{"id":28852,"date":"2023-04-29T14:39:11","date_gmt":"2023-04-29T07:39:11","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28852"},"modified":"2023-04-29T14:39:11","modified_gmt":"2023-04-29T07:39:11","slug":"tiep-can-lam-sang-tao-bon-o-tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/29\/tiep-can-lam-sang-tao-bon-o-tre-em\/","title":{"rendered":"Ti\u1ebfp c\u1eadn t\u00e1o b\u00f3n tr\u1ebb em: \u0110\u1ecbnh ngh\u0129a, sinh l\u00fd, tri\u00eau ch\u1ee9ng l\u00e2m s\u00e0ng"},"content":{"rendered":"

T\u00e1o b\u00f3n \u1edf tr\u1ebb em l\u00e0 t\u00ecnh tr\u1ea1ng khi tr\u1ebb c\u00f3 kh\u00f3 kh\u0103n ho\u1eb7c kh\u00f4ng th\u1ec3 \u0111i ti\u00eau ho\u00e1 \u0111\u01b0\u1eddng ti\u00eau h\u00f3a \u0111\u1ea7y \u0111\u1ee7, th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi ngh\u1ebdn, \u0111au b\u1ee5ng, kh\u00f3 ch\u1ecbu v\u00e0 s\u01b0ng \u0111au h\u1eadu m\u00f4n. T\u00e1o b\u00f3n th\u01b0\u1eddng x\u1ea3y ra khi l\u01b0\u1ee3ng n\u01b0\u1edbc trong ph\u00e2n \u00edt, ph\u00e2n c\u1ee9ng v\u00e0 kh\u00f3 di chuy\u1ec3n qua \u0111\u01b0\u1eddng ru\u1ed9t.<\/strong><\/p>\n

1. \u0110\u1ecbnh ngh\u0129a t\u00e1o b\u00f3n:<\/strong><\/h2>\n

T\u00e1o b\u00f3n l\u00e0 s\u1ef1 gi\u1ea3m t\u1ea7n su\u1ea5t b\u00e0i xu\u1ea5t ph\u00e2n b\u00ecnh th\u01b0\u1eddng, k\u00e8m theo kh\u00f3 v\u00e0 \u0111au khi b\u00e0i xu\u1ea5t ph\u00e2n do ph\u00e2n c\u1ee9ng ho\u1eb7c qu\u00e1 to.<\/p>\n\n\n\n\n\n
Tr\u1ebb s\u01a1 sinh<\/td>\n\u00a0< 2 l\u1ea7n\/ng\u00e0y<\/td>\n<\/tr>\n
Tr\u1ebb b\u00fa m\u1eb9<\/td>\n< 3 l\u1ea7n\/tu\u1ea7n\u00a0 (>2 ng\u00e0y\/l\u1ea7n)<\/td>\n<\/tr>\n
Tr\u1ebb l\u1edbn<\/td>\n<2 l\u1ea7n\/tu\u1ea7n (>3 ng\u00e0y \/l\u1ea7n)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u2022 T\u00e1o b\u00f3n c\u1ea5p: < 8 tu\u1ea7n.
\n\u2022 T\u00e1o b\u00f3n m\u1ea1n: t\u00e1o b\u00f3n k\u00e9o d\u00e0i \u2265 8 tu\u1ea7n.
\n+ T\u00e1o b\u00f3n th\u1ef1c th\u1ec3 l\u00e0 t\u00e1o b\u00f3n c\u00f3 c\u00e1c nguy\u00ean nh\u00e2n th\u1ef1c th\u1ec3 v\u1ec1 gi\u1ea3i ph\u1eabu, t\u1ed5 ch\u1ee9c sinh h\u00f3a h\u1ecdc, t\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng \u1ed1ng ti\u00eau h\u00f3a. Chi\u1ebfm 5 \u2013 10 %.
\n+ T\u00e1o b\u00f3n c\u01a1 n\u0103ng l\u00e0 t\u00e1o b\u00f3n khi \u0111\u00e3 lo\u1ea1i tr\u1eeb nguy\u00ean nh\u00e2n th\u1ef1c th\u1ec3<\/p>\n

