{"id":2930,"date":"2023-04-09T22:48:50","date_gmt":"2023-04-09T15:48:50","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2930"},"modified":"2023-04-14T16:40:04","modified_gmt":"2023-04-14T09:40:04","slug":"phau-thuat-noi-soi-dieu-tri-hoi-chung-ong-co-tay","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/phau-thuat-noi-soi-dieu-tri-hoi-chung-ong-co-tay\/","title":{"rendered":"Ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay"},"content":{"rendered":"<p><strong>Ph\u1eabu thu\u1eadt n\u1ed9i soi l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ti\u00ean ti\u1ebfn v\u00e0 an to\u00e0n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y gi\u00fap gi\u1ea3m \u0111au v\u00e0 th\u1eddi gian ph\u1ee5c h\u1ed3i sau ph\u1eabu thu\u1eadt ng\u1eafn h\u01a1n so v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p truy\u1ec1n th\u1ed1ng kh\u00e1c. B\u00e0i vi\u1ebft n\u00e0y s\u1ebd cung c\u00e2p th\u00eam m\u1ed9t s\u1ed1 th\u00f4ng tin chi ti\u1ebft v\u1ec1 ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay.<\/strong><\/p>\n<p><strong>Nh\u00f3m t\u00e1c gi\u1ea3:<\/strong> PGS.TS Tr\u1ea7n Trung D\u0169ng, BS. Ma Ng\u1ecdc Th\u00e0nh, TS. Nguy\u1ec5n Th\u1ecb Li\u1ec5u, BS. Tr\u1ea7n Quy\u1ebft.<\/p>\n<p><strong>Ng\u00e0y ph\u00e1t h\u00e0nh:\u00a0<\/strong><\/p>\n<p>Ph\u1eabu thu\u1eadt n\u1ed9i soi c\u1eaft d\u00e2y ch\u1eb1ng ngang (Endoscopic carpal tunnel release -ECTR) \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u t\u1eeb n\u0103m 1985, \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng t\u1eeb 1987, c\u00f9ng th\u1eddi gian \u0111\u00f3 c\u00f3 nhi\u1ec1u h\u01b0\u1edbng nghi\u00ean c\u1ee9u t\u1eadp trung c\u1ea3i ti\u1ebfn n\u00e2ng cao hi\u1ec7u qu\u1ea3 ph\u1eabu thu\u1eadt n\u1ed9i soi \u1ed1ng c\u1ed5 tay (OCT): Chow.J.C, Okutsu, Agee,&#8230; [1],[2],[3],[5],[6],[ 7].[8],[9]. C\u00e1c k\u1ef9 thu\u1eadt n\u00e0y c\u00f3 kh\u00e1c nhau v\u1ec1 d\u1ee5ng c\u1ee5 v\u00e0 l\u1ed1i v\u00e0o, vi\u1ec7c m\u1edf nh\u1ecf, quan s\u00e1t v\u00e0 c\u1eaft d\u00e2y ch\u1eb1ng ngang (TCL) qua n\u1ed9i soi c\u00f3 nh\u1eefng \u01b0u \u0111i\u1ec3m: th\u1ea9m m\u1ef9, \u0111au \u00edt, th\u1eddi gian ph\u1ee5c h\u1ed3i nhanh h\u01a1n.<\/p>\n<p><span style=\"font-weight: 400;\">Tuy nhi\u00ean c\u0169ng c\u00f3 1 s\u1ed1 b\u00e1o c\u00e1o v\u1ec1 c\u00e1c bi\u1ebfn ch\u1ee9ng: kh\u00f4ng c\u1eaft h\u1ebft TCL, t\u1ed5n th\u01b0\u01a1ng b\u00f3 m\u1ea1ch th\u1ea7n kinh tr\u1ee5, nh\u00e1nh c\u1ea3m gi\u00e1c gan tay c\u1ee7a th\u1ea7n kinh gi\u1eefa, cung m\u1ea1ch gan tay n\u00f4ng, nh\u00e1nh v\u1eadn \u0111\u1ed9ng \u00f4 m\u00f4 c\u00e1i. C\u00e1c bi\u1ebfn ch\u1ee9ng n\u00e0y chi\u1ebfm t\u1ef7 l\u1ec7 nh\u1ecf, ch\u1ee7 y\u1ebfu x\u1ea3y ra \u1edf c\u00e1c ph\u1eabu thu\u1eadt vi\u00ean m\u1edbi th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt, ch\u01b0a c\u00f3 nhi\u1ec1u kinh nghi\u1ec7m [4], [5], [7].\u00a0<\/span><\/p>\n<h2><strong>1. Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u0169ng nh\u01b0 k\u1ef9 thu\u1eadt m\u1ed5 \u00edt x\u00e2m l\u1ea5n, k\u1ef9 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p <a href=\"http:\/\/noithathoaphat.in\/ctv\/?p=503&amp;preview=true\">HCOCT<\/a> c\u00f3 ch\u1ec9 \u0111\u1ecbnh m\u1ed5, lo\u1ea1i tr\u1eeb nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ch\u00e8n \u00e9p do kh\u1ed1i u, tr\u1eadt kh\u1edbp, hay nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ph\u1ea3i c\u1eaft l\u1ecdc t\u1ed5 ch\u1ee9c vi\u00eam, t\u1ed5 ch\u1ee9c h\u1ea1t tophi, ho\u1eb7c ph\u1ea3i m\u1edf bao th\u1ea7n kinh.<\/span><\/li>\n<\/ul>\n<h2><strong>2. K\u1ef9 thu\u1eadt n\u1ed9i soi 2 l\u1ed7 v\u00e0o<\/strong><\/h2>\n<ul>\n<li><span style=\"font-weight: 400;\">\u0110i\u1ec3n h\u00ecnh l\u00e0 k\u1ef9 thu\u1eadt c\u1ee7a Chow [6]. V\u1edbi hai ng\u00f5 v\u00e0o \u1edf c\u1ed5 tay v\u00e0 gan tay.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">K\u1ef9 thu\u1eadt:<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">D\u1ee5ng c\u1ee5: b\u1ed9 d\u1ee5ng c\u1ee5 b\u00e0n tay, b\u1ed9 d\u1ee5ng c\u1ee5 n\u1ed9i soi 2 ng\u00f5.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2966 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-9-300x163.png\" alt=\"\" width=\"300\" height=\"163\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-9-300x163.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-9-1024x557.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-9-768x418.