{"id":27567,"date":"2023-04-30T19:31:32","date_gmt":"2023-04-30T12:31:32","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27567"},"modified":"2023-04-30T19:31:32","modified_gmt":"2023-04-30T12:31:32","slug":"hoi-chung-chum-duoi-ngua-cauda-equina-syndrome","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/30\/hoi-chung-chum-duoi-ngua-cauda-equina-syndrome\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng ch\u00f9m \u0111u\u00f4i ng\u1ef1a (Cauda Equina Syndrome)"},"content":{"rendered":"

H\u1ed9i ch\u1ee9ng ch\u00f9m \u0111u\u00f4i ng\u1ef1a l\u00e0 m\u1ed9t trong c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y \u0111au d\u1eef d\u1ed9i \u1edf v\u00f9ng th\u1eaft l\u01b0ng, th\u01b0\u1eddng do t\u1ed5n th\u01b0\u01a1ng (ch\u1ea5n th\u01b0\u01a1ng) ho\u1eb7c ch\u00e8n \u00e9p (tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m, u,…) g\u00e2y n\u00ean. D\u01b0\u1edbi \u0111\u00e2y tr\u00ecnh b\u00e0y v\u1ec1 c\u00e1ch ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb H\u1ed9i ch\u1ee9ng n\u00e0y.<\/p>\n

1. T\u1ed5ng quan<\/span><\/h2>\n

H\u1ed9i ch\u1ee9ng ch\u00f9m \u0111u\u00f4i ng\u1ef1a (CES)<\/strong> x\u1ea3y ra khi c\u00e1c r\u1ec5 th\u1ea7n kinh c\u1ee7a ch\u00f9m \u0111u\u00f4i ng\u1ef1a b\u1ecb ch\u00e8n \u00e9p. N\u00f3 l\u00e0m gi\u00e1n \u0111o\u1ea1n c\u00e1c ch\u1ee9c n\u0103ng v\u1eadn \u0111\u1ed9ng, c\u1ea3m gi\u00e1c \u0111\u1ebfn hai chi d\u01b0\u1edbi v\u00e0 b\u00e0ng quang. B\u1ec7nh nh\u00e2n b\u1ecb h\u1ed9i ch\u1ee9ng n\u00e0y th\u01b0\u1eddng nh\u1eadp vi\u1ec7n trong t\u00ecnh tr\u1ea1ng c\u1ea5p c\u1ee9u. CES c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng ti\u1ec3u kh\u00f4ng t\u1ef1 ch\u1ee7<\/strong>\u00a0v\u00e0\u00a0th\u1eadm ch\u00ed t\u00ea li\u1ec7t v\u0129nh vi\u1ec5n.<\/strong><\/p>\n

Ch\u00f9m \u0111u\u00f4i ng\u1ef1a l\u00e0 t\u1eadp h\u1ee3p c\u00e1c d\u00e2y th\u1ea7n kinh \u1edf ph\u1ea7n cu\u1ed1i c\u1ee7a t\u1ee7y s\u1ed1ng<\/strong>, do h\u00ecnh th\u1ec3 c\u1ee7a n\u00f3 gi\u1ed1ng v\u1edbi \u0111u\u00f4i ng\u1ef1a. T\u1ee7y s\u1ed1ng k\u1ebft th\u00fac \u1edf ph\u1ea7n tr\u00ean c\u1ee7a c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng. C\u00e1c r\u1ec5 th\u1ea7n kinh ri\u00eang r\u1ebd \u1edf \u0111o\u1ea1n cu\u1ed1i c\u1ee7a t\u1ee7y s\u1ed1ng ti\u1ebfp t\u1ee5c d\u1ecdc trong \u1ed1ng s\u1ed1ng. Ch\u00fang chi ph\u1ed1i v\u1eadn \u0111\u1ed9ng, c\u1ea3m gi\u00e1c cho \u0111\u00f4i ch\u00e2n v\u00e0 b\u00e0ng quang. Ch\u00f9m \u0111u\u00f4i ng\u1ef1a l\u00e0 s\u1ef1 ti\u1ebfp n\u1ed1i c\u1ee7a c\u00e1c r\u1ec5 th\u1ea7n kinh \u1edf v\u00f9ng th\u1eaft l\u01b0ng. Nh\u1eefng d\u00e2y th\u1ea7n kinh n\u00e0y g\u1eedi, nh\u1eadn t\u00edn hi\u1ec7u \u0111\u1ebfn v\u00e0 \u0111i t\u1eeb hai chi d\u01b0\u1edbi v\u00e0 c\u00e1c c\u01a1 quan v\u00f9ng ch\u1eadu.<\/p>\n

