{"id":3073,"date":"2023-04-09T23:32:10","date_gmt":"2023-04-09T16:32:10","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=3073"},"modified":"2023-04-10T09:59:45","modified_gmt":"2023-04-10T02:59:45","slug":"chan-doan-va-dieu-tri-hoi-chung-ong-co-tay","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay"},"content":{"rendered":"<p><strong>H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf c\u1ed5 tay, do s\u1ef1 ch\u00e8n \u00e9p ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a d\u00e2y ch\u1eb1ng v\u00e0 d\u00e2y th\u1ea7n kinh \u1edf khu v\u1ef1c \u1ed1ng c\u1ed5 tay. B\u1ec7nh n\u00e0y th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng ng\u01b0\u1eddi th\u01b0\u1eddng xuy\u00ean ph\u1ea3i s\u1eed d\u1ee5ng c\u1ed5 tay, v\u00ed d\u1ee5 nh\u01b0 nh\u1eefng ng\u01b0\u1eddi l\u00e0m vi\u1ec7c v\u0103n ph\u00f2ng, nh\u1eefng ng\u01b0\u1eddi ch\u01a1i th\u1ec3 thao ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi \u0111eo \u0111\u1ed3ng h\u1ed3 qu\u00e1 l\u00e2u. B\u00e0i vi\u1ebft n\u00e0y, ch\u00fang t\u00f4i s\u1ebd \u0111\u01b0a ra nh\u1eefng tri\u1ec7u ch\u1ee9ng gi\u00fap ch\u1ea9n \u0111o\u00e1n v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay.<\/strong><\/p>\n<p><strong>T\u00e1c gi\u1ea3:<\/strong> PGS.TS. Tr\u1ea7n Trung D\u0169ng<\/p>\n<p>Ch\u1ea9n \u0111o\u00e1n l\u00e0 qu\u00e1 tr\u00ecnh x\u00e1c \u0111\u1ecbnh b\u1ec7nh l\u00fd d\u1ef1a tr\u00ean c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a c\u00e1c b\u00e0i ki\u1ec3m tra v\u00e0 x\u00e9t nghi\u1ec7m. M\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n ph\u1ed5 bi\u1ebfn bao g\u1ed3m:<\/p>\n<h2><strong><u>1. Ch\u1ea9n \u0111o\u00e1n h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay (HCOCT)<\/u><\/strong><\/h2>\n<h3><strong>1.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh: <\/strong><\/h3>\n<p>Ph\u1ed1i h\u1ee3p gi\u1eefa l\u00e2m s\u00e0ng v\u00e0 th\u0103m d\u00f2 \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh.<\/p>\n<p><em><strong>Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/strong><\/em><\/p>\n<p>HCOCT: B\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c ti\u00eau chu\u1ea9n:<\/p>\n<p>+ C\u00f3 \u00edt nh\u1ea5t m\u1ed9t trong c\u1ed1c tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng bao g\u1ed3m \u0111au c\u1ed5 tay, d\u1ecb c\u1ea3m b\u00e0n tay, t\u00ea b\u00ec b\u00e0n tay, gi\u1ea3m ho\u1eb7c m\u1ea5t c\u1ea3m gi\u00e1c v\u00f9ng th\u1ea7n kinh gi\u1eefa chi ph\u1ed1i v\u00e0 y\u1ebfu t\u1ed1 b\u00e0n tay, c\u00f3 th\u1ec3 x\u1ea3y ra ban ng\u00e0y, ban \u0111\u00eam ho\u1eb7c li\u00ean t\u1ee5c c\u1ea3 ng\u00e0y,<\/p>\n<p>+ C\u00f3 \u00edt nh\u1ea5t m\u1ed9t tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3 bao g\u1ed3m nghi\u1ec7m ph\u00e1p Phalen, Tinel, Durkan d\u01b0\u01a1ng t\u00ednh.