{"id":28620,"date":"2023-04-26T16:46:40","date_gmt":"2023-04-26T09:46:40","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28620"},"modified":"2023-05-01T23:49:19","modified_gmt":"2023-05-01T16:49:19","slug":"dieu-tri-noi-nha-khong-phau-thuat-lan-dau-tong-quan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/26\/dieu-tri-noi-nha-khong-phau-thuat-lan-dau-tong-quan\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u &#8211; T\u1ed5ng quan."},"content":{"rendered":"<p><strong>\u0110i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u c\u00f3 t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng r\u1ea5t cao, \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1edfi b\u1ec7nh nh\u00e2n, l\u00e0m gi\u1ea3m \u0111au v\u00e0 c\u00f3 chi ph\u00ed h\u1ee3p l\u00ed. \u0110i\u1ec1u tr\u1ecb n\u1ed9i nha l\u1ea1i kh\u00f4ng ph\u1eabu thu\u1eadt l\u00e0 ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 v\u00e0 b\u1ea3o t\u1ed3n \u0111\u1ec3 x\u1eed l\u00ed vi khu\u1ea9n c\u00f2n s\u00f3t l\u1ea1i trong h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y. T\u1ec9 l\u1ec7 l\u00e0nh th\u01b0\u01a1ng t\u0103ng theo th\u1eddi gian sau khi \u0111i\u1ec1u tr\u1ecb l\u1ea1i kh\u00f4ng ph\u1eabu thu\u1eadt. Ch\u1ec9 c\u00f3 m\u1ed9t s\u1ed1 \u00edt tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng l\u00e0nh th\u01b0\u01a1ng sau khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb l\u1ea1i th\u00ec \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft t\u1ed1t nh\u1ea5t b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p vi ph\u1eabu c\u1eaft ch\u00f3p hi\u1ec7n \u0111\u1ea1i. C\u00f9ng \u0111i v\u00e0o t\u00ecm hi\u1ec3u s\u01a1 l\u01b0\u1ee3c v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p n\u00e0y.<\/strong><\/p>\n<h2>1. T\u1ed5ng quan chung v\u1ec1 \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u<\/h2>\n<p>M\u1ee5c ti\u00eau ch\u00ednh c\u1ee7a vi\u1ec7c gi\u1eef l\u1ea1i r\u0103ng th\u00f4ng qua \u0111i\u1ec1u tr\u1ecb t\u1ee7y r\u1ed3i ph\u1ee5c h\u1ed3i l\u1ea1i l\u00e0 \u0111\u1ec3 cung c\u1ea5p s\u1ef1 tho\u1ea3i m\u00e1i, ch\u1ee9c n\u0103ng v\u00e0 th\u1ea9m m\u1ef9 l\u00e2u d\u00e0i cho b\u1ec7nh nh\u00e2n. M\u1ee5c \u0111\u00edch c\u1ea7n thi\u1ebft l\u00e0 \u0111\u00e1nh gi\u00e1 ti\u00ean l\u01b0\u1ee3ng nh\u1eefng y\u1ebfu t\u1ed1 \u0111i\u1ec1u tr\u1ecb tr\u00ean b\u1ec7nh nh\u00e2n \u0111\u1ec3 \u0111\u01b0a \u0111\u1ebfn ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p, gi\u1ea3i quy\u1ebft m\u1ed9t r\u0103ng kh\u00f4ng l\u00e0nh th\u01b0\u01a1ng sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u kh\u00f4ng ph\u1eabu thu\u1eadt (initial nonsurgical root canal treatment \u2013 NSRCT), quy\u1ebft \u0111\u1ecbnh nh\u1ed5 r\u0103ng, thay th\u1ebf r\u0103ng v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 implant. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u1eafm gh\u00e9p implant l\u00e0 nh\u1eefng bi\u1ec7n ph\u00e1p b\u1ed5 sung cho nhau ch\u1ee9 kh\u00f4ng ph\u1ea3i l\u00e0 \u0111i\u1ec1u tr\u1ecb c\u1ea1nh tranh, v\u1edbi c\u00e1c ch\u1ec9 \u0111\u1ecbnh, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, \u01b0u \u0111i\u1ec3m v\u00e0 nh\u01b0\u1ee3c \u0111i\u1ec3m kh\u00e1 kh\u00e1c bi\u1ec7t.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u c\u00f3 t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng r\u1ea5t cao, \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1edfi b\u1ec7nh nh\u00e2n, l\u00e0m gi\u1ea3m \u0111au v\u00e0 c\u00f3 chi ph\u00ed h\u1ee3p l\u00ed. K\u1ebft qu\u1ea3 t\u1eeb c\u00e1c b\u00e0i t\u1ed5ng quan h\u1ec7 th\u1ed1ng v\u00e0 c\u00e1c nghi\u00ean c\u1ee9u c\u00f3 k\u00edch th\u01b0\u1edbc m\u1eabu r\u1ea5t l\u1edbn cho th\u1ea5y t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i c\u1ee7a r\u0103ng r\u1ea5t cao sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u. R\u1ea5t \u00edt y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m ti\u00ean l\u01b0\u1ee3ng l\u00e0nh th\u01b0\u01a1ng sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u. Ph\u1ea7n l\u1edbn c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec1u l\u00e0nh th\u01b0\u01a1ng sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u, ch\u1ec9 m\u1ed9t s\u1ed1 \u00edt kh\u00f4ng th\u1ec3 ch\u1eefa l\u00e0nh n\u00f3i chung l\u00e0 gi\u1ea3i quy\u1ebft t\u1ed1t nh\u1ea5t b\u1eb1ng c\u00e1ch \u0111i\u1ec1u tr\u1ecb l\u1ea1i kh\u00f4ng ph\u1eabu thu\u1eadt. \u0110i\u1ec1u tr\u1ecb n\u1ed9i nha l\u1ea1i kh\u00f4ng ph\u1eabu thu\u1eadt l\u00e0 ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 v\u00e0 b\u1ea3o t\u1ed3n \u0111\u1ec3 x\u1eed l\u00ed vi khu\u1ea9n c\u00f2n s\u00f3t l\u1ea1i trong h\u1ec7 th\u1ed1ng \u1ed1ng t\u1ee7y. T\u1ec9 l\u1ec7 l\u00e0nh th\u01b0\u01a1ng t\u0103ng theo th\u1eddi gian sau khi \u0111i\u1ec1u tr\u1ecb l\u1ea1i kh\u00f4ng ph\u1eabu thu\u1eadt.<\/p>\n<p>Ch\u1ec9 c\u00f3 m\u1ed9t s\u1ed1 \u00edt tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng l\u00e0nh th\u01b0\u01a1ng sau khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb l\u1ea1i th\u00ec \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft t\u1ed1t nh\u1ea5t b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p vi ph\u1eabu c\u1eaft ch\u00f3p (apical microsurgery) hi\u1ec7n \u0111\u1ea1i. N\u00ean xem x\u00e9t th\u00eam c\u00e1c l\u1ef1a ch\u1ecdn ph\u1eabu thu\u1eadt c\u1ee5 th\u1ec3 cho t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3 tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh nh\u1ed5 r\u0103ng. Nh\u1ed5 r\u0103ng \u0111\u1ec3 tr\u1ed3ng l\u1ea1i r\u0103ng (tr\u1ed3ng r\u0103ng c\u00f3 ch\u1ee7 \u0111\u00edch \u2014 intentional replantation) c\u0169ng l\u00e0 m\u1ed9t ph\u01b0\u01a1ng \u00e1n thay th\u1ebf c\u00f3 th\u1ec3 l\u1ef1a ch\u1ecdn. C\u1eafm gh\u00e9p r\u0103ng t\u1ef1 th\u00e2n (auto-transplantation) \u0111\u1eb7c bi\u1ec7t t\u1ed1t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang ph\u00e1t tri\u1ec3n v\u00e0 c\u00f3 m\u1ed9t r\u0103ng