{"id":27409,"date":"2023-04-23T13:54:22","date_gmt":"2023-04-23T06:54:22","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27409"},"modified":"2023-05-02T09:41:40","modified_gmt":"2023-05-02T02:41:40","slug":"lua-chon-kieu-gay-te-tai-cho-kiem-soat-dau-truoc-dieu-tri-noi-nha","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/lua-chon-kieu-gay-te-tai-cho-kiem-soat-dau-truoc-dieu-tri-noi-nha\/","title":{"rendered":"L\u1ef1a ch\u1ecdn ki\u1ec3u g\u00e2y t\u00ea t\u1ea1i ch\u1ed7 ki\u1ec3m so\u00e1t \u0111au tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha."},"content":{"rendered":"

Tr\u01b0\u1edbc m\u1ed7i cu\u1ed9c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha, \u0111\u1eb7c bi\u1ec7t v\u1edbi tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n \u0111ang m\u1eafc c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn b\u1ec7nh l\u00fd, vi\u1ec7c l\u1ef1a ch\u1ecdn ki\u1ec3u g\u00e2y t\u00ea l\u00e0 quan tr\u1ecdng, quy\u1ebft \u0111\u1ecbnh qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng hay th\u1ea5t b\u1ea1i. B\u00e0i vi\u1ebft n\u00e0y gi\u1edbi thi\u1ec7u qua m\u1ed9t s\u1ed1 ki\u1ec3u g\u00e2y t\u00ea tr\u00ean l\u00e2m s\u00e0ng, v\u00e0 \u0111\u01b0a ra m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p gi\u00fap l\u00e0m t\u0103ng hi\u1ec7u qu\u1ea3 t\u00ea trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb. C\u00f9ng t\u00ecm hi\u1ec3u.<\/strong><\/p>\n

\"kieu-gay-te\"<\/p>\n

1. G\u00e2y t\u00ea t\u1ee7y r\u0103ng v\u00e0 g\u00e2y t\u00ea m\u00f4 m\u1ec1m<\/h2>\n

Khi g\u00e2y t\u00ea tr\u00ean r\u0103ng kh\u00f4ng tri\u1ec7u ch\u1ee9ng, v\u00ed d\u1ee5 nh\u01b0 tr\u01b0\u1eddng h\u1ee3p t\u1ee7y r\u0103ng kh\u00f4ng b\u1ecb vi\u00eam, th\u00ec \u0111i\u1ec1u quan tr\u1ecdng ph\u1ea3i nh\u1edb l\u00e0 g\u00e2y t\u00ea m\u00f4 m\u1ec1m l\u00e2n c\u1eadn kh\u00f4ng \u0111\u1ea3m b\u1ea3o l\u00e0 s\u1ebd \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u00ea t\u1ee7y r\u0103ng. \u0110i\u1ec1u n\u00e0y \u0111\u1eb7c bi\u1ec7t \u0111\u00fang \u1edf r\u0103ng h\u00e0m d\u01b0\u1edbi, l\u00e0 n\u01a1i m\u00e0 t\u00ea t\u1ee7y r\u0103ng th\u00e0nh c\u00f4ng sau khi g\u00e2y t\u00ea ch\u1eb7n th\u1ea7n kinh r\u0103ng d\u01b0\u1edbi, v\u1edbi t\u1ec9 l\u1ec7 l\u00e0 35 \u2013 60% t\u00f9y thu\u1ed9c v\u00e0o r\u0103ng. Do \u0111\u00f3 tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha, \u0111\u1eb7c bi\u1ec7t tr\u00ean r\u0103ng c\u00f3 vi\u00eam, th\u00ec \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 x\u00e1c \u0111\u1ecbnh xem li\u1ec7u \u0111\u00e3 \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u00ea t\u1ee7y r\u0103ng hay ch\u01b0a. C\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh b\u1eb1ng c\u00e1ch l\u1eb7p l\u1ea1i c\u00e1c test th\u1eed t\u1ee7y v\u1edbi k\u00edch th\u00edch l\u1ea1nh ho\u1eb7c \u0111i\u1ec7n. Tuy nhi\u00ean, trong tr\u01b0\u1eddng h\u1ee3p vi\u00eam t\u1ee7y kh\u00f4ng h\u1ed3i ph\u1ee5c, \u0111\u00f4i khi t\u00ea t\u1ee7y r\u0103ng \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn sau khi test m\u00e0 v\u1eabn c\u00f3 m\u1ed9t v\u00e0i b\u1ec7nh nh\u00e2n b\u1ecb \u0111au trong su\u1ed1t qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. V\u00ec l\u00ed do n\u00e0y m\u00e0 vi\u1ec7c g\u00e2y t\u00ea b\u1ed5 sung v\u00e0\/ho\u1eb7c c\u00e1c bi\u1ec7n ph\u00e1p b\u1ed5 tr\u1ee3 lu\u00f4n \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 l\u00e0m gi\u1ea3m thi\u1ec3u s\u1ef1 kh\u00f3 ch\u1ecbu cho b\u1ec7nh nh\u00e2n.<\/p>\n

