{"id":28970,"date":"2023-04-27T23:17:05","date_gmt":"2023-04-27T16:17:05","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28970"},"modified":"2023-05-01T23:33:25","modified_gmt":"2023-05-01T16:33:25","slug":"benh-ly-y-khoa-nguy-co-trung-binh-den-ket-qua-implant","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/27\/benh-ly-y-khoa-nguy-co-trung-binh-den-ket-qua-implant\/","title":{"rendered":"B\u1ec7nh l\u00fd Y khoa nguy c\u01a1 trung b\u00ecnh \u0111\u1ebfn k\u1ebft qu\u1ea3 Implant."},"content":{"rendered":"

B\u00e0i vi\u1ebft n\u00e0y s\u1ebd t\u00f3m l\u01b0\u1ee3c m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd y khoa c\u00f3 nguy c\u01a1 trung b\u00ecnh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 ph\u1eabu thu\u1eadt Implant tr\u00ean \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n. Nha s\u0129 c\u1ea7n n\u1eafm v\u1eefng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 v\u00e0 t\u00ednh to\u00e1n \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 ti\u00ean l\u01b0\u1ee3ng tr\u00ean b\u1ec7nh nh\u00e2n v\u1ec1 sau. C\u00f9ng t\u00ecm hi\u1ec3u.<\/strong><\/p>\n

\"benh-ly-y-khoa\"<\/p>\n

1. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng – B\u1ec7nh l\u00fd Y khoa nguy c\u01a1 trung b\u00ecnh \u0111\u1ebfn k\u1ebft qu\u1ea3 Implant<\/strong><\/h2>\n

\u0110\u00e2y l\u00e0 r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a g\u00e2y t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft, do khi\u1ebfm khuy\u1ebft ti\u1ebft insulin ho\u1eb7c gi\u1ea3m dung n\u1ea1p glucose ho\u1eb7c c\u1ea3 hai. \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 b\u1ec7nh n\u1ed9i ti\u1ebft th\u01b0\u1eddng g\u1eb7p nh\u1ea5t, l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y t\u00e0n t\u1eadt v\u00e0 b\u1ec7nh t\u1eadt cao th\u1ee9 3 \u1edf c\u00e1c n\u01b0\u1edbc ph\u01b0\u01a1ng T\u00e2y. HbA1c l\u00e0 s\u1ed1 \u0111o ki\u1ec3m so\u00e1t glucose d\u00e0i h\u1ea1n. M\u1ee9c b\u00ecnh th\u01b0\u1eddng l\u00e0 4.0-6.0%; c\u00e2n b\u1eb1ng t\u1ed1t l\u00e0 6.0-7.5%, t\u01b0\u01a1ng \u0111\u1ed1i l\u00e0 7.6-8.9%, v\u00e0 k\u00e9m l\u00e0 9.0-20.0%. Ng\u01b0\u1eddi ta bi\u1ebft r\u1eb1ng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng d\u1ec5 b\u1ecb c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn s\u1ef1 l\u00e0nh th\u01b0\u01a1ng, th\u01b0\u1eddng l\u00e0 ch\u1eadm l\u00e0nh th\u01b0\u01a1ng. C\u00f3 2 lo\u1ea1i \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ch\u00ednh. Lo\u1ea1i 1 (tr\u01b0\u1edbc \u0111\u00e2y g\u1ecdi l\u00e0 “ph\u1ee5 thu\u1ed9c insulin\u201d) l\u00e0 do ph\u1ea3n \u1ee9ng t\u1ef1 mi\u1ec5n l\u00e0m ph\u00e1 h\u1ee7y c\u00e1c t\u1ebf b\u00e0o beta c\u1ee7a tuy\u1ebfn t\u1ee5y, d\u1eabn t\u1edbi thi\u1ebfu s\u1ea3n xu\u1ea5t insulin. Lo\u1ea1i 2 (tr\u01b0\u1edbc \u0111\u00e2y g\u1ecdi l\u00e0 “kh\u00f4ng ph\u1ee5 thu\u1ed9c insulin\u201d) \u0111\u01b0\u1ee3c cho l\u00e0 do kh\u00e1ng insulin k\u1ebft h\u1ee3p v\u1edbi kh\u00f4ng th\u1ec3 s\u1ea3n xu\u1ea5t th\u00eam insulin b\u00f9 tr\u1eeb.<\/p>\n

