{"id":28281,"date":"2023-04-25T13:38:36","date_gmt":"2023-04-25T06:38:36","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28281"},"modified":"2023-05-07T23:25:27","modified_gmt":"2023-05-07T16:25:27","slug":"ung-thu-duong-vat-huong-dan-chan-doan-theo-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/ung-thu-duong-vat-huong-dan-chan-doan-theo-bo-y-te\/","title":{"rendered":"Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt: H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n theo b\u1ed9 Y t\u1ebf"},"content":{"rendered":"

Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt l\u00e0 b\u1ec7nh l\u00fd hi\u1ebfm g\u1eb7p nh\u01b0ng l\u1ea1i nguy hi\u1ec3m \u0111\u1ed1i v\u1edbi nam gi\u1edbi. Ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 ch\u00ednh x\u00e1c gi\u00fap t\u0103ng kh\u1ea3 n\u0103ng ch\u1eefa kh\u1ecfi ho\u00e0n to\u00e0n v\u00e0 n\u00e2ng cao ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. B\u00e0i vi\u1ebft sau \u0111\u00e2y s\u1ebd gi\u1edbi thi\u1ec7u v\u1ec1 h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n c\u1ee7a ung th\u01b0 d\u01b0\u01a1ng v\u1eadt theo b\u1ed9 Y t\u1ebf.<\/strong><\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng v\u1ec1 ung th\u01b0 d\u01b0\u01a1ng v\u1eadt<\/h2>\n

Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt (UTDV) l\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 xu\u1ea5t ph\u00e1t t\u1eeb ni\u00eam m\u1ea1c bao quy \u0111\u1ea7u, quy \u0111\u1ea7u v\u00e0 sarcoma xu\u1ea5t ph\u00e1t t\u1eeb t\u1ebf b\u00e0o li\u00ean k\u1ebft c\u1ee7a d\u01b0\u01a1ng v\u1eadt. Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt h\u1ea7u h\u1ebft l\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o v\u1ea3y, sinh ra t\u1eeb l\u1edbp bi\u1ec3u m\u00f4 l\u00e1t t\u1ea7ng kh\u00f4ng s\u1eebng ho\u00e1, h\u1ea7u nh\u01b0 kh\u00f4ng g\u1eb7p ung th\u01b0 t\u1ebf b\u00e0o \u0111\u00e1y. Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt l\u00e0 b\u1ec7nh kh\u00f4ng ph\u1ed5 bi\u1ebfn v\u00e0 t\u1ea1i Vi\u1ec7t Nam t\u1ef7 l\u1ec7 m\u1eafc chu\u1ea9n theo tu\u1ed5i l\u00e0 0,67\/100.000 d\u00e2n. T\u1ef7 l\u1ec7 m\u1eafc thay \u0111\u1ed5i t\u00f9y theo nh\u00f3m ch\u1ee7ng t\u1ed9c, d\u00e2n t\u1ed9c v\u00e0 v\u1ecb tr\u00ed \u0111\u1ecba l\u00fd. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 quan tr\u1ecdng bao g\u1ed3m c\u00e1c th\u00f3i quen v\u0103n h\u00f3a v\u00e0 x\u00e3 h\u1ed9i c\u00e1c \u0111i\u1ec1u ki\u1ec7n v\u1ec7 sinh v\u00e0 t\u00edn ng\u01b0\u1ee1ng t\u00f4n gi\u00e1o.<\/p>\n

Nguy\u00ean nh\u00e2n hay g\u1eb7p nh\u1ea5t l\u00e0 h\u1eb9p bao quy \u0111\u1ea7u chi\u1ebfm t\u1ef7 l\u1ec7 kho\u1ea3ng 25-75% \u1edf nam gi\u1edbi. UTDV th\u01b0\u1eddng g\u1eb7p h\u01a1n tr\u00ean b\u1ec7nh nh\u00e2n c\u1eaft bao quy \u0111\u1ea7u mu\u1ed9n \u0111\u1ebfn tu\u1ed5i d\u1eady th\u00ec. C\u1ea3 ung th\u01b0 d\u01b0\u01a1ng v\u1eadt \u1edf nam gi\u1edbi v\u00e0 ung th\u01b0 c\u1ed5 t\u1eed cung \u1edf ph\u1ee5 n\u1eef \u0111\u1ec1u c\u00f3 li\u00ean quan \u0111\u1ebfn nhi\u1ec5m tr\u00f9ng Papilloma virus (HPV).<\/a> Typ virus HPV-16 v\u00e0 HPV-18 \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf m\u1ed9t ph\u1ea7n ba nam gi\u1edbi b\u1ecb ung th\u01b0 d\u01b0\u01a1ng v\u1eadt.<\/p>\n

\"minh-hoa-ung-thu-duong-vat\"
Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt l\u00e0 b\u1ec7nh l\u00fd hi\u1ebfm g\u1eb7p nh\u01b0ng nguy hi\u1ec3m \u1edf nam gi\u1edbi<\/figcaption><\/figure>\n

