{"id":30045,"date":"2023-05-02T15:58:37","date_gmt":"2023-05-02T08:58:37","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30045"},"modified":"2023-05-02T15:58:37","modified_gmt":"2023-05-02T08:58:37","slug":"cap-nhap-phau-thuat-cat-ta-trang-bao-ton-dau-tuy","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/02\/cap-nhap-phau-thuat-cat-ta-trang-bao-ton-dau-tuy\/","title":{"rendered":"C\u1eadp nh\u1eadp ph\u1eabu thu\u1eadt c\u1eaft t\u00e1 tr\u00e0ng b\u1ea3o t\u1ed3n \u0111\u1ea7u t\u1ee5y"},"content":{"rendered":"

Ph\u1eabu thu\u1eadt c\u1eaft to\u00e0n b\u1ed9 t\u00e1 tr\u00e0ng b\u1ea3o t\u1ed3n \u0111\u1ea7u t\u1ee5y l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 b\u1edfi Chung v\u00e0 c\u1ed9ng s\u1ef1 n\u0103m 1994. K\u1ec3 t\u1eeb \u0111\u00f3, k\u1ef9 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh lan t\u1ecfa c\u1ee7a t\u00e1 tr\u00e0ng nh\u01b0ng ch\u01b0a lan v\u00e0o \u0111\u1ea7u t\u1ee5y, ch\u1ee7 y\u1ebfu l\u00e0 b\u1ec7nh \u0111a polyp tuy\u1ebfn gia \u0111\u00ecnh. Ph\u1eabu thu\u1eadt c\u1eaft t\u00e1 tr\u00e0ng b\u1ea3o t\u1ed3n \u0111\u1ea7u t\u1ee5y l\u00e0 m\u1ed9t ph\u1eabu thu\u1eadt l\u1edbn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb u c\u1ee7a t\u00e1 tr\u00e0ng, mang l\u1ea1i hi\u1ec7u qu\u1ea3 kh\u1ea3 quan cho ng\u01b0\u1eddi b\u1ec7nh.<\/strong><\/p>\n

\"\"<\/p>\n

1. Ch\u1ec9 \u0111\u1ecbnh\u00a0 c\u1ee7a ph\u1eabu thu\u1eadt c\u1eaft to\u00e0n b\u1ed9 t\u00e1 tr\u00e0ng b\u1ea3o t\u1ed3n \u0111\u1ea7u t\u1ee5y<\/strong><\/h2>\n

U t\u00e1 tr\u00e0ng \u1edf nhi\u1ec1u v\u1ecb tr\u00ed c\u1ee7a t\u00e1 tr\u00e0ng: \u0111a polyp<\/a> tuy\u1ebfn, u n\u1ed9i ti\u1ebft. Ch\u1ea5n th\u01b0\u01a1ng t\u00e1 tr\u00e0ng<\/p>\n

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

Ung th\u01b0 t\u00e1 tr\u00e0ng c\u00f3 x\u00e2m l\u1ea5n \u0111\u1ea7u t\u1ee5y<\/p>\n

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

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

– 01 Ph\u1eabu thu\u1eadt vi\u00ean chuy\u00ean khoa ti\u00eau h\u00f3a<\/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

3.2. 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

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

B\u1ed9 d\u1ee5ng c\u1ee5 \u0111\u1ea1i ph\u1eabu, dao si\u00eau \u00e2m, Ligasure, m\u00e1y c\u1eaft n\u1ed1i, ch\u1ec9 ph\u1eabu thu\u1eadt, thu\u1ed1c, d\u1ecbch truy\u1ec1n,\u2026<\/p>\n

3.4. D\u1ef1 ki\u1ebfn th\u1eddi gian ph\u1eabu thu\u1eadt: <\/b>240 ph\u00fat<\/h3>\n

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

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

Ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m ng\u1eeda, k\u00ea m\u1ed9t g\u1ed1i \u0111\u1ec7m d\u01b0\u1edbi l\u01b0ng ngang \u0111\u1ed1t s\u1ed1ng l\u01b0ng 12 (D12).<\/p>\n