Nh\u1eefng thay \u0111\u1ed5i v\u1ec1 chuy\u1ec3n h\u00f3a do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng g\u00e2y ra c\u00f3 li\u00ean quan \u0111\u1ebfn s\u1ef1 t\u1ed5ng h\u1ee3p khu\u00f4n nguy\u00ean b\u00e0o x\u01b0\u01a1ng nh\u1edd insulin. Nh\u1eefng thay \u0111\u1ed5i trong s\u1ef1 bi\u1ec7t h\u00f3a nguy\u00ean b\u00e0o x\u01b0\u01a1ng v\u00e0 thay \u0111\u1ed5i hormone \u0111i\u1ec1u h\u00f2a s\u1ef1 trao \u0111\u1ed5i calcium \u0111\u00e3 t\u1ea1o ra s\u1ef1 c\u00e2n b\u1eb1ng n\u1ed9i m\u00f4 trong m\u00f4 x\u01b0\u01a1ng kho\u00e1ng h\u00f3a, t\u1eeb \u0111\u00f3 \u0111\u00f2i h\u1ecfi ph\u1ea3i thay \u0111\u1ed5i n\u1ed3ng \u0111\u1ed9 khu\u00f4n x\u01b0\u01a1ng \u0111\u1ec3 s\u1ea3n xu\u1ea5t ra c\u00e1c c\u1ed1t b\u00e0o tr\u01b0\u1edfng th\u00e0nh nh\u1eb1m t\u0103ng c\u01b0\u1eddng s\u1ef1 t\u00edch h\u1ee3p x\u01b0\u01a1ng c\u1ee7a implant nha khoa. C\u00e1c nghi\u00ean c\u1ee9u b\u1ec7nh- ch\u1ee9ng tr\u00ean \u0111\u1ed9ng v\u1eadt cho th\u1ea5y c\u00f3 s\u1ef1 thay \u0111\u1ed5i m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng quanh implant \u1edf nh\u1eefng m\u1eabu \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng kh\u00f4ng ki\u1ec3m so\u00e1t. H\u1ea7u h\u1ebft nghi\u00ean c\u1ee9u \u0111\u1ec1u \u1ee7ng h\u1ed9 c\u00e1c k\u1ebft qu\u1ea3 th\u1ef1c nghi\u1ec7m n\u00e0y. Trong m\u1ed9t nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u 3 n\u0103m, t\u1ea7n s\u1ed1 c\u1ea5y gh\u00e9p th\u1ea5t b\u1ea1i \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 cao h\u01a1n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng (7.8%) so v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n kh\u1ecfe m\u1ea1nh (6.8%).<\/p>\n