\"Gi\u1ea3i
Gi\u1ea3i ph\u1eabu v\u00f9ng c\u00f9ng c\u1ee5t<\/figcaption><\/figure>\n

2. T\u1ef7 l\u1ec7 m\u1eafc h\u1ed9i ch\u1ee9ng ch\u00f9m \u0111u\u00f4i ng\u1ef1a<\/span><\/h2>\n

CES kh\u00f4ng li\u00ean quan \u0111\u1ebfn gi\u1edbi t\u00ednh hay ch\u1ee7ng t\u1ed9c. N\u00f3 x\u1ea3y ra\u00a0ch\u1ee7 y\u1ebfu \u1edf ng\u01b0\u1eddi l\u1edbn<\/strong>, m\u1eb7c d\u00f9 CES do ch\u1ea5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1ecdi l\u1ee9a tu\u1ed5i. CES \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1ed9t t\u1ef7 l\u1ec7 r\u1ea5t nh\u1ecf c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt cho tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m th\u1eaft l\u01b0ng.<\/p>\n

3. Nguy\u00ean nh\u00e2n c\u1ee7a h\u1ed9i ch\u1ee9ng ch\u00f9m \u0111u\u00f4i ng\u1ef1a\u00a0<\/span><\/h2>\n

Nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p c\u1ee7a CES l\u00e0\u00a0tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m l\u1edbn \u1edf v\u00f9ng th\u1eaft l\u01b0ng.<\/strong>\u00a0M\u1ed9t l\u1ea7n k\u00e9o c\u0103ng qu\u00e1 m\u1ee9c ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 g\u00e2y ra tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m. Tuy nhi\u00ean, \u0111\u0129a \u0111\u1ec7m tho\u00e1i h\u00f3a t\u1ef1 nhi\u00ean theo tu\u1ed5i, v\u00e0 c\u00e1c d\u00e2y ch\u1eb1ng c\u1ed1 \u0111\u1ecbnh n\u00f3 b\u1eaft \u0111\u1ea7u y\u1ebfu \u0111i. Khi tr\u00ecnh tho\u00e1i h\u00f3a n\u00e0y ti\u1ebfn tri\u1ec3n, m\u1ed9t l\u1ea7n k\u00e9o c\u0103ng ho\u1eb7c xoay ng\u01b0\u1eddi t\u01b0\u01a1ng \u0111\u1ed1i nh\u1ecf c\u00f3 th\u1ec3 g\u00e2y v\u1ee1 \u0111\u0129a \u0111\u1ec7m.<\/p>\n

Sau \u0111\u00e2y l\u00e0 nh\u1eefng nguy\u00ean nh\u00e2n kh\u00e1c c\u1ee7a CES :<\/p>\n

