{"id":32924,"date":"2023-05-13T14:42:34","date_gmt":"2023-05-13T07:42:34","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32924"},"modified":"2023-05-14T17:42:49","modified_gmt":"2023-05-14T10:42:49","slug":"u-trung-that","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/13\/u-trung-that\/","title":{"rendered":"U trung th\u1ea5t nguy\u00ean ph\u00e1t: Ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00e2n lo\u1ea1i"},"content":{"rendered":"<p><strong>U trung th\u1ea5t nguy\u00ean ph\u00e1t l\u00e0 m\u1ed9t trong c\u00e1c b\u1ec7nh l\u00fd ph\u1ed5i bi\u1ebfn trong y khoa. B\u1ec7nh l\u00fd c\u00f3 th\u1ec3 g\u1eb7p \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i g\u00e2y \u1ea3nh h\u01b0\u1edbng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng. Do \u0111\u00f3, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n u trung th\u1ea5t nguy\u00ean ph\u00e1t \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u00e0 quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh ti\u1ebfp c\u1eadn b\u1ec7nh nh\u00e2n, nh\u1eb1m t\u00ecm ra ph\u01b0\u01a1ng h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t cho b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n<h1><strong>1. \u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/h1>\n<p>Trung th\u1ea5t l\u00e0 v\u00f9ng n\u1eb1m trong l\u1ed3ng ng\u1ef1c, gi\u1eefa c\u00e1c khoang m\u00e0ng ph\u1ed5i bao g\u1ed3m tim v\u00e0 c\u00e1c t\u1ea1ng trong l\u1ed3ng ng\u1ef1c, ngo\u1ea1i tr\u1eeb ph\u1ed5i. Trung th\u1ea5t \u0111\u01b0\u1ee3c bao quanh b\u1edfi c\u00e1c m\u00e0ng ph\u1ed5i l\u00e1 th\u00e0nh, ph\u00eda tr\u01b0\u1edbc l\u00e0 x\u01b0\u01a1ng \u1ee9c, ph\u00eda sau l\u00e0 c\u1ed9t s\u1ed1ng, chu\u1ed7i h\u1ea1ch giao c\u1ea3m c\u1ea1nh c\u1ed9t s\u1ed1ng. Ph\u00eda tr\u00ean l\u00e0 n\u1ec1n c\u1ed5 v\u00e0 ph\u00eda d\u01b0\u1edbi l\u00e0 c\u01a1 ho\u00e0nh.<\/p>\n<p>C\u00e1c u trung th\u1ea5t th\u01b0\u1eddng g\u1eb7p theo \u0111\u1ecbnh khu trung th\u1ea5t nh\u01b0 sau:<\/p>\n<p>&#8211; C\u00e1c u \u1edf trung th\u1ea5t tr\u01b0\u1edbc: C\u00e1c u tuy\u1ebfn \u1ee9c (u tuy\u1ebfn \u1ee9c, ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn \u1ee9c, u carcinoid tuy\u1ebfn \u1ee9c, u m\u1ee1 tuy\u1ebfn \u1ee9c), k\u00e9n tuy\u1ebfn \u1ee9c, u t\u1ebf b\u00e0o m\u1ea7m, c\u00e1c u lympho, b\u01b0\u1edbu gi\u00e1p, u tuy\u1ebfn c\u1eadn gi\u00e1p, c\u00e1c u t\u1ed5 ch\u1ee9c li\u00ean k\u1ebft, k\u00e9n m\u00e0ng ngo\u00e0i tim.<\/p>\n<p>&#8211; U th\u01b0\u1eddng g\u1eb7p \u1edf trung th\u1ea5t gi\u1eefa: U tuy\u1ebfn gi\u00e1p, u kh\u00ed qu\u1ea3n, u lympho, c\u00e1c t\u1ed5n th\u01b0\u01a1ng h\u1ea1ch th\u1ee9 ph\u00e1t do nhi\u1ec5m tr\u00f9ng, di c\u0103n ung th\u01b0.