Nh\u1eefng d\u1eef li\u1ec7u tr\u00ean c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1eeba nh\u1eadn trong c\u00e1c t\u1ed5ng quan g\u1ea7n \u0111\u00e2y. M\u1ed9t s\u1ed1 \u1ea5n ph\u1ea9m kh\u00e1c g\u1ea7n \u0111\u00e2y c\u00f4ng b\u1ed1 nhi\u1ec1u k\u1ebft qu\u1ea3 kh\u00e1c nhau nh\u01b0ng \u0111\u1ec1u nh\u1ea5n m\u1ea1nh v\u00e0o nguy c\u01a1 th\u1ea5t b\u1ea1i cao h\u01a1n \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. \u0110a s\u1ed1 c\u00e1c nghi\u00ean c\u1ee9u lo\u1ea1t case, \u0111o\u00e0n-h\u1ec7, v\u00e0 c\u00e1c t\u1ed5ng quan h\u1ec7 th\u1ed1ng \u0111\u1ec1u \u1ee7ng h\u1ed9 r\u1eb1ng c\u1ea5y gh\u00e9p nha khoa \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ki\u1ec3m so\u00e1t t\u1ed1t c\u00f3 t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh nh\u00e2n kh\u1ecfe m\u1ea1nh. Tuy nhi\u00ean, gi\u1ea3m t\u00edch h\u1ee3p implant \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Trong m\u1ed9t t\u1ed5ng quan h\u1ec7 th\u1ed1ng g\u1ea7n \u0111\u00e2y, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 k\u1ebft lu\u1eadn r\u1eb1ng \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ki\u1ec3m so\u00e1t k\u00e9m c\u00f3 \u1ea3nh h\u01b0\u1edfng ti\u00eau c\u1ef1c \u0111\u1ebfn s\u1ef1 t\u00ednh h\u1ee3p x\u01b0\u01a1ng c\u1ee7a implant. \u0110i\u1ec1u n\u00e0y ph\u00f9 h\u1ee3p v\u1edbi c\u00e1c t\u00e1c \u0111\u1ed9ng \u0111\u00e3 bi\u1ebft c\u1ee7a t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft l\u00ean s\u1ef1 suy gi\u1ea3m mi\u1ec5n d\u1ecbch, c\u00e1c bi\u1ebfn ch\u1ee9ng vi m\u1ea1ch, v\u00e0\/ho\u1eb7c lo\u00e3ng x\u01b0\u01a1ng. N\u00f3i chung, kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng l\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p nha khoa, nh\u01b0ng v\u00ec HbA1c c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 \u0111\u1ed9c l\u1eadp li\u00ean quan \u0111\u1ebfn nh\u1eefng bi\u1ebfn ch\u1ee9ng h\u1eadu ph\u1eabu v\u00e0 do c\u00e1c t\u00e1c \u0111\u1ed9ng \u0111\u00e3 bi\u1ebft c\u1ee7a t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft l\u00ean s\u1ef1 l\u00e0nh th\u01b0\u01a1ng n\u00ean c\u1ea7n ph\u1ea3i tham v\u1ea5n y khoa v\u00e0 ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft nghi\u00eam ng\u1eb7t tr\u01b0\u1edbc v\u00e0 sau \u0111i\u1ec1u tr\u1ecb nha khoa. N\u00ean s\u1eed d\u1ee5ng kh\u00e1ng sinh ph\u1ee7 nh\u01b0 penicillin, amoxicillin, clindamycin, ho\u1eb7c metronidazole trong su\u1ed1t ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p. Nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u0169ng n\u00ean b\u1ecf h\u00fat thu\u1ed1c l\u00e1, t\u1ed1i \u01b0u h\u00f3a v\u1ec7 sinh r\u0103ng mi\u1ec7ng, v\u00e0 s\u1eed d\u1ee5ng n\u01b0\u1edbc s\u00fac mi\u1ec7ng di\u1ec7t khu\u1ea9n \u0111\u1ec3 ng\u0103n ng\u1eeba t\u00ecnh tr\u1ea1ng vi\u00eam nha chu v\u00e0 vi\u00eam quanh implant.<\/p>\n

D\u1ef1a tr\u00ean c\u00e1c k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ea5y gh\u00e9p nha khoa \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng do t\u1ea7n s\u1ed1 th\u1ea5t b\u1ea1i cao t\u1eeb nguy c\u01a1 nhi\u1ec5m tr\u00f9ng \u0111\u00e3 thay \u0111\u1ed5i. N\u1ebfu \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t, s\u1eed d\u1ee5ng kh\u00e1ng sinh ph\u00f2ng ng\u1eeba v\u00e0 k\u1ef9 thu\u1eadt v\u00f4 khu\u1ea9n v\u1edbi chlorhexidine gluconate 0.12% trong qu\u00e1 tr\u00ecnh \u0111\u1eb7t implant th\u00ec t\u1ef7 l\u1ec7 th\u1ea5t b\u1ea1i l\u00e0 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi b\u1ec7nh nh\u00e2n kh\u1ecfe m\u1ea1nh.<\/p>\n