    \n
  • C\u00e1c th\u01b0\u01a1ng t\u1ed5n v\u00e0 kh\u1ed1i u c\u1ed9t s\u1ed1ng.<\/li>\n
  • Nhi\u1ec5m tr\u00f9ng ho\u1eb7c vi\u00eam c\u1ed9t s\u1ed1ng.<\/li>\n
  • H\u1eb9p \u1ed1ng s\u1ed1ng th\u1eaft l\u01b0ng.<\/li>\n
  • Ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng (h\u1ecfa kh\u00ed, t\u00e9 ng\u00e3, tai n\u1ea1n \u00f4 t\u00f4).<\/li>\n
  • B\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh.<\/li>\n
  • D\u1ecb d\u1ea1ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch c\u1ed9t s\u1ed1ng (AVM).<\/li>\n
  • Xu\u1ea5t huy\u1ebft t\u1ee7y s\u1ed1ng (d\u01b0\u1edbi nh\u1ec7n, d\u01b0\u1edbi m\u00e0ng c\u1ee9ng, ngo\u00e0i m\u00e0ng c\u1ee9ng).<\/li>\n
  • Bi\u1ebfn ch\u1ee9ng ph\u1eabu thu\u1eadt sau ph\u1eabu thu\u1eadt c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng.<\/li>\n
  • G\u00e2y t\u00ea t\u1ee7y s\u1ed1ng.<\/li>\n<\/ul>\n

    4. Tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n<\/span><\/h2>\n

    Tri\u1ec7u ch\u1ee9ng c\u1ee7a CES gi\u1ed1ng nh\u01b0 nh\u1eefng t\u00ecnh tr\u1ea1ng kh\u00e1c. Tri\u1ec7u ch\u1ee9ng c\u1ee7a n\u00f3 c\u00f3 th\u1ec3 thay \u0111\u1ed5i v\u1ec1 c\u01b0\u1eddng \u0111\u1ed9 v\u00e0 ti\u1ebfn tri\u1ec3n ch\u1eadm theo th\u1eddi gian<\/strong>. CES bi\u1ec3u hi\u1ec7n qua m\u1ed9t d\u1ea3i bi\u1ebfn thi\u00ean c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1edbi \u0111\u1ed9 n\u1eb7ng ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 ch\u00e8n \u00e9p v\u00e0 c\u00e1c r\u1ec5 th\u1ea7n kinh c\u1ee5 th\u1ec3 \u0111ang b\u1ecb ch\u00e8n \u00e9p. Ngo\u00e0i tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m, c\u00e1c b\u1ec7nh c\u00f3 tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng t\u1ef1 CES bao g\u1ed3m: b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i bi\u00ean, h\u1ed9i ch\u1ee9ng n\u00f3n t\u1ee7y (medullaris conus), ch\u00e8n \u00e9p t\u1ee7y, v\u00e0 k\u00edch th\u00edch ho\u1eb7c ch\u00e8n \u00e9p c\u00e1c d\u00e2y th\u1ea7n kinh sau khi ch\u00fang \u0111i ra kh\u1ecfi c\u1ed9t s\u1ed1ng v\u00e0 \u0111i v\u00e0o v\u00f9ng ch\u1eadu. Hay c\u00f2n g\u1ecdi l\u00e0\u00a0b\u1ec7nh \u0111\u00e1m r\u1ed1i th\u1eaft l\u01b0ng c\u00f9ng.<\/strong><\/p>\n

    B\u1ec7nh nh\u00e2n b\u1ecb \u0111au l\u01b0ng n\u00ean c\u1ea3nh gi\u00e1c v\u1edbi c\u00e1c\u00a0tri\u1ec7u ch\u1ee9ng \u201cc\u1edd \u0111\u1ecf\u201d<\/strong>\u00a0sau \u0111\u00e2y c\u00f3 th\u1ec3 g\u1ee3i \u00fd CES:<\/p>\n

