{"id":31424,"date":"2023-05-04T16:24:14","date_gmt":"2023-05-04T09:24:14","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31424"},"modified":"2023-05-04T16:24:14","modified_gmt":"2023-05-04T09:24:14","slug":"cap-nhap-ky-thuat-noi-soi-ruot-non-bong-don","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/cap-nhap-ky-thuat-noi-soi-ruot-non-bong-don\/","title":{"rendered":"C\u1eadp nh\u1eadp k\u1ef9 thu\u1eadt n\u1ed9i soi ru\u1ed9t non b\u00f3ng \u0111\u01a1n"},"content":{"rendered":"

K\u1ef9 thu\u1eadt n\u1ed9i soi ru\u1ed9t non b\u1eb1ng b\u00f3ng \u0111\u01a1n(Single Baloon Endoscopy) \u0111\u01b0\u1ee3c ph\u00e1t minh nh\u1eb1m h\u1ea1n ch\u1ebf th\u0103m kh\u00e1m ru\u1ed9t non, v\u00ec c\u00e1c m\u00e1y n\u1ed9i soi th\u00f4ng th\u01b0\u1eddng ch\u1ec9 c\u00f3 th\u1ec3 quan s\u00e1t \u0111\u01b0\u1ee3c \u0111\u1ebfn t\u00e1 tr\u00e0ng, n\u1ed9i soi ru\u1ed9t non b\u00f3ng \u0111\u01a1n \u0111i \u0111\u01b0\u1eddng mi\u1ec7ng c\u00f3 th\u1ec3 \u0111\u01b0a xu\u1ed1ng t\u1edbi g\u00f3c Treitz v\u00e0 \u0111i s\u00e2u xu\u1ed1ng t\u1edbi 80 cm. N\u1ed9i soi ru\u1ed9t non b\u00f3ng \u0111\u01a1n \u0111i qua h\u1eadu m\u00f4n c\u00f3 th\u1ec3 kh\u1eafc ph\u1ee5c h\u1ea1n ch\u1ebf c\u1ee7a n\u1ed9i soi \u0111\u1ea1i tr\u00e0ng, c\u00f3 th\u1ec3 v\u00e0o s\u00e2u kh\u1ea3o s\u00e1t ru\u1ed9t non qua van h\u1ed3i manh tr\u00e0ng.<\/span><\/strong><\/p>\n

\"\"<\/p>\n

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

– Sinh thi\u1ebft c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u1edf ru\u1ed9t non sau khi ti\u1ebfn h\u00e0nh n\u1ed9i soi b\u1eb1ng vi\u00ean nang ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c.<\/span><\/p>\n

– Ch\u1ea3y m\u00e1u do t\u1ed5n th\u01b0\u01a1ng nghi ng\u1edd t\u1eeb ru\u1ed9t non<\/span><\/p>\n

– Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u1ed5n th\u01b0\u01a1ng l\u00e0m h\u1eb9p ru\u1ed9t non<\/span><\/p>\n

– Ch\u1ea9n \u0111o\u00e1n kh\u1ed1i u ru\u1ed9t non<\/span><\/p>\n

– B\u1ec7nh Crohn<\/a> ru\u1ed9t non<\/span><\/p>\n

– \u0110i\u1ec1u tr\u1ecb l\u1ea5y d\u1ecb v\u1eadt \u1edf ru\u1ed9t non<\/span><\/p>\n

– Ph\u00e1t hi\u1ec7n c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y t\u1eafc ru\u1ed9t<\/a><\/span><\/p>\n

– Soi \u0111\u1ea1i tr\u00e0ng c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f3<\/span><\/p>\n

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

– Nghi ng\u1edd h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p<\/span><\/p>\n

– T\u0103ng huy\u1ebft \u00e1p ch\u01b0a ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c<\/span><\/p>\n

– Nghi ng\u1edd th\u1ee7ng t\u1ea1ng r\u1ed7ng<\/span><\/p>\n

– Nghi ng\u1edd ph\u00ecnh, t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/span><\/p>\n

– B\u1ec7nh nh\u00e2n (ng\u01b0\u1eddi b\u1ec7nh) trong t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p<\/span><\/p>\n

