{"id":3357,"date":"2023-04-10T11:00:14","date_gmt":"2023-04-10T04:00:14","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=3357"},"modified":"2023-04-10T12:19:02","modified_gmt":"2023-04-10T05:19:02","slug":"giai-phau-sieu-am-ong-co-tay-va-day-than-kinh-giua","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/giai-phau-sieu-am-ong-co-tay-va-day-than-kinh-giua\/","title":{"rendered":"Gi\u1ea3i ph\u1eabu si\u00eau \u00e2m \u1ed1ng c\u1ed5 tay v\u00e0 d\u00e2y th\u1ea7n kinh gi\u1eefa"},"content":{"rendered":"

Si\u00eau \u00e2m ho\u1eb7c c\u1ed9ng h\u01b0\u1edfng t\u1eeb c\u00f3 th\u1ec3 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ef1 thay \u0111\u1ed5i h\u00ecnh th\u00e1i c\u1ee7a d\u00e2y th\u1ea7n kinh gi\u1eefa qua khu v\u1ef1c \u1ed1ng c\u1ed5 tay, tuy nhi\u00ean si\u00eau \u00e2m c\u00f3 \u01b0u \u0111i\u1ec3m v\u01b0\u1ee3t tr\u1ed9i nh\u01b0 r\u1ebb ti\u1ec1n, c\u01a1 \u0111\u1ed9ng v\u00e0 cho ch\u1ea5t l\u01b0\u1ee3ng th\u0103m kh\u00e1m v\u1edbi \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u cao, c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n ngay c\u00f9ng v\u1edbi th\u0103m kh\u00e1m l\u00e2m s\u00e0ng c\u1ee7a b\u00e1c s\u0129 l\u00e2m s\u00e0ng ho\u1eb7c ph\u1ed1i h\u1ee3p \u0111\u1ed3ng th\u1eddi v\u1edbi b\u00e1c s\u0129 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh. C\u00f9ng v\u1edbi \u0111i\u1ec7n sinh l\u00fd th\u1ea7n kinh, si\u00eau \u00e2m th\u1ea7n kinh \u0111\u00e3 tr\u1edf th\u00e0nh 1 y\u1ebfu t\u1ed1 kh\u00f4ng th\u1ec3 thi\u1ec3u trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay.<\/strong><\/p>\n

Nh\u00f3m t\u00e1c gi\u1ea3: <\/strong>PGS.TS. Tr\u1ea7n Trung D\u0169ng, BS. Ma Ng\u1ecdc Th\u00e0nh, TS. Nguy\u1ec5n Th\u1ecb Li\u1ec5u, BS. Tr\u1ea7n Quy\u1ebft<\/p>\n