2. X\u1ea1 tr\u1ecb\u00a0<\/strong><\/h2>\n

\u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn k\u1ebft qu\u1ea3 c\u1ea5y gh\u00e9p nha khoa, ch\u1ee7 y\u1ebfu l\u00e0 trong giai \u0111o\u1ea1n l\u00e0nh th\u01b0\u01a1ng. X\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 g\u00e2y vi\u00eam t\u1eafc n\u1ed9i m\u1ea1c \u0111\u1ed9ng m\u1ea1ch, t\u1eeb \u0111\u00f3 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ho\u1ea1i t\u1eed x\u01b0\u01a1ng h\u00e0m do tia x\u1ea1. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u v\u1ec1 c\u1ea5y gh\u00e9p implant \u1edf b\u1ec7nh nh\u00e2n tr\u01b0\u1edfng th\u00e0nh \u0111\u00e3 x\u1ea1 tr\u1ecb cho th\u1ea5y t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng th\u1ea5p h\u01a1n, nh\u01b0ng c\u0169ng c\u00f3 m\u1ed9t v\u00e0i nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y implant c\u00f3 th\u1ec3 t\u00edch h\u1ee3p x\u01b0\u01a1ng v\u00e0 \u1ed5n \u0111\u1ecbnh ch\u1ee9c n\u0103ng \u1edf c\u00e1c b\u1ec7nh nh\u00e2n x\u1ea1 tr\u1ecb. Nh\u1eefng t\u00e1c gi\u1ea3 kh\u00e1c l\u1ea1i b\u00e1o c\u00e1o v\u1ec1 k\u1ebft qu\u1ea3 c\u1ea5y gh\u00e9p nha khoa th\u00e0nh c\u00f4ng nh\u01b0ng c\u00f3 s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a c\u00e1c bi\u1ebfn ch\u1ee9ng mu\u1ed9n, ch\u1eb3ng h\u1ea1n nh\u01b0 ti\u00eau x\u01b0\u01a1ng v\u00e0 t\u1ee5t ni\u00eam m\u1ea1c, c\u00f3 th\u1ec3 l\u00e0 do l\u01b0u l\u01b0\u1ee3ng n\u01b0\u1edbc b\u1ecdt thay \u0111\u1ed5i v\u00e0 h\u1ec7 vi khu\u1ea9n gia t\u0103ng. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u b\u1ec7nh ch\u1ee9ng \u0111\u00e3 cho th\u1ea5y b\u1eb1ng ch\u1ee9ng v\u1ec1 k\u1ebft qu\u1ea3 c\u1ea3i thi\u1ec7n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed x\u1ea1 tr\u1ecb \u0111\u01b0\u1ee3c c\u1ea5y gh\u00e9p implant k\u1ebft h\u1ee3p v\u1edbi li\u1ec7u ph\u00e1p oxy cao \u00e1p, ch\u1ee7 y\u1ebfu l\u00e0 gi\u1ea3m t\u1ef7 l\u1ec7 ho\u1ea1i t\u1eed x\u01b0\u01a1ng do tia x\u1ea1 v\u00e0 c\u1ea5y gh\u00e9p th\u1ea5t b\u1ea1i. Tuy nhi\u00ean, trong m\u1ed9t t\u1ed5ng quan h\u1ec7 th\u1ed1ng g\u1ea7n \u0111\u00e2y, c\u00e1c t\u00e1c gi\u1ea3 kh\u00f4ng t\u00ecm \u0111\u01b0\u1ee3c b\u1eb1ng ch\u1ee9ng m\u1ea1nh m\u1ebd n\u00e0o \u1ee7ng h\u1ed9 ho\u1eb7c ph\u1ea3n \u0111\u1ed1i vi\u1ec7c s\u1eed d\u1ee5ng li\u1ec7u ph\u00e1p oxy cao \u00e1p \u0111\u1ec3 c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 c\u1ea5y gh\u00e9p, \u0111\u01b0a \u0111\u1ebfn k\u1ebft lu\u1eadn vi\u1ec7c \u0111i\u1ec1u tr\u1ecb cao \u00e1p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u1ea5y gh\u00e9p d\u01b0\u1eddng nh\u01b0 kh\u00f4ng th\u1eadt s\u1ef1 hi\u1ec7u qu\u1ea3. X\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a c\u1ea5y gh\u00e9p nha khoa khi li\u1ec1u chi\u1ebfu x\u1ea1 v\u01b0\u1ee3t qu\u00e1 50 Gy, \u0111i\u1ec1u n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh \u0111\u1ed1i v\u1edbi c\u00e1c c\u1ea5y gh\u00e9p ngo\u00e0i v\u00f9ng mi\u1ec7ng. M\u1ed9t nghi\u00ean c\u1ee9u b\u1ec7nh-ch\u1ee9ng \u1edf x\u01b0\u01a1ng h\u00e0m tr\u00ean v\u00e0 x\u01b0\u01a1ng h\u00e0m d\u01b0\u1edbi \u0111\u00e3 chi\u1ebfu x\u1ea1 (24-120 Gy) cho th\u1ea5y th\u01b0\u01a1ng s\u1ed1 \u1ed5n \u0111\u1ecbnh implant d\u00e0i h\u1ea1n \u1edf x\u01b0\u01a1ng \u0111\u00e3 chi\u1ebfu x\u1ea1 th\u1ea5p h\u01a1n so v\u1edbi x\u01b0\u01a1ng kh\u00f4ng chi\u1ebfu x\u1ea1.<\/p>\n