o \u0110\u1ecbnh ngh\u0129a v\u1ec1 t\u00e1o b\u00f3n k\u00e9o d\u00e0i ( PACCT): Khi c\u00f3 \u22652 bi\u1ec3u hi\u1ec7n sau v\u00e0 k\u00e9o d\u00e0i \u00edt nh\u1ea5t 8 tu\u1ea7n
\n+ \u0110i ngo\u00e0i <3 l\u1ea7n\/tu\u1ea7n
\n+I\u1ea3 \u0111\u00f9n \u2265 1 l\u1ea7n\/ tu\u1ea7n
\n+ \u0110i ngo\u00e0i ph\u00e2n to c\u00f3 th\u1ec3 t\u1eafc b\u1ed3n c\u1ea7u
\n+ S\u1edd th\u1ea5y kh\u1ed1i u ph\u00e2n \u1edf b\u1ee5ng ho\u1eb7c tr\u1ef1c tr\u00e0ng
\n+ \u0110au khi \u0111i ngo\u00e0i
\n+ T\u01b0 th\u1ebf n\u00edn gi\u1eef ph\u00e2n, h\u00e0nh vi gi\u1eef ph\u00e2n<\/p>\n

2. Sinh l\u00fd h\u1ecdc \u2013 sinh b\u1ec7nh h\u1ecdc t\u00e1o b\u00f3n:<\/strong><\/h2>\n

2.1. Nh\u1eafc l\u1ea1i v\u1ec1 sinh l\u00fd co c\u01a1 tr\u01a1n:<\/strong><\/h3>\n

\u2022 C\u01a1 tr\u01a1n kh\u00f4ng c\u00f3 troponin- protein \u0111\u01b0\u1ee3c ho\u1ea1t h\u00f3a b\u1edfi Ca g\u00e2y ra co c\u01a1 \u1edf c\u01a1 v\u00e2n.
\n\u2022 Ion Ca2+ k\u1ebft h\u1ee3p v\u1edbi Calmodulin \u0111\u1ec3 ho\u1ea1t h\u00f3a Myosin Kinase v\u00e0 phosphorin h\u00f3a Myosin.
\n\u2022 Thay v\u00ec troponin, c\u01a1 tr\u01a1n ch\u1ee9a l\u01b0\u1ee3ng l\u1edbn m\u1ed9t protein g\u1ecdi l\u00e0 calmodulin. M\u1eb7c d\u00f9 c\u1ea5u t\u1ea1o t\u01b0\u01a1ng t\u1ef1 nhau nh\u01b0ng kh\u00e1c v\u1ec1 c\u01a1 ch\u1ebf k\u00edch ho\u1ea1t co c\u01a1.
\n\u2022 Gi\u1ea3i th\u00edch cho nguy\u00ean nh\u00e2n v\u00ec sao t\u0103ng Calci m\u00e1u l\u1ea1i d\u1eabn \u0111\u1ebfn t\u00e1o b\u00f3n.<\/p>\n

2.2. Ti\u00eau h\u00f3a \u1edf \u0111\u1ea1i tr\u00e0ng:<\/strong><\/h3>\n

2.2.1 C\u00e1c ho\u1ea1t \u0111\u1ed9ng c\u01a1 h\u1ecdc c\u1ee7a \u0111\u1ea1i tr\u00e0ng:<\/strong><\/h3>\n

\u2022 \u0110\u00f3ng m\u1edf van h\u1ed3i manh tr\u00e0ng.
\n\u2022 C\u00e1c v\u1eadn \u0111\u1ed9ng c\u1ee7a ru\u1ed9t gi\u00e0.
\n– Bao g\u1ed3m co b\u00f3p ph\u00e2n \u0111o\u1ea1n v\u00e0 s\u00f3ng nhu \u0111\u1ed9ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u1edf ru\u1ed9t non
\n– Co b\u00f3p ph\u00e2n \u0111o\u1ea1n ch\u1ee7 y\u1ebfu gi\u00fap cho s\u1ef1 nh\u00e0o tr\u1ed9n v\u00e0 ti\u1ebfp x\u00fac \u0111\u1ec3 t\u00e1i h\u1ea5p thu.
\n– C\u00e1c s\u00f3ng nhu \u0111\u1ed9ng \u0111\u1ea9y th\u1ee9c \u0103n v\u1ec1 ph\u00eda tr\u1ef1c tr\u00e0ng nh\u01b0ng \u0111\u00f4i khi v\u1eabn c\u00f3 s\u00f3ng ph\u1ea3n nhu \u0111\u1ed9ng nh\u01b0ng y\u1ebfu.
\n– Ngo\u00e0i ra c\u00f2n c\u00f3 s\u00f3ng co b\u00f3p kh\u1ed1i \u2013 \u0111\u00e2y l\u00e0 h\u00ecnh th\u1ee9c \u0111\u1eb7c bi\u1ec7t c\u1ee7a nhu \u0111\u1ed9ng.<\/p>\n

