{"id":2656,"date":"2023-04-09T16:23:54","date_gmt":"2023-04-09T09:23:54","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2656"},"modified":"2023-04-10T19:24:41","modified_gmt":"2023-04-10T12:24:41","slug":"giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/","title":{"rendered":"Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay \u1ee9ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi"},"content":{"rendered":"<p><strong>H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 t\u00ecnh tr\u1ea1ng d\u00e2y th\u1ea7n kinh gi\u1eefa b\u1ecb ch\u00e8n \u00e9p \u1edf \u1ed1ng c\u1ed5 tay c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 sau ch\u1ea5n th\u01b0\u01a1ng, l\u1eafng \u0111\u1ecdng tinh th\u1ec3 trong b\u1ec7nh Gout,,.. trong \u0111\u00f3 t\u1ef7 l\u1ec7 cao c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng x\u00e1c \u0111\u1ecbnh r\u00f5 \u0111\u01b0\u1ee3c c\u0103n nguy\u00ean ch\u00e8n \u00e9p, t\u1ea1m g\u1ecdi l\u00e0 v\u00f4 c\u0103n v\u00e0 cho r\u1eb1ng c\u00f3 th\u1ec3 l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a t\u00ecnh tr\u1ea1ng t\u0103ng \u00e1p l\u1ef1c kho\u1ea3ng k\u1ebd trong \u1ed1ng c\u1ed5 tay do c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c nhau. Th\u00f4ng qua b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang t\u00f4i tr\u00ecnh b\u00e0y v\u1ea5n \u0111\u1ec1 \u0111\u1ea7u ti\u00ean trong vi\u1ec7c ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb HC \u1ed1ng c\u1ed5 tay b\u1eb1ng n\u1ed9i soi: Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay v\u00e0 th\u1ea7n kinh gi\u1eefa.<\/strong><\/p>\n<p>Nh\u00f3m t\u00e1c gi\u1ea3:<\/p>\n<p>PGS. TS. Tr\u1ea7n Trung D\u0169ng, BS Ma Ng\u1ecdc Th\u00e0nh, TS. Nguy\u1ec5n Th\u1ecb Li\u1ec5u, BS. Tr\u1ea7n Quy\u1ebft<\/p>\n<p>Ng\u00e0y ph\u00e1t h\u00e0nh: 9\/4\/2023<\/p>\n<h2><strong>1. H\u00ecnh th\u1ec3 \u1ed1ng c\u1ed5 tay<\/strong><\/h2>\n<ul>\n<li><a href=\"https:\/\/www.vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/tim-hieu-ve-hoi-chung-ong-co-tay\/\">\u1ed0ng c\u1ed5 tay<\/a> l\u00e0 \u0111\u01b0\u1eddng h\u1ea7m n\u1eb1m \u1edf m\u1eb7t tr\u01b0\u1edbc c\u1ed5 tay, n\u1ed1i khoang g\u1ea5p c\u1ee7a m\u1eb7t tr\u01b0\u1edbc c\u1eb3ng tay v\u1edbi \u00f4 gi\u1eefa gan b\u00e0n tay. \u0110\u01b0\u1ee3c c\u1ea5u t\u1ea1o b\u1edfi m\u1eb7t sau v\u00e0 hai b\u00ean l\u00e0 c\u00e1c x\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay, m\u1eb7t tr\u01b0\u1edbc l\u00e0 m\u1ea1c h\u00e3m g\u00e2n g\u1ea5p hay c\u00f2n g\u1ecdi l\u00e0 d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay (transverse carpal ligament &#8211; TCL).<\/li>\n<li>Chi\u1ec1u d\u00e0i kho\u1ea3ng t\u1eeb 20 mm \u0111\u1ebfn 25 Th\u1ec3 t\u00edch c\u1ee7a \u1ed1ng c\u1ed1 tay kho\u1ea3ng 5ml v\u00e0 thay \u0111\u1ed5i t\u00f9y thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc c\u1ee7a b\u00e0n tay, th\u01b0\u1eddng nh\u1ecf h\u01a1n \u1edf n\u1eef gi\u1edbi. Khu v\u1ef1c c\u1eaft ngang qua \u00f4ng c\u1ed1 tay c\u00f3 di\u1ec7n t\u00edch kho\u1ea3ng 185 mm<sup>2<\/sup> v\u00e0 chi\u1ebfm kho\u1ea3ng 20% t\u1ed5ng di\u1ec7n t\u00edch m\u1eb7t c\u1eaft ngang c\u1ee7a c\u1ed5 tay.<\/li>\n<li>Chi\u1ec1u r\u1ed9ng c\u1ee7a OCT trung b\u00ecnh l\u00e0 25 mm, trong \u0111\u00f3 \u0111\u1ea7u g\u1ea7n l\u00e0 20 mill v\u00f9ng h\u1eb9p nh\u1ea5t \u1edf ngang m\u1ee9c m\u1ecfm x\u01b0\u01a1ng m\u00f3c, v\u1ea3 \u0111\u1ea7u xa l\u00e0 26 mm. Chi\u1ec1u s\u00e2u kho\u1ea3ng 12 mm \u1edf \u0111\u1ea7u g\u1ea7n v\u00e0 13 mm \u1edf \u0111\u1ea7u xa. Chi\u1ec3u s\u00e2u t\u1ea1i \u0111i\u1ec3m h\u1eb9p nh\u1ea5t l\u00e0 10 mm \u1edf ngang m\u1ee9c x\u01b0\u01a1ng m\u00f3c, v\u00ec v\u00f9ng n\u00e0y l\u00e0 v\u00f9ng g\u1ed3 l\u00ean c\u1ee7a x\u01b0\u01a1ng c\u1ed5 tay \u1edf m\u1eb7t sau v\u00e0 ph\u1ea7n \u0111\u00e0y nh\u1ea5t c\u1ee7a TCL \u1edf tr\u01b0\u1edbc.\n<figure id=\"attachment_2660\" aria-describedby=\"caption-attachment-2660\" style=\"width: 458px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\" wp-image-2660\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/oct.jpg\" alt=\"thiet-do-cat-qua-phia-gan-cua-ong-co-tay\" width=\"458\" height=\"283\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/oct.jpg 502w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/oct-300x185.jpg 300w\" sizes=\"(max-width: 458px) 100vw, 458px\" \/><figcaption id=\"caption-attachment-2660\" class=\"wp-caption-text\">Thi\u1ebft \u0111\u1ed3 c\u1eaft qua ph\u00eda g\u1ea7n c\u1ee7a \u1ed1ng c\u1ed5 tay<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<ul>\n<li>Chi\u1ec1u d\u00e0i kho\u1ea3ng t\u1eeb 20 mm \u0111\u1ebfn 25 Th\u1ec3 t\u00edch c\u1ee7a \u1ed1ng c\u1ed1 tay kho\u1ea3ng 5ml v\u00e0 thay \u0111\u1ed5i t\u00f9y thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc c\u1ee7a b\u00e0n tay, th\u01b0\u1eddng nh\u1ecf h\u01a1n \u1edf n\u1eef gi\u1edbi. Khu v\u1ef1c c\u1eaft ngang qua \u00f4ng c\u1ed1 tay c\u00f3 di\u1ec7n t\u00edch kho\u1ea3ng 185 mm<sup>2<\/sup> v\u00e0 chi\u1ebfm kho\u1ea3ng 20% t\u1ed5ng di\u1ec7n t\u00edch m\u1eb7t c\u1eaft ngang c\u1ee7a c\u1ed5 tay.