– B\u1ec7nh nh\u00e2n suy tim n\u1eb7ng<\/span><\/p>\n

– B\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n kh\u00f4ng h\u1ee3p t\u00e1c<\/span><\/p>\n

– Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng \u0111\u1ed1i: t\u1ee5t huy\u1ebft \u00e1p HA t\u00e2m thu < 90mmHg.<\/span><\/p>\n

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

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

– B\u00e1c s\u1ef9: 01 b\u00e1c s\u1ef9 \u0111\u00e3 c\u00f3 ch\u1ee9ng ch\u1ec9 t\u1ed1t nghi\u1ec7p n\u1ed9i soi Ti\u00eau h\u00f3a.<\/span><\/p>\n

– \u0110i\u1ec1u d\u01b0\u1ee1ng: 02<\/span><\/p>\n

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

– 01 h\u1ec7 th\u1ed1ng m\u00e1y n\u1ed9i soi b\u00f3ng \u0111\u01a1n bao g\u1ed3m: d\u00e2y soi SIF-Q180, 01 b\u00f3ng overtube.<\/span><\/p>\n

– M\u00e1y b\u01a1m CO<\/span>2<\/span><\/p>\n

– M\u00e1y C- arm.<\/span><\/p>\n

– M\u00e1y theo d\u00f5i lifescope v\u00e0 d\u1ee5ng c\u1ee5 c\u1ea5p c\u1ee9u: m\u1eb7t n\u1ea1, b\u00f3ng b\u00f3p, n\u1ed9i kh\u00ed qu\u1ea3n.<\/span><\/p>\n

– Thu\u1ed1c m\u00ea v\u00e0 ti\u1ec1n m\u00ea: midazolam 5mg: 2 \u1ed1ng, fantanyl 0,1 mg: 2 \u1ed1ng, propofol: 2 \u1ed1ng.<\/span><\/p>\n

– 01 k\u00ecm sinh thi\u1ebft.<\/span><\/p>\n

– 05 L\u1ecd \u0111\u1ef1ng b\u1ec7nh ph\u1ea9m.<\/span><\/p>\n

– B\u01a1m ti\u00eam 20 ml: 2 b\u01a1m.<\/span><\/p>\n

– G\u0103ng tay 6 \u0111\u00f4i.<\/span><\/p>\n

– \u00c1o m\u1ed5 02<\/span><\/p>\n

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

Chu\u1ea9n b\u1ecb ng\u01b0\u1eddi b\u1ec7nh<\/span><\/p>\n

– Gi\u1ea3i th\u00edch ng\u01b0\u1eddi b\u1ec7nh: m\u1ee5c \u0111\u00edch, tai bi\u1ebfn th\u1ee7 thu\u1eadt.<\/span><\/p>\n

– C\u00e1c ng\u01b0\u1eddi b\u1ec7nh nguy c\u01a1 cao: tu\u1ed5i > 60, nghi ng\u1edd c\u00f3 b\u1ec7nh l\u00fd tim- ph\u1ed5i m\u1ea1n t\u00ednh c\u1ea7n l\u00e0m th\u00eam x\u00e9t nghi\u1ec7m \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 v\u00e0 X quang tim ph\u1ed5i.<\/span><\/p>\n

– Chu\u1ea9n b\u1ecb n\u1ed9i soi b\u00f3ng k\u00e9p qua \u0111\u01b0\u1eddng mi\u1ec7ng ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n chu\u1ea9n b\u1ecb nh\u1ecbn \u0103n,<\/span><\/p>\n

– Chu\u1ea9n b\u1ecb n\u1ed9i soi b\u00f3ng k\u00e9p qua \u0111\u01b0\u1eddng h\u1eadu m\u00f4n ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c th\u1ee5t th\u00e1o, ho\u1eb7c u\u1ed1ng thu\u1ed1c l\u00e0m s\u1ea1ch \u0111\u1ea1i tr\u00e0ng: t\u1ed1i ng\u00e0y h\u00f4m tr\u01b0\u1edbc ti\u1ebfn h\u00e0nh n\u1ed9i soi b\u00f3ng k\u00e9p u\u1ed1ng sennoside tr\u01b0\u1edbc khi \u0111i ng\u1ee7, d\u00f9ng polyethylene glycol.<\/span><\/p>\n