2. Ch\u1ea9n \u0111o\u00e1n ung th\u01b0 d\u01b0\u01a1ng v\u1eadt<\/h2>\n

2.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/h3>\n

2.1.1. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/h3>\n

2.1.1.1. Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng<\/h4>\n
    \n
  • Quy \u0111\u1ea7u ng\u1ee9a, ti\u1ebft d\u1ecbch h\u00f4i k\u00e9o d\u00e0i, \u0111au khi va ch\u1ea1m, khi giao h\u1ee3p, th\u1eadm ch\u00ed khi \u0111i ti\u1ec3u. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng n\u00e9 tr\u00e1nh quan h\u1ec7 t\u00ecnh d\u1ee5c.<\/li>\n
  • Ch\u1ea3y m\u00e1u khi v\u1ec7 sinh sinh d\u1ee5c, khi va ch\u1ea1m ho\u1eb7c khi giao h\u1ee3p.<\/li>\n
  • S\u1ed1t do t\u1ed5n th\u01b0\u01a1ng b\u1ed9i nhi\u1ec5m, nhi\u1ec5m tr\u00f9ng.<\/li>\n
  • T\u00f9y thu\u1ed9c v\u1ecb tr\u00ed s\u1ed1 l\u01b0\u1ee3ng c\u01a1 quan di c\u0103n bi\u1ec3u hi\u1ec7n \u0111au, g\u1ea7y s\u00fat, m\u1ec7t m\u1ecfi\u2026<\/li>\n<\/ul>\n