2.2.2 C\u00e1c ho\u1ea1t \u0111\u1ed9ng b\u00e0i ti\u1ebft v\u00e0 h\u1ea5p thu \u1edf \u0111\u1ea1i tr\u00e0ng:<\/strong><\/h3>\n

\u2022 B\u00e0i ti\u1ebft:<\/strong>
\no B\u00e0i ti\u1ebft ch\u1ea5t nh\u1ea7y.
\no Kh\u00f4ng b\u00e0i ti\u1ebft men ti\u00eau h\u00f3a.
\no S\u1ef1 b\u00e0i ti\u1ebft nh\u1ea7y ch\u1ec9 ph\u1ee5 thu\u1ed9c v\u00e0o c\u00e1c ch\u1ea5t trong ru\u1ed9t ti\u1ebfp x\u00fac v\u1edbi th\u00e0nh ru\u1ed9t m\u00e0 kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o c\u01a1 ch\u1ebf th\u1ea7n kinh hay hormon.<\/p>\n

\u2022 H\u1ea5p thu:<\/strong>
\no X\u1ea3y ra \u1edf n\u1eeda \u0111\u1ea7u c\u1ee7a ru\u1ed9t gi\u00e0.
\no Kh\u1ea3 n\u0103ng h\u1ea5p thu c\u1ee7a ru\u1ed9t gi\u00e0 r\u1ea5t l\u1edbn. H\u1ea5p thu t\u00edch c\u1ef1c Na+, Cl- t\u1eeb \u0111\u00f3 k\u00e9o theo h\u1ea5p thu n\u01b0\u1edbc.<\/p>\n

3. H\u1eadu qu\u1ea3 :<\/strong><\/h2>\n

Th\u1eddi gian m\u1eafc ch\u1ee9ng t\u00e1o b\u00f3n c\u00e0ng l\u00e2u th\u00ec h\u1eadu qu\u1ea3 g\u00e2y ra c\u00e0ng nhi\u1ec1u, c\u00e0ng tr\u1ea7m tr\u1ecdng:
\n– Thay \u0111\u1ed5i t\u00e2m l\u00fd, stress.: Tr\u1ebb c\u1ea3m th\u1ea5y b\u1ef1c b\u1ed9i, kh\u00f3 ch\u1ecbu, \u0103n u\u1ed1ng kh\u00f4ng ngon, ng\u1ee7 k\u00e9m g\u00e2y m\u1ec7t m\u1ecfi,.. khi\u1ebfn s\u1ee9c kh\u1ecfe sa s\u00fat.
\n– Bi\u1ebfng \u0103n, ch\u1eadm l\u1edbn suy dinh d\u01b0\u1ee1ng.
\n– Sa tr\u1ef1c tr\u00e0ng , ch\u1ea3y m\u00e1u tr\u1ef1c tr\u00e0ng , n\u1ee9t k\u1ebd h\u1eadu m\u00f4n.
\n– Vi\u00eam \u1ed1ng h\u1eadu m\u00f4n tr\u1ef1c tr\u00e0ng- Abces h\u1eadu m\u00f4n \u2013 R\u00f2 h\u1eadu m\u00f4n
\n– T\u1eafc ru\u1ed9t do kh\u1ed1i\u00a0 ph\u00e2n
\n– Suy ki\u1ec7t \u2013 nhi\u1ec5m \u0111\u1ed9c m\u1ea1n
\n– T\u0103ng nguy c\u01a1 b\u1ecb ung th\u01b0 h\u1eadu m\u00f4n \u2013 tr\u1ef1c tr\u00e0ng
\n– T\u00e1o b\u00f3n c\u0169ng l\u00e0m t\u0103ng \u00e1p l\u1ef1c trong ru\u1ed9t, t\u0103ng \u1ee9 \u0111\u1ecdng ph\u00e2n \u2013 d\u1ecbch trong l\u00f2ng ru\u1ed9t th\u1eeba khi\u1ebfn cho ng\u01b0\u1eddi b\u1ec7nh c\u00f2n d\u1ec5 vi\u00eam ru\u1ed9t th\u1eeba h\u01a1n.
\n– T\u00e1o b\u00f3n d\u00e0i ng\u00e0y l\u00e0m ru\u1ed9t gi\u00e0 b\u1ecb suy y\u1ebfu, d\u00e3n ra t\u1ea1o c\u00e1c t\u00fai th\u1eeba \u0111\u1ea1i tr\u00e0ng v\u00e0 c\u00f3 nguy c\u01a1 th\u1ee7ng ru\u1ed9t.<\/p>\n

4. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/h2>\n

– Ph\u00e2n c\u00f3 m\u00e1u t\u01b0\u01a1i.<\/a>
\n– \u1ec8a \u0111\u00f9n ( S\u00f3n ph\u00e2n): l\u00e0 s\u1ef1 gi\u00e3n tr\u1ef1c tr\u00e0ng l\u00e0m \u1ed1ng h\u1eadu m\u00f4n ng\u1eafn v\u00e0 c\u01a1 tr\u01a1n th\u1eaft trong h\u1eadu m\u00f4n gi\u00e3n ra, khi c\u00f3 s\u1ef1 gi\u00e3n tho\u00e1ng qua c\u1ee7a c\u01a1 th\u1eaft ngo\u00e0i h\u1eadu m\u00f4n l\u00e0m ph\u00e2n s\u1ec7t kh\u00f4ng r\u1eafn ch\u1ea3y d\u00ednh ra h\u1eadu m\u00f4n v\u00e0 qu\u1ea7n s\u00e2y s\u00f3n ph\u00e2n. \u1ec8a \u0111\u00f9n l\u00e0 tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng hay g\u1eb7p \u1edf tr\u1ebb t\u00e1o b\u00f3n.
\n– Thay \u0111\u1ed5i ch\u1ebf \u0111\u1ed9 \u0103n, t\u1eadp \u0111i ti\u00eau m\u1ed9t m\u00ecnh. \u1ede tr\u1ebb l\u1edbn xu\u1ea5t hi\u1ec7n khi tr\u1ebb b\u1eaft \u0111\u1ea7u \u0111i h\u1ecdc v\u00ec kh\u00f4ng mu\u1ed1n \u1ec9a \u1edf tr\u01b0\u1eddng.<\/p>\n

5. Th\u0103m kh\u00e1m th\u1ef1c th\u1ec3:<\/strong><\/h2>\n

Th\u0103m kh\u00e1m th\u1ef1c th\u1ec3 th\u00f4ng th\u01b0\u1eddng n\u00ean bao g\u1ed3m \u0111\u00e1nh gi\u00e1<\/p>\n

5.1: S\u1ef1 t\u0103ng tr\u01b0\u1edfng: <\/strong><\/h3>\n

T\u00e1o b\u00f3n th\u1ef1c th\u1ec3 th\u01b0\u1eddng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n to\u00e0n th\u00e2n c\u1ee7a tr\u1ebb. T\u00e1o b\u00f3n c\u01a1 n\u0103ng \u00edt \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn to\u00e0n th\u00e2n tr\u1ebb. \u0110\u1ed1i v\u1edbi tr\u1ebb: <6 th\u00e1ng: th\u01b0\u1eddng t\u0103ng 0,6kg\/th\u00e1ng, 6 th\u00e1ng \u0111\u1ebfn 12 th\u00e1ng: t\u0103ng 0,5kg\/th\u00e1ng. \u0110\u1ec3 c\u00f3 m\u1ed9t \u0111\u00e1nh gi\u00e1 t\u0103ng tr\u01b0\u1edfng ch\u00ednh x\u00e1c ch\u00fang ta n\u00ean \u00e1p d\u1ee5ng bi\u1ec3u \u0111\u1ed3 t\u0103ng tr\u01b0\u1edfng tr\u1ebb em.<\/p>\n