<\/p>\n<p>&#8211; U th\u01b0\u1eddng g\u1eb7p \u1edf trung th\u1ea5t sau: U, k\u00e9n th\u1ea7n kinh, u th\u1ef1c qu\u1ea3n, tho\u00e1t v\u1ecb c\u01a1 ho\u00e0nh, nang gi\u1ea3 t\u1ee5y.<\/p>\n<figure id=\"attachment_32925\" aria-describedby=\"caption-attachment-32925\" style=\"width: 620px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-32925\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/4-1.png\" alt=\"\" width=\"620\" height=\"869\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/4-1.png 331w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/4-1-214x300.png 214w\" sizes=\"(max-width: 620px) 100vw, 620px\" \/><figcaption id=\"caption-attachment-32925\" class=\"wp-caption-text\"><strong>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Ngu\u1ed3n: Mediastinal Tumor &#8211; Cleveland Clinic<\/strong><\/figcaption><\/figure>\n<h2><strong>2. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h2>\n<h3><strong>2.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/strong><\/h3>\n<p>\u2666\u00a0<strong>Tu\u1ed5i:<\/strong>\u00a0Gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng nguy\u00ean nh\u00e2n u trung th\u1ea5t:<\/p>\n<p>&#8211; S\u01a1 sinh, tr\u1ebb nh\u1ecf: U th\u1ea7n kinh, k\u00e9n.<\/p>\n<p>&#8211; Ng\u01b0\u1eddi l\u1edbn: U th\u1ea7n kinh, u, k\u00e9n tuy\u1ebfn \u1ee9c. U lympho v\u00e0 u t\u1ebf b\u00e0o m\u1ea7m th\u01b0\u1eddng g\u1eb7p \u1edf c\u00e1c b\u1ec7nh nh\u00e2n 20-40 tu\u1ed5i.<\/p>\n<p>\u2666\u00a0<strong>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng.<\/strong><\/p>\n<p>&#8211; C\u00f3 th\u1ec3 g\u1eb7p u trung th\u1ea5t kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng.<\/p>\n<p>&#8211; C\u00e1c tri\u1ec7u ch\u1ee9ng do ch\u00e8n \u00e9p, x\u00e2m l\u1ea5n c\u00e1c c\u1ea5u tr\u00fac, th\u00e0nh ph\u1ea7n trong trung th\u1ea5t: l\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t v\u00e0 r\u1ea5t c\u00f3 gi\u00e1 tr\u1ecb trong ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh.<\/p>\n<p>+ Ch\u00e8n \u00e9p t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean: Ph\u00f9 \u00e1o kho\u00e1c<\/p>\n<p>+ Ch\u00e8n \u00e9p kh\u00ed, ph\u1ebf qu\u1ea3n: Ho, nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p t\u00e1i ph\u00e1t, kh\u1ea1c m\u00e1u<\/p>\n<p>+ Ch\u00e8n \u00e9p th\u1ef1c qu\u1ea3n: Nu\u1ed1t ngh\u1eb9n<\/p>\n<p>+ Ch\u00e8n \u00e9p th\u1ea7n kinh qu\u1eb7t ng\u01b0\u1ee3c: N\u00f3i kh\u00e0n, h\u1ed9i ch\u1ee9ng Claude Bernard Horner.<\/p>\n<p>+ Ch\u00e8n \u00e9p, x\u00e2m l\u1ea5n th\u00e0nh ng\u1ef1c: \u0110au ng\u1ef1c.