2. G\u00e2y t\u00ea b\u1ed5 sung\/Bi\u1ec7n ph\u00e1p b\u1ed5 tr\u1ee3<\/h2>\n

Nh\u01b0 \u0111\u00e3 \u0111\u1ec1 c\u1eadp \u1edf tr\u01b0\u1edbc, do t\u1ec9 l\u1ec7 g\u00e2y t\u00ea th\u1ea5t b\u1ea1i cao khi \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha \u1edf nh\u1eefng r\u0103ng b\u1ecb \u0111au, \u0111\u1eb7c bi\u1ec7t l\u00e0 r\u0103ng h\u00e0m d\u01b0\u1edbi sau khi ch\u1eb7n d\u00e2y th\u1ea7n kinh r\u0103ng d\u01b0\u1edbi, n\u00ean r\u1ea5t c\u1ea7n thi\u1ebft th\u1ef1c hi\u1ec7n g\u00e2y t\u00ea b\u1ed5 sung qua c\u00e1c c\u00e1ch kh\u00e1c tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. M\u1eb7c d\u00f9 vi\u1ec7c \u0111\u00e1nh gi\u00e1 to\u00e0n di\u1ec7n c\u00e1c ph\u01b0\u01a1ng ph\u00e1p v\u00e0 b\u1eb1ng ch\u1ee9ng c\u1ee7a nhi\u1ec1u ki\u1ec3u g\u00e2y t\u00ea b\u00f4 kh\u00e1c nhau n\u1eb1m ngo\u00e0i ph\u1ea1m vi th\u1ea3o lu\u1eadn c\u1ee7a ch\u01b0\u01a1ng n\u00e0y, nh\u01b0ng ch\u00fang sung t\u00f4i mu\u1ed1n \u0111\u1ec1 c\u1eadp v\u1ea5n \u0111\u1ec1 s\u1ef1 h\u1ed7 tr\u1ee3 t\u1ed1t c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p g\u00e2y t\u00ea m\u1eb7t ngo\u00e0i (\u0111\u1eb7c bi\u1ec7t l\u00e0 v\u1edbi articaine 4%), g\u00e2y t\u00ea d\u00e2y ch\u1eb1ng nha chu c\u0169ng nh\u01b0 g\u00e2y t\u00ea x\u01b0\u01a1ng \u1ed5 \u0111\u1ec3 b\u1ed5 tr\u1ee3 cho g\u00e2y t\u00ea d\u00e2y th\u1ea7n kinh r\u0103ng d\u01b0\u1edbi, gi\u00fap t\u0103ng kh\u1ea3 n\u0103ng \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u00ea t\u1ee7y r\u0103ng.<\/p>\n