<\/li>\n<li>C\u00e1c x\u01b0\u01a1ng c\u1ed5 tay kh\u00f4ng c\u1ed1 \u0111\u1ecbnh m\u00e0 c\u00f3 s\u1ef1 v\u1eadn \u0111\u1ed9ng khi c\u1ed5 tay g\u1ea5p du\u1ed7i. Khi g\u1ea5p c\u1ed5 tay di\u1ec7n t\u00edch c\u1eaft ngang c\u1ee7a \u1ed1ng c\u1ed5 tay ph\u00eda g\u1ea7n t\u0103ng 20%, nh\u01b0ng ph\u00eda xa b\u1ecb \u0111\u00e8 \u00e9p h\u1eb9p l\u1ea1i, khi du\u1ed7i th\u1ec3 t\u00edch \u1ed1ng c\u1ed1 tay h\u1eb9p l\u1ea1i, nh\u1ea5t l\u00e0 khi du\u1ed7i t\u1ed1i \u0111a khi \u0111\u00f3 x\u01b0\u01a1ng nguy\u1ec7t s\u1ebd \u0111\u00e8 \u00e9p v\u00e0o trong \u1ed1ng c\u1ed5 tay. Ch\u00ednh v\u00ec v\u1eady m\u00e0 \u00e1p l\u1ef1c trong \u1ed5ng c\u1ed5 tay t\u0103ng l\u00ean, t\u0103ng cao nh\u1ea5t khi c\u1eb3ng tay s\u1ea5p v\u00e0 c\u1ed5 tay g\u1ea5p 90\u00b0. \u0110\u00e2y l\u00e0 c\u01a1 c\u1edf cho nghi\u1ec7m ph\u00e1p Phalen v\u00e0 Phalen ng\u01b0\u1ee3c tr\u00ean l\u00e2m s\u00e0ng.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><strong>2. C\u1ea5u t\u1ea1o x\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay<\/strong><\/h2>\n<p style=\"text-align: justify; line-height: 115%; margin: 0cm 0cm .0001pt 36.0pt;\"><span style=\"font-size: 11.0pt; line-height: 115%; color: black;\">G\u1ed3m \u0111\u1ea7u d\u01b0\u1edbi 2 x\u01b0\u01a1ng c\u1eb3ng tay, c\u00e1c x\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay v\u00e0 n\u1ec1n c\u00e1c x\u01b0\u01a1ng \u0111\u1ed1t b\u00e0n tay.<\/span><\/p>\n<figure id=\"attachment_2662\" aria-describedby=\"caption-attachment-2662\" style=\"width: 415px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-2662\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/xuong.jpg\" alt=\"cau-tao-xuong-vung-co-tay\" width=\"415\" height=\"496\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/xuong.jpg 415w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/xuong-251x300.jpg 251w\" sizes=\"(max-width: 415px) 100vw, 415px\" \/><figcaption id=\"caption-attachment-2662\" class=\"wp-caption-text\">C\u1ea5u t\u1ea1o x\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay<\/figcaption><\/figure>\n<h3><strong>2.1. \u0110\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay<\/strong><\/h3>\n<ul>\n<li>\u0110\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay to h\u01a1n th\u00e2n x\u01b0\u01a1ng v\u00e0 \u0111\u1ea7u tr\u00ean. Ph\u00eda ngo\u00e0i c\u00f3 m\u1ecfm tr\u00e2m quay.<\/li>\n<li>C\u00f3 di\u1ec7n kh\u1edbp v\u1edbi x\u01b0\u01a1ng tr\u1ee5 \u1edf b\u1edd tr\u1ee5 (b\u1edd trong), l\u00f5m h\u00ecnh tam gi\u00e1c c\u00f2n g\u1ecdi l\u00e0 khuy\u1ebft tr\u1ee5, t\u1ea1o n\u00ean kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi. Ph\u00eda d\u01b0\u1edbi c\u00f3 di\u1ec7n kh\u1edbp ti\u1ebfp kh\u1edbp v\u1edbi x\u01b0\u01a1ng thuy\u1ec1n v\u00e0 x\u01b0\u01a1ng nguy\u1ec7t t\u1ea1o n\u00ean kh\u1edbp quay c\u1ed3 tay.<\/li>\n<\/ul>\n<p>G\u00e3y \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay n\u1ebfu kh\u00f4ng n\u1eafn ch\u1ec9nh t\u1ed1t, can l\u1ec7ch c\u00f3 th\u1ec3 g\u00e2y n\u00ean gi\u1ea3m th\u1ec3 t\u00edch \u1ed5ng c\u1ed5 tay, l\u00e0m ch\u00e8n \u00e9p th\u1ea9n kinh gi\u1eefa, l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n c\u00f9a h\u1ed9i ch\u1ee9ng \u1ed0ng c\u1ed5 tay.<\/p>\n<h3><strong>2.2. \u0110\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng tr\u1ee5<\/strong><\/h3>\n<ul>\n<li>Nh\u1ecf h\u01a1n \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay. C\u00f3 m\u1ecfm tr\u00e2m tr\u1ee5 v\u00e0 di\u1ec7n kh\u1edbp v\u1edbi \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay \u1edd b\u1edd quay.<\/li>\n<\/ul>\n<p>\u0110\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng tr\u1ee5 kh\u00f4ng c\u00f3 kh\u1edbp tr\u1ef1c ti\u1ebfp v\u1edbi c\u00e1c x\u01b0\u01a1ng c\u1ed5 tay m\u00e0 qua m\u1ed9t ph\u1ee9c h\u1ee3p tam gi\u00e1c s\u1ee5n s\u1ee3i (triangular Fibrocartilaee complex &#8211; TFCC), t\u1ed5n th\u01b0\u01a1ng ph\u1ee9c h\u1ee3p n\u00e0y c\u00f3 th\u1ec3 g\u00e2y \u0111au v\u00f9ng c\u1ed5 tay t\u01b0\u01a1ng \u1ee9ng d\u01b0\u1edbi m\u1ecfm tr\u00e2m tr\u1ee5.<\/p>\n<h3><strong>2.3. C\u00e1c x\u01b0\u01a1ng c\u1ed5 tay<\/strong><\/h3>\n<ul>\n<li>G\u1ed3m c\u00f3 8 x\u01b0\u01a1ng x\u1ebfp th\u00e0nh 2 h\u00e0ng. Khi g\u1ea5p b\u00e0n tay v\u00e0o c\u0103ng tay, 4 x\u01b0\u01a1ng h\u00e0ng tr\u00ean \u0111i li\u1ec1n v\u1edbi \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u1eb3ng tay, 4 x\u01b0\u01a1ng h\u00e0ng d\u01b0\u1edbi \u0111i li\u1ec1n v\u1edbi c\u00e1c x\u01b0\u01a1ng b\u00e0n tay v\u00e0 g\u1ea5p v\u00e0o h\u00e0ng tr\u00ean.<\/li>\n<li>B\u1ed1n x\u01b0\u01a1ng h\u00e0ng tr\u00ean theo th\u1ee9 t\u1ee5 t\u1eeb ngo\u00e0i v\u00e0o trong: x\u01b0\u01a1ng thuy\u1ec1n, x\u01b0\u01a1ng nguy\u1ec7t, x\u01b0\u01a1ng th\u00e1p, x\u01b0\u01a1ng \u0111\u1eadu<\/li>\n<li>B\u1ed1n x\u01b0\u01a1ng h\u00e0ng d\u01b0\u1edbi theo th\u1ee9 t\u1ef1 t\u1eeb ngo\u00e0i v\u00e0o trong: x\u01b0\u01a1ng thang, x\u01b0\u01a1ng th\u00ea, x\u01b0\u01a1ng c\u1ea3, x\u01b0\u01a1ng m\u00f3c.<\/li>\n<\/ul>\n<p>C\u00e1c x\u01b0\u01a1ng c\u1ed5 tay t\u1ea1o th\u00e0nh m\u1ed9t h\u00ecnh l\u00f2ng m\u00e1ng l\u00f5m \u1edd gi\u1eefa g\u1ecdi l\u00e0 r\u00e3nh c\u1ed5 tay v\u00e0 nh\u00f4 l\u00ean 2 b\u1edd.<\/p>\n<ul>\n<li>B\u1edd ngo\u00e0i l\u00e0 c\u1ee7 x\u01b0\u01a1ng thuy\u1ec1n v\u00e0 c\u1ee7 x\u01b0\u01a1ng thang<\/li>\n<li>B\u1edd trong l\u00e0 x\u01b0\u01a1ng \u0111\u1eadu v\u00e0 m\u00f3c cua x\u01b0\u01a1ng m\u00f3c<\/li>\n<\/ul>\n<p>N\u1ed1i gi\u1eefa 2 b\u1edd c\u00f3 m\u1ed9t m\u1ea1c r\u1ed9ng, ch\u1eafc kh\u1ecfe g\u1ecdi l\u00e0 h\u00e3m c\u00e1c g\u00e2n g\u1ea5p (hay d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay) bi\u1ebfn r\u00e3nh c\u1ed5 tay th\u00e0nh \u1ed1ng c\u1ed5 tay: cho c\u00e1c g\u00e2n g\u1ea5p v\u00e0 th\u1ea7n kinh \u0111i qua.<\/p>\n<ul>\n<li>Ph\u00eda tr\u00ean c\u00f3 kh\u1edbp quay c\u1ed5 tay g\u1ed3m \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay v\u1edbi x\u01b0\u01a1ng thuy\u1ec1n v\u00e0 x\u01b0\u01a1ng nguy\u1ec7t.