<\/p>\n<p>&#8211; C\u00e1c tri\u1ec7u ch\u1ee9ng to\u00e0n th\u00e2n:<\/p>\n<p>+ Nh\u01b0\u1ee3c c\u01a1: Bi\u1ebfn \u0111\u1ed5i trong ng\u00e0y, th\u00e1ng v\u00e0 n\u0103m t\u1ea1o ra c\u00e1c \u0111\u1ee3t b\u00f9ng ph\u00e1t sau \u0111\u00f3 tho\u00e1i lui. Nh\u01b0\u1ee3c c\u01a1 c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u1edf m\u1eaft, li\u1ec7t m\u1eb7t, mi\u1ec7ng h\u1ea7u ho\u1eb7c li\u1ec7t ch\u00e2n tay. Ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh v\u1edbi test prostigmin, ho\u1eb7c t\u00ecm th\u1ea5y kh\u00e1ng th\u1ec3 kh\u00e1ng receptor acetylcholin trong huy\u1ebft thanh. Nh\u01b0\u1ee3c c\u01a1 th\u01b0\u1eddng ch\u1ec9 g\u1eb7p \u1edf u tuy\u1ebfn \u1ee9c l\u00e0nh t\u00ednh.<\/p>\n<p>+ S\u1ed1t, g\u1ea7y s\u00fat c\u00e2n, ch\u00e1n \u0103n, c\u00e1c bi\u1ec3u hi\u1ec7n c\u1ee7a h\u1ed9i ch\u1ee9ng c\u1eadn u.<\/p>\n<p>\u2666\u00a0<strong>Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh<\/strong><\/p>\n<p>&#8211;\u00a0<strong><em>Ch\u1ee5p X-quang ng\u1ef1c:<\/em><\/strong>\u00a0C\u1ea7n \u0111\u00e1nh gi\u00e1 chi ti\u1ebft h\u00ecnh \u1ea3nh c\u00e1c b\u1edd trung th\u1ea5t (cung t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean, cung nh\u0129 ph\u1ea3i, h\u00ecnh quai \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, cung th\u1ea5t tr\u00e1i), c\u1eeda s\u1ed5 ch\u1ee7 &#8211; ph\u1ed5i, h\u00ecnh quai t\u0129nh m\u1ea1ch azygos, \u0111\u01b0\u1eddng m\u1edd th\u1ef1c qu\u1ea3n, b\u1edd tr\u00e1i v\u00e0 ph\u1ea3i c\u1ee7a c\u1ed9t s\u1ed1ng, c\u00e1c kho\u1ea3ng s\u00e1ng sau x\u01b0\u01a1ng \u1ee9c, sau tim, h\u00ecnh c\u1ed9t s\u1ed1ng&#8230;<\/p>\n<p><strong><em>&#8211; Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh ng\u1ef1c c\u00f3 ti\u00eam thu\u1ed1c c\u1ea3n quang<\/em><\/strong><\/p>\n<p>+ X\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c v\u1ecb tr\u00ed, k\u00edch th\u01b0\u1edbc u trung th\u1ea5t v\u00e0 cho ph\u00e9p \u0111\u00e1nh gi\u00e1 t\u1ef7 tr\u1ecdng c\u0169ng nh\u01b0 m\u1ee9c \u0111\u1ed9 ng\u1ea5m thu\u1ed1c c\u1ee7a u, t\u00ecnh tr\u1ea1ng x\u00e2m l\u1ea5n, ch\u00e8n \u00e9p c\u1ee7a u trung th\u1ea5t v\u00e0o c\u00e1c c\u1ea5u tr\u00fac, th\u00e0nh ph\u1ea7n trung th\u1ea5t.<\/p>\n<p>+ Gi\u00fap ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t u trung th\u1ea5t v\u1edbi ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, u m\u1ee1 trung th\u1ea5t, m\u1ea3ng m\u1ee1 m\u00e0ng ngo\u00e0i tim.<\/p>\n<p>+ H\u1ed7 tr\u1ee3 sinh thi\u1ebft, ch\u1ecdc h\u00fat xuy\u00ean th\u00e0nh ng\u1ef1c, ch\u1ecdn \u0111\u01b0\u1eddng ti\u1ebfp c\u1eadn ph\u1eabu thu\u1eadt u trung th\u1ea5t.