{"id":2771,"date":"2023-04-09T20:10:49","date_gmt":"2023-04-09T13:10:49","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2771"},"modified":"2023-04-14T14:44:29","modified_gmt":"2023-04-14T07:44:29","slug":"chan-doan-va-dieu-tri-ton-thuong-slap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-ton-thuong-slap\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng SLAP"},"content":{"rendered":"<p><strong>SLAP (superior labrum anterior to posterior) l\u00e0 c\u1ea5u tr\u00fac s\u1ee5n vi\u1ec1n v\u00e0 g\u00e2n c\u01a1 nh\u1ecb \u0111\u1ea9u \u1edf ch\u1ed7 b\u00e1m v\u00e0o b\u1edd tr\u00ean \u1ed5 ch\u1ea3o x\u01b0\u01a1ng vai.\u00a0 C\u1ea5u tr\u00fac n\u00e0y d\u1ec5 b\u1ecb th\u01b0\u01a1ng t\u1ed5n khi d\u01b0 l\u1ef1c c\u1ee7a c\u01a1 nh\u1ecb \u0111\u1ea7u t\u00e1c \u0111\u1ed9ng v\u00e0o ch\u1ed3 b\u00e1m \u1edf b\u1edd tr\u00ean \u00f4 ch\u1ea3o g\u00e2y n\u00ean th\u01b0\u01a1ng t\u00f4n. T\u1ed3n th\u01b0\u01a1ng SLAP c\u00f3 th\u1ec3 l\u00e0 m\u1ea1n tinh v\u00e0 th\u01b0\u1eddng l\u00e0 nh\u1eefng ph\u00e1t hi\u1ec7n tinh t\u1ebf. Th\u00f4ng qua b\u00e0i vi\u1ebft, ch\u00fang t\u00f4i tr\u00ecnh b\u00e0y ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng SLAP.<\/strong><\/p>\n<p><strong>Nh\u00f3m t\u00e1c gi\u1ea3:<\/strong> PGS.TS. Tr\u1ea7n Trung D\u0169ng, <span class=\"BodyText1\">TS. \u0110\u1ed7 V\u0103n Minh, ThS. L\u00ea Kh\u00e1nh Tr\u00ecnh, ThS. Nguy\u1ec5n Anh \u0110\u1ee9c, ThS. Nguy\u1ec5n Trung V\u00e3n, ThS. Tr\u1ea7n \u0110\u1ee9c Tu\u1ea5n, BsCKII. V\u0169 Quang Ngh\u0129a<\/span><\/p>\n<h1>1.Ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng<\/h1>\n<p><strong>1.1.B\u1ec7nh s\u1eed<\/strong><\/p>\n<p>-Th\u01b0\u1eddng x\u1ea3y ra \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n ch\u01a1i th\u1ec3 thao c\u00f3 t\u1ea7m qu\u00e1 \u0111\u1ea7u nh\u01b0 n\u00e9m b\u00f3ng, c\u1ea7u l\u00f4ng, tennis, b\u00f3ng r\u1ed5, b\u01a1i l\u1ed9i&#8230; ho\u1eb7c sau m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng c\u1ee5 th\u1ec3.<\/p>\n<p>-B\u1ec7nh nh\u00e2n th\u01b0\u1eddng ph\u00e0n n\u00e0n v\u1ec1 tri\u1ec7u ch\u1ee9ng \u0111au:<\/p>\n<ul>\n<li>\u0110au ph\u00eda tr\u01b0\u1edbc vai, t\u0103ng khi \u0111\u01b0a tay qu\u00e1 \u0111\u1ea7u ho\u1eb7c b\u1ea5t ch\u00e9o th\u00e2n m\u00ecnh.<\/li>\n<li>K\u00e8m ti\u1ebfng k\u00eau \u201cl\u00e1ch c\u00e1ch\u201d v\u00e0 \u201cb\u1ed1p b\u1ed1p\u201d \u1edf trong vai.<\/li>\n<li>Th\u1ec9nh tho\u1ea3ng \u0111au v\u00e0o ban \u0111\u00eam ho\u1eb7c \u0111au v\u1edbi ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng h\u1eb1ng ng\u00e0y.<\/li>\n<li>K\u00e8m gi\u1ea3m ch\u1ee9c n\u0103ng c\u00f9a vai: gi\u1ea3m t\u1ed1c \u0111\u1ed9 v\u00e0 gi\u1ea3m s\u1ee9c m\u1ea1nh.