5.2: B\u1ee5ng – Ch\u1eadu – H\u1eadu m\u00f4n:<\/strong><\/h3>\n

– Ch\u01b0\u1edbng b\u1ee5ng: s\u1ef1 ch\u01b0\u1edbng b\u1ee5ng nghi\u00eam tr\u1ecdng l\u00e0m t\u0103ng li\u00ean quan \u0111\u1ed1i v\u1edbi b\u1ec7nh th\u1ef1c th\u1ec3.
\n– S\u1edd \u0111\u01b0\u1ee3c kh\u1ed1i ph\u00e2n: Ph\u00f9 h\u1ee3p v\u1edbi t\u00e1o b\u00f3n do b\u1ea5t c\u1ee9 nguy\u00ean nh\u00e2n n\u00e0o, nh\u01b0ng kh\u00f4ng s\u1edd th\u1ea5y ph\u00e2n c\u0169ng kh\u00f4ng lo\u1ea1i tr\u1eeb t\u00e1o b\u00f3n.
\n– Kh\u1ed1i tr\u00ean kh\u1edbp mu: Ph\u00e1t hi\u1ec7n th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb n\u00e9n ch\u1eb7t ph\u00e2n \u1edf tr\u1ef1c tr\u00e0ng, nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 g\u1ee3i \u00fd u qu\u00e1i v\u00f9ng t\u00fai c\u00f9ng.
\n– N\u1ee9t k\u1ebd ho\u1eb7c s\u1eb9o h\u1eadu m\u00f4n: C\u00e1c v\u1ebft n\u1ee9t k\u1ebd h\u1eadu m\u00f4n c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n ho\u1eb7c h\u1eadu qu\u1ea3 c\u1ee7a t\u00e1o b\u00f3n ch\u1ee9c n\u0103ng.<\/p>\n

5.3: H\u1ec7 th\u1ea7n kinh<\/strong><\/h3>\n

Th\u0103m kh\u00e1m th\u1ea7n kinh c\u1ee7a tr\u1ebb b\u1ecb t\u00e1o b\u00f3n m\u1ea1n t\u00ednh n\u00ean tr\u00fa tr\u1ecdng c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ea5u hi\u1ec7u nghi ng\u1edd r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u1ee7y s\u1ed1ng v\u00e0\/ho\u1eb7c h\u1ec7 th\u1ea7n kinh t\u1ef1 \u0111\u1ed9ng, bao g\u1ed3m:<\/p>\n

5.3.1. M\u1ea5t c\u1ea3m gi\u00e1c ho\u1eb7c gi\u1ea3m v\u1eadn \u0111\u1ed9ng<\/strong><\/h3>\n

– Tr\u01b0\u01a1ng l\u1ef1c c\u01a1 b\u1ea5t th\u01b0\u1eddng: T\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 g\u1ee3i \u00fd b\u1ec7nh Hirschsprung, gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c c\u01a1 g\u1ee3i \u00fd t\u00e1o b\u00f3n th\u1ea7n kinh
\n– Ph\u1ea3n x\u1ea1 g\u00e2n x\u01b0\u01a1ng b\u1ea5t th\u01b0\u1eddng.
\n– H\u1eadu m\u00f4n x\u00f2e ra.
\n– M\u1ea5t ph\u1ea3n x\u1ea1 co th\u1eaft h\u1eadu m\u00f4n ho\u1eb7c gi\u1ea3m ph\u1ea3n x\u1ea1 c\u01a1 b\u00ecu
\n– R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng b\u00e0ng quang<\/p>\n

Tr\u1ebb gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c c\u01a1 to\u00e0n th\u00e2n (v\u00ed d\u1ee5: HC Down)c\u00f3 th\u1ec3 c\u00f3 t\u00e1o b\u00f3n b\u1edfi v\u00ec tr\u1ebb kh\u00f4ng t\u1ea1o \u0111\u1ee7 \u00e1p l\u1ef1c \u1ed5 b\u1ee5ng \u0111\u1ec3 \u0111\u1ea1i ti\u1ec7n; \u0111\u00e2y l\u00e0 m\u1ed9t d\u1ea1ng c\u1ee7a ch\u1ee9ng co th\u1eaft c\u01a1 mu tr\u1ef1c tr\u00e0n ngh\u1ecbch l\u00fd.<\/p>\n

