{"id":29668,"date":"2023-05-02T16:06:50","date_gmt":"2023-05-02T09:06:50","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29668"},"modified":"2023-05-02T16:06:50","modified_gmt":"2023-05-02T09:06:50","slug":"phuong-phap-dieu-tri-tao-bon-do-roi-loan-co-that-co-mu-truc-trang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/02\/phuong-phap-dieu-tri-tao-bon-do-roi-loan-co-that-co-mu-truc-trang\/","title":{"rendered":"Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng"},"content":{"rendered":"

T\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu – tr\u1ef1c tr\u00e0ng (Anismus) l\u00e0 b\u1ec7nh th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong h\u1ed9i ch\u1ee9ng t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ra (outlet obstruction syndronme) hay h\u1ed9i ch\u1ee9ng t\u1eafc ngh\u1ebdn \u0111\u1ea1i ti\u1ec7n (obstructed defecation syndrome – ODS) do b\u1ea5t \u0111\u1ed3ng v\u1eadn c\u01a1 s\u00e0n ch\u1eadu, hi\u1ec7n nay \u0111i\u1ec1u tr\u1ecb ch\u1ee7 y\u1ebfu b\u1eb1ng ti\u00eam \u0111\u1ed9c t\u1ed1 botolinum<\/a> (botulinum toxin A) v\u00e0o 2 b\u00ean \u0111ai c\u01a1 mu tr\u1ef1c tr\u00e0ng.<\/strong><\/p>\n

\"\"<\/p>\n

1. Ch\u1ec9 \u0111\u1ecbnh<\/b><\/h2>\n

C\u01a1 mu – tr\u1ef1c tr\u00e0ng kh\u00f4ng gi\u00e3n khi\u1ebfn g\u00f3c h\u1eadu m\u00f4n – tr\u1ef1c tr\u00e0ng kh\u00f4ng m\u1edf r\u1ed9ng trong th\u00ec r\u1eb7n t\u1ed1ng ph\u00e2n.<\/p>\n

2. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/b><\/h2>\n

– Th\u1ec3 tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh qu\u00e1 y\u1ebfu, c\u1ea7n h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c tr\u01b0\u1edbc ph\u1eabu thu\u1eadt: N\u1ebfu ng\u01b0\u1eddi b\u1ec7nh \u0111ang trong t\u00ecnh tr\u1ea1ng qu\u00e1 y\u1ebfu, th\u00ec ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i th\u00eam cho s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh. Tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt, ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c \u0111\u1ec3 t\u0103ng c\u01b0\u1eddng s\u1ee9c kh\u1ecfe tr\u01b0\u1edbc khi ph\u1eabu thu\u1eadt.<\/p>\n

– Ng\u01b0\u1eddi b\u1ec7nh gi\u00e0 y\u1ebfu c\u00f3 c\u00e1c b\u1ec7nh ph\u1ed1i h\u1ee3p tim, ph\u1ed5i n\u1eb7ng: Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh gi\u00e0 y\u1ebfu v\u00e0 c\u00f3 c\u00e1c b\u1ec7nh ph\u1ed1i h\u1ee3p nh\u01b0 b\u1ec7nh tim, b\u1ec7nh ph\u1ed5i n\u1eb7ng, ung th\u01b0, b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng c\u00f3 th\u1ec3 g\u1eb7p nguy c\u01a1 cao khi ph\u1eabu thu\u1eadt. Vi\u1ec7c th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i cho s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t k\u1ef9 l\u01b0\u1ee1ng.<\/p>\n

– Ph\u1ee5 n\u1eef mang thai ho\u1eb7c cho con b\u00fa: Ph\u1ee5 n\u1eef mang thai ho\u1eb7c cho con b\u00fa kh\u00f4ng n\u00ean th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt n\u1ebfu kh\u00f4ng c\u1ea7n thi\u1ebft. Vi\u1ec7c th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a m\u1eb9 v\u00e0 \u0111\u1ee9a tr\u1ebb trong th\u1eddi k\u1ef3 mang thai ho\u1eb7c cho con b\u00fa.<\/p>\n