    2.1.1.2. Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3<\/h4>\n
      \n
    • Tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng h\u1eb9p bao quy \u0111\u1ea7u kh\u1ed1i u xu\u1ea5t hi\u1ec7n \u1edf m\u1eb7t trong bao quy \u0111\u1ea7u ho\u1eb7c \u1edf r\u00e3nh bao quy \u0111\u1ea7u. \u0110\u1ea7u ti\u00ean, u bi\u1ec3u hi\u1ec7n l\u00e0 m\u1ed9t n\u1ed1t s\u00f9i, d\u1ec5 ch\u1ea3y m\u00e1u khi va ch\u1ea1m.<\/li>\n
    • Tr\u01b0\u1eddng h\u1ee3p c\u00f3 h\u1eb9p bao quy \u0111\u1ea7u, ung th\u01b0 b\u1ecb che l\u1ea5p, kh\u00f3 ch\u1ea9n \u0111o\u00e1n s\u1edbm. Giai \u0111o\u1ea1n \u0111\u1ea7u u nh\u1ecf, k\u00edn \u0111\u00e1o. \u0110\u1ebfn kh\u00e1m, th\u1ea7y thu\u1ed1c ph\u1ea3i m\u1edf bao quy \u0111\u1ea7u m\u1edbi th\u1ea5y kh\u1ed1i u d\u1ea1ng s\u00f9i, d\u1ea1ng lo\u00e9t, ho\u1eb7c lo\u00e9t s\u00f9i. T\u1ed5n th\u01b0\u01a1ng d\u1ec5 ch\u1ea3y m\u00e1u, c\u00f3 m\u00f9i h\u00f4i \u0111\u1eb7c bi\u1ec7t kh\u00f3 ch\u1ecbu. C\u1ea7n sinh thi\u1ebft ch\u1ea9n \u0111o\u00e1n gi\u1ea3i ph\u1eabu b\u1ec7nh, kh\u00f4ng n\u00ean c\u1eaft b\u1ecf u ho\u1eb7c c\u1eaft bao quy \u0111\u1ea7u m\u00e0 kh\u00f4ng x\u00e9t nghi\u1ec7m m\u00f4 b\u1ec7nh h\u1ecdc.<\/li>\n
    • Giai \u0111o\u1ea1n mu\u1ed9n h\u01a1n, kh\u1ed1i u l\u1edbn, d\u01b0\u01a1ng v\u1eadt nh\u01b0 qu\u1ea3 l\u1eafc chu\u00f4ng. Kh\u1ed1i u chi\u1ebfm ch\u1ed7, \u0111\u1ea9y c\u0103ng bao quy \u0111\u1ea7u. \u0110\u1ea7u d\u01b0\u01a1ng v\u1eadt tr\u1edf n\u00ean to v\u00e0 n\u1eb7ng, k\u00e9o th\u00f5ng d\u01b0\u01a1ng v\u1eadt xu\u1ed1ng d\u01b0\u1edbi nh\u01b0 m\u1ed9t chi\u1ebfc d\u00f9i tr\u1ed1ng. Kh\u1ed1i u c\u00f3 th\u1ec3 x\u00e2m l\u1ea5n, ph\u00e1 hu\u1ef7 m\u1ed9t ph\u1ea7n bao quy \u0111\u1ea7u, s\u00f9i lo\u00e9t d\u1ec5 ch\u1ea3y m\u00e1u, ti\u1ebft d\u1ecbch h\u00f4i. Da d\u01b0\u01a1ng v\u1eadt b\u1ecb b\u1ed9i nhi\u1ec5m, n\u1ec1 \u0111\u1ecf, r\u1ed1i lo\u1ea1n v\u1eadn m\u1ea1ch t\u1ea1i ch\u1ed7 l\u00e0m cho d\u01b0\u01a1ng v\u1eadt \u1ee9 m\u00e1u, to v\u00e0 d\u00e0i h\u01a1n b\u00ecnh th\u01b0\u1eddng trong t\u00ecnh tr\u1ea1ng kh\u00f4ng c\u01b0\u01a1ng c\u1ee9ng. Ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n n\u00e0y d\u1ec5 nh\u01b0ng c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 nh\u1ea7m. M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p u r\u1ea5t l\u1edbn nh\u01b0ng th\u1ef1c ra u ch\u1ec9 chi\u1ebfm g\u1ea7n h\u1ebft bao quy \u0111\u1ea7u, ch\u01b0a lan \u0111\u1ebfn quy \u0111\u1ea7u. Kh\u1ed1i u l\u00e0 m\u1ed9t kh\u1ed1i l\u1edbn, \u0111\u1ea9y quy \u0111\u1ea7u qua m\u1ed9t b\u00ean. N\u1ebfu nh\u1ea7m l\u00e0 ung th\u01b0 ph\u00e1 hu\u1ef7 to\u00e0n b\u1ed9 quy \u0111\u1ea7u, c\u00f3 th\u1ec3 ch\u1ec9 \u0111\u1ecbnh c\u1eaft c\u1ee5t kh\u00f4ng h\u1ee3p l\u00fd. V\u00ec v\u1eady, khi c\u00f3 h\u1eb9p bao quy \u0111\u1ea7u che l\u1ea5p u th\u00ec n\u00ean m\u1edf bao \u0111\u00e1nh gi\u00e1 \u0111\u00fang ung th\u01b0 lan r\u1ed9ng \u1edf m\u1ee9c \u0111\u1ed9 n\u00e0o \u0111\u1ec3 ch\u1ec9 \u0111\u1ecbnh c\u1eaft c\u1ee5t hay kh\u00f4ng.<\/li>\n
    • Ung th\u01b0 x\u00e2m l\u1ea5n th\u00e2n d\u01b0\u01a1ng v\u1eadt b\u1eb1ng hai h\u00ecnh th\u00e1i l\u00e2m s\u00e0ng kh\u00e1c nhau. H\u00ecnh th\u00e1i th\u1ee9 nh\u1ea5t, u lan theo da d\u01b0\u01a1ng v\u1eadt, th\u01b0\u1eddng l\u00e0 th\u1ec3 s\u00f9i, ph\u00e1t tri\u1ec3n nhanh hay ch\u1eadm tu\u1ef3 m\u1ee9c \u0111\u1ed9 \u00e1c t\u00ednh. Khi lan h\u1ebft da d\u01b0\u01a1ng v\u1eadt, u x\u00e2m l\u1ea5n ti\u1ebfp \u0111\u1ebfn da b\u00ecu v\u00e0 da mu. Kh\u1ed1i s\u00f9i to, h\u00f4i h\u00e1m, d\u1ec5 ch\u1ea3y m\u00e1u, th\u1eadm ch\u00ed c\u00f3 ho\u1ea1i t\u1eed c\u1ee5t d\u1ea7n \u0111\u1ea7u d\u01b0\u01a1ng