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-9.png 1137w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 1: B\u1ed9 d\u1ee5ng c\u1ee5 ph\u1eabu thu\u1eadt [6]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li aria-level=\"2\"><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eeda, tay d\u1ea1ng tr\u00ean b\u00e0n, s\u00e1t tr\u00f9ng, d\u1ed3n m\u00e1u, ga r\u00f4.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p style=\"text-align: center;\"><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-medium wp-image-2971\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-10-300x201.png\" alt=\"\" width=\"300\" height=\"201\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-10-300x201.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-10-1024x687.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-10-768x516.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-10.png 1144w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><br \/>\n<em>H\u00ecnh 2: T\u01b0 th\u1ebf ph\u1eabu thu\u1eadt [6]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li aria-level=\"2\"><span style=\"font-weight: 400;\">R\u1ea1ch da nh\u1ecf 2 \u0111\u01b0\u1eddng v\u00e0o:<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2976 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-11-300x195.png\" alt=\"\" width=\"300\" height=\"195\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-11-300x195.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-11-1024x666.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-11-768x499.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-11.png 1135w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 3: Hai \u0111\u01b0\u1eddng m\u1ed5 c\u1ed5 tay v\u00e0 gan tay [6]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li aria-level=\"2\"><span style=\"font-weight: 400;\">D\u00f9ng cannula \u0111\u01b0a v\u00e0o v\u1ebft m\u1ed5 c\u1ed5 tay, qua OCT, \u0111\u01b0a qua v\u1ebft m\u1ed5 gan tay<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2978 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-12-300x200.png\" alt=\"\" width=\"300\" height=\"200\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-12-300x200.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-12-1024x684.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-12-768x513.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-12.png 1165w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 4: \u0110\u01b0a cannula v\u00e0o \u1ed1ng c\u1ed5 ta<\/em>y<\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li aria-level=\"2\"><span style=\"font-weight: 400;\">\u0110\u01b0a camera qua cannula quan s\u00e1t TCL qua ng\u00f5 c\u1ed5 tay, \u0111\u01b0a dao c\u1eaft v\u00e0o ng\u00f5 d\u01b0\u1edbi.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2979 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-13-300x183.png\" alt=\"\" width=\"300\" height=\"183\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-13-300x183.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-13-1024x625.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-13-768x468.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-13.png 1141w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 5: \u0110\u01b0a camera v\u00e0 dao c\u1eaft [6]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li aria-level=\"2\"><span style=\"font-weight: 400;\">Quan s\u00e1t v\u00e0 c\u1eaft TCL<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2981 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-14-300x200.png\" alt=\"\" width=\"300\" height=\"200\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-14-300x200.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-14-1024x682.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-14-768x511.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-14.png 1146w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 6: C\u1eaft TCL [6]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li aria-level=\"2\"><span style=\"font-weight: 400;\">C\u00f3 th\u1ec3 \u0111\u1ed5i ng\u00f5 camera v\u00e0 dao c\u1eaft \u0111\u1ec3 c\u1eaft h\u1ebft TCL.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2983 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-15-300x102.png\" alt=\"\" width=\"300\" height=\"102\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-15-300x102.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-15-1024x349.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-15-768x262.