Tr\u1ebb b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng neuron v\u1eadn \u0111\u1ed9ng d\u01b0\u1edbi, th\u00ec c\u00f3 th\u1ec3 do gi\u1ea3m ph\u1ea3n x\u1ea1 v\u00e0 gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c c\u01a1, b\u1ecb t\u00e1o b\u00f3n l\u00e0 do gi\u1ea3m nhu \u0111\u1ed9ng ru\u1ed9t, v\u00e0 t\u00ecnh tr\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 ph\u1ee9c t\u1ea1p b\u1edfi ch\u1ee9ng \u0111\u1ea1i ti\u1ec7n kh\u00f4ng t\u1ef1 ch\u1ee7 do gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c c\u01a1 th\u1eaft h\u1eadu m\u00f4n. \u1ede b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng neuron v\u1eadn \u0111\u1ed9ng cao, g\u1ee3i \u00fd ch\u1ee9ng t\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 v\u00e0 t\u0103ng ph\u1ea3n x\u1ea1, t\u00e1o b\u00f3n l\u00e0 do co c\u01a1 co th\u1eaft qu\u00e1 m\u1ee9c v\u00e0 kh\u00f4ng \u0111\u1ee7 kh\u1ea3 n\u0103ng gi\u00e3n t\u1ef1 ch\u1ee7 c\u01a1 th\u1eaft h\u1eadu m\u00f4n ngo\u00e0i. Ph\u1ea3n x\u1ea1 g\u00e2n x\u01b0\u01a1ng b\u1ea5t th\u01b0\u1eddng c\u0169ng g\u1eb7p \u1edf tr\u1ebb suy gi\u00e1p, l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y t\u00e1o b\u00f3n hi\u1ebfm g\u1eb7p \u1edf tr\u1ebb em.<\/p>\n

5.3.2. S\u1ef1 thay \u0111\u1ed5i da \u1edf v\u00f9ng th\u1eaft l\u01b0ng-c\u00f9ng (l\u00f5m, ch\u00f9m l\u00f4ng, u m\u1ee1, hay \u0111\u1ed9 l\u1ec7ch c\u1ee7a r\u00e3nh li\u00ean m\u00f4ng)<\/strong><\/h3>\n

5.4: \u0110\u00e1y ch\u1eadu:<\/strong><\/h3>\n

C\u1ea7n kh\u00e1m k\u0129 \u0111\u00e1y ch\u1eadu \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c b\u1ea5t th\u01b0\u1eddng v\u1ec1 s\u1ef1 ph\u00e1t tri\u1ec3n h\u1eadu m\u00f4n-tr\u1ef1c tr\u00e0ng, m\u00e0 \u0111\u1eb7c tr\u01b0ng l\u00e0:
\n– H\u1eb9p tr\u1ef1c tr\u00e0ng h\u1eadu m\u00f4n b\u1ea9m sinh.
\n– Tr\u1ef1c tr\u00e0ng \u0111\u1ed5 ra tr\u01b0\u1edbc. Ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 b\u1edfi \u0111o ch\u1ec9 s\u1ed1 v\u1ecb tr\u00ed h\u1eadu m\u00f4n (Anal Position Index (API)).<\/p>\n\n\n\n\n\n
Gi\u1edbi<\/strong><\/td>\nC\u00e1ch \u0111o<\/strong><\/td>\nB\u00ecnh th\u01b0\u1eddng<\/strong><\/td>\n<\/tr>\n
Tr\u1ebb trai<\/strong><\/td>\nH\u1eadu m\u00f4n – H\u1ea1 nang\/ x\u01b0\u01a1ng c\u1ee5t – H\u1ea1 nang<\/td>\nAPI = 0,45 +\/- 0,16<\/td>\n<\/tr>\n
Tr\u1ebb g\u00e1i<\/strong><\/td>\nH\u1eadu m\u00f4n – g\u00f2 mu\/ x\u01b0\u01a1ng c\u1ee5t – g\u00f2 mu<\/td>\nAPI = 0,54+\/- 0.14<\/p>\n

 <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

H\u1eadu m\u00f4n m\u1edf ra tr\u01b0\u1edbc khi ch\u1ec9 s\u1ed1 h\u1eadu m\u00f4n API < 0,29 \u1edf tr\u1ebb g\u00e1i v\u00e0 < 0,40 \u1edf tr\u1ebb trai.
\nCh\u1ec9 s\u1ed1 API ch\u1ec9 h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt kh\u00f4ng ch\u1ec9 d\u1ef1a v\u00e0o ch\u1ec9 s\u1ed1 n\u00e0y.<\/p>\n