v\u1eadt. H\u00ecnh th\u00e1i th\u1ee9 hai, u g\u00e2y \u0111\u00f4ng m\u00e1u trong v\u1eadt hang, l\u00e0m cho d\u01b0\u01a1ng v\u1eadt c\u1ee9ng th\u00e0nh m\u1ed9t kh\u1ed1i t\u1eeb ng\u1ecdn cho \u0111\u1ebfn t\u1eadn g\u1ed1c. U th\u01b0\u1eddng ph\u00e1t tri\u1ec3n nhanh, \u0111\u1ed9 \u00e1c t\u00ednh cao. Khi lan h\u1ebft th\u00e2n d\u01b0\u01a1ng v\u1eadt, u x\u00e2m l\u1ea5n ti\u1ebfp \u0111\u1ebfn tuy\u1ebfn ti\u1ec1n li\u1ec7t, th\u1eadm ch\u00ed \u0111\u1ebfn c\u1ed5 b\u00e0ng quang. N\u00ean th\u0103m tr\u1ef1c tr\u00e0ng \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng v\u00f9ng tuy\u1ebfn ti\u1ec1n li\u1ec7t.<\/li>\n
    • Trong m\u1ecdi tr\u01b0\u1eddng h\u1ee3p, ni\u1ec7u \u0111\u1ea1o v\u00e0 v\u1eadt x\u1ed1p c\u1ee7a d\u01b0\u01a1ng v\u1eadt \u00edt b\u1ecb x\u00e2m l\u1ea5n h\u01a1n v\u1eadt hang v\u00e0 da. \u0110i\u1ec1u n\u00e0y kh\u00f3 gi\u1ea3i th\u00edch nh\u01b0ng c\u1ea7n quan t\u00e2m khi \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng trong ph\u1eabu thu\u1eadt v\u00e0 ki\u1ec3m tra di\u1ec7n c\u1eaft.<\/li>\n
    • H\u1ea1ch khu v\u1ef1c c\u1ee7a d\u01b0\u01a1ng v\u1eadt thu\u1ed9c c\u00e1c nh\u00f3m h\u1ea1ch b\u1eb9n n\u00f4ng, h\u1ea1ch b\u1eb9n s\u00e2u, h\u1ea1ch ch\u1eadu ngo\u00e0i. Th\u00f4ng th\u01b0\u1eddng, ung th\u01b0 x\u00e2m nh\u1eadp v\u00e0o ch\u1eb7ng h\u1ea1ch th\u1ee9 nh\u1ea5t l\u00e0 h\u1ea1ch b\u1eb9n n\u00f4ng. \u0110\u1ebfn ch\u1eb7ng hai, ung th\u01b0 x\u00e2m nh\u1eadp h\u1ea1ch b\u1eb9n s\u00e2u ho\u1eb7c v\u00e0o h\u1ea1ch ch\u1eadu ngo\u00e0i. Tu\u1ef3 theo u khu tr\u00fa b\u00ean n\u00e0o c\u1ee7a d\u01b0\u01a1ng v\u1eadt m\u00e0 c\u00f3 h\u1ea1ch b\u00ean \u0111\u00f3 s\u1edbm b\u1ecb di c\u0103n h\u01a1n b\u00ean kia. \u0110\u1ed9 \u00e1c t\u00ednh v\u1ec1 m\u1eb7t m\u00f4 h\u1ecdc c\u00e0ng cao th\u00ec c\u00e0ng s\u1edbm di c\u0103n h\u1ea1ch, c\u00e0ng di c\u0103n nhi\u1ec1u h\u1ea1ch v\u00e0 nhi\u1ec1u ch\u1eb7ng h\u1ea1ch. Kh\u00f4ng nh\u1ea5t thi\u1ebft kh\u1ed1i u c\u00e0ng l\u1edbn th\u00ec c\u00e0ng nhi\u1ec1u di c\u0103n h\u1ea1ch.<\/li>\n
    • Ch\u1ea9n \u0111o\u00e1n di c\u0103n h\u1ea1ch b\u1eb9n trong UTDV b\u1eb1ng l\u00e2m s\u00e0ng kh\u00e1 d\u1ec5 d\u00e0ng khi h\u1ea1ch to, ch\u1eafc, v\u1ee1 ra ngo\u00e0i da. Tr\u01b0\u1eddng h\u1ee3p h\u1ea1ch to v\u1eeba, \u0111\u01a1n \u0111\u1ed9c, di \u0111\u1ed9ng th\u00ec kh\u00f3 ch\u1ea9n \u0111o\u00e1n h\u01a1n, kh\u00f3 ph\u00e2n bi\u1ec7t h\u1ea1ch to ph\u1ea3n \u1ee9ng v\u1edbi vi\u00eam nhi\u1ec5m t\u1ea1i d\u01b0\u01a1ng v\u1eadt hay h\u1ea1ch to do di c\u0103n h\u1ea1ch. Kh\u00f4ng n\u00ean ch\u1ecdc h\u00fat ch\u1ea9n \u0111o\u00e1n t\u1ebf b\u00e0o h\u1ea1ch v\u00ec gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n th\u1ea5p, t\u00e1c h\u1ea1i nhi\u1ec1u do ch\u1ecdc v\u1ee1 v\u1ecf h\u1ea1ch, lan tr\u00e0n t\u1ebf b\u00e0o ung th\u01b0 ra ngo\u00e0i h\u1ea1ch.<\/li>\n
    • Di c\u0103n h\u1ea1ch b\u1eb9n s\u00e2u v\u00e0 h\u1ea1ch ch\u1eadu \u00edt khi s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c. Tr\u01b0\u1eddng h\u1ee3p h\u1ea1ch ch\u1eadu b\u1ecb di c\u0103n nhi\u1ec1u, d\u00ednh th\u00e0nh \u0111\u00e1m, \u00f4m ch\u1eb7t, th\u1eadm ch\u00ed x\u00e2m l\u1ea5n v\u00e0o l\u00f2ng t\u0129nh m\u1ea1ch ch\u1eadu v\u00e0 h\u1ec7 b\u1ea1ch m\u1ea1ch ch\u1eadu g\u00e2y n\u00ean ph\u00f9 ch\u00e2n 1 ho\u1eb7c 2 b\u00ean. Tri\u1ec7u ch\u1ee9ng ph\u00f9 ch\u00e2n c\u00f3 th\u1ec3 k\u00edn \u0111\u00e1o, nh\u01b0ng c\u1ea7n ph\u00e1t hi\u1ec7n v\u00ec \u0111\u00f3 l\u00e0 d\u1ea5u hi\u1ec7u ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt. Si\u00eau \u00e2m \u0111\u00e1nh gi\u00e1 h\u1ea1ch ch\u1eadu l\u00e0 c\u1ea7n thi\u1ebft.<\/li>\n<\/ul>\n

