{"id":29693,"date":"2023-04-30T13:19:47","date_gmt":"2023-04-30T06:19:47","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29693"},"modified":"2023-04-30T13:19:47","modified_gmt":"2023-04-30T06:19:47","slug":"quy-trinh-phau-thuat-tao-van-chong-trao-nguoc-da-day-thuc-quan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/30\/quy-trinh-phau-thuat-tao-van-chong-trao-nguoc-da-day-thuc-quan\/","title":{"rendered":"Quy tr\u00ecnh ph\u1eabu thu\u1eadt t\u1ea1o van ch\u1ed1ng tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n"},"content":{"rendered":"

B\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n (GERD<\/a>) l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u00e2m s\u00e0ng r\u1ea5t th\u01b0\u1eddng g\u1eb7p, chi\u1ebfm m\u1ed9t t\u1ef7 l\u1ec7 l\u1edbn trong nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh \u0111i kh\u00e1m b\u1ec7nh v\u00ec nh\u1eefng tri\u1ec7u ch\u1ee9ng r\u1ed1i lo\u1ea1n \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. T\u1ed5n th\u01b0\u01a1ng ni\u00eam m\u1ea1c th\u1ef1c qu\u1ea3n v\u00ec tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y – th\u1ef1c qu\u1ea3n ( bao g\u1ed3m tr\u00edt h\u1eb9p v\u00e0 d\u1ecb s\u1ea3n th\u1ef1c qu\u1ea3n Barrett ) \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y – th\u1ef1c qu\u1ea3n. Hi\u1ec7n nay, ph\u01b0\u01a1ng ph\u00e1p t\u1ea1o van ch\u1ed1ng tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n mang l\u1ea1i nhi\u1ec1u l\u1ee3i \u00edch cho ng\u01b0\u1eddi b\u1ec7nh khi kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa.<\/strong><\/p>\n

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H\u00ecnh \u1ea3nh minh h\u1ecda b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n<\/figcaption><\/figure>\n

1. Ph\u01b0\u01a1ng ph\u00e1p t\u1ea1o van ch\u1ed1ng tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n l\u00e0 g\u00ec?<\/h2>\n

Ph\u01b0\u01a1ng ph\u00e1p t\u1ea1o van ch\u1ed1ng tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt m\u1edbi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n. K\u1ef9 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng c\u00e1ch t\u1ea1o m\u1ed9t van nh\u00e2n t\u1ea1o trong d\u1ea1 d\u00e0y ho\u1eb7c th\u1ef1c qu\u1ea3n c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u1ec3 ng\u0103n ch\u1eb7n d\u1ecbch d\u1ea1 d\u00e0y tr\u00e0o ng\u01b0\u1ee3c l\u00ean th\u1ef1c qu\u1ea3n.<\/p>\n

Ph\u01b0\u01a1ng ph\u00e1p Nissen l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn nh\u1ea5t \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n. K\u1ef9 thu\u1eadt n\u00e0y li\u00ean quan \u0111\u1ebfn vi\u1ec7c cu\u1ed1n ph\u00ecnh v\u1ecb xung quanh th\u1ef1c qu\u1ea3n l\u00ean tr\u00ean t\u00e2m v\u1ecb kho\u1ea3ng 2-3 cm v\u00e0 kh\u00e2u l\u1ea1i m\u1ed9t g\u00f3c 360 \u0111\u1ed9, t\u1ea1o ra m\u1ed9t van nh\u00e2n t\u1ea1o \u0111\u1ec3 ng\u0103n ch\u1eb7n d\u1ecbch d\u1ea1 d\u00e0y tr\u00e0o ng\u01b0\u1ee3c l\u00ean th\u1ef1c qu\u1ea3n.<\/p>\n

Ph\u01b0\u01a1ng ph\u00e1p Dor l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt thay th\u1ebf cho ph\u01b0\u01a1ng ph\u00e1p Nissen, trong \u0111\u00f3 ph\u00ecnh v\u1ecb ch\u1ec9 \u0111\u01b0\u1ee3c cu\u1ed1n m\u1eb7t tr\u01b0\u1edbc 180 \u0111\u1ed9. K\u1ef9 thu\u1eadt n\u00e0y \u00edt g\u00e2y \u0111au h\u01a1n v\u00e0 th\u1eddi gian h\u1ed3i ph\u1ee5c c\u0169ng nhanh h\u01a1n so v\u1edbi ph\u01b0\u01a1ng ph\u00e1p Nissen, tuy nhi\u00ean hi\u1ec7u qu\u1ea3 tr\u1ecb li\u1ec7u c\u1ee7a n\u00f3 kh\u00f4ng b\u1eb1ng.<\/p>\n

