{"id":29171,"date":"2023-05-06T22:15:01","date_gmt":"2023-05-06T15:15:01","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29171"},"modified":"2023-05-06T22:15:01","modified_gmt":"2023-05-06T15:15:01","slug":"chan-thuong-so-nao-dai-cuong","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/chan-thuong-so-nao-dai-cuong\/","title":{"rendered":"Ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o – \u0110a\u0323i c\u01b0\u01a1ng"},"content":{"rendered":"

Ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o<\/strong>\u00a0l\u00e0 m\u1ed9t lo\u1ea1i ch\u1ea5n th\u01b0\u01a1ng nghi\u00eam tr\u1ecdng \u0111\u1ed1i v\u1edbi h\u1ec7 th\u1ed1ng th\u1ea7n kinh v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ch\u1ee9c n\u0103ng v\u00e0 s\u1ee9c kh\u1ecfe. Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o<\/a> th\u01b0\u1eddng x\u1ea3y ra khi \u0111\u1ea7u b\u1ecb t\u00e1c \u0111\u1ed9ng m\u1ea1nh ho\u1eb7c va ch\u1ea1m v\u00e0o m\u1ed9t v\u1eadt c\u1ee9ng, g\u00e2y ra s\u1ef1 ch\u1ea5n \u0111\u1ed9ng cho n\u00e3o b\u00ean trong s\u1ecd. C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o c\u00f3 th\u1ec3 bao g\u1ed3m \u0111au \u0111\u1ea7u, m\u1ec7t m\u1ecfi, ch\u00f3ng m\u1eb7t, bu\u1ed3n n\u00f4n ho\u1eb7c n\u00f4n m\u1eeda, nh\u1ee9c \u0111\u1ea7u, kh\u00f3 kh\u0103n trong vi\u1ec7c t\u1eadp trung, suy gi\u1ea3m tr\u00ed nh\u1edb, lo\u1ea1n th\u1ecb ho\u1eb7c m\u1ea5t th\u00ednh l\u1ef1c. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nghi\u00eam tr\u1ecdng h\u01a1n, ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o c\u00f3 th\u1ec3 g\u00e2y ra li\u1ec7t c\u1ea3 hai ch\u00e2n ho\u1eb7c c\u1ea3 hai tay, s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng, ho\u1eb7c m\u1ea5t \u00fd th\u1ee9c. Vi\u1ec7c ph\u00f2ng ng\u1eeba ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o l\u00e0 r\u1ea5t quan tr\u1ecdng, bao g\u1ed3m \u0111eo m\u0169 b\u1ea3o hi\u1ec3m khi tham gia c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao ho\u1eb7c c\u00f4ng vi\u1ec7c nguy hi\u1ec3m v\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c r\u1ee7i ro ti\u1ec1m \u1ea9n c\u00f3 th\u1ec3 g\u00e2y ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o.<\/p>\n

Ba\u0300i vi\u00ea\u0301t tham kha\u0309o t\u01b0\u0300 ta\u0300i li\u00ea\u0323u ban ha\u0300nh theo Quy\u1ebft \u0111\u1ecbnh s\u1ed1 5623 \/Q\u0110-BYT ng\u00e0y 21\/9\/2018 c\u1ee7a B\u1ed9 tr\u01b0\u1edfng B\u1ed9 Y t\u1ebf.\u00a0<\/em><\/p>\n

\"Ch\u00e2\u0301n
Ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o<\/figcaption><\/figure>\n

1.1.\u00a0\u00a0\u0110\u1ecbnh ngh\u0129a ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o<\/h2>\n

Ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o (CTSN) l\u00e0 t\u00ecnh tr\u1ea1ng t\u1ed5n th\u01b0\u01a1ng n\u00e3o c\u1ea5p t\u00ednh g\u00e2y ra b\u1edfi m\u1ed9t l\u1ef1c c\u01a1 h\u1ecdc b\u00ean ngo\u00e0i t\u00e1c \u0111\u1ed9ng v\u00e0o \u0111\u1ea7u. (Nh\u00f3m C\u00e1c H\u01b0\u1edbng d\u1eabn New Zealand, 2006)<\/p>\n