<\/li>\n<li>Ph\u00eda d\u01b0\u1edbi kh\u1ed1i x\u01b0\u01a1ng c\u00f4 tay ti\u1ebfp kh\u1edbp v\u1edbi n\u1ec1n c\u00e1c x\u01b0\u01a1ng b\u00e0n tay.<\/li>\n<\/ul>\n<p>C\u00e1c ch\u1ea5n th\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay hay g\u1eb7p nh\u01b0 g\u00e3y x\u01b0\u01a1ng Thuy\u1ec1n, c\u00f3 th\u1ec3 k\u00e8m theo tr\u1eadt x\u01b0\u01a1ng Nguy\u1ec7t c\u00f3 th\u1ec3 g\u00e2y n\u00ean hi\u1ec7n t\u01b0\u1ee3ng ch\u00e8n \u00e9p trong \u1ed1ng c\u1ed5 tay.<\/p>\n<h4>2.3.1.<a href=\"https:\/\/www.vinmec.com\/vi\/co-xuong-khop\/suc-khoe-thuong-thuc\/lam-gi-khi-gay-xuong-thuyen-co-tay\/\"> X\u01b0\u01a1ng thuy\u1ec1n<\/a><\/h4>\n<p>L\u00e0 x\u01b0\u01a1ng n\u1eb1m ngo\u00e0i nh\u1ea5t v\u00e0 to nh\u1ea5t c\u1ee7a h\u00e0ng tr\u00ean x\u01b0\u01a1ng c\u1ed1 lay. X\u01b0\u01a1ng thuy\u1ec1n g\u1ed3m: C\u1ef1c g\u1ea7n (\u0111\u1ee9ng d\u1ecdc, h\u01a1i nghi\u00eang xu\u1ed1ng d\u01b0\u1edbi v\u00e0 ra ngo\u00e0i) v\u00e0 c\u1ef1c xa (n\u1eb1m ngang, ch\u00e9o ra tr\u01b0\u1edbc v\u00e0 ra ngo\u00e0i). N\u1ed1i gi\u1eefa c\u1ef1c g\u1ea7n v\u00e0 c\u1ef1c xa l\u00e0 eo. X\u01b0\u01a1ng thuy\u1ec1n cong l\u00f5m v\u1ec1 ph\u00eda x\u01b0\u01a1ng tr\u1ee5. Ph\u00eda tr\u00ean ti\u1ebfp kh\u1edbp v\u1edbi x\u01b0\u01a1ng quay, ph\u00eda d\u01b0\u1edbi v\u00e0 trong v\u1edbi x\u01b0\u01a1ng thang, x\u01b0\u01a1ng th\u00ea, x\u01b0\u01a1ng nguy\u1ec7t.<\/p>\n<p>L\u1ed3i c\u1ee7 x\u01b0\u01a1ng thuy\u1ec1n \u1edf ch\u1ed7 n\u1ed5i c\u1ef1c xa c\u1ee7a m\u1eb7t l\u01b0ng v\u00e0 m\u1eb7t l\u00f2ng. L\u00e0 n\u01a1i b\u00e1m c\u1ee7a d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay.<\/p>\n<h4>2.3.2. X\u01b0\u01a1ng nguy\u1ec7t<\/h4>\n<p>H\u00ecnh b\u00e1n nguy\u1ec7t, ti\u1ebfp kh\u1edbp v\u1edbi x\u01b0\u01a1ng quay, x\u01b0\u01a1ng thuy\u1ec1n, x\u01b0\u01a1ng c\u1ea3, x\u01b0\u01a1ng th\u00e1p. Khi b\u1ecb ch\u1ea5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 tr\u1eadt ra tr\u01b0\u1edbc g\u00e2y ch\u00e8n \u00e9p trong \u1ed1ng c\u1ed5 tay.<\/p>\n<h4>2.3.3. X\u01b0\u01a1ng th\u00e1p<\/h4>\n<p>H\u00ecnh th\u00e1p, ti\u1ebfp kh\u1edbp v\u1edbi x\u01b0\u01a1ng nguy\u1ec7t, x\u01b0\u01a1ng m\u00f3c.<\/p>\n<h4>2.3.4.X\u01b0\u01a1ng \u0111\u1eadu<\/h4>\n<p>H\u00ecnh h\u1ea1t \u0111\u1eadu, n\u1eb1m tr\u01b0\u1edbc x\u01b0\u01a1ng th\u00e1p, c\u00f3 g\u00e2n g\u1ea5p c\u1ed5 tay tr\u1ee5 v\u00e0 d\u00e2y ch\u1eb3ng ngang c\u1ed1 tay b\u00e1m v\u00e0o.<\/p>\n<h4>2.3.5. X\u01b0\u01a1ng thang<\/h4>\n<p>H\u00ecnh thang, ti\u1ebfp kh\u1edbp v\u1edbi x\u01b0\u01a1ng thuy\u1ec1n, n\u1ec1n x\u01b0\u01a1ng \u0111\u1ed1t b\u00e0n ng\u00f3n I, x\u01b0\u01a1ng th\u00ea, m\u1eb7t tr\u01b0\u1edbc x\u01b0\u01a1ng thang c\u00f3 c\u1ee7 x\u01b0\u01a1ng thang, l\u00e0 ch\u1ed7 b\u00e1m c\u1ee7a m\u1ed9t ph\u1ea7n d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay.<\/p>\n<h4><u>2.3.6<\/u> X\u01b0\u01a1ng th\u00ea<\/h4>\n<p>Nh\u1ecf h\u01a1n, n\u1eb1m \u1edf gi\u1eefa x\u01b0\u01a1ng thang, x\u01b0\u01a1ng c\u1ea3, n\u1ec1n x\u01b0\u01a1ng \u0111\u1ed1t b\u00e0n II.<\/p>\n<h4>2.3.7. X\u01b0\u01a1ng c\u1ea3<\/h4>\n<p>L\u00e0 x\u01b0\u01a1ng l\u1edbn nh\u1ea5t \u1edf c\u1ed5 tay, n\u1eb1m ch\u00ednh gi\u1eefa tr\u1ee5c c\u1ed5 tay, ti\u1ebfp kh\u1edbp v\u1edbi x\u01b0\u01a1ng nguy\u1ec7t \u1edf tr\u00ean, hai b\u00ean l\u1ea3 x\u01b0\u01a1ng th\u00ea v\u00e0 x\u01b0\u01a1ng m\u00f3c, ph\u00eda d\u01b0\u1edbi ti\u1ebfp kh\u1edbp v\u1edbi x\u01b0\u01a1ng \u0111\u1ed1t b\u00e0n III. C\u00f9ng v\u1edbi x\u01b0\u01a1ng th\u00ea, x\u01b0\u01a1ng nguy\u1ec7t l\u00e0 m\u1eb7t sau c\u1ee7a \u1ed1ng c\u1ed5 tay.<\/p>\n<h4>2.3.8.\u00a0 X\u01b0\u01a1ng m\u00f3c<\/h4>\n<p>M\u1eb7t tr\u01b0\u1edbc c\u00f3 m\u1ed9t m\u1ecfm g\u1ecdi l\u00e0 m\u00f3c c\u1ee7a x\u01b0\u01a1ng m\u00f3c, m\u1ed9t ph\u1ea7n c\u1ee7a d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay b\u00e1m v\u00e0o \u0111\u00e2y.<\/p>\n<h3><strong>2.4. C\u00e1c x\u01b0\u01a1ng \u0111\u1ed1t b\u00e0n tay<\/strong><\/h3>\n<p>G\u1ed3m c\u00f3 5 x\u01b0\u01a1ng \u0111\u1ed1t b\u00e0n, ti\u1ebfp kh\u1edbp v\u1edbi h\u00e0ng d\u01b0\u1edbi c\u1ee7a c\u00e1c x\u01b0\u01a1ng co tay t\u1ea1i n\u1ec1n c\u00e1c x\u01b0\u01a1ng \u0111\u1ed1t b\u00e0n.<\/p>\n<p><strong>M\u1ea1c h\u00e3m g\u00e2n g\u1ea5p<\/strong><\/p>\n<p>M\u1ea1c h\u00e3m g\u00e2n g\u1ea5p (flexor retinaculum) hay c\u00f2n g\u1ecdi l\u00e0 D\u00e2y ch\u1eb1ng ngang c\u1ed5 tay (transverse carpal ligament &#8211; TCL), \u0111\u00e2y l\u00e0 2 thu\u1eadt ng\u1eef \u0111\u1ed3ng ngh\u0129a, l\u00e0 m\u1ed9t t\u1ed5 ch\u1ee9c x\u01a1 s\u1ee3i n\u1ed1i t\u1eeb b\u1edd ngo\u00e0i l\u00e0 c\u1ee7 x\u01b0\u01a1ng thuy\u1ec1n v\u00e0 c\u1ee7 x\u01b0\u01a1ng thang t\u1edbi b\u1edd trong l\u00e0 x\u01b0\u01a1ng \u0111\u1eadu v\u00e0 m\u00f3c c\u1ee7a x\u01b0\u01a1ng m\u00f3c, gi\u1edbi h\u1ea1n tr\u00ean t\u01b0\u01a1ng \u1ee9ng v\u1edbi \u0111\u1ea7u d\u01b0\u1edbi 2 x\u01b0\u01a1ng c\u1eb3ng tay, gi\u1edbi h\u1ea1n d\u01b0\u1edbi t\u01b0\u01a1ng \u1ee9ng v\u1edbi n\u1ec1n x\u01b0\u01a1ng \u0111\u1ed1t b\u00e0n III.