1. Gi\u1ea3i ph\u1eabu v\u00e0 gi\u1ea3i ph\u1eabu si\u00eau \u00e2m \u1ed1ng c\u1ed5 tay\u00a0<\/b><\/h2>\n

\u1ed0ng c\u1ed5 tay v\u00e0 \u1ed1ng x\u01a1 x\u01b0\u01a1ng h\u00ecnh b\u1ea7u d\u1ee5c, \u0111\u00e1y \u0111\u01b0\u1ee3c t\u1ea1o b\u1edfi m\u1eb7t gan tay c\u1ee7a kh\u1ed1i x\u01b0\u01a1ng c\u1ed5 tay, b\u1ec1 m\u1eb7t \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh b\u1edfi m\u1ea1c ch\u1eb3ng c\u1ee7a c\u00e1c g\u00e2n g\u1ea5p. \u1ed0ng c\u1ed5 tay l\u00e0m t\u1eeb n\u1ebfp l\u1eb1n c\u1ed5 tay k\u00e9o d\u00e0i xu\u1ed1ng d\u01b0\u1edbi gan tay 3,5 cm. Di\u1ec7n t\u00edch \u0111\u1ea7u g\u1ea7n \u1ed1ng c\u00f4 tay 5cm2, \u0111\u1ea7u xa 3,5cm2. Chi\u1ec1u r\u1ed9ng \u1ed1ng c\u1ed5 tay trung b\u00ecnh l\u00e0 25mm, trong \u0111\u00f3 \u0111\u1ea7u g\u1ea7n l\u00e0 20mm, v\u00f9ng h\u1eb9p nh\u1ea5t \u1edf ngang m\u1ee9c m\u1ecfm x\u01b0\u01a1ng m\u00f3c, v\u00e0 \u0111\u1ea7u xa l\u00e0 26mm. Chi\u1ec1u s\u00e2u kho\u1ea3ng 12mm \u1edf \u0111\u1ea7u g\u1ea7n v\u00e0 13mm \u1edf \u0111\u1ea7u xa. Chi\u1ec1u s\u00e2u t\u1ea1i \u0111i\u1ec3m h\u1eb9p nh\u1ea5t l\u00e0 10mm \u1edf ngang m\u1ee9c x\u01b0\u01a1ng m\u00f3c, v\u00ec v\u00f9ng n\u00e0y l\u00e0 v\u00f9ng g\u1ed3 l\u00ean c\u1ee7a x\u01b0\u01a1ng c\u1ed5 tay \u1edf m\u1eb7t sau v\u00e0 ph\u1ea7n d\u00e0y nh\u1ea5t c\u1ee7a d\u00e2y ch\u1eb1ng v\u00f2ng c\u1ed5 tay \u1edf tr\u01b0\u1edbc. Chi\u1ec1u d\u00e0i kho\u1ea3ng t\u1eeb 2 \u0111\u1ebfn 2,5mm.<\/span><\/p>\n

Th\u1ec3 t\u00edch c\u1ee7a \u1ed1ng c\u1ed5 tay kho\u1ea3ng 5ml v\u00e0 thay \u0111\u1ed5i t\u00f9y theo k\u00edch th\u01b0\u1edbc c\u1ee7a b\u00e0n tay, th\u01b0\u1eddng nh\u1ecf h\u01a1n \u1edf n\u1eef gi\u1edbi. Khu v\u1ef1c c\u1eaft ngang qua one c\u1ed5 tay c\u00f3 di\u1ec7n t\u00edch kho\u1ea3ng 185mm2 v\u00e0 chi\u1ebfm kho\u1ea3ng 20% t\u1ed5ng di\u1ec7n t\u00edch m\u1eb7t c\u1eaft ngang c\u1ee7a c\u1ed5 tay.<\/span><\/p>\n

\u1ed0ng c\u1ed5 tay \u0111\u01b0\u1ee3c gi\u1edbi h\u1ea1n b\u1edfi th\u00e0nh sau l\u00e0 kh\u1ed1i x\u01b0\u01a1ng c\u1ed5 tay v\u00e0 th\u00e0nh tr\u01b0\u1edbc l\u00e0 d\u00e2y ch\u1eb1ng. Th\u00e0nh sau \u1ed1ng c\u1ed5 tay l\u00e0 m\u1ed9t m\u00e1ng l\u00f5m g\u1ed3m hai v\u00f9ng c\u1ee7a kh\u1ed1i x\u01b0\u01a1ng c\u1ed5 tay. V\u00f9ng g\u1ea7n gi\u1edbi h\u1ea1n b\u1edfi m\u1eb7t b\u00ean c\u1ee7 x\u01b0\u01a1ng thuy\u1ec1n t\u1edbi gi\u1eefa x\u01b0\u01a1ng \u0111\u1eadu. Chi\u1ec1u s\u00e2u t\u1ea1o b\u1edfi x\u01b0\u01a1ng nguy\u1ec7t v\u00e0 x\u01b0\u01a1ng th\u00e1p c\u00f9ng v\u1edbi d\u00e2y ch\u1eb1ng tr\u01b0\u1edbc c\u1ee7a l\u1edbp quay c\u1ed5 tay. V\u00f9ng xa ch\u1ec9 gi\u1edbi h\u1ea1n d\u01b0\u1edbi c\u1ee7a \u1ed1ng c\u00f4 tay, m\u1eb7t b\u00ean gi\u1edbi h\u1ea1n b\u1edfi x\u01b0\u01a1ng thang \u1edf gi\u1eefa x\u01b0\u01a1ng m\u00f3c. Chi\u1ec1u s\u00e2u t\u1ea1o b\u1edfi x\u01b0\u01a1ng thang, x\u01b0\u01a1ng c\u1ea3 v\u00e0 d\u00e2y ch\u1eb1ng gi\u1eefa c\u1ed5 tay. C\u1ea5u t\u1ea1o l\u00f5m c\u1ee7a \u1ed1ng c\u1ed5 tay t\u1ea1o b\u1edfi d\u00e2y ch\u1eb1ng gi\u1eefa c\u00e1c x\u01b0\u01a1ng c\u0169ng nh\u01b0 m\u1ea1c ch\u1eb1ng c\u1ee7a c\u00e1c g\u00e2n g\u1ea5p.<\/span><\/p>\n

