{"id":31472,"date":"2023-05-04T16:26:10","date_gmt":"2023-05-04T09:26:10","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31472"},"modified":"2023-05-04T16:26:10","modified_gmt":"2023-05-04T09:26:10","slug":"quy-trinh-noi-soi-thuc-quan-da-day-ta-trang-co-sinh-thiet","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/quy-trinh-noi-soi-thuc-quan-da-day-ta-trang-co-sinh-thiet\/","title":{"rendered":"Quy tr\u00ecnh n\u1ed9i soi th\u1ef1c qu\u1ea3n-d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng c\u00f3 sinh thi\u1ebft"},"content":{"rendered":"

N\u1ed9i soi th\u1ef1c qu\u1ea3n- d\u1ea1 d\u00e0y- t\u00e1 tr\u00e0ng c\u00f3 sinh thi\u1ebft l\u00e0 \u0111\u01b0a \u1ed1ng soi d\u1ea1 d\u00e0y qua \u0111\u01b0\u1eddng mi\u1ec7ng v\u00e0o th\u1ef1c qu\u1ea3n r\u1ed3i xu\u1ed1ng d\u1ea1 d\u00e0y v\u00e0 t\u00e1 tr\u00e0ng nh\u1eb1m m\u1ee5c \u0111\u00edch ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb nh\u1eefng b\u1ec7nh l\u00fd c\u1ee7a th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y v\u00e0 t\u00e1 tr\u00e0ng. Trong qu\u00e1 tr\u00ecnh n\u00e0y c\u00f3 l\u1ea5y c\u00e1c m\u1ea3nh th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y ho\u1eb7c t\u00e1 tr\u00e0ng b\u1eb1ng k\u00ecm sinh thi\u1ebft \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m m\u00f4 b\u1ec7nh h\u1ecdc. N\u1ed9i soi th\u1ef1c qu\u1ea3n-d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng c\u00f3 sinh thi\u1ebft gi\u00fap qu\u00e1 tr\u00ecnh ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c v\u00e0 k\u1ecbp th\u1eddi, h\u1ed7 tr\u1ee3 trong vi\u1ec7c ph\u00e1t hi\u1ec7n ra c\u00e1c b\u1ec7nh l\u00fd v\u1ec1 th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y, t\u00e1 tr\u00e0ng m\u1ed9t c\u00e1ch s\u1edbm nh\u1ea5t.<\/span><\/strong><\/p>\n

\"\"<\/p>\n

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

– \u0110au th\u01b0\u1ee3ng v\u1ecb, n\u00f4n kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n, h\u1ed9i ch\u1ee9ng tr\u00e0o ng\u01b0\u1ee3c<\/span><\/p>\n

– Thi\u1ebfu m\u00e1u, g\u1ea7y s\u00fat c\u00e2n<\/span><\/p>\n

– \u0110au ng\u1ef1c sau khi \u0111\u00e3 ki\u1ec3m tra tim m\u1ea1ch b\u00ecnh th\u01b0\u1eddng<\/span><\/p>\n

– Nu\u1ed1t ngh\u1eb9n<\/span><\/p>\n

– H\u1ed9i ch\u1ee9ng k\u00e9m h\u1ea5p thu<\/span><\/p>\n

– Ti\u1ec1n s\u1eed d\u00f9ng thu\u1ed1c ch\u1ed1ng vi\u00eam, gi\u1ea3m \u0111au<\/span><\/p>\n

– C\u1eaft 2\/3 d\u1ea1 d\u00e0y sau 10 n\u0103m<\/span><\/p>\n

– B\u1ec7nh polyp gia \u0111\u00ecnh<\/a><\/span><\/p>\n

– B\u1ec7nh Crohn<\/span><\/p>\n

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

2.1. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh tuy\u1ec7t \u0111\u1ed1i<\/span><\/b><\/h3>\n