<\/p>\n<figure id=\"attachment_2666\" aria-describedby=\"caption-attachment-2666\" style=\"width: 675px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-2666\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-537.png\" alt=\"Anh-day-chang-ngang-co-tay\" width=\"675\" height=\"386\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-537.png 675w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-537-300x172.png 300w\" sizes=\"(max-width: 675px) 100vw, 675px\" \/><figcaption id=\"caption-attachment-2666\" class=\"wp-caption-text\">\u1ea2nh: D\u00e2y ch\u1eb1ng ngang c\u1ed5 tay<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>\u0110\u00e2y l\u00e0 \u0111\u00e2y ch\u1eb1ng n\u1eb1m ngang, c\u1ea5u t\u1ea1o b\u1edfi t\u1ed5 ch\u1ee9c x\u01a1 kh\u1ecfe, ch\u1eafc n\u1eb1m ch\u00ednh gi\u1eefa m\u1eb7t tr\u01b0\u1edbc c\u1ed5 tay, g\u00f3p ph\u1ea7n gi\u1eef v\u00f2m m\u1eb7t tr\u01b0\u1edbc c\u1ed5 tay. Ch\u1ee9c n\u0103ng c\u1ee7a n\u00f3 gi\u1ed1ng nh\u01b0 m\u1ed9t r\u00f2ng r\u1ecdc (pulley) c\u1ee7a g\u00e2n g\u1ea5p. Hai b\u00ean l\u00e0 \u00f4 m\u00f4 c\u00e1i v\u00e0 \u00f4 m\u00f4 \u00fat. Ph\u00eda tr\u01b0\u1edbc l\u00e0 c\u00e2n n\u00f4ng c\u1ed5 tay v\u00e0 da. C\u00e2n n\u00f4ng c\u1ed5 tay l\u00e0 t\u1ed5 ch\u1ee9c x\u01a1 c\u00f3 h\u01b0\u1edbng ch\u1ea1y d\u1ecdc, ph\u00eda tr\u00ean li\u00ean ti\u1ebfp v\u1edbi g\u00e2n gan tay d\u00e0i, ph\u00eda d\u01b0\u1edbi li\u00ean ti\u1ebfp v\u1edbi c\u00e2n n\u00f4ng b\u00e0n tay.<\/p>\n<p>Chi\u1ec1u ngang t\u1eeb b\u1edd tr\u1ee5 \u0111\u1ebfn b\u1edd quay c\u1ee7a TCL trung b\u00ecnh l\u00e0 22 mm. Chi\u1ec1u d\u00e0i trung b\u1ec9nh theo chi\u1ec1u tr\u00ean d\u01b0\u1edbi l\u00e0 26min. Ch\u1ed3 d\u00e0y nh\u1ea5t l\u00e0 1.6 mm. Ph\u00eda g\u1ea7n v\u00e0 ph\u00eda xa trung b\u00ecnh 0.6 111111. K\u00edch th\u01b0\u1edbc n\u00e0y t\u00f9y thu\u1ed9c v\u00e0o t\u1eebng c\u00e1 nh\u00e2n v\u00e0 ch\u1ee7ng t\u1ed9c, d\u00e2y ch\u1eb1ng \u0111\u01b0\u1ee3c \u0111o khi c\u1eaft hay \u0111\u1ec3 nguy\u00ean.<\/p>\n<p>TCL c\u00f3 h\u1ec7 th\u1ed1ng c\u00e1c m\u1ea1ch m\u00e1u nh\u1ecf nu\u00f4i d\u01b0\u1ee1ng. M\u1eb7t tr\u01b0\u1edbc c\u00f3 c\u00e1c m\u1ea1ch nh\u1ecf t\u00e1ch t\u1eeb nh\u00e1nh c\u00f9ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch tr\u1ee5 v\u00e0 nh\u00e1nh gan tay c\u1ee7a \u0111\u1ed9ng m\u1ea1ch quay. M\u1eb7t sau c\u00f3 c\u00e1c m\u1ea1ch t\u00e1ch t\u00f9 cung m\u1ea1ch gan tay n\u00f4ng. Tuy nhi\u00ean c\u00e1c m\u1ea1ch n\u00e0y r\u1ea5t nh\u1ecf, kh\u00f4ng g\u00e2y ch\u1ea3y m\u00e1u khi c\u1eaft.<\/p>\n<figure id=\"attachment_2668\" aria-describedby=\"caption-attachment-2668\" style=\"width: 595px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-2668\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mm.jpg\" alt=\"h\u1eb9-thong-mach-mau-cua-TCL\" width=\"595\" height=\"358\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mm.jpg 595w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mm-300x181.jpg 300w\" sizes=\"(max-width: 595px) 100vw, 595px\" \/><figcaption id=\"caption-attachment-2668\" class=\"wp-caption-text\">H\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u c\u1ee7a TCL<\/figcaption><\/figure>\n<p><strong><u>C\u00e1c th\u00e0nh ph\u1ea7n trong OCT<\/u><\/strong><\/p>\n<p>&nbsp;<\/p>\n<div class=\"mceTemp\">\n<p><img decoding=\"async\" loading=\"lazy\" class=\" wp-image-2671\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-538.png\" alt=\"ong-co-tay-nhin-tu-mat-gan-tay\" width=\"477\" height=\"278\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-538.png 839w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-538-300x175.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-538-768x448.png 768w\" sizes=\"(max-width: 477px) 100vw, 477px\" \/><\/p>\n<h3 style=\"text-align: left;\"><strong>2.5. C\u00e1c g\u00e2n \u0111i trong OCT\u00a0 \u00a0\u00a0<\/strong><\/h3>\n<\/div>\n<h4 style=\"text-align: left;\">2.5.1. G\u00e2n g\u1ea5p d\u00e0i ng\u00f3n d\u00e0i<\/h4>\n<ul>\n<li>Nguy\u00ean \u1ee7y c\u00f9a c\u01a1 g\u1ea5p d\u00e0i ng\u00f3n c\u00e1i l\u00e0 m\u1eb7t tr\u01b0\u1edbc x\u01b0\u01a1ng quay.<\/li>\n<li>B\u00e1m t\u1eadn: \u0111\u1ed1t 2 ng\u00f3n c\u00e1i<\/li>\n<li>\u0110\u1ed9ng t\u00e1c: g\u1ea5p \u0111\u1ed1t II v\u00e0o \u0111\u1ed1t I, g\u1ea5p \u0111\u1ed1t I v\u00e0o b\u00e0n tay.<\/li>\n<li>Trong \u1ed1ng c\u1ed5 tay g\u00e2n n\u1eb1m \u1edf ph\u00eda b\u1edd quay v\u00e0 n\u1eb1m trong bao ho\u1ea1t d\u1ecbch quay.<\/li>\n<\/ul>\n<h4>2.5.2. G\u00e2n g\u1ea5p s\u00e2u c\u00e1c ng\u00f3n<\/h4>\n<ul>\n<li>Nguy\u00ean \u1ee7y c\u1ee7a c\u01a1 g\u1ea5p s\u00e2u c\u00e1c ng\u00f3n l\u00e0 m\u1eb7t tr\u01b0\u1edbc trong x\u01b0\u01a1ng tr\u1ee5, m\u1ecfm v\u1eb9t v\u00e0 m\u00e0ng gian c\u1ed1t c\u1eb3ng tay.<\/li>\n<li>B\u00e1m t\u1eadn: c\u00f3 4 g\u00e2n \u0111i xu\u1ed1ng c\u00e1c ng\u00f3n t\u1eeb II-V, ch\u1ecdc qua g\u00e2n th\u1ee7ng b\u00e1m v\u00e0o n\u1ec1n \u0111\u1ed1t III c\u00e1c ng\u00f3n.<\/li>\n<li>\u0110\u1ed9ng t\u00e1c: g\u1ea5p \u0111\u1ed1t II v\u00e0o \u0111\u1ed1t \u1ec9, g\u1ea5p \u0111\u1ed1t I v\u00e0o b\u00e0n tay. G\u1ea5p b\u00e0n tay v\u00e0o c\u1ea3ng tay.<\/li>\n<li>Trong \u1ed5ng c\u1ed5 tay 4 g\u00e2n x\u1ebfp \u1edf h\u00e0ng sau.<\/li>\n<\/ul>\n<h4>2.5.3.G\u00e2n g\u1ea5p n\u00f4ng c\u00e1c ng\u00f3n<\/h4>\n<ul>\n<li>Nguy\u00ean \u1ee7y: b\u00e1m m\u1ecfm tr\u00ean l\u1ed3i trong x\u01b0\u01a1ng c\u00e1nh tay, m\u1ecfm v\u1eb9t x\u01b0\u01a1ng tr\u1ee5, b\u1edd tr\u01b0\u1edbc x\u01b0\u01a1ng quay<\/li>\n<li>B\u00e1m t\u1eadn: c\u00f3 4 g\u00e2n chia l\u00e0m 2 ch\u1ebd, b\u00e1m 2 b\u00ean s\u01b0\u1eddn n\u1ec1n \u0111\u1ed1t gi\u1eefa ng\u00f3n tay t\u1eeb II-V<\/li>\n<li>\u0110\u1ed9ng t\u00e1c: G\u1ea5p \u0111\u1ed1t II v\u00e0o \u0111\u1ed1t I, g\u1ea5p b\u00e0n tay v\u00e0o c\u1eb3ng tay<\/li>\n<li>Trong \u1ed5ng c\u1ed5 tay 4 g\u00e2n n\u1eb1m \u1edf h\u00e0ng tr\u01b0\u1edbc.