{"id":29685,"date":"2023-04-30T13:20:27","date_gmt":"2023-04-30T06:20:27","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29685"},"modified":"2023-04-30T13:20:27","modified_gmt":"2023-04-30T06:20:27","slug":"phuong-phap-phau-thuat-dieu-tri-tri-vong","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/30\/phuong-phap-phau-thuat-dieu-tri-tri-vong\/","title":{"rendered":"Ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb tr\u0129 v\u00f2ng"},"content":{"rendered":"

Tr\u0129 v\u00f2ng l\u00e0 tr\u0129 chi\u1ebfm h\u1ebft v\u00f2ng h\u1eadu m\u00f4n. C\u00f3 nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt c\u1eaft to\u00e0n b\u1ed9 tr\u0129 v\u00f2ng ch\u1ee7 y\u1ebfu l\u00e0 ph\u1eabu thu\u1eadt Whitehead, ph\u1eabu thu\u1eadt Toupet, ph\u1eabu thu\u1eadt Longo. Ngo\u00e0i ra c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt Milligan- Morgan, ph\u1eabu thu\u1eadt Ferguson<\/a> ho\u1eb7c tri\u1ec7t m\u1ea1ch treo tr\u0129. Vi\u1ec7c s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh b\u1edfi b\u00e1c s\u0129 chuy\u00ean khoa v\u00e0 b\u1ec7nh nh\u00e2n c\u1ea7n ph\u1ea3i th\u1ea3o lu\u1eadn k\u1ef9 v\u1edbi b\u00e1c s\u0129 \u0111\u1ec3 hi\u1ec3u r\u00f5 c\u00e1c l\u1ee3i \u00edch v\u00e0 h\u1ea1n ch\u1ebf c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y.<\/strong><\/p>\n

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Ng\u01b0\u1eddi m\u1eafc b\u1ec7nh tr\u0129 v\u00f2ng g\u1eb7p nhi\u1ec1u b\u1ea5t ti\u1ec7n trong sinh ho\u1ea1t n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi<\/figcaption><\/figure>\n

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

Tr\u0129 v\u00f2ng \u0111\u1ed9 3, \u0111\u1ed9 4.<\/p>\n

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

Tr\u0129 v\u00f2ng \u0111ang c\u00f3 vi\u00eam nhi\u1ec5m \u1ed1ng h\u1eadu m\u00f4n.<\/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 h\u00f3a hay ngo\u1ea1i chung \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o chuy\u00ean s\u00e2u ho\u1eb7c c\u00f3 ch\u1ee9ng ch\u1ec9 v\u1ec1 ph\u1eabu thu\u1eadt v\u00f9ng h\u1eadu m\u00f4n tr\u1ef1c tr\u00e0ng – t\u1ea7ng sinh m\u00f4n.<\/p>\n

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

– \u0110\u00e8n chi\u1ebfu s\u00e1ng t\u1ed1t, \u00e1nh s\u00e1ng l\u1ea1nh.<\/p>\n

– B\u1ed9 d\u1ee5ng c\u1ee5 ph\u1eabu thu\u1eadt h\u1eadu m\u00f4n: c\u00f3 \u00f4ng soi h\u1eadu m\u00f4n, van h\u1eadu m\u00f4n, que th\u0103m d\u00f2, dao \u0111i\u1ec7n, m\u00e1y h\u00fat, panh, k\u00e9o, k\u1eb9p ph\u1eabu t\u00edch,\u2026<\/p>\n

– C\u00e1c lo\u1ea1i ch\u1ec9 kh\u00e2u, thu\u1ed1c b\u00f4i tr\u01a1n (vaselin), oxy gi\u00e0, xanh metylen,\u2026<\/p>\n

– B\u00e0n ph\u1eabu thu\u1eadt: th\u01b0\u1eddng \u0111\u1eb7t \u0111\u01b0\u1ee3c ng\u01b0\u1eddi b\u1ec7nh t\u01b0 th\u1ebf ph\u1ee5 khoa, b\u00e0n c\u00f3 th\u1ec3 xoay \u0111\u01b0\u1ee3c c\u00e1c t\u01b0 th\u1ebf.<\/p>\n