      \n
    • \u0110au d\u1eef d\u1ed9i th\u1eaft l\u01b0ng.<\/li>\n
    • Y\u1ebfu c\u01a1, m\u1ea5t c\u1ea3m gi\u00e1c, ho\u1eb7c \u0111au m\u1ed9t, ho\u1eb7c th\u01b0\u1eddng g\u1eb7p h\u01a1n l\u00e0 c\u1ea3 hai ch\u00e2n.<\/li>\n
    • M\u1ea5t c\u1ea3m gi\u00e1c v\u00f9ng c\u01a1 th\u1ec3 ng\u1ed3i tr\u00ean y\u00ean ng\u1ef1a.<\/li>\n
    • R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng b\u00e0ng quang m\u1edbi xu\u1ea5t hi\u1ec7n (nh\u01b0 b\u00ed ti\u1ec3u ho\u1eb7c ti\u1ec3u kh\u00f4ng t\u1ef1 ch\u1ee7).<\/li>\n
    • \u0110i ti\u1ec3u kh\u00f4ng t\u1ef1 ch\u1ee7 m\u1edbi xu\u1ea5t hi\u1ec7n.<\/li>\n
    • R\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c trong b\u00e0ng quang ho\u1eb7c tr\u1ef1c tr\u00e0ng.<\/li>\n
    • R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00ecnh d\u1ee5c m\u1edbi xu\u1ea5t hi\u1ec7n.<\/li>\n
    • M\u1ea5t ph\u1ea3n x\u1ea1 \u1edf ch\u00e2n.<\/li>\n<\/ul>\n

      B\u1ec7nh s\u1eed c\u00f3 li\u00ean quan<\/strong>:<\/strong><\/p>\n

        \n
      • Ch\u1ea5n th\u01b0\u01a1ng l\u01b0ng g\u1ea7n \u0111\u00e2y.<\/li>\n
      • Ph\u1eabu thu\u1eadt c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng g\u1ea7n \u0111\u00e2y.<\/li>\n
      • Ti\u1ec1n s\u1eed ung th\u01b0.<\/li>\n
      • Nhi\u1ec5m tr\u00f9ng n\u1eb7ng g\u1ea7n \u0111\u00e2y.<\/li>\n<\/ul>\n

        C\u00e1c x\u00e9t nghi\u1ec7m sau \u0111\u00e2y c\u00f3 th\u1ec3 h\u1eefu \u00edch trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n CES:<\/p>\n

          \n
        • Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (<\/strong>MRI<\/strong>):<\/strong>\u00a0m\u1ed9t x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n gi\u00fap d\u1ef1ng h\u00ecnh \u1ea3nh ba chi\u1ec1u c\u1ea5u tr\u00fac c\u01a1 th\u1ec3 nh\u1edd s\u1eed d\u1ee5ng t\u1eeb tr\u01b0\u1eddng v\u00e0 c\u00f4ng ngh\u1ec7 m\u00e1y t\u00ednh. MRI cho h\u00ecnh \u1ea3nh c\u1ee7a t\u1ee7y s\u1ed1ng, r\u1ec5 th\u1ea7n kinh, v\u00e0 c\u00e1c khu v\u1ef1c xung quanh.<\/li>\n<\/ul>\n
          \"H\u00ecnh
          H\u00ecnh \u1ea3nh MRI h\u1ed9i ch\u1ee9ng ch\u00f9m \u0111u\u00f4i ng\u1ef1a<\/figcaption><\/figure>\n
            \n
          • Myleogram:<\/strong> ch\u1ee5p X quang \u1ed1ng s\u1ed1ng sau khi ti\u00eam ch\u1ea5t c\u1ea3n quang v\u00e0o khoang d\u1ecbch n\u00e3o t\u1ee7y. C\u00f3 th\u1ec3 cho th\u1ea5y t\u1ee7y s\u1ed1ng ho\u1eb7c c\u00e1c d\u00e2y th\u1ea7n kinh trong \u1ed1ng s\u1ed1ng b\u1ecb \u0111\u1ea9y l\u1ec7ch do nh\u00e2n \u0111\u1ec7m tho\u00e1t v\u1ecb, gai x\u01b0\u01a1ng, kh\u1ed1i u,\u2026<\/li>\n<\/ul>\n