3. L\u1ef1a ch\u1ecdn ki\u1ec3u t\u00ea t\u1ea1i ch\u1ed7<\/h2>\n

M\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u lo\u1ea1i thu\u1ed1c t\u00ea t\u1ea1i ch\u1ed7 nh\u01b0ng \u0111a s\u1ed1 c\u00e1c nh\u00e0 l\u00e2m s\u00e0ng \u0111\u1ec1u s\u1eed d\u1ee5ng lidocaine 2%, v\u00e0 coi n\u00f3 l\u00e0 ti\u00eau chu\u1ea9n \u0111\u1ec3 so s\u00e1nh v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c t\u00ea kh\u00e1c. Articaine (4%) l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c kh\u00e1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn \u0111\u1ec3 g\u00e2y t\u00ea t\u1ea1i ch\u1ed7, v\u00e0 c\u00f3 h\u00e0ng lo\u1ea1t nghi\u00ean c\u1ee9u so s\u00e1nh c\u00f4ng d\u1ee5ng c\u1ee7a lidocaine v\u1edbi articaine trong vi\u1ec7c g\u00e2y t\u00ea m\u00f4 m\u1ec1m v\u00e0 g\u00e2y t\u00ea t\u1ee7y r\u0103ng tr\u00ean nh\u1eefng r\u0103ng c\u00f3 t\u1ee7y s\u1ed1ng b\u00ecnh th\u01b0\u1eddng c\u0169ng nh\u01b0 tr\u00ean nh\u1eefng r\u0103ng vi\u00eam t\u1ee7y kh\u00f4ng h\u1ed3i ph\u1ee5c c\u00f3 tri\u1ec7u ch\u1ee9ng. N\u00f3i chung c\u1ea3 2 lo\u1ea1i thu\u1ed1c \u0111\u1ec1u cho hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng \u0111\u1ed3ng tr\u00ean g\u00e2y t\u00ea t\u1ee7y. Ngo\u1ea1i l\u1ec7 l\u00e0 articaine c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n khi th\u1ef1c hi\u1ec7n g\u00e2y t\u00ea th\u1ea5m (infiltration). \u0110i\u1ec1u n\u00e0y \u0111\u1eb7c bi\u1ec7t \u0111\u00fang v\u1edbi g\u00e2y t\u00ea t\u1ee7y \u1edf c\u1ea3 tr\u01b0\u1eddng h\u1ee3p vi\u00eam t\u1ee7y c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, khi th\u1ef1c hi\u1ec7n g\u00e2y t\u00ea b\u1ed5 sung m\u1eb7t ngo\u00e0i \u1edf r\u0103ng sau h\u00e0m d\u01b0\u1edbi. Do v\u1eady, khuy\u1ebfn c\u00e1o l\u1ef1a ch\u1ecdn articaine thay v\u00ec lidocaine \u0111\u1ec3 g\u00e2y t\u00ea b\u1ed5 sung m\u1eb7t ngo\u00e0i, nh\u1eb1m m\u1ee5c \u0111\u00edch th\u1ef1c hi\u1ec7n th\u1ee7 thu\u1eadt n\u1ed9i nha kh\u00f4ng \u0111au \u1edf c\u00e1c r\u0103ng sau h\u00e0m d\u01b0\u1edbi.<\/p>\n