<\/li>\n<li>\u0110\u1ed1i v\u1edbi <a href=\"https:\/\/vinmecdr.com\/ton-thuong-slap-mot-nguyen-nhan-gay-dau-vai-hay-gap-trong-the-thao\/\">v\u1eadn \u0111\u1ed9ng vi\u00ean th\u1ec3 thao<\/a> th\u01b0\u1eddng s\u1ebd xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng \u0111au v\u1edbi ho\u1ea1t \u0111\u1ed9ng t\u1ea7m qu\u00e1 \u0111\u1ea7u, v\u1eadn \u0111\u1ed9ng vi\u00ean n\u00e9m s\u1ebd gi\u1ea3m s\u1ee9c v\u00e0 l\u1ef1c n\u00e9m (h\u1ed9i ch\u1ee9ng gi\u1ea3 li\u1ec7t c\u00e1nh tay), tri\u1ec7u ch\u1ee9ng s\u1ebd th\u1ec3 hi\u1ec7n r\u00f5 r\u00e0ng ho\u1eb7c t\u0103ng d\u1ea7n theo th\u1eddi gian.<\/li>\n<\/ul>\n<p>-C\u00e1c t\u1ed5n th\u01b0\u01a1ng SLAP c\u00f3 nhi\u1ec1u c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng kh\u00e1c nhau,bao g\u1ed3m:<\/p>\n<ul>\n<li>L\u1ecbch s\u1eed c\u00f3 li\u00ean quan-\u00a0\u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng do l\u1ef1c k\u00e9o ho\u1eb7c h\u01b0\u1edbng ch\u1ea5n th\u01b0\u01a1ng tr\u1ef1c ti\u1ebfp v\u00e0o vai.<\/li>\n<li>Ch\u1ea5n th\u01b0\u01a1ng l\u1eadp \u0111i l\u1eb7p l\u1ea1i: chuy\u1ec3n \u0111\u1ed9ng c\u00e1nh tay t\u1ea7m qu\u00e1 \u0111\u1ea7u \u1edf v\u1eadn \u0111\u1ed9ng vi\u00ean n\u00e9m, b\u01a1i l\u1ed9i&#8230;<\/li>\n<\/ul>\n<p><strong>1.2.L\u00e2m s\u00e0ng<\/strong><\/p>\n<p>&#8211; \u0110\u00e1nh gi\u00e1 t\u1ed5ng th\u1ec3 kh\u1edbp vai:<\/p>\n<ul>\n<li>Tinh tr\u1ea1ng b\u1ea5t \u0111\u1ed1i x\u1ee9ng c\u1ee7a x\u01b0\u01a1ng vai hai b\u00ean?<\/li>\n<li>T\u00ecnh tr\u1ea1ng c\u01a1 b\u1eafp: c\u00f3 hay kh\u00f4ng c\u00f3 teo c\u01a1 ch\u00f3p xoay?<\/li>\n<li>T\u1ea7m v\u1eadn \u0111\u1ed9ng kh\u1edbp vai? (Th\u01b0\u1eddng n\u1ebfu t\u1ed5n th\u01b0\u01a1ng SLAP \u0111\u01a1n thu\u1ea7n thi t\u1ea7m v\u1eadn \u0111\u1ed9ng kh\u1edbp vai \u0111\u01b0\u1ee3c b\u1ea3o t\u1ed3n)<\/li>\n<li>L\u01b0u \u00fd c\u00e1c v\u1ecb tr\u00ed \u0111au c\u1ee7a s\u1ef1 va ch\u1ea1m b\u00ean trong (v\u00ed d\u1ee5 xoay ngo\u00e0i v\u00e0 d\u1ea1ng, xoay ngo\u00e0i kh\u1edbp vai)<\/li>\n<li>C\u00e1c tri\u1ec7u ch\u1ee9ng c\u01a1 h\u1ecdc c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u1ea1o ra khi kh\u1edbp vai d\u1ea1ng v\u00e0 xoay ngo\u00e0i.<\/li>\n<li>Ki \u1ec3m tra s\u1ef1 \u1ed5n \u0111\u1ecbnh c\u1ee7a kh\u1edbp vai \u0111\u1ec3 lo\u1ea1i tr\u1eeb c\u00e1c m\u1ea5t v\u1eefng li\u00ean quan.<\/li>\n<li>Th\u01b0\u1eddng \u1edf nh\u1eefng v\u1eadn \u0111\u1ed9ng vi\u00ean c\u00f3 v\u1eadn \u0111\u1ed9ng t\u1ea7m qu\u00e1 \u0111\u1ea7u, t\u1ea7m v\u1eadn \u0111\u1ed9ng xoay th\u01b0\u1eddng t\u0103ng xoay ngo\u00e0i v\u00e0 gi\u1ea3m xoay trong nh\u01b0ng khi thi\u1ebfu h\u1ee5t xoay trong &gt; 25 \u0111\u1ebfn 30 \u0111\u1ed9 so v\u1edbi b\u00ean \u0111\u1ed1i di\u1ec7n c\u00f3 th\u1ebf g\u1ee3i \u00fd c\u00f3 s\u1ef1 va ch\u1ea1m b\u00ean trong v\u00e0 r\u00e1ch SLAP.<\/li>\n<\/ul>\n<p>-C\u00e1c nghi\u1ec7m ph\u00e1p ki\u1ec3m tra :<\/p>\n<p><strong>The O\u2019Brien test: <\/strong>ki\u1ec3m tra cho r\u00e1ch s\u1ee5n vi\u1ec1n c\u1ee7a kh\u1edbp vai (d\u01b0\u01a1ng t\u00ednh gi\u1ea3 n\u1ebfu c\u00f3 m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng c\u1ee7a ch\u00f3p xoay ho\u1eb7c kh\u1edbp c\u00f9ng \u0111\u00f2n).