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

G\u00e2y m\u00ea to\u00e0n th\u00e2n c\u00f3 gi\u00e3n c\u01a1<\/p>\n

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

–\u00a0B\u01b0\u1edbc 1:\u00a0<\/b>M\u1edf b\u1ee5ng \u0111\u01b0\u1eddng tr\u1eafng gi\u1eefa tr\u00ean d\u01b0\u1edbi r\u1ed1n, \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng.<\/p>\n

. \u0110\u00e1nh gi\u00e1 d\u1ecbch \u1ed5 b\u1ee5ng, t\u00ecnh tr\u1ea1ng ph\u00fac m\u1ea1c.<\/p>\n

. \u0110\u00e1nh gi\u00e1 c\u00e1c c\u01a1 quan kh\u00e1c trong \u1ed5 b\u1ee5ng.<\/p>\n

. \u0110\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng t\u1ea1i t\u00e1 tr\u00e0ng, \u0111\u1ea7u t\u1ee5y.<\/p>\n

. \u0110\u00e1nh gi\u00e1 di c\u0103n h\u1ea1ch.<\/p>\n

–\u00a0B\u01b0\u1edbc 2<\/b>: L\u00e0m \u0111\u1ed9ng t\u00e1c Kocher di \u0111\u1ed9ng to\u00e0n b\u1ed9 t\u00e1 tr\u00e0ng kh\u1ecfi ph\u00fac m\u1ea1c th\u00e0nh sau. C\u1eaft t\u00fai m\u1eadt, lu\u1ed3n \u1ed1ng nh\u1ef1a qua \u1ed1ng c\u1ed5 t\u00fai m\u1eadt, qua \u1ed1ng m\u1eadt ch\u1ee7 xu\u1ed1ng t\u00e1 tr\u00e0ng. S\u1edd \u0111\u1ea7u \u1ed1ng nh\u1ef1a qua th\u00e0nh t\u00e1 tr\u00e0ng \u0111\u1ec3 nh\u1eadn bi\u1ebft nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn.<\/p>\n

–\u00a0B\u01b0\u1edbc 3:\u00a0<\/b>C\u1eaft r\u1eddi n\u1eeda d\u01b0\u1edbi t\u00e1 tr\u00e0ng kh\u1ecfi \u0111\u1ea7u t\u1ee5y b\u1eaft \u0111\u1ea7u t\u1eeb nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn b\u1eb1ng c\u00e1ch ph\u1eabu t\u00edch c\u00e1c nh\u00e1nh m\u1ea1ch t\u00e1 t\u1ee5y (n\u00ean d\u00f9ng da si\u00eau \u00e2m ho\u1eb7c dao Ligasure). C\u1eaft \u0111\u00f4i d\u1ea1 d\u00e0y c\u00e1ch m\u00f4n v\u1ecb kho\u1ea3ng 5 cm (ph\u1ee5 thu\u1ed9c m\u1ee9c \u0111\u1ed9 lan t\u1ecfa c\u1ee7a u t\u00e1 tr\u00e0ng). N\u00e2ng m\u1ecfm c\u1eaft d\u01b0\u1edbi c\u1ee7a d\u1ea1 d\u00e0y l\u00ean, c\u1eaft r\u1eddi n\u1eeda tr\u00ean c\u1ee7a t\u00e1 tr\u00e0ng kh\u1ecfi \u0111\u1ea7u t\u1ee5y (n\u00ean d\u00f9ng dao si\u00eau \u00e2m ho\u1eb7c dao Ligasure), t\u00ecm v\u00e0 th\u1eaft \u1ed1ng Santorini b\u1eb1ng nhi\u1ec1u m\u0169i kh\u00e2u ch\u1ec9 kh\u00f4ng ti\u00eau 3\/ ho\u1eb7c 4\/0. C\u1eaft \u0111\u00f4i quai h\u1ed7ng tr\u00e0ng \u0111\u1ea7u ti\u00ean, t\u00e1ch r\u1eddi ho\u00e0n to\u00e0n n\u1eeda d\u01b0\u1edbi t\u00e1 tr\u00e0ng kh\u1ecfi \u0111\u1ea7u t\u1ee5y.<\/p>\n

