{"id":27518,"date":"2023-04-23T17:13:02","date_gmt":"2023-04-23T10:13:02","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27518"},"modified":"2023-05-02T09:37:09","modified_gmt":"2023-05-02T02:37:09","slug":"vai-tro-cua-vi-khuan-trong-benh-ly-noi-nha","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/vai-tro-cua-vi-khuan-trong-benh-ly-noi-nha\/","title":{"rendered":"Vai tr\u00f2 vi khu\u1ea9n trong b\u1ec7nh l\u00fd N\u1ed9i nha."},"content":{"rendered":"

C\u00e1c k\u0129 thu\u1eadt hi\u1ec7n t\u1ea1i \u0111\u1ec3 lo\u1ea1i b\u1ecf ho\u1eb7c gi\u1ea3m thi\u1ec3u l\u01b0\u1ee3ng vi khu\u1ea9n trong h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y bao g\u1ed3m s\u1eeda so\u1ea1n c\u01a1 h\u1ecdc, b\u01a1m r\u1eeda \u1ed1ng t\u1ee7y v\u1edbi t\u00e1c nh\u00e2n kh\u00e1ng khu\u1ea9n v\u00e0 b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 qu\u00e1 tr\u00ecnh tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y v\u00e0 sau \u0111\u00f3 l\u00e0 tr\u00e1m k\u00edn th\u00e2n r\u0103ng s\u1ebd ng\u0103n ng\u1eeba \u0111\u01b0\u1ee3c s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a c\u00e1c vi khu\u1ea9n m\u1edbi. Tuy nhi\u00ean, ngay c\u1ea3 khi \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u1ee3p l\u00fd, m\u1ed9t v\u00e0i ch\u1ee7ng vi khu\u1ea9n v\u1eabn c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i trong l\u00f2ng \u1ed1ng t\u1ee7y g\u00e2y ra vi\u00eam quanh ch\u00f3p v\u1edbi \u0111au dai d\u1eb3ng v\u00e0 \u0111\u00f4i khi l\u00e0 \u0111au b\u00f9ng ph\u00e1t. B\u00e0i vi\u1ebft n\u00e0y nh\u1eb1m \u0111\u00e1nh gi\u00e1 v\u00e0 nh\u00ecn nh\u1eadn l\u1ea1i vai tr\u00f2 Vi khu\u1ea9n trong b\u1ec7nh l\u00fd N\u1ed9i nha. C\u00f9ng t\u00ecm hi\u1ec3u.<\/strong><\/p>\n

1. Vai tr\u00f2 c\u1ee7a vi khu\u1ea9n trong b\u1ec7nh l\u00fd n\u1ed9i nha<\/h2>\n

S\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a vi khu\u1ea9n v\u00e0o h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y s\u1ebd g\u00e2y ra c\u00e1c b\u1ec7nh l\u00fd v\u1ec1 sau c\u1ee7a m\u00f4 t\u1ee7y v\u00e0 m\u00f4 quanh ch\u00f3p. M\u1ee5c ti\u00eau cu\u1ed1i c\u00f9ng c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e0 s\u1eeda so\u1ea1n h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y b\u1eb1ng c\u01a1 \u2013 h\u00f3a h\u1ecdc, bao g\u1ed3m vi\u1ec7c l\u00e0m s\u1ea1ch, t\u1ea1o h\u00ecnh v\u00e0 kh\u1eed tr\u00f9ng, c\u0169ng nh\u01b0 b\u1ecbt k\u00edn \u1ed1ng t\u1ee7y, do \u0111\u00f3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho s\u1ef1 l\u00e0nh th\u01b0\u01a1ng c\u1ee7a m\u00f4 quanh ch\u00f3p b\u1ecb b\u1ec7nh. Nhi\u1ec5m tr\u00f9ng n\u1ed9i nha nguy\u00ean ph\u00e1t l\u00e0 do nhi\u1ec1u lo\u1ea1i vi khu\u1ea9n, m\u00e0 ch\u1ee7 y\u1ebfu l\u00e0 vi khu\u1ea9n gram \u00e2m k\u1ecb kh\u00ed nh\u01b0 Prevotella ssp., Porphyromonas ssp., Treponema ssp., v\u00e0 Fusobacterium ssp. Nhi\u1ec5m tr\u00f9ng n\u1ed9i nha c\u00f3 th\u1ec3 lan r\u1ed9ng ra ngo\u00e0i h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y, g\u00e2y ra vi\u00eam nhi\u1ec5m t\u1ea1i ch\u1ed7, s\u01b0ng n\u1ec1 m\u00f4 m\u1ec1m r\u0103ng l\u00e2n c\u1eadn v\u00e0 hi\u1ebfm g\u1eb7p h\u01a1n l\u00e0 vi\u00eam m\u00f4 t\u1ebf b\u00e0o lan t\u1ecfa.<\/p>\n

