{"id":33867,"date":"2023-05-15T23:21:06","date_gmt":"2023-05-15T16:21:06","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=33867"},"modified":"2023-05-15T23:21:06","modified_gmt":"2023-05-15T16:21:06","slug":"giai-phau-cua-day-chang-cheo-truoc","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/15\/giai-phau-cua-day-chang-cheo-truoc\/","title":{"rendered":"\u00a0Gi\u1ea3i ph\u1eabu c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc kh\u1edbp g\u1ed1i"},"content":{"rendered":"

\u00a0<\/span>Nh\u1eefng m\u00f4 t\u1ea3 gi\u1ea3i ph\u1eabu c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc kh\u1edbp g\u1ed1i (DCCT) \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong c\u00e1c t\u00e0i li\u1ec7u c\u1ee7a ng\u01b0\u1eddi Ai c\u1eadp c\u1ed5 \u0111\u1ea1i t\u1eeb 3000 n\u0103m Tr\u01b0\u1edbc C\u00f4ng Nguy\u00ean (TCN). M\u1eb7c d\u00f9 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 r\u1ea5t s\u1edbm nh\u01b0ng cho t\u1edbi t\u1eadn ng\u00e0y nay, nh\u1eefng nghi\u00ean c\u1ee9u v\u1ec1 gi\u1ea3i ph\u1eabu c\u1ee7a DCCT v\u1eabn \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c nh\u1eb1m g\u00f3p ph\u1ea7n gi\u00fap cho ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh l\u1ea1i d\u00e2y ch\u1eb1ng \u0111\u1ea1t \u0111\u01b0\u1ee3c nh\u1eefng k\u1ebft qu\u1ea3 t\u1ed1t h\u01a1n n\u1eefa.<\/strong><\/p>\n

1.\u00a0 Gi\u1ea3i ph\u1eabu b\u00e0o thai c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc kh\u1edbp g\u1ed1i<\/strong><\/h2>\n

1.1 \u0110\u1ea1i th\u1ec3<\/strong><\/h3>\n

DCCT \u0111\u00e3 \u0111\u01b0\u1ee3c bao ph\u1ee7 b\u1edfi m\u00e0ng ho\u1ea1t d\u1ecbch v\u00e0 c\u00f3 c\u1ea5u tr\u00fac 2 b\u00f3 l\u00e0 b\u00f3 tr\u01b0\u1edbc trong v\u00e0 b\u00f3 sau ngo\u00e0i nh\u01b0 \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh, t\u00ean hai b\u00f3 n\u00e0y \u0111\u01b0\u1ee3c \u0111\u1eb7t theo t\u01b0\u01a1ng quan gi\u1ea3i ph\u1eabu gi\u1eefa ch\u00fang v\u1edbi nhau \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh. Tuy nhi\u00ean, \u1edf kh\u1edbp g\u1ed1i b\u00e0o thai, t\u01b0\u01a1ng quan n\u00e0y c\u1ee7a ch\u00fang ch\u01b0a th\u1eadt s\u1ef1 gi\u1ed1ng nh\u01b0 \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh, c\u1ee5 th\u1ec3 l\u00e0 \u1edf t\u01b0 th\u1ebf 0\u00b0, hai b\u00f3 n\u00e0y song song v\u1edbi nhau. Khi g\u1ed1i t\u1eeb t\u1eeb g\u1ea5p l\u1ea1i th\u00ec b\u00f3 sau ngo\u00e0i c\u00f3 xu h\u01b0\u1edbng di chuy\u1ec3n ra tr\u01b0\u1edbc so v\u1edbi b\u00f3 tr\u01b0\u1edbc trong v\u00e0 \u1edf t\u01b0 th\u1ebf 90\u00b0, b\u00f3 tr\u01b0\u1edbc trong c\u00f3 xu h\u01b0\u1edbng n\u1eb1m ngang h\u01a1n c\u00f2n b\u00f3 sau ngo\u00e0i c\u00f3 xu h\u01b0\u1edbng n\u1eb1m d\u1ecdc.<\/span><\/p>\n

1.2. V\u1ecb tr\u00ed b\u00e1m v\u00e0o m\u00e2m ch\u00e0y v\u00e0 l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i<\/strong><\/h3>\n

\u1eda m\u00e2m ch\u00e0y, b\u00f3 tr\u01b0\u1edbc trong c\u1ee7a DCCT n\u1eb1m ph\u00eda ngo\u00e0i v\u00e0 sau ch\u1ed7 b\u00e1m c\u1ee7a s\u1eebng tr\u01b0\u1edbc s\u1ee5n ch\u00eam trong v\u00e0 m\u1edf r\u1ed9ng ra s\u1eebng tr\u01b0\u1edbc c\u1ee7a s\u1ee5n ch\u00eam ngo\u00e0i c\u00f2n b\u00f3 sau ngo\u00e0i n\u1eb1m gi\u1eefa s\u1eebng tr\u01b0\u1edbc v\u00e0 sau c\u1ee7a s\u1ee5n ch\u00eam ngo\u00e0i, ph\u00eda sau v\u00e0 ngo\u00e0i so v\u1edbi b\u00f3 tr\u01b0\u1edbc trong.<\/span><\/p>\n