Th\u00e0nh tr\u01b0\u1edbc \u1ed1ng c\u00f4 tay l\u00e0 m\u1ed9t l\u1edbp li\u00ean k\u1ebft d\u00e0y v\u00e0 d\u00e0i t\u1ea1o b\u1edfi m\u1ea1c ch\u1eb1ng c\u1ee7a c\u00e1c g\u00e2n g\u1ea5p v\u00e0 d\u00e2y ch\u1eb1ng v\u00f2ng c\u1ed5 tay. \u0110\u00e2y l\u00e0 m\u00e1i c\u1ee7a \u1ed1ng c\u1ed5 tay. M\u1ea1c ch\u1eb1ng c\u1ee7a c\u00e1c g\u00e2n g\u1ea5p \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh t\u1eeb b\u1edd m\u1eb7t tr\u00ean c\u1ee7a x\u01b0\u01a1ng quay l\u00ean \u0111\u1ebfn c\u1ee7 x\u01b0\u01a1ng thuy\u1ec1n v\u00e0 \u0111\u1ec9nh c\u1ee7a x\u01b0\u01a1ng thang, v\u00e0 t\u1eeb b\u1edd c\u1ee7a x\u01b0\u01a1ng tr\u1ee5 t\u1edbi x\u01b0\u01a1ng \u0111\u1eadu v\u00e0 m\u00f3c c\u1ee7a x\u01b0\u01a1ng m\u00f3c.<\/span><\/p>\n

\"VonFrey's
VonFrey’s pressure test<\/figcaption><\/figure>\u1ed0ng c\u1ed5 tay nh\u01b0 m\u1ed9t \u1ed1ng ch\u1ee9a c\u00e1c th\u00e0nh ph\u1ea7n n\u1ed1i gi\u1eefa v\u00f9ng c\u1eb3ng tay tr\u01b0\u1edbc v\u1edbi b\u00e0n tay. \u0110i qua \u1ed1ng c\u1ed1 tay c\u00f3 m\u01b0\u1eddi c\u1ea5u tr\u00fac bao g\u1ed3m: b\u1ed1n g\u00e2n g\u1ea5p c\u00e1c ng\u00f3n n\u00f4ng, b\u1ed1n g\u00e2n g\u1ea5p c\u00e1c ng\u00f3n s\u00e2u, c\u1ea3 t\u00e1m c\u1ea5u tr\u00fac n\u00e0y \u0111\u01b0\u1ee3c bao b\u1ecdc b\u1edfi t\u00fai ho\u1ea1t d\u1ecbch tr\u1ee5, th\u1ee9 ch\u00edn l\u00e0 g\u00e2n g\u1ea5p ng\u00f3n c\u00e1i d\u00e0i \u0111\u01b0\u1ee3c bao b\u1ecdc b\u1edfi t\u00fai ho\u1ea1t d\u1ecbch quay. Cu\u1ed1i c\u00f9ng l\u00e0 d\u00e2y th\u1ea7n kinh gi\u1eefa, \u0111\u00e2y l\u00e0 c\u1ea5u tr\u00fac n\u1eb1m n\u00f4ng nh\u1ea5t trong \u1ed1ng c\u1ed5 tay, \u0111\u01b0\u1ee3c che ph\u1ee7 b\u1edfi m\u00f4 m\u1ee1 – x\u01a1 v\u00e0 d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay, d\u00e2y th\u1ea7n kinh tr\u1ee5 n\u1eb1m ph\u00eda trong s\u00e1t \u0111\u1ed9ng m\u1ea1ch tr\u1ee5.<\/span><\/p>\n
\"So-do-cat-ngang-ong-co-tay-[12]\"
S\u01a1 \u0111\u1ed3 c\u1eaft ngang \u1ed1ng c\u1ed5 tay [12]<\/figcaption><\/figure>\n