– B\u00e0n \u0111\u1ec3 d\u1ee5ng c\u1ee5: n\u00ean c\u00f3 2 b\u00e0n (b\u00e0n \u0111\u1ec3 d\u1ee5ng c\u1ee5 chung v\u00e0 b\u00e0n \u0111\u1ec3 d\u1ee5ng c\u1ee5 c\u1ea7n thi\u1ebft trong khi m\u1ed5 \u0111\u1eb7t tr\u01b0\u1edbc m\u1eb7t ph\u1eabu thu\u1eadt vi\u00ean 50cm x 30cm).<\/p>\n

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

Gi\u1ea3i th\u00edch cho ng\u01b0\u1eddi b\u1ec7nh v\u00e0 gia \u0111\u00ecnh bi\u1ebft r\u00f5 t\u00ecnh tr\u1ea1ng b\u1ec7nh t\u1ea1i ch\u1ed7 v\u00e0 t\u00ecnh tr\u1ea1ng chung c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, v\u1ec1 kh\u1ea3 n\u0103ng ph\u1eabu thu\u1eadt s\u1ebd th\u1ef1c hi\u1ec7n, v\u1ec1 c\u00e1c 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

Gi\u1ea3i \u0111\u00e1p nh\u1eefng kh\u00fac m\u1eafc c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u1ec1 b\u1ec7nh t\u1eadt, v\u1ec1 ph\u1eabu thu\u1eadt,\u2026trong ph\u1ea1m vi<\/p>\n

cho ph\u00e9p.<\/p>\n

+\u00a0T\u1ed1i h\u00f4m tr\u01b0\u1edbc ng\u00e0y ph\u1eabu thu\u1eadt:<\/i><\/p>\n

Th\u1ee5t th\u00e1o s\u1ea1ch ph\u00e2n, c\u00f3 th\u1ec3 th\u1ee5t thu\u1ed1c t\u1ea9y nh\u01b0 Fleet,\u2026Kh\u00f4ng c\u1ea7n t\u1ea9y s\u1ea1ch nh\u01b0 ph\u1eabu thu\u1eadt \u0111\u1ea1i tr\u1ef1c tr\u00e0ng.<\/p>\n

D\u00f9ng thu\u1ed1c an th\u1ea7n nh\u01b0 seduxen 5mg x 1 vi\u00ean, u\u1ed1ng l\u00fac 20 gi\u1edd.<\/p>\n

C\u1ea1o l\u00f4ng quanh h\u1eadu m\u00f4n: n\u00ean th\u1ef1c hi\u1ec7n tr\u00ean b\u00e0n ph\u1eabu thu\u1eadt sau khi g\u00e2y t\u00ea v\u00f9ng ho\u1eb7c g\u00e2y m\u00ea.<\/p>\n

+\u00a0Ng\u00e0y ph\u1eabu thu\u1eadt<\/i>: nh\u1ecbn \u0103n, u\u1ed1ng, \u0111i ti\u1ec3u tr\u01b0\u1edbc khi l\u00ean b\u00e0n m\u1ed5.<\/p>\n

3.4. H\u1ed3 s\u01a1 b\u1ec7nh \u00e1n<\/b><\/h3>\n

Ho\u00e0n th\u00e0nh c\u00e1c th\u1ee7 t\u1ee5c h\u00e0nh ch\u00ednh theo qui \u0111\u1ecbnh. Ng\u01b0\u1eddi b\u1ec7nh v\u00e0 gia \u0111\u00ecnh ghi h\u1ed3 s\u01a1 nh\u01b0 \u0111\u00e3 n\u00eau \u1edf m\u1ee5c 3 tr\u00ean \u0111\u00e2y (ghi r\u00f5 \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch r\u00f5 r\u00e0ng v\u00e0 hi\u1ec3u v\u1ec1 nh\u1eefng \u0111i\u1ec1u b\u00e1c s\u1ef9 gi\u1ea3i th\u00edch n\u00eau tr\u00ean).<\/p>\n