<\/p>\n<p>+ C\u00f3 \u00edt nh\u1ea5t m\u1ed9t trong 2 ch\u1ec9 s\u1ed1 hi\u1ec7u ti\u1ec1m v\u1eadn \u0111\u1ed9ng v\u00e0 c\u1ea3m gi\u00e1c th\u1ea7n kinh gi\u1eefa v\u1edbi th\u1ea7n kinh tr\u1ee5 cao h\u01a1n ch\u1ec9 s\u1ed1 b\u00ecnh th\u01b0\u1eddng.<\/p>\n<ul>\n<li>Hi\u1ec7u ti\u1ec1m v\u1eadn \u0111\u1ed9ng th\u1ea7n kinh gi\u1eefa &#8211; th\u1ea7n kinh tr\u1ee5 l\u1edbn h\u01a1n 1,25 ms.<\/li>\n<li>Hi\u1ec7u ti\u1ec1m v\u1eadn \u0111\u1ed9ng c\u1ea3m gi\u00e1c th\u1ea7n kinh gi\u1eefa &#8211; tr\u1ee5 l\u1edbn h\u01a1n 0,79 ms.<\/li>\n<\/ul>\n<h3><strong>1.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/strong><\/h3>\n<p><strong>Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong> l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh, trong \u0111\u00f3 b\u00e1c s\u0129 ph\u00e2n bi\u1ec7t gi\u1eefa hai ho\u1eb7c nhi\u1ec1u t\u00ecnh tr\u1ea1ng c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a m\u1ed9t ng\u01b0\u1eddi. Khi ch\u1ea9n \u0111o\u00e1n, b\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u01b0a ra m\u1ed9t gi\u1ea3 thuy\u1ebft duy nh\u1ea5t v\u1ec1 nguy\u00ean nh\u00e2n g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a m\u1ed9t ng\u01b0\u1eddi. Sau \u0111\u00f3, b\u00e1c s\u0129 c\u00f3 th\u1ec3 y\u00eau c\u1ea7u c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 x\u00e1c nh\u1eadn ch\u1ea9n \u0111o\u00e1n nghi ng\u1edd.<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0 C\u00e1c b\u1ec7nh l\u00fd c\u1ee7a c\u1ed9t s\u1ed1ng c\u1ed5 nh\u01b0 b\u1ec7nh <a href=\"http:\/\/Vinmec.com\">tho\u00e1i h\u00f3a &#8211; tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m<\/a>:<\/p>\n<p>+ B\u1ec7nh c\u1ee7a d\u00e2y th\u1ea7n kinh nh\u01b0 vi\u00eam d\u00e2y th\u1ea7n kinh trong b\u1ec7nh l\u00fd ti\u1ec3u \u0111\u01b0\u1eddng, b\u1ec7nh tuy\u1ebfn gi\u00e1p: x\u00e9t nghi\u1ec7m \u0111\u01b0\u1eddng m\u00e1u, hormon tuy\u1ebfn gi\u00e1p v\u00e0 si\u00eau \u00e2m tuy\u1ebfn gi\u00e1p \u0111\u1ed5 ch\u1ea9n \u0111o\u00e1n.<\/p>\n<p>+ Ch\u00e8n \u00e9p sau ch\u1ea5n th\u01b0\u01a1ng: c\u00f3 ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay, t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay.<\/p>\n<p>+ Th\u1ea7n kinh: X quang, c\u1ed9ng h\u01b0\u1edfng t\u1eeb c\u1ed9t s\u1ed1ng d\u00ea ch\u1ea9n \u0111o\u00e1n. H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay c\u0169ng c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n song song v\u1edbi b\u1ec7nh tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng c\u1ed5 (khi \u0111\u00f3 g\u1ecdi l\u00e0 h\u1ed9i ch\u1ee9ng Upton-McComas), do v\u1eady n\u1ebfu th\u1ea5y b\u1ec7nh nh\u00e2n b\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay th\u00ec ch\u01b0a lo\u1ea1i tr\u1eeb tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng c\u1ed5 v\u00e0 ng\u01b0\u1ee3c l\u1ea1i.