{"id":27438,"date":"2023-05-14T18:18:40","date_gmt":"2023-05-14T11:18:40","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27438"},"modified":"2023-05-14T18:18:40","modified_gmt":"2023-05-14T11:18:40","slug":"xu-ly-roi-loan-van-dong-o-tre-bai-nao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/14\/xu-ly-roi-loan-van-dong-o-tre-bai-nao\/","title":{"rendered":"X\u01b0\u0309 ly\u0301 r\u00f4\u0301i loa\u0323n v\u00e2\u0323n \u0111\u00f4\u0323ng \u01a1\u0309 tre\u0309 ba\u0323i na\u0303o"},"content":{"rendered":"

\u0110\u00ea\u0309 x\u01b0\u0309 ly\u0301 r\u00f4\u0301i loa\u0323n v\u00e2\u0323n \u0111\u00f4\u0323ng \u1edf tr\u1ebb b\u1ea1i n\u00e3o<\/a> co\u0301 th\u00ea\u0309 du\u0300ng thu\u1ed1c v\u00e0 ph\u1eabu thu\u1eadt. <\/strong>Ngo\u00e0i c\u00e1c ph\u01b0\u01a1ng ph\u00e1p v\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u00e0 t\u1eadp th\u1ec3 d\u1ee5c, c\u00e1c lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng, ch\u1eb3ng h\u1ea1n nh\u01b0 ti\u00eam botulinum toxin A (BoNT-A), thu\u1ed1c u\u1ed1ng, baclofen trong m\u00e0ng tu\u1ef7 (ITB, Intrathecal baclofen). N\u1ebfu c\u00e1c bi\u1ec7n ph\u00e1p kh\u00e1c kh\u00f4ng hi\u1ec7u qu\u1ea3, co\u0301 th\u00ea\u0309 c\u00e2n nh\u0103\u0301c ph\u1eabu thu\u1eadt ph\u00e1 hu\u1ef7 r\u1ec5 c\u1ed9t s\u1ed1ng l\u01b0ng ch\u1ecdn l\u1ecdc. Tuy nhi\u00ean, quy\u1ebft \u0111\u1ecbnh s\u1eed d\u1ee5ng ph\u1eabu thu\u1eadt ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u01b0a ra sau khi xem x\u00e9t k\u1ef9 l\u01b0\u1ee1ng v\u00e0 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng c\u1ee7a tr\u1ebb.<\/p>\n

Vi\u1ec7c x\u1eed l\u00fd r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng \u1edf tr\u1ebb b\u1ecb b\u1ea1i n\u00e3o l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u00fap tr\u1ebb ph\u00e1t tri\u1ec3n t\u1ed1i \u0111a ti\u1ec1m n\u0103ng c\u1ee7a m\u00ecnh v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a tr\u1ebb. Vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p v\u1eadt l\u00fd tr\u1ecb li\u1ec7u, t\u1eadp th\u1ec3 d\u1ee5c, thu\u1ed1c ho\u1eb7c ph\u1eabu thu\u1eadt t\u00f9y thu\u1ed9c v\u00e0o t\u00ecnh tr\u1ea1ng c\u1ee5 th\u1ec3 c\u1ee7a tr\u1ebb v\u00e0 ph\u1ea3i \u0111\u01b0\u1ee3c xem x\u00e9t k\u1ef9 l\u01b0\u1ee1ng v\u00e0 th\u1ef1c hi\u1ec7n d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t c\u1ee7a c\u00e1c chuy\u00ean gia y t\u1ebf.<\/p>\n

Ba\u0300i vi\u00ea\u0301t d\u01b0\u0323a tr\u00ean Quy\u1ebft \u0111\u1ecbnh s\u1ed1 5623 \/Q\u0110-BYT ng\u00e0y 21\/9\/2018 c\u1ee7a B\u1ed9 tr\u01b0\u1edfng B\u1ed9 Y t\u00ea\u0301.<\/em><\/p>\n