Ho\u00e0n thi\u1ec7n \u0111\u1ea7y \u0111\u1ee7 c\u00e1c b\u01b0\u1edbc kh\u00e1m l\u00e2m s\u00e0ng, c\u1eadn l\u00e2m s\u00e0ng c\u1ea7n thi\u1ebft \u0111\u1ec3 c\u00f3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1ec7nh (t\u00f9y thu\u1ed9c c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n, c\u01a1 s\u1edf y t\u1ebf). \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng to\u00e0n th\u00e2n nh\u01b0 tu\u1ed5i, c\u01a1 \u0111\u1ecba, nh\u1eefng b\u1ec7nh m\u00e3n t\u00ednh n\u1eb7ng ph\u1ed1i h\u1ee3p c\u00f3 \u1ea3nh h\u01b0\u1edfng t\u1edbi cu\u1ed9c ph\u1eabu thu\u1eadt, trong th\u1eddi k\u1ef3 h\u1eadu ph\u1eabu. \u0110\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng ph\u1eabu thu\u1eadt \u0111\u1ec3 chu\u1ea9n b\u1ecb cho cu\u1ed9c m\u1ed5 di\u1ec5n ra an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 nh\u1ea5t.<\/p>\n

\u0110\u1ed1i v\u1edbi c\u00e1c th\u1ee7 thu\u1eadt \u0111\u01a1n gi\u1ea3n h\u01a1n (v\u00ed d\u1ee5 l\u1ea5y m\u00e1u c\u1ee5c do tr\u0129 t\u1eafc m\u1ea1ch, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n th\u1ee7 thu\u1eadt v\u00e0 ra v\u1ec1 ngay trong ng\u00e0y. Hay ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i m\u1ed5 c\u1ea5p c\u1ee9u nh\u01b0 \u00e1p xe c\u1ea1nh h\u1eadu m\u00f4n) th\u00ec c\u00e1c b\u01b0\u1edbc chu\u1ea9n b\u1ecb c\u00f3 th\u1ec3 r\u00fat g\u1ecdn \u0111\u01a1n gi\u1ea3n h\u01a1n, ph\u00f9 h\u1ee3p v\u1edbi t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3.<\/p>\n

4. Ti\u1ebfn h\u00e0nh<\/b><\/h2>\n

4.1. T\u01b0 th\u1ebf: Ph\u1ee5 khoa<\/b><\/h3>\n

4.2. V\u00f4 c\u1ea3m:\u00a0<\/b><\/h3>\n

G\u00e2y m\u00ea to\u00e0n th\u00e2n<\/p>\n

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

4.3.1. Ph\u1eabu thu\u1eadt Whitehead ( Anh- 1882):<\/i><\/h4>\n

L\u1ea5y to\u00e0n b\u1ed9 b\u00fai tr\u0129 v\u00e0 ni\u00eam m\u1ea1c \u1ed1ng h\u1eadu m\u00f4n b\u1eb1ng 4 \u0111\u01b0\u1eddng r\u1ea1ch d\u1ecdc theo tr\u1ee5c h\u1eadu m\u00f4n. Sau \u0111\u00f3 kh\u00e2u n\u1ed1i ni\u00eam m\u1ea1c tr\u1ef1c tr\u00e0ng v\u1edbi da r\u00eca h\u1eadu m\u00f4n.<\/p>\n

Hi\u1ec7n nay \u00edt s\u1eed d\u1ee5ng v\u00ec c\u00f3 nhi\u1ec1u bi\u1ebfn ch\u1ee9ng: \u0111\u1ea1i ti\u1ec7n kh\u00f4ng t\u1ef1 ch\u1ee7, s\u1eb9o ch\u00edt h\u1eb9p h\u1eadu m\u00f4n, sa ni\u00eam m\u1ea1c tr\u1ef1c tr\u00e0ng\u2026\u0110\u1ec3 h\u1ea1n ch\u1ebf c\u00e1c bi\u1ebfn ch\u1ee9ng n\u00e0y c\u1ea7n c\u1eaft h\u1ebft tr\u0129, kh\u00e2u n\u1ed1i ni\u00eam m\u1ea1c tr\u1ef1c tr\u00e0ng v\u1edbi da r\u00eca h\u1eadu m\u00f4n cao h\u01a1n \u0111\u1ec3 \u0111\u01b0\u1eddng kh\u00e2u n\u1eb1m trong \u1ed1ng h\u1eadu m\u00f4n, kh\u00f4ng g\u00e2y l\u1ed9 ni\u00eam m\u1ea1c tr\u1ef1c tr\u00e0ng.<\/p>\n

