{"id":28513,"date":"2023-04-26T07:36:57","date_gmt":"2023-04-26T00:36:57","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28513"},"modified":"2023-05-02T08:36:07","modified_gmt":"2023-05-02T01:36:07","slug":"danh-gia-ket-qua-dieu-tri-noi-nha-khong-phau-thuat-tong-quan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/26\/danh-gia-ket-qua-dieu-tri-noi-nha-khong-phau-thuat-tong-quan\/","title":{"rendered":"\u0110\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt – T\u1ed5ng quan."},"content":{"rendered":"

M\u1ed9t trong m\u1eb7t quan tr\u1ecdng c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u00e0 theo d\u00f5i b\u1ec7nh nh\u00e2n v\u00e0 \u0111\u00e1nh gi\u00e1 xem \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 th\u1ef1c hi\u1ec7n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 nh\u01b0 th\u1ebf n\u00e0o, ch\u1eb3ng h\u1ea1n nh\u01b0 gi\u00fap gi\u1ea3i quy\u1ebft tri\u1ec7u ch\u1ee9ng cho b\u1ec7nh nh\u00e2n, ph\u1ee5c h\u1ed3i c\u1ea5u tr\u00fac, ch\u1ee9c n\u0103ng b\u00ecnh th\u01b0\u1eddng c\u1ee7a m\u00f4 quanh ch\u00f3p v\u00e0 cu\u1ed1i c\u00f9ng l\u00e0 gi\u1eef l\u1ea1i r\u0103ng, v\u00e0 v\u00ec th\u1ebf, tho\u1ea3 m\u00e3n ti\u00eau chu\u1ea9n \u0111\u00e1nh gi\u00e1 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 mang t\u00ednh quy\u1ebft \u0111\u1ecbnh \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh m\u1ed9t k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng. C\u00f9ng t\u00ecm hi\u1ec3u qu\u00e1 tr\u00ecnh \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt m\u1ed9t c\u00e1ch t\u1ed5ng quan \u1edf b\u00e0i vi\u1ebft n\u00e0y.<\/strong><\/p>\n

1. T\u1ed5ng quan v\u1ec1 \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt<\/h2>\n

Ti\u00eau chu\u1ea9n \u0111\u00e1nh gi\u00e1 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 mang t\u00ednh quy\u1ebft \u0111\u1ecbnh \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh m\u1ed9t k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng. Strindberg (1956) \u0111\u00e3 x\u00e2y d\u1ef1ng m\u1ed9t h\u1ec7 th\u1ed1ng ti\u00eau chu\u1ea9n kh\u00e1 nghi\u00eam ng\u1eb7t \u0111\u00e1nh gi\u00e1 tr\u00ean l\u00e2m s\u00e0ng v\u00e0 tr\u00ean phim X quang c\u1ee7a m\u1ed9t r\u0103ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha trong nh\u1eefng l\u1ea7n ki\u1ec3m tra theo d\u00f5i sau \u0111i\u1ec1u tr\u1ecb. S\u1ef1 m\u1ea5t \u0111i c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, s\u1ef1 hi\u1ec7n di\u1ec7n hay m\u1ea5t \u0111i c\u1ee7a t\u1ed5n th\u01b0\u01a1ng th\u1ea5u quang quanh ch\u00f3p tr\u1edf th\u00e0nh th\u01b0\u1edbc \u0111o k\u1ebft qu\u1ea3 ch\u00ednh c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha.<\/p>\n