<\/p>\n<p>+ Kh\u1ed1i u th\u1ea7n kinh: s\u1eed d\u1ee5ng si\u00eau \u00e2m, c\u1ed9ng h\u01b0\u1edfng t\u1eeb ch\u1ea9n \u0111o\u00e1n.<\/p>\n<h2><strong>2. \u0110i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay<\/strong><\/h2>\n<h3><strong>2.1. \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/strong><\/h3>\n<p><strong><em>a. Ch\u1ec9 \u0111\u1ecbnh<\/em><\/strong><\/p>\n<p>\u0110\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong giai \u0111o\u1ea1n \u0111\u1ea7u, HCOCT tr\u00ean l\u00e2m s\u00e0ng \u1edf\u1edf giai \u0111o\u1ea1n nh\u1eb9, tr\u00ean \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh \u1edf giai \u0111o\u1ea1n 1,11, tr\u00ean si\u00eau \u00e2m \u1edf giai \u0111o\u1ea1n nh\u1eb9 [1],[2]&gt;[3],[4].<\/p>\n<p><strong><em>b. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb<\/em><\/strong><\/p>\n<p>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng:<\/p>\n<ul>\n<li>H\u1ea1n ch\u1ebf c\u00e1c v\u1eadn \u0111\u1ed9ng l\u00e0m g\u1ea5p ho\u1eb7c ng\u1eeda c\u1ed5 tay qu\u00e1 m\u1ee9c. Nh\u1eefng t\u01b0 th\u1ebf n\u00e0y s\u1ebd l\u00e0m \u00e1p l\u1ef1c trong \u1ed1ng c\u1ed5 tay t\u0103ng l\u00ean. D\u00f9ng n\u1eb9p c\u1ed5 tay: c\u00f3 th\u1ec3 d\u00f9ng v\u00e0o ban \u0111\u00eam ho\u1eb7c d\u00f9ng li\u00ean t\u1ee5c c\u1ea3 ng\u00e0y. Nh\u1eefng nghi\u00ean c\u1ee9u cho th\u1ea5y s\u1eed d\u1ee5ng n\u1eb9p c\u1ed5 tay c\u00f3 th\u1ebf l\u00e0m c\u1ea3i thi\u1ec7n \u0111\u01b0\u1ee3c c\u00e1c tri\u1ec7u ch\u1ee9ng sau 4 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<ul>\n<li>Corticosteroids v\u00e0 c\u00e1c thu\u1ed1c ch\u1ed1ng vi\u00eam.<\/li>\n<\/ul>\n<p>+ \u0110\u01b0\u1eddng u\u1ed1ng: d\u00f9ng thu\u1ed1c ch\u1ed1ng vi\u00eam phi steroid, ho\u1eb7c d\u00f9ng corticoid \u0111\u01b0\u1eddng u\u1ed1ng, m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u \u0111\u01b0a ra k\u1ebft qu\u1ea3 c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng t\u1ea1m th\u1eddi c\u1ee7a vi\u1ec7c d\u00f9ng Prednisolon \u0111\u01b0\u1eddng u\u1ed1ng. Tuy nhi\u00ean t\u00e1c d\u1ee5ng k\u00e9m h\u01a1n so v\u1edbi ti\u00eam t\u1ea1i ch\u1ed7 Steroid.<\/p>\n<p>+ Ti\u00eam corticoid v\u00e0o v\u00f9ng \u1ed1ng c\u1ed5 tay \u0111\u01b0\u1ee3c c\u00e1c t\u00e1c gi\u1ea3 nghi\u00ean c\u1ee9u nhi\u1ec1u, cho th\u1ea5y t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m qu\u00e1 tr\u00ecnh vi\u00eam, c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng nhanh v\u00e0 r\u00f5 r\u1ec7t. Trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng \u0111\u00e1p \u1ee9ng c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt.<\/p>\n<p>C\u00e1c ch\u1ebf ph\u1ea9m c\u00f3 Vitamin nh\u00f3m B c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p th\u00eam.<\/p>\n<h3><strong>2.2. \u0110i\u1ec1u tr\u1ecb ngo\u1ea1i khoa<\/strong><\/h3>\n<p>N\u1ed9i dung ph\u1eabu thu\u1eadt n\u1ed9i soi s\u1ebd \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y chi ti\u1ebft trong 1 b\u00e0i ri\u00eang, trong ph\u1ea1m vi b\u00e0i vi\u1ebft n\u00e0y ch\u1ec9 gi\u1edbi thi\u1ec7u c\u00e1c k\u1ef9 thu\u1eadt m\u1ed5 m\u1edf.<\/p>\n<p><strong><em>a.<\/em> <em>Ch\u1ec9 \u0111\u1ecbnh<\/em><\/strong><\/p>\n<p>&#8211;\u00a0\u00a0 B\u1ec7nh nh\u00e2n \u0111\u1ebfn kh\u1ea3m v\u1edbi d\u1ea5u hi\u1ec7u r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c, ph\u00e2n \u0111\u1ed9 l\u00e2m s\u00e0ng t\u1eeb m\u1ee9c \u0111\u1ed9 trung b\u00ecnh tr\u1edf l\u00ean (\u0111\u1ed9 II), teo c\u01a1 \u00f4 m\u00f4 c\u00e1i.<\/p>\n<ul>\n<li>Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng \u1ea3nh h\u01b0\u1edfng ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng d\u1ef1a tr\u00ean b\u1ea3ng \u0111i\u1ec3m Boston questionnaire t\u1eeb m\u1ee9c \u0111\u1ed9 trung b\u00ecnh tr\u1edf l\u00ean, k\u00e8m theo test Phalen 30s (+).<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa tr\u00ean 3 th\u00e1ng kh\u00f4ng c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng c\u01a1 t\u0103ng, \u0111i\u1ec3m Boston questionnaire, th\u1ef1c th\u1ec3.<\/li>\n<li>Ph\u00e2n \u0111\u1ed9 b\u1ea5t th\u01b0\u1eddng \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh t\u1eeb \u0111\u1ed9 2 tr\u1edf l\u00ean<\/li>\n<\/ul>\n<p><strong><em>b. K\u1ef9 thu\u1eadt m\u1ed5 m\u1edf kinh \u0111i\u1ec3n v\u1edbi \u0111\u01b0\u1eddng m\u1ed5 d\u1ecdc ngang tay<\/em><\/strong><\/p>\n<p><strong>b.1. Chu\u1ea9n b\u1ecb:<\/strong><\/p>\n<ul>\n<li>D\u1ee5ng c\u1ee5: B\u1ed9 d\u1ee5ng c\u1ee5 ph\u1eabu thu\u1eadt b\u00e0n tay c\u01a1 b\u1ea3n<\/li>\n<li>B\u1ec7nh nh\u00e2n: \u0110\u01b0\u1ee3c g\u00e2y m\u00ea ho\u1eb7c t\u00ea \u0111\u00e1m r\u1ed1i, n\u1eb1m ng\u1eeda tr\u00ean b\u00e0n m\u1ed5, tay d\u1ea1ng \u0111\u1ec3 tr\u00ean b\u00e0n, garo c\u00e1nh tay.<\/li>\n<\/ul>\n<p><strong>b.2.C\u00e1c b\u01b0\u1edbc ph\u1eabu thu\u1eadt:<\/strong><\/p>\n<ul>\n<li>R\u1ea1ch da d\u1ecdc tr\u01b0\u1edbc c\u1ed5 tay, th\u01b0\u1eddng theo n\u1ebfp l\u1eb1n d\u1ecdc \u1edf m\u1eb7t g\u00e2n c\u1ed5 tay. Ch\u00fa \u00fd nh\u00e1nh gan tay c\u1ee7a th\u1ea7n kinh gi\u1eefa t\u00e1ch ra tr\u00ean OCT, \u0111i n\u00f4ng d\u01b0\u1edbi da, t\u00e1ch c\u00e1c nh\u00e1nh, tr\u00e1nh l\u00e0m t\u1ed5n th\u01b0\u01a1ng g\u00e2y t\u00ea b\u00ec, \u0111au sau m\u1ed5.