– C\u00e1c b\u1ec7nh l\u00fd c\u00f3 r\u1ed1i lo\u1ea1n \u0111\u00f4ng c\u1ea7m m\u00e1u nh\u01b0: Hemophilie, L\u01a1 x\u00ea mi, Xu\u1ea5t huy\u1ebft gi\u1ea3m ti\u1ec3u c\u1ea7u\u2026<\/span><\/p>\n

– C\u00e1c b\u1ec7nh l\u00fd \u1edf th\u1ef1c qu\u1ea3n c\u00f3 nguy c\u01a1 l\u00e0m th\u1ee7ng th\u1ef1c qu\u1ea3n nh\u01b0 b\u1ecfng th\u1ef1c qu\u1ea3n do h\u00f3a ch\u1ea5t v\u00e0 thu\u1ed1c g\u00e2y h\u1eb9p th\u1ef1c qu\u1ea3n.<\/span><\/p>\n

– Ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ng\u1ef1c<\/span><\/p>\n

– Suy tim, nh\u1ed3i m\u00e1u c\u01a1 tim, c\u01a1n t\u0103ng huy\u1ebft \u00e1p<\/span><\/p>\n

– Suy h\u00f4 h\u1ea5p, kh\u00f3 th\u1edf do b\u1ea5t c\u1ee9 nguy\u00ean nh\u00e2n g\u00ec, ho nhi\u1ec1u<\/span><\/p>\n

2.2. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng \u0111\u1ed1i<\/span><\/b><\/h3>\n

– Ng\u01b0\u1eddi b\u1ec7nh t\u00e2m th\u1ea7n kh\u00f4ng ph\u1ed1i h\u1ee3p \u0111\u01b0\u1ee3c.<\/span><\/p>\n

– T\u1ee5t huy\u1ebft \u00e1p.<\/span><\/p>\n

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

3.1. Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n<\/span><\/b>: <\/span><\/h2>\n

01 b\u00e1c s\u0129 chuy\u00ean khoa n\u1ed9i soi ti\u00eau h\u00f3a, 02 \u0111i\u1ec1u d\u01b0\u1ee1ng ho\u1eb7c k\u1ef9 thu\u1eadt vi\u00ean.<\/span><\/p>\n

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

– M\u00e1y n\u1ed9i soi th\u1ef1c qu\u1ea3n – d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng \u1ed1ng m\u1ec1m, lo\u1ea1i c\u1eeda s\u1ed5 th\u1eb3ng v\u00e0 c\u00e1c d\u1ee5ng c\u1ee5 \u0111i k\u00e8m m\u00e1y n\u1ed9i soi<\/span><\/p>\n

– Ngu\u1ed3n s\u00e1ng<\/span><\/p>\n

– M\u00e1y h\u00fat<\/span><\/p>\n

– \u1ed0ng ng\u1eadm mi\u1ec7ng<\/span><\/p>\n

– K\u00ecm sinh thi\u1ebft<\/span><\/p>\n

– \u1ed0ng nh\u1ef1a, dung d\u1ecbch c\u1ed1 \u0111\u1ecbnh m\u1ea9u sinh thi\u1ebft (ph\u00f3c m\u00f4n )<\/span><\/p>\n

– N\u01b0\u1edbc c\u1ea5t \u0111\u1ec3 b\u01a1m r\u1eeda khi c\u1ea7n thi\u1ebft trong qu\u00e1 tr\u00ecnh n\u1ed9i soi<\/span><\/p>\n

– Ch\u1ea5t b\u00f4i tr\u01a1n \u0111\u1ea7u m\u00e1y soi: K- Y<\/span><\/p>\n

– Thu\u1ed1c g\u00e2y t\u00ea v\u00f9ng h\u1ecdng: Xylocain 2% ho\u1eb7c Lidocain 10 %.<\/span><\/p>\n

– G\u0103ng, g\u1ea1c, b\u01a1m ti\u00eam 20 ml.<\/span><\/p>\n

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

– Nh\u1ecbn \u0103n t\u1ed1i thi\u1ec3u 6 gi\u1edd tr\u01b0\u1edbc n\u1ed9i soi. Ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch k\u1ef9 v\u1ec1 l\u1ee3i \u00edch v\u00e0 tai bi\u1ebfn c\u1ee7a th\u1ee7 thu\u1eadt v\u00e0 \u0111\u1ed3ng \u00fd soi.<\/span><\/p>\n