5.5. Th\u0103m h\u1eadu m\u00f4n-tr\u1ef1c tr\u00e0ng b\u1eb1ng tay<\/strong><\/h3>\n

Th\u0103m h\u1eadu m\u00f4n tr\u1ef1c tr\u00e0ng b\u1eb1ng tay kh\u00f4ng th\u1ef1c s\u1ef1 c\u1ea7n l\u00e0m th\u01b0\u1eddng quy \u0111\u1ed1i v\u1edbi tr\u1ebb c\u00f3 ti\u1ec1n s\u1eed v\u00e0 tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh t\u00e1o b\u00f3n ch\u1ee9c n\u0103ng. B\u1edfi v\u00ec th\u0103m h\u1eadu m\u00f4n-tr\u1ef1c tr\u00e0ng b\u1eb1ng tay g\u00e2y kh\u00f3 ch\u1ecbu cho tr\u1ebb v\u00e0 ch\u1ec9 c\u00f3 \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u t\u01b0\u01a1ng \u0111\u1ed1i \u0111\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 x\u00e1c \u0111\u1ecbnh c\u00f3 t\u00e1o b\u00f3n \u1edf nh\u1eefng tr\u1ebb n\u00e0y. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 th\u1ea7y thu\u1ed1c c\u0169ng th\u1ef1c hi\u1ec7n th\u0103m kh\u00e1m \u1edf nh\u1eefng tr\u1ebb nghi ng\u1edd c\u00f3 t\u00e1o b\u00f3n ch\u1ee9c n\u0103ng. M\u1ee5c \u0111\u00edch c\u1ee7a vi\u1ec7c th\u0103m kh\u00e1m n\u00e0y \u0111\u1ec3 ph\u00e1t hi\u1ec7n ph\u00e2n b\u1ecb n\u00e9n ch\u1eb7t, v\u00e0 \u0111\u1ec3 ph\u00e1t hi\u1ec7n m\u00e1u \u1ea9n, \u0111\u00f2i h\u1ecfi x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n h\u1ed7 tr\u1ee3.<\/p>\n

\"Th\u0103m
Th\u0103m kh\u00e1m tr\u1ef1c tr\u00e0ng \u2013 Ngu\u1ed3n Wikipedia ti\u1ebfng Vi\u1ec7t<\/figcaption><\/figure>\n

Th\u0103m tr\u1ef1c tr\u00e0ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho nh\u00f3m tr\u1ebb c\u00f3 nh\u1eefng bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng nghi ng\u1edd b\u1ec7nh Hirschsprung: khi th\u0103m tr\u1ef1c tr\u00e0ng trong b\u1ec7nh Hirchsprung s\u1ebd kh\u00e1m \u0111\u01b0\u1ee3c.
\n+ T\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 th\u1eaft h\u1eadu m\u00f4n.
\n+ \u1ed0ng h\u1eadu m\u00f4n kh\u00edt k\u00e8m b\u00f3ng tr\u1ef1c tr\u00e0ng r\u1ed7ng.
\n+ C\u00f3 th\u1ec3 c\u00f3 d\u1ea5u hi\u1ec7u th\u00e1o c\u1ed1ng sau khi th\u0103m tr\u1ef1c tr\u00e0ng b\u1eb1ng tay, v\u00e0 c\u00f3 th\u1ec3 gi\u1ea3m t\u00e1o b\u00f3n t\u1ea1m th\u1eddi.
\n+ Tr\u1ebb s\u01a1 sinh b\u1ecb Hirschsprung th\u01b0\u1eddng c\u00f3 kh\u1ed1i c\u0103ng ch\u01b0\u1edbng \u1edf b\u1ee5ng v\u00e0 ch\u1eadm ph\u00e1t tri\u1ec3n.<\/p>\n

– D\u1ea5u hi\u1ec7u nghi ng\u1edd t\u00e1o b\u00f3n ch\u1ee9c n\u0103ng:<\/strong><\/h3>\n

+ K\u00edch th\u01b0\u1edbc v\u00f2m tr\u1ef1c tr\u00e0ng l\u1edbn.
\n+ Tr\u1ef1c tr\u00e0ng c\u0103ng m\u00e0 ch\u1ee9a \u0111\u1ea7y ph\u00e2n \u1edf ngay m\u00e9p h\u1eadu m\u00f4n. Tuy nhi\u00ean, khi kh\u00f4ng c\u00f3 ph\u00e2n c\u0169ng kh\u00f4ng lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c t\u00e1o b\u00f3n ch\u1ee9c n\u0103ng.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
L\u00e2m s\u00e0ng<\/strong><\/td>\nT\u00e1o b\u00f3n ch\u1ee9c n\u0103ng<\/strong><\/td>\nB\u1ec7nh Hirschsprung<\/strong><\/td>\n<\/tr>\n
Tu\u1ed5i kh\u1edfi ph\u00e1t<\/p>\n