<\/li>\n<\/ul>\n<figure style=\"width: 729px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/i.imgur.com\/W5eFh03.png\" alt=\"H\u00ecnh 11.1: \u0110\u01b0\u1eddng m\u1ed5\" width=\"729\" height=\"449\" \/><figcaption class=\"wp-caption-text\">H\u00ecnh 11.1: \u0110\u01b0\u1eddng m\u1ed5<\/figcaption><\/figure>\n<figure style=\"width: 323px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/i.imgur.com\/P5cnxod.png\" alt=\"H\u00ecnh 11.2: C\u00e2n gan tay\" width=\"323\" height=\"243\" \/><figcaption class=\"wp-caption-text\">H\u00ecnh 11.2: C\u00e2n gan tay<\/figcaption><\/figure>\n<ul>\n<li>R\u1ea1ch c\u00e2n n\u00f4ng c\u1ed5 tay theo chi\u1ec1u d\u1ecdc, \u0111\u00e2y l\u00e0 l\u1edbp c\u00e2n n\u00f4ng ngay d\u01b0\u1edbi da, ch\u1ea1y theo chi\u1ec1u d\u1ecdc, n\u1ed5i ph\u00eda tr\u00ean v\u1edbi g\u00e2n gan tay d\u00e0i, ph\u00eda d\u01b0\u1edbi v\u1edbi c\u00e2n n\u00f4ng b\u00e0n tay. Qua l\u1edbp n\u00e0y nh\u00ecn th\u1ea5y TCL.<\/li>\n<li>B\u1ed9c l\u1ed9 TCL: l\u00e0 d\u00e2y ch\u1eb1ng c\u00f3 h\u01b0\u1edbng c\u00e1c s\u1ee3i x\u01a1 n\u1eb1m ngang, ch\u1eafc, d\u00e0y h\u01a1n l\u1edbp c\u00e2n. R\u1ea1ch d\u1ecdc d\u00e2y ch\u1eb1ng theo chi\u1ec1u v\u1ebft m\u1ed5 t\u1eeb tr\u00ean xu\u1ed1ng d\u01b0\u1edbi. Ch\u00fa \u00fd nh\u00e1nh v\u1eadn \u0111\u1ed9ng cho \u00f4 m\u00f4 c\u00e1i th\u01b0\u1eddng t\u00e1ch ngay b\u1edd d\u01b0\u1edbi d\u00e2y ch\u1eb1ng ngang, \u1edf b\u00ean b\u1edd quay. Nh\u00e1nh n\u00e0y c\u00f3 nhi\u1ec1u bi\u1ebfn th\u1ec3, c\u00f3 th\u1ebf t\u00e1ch ra tr\u00ean \u1ed1ng c\u1ed5 tay \u0111i v\u00e0o trong \u1ed1ng c\u1ed5 tay c\u00f9ng th\u1ea7n kinh gi\u1eefa, hay t\u00e1ch ra trong OCT, xuy\u00ean qua TCL v\u00e0o \u00f4 m\u00f4 c\u00e1i. Khi r\u1ea1ch xu\u1ed1ng d\u01b0\u1edbi c\u0169ng tr\u00e1nh kh\u00f4ng l\u00e0m t\u1ed5n th\u01b0\u01a1ng cung m\u1ea1ch gan tay n\u00f4ng, cung m\u1ea1c n\u00e0y n\u1eb1m c\u00e1ch b\u1edd d\u01b0\u1edbi TCL kho\u1ea3ng lem.<\/li>\n<\/ul>\n<figure style=\"width: 434px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/i.imgur.com\/1pwODqc.png\" alt=\"H\u00ecnh 11.33: Kh\u00e2u da [7]\" width=\"434\" height=\"270\" \/><figcaption class=\"wp-caption-text\">H\u00ecnh 11.33: Kh\u00e2u da [7]<\/figcaption><\/figure>\n<ul>\n<li>Ki\u1ec3m tra, c\u00f3 th\u1ebf c\u1eaft l\u1ecdc m\u00e0ng ho\u1ea1t d\u1ecbch vi\u00eam, l\u1ea5y u ch\u00e8n \u00e9p, g\u1ee1 d\u00ednh. Sau m\u1ed5 d\u00f9ng kh\u00e1ng sinh, gi\u1ea3m \u0111au, ch\u1ed1ng vi\u00eam. C\u00f3 th\u1ebf d\u00f9ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng. T\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng s\u1edbm sau m\u1ed5, tr\u00e1nh d\u00ednh g\u00e2n v\u00e0 th\u1ea7n kinh.