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-15.png 1376w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 7: \u0110\u1ed5i ng\u00f5 camera v\u00e0 dao c\u1eaft [6]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li aria-level=\"2\"><span style=\"font-weight: 400;\">Kh\u00e2u v\u1ebft m\u1ed5 1 l\u1edbp.<\/span><\/li>\n<li aria-level=\"2\"><span style=\"font-weight: 400;\">T\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng, c\u1eaft ch\u1ec9 sau m\u1ed5 2 tu\u1ea7n.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><b>3. K\u1ef9 thu\u1eadt n\u1ed9i soi 1 ng\u00f5 v\u00e0o<\/b><\/h2>\n<h3><b>3.1. K\u1ef9 thu\u1eadt m\u1ed5 n\u1ed9i soi 1 ng\u00f5 v\u00e0o v\u1edbi ng\u00f5 v\u00e0o \u1edf c\u1ed5 tay<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u1ea1i di\u1ec7n cho k\u1ef9 thu\u1eadt n\u00e0y l\u00e0 k\u1ef9 thu\u1eadt c\u1ee7a John Agee[9], v\u1edbi 1 ng\u00f5 v\u00e0o \u1edf c\u1ed5 tay.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">K\u1ef9 thu\u1eadt:<\/span>\n<ul>\n<li><span style=\"font-weight: 400;\">D\u1ee5ng c\u1ee5: b\u1ed9 ph\u1eabu thu\u1eadt b\u00e0n tay, b\u1ed9 d\u1ee5ng c\u1ee5 n\u1ed9i soi 1 ng\u00f5.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">B\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eeda, tay d\u1ea1ng tr\u00ean b\u00e0n, s\u00e1t tr\u00f9ng, d\u1ed3n m\u00e1u, ga r\u00f4.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">R\u1ea1ch \u0111a: r\u1ea1ch da 1cm ngang n\u1ebfp l\u1eb1n c\u1ed5 tay, t\u1eeb b\u1edd trong g\u00e2n gan tay d\u00e0i \u0111\u1ebfn x\u01b0\u01a1ng \u0111\u1eadu<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2988 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-16-300x203.png\" alt=\"\" width=\"300\" height=\"203\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-16-300x203.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-16-1024x693.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-16-768x520.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-16.png 1114w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 8: \u0110\u01b0\u1eddng r\u1ea1ch da [1]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ed9c <\/span><span style=\"font-weight: 400;\">l\u1ed9 OCT: qua \u0111\u01b0\u1eddng r\u1ea1ch da b\u1ed9c l\u1ed9 OCT, <\/span><span style=\"font-weight: 400;\">c\u1eaft <\/span><span style=\"font-weight: 400;\">c\u00e2n, m\u1edf r\u1ed9ng l\u1ed7 v\u00e0o, t\u00e1ch m\u1eb7t d\u01b0\u1edbi TCL v\u1edbi <\/span><span style=\"font-weight: 400;\">c\u00e1c <\/span><span style=\"font-weight: 400;\">th\u00e0nh ph\u1ea7n <\/span><span style=\"font-weight: 400;\">kh\u00e1c.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2989 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-17-300x201.png\" alt=\"\" width=\"300\" height=\"201\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-17-300x201.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-17-1024x685.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-17-768x514.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-17.png 1227w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 9: T\u00e1ch, nong r\u1ed9ng l\u1ed7 v\u00e0o [1]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110\u01b0a Camera v\u00e0o quan s\u00e1t TCL<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-medium wp-image-2990 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-18-300x120.png\" alt=\"\" width=\"300\" height=\"120\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-18-300x120.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-18-1024x411.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-18-768x308.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-18-1536x616.png 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-18.png 1794w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 10: \u0110\u01b0a dao v\u00e0 camera quan s\u00e1t TCL [1]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u1eaft TCL d\u01b0\u1edbi quan s\u00e1t camera<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-medium wp-image-2991 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-19-300x88.png\" alt=\"\" width=\"300\" height=\"88\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-19-300x88.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-19-1024x299.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-19-768x224.