Ghi ch\u00fa: FCR-g\u00e2n du\u1ed7i c\u1ed5 tay quay; Sc – x\u01b0\u01a1ng thuy\u1ec1n; Ps x\u01b0\u01a1ng \u0111\u1eadu; \u0111\u1ea7u m\u0169i t\u00ean tr\u1eafng – d\u00e2y th\u1ea7n kinh gi\u1eefa; 3 m\u0169i t\u00ean tr\u1eafng – m\u1ea1c ch\u1eb1ng c\u1ed5 tay; s – c\u00e1c g\u00e2n g\u1ea5p chung n\u00f4ng; p – c\u00e1c g\u00e2n g\u1ea5p chung s\u00e2u.<\/em><\/p>\n

2. Gi\u1ea3i ph\u1eabu v\u00e0 gi\u1ea3i ph\u1eabu si\u00eau \u00e2m th\u1ea7n kinh gi\u1eefa<\/b><\/h2>\n

D\u00e2y th\u1ea7n kinh gi\u1eefa n\u1eb1m ngay d\u01b0\u1edbi m\u1ea1c gi\u1eef c\u00e1c g\u00e2n g\u1ea5p v\u00e0 n\u1eb1m ph\u00eda tr\u00ean v\u00e0 song song v\u1edbi g\u00e2n g\u1ea5p ng\u00f3n 2 v\u00e0 g\u00e2n g\u1ea5p ng\u00f3n c\u00e1i d\u00e0i.<\/span><\/p>\n

D\u00e2y th\u1ea7n kinh gi\u1eefa \u0111\u01b0\u1ee3c t\u1ea1o n\u00ean b\u1edfi 2 r\u1ec5: r\u1ec5 ngo\u00e0i t\u00e1ch ra t\u1eeb b\u00f3 ngo\u00e0i \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay (b\u1eaft ngu\u1ed3n t\u1eeb r\u1ec5 c\u1ed5 5 \u0111\u1ebfn c\u1ed5 7) v\u00e0 r\u1ec5 trong t\u00e1ch ra t\u00f9 b\u00f3 trong c\u1ee7a \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay (b\u1eaft ngu\u1ed3n t\u1eeb r\u1ec5 c\u1ed5 8 v\u00e0 r\u1ec1 ng\u1ef1c 1 h\u1ee3p l\u1ea1i \u1edf \u0111o\u1ea1n tr\u01b0\u1edbc c\u1ee7a \u0111\u1ed9ng m\u1ea1ch n\u00e1ch t\u1ea1o n\u00ean. V\u00f9ng c\u00e1nh tay th\u1ea7n kinh gi\u1eefa \u0111i xu\u1ed1ng d\u1ecdc b\u00ean ngo\u00e0i \u0111\u1ed9ng m\u1ea1ch c\u00e1nh tay (\u0111\u00f4i khi b\u1eaft ch\u00e9o sau) \u1edf kho\u1ea3ng gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay \u0111\u1ec3 ti\u1ebfp t\u1ee5c \u0111i xu\u1ed1ng b\u00ean trong \u0111\u1ed9ng m\u1ea1ch. V\u00f9ng c\u1eb3ng tay th\u1ea7n kinh \u0111i \u1edf gi\u1eefa hai b\u00f3 c\u01a1 s\u1ea5p tr\u00f2n, b\u00f3 s\u00e2u c\u01a1 s\u1ea5p tr\u00f2n ng\u0103n c\u00e1ch th\u1ea7n kinh v\u1edbi \u0111\u1ed9ng m\u1ea1ch tr\u1ee5. T\u1ea1i \u0111\u00e2y th\u1ea7n kinh t\u00e1ch ra nh\u00e1nh gian c\u1ed1t tr\u01b0\u1edbc r\u1ed3i ti\u1ebfp t\u1ee5c \u0111\u00e8 xu\u1ed1ng \u01b0 d\u01b0\u1edbi m\u1eb7t s\u00e2u c\u01a1 g\u1ea5p c\u00e1c ng\u00f3n n\u00f4ng v\u00e0 n\u0103m trong c\u00e2n c\u1ee7a c\u01a1 n\u00e0y. D\u00e2y th\u1ea7n kinh gi\u1eefa kh\u00f4ng ph\u00e2n nh\u00e1nh \u1edf c\u00e1nh tay nh\u01b0ng c\u00f3 m\u1ed9t s\u1ed1 nh\u00e1nh v\u00e0o kh\u1edbp khu\u1ef7u, \u01a1 h\u1ed1 khu\u1ef7u tr\u01b0\u1edbc d\u00e2y th\u1ea7n kinh n\u00e0y ch\u1ea1y s\u00e1t v\u1edbi \u0111\u1ed9ng m\u1ea1ch c\u00e1nh tay v\u00e0 \u0111i xu\u1ed1ng c\u00e1nh tay gi\u1eefa hai \u0111\u1ea7u c\u1ee7a c\u01a1 s\u1ea5p, tr\u01b0\u1edbc khi ph\u00e2n nh\u00e1nh chi ph\u1ed1i cho c\u01a1 s\u1ea5p, c\u01a1 g\u1ea5p c\u1ed5 tay quay, c\u01a1 g\u1ea5p c\u00e1c ng\u00f3n n\u00f4ng v\u00e0 \u1edf m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p chi ph\u1ed1i c\u1ea3 c\u01a1 gan b\u00e0n tay.<\/span><\/p>\n