Ph\u01b0\u01a1ng ph\u00e1p Toupet c\u0169ng l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n, trong \u0111\u00f3 ph\u00ecnh v\u1ecb \u0111\u01b0\u1ee3c qu\u1ea5n m\u1ed9t g\u00f3c 270 \u0111\u1ed9 v\u00e0 kh\u00e2u l\u1ea1i. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 \u01b0u \u0111i\u1ec3m l\u00e0 \u00edt g\u00e2y \u0111au h\u01a1n v\u00e0 th\u1eddi gian h\u1ed3i ph\u1ee5c c\u0169ng nhanh h\u01a1n so v\u1edbi ph\u01b0\u01a1ng ph\u00e1p Nissen, tuy nhi\u00ean c\u0169ng kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 tr\u1ecb li\u1ec7u cao nh\u01b0 ph\u01b0\u01a1ng ph\u00e1p Nissen.<\/p>\n

Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 k\u1ef9 l\u01b0\u1ee1ng v\u00e0 ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng b\u1ec7nh nh\u00e2n th\u00edch h\u1ee3p. B\u1ec7nh nh\u00e2n c\u1ea7n th\u1ea3o lu\u1eadn v\u1edbi b\u00e1c s\u0129 \u0111\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin v\u1ec1 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p n\u00e0y v\u00e0 quy\u1ebft \u0111\u1ecbnh li\u1ec7u ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 ph\u00f9 h\u1ee3p v\u1edbi tr\u01b0\u1eddng h\u1ee3p c\u1ee7a h\u1ecd hay kh\u00f4ng.<\/p>\n

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

–\u00a0<\/b>Tr\u00e0o ng\u01b0\u1ee3c th\u1ef1c qu\u1ea3n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa \u0111\u00fang ph\u00e1c \u0111\u1ed3, \u0111\u1ee7 th\u1eddi gian.<\/p>\n

– Tho\u00e1t v\u1ecb khe ho\u00e0nh<\/p>\n

– Lo\u00e9t th\u1ef1c qu\u1ea3n<\/p>\n

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

–\u00a0<\/b>B\u1ec7nh l\u00fd ph\u1ed5i n\u1eb7ng<\/p>\n

– C\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p ngo\u1ea1i khoa n\u00f3i chung<\/p>\n

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

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

– 01 Ph\u1eabu thu\u1eadt vi\u00ean chuy\u00ean khoa ti\u00eau h\u00f3a ho\u1eb7c ngo\u1ea1i chung<\/p>\n

– 02 ph\u1ee5 m\u1ed5<\/p>\n

– K\u00edp g\u00e2y m\u00ea: 01 B\u00e1c s\u0129 g\u00e2y m\u00ea, 01 \u0110i\u1ec1u d\u01b0\u1ee1ng ph\u1ee5 g\u00e2y m\u00ea<\/p>\n

– K\u00edp d\u1ee5ng c\u1ee5: 01 D\u1ee5ng c\u1ee5 vi\u00ean, 01 nh\u00e2n vi\u00ean ch\u1ea1y ngo\u00e0i<\/p>\n

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

– \u0110\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh, x\u00e9t nghi\u1ec7m sinh h\u1ecdc, \u0111\u00e1nh gi\u00e1 to\u00e0n tr\u1ea1ng b\u1ec7nh ph\u1ed1i h\u1ee3p v\u00e0 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, nu\u00f4i d\u01b0\u1ee1ng, c\u00e2n b\u1eb1ng \u0111\u1ee7 \u0111\u1ea3m b\u1ea3o cho cu\u1ed9c ph\u1eabu thu\u1eadt d\u1ef1 ki\u1ebfn.<\/p>\n

– N\u00e2ng cao th\u1ec3 tr\u1ea1ng, c\u00e2n b\u1eb1ng nh\u1eefng r\u1ed1i lo\u1ea1n do h\u1eadu qu\u1ea3 c\u1ee7a b\u1ec7nh ho\u1eb7c do c\u01a1 \u0111\u1ecba, b\u1ec7nh m\u00e3n t\u00ednh, tu\u1ed5i\u2026<\/p>\n

– Ng\u01b0\u1eddi b\u1ec7nh v\u00e0 gia \u0111\u00ecnh \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

– Nh\u1ecbn \u0103n, th\u1ee5t th\u00e1o, v\u1ec7 sinh v\u00f9ng ph\u1eabu thu\u1eadt v\u00e0 to\u00e0n th\u00e2n.<\/p>\n

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

B\u1ed9 d\u1ee5ng c\u1ee5 \u0111\u1ea1i ph\u1eabu, dao si\u00eau \u00e2m, Ligasure, ch\u1ec9 ph\u1eabu thu\u1eadt, thu\u1ed1c, d\u1ecbch truy\u1ec1n,\u2026<\/p>\n

4.4. D\u1ef1 ki\u1ebfn th\u1eddi gian ph\u1eabu thu\u1eadt: <\/b>90 ph\u00fat<\/h3>\n

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

Ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m ng\u1eeda.<\/p>\n

B\u01b0\u1edbc 1:\u00a0<\/b>M\u1edf b\u1ee5ng \u0111\u01b0\u1eddng tr\u1eafng tr\u00ean r\u1ed1n. Ph\u1eabu t\u00edch th\u1ef1c qu\u1ea3n c\u1ed5 v\u00e0 v\u00f9ng ph\u00ecnh v\u1ecb, th\u1eaft v\u00e0 c\u1eaft c\u00e1c nh\u00e1nh v\u1ecb ng\u1eafn kho\u1ea3ng 3-4 nh\u00e1nh.<\/p>\n