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-19-1536x449.png 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-19.png 1916w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 11: TCL \u0111\u00e3 c\u1eaft 1 ph\u1ea7n v\u00e0 ho\u00e0n to\u00e0n [1]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u00e2u da 1 l\u1edbp<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng, c\u1eaft ch\u1ec9 sau m\u1ed5 2 tu\u1ea7n.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><b>3.2. Ph\u1eabu thu\u1eadt n\u1ed9i soi 1 ng\u00f5 v\u00e0o v\u00f3i \u0111\u01b0\u1eddng m\u1ed5 gan tay, [8]<\/b><\/h3>\n<p style=\"text-align: center;\"><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-medium wp-image-2996 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-20-300x138.png\" alt=\"\" width=\"300\" height=\"138\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-20-300x138.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-20-1024x472.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-20-768x354.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-20-1536x708.png 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-20.png 1728w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><br \/>\n<em>H\u00ecnh 12: N\u1ed9i soi 1 ng\u00f5 v\u00e0o gan tay [8]<\/em><\/p>\n<h2><b>4. Ph\u1eabu thu\u1eadt x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u d\u01b0\u1edbi h\u01b0\u1edbng d\u00e2n si\u00eau \u00e2m (Ultra- Minimally Invasive Sonographically Guided) [10], [11]<\/b> <b><br \/>\n<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Hay c\u00f2n g\u1ecdi l\u00e0 ph\u1eabu thu\u1eadt c\u1eaft d\u00e2y ch\u1eb1ng ngang qua da d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn si\u00eau \u00e2m (Percutaneous Ultrasound- Guided Carpal Tunnel Release PCTR) ho\u1eb7c c\u00f2n g\u1ecdi l\u00e0 Need\u1ec9escopy v\u00ec v\u1ebft m\u1ed5 nh\u1ecf nh\u01b0 v\u1ebft kim, kh\u00f4ng ph\u1ea3i kh\u00e2u da sau ph\u1eabu thu\u1eadt. \u0110\u00e2y l\u00e0 ph\u1eabu thu\u1eadt v\u1edbi v\u1ebft m\u1ed5 nh\u1ecf kho\u1ea3ng 2mm, v\u1edbi d\u1ee5ng c\u1ee5 l\u1ea3 dao c\u1eaft nh\u1ecf 2mm, \u0111\u01b0a qua v\u1ebft m\u1ed5 ph\u00eda tr\u00ean n\u1ebfp l\u1eb1n c\u1ed5 tay v\u00e0o OCT, d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn c\u1ee7a si\u00eau \u00e2m c\u1ea5t TCL.<\/span><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-medium wp-image-3003 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-21-268x300.png\" alt=\"\" width=\"268\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-21-268x300.png 268w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-21-914x1024.png 914w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-21-768x860.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-21-1372x1536.png 1372w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-21.png 1436w\" sizes=\"(max-width: 268px) 100vw, 268px\" \/><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-medium wp-image-3004 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-22-300x166.png\" alt=\"\" width=\"300\" height=\"166\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-22-300x166.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-22-1024x567.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-22-768x426.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-22.png 1480w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><i><span style=\"font-weight: 400;\">H\u00ecnh 13: D\u1ee5ng c\u1ee5 v\u00e0 k\u1ef9 thu\u1eadt c\u1eaft TCL d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn si\u00eau \u00e2m [10].<\/span><\/i><\/p>\n<h2><b>5. \u0110i\u1ec1u tr\u1ecb v\u00e0 theo d\u00f5i sau m\u1ed5<\/b><b><\/b><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sau m\u1ed5 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c d\u00f9ng kh\u00e1ng sinh, c\u00f3 th\u1ec3 d\u00f9ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng, thu\u1ed1c gi\u1ea3m \u0111au ch\u1ed1ng vi\u00eam phi steroid, c\u00e1c ch\u1ebf ph\u1ea9m vitamin nh\u00f3m B. C\u00f3 th\u1ec3 d\u00f9ng n\u1eb9p c\u1ed5 tay h\u1ed7 tr\u1ee3 trong tu\u1ea7n \u0111\u1ea7u, b\u1ecf n\u1eb9p khi t\u1eadp.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Thay b\u0103ng h\u00e0ng ng\u00e0y, c\u1eaft ch\u1ec9 sau m\u1ed5 2 tu\u1ea7n.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kh\u00e1m l\u1ea1i theo h\u1eb9n, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c l\u00e0m \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh, \u0111\u00e1nh gi\u00e1 thang \u0111i\u1ec3m BQ.