<\/li>\n<\/ul>\n<h3><strong>2.6. Th\u1ea7n kinh gi\u1eefa<\/strong><\/h3>\n<ul>\n<li>Th\u1ea7n kinh gi\u1eefa l\u00e0 m\u1ed9t d\u00e2y th\u1ea7n kinh h\u1ed7n h\u1ee3p c\u00e1 v\u1eadn \u0111\u1ed9ng v\u00e0 c\u1ea3m gi\u00e1c \u1edd chi tr\u00ean<\/li>\n<li>C\u1ea5u t\u1ea1o: \u0111\u01b0\u1ee3c t\u1ea1o b\u1edfi 2 r\u1ec5:<\/li>\n<\/ul>\n<p>+ R\u1ec5 ngo\u00e0i t\u00e1ch ra t\u1eeb b\u1ecf ngo\u00e0i \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay (b\u1eaft ngu\u1ed3n t\u1eeb r\u1ec5 c\u1ed5 5 \u0111\u1ebfn c\u1ed5 7)<\/p>\n<p>+ R\u1ec5 trong t\u00e1ch ra t\u1eeb b\u00f3 trong c\u1ee7a \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay (b\u1eaft ngu\u1ed3n t\u1eeb r\u1ec3 c\u1ed5 8 v\u00e0 r\u1ec5 ng\u1ef1c 1).<\/p>\n<ul>\n<li>\u0110\u01b0\u1eddng \u0111i v\u00e0 ph\u00e2n nh\u00e1nh v\u00e0 chi ph\u1ed1i: th\u1ea7n kinh gi\u1eefa \u0111i t\u1eeb h\u00f5m n\u00e1ch \u0111\u1ebfn c\u00e1nh tay, c\u1eb3ng tay, chui qua \u1ed1ng c\u1ed5 tay xu\u1ed1ng chi ph\u1ed1i c\u1ea3m gi\u00e1c v\u00e0 v\u1eadn \u0111\u1ed9ng c\u00e1c c\u01a1 b\u00e0n tay.<\/li>\n<\/ul>\n<p>D\u00e2y th\u1ea7n kinh gi\u1eefa kh\u00f4ng ph\u00e2n nh\u00e1nh \u1edf c\u00e1nh tay nh\u01b0ng c\u00f3 m\u1ed9t s\u1ed1 nh\u00e1nh v\u00e0o kh\u1edbp khu\u1ef7u. \u1ede h\u1ed1 khu\u1ef7u tr\u01b0\u1edbc d\u00e2y th\u1ea7n kinh n\u00e0y ch\u1ea1y s\u00e1t v\u1edbi \u0111\u1ed9ng m\u1ea1ch c\u00e1nh tay v\u00e0 \u0111i xu\u1ed1ng c\u1eb3ng tay gi\u1eefa hai \u0111\u1ea7u c\u1ee7a c\u01a1 s\u1ea5p tr\u00f2n, ph\u00e2n nh\u00e1nh chi ph\u1ed1i cho c\u01a1 s\u1ea5p tr\u00f2n, c\u01a1 g\u1ea5p c\u1ed5 tay quay, c\u01a1 g\u1ea5p c\u00e1c ng\u00f3n n\u00f4ng. Nh\u00e1nh gian c\u1ed1t tr\u01b0\u1edbc c\u1ee7a \u0111\u00e2y gi\u1eefa chi ph\u1ed1i c\u01a1 g\u1ea5p ng\u00f3n tay d\u00e0i, c\u00e1c c\u01a1 g\u1ea5p ng\u00f3n tay s\u00e2u c\u1ee7a c\u00e1c ng\u00f3n tr\u1ecf v\u00e0 ng\u00f3n gi\u1eefa, c\u01a1 s\u1ea5p vu\u00f4ng.<\/p>\n<p>Tr\u01b0\u1edbc khi \u0111i qua \u1ed1ng c\u1ed5 tay d\u00e2y th\u1ea7n kinh gi\u1eefa t\u00e1ch ra nh\u00e1nh c\u1ea3m gi\u00e1c \u0111a b\u00e0n tay ch\u1ea1y d\u01b0\u1edbi da v\u00e0 chi ph\u1ed1i c\u1ea3m gi\u00e1c v\u00f9ng \u00f4 m\u00f4 c\u00e1i, nh\u00e1nh n\u00e0y kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng trong h\u1ed9i ch\u1ee9ng \u1ed5ng c\u1ed5 tay nh\u01b0ng l\u1ea1i d\u1ec5 b\u1ecb t\u1ed5n th\u01b0\u01a1ng khi ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng n\u00e0y \u1edf b\u00e0n tay d\u00e2y th\u1ea7n kinh gi\u1eefa chia ra 5 nh\u00e1nh: 3 nh\u00e1nh gan ng\u00f3n tay, 1 nh\u00e1nh v\u1eadn \u0111\u1ed9ng cho m\u1ed9t s\u1ed5 c\u01a1 \u00f4 m\u00f4 c\u00e1i, 1 nh\u00e1nh n\u1ed1i v\u1edbi th\u1ea7n kinh tr\u1ee5.<\/p>\n<ul>\n<li>V\u1ec1 c\u1ea3m gi\u00e1c d\u00e2y th\u1ea7n kinh gi\u1eefa ch\u00ed ph\u1ed1i cho h\u01a1n m\u1ed9t n\u1eeda gan tay \u1edf ph\u00eda ngo\u00e0i (tr\u1eeb m\u1ed9t ph\u1ea7n nh\u1ecf da \u1edf ph\u00eda ngo\u00e0i m\u00f4 c\u00e1i do d\u00e2y th\u1ea7n kinh quay c\u1ea3m gi\u00e1c), m\u1eadt gan tay c\u1ee7a 3 ng\u00f3n r\u01b0\u1ee1i \u1edf ph\u00eda ngo\u00e0i ke t\u1eeb ng\u00f3n c\u00e1i v\u00e0 c\u1ea3 m\u1eb7t mu c\u00e1c \u0111\u1ed1t II-III c\u1ee7a c\u00e1c ng\u00f3n \u0111\u00f3. Trong h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay th\u01b0\u1eddng c\u1ecf t\u1ed5n th\u01b0\u01a1ng c\u1ea3m gi\u00e1c theo v\u00f9ng chi ph\u1ed1i n\u00e0y.<\/li>\n<\/ul>\n<figure id=\"attachment_2682\" aria-describedby=\"caption-attachment-2682\" style=\"width: 384px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-2682\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mc.jpg\" alt=\"than-kinh-giua-va-vung-chi-phoi-cam-giac-da-o-ban-tay\" width=\"384\" height=\"453\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mc.jpg 384w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/mc-254x300.jpg 254w\" sizes=\"(max-width: 384px) 100vw, 384px\" \/><figcaption id=\"caption-attachment-2682\" class=\"wp-caption-text\">Th\u1ea7n kinh gi\u1eefa v\u00e0 v\u00f9ng chi ph\u1ed1i c\u1ea3m gi\u00e1c da \u1edf b\u00e0n tay<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<ul>\n<li>V\u1ec1 v\u1eadn \u0111\u1ed9ng \u1edf b\u00e0n tay, d\u00e2y th\u1ea7n kinh n\u00e0y chi ph\u1ed1i c\u00e1c c\u01a1 giun th\u1ee9 nh\u1ea5t v\u00e0 th\u1ee9 hai, c\u01a1 \u0111\u1ed1i chi\u1ebfu ng\u00f3n c\u00e1i, c\u01a1 d\u1ea1ng ng\u1eafn ng\u00f3n c\u00e1i v\u00e0 \u0111\u00e0u n\u00f4ng c\u01a1 g\u1ea5p ng\u00f3n c\u00e1i ng\u1eafn. Khi t\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 th\u1ea5y c\u00e1c d\u1ea5u hi\u1ec7u kh\u00f3 d\u1ea1ng ng\u00f3n c\u00e1i k\u00e8m theo teo c\u01a1 \u00f4 m\u00f4 c\u00e1i. \u0110i\u1ec3m xu\u1ea5t ph\u00e1t nh\u00e1nh v\u1eadn \u0111\u1ed9ng th\u1ea7n kinh gi\u1eefa c\u00f3 th\u1ec3 thay \u0111\u1ed5i khi \u0111\u1ed1i chi\u1ec1u v\u1edbi b\u1edd xa c\u1ee7a m\u1ea1c gi\u1eef g\u00e2n g\u1ea5p.<\/li>\n<\/ul>\n<p>C\u00f3 c\u00e1c bi\u1ebfn th\u1ec3 c\u1ee7a nh\u00e1nh v\u1eadn \u0111\u1ed9ng c\u1ee7a th\u1ea7n kinh gi\u1eefa.<\/p>\n<ul>\n<li>Ngo\u00e0i d\u00e2y ch\u1eb1ng: Chi\u1ebfm 46%, c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y nh\u00e1nh \u0111i qua OCT r\u1ed3i qu\u1eb7t ng\u01b0\u1ee3c l\u1ea1i v\u00e0o c\u01a1 \u00f4 m\u00f4 c\u00e1i.<\/li>\n<li>D\u01b0\u1edbi d\u00e2y ch\u1eb1ng: Chi\u1ebfm 31%, c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y nh\u00e1nh xu\u1ea5t ph\u00e1t \u1edf v\u1ecb tr\u00ed ngay b\u00ean trong OCT, r\u1ed3i \u0111i v\u00f2ng qua b\u1edd xa c\u1ee7a TCL.<\/li>\n<li>Xuy\u00ean d\u00e2y ch\u1eb1ng: Chi\u1ebfm 23%, c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y nh\u00e1nh c\u0169ng xu\u1ea5t ph\u00e1t b\u00ean trong OCT nh\u01b0ng n\u00f3 \u0111i xuy\u00ean qua TCL.