            \u0110i\u1ec1u tr\u1ecb<\/span><\/h2>\n

            Khi CES \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n, nguy\u00ean nh\u00e2n \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh,\u00a0ph\u1eabu thu\u1eadt kh\u1ea9n c\u1ea5p<\/strong>\u00a0l\u00e0 \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ecdn. M\u1ee5c \u0111\u00edch l\u00e0 \u0111\u1ec3 c\u1ee9u v\u00e3n c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a m\u1ea5t ch\u1ee9c n\u0103ng th\u1ea7n kinh.\u00a0N\u1ebfu kh\u00f4ng \u0111i\u1ec1u tr\u1ecb, CES c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u00ea li\u1ec7t v\u0129nh vi\u1ec5n v\u00e0 m\u1ea5t ki\u1ec3m so\u00e1t \u0111\u1ea1i \u2013 ti\u1ec3u ti\u1ec7n.<\/strong><\/p>\n

            B\u1ec7nh nh\u00e2n c\u00f3 b\u1ea5t c\u1ee9 tri\u1ec7u ch\u1ee9ng n\u00e0o trong c\u00e1c\u00a0\u201ctri\u1ec7u ch\u1ee9ng c\u1edd \u0111\u1ecf\u201d<\/strong>\u00a0n\u00ean \u0111i kh\u00e1m chuy\u00ean khoa ngo\u1ea1i th\u1ea7n kinh c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t. Ph\u1eabu thu\u1eadt k\u1ecbp th\u1eddi l\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t cho b\u1ec7nh nh\u00e2n b\u1ecb CES. \u0110i\u1ec1u tr\u1ecb trong v\u00f2ng 48 gi\u1edd sau khi kh\u1edfi ph\u00e1t h\u1ed9i ch\u1ee9ng t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i \u0111\u00e1ng k\u1ec3 trong vi\u1ec7c c\u1ea3i thi\u1ec7n khi\u1ebfm khuy\u1ebft c\u1ea3m gi\u00e1c, v\u1eadn \u0111\u1ed9ng c\u0169ng nh\u01b0 ch\u1ee9c n\u0103ng ti\u1ebft ni\u1ec7u v\u00e0 tr\u1ef1c tr\u00e0ng. Nh\u01b0ng ngay c\u1ea3 nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt sau khung gi\u1edd l\u00fd t\u01b0\u1edfng 48 gi\u1edd c\u0169ng c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3.<\/p>\n

            M\u1eb7c d\u00f9 h\u1ed3i ph\u1ee5c ng\u1eafn h\u1ea1n c\u1ee7a ch\u1ee9c n\u0103ng b\u00e0ng quang c\u00f3 th\u1ec3 h\u01a1i tr\u1ec5 sau h\u1ed3i ph\u1ee5c v\u1eadn \u0111\u1ed9ng c\u1ee7a chi d\u01b0\u1edbi, ch\u1ee9c n\u0103ng n\u00e0y c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c c\u1ea3i thi\u1ec7n nhi\u1ec1u n\u0103m sau ph\u1eabu thu\u1eadt. Sau ph\u1eabu thu\u1eadt, \u0111i\u1ec1u tr\u1ecb thu\u1ed1c k\u1ebft h\u1ee3p v\u1edbi vi\u1ec7c t\u1ef1 \u0111\u1eb7t \u1ed1ng th\u00f4ng ng\u1eaft qu\u00e3ng c\u00f3 th\u1ec3 gi\u00fap h\u1ed3i ph\u1ee5c ch\u1eadm nh\u01b0ng \u1ed5n \u0111\u1ecbnh ch\u1ee9c n\u0103ng c\u1ee7a b\u00e0ng quang v\u00e0 ru\u1ed9t.<\/p>\n