\"X\u01b0\u0309
X\u01b0\u0309 ly\u0301 r\u00f4\u0301i loa\u0323n v\u00e2\u0323n \u0111\u00f4\u0323ng \u01a1\u0309 tre\u0309 ba\u0323i na\u0303o<\/figcaption><\/figure>\n

1. X\u01b0\u0309 ly\u0301 r\u00f4\u0301i loa\u0323n v\u00e2\u0323n \u0111\u00f4\u0323ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 b\u1eb1ng thu\u1ed1c<\/strong>\u00a0<\/strong><\/h2>\n

Quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng c\u1ea7n ph\u1ea3i d\u1ef1a tr\u00ean m\u1ed9t \u0111\u00e1nh gi\u00e1 v\u00e0 l\u01b0\u1ee3ng gi\u00e1 to\u00e0n di\u1ec7n v\u1ec1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng l\u00ean vi\u1ec7c \u0111\u1ea1t \u0111\u01b0\u1ee3c c\u00e1c m\u1ee5c ti\u00eau x\u00e1c \u0111\u1ecbnh. C\u00f3 th\u1ec3 c\u1ea7n \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng \u0111\u1ec3 gi\u1ea3m t\u00e1c \u0111\u1ed9ng x\u1ea5u c\u1ee7a t\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 l\u00ean ch\u1ee9c n\u0103ng v\u00e0 ch\u0103m s\u00f3c\/s\u1ef1 tho\u1ea3i m\u00e1i. Ph\u1ea3i l\u01b0u \u00fd ch\u1eafc ch\u1eafn r\u1eb1ng c\u00f3 c\u1ea7n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb t\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 hay kh\u00f4ng, r\u1eb1ng t\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 kh\u00f4ng ph\u1ea3i \u0111ang c\u00f3 l\u1ee3i cho ch\u1ee9c n\u0103ng (v\u00ed d\u1ee5 m\u1ed9t s\u1ed1 tr\u1ebb b\u1ecb t\u0103ng tr\u01b0\u01a1ng l\u1ef1c \u1edf m\u1ed9t s\u1ed1 nh\u00f3m c\u01a1 nh\u01b0 c\u01a1 t\u1ee9 \u0111\u1ea7u, d\u1ef1a v\u00e0o s\u1ef1 t\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 n\u00e0y \u0111\u1ec3 gi\u1eef g\u1ed1i du\u1ed7i khi \u0111\u1ee9ng).<\/p>\n

C\u00e1c ch\u1ecdn l\u1ef1a thu\u1ed1c \u0111i\u1ec1u tr\u1ecb tr\u01b0\u01a1ng l\u1ef1c c\u01a1 bao g\u1ed3m:<\/p>\n

    \n
  • Ti\u00eam botulinum toxin A (BoNT-A)<\/li>\n
  • C\u00e1c lo\u1ea1i thu\u1ed1c u\u1ed1ng<\/li>\n
  • Baclofen trong m\u00e0ng tu\u1ef7 (ITB, Intrathecal baclofen)<\/li>\n<\/ul>\n

    H\u01b0\u1edbng d\u1eabn n\u00e0y s\u01a1 l\u01b0\u1ee3c c\u00e1c th\u00f4ng tin c\u01a1 b\u1ea3n li\u00ean quan \u0111\u1ebfn c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb n\u00e0y. C\u00e1c chi ti\u1ebft r\u00f5 h\u01a1n, bao g\u1ed3m li\u1ec1u l\u01b0\u1ee3ng khuy\u1ebfn c\u00e1o v\u00e0 c\u00e1c k\u1ef9 thu\u1eadt \u00e1p d\u1ee5ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf c\u00e1c h\u01b0\u1edbng d\u1eabn c\u00f3 li\u00ean quan d\u00e0nh cho c\u00e1c b\u00e1c s\u0129.<\/em><\/p>\n

