{"id":31430,"date":"2023-05-04T16:25:23","date_gmt":"2023-05-04T09:25:23","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31430"},"modified":"2023-05-04T16:25:23","modified_gmt":"2023-05-04T09:25:23","slug":"noi-soi-can-thiep-trong-dat-stent-ong-tieu-hoa","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/noi-soi-can-thiep-trong-dat-stent-ong-tieu-hoa\/","title":{"rendered":"N\u1ed9i soi can thi\u1ec7p trong \u0111\u1eb7t stent \u1ed1ng ti\u00eau h\u00f3a"},"content":{"rendered":"

N\u1ed9i soi can thi\u1ec7p (NSCT) \u0111\u1eb7t stent \u1ed1ng ti\u00eau h\u00f3a l\u00e0 ti\u1ebfn h\u00e0nh \u0111\u01b0a stent kim lo\u1ea1i v\u00e0o v\u1ecb tr\u00ed h\u1eb9p c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a qua \u0111\u01b0\u1eddng n\u1ed9i soi v\u1edbi m\u1ee5c \u0111\u00edch t\u00e1i l\u1eadp l\u1ea1i l\u01b0u th\u00f4ng c\u1ee7a \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Ph\u1ea7n l\u1edbn k\u1ef9 thu\u1eadt n\u00e0y ti\u1ebfn h\u00e0nh trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p h\u1eb9p do nguy\u00ean nh\u00e2n \u00e1c t\u00ednh.<\/span><\/strong><\/p>\n

\"\"<\/p>\n

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

–\u00a0<\/span>Ung th\u01b0 th\u1ef1c qu\u1ea3n<\/a> g\u00e2y h\u1eb9p m\u00e0 kh\u00f4ng c\u00f2n ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt, \u0111\u00e2y l\u00e0 ch\u1ec9 \u0111\u1ecbnh \u0111\u01b0\u1ee3c l\u00e0m ch\u1ee7 y\u1ebfu c\u1ee7a \u0111\u1eb7t stent \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/span><\/p>\n

– D\u00f2 th\u1ef1c qu\u1ea3n ph\u1ebf qu\u1ea3n do kh\u1ed1 u<\/span><\/p>\n

– H\u1eb9p \u0111\u01b0\u1eddng xu\u1ed1ng c\u1ee7a d\u1ea1 d\u00e0y nh\u01b0 ung th\u01b0 t\u1ee5y<\/a> g\u00e2y ch\u00e8n \u00e9p.<\/span><\/p>\n

– Ung th\u01b0 \u0111\u1ea1i tr\u00e0ng g\u00e2y h\u1eb9p m\u00e0 ng\u01b0\u1eddi b\u1ec7nh n\u1eb7ng kh\u00f4ng c\u00f2n kh\u1ea3 n\u0103ng ph\u1eabu thu\u1eadt.<\/span><\/p>\n

– H\u1eb9p \u0111\u1ea1i tr\u00e0ng do b\u1ec7nh l\u00e0nh t\u00ednh nh\u01b0 b\u1ec7nh crohn \u0111\u1ea1i tr\u00e0ng<\/span><\/p>\n

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

– Ng\u01b0\u1eddi b\u1ec7nh m\u1edbi b\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim<\/span><\/p>\n

– B\u1ec7nh l\u00fd tim ph\u1ed5i n\u1eb7ng<\/span><\/p>\n

– R\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u n\u1eb7ng<\/span><\/p>\n

– Gi\u1ea3m ti\u1ec3u c\u1ea7u n\u1eb7ng<\/span><\/p>\n

– \u0110ang d\u00f9ng thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u<\/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

1 b\u00e1c s\u1ef9 chuy\u00ean n\u1ed9i soi ti\u00eau h\u00f3a, 1 k\u1ef9 thu\u1eadt vi\u00ean g\u00e2y m\u00ea, 2 \u0111i\u1ec1u d\u01b0\u1ee1ng trong \u0111\u00f3 c\u00f3 \u0111i\u1ec1u d\u01b0\u1ee1ng ph\u1ea3i s\u1eed d\u1ee5ng \u0111\u01b0\u1ee3c m\u00e1y C- Arm.<\/span><\/p>\n