Nh\u01b0 v\u1eady, kh\u1eed tr\u00f9ng \u1ed1ng t\u1ee7y l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 c\u01a1 b\u1ea3n \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha th\u00e0nh c\u00f4ng. C\u00e1c k\u0129 thu\u1eadt hi\u1ec7n t\u1ea1i \u0111\u1ec3 lo\u1ea1i b\u1ecf ho\u1eb7c gi\u1ea3m thi\u1ec3u l\u01b0\u1ee3ng vi khu\u1ea9n trong h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y bao g\u1ed3m s\u1eeda so\u1ea1n c\u01a1 h\u1ecdc, b\u01a1m r\u1eeda \u1ed1ng t\u1ee7y v\u1edbi t\u00e1c nh\u00e2n kh\u00e1ng khu\u1ea9n v\u00e0 b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 qu\u00e1 tr\u00ecnh tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y v\u00e0 sau \u0111\u00f3 l\u00e0 tr\u00e1m k\u00edn th\u00e2n r\u0103ng s\u1ebd ng\u0103n ng\u1eeba \u0111\u01b0\u1ee3c s\u1ef1 x\u00e2m nh\u1eadp c\u1ee7a c\u00e1c vi khu\u1ea9n m\u1edbi. Tuy nhi\u00ean, ngay c\u1ea3 khi \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u1ee3p l\u00fd, m\u1ed9t v\u00e0i ch\u1ee7ng vi khu\u1ea9n v\u1eabn c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i trong l\u00f2ng \u1ed1ng t\u1ee7y g\u00e2y ra vi\u00eam quanh ch\u00f3p v\u1edbi \u0111au dai d\u1eb3ng v\u00e0 \u0111\u00f4i khi l\u00e0 \u0111au b\u00f9ng ph\u00e1t. M\u1ed9t v\u00e0i b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 tr\u1ea3i qua c\u01a1n \u0111au b\u00f9ng ph\u00e1t do nhi\u1ec5m tr\u00f9ng n\u1ed9i nha ch\u1ec9 trong v\u00f2ng v\u00e0i gi\u1edd ho\u1eb7c v\u00e0i ng\u00e0y sau \u0111i\u1ec1u tr\u1ecb. T\u1ec9 l\u1ec7 \u0111au b\u00f9ng ph\u00e1t sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha r\u1ea5t thay \u0111\u1ed5i, t\u1eeb th\u1ea5p 1.5% \u0111\u1ebfn cao 20%.<\/p>\n

2. Th\u00e0nh ph\u1ea7n vi khu\u1ea9n trong nhi\u1ec5m tr\u00f9ng<\/h2>\n

Th\u00e0nh ph\u1ea7n c\u1ee7a vi khu\u1ea9n trong nhi\u1ec5m tr\u00f9ng th\u1ee9 ph\u00e1t ho\u1eb7c t\u00e1i ph\u00e1t \u1edf c\u00e1c r\u0103ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc \u0111\u00f3 kh\u00e1c v\u1edbi th\u00e0nh ph\u1ea7n \u0111\u01b0\u1ee3c th\u1ea5y \u1edf nh\u1eefng r\u0103ng ch\u01b0a \u0111i\u1ec1u tr\u1ecb. Vi khu\u1ea9n gram d\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p h\u01a1n vi khu\u1ea9n gram \u00e2m v\u00e0 l\u00e0 th\u00e0nh ph\u1ea7n ch\u1ee7 y\u1ebfu nh\u1ea5t c\u1ee7a nhi\u1ec5m tr\u00f9ng nguy\u00ean ph\u00e1t, th\u01b0\u1eddng \u0111\u00e3 \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf. C\u00e1c vi khu\u1ea9n th\u01b0\u1eddng g\u1eb7p g\u1ed3m c\u00e1c c\u1ea7u khu\u1ea9n, Parvimonas micra, c\u00e1c lo\u00e0i Actinomyces, c\u00e1c lo\u00e0i Propionibacterium, Pseudoramibacter alactolyticus, Lactobacillus v\u00e0 Enterococcus faecalis. Enterococcus faecalis l\u00e0 lo\u1ea1i th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec1u tr\u1ecb th\u1ea5t b\u1ea1i.<\/p>\n