<\/p>\n<p>&#8211;\u00a0<strong><em>Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb h\u1ea1t nh\u00e2n (MRI):<\/em><\/strong>\u00a0MRI t\u1ed1t h\u01a1n ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p sau:<\/p>\n<p>+ X\u00e1c \u0111\u1ecbnh x\u00e2m l\u1ea5n m\u1ea1ch m\u00e1u v\u00e0 c\u1ea5u tr\u00fac th\u1ea7n kinh.<\/p>\n<p>+ Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u1ea7n m\u1eb7t c\u1eaft coronal v\u00e0 radial.<\/p>\n<p>+ Khi kh\u00f4ng d\u00f9ng \u0111\u01b0\u1ee3c ch\u1ea5t c\u1ea3n quang t\u0129nh m\u1ea1ch do b\u1ec7nh th\u1eadn hay d\u1ecb \u1ee9ng.<\/p>\n<p>+ Ph\u00e2n bi\u1ec7t u v\u1edbi m\u1ee1 trung th\u1ea5t hay m\u00f4 m\u1ec1m xung quanh<\/p>\n<p>+ MRI t\u1ed1t h\u01a1n CLVT trong x\u00e1c \u0111\u1ecbnh x\u00e2m l\u1ea5n \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay.<\/p>\n<p><strong><em>&#8211; Si\u00eau \u00e2m<\/em><\/strong><\/p>\n<p>+ Gi\u00fap ph\u00e2n bi\u1ec7t nang hay u c\u1ee9ng, h\u01b0\u1edbng d\u1eabn sinh thi\u1ebft kim nh\u1ecf.<\/p>\n<p>+ Si\u00eau \u00e2m qua n\u1ed9i soi gi\u00fap \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng th\u1ef1c qu\u1ea3n, quanh th\u1ef1c qu\u1ea3n.<\/p>\n<p><strong><em>\u2666 Y h\u1ecdc h\u1ea1t nh\u00e2n<\/em><\/strong><\/p>\n<p>&#8211; X\u1ea1 h\u00ecnh tuy\u1ebfn gi\u00e1p v\u1edbi I<sup>131<\/sup>\u00a0hay I<sup>123<\/sup>\u00a0c\u00f3 \u00edch trong BN c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u1ea9n v\u00f9ng tr\u01b0\u1edbc tr\u00ean, sau x\u01b0\u01a1ng \u1ee9c.<\/p>\n<p>&#8211; Technitium d\u00f9ng ch\u1ea9n \u0111o\u00e1n b\u1ec7nh trung th\u1ea5t t\u01b0\u01a1ng \u0111\u1ed1i ph\u1ee9c t\u1ea1p v\u00ec tuy\u1ebfn n\u01b0\u1edbc b\u1ecdt b\u00e0i ti\u1ebft technitium sau \u0111\u00f3 \u0111\u01b0\u1ee3c nu\u1ed1t v\u00e0o, to\u00e0n b\u1ed9 th\u1ef1c qu\u1ea3n \u0111\u1ec1u cho k\u1ebft qu\u1ea3 d\u01b0\u01a1ng t\u00ednh. Tuy nhi\u00ean, technitum c\u00f3 \u01b0u \u0111i\u1ec3m l\u1edbn l\u00e0 \u0111\u01b0\u1ee3c tuy\u1ebfn gi\u00e1p b\u1eaft ngay c\u1ea3 khi \u0111\u00e3 b\u00e3o h\u00f2a iod.<\/p>\n<p><strong>B\u1ea3ng 1:<\/strong>\u00a0Ch\u1ea5t ph\u00f3ng x\u1ea1 trong ch\u1ea9n \u0111o\u00e1n u trung th\u1ea5t<\/p>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td width=\"51%\"><strong>Ch\u1ea5t ph\u00f3ng x\u1ea1<\/strong><\/td>\n<td width=\"48%\"><strong>B\u1ec7nh l\u00fd<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"51%\">I<sup>131<\/sup>\u00a0hay I<sup>123<\/sup><\/td>\n<td width=\"48%\">K tuy\u1ebfn gi\u00e1p sau \u1ee9c<\/td>\n<\/tr>\n<tr>\n<td width=\"51%\">I<sup>131<\/sup>\u00a0meta idobenzylguanine<\/td>\n<td width=\"48%\">Pheochromocytoma<\/td>\n<\/tr>\n<tr>\n<td width=\"51%\">Gallium 67<\/td>\n<td width=\"48%\">Lymphoma<\/td>\n<\/tr>\n<tr>\n<td