Nh\u1eefng nghi\u00ean c\u1ee9u v\u1ec1 sau \u0111\u00e3 xem x\u00e9t \u0111\u1ebfn nh\u1eefng y\u1ebfu t\u1ed1 kh\u00e1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb nh\u01b0 t\u00ecnh tr\u1ea1ng vi khu\u1ea9n tr\u01b0\u1edbc khi tr\u00e1m b\u00edt, t\u00ecnh tr\u1ea1ng m\u00f4 b\u1ec7nh h\u1ecdc, hi\u1ec7u qu\u1ea3 c\u1ee7a nh\u1eefng k\u0129 thu\u1eadt v\u00e0 v\u1eadt li\u1ec7u kh\u00e1c nhau. \u201cCh\u1ec9 s\u1ed1 quanh ch\u00f3p\u201d (periapical index \u2013 PAI) gi\u1edbi thi\u1ec7u kh\u00e1i ni\u1ec7m v\u1ec1 m\u1ed9t \u201cth\u1ec3 li\u00ean t\u1ee5c\u201d (continuum) t\u1ed3n t\u1ea1i gi\u1eefa s\u1ef1 th\u1ea5t b\u1ea1i v\u00e0 s\u1ef1 th\u00e0nh c\u00f4ng t\u1ea1i n\u01a1i sang th\u01b0\u01a1ng \u0111\u01b0\u1ee3c cho l\u00e0 \u0111ang l\u00e0nh th\u01b0\u01a1ng. Nghi\u00ean c\u1ee9u Toronto gi\u1edbi thi\u1ec7u ti\u00eau chu\u1ea9n k\u1ebft qu\u1ea3 m\u1edbi v\u1ec1 \u201cch\u1ee9c n\u0103ng\u201d cho nh\u1eefng r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb kh\u00f4ng c\u00f2n tri\u1ec7u ch\u1ee9ng b\u1ea5t k\u1ec3 \u0111i\u1ec3m PAI bao nhi\u00eau. Hi\u1ec7p h\u1ed9i n\u1ed9i nha M\u1ef9 (AAE) th\u00ec \u0111\u01b0a ra c\u00e1c \u0111\u00e1nh gi\u00e1 cho nh\u1eefng r\u0103ng \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e0 \u0111\u00e3 l\u00e0nh th\u01b0\u01a1ng (1), kh\u00f4ng l\u00e0nh th\u01b0\u01a1ng (2), \u0111ang l\u00e0nh th\u01b0\u01a1ng (3) ho\u1eb7c th\u1ef1c hi\u1ec7n t\u1ed1t ch\u1ee9c n\u0103ng (4). G\u1ea7n \u0111\u00e2y, nh\u1eefng ti\u1ebfn b\u1ed9 c\u00f4ng ngh\u1ec7 trong ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh v\u00e0 \u1ee9ng d\u1ee5ng cone-beam CT (CBCT) \u0111\u1ed9 ph\u00e2n gi\u1ea3i cao \u0111\u00e3 g\u00f3p ph\u1ea7n l\u00e0m t\u0103ng \u0111\u1ed9 ch\u00ednh x\u00e1c trong ch\u1ea9n \u0111o\u00e1n s\u1ef1 thay \u0111\u1ed5i tr\u00ean phim \u1edf v\u00f9ng m\u00f4 quanh ch\u00f3p. Tuy nhi\u00ean, vi\u1ec7c \u1ee9ng d\u1ee5ng nh\u1eefng c\u00f4ng ngh\u1ec7 n\u00e0y c\u00f2n b\u1ecb h\u1ea1n ch\u1ebf trong c\u00e1c nghi\u00ean c\u1ee9u. Nghi\u00ean c\u1ee9u vi sinh ch\u1ec9 ra t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c l\u00e0m s\u1ea1ch h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y \u1ea3nh h\u01b0\u1edfng t\u1edbi k\u1ebft qu\u1ea3 n\u1ed9i nha. Do \u0111\u00f3, s\u1ef1 m\u1ea5t \u0111i c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, s\u1ef1 t\u1ed3n t\u1ea1i hay bi\u1ebfn m\u1ea5t c\u1ee7a t\u1ed5n th\u01b0\u01a1ng quanh ch\u00f3p tr\u00ean phim v\u1eabn c\u00f2n l\u00e0 th\u01b0\u1edbc \u0111o k\u1ebft qu\u1ea3 ch\u1ee7 y\u1ebfu c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha.<\/p>\n