<\/p>\n<p>T\u01b0 th\u1ebf: C\u00e1nh tay g\u1ea5p ra tr\u01b0\u1edbc kho\u1ea3ng 90 \u0111\u1ed9 v\u00e0 kh\u00e9p kho\u1ea3ng 10 \u0111\u1ed9. Th\u1ef1c hi\u1ec7n xoay trong c\u00e1nh tay, quay s\u1ea5p b\u00e0n tay t\u1ea1i khu\u1ef7u sao cho ng\u00f3n tay c\u00e1i ch\u1ec9 xu\u1ed1ng m\u1eb7t s\u00e0n.<img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2781 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-190525-300x164.png\" alt=\"\" width=\"300\" height=\"164\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-190525-300x164.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-190525.png 343w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p>Ng\u01b0\u00f2i kh\u00e1m \u0111\u1eb7t m\u1ed9t l\u1ef1c \u0111\u00e8 l\u00ean tr\u00ean c\u1ed5 tay c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 y\u00eau c\u1ea7u b\u1ec7nh nh\u00e2n n\u00e2ng c\u00e1nh tay \u0111\u1ed1i l\u1ea1i l\u1ef1c c\u1ee7a ng\u01b0\u1eddi kh\u00e1m. N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 \u0111au th\u00ec d\u01b0\u01a1ng t\u00ednh, g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng SLAP (\u0111au t\u1ea1i kh\u1edbp c\u00f9ng \u0111\u00f2n k\u1ebft h\u1ee3p v\u1edbi s\u1edd n\u1eafn t\u1ea1i ch\u1ed3 g\u1ee3i \u00fd b\u1ec7nh l\u00fd kh\u1edbp c\u00f9ng \u0111\u00f2n).<\/p>\n<p><strong>Speed test:<\/strong> ki\u1ec3m tra t\u1ed5n th\u01b0\u01a1ng c\u1ee7a \u0111\u1ea7u d\u00e0i g\u00e2n nh\u1ecb \u0111\u1ea7u.<\/p>\n<p>T\u01b0 th\u1ebf: C\u00e1nh tay g\u1ea5p v\u1ec1 tr\u01b0\u1edbc kho\u1ea3ng 60 \u0111\u1ed9, c\u1eb3ng tay ng\u1eeba v\u00e0 khu\u1ef7u tay du\u1ed7i h\u1ebft.<img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2783 size-full aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-190841.png\" alt=\"SLAP\" width=\"265\" height=\"148\" \/><\/p>\n<p>Ng\u01b0\u1eddi kh\u00e1m \u00e1p m\u1ed9t l\u1ef1c v\u00e0o c\u00e1nh tay t\u1ea1i c\u1eb3ng tay c\u1ee7a b\u1ec7nh nh\u00e2n. B\u1ec7nh nh\u00e2n ch\u1ed1ng l\u1ea1i \u00e1p l\u1ef1c c\u1ee7a ng\u01b0\u1eddi ki\u1ebfm tra. D\u01b0\u01a1ng t\u00ednh khi b\u1ec7nh nh\u00e2n c\u00f3 c\u1ea3m gi\u00e1c \u0111au \u1edf r\u00e3nh g\u00e2n nh\u1ecb \u0111\u1ea7u (\u0111\u00f4i l\u00fac b\u1ec7nh nh\u00e2n \u0111\u01b0a vai ra tr\u01b0\u1edbc \u0111\u1ec3 ch\u1ed1ng l\u1ea1i l\u1ef1c kh\u00e1m) . Tr\u01b0\u1eddng h\u1ee3p khi ng\u01b0\u1eddi kh\u00e1m d\u1eebng \u0111\u1ea9y c\u00e1nh tay xu\u1ed1ng, b\u1ec7nh nh\u00e2n c\u00f3 t\u00ecnh tr\u1ea1ng gi\u1eadt tay \u0111\u1ed9t ng\u1ed9t, g\u1ee3i \u00fd vi\u00eam t\u00fai ho\u1ea1t d\u1ecbch d\u01b0\u1edbi m\u1ecfm c\u00f9ng vai.