<\/li>\n<\/ul>\n<p>B\u1ea5t th\u01b0\u1eddng v\u1ec1 ph\u00e2n b\u1ed1 c\u1ee7a th\u1ea7n kinh gi\u1eefa th\u01b0\u1eddng g\u1eb7p l\u00e0 th\u00f4ng n\u1ed1i nh\u00e1nh m\u00f4 c\u00e1i c\u1ee7a th\u1ea7n kinh gi\u1eefa v\u1edbi nh\u00e1nh s\u00e2u c\u1ee7a th\u1ea7n kinh tr\u1ee5 \u1edf b\u00e0n tay v\u00e0 c\u00e1c ng\u00f3n g\u1ecdi l\u00e0 nh\u00e1nh Riche- Cannieu. \u00edt g\u1eb7p h\u01a1n (15- 31%) l\u00e0 th\u00f4ng n\u1ed1i ph\u1ea7n chi ph\u1ed1i b\u00e0n tay c\u1ee7a th\u1ea7n kinh gi\u1eefa v\u00e0o th\u1ea7n kinh tr\u1ee5 x\u1ea3y ra \u1edf c\u1eb3ng tay, th\u1ea7n kinh gi\u1eefa kh\u00f4ng \u0111i v\u00e0o b\u00e0n tay, \u0111\u01b0\u1ee3c bi\u1ebft nh\u01b0 l\u00e0 c\u1ea7u n\u1ed1i Martin &#8211; Gruber<\/p>\n<h2><strong>3. C\u00e1c th\u00e0nh ph\u1ea7n li\u00ean quan v\u00f9ng \u1ed1ng c\u1ed5 tay<\/strong><\/h2>\n<h3><strong>3.1. B\u00f3 m\u1ea1ch th\u1ea7n kinh tr\u1ee5 \u0111o\u1ea1n c\u1ed5 tay<\/strong><\/h3>\n<h4><strong>\u00a0\u00a0\u00a0 <\/strong>3.1.1. \u0110\u1ed9ng m\u1ea1ch tr\u1ee5<\/h4>\n<p>&#8211;\u00a0\u00a0\u00a0 T\u00e1ch ra t\u1eeb \u0111\u1ed9ng m\u1ea1ch c\u00e1nh tay d\u01b0\u1edbi n\u1ebfp g\u1ea5p khu\u1ef7u 3 cm, ch\u1ea1y ch\u1ebfch xu\u1ed1ng d\u01b0\u1edbi v\u00e0o trong. T\u1eeb 2\/3 d\u01b0\u1edbi c\u1eb3ng tay ch\u1ea1y theo \u0111\u01b0\u1eddng n\u1ed1i t\u1eeb m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u trong t\u1edbi b\u1edd ngo\u00e0i x\u01b0\u01a1ng \u0111\u1eadu, d\u1ecdc theo ph\u00eda ngo\u00e0i g\u00e2n g\u1ea5p c\u1ed5 tay tr\u1ee5.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0 \u0110o\u1ea1n c\u1ed5 tay \u0111\u1ed9ng mach tr\u1ee5 ch\u1ea1y tr\u01b0\u1edbc TCL c\u00f9ng v\u1edbi th\u1ea7n kinh tr\u1ee5 qua \u00f4ng Guyon (Guyon canal), n\u1eb1m ph\u00eda ngo\u00e0i th\u1ea7n kinh tr\u1ee5, t\u00e1ch ra nh\u00e1nh gan tay s\u00e2u n\u1ed1i v\u1edbi ng\u00e0nh c\u00f9ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch quay t\u1ea1o n\u00ean cung gan tay s\u00e2u<\/p>\n<p>&#8211;\u00a0\u00a0 \u00a0Ng\u00e0nh c\u00f9ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch tr\u1ee5 n\u1ed1i v\u1edbi nh\u00e1nh gan tay n\u00f4ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch quay t\u1ea1o th\u00e0nh \u00a0\u00a0\u00a0\u00a0\u00a0cung gan tay n\u00f4ng.<\/p>\n<h4>3.1.2. Th\u1ea7n kinh tr\u1ee5<\/h4>\n<p>&#8211;\u00a0\u00a0\u00a0 L\u00e0 d\u00e2y th\u1ea7n kinh h\u1ed3n h\u1ee3p \u1edf chi tr\u00ean, t\u00e1ch ra t\u1eeb b\u00f3 trong c\u1ee7a \u0111\u00e1m r\u1ed1i c\u00e1nh tay.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0 \u1ede 1\/2 d\u01b0\u1edbi c\u1eb3ng tay th\u1ea7n kinh tr\u1ee5 ch\u1ea1y theo c\u01a1 g\u1ea5p c\u1ed5 tay tr\u1ee5 c\u00f9ng \u0111\u1ed9ng m\u1ea1ch tr\u1ee5, song song \u1edf ph\u00eda trong \u0111\u1ed9ng m\u1ea1ch.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0 \u0110o\u1ea1n c\u1ed5 tay c\u00f9ng \u0111\u1ed9ng m\u1ea1ch tr\u1ee5 ch\u1ea1y tr\u01b0\u1edbc TCL \u1edf ph\u00eda ngo\u00e0i x\u01b0\u01a1ng \u0111\u1eadu \u0111\u1ec3 xu\u1ed1ng gan tay chia l\u00e0m hai ng\u00e0nh c\u00f9ng: n\u00f4ng v\u00e0 s\u00e2u. Khi ph\u1eabu thu\u1eadt n\u1ed9i soi n\u1ebfu \u0111\u1ec3 l\u01b0\u1ee1i dao h\u01b0\u1edbng v\u1ec1 ph\u00eda tr\u1ee5 nhi\u1ec1u, khi c\u1eaft TCL d\u1ec5 g\u00e2y t\u1ed5n th\u01b0\u01a1ng b\u00f3 m\u1ea1ch n\u00e0y.<\/p>\n<figure id=\"attachment_2683\" aria-describedby=\"caption-attachment-2683\" style=\"width: 653px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-2683\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-539.png\" alt=\"bo-mach-than-kinh-tru-doan-co-tay\" width=\"653\" height=\"368\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-539.png 653w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-539-300x169.png 300w\" sizes=\"(max-width: 653px) 100vw, 653px\" \/><figcaption id=\"caption-attachment-2683\" class=\"wp-caption-text\">B\u00f3 m\u1ea1ch th\u1ea7n kinh tr\u1ee5 \u0111o\u1ea1n c\u1ed5 tay<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<h3><strong>3.2. <\/strong><strong>Cung gan tay n\u00f4ng (Arcus palmaris superficialis)<\/strong><\/h3>\n<p>&#8211;\u00a0\u00a0 \u0110\u01b0\u1ee3c t\u1ea1o n\u00ean b\u1edfi s\u1ef1 ti\u1ebfp n\u1ed1i gi\u1eefa ng\u00e0nh c\u00f9ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch tr\u1ee5 v\u1edbi nh\u00e1nh gan tay n\u00f4ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch quay.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0 \u0110\u01b0\u1eddng \u0111i v\u00e0 \u0111\u1ecbnh m\u1ed1c: Ng\u00e0nh c\u00f9ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch tr\u1ee5 t\u1eeb b\u1edd ngo\u00e0i x\u01b0\u01a1ng \u0111\u1eadu ch\u1ea1y ch\u1ebfch xu\u1ed1ng d\u01b0\u1edbi v\u00e0 ra ngo\u00e0i theo h\u01b0\u1edbng v\u1ec1 khe ng\u00f3n II-III. \u0110en ngang m\u1ee9c b\u1edd d\u01b0\u1edbi ng\u00f3n c\u00e1i khi d\u1ea1ng t\u1ed1i \u0111a thi t\u1ea1t ra ngo\u00e0i n\u1ed1i v\u1edbi nh\u00e1nh gan tay n\u00f4ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch quay.<\/p>\n<p>&#8211;\u00a0\u00a0 Li\u00ean quan: cung \u0111\u1ed9ng m\u1ea1ch gan tay n\u00f4ng n\u1eb1m d\u01b0\u1edbi l\u1edbp c\u00e2n n\u00f4ng b\u00e0n tay \u1edf \u00f4 gan tay gi\u1eefa. N\u1eb1m ph\u00eda tr\u01b0\u1edbc c\u00e1c g\u00e2n g\u1ea5p n\u00f4ng c\u1ed5 tay. Ph\u1ea7n ngang c\u1ee7a cung n\u1eb1m d\u01b0\u1edbi b\u1edd d\u01b0\u1edbi TCL t\u1eeb 0,5 &#8211; lem. Khi ph\u1eabu thu\u1eadt n\u1ed9i soi n\u1ebfu \u0111\u01b0a dao v\u00e0o qu\u00e1 s\u00e2u d\u1ed7 g\u00e2y t\u1ed5n th\u01b0\u01a1ng cung \u0111\u1ed9ng m\u1ea1ch n\u00e0y.