2. Gi\u1edbi thi\u1ec7u chung<\/h2>\n

Cho d\u00f9 \u0111\u00e3 ho\u00e0n th\u00e0nh vi\u1ec7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha v\u00e0 th\u1ef1c hi\u1ec7n ph\u1ee5c h\u1ed3i sau c\u00f9ng th\u00ec ngh\u0129a v\u1ee5 c\u1ee7a th\u1ea7y thu\u1ed1c v\u1edbi b\u1ec7nh nh\u00e2n v\u1eabn ch\u01b0a d\u1eebng l\u1ea1i. M\u1ed9t trong m\u1eb7t quan tr\u1ecdng c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e0 theo d\u00f5i b\u1ec7nh nh\u00e2n v\u00e0 \u0111\u00e1nh gi\u00e1 xem \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 th\u1ef1c hi\u1ec7n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 nh\u01b0 th\u1ebf n\u00e0o, ch\u1eb3ng h\u1ea1n nh\u01b0 gi\u00fap gi\u1ea3i quy\u1ebft tri\u1ec7u ch\u1ee9ng cho b\u1ec7nh nh\u00e2n, ph\u1ee5c h\u1ed3i c\u1ea5u tr\u00fac, ch\u1ee9c n\u0103ng b\u00ecnh th\u01b0\u1eddng c\u1ee7a m\u00f4 quanh ch\u00f3p v\u00e0 cu\u1ed1i c\u00f9ng l\u00e0 gi\u1eef l\u1ea1i r\u0103ng. Vi\u1ec7c \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 c\u1ee7a r\u0103ng \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha v\u1eabn \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u r\u1ed9ng r\u00e3i. Thu\u1eadt ng\u1eef \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 th\u00ec \u0111a d\u1ea1ng v\u00e0 c\u00f3 th\u1ec3 g\u00e2y nh\u1ea7m l\u1eabn \u0111\u1ed1i v\u1edbi nha s\u0129 khi th\u1ef1c h\u00e0nh. M\u1ee5c \u0111\u00edch c\u1ee7a ch\u01b0\u01a1ng n\u00e0y l\u00e0 l\u00e0m r\u00f5 m\u1ed9t v\u00e0i thu\u1eadt ng\u1eef ch\u1ee7 y\u1ebfu v\u00e0 tr\u00ecnh b\u00e0y c\u00e1ch \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 ph\u00f9 h\u1ee3p m\u00e0 m\u1ed9t nha s\u0129 trong ch\u0103m s\u00f3c ban \u0111\u1ea7u c\u1ea7n thi\u1ebft ph\u1ea3i ghi nh\u1edb. Ki\u1ebfn th\u1ee9c thu \u0111\u01b0\u1ee3c t\u1eeb c\u00e1c k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u n\u00ean \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng v\u00e0o vi\u1ec7c \u0111\u00e1nh gi\u00e1 tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. Nh\u1eefng ki\u1ebfn th\u1ee9c n\u00e0y ph\u1ea3i l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a th\u1ea3o lu\u1eadn tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb, l\u00ean k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb v\u00e0 s\u1ef1 \u0111\u1ed3ng \u00fd c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