<\/p>\n<p><strong>Biceps load test<\/strong><\/p>\n<p>T\u01b0 th\u1ebf: c\u00e1nh tay d\u1ea1ng 90 \u0111\u1ed9 v\u00e0 xoay ngo\u00e0i t\u1ed1i \u0111a, khu\u1ef7u g\u1ea5p 90 \u0111\u1ed9, c\u1eb3ng tay \u1edf v\u1ecb tr\u00ed s\u1ea5p. Ng\u01b0\u1eddi kh\u00e1m \u0111\u1eb7t m\u1ed9t l\u1ef1c l\u00ean c\u1eb3ng tay t\u1ea1i c\u1ed5 tay (h\u01b0\u1edbng l\u1ef1c l\u00e0 h\u01b0\u1edbng du\u1ed7i khu\u1ef7u), b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn \u0111\u1ec3 th\u1ef1c hi\u1ec7n co c\u01a1 nh\u1ecb \u0111\u1ea7u kh\u00e1ng l\u1ea1i l\u1ef1c c\u1ee7a ng\u01b0\u1eddi kh\u00e1m. \u0110au s\u00e2u trong vai trong su\u1ed1t th\u1eddi gian n\u00e0y l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a t\u1ed5n th\u01b0\u01a1ng SLAP.<img decoding=\"async\" loading=\"lazy\" class=\"wp-image-2787 size-full aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-191146.png\" alt=\"SLAP\" width=\"268\" height=\"153\" \/><\/p>\n<p><strong>Yergason Sign:<\/strong> d\u1ea5u hi\u1ec7u \u201cl\u1eadt ng\u1eeda\u201d, ki\u1ec3m tra \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng c\u1ee7a g\u00e2n nh\u1ecb \u0111\u1ea7u, s\u1ee5n vi\u1ec1n, d\u00e2y ch\u1eb1ng ngang c\u00e1nh tay.<\/p>\n<p>T\u01b0 th\u1ec3: b\u1ec7nh nh\u00e2n ng\u1ed3i, ng\u01b0\u1eddi kh\u00e1m \u0111\u1ee9ng b\u00ean c\u1ea1nh \u0111\u1ed3ng th\u1eddi m\u1ed9t tay \u1ea5n v\u00e0o r\u00e3nh nh\u1ecb \u0111\u1ea9u ho\u1eb7c gi\u1eef khu\u1ef7u. Khu\u1ef7u b\u1ec7nh nh\u00e2n g\u1ea5p 90 \u0111\u1ed9, c\u1eb3ng tay \u1edf t\u01b0 th\u1ebf trung gian ho\u1eb7c s\u1ea5p.<img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-2796 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-191852.png\" alt=\"\" width=\"226\" height=\"196\" \/><\/p>\n<p>Ng\u01b0\u1eddi kh\u00e1m \u00e1p m\u1ed9t l\u1ef1c v\u00e0o c\u1eb3ng tay t\u1ea1i c\u01a1 tay b\u1ec7nh nh\u00e2n, b\u1ec7nh nh\u00e2n c\u1ed1 g\u1eafng ng\u1eeda c\u1eb3ng tay ch\u1ed1ng l\u1ea1i \u00e1p l\u1ef1c c\u1ee7a ng\u01b0\u1eddi kh\u00e1m. D\u01b0\u01a1ng t\u00ednh n\u1ebfu c\u00f3 \u0111au \u1edf r\u00e3nh g\u00e2n nh\u1ecb \u0111\u1ea7u, g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng g\u00e2n nh\u1ecb \u0111\u1ea7u ho\u1eb7c c\u00f3 d\u1ea5u hi\u1ec7u b\u1eadt t\u00e1ch t\u00e1ch t\u1ea1i r\u00e3nh nh\u1ecb \u0111\u1ea7u g\u1ee3i \u1ef7 c\u00f3 t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng ngang.<\/p>\n<p><strong>Test \u0111o g\u00f3c xoay trong kh\u1edbp vai<\/strong><\/p>\n<p>T\u01b0 th\u1ebf: b\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eeba \u0111\u1ec3 x\u01b0\u01a1ng vai \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh. C\u00e1nh tay d\u1ea1ng 90 \u0111\u1ed9. Th\u1ef1c hi\u1ec7n xoay vai v\u00e0 \u0111o b\u1eb1ng gi\u00e1c k\u1ebf.<img decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-2800\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-192205-300x249.png\" alt=\"SLAP\" width=\"251\" height=\"208\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-192205-300x249.