Nh\u00e1nh gian c\u1ed1t tr\u01b0\u1edbc c\u1ee7a d\u00e2y gi\u1eefa chi ph\u1ed1i c\u01a1 g\u1ea5p ng\u00f3n tay d\u00e0i, c\u00e1c c\u01a1 g\u1ea5p ng\u00f3n tay s\u00e2u c\u1ee7a c\u00e1c ng\u00f3n tr\u1ecf v\u00e0 ng\u00f3n gi\u1eefa, c\u01a1 s\u1ea5p vu\u00f4ng, Tr\u01b0\u1edbc khi \u0111i qua \u1ed1ng c\u00f4 tay d\u00e2y th\u1ea7n kinh gi\u1eefa t\u00e1ch ra nh\u00e1nh c\u1ea3m gi\u00e1c da b\u00e0n tay ch\u1ea1y d\u01b0\u1edbi da v\u00e0 chi ph\u1ed1i c\u1ea3m gi\u00e1c v\u00f9ng \u00f4 m\u00f4 c\u00e1i, nh\u00e1nh n\u00e0y kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng trong h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay nh\u01b0ng l\u1ea1i d\u1ec5 b\u1ecb t\u1ed5n th\u01b0\u01a1ng khi ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng n\u00e0y. \u1ede b\u00e0n tay d\u00e2y th\u1ea7n kinh gi\u1eefa chia ra c\u00e1c nh\u00e1nh v\u1eadn \u0111\u1ed9ng v\u00e0 c\u1ea3m gi\u00e1c.<\/span><\/p>\n

V\u1ec1 <\/span>c\u1ea3m gi\u00e1c d\u00e2y th\u1ea7n kinh gi\u1eefa chi ph\u1ed1i cho h\u01a1n m\u1ed9t n\u1eeda gan tay \u1edf ph\u00eda ngo\u00e0i (tr\u1eeb m\u1ed9t ph\u1ea7n nh\u1ecf da \u1edf ph\u00eda ngo\u00e0i m\u00f4 c\u00e1i do d\u00e2y th\u1ea7n kinh quay c\u1ea3m gi\u00e1c), m\u1eb7t gan tay c\u1ee7a 3 ng\u00f3n r\u01b0\u1ee1i \u1edf ph\u00eda ngo\u00e0i k\u1ec3 t\u1eeb ng\u00f3n c\u00e1i <\/span>v\u00e0 c\u1ea3 m\u1eb7t mu c\u00e1c \u0111\u1ed1t II-III c\u1ee7a c\u00e1c <\/span>ng\u00f3n \u0111\u00f3, Trong h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay th\u01b0\u1eddng b\u1ecb t\u1ed5n th\u01b0\u01a1ng c\u1ea3m gi\u00e1c theo chi ph\u1ed1i n\u00e0y.<\/span><\/p>\n

