{"id":28587,"date":"2023-04-26T12:37:50","date_gmt":"2023-04-26T05:37:50","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28587"},"modified":"2023-05-01T23:53:18","modified_gmt":"2023-05-01T16:53:18","slug":"tieu-chuan-danh-gia-ket-qua-dieu-tri-noi-nha-hoi-noi-nha-hoa-ky","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/26\/tieu-chuan-danh-gia-ket-qua-dieu-tri-noi-nha-hoi-noi-nha-hoa-ky\/","title":{"rendered":"Ti\u00eau chu\u1ea9n \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha – H\u1ed9i N\u1ed9i nha Hoa K\u1ef3."},"content":{"rendered":"

Ti\u00eau chu\u1ea9n th\u00e0nh c\u00f4ng nghi\u00eam ng\u1eb7t \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi s\u1ef1 bi\u1ebfn m\u1ea5t c\u1ee7a c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, s\u1ef1 l\u00e0nh th\u01b0\u01a1ng ho\u00e0n to\u00e0n ho\u1eb7c kho\u1ea3ng d\u00e2y ch\u1eb1ng nha chu b\u00ecnh th\u01b0\u1eddng. \u0110i\u1ec1u n\u00e0y g\u00e2y kh\u00f3 kh\u0103n cho c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng khi ph\u1ea3i quy\u1ebft \u0111\u1ecbnh thu\u1eadt ng\u1eef v\u00e0 \u00e1p d\u1ee5ng n\u00f3 v\u00e0o \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha tr\u00ean th\u1ef1c t\u1ebf. V\u00ec th\u1ebf, v\u00e0o n\u0103m 2005, Hi\u1ec7p h\u1ed9i N\u1ed9i nha Hoa K\u1ef3 (AAE) \u0111\u00e3 th\u00f4ng qua ti\u00eau chu\u1ea9n \u0111\u00e1nh gi\u00e1 v\u1ec1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb N\u1ed9i nha. Ti\u00eau chu\u1ea9n n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn v\u00e0 l\u00e0m n\u1ec1n t\u1ea3ng trong qu\u00e1 tr\u00ecnh th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng c\u1ee7a c\u00e1c Nha s\u0129 \u0111i\u1ec1u tr\u1ecb. C\u00f9ng t\u00ecm hi\u1ec3u th\u00eam v\u1ec1 ti\u00eau chu\u1ea9n n\u00e0y.<\/strong><\/p>\n

1. C\u00e1c \u0111\u1ecbnh ngh\u0129a v\u1ec1 k\u1ebft qu\u1ea3 c\u00f2n ch\u01b0a nh\u1ea5t qu\u00e1n<\/h2>\n

Qua nhi\u1ec1u n\u0103m, thu\u1eadt ng\u1eef \u201cth\u00e0nh c\u00f4ng\u201d v\u00e0 \u201cth\u1ea5t b\u1ea1i\u201d \u0111\u00e3 \u0111\u01b0\u1ee3c xem x\u00e9t k\u1ef9 l\u01b0\u1ee1ng h\u01a1n do s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 l\u00e2m s\u00e0ng, m\u00f4 h\u1ecdc v\u00e0 quan s\u00e1t tr\u00ean phim X quang. Nh\u1eefng b\u1ed5 sung v\u00e0 ti\u00eau chu\u1ea9n \u0111\u01b0\u1ee3c th\u00eam v\u00e0o, nh\u01b0 \u201cnghi\u00eam ng\u1eb7t\u201d v\u00e0 \u201ct\u01b0\u01a1ng \u0111\u1ed1i\u201d, khi m\u00e0 \u0111\u1ecbnh ngh\u0129a th\u00e0nh c\u00f4ng \u201cnghi\u00eam ng\u1eb7t\u201d \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi \u201cl\u00e2m s\u00e0ng\u00a0 v\u00e0 X quang b\u00ecnh th\u01b0\u1eddng\u201d c\u00f2n \u201ct\u01b0\u01a1ng \u0111\u1ed1i\u201d th\u00ec ch\u1ec9 c\u1ea7n l\u00e2m s\u00e0ng b\u00ecnh th\u01b0\u1eddng. Ti\u00eau chu\u1ea9n th\u00e0nh c\u00f4ng nghi\u00eam ng\u1eb7t \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi s\u1ef1 bi\u1ebfn m\u1ea5t c\u1ee7a c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, s\u1ef1 l\u00e0nh th\u01b0\u01a1ng ho\u00e0n to\u00e0n ho\u1eb7c kho\u1ea3ng d\u00e2y ch\u1eb1ng nha chu b\u00ecnh th\u01b0\u1eddng. \u0110i\u1ec1u n\u00e0y g\u00e2y kh\u00f3 kh\u0103n cho c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng khi ph\u1ea3i quy\u1ebft \u0111\u1ecbnh thu\u1eadt ng\u1eef v\u00e0 \u00e1p d\u1ee5ng n\u00f3 v\u00e0o \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha tr\u00ean th\u1ef1c t\u1ebf.<\/p>\n