      2.1.2. Tri\u1ec7u ch\u1ee9ng c\u1eadn l\u00e2m s\u00e0ng<\/h3>\n

      2.1.2.1. X\u00e9t nghi\u1ec7m<\/h4>\n
        \n
      • X\u00e9t nghi\u1ec7m \u0111\u00e1nh gi\u00e1 chung, bao g\u1ed3m c\u00f4ng th\u1ee9c m\u00e1u; x\u00e9t nghi\u1ec7m sinh h\u00f3a m\u00e1u, \u0111\u00f4ng m\u00e1u, HbsAg, HIV \u2026<\/li>\n
      • B\u1ec7nh nh\u00e2n ung th\u01b0 d\u01b0\u01a1ng v\u1eadt ti\u1ebfn tri\u1ec3n c\u00f3 th\u1ec3 b\u1ecb thi\u1ebfu m\u00e1u, t\u0103ng b\u1ea1ch c\u1ea7u v\u00e0 gi\u1ea3m glucose m\u00e1u.<\/li>\n
      • T\u0103ng calci m\u00e1u \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 di c\u0103n.<\/li>\n
      • X\u00e9t nghi\u1ec7m ch\u1ea5t ch\u1ec9 \u0111i\u1ec3m kh\u1ed1i u (tumor marker): CEA, SCC c\u00f3 th\u1ec3 t\u0103ng trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. C\u00f3 gi\u00e1 tr\u1ecb theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, ph\u00e1t hi\u1ec7n b\u1ec7nh t\u00e1i ph\u00e1t, di c\u0103n xa.<\/li>\n
      • X\u00e9t nghi\u1ec7m sinh h\u1ecdc ph\u00e2n t\u1eed: Gi\u1ea3i tr\u00ecnh t\u1ef1 nhi\u1ec1u gen.<\/li>\n<\/ul>\n

        2.1.2.2. Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh v\u00e0 y h\u1ecdc h\u1ea1t nh\u00e2n<\/h4>\n
          \n
        • Si\u00eau \u00e2m h\u1ea1ch b\u1eb9n, si\u00eau \u00e2m \u1ed5 b\u1ee5ng \u0111\u00e1nh gi\u00e1 k\u00edch th\u01b0\u1edbc v\u1ecb tr\u00ed s\u1ed1 l\u01b0\u1ee3ng, t\u00ednh ch\u1ea5t h\u1ea1ch v\u00f9ng b\u1eb9n \u0111\u00f9i, \u1ed5 b\u1ee5ng.<\/li>\n
        • Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI) \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng t\u1ea1i ch\u1ed7 c\u1ee7a kh\u1ed1i u, m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n v\u00e0 t\u00ecnh tr\u1ea1ng h\u1ea1ch b\u1ea1ch huy\u1ebft. H\u00ecnh \u1ea3nh MRI t\u1ea1o ra h\u00ecnh \u1ea3nh r\u00f5 r\u00e0ng ch\u00ednh x\u00e1c c\u1ea5u tr\u00fac d\u01b0\u01a1ng v\u1eadt \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ef1 x\u00e2m l\u1ea5n c\u1ee7a kh\u1ed1i u v\u00e0 c\u00f3 th\u1ec3 gi\u00fap x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ung th\u01b0 d\u1ecdc theo b\u1ec1 m\u1eb7t d\u01b0\u01a1ng v\u1eadt \u1edf b\u1ec7nh nh\u00e2n c\u00f3 kh\u1ed1i u l\u1edbn h\u01a1n 2cm.<\/li>\n
        • Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh: \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng kh\u1ed1i u, m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n, t\u00ecnh tr\u1ea1ng h\u1ea1ch v\u00f9ng v\u00e0 di c\u0103n xa.<\/li>\n
        • Ch\u1ee5p Xquang ng\u1ef1c c\u00f3 th\u1ec3 gi\u00fap ph\u00e1t hi\u1ec7n di c\u0103n ph\u1ed5i.<\/li>\n
        • Ch\u1ee5p PET\/CT \u0111\u00e1nh gi\u00e1 k\u00edch th\u01b0\u1edbc, x\u00e2m l\u1ea5n c\u1ee7a t\u1ed5n th\u01b0\u01a1ng, di c\u0103n h\u1ea1ch v\u00f9ng \u0111\u00f9i, b\u1eb9n, ch\u1eadu.<\/li>\n
        • X\u1ea1 h\u00ecnh x\u01b0\u01a1ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-MDP \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng di c\u0103n x\u01b0\u01a1ng, ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n b\u1ec7nh tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb, theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n.<\/li>\n
        • X\u1ea1 h\u00ecnh th\u1eadn ch\u1ee9c n\u0103ng b\u1eb1ng m\u00e1y SPECT, SPECT\/CT v\u1edbi 99m<\/sup>Tc-DTPA \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb v\u00e0 sau \u0111i\u1ec1u tr\u1ecb.<\/li>\n
        • Ch\u1ee5p PET\/CT v\u1edbi 18<\/sup>F-FDG tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n u nguy\u00ean ph\u00e1t, ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n b\u1ec7nh; ch\u1ee5p sau \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00e1i ph\u00e1t v\u00e0 di c\u0103n; m\u00f4 ph\u1ecfng l\u1eadp k\u1ebf ho\u1ea1ch x\u1ea1 tr\u1ecb.<\/li>\n<\/ul>\n