Ph\u01b0\u01a1ng ph\u00e1p s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha bao g\u1ed3m quan s\u00e1t s\u1ef1 gi\u1ea3i quy\u1ebft tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng, \u0111\u00e1nh gi\u00e1 phim X quang t\u00ecnh tr\u1ea1ng m\u00f4 quanh ch\u00f3p v\u00e0 nh\u1eefng ph\u00e1t hi\u1ec7n m\u00f4 h\u1ecdc t\u1eeb c\u00e1c m\u1eabu sinh thi\u1ebft. Tri\u1ec7u ch\u1ee9ng bao g\u1ed3m \u0111au t\u1ef1 ph\u00e1t ho\u1eb7c\/v\u00e0 \u0111au khi g\u00f5, s\u1edd ho\u1eb7c c\u1eafn, xu\u1ea5t hi\u1ec7n sau \u0111i\u1ec1u tr\u1ecb. D\u1ea5u hi\u1ec7u bao g\u1ed3m s\u01b0ng ho\u1eb7c l\u1ed7 d\u00f2 sau \u0111i\u1ec1u tr\u1ecb.
\nT\u1ef7 l\u1ec7 \u0111au cao tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb gi\u1ea3m xu\u1ed1ng m\u1ee9c trung b\u00ecnh trong v\u00f2ng 1 ng\u00e0y v\u00e0 sau \u0111\u00f3 gi\u1ea3m t\u1edbi m\u1ee9c th\u1ea5p nh\u1ea5t v\u00e0o 7 ng\u00e0y sau khi \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha. T\u1ea7n su\u1ea5t c\u1ee7a \u0111au dai d\u1eb3ng trong 6 th\u00e1ng ho\u1eb7c h\u01a1n sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha r\u0103ng v\u0129nh vi\u1ec5n l\u00e0 kho\u1ea3ng 5% v\u00e0 c\u00f3 th\u1ec3 bao g\u1ed3m c\u1ea3 \u0111au t\u1eeb nh\u1eefng r\u0103ng k\u1ebf c\u1eadn, \u0111au chuy\u1ec3n v\u1ecb t\u1eeb c\u00e1c c\u1ea5u tr\u00fac kh\u00f4ng thu\u1ed9c r\u0103ng ho\u1eb7c \u0111au lo\u1ea1n c\u1ea3m (deafferentation pain).<\/p>\n

\u0110au c\u00f2n t\u1ed3n t\u1ea1i c\u0169ng c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u c\u1ee7a nhi\u1ec5m tr\u00f9ng dai d\u1eb3ng. Ph\u00e2n t\u00edch m\u00f4 b\u1ec7nh h\u1ecdc th\u01b0\u1eddng kh\u00f4ng th\u1ec3 th\u1ef1c hi\u1ec7n trong \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ph\u1eabu thu\u1eadt th\u00f4ng th\u01b0\u1eddng. Do \u0111\u00f3, \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng m\u00f4 quanh ch\u00f3p tr\u00ean phim X quang v\u1eabn l\u00e0 ph\u01b0\u01a1ng ti\u1ec7n c\u01a1 b\u1ea3n \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha.<\/p>\n

M\u1ed9t nghi\u00ean c\u1ee9u mang t\u00ednh b\u01b0\u1edbc ngo\u1eb7t v\u1ec1 \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 v\u00e0o n\u0103m 1956, \u0111\u00f3 l\u00e0 nghi\u00ean c\u1ee9u c\u1ed5 \u0111i\u1ec3n c\u1ee7a Strindberg \u0111\u00e3 \u0111\u1eb7t n\u1ec1n m\u00f3ng cho vi\u1ec7c ti\u1ebfn h\u00e0nh c\u00e1c nghi\u00ean c\u1ee9u k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha sau n\u00e0y. Nghi\u00ean c\u1ee9u n\u00e0y l\u00e0 nghi\u00ean c\u1ee9u thu\u1ea7n t\u1eadp ti\u1ebfn c\u1ee9u l\u00e2m s\u00e0ng tr\u00ean 344 b\u1ec7nh nh\u00e2n, trong \u0111\u00f3 bao g\u1ed3m 539 r\u0103ng v\u00e0 779 ch\u00e2n r\u0103ng, \u0111\u1ec1u \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1edfi c\u00f9ng m\u1ed9t b\u00e1c s\u0129. T\u1ea5t c\u1ea3 c\u00e1c d\u1eef li\u1ec7u y khoa, nha khoa v\u00e0 d\u1eef li\u1ec7u \u0111i\u1ec1u tr\u1ecb \u0111\u00e1ng l\u01b0u \u00fd \u0111\u00e3 \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p, ghi ch\u00e9p v\u00e0 ph\u00e2n t\u00edch. Th\u1eddi gian theo d\u00f5i l\u00e0 6 n\u0103m, m\u1ed7i 6 th\u00e1ng trong v\u00f2ng 2 n\u0103m \u0111\u1ea7u v\u00e0 sau \u0111\u00f3 l\u00e0 m\u1ed7i n\u0103m 1 l\u1ea7n. T\u1ec9 l\u1ec7 gi\u1eef \u0111\u01b0\u1ee3c r\u0103ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb (75%) t\u01b0\u01a1ng \u0111\u1ed1i cao. Nh\u1eefng \u0111i\u1ec3m nh\u1ea5n c\u1ee7a nghi\u00ean c\u1ee9u n\u00e0y l\u00e0 n\u00f3 \u0111\u00e3:<\/p>\n