<\/p>\n<h3><strong>3.3. <\/strong><strong>Cung gan tay s\u00e2u (Arcus palmaris profond lis)<\/strong><\/h3>\n<p>&#8211;\u00a0\u00a0 \u0110\u01b0\u1ee3c t\u1ea1o n\u00ean b\u1edfi ng\u00e0nh c\u00f9ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch quay v\u00e0 nh\u00e1nh gan tay s\u00e2u c\u1ee7a \u0111\u1ed9ng m\u1ea1ch tr\u1ee5.<\/p>\n<p>&#8211;\u00a0\u00a0 Cung n\u00e0y n\u1eb1m s\u00e2u sau l\u00e1 m\u1ea1c s\u00e2u gan tay n\u00ean kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edbng khi ph\u1eabu thu\u1eadt.<\/p>\n<figure id=\"attachment_2684\" aria-describedby=\"caption-attachment-2684\" style=\"width: 697px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-2684\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-540.png\" alt=\"mach-mau-lien-quan-vung-OCT\" width=\"697\" height=\"364\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-540.png 697w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-540-300x157.png 300w\" sizes=\"(max-width: 697px) 100vw, 697px\" \/><figcaption id=\"caption-attachment-2684\" class=\"wp-caption-text\">M\u1ea1ch m\u00e1u li\u00ean quan v\u00f9ng OCT<\/figcaption><\/figure>\n<h3><strong>\u00a03.4<\/strong>. <strong>C\u00e1c \u1ed5 ho\u1ea1t d\u1ecbch v\u00f9ng c\u1ed1 b\u00e0n tay (g\u00e2n g\u1ea5p)<\/strong><\/h3>\n<h4>3.4.1. \u1ed4 ho\u1ea1t d\u1ecbch quay<\/h4>\n<p>Bao ho\u1ea1t \u0111\u1ecbch g\u00e2n g\u1ea5p d\u00e0i ng\u00f3n c\u00e1i k\u00e9o d\u00e0i l\u00ean c\u1ed5 tay g\u1ecdi l\u00e0 bao ng\u00f3n tay &#8211; c\u1ed5 tay ngo\u00e0i (bao quay): bao ch\u1ea1y qua m\u00f4 c\u00e1i v\u00e0 \u1ed1ng c\u1ed5 tay t\u1eadn h\u1ebft \u1edf tr\u00ean d\u00e2y ch\u1eb1ng ngang c\u1ed1 tay (m\u1ea1c h\u00e3m g\u00e2n g\u1ea5p) kho\u1ea3ng 3cm.<\/p>\n<h4>3.4.2. \u1ed4 ho\u1ea1t d\u1ecbch tr\u1ee5<\/h4>\n<p>Bao ho\u1ea1t d\u1ecbch ng\u00f3n tay &#8211; c\u1ed5 tay trong (bao tr\u1ee5): \u0111i t\u1eeb \u0111\u1ed1t 2-3 ng\u00f3n \u00fat l\u00ean t\u1edbi tr\u00ean m\u1ea1c h\u00e3m g\u00e2n g\u1ea5p kho\u1ea3ng 4cm. \u1edf \u00f4 gan tay gi\u1eefa v\u00e0 \u1ed1ng c\u1ed3 tay bao to\u1ea3 r\u1ed9ng \u0111\u1ec3 b\u1ecdc c\u1ea3 c\u00e1c g\u00e2n g\u1ea5p n\u00f4ng v\u00e0 g\u1ea5p s\u00e2u c\u1ee7a c\u00e1c ng\u00f3n kh\u00e1c, t\u1ea1o n\u00ean c\u00e1c t\u00fai c\u00f9ng \u1edf tr\u01b0\u1edbc g\u00e2n g\u1ea5p n\u00f4ng, \u1edf sau g\u00e2n g\u1ea9p s\u00e2u v\u00e0 l\u00e1ch gi\u1eefa hai l\u1edbp g\u00e2n n\u00e0y.<\/p>\n<figure id=\"attachment_2687\" aria-describedby=\"caption-attachment-2687\" style=\"width: 278px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-2687\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/bhd.jpg\" alt=\"he-thong-hoat-d\u1ecbch-gan-gap\" width=\"278\" height=\"419\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/bhd.jpg 278w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/bhd-199x300.jpg 199w\" sizes=\"(max-width: 278px) 100vw, 278px\" \/><figcaption id=\"caption-attachment-2687\" class=\"wp-caption-text\">H\u1ec7 th\u1ed1ng ho\u1ea1t d\u1ecbch g\u00e2n g\u1ea5p<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>T\u1ea2I LI\u1ec6U THAM KH\u1ea2O<\/p>\n<ol>\n<li>A. Berger p. Yugueros (2007), Anatomy of the Carpal Tunnel. Carpal tunnel syndrome. Vol. 2.: Springer, p. 10-12<\/li>\n<li>Tr\u1ecbnh V\u0103n Minh (2004), Gi\u1ea3i ph\u1eabu ng\u01b0\u1eddi.: NXB Y h\u1ecdc.<\/li>\n<li>Leti Acciaro A. Landi, N. Della Rosa, A. Pellacani (2007), Carpal Tunnel Syndrome: Rare Causes. Carpal Tunnel Syndrome. Vol. 13.: Springer, p.95-100<\/li>\n<li>Luchetti (2007), Etiopathogenesis. Carpal tunnel syndrome. Vol. 2., Springer, p. 21-27.<\/li>\n<li>-M. Schmidt (2007), Normal Anatomy and Variations of the Median Nerve in the Carpal Tunnel. Carpal tunnel syndrome. Vol. 3.: springer, p 13-19<\/li>\n<li>Robbins H ( 1963), Anatomical study of the median nerve in the carpal tunnel and etiologies of the carpal tunnel syndrome. J Bone Jt Surg. 45 A: 953-966<\/li>\n<li>Bauman TD, Gelberman RH, Mubarak SJ, Garfin SR (1981), The acute carpal tunnel syndrome. Clin Or (hop 156: 151-156<\/li>\n<li>Gelberman RH , Hergenroeder PT, Hargens AR (1981), The carpal tunnel syndrome. J Bone Jt Surg 63 A:380-383<\/li>\n<li>Keir PJ, Wells RP, Ranney DA, Lavery W( 1997), The effects of tendon load and posture on carpal tunnel pressure. JHandSurg 22 A: 628-634<\/li>\n<li>Okutsu I, Ninomiya s, Hamanaka I (1989),Measurement of pressure in the carpal canal before and after endoscopic management of carpal tunnel syndrome, J Bone Jt Sarg 71 A: 679-6<\/li>\n<li>Seradke H, Jia YC, Owens w (1995),111 vivo measurement of carpal tunnel<\/li>\n<li>pressure in the functioning hand. JHandSitrg 20\u00a0 A: 855-859<\/li>\n<li>Yoshioka s, Okuda Y, Tainai K (1993). Changes in the carpal tunnel shape during wrist motion. MR! evaluation of normal volunteers. J Hand Surg 18 B: 620-623<\/li>\n<\/ol>\n<p>14. Frank H. Netter (1998),Atias of Human Anatomy, 3.: Saunder.