    1.1. Ti\u00eam \u0111\u1ed9c t\u1ed1 Botulinum A (BoNT-A)<\/strong><\/h3>\n

    BoNT-A l\u00e0 m\u1ed9t ch\u1ea5t \u0111\u1ed9c th\u1ea7n kinh \u0111\u01b0\u1ee3c ti\u00eam v\u00e0o c\u00e1c c\u01a1 \u0111\u00edch \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb co c\u1ee9ng v\u00e0 lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c khu tr\u00fa (c\u1ee5c b\u1ed9) \u1edf tr\u1ebb b\u1ea1i n\u00e3o. BoNT-A ng\u0103n ch\u1eb7n s\u1ef1 ph\u00f3ng th\u00edch acetylcholine, m\u1ed9t trong nh\u1eefng ch\u1ea5t d\u1eabn truy\u1ec1n th\u1ea7n kinh ch\u00ednh, t\u1ea1i ch\u1ed7 n\u1ed1i th\u1ea7n kinh – c\u01a1 v\u00e0 g\u00e2y li\u1ec7t c\u01a1 t\u1ea1m th\u1eddi. T\u00ecnh tr\u1ea1ng y\u1ebfu c\u01a1 n\u00e0y th\u01b0\u1eddng k\u00e9o d\u00e0i t\u1eeb ba \u0111\u1ebfn s\u00e1u th\u00e1ng, khi \u0111\u00f3 c\u00f3 th\u1ec3 ch\u1ec9 \u0111\u1ecbnh ti\u00eam l\u1eb7p l\u1ea1i.<\/p>\n

    C\u00f3 th\u1ec3 xem x\u00e9t ch\u1ec9 \u0111\u1ecbnh ti\u00eam BoNT-A khi \u0111\u00e3 x\u00e1c \u0111\u1ecbnh m\u1ee5c ti\u00eau ch\u1ee9c n\u0103ng v\u00e0\/ho\u1eb7c ng\u01b0\u1eddi ch\u0103m s\u00f3c c\u1ea9n th\u1eadn v\u00e0 c\u1ea7n theo d\u00f5i ch\u1eb7t ch\u1ebd vi\u1ec7c \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c ti\u00eau v\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng ph\u1ee5 sau c\u00e1c m\u0169i ti\u00eam. Y v\u0103n hi\u1ec7n t\u1ea1i cho th\u1ea5y c\u00f3 nhi\u1ec1u ch\u1ee9ng c\u1ee9 \u1ee7ng h\u1ed9 vi\u1ec7c s\u1eed d\u1ee5ng ti\u00eam BoNT-A \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb co c\u1ee9ng cho chi tr\u00ean v\u00e0 chi d\u01b0\u1edbi.<\/p>\n

    Ti\u00eam BoNT-A \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb ti\u00eau chu\u1ea9n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng t\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 \u1edf tr\u1ebb b\u1ea1i n\u00e3o \u1edf c\u00e1c n\u01b0\u1edbc c\u00f3 thu nh\u1eadp cao. C\u00e1c m\u0169i ti\u00eam th\u01b0\u1eddng \u0111\u01b0\u1ee3c c\u00e1c b\u00e1c s\u0129 PHCN th\u1ef1c hi\u1ec7n.<\/p>\n

    Thu\u1ed1c BoNT-A hi\u1ec7n \u0111ang c\u00f3 s\u1eb5n \u1edf Vi\u1ec7t Nam, tuy nhi\u00ean ch\u00fang ch\u01b0a \u0111\u01b0\u1ee3c b\u1ea3o hi\u1ec3m y t\u1ebf chi tr\u1ea3 r\u1ed9ng r\u00e3i, c\u00f3 ngh\u0129a l\u00e0 c\u00e1c gia \u0111\u00ecnh c\u00f3 th\u1ec3 ph\u1ea3i tr\u1ea3 chi ph\u00ed cho c\u00e1c m\u0169i ti\u00eam. V\u1edbi nhi\u1ec1u gia \u0111\u00ecnh, chi ph\u00ed ti\u00eam \u0111\u01b0\u1ee3c xem l\u00e0 qu\u00e1 cao.<\/p>\n