3.2. Ph\u01b0\u01a1ng ti\u1ec7n, thu\u1ed1c, v\u1eadt t\u01b0 ti\u00eau hao<\/span><\/b><\/h3>\n

3.2.1. Ph\u01b0\u01a1ng ti\u1ec7n<\/span><\/i><\/b><\/p>\n

– Ph\u00f2ng n\u1ed9i soi cho ph\u00e9p chi\u1ebfu tia Xquang, c\u00f3 h\u1ec7 th\u1ed1ng oxy<\/span><\/p>\n

– M\u00e1y t\u0103ng s\u00e1ng xquang (C.Arm)<\/span><\/p>\n

– H\u1ec7 th\u1ed1ng m\u00e1y n\u1ed9i soi d\u1ea1 d\u00e0y c\u1eeda s\u1ed5 th\u1eb3ng ho\u1eb7c m\u00e1y n\u1ed9i soi \u0111\u1ea1i tr\u00e0ng c\u1eeda s\u1ed5 th\u1eb3ng, canun, 01 b\u1ed9 d\u00e2y d\u1eabn (guidewire).<\/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

– \u00c1o ch\u00ec: 4 b\u1ed9.<\/span><\/p>\n

– Thu\u1ed1c v\u00e0 trang thi\u1ebft b\u1ecb v\u1eadt t\u01b0 ti\u00eau hao.<\/span><\/p>\n

3.2.2. Thu\u1ed1c<\/span><\/i><\/b><\/p>\n

Thu\u1ed1c m\u00ea v\u00e0 ti\u1ec1n m\u00ea: midazolam 5mg t\u1eeb 1- 4 \u1ed1ng, fantanyl 0,1 mg t\u1eeb 1-3 \u1ed1ng, propofol 20 ml 1- 4 \u1ed1ng.<\/span><\/p>\n

3.2.3. V\u1eadt t\u01b0:<\/span><\/i><\/b><\/p>\n

+ Stent kim lo\u1ea1i c\u00f3 v\u1ecf b\u1ecdc \u0111\u01b0\u1eddng k\u00ednh ngang18- 20 mm, chi\u1ec1u d\u00e0i t\u00f9y thu\u1ed9c v\u00e0o chi\u1ec1u d\u00e0i ph\u1ea7n \u1ed1ng ti\u00eau h\u00f3a b\u1ecb h\u1eb9p.<\/span><\/p>\n

+ G\u0103ng tay 8 \u0111\u00f4i<\/span><\/p>\n

+ \u00c1o m\u1ed5 02<\/span><\/p>\n

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

– Nh\u1ecbn \u0103n tr\u01b0\u1edbc khi l\u00e0m th\u1ee7 thu\u1eadt 8 gi\u1edd \u0111\u1ed1i \u0111\u1eb7t stent th\u1ef1c qu\u1ea3n ho\u1eb7c t\u00e1 tr\u00e0ng<\/span><\/p>\n

– \u0110\u1ed1i ng\u01b0\u1eddi b\u1ec7nh \u0111\u1eb7t stent \u0111\u1ea1i tr\u00e0ng c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c l\u00e0m s\u1ea1ch \u0111\u1ea1i tr\u00e0ng tr\u01b0\u1edbc khi \u0111\u1eb7t stent gi\u1ed1ng soi \u0111\u1ea1i tr\u00e0ng nh\u01b0ng b\u1eb1ng c\u00e1ch th\u1ee5t th\u00e1o.<\/span><\/p>\n

– \u0110\u1eb7t \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch<\/span><\/p>\n

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

Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c l\u00e0m h\u1ed3 s\u01a1 v\u00e0o vi\u1ec7n \u0111i\u1ec1u tr\u1ecb n\u1ed9i tr\u00fa, \u0111\u00e3 \u0111\u01b0\u1ee3c l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m c\u01a1 b\u1ea3n, nh\u01b0: ch\u1ee9c n\u0103ng gan, th\u1eadn, nh\u00f3m m\u00e1u, \u0111\u00f4ng m\u00e1u c\u01a1 b\u1ea3n, ch\u1ee9c n\u0103ng t\u1ee5y, c\u00e1c marker virut, \u0111i\u1ec7n t\u00e2m \u0111\u1ed3.<\/span><\/p>\n