– C\u1ea9n th\u1eadn \u0111\u1ed1i v\u1edbi nh\u1eefng Ng\u01b0\u1eddi b\u1ec7nh m\u1eafc b\u1ec7nh nh\u01b0\u1ee3c c\u01a1 ho\u1eb7c \u0111ang \u0111i\u1ec1u tr\u1ecb aminoglycosides: Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh m\u1eafc b\u1ec7nh nh\u01b0\u1ee3c c\u01a1 ho\u1eb7c \u0111ang \u0111i\u1ec1u tr\u1ecb aminoglycosides c\u00f3 th\u1ec3 g\u1eb7p nguy c\u01a1 cao khi ph\u1eabu thu\u1eadt. Vi\u1ec7c th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 t\u00ecnh tr\u1ea1ng suy nh\u01b0\u1ee3c c\u01a1 v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c c\u1ee7a aminoglycosides.<\/p>\n

3. Chu\u1ea9n b\u1ecb<\/b><\/h2>\n

3.1. Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n: <\/b><\/h3>\n

Ph\u1eabu thu\u1eadt vi\u00ean ti\u00eau ho\u00e1 hay chuy\u00ean khoa s\u00e0n ch\u1eadu<\/p>\n

3.2. Ng\u01b0\u1eddi b\u1ec7nh:<\/b><\/h3>\n

– Kh\u00e1m l\u00e2m s\u00e0ng ng\u01b0\u1eddi b\u1ec7nh t\u00e1o b\u00f3n m\u1ea1n t\u00ednh th\u1ea5y s\u1ef1 co c\u1ee9ng c\u1ee7a c\u01a1 mu – tr\u1ef1c tr\u00e0ng khi r\u1eb7n.<\/p>\n

– C\u00e1c x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng: \u0111o \u00e1p l\u1ef1c h\u1eadu m\u00f4n – tr\u1ef1c tr\u00e0ng; nghi\u1ec7m ph\u00e1p t\u1ed1ng b\u00f3ng; \u0111o \u0111i\u1ec7n c\u01a1; c\u1ed9ng h\u01b0\u1edfng t\u1eeb t\u1ed1ng ph\u00e2n<\/p>\n

– Ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch r\u00f5 tr\u01b0\u1edbc m\u1ed5 v\u1ec1 t\u00ecnh tr\u1ea1ng b\u1ec7nh v\u00e0 t\u00ecnh tr\u1ea1ng chung, v\u1ec1 nh\u1eefng kh\u1ea3 n\u0103ng ph\u1eabu thu\u1eadt s\u1ebd th\u1ef1c hi\u1ec7n, v\u1ec1 nh\u1eefng tai bi\u1ebfn, bi\u1ebfn ch\u1ee9ng, di ch\u1ee9ng c\u00f3 th\u1ec3 g\u1eb7p do b\u1ec7nh, do ph\u1eabu thu\u1eadt, do g\u00e2y m\u00ea, t\u00ea, gi\u1ea3m \u0111au, do c\u01a1 \u0111\u1ecba c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

3.3. Ph\u01b0\u01a1ng ti\u1ec7n:<\/b><\/h3>\n

– \u0110\u1ed9c t\u1ed1 Botulinum type A (Botox ho\u1eb7c Dysport…)<\/p>\n

– Van \u1ed1ng h\u1eadu m\u00f4n<\/p>\n

4. C\u00e1c b\u01b0\u1edbc ti\u1ebfn h\u00e0nh<\/b><\/h2>\n

4.1. T\u01b0 th\u1ebf: <\/b><\/h3>\n

T\u01b0 th\u1ebf s\u1ea3n khoa: \u0110\u1ed1i v\u1edbi t\u01b0 th\u1ebfs\u1ea3n khoa, \u0111\u1eb7t b\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eeda, hai ch\u00e2n treo l\u00ean ho\u1eb7c \u0111\u1eb7t tr\u00ean m\u00e1ng v\u00e0o hai b\u00ean gi\u00e1 \u0111\u1ee1 c\u00f3 l\u00f3t \u0111\u1ec7m g\u1eafn v\u00e0o b\u00e0n ph\u1ea9u thu\u1eadt.<\/p>\n