–\u00a0B\u01b0\u1edbc 4<\/b>: T\u1ea1i v\u1ecb tr\u00ed nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn, c\u1eaft l\u1edbp d\u01b0\u1edbi ni\u00eam m\u1ea1c quanh nh\u00fa t\u00e1 tr\u00e0ng (m\u1ed9t tay v\u1eabn nh\u1eadn bi\u1ebft \u1ed1ng nh\u1ef1a lu\u1ed3n qua \u1ed1ng m\u1eadt ch\u1ee7 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed c\u1ee7a nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn). Nh\u01b0 v\u1eady s\u1ebd b\u1ea3o t\u1ed3n \u0111\u01b0\u1ee3c m\u1ed9t ph\u1ea7n t\u1ed5 ch\u1ee9c d\u01b0\u1edbi ni\u00eam m\u1ea1c v\u00e0 l\u1edbp c\u01a1 quanh nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn<\/p>\n

–\u00a0B\u01b0\u1edbc 5:\u00a0<\/b>Ph\u1ee5c h\u1ed3i l\u01b0u th\u00f4ng ti\u00eau h\u00f3a ki\u1ec3u Billroth I ho\u1eb7c II:<\/p>\n

. Mi\u1ec7ng n\u1ed1i nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn – h\u1ed7ng tr\u00e0ng: \u0111\u00e2y l\u00e0 th\u00ec quan tr\u1ecdng nh\u1ea5t c\u1ee7a ph\u1eabu thu\u1eadt. D\u00f9ng dao nh\u1ecdn c\u1eaft m\u1edf 8 mm nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn \u1edf v\u1ecb tr\u00ed th\u00e0nh \u0111\u1ed1i di\u1ec7n v\u1edbi l\u1ed7 \u0111\u1ed5 \u1ed1ng t\u1ee5y ch\u00ednh (c\u1eaft c\u01a1 Oddi). Lu\u1ed3n 1 \u1ed1ng nh\u1ef1a v\u00e0o \u1ed1ng t\u1ee5y ch\u00ednh \u0111\u1ec3 b\u1ea3o \u0111\u1ea3m kh\u00f4ng kh\u00e2u h\u1eb9p \u1ed1ng t\u1ee5y ch\u00ednh khi l\u00e0m mi\u1ec7ng n\u1ed1i. N\u1ed1i ch\u1ed7 c\u1eaft m\u1edf nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn v\u1edbi h\u1ed7ng tr\u00e0ng s\u1eed d\u1ee5ng ch\u1ec9 ti\u00eau 5\/0 m\u0169i r\u1eddi. Ph\u1ea7n \u0111\u1ea7u t\u1ee5y li\u1ec1n v\u1edbi b\u1edd trong t\u00e1 tr\u00e0ng \u0111\u01b0\u1ee3c kh\u00e2u v\u1edbi thanh m\u1ea1c quai h\u1ed7ng tr\u00e0ng b\u1eb1ng ch\u1ec9 4\/0 m\u0169i r\u1eddi.<\/p>\n

. Mi\u1ec7ng n\u1ed1i d\u1ea1 d\u00e0y – h\u1ed7ng tr\u00e0ng c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n theo Billroth I (n\u1ed1i m\u1ecfm d\u1ea1 d\u00e0y v\u1edbi h\u1ed7ng tr\u00e0ng \u1edf 10 cm ph\u00eda tr\u00ean mi\u1ec7ng n\u1ed1i nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn – h\u1ed7ng tr\u00e0ng) ho\u1eb7c II (n\u1ed1i m\u1ecfm d\u1ea1 d\u00e0y v\u1edbi quai h\u1ed7ng tr\u00e0ng \u1edf 30 cm d\u01b0\u1edbi mi\u1ec7ng n\u1ed1i nh\u00fa t\u00e1 tr\u00e0ng l\u1edbn – h\u1ed7ng tr\u00e0ng, n\u1ed1i qua m\u1ea1c treo \u0111\u1ea1i tr\u00e0ng ngang)<\/p>\n

–\u00a0B\u01b0\u1edbc 6<\/b>: ki\u1ec3m tra, \u0111\u1eb7t d\u1eabn l\u01b0u, \u0111\u00f3ng b\u1ee5ng.<\/p>\n