          2.1.2.3. M\u00f4 b\u1ec7nh h\u1ecdc<\/h4>\n

          Ch\u1ea9n \u0111o\u00e1n ung th\u01b0 d\u01b0\u01a1ng v\u1eadt ch\u1ee7 y\u1ebfu b\u1eb1ng l\u00e2m s\u00e0ng. Tuy nhi\u00ean, quy\u1ebft \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n ph\u1ea3i d\u1ef1a tr\u00ean k\u1ebft qu\u1ea3 sinh thi\u1ebft. Sinh thi\u1ebft ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc v\u1eeba gi\u00fap ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t, v\u1eeba c\u00f3 t\u00ednh nguy\u00ean t\u1eafc trong x\u1ebfp lo\u1ea1i giai \u0111o\u1ea1n b\u1ec7nh, x\u1ebfp \u0111\u1ed9 \u00e1c t\u00ednh c\u1ee7a ung th\u01b0. Th\u00eam n\u1eefa, m\u00f4 b\u1ec7nh h\u1ecdc l\u00e0 c\u01a1 s\u1edf quan tr\u1ecdng khi ch\u1ec9 \u0111\u1ecbnh c\u1eaft c\u1ee5t ho\u1eb7c c\u1eaft to\u00e0n b\u1ed9 d\u01b0\u01a1ng v\u1eadt, \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt \u0111\u01a1n thu\u1ea7n ho\u1eb7c ph\u1ed1i h\u1ee3p. H\u1ea7u h\u1ebft d\u1ea1ng m\u00f4 b\u1ec7nh h\u1ecdc ung th\u01b0 d\u01b0\u01a1ng v\u1eadt l\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o v\u1ea3y s\u1eebng h\u00f3a, v\u1edbi \u0111\u1ed9 bi\u1ec7t h\u00f3a kh\u00e1c nhau.<\/p>\n

          T\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng ph\u00e1 v\u1ee1 m\u00e0ng \u0111\u00e1y, x\u00e2m l\u1ea5n c\u00e1c c\u1ea5u tr\u00fac xung quanh.<\/p>\n

          2.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h3>\n

          Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh.<\/p>\n

            \n
          • Giai \u0111o\u1ea1n \u0111\u1ea7u c\u00f3 th\u1ec3 nh\u1ea7m v\u1edbi t\u00ecnh tr\u1ea1ng vi\u00eam ni\u00eam m\u1ea1c quy \u0111\u1ea7u do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. X\u00e9t nghi\u1ec7m \u0111\u01b0\u1eddng huy\u1ebft cao, \u0111\u01b0\u1eddng ni\u1ec7u d\u01b0\u01a1ng t\u00ednh, b\u1ec1 m\u1eb7t quy \u0111\u1ea7u vi\u00eam \u0111\u1ecf, ph\u1eb3ng, kh\u00f4ng s\u00f9i, c\u00f3 th\u1ec3 c\u00f3 lo\u00e9t tr\u1ee3t ni\u00eam m\u1ea1c. Kh\u00f4ng n\u00ean sinh thi\u1ebft ngay m\u00e0 c\u1ea7n \u0111i\u1ec1u tr\u1ecb h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, v\u1ec7 sinh quy \u0111\u1ea7u, d\u00f9ng kh\u00e1ng sinh \u0111\u01b0\u1eddng u\u1ed1ng. Sau 3 tu\u1ea7n, t\u1ed5n th\u01b0\u01a1ng t\u1ef1 l\u00e0nh, \u00edt khi c\u1ea7n sinh thi\u1ebft.<\/li>\n
          • U nh\u00fa l\u00e0nh t\u00ednh, bi\u1ec3u hi\u1ec7n c\u00e1c nh\u00fa li ti n\u1ed5i tr\u00ean m\u1eb7t ni\u00eam m\u1ea1c, khu tr\u00fa th\u00e0nh \u0111\u00e1m ho\u1eb7c lan to\u1ea3 r\u1ed9ng. Quan s\u00e1t u nh\u00fa b\u1eb1ng k\u00ednh l\u00fap s\u1ebd th\u1ea5y r\u00f5 c\u00e1c nh\u00fa, b\u1ec1 m\u1eb7t u r\u1ea5t \u00edt m\u1ea1ch m\u00e1u t\u00e2n t\u1ea1o. C\u1ea7n sinh thi\u1ebft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c h\u00ecnh \u1ea3nh m\u00f4 b\u1ec7nh h\u1ecdc c\u1ee7a u nh\u00fa l\u00e0nh t\u00ednh kh\u00f4ng ph\u00e1 v\u1ee1 m\u00e0ng \u0111\u00e1y.<\/li>\n
          • M\u1ed9t s\u1ed1 b\u1ec7nh kh\u00e1c v\u1ec1 da li\u1ec5u nh\u01b0 g\u00f4m giang mai, vi\u00eam lo\u00e9t quy \u0111\u1ea7u c\u0169ng c\u1ea7n \u0111\u01b0\u1ee3c l\u01b0u \u00fd ch\u1ea9n \u0111o\u00e1n.<\/li>\n<\/ul>\n