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  1. X\u00e2y d\u1ef1ng ti\u00eau chu\u1ea9n \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha, th\u01b0\u1eddng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ti\u00eau chu\u1ea9n Strindberg.<\/li>\n
  2. Cho th\u1ea5y t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng cao c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha theo l\u1ed1i c\u1ed5 \u0111i\u1ec3n.<\/li>\n
  3. Li\u00ean h\u1ec7 gi\u1eefa k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha v\u1edbi ch\u1ea9n \u0111o\u00e1n t\u00ecnh tr\u1ea1ng m\u00f4 quanh ch\u00f3p tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb.<\/li>\n
  4. X\u00e1c \u0111\u1ecbnh kho\u1ea3ng th\u1eddi gian v\u00e0 t\u1ea7n su\u1ea5t theo d\u00f5i: m\u1ed7i 6 th\u00e1ng trong 2 n\u0103m \u0111\u1ea7u v\u00e0 sau \u0111\u00f3 l\u00e0 m\u1ed7i n\u0103m 1 l\u1ea7n cho \u0111\u1ebfn \u00edt nh\u1ea5t l\u00e0 4 n\u0103m sau \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ol>\n

    C\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb sau \u0111\u00f3 \u0111\u1ec1u s\u1eed d\u1ee5ng ti\u00eau chu\u1ea9n Strindberg ho\u1eb7c c\u00e1c bi\u1ebfn \u0111\u1ed5i c\u1ee7a n\u00f3. S\u1ef1 m\u1edf r\u1ed9ng ph\u1ea1m vi c\u1ee7a c\u00e1c ti\u00eau chu\u1ea9n \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u, ch\u1eb3ng h\u1ea1n nh\u01b0 t\u00ecnh tr\u1ea1ng vi khu\u1ea9n tr\u01b0\u1edbc khi tr\u00e1m b\u00edt, hi\u1ec7u qu\u1ea3 c\u1ee7a b\u0103ng thu\u1ed1c n\u1ed9i t\u1ee7y, ch\u1ea5t tr\u00e1m b\u00edt, k\u0129 thu\u1eadt \u0111i\u1ec1u tr\u1ecb v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng c\u1ee7a ph\u1ee5c h\u1ed3i sau c\u00f9ng.<\/p>\n

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

    M\u1ed9t trong m\u1eb7t quan tr\u1ecdng c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u00e0 theo d\u00f5i b\u1ec7nh nh\u00e2n v\u00e0 \u0111\u00e1nh gi\u00e1 xem \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 th\u1ef1c hi\u1ec7n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 nh\u01b0 th\u1ebf n\u00e0o, ch\u1eb3ng h\u1ea1n nh\u01b0 gi\u00fap gi\u1ea3i quy\u1ebft tri\u1ec7u ch\u1ee9ng cho b\u1ec7nh nh\u00e2n, ph\u1ee5c h\u1ed3i c\u1ea5u tr\u00fac, ch\u1ee9c n\u0103ng b\u00ecnh th\u01b0\u1eddng c\u1ee7a […]<\/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":"\n\u0110\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt - T\u1ed5ng quan.<\/title>\n<meta name=\"description\" content=\"C\u00f9ng t\u00ecm hi\u1ec3u qu\u00e1 tr\u00ecnh \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt m\u1ed9t c\u00e1ch t\u1ed5ng quan \u1edf b\u00e0i vi\u1ebft n\u00e0y.\" \/>\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=\"\u0110\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt - 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