V\u1ec1 v\u1eadn \u0111\u1ed9ng \u1edf b\u00e0n tay, d\u00e2y th\u1ea7n kinh n\u00e0y chi ph\u1ed1i c\u00e1c c\u01a1 giun th\u1ee9 nh\u1ea5t v\u00e0 th\u1ee9 hai, c\u01a1 \u0111\u1ed1i chi\u1ebfu ng\u00f3n c\u00e1i, c\u01a1 d\u1ea1ng ng\u1eafn ng\u00f3n c\u00e1i v\u00e0 \u0111\u1ea7u n\u00f4ng c\u01a1 g\u1ea5p ng\u00f3n c\u00e1i ng\u1eafn. Khi t\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 th\u1ea5y c\u00e1c d\u1ea5u hi\u1ec7u kh\u00f3 d\u1ea1ng ng\u00f3n c\u00e1i k\u00e8m theo teo c\u01a1 \u00f4 m\u00f4 c\u00e1i. M\u1ed9t \u0111i\u1ec3m c\u1ea7n l\u01b0u \u00fd l\u00e0 \u0111i\u1ec3m xu\u1ea5t ph\u00e1t nh\u00e1nh v\u1eadn \u0111\u1ed9ng th\u1ea7n kinh gi\u1eefa c\u00f3 th\u1ec3 thay \u0111\u1ed5i khi \u0111\u1ed1i chi\u1ebfu v\u1edbi b\u1edd xa c\u1ee7a m\u1ea1c gi\u1eef g\u00e2n g\u1ea5p. C\u00f3 46% tr\u01b0\u1eddng h\u1ee3p nh\u00e1nh n\u00e0y \u0111i qua \u1ed1ng c\u1ed5 tay r\u1ed3i qu\u1eb7t ng\u01b0\u1ee3c l\u1ea1i v\u00e0o c\u01a1 \u00f4 m\u00f4 c\u00e1i, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ngo\u00e0i d\u00e2y ch\u1eb1ng, 31% tr\u01b0\u1eddng h\u1ee3p nh\u00e1nh n\u00e0y xu\u1ea5t ph\u00e1t \u1edd v\u1ecb tr\u00ed ngay b\u00ean trong \u1ed1ng c\u1ed1 tay, r\u1ed3i \u0111i v\u00f2ng qua b\u1edd xa c\u1ee7a d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay, g\u1ecdi l\u00e0 d\u01b0\u1edbi d\u00e2y ch\u1eb1ng. 23% tr\u01b0\u1eddng h\u1ee3p nh\u00e1nh n\u00e0y c\u0169ng xu\u1ea5t ph\u00e1t b\u00ean trong \u1ed1ng c\u1ed5 tay nh\u01b0ng n\u00f3 \u0111i xuy\u00ean qua d\u00e2y ch\u1eb1ng ngang c\u1ed5 tay, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 xuy\u00ean d\u00e2y ch\u1eb1ng. B\u1ea5t th\u01b0\u1edfng v\u1ec1 ph\u00e2n b\u1ed1 c\u1ee7a th\u1ea7n kinh gi\u1eefa th\u01b0\u1eddng g\u1eb7p l\u1ea3 th\u00f4ng n\u1ed1i nh\u00e1nh m\u00f4 c\u00e1i c\u1ee7a th\u1ea7n kinh gi\u1eefa v\u1edbi nh\u00e1nh s\u00e2u c\u1ee7a th\u1ea7n kinh tr\u1ee5 \u1edf b\u00e0n tay v\u00e0 c\u00e1c ng\u00f3n g\u1ecdi l\u00e0 nh\u00e1nh Riche-Cannieu. \u00edt g\u1eb7p h\u01a1n (15- 31%) l\u00e0 th\u00f4ng n\u1ed1i ph\u1ea7n chi ph\u1ed1i b\u00e0n tay c\u1ee7a th\u1ea7n kinh gi\u1eefa v\u00e0o th\u1ea7n kinh tr\u1ee5 x\u1ea3y ra \u1edf c\u1eb3ng tay, th\u1ea7n kinh gi\u1eefa kh\u00f4ng \u0111i v\u00e0o b\u00e0n tay, \u0111\u01b0\u1ee3c bi\u1ebft nh\u01b0 l\u00e0 c\u1ea7u n\u1ed1i Martin- Gruber.<\/span><\/p>\n