\"vai-tro-vi-khuan-1\"
(a) H\u00ecnh \u1ea3nh theo chi\u1ec1u d\u1ecdc c\u1ee7a m\u1ed9t r\u0103ng \u0111\u00e3 nh\u1ed5 b\u1ecb ho\u1ea1i t\u1eed t\u1ee7y, v\u1edbi 1 tr\u00e2m tay \u0111\u1eb7t \u0111\u00fang chi\u1ec1u d\u00e0i l\u00e0m vi\u1ec7c. (b) M\u1ed9t c\u1ee5m vi khu\u1ea9n bao g\u1ed3m ch\u1ee7ng Enterococcus faecalis trong m\u1ed9t h\u1ed1c \u1edf th\u00e0nh \u1ed1ng t\u1ee7y. C\u00e1c vi khu\u1ea9n t\u1eadp h\u1ee3p l\u1ea1i v\u00e0 m\u1ed9t s\u1ed1 x\u00e2m nh\u1eadp v\u00e0o \u1ed1ng ng\u00e0. H\u00ecnh \u1ea3nh qu\u00e9t k\u00ednh hi\u1ec3n vi \u0111i\u1ec7n t\u1eed, v\u1edbi \u0111\u1ed9 ph\u00f3ng \u0111\u1ea1i x3500. (c) H\u00ecnh \u1ea3nh s\u1eed d\u1ee5ng k\u00ednh hi\u1ec3n vi qu\u00e9t laser \u1edf c\u00e1c \u1ed1ng ng\u00e0 v\u1edbi Enterococcus faecalis. Nh\u1eefng m\u1ea3nh v\u1ee5n n\u00e0y \u0111\u01b0\u1ee3c nhu\u1ed9m b\u1eb1ng thu\u1ed1c nhu\u1ed9m m\u00e0u Live\/Dead, cho th\u1ea5y vi khu\u1ea9n c\u00f2n s\u1ed1ng th\u00ec b\u1eaft m\u00e0u xanh l\u00e1 c\u00e2y.<\/figcaption><\/figure>\n

C\u00e1c b\u1eb1ng ch\u1ee9ng hi\u1ec7n t\u1ea1i cho th\u1ea5y ‘ sau Enterococcus faecalis v\u00e0 Actinomyces th\u00ec Candida albicans l\u00e0 nh\u1eefng vi khu\u1ea9n ph\u1ed5 bi\u1ebfn nh\u1ea5t li\u00ean quan \u0111\u1ebfn \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha th\u1ea5t b\u1ea1i. D\u01b0\u1eddng nh\u01b0 ch\u00fang c\u00f3 th\u1ec3 \u1ea9n n\u00e1u v\u00e0 x\u00e2m nh\u1eadp v\u00e0o ng\u00e0 r\u0103ng v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng \u0111\u1ec1 kh\u00e1ng v\u1edbi calcium.<\/p>\n

\"vai-tro-vi-khuan-2\"
(a) C\u00e1c \u1ed1ng ng\u00e0 c\u1ee7a th\u00e0nh \u1ed1ng t\u1ee7y ch\u1ee9a \u0111\u1ea7y vi khu\u1ea9n g\u1ed3m c\u00e1c c\u1ea7u khu\u1ea9n (cocci) d\u1ecdc theo \u0111\u01b0\u1eddng \u0111i c\u1ee7a ch\u00fang \u0111\u1ebfn t\u1ee7y r\u0103ng, sau khi s\u1eeda so\u1ea1n c\u01a1 h\u1ecdc b\u1eb1ng tr\u00e2m tay. (b) R\u0103ng c\u1ed1i l\u1edbn h\u00e0m d\u01b0\u1edbi \u0111\u00e3 nh\u1ed5, c\u1eaft d\u1ecdc r\u0103ng. H\u00ecnh \u1ea3nh qu\u00e9t k\u00ednh hi\u1ec3n vi \u0111i\u1ec7n t\u1eed, \u0111\u1ed9 ph\u00f3ng \u0111\u1ea1i x1500.<\/figcaption><\/figure>\n

S\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a vi sinh v\u1eadt trong h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y c\u0169ng l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra b\u1ec7nh l\u00fd vi\u00eam quanh ch\u00f3p. Vi khu\u1ea9n v\u00e0 \u0111\u1ed9c t\u1ed1 c\u1ee7a ch\u00fang c\u00f3 th\u1ec3 x\u00e2m nh\u1eadp v\u00e0o v\u00f9ng m\u00f4 quanh ch\u00f3p g\u00e2y ra vi\u00eam, m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng th\u00ec ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1ed9c t\u00ednh v\u00e0 s\u1ed1 l\u01b0\u1ee3ng vi sinh v\u1eadt hi\u1ec7n di\u1ec7n.<\/p>\n