C\u00e1c cu\u1ed9c tranh lu\u1eadn v\u1ec1 v\u1ea5n \u0111\u1ec1 l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha l\u00e0 m\u1ed9t s\u1ef1 so s\u00e1nh sai l\u1ec7ch gi\u1eefa k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha v\u1edbi t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a m\u1ed9t implant c\u1eafm gh\u00e9p. Thu\u1eadt ng\u1eef \u201cth\u00e0nh c\u00f4ng\u201d c\u1ee7a 2 ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb tr\u00ean l\u00e0 d\u1ef1a tr\u00ean nh\u1eefng ti\u00eau chu\u1ea9n ho\u00e0n to\u00e0n kh\u00e1c nhau. S\u1ef1 so s\u00e1nh n\u00e0y c\u0169ng g\u00e2y nh\u1ea7m l\u1eabn cho b\u1ec7nh nh\u00e2n khi ph\u1ea3i quy\u1ebft \u0111\u1ecbnh l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha hay nh\u1ed5 r\u0103ng \u0111\u1ec3 thay th\u1ebf b\u1eb1ng m\u1ed9t implant.<\/p>\n

M\u1ed9t lo\u1ea1t b\u00e0i b\u00e1o c\u00e1o m\u00e0 b\u00e2y gi\u1edd \u0111\u01b0\u1ee3c m\u1ecdi ng\u01b0\u1eddi bi\u1ebft \u0111\u1ebfn l\u00e0 nghi\u00ean c\u1ee9u Toronto \u0111\u00e3 gi\u1edbi thi\u1ec7u nhi\u1ec1u thu\u1eadt ng\u1eef kh\u00e1c \u0111\u01b0\u1ee3c coi l\u00e0 ph\u00f9 h\u1ee3p h\u01a1n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha v\u00e0 kh\u00e1c v\u1edbi ph\u00e2n lo\u1ea1i \u201cth\u00e0nh c\u00f4ng\u201d th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. Vi\u1ec7c \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u1ee7a nghi\u00ean c\u1ee9u Toronto d\u1ef1a tr\u00ean ch\u1ec9 s\u1ed1 quanh ch\u00f3p (PAI), v\u00e0 x\u1ebfp lo\u1ea1i \u201c\u0111\u00e3 l\u00e0nh th\u01b0\u01a1ng\u201d khi PAI <3 ho\u1eb7c \u201cb\u1ec7nh l\u00fd\u201d khi PAI>3. Quan tr\u1ecdng l\u00e0, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 gi\u1edbi thi\u1ec7u m\u1ed9t ph\u00e2n lo\u1ea1i m\u1edbi l\u00e0 \u201cc\u00f3 ch\u1ee9c n\u0103ng\u201d cho t\u1ea5t c\u1ea3 nh\u1eefng r\u0103ng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng b\u1ea5t k\u1ec3 s\u1ed1 \u0111i\u1ec3m PAI l\u00e0 bao nhi\u00eau. Sau \u0111\u00f3, ng\u01b0\u1eddi ta cho r\u1eb1ng k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha n\u00ean \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 b\u1eb1ng thu\u1eadt ng\u1eef l\u00e0nh th\u01b0\u01a1ng, v\u00e0 nay nh\u1eefng thu\u1eadt ng\u1eef m\u1edbi \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb n\u00e0y bao g\u1ed3m: \u0111\u00e3 l\u00e0nh th\u01b0\u01a1ng, \u0111ang l\u00e0nh th\u01b0\u01a1ng, b\u1ec7nh l\u00fd v\u00e0 c\u00f3 ch\u1ee9c n\u0103ng.<\/p>\n