C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 bao g\u1ed3m m\u1ed9t <\/strong>ho\u1eb7c nhi\u1ec1u <\/strong>r\u1ed1i lo\u1ea1n sau:<\/p>\n

    \n
  • L\u00fa l\u1eabn ho\u1eb7c m\u1ea5t \u0111\u1ecbnh h\u01b0\u1edbng<\/li>\n
  • M\u1ea5t \u00fd th\u1ee9c<\/li>\n
  • Qu\u00ean sau ch\u1ea5n th\u01b0\u01a1ng (PTA)<\/li>\n
  • C\u00e1c thay \u0111\u1ed5i v\u1ec1 th\u1ea7n kinh kh\u00e1c nh\u01b0 c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa, co gi\u1eadt v\u00e0\/ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng n\u1ed9i s\u1ecd.<\/li>\n<\/ul>\n

    C\u00e1c bi\u1ec3u hi\u1ec7n n\u00e0y kh\u00f4ng ph\u1ea3i \u0111\u01b0\u1ee3c g\u00e2y ra b\u1edfi vi\u1ec7c s\u1eed d\u1ee5ng ma t\u00fay, r\u01b0\u1ee3u hay c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb, c\u0169ng kh\u00f4ng ph\u1ea3i b\u1edfi c\u00e1c t\u00ecnh tr\u1ea1ng ch\u1ea5n th\u01b0\u01a1ng kh\u00e1c ho\u1eb7c b\u1edfi vi\u1ec7c \u0111i\u1ec1u tr\u1ecb cho\u00a0 c\u00e1c ch\u1ea5n th\u01b0\u01a1ng \u0111\u00f3 (v\u00ed d\u1ee5: c\u00e1c ch\u1ea5n th\u01b0\u01a1ng to\u00e0n th\u00e2n, ch\u1ea5n th\u01b0\u01a1ng m\u1eb7t ho\u1eb7c do \u0111\u1eb7t n\u1ed9i\u00a0 kh\u00ed qu\u1ea3n), ho\u1eb7c g\u00e2y ra b\u1edfi c\u00e1c v\u1ea5n \u0111\u1ec1 kh\u00e1c (v\u00ed d\u1ee5: sang ch\u1ea5n t\u00e2m l\u00fd, r\u00e0o c\u1ea3n ng\u00f4n ng\u1eef hay c\u00e1c t\u00ecnh tr\u1ea1ng b\u1ec7nh t\u1eadt kh\u00e1c k\u00e8m theo).<\/p>\n

    CTSN c\u00f3 th\u1ec3 x\u1ea3y ra theo c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng xuy\u00ean th\u1ea5u, nh\u01b0ng trong t\u00ecnh hu\u1ed1ng n\u00e0y, c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa th\u01b0\u1eddng quan tr\u1ecdng h\u01a1n c\u00e1c y\u1ebfu t\u1ed1 lan t\u1ecfa kh\u00e1c.<\/p>\n