– N\u1ebfu ng\u01b0\u1eddi b\u1ec7nh n\u1ed9i tr\u00fa ph\u1ea3i c\u00f3 b\u1ec7nh \u00e1n<\/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 b\u1ec7nh \u00e1n: <\/span><\/b><\/h3>\n

N\u1ebfu ng\u01b0\u1eddi soi l\u00e0 ng\u01b0\u1eddi b\u1ec7nh n\u1ed9i tr\u00fa<\/span><\/p>\n

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

\u0110\u00fang h\u1ecd t\u00ean, tu\u1ed5i, gi\u1edbi, \u0111\u1ecba ch\u1ec9. Ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m nghi\u00eang tr\u00e1i, ch\u00e2n ph\u1ea3i co, ch\u00e2n tr\u00e1i du\u1ed7i.<\/span><\/p>\n

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

4.3.1. Chu\u1ea9n b\u1ecb v\u00e0 ki\u1ec3m tra m\u00e1y soi<\/span><\/i><\/b><\/p>\n

4.3.2. G\u00e2y t\u00ea v\u00f9ng h\u1ea7u h\u1ecdng: <\/span><\/i><\/b><\/p>\n

B\u1eb1ng Xylocain 2% ho\u1eb7c Lidocain 10%<\/span><\/p>\n

4.3.3. \u0110\u1eb7t \u1ed1ng ng\u1eadm mi\u1ec7ng: <\/span><\/i><\/b><\/p>\n

v\u00e0o gi\u1eefa 2 cung r\u0103ng v\u00e0 b\u1ea3o ng\u01b0\u1eddi b\u1ec7nh ng\u1eadm ch\u1eb7t<\/span><\/p>\n

4.3.4. \u0110\u01b0a m\u00e1y soi qua mi\u1ec7ng, h\u1ecdng v\u00e0o th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y, t\u00e1 tr\u00e0ng: <\/span><\/i><\/b><\/p>\n

B\u01a1m h\u01a1i v\u00e0 quan s\u00e1t.<\/span><\/p>\n

4.3.5. Khi ph\u00e1t hi\u1ec7n v\u00f9ng t\u1ed5n th\u01b0\u01a1ng nghi ng\u1edd: <\/span><\/i><\/b><\/p>\n

\u0110i\u1ec1u d\u01b0\u1ee1ng \u0111\u01b0a k\u00ecm sinh thi\u1ebft qua k\u00eanh c\u1ee7a m\u00e1y v\u00e0 b\u00e1c s\u0129 n\u1ed9i soi d\u00f9ng k\u00ecm sinh thi\u1ebft b\u1ea5m t\u1eeb 4 \u0111\u1ebfn 6 m\u1ea3nh g\u1eedi cho v\u00e0 \u1ed1ng \u0111\u1ef1ng ph\u00f3c m\u00f4n \u0111\u1ec3 g\u1eedi x\u00e9t nghi\u1ec7m m\u00f4 b\u1ec7nh h\u1ecdc<\/span><\/p>\n

4.3.6. R\u00fat m\u00e1y v\u00e0 t\u1ea9y u\u1ebf kh\u1eed khu\u1ea9n m\u00e1y soi theo \u0111\u00fang quy \u0111\u1ecbnh sau:<\/span><\/i><\/b><\/p>\n

– R\u1eeda m\u00e1y: D\u00f9ng 500 ml dung d\u1ecbch x\u00e0 ph\u00f2ng trung t\u00ednh 0,5 %, van b\u01a1m t\u0103ng c\u01b0\u1eddng \u0111\u1ec3 r\u1eeda s\u1ea1ch ph\u1ea7n ngo\u00e0i c\u1ee7a m\u00e1y v\u00e0 c\u00e1c \u0111\u01b0\u1eddng b\u00ean trong m\u00e1y.<\/span><\/p>\n