2. Ti\u00eau chu\u1ea9n \u0111\u00e1nh gi\u00e1 c\u1ee7a hi\u1ec7p h\u1ed9i n\u1ed9i nha M\u1ef9<\/h2>\n

C\u00e1c \u0111\u1eb7c \u0111i\u1ec3m \u0111\u1eb7c tr\u01b0ng c\u1ee7a vi\u00eam quanh ch\u00f3p c\u00f3 bi\u1ec3u hi\u1ec7n r\u00f5 r\u00e0ng tr\u00ean phim X quang bao g\u1ed3m s\u1ef1 m\u1ea5t li\u00ean t\u1ee5c c\u1ee7a lamina dura, s\u1ef1 m\u1edf r\u1ed9ng c\u1ee7a kho\u1ea3ng d\u00e2y ch\u1eb3ng nha chu, c\u00f3 v\u00f9ng th\u1ea5u quang quanh ch\u00f3p v\u00e0 ti\u00eau ng\u00f3t ch\u00e2n r\u0103ng. Trong tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha th\u00e0nh c\u00f4ng, vi\u00eam quanh ch\u00f3p bi\u1ebfn m\u1ea5t, c\u1ea5u tr\u00fac x\u01b0\u01a1ng v\u00e0 nha chu \u0111\u01b0\u1ee3c t\u00e1i l\u1eadp quanh ch\u00f3p r\u0103ng. \u0110\u1ec3 nh\u1eefng thay \u0111\u1ed5i n\u00e0y c\u00f3 bi\u1ec3u hi\u1ec7n r\u00f5 r\u1ec7t tr\u00ean phim X quang th\u00ec x\u01b0\u01a1ng ph\u1ea3i c\u00f3 m\u1ee9c t\u00e1i kho\u00e1ng th\u00edch h\u1ee3p. \u0110i\u1ec1u n\u00e0y nh\u1ea5n m\u1ea1nh s\u1ef1 c\u1ea7n thi\u1ebft ph\u1ea3i xem x\u00e9t nh\u1eefng thay \u0111\u1ed5i tr\u00ean X quang trong ; b\u1ed1i c\u1ea3nh ch\u1ee9c n\u0103ng c\u1ee7a r\u0103ng v\u00e0 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng. Nh\u1eadn th\u1ee9c \u0111\u01b0\u1ee3c \u0111i\u1ec1u n\u00e0y, AAE \u0111\u00e3 xem x\u00e9t nh\u1eefng ti\u00eau chu\u1ea9n hi\u1ec7n t\u1ea1i \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong n\u1ed9i nha v\u00e0 so s\u00e1nh ch\u00fang v\u1edbi c\u00e1c bi\u1ec7n ph\u00e1p s\u1eed d\u1ee5ng c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m kh\u00e1c. Sau \u0111\u00f3 AAE \u0111\u00e3 \u0111\u1ecbnh ngh\u0129a thu\u1eadt ng\u1eef m\u1edbi \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3, ph\u00f9 h\u1ee3p h\u01a1n trong n\u1ed9i nha. C\u01a1 s\u1edf c\u1ee7a nh\u1eefng \u0111\u1ecbnh ngh\u0129a m\u1edbi n\u00e0y l\u00e0 do c\u00e1c thu\u1eadt ng\u1eef nh\u01b0 \u201cth\u00e0nh c\u00f4ng\u201d v\u00e0 \u201cth\u1ea5t b\u1ea1i\u201d l\u00e0 qu\u00e1 m\u01a1 h\u1ed3. Nh\u01b0 m\u1ed9t s\u1ef1 thay th\u1ebf cho c\u00e1c ti\u00eau chu\u1ea9n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i c\u1ee7a Strindberg, c\u00e1c \u0111\u1ecbnh ngh\u0129a m\u1edbi \u0111\u00e3 \u0111\u01b0\u1ee3c h\u1ed9i \u0111\u1ed3ng qu\u1ea3n tr\u1ecb M\u1ef9 (Foundation\u2019s Board of Trustees) th\u00f4ng qua v\u00e0o n\u0103m 2004 v\u00e0 b\u1edfi h\u1ed9i \u0111\u1ed3ng AAE v\u00e0o n\u0103m 2005.<\/p>\n