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-192205.png 316w\" sizes=\"(max-width: 251px) 100vw, 251px\" \/><\/p>\n<p>Khi c\u00f3 s\u1ef1 ng\u1ea3 ra sau qu\u00e1 m\u1ee9c c\u1ee7a ch\u1ecfm x\u01b0\u01a1ng c\u00e1nh tay, nh\u01b0 \u1edf c\u00e1c v\u1eadn \u0111\u1ed9ng vi\u00ean n\u00e9m b\u00f3ng, c\u00f3 th\u1ec3 c\u00f3 t\u00ecnh tr\u1ea1ng t\u0103ng xoay b\u00ean ngo\u00e0i v\u00e0 gi\u1ea3m xoay b\u00ean trong. N\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c chuy\u1ebfn \u0111\u1ed9ng \u0111\u1ea7y \u0111\u1ee7 sau m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh v\u1eadt l\u00fd tr\u1ecb li\u1ec7u, s\u1ef1 xu\u1ea5t hi\u1ec7n m\u1ed9t t\u1ed5n th\u01b0\u01a1ng SLAP n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t.<\/p>\n<h2>2.Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng SLAP<\/h2>\n<p><strong>2.1.X-quang<\/strong><\/p>\n<p>H\u00ecnh \u1ea3nh X-quang ban \u0111\u1ea7u n\u00ean ch\u1ee5p l\u00e0 phim X-quang vai ti\u00eau chu\u1ea9n g\u1ed3m: X-quang vai th\u1eb3ng tr\u01b0\u1edbc &#8211; sau (phim AP), Y outlet, Axillary Views&#8230; \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh xem c\u00f3 t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng n\u00e0o li\u00ean quan kh\u00f4ng.<\/p>\n<p><strong>2.2.C\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI)<\/strong><\/p>\n<p>MRI l\u00e0 k\u1ef9 thu\u1eadt \u01b0u ti\u00ean cho nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb nghi ng\u1edd c\u00f3 t\u1ed5n th\u01b0\u01a1ng SLAP. Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb c\u00f3 thu\u1ed1c \u0111\u1ed1i quang \u1edf t\u01b0 th\u1ebf c\u00e1nh tay d\u1ea1ng v\u00e0 xoay ngo\u00e0i th\u00ec \u0111\u1ed9 ch\u00ednh x\u00e1c c\u00e0ng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n.<\/p>\n<p>So s\u00e1nh v\u1edbi nh\u1eefng ph\u00e1t hi\u1ec7n tr\u00ean n\u1ed9i soi kh\u1edbp, b\u00e1o c\u00e1o \u0111\u1ed9 nh\u1ea1y, \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u v\u00e0 \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a MRI th\u00f4ng th\u01b0\u1eddng l\u1ea7n l\u01b0\u1ee3t l\u00e0: t\u1eeb 84% \u0111\u1ebfn 98%, 63% \u0111\u1ebfn 91%, v\u00e0 74% \u0111\u1ebfn 96%.<\/p>\n<p>V\u1edbi MRI c\u00f3 thu\u1ed1c \u0111\u1ed9 nh\u1ea1y b\u00e1o c\u00e1o dao \u0111\u1ed9ng t\u1eeb 82 \u0111\u1ebfn 100%, \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u t\u1eeb 71 \u0111\u1ebfn 98% v\u00e0 \u0111\u1ed9 ch\u00ednh x\u00e1c t\u1eeb 83 \u0111\u1ebfn 94%.<img decoding=\"async\" loading=\"lazy\" class=\"aligncenter\" src=\"https:\/\/hahoangkiem.com\/Upload\/images\/72(3).png\" alt=\"SLAP\" width=\"501\" height=\"180\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><strong>2.3.N\u1ed9i soi kh\u1edbp\u00a0<\/strong><\/p>\n<p>N\u1ed9i soi kh\u1edbp \u0111\u01b0\u1ee3c coi l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng trong ch\u1ea9n \u0111o\u00e1n t\u1ed5n th\u01b0\u01a1ng SLAP. N\u1ed9i soi th\u01b0\u1eddng s\u1eed d\u1ee5ng \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n v\u00e0 k\u1ebft h\u1ee3p v\u1edbi \u0111i\u1ec1u tr\u1ecb s\u1eeda ch\u1eefa t\u1ed5n