<\/li>\n<\/ul>\n<p><strong>c. <em>M\u1ed5 m\u1edf \u00edt x\u00e2m l\u1ea5n v\u1edbi \u0111\u01b0\u1eddng m\u00f4 gan tay<\/em><\/strong><\/p>\n<ul>\n<li>Chu\u1ea9n b\u1ecb nh\u01b0 ph\u1eabu thu\u1eadt m\u1ed5 m\u1edf kinh \u0111i\u1ec3n.<\/li>\n<li>K\u1ef9 thu\u1eadt:<\/li>\n<\/ul>\n<p>+ \u0110\u01b0\u1eddng m\u1ed5: R\u1ea1ch d\u1ecdc 1.5-2cm<\/p>\n<p>+ Sau khi r\u1ea1ch da d\u00f9ng 2 van nh\u1ecf banh v\u1ebft m\u1ed5, s\u1ebd th\u1ea5y g\u00e2n c\u1ed5 tay g\u1ed3m c\u00e1c s\u1ee3i x\u01a1 ch\u1ea1y d\u1ecdc t\u1eeb tr\u00ean xu\u1ed1ng d\u01b0\u1edbi, r\u1ea1ch d\u1ecdc g\u00e2n v\u00e0 t\u00e1ch sang 2 b\u00ean s\u1ebd th\u1ea5y TLC l\u00e0 nh\u1eefng s\u1ee3i x\u01a1 m\u00e0u tr\u1eafng , c\u00e1c th\u1edb s\u1ee3i n\u1eb1m ngang, d\u00e0y, ch\u1eafc.<\/p>\n<p>+ R\u1ea1ch l\u1edbp TCL theo chi\u1ec1u r\u1ea1ch da h\u00e9t chi\u1ec1u d\u00e0y s\u1ebd th\u1ea5y th\u1ea7n kinh gi\u1eefa v\u00e0 c\u00e1c g\u00e2n g\u1ea5p.<\/p>\n<p>+ D\u00f9ng k\u00e9o c\u1eaft ng\u1ea7m TCL d\u01b0\u1edbi da h\u1ebft chi\u1ec1u d\u00e0i<\/p>\n<p>+ Kh\u00e2u da m\u1ed9t l\u1edbp.<\/p>\n<p>+ T\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng, sau m\u1ed5 d\u00f9ng kh\u00e1ng sinh, ch\u1ed1ng vi\u00eam gi\u1ea3m \u0111au.<\/p>\n<p><strong><em>d. M\u1ed5 m\u1edf \u00edt x\u00e2m l\u1ea5n v\u1edbi \u0111\u01b0\u1eddng m\u1ed5 gan tay<\/em><\/strong><\/p>\n<p>Sau khi ph\u1eabu thu\u1eadt n\u1ed9i soi \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u v\u00e0 th\u1ef1c hi\u1ec7n th\u00e0nh c\u00f4ng, m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 \u0111\u00e3 nghi\u00ean c\u1ee9u m\u1ed9t s\u1ed1 tr\u1ee3 c\u1ee5 \u0111\u1eb7c bi\u1ec7t \u0111\u1ed3 h\u1ed7 tr\u1ee3 cho ph\u1eabu thu\u1eadt \u00edt x\u00e2m l\u1ea5n, ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 ti\u1ebft ki\u1ec7m chi ph\u00ed h\u01a1n so v\u1edbi m\u1ed5 n\u1ed9i soi, m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u cho th\u1ea5y c\u1ea3i thi\u1ec7n t\u1ed1t v\u1ec1 l\u00e2m s\u00e0ng. Tuy nhi\u00ean c\u0169ng c\u00f3 m\u1ed9t s\u1ed1 b\u00e1o c\u00e1o v\u1ec1 m\u1ed9t s\u1ed1 bi\u1ebfn ch\u1ee9ng: t\u1ed5n th\u01b0\u01a1ng nh\u00e1nh c\u1ea3m gi\u00e1c gan tay, b\u1ecf m\u1ea1ch th\u1ea7n kinh tr\u1ee5, cung m\u1ea1ch gan tay n\u00f4ng, nh\u00e1nh v\u1eadn \u0111\u1ed9ng \u00f4 m\u00f4 c\u00e1i. C\u00f3 nhi\u1ec1u lo\u1ea1i tr\u1ee3 c\u1ee5 kh\u00e1c nhau, lay thu\u1ed9c v\u00e0o k\u1ef9 thu\u1eadt c\u1ee7a c\u00e1c t\u00e1c gi\u1ea3.<\/p>\n<p>K\u1ef9 thu\u1eadt: C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng m\u1ed5 nh\u1ecf \u1edf gan tay ho\u1eb7c n\u1ebfp tan c\u1ed5 tay, ho\u1eb7c hai \u0111\u01b0\u1eddng m\u1ed5 \u1edf c\u1ed5 tay v\u00e0 gan tay. \u0110i\u1ec3m chung c\u1ee7a c\u00e1c k\u1ef9 thu\u1eadt n\u00e0y l\u00e0 d\u00f9ng \u0111\u01b0\u1eddng m\u1ed5 nh\u1ecf b\u1ed9c l\u1ed9 OCT, t\u00e1ch TCL kh\u1ecfi c\u00e1c th\u00e0nh ph\u1ea7n xung quanh b\u1eb1ng d\u1ee5ng c\u1ee5 chuy\u00ean d\u1ee5ng, sau \u0111\u00f3 c\u1eaft ng\u1ea7m TCL b\u1eb1ng tr\u1ee3 c\u1ee5.