Th\u1ea7n kinh gi\u1eefa<\/a> g\u1ed3m nhi\u1ec1u s\u1ee3i s\u1eafp x\u1ebfp trong m\u1ed9t b\u00f3 bao quanh b\u1edfi t\u1ed5 ch\u1ee9c H\u00ean k\u1ebft g\u1ecdi l\u00e0 nh\u00fa (n\u1ee5) th\u1ea7n kinh. S\u1ee3i th\u1ea7n kinh \u0111\u01b0\u1ee3c gi\u1edbi h\u1ea1n b\u1edfi bao th\u1ea7n kinh. T\u1eeb b\u1edd tr\u00ean c\u1ee7a \u1ed1ng c\u1ed5 tay th\u1ea7n kinh gi\u1eefa nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 c\u1ea5p m\u00e1u c\u1ee7a m\u1ed9t ho\u1eb7c hai \u0111\u1ed9ng m\u1ea1ch quay ho\u1eb7c tr\u1ee5. C\u00e1c \u0111\u1ed9ng m\u1ea1ch \u1edf bao quanh d\u00e2y th\u1ea7n kinh 1-2cm \u1edf ph\u00eda d\u01b0\u1edbi \u0111\u1ea7u tr\u00ean c\u1ee7a m\u1ea1c ch\u1eb1ng g\u00e2n g\u1ea5p. C\u1ea5p m\u00e1u cho d\u00e2y th\u1ea7n kinh l\u00e0 h\u1ec7 ti\u1ec3u tu\u1ea7n ho\u00e0n. D\u00e2y th\u1ea7n kinh th\u00edch nghi t\u1ed1t v\u1edbi s\u1ef1 thi\u1ebfu m\u00e1u. \u0110\u1ed9ng m\u1ea1ch xu\u1ea5t th\u00e2n t\u1eeb quanh bao d\u00e2y th\u1ea7n kinh th\u1ea9m th\u1ea5u v\u00e0o quanh th\u01b0\u01a1ng r\u1ed9ng.<\/span><\/p>\n

Gi\u1ea3i ph\u1eabu si\u00eau \u00e2m th\u1ea7n kinh gi\u1eefa: m\u1eb7t c\u1eaft ngang th\u1ea7n kinh gi\u1eefa h\u00ecnh ovan, m\u1ecfng d\u1ea7n khi n\u00f3 \u0111i ra c\u00f4 tay. M\u1eb7t c\u1eaft d\u1ecdc xen k\u1ebd d\u1ea3i t\u0103ng \u00e2m v\u00e0 gi\u1ea3m \u00e2m. Tr\u00ean si\u00eau \u00e2m b\u00f3 th\u1ea7n kinh th\u01b0\u1eddng gi\u1ea3m \u00e2m bao xung quanh b\u1edfi n\u1ee5 th\u1ea7n kinh (nh\u00fa th\u1ea7n kinh t\u0103ng echo). C\u1ea7n ph\u00e2n bi\u1ec7t g\u00e2n v\u00e0 d\u00e2y th\u1ea7n kinh n\u1eb1m k\u1ec1 s\u00e1t nhau. \u1ede tr\u1ea1ng th\u00e1i b\u00ecnh th\u01b0\u1eddng t\u01b0\u1edbi m\u00e1u th\u1ea7n kinh kh\u00f4ng quan s\u00e1t \u0111\u01b0\u1ee3c ngay c\u1ea3 tr\u00ean si\u00eau \u00e2m Doppler n\u0103ng l\u01b0\u1ee3ng. Si\u00eau \u00e2m l\u00e0 m\u1ed9t th\u0103m kh\u00e1m \u0111\u1ed9ng cho ph\u00e9p th\u1ea5y nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m bi\u1ebfn d\u1ea1ng v\u00e0 chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a d\u00e2y th\u1ea7n kinh trong nh\u1eefng chuy\u1ec3n \u0111\u1ed9ng g\u1ea5p du\u1ed7i c\u1ee7a ng\u00f3n tay.<\/span><\/p>\n