th\u01b0\u01a1ng. M\u1ed9t s\u1ed1 d\u1ea5u hi\u1ec7u cho th\u1ea5y t\u1ed5n th\u01b0\u01a1ng SLAP trong n\u1ed9i soi:<\/p>\n<ul>\n<li>D\u1ea5u hi\u1ec7u \u201cb\u00f3c v\u1ecf ng\u01b0\u1ee3c\u201d (peel\u00adback)<img decoding=\"async\" loading=\"lazy\" class=\"aligncenter wp-image-2848 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-201520-300x123.png\" alt=\"SLAP\" width=\"300\" height=\"123\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-201520-300x123.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-201520.png 601w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/li>\n<li>D\u1ea5u hi\u1ec7u \u201cKhe\u201d (\u201csulcus\u201d)<img decoding=\"async\" loading=\"lazy\" class=\" wp-image-2849 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-201559x-300x257.png\" alt=\"\" width=\"217\" height=\"186\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-201559x-300x257.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-man-hinh-2023-04-09-201559x.png 309w\" sizes=\"(max-width: 217px) 100vw, 217px\" \/><\/li>\n<\/ul>\n<h3>3.\u0110i\u1ec1u tr\u1ecb<\/h3>\n<p>3.2.\u0110i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt:<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb ban \u0111\u1ea7u c\u1ee7a t\u1ed5n th\u01b0\u01a1ng SLAP n\u00ean \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt v\u1edbi ngh\u1ec9 ng\u01a1i v\u00e0 bao g\u1ed3m: thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid (NSA1DS), v\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u1edbi c\u00e1c b\u00e0i t\u1eadp k\u00e9o gi\u00e3n, b\u00e0i t\u1eadp t\u0103ng c\u01b0\u1eddng.<\/p>\n<p>\u0110\u1ed1i v\u1edbi v\u1eadn \u0111\u1ed9ng vi\u00ean n\u00e9m v\u00e0 v\u1eadn \u0111\u1ed9ng vi\u00ean c\u00f3 t\u1ea7m qu\u00e1 \u0111\u1ea7u c\u00f3 t\u00ecnh tr\u1ea1ng gi\u1ea3m xoay trong kh\u1edbp vai (bao kh\u1edbp ph\u00eda sau qu\u00e1 ch\u1eb7t), v\u1eadt l\u00fd tr\u1ecb li\u1ec7u k\u00e9o gi\u00e3n bao kh\u1edbp l\u00e0 c\u01a1 s\u1edf ch\u00ednh cho \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u. B\u00e0i t\u1eadp \u201cK\u00e9o gi\u00e3n \u1edf t\u01b0 th\u1ebf n\u0103m (Sleeper Stretch)\u201d r\u1ea5t c\u00f3 hi\u1ec7u qu\u1ea3 trong k\u00e9o gi\u00e3n bao kh\u1edbp ph\u00eda sau. N\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1eabn t\u1ed3n t\u1ea1i sau 03 th\u00e1ng \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt, x\u00e9t ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt.<\/p>\n<p>Ti\u00eam n\u1ed9i kh\u1edbp c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n v\u00e0 t\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng \u0111i\u1ec1u tr\u1ecb \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nghi ng\u1edd t\u1ed5n th\u01b0\u01a1ng SLAP.<\/p>\n<p><strong>3.2.\u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt<\/strong><\/p>\n<p>-Ch\u1ec9 \u0111\u1ecbnh:<\/p>\n<ul>\n<li>Th\u1ea5t b\u1ea1i c\u1ee7a \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt k\u00e9o d\u00e0i tr\u00ean 3 th\u00e1ng \u1edd nh\u1eefng b\u1ec7nh nh\u00e2n l\u00e2m s\u00e0ng nghi ng\u1edd r\u00e1ch SLAP.