Lidocaine l\u00e0 thu\u1ed1c t\u00ea \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn ch\u1ee7 y\u1ebfu cho g\u00e2y t\u00ea ch\u1eb7n th\u1ea7n kinh bao g\u1ed3m d\u00e2y th\u1ea7n kinh r\u0103ng d\u01b0\u1edbi, th\u1ea7n kinh l\u01b0\u1ee1i v\u00e0 th\u1ea7n kinh c\u1eb1m. T\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c t\u00ea t\u1ea1i ch\u1ed7 \u0111\u1ec1u \u0111\u1ed9c th\u1ea7n kinh v\u00e0 c\u00f3 nguy c\u01a1 ti\u1ec1m t\u00e0ng g\u00e2y ra b\u1ec7nh l\u00fd th\u1ea7n kinh khi s\u1eed d\u1ee5ng v\u1edbi n\u1ed3ng \u0111\u1ed9 th\u00edch h\u1ee3p, g\u1ea7n b\u00f3 ho\u1eb7c nh\u00e1nh th\u1ea7n kinh. V\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 b\u1ecb t\u00ea k\u00e9o d\u00e0i (anesthesia), c\u1ea3m gi\u00e1c ch\u00e2m ch\u00edch, c\u1ea3m gi\u00e1c \u201cghim v\u00e0 kim\u201d (pins and needles) (d\u1ecb c\u1ea3m) ho\u1eb7c tri\u1ec7u ch\u1ee9ng \u0111au th\u1ea7n kinh nghi\u00eam tr\u1ecdng \u1edf v\u00f9ng chi ph\u1ed1i c\u1ee7a d\u00e2y th\u1ea7n kinh b\u1ecb t\u1ed5n th\u01b0\u01a1ng. Thu\u1ed1c t\u00ea v\u1edbi n\u1ed3ng \u0111\u1ed9 c\u00e0ng cao nh\u01b0 articaine (4%) v\u00e0 prilocaine (4%) c\u00e0ng c\u00f3 nguy c\u01a1 cao g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh, th\u01b0\u1eddng l\u00e0 khi s\u1eed d\u1ee5ng ch\u1eb7n d\u00e2y th\u1ea7n kinh r\u0103ng d\u01b0\u1edbi. T\u1eeb hi\u1ec7u qu\u1ea3 so s\u00e1nh gi\u1eefa articaine v\u1edbi lidocaine trong g\u00e2y t\u00ea t\u1ee7y r\u0103ng v\u00e0 m\u00f4 m\u1ec1m, k\u1ebft h\u1ee3p v\u1edbi nguy c\u01a1 g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh cao h\u01a1n c\u1ee7a articaine n\u00ean lidocaine v\u1eabn l\u00e0 l\u1ef1a ch\u1ecdn ph\u00f9 h\u1ee3p \u0111\u1ec3 ch\u1eb7n d\u00e2y th\u1ea7n kinh r\u0103ng d\u01b0\u1edbi.<\/p>\n

Bupivacaine (0.5%) l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c t\u00ea t\u1ea1i ch\u1ed7 kh\u00e1 ph\u1ed5 bi\u1ebfn v\u00ec n\u00f3 cho k\u1ebft qu\u1ea3 t\u00ea k\u00e9o d\u00e0i, l\u00ean \u0111\u1ebfn 8 gi\u1edd. S\u1eed d\u1ee5ng bupivacaine v\u00e0o giai \u0111o\u1ea1n cu\u1ed1i c\u1ee7a th\u1ee7 thu\u1eadt l\u00e2m s\u00e0ng l\u00e0 m\u1ed9t vi\u1ec7c l\u00e0m h\u1eefu \u00edch gi\u00fap gi\u1ea3m \u0111au sau \u0111i\u1ec1u tr\u1ecb. \u0110\u00e2y l\u00e0 bi\u1ec7n ph\u00e1p l\u00fd t\u01b0\u1edfng khi \u0111\u00e3 ti\u00ean l\u01b0\u1ee3ng tr\u01b0\u1edbc \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 \u0111au sau \u0111i\u1ec1u tr\u1ecb, bao g\u1ed3m tr\u01b0\u1eddng h\u1ee3p ph\u1eabu thu\u1eadt n\u1ed9i nha v\u00e0 c\u1ea3 v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n \u0111au nhi\u1ec1u tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb.<\/p>\n

4. S\u1eed d\u1ee5ng thu\u1ed1c gi\u1ea3m \u0111au tr\u01b0\u1edbc \u0111\u1ec3 c\u1ea3i thi\u1ec7n hi\u1ec7u qu\u1ea3<\/h2>\n