    Khuy\u1ebfn c\u00e1o:<\/h3>\n

    C\u1ea7n ph\u1ea3i xem x\u00e9t vai tr\u00f2 c\u1ee7a vi\u1ec7c ti\u00eam BoNT-A trong \u0111i\u1ec1u tr\u1ecb t\u0103ng tr\u01b0\u01a1ng l\u1ef1c \u1edf tr\u1ebb b\u1ea1i n\u00e3o v\u00e0 c\u1ea7n x\u00e1c \u0111\u1ecbnh c\u00e1c chi\u1ebfn l\u01b0\u1ee3c \u0111\u1ec3 c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng s\u1eed d\u1ee5ng c\u00e1c m\u0169i ti\u00eam BoNT-A \u1edf Vi\u1ec7t Nam.<\/em><\/p>\n

    1.2. C\u00e1c lo\u1ea1i thu\u1ed1c u\u1ed1ng<\/strong><\/h3>\n

    Nhi\u1ec1u lo\u1ea1i thu\u1ed1c u\u1ed1ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c k\u00ea toa cho tr\u1ebb b\u1ea1i n\u00e3o khi k\u1ebft qu\u1ea3 mong mu\u1ed1n l\u00e0 gi\u1ea3m co c\u1ee9ng v\u00e0\/ho\u1eb7c tr\u01b0\u01a1ng l\u1ef1c c\u01a1 to\u00e0n th\u1ec3.<\/p>\n

    C\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho co c\u1ee9ng to\u00e0n th\u1ec3 th\u01b0\u1eddng \u0111\u01b0\u1ee3c k\u00ea toa bao g\u1ed3m:<\/p>\n

      \n
    • Baclofen<\/li>\n
    • Diazepam<\/li>\n
    • Dantrolene<\/li>\n
    • Tizanidine<\/li>\n<\/ul>\n

      C\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea toa \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c to\u00e0n th\u1ec3 bao g\u1ed3m:<\/p>\n

        \n
      • Baclofen<\/li>\n
      • Haloperidol<\/li>\n
      • L dopa<\/li>\n
      • Tetrabenazine<\/li>\n
      • Benzhexol<\/li>\n<\/ul>\n

        Nhi\u1ec1u thu\u1ed1c k\u1ec3 tr\u00ean c\u00f3 th\u1ec3 c\u00f3 c\u00e1c ph\u1ea3n \u1ee9ng ph\u1ee5 nh\u01b0 bu\u1ed3n ng\u1ee7, an th\u1ea7n v\u00e0 y\u1ebfu c\u01a1. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i \u0111\u1eb7t c\u00e1c m\u1ee5c ti\u00eau c\u1ee5 th\u1ec3 khi d\u00f9ng thu\u1ed1c v\u00e0 theo d\u00f5i li\u00ean t\u1ee5c c\u00e1c t\u00e1c d\u1ee5ng c\u00f3 l\u1ee3i v\u00e0\/ho\u1eb7c c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c \u0111ang s\u1eed d\u1ee5ng.<\/p>\n

        1.3. B\u01a1m Baclofen trong khoang m\u00e0ng tu\u1ef7 (ITB)<\/strong><\/h3>\n

        Baclofen l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c u\u1ed1ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m cho tr\u1ebb b\u1ecb t\u0103ng tr\u01b0\u01a1ng l\u1ef1c v\u00e0 lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c to\u00e0n th\u1ec3. Thu\u1ed1c t\u00e1c d\u1ee5ng tr\u00ean c\u00e1c th\u1ee5 th\u1ec3 trong t\u1ee7y s\u1ed1ng, \u1ee9c ch\u1ebf co th\u1eaft c\u01a1 v\u00e0 l\u00e0m gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c c\u01a1. \u1ede d\u1ea1ng u\u1ed1ng, thu\u1ed1c kh\u00f4ng d\u1ec5 d\u00e0ng v\u01b0\u1ee3t qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o, do v\u1eady c\u00f3 th\u1ec3 c\u1ea7n li\u1ec1u cao h\u01a1n g\u00e2y ra c\u00e1c ph\u1ea3n \u1ee9ng ph\u1ee5 kh\u00f4ng mong mu\u1ed1n.<\/p>\n