    1.2.\u00a0\u00a0 D\u1ecbch t\u1ec5 h\u1ecdc CTSN<\/h2>\n

    R\u1ea5t kh\u00f3 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh s\u1ed1 ng\u01b0\u1eddi b\u1ecb CTSN, b\u1ea5t k\u1ec3 th\u1ec3 n\u1eb7ng hay nh\u1eb9, do nh\u1eefng kh\u00f3 kh\u0103n trong vi\u1ec7c m\u00e3 h\u00f3a t\u00ecnh tr\u1ea1ng n\u00e0y t\u1ea1i c\u00e1c b\u1ec7nh vi\u1ec7n. R\u1ea5t nhi\u1ec1u ng\u01b0\u1eddi b\u1ecb CTSN nh\u1eb9 kh\u00f4ng t\u00ecm \u0111\u1ebfn c\u00e1c d\u1ecbch v\u1ee5 y t\u1ebf. Hi\u1ec7n t\u1ea1i, g\u1ea7n nh\u01b0 kh\u00f4ng th\u1ec3 bi\u1ebft \u0111\u01b0\u1ee3c c\u00f3 bao nhi\u00eau ng\u01b0\u1eddi ph\u1ea3i v\u00e0o c\u1ea5p c\u1ee9u ho\u1eb7c \u0111i kh\u00e1m b\u00e1c s\u0129 v\u1edbi t\u00ecnh tr\u1ea1ng ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u l\u00e0 do th\u1eadt s\u1ef1 b\u1ecb CTSN ((New Zealand Guidelines Group, 2006). Nghi\u00ean c\u1ee9u t\u1ed5ng h\u1ee3p y v\u0103n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury k\u1ebft lu\u1eadn r\u1eb1ng t\u1ef7 l\u1ec7 \u201cth\u1eadt s\u1ef1\u201d tr\u00ean t\u1ed5ng d\u00e2n s\u1ed1 b\u1ecb CTSN nh\u1eb9 l\u00e0 l\u1edbn h\u01a1n 600 tr\u01b0\u1eddng h\u1ee3p tr\u00ean 100.000 ng\u01b0\u1eddi m\u1ed7i n\u0103m<\/p>\n

    (Cassidy JD et al, 2004). T\u1ef7 l\u1ec7 \u0111\u00f3 n\u1ebfu t\u00ednh cho Vi\u1ec7t Nam s\u1ebd l\u00e0 l\u1edbn h\u01a1n 560.000 tr\u01b0\u1eddng h\u1ee3p m\u1ed7i n\u0103m.<\/p>\n

    Ch\u1ea5n th\u01b0\u01a1ng g\u00e2y ra do tai n\u1ea1n giao th\u00f4ng \u0111\u01b0\u1ee3c cho l\u00e0 nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn t\u1eed vong x\u1ebfp h\u00e0ng th\u1ee9 t\u00e1m tr\u00ean to\u00e0n th\u1ebf gi\u1edbi (x\u1ea5p x\u1ec9 1,24 tri\u1ec7u ng\u01b0\u1eddi ch\u1ebft m\u1ed7i n\u0103m do tai n\u1ea1n giao th\u00f4ng tr\u00ean to\u00e0n th\u1ebf gi\u1edbi), g\u00e2y ra h\u1eadu qu\u1ea3 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi h\u1eadu qu\u1ea3 c\u1ee7a c\u00e1c b\u1ec7nh truy\u1ec1n nhi\u1ec5m\u00a0 nh\u01b0 s\u1ed1t r\u00e9t (WHO, 2013). Theo s\u1ed1 li\u1ec7u c\u1ee7a TCYTTG, h\u00e0ng n\u0103m, t\u1ea1i Vi\u1ec7t Nam tai n\u1ea1n giao th\u00f4ng (4,1%) l\u00e0 nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn t\u1eed vong x\u1ebfp h\u00e0ng th\u1ee9 t\u01b0, l\u00e0m 21.000 ng\u01b0\u1eddi ch\u1ebft trong n\u0103m 2012. (WHO, 2015).<\/p>\n

    CTSN l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n ch\u00ednh d\u1eabn \u0111\u1ebfn ch\u1ebft do t\u1ed5n th\u01b0\u01a1ng n\u00e3o t\u1ea1i c\u00e1c \u0111\u01a1n v\u1ecb \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c. Nh\u1eefng nguy\u00ean nh\u00e2n ch\u00ednh c\u1ee7a CTSN n\u1eb7ng l\u00e0 tai n\u1ea1n giao th\u00f4ng (tai n\u1ea1n xe m\u00e1y) v\u00e0 ng\u00e3 t\u1eeb tr\u00ean cao xu\u1ed1ng (Rzheutskaya, 2012).<\/p>\n