<\/p>\n<p><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/i.imgur.com\/uem8gTG.png\" \/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf c\u1ed5 tay, do s\u1ef1 ch\u00e8n \u00e9p ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a d\u00e2y ch\u1eb1ng v\u00e0 d\u00e2y th\u1ea7n kinh \u1edf khu v\u1ef1c \u1ed1ng c\u1ed5 tay. B\u1ec7nh n\u00e0y th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng ng\u01b0\u1eddi th\u01b0\u1eddng xuy\u00ean ph\u1ea3i s\u1eed d\u1ee5ng c\u1ed5 tay, v\u00ed d\u1ee5 nh\u01b0 nh\u1eefng ng\u01b0\u1eddi l\u00e0m vi\u1ec7c [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[40],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf c\u1ed5 tay, do s\u1ef1 ch\u00e8n \u00e9p ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a d\u00e2y ch\u1eb1ng v\u00e0 d\u00e2y th\u1ea7n kinh \u1edf khu v\u1ef1c \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=\"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay - Vinmec\" \/>\n<meta property=\"og:description\" content=\"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf c\u1ed5 tay, do s\u1ef1 ch\u00e8n \u00e9p ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a d\u00e2y ch\u1eb1ng v\u00e0 d\u00e2y th\u1ea7n kinh \u1edf khu v\u1ef1c \u1ed1ng c\u1ed5 tay.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-09T16:32:10+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-10T02:59:45+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/i.imgur.com\/W5eFh03.png\" \/>\n<meta name=\"author\" content=\"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/\",\"url\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/\",\"name\":\"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-09T16:32:10+00:00\",\"dateModified\":\"2023-04-10T02:59:45+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/93244bcbae85b37711d0dde67f41b5f6\"},\"description\":\"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf c\u1ed5 tay, do s\u1ef1 ch\u00e8n \u00e9p ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a d\u00e2y ch\u1eb1ng v\u00e0 d\u00e2y th\u1ea7n kinh \u1edf khu v\u1ef1c \u1ed1ng c\u1ed5 tay.\",\"breadcrumb\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/93244bcbae85b37711d0dde67f41b5f6\",\"name\":\"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/1.gravatar.com\/avatar\/1b748902abde9a821c917fe33912a06a?