp-caption-text\">K\u1ef9 thu\u1eadt EMR<\/figcaption><\/figure>\n<figure id=\"attachment_25334\" aria-describedby=\"caption-attachment-25334\" style=\"width: 2066px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-25334\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/esd.png\" alt=\"sinh thi\u1ebft qua n\u1ed9i soi\" width=\"2066\" height=\"1126\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/esd.png 2066w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/esd-300x164.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/esd-1024x558.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/esd-768x419.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/esd-1536x837.png 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/esd-2048x1116.png 2048w\" sizes=\"(max-width: 2066px) 100vw, 2066px\" \/><figcaption id=\"caption-attachment-25334\" class=\"wp-caption-text\">K\u1ef9 thu\u1eadt ESD<\/figcaption><\/figure>\n<h2>4. Bi\u1ebfn ch\u1ee9ng<\/h2>\n<p>R\u1ea5t hi\u1ebfm<\/p>\n<ul>\n<li>Xu\u1ea5t huy\u1ebft th\u01b0\u1eddng nh\u1eb9 v\u00e0 t\u1ef1 gi\u1edbi h\u1ea1n. Tuy nhi\u00ean v\u1edbi ph\u01b0\u01a1ng ph\u00e1p EMR v\u00e0 ESD c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn xu\u1ea5t huy\u1ebft nhi\u1ec1u c\u1ea7n ph\u1ea3i n\u1ed9i soi can thi\u1ec7p c\u1ea7m m\u00e1u.<\/li>\n<li>Th\u1ee7ng khi sinh thi\u1ebft \u0111\u1ea1i tr\u00e0ng, \u0111\u1eb7c bi\u1ec7t \u1edf \u0111\u1ea1i tr\u00e0ng ph\u1ea3i khi c\u00f3 b\u1ec7nh l\u00fd \u0111\u1eb7c bi\u1ec7t nh\u01b0 t\u00fai th\u1eeba hay vi\u00eam \u0111\u1ea1i tr\u00e0ng n\u1eb7ng.<\/li>\n<li>Nhi\u1ec5m khu\u1ea9n huy\u1ebft: th\u01b0\u1eddng ch\u1ec9 tho\u00e1ng qua.<\/li>\n<li>T\u1ee5 m\u00e1u trong th\u00e0nh.<\/li>\n<\/ul>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<ol>\n<li>N\u1ed9i soi ti\u00eau ho\u00e1. B\u1ec7nh vi\u1ec7n B\u1ea1ch Mai<\/li>\n<li>Abraham H. Dachman, Andrea Laghi (2011), Atlas of Virtual colonscopy. Springer.<\/li>\n<li>Gastrointestinal Endoscopy in practice<\/li>\n<li>Jean Macr Canard (2011), Gastrointestinal Endoscopy in practice. Elsevier Churchill Livingstone.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Sinh thi\u1ebft qua n\u1ed9i soi l\u00e0 m\u1ed9t \u01b0u \u0111i\u1ec3m v\u01b0\u1ee3t tr\u1ed9i c\u1ee7a n\u1ed9i soi ti\u00eau h\u00f3a v\u1edbi kh\u1ea3 n\u0103ng h\u01b0\u1edbng d\u1eabn sinh thi\u1ebft ni\u00eam m\u1ea1c \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m v\u1ec1 m\u00f4 b\u1ec7nh h\u1ecdc, g\u00f3p ph\u1ea7n ch\u1ea9n \u0111o\u00e1n m\u1ed9t c\u00e1ch ch\u00ednh x\u00e1c th\u01b0\u01a1ng t\u1ed5n. C\u00f9ng v\u1edbi s\u1ef1 ti\u1ebfn b\u1ed9 c\u1ee7a khoa h\u1ecdc c\u00f4ng ngh\u1ec7, sinh thi\u1ebft [&hellip;]<\/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":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>K\u1ef9 thu\u1eadt sinh thi\u1ebft qua n\u1ed9i soi - Vinmec<\/title>\n<meta name=\"description\" content=\"Sinh thi\u1ebft qua n\u1ed9i soi l\u00e0 m\u1ed9t \u01b0u \u0111i\u1ec3m v\u01b0\u1ee3t tr\u1ed9i v\u1edbi kh\u1ea3 n\u0103ng h\u01b0\u1edbng d\u1eabn sinh thi\u1ebft ni\u00eam m\u1ea1c \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m v\u1ec1 m\u00f4 b\u1ec7nh h\u1ecdc\" \/>\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=\"K\u1ef9 thu\u1eadt sinh thi\u1ebft qua n\u1ed9i soi - 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