4.2. V\u00f4 c\u1ea3m: <\/b><\/h3>\n

G\u00e2y m\u00ea n\u1ed9i kh\u00ed qu\u1ea3n hay t\u00ea v\u00f9ng (ngo\u00e0i m\u00e0ng c\u1ee9ng, t\u00ea t\u1ea1i ch\u1ed7).<\/p>\n

4.3. K\u1ef9 thu\u1eadt: <\/b><\/h3>\n

Th\u1eddi gian d\u1ef1 ki\u1ebfn 30 – 45 ph\u00fat<\/p>\n

3.1. X\u00e1c \u0111\u1ecbnh 2 quai b\u00ean ho\u1eb7c quai sau c\u1ee7a b\u00f3 c\u01a1 mu – tr\u1ef1c tr\u00e0ng.<\/p>\n

3.2. Ti\u00eam \u0111\u1ed9c t\u1ed1 botulinum type A v\u00e0o 2 quai b\u00ean li\u1ec1u 10U (Botox) m\u1ed7i quai b\u00ean (v\u1ecb tr\u00ed 4 gi\u1edd v\u00e0 8 gi\u1edd) ho\u1eb7c 20U v\u00e0o quai sau c\u1ee7a c\u01a1 mu tr\u1ef1c tr\u00e0ng (1 \u0111\u01a1n v\u1ecb c\u1ee7a Botox = 3-4 \u0111\u01a1n v\u1ecb Dysport)<\/p>\n

5. Theo d\u00f5i v\u00e0 x\u1eed tr\u00ed bi\u1ebfn ch\u1ee9ng<\/b><\/h2>\n

5.1. Theo d\u00f5i:<\/b><\/h3>\n

– Ph\u1ea3n \u1ee9ng ph\u1ee5 c\u1ee7a \u0111\u1ed9c t\u1ed1 Botulinum c\u00f3 th\u1ec3 l\u00e0m y\u1ebfu c\u00e1c m\u00f4 ho\u1eb7c c\u01a1 l\u00e2n c\u1eadn.<\/p>\n

– Theo d\u00f5i t\u00ecnh tr\u1ea1ng b\u1ec7nh do th\u1eddi gian t\u00e1c \u0111\u1ed9ng c\u1ee7a \u0111\u1ed9c t\u1ed1 Botulinum c\u00f3 gi\u1edbi\u00a0<\/sub>h\u1ea1n.<\/p>\n

5.2. X\u1eed tr\u00ed tai bi\u1ebfn:<\/b><\/h3>\n

– Cho\u00e1ng do d\u1ecb \u1ee9ng thu\u1ed1c. C\u1ea7n n\u1eb1m l\u1ea1i theo d\u00f5i 1-2 gi\u1edd.<\/p>\n

– Ch\u1ea3y m\u00e1u hay t\u1ee5 m\u00e1u ch\u1ed7 ti\u00eam: \u00e9p g\u1ea1c ho\u1eb7c mi\u1ebfng c\u1ea7m m\u00e1u.<\/p>\n

6. \u01afu \u0111i\u1ec3m c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng:<\/h2>\n

\u01afu \u0111i\u1ec3m c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng:<\/p>\n

– Gi\u1ea3i quy\u1ebft t\u00e1o b\u00f3n nghi\u00eam tr\u1ecdng: ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 gi\u00fap gi\u1ea3i quy\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p t\u00e1o b\u00f3n nghi\u00eam tr\u1ecdng do c\u00e1c r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng.<\/p>\n

– C\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng ti\u00eau h\u00f3a: ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng ti\u00eau h\u00f3a b\u1eb1ng c\u00e1ch lo\u1ea1i b\u1ecf c\u00e1c r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng, gi\u00fap c\u00e1c c\u01a1 ho\u1ea1t \u0111\u1ed9ng m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3 h\u01a1n.<\/p>\n