    Theo t\u00e1c gi\u1ea3 Peden v\u00e0 c\u1ed9ng s\u1ef1, tai n\u1ea1n giao th\u00f4ng \u1edf Vi\u1ec7t Nam hi\u1ec7n \u0111ang l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u d\u1eabn \u0111\u1ebfn t\u1eed vong v\u00e0 th\u01b0\u01a1ng t\u1eadt. Xe m\u00e1y chi\u1ebfm \u0111\u1ebfn 95% t\u1ed5ng s\u1ed1 ph\u01b0\u01a1ng ti\u1ec7n giao th\u00f4ng t\u1ea1i Vi\u1ec7t Nam n\u00ean ng\u01b0\u1eddi \u0111i xe m\u00e1y l\u00e0 \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 nguy c\u01a1 b\u1ecb tai n\u1ea1n giao th\u00f4ng cao nh\u1ea5t. Theo TCYTTG, CTSN l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh d\u1eabn \u0111\u1ebfn t\u1eed vong v\u00e0 th\u01b0\u01a1ng t\u1eadt cho ng\u01b0\u1eddi \u0111i xe m\u00e1y t\u1ea1i Vi\u1ec7t Nam. Hi\u1ec7n kh\u00f4ng c\u00f3 s\u1ed1 li\u1ec7u d\u1ecbch t\u1ec5 t\u1ea1i c\u1ed9ng \u0111\u1ed3ng c\u0169ng nh\u01b0 c\u01a1 s\u1edf d\u1eef li\u1ec7u t\u1ea1i b\u1ec7nh vi\u1ec7n v\u1ec1 CTSN \u1edf ng\u01b0\u1eddi \u0111i xe m\u00e1y t\u1ea1i Vi\u1ec7t Nam. Tuy nhi\u00ean, c\u00f3 v\u1ebb nh\u01b0 nh\u1eefng h\u1eadu qu\u1ea3 do CTSN g\u00e2y ra t\u1ea1i Vi\u1ec7t Nam l\u00e0 r\u1ea5t l\u1edbn, li\u00ean quan \u0111\u1ebfn s\u1ed1 ng\u01b0\u1eddi \u0111\u1ed9i m\u0169 b\u1ea3o hi\u1ec3m c\u00f2n h\u1ea1n ch\u1ebf c\u0169ng nh\u01b0 do xe m\u00e1y l\u00e0 ph\u01b0\u01a1ng ti\u1ec7n giao th\u00f4ng ch\u00ednh. (Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, Mathers C, 2004).<\/p>\n

    Do \u0111\u00f3, vi\u1ec7c thi\u1ebft l\u1eadp h\u1ec7 th\u1ed1ng c\u01a1 s\u1edf d\u1eef li\u1ec7u v\u1ec1 tai n\u1ea1n giao th\u00f4ng nh\u1eb1m cung c\u1ea5p th\u00f4ng tin v\u1ec1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng li\u00ean quan \u0111\u1ebfn tai n\u1ea1n giao th\u00f4ng s\u1ebd gi\u00fap x\u00e1c \u0111\u1ecbnh t\u1ef7 l\u1ec7 CTSN hi\u1ec7n m\u1eafc v\u00e0 m\u1edbi m\u1eafc t\u1ea1i Vi\u1ec7t Nam. \u0110i\u1ec1u n\u00e0y c\u0169ng gi\u00fap theo d\u00f5i v\u00e0 \u0111\u00e1nh gi\u00e1 h\u1eadu qu\u1ea3 \u1edf m\u1ee9c \u0111\u1ed9 c\u1ed9ng \u0111\u1ed3ng c\u0169ng nh\u01b0 t\u0103ng kh\u1ea3 n\u0103ng tri\u1ec3n khai c\u00e1c ph\u01b0\u01a1ng th\u1ee9c d\u1ef1 ph\u00f2ng m\u1ed9t c\u00e1ch \u0111\u1ea7y \u0111\u1ee7 h\u01a1n.<\/p>\n