\"vai-tro-vi-khuan-3\"
(a) H\u00ecnh \u1ea3nh qu\u00e9t tr\u00ean k\u00ednh hi\u1ec3n vi \u0111i\u1ec7n t\u1eed m\u1ed9t tr\u00e2m tay sau khi \u0111i qua l\u1ed7 ch\u00f3p, mang theo m\u00f9n ng\u00e0 t\u1eeb th\u00e0nh \u1ed1ng t\u1ee7y. \u0110\u1ed9 ph\u00f3ng \u0111\u1ea1i x120. (b) H\u00ecnh \u1ea3nh s\u1eed d\u1ee5ng k\u00ednh hi\u1ec3n vi hu\u1ef3nh quang c\u1ee7a l\u1edbp m\u00f9n v\u1edbi Candida albicans. Nh\u1eefng m\u1ea3nh v\u1ee5n n\u00e0y \u0111\u01b0\u1ee3c nhu\u1ed9m m\u00e0u v\u1edbi thu\u1ed1c nhu\u1ed9m m\u00e0u Live\/Dead, cho th\u1ea5y nh\u1eefng vi khu\u1ea9n s\u1ed1ng th\u00ec b\u1eaft m\u00e0u xanh l\u00e1 v\u00e0 vi khu\u1ea9n ch\u1ebft th\u00ec b\u1eaft m\u00e0u \u0111\u1ecf (c).<\/figcaption><\/figure>\n

Trong tr\u01b0\u1eddng h\u1ee3p vi\u00eam quanh ch\u00f3p c\u00f3 tri\u1ec7u ch\u1ee9ng th\u00ec c\u00e1c ch\u1ee7ng vi khu\u1ea9n ch\u1ee7 y\u1ebfu \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y l\u00e0 Parvimonas micra, Eubacterium, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella, v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 \u201cvi khu\u1ea9n s\u1eafc t\u1ed1 \u0111en\u201d (black pigmented bacteria) thu h\u00fat nhi\u1ec1u s\u1ef1 ch\u00fa \u00fd. \u0110\u1ed1i v\u1edbi gi\u1ea3i ph\u1eabu \u1ed1ng t\u1ee7y ph\u1ee9c t\u1ea1p \u1edf v\u00f9ng ch\u1ebd, eo th\u1eaft, delta ch\u00f3p v\u00e0 \u1edf c\u00e1c \u1ed1ng t\u1ee7y ph\u1ee5 th\u00ec vi\u1ec7c lo\u1ea1i b\u1ecf ho\u00e0n to\u00e0n vi khu\u1ea9n v\u1eabn l\u00e0 m\u1ed9t kh\u00f3 kh\u0103n. Ng\u01b0\u1eddi ta th\u1ea5y c\u00f3 m\u1ed1i li\u00ean h\u1ec7 r\u00f5 r\u00e0ng gi\u1eefa s\u1ef1 t\u1ed3n t\u1ea1i dai d\u1eb3ng c\u1ee7a l\u01b0\u1ee3ng l\u1edbn vi khu\u1ea9n, \u0111\u1ed9c t\u1ed1 c\u1ee7a ch\u00fang, \u0111au khi s\u1edd n\u1eafn, s\u1ef1 r\u1ec9 d\u1ecbch v\u00e0 l\u01b0\u1ee3ng TNF-\u03b1, IL-1\u03b2.<\/p>\n

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

C\u00e1c k\u0129 thu\u1eadt hi\u1ec7n t\u1ea1i \u0111\u1ec3 lo\u1ea1i b\u1ecf ho\u1eb7c gi\u1ea3m thi\u1ec3u l\u01b0\u1ee3ng vi khu\u1ea9n trong h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y bao g\u1ed3m s\u1eeda so\u1ea1n c\u01a1 h\u1ecdc, b\u01a1m r\u1eeda \u1ed1ng t\u1ee7y v\u1edbi t\u00e1c nh\u00e2n kh\u00e1ng khu\u1ea9n v\u00e0 b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 qu\u00e1 tr\u00ecnh tr\u00e1m b\u00edt \u1ed1ng t\u1ee7y v\u00e0 sau \u0111\u00f3 l\u00e0 tr\u00e1m k\u00edn […]<\/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":"\nVai tr\u00f2 vi khu\u1ea9n trong b\u1ec7nh l\u00fd N\u1ed9i nha. - Vinmec<\/title>\n<meta name=\"description\" content=\"Ngay c\u1ea3 khi \u0111i\u1ec1u tr\u1ecb t\u1ed1t, vi khu\u1ea9n c\u00f3 th\u1ec3 g\u00e2y vi\u00eam quanh ch\u00f3p. B\u00e0i vi\u1ebft \u0111\u00e1nh gi\u00e1 v\u00e0 nh\u00ecn nh\u1eadn vai tr\u00f2 Vi khu\u1ea9n trong b\u1ec7nh l\u00fd N\u1ed9i nha.\" \/>\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=\"Vai tr\u00f2 vi khu\u1ea9n trong b\u1ec7nh l\u00fd N\u1ed9i nha. - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Ngay c\u1ea3 khi \u0111i\u1ec1u tr\u1ecb t\u1ed1t, vi khu\u1ea9n c\u00f3 th\u1ec3 g\u00e2y vi\u00eam quanh ch\u00f3p. 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