<\/li>\n<li>Sau m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng c\u1ee5 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng SLAP<\/li>\n<\/ul>\n<p>-Ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"193\">LO\u1ea0I T\u1ed4N TH\u01af\u01a0NG SLAP<\/td>\n<td width=\"556\">C\u00c1CH TH\u1ee8C PH\u1eaaU THU\u1eacT N\u1ed8I SOI<\/td>\n<\/tr>\n<tr>\n<td width=\"193\">Type 1<\/td>\n<td width=\"556\">Ph\u1eabu thu\u1eadt c\u1eaft l\u1ecdc t\u1ed1 ch\u1ee9c b\u1ecb x\u01b0\u1edbc kh\u1ecfi s\u1ee5n vi\u1ec1n (t\u01b0\u01a1ng t\u1ef1 c\u1eaft l\u1ecdc trong r\u00e1ch s\u1ee5n ch\u00eam kh\u1edbp g\u1ed1i)<\/td>\n<\/tr>\n<tr>\n<td width=\"193\">Type il<\/td>\n<td width=\"556\">Ph\u1eabu thu\u1eadt c\u1ed1 \u0111\u1ecbnh ph\u1ee9C\u1ecbh\u1ee3p s\u1ee5n vi\u1ec1n &#8211; g\u00e2n nh\u1ecb \u0111\u1ea7u b\u1eb1ng v\u00edt ch\u1ec9 neo<\/td>\n<\/tr>\n<tr>\n<td width=\"193\">Type III<\/td>\n<td width=\"556\">Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf t\u1ed5n th\u01b0\u01a1ng \u201cquai x\u00e1ch\u201d c\u1ee7a s\u1ee5n vi\u1ec1n tr\u00ean.<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"2\" width=\"193\">Type IV<\/td>\n<td width=\"556\">Neu r\u00e1ch g\u00e2n nh\u1ecb \u0111\u1ea7u &lt; 30%, \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u1eaft b\u1ecf t\u1ed5n th\u01b0\u01a1ng \u201cquai x\u00e1ch\u201d v\u00e0 c\u1ed1 \u0111\u1ecbnh ph\u1ea7n g\u00e2n nh\u1ecb \u0111\u1ea7u c\u00f2n l\u1ea1i b\u1eb1ng neo<\/td>\n<\/tr>\n<tr>\n<td width=\"556\">N\u1ebfu r\u00e1ch g\u00e2n nh\u1ecb \u0111\u1ea7u &gt; 30%, \u0111i\u1ec1u tr\u1ecb b\u00e0ng c\u00e1ch kh\u00e2u l\u1ea1i s\u1ee5n vi\u1ec1n v\u00e0 g\u00e2n nh\u1ecb \u0111\u1ea7u n\u1ebfu b\u1ec7nh nh\u00e2n tr\u1ebb (&lt; 40 tu\u1ed5i); \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n gi\u00e0 ti\u1ebfn h\u00e0nh c\u1eaft b\u1ecf s\u1ee5n vi\u1ec1n t\u1ed5n th\u01b0\u01a1ng, g\u00e2n nh\u1ecb \u0111\u1ea7u c\u00f3 th\u1ec3 c\u1eaft b\u1ecf ho\u1eb7c kh\u00e2u c\u1ed1 \u0111\u1ecbnh l\u1ea1i (kh\u00e2u b\u00ean &#8211; b\u00ean)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>T\u1ed5n th\u01b0\u01a1ng SLAP l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n g\u00e2y \u0111au vai v\u00e0 m\u1ea5t v\u1eefng. Nh\u1eefng t\u1ed5n th\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ebf l\u00e0 m\u1ed9t th\u00e1ch th\u1ee9c ch\u1ea5n \u0111o\u00e1n cho c\u00e1c b\u00e1c s\u1ef9 l\u00e2m s\u00e0ng do nh\u1eefng bi\u1ebfn \u0111\u1ed5i gi\u1ea3i ph\u1eabu b\u00ecnh th\u01b0\u1eddng c\u1ee7a ph\u1ee9c h\u1ee3p s\u1ee5n vi\u1ec1n tr\u00ean. T\u1ed5n th\u01b0\u01a1ng SLAP type II l\u00e0 th\u1ec3 l\u00e2m s\u00e0ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t v\u00e0 c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c.