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

– Ch\u1ea3y m\u00e1u trong \u1ed5 b\u1ee5ng: th\u01b0\u1eddng trong 48h \u0111\u1ea7u ho\u1eb7c nh\u1eefng ng\u00e0y ti\u1ebfp theo. Ch\u1ea3y m\u00e1u \u0111\u1ecf t\u01b0\u01a1i, s\u1ed1 l\u01b0\u1ee3ng nhi\u1ec1u qua d\u1eabn l\u01b0u, to\u00e0n tr\u1ea1ng thay \u0111\u1ed5i (nh\u1ee3t, lo \u00e2u, m\u1ea1ch nhanh, huy\u1ebft \u00e1p h\u1ea1) c\u1ea7n m\u1ed5 l\u1ea1i ki\u1ec3m tra, c\u1ea7m m\u00e1u.<\/p>\n

– Theo d\u00f5i \u00e1p xe t\u1ed3n d\u01b0, theo d\u00f5i t\u00ecnh tr\u1ea1ng b\u1ee5c mi\u1ec7ng n\u1ed1i, nhi\u1ec5m tr\u00f9ng v\u1ebft m\u1ed5 \u0111\u1ec3 c\u00f3 ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p k\u1ecbp th\u1eddi.<\/p>\n

– Theo d\u00f5i t\u00ecnh tr\u1ea1ng chung: vi\u00eam ph\u1ed5i\u2026<\/p>\n

– Truy\u1ec1n d\u1ecbch: t\u00ednh \u0111\u1ee7 n\u0103ng l\u01b0\u1ee3ng, l\u01b0\u1ee3ng d\u1ecbch v\u00e0o cho t\u1eebng ng\u01b0\u1eddi b\u1ec7nh c\u1ee5 th\u1ec3.<\/p>\n

– Kh\u00e1ng sinh: s\u1eed d\u1ee5ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng ho\u1eb7c s\u1eed d\u1ee5ng kh\u00e1ng sinh \u0111i\u1ec1u tr\u1ecb khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh, t\u00f9y thu\u1ed9c ho\u00e0n c\u1ea3nh c\u1ee5 th\u1ec3.<\/p>\n

K\u1ebft qu\u1ea3 c\u1ee7a ph\u1eabu thu\u1eadt c\u1eaft t\u00e1 tr\u00e0ng b\u1ea3o t\u1ed3n \u0111\u1ea7u t\u1ee5y c\u00f3 th\u1ec3 kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3. Tuy nhi\u00ean, c\u00e1c c\u1eadp nh\u1eadp v\u00e0 ti\u1ebfn b\u1ed9 trong k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1ebd gi\u00fap c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 cho b\u1ec7nh nh\u00e2n c\u00f3 u \u1edf t\u00e1 tr\u00e0ng ho\u1eb7c b\u1ecb ch\u1ea5n th\u01b0\u01a1ng t\u00e1 tr\u00e0ng c\u1ea7n ph\u1eabu thu\u1eadt c\u1ea5p c\u1ee9u \u0111\u1ec3 x\u1eed tr\u00ed k\u1ecbp th\u1eddi v\u00e0 nhanh ch\u00f3ng.<\/p>\n

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

Ph\u1eabu thu\u1eadt c\u1eaft to\u00e0n b\u1ed9 t\u00e1 tr\u00e0ng b\u1ea3o t\u1ed3n \u0111\u1ea7u t\u1ee5y l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 b\u1edfi Chung v\u00e0 c\u1ed9ng s\u1ef1 n\u0103m 1994. K\u1ec3 t\u1eeb \u0111\u00f3, k\u1ef9 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh lan t\u1ecfa c\u1ee7a t\u00e1 tr\u00e0ng nh\u01b0ng ch\u01b0a lan v\u00e0o \u0111\u1ea7u t\u1ee5y, ch\u1ee7 y\u1ebfu l\u00e0 b\u1ec7nh \u0111a […]<\/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":"\nC\u1eadp nh\u1eadp ph\u1eabu thu\u1eadt c\u1eaft t\u00e1 tr\u00e0ng b\u1ea3o t\u1ed3n \u0111\u1ea7u t\u1ee5y - Vinmec<\/title>\n<meta name=\"description\" content=\"Ph\u1eabu thu\u1eadt c\u1eaft to\u00e0n b\u1ed9 t\u00e1 tr\u00e0ng b\u1ea3o t\u1ed3n \u0111\u1ea7u t\u1ee5y l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 b\u1edfi Chung v\u00e0 c\u1ed9ng s\u1ef1 n\u0103m 1994. 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