– Th\u1eed h\u01a1i: D\u00f9ng d\u1ee5ng c\u1ee5 th\u1eed h\u01a1i k\u00e8m m\u00e1y soi \u0111\u1ec3 xem v\u1ecf cao su c\u1ee7a m\u00e1y c\u00f3 b\u1ecb r\u00e1ch kh\u00f4ng, n\u1ebfu r\u00e1ch kh\u00f4ng \u0111\u01b0\u1ee3c ng\u00e2m m\u00e1y v\u00e0o dung d\u1ecbch t\u1ea9y u\u1ebf m\u00e0 ph\u1ea3i g\u1eedi m\u00e1y \u0111i s\u1eeda ngay.<\/span><\/p>\n

– T\u1ea9y u\u1ebf: ch\u1ec9 ti\u1ebfn h\u00e0nh khi m\u00e1y soi kh\u00f4ng b\u1ecb r\u00e1ch<\/span><\/p>\n

+ D\u00f9ng 5 l\u00edt x\u00e0 ph\u00f2ng trung t\u00ednh 0,5%, b\u00e0n ch\u1ea3i, van 3 chi\u1ec1u \u0111\u1ec3 t\u1ea9y u\u1ebf<\/span><\/p>\n

+ Ng\u00e2m to\u00e0n b\u1ed9 m\u00e1y v\u00e0o dung d\u1ecbch t\u1ea9y u\u1ebf, d\u00f9ng b\u00e0n ch\u1ea3i, van 3 chi\u1ec1u \u0111\u1ec3 r\u1eeda s\u1ea1ch ph\u1ea7n ngo\u00e0i v\u00e0 c\u00e1c \u0111\u01b0\u1eddng b\u00ean trong c\u1ee7a m\u00e1y<\/span><\/p>\n

4.3.7. S\u00e1t khu\u1ea9n<\/span><\/i><\/b><\/p>\n

– D\u00f9ng 5 l\u00edt dung d\u1ecbch s\u00e1t khu\u1ea9n Glutaraldehyd 2%, van 3 chi\u1ec1u \u0111\u1ec3 s\u00e1t khu\u1ea9n m\u00e1y.<\/span><\/p>\n

– Ng\u00e2m to\u00e0n b\u1ed9 m\u00e1y v\u00e0o dung d\u1ecbch s\u00e1t khu\u1ea9n \u0111\u1ec3 r\u1eeda s\u1ea1ch c\u00e1c \u0111\u01b0\u1eddng b\u00ean trong c\u1ee7a m\u00e1y.<\/span><\/p>\n

4.3.8. S\u1ea5y kh\u00f4 m\u00e1y<\/span><\/i><\/b>: d\u00f9ng van b\u01a1m t\u0103ng c\u01b0\u1eddng, b\u1ed9 ph\u1eadn b\u01a1m kh\u00ed c\u1ee7a ngu\u1ed3n s\u00e1ng, m\u00e1y h\u00fat \u0111\u1ec3 l\u00e0m kh\u00f4 c\u00e1c \u0111\u01b0\u1eddng b\u00ean trong c\u1ee7a m\u00e1y tr\u01b0\u1edbc khi c\u1ea5t m\u00e1y.<\/span><\/p>\n

4.3.9. R\u1eeda, t\u1ea9y u\u1ebf v\u00e0 kh\u1eed khu\u1ea9n k\u00ecm sinh thi\u1ebft <\/span><\/i><\/b>v\u1edbi c\u00e1c dung d\u1ecbch nh\u01b0 v\u1edbi m\u00e1y n\u1ed9i soi<\/span><\/p>\n

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

T\u00ecnh tr\u1ea1ng chung c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, m\u1ea1ch, huy\u1ebft \u00e1p n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh c\u00f3 ch\u1ea3y m\u00e1u<\/span><\/p>\n