V\u1edbi nh\u1eefng kh\u00f3 kh\u0103n khi g\u00e2y t\u00ea t\u1ee7y \u1edf nh\u1eefng r\u0103ng b\u1ecb vi\u00eam th\u00ec c\u1ea7n nhi\u1ec1u bi\u1ec7n ph\u00e1p \u0111\u1ec3 gi\u00fap c\u00e1c nh\u00e0 l\u00e2m s\u00e0ng c\u00f3 kh\u1ea3 n\u0103ng th\u1ef1c hi\u1ec7n c\u00e1c th\u1ee7 thu\u1eadt n\u1ed9i nha kh\u00f4ng \u0111au. C\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e1nh gi\u00e1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a c\u00e1c ch\u1ea5t trung gian g\u00e2y vi\u00eam l\u00ean k\u00eanh natri \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng prostaglandine E2 l\u00e0m t\u0103ng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a k\u00eanh natri kh\u00e1ng tetrodotoxin. V\u1edbi quan \u0111i\u1ec3m cho r\u1eb1ng nh\u1eefng k\u00eanh kh\u00e1ng tetrodotoxin \u0111\u00f3 c\u00f3 kh\u1ea3 n\u0103ng kh\u00e1ng thu\u1ed1c t\u00ea t\u1ea1i ch\u1ed7 nhi\u1ec1u h\u01a1n, n\u00ean c\u00e2u h\u1ecfi quan tr\u1ecdng v\u00e0 li\u00ean quan v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng l\u00e0 li\u1ec7u s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng vi\u00eam tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb, ch\u1eb3ng h\u1ea1n nh\u01b0 thu\u1ed1c kh\u00e1ng vi\u00eam kh\u00f4ng steroid (NSAID), ibuprofen, c\u00f3 l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u00ea t\u1ee7y r\u0103ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam t\u1ee7y c\u00f3 tri\u1ec7u ch\u1ee9ng hay kh\u00f4ng. Gi\u1ea3 thi\u1ebft n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c ki\u1ec3m ch\u1ee9ng nhi\u1ec1u trong c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng, \u0111a s\u1ed1 l\u00e0 c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean c\u00f3 \u0111\u1ed1i ch\u1ee9ng. M\u1ed9t v\u00e0i nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ee9ng minh hi\u1ec7u qu\u1ea3 c\u1ee7a NSAID l\u00e0 cao h\u01a1n so v\u1edbi nh\u1eefng gi\u1ea3 d\u01b0\u1ee3c trong vi\u1ec7c \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u00ea t\u1ee7y r\u0103ng v\u00e0\/ho\u1eb7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng \u0111au. Tuy nhi\u00ean, m\u1ed9t v\u00e0i th\u1eed nghi\u1ec7m kh\u00e1c l\u1ea1i kh\u00f4ng nh\u1eadn th\u1ea5y s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 gi\u1eefa thu\u1ed1c v\u00e0 gi\u1ea3 d\u01b0\u1ee3c, m\u1eb7c d\u00f9 c\u1ea7n l\u01b0u \u00fd r\u1eb1ng ph\u1ea7n l\u1edbn nh\u1eefng nghi\u00ean c\u1ee9u n\u00e0y \u0111\u1ec1u cho th\u1ea5y k\u1ebft s\u1eed d\u1ee5ng NSAID \u0111em l\u1ea1i t\u1ec9 l\u1ec7 t\u00ea th\u00e0nh c\u00f4ng cao h\u01a1n. S\u1ef1 kh\u00e1c bi\u1ec7t k\u1ebft qu\u1ea3 gi\u1eefa c\u00e1c nghi\u00ean c\u1ee9u c\u00f3 th\u1ec3 l\u00e0 do s\u1ef1 kh\u00e1c bi\u1ec7t trong thi\u1ebft k\u1ebf nghi\u00ean c\u1ee9u bao g\u1ed3m \u0111\u1ecbnh qu\u1ea3 l\u00e0 ngh\u0129a vi\u00eam t\u1ee7y kh\u00f4ng h\u1ed3i ph\u1ee5c kh\u00e1c nhau (v\u00ed d\u1ee5 nh\u01b0 qu\u1ea7n th\u1ec3 \u0111\u00edch) v\u00e0 c\u00e1ch th\u1ef1c hi\u1ec7n nghi\u00ean c\u1ee9u kh\u00e1c nhau (ch\u1eb3ng h\u1ea1n nh\u01b0 c\u1ee1 m\u1eabu). \u0110i\u1ec1u quan tr\u1ecdng l\u00e0, c\u00e1c b\u1eb1ng ch\u1ee9ng t\u1ed5ng th\u1ec3 \u0111\u1ec1u h\u1ed7 tr\u1ee3 cho vi\u1ec7c s\u1eed d\u1ee5ng m\u1ed9t li\u1ec1u NSAID tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 t\u0103ng kh\u1ea3 n\u0103ng g\u00e2y t\u00ea t\u1ee7y r\u0103ng h\u00e0m d\u01b0\u1edbi nh\u1edd ch\u1eb7n d\u00e2y th\u1ea7n kinh r\u0103ng d\u01b0\u1edbi \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam t\u1ee7y, nh\u01b0 \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh trong nh\u1eefng b\u00e0i t\u1ed5ng quan g\u1ea7n \u0111\u00e2y (ibuprofen 600\u2013800 mg, lornoxicam 8 mg v\u00e0 kali diclofenac 50 mg \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 t\u1ed1t h\u01a1n so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c; ketorolac, ibuprofen\/acetaminophen ph\u1ed1i h\u1ee3p, v\u00e0 acetaminophen \u0111\u01a1n thu\u1ea7n kh\u00f4ng t\u1ed1t h\u01a1n so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c). M\u1eb7c d\u00f9 \u00edt \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u nh\u01b0ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y, s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng vi\u00eam kh\u00e1c tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb, ch\u1eb3ng h\u1ea1n nh\u01b0 steroid, c\u00f3 th\u1ec3 l\u00e0m t\u0103ng hi\u1ec7u qu\u1ea3 t\u00ea t\u1ee7y ho\u1eb7c th\u1eddi gian t\u00ea. N\u00f3i t\u00f3m l\u1ea1i, \u0111i\u1ec1u tr\u1ecb b\u1eb1ng NSAID nh\u01b0 ibuprofen 600 mg, 1 gi\u1edd tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha s\u1ebd l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u00ea t\u1ee7y, gi\u00fap gi\u1ea3m thi\u1ec3u nh\u1eefng c\u01a1n \u0111au c\u1ee7a b\u1ec7nh nh\u00e2n trong su\u1ed1t qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha.<\/p>\n