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

– Ki\u1ec3m tra kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/span><\/p>\n

– Nh\u1eadn gi\u1ea5y ch\u1ec9 \u0111\u1ecbnh<\/span><\/p>\n

– Gi\u1ea3i th\u00edch b\u1ec7nh nh\u00e2n k\u00fd gi\u1ea5y \u0111\u1ed3ng \u00fd l\u00e0m th\u1ee7 thu\u1eadt<\/span><\/p>\n

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

– M\u1eddi ng\u01b0\u1eddi b\u1ec7nh v\u00e0o ph\u00f2ng, h\u01b0\u1edbng d\u1eabn ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m l\u00ean c\u00e1ng th\u1ee7 thu\u1eadt<\/span><\/p>\n

– M\u1eafc monitor theo d\u00f5i, theo ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129 soi.<\/span><\/p>\n

– Ti\u1ebfn h\u00e0nh g\u00e2y m\u00ea theo ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u1ef9<\/span><\/p>\n

– N\u1ed9i soi b\u00f3ng \u0111\u01a1n qua mi\u1ec7ng h\u01b0\u1edbng d\u1eabn BN n\u1eb1m t\u01b0 th\u1ebf nghi\u00eang tr\u00e1i, ch\u00e2n tr\u00ean co, ch\u00e2n d\u01b0\u1edbi du\u1ed7i. Cho BN ng\u1eadm canuyl. B\u1eaft \u0111\u1ea7u \u0111\u01b0a m\u00e1y soi v\u00e0 b\u00f3ng c\u00f3 b\u00f4i tr\u01a1n Xylocaine jelly qua \u0111\u01b0\u1eddng mi\u1ec7ng, khi m\u00e1y soi v\u00e0o d\u1ea1 d\u00e0y h\u00fat h\u01a1i v\u00e0 d\u1ecbch d\u1ea1 d\u00e0y tr\u00e1nh \u0111\u1ec3 cu\u1ed9n m\u00e1y, khi m\u00e1y n\u1ed9i soi t\u1edbi hang v\u1ecb \u0111\u01b0a overtube v\u00e0o hang v\u1ecb, sau \u0111\u00f3 \u0111\u01b0a m\u00e1y n\u1ed9i soi \u0111\u1ebfn \u0111o\u1ea1n ba t\u00e1 tr\u00e0ng. Ti\u1ebfp t\u1ee5c \u0111\u01b0a overtube \u0111\u1ebfn \u0111o\u1ea1n ba t\u00e1 tr\u00e0ng, sau \u0111\u00f3 b\u01a1m b\u00f3ng v\u00e0 c\u1ed1 \u0111\u1ecbnh overtube \u1edf \u0111o\u1ea1n ba t\u00e1 tr\u00e0ng, r\u1ed3i b\u1eaft \u0111\u1ea7u r\u00fat m\u00e1y v\u00e0 overtube \u0111\u1ec3 l\u00e0m ng\u1eafn ru\u1ed9t, sau \u0111\u00f3 ti\u1ebfp t\u1ee5c \u0111\u1ea9y m\u00e1y soi v\u00e0o g\u00f3c Treitz v\u00e0 h\u1ed7ng tr\u00e0ng, c\u1ed1 \u0111\u1ecbnh \u0111\u1ea7u m\u00e1y soi \u1edf \u0111\u00e2y, ti\u1ebfp t\u1ee5c th\u00e1o h\u01a1i b\u00f3ng r\u1ed3i \u0111\u1ea9y overtube theo m\u00e1y n\u1ed9i soi v\u00e0o h\u1ed3i tr\u00e0ng. C\u1ee9 theo nguy\u00ean t\u1eafc \u0111\u1ea9y v\u00e0 r\u00fat m\u00e1y nh\u01b0 v\u1eady s\u1ebd ti\u1ebfp t\u1ee5c n\u1ed9i soi \u0111\u1ebfn h\u1ebft ru\u1ed9t non v\u00e0 quan s\u00e1t ni\u00eam m\u1ea1c ru\u1ed9t non. Ra y l\u1ec7nh ch\u1ee5p \u1ea3nh minh h\u1ecda t\u1ed5n th\u01b0\u01a1ng, ho\u1eb7c sinh thi\u1ebft n\u1ebfu c\u1ea7n.<\/span><\/p>\n