        Khi \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o trong m\u00e0ng tu\u1ef7, baclofen c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n ph\u1ed1i tr\u1ef1c ti\u1ebfp \u0111\u1ebfn v\u1ecb tr\u00ed t\u00e1c d\u1ee5ng, cho ph\u00e9p d\u00f9ng li\u1ec1u nh\u1ecf h\u01a1n v\u00e0 \u00edt t\u00e1c d\u1ee5ng ph\u1ee5 h\u01a1n. M\u1ed9t m\u00e1y b\u01a1m Baclofen trong m\u00e0ng tu\u1ef7, bao g\u1ed3m m\u1ed9t b\u01a1m l\u1eadp tr\u00ecnh \u0111\u01b0\u1ee3c v\u00e0 \u1ed1ng d\u1eabn l\u01b0u trong m\u00e0ng tu\u1ef7, c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u1eadp tr\u00ecnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t li\u1ec1u truy\u1ec1n t\u0129nh m\u1ea1ch li\u00ean t\u1ee5c k\u00e8m\/ho\u1eb7c kh\u00f4ng k\u00e8m v\u1edbi li\u1ec1u nhanh baclofen trong kho\u1ea3ng th\u1eddi gian 24 gi\u1edd.<\/p>\n

        C\u00e1c quy tr\u00ecnh v\u00e0 \u0111i\u1ec1u ki\u1ec7n cho b\u01a1m Baclofen trong m\u00e0ng tu\u1ef7 kh\u00e1c nhau gi\u1eefa c\u00e1c qu\u1ed1c gia. Do b\u1ea3n ch\u1ea5t x\u00e2m l\u1ea5n c\u1ee7a can thi\u1ec7p v\u00e0 c\u00e1c r\u1ee7i ro li\u00ean quan (nh\u01b0 s\u1ef1 c\u1ed1 b\u01a1m, r\u00f2 \u1ed1ng d\u1eabn v\u00e0 nh\u1eefng kh\u00f3 kh\u0103n trong ch\u0103m s\u00f3c v\u1ebft th\u01b0\u01a1ng), vi\u1ec7c ti\u1ebfp c\u1eadn nhanh ch\u00f3ng v\u00e0 d\u1ec5 d\u00e0ng t\u1edbi \u0111\u1ed9i ng\u0169 y t\u1ebf chuy\u00ean khoa th\u01b0\u1eddng l\u00e0 \u0111i\u1ec1u ki\u1ec7n ti\u00ean quy\u1ebft cho vi\u1ec7c c\u1ea5y gh\u00e9p b\u01a1m.<\/p>\n

        2. X\u01b0\u0309 ly\u0301 r\u00f4\u0301i loa\u0323n v\u00e2\u0323n \u0111\u00f4\u0323ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 b\u1eb1ng ph\u1eabu thu\u1eadt<\/strong><\/h2>\n

        2.1. Ph\u1eabu thu\u1eadt ph\u00e1 hu\u1ef7 r\u1ec5 c\u1ed9t s\u1ed1ng l\u01b0ng ch\u1ecdn l\u1ecdc (SDR)<\/strong><\/h3>\n

        Ph\u1eabu thu\u1eadt ph\u00e1 hu\u1ef7 r\u1ec5 c\u1ed9t s\u1ed1ng l\u01b0ng ch\u1ecdn l\u1ecdc (SDR) l\u00e0 m\u1ed9t can thi\u1ec7p ph\u1eabu thu\u1eadt th\u1ea7n kinh l\u00e0m gi\u1ea3m co c\u1ee9ng cho tr\u1ebb b\u1ea1i n\u00e3o th\u1ec3 co c\u1ee9ng. M\u1ee5c \u0111\u00edch l\u00e0 gi\u1ea3m co c\u1ee9ng \u1edf hai chi d\u01b0\u1edbi v\u0129nh vi\u1ec5n b\u1eb1ng c\u00e1ch ph\u00e1 v\u1ee1 cung ph\u1ea3n x\u1ea1 t\u1ee7y s\u1ed1ng b\u1ea5t th\u01b0\u1eddng, nh\u1eb1m c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng v\u1eadn \u0111\u1ed9ng.<\/p>\n