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/1.gravatar.com\/avatar\/1b748902abde9a821c917fe33912a06a?s=96&d=mm&r=g\",\"caption\":\"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/phamvanhoa1612gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay - Vinmec","description":"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf c\u1ed5 tay, do s\u1ef1 ch\u00e8n \u00e9p ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a d\u00e2y ch\u1eb1ng v\u00e0 d\u00e2y th\u1ea7n kinh \u1edf khu v\u1ef1c \u1ed1ng c\u1ed5 tay.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay - Vinmec","og_description":"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf c\u1ed5 tay, do s\u1ef1 ch\u00e8n \u00e9p ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a d\u00e2y ch\u1eb1ng v\u00e0 d\u00e2y th\u1ea7n kinh \u1edf khu v\u1ef1c \u1ed1ng c\u1ed5 tay.","og_url":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/","og_site_name":"Vinmec","article_published_time":"2023-04-09T16:32:10+00:00","article_modified_time":"2023-04-10T02:59:45+00:00","og_image":[{"url":"https:\/\/i.imgur.com\/W5eFh03.png"}],"author":"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy","Est. reading time":"8 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/","url":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/","name":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-09T16:32:10+00:00","dateModified":"2023-04-10T02:59:45+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/93244bcbae85b37711d0dde67f41b5f6"},"description":"H\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p \u1edf c\u1ed5 tay, do s\u1ef1 ch\u00e8n \u00e9p ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a d\u00e2y ch\u1eb1ng v\u00e0 d\u00e2y th\u1ea7n kinh \u1edf khu v\u1ef1c \u1ed1ng c\u1ed5 tay.","breadcrumb":{"@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/09\/chan-doan-va-dieu-tri-hoi-chung-ong-co-tay\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/93244bcbae85b37711d0dde67f41b5f6","name":"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/1.gravatar.com\/avatar\/1b748902abde9a821c917fe33912a06a?s=96&d=mm&r=g","contentUrl":"http:\/\/1.gravatar.com\/avatar\/1b748902abde9a821c917fe33912a06a?s=96&d=mm&r=g","caption":"Nguy\u1ec5n H\u00f9ng Nh\u1eadt Duy"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/phamvanhoa1612gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/3073"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=3073"}],"version-history":[{"count":3,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/3073\/revisions"}],"predecessor-version":[{"id":3178,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/3073\/revisions\/3178"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=3073"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=3073"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=3073"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}