cho ph\u00f9 h\u1ee3p. C\u1eaft b\u1ecf ch\u00e2n r\u0103ng hi\u1ec7u qu\u1ea3 khi b\u1ec7nh l\u00fd ch\u1ec9 khu tr\u00fa t\u1ea1i m\u1ed9t ch\u00e2n r\u0103ng \u0111\u01a1n \u0111\u1ed9c, v\u1eabn c\u00f3 c\u1ea5u tr\u00fac r\u0103ng c\u00f2n l\u1ea1i v\u00e0 m\u00f4 nha chu n\u00e2ng \u0111\u1ee1 v\u1eabn c\u00f2n. Nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ebfu ph\u1ea3i nh\u1ed5 r\u0103ng v\u00e0 thay th\u1ebf m\u1ed9t r\u0103ng \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u kh\u00f4ng l\u00e0nh th\u01b0\u01a1ng bao g\u1ed3m: thi\u1ebfu c\u1ea5u tr\u00fac r\u0103ng c\u00f2n l\u1ea1i, nguy c\u01a1 s\u00e2u r\u0103ng cao ho\u1eb7c nguy c\u01a1 b\u1ec7nh l\u00fd nha chu cao. Kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c r\u0103ng nh\u1ed5 \u0111\u1ec1u c\u1ea7n \u0111\u01b0\u1ee3c thay th\u1ebf, nh\u01b0ng n\u1ebfu c\u00f3 ch\u1ec9 \u0111\u1ecbnh th\u00ec c\u1eafm gh\u00e9p implant \u0111\u01a1n l\u1ebb th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u01b0u chu\u1ed9ng h\u01a1n. C\u1eafm gh\u00e9p implant \u0111\u01a1n l\u1ebb c\u00f3 t\u1ec9 l\u1ec7 s\u1ed1ng cao.<\/p>\n<p>Vi\u1ec7c \u0111\u00e1nh gi\u00e1 to\u00e0n di\u1ec7n tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh, \u0111\u00e1nh gi\u00e1 t\u1ea5t c\u1ea3 c\u00e1c ph\u01b0\u01a1ng \u00e1n l\u1ef1a ch\u1ecdn n\u1ed9i nha, nguy c\u01a1 s\u00e2u r\u0103ng v\u00e0 b\u1ec7nh l\u00fd nha chu lu\u00f4n lu\u00f4n c\u1ea7n thi\u1ebft \u0111\u1ec3 l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng \u00e1n t\u1ed1i \u01b0u cho b\u1ec7nh nh\u00e2n khi \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u th\u1ea5t b\u1ea1i trong vi\u1ec7c l\u00e0nh th\u01b0\u01a1ng.<\/p>\n<h2>2. T\u1ec9 l\u1ec7 r\u0103ng t\u1ed3n t\u1ea1i cao &#8211; \u01afu \u0111i\u1ec3m ch\u00ednh<\/h2>\n<p>Ti\u00ean l\u01b0\u1ee3ng r\u0103ng l\u00e0nh th\u01b0\u01a1ng sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u kh\u00f4ng ph\u1eabu thu\u1eadt l\u00e0 r\u1ea5t t\u1ed1t. C\u00e1c b\u00e0i \u0111\u00e1nh gi\u00e1 h\u1ec7 th\u1ed1ng, l\u00e0 d\u1ea1ng ch\u1ee9ng c\u1ee9 l\u00e2m s\u00e0ng cao nh\u1ea5t, \u0111\u00e3 ch\u1ee9ng minh t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i r\u1ea5t cao c\u1ee7a r\u0103ng \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u kh\u00f4ng ph\u1eabu thu\u1eadt. Iqbal v\u00e0 Kim b\u00e1o c\u00e1o t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i \u0111\u1ebfn 6 n\u0103m \u1edf nh\u1eefng r\u0103ng \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u kh\u00f4ng ph\u1eabu thu\u1eadt l\u00e0 97%. Torabinejad v\u00e0 c\u1ed9ng s\u1ef1 b\u00e1o c\u00e1o t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i tr\u00ean 6 n\u0103m l\u00e0 97%. M\u1ed9t b\u00e0i \u0111\u00e1nh gi\u00e1 t\u1ed5ng quan kh\u00e1c c\u1ee7a Ng v\u00e0 c\u1ed9ng s\u1ef1 \u01b0\u1edbc l\u01b0\u1ee3ng t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i t\u1eeb 8 \u2212 10 n\u0103m l\u00e0 87%. C\u00e1c t\u00e0i li\u1ec7u n\u1ed9i