4.3.2. Ph\u1eabu thu\u1eadt Toupet (Ph\u00e1p – 1965):<\/i><\/h4>\n

V\u1ec1 nguy\u00ean t\u1eafc gi\u1ed1ng ph\u1eabu thu\u1eadt Whitehead nh\u01b0ng kh\u00e1c \u1edf \u0111i\u1ec3m l\u00e0 ph\u1eabu t\u00edch b\u1eaft \u0111\u1ea7u t\u1eeb \u0111\u01b0\u1eddng l\u01b0\u1ee3c \u0111\u1ec3 b\u1ea3o t\u1ed3n ni\u00eam m\u1ea1c \u1ed1ng h\u1eadu m\u00f4n.<\/p>\n

4.3.3. Ph\u1eabu thu\u1eadt Longo (\u00dd – 1983): <\/i><\/h4>\n

Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf m\u1ed9t khoang ni\u00eam m\u1ea1c tr\u1ef1c tr\u00e0ng tr\u00ean \u0111\u01b0\u1eddng l\u01b0\u1ee3c kho\u1ea3ng 1 – 1,5cm, c\u00f3 t\u00e1c d\u1ee5ng c\u1ed1 \u0111\u1ecbnh b\u00fai tr\u0129 b\u1ecb sa v\u00e0 gi\u1ea3m ngu\u1ed3n m\u00e1u t\u1edbi b\u00fai tr\u0129. Do v\u1eady c\u00f3 t\u00e1c d\u1ee5ng \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tr\u0129.<\/p>\n

4.3.4. M\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng:<\/i><\/h4>\n

– Tri\u1ec7t m\u1ea1ch tr\u0129: th\u01b0\u1eddng \u00e1p d\u1ee5ng cho tr\u0129 v\u00f2ng nh\u1ecf.<\/p>\n

– Ph\u1eabu thu\u1eadt Milligan-Morgan ho\u1eb7c ph\u1eabu thu\u1eadt Ferguson (xem b\u00e0i ph\u1eabu thu\u1eadt Milligan- Morgan v\u00e0 Ferguson): L\u01b0u \u00fd, n\u1ebfu c\u1ea7u da – ni\u00eam m\u1ea1c d\u00e0i th\u00ec c\u1ea7n c\u1eaft ng\u1eafn c\u1ea7u da- ni\u00eam m\u1ea1c v\u00e0 kh\u00e2u n\u1ed1i l\u1ea1i.<\/p>\n

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

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

– Th\u01b0\u1eddng cho kh\u00e1ng sinh to\u00e0n th\u00e2n 5 ng\u00e0y, d\u00f9ng gi\u1ea3m \u0111au lo\u1ea1i Paracetamol v\u00e0 morphin n\u1ebfu c\u1ea7n thi\u1ebft. Ng\u00e0y \u0111\u1ea7u d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam, t\u1eeb ng\u00e0y th\u1ee9 2 d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng.U\u1ed1ng th\u00eam thu\u1ed1c nhu\u1eadn tr\u00e0ng, tr\u00e1nh t\u00e1o b\u00f3n \u0111\u1ecdng ph\u00e2n trong tr\u1ef1c tr\u00e0ng g\u00e2y k\u00edch th\u00edch \u0111\u1ea1i ti\u1ec7n, g\u00e2y \u0111au k\u00e9o d\u00e0i. B\u1eaft \u0111\u1ea7u \u0103n tr\u1edf l\u1ea1i sau m\u1ed5 12 gi\u1edd. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1eb7c bi\u1ec7t, \u0111\u1ec3 tr\u00e1nh nguy c\u01a1 nhi\u1ec5m tr\u00f9ng, c\u00f3 th\u1ec3 cho Ng\u01b0\u1eddi b\u1ec7nh nh\u1ecbn \u0103n, nu\u00f4i d\u01b0\u1ee1ng t\u0129nh m\u1ea1ch, g\u00e2y t\u00e1o b\u00f3n b\u1eb1ng Imodium trong 2-5 ng\u00e0y.<\/p>\n