            Th\u00edch \u1ee9ng v\u1edbi CES<\/span><\/h2>\n

            CES c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng c\u1ea3 v\u1ec1 th\u1ec3 ch\u1ea5t l\u1eabn tinh th\u1ea7n, nh\u1ea5t l\u00e0 khi n\u00f3 m\u00e3n t\u00ednh.<\/strong>\u00a0Nh\u1eefng ng\u01b0\u1eddi b\u1ecb CES c\u00f3 th\u1ec3 kh\u00f4ng ti\u1ebfp t\u1ee5c l\u00e0m vi\u1ec7c \u0111\u01b0\u1ee3c v\u00ec \u0111au nhi\u1ec1u ho\u1eb7c c\u00e1c v\u1ea5n \u0111\u1ec1 kh\u00f4ng ki\u1ec3m so\u00e1t m\u00e0 x\u00e3 h\u1ed9i kh\u00f4ng th\u1ec3 ch\u1ea5p nh\u1eadn, hay do y\u1ebfu v\u1eadn \u0111\u1ed9ng v\u00e0 m\u1ea5t c\u1ea3m gi\u00e1c, hay k\u1ebft h\u1ee3p c\u1ee7a nh\u1eefng v\u1ea5n \u0111\u1ec1 tr\u00ean.<\/p>\n

            M\u1ea5t ki\u1ec3m so\u00e1t b\u00e0ng quang v\u00e0 \u0111\u1ea1i tr\u00e0ng c\u00f3 th\u1ec3 v\u00f4 c\u00f9ng kh\u1ed5 s\u1edf cho b\u1ec7nh nh\u00e2n. N\u00f3 g\u00e2y t\u00e1c \u0111\u1ed9ng r\u1ea5t ti\u00eau c\u1ef1c v\u1ec1 cu\u1ed9c s\u1ed1ng, c\u00f4ng t\u00e1c x\u00e3 h\u1ed9i v\u00e0 c\u00e1c m\u1ed1i quan h\u1ec7 c\u1ee7a b\u1ec7nh nh\u00e2n. B\u1ec7nh nh\u00e2n CES\u00a0c\u00f3 th\u1ec3 b\u1ecb nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ec3u th\u01b0\u1eddng xuy\u00ean<\/strong>. R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00ecnh d\u1ee5c c\u00f3 th\u1ec3 r\u1ea5t \u0111au kh\u1ed5 cho b\u1ec7nh nh\u00e2n v\u00e0 b\u1ea1n t\u00ecnh c\u1ee7a h\u1ecd. \u0110i\u1ec1u \u0111\u00f3 d\u1eabn \u0111\u1ebfn nh\u1eefng tr\u1ee5c tr\u1eb7c trong m\u1ed1i quan h\u1ec7 v\u00e0 tr\u1ea7m c\u1ea3m.<\/p>\n

            \u0110au th\u1ea7n kinh n\u1eb7ng c\u00f3 th\u1ec3 ph\u1ea3i \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c gi\u1ea3m \u0111au v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c c\u00f3 th\u1ec3 k\u00e9o theo c\u00e1c v\u1ea5n \u0111\u1ec1 kh\u00e1c. N\u1ebfu c\u01a1n \u0111au m\u00e3n t\u00ednh, n\u00f3 c\u00f3 th\u1ec3 \u201ctrung \u01b0\u01a1ng h\u00f3a\u201d v\u00e0 lan ra c\u00e1c khu v\u1ef1c kh\u00e1c c\u1ee7a c\u01a1 th\u1ec3. \u0110au do th\u1ea7n kinh c\u00f3 xu h\u01b0\u1edbng t\u1ed3i t\u1ec7 h\u01a1n v\u00e0o ban \u0111\u00eam v\u00e0 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn gi\u1ea5c ng\u1ee7. Lo\u1ea1i \u0111au n\u00e0y c\u00f3 xu h\u01b0\u1edbng t\u1ea1o ra m\u1ed9t c\u1ea3m gi\u00e1c b\u1ecfng r\u00e1t, r\u1ed3i tr\u1edf th\u00e0nh li\u00ean t\u1ee5c v\u00e0 kh\u00f4ng th\u1ec3 ch\u1ecbu n\u1ed5i. M\u1ea5t c\u1ea3m gi\u00e1c c\u00f3 th\u1ec3 ch\u1ec9 l\u00e0 c\u1ea3m gi\u00e1c ch\u00e2m ch\u00edch \u0111\u1ebfn t\u00ea d\u1ea1i ho\u00e0n to\u00e0n. C\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn b\u00e0ng quang, ru\u1ed9t v\u00e0 b\u1ed9 ph\u1eadn sinh d\u1ee5c. Y\u1ebfu c\u01a1 th\u01b0\u1eddng l\u00e0 \u1edf ch\u00e2n v\u00e0 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng vi\u1ec7c \u0111i l\u1ea1i.<\/p>\n