3. \u0110\u1ecbnh ngh\u0129a k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn c\u1ee7a AAE<\/h2>\n
    \n
  • I. \u0110\u00e3 l\u00e0nh th\u01b0\u01a1ng \u2013 R\u0103ng th\u1ef1c hi\u1ec7n t\u1ed1t ch\u1ee9c n\u0103ng, kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, r\u0103ng kh\u00f4ng c\u00f3 ho\u1eb7c c\u00f3 bi\u1ec3u hi\u1ec7n r\u1ea5t nh\u1ecf c\u1ee7a b\u1ec7nh quanh ch\u00f3p tr\u00ean phim X quang.<\/li>\n
  • II. Kh\u00f4ng l\u00e0nh th\u01b0\u01a1ng \u2013 R\u0103ng kh\u00f4ng th\u1ef1c hi\u1ec7n ch\u1ee9c n\u0103ng, c\u00f3 tri\u1ec7u ch\u1ee9ng, c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh l\u00fd quanh ch\u00f3p tr\u00ean phim.<\/li>\n
  • III. \u0110ang l\u00e0nh th\u01b0\u01a1ng \u2013 R\u0103ng c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh l\u00fd quanh ch\u00f3p tr\u00ean phim X quang nh\u01b0ng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 th\u1ef1c hi\u1ec7n t\u1ed1t ch\u1ee9c n\u0103ng ho\u1eb7c r\u0103ng c\u00f3 hay kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh l\u00fd quanh ch\u00f3p tr\u00ean phim, c\u00f3 tri\u1ec7u ch\u1ee9ng nh\u01b0ng ch\u1ee9c n\u0103ng d\u01b0\u1eddng nh\u01b0 kh\u00f4ng b\u1ecb thay \u0111\u1ed5i.<\/li>\n
  • IV. C\u00f3 ch\u1ee9c n\u0103ng \u2013 R\u0103ng ho\u1eb7c ch\u00e2n r\u0103ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111ang ho\u1ea1t \u0111\u1ed9ng nh\u01b0 ch\u1ee9c n\u0103ng ban \u0111\u1ea7u c\u1ee7a n\u00f3 trong b\u1ed9 r\u0103ng.<\/li>\n<\/ul>\n

    T\u1ed5ng k\u1ebft l\u1ea1i, c\u00e1c ti\u00eau chu\u1ea9n c\u1ee7a Strindberg v\u1ec1 ph\u00e2n lo\u1ea1i tr\u00ean X quang l\u00e0 r\u1ea5t nghi\u00eam ng\u1eb7t, s\u1ef1 chu\u1ea9n h\u00f3a gi\u1eefa c\u00e1c nh\u00e0 \u0111\u00e1nh gi\u00e1 c\u00f2n kh\u00f3 kh\u0103n v\u00e0 do v\u1eady \u1ee9ng d\u1ee5ng c\u1ee7a n\u00f3 \u0111\u1ed1i v\u1edbi th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng c\u00f2n h\u1ea1n ch\u1ebf. Theo \u0111\u00f3, m\u1ed9t ch\u1ec9 s\u1ed1 c\u00f3 gi\u00e1 tr\u1ecb h\u01a1n, PAI \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u \u0111\u1ec3 h\u01b0\u1edbng d\u1eabn c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng \u0111\u00e1nh gi\u00e1 \u0111\u1ed9 l\u00e0nh th\u01b0\u01a1ng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng quanh ch\u00f3p sau \u0111i\u1ec1u tr\u1ecb, nh\u01b0 \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 tr\u00ean c\u00e1c phim X quang c\u1eadn ch\u00f3p th\u01b0\u1eddng quy. Gi\u1ea3i th\u00edch v\u1ec1 ch\u1ec9 s\u1ed1 PAI cho ph\u00e9p \u0111\u01b0a ra c\u00e1c quy\u1ebft \u0111\u1ecbnh l\u00e2m s\u00e0ng v\u1ec1 c\u00e1c giai \u0111o\u1ea1n chuy\u1ec3n ti\u1ebfp trong qu\u00e1 tr\u00ecnh l\u00e0nh th\u01b0\u01a1ng\/th\u1ea5t b\u1ea1i.<\/p>\n

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

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