Ngu\u1ed3n: Clinical Guide for Optimal Treatment Outcome – Springer International Publishing Switzerland 2017<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Tr\u01b0\u1edbc m\u1ed7i cu\u1ed9c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha, \u0111\u1eb7c bi\u1ec7t v\u1edbi tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n \u0111ang m\u1eafc c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn b\u1ec7nh l\u00fd, vi\u1ec7c l\u1ef1a ch\u1ecdn ki\u1ec3u g\u00e2y t\u00ea l\u00e0 quan tr\u1ecdng, quy\u1ebft \u0111\u1ecbnh qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng hay th\u1ea5t b\u1ea1i. B\u00e0i vi\u1ebft n\u00e0y gi\u1edbi thi\u1ec7u qua m\u1ed9t s\u1ed1 ki\u1ec3u g\u00e2y t\u00ea […]<\/p>\n","protected":false},"author":21,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[28,33],"tags":[],"yoast_head":"\nL\u1ef1a ch\u1ecdn ki\u1ec3u g\u00e2y t\u00ea t\u1ea1i ch\u1ed7 ki\u1ec3m so\u00e1t \u0111au tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha.<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft gi\u1edbi thi\u1ec7u m\u1ed9t s\u1ed1 ki\u1ec3u g\u00e2y t\u00ea tr\u00ean l\u00e2m s\u00e0ng, \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p gi\u00fap l\u00e0m t\u0103ng hi\u1ec7u qu\u1ea3 t\u00ea trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb. 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