width=\"51%\">Selenomethionin<\/td>\n<td width=\"48%\">Tuy\u1ebfn c\u1eadn gi\u00e1p<\/td>\n<\/tr>\n<tr>\n<td width=\"51%\">Technetium<\/td>\n<td width=\"48%\">Ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y l\u1ea1c ch\u1ed7<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>\u2666 C\u00e1c d\u1ea5u \u1ea5n u trung th\u1ea5t<\/strong><\/p>\n<p>&#8211; B\u1ec7nh nh\u00e2n u trung th\u1ea5t tr\u01b0\u1edbc, \u0111\u1eb7c bi\u1ec7t \u1edf ng\u01b0\u1eddi tr\u1ebb c\u1ea7n \u0111o AFP, \u03b2HCG, CEA k\u1ebft h\u1ee3p AFP, \u03b2HCG hay c\u1ea3 2 t\u0103ng trong u t\u1ebf b\u00e0o m\u1ea7m \u00e1c t\u00ednh, 1 s\u1ed1 u qu\u00e1i v\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4.<\/p>\n<p>&#8211; Pheochromocytoma: t\u0103ng catecholamin v\u00e0 c\u00e1c s\u1ea3n ph\u1ea7m tho\u00e1i gi\u00e1ng (catecholamin, vanillylmandelic acid, homovanillic acid).<\/p>\n<p>&#8211; C\u00e1c d\u1ea5u \u1ea5n n\u00e0y c\u00f3 gi\u00e1 tr\u1ecb trong theo d\u00f5i b\u1ec7nh nh\u00e2n.<\/p>\n<p>&#8211; Ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ecf b\u1eebng m\u1eb7t, tim nhanh, nh\u1ee9c \u0111\u1ea7u ch\u01b0a r\u00f5 nguy\u00ean nh\u00e2n.<\/p>\n<p>&#8211; M\u1ed9t s\u1ed1 u c\u1ea1nh c\u1ed9t s\u1ed1ng (Paragangliomas, ganglioneuromas, m\u1ed9t s\u1ed1 u nguy\u00ean b\u00e0o th\u1ea7n kinh (neuroblastoma) c\u0169ng s\u1ea3n xu\u1ea5t norepinephrin v\u00e0 epinephrin).<\/p>\n<figure id=\"attachment_32928\" aria-describedby=\"caption-attachment-32928\" style=\"width: 600px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-32928\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/7-2.jpg\" alt=\"\" width=\"600\" height=\"600\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/7-2.jpg 442w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/7-2-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/7-2-150x150.jpg 150w\" sizes=\"(max-width: 600px) 100vw, 600px\" \/><figcaption id=\"caption-attachment-32928\" class=\"wp-caption-text\"><strong>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Ganglioneuromas. Ngu\u1ed3n: Radiopaedia<\/strong><\/figcaption><\/figure>\n<p><strong>\u2666 Sinh thi\u1ebft b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p x\u00e2m l\u1ea5n<\/strong><\/p>\n<p>&#8211; Kh\u1ea3 n\u0103ng sinh thi\u1ebft d\u01b0\u01a1ng t\u00ednh ph\u1ee5 thu\u1ed9c v\u00e0o nhi\u1ec1u y\u1ebfu t\u1ed1:<\/p>\n<p>+ C\u00f3 hay kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng t\u1ea1i ch\u1ed7.<\/p>\n<p>+ V\u1ecb tr\u00ed v\u00e0 m\u1ee9c \u0111\u1ed9 lan r\u1ed9ng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<p>+ C\u00f3 hay kh\u00f4ng c\u00f3 c\u00e1c d\u1ea5u \u1ea5n u.