\u0110\u1ec3 t\u0103ng kh\u1ea3 n\u0103ng c\u1ea5y gh\u00e9p th\u00e0nh c\u00f4ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n x\u1ea1 tr\u1ecb \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ea7u-c\u1ed5, nh\u1eefng bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba sau n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t:<\/p>\n

    \n
  1. Ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ed1t nh\u1ea5t > 21 ng\u00e0y tr\u01b0\u1edbc x\u1ea1 tr\u1ecb.<\/li>\n
  2. T\u1ed5ng li\u1ec1u chi\u1ebfu x\u1ea1 < 66 Gy n\u1ebfu nguy c\u01a1 ho\u1ea1i t\u1eed x\u01b0\u01a1ng do fia x\u1ea1 l\u00e0 t\u1ed1i thi\u1ec3u ho\u1eb7c < 50 Gy \u0111\u1ec3 gi\u1ea3m th\u1ea5t b\u1ea1i t\u00edch h\u1ee3p x\u01b0\u01a1ng t\u1ea1i v\u1ecb tr\u00ed c\u1ea5y gh\u00e9p.<\/li>\n
  3. S\u1eed d\u1ee5ng oxy cao \u00e1p n\u1ebfu li\u1ec1u chi\u1ebfu x\u1ea1 > 50 Gy.<\/li>\n
  4. Kh\u00f4ng ti\u1ebfn h\u00e0nh ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p trong qu\u00e1 tr\u00ecnh x\u1ea1 tr\u1ecb.<\/li>\n
  5. Kh\u00f4ng ti\u1ebfn h\u00e0nh ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p khi b\u1ecb vi\u00eam ni\u00eam m\u1ea1c.<\/li>\n
  6. Tr\u00ec ho\u00e3n \u0111\u1eb7t implant 9 th\u00e1ng sau x\u1ea1 tr\u1ecb.<\/li>\n
  7. L\u00e0m ph\u1ee5c h\u00ecnh tr\u00ean implant kh\u00f4ng ti\u1ebfp x\u00fac ni\u00eam m\u1ea1c \u0111\u1ed3ng th\u1eddi tr\u00e1nh t\u1ea3i l\u1ef1c t\u1ee9c th\u00ec.<\/li>\n
  8. \u0110\u1ea3m b\u1ea3o v\u00f4 khu\u1ea9n nghi\u00eam ng\u1eb7t trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt.<\/li>\n
  9. Xem x\u00e9t s\u1eed d\u1ee5ng kh\u00e1ng sinh ph\u00f2ng ng\u1eeba.<\/li>\n<\/ol>\n