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">S\u1ef1 h\u1ed3i ph\u1ee5c sau ph\u1eabu thu\u1eadt t\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 n\u1eb7ng, th\u1eddi gian b\u1ecb b\u1ec7nh, ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt v\u00e0 t\u1eadp luy\u1ec7n sau m\u00f4. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n n\u1eb7ng, m\u1ea5t c\u1ea3m gi\u00e1c v\u00f9ng chi ph\u1ed1i th\u1ea7n kinh gi\u1eefa, khi h\u1ed3i ph\u1ee5c c\u00f3 th\u1ec3 s\u1ebd c\u00f3 qu\u00e3ng th\u1eddi gian c\u1ea3m gi\u00e1c t\u00ea t\u0103ng l\u00ean do s\u1ef1 d\u1eabn truy\u1ec1n th\u1ea7n kinh h\u1ed3i ph\u1ee5c, tuy nhi\u00ean c\u1ea3m gi\u00e1c n\u00e0y s\u1ebd gi\u1ea3m d\u1ea7n v\u00e0 h\u1ebft sau m\u1ed9t th\u1eddi gian nh\u1ea5t \u0111\u1ecbnh.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng [12]<\/span>\n<ul>\n<li><span style=\"font-weight: 400;\">Trong 2 tu\u1ea7n \u0111\u1ea7u: <\/span><\/li>\n<li>T\u1eadp s\u1edbm ngay sau m\u1ed5, v\u1edbi m\u1ee5c \u0111\u00edch: Ki\u1ec3m so\u00e1t ph\u00f9 n\u1ec1, gi\u1eef&#8217; h\u1ebft t\u1ea7m v\u1eadn \u0111\u1ed9ng c\u1ee7a ng\u00f3n, ng\u0103n ng\u1eeba d\u00ednh g\u00e2n g\u1ea5p, gi\u1eef c\u1ed5 tay \u1edf t\u01b0 th\u1ebf c\u01a1 n\u0103ng.<\/li>\n<li><span style=\"font-weight: 400;\">C\u1ee5 th\u1ec3: t\u1eadp c\u00e1c b\u00e0i t\u1eadp g\u1ea5p du\u1ed7i ng\u00f3n tay th\u1ee5 \u0111\u1ed9ng v\u00e0 ch\u1ee7 \u0111\u1ed9ng, b\u1ecf n\u1eb9p t\u1eadp nh\u1eb9 c\u1ed5 tay, n\u1ebfu s\u01b0ng n\u1ec1 c\u00f3 th\u1ec3 s\u1ee9 d\u1ee5ng m\u1ed9t v\u00e0i lo\u1ea1i t\u1ea5t bao tr\u00f9m c\u1ed5 tay \u0111\u1ebfn \u0111\u1ea7u c\u00e1c ng\u00f3n tay.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3028 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-23-300x266.png\" alt=\"\" width=\"300\" height=\"266\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-23-300x266.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-23-768x682.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-23.png 948w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><i><span style=\"font-weight: 400;\">H\u00ecnh 14: B\u00e0i t\u1eadp c\u00e1c ng\u00f3n tay sau ph\u1eabu thu\u1eadt [12]<\/span><\/i><\/p>\n<p style=\"text-align: center;\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3036 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-24-300x108.png\" alt=\"\" width=\"300\" height=\"108\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-24-300x108.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-24-1024x370.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-24-768x277.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-24-1536x555.png 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-24.png 1794w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><br \/>\n<em>H\u00ecnh 15: \u0110i\u1ec1u tr\u1ecb ph\u00f9 n\u1ec1 sau m\u1ed5 HC OCT [12]<\/em><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><span style=\"font-weight: 400;\">Tu\u1ea7n 3, 4:<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Xoa b\u00f3p l\u00e0m m\u1ec1m s\u1eb9o m\u1ed5, t\u0103ng c\u01b0\u1eddng \u0111\u1ed9 t\u1eadp c\u00e1c \u0111\u1ed9ng t\u00e1c g\u1ea5p du\u1ed7i ng\u00f3n tay v\u00e0 c\u00e1c b\u00e0i t\u1eadp c\u1ed5 tay. B\u1eaft \u0111\u1ea7u t\u1eadp c\u00e1c b\u00e0i t\u1eadp t\u0103ng s\u1ee9c c\u01a1, t\u1eadp \u0111\u1ed1i chi\u1ebfu c\u00e1c ng\u00f3n.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-3044 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-25-300x101.png\" alt=\"\" width=\"300\" height=\"101\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-25-300x101.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-25-1024x345.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-25-768x259.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-25-1536x517.png 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-25.png 1830w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><i><span style=\"font-weight: 400;\">H\u00ecnh 16: \u0110\u1ed9ng t\u00e1c t\u1eadp c\u1ed5 tay [12]<\/span><\/i><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><span style=\"font-weight: 400;\">T\u1eeb tu\u1ea7n th\u1ee9 5: m\u1ee5c \u0111\u00edch h\u1ed3i ph\u1ee5c l\u1ea1i s\u1ee9c c\u01a1, s\u1ee9c b\u1ec1n c\u1ed5 tay v\u00e0 b\u00e0n tay. Kh\u00f4ng mang c\u00e1c v\u1eadt d\u1ee5ng n\u1eb7ng &gt; 5kg trong 2 th\u00e1ng sau <\/span><span style=\"font-weight: 400;\">m\u1ed5<\/span><span style=\"font-weight: 400;\">. T\u1eadp c\u00e1c \u0111\u1ed9ng t\u00e1c c\u00f3 s\u1ee9c \u0111\u1ed1i kh\u00e1ng.