<\/p>\n<p>C\u00e1c t\u1ed5n th\u01b0\u01a1ng SLAP c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n d\u01b0\u1edbi 40 tu\u1ed5i c\u00f3 tham gia v\u00e0o ho\u1ea1t d\u00f4ng th\u1ec3 thao t\u1ea7m qu\u00e1 \u0111\u1ea7u ho\u1eb7c v\u1eadn \u0111\u1ed9ng vi\u00ean b\u00f3ng n\u00e9m ho\u1eb7c b\u1ecb ng\u00e3 tr\u00ean c\u00e1nh tay \u0111ang du\u1ed7i ho\u1eb7c m\u1ed9t vai b\u1ecb tr\u1eadt kli\u1edbp. Ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc ph\u1eabu thu\u1eadt t\u1ed5n th\u01b0\u01a1ng s\u1ee5n vi\u1ec1n tr\u00ean c\u1ea7n k\u1ebft h\u1ee3p b\u1ec7nh s\u1eed, kh\u00e1m l\u00e2m s\u00e0ng v\u00e0 c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh \u0111\u1eb7c bi\u1ec7t l\u00e0 n\u1ed9i soi kh\u1edbp. H\u1ea7u h\u1ebft c\u00e1c t\u1ed5n thir\u01a1ng SLAP type II c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ph\u1eabu thu\u1eadt n\u1ed9i soi. Th\u00e1ch th\u1ee9c sau ph\u1eabu thu\u1eadt khi s\u1ee9a ch\u1eefa t\u00f4n th\u01b0\u01a1ng SLAP l\u00e0 qui tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng nghi\u00eam ng\u1eb7t \u0111\u1ec3 ph\u00f2ng tr\u00e1nh c\u1ee9ng kh\u1edbp<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>SLAP (superior labrum anterior to posterior) l\u00e0 c\u1ea5u tr\u00fac s\u1ee5n vi\u1ec1n v\u00e0 g\u00e2n c\u01a1 nh\u1ecb \u0111\u1ea9u \u1edf ch\u1ed7 b\u00e1m v\u00e0o b\u1edd tr\u00ean \u1ed5 ch\u1ea3o x\u01b0\u01a1ng vai.\u00a0 C\u1ea5u tr\u00fac n\u00e0y d\u1ec5 b\u1ecb th\u01b0\u01a1ng t\u1ed5n khi d\u01b0 l\u1ef1c c\u1ee7a c\u01a1 nh\u1ecb \u0111\u1ea7u t\u00e1c \u0111\u1ed9ng v\u00e0o ch\u1ed3 b\u00e1m \u1edf b\u1edd tr\u00ean \u00f4 ch\u1ea3o g\u00e2y n\u00ean th\u01b0\u01a1ng t\u00f4n. T\u1ed3n [&hellip;]<\/p>\n","protected":false},"author":36,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[75,40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng SLAP - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110i\u1ec1u tr\u1ecb ban \u0111\u00e0u c\u1ee7a t\u1ed5n th\u01b0\u01a1ng SLAP n\u00ean \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt v\u1edbi nghi ng\u01a1i v\u00e0 bao g\u1ed3m: thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid (NSA1DS), v\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u1edbi c\u00e1c b\u00e0i t\u1eadp k\u00e9o gi\u00e3n, b\u00e0i t\u1eadp t\u0103ng c\u01b0\u1eddng. \u0110\u1ed1i v\u1edbi v\u1eadn \u0111\u1ed9ng vi\u00ean n\u00e9m v\u00e0 v\u1eadn \u0111\u1ed9ng vi\u00ean c\u00f3 t\u1ea7m qu\u00e1 \u0111\u1ea7u c\u00f3 t\u00ecnh tr\u1ea1ng gi\u1ea3m xoay trong kh\u1edbp vai (bao kh\u1edbp ph\u00eda sau qu\u00e1 ch\u1eb7t), v\u1eadt l\u00fd tr\u1ecb li\u1ec7u k\u00e9o gi\u00e3n bao kh\u1edbp l\u00e0 c\u01a1 s\u1edf ch\u00ednh cho \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u.\" \/>\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=\"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng SLAP - 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