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

– N\u1ebfu c\u00f3 ch\u1ea3y m\u00e1u t\u1ea1i n\u01a1i v\u1eeba sinh thi\u1ebft: ti\u00eam c\u1ea7m m\u00e1u t\u1ea1i ch\u1ed7 b\u1eb1ng Adrenalin 1\/ 10000. N\u1ebfu ti\u1ebfp t\u1ee5c ch\u1ea3y m\u00e1u c\u00f3 th\u1ec3 d\u00f9ng k\u1eb9p Clip \u0111\u1ec3 c\u1ea7m m\u00e1u.<\/span><\/p>\n

– C\u00e1c tai bi\u1ebfn kh\u00e1c v\u00e0 x\u1eed tr\u00ed gi\u1ed1ng n\u1ed9i soi d\u1ea1 d\u00e0y kh\u00f4ng sinh thi\u1ebft.<\/span><\/p>\n

T\u00f3m l\u1ea1i, n\u1ed9i soi th\u1ef1c qu\u1ea3n – d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt y t\u1ebf s\u1eed d\u1ee5ng thi\u1ebft b\u1ecb n\u1ed9i soi \u0111\u1ec3 ki\u1ec3m tra v\u00e0 ch\u1ea9n \u0111o\u00e1n c\u00e1c v\u1ea5n \u0111\u1ec1 trong \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. K\u1ef9 thu\u1eadt n\u00e0y c\u00f2n cho ph\u00e9p l\u1ea5y m\u1eabu sinh thi\u1ebft t\u1eeb c\u00e1c v\u00f9ng b\u1ecb nghi ng\u1edd \u0111\u1ec3 ph\u00e2n t\u00edch v\u00e0 gi\u00fap ch\u1ea9n \u0111o\u00e1n b\u1ec7nh ch\u00ednh x\u00e1c h\u01a1n. N\u1ed9i soi th\u1ef1c qu\u1ea3n – d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng c\u00f3 sinh thi\u1ebft l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p kh\u00f4ng th\u1ec3 thi\u1ebfu trong ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd ti\u00eau h\u00f3a, Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y gi\u00fap \u0111\u1ea3m b\u1ea3o ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c, \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi v\u00e0 gi\u1ea3m nguy c\u01a1 b\u1ec7nh t\u1eadt ph\u00e1t tri\u1ec3n n\u1eb7ng h\u01a1n.<\/p>\n

T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/span><\/b><\/p>\n

1. Soi d\u1ea1 d\u00e0y- t\u00e1 tr\u00e0ng. H\u01b0\u1edbng d\u1eabn quy tr\u00ecnh k\u1ef9 thu\u1eadt b\u1ec7nh vi\u1ec7n T\u1eadp I. Nh\u00e0 xu\u1ea5t b\u1ea3n y h\u1ecdc 1999, 506 – 507.<\/span><\/p>\n

2. Ph\u1ea1m Th\u1ecb B\u00ecnh. Soi d\u1ea1 d\u00e0y- t\u00e1 tr\u00e0ng. \u1ee8ng d\u1ee5ng n\u1ed9i soi trong ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd ti\u00eau h\u00f3a.\u00a0<\/span>B\u1ec7nh vi\u1ec7n B\u1ea1ch mai. 2001, 14 – 30.<\/span><\/p>\n

3. Mark Topazian. Upper endoscopy. Harrison<\/span>,<\/span>s Gastroenterology and Hepatology. 2010: 94.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

N\u1ed9i soi th\u1ef1c qu\u1ea3n- d\u1ea1 d\u00e0y- t\u00e1 tr\u00e0ng c\u00f3 sinh thi\u1ebft l\u00e0 \u0111\u01b0a \u1ed1ng soi d\u1ea1 d\u00e0y qua \u0111\u01b0\u1eddng mi\u1ec7ng v\u00e0o th\u1ef1c qu\u1ea3n r\u1ed3i xu\u1ed1ng d\u1ea1 d\u00e0y v\u00e0 t\u00e1 tr\u00e0ng nh\u1eb1m m\u1ee5c \u0111\u00edch ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb nh\u1eefng b\u1ec7nh l\u00fd c\u1ee7a th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y v\u00e0 t\u00e1 tr\u00e0ng. 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