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-medium wp-image-3046 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-26-300x67.png\" alt=\"\" width=\"300\" height=\"67\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-26-300x67.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-26-1024x229.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-26-768x172.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-26-1536x343.png 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-26.png 1862w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><i><span style=\"font-weight: 400;\">H\u00ecnh 17: T\u1eadp s\u1ee9c c\u01a1 v\u00e0 \u0111\u1ed1i kh\u00e1ng l\u1ef1c <\/span><\/i><\/p>\n<h2>6. Bi\u1ebfn ch\u1ee9ng c\u1ee7a ph\u1eabu thu\u1eadt [4], [5], [7], [9]<\/h2>\n<h3><b>6.1. T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh<\/b><\/h3>\n<h4><em><b>6.1.1. Nh\u00e1nh c\u1ea3m gi\u00e1c gan tay c\u1ee7a th\u1ea7n kinh gi\u1eefa<\/b><\/em><\/h4>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nh\u00e1nh n\u00e0y th\u01b0\u1eddng t\u00e1ch ra tr\u00ean \u1ed1ng c\u1ed5 tay, \u0111i tr\u01b0\u1edbc \u0111\u00e2y ch\u00e0ng ngang,<\/span> <span style=\"font-weight: 400;\"> n\u1eb1m l\u1ec7ch v\u1ec1 b\u1edd quay, c\u1ea3m gi\u00e1c da v\u00f9ng \u00f4 m\u00f4 c\u00e1i. Khi t\u1ed5n th\u01b0\u01a1ng g\u00e2y t\u00ea<\/span> <span style=\"font-weight: 400;\">b\u00ec, m\u1ea5t c\u1ea3m gi\u00e1c, ho\u1eb7c b\u1ecfng bu\u1ed1t v\u00f9ng \u00f4 m\u00f4 c\u00e1i.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p trong m\u1ed5 m\u1edf. m\u1ed5 \u00edt x\u00e2m l\u1ea5n v\u00e0 n\u1ed9i soi c\u0169ng c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng n\u1ebfu dao c\u1eaft \u0111i l\u1ec7ch nhi\u1ec1u v\u1ec1 b\u1edd quay.<\/span><\/li>\n<\/ul>\n<h4><strong><em>6.1.2. Nh\u00e1nh v\u1eadn \u0111\u1ed9ng c\u1ee7a th\u1ea7n kinh gi\u1eefa<\/em><\/strong><\/h4>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nh\u00e1nh n\u00e0y c\u00f3 nhi\u1ec1u bi\u1ebfn th\u1ec3, tuy nhi\u00ean th\u01b0\u1eddng n\u1eb1m \u1edf b\u1edd quay c\u1ee7a TCL, khi ph\u1eabu thu\u1eadt quan s\u00e1t kh\u00f4ng k\u1ef9 c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng nh\u00e1nh n\u00e0y.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng n\u00e0y: y\u1ebfu ho\u1eb7c m\u1ea5t \u0111\u1ed9ng t\u00e1c d\u1ea1ng c\u1ee7a ng\u00f3n c\u00e1i, mu\u1ed9n c\u00f3 th\u1ec3 g\u00e2y teo c\u01a1 \u00f4 m\u00f4 c\u00e1i.<\/span><\/li>\n<\/ul>\n<h4><b><i>6.1.3. C\u00e1c nh\u00e1nh c\u1ea3m gi\u00e1c c\u00e1c ng\u00f3n c\u1ee7a th\u1ea7n kinh gi\u1eefa<\/i><\/b><\/h4>\n<p><span style=\"font-weight: 400;\">C\u00e1c nh\u00e1nh n\u00e0y c\u1ea3m gi\u00e1c cho ng\u00f3n 1,2,3 v\u00e0 1\/2 ng\u00f3n 4 \u1edf b\u1edd quay. T\u00f9y thu\u1ed9c v\u00e0o t\u1ed5n th\u01b0\u01a1ng nh\u00e1nh n\u00e0o c\u00f3 th\u1ebf g\u00e2y t\u00ea b\u00ec, m\u1ea5t c\u1ea3m gi\u00e1c v\u00f9ng chi ph\u1ed1i c\u1ee7a nh\u00e1nh \u0111\u1ea5y.<\/span><\/p>\n<h4><strong><i>6.1.4. Th\u1ea7n kinh tr\u1ee5<\/i><\/strong><\/h4>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u00f3 th\u1ec3 t\u1ed5n th\u01b0\u01a1ng do c\u1eaft ph\u1ea3i, c\u00f9ng c\u00f3 th\u1ec3 g\u1eb7p ch\u00e8n \u00e9p \u1edf \u1ed1ng Guyon do t\u1ed5 ch\u1ee9c x\u01a1 l\u00e2n c\u1eadn v\u00f9ng c\u1eaft.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tri\u1ec7u ch\u1ee9ng: t\u00ea b\u00ec ho\u1eb7c m\u1ea5t c\u1ea3m gi\u00e1c ng\u00f3n 5, b\u1edd tr\u1ee5 ng\u00f3n 4. N\u1eb7ng h\u01a1n c\u00f3 th\u1ec3 teo c\u01a1 gian c\u1ed1t, c\u01a1 kh\u00e9p ng\u00f3n c\u00e1i, test Froment (+).<\/span><\/li>\n<\/ul>\n<h3><strong>6.2. T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u<\/strong><\/h3>\n<h4><strong><i>6.2.1. T\u1ee5 m\u00e1u v\u00f9ng m\u1ed5<\/i><\/strong><\/h4>\n<p><span style=\"font-weight: 400;\">Th\u01b0\u1eddng do t\u1ed5n th\u01b0\u01a1ng c\u00e1c m\u1ea1ch m\u00e1u nh\u1ecf d\u01b0\u1edbi da. C\u00f3 th\u1ec3 b\u0103ng \u00e9p c\u1ea7m m\u00e1u, ch\u01b0\u1eddm l\u1ea1nh, t\u1ed5n th\u01b0\u01a1ng m\u1ea5t \u0111i sau v\u00e0i ng\u00e0y.<\/span><\/p>\n<h4><strong><i>6.2.2. T\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch tr\u1ee5<\/i><\/strong><\/h4>\n<p><span style=\"font-weight: 400;\">T\u1ed5n th\u01b0\u01a1ng n\u00e0y \u00edt g\u1eb7p, c\u00f3 th\u1ec3 k\u00e8m theo t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh tr\u1ee5.