            2.3. Ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n<\/h3>\n

            Ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n b\u1ec7nh UTDV d\u1ef1a v\u00e0o x\u1ebfp lo\u1ea1i l\u00e2m s\u00e0ng TNM theo AJCC 2017. V\u1ec1 nguy\u00ean t\u1eafc, x\u1ebfp lo\u1ea1i n\u00e0y ch\u1ec9 d\u00e0nh ri\u00eang cho ung th\u01b0 bi\u1ec3u m\u00f4, v\u1eady n\u00ean c\u1ea7n c\u00f3 ch\u1ea9n \u0111o\u00e1n m\u00f4 b\u1ec7nh h\u1ecdc. C\u00e1c ph\u00e2n lo\u1ea1i TN sau m\u1ed5 th\u00ec g\u1ecdi l\u00e0 pTN. U nguy\u00ean ph\u00e1t (T) \u1edf bao quy \u0111\u1ea7u, \u1edf quy \u0111\u1ea7u, th\u00e2n d\u01b0\u01a1ng v\u1eadt v\u00e0 g\u1ed1c d\u01b0\u01a1ng v\u1eadt. H\u1ea1ch v\u00f9ng (N) l\u00e0 nh\u1eefng h\u1ea1ch b\u1eb9n n\u00f4ng, s\u00e2u, h\u1ea1ch ch\u1eadu.<\/p>\n

            * X\u1ebfp lo\u1ea1i:<\/p>\n

            T: Kh\u1ed1i u nguy\u00ean ph\u00e1t<\/strong><\/p>\n

            Tx<\/sub> Ch\u01b0a \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c u nguy\u00ean ph\u00e1t<\/p>\n

            T0<\/sub> Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a u nguy\u00ean ph\u00e1t<\/p>\n

            Tis<\/sub> Ung th\u01b0 t\u1ea1i ch\u1ed7<\/p>\n

            Ta<\/sub> Ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o v\u1ea3y ch\u01b0a x\u00e2m l\u1ea5n<\/p>\n

            T1<\/sub> U x\u00e2m l\u1ea5n l\u1ea5n d\u01b0\u1edbi ni\u00eam m\u1ea1c<\/p>\n

            T1a<\/sub> U x\u00e2m l\u1ea5n d\u01b0\u1edbi ni\u00eam m\u1ea1c nh\u01b0ng ch\u01b0a x\u00e2m l\u1ea5n m\u1ea1ch b\u1ea1ch huy\u1ebft v\u00e0 b\u1ea1ch m\u1ea1ch ho\u1eb7c quanh th\u1ea7n kinh v\u00e0 kh\u00f4ng ph\u1ea3i \u0111\u1ed9 \u00e1c t\u00ednh cao.<\/p>\n

            T1b<\/sub> U x\u00e2m l\u1ea5n m\u1ea1ch b\u1ea1ch huy\u1ebft v\u00e0\/ho\u1eb7c quanh th\u1ea7n kinh ho\u1eb7c \u0111\u1ed9 \u00e1c t\u00ednh cao<\/p>\n

            T2 \u00a0 <\/sub>U x\u00e2m l\u1ea5n th\u1ec3 x\u1ed1p c\u00f3 ho\u1eb7c kh\u00f4ng x\u00e2m l\u1ea5n ni\u1ec7u \u0111\u1ea1o<\/p>\n

            T3<\/sub> U th\u01b0 x\u00e2m l\u1ea5n th\u1ec3 hang c\u00f3 ho\u1eb7c kh\u00f4ng x\u00e2m l\u1ea5n ni\u1ec7u \u0111\u1ea1o<\/p>\n

            T4<\/sub> U x\u00e2m l\u1ea5n v\u00e0o c\u00e1c c\u1ea5u tr\u00fac xung quanh (nh\u01b0 b\u00ecu, tuy\u1ebfn ti\u1ec1n li\u1ec7t, x\u01b0\u01a1ng mu)<\/p>\n

            N: H\u1ea1ch v\u00f9ng <\/strong><\/p>\n

            cNx<\/sub> Ch\u01b0a th\u1ec3 \u0111\u00e1nh gi\u00e1 h\u1ea1ch v\u00f9ng<\/p>\n

            cN0<\/sub> Ch\u01b0a c\u00f3 h\u1ea1ch b\u1eb9n nh\u00ecn th\u1ea5y ho\u1eb7c s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c<\/p>\n

            cN1<\/sub> Di c\u0103n h\u1ea1ch b\u1eb9n 1 b\u00ean<\/p>\n

            cN2<\/sub> H\u1ea1ch c\u00f2n di \u0111\u1ed9ng, \u22652 h\u1ea1ch c\u00f9ng b\u00ean ho\u1eb7c di c\u0103n h\u1ea1ch b\u1eb9n 2 b\u00ean<\/p>\n