<\/p>\n<p>+ S\u1ef1 thu nh\u1eadn gallium b\u1edfi t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<p>&#8211; L\u01b0u \u00fd khi sinh thi\u1ebft:<\/p>\n<p>+ T\u1ed5n th\u01b0\u01a1ng khu tr\u00fa kh\u00f4ng tri\u1ec7u ch\u1ee9ng: Kh\u00f4ng n\u00ean sinh thi\u1ebft tr\u01b0\u1edbc m\u1ed5 n\u1ebfu kh\u00f4ng lan ra trung th\u1ea5t tr\u01b0\u1edbc, kh\u00f4ng t\u0103ng d\u1ea5u \u1ea5n u v\u00e0 kh\u00f4ng thu nh\u1eadn gallium.<\/p>\n<p>+ Kh\u00f4ng sinh thi\u1ebft u trung th\u1ea5t c\u00f3 v\u1ecf b\u1ecdc r\u00f5 v\u00ec c\u00f3 th\u1ec3 gieo r\u1eafc t\u1ebf b\u00e0o u v\u00e0 c\u1ea3n tr\u1edf c\u1eaft u giai \u0111o\u1ea1n s\u1edbm m\u1ed9t c\u00e1ch tri\u1ec7t \u0111\u1ec3.<\/p>\n<p>+ B\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng x\u1ea5m l\u1ea5n t\u1ea1i ch\u1ed7 nh\u01b0 \u0111au ng\u1ef1c n\u1eb7ng, kh\u00f3 th\u1edf, ho, kh\u00f3 nu\u1ed1t, tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i, t\u1eafc t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean: C\u1ea7n sinh thi\u1ebft kim nh\u1ecf tr\u01b0\u1edbc m\u1ed5. C\u00e1c u n\u00e0y th\u01b0\u1eddng l\u00e0 \u00e1c t\u00ednh v\u00e0 c\u1ea7n ho\u00e1 tr\u1ecb hay x\u1ea1 tr\u1ecb.<\/p>\n<p>+ Kh\u1ed1i h\u1ea1ch lu\u00f4n lu\u00f4n c\u1ea7n sinh thi\u1ebft v\u00ec hi\u1ebfm khi c\u1ea7n m\u1ed5.<\/p>\n<p>&#8211; L\u1ef1a ch\u1ecdn k\u1ef9 thu\u1eadt sinh thi\u1ebft theo v\u1ecb tr\u00ed u.<\/p>\n<p>+ T\u1ed5n th\u01b0\u01a1ng \u1edf trung th\u1ea5t tr\u01b0\u1edbc: N\u1ed9i soi trung th\u1ea5t, sinh thi\u1ebft kim nh\u1ecf.<\/p>\n<p>+ T\u1ed5n th\u01b0\u01a1ng \u1edf trung th\u1ea5t sau: Sinh thi\u1ebft kim nh\u1ecf hay n\u1ed9i soi l\u1ed3ng ng\u1ef1c.<\/p>\n<p>+ T\u1ed5n th\u01b0\u01a1ng \u1edf trung th\u1ea5t gi\u1eefa: N\u1ed9i soi trung th\u1ea5t qua \u0111\u01b0\u1eddng d\u01b0\u1edbi m\u0169i \u1ee9c n\u1ebfu n\u1eb1m s\u00e2u d\u01b0\u1edbi x\u01b0\u01a1ng \u1ee9c; sinh thi\u1ebft kim nh\u1ecf hay n\u1ed9i soi l\u1ed3ng ng\u1ef1c.<\/p>\n<h3><strong>2.3. Ch\u1ea9n \u0111o\u00e1n giai \u0111o\u1ea1n u trung th\u1ea5t<\/strong><\/h3>\n<p><strong>Ph\u00e2n giai \u0111o\u1ea1n u tuy\u1ebfn \u1ee9c theo WHO (2004)<\/strong><\/p>\n<p><strong>&#8211; T: u nguy\u00ean ph\u00e1t<\/strong><\/p>\n<p>+ TX: u nguy\u00ean ph\u00e1t kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c<\/p>\n<p>+ T0: kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a u nguy\u00ean ph\u00e1t<\/p>\n<p>+ T1: u n\u1eb1m ho\u00e0n to\u00e0n trong nang<\/p>\n<p>+ T2: u x\u00e2m l\u1ea5n c\u00e1c t\u1ed5 ch\u1ee9c li\u00ean k\u1ebft c\u1ea1nh nang<\/p>\n<p>+ T3: u x\u00e2m l\u1ea5n v\u00e0o c\u00e1c c\u1ea5u tr\u00fac xung quanh u nh\u01b0 m\u00e0ng ngo\u00e0i tim, m\u00e0ng ph\u1ed5i trung th\u1ea5t, th\u00e0nh ng\u1ef1c, ph\u1ed5i v\u00e0 c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn.<\/p>\n<p>+ T4: u c\u00f3 t\u1ed5n th\u01b0\u01a1ng ph\u00e2n t\u00e1n \u1edf m\u00e0ng ph\u1ed5i, c\u1ea1nh tim.<\/p>\n<p><strong>&#8211; N: H\u1ea1ch v\u00f9ng<\/strong><\/p>\n<p>+ NX: kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c h\u1ea1ch v\u00f9ng<\/p>\n<p>+ N0: kh\u00f4ng c\u00f3 di c\u0103n h\u1ea1ch v\u00f9ng<\/p>\n<p>+ N1: di c\u0103n t\u1edbi h\u1ea1ch trung th\u1ea5t tr\u01b0\u1edbc<\/p>\n<p>+ N2: di c\u0103n t\u1edbi c\u00e1c h\u1ea1ch trong l\u1ed3ng ng\u1ef1c kh\u00e1c ngo\u1ea1i tr\u1eeb c\u00e1c h\u1ea1ch trung th\u1ea5t tr\u01b0\u1edbc<\/p>\n<p>+ N3: di c\u0103n h\u1ea1ch c\u01a1 thang \/ h\u1ea1ch h\u1ed1 th\u01b0\u1ee3ng \u0111\u00f2n<\/p>\n<p><strong>&#8211; M: Di c\u0103n<\/strong><\/p>\n<p>+ MX: kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c di c\u0103n<\/p>\n<p>+ M0: kh\u00f4ng c\u00f3 di c\u0103n xa<\/p>\n<p>+ M1: di c\u0103n xa<\/p>\n<p><strong>&#8211; Ph\u00e2n nh\u00f3m<\/strong><\/p>\n<p>+ Giai \u0111o\u1ea1n I: T1 N0 M0<\/p>\n<p>+ Giai \u0111o\u1ea1n II: T2 N0 M0<\/p>\n<p>+ Giai \u0111o\u1ea1n III: T1 N1 M0; T2 N1 M0; T3 N0, 1 M0<\/p>\n<p>+ Giai \u0111o\u1ea1n IV: T4 N b\u1ea5t k\u1ef3 M0; T b\u1ea5t k\u1ef3, N2, 3 M0; T b\u1ea5t k\u1ef3, N b\u1ea5t k\u1ef3, M1.<\/p>\n<p><strong>Ph\u00e2n giai \u0111o\u1ea1n c\u00e1c u t\u1ebf b\u00e0o m\u1ea7m theo WHO (2004)<\/strong><\/p>\n<p><strong>&#8211; T: U nguy\u00ean ph\u00e1t<\/strong><\/p>\n<p>+ TX: Kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c u nguy\u00ean ph\u00e1t<\/p>\n<p>+ T0: Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a u nguy\u00ean ph\u00e1t<\/p>\n<p>+ T1: U khu tr\u00fa t\u1ea1i c\u01a1 quan nguy\u00ean ph\u00e1t (tuy\u1ebfn \u1ee9c v\u00e0 m\u1ee1 trung th\u1ea5t)<\/p>\n<p>T1a: U \u2264 5 cm<\/p>\n<p>T1b: U &gt; 5 cm<\/p>\n<p>+ T2: U x\u00e2m l\u1ea5n c\u00e1c c\u01a1 quan li\u1ec1n k\u1ec1 ho\u1eb7c c\u00f3 tr\u00e0n d\u1ecbch \u00e1c t\u00ednh<\/p>\n<p>T2a: U \u2264 5 cm<\/p>\n<p>T2b: U &gt; 5 cm<\/p>\n<p>+ T3: U x\u00e2m l\u1ea5n v\u00e0o c\u00e1c c\u1ea5u tr\u00fac xung quanh nh\u01b0 m\u00e0ng ngo\u00e0i tim, m\u00e0ng ph\u1ed5i trung th\u1ea5t, th\u00e0nh ng\u1ef1c, m\u1ea1ch m\u00e1u l\u1edbn, ph\u1ed5i<\/p>\n<p>+ T4: U k\u00e8m lan tr\u00e0n m\u00e0ng ph\u1ed5i, m\u00e0ng ngo\u00e0i tim<\/p>\n<p><strong>&#8211; N: H\u1ea1ch v\u00f9ng<\/strong><\/p>\n<p>+ NX: Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c h\u1ea1ch v\u00f9ng<\/p>\n<p>+ N0: Kh\u00f4ng di c\u0103n h\u1ea1ch v\u00f9ng<\/p>\n<p>+ N1: Di c\u0103n t\u1edbi h\u1ea1ch