        C\u00e1c b\u00e1c s\u0129 ph\u1eabu thu\u1eadt th\u1ea7n kinh t\u00e1ch c\u00e1c r\u1ec5 c\u1ea3m gi\u00e1c l\u01b0ng L1\/L2-S1 v\u00e0 k\u00edch th\u00edch t\u1eebng r\u1ec5 m\u1ed9t v\u1edbi \u0111i\u1ec7n c\u01a1 \u0111\u1ed3 (EMG). C\u00e1c r\u1ec5 th\u1ea7n kinh c\u1ea3m gi\u00e1c c\u00f3 c\u00e1c \u0111\u00e1p \u1ee9ng (EMG) b\u1ea5t th\u01b0\u1eddng, qu\u00e1 m\u1ee9c v\u00e0 \u0111\u1ed1i b\u00ean b\u1ecb c\u1eaft b\u1ecf. K\u1ebft h\u1ee3p v\u1edbi v\u1eadt l\u00fd tr\u1ecb li\u1ec7u, SDR \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 ch\u1ee9c n\u0103ng trong b\u1ea1i n\u00e3o th\u1ec3 co c\u1ee9ng li\u1ec7t hai ch\u00e2n (Josenby v\u00e0 c\u1ed9ng s\u1ef1, 2012).<\/p>\n

        Can thi\u1ec7p n\u00e0y ph\u00f9 h\u1ee3p cho m\u1ed9t s\u1ed1 \u00edt tr\u1ebb em b\u1ecb \u1ea3nh h\u01b0\u1edfng c\u1ea3 hai b\u00ean, tho\u1ea3 m\u00e3n c\u00e1c ti\u00eau chu\u1ea9n sau:<\/p>\n

          \n
        • GMFCS II\/III<\/li>\n
        • Th\u1ec3 co c\u1ee9ng \u0111\u01a1n thu\u1ea7n (kh\u00f4ng ph\u1ea3i th\u1ec3 ph\u1ed1i h\u1ee3p)<\/li>\n
        • M\u1ea1nh kh\u1ecfe<\/li>\n
        • \u0110\u1ed1i x\u1ee9ng<\/li>\n
        • Ch\u00e2n th\u1eb3ng, kh\u00f4ng c\u00f3 co r\u00fat \u0111\u00e1ng k\u1ec3<\/li>\n
        • Ki\u1ec3m so\u00e1t v\u1eadn \u0111\u1ed9ng ch\u1ecdn l\u1ecdc t\u1ed1t<\/li>\n
        • M\u00f4i tr\u01b0\u1eddng gia \u0111\u00ecnh h\u1ed7 tr\u1ee3 v\u00e0 tr\u1ebb c\u00f2n nh\u1ecf (ngh\u0129a l\u00e0 kho\u1ea3ng 4-6 tu\u1ed5i)<\/li>\n<\/ul>\n