            cN3<\/sub> Kh\u1ed1i h\u1ea1ch b\u1eb9n c\u1ed1 \u0111\u1ecbnh s\u1edd th\u1ea5y ho\u1eb7c di c\u0103n h\u1ea1ch b\u1eb9n m\u1ed9t ho\u1eb7c 2 b\u00ean pNx<\/sub> Ch\u01b0a th\u1ec3 \u0111\u00e1nh gi\u00e1 h\u1ea1ch khu v\u1ef1c<\/p>\n

            pN0<\/sub> Ch\u01b0a di c\u0103n h\u1ea1ch<\/p>\n

            pN1<\/sub> Di c\u0103n \u22642 h\u1ea1ch b\u1eb9n c\u00f9ng b\u00ean, h\u1ea1ch ch\u01b0a ph\u00e1 v\u1ee1 v\u1ecf<\/p>\n

            pN2<\/sub> Di c\u0103n \u22653 h\u1ea1ch b\u1eb9n c\u00f9ng b\u00ean ho\u1eb7c di c\u0103n h\u1ea1ch 2 b\u00ean, h\u1ea1ch ch\u01b0a ph\u00e1 v\u1ee1 v\u1ecf<\/p>\n

            pN3<\/sub> H\u1ea1ch di c\u0103n ph\u00e1 v\u1ee1 v\u1ecf ho\u1eb7c di c\u0103n h\u1ea1ch ch\u1eadu<\/p>\n

            M: Di c\u0103n xa<\/strong><\/p>\n

            M0<\/sub> Ch\u01b0a di c\u0103n xa<\/p>\n

            M1<\/sub> C\u00f3 di c\u0103n xa<\/p>\n

              \n
            • X\u1ebfp giai \u0111o\u1ea1n<\/li>\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
              Giai \u0111o\u1ea1n Ois<\/sub><\/td>\nTisN0M0<\/td>\n<\/tr>\n
              Giai \u0111o\u1ea1n Oa<\/sub><\/td>\nTaN0M0<\/td>\n<\/tr>\n
              Giai \u0111o\u1ea1n I<\/td>\nT1aN0M0<\/td>\n<\/tr>\n
              Giai \u0111o\u1ea1n IIA<\/sub><\/td>\nT1bN0M0<\/td>\n<\/tr>\n
              <\/td>\nT2N0M0<\/td>\n<\/tr>\n
              Giai \u0111o\u1ea1n IIB<\/sub><\/td>\nT3N0M0<\/td>\n<\/tr>\n
              Giai \u0111o\u1ea1n IIIA<\/sub><\/td>\nT1-3N1M0<\/td>\n<\/tr>\n
              Giai \u0111o\u1ea1n IIIB<\/sub><\/td>\nT1-3N2M0<\/td>\n<\/tr>\n
              Giai \u0111o\u1ea1n IV<\/td>\nT4Nb\u1ea5t k\u1ef3M0<\/td>\n<\/tr>\n
              <\/td>\nTb\u1ea5t k\u1ef3N3M0<\/td>\n<\/tr>\n
              <\/td>\nTb\u1ea5t k\u1ef3Nb\u1ea5t k\u1ef3M1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
                \n
              • Ph\u00e2n lo\u1ea1i \u0111\u1ed9 m\u00f4 h\u1ecdc: G<\/li>\n<\/ul>\n

                Gx<\/sub> Kh\u00f4ng th\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 bi\u1ec7t h\u00f3a.<\/p>\n

                G1<\/sub> Bi\u1ec7t h\u00f3a cao.<\/p>\n

                G2<\/sub> Bi\u1ec7t h\u00f3a v\u1eeba.<\/p>\n

                G3-4<\/sub> Bi\u1ec7t h\u00f3a k\u00e9m\/ \u0111\u1ed9 \u00e1c t\u00ednh cao<\/p>\n

                * \u0110\u00e1nh gi\u00e1 nguy c\u01a1:<\/p>\n

                B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c x\u1ebfp nh\u00f3m ti\u00ean l\u01b0\u1ee3ng d\u1ef1a tr\u00ean giai \u0111o\u1ea1n v\u00e0 \u0111\u1ed9 m\u00f4 h\u1ecdc<\/p>\n

                Nh\u00f3m nguy c\u01a1 th\u1ea5p: Tis<\/sub>, Ta<\/sub>G1-2<\/sub> ho\u1eb7c T1<\/sub>G1<\/sub>.<\/p>\n

                Nh\u00f3m nguy c\u01a1 trung b\u00ecnh: T1<\/sub>G2<\/sub>.<\/p>\n

                Nh\u00f3m c\u00f3 nguy c\u01a1 cao: T2<\/sub> ho\u1eb7c b\u1ea5t k\u1ef3 G3<\/sub>.<\/p>\n

                 <\/p>\n","protected":false},"excerpt":{"rendered":"

                Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt l\u00e0 b\u1ec7nh l\u00fd hi\u1ebfm g\u1eb7p nh\u01b0ng l\u1ea1i nguy hi\u1ec3m \u0111\u1ed1i v\u1edbi nam gi\u1edbi. Ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 ch\u00ednh x\u00e1c gi\u00fap t\u0103ng kh\u1ea3 n\u0103ng ch\u1eefa kh\u1ecfi ho\u00e0n to\u00e0n v\u00e0 n\u00e2ng cao ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. 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