            Ng\u01b0\u1eddi b\u1ecb CES r\u1ea5t c\u1ea7n s\u1ef1 h\u1ed7 tr\u1ee3 tinh th\u1ea7n t\u1eeb b\u1ea1n b\u00e8 v\u00e0 c\u00e1c th\u00e0nh vi\u00ean trong gia \u0111\u00ecnh. N\u1ebfu c\u00f3 th\u1ec3, h\u1ecd c\u0169ng c\u1ea7n ph\u1ed1i h\u1ee3p ch\u1eb7t ch\u1ebd v\u1edbi b\u00e1c s\u0129 v\u1ec1 thu\u1ed1c v\u00e0 qu\u1ea3n l\u00fd b\u1ec7nh. C\u00f3 m\u1ed9t s\u1ed1 thu\u1ed1c c\u00f3 th\u1ec3 k\u00ea toa \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111au, c\u00e1c v\u1ea5n \u0111\u1ec1 b\u00e0ng quang v\u00e0 \u0111\u1ea1i tr\u00e0ng. Ngo\u00e0i ra, m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n th\u1ea5y r\u1eb1ng v\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u00e0 t\u01b0 v\u1ea5n t\u00e2m l\u00fd gi\u00fap h\u1ecd \u0111\u1ed1i ph\u00f3 v\u1edbi CES .<\/p>\n

            Ngu\u1ed3n:<\/p>\n

              \n
            1. Y h\u1ecdc c\u1ed9ng \u0111\u1ed3ng<\/li>\n
            2. American Association of Neurological Surgeons<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

              H\u1ed9i ch\u1ee9ng ch\u00f9m \u0111u\u00f4i ng\u1ef1a l\u00e0 m\u1ed9t trong c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y \u0111au d\u1eef d\u1ed9i \u1edf v\u00f9ng th\u1eaft l\u01b0ng, th\u01b0\u1eddng do t\u1ed5n th\u01b0\u01a1ng (ch\u1ea5n th\u01b0\u01a1ng) ho\u1eb7c ch\u00e8n \u00e9p (tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m, u,…) g\u00e2y n\u00ean. D\u01b0\u1edbi \u0111\u00e2y tr\u00ecnh b\u00e0y v\u1ec1 c\u00e1ch ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb H\u1ed9i ch\u1ee9ng n\u00e0y. 1. T\u1ed5ng quan H\u1ed9i ch\u1ee9ng ch\u00f9m […]<\/p>\n","protected":false},"author":10,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nH\u1ed9i ch\u1ee9ng ch\u00f9m \u0111u\u00f4i ng\u1ef1a (Cauda Equina Syndrome) - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng ch\u00f9m \u0111u\u00f4i ng\u1ef1a l\u00e0 m\u1ed9t trong c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y \u0111au d\u1eef d\u1ed9i \u1edf v\u00f9ng th\u1eaft l\u01b0ng. 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