<\/p>\n<p>15. Gray H, Clemente CD (1985), Anatomy of the human body. \u00a13th\u00a0\u00a0\u00a0 ed, Le\u00a0 &amp; Febiger,\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Philadelphia, pp 531, 542, 551 2<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 t\u00ecnh tr\u1ea1ng d\u00e2y th\u1ea7n kinh gi\u1eefa b\u1ecb ch\u00e8n \u00e9p \u1edf \u1ed1ng c\u1ed5 tay c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 sau ch\u1ea5n th\u01b0\u01a1ng, l\u1eafng \u0111\u1ecdng tinh th\u1ec3 trong b\u1ec7nh Gout,,.. trong \u0111\u00f3 t\u1ef7 l\u1ec7 cao c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng x\u00e1c \u0111\u1ecbnh r\u00f5 \u0111\u01b0\u1ee3c c\u0103n nguy\u00ean ch\u00e8n \u00e9p, [&hellip;]<\/p>\n","protected":false},"author":17,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay \u1ee9ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 t\u1ec9nh tr\u1ea1ng d\u00e2y th\u1ea7n kinh gi\u1eefa b\u1ecb ch\u00e8n \u00e9p \u1edf \u1ed1ng c\u1ed5 tay c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 sau ch\u1ea5n th\u01b0\u01a1ng...\" \/>\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=\"Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay \u1ee9ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi\" \/>\n<meta property=\"og:description\" content=\"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 t\u1ec9nh tr\u1ea1ng d\u00e2y th\u1ea7n kinh gi\u1eefa b\u1ecb ch\u00e8n \u00e9p \u1edf \u1ed1ng c\u1ed5 tay c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 sau ch\u1ea5n th\u01b0\u01a1ng...\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-09T09:23:54+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-10T12:24:41+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/oct.jpg\" \/>\n<meta name=\"author\" content=\"An Huynh Phan Ngoc\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"An Huynh Phan Ngoc\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"17 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/\",\"name\":\"Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay \u1ee9ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-09T09:23:54+00:00\",\"dateModified\":\"2023-04-10T12:24:41+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/106da77d14bd9697d17d477cee4fe3b8\"},\"description\":\"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 t\u1ec9nh tr\u1ea1ng d\u00e2y th\u1ea7n kinh gi\u1eefa b\u1ecb ch\u00e8n \u00e9p \u1edf \u1ed1ng c\u1ed5 tay c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 sau ch\u1ea5n th\u01b0\u01a1ng...\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay \u1ee9ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/106da77d14bd9697d17d477cee4fe3b8\",\"name\":\"An Huynh Phan Ngoc\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/1.gravatar.com\/avatar\/17bc5ae83cce85dafb710d1c71eb7825?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/1.gravatar.com\/avatar\/17bc5ae83cce85dafb710d1c71eb7825?s=96&d=mm&r=g\",\"caption\":\"An Huynh Phan Ngoc\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/huynhphanngocangmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay \u1ee9ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi","description":"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 t\u1ec9nh tr\u1ea1ng d\u00e2y th\u1ea7n kinh gi\u1eefa b\u1ecb ch\u00e8n \u00e9p \u1edf \u1ed1ng c\u1ed5 tay c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 sau ch\u1ea5n th\u01b0\u01a1ng...","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay \u1ee9ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi","og_description":"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 t\u1ec9nh tr\u1ea1ng d\u00e2y th\u1ea7n kinh gi\u1eefa b\u1ecb ch\u00e8n \u00e9p \u1edf \u1ed1ng c\u1ed5 tay c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 sau ch\u1ea5n th\u01b0\u01a1ng...","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/","og_site_name":"Vinmec","article_published_time":"2023-04-09T09:23:54+00:00","article_modified_time":"2023-04-10T12:24:41+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/oct.jpg"}],"author":"An Huynh Phan Ngoc","twitter_card":"summary_large_image","twitter_misc":{"Written by":"An Huynh Phan Ngoc","Est. reading time":"17 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/","name":"Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay \u1ee9ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-09T09:23:54+00:00","dateModified":"2023-04-10T12:24:41+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/106da77d14bd9697d17d477cee4fe3b8"},"description":"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 t\u1ec9nh tr\u1ea1ng d\u00e2y th\u1ea7n kinh gi\u1eefa b\u1ecb ch\u00e8n \u00e9p \u1edf \u1ed1ng c\u1ed5 tay c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 sau ch\u1ea5n th\u01b0\u01a1ng...","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/giai-phau-ong-co-tay-ung-dung-trong-phau-thuat-noi-soi\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Gi\u1ea3i ph\u1eabu \u1ed1ng c\u1ed5 tay \u1ee9ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/106da77d14bd9697d17d477cee4fe3b8","name":"An Huynh Phan Ngoc","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/1.gravatar.com\/avatar\/17bc5ae83cce85dafb710d1c71eb7825?s=96&d=mm&r=g","contentUrl":"http:\/\/1.gravatar.com\/avatar\/17bc5ae83cce85dafb710d1c71eb7825?s=96&d=mm&r=g","caption":"An Huynh Phan Ngoc"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/huynhphanngocangmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/2656"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=2656"}],"version-history":[{"count":9,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/2656\/revisions"}],"predecessor-version":[{"id":17866,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/2656\/revisions\/17866"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=2656"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=2656"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=2656"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}