 <\/td>\n

> 1 n\u0103m<\/strong><\/td>\n<1 n\u0103m<\/strong><\/td>\n<\/tr>\n
\u0110i ti\u00eau ph\u00e2n su<\/td>\nTrong v\u00f2ng 24h<\/strong><\/td>\nSau 24h<\/strong><\/td>\n<\/tr>\n
K\u00edch th\u01b0\u1edbc ph\u00e2n<\/td>\nL\u1edbn<\/strong><\/td>\nNh\u1ecf v\u00e0 d\u1ea1ng d\u00e2y<\/strong><\/td>\n<\/tr>\n
H\u00e0nh vi n\u00edn gi\u1eef ph\u00e2n<\/td>\nC\u00f3<\/strong><\/td>\nKh\u00f4ng<\/strong><\/td>\n<\/tr>\n
S\u00f3n ph\u00e2n<\/td>\nC\u00f3<\/strong><\/td>\nR\u1ea5t hi\u1ebfm<\/strong><\/td>\n<\/tr>\n
Tr\u1ef1c tr\u00e0ng<\/td>\n\u0110\u1ea7y ph\u00e2n<\/strong><\/td>\nTr\u1ed1ng<\/strong><\/td>\n<\/tr>\n
Kh\u00e1m tr\u1ef1c tr\u00e0ng<\/td>\nPh\u00e2n trong tr\u1ef1c tr\u00e0ng <\/strong><\/td>\nD\u1ea5u hi\u1ec7u th\u00e1o c\u1ed1ng<\/strong><\/td>\n<\/tr>\n
T\u0103ng tr\u01b0\u1edfng<\/td>\nB\u00ecnh th\u01b0\u1eddng<\/strong><\/td>\nCh\u1eadm<\/strong><\/p>\n

\u00a0<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Ngu\u1ed3n tham kh\u1ea3o<\/strong>
\n1. \u2018T\u00e1o b\u00f3n \u1edf tr\u1ebb em\u2019 trang 163 Gi\u00e1o tr\u00ecnh Nhi khoa \u0110\u1ea1i h\u1ecdc y d\u01b0\u1ee3c Hu\u1ebf
\n2. ncbi.nlm.nih.gov\/pubmed
\n3. Signs & Symptoms IN PEDIATRICS Editors: Henry M. Adam, MD, FAAP Jane Meschan Foy, MD, FAAP<\/p>\n","protected":false},"excerpt":{"rendered":"

T\u00e1o b\u00f3n \u1edf tr\u1ebb em l\u00e0 t\u00ecnh tr\u1ea1ng khi tr\u1ebb c\u00f3 kh\u00f3 kh\u0103n ho\u1eb7c kh\u00f4ng th\u1ec3 \u0111i ti\u00eau ho\u00e1 \u0111\u01b0\u1eddng ti\u00eau h\u00f3a \u0111\u1ea7y \u0111\u1ee7, th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi ngh\u1ebdn, \u0111au b\u1ee5ng, kh\u00f3 ch\u1ecbu v\u00e0 s\u01b0ng \u0111au h\u1eadu m\u00f4n. T\u00e1o b\u00f3n th\u01b0\u1eddng x\u1ea3y ra khi l\u01b0\u1ee3ng n\u01b0\u1edbc trong ph\u00e2n \u00edt, ph\u00e2n c\u1ee9ng v\u00e0 kh\u00f3 di chuy\u1ec3n […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[15,33],"tags":[],"yoast_head":"\nTi\u1ebfp c\u1eadn t\u00e1o b\u00f3n tr\u1ebb em: \u0110\u1ecbnh ngh\u0129a, sinh l\u00fd, tri\u00eau ch\u1ee9ng l\u00e2m s\u00e0ng<\/title>\n<meta name=\"description\" content=\"T\u00e1o b\u00f3n \u1edf tr\u1ebb em l\u00e0 t\u00ecnh tr\u1ea1ng khi tr\u1ebb c\u00f3 kh\u00f3 kh\u0103n ho\u1eb7c kh\u00f4ng th\u1ec3 \u0111i ti\u00eau ho\u00e1 \u0111\u01b0\u1eddng ti\u00eau h\u00f3a \u0111\u1ea7y \u0111\u1ee7, th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi ngh\u1ebdn, \u0111au b\u1ee5ng,\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta 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