    3. R\u1ed1i lo\u1ea1n ch\u1ea3y m\u00e1u\/c\u00f3 khuynh h\u01b0\u1edbng ch\u1ea3y m\u00e1u nhi\u1ec1u (c\u01a1 \u0111\u1ecba xu\u1ea5t huy\u1ebft, kh\u00f4ng \u0111\u00f4ng m\u00e1u do thu\u1ed1c)<\/strong><\/h2>\n

    M\u1eb7c d\u00f9 xu\u1ea5t huy\u1ebft c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng t\u01b0\u01a1ng \u0111\u1ed1i ph\u1ed5 bi\u1ebfn trong c\u1ea5y gh\u00e9p nha khoa, nh\u01b0ng kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng \u0111\u00e1ng tin c\u1eady cho th\u1ea5y c\u00e1c r\u1ed1i lo\u1ea1n ch\u1ea3y m\u00e1u l\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a implant: ngay c\u1ea3 nh\u1eefng b\u1ec7nh nh\u00e2n hemophilia (b\u1ec7nh \u01b0a ch\u1ea3y m\u00e1u) c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb implant th\u00e0nh c\u00f4ng. B\u1ea5t k\u1ef3 quy tr\u00ecnh ph\u1eabu thu\u1eadt mi\u1ec7ng n\u00e0o c\u0169ng \u0111\u1ec1u c\u00f3 th\u1ec3 g\u00e2y ch\u1ea3y m\u00e1u v\u00e0 m\u1ea5t m\u00e1u, v\u00e0 n\u1ebfu m\u00e1u \u0111i v\u00e0o c\u00e1c khoang c\u1ed5 th\u00ec n\u00f3 c\u00f3 th\u1ec3 \u0111e d\u1ecda \u0111\u01b0\u1eddng th\u1edf. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ea3y m\u00e1u, xu\u1ea5t huy\u1ebft do ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p l\u00e0 kh\u00e1 ph\u1ed5 bi\u1ebfn v\u00e0 c\u00f3 th\u1ec3 k\u00e9o d\u00e0i, \u0111\u1eb7c bi\u1ec7t l\u00e0 b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng warfarin ho\u1eb7c acenocoumarol. \u0110\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y, khuy\u1ebfn c\u00e1o hi\u1ec7n nay l\u00e0 th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p kh\u00f4ng c\u1ea7n thay \u0111\u1ed5i thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng, mi\u1ec5n l\u00e0 INR nh\u1ecf h\u01a1n 3-3.5. C\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb huy\u1ebft kh\u1ed1i (INR 2-4) kh\u00f4ng ng\u01b0ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng v\u1eabn kh\u00f4ng c\u00f3 nguy c\u01a1 ch\u1ea3y m\u00e1u h\u1eadu ph\u1eabu cao h\u01a1n \u0111\u00e1ng k\u1ec3, v\u00e0 c\u00e1c ch\u1ea5t c\u1ea7m m\u00e1u t\u1ea1i ch\u1ed7 v\u1eabn \u0111\u1ea1t hi\u1ec7u qu\u1ea3 ph\u00f2ng ng\u1eeba ch\u1ea3y m\u00e1u h\u1eadu ph\u1eabu. Do \u0111\u00f3, ng\u01b0ng u\u1ed1ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong ph\u1eabu thu\u1eadt implant, mi\u1ec5n l\u00e0 kh\u00f4ng gh\u00e9p x\u01b0\u01a1ng t\u1ef1 th\u00e2n, t\u1ea1o v\u1ea1t l\u1edbn, ho\u1eb7c khoan x\u01b0\u01a1ng ra ngo\u00e0i v\u1ecf x\u01b0\u01a1ng. Nh\u1eefng b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb heparin c\u0169ng c\u00f3 nguy c\u01a1 ch\u1ea3y m\u00e1u th\u1ea5p. Nh\u00ecn chung, kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y c\u00e1c r\u1ed1i lo\u1ea1n ch\u1ea3y m\u00e1u l\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh tuy\u1ec7t \u0111\u1ed1i c\u1ee7a ph\u1eabu thu\u1eadt c\u1ea5y gh\u00e9p nha khoa, m\u1eb7c d\u00f9 nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u00f3 nguy c\u01a1 ch\u1ea3y m\u00e1u k\u00e9o d\u00e0i v\u00e0 m\u1ea5t m\u00e1u, do \u0111\u00f3 tr\u01b0\u1edbc h\u1ebft c\u1ea7n tham v\u1ea5n y khoa, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n ch\u1ea3y m\u00e1u b\u1ea9m sinh [1]. B\u00e1c s\u0129 t\u1ed5ng qu\u00e1t c\u00f3 th\u1ec3 quy\u1ebft \u0111\u1ecbnh thay \u0111\u1ed5i thu\u1ed1c ho\u1eb7c “t\u1ea1m th\u1eddi” cho b\u1ec7nh nh\u00e2n u\u1ed1ng heparin tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb c\u1ea5y gh\u00e9p \u0111\u1ec3 gi\u1eef INR \u1edf m\u1ee9c ph\u00f9 h\u1ee3p cho ph\u1eabu thu\u1eadt. Nha s\u0129 ph\u1ea3i c\u00e2n nh\u1eafc gi\u1eefa nguy c\u01a1 do s\u1ef1 thay \u0111\u1ed5i ho\u1eb7c ng\u01b0ng s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng huy\u1ebft kh\u1ed1i l\u00e0 nguy c\u01a1 thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i \u2013 so v\u1edbi nguy c\u01a1 xu\u1ea5t huy\u1ebft, v\u00e0 do \u0111\u00f3 c\u1ea7n ph\u1ea3i tham v\u1ea5n y khoa tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb<\/p>\n