v\u00f9ng<\/p>\n<p>+ N2: Di c\u0103n t\u1edbi h\u1ea1ch trong l\u1ed3ng ng\u1ef1c bao g\u1ed3m c\u1ea3 h\u1ea1ch trung th\u1ea5t tr\u01b0\u1edbc<\/p>\n<p>+ N3: Di c\u0103n t\u1edbi h\u1ea1ch c\u01a1 thang ho\u1eb7c h\u1ea1ch th\u01b0\u1ee3ng \u0111\u00f2n<\/p>\n<p><strong>&#8211; M: Di c\u0103n xa<\/strong><\/p>\n<p>+ MX: Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c di c\u0103n<\/p>\n<p>+ M0: Kh\u00f4ng c\u00f3 di c\u0103n xa<\/p>\n<p>+ M1: C\u00f3 di c\u0103n xa<\/p>\n<p><strong>&#8211; Ph\u00e2n giai \u0111o\u1ea1n<\/strong><\/p>\n<p>+ Giai \u0111o\u1ea1n I: U khu tr\u00fa, kh\u00f4ng di c\u0103n, c\u00f3 th\u1ec3 c\u1eaft b\u1ecf ho\u00e0n to\u00e0n u<\/p>\n<p>+ Giai \u0111o\u1ea1n II: U khu tr\u00fa, kh\u00f4ng di c\u0103n, c\u00f3 th\u1ec3 c\u1eaft b\u1ecf u tr\u00ean \u0111\u1ea1i th\u1ec3 nh\u01b0ng c\u00f3 th\u1ec3 c\u00f2n t\u1ed3n d\u01b0 u vi th\u1ec3.<\/p>\n<p>+ Giai \u0111o\u1ea1n III: U khu tr\u00fa, h\u1ea1ch v\u00f9ng c\u00f3 ho\u1eb7c kh\u00f4ng, kh\u00f4ng di c\u0103n xa, kh\u00f4ng th\u1ec3 c\u1eaft b\u1ecf ho\u00e0n to\u00e0n u nguy\u00ean ph\u00e1t.<\/p>\n<p>+ Giai \u0111o\u1ea1n IV: U c\u00f3 di c\u0103n xa.<\/p>\n<p><strong>Ngu\u1ed3n tham kh\u1ea3o<\/strong>:<\/p>\n<ul>\n<li>H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n\u00a0 v\u00e0 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh h\u00f4 h\u1ea5p c\u1ee7a B\u1ed9 Y t\u1ebf 2015.<\/li>\n<\/ul>\n<div id=\"USE_CHAT_GPT_AI_ROOT\" style=\"display: none; z-index: -1; position: absolute; top: -10000px; left: -10000px; width: 1px; height: 1px; overflow: hidden; opacity: 0; pointer-events: none;\">usechatgpt init success<\/div>\n","protected":false},"excerpt":{"rendered":"<p>U trung th\u1ea5t nguy\u00ean ph\u00e1t l\u00e0 m\u1ed9t trong c\u00e1c b\u1ec7nh l\u00fd ph\u1ed5i bi\u1ebfn trong y khoa. B\u1ec7nh l\u00fd c\u00f3 th\u1ec3 g\u1eb7p \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i g\u00e2y \u1ea3nh h\u01b0\u1edbng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng. Do \u0111\u00f3, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n u trung th\u1ea5t nguy\u00ean ph\u00e1t \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u00e0 quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh ti\u1ebfp c\u1eadn b\u1ec7nh [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>U trung th\u1ea5t nguy\u00ean ph\u00e1t: Ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00e2n lo\u1ea1i - Vinmec<\/title>\n<meta name=\"description\" content=\"U trung th\u1ea5t nguy\u00ean ph\u00e1t l\u00e0 m\u1ed9t trong c\u00e1c b\u1ec7nh l\u00fd ph\u1ed5i bi\u1ebfn trong y khoa. 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