    1.3.\u00a0\u00a0Ph\u00f2ng ng\u1eeba CTSN<\/h2>\n

    Vi\u1ec7c b\u1eaft bu\u1ed9c s\u1eed d\u1ee5ng m\u0169 b\u1ea3o hi\u1ec3m \u0111\u01b0\u1ee3c xem l\u00e0 bi\u1ec7n ph\u00e1p hi\u1ec7u qu\u1ea3 nh\u1ea5t \u0111\u1ec3 ph\u00f2ng ng\u1eeba CTSN \u1edf nh\u1eefng ng\u01b0\u1eddi \u0111i\u1ec1u khi\u1ec3n xe m\u00e1y \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n v\u00e0 c\u1ea3 c\u00e1c n\u01b0\u1edbc \u0111ang ph\u00e1t tri\u1ec3n. \u0110\u1ed9i m\u0169 b\u1ea3o hi\u1ec3m gi\u1ea3m t\u1ef7 l\u1ec7 m\u1eafc m\u1edbi, m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng v\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong do CTSN trong tai n\u1ea1n xe m\u00e1y, gi\u1ea3m t\u1eeb 20% \u0111\u1ebfn 45% ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u nghi\u00eam tr\u1ecdng v\u00e0 t\u1eed vong (Servadei F, Begliomini C, Gardini E, Giustini M, Taggi F, Kraus J. 2003). M\u1eb7c d\u00f9 vi\u1ec7c t\u1ef7 l\u1ec7 s\u1eed d\u1ee5ng m\u0169 b\u1ea3o hi\u1ec3m \u1edf Vi\u1ec7t Nam \u0111\u00e3 t\u0103ng \u0111\u1ec1u \u0111\u1eb7n trong th\u1eadp k\u1ef7 qua, nh\u01b0ng kh\u00f4ng ph\u1ea3i m\u1ecdi lo\u1ea1i m\u0169 b\u1ea3o hi\u1ec3m \u0111\u1ec1u c\u00f3 ch\u1ea5t l\u01b0\u1ee3ng t\u1ed1t v\u00e0 kh\u00f4ng ph\u1ea3i m\u1ecdi ng\u01b0\u1eddi \u0111\u1ec1u \u0111\u1ed9i m\u0169 \u0111\u00fang c\u00e1ch.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o\u00a0l\u00e0 m\u1ed9t lo\u1ea1i ch\u1ea5n th\u01b0\u01a1ng nghi\u00eam tr\u1ecdng \u0111\u1ed1i v\u1edbi h\u1ec7 th\u1ed1ng th\u1ea7n kinh v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ch\u1ee9c n\u0103ng v\u00e0 s\u1ee9c kh\u1ecfe. Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o th\u01b0\u1eddng x\u1ea3y ra khi \u0111\u1ea7u b\u1ecb t\u00e1c \u0111\u1ed9ng m\u1ea1nh ho\u1eb7c va ch\u1ea1m v\u00e0o m\u1ed9t v\u1eadt c\u1ee9ng, g\u00e2y ra s\u1ef1 ch\u1ea5n \u0111\u1ed9ng […]<\/p>\n","protected":false},"author":42,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nCh\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o - \u0110a\u0323i c\u01b0\u01a1ng - Vinmec<\/title>\n<meta name=\"description\" content=\"Ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o l\u00e0 m\u1ed9t lo\u1ea1i ch\u1ea5n th\u01b0\u01a1ng nghi\u00eam tr\u1ecdng \u0111\u1ed1i v\u1edbi h\u1ec7 th\u1ed1ng th\u1ea7n kinh v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ch\u1ee9c n\u0103ng v\u00e0 s\u1ee9c kh\u1ecfe.\" \/>\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=\"Ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o - 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