<\/span><\/p>\n<h4><strong><i>6.2.3. T\u1ed5n th\u01b0\u01a1ng cung m\u1ea1ch gan tay n\u00f4ng<\/i><\/strong><\/h4>\n<p><span style=\"font-weight: 400;\">\u0110\u00e2y l\u00e0 bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 g\u1eb7p ph\u1ea3i khi c\u1eaft TCL. Cung m\u1ea1ch n\u00e0y n\u1eb1m c\u00e1ch b\u1edd d\u01b0\u1edbi TCL trung b\u00ecnh kho\u00e1ng 1,2 cm. Tuy nhi\u00ean c\u00f3 th\u1ec3 kho\u00e1ng c\u00e1ch n\u00e0y c\u00f3 th\u1ec3 ng\u1eafn h\u01a1n. Khi ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111\u01b0a dao v\u00e0o qu\u00e1 s\u00e2u c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng n\u00e0y<\/span><\/p>\n<h3><strong>6.3. C\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c<\/strong><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u00e1c bi\u1ebfn ch\u1ee9ng n\u00e0y l\u00e0: nhi\u1ec5m tr\u00f9ng, t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch quay, \u0111au sau m\u1ed5, \u0111\u1ee9t g\u00e2n, d\u00ednh g\u00e2n, ho\u1ea1i t\u1eed da gan tay, c\u1eaft kh\u00f4ng h\u1ebft TCL.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c th\u00f4ng b\u00e1o trong m\u1ed9t s\u1ed1 b\u00e1o c\u00e1o, m\u1eb7c d\u00f9 t\u1ef7 l\u1ec7 nh\u1ecf, th\u01b0\u1eddng g\u1eb7p \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3n \u0111\u1ed1i gi\u1ea3i ph\u1eabu, ph\u1eabu thu\u1eadt vi\u00ean \u00edt kinh nghi\u1ec7m.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: center;\"><img decoding=\"async\" loading=\"lazy\" class=\"alignnone size-medium wp-image-3074 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-27-300x227.png\" alt=\"\" width=\"300\" height=\"227\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-27-300x227.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-27-1024x775.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-27-768x581.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/sa-27.png 1110w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p style=\"text-align: center;\"><em>H\u00ecnh 18: C\u00e1c bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 g\u1eb7p ph\u1ea3i khi ph\u1eabu thu\u1eadt n\u1ed9i soi [9]<\/em><\/p>\n<h2 style=\"text-align: left;\">7. C\u00e1c k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u c\u1ee7a ch\u00fang t\u00f4i<\/h2>\n<p><span style=\"font-weight: 400;\">Tri\u1ec3n khai ph\u1eabu thu\u1eadt h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay v\u1edbi c\u00e1c k\u1ef9 thu\u1eadt n\u1ed9i soi kh\u00e1c nhau \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u00fang t\u00f4i ti\u1ebfn h\u00e0nh t\u1eeb h\u01a1n 5 n\u0103m v\u1ec1 tr\u01b0\u1edbc v\u1edbi s\u1ed1 l\u01b0\u1ee3ng h\u00e0ng tr\u0103m ca. C\u00e1c k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u0103ng t\u1ea3i tr\u00ean c\u00e1c b\u00e1o trong n\u01b0\u1edbc v\u00e0 qu\u1ed1c t\u1ebf v\u1edbi s\u1ed1 l\u01b0\u1ee3ng ca l\u00e2m s\u00e0ng l\u1edbn 100 ca v\u00e0 150 ca. Hi\u1ec7n t\u1ea1i nghi\u00ean c\u1ee9u sinh chu\u1ea9n b\u1ecb b\u00e1o v\u1ec7 t\u1ed1t nghi\u1ec7p v\u1edbi s\u1ed1 l\u01b0\u1ee3ng 200 ca ph\u1eabu thu\u1eadt n\u1ed9i soi v\u1edbi th\u1eddi gian theo d\u00f5i d\u00e0i tr\u00ean 1 n\u0103m. C\u01a1 b\u00e1n t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng tr\u00ean 90%, ch\u1ec9 1 s\u1ed1 \u00edt c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c kh\u00f3 ch\u1ecbu do ph\u1eabu thu\u1eadt sau m\u1ed5. G\u1ea7n nh\u01b0 kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng t\u1ed5n th\u01b0\u01a1ng nh\u00e1nh c\u1ee7a th\u1ea7n kinh gi\u1eefa. C\u00f3 2 b\u1ec7nh nh\u00e2n c\u00f3 d\u1ecb c\u1ea3m th\u1ea7n kinh tr\u1ee5 do k\u1ef9 thu\u1eadt ph\u1eabu t\u00edch g\u00e2y c\u0103ng l\u00ean th\u1ea7n kinh tr\u1ee5, \u0111\u00e3 r\u00fat kinh nghi\u1ec7m v\u00e0 g\u1ea7n nh\u01b0 kh\u00f4ng c\u00f2n tr\u01b0\u1eddng h\u1ee3p n\u00e0o b\u1ecb nh\u01b0 v\u1eady n\u1eefa. C\u00e1c k\u1ebft qu\u1ea3 cho th\u1ea5y hi\u1ec7u qu\u1ea3 cao v\u00e0 \u01b0u \u0111i\u1ec3m v\u01b0\u1ee3t tr\u1ed9i c\u1ee7a ph\u1eabu thu\u1eadt n\u1ed9i soi so v\u1edbi m\u1ed5 m\u1edf. Tuy nhi\u00ean v\u1ea5n \u0111\u1ec1 r\u1ea5t quan tr\u1ecdng \u0111\u00f3 l\u00e0 ch\u1ea9n \u0111o\u00e1n v\u00e0 ch\u1ec9 \u0111\u1ecbnh ph\u1ea3i ch\u00ednh x\u00e1c, ph\u1eabu thu\u1eadt vi\u00ean ph\u1ea3i th\u1eadt quen thu\u1ed9c v\u1edbi m\u1ed5 m\u1edf v\u00e0 \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o c\u1ea9n th\u1eadn v\u1ec1 k\u1ef9 thu\u1eadt n\u1ed9i soi \u1ed1ng c\u1ed5 tay.