          Ph\u1eabu thu\u1eadt s\u1ebd kh\u00f4ng ch\u1ec9nh s\u1eeda c\u00e1c co r\u00fat ho\u1eb7c bi\u1ebfn d\u1ea1ng hi\u1ec7n t\u1ea1i v\u00e0 kh\u00f4ng ch\u1eefa kh\u1ecfi nh\u1eefng \u1ea3nh h\u01b0\u1edfng nguy\u00ean ph\u00e1t c\u1ee7a b\u1ea1i n\u00e3o, g\u1ed3m m\u1ea5t ki\u1ec3m so\u00e1t v\u1eadn \u0111\u1ed9ng, y\u1ebfu c\u01a1, c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 th\u0103ng b\u1eb1ng… \u0110\u1ed1i v\u1edbi \u0111a s\u1ed1 tr\u1ebb, n\u1ebfu mu\u1ed1n \u0111\u1ea1t \u0111\u01b0\u1ee3c kh\u1ea3 n\u0103ng di chuy\u1ec3n ch\u1ee9c n\u0103ng t\u1ed1i \u01b0u, tr\u1ebb c\u00f3 th\u1ec3 c\u1ea7n \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh m\u1ed9t th\u1eddi gian sau SDR \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh c\u00e1c co r\u00fat v\u00e0 bi\u1ebfn d\u1ea1ng c\u1ed1 \u0111\u1ecbnh c\u1ee7a x\u01b0\u01a1ng.<\/p>\n

          Tr\u1ebb \u0111\u01b0\u1ee3c m\u1ed5 SDR lu\u00f4n c\u1ea7n ph\u1ea3i k\u1ebft h\u1ee3p t\u1eadp v\u1eadt l\u00fd tr\u1ecb li\u1ec7u t\u00edch c\u1ef1c sau khi ph\u1eabu thu\u1eadt \u0111\u1ec3 ph\u1ee5c h\u1ed3i v\u00e0 c\u1ea3i thi\u1ec7n c\u00e1c k\u1ef9 n\u0103ng v\u1eadn \u0111\u1ed9ng.<\/p>\n

          H\u01b0\u1edbng d\u1eabn n\u00e0y ph\u00e1c th\u1ea3o c\u00e1c th\u00f4ng tin c\u01a1 b\u1ea3n li\u00ean quan \u0111\u1ebfn SDR. C\u00e1c chi ti\u1ebft c\u1ee5 th\u1ec3 h\u01a1n, bao g\u1ed3m li\u1ec1u l\u01b0\u1ee3ng v\u00e0 k\u1ef9 thu\u1eadt \u00e1p d\u1ee5ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o ph\u1ea3i \u0111\u01b0\u1ee3c xem t\u1eeb c\u00e1c h\u01b0\u1edbng d\u1eabn c\u00f3 li\u00ean quan d\u00e0nh cho c\u00e1c b\u00e1c s\u0129.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

          \u0110\u00ea\u0309 x\u01b0\u0309 ly\u0301 r\u00f4\u0301i loa\u0323n v\u00e2\u0323n \u0111\u00f4\u0323ng \u1edf tr\u1ebb b\u1ea1i n\u00e3o co\u0301 th\u00ea\u0309 du\u0300ng thu\u1ed1c v\u00e0 ph\u1eabu thu\u1eadt. Ngo\u00e0i c\u00e1c ph\u01b0\u01a1ng ph\u00e1p v\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u00e0 t\u1eadp th\u1ec3 d\u1ee5c, c\u00e1c lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng, ch\u1eb3ng h\u1ea1n nh\u01b0 ti\u00eam botulinum toxin A (BoNT-A), […]<\/p>\n","protected":false},"author":42,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nX\u01b0\u0309 ly\u0301 r\u00f4\u0301i loa\u0323n v\u00e2\u0323n \u0111\u00f4\u0323ng \u01a1\u0309 tre\u0309 ba\u0323i na\u0303o - Vinmec<\/title>\n<meta name=\"description\" content=\"X\u01b0\u0309 ly\u0301 r\u00f4\u0301i loa\u0323n v\u00e2\u0323n \u0111\u00f4\u0323ng \u1edf tre\u0309 b\u1ea1i n\u00e3o go\u0301p ph\u00e2\u0300n gi\u00fap tr\u1ebb ph\u00e1t tri\u1ec3n t\u1ed1i \u0111a ti\u1ec1m n\u0103ng v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a tr\u1ebb.\" \/>\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=\"X\u01b0\u0309 ly\u0301 r\u00f4\u0301i loa\u0323n v\u00e2\u0323n \u0111\u00f4\u0323ng \u01a1\u0309 tre\u0309 ba\u0323i na\u0303o - 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