<\/span><\/p>\n

H\u00ecnh 1. H\u00ecnh \u1ea3nh minh h\u1ecda c\u00e1c b\u01b0\u1edbc n\u1ed9i soi b\u00f3ng \u0111\u01a1n qua \u0111\u01b0\u1eddng mi\u1ec7ng<\/span><\/p>\n

– N\u1ed9i soi b\u00f3ng \u0111\u01a1n qua \u0111\u01b0\u1eddng h\u1eadu m\u00f4n c\u0169ng theo nguy\u00ean t\u1eafc \u0111\u1ea9y v\u00e0 r\u00fat m\u00e1y ph\u1ed1i h\u1ee3p v\u1edbi thay \u0111\u1ed5i t\u01b0 th\u1ebf ng\u01b0\u1eddi b\u1ec7nh khi c\u1ea7n thi\u1ebft, \u0111\u01b0a m\u00e1y qua \u0111\u1ea1i tr\u00e0ng v\u00e0 van h\u1ed3i manh tr\u00e0ng \u0111\u1ebfn v\u1ecb tr\u00ed ru\u1ed9t non quan s\u00e1t ni\u00eam m\u1ea1c \u0111\u1ea1i tr\u00e0ng v\u00e0 ni\u00eam m\u1ea1c ru\u1ed9t non.<\/span><\/p>\n

– Theo d\u00f5i to\u00e0n tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh trong to\u00e0n b\u1ed9 qu\u00e1 tr\u00ecnh l\u00e0m th\u1ee7 thu\u1eadt.<\/span><\/p>\n

– Sau khi k\u1ebft th\u00fac th\u1ee7 thu\u1eadt, \u0111\u00e1nh v\u00e0 in k\u1ebft qu\u1ea3<\/span><\/p>\n

– Sau khi b\u00e1c s\u0129 k\u1ebft th\u00fac qu\u00e1 tr\u00ecnh n\u1ed9i soi, \u0111i\u1ec1u d\u01b0\u1ee1ng ph\u1ea3i gi\u00fap ng\u01b0\u1eddi b\u1ec7nh lau mi\u1ec7ng, \u0111\u1ee1 ng\u01b0\u1eddi b\u1ec7nh d\u1eady v\u00e0 \u0111\u01b0a ng\u01b0\u1eddi b\u1ec7nh ra kh\u1ecfi ph\u00f2ng n\u1ed9i soi t\u1edbi n\u01a1i ng\u1ed3i ch\u1edd.<\/span><\/p>\n

– H\u01b0\u1edbng d\u1eabn ng\u01b0\u1eddi b\u1ec7nh b\u1ed5 sung th\u00eam phi\u1ebfu x\u00e9t nghi\u1ec7m sinh thi\u1ebft n\u1ebfu c\u1ea7n.<\/span><\/p>\n

– \u0110i\u1ec1u d\u01b0\u1ee1ng r\u1eeda m\u00e1y theo quy tr\u00ecnh k\u1ef9 thu\u1eadt.<\/span><\/p>\n

– Tr\u1ea3 k\u1ebft qu\u1ea3 n\u1ed9i soi cho ng\u01b0\u1eddi b\u1ec7nh.<\/span><\/p>\n

5. Theo d\u00f5i<\/span><\/b><\/h2>\n

Theo d\u00f5i to\u00e0n tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh trong qu\u00e1 tr\u00ecnh l\u00e0m th\u1ee7 thu\u1eadt.<\/span><\/p>\n

Theo d\u00f5i t\u00ecnh tr\u1ea1ng th\u00e0nh b\u1ee5ng v\u00e0 \u1ec9a m\u00e1u (v\u00ec hai bi\u1ebfn ch\u1ee9ng hay g\u1eb7p l\u00e0 th\u1ee7ng ru\u1ed9t non v\u00e0 ch\u1ea3y m\u00e1u ru\u1ed9t non)<\/span><\/p>\n