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><strong>T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/strong><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">F. Brunelli, c. Spalvieri, A. Gilbert, M. Merlc (2007), Endoscopic Technique: The Gilbert Technique (or Technique by Two Different Portals), <\/span><i><span style=\"font-weight: 400;\">Carpal tunnel syndrome.<\/span><\/i><span style=\"font-weight: 400;\"> Vol. 3.: springer, p 166-170<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C.A. Peinier, R.K. Brown (2007), Endoscopic Carpal Tunnel Release, <\/span><i><span style=\"font-weight: 400;\">Carpal tunnel syndrome.<\/span><\/i><span style=\"font-weight: 400;\"> Vol. 3.: Springer, p 171-176<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Scott 11. Kozin (2002), Single-portal endoscopic carpal tunnel release, <\/span><i><span style=\"font-weight: 400;\">Atlas of the Hand Clinics<\/span><\/i><span style=\"font-weight: 400;\"> p 229-241<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">G. Pajardi, G. Pivato, L. Pegoli, D. Pisani (2007), Complications Following Endoscopic Treatment, <\/span><i><span style=\"font-weight: 400;\">Carpal tunnel syndrome.<\/span><\/i><span style=\"font-weight: 400;\"> Vol. 3,: Springer, p 290-297<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">RW Tse, LN Hurst, TA Al-Yafi (2003). Early major complications of endoscopic carpal tunnel release: A review of 1200 cases. <\/span><i><span style=\"font-weight: 400;\">Can J Plast Surg;<\/span><\/i><span style=\"font-weight: 400;\"> 11(3): 131-134.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chow J.C.Y (2007), Endoscopic Carpal Tunnel Release, <\/span><i><span style=\"font-weight: 400;\">Carpal tunnel syndrome. <\/span><\/i><span style=\"font-weight: 400;\">Vo!. 3.: Springer, p 156-165<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Thomas Kretschmer, Gregor Antoniadis (2009), Avoiding Injury in Endoscopic Carpal Tunnel Release, Neurosurg Clin N Am 20 65-71<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Michael Sean Murphy (2002), Single distal portal endoscopic carpal tunnel release, <\/span><i><span style=\"font-weight: 400;\">Atlas of the Hand Clinics<\/span><\/i><span style=\"font-weight: 400;\"> p 223-22X<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Agee, John M. et al(1995), Endoscopic carpal tunnel release: A prospective study of complications and surgical experience. Journal of Hand Surgery, Volume 20, Issue 2, 165-171<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Petrover D, Richette P (2017), Treatment of carpal tunnel syndrome:from ultrasonography to ultrasound guided carpal tunnel release. <\/span><i><span style=\"font-weight: 400;\">Joint Bone Spine<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">Jose Manuel Rojo-Manaute, Alberto Capa-Grasa, Guillermo E. Rodriguez- Maruri (2013), Ultra-Minimaily Invasive Sonographically Guided Carpal Tunnel Release. <i>J Ultrasound Med&#8217;,<\/i> 32:131\u2014142<\/li>\n<\/ol>\n<ol start=\"12\">\n<li><span style=\"font-weight: 400;\">T. Fairplay, G. Urso (2007), Postoperative Treatment of Carpal Tunnel Syndrome <\/span>After Median Nerve Decompression (Open Field or Endoscopic Technique), <i>Carpal tunnel syndrome.<\/i> Vol. 3.: Springer, p 255-265<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Ph\u1eabu thu\u1eadt n\u1ed9i soi l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ti\u00ean ti\u1ebfn v\u00e0 an to\u00e0n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y gi\u00fap gi\u1ea3m \u0111au v\u00e0 th\u1eddi gian ph\u1ee5c h\u1ed3i sau ph\u1eabu thu\u1eadt ng\u1eafn h\u01a1n so v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p truy\u1ec1n th\u1ed1ng kh\u00e1c. B\u00e0i vi\u1ebft n\u00e0y s\u1ebd cung c\u00e2p th\u00eam m\u1ed9t s\u1ed1 th\u00f4ng [&hellip;]<\/p>\n","protected":false},"author":32,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[75,40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay - Vinmec<\/title>\n<meta name=\"description\" content=\"Ph\u1eabu thu\u1eadt n\u1ed9i soi c\u1eaft d\u00e2y ch\u1eb1ng ngang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u t\u1eadp trung c\u1ea3i ti\u1ebfn n\u00e2ng cao hi\u1ec7u qu\u1ea3 ph\u1eabu thu\u1eadt n\u1ed9i soi \u1ed1ng c\u1ed5 tay...\" \/>\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=\"Ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay - 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