– S\u0103n s\u00f3c t\u1ea1i ch\u1ed7: gi\u1eef s\u1ea1ch v\u1ebft m\u1ed5 (sau \u0111\u1ea1i ti\u1ec7n r\u1eeda s\u1ea1ch h\u1eadu m\u00f4n, th\u1ea5m kh\u00f4). C\u00f3 th\u1ec3 \u0111\u1eb7t vi\u00ean \u0111\u1ea1n tr\u0129 v\u00e0o h\u1eadu m\u00f4n. Thay b\u0103ng v\u1ebft m\u1ed5 h\u00e0ng ng\u00e0y.<\/p>\n

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

– \u0110au: D\u00f9ng thu\u1ed1c gi\u1ea3m \u0111au lo\u1ea1i Paracetamol.<\/p>\n

– Ch\u1ea3y m\u00e1u: \u00cdt g\u1eb7p, th\u01b0\u1eddng \u0111\u1ea1i ti\u1ec7n l\u1ea7n \u0111\u1ea7u d\u00ednh \u00edt m\u00e1u. N\u1ebfu m\u1ee9c \u0111\u1ed9 ch\u1ea3y m\u00e1u nhi\u1ec1u kh\u00f4ng t\u1ef1 c\u1ea7m, c\u1ea7n ki\u1ec3m tra l\u1ea1i v\u1ebft m\u1ed5 \u0111\u1ec3 c\u1ea7m m\u00e1u.<\/p>\n

– B\u00ed \u0111\u00e1i: Th\u01b0\u1eddng g\u1eb7p sau g\u00e2y t\u00ea t\u1ee7y s\u1ed1ng, ho\u1eb7c do ng\u01b0\u1eddi b\u1ec7nh \u0111au nhi\u1ec1u c\u0169ng g\u00e2y kh\u00f3 ti\u1ec3u ti\u1ec7n. N\u1ebfu c\u1ea7n thi\u1ebft ph\u1ea3i \u0111\u1eb7t sonde b\u00e0ng quang.<\/p>\n

– M\u1ea5t t\u1ef1 ch\u1ee7 h\u1eadu m\u00f4n: \u00cdt g\u1eb7p.<\/p>\n

– Nhi\u1ec5m tr\u00f9ng, t\u1ee5 d\u1ecbch v\u1ebft m\u1ed5: Thay b\u0103ng, n\u1eb7n d\u1ecbch v\u1ebft m\u1ed5.<\/p>\n

– H\u1eb9p \u1ed1ng h\u1eadu m\u00f4n: \u00cdt g\u1eb7p<\/p>\n

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

Tr\u0129 v\u00f2ng l\u00e0 tr\u0129 chi\u1ebfm h\u1ebft v\u00f2ng h\u1eadu m\u00f4n. C\u00f3 nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt c\u1eaft to\u00e0n b\u1ed9 tr\u0129 v\u00f2ng ch\u1ee7 y\u1ebfu l\u00e0 ph\u1eabu thu\u1eadt Whitehead, ph\u1eabu thu\u1eadt Toupet, ph\u1eabu thu\u1eadt Longo. Ngo\u00e0i ra c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt Milligan- Morgan, ph\u1eabu thu\u1eadt Ferguson ho\u1eb7c tri\u1ec7t m\u1ea1ch treo tr\u0129. Vi\u1ec7c s\u1eed d\u1ee5ng […]<\/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 ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb tr\u0129 v\u00f2ng - Vinmec<\/title>\n<meta name=\"description\" content=\"Tr\u0129 v\u00f2ng l\u00e0 tr\u0129 chi\u1ebfm h\u1ebft v\u00f2ng h\u1eadu m\u00f4n. 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