6. X\u1eed tr\u00ed tai bi\u1ebfn<\/span><\/b><\/h2>\n

Ph\u00e1t hi\u1ec7n v\u00e0 x\u1eed tr\u00ed c\u00e1c bi\u1ebfn ch\u1ee9ng ch\u1ea3y m\u00e1u khi l\u1ea5y b\u1ec7nh ph\u1ea9m, m\u1ea1ch ch\u1eadm ho\u1eb7c ng\u1eebng tim do c\u01b0\u1eddng ph\u1ebf v\u1ecb, bi\u1ebfn ch\u1ee9ng th\u1ee7ng ru\u1ed9t non, ghi v\u00e0o phi\u1ebfu tr\u1ea3 k\u1ebft qu\u1ea3 ho\u1eb7c cho BN nh\u1eadp vi\u1ec7n x\u1eed tr\u00ed ti\u1ebfp t\u00f9y thu\u1ed9c t\u1eebng bi\u1ebfn ch\u1ee9ng.<\/span><\/p>\n

T\u00f3m l\u1ea1i, k\u1ef9 thu\u1eadt n\u1ed9i soi ru\u1ed9t non b\u00f3ng \u0111\u01a1n l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ti\u00ean ti\u1ebfn cho c\u00e1c b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, v\u1edbi nhi\u1ec1u \u01b0u \u0111i\u1ec3m nh\u01b0 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c, \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c c\u00e1c khu v\u1ef1c kh\u00f3 ti\u1ebfp c\u1eadn, gi\u1ea3m thi\u1ec3u nguy c\u01a1 nhi\u1ec5m tr\u00f9ng, \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 v\u00e0 gi\u1ea3m \u0111au \u0111\u1edbn v\u00e0 kh\u00f3 ch\u1ecbu cho b\u1ec7nh nh\u00e2n. V\u00ec v\u1eady hi\u1ec7n nay ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111ang \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng r\u1ed9ng r\u00e3i trong n\u01b0\u1edbc v\u00e0 th\u1ebf gi\u1edbi.<\/p>\n

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

K\u1ef9 thu\u1eadt n\u1ed9i soi ru\u1ed9t non b\u1eb1ng b\u00f3ng \u0111\u01a1n(Single Baloon Endoscopy) \u0111\u01b0\u1ee3c ph\u00e1t minh nh\u1eb1m h\u1ea1n ch\u1ebf th\u0103m kh\u00e1m ru\u1ed9t non, v\u00ec c\u00e1c m\u00e1y n\u1ed9i soi th\u00f4ng th\u01b0\u1eddng ch\u1ec9 c\u00f3 th\u1ec3 quan s\u00e1t \u0111\u01b0\u1ee3c \u0111\u1ebfn t\u00e1 tr\u00e0ng, n\u1ed9i soi ru\u1ed9t non b\u00f3ng \u0111\u01a1n \u0111i \u0111\u01b0\u1eddng mi\u1ec7ng c\u00f3 th\u1ec3 \u0111\u01b0a xu\u1ed1ng t\u1edbi g\u00f3c Treitz v\u00e0 \u0111i […]<\/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 k\u1ef9 thu\u1eadt n\u1ed9i soi ru\u1ed9t non b\u00f3ng \u0111\u01a1n - Vinmec<\/title>\n<meta name=\"description\" content=\"K\u1ef9 thu\u1eadt n\u1ed9i soi ru\u1ed9t non b\u1eb1ng b\u00f3ng \u0111\u01a1n(Single Baloon Endoscopy) \u0111\u01b0\u1ee3c ph\u00e1t minh nh\u1eb1m h\u1ea1n ch\u1ebf th\u0103m kh\u00e1m ru\u1ed9t non, v\u00ec c\u00e1c m\u00e1y n\u1ed9i soi ...\" \/>\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=\"C\u1eadp nh\u1eadp k\u1ef9 thu\u1eadt n\u1ed9i soi ru\u1ed9t non b\u00f3ng \u0111\u01a1n - 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