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

4.1. Ki\u1ec3m tra h\u1ed3 s\u01a1<\/span><\/b>: <\/span><\/h3>\n

\u0110\u1ec3 \u0111\u1ea3m b\u1ea3o c\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh ti\u1ec1n m\u00ea ho\u1eb7c g\u00e2y m\u00ea, \u0111\u1ea3m b\u1ea3o c\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh th\u1ee7 thu\u1eadt g\u00e2y ch\u1ea3y m\u00e1u.<\/span><\/p>\n

4.2. Ki\u1ec3m tra ng\u01b0\u1eddi b\u1ec7nh<\/span><\/b>: <\/span><\/h3>\n

\u0110\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng s\u1ed1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n tr\u01b0\u1edbc khi l\u00e0m th\u1ee7 thu\u1eadt, \u0111\u00e3 tu\u00e2n th\u1ee7 nh\u1ecbn \u0103n tr\u01b0\u1edbc \u0111\u00f3<\/span><\/p>\n

4.3. Th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt<\/span><\/b><\/h3>\n

Sau khi ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c ti\u1ec1n m\u00ea ho\u1eb7c g\u00e2y m\u00ea, s\u1ebd ti\u1ebfn h\u00e0nh th\u1ee7 thu\u1eadt:<\/span><\/p>\n

4.3.1. \u0110\u1eb7t stent th\u1ef1c qu\u1ea3n<\/span><\/i><\/b><\/p>\n

– Ti\u1ebfn h\u00e0nh \u0111\u01b0a \u0111\u00e8n soi xu\u1ed1ng qua mi\u1ec7ng v\u00e0o th\u1ef1c qu\u1ea3n \u0111i qua ch\u1ed7 h\u1eb9p th\u1ef1c qu\u1ea3n, \u0111\u1ed3ng th\u1eddi chi\u1ebfu m\u00e0n t\u0103ng s\u00e1ng X.quang \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed h\u1eb9p t\u01b0\u01a1ng \u1ee9ng v\u1edbi v\u1ecb tr\u00ed tr\u00ean th\u00e0nh ng\u1ef1c v\u00e0 \u0111\u00e1nh d\u1ea5u. Sau \u0111\u00f3 ti\u1ebfp t\u1ee5c \u0111\u01b0a \u0111\u00e8n soi xu\u1ed1ng d\u1ea1 d\u00e0y.<\/span><\/p>\n

– Lu\u1ed3n guidewire: qua k\u00eanh th\u1ee7 thu\u1eadt c\u1ee7a m\u00e1y n\u1ed9i soi lu\u1ed3n guidewire v\u00e0o d\u1ea1 d\u00e0y. Gi\u1eef guidewire \u1edf l\u1ea1i trong d\u1ea1 d\u00e0y, r\u00fat m\u00e1y n\u1ed9i soi ra ngo\u00e0i th\u1ef1c qu\u1ea3n.<\/span><\/p>\n

– Qua guidewire \u0111\u01b0a stent v\u00e0o th\u1ef1c qu\u1ea3n t\u1edbi v\u1ecb tr\u00ed \u0111\u00e1nh d\u1ea5u d\u01b0\u1edbi m\u00e0n tang s\u00e1ng Xquang. Ti\u1ebfn h\u00e0nh m\u1edf stent, sau khi m\u1edf ho\u00e0n to\u00e0n stent r\u00fat h\u1ebft guidewire.<\/span><\/p>\n

– \u0110\u01b0a \u0111\u00e8n soi v\u00e0o ki\u1ec3m tra l\u1ea1i v\u1ecb tr\u00ed c\u1ee7a stent.<\/span><\/p>\n