nha c\u00f3 ch\u1ee9a m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u v\u1ec1 k\u1ebft qu\u1ea3 v\u1edbi k\u00edch c\u1ee1 m\u1eabu r\u1ea5t l\u1edbn, cho th\u1ea5y t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i c\u1ef1c k\u1ef3 cao c\u1ee7a r\u0103ng. Nh\u1eefng k\u1ebft qu\u1ea3 n\u00e0y n\u00f3i l\u00ean nh\u1eefng th\u00e0nh t\u00edch \u0111\u00e1ng ch\u00fa \u00fd c\u1ee7a \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u kh\u00f4ng ph\u1eabu thu\u1eadt theo th\u1eddi gian.<\/p>\n<p>\u0110i\u1ec1u th\u00fa v\u1ecb l\u00e0, nh\u1eefng l\u00ed do ph\u1ed5 bi\u1ebfn ph\u1ea3i nh\u1ed5 r\u0103ng \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u kh\u00f4ng ph\u1eabu thu\u1eadt ch\u1ee7 y\u1ebfu l\u00e0 do s\u00e2u r\u0103ng, b\u1ec7nh l\u00fd nha chu, r\u0103ng kh\u00f4ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ph\u1ee5c h\u1ed3i, th\u1ea5t b\u1ea1i c\u1ee7a ph\u1ee5c h\u1ed3i v\u00e0 n\u1ee9t g\u00e3y ch\u1ee9 kh\u00f4ng ph\u1ea3i do th\u1ea5t b\u1ea1i c\u1ee7a th\u1ee7 thu\u1eadt \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u kh\u00f4ng ph\u1eabu thu\u1eadt.<\/p>\n<p>M\u1ed9t b\u00e0i \u0111\u00e1nh gi\u00e1 v\u1ec1 s\u1ef1 ph\u1ed5 bi\u1ebfn c\u1ee7a th\u1ea5u quang quanh ch\u00f3p v\u1edbi \u0111i\u1ec1u tr\u1ecb n\u1ed9i nha ban \u0111\u1ea7u kh\u00f4ng ph\u1eabu thu\u1eadt ch\u1ec9 ra r\u1eb1ng v\u1eabn c\u00f2n m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd v\u00e0 nhu c\u1ea7u ch\u01b0a \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng; tuy nhi\u00ean, h\u00e0ng t\u1ec9 r\u0103ng \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1eef l\u1ea1i nh\u1edd vi\u1ec7c \u0111i\u1ec1u tr\u1ecb t\u1ee7y.<\/p>\n<p><em>Ngu\u1ed3n: <span class=\"c-bibliographic-information__value\">Clinical Guide for Optimal Treatment Outcome &#8211; Springer International Publishing Switzerland 2017<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u0110i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u c\u00f3 t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng r\u1ea5t cao, \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1edfi b\u1ec7nh nh\u00e2n, l\u00e0m gi\u1ea3m \u0111au v\u00e0 c\u00f3 chi ph\u00ed h\u1ee3p l\u00ed. \u0110i\u1ec1u tr\u1ecb n\u1ed9i nha l\u1ea1i kh\u00f4ng ph\u1eabu thu\u1eadt l\u00e0 ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 v\u00e0 b\u1ea3o t\u1ed3n \u0111\u1ec3 x\u1eed l\u00ed vi khu\u1ea9n c\u00f2n s\u00f3t l\u1ea1i [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u0110i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u - T\u1ed5ng quan. - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110i\u1ec1u tr\u1ecb n\u1ed9i nha kh\u00f4ng ph\u1eabu thu\u1eadt l\u1ea7n \u0111\u1ea7u c\u00f3 t\u1ec9 l\u1ec7 th\u00e0nh c\u00f4ng r\u1ea5t cao, \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1edfi b\u1ec7nh nh\u00e2n, gi\u1ea3m \u0111au v\u00e0 chi ph\u00ed h\u1ee3p l\u00ed. 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