    Ngu\u1ed3n t\u00e0i li\u1ec7u: Clinical Cases in Implant Dentistry, First Edition – Published 2017 by John Wiley & Sons, Inc.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

    B\u00e0i vi\u1ebft n\u00e0y s\u1ebd t\u00f3m l\u01b0\u1ee3c m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd y khoa c\u00f3 nguy c\u01a1 trung b\u00ecnh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 ph\u1eabu thu\u1eadt Implant tr\u00ean \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n. Nha s\u0129 c\u1ea7n n\u1eafm v\u1eefng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 v\u00e0 t\u00ednh to\u00e1n \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 ti\u00ean l\u01b0\u1ee3ng tr\u00ean b\u1ec7nh nh\u00e2n v\u1ec1 sau. C\u00f9ng […]<\/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":"\nB\u1ec7nh l\u00fd Y khoa nguy c\u01a1 trung b\u00ecnh \u0111\u1ebfn k\u1ebft qu\u1ea3 Implant.<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft n\u00e0y s\u1ebd t\u00f3m l\u01b0\u1ee3c m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd y khoa c\u00f3 nguy c\u01a1 trung b\u00ecnh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 ph\u1eabu thu\u1eadt Implant. C\u00f9ng t\u00ecm hi\u1ec3u.\" \/>\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=\"B\u1ec7nh l\u00fd Y khoa nguy c\u01a1 trung b\u00ecnh \u0111\u1ebfn k\u1ebft qu\u1ea3 Implant.\" \/>\n<meta property=\"og:description\" content=\"B\u00e0i vi\u1ebft n\u00e0y s\u1ebd t\u00f3m l\u01b0\u1ee3c m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd y khoa c\u00f3 nguy c\u01a1 trung b\u00ecnh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 ph\u1eabu thu\u1eadt Implant. 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