\"Cau-tao-day-than-kinh
C\u1ea5u t\u1ea1o d\u00e2y th\u1ea7n kinh<\/figcaption><\/figure>M\u1ed9t bi\u1ebfn thi\u00ean v\u1ec1 gi\u1ea3i ph\u1eabu \u0111\u00e3 bi\u1ebft: \u1edf ph\u00eda tr\u00ean h\u1ed9i ch\u1ee9ng \u0111\u01b0\u1eddng h\u1ea7m d\u00e2y th\u1ea7n kinh c\u00f3 th\u1ec3 chia l\u00e0m hai th\u00e2n. T\u1ec9 l\u1ec7 n\u00e0y chi\u1ebfm 11,7% c\u00e1c ca. S\u1ef1 thay \u0111\u1ed5i gi\u1ea3i ph\u1eabu n\u00e0y th\u01b0\u1eddng \u0111i k\u00e8m s\u1ef1 t\u1ed3n t\u1ea1i m\u1ed9t \u0111\u1ed9ng m\u1ea1ch gi\u1eefa ngu\u1ed3n g\u1ed1c t\u1eeb \u0111\u1ed9ng m\u1ea1ch tr\u1ee5 n\u1eb1m gi\u1eefa hai nh\u00e1nh c\u1ee7a d\u00e2y th\u1ea7n kinh.<\/span><\/p>\n

\"Mat-cat-ngang-day-than-kinh-giua-(mui-ten-trang)-[24]\"
M\u1eb7t c\u1eaft ngang d\u00e2y th\u1ea7n kinh gi\u1eefa (m\u0169i t\u00ean tr\u1eafng)<\/figcaption><\/figure>
\"Than-kinh-giua-bi-tach-doi-(mui-ten-trang)-[24]\"
Th\u1ea7n kinh gi\u1eefa b\u1ecb t\u00e1ch \u0111\u00f4i (m\u0169i t\u00ean tr\u1eafng)<\/figcaption><\/figure><\/p>\n

Ngu\u1ed3n t\u00e1c gi\u1ea3<\/p>\n","protected":false},"excerpt":{"rendered":"

Si\u00eau \u00e2m ho\u1eb7c c\u1ed9ng h\u01b0\u1edfng t\u1eeb c\u00f3 th\u1ec3 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ef1 thay \u0111\u1ed5i h\u00ecnh th\u00e1i c\u1ee7a d\u00e2y th\u1ea7n kinh gi\u1eefa qua khu v\u1ef1c \u1ed1ng c\u1ed5 tay, tuy nhi\u00ean si\u00eau \u00e2m c\u00f3 \u01b0u \u0111i\u1ec3m v\u01b0\u1ee3t tr\u1ed9i nh\u01b0 r\u1ebb ti\u1ec1n, c\u01a1 \u0111\u1ed9ng v\u00e0 cho ch\u1ea5t l\u01b0\u1ee3ng th\u0103m kh\u00e1m v\u1edbi \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u cao, […]<\/p>\n","protected":false},"author":53,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[40],"tags":[3],"yoast_head":"\nGi\u1ea3i ph\u1eabu si\u00eau \u00e2m \u1ed1ng c\u1ed5 tay v\u00e0 d\u00e2y th\u1ea7n kinh gi\u1eefa - Vinmec<\/title>\n<meta name=\"description\" content=\"Si\u00eau \u00e2m c\u00f3 \u01b0u \u0111i\u1ec3m v\u01b0\u1ee3t tr\u1ed9i nh\u01b0 r\u1ebb ti\u1ec1n, c\u01a1 \u0111\u1ed9ng v\u00e0 cho ch\u1ea5t l\u01b0\u1ee3ng th\u0103m kh\u00e1m v\u1edbi \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u cao. 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