B\u01b0\u1edbc 2:\u00a0<\/b>Kh\u00e2u cu\u1ed1n ph\u00ecnh v\u1ecb xung quanh th\u1ef1c qu\u1ea3n l\u00ean tr\u00ean t\u00e2m v\u1ecb 2-3 cm. Ph\u00ecnh v\u1ecb cu\u1ed1n quanh th\u1ef1c qu\u1ea3n \u0111\u01b0\u1ee3c kh\u00e2u l\u1ea1i m\u1ed9t g\u00f3c 360o<\/sup>\u00a0th\u00ec g\u1ecdi l\u00e0 ph\u01b0\u01a1ng ph\u00e1p Nissen. Ph\u00ecnh v\u1ecb cu\u1ed1n m\u1eb7t tr\u01b0\u1edbc 180o<\/sup>\u00a0g\u1ecdi l\u00e0 ph\u01b0\u01a1ng ph\u00e1p Dor. Ph\u00ecnh v\u1ecb qu\u1ea5n m\u1ed9t g\u00f3c 270o<\/sup>\u00a0th\u00ec g\u1ecdi l\u00e0 ph\u01b0\u01a1ng ph\u00e1p Toupet.<\/p>\n

B\u01b0\u1edbc 3:\u00a0<\/b>Kh\u00e2u \u0111\u00ednh c\u00e1c m\u0169i ch\u1ec9 b\u1eb1ng m\u0169i r\u1eddi Vicryl 3.0<\/p>\n

B\u01b0\u1edbc 4:\u00a0<\/b>\u0110\u00f3ng b\u1ee5ng<\/p>\n

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

– H\u00f4 h\u1ea5p: ng\u1ed3i d\u1eady, v\u1ed7 rung, l\u00fd li\u1ec7u ph\u00e1p<\/p>\n

– R\u00f2 mi\u1ec7ng n\u1ed1i: nu\u00f4i d\u01b0\u1ee1ng qua m\u1edf th\u00f4ng h\u1ed7ng tr\u00e0ng<\/p>\n

– Ch\u1ea3y m\u00e1u: t\u00f9y m\u1ee9c \u0111\u1ed9 ch\u1ea3y m\u00e1u m\u00e0 c\u00f3 th\u00e1i \u0111\u1ed9 x\u1eed tr\u00ed: b\u1ea3o t\u1ed3n ho\u1eb7c m\u1ed5 l\u1ea1i<\/p>\n

B\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y – th\u1ef1c qu\u1ea3n th\u01b0\u1eddng c\u00f3 nh\u1eefng tr\u1ea7m tr\u1ecdng v\u00e0 k\u00e9o d\u00e0i su\u1ed1t \u0111\u1eddi, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ef1 suy gi\u1ea3m \u0111\u00e1ng k\u1ec3 ch\u1ee9c n\u0103ng b\u00ecnh th\u01b0\u1eddng v\u00e0 t\u00ecnh tr\u1ea1ng t\u00e2m l\u00fd c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh. Hi\u1ec7n nay, ph\u01b0\u01a1ng ph\u00e1p t\u1ea1o van ch\u1ed1ng tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n gi\u00fap cho ng\u01b0\u1eddi b\u1ec7nh c\u00f3 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb kh\u1ea3 quan v\u00e0 \u0111em l\u1ea1i cu\u1ed9c s\u1ed1ng t\u1ed1t tho\u1ea3i m\u00e1i cho ng\u01b0\u1eddi b\u1ec7nh. Ph\u01b0\u01a1ng ph\u00e1p t\u1ea1o van ch\u1ed1ng tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt m\u1edbi v\u00e0 ti\u00ean ti\u1ebfn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 nhi\u1ec1u \u01b0u \u0111i\u1ec3m so v\u1edbi ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1eb1ng n\u1ed9i khoa. Tuy nhi\u00ean, nh\u01b0 m\u1ecdi ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb, ph\u01b0\u01a1ng ph\u00e1p t\u1ea1o van ch\u1ed1ng tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y- th\u1ef1c qu\u1ea3n c\u0169ng c\u00f3 nh\u1eefng h\u1ea1n ch\u1ebf v\u00e0 tai bi\u1ebfn trong ph\u1eabu thu\u1eadt. B\u1ec7nh nh\u00e2n c\u1ea7n th\u1ea3o lu\u1eadn v\u1edbi b\u00e1c s\u0129 \u0111\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin chi ti\u1ebft v\u00e0 \u0111\u00e1nh gi\u00e1 s\u1ef1 ph\u00f9 h\u1ee3p c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p c\u1ee7a m\u00ecnh.<\/p>\n

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

B\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n (GERD) l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u00e2m s\u00e0ng r\u1ea5t th\u01b0\u1eddng g\u1eb7p, chi\u1ebfm m\u1ed9t t\u1ef7 l\u1ec7 l\u1edbn trong nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh \u0111i kh\u00e1m b\u1ec7nh v\u00ec nh\u1eefng tri\u1ec7u ch\u1ee9ng r\u1ed1i lo\u1ea1n \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. 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