Hi\u1ec7n nay \u0111\u1ed1i v\u1edbi lo\u1ea1i stent c\u00f3 th\u1ec3 thu l\u1ea1i sau khi \u0111\u1eb7t c\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh \u0111\u1eb7t stent m\u00e0 kh\u00f4ng c\u1ea7n m\u00e0n t\u0103ng s\u00e1ng X.quang, b\u1edfi v\u00ec sau khi \u0111\u1eb7t stent n\u1ebfu th\u1ea5y v\u1ecb tr\u00ed ch\u01b0a ch\u00ednh x\u00e1c ho\u00e0n to\u00e0n c\u00f3 th\u1ec3 k\u00e9o \u0111\u1ec3 \u0111\u01b0a stent v\u1ec1 v\u1ecb tr\u00ed c\u1ea7n \u0111\u1eb7t.<\/span><\/p>\n

4.3.2. \u0110\u1eb7t stent \u0111\u1ea1i tr\u00e0ng<\/span><\/i><\/b><\/p>\n

– Ti\u1ebfn h\u00e0nh \u0111\u01b0a \u0111\u00e8n soi qua h\u1eadu m\u00f4 v\u00e0o \u0111\u1ea1i tr\u00e0ng \u0111i qua ch\u1ed7 h\u1eb9p c\u1ee7a \u0111\u1ea1i tr\u00e0ng. Sau \u0111\u00f3 ti\u1ebfp t\u1ee5c \u0111\u01b0a \u0111\u00e8n soi qua ch\u1ed7 h\u1eb9p v\u00e0o trong.<\/span><\/p>\n

– Lu\u1ed3n guidewire: qua k\u00eanh th\u1ee7 thu\u1eadt c\u1ee7a m\u00e1y n\u1ed9i soi lu\u1ed3n guidewire v\u00e0o long \u0111\u1ea1i tr\u00e0ng ph\u00eda trong ch\u1ed7 h\u1eb9p. Gi\u1eef guidewire \u1edf l\u1ea1i ph\u00eda trong ch\u1ed7 h\u1eb9p c\u1ee7a \u0111\u1ea1i tr\u00e0ng, r\u00fat m\u00e1y n\u1ed9i soi ra ngo\u00e0i h\u1eadu m\u00f4n.<\/span><\/p>\n

– Qua guidewire \u0111\u01b0a stent v\u00e0o \u0111\u1ea1i tr\u00e0ng t\u1edbi v\u1ecb tr\u00ed h\u1eb9p, \u0111\u1ed3ng th\u1eddi \u0111\u01b0a m\u00e1y n\u1ed9i soi \u0111i c\u00f9ng v\u1edbi stent d\u01b0\u1edbi m\u00e0n t\u0103ng s\u00e1ng X.quang. Ti\u1ebfn h\u00e0nh m\u1edf stent, sau khi m\u1edf ho\u00e0n to\u00e0n stent r\u00fat h\u1ebft guidewire. Ki\u1ec3m tra l\u1ea1i v\u1ecb tr\u00ed c\u1ee7a stent qua n\u1ed9i soi.<\/span><\/p>\n

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

– Theo d\u00f5i nh\u1eefng bi\u1ebfn ch\u1ee9ng c\u1ee7a g\u00e2y m\u00ea nh\u01b0 suy h\u00f4 h\u1ea5p, t\u1ee5t huy\u1ebft \u00e1p.<\/span><\/p>\n

– Theo d\u00f5i ph\u00e1t hi\u1ec7n th\u1ee7ng \u0111\u1ea1i tr\u00e0ng: \u0111au b\u1ee5ng, t\u00ecnh tr\u1ea1ng \u1ed5 b\u1ee5ng, ch\u1ee5p b\u1ee5ng kh\u00f4ng chu\u1ea9n b\u1ecb n\u1ebfu nghi ng\u1edd c\u00f3 th\u1ee7ng \u0111\u1ea1i tr\u00e0ng.<\/span><\/p>\n

6. Tai bi\u1ebfn v\u00e0 x\u1eed tr\u00ed<\/span><\/b><\/h2>\n

– Th\u1ee7ng \u0111\u1ea1i tr\u00e0ng sau \u0111\u1eb7t stent \u0111\u1ea1i tr\u00e0ng. \u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt<\/span><\/p>\n