– Gi\u1ea3m \u0111au v\u00e0 kh\u00f4i ph\u1ee5c ch\u1ee9c n\u0103ng nhanh ch\u00f3ng: Ph\u1eabu thu\u1eadt gi\u00fap gi\u1ea3m \u0111au v\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng nhanh ch\u00f3ng, gi\u00fap b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 tr\u1edf l\u1ea1i ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng m\u1ed9t c\u00e1ch nhanh ch\u00f3ng h\u01a1n.<\/p>\n

7. H\u1ea1n ch\u1ebf<\/h2>\n

H\u1ea1n ch\u1ebf c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng:<\/p>\n

– Nguy c\u01a1 m\u1eafc c\u00e1c bi\u1ebfn ch\u1ee9ng: Ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 ch\u1ea3y m\u00e1u, nhi\u1ec5m tr\u00f9ng, t\u1ed5n th\u01b0\u01a1ng \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh, s\u01b0ng t\u1ea5y v\u00e0 \u0111au.<\/p>\n

– Y\u00eau c\u1ea7u k\u1ef9 thu\u1eadt cao: Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt ph\u1ee9c t\u1ea1p v\u00e0 y\u00eau c\u1ea7u k\u1ef9 thu\u1eadt cao c\u1ee7a b\u00e1c s\u0129. Vi\u1ec7c th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi c\u00e1c chuy\u00ean gia y t\u1ebf c\u00f3 kinh nghi\u1ec7m v\u00e0 \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o chuy\u00ean s\u00e2u.<\/p>\n

– Chi ph\u00ed cao: \u0110\u00e2y l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt \u0111\u1eaft ti\u1ec1n. N\u1ebfu kh\u00f4ng c\u00f3 b\u1ea3o hi\u1ec3m y t\u1ebf ho\u1eb7c c\u00e1c ngu\u1ed3n t\u00e0i ch\u00ednh kh\u00e1c, chi ph\u00ed ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t h\u1ea1n ch\u1ebf l\u1edbn \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n.<\/p>\n

– Ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 c\u00f3 th\u1eddi gian h\u1ed3i ph\u1ee5c t\u00f9y theo th\u1ec3 tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 y\u00eau c\u1ea7u b\u1ec7nh nh\u00e2n ph\u1ea3i c\u00f3 m\u1ed9t ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng v\u00e0 l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o ph\u1ee5c h\u1ed3i t\u1ed1i \u01b0u.<\/p>\n

Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng r\u1ea5t \u0111a d\u1ea1ng v\u00e0 \u0111\u01b0\u1ee3c \u0111\u01b0a ra t\u00f9y theo t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3. B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn ch\u00ednh x\u00e1c v\u1ec1 quy tr\u00ecnh v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o s\u1ef1 an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

T\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu – tr\u1ef1c tr\u00e0ng (Anismus) l\u00e0 b\u1ec7nh th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong h\u1ed9i ch\u1ee9ng t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ra (outlet obstruction syndronme) hay h\u1ed9i ch\u1ee9ng t\u1eafc ngh\u1ebdn \u0111\u1ea1i ti\u1ec7n (obstructed defecation syndrome – ODS) do b\u1ea5t \u0111\u1ed3ng v\u1eadn c\u01a1 s\u00e0n ch\u1eadu, hi\u1ec7n nay \u0111i\u1ec1u tr\u1ecb ch\u1ee7 y\u1ebfu b\u1eb1ng ti\u00eam […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[],"yoast_head":"\nPh\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng<\/title>\n<meta name=\"description\" content=\"T\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu - tr\u1ef1c tr\u00e0ng (Anismus) l\u00e0 b\u1ec7nh th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong h\u1ed9i ch\u1ee9ng t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ra (outlet obstruction ...\" \/>\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\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu-tr\u1ef1c tr\u00e0ng\" \/>\n<meta property=\"og:description\" content=\"T\u00e1o b\u00f3n do r\u1ed1i lo\u1ea1n co th\u1eaft c\u01a1 mu - 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