– Di chuy\u1ec3n stent. C\u1ea7n \u0111\u1eb7t l\u1ea1i ho\u1eb7c k\u00e9o stent v\u1ec1 v\u1ecb tr\u00ed c\u0169 \u0111\u1ed1i v\u1edbi stent c\u00f3 th\u1ec3 thu l\u1ea1i \u0111\u01b0\u1ee3c.<\/span><\/p>\n

– Bi\u1ebfn ch\u1ee9ng li\u00ean quan t\u1edbi g\u00e2y m\u00ea: t\u1ee5t huy\u1ebft \u00e1p, suy h\u00f4 h\u1ea5p, bu\u1ed3n n\u00f4n ho\u1eb7c n\u00f4n. Ti\u1ebfn h\u00e0nh truy\u1ec1n d\u1ecbch, th\u1edf oxy.<\/span><\/p>\n

N\u1ed9i soi can thi\u1ec7p trong \u0111\u1eb7t stent \u1ed1ng ti\u00eau h\u00f3a l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ti\u00ean ti\u1ebfn cho c\u00e1c b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 nhi\u1ec1u \u01b0u \u0111i\u1ec3m nh\u01b0 \u0111\u1ed9 an to\u00e0n v\u00e0 ch\u00ednh x\u00e1c cao, ti\u1ebft ki\u1ec7m chi ph\u00ed v\u00e0 th\u1eddi gian, gi\u1ea3m nguy c\u01a1 ph\u1eabu thu\u1eadt cho b\u1ec7nh nh\u00e2n. T\u00f3m l\u1ea1i, n\u1ed9i soi can thi\u1ec7p trong \u0111\u1eb7t stent \u1ed1ng ti\u00eau h\u00f3a l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \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 gi\u1ea3m thi\u1ec3u nguy c\u01a1 ph\u1eabu thu\u1eadt l\u1edbn, \u0111\u1ed9 an to\u00e0n cao, gi\u1ea3m \u0111au \u0111\u1edbn v\u00e0 kh\u00f3 ch\u1ecbu, ti\u1ebft ki\u1ec7m th\u1eddi gian v\u00e0 hi\u1ec7u qu\u1ea3 cao trong vi\u1ec7c gi\u1ea3m t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/p>\n

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

N\u1ed9i soi can thi\u1ec7p (NSCT) \u0111\u1eb7t stent \u1ed1ng ti\u00eau h\u00f3a l\u00e0 ti\u1ebfn h\u00e0nh \u0111\u01b0a stent kim lo\u1ea1i v\u00e0o v\u1ecb tr\u00ed h\u1eb9p c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a qua \u0111\u01b0\u1eddng n\u1ed9i soi v\u1edbi m\u1ee5c \u0111\u00edch t\u00e1i l\u1eadp l\u1ea1i l\u01b0u th\u00f4ng c\u1ee7a \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Ph\u1ea7n l\u1edbn k\u1ef9 thu\u1eadt n\u00e0y ti\u1ebfn h\u00e0nh trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p h\u1eb9p do nguy\u00ean […]<\/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":"\nN\u1ed9i soi can thi\u1ec7p trong \u0111\u1eb7t stent \u1ed1ng ti\u00eau h\u00f3a - Vinmec<\/title>\n<meta name=\"description\" content=\"N\u1ed9i soi can thi\u1ec7p (NSCT) \u0111\u1eb7t stent \u1ed1ng ti\u00eau h\u00f3a l\u00e0 ti\u1ebfn h\u00e0nh \u0111\u01b0a stent kim lo\u1ea1i v\u00e0o v\u1ecb tr\u00ed h\u1eb9p c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a qua \u0111\u01b0\u1eddng n\u1ed9i soi v\u1edbi m\u1ee5c...\" \/>\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=\"N\u1ed9i soi can thi\u1ec7p trong \u0111\u1eb7t stent \u1ed1ng ti\u00eau h\u00f3a - 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