\"giai-phau-day-chang-cheo-truoc\"
H\u00ecnh: V\u1ecb tr\u00ed b\u00e1m c\u1ee7a hai b\u00f3 c\u1ee7a DCCT v\u00e0o l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i \u1edf t\u01b0 th\u1ebf du\u1ed7i g\u1ed1i (A) v\u00e0 t\u01b0 th\u1ebf g\u1ea5p g\u1ed1i (B)<\/figcaption><\/figure>\n

2. Gi\u1ea3i ph\u1eabu d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc kh\u1edbp g\u1ed1i<\/strong><\/h2>\n

2.1 \u0110\u1ea1i th\u1ec3<\/strong><\/h3>\n

DCCT c\u00f3 nguy\u00ean u\u1ef7 t\u1eeb h\u1ed1 li\u00ean l\u1ed3i c\u1ea7u c\u1ee7a x\u01b0\u01a1ng \u0111\u00f9i, n\u1eb1m \u1edf m\u1eb7t trong c\u1ee7a l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i v\u00e0 b\u00e1m t\u1eadn \u1edf di\u1ec7n ph\u00eda tr\u01b0\u1edbc c\u1ee7a m\u00e2m ch\u00e0y theo h\u01b0\u1edbng t\u1eeb tr\u00ean xu\u1ed1ng d\u01b0\u1edbi, t\u1eeb ngo\u00e0i v\u00e0o trong v\u00e0 t\u1eeb sau ra tr\u01b0\u1edbc. Nh\u00ecn b\u1ec1 ngo\u00e0i, DCCT nh\u01b0 m\u1ed9t d\u1ea3i x\u01a1 n\u1ed9i kh\u1edbp \u0111\u01b0\u1ee3c m\u00e0ng ho\u1ea1t d\u1ecbch bao b\u1ecdc.<\/span><\/p>\n

DCCT c\u00f3 chi\u1ec1u d\u00e0i trung b\u00ecnh 38,2mm(t\u1eeb 37mm \u0111\u1ebfn 41mm) v\u00e0 \u0111\u01b0\u1eddng k\u00ednh kho\u1ea3ng 1,1 cm. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 kh\u00e1c l\u1ea1i c\u00f4ng b\u1ed1 k\u1ebft qu\u1ea3 c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t m\u1ed9t ch\u00fat, s\u1ef1 kh\u00e1c bi\u1ec7t n\u00e0y l\u00e0 do vi\u1ec7c \u0111o \u0111\u1ea1c th\u1ef1c hi\u1ec7n \u1edf t\u01b0 th\u1ebf g\u1ea5p hay du\u1ed7i g\u1ed1i, c\u1eb3ng ch\u00e2n xoay trong hay ngo\u00e0i. DCCT kh\u00f4ng c\u00f3 c\u1ea5u tr\u00fac h\u00ecnh tr\u00f2n m\u00e0 l\u00e0 d\u1ea1ng ellip, trong \u0111\u00f3 ph\u1ea7n gi\u1eefa c\u1ee7a d\u00e2y ch\u1eb1ng l\u00e0 ph\u1ea7n h\u1eb9p nh\u1ea5t,v\u1edbi di\u1ec7n t\u00edch t\u01b0\u01a1ng \u1ee9ng l\u00e0 36mm<\/span>2<\/span> \u1edf n\u1eef v\u00e0 42mm<\/span>2<\/span> \u1edf nam, t\u1ee9c l\u00e0 nh\u1ecf h\u01a1n 3,5 l\u1ea7n so v\u1edbi di\u1ec7n t\u00edch \u0111i\u1ec3m b\u00e1m c\u1ee7a d\u00e2y ch\u1eb1ng.<\/span><\/p>\n

Tr\u1ee5c c\u1ee7a DCCT so v\u1edbi tr\u1ee5c c\u01a1 th\u1ec3 l\u00e0 kho\u1ea3ng 26,6\u00b0 so v\u1edbi tr\u1ee5c chi.<\/span><\/p>\n

2.2 Vi th\u1ec3<\/strong><\/h3>\n

DCCT c\u00f3 c\u1ea5u tr\u00fac g\u1ed3m nhi\u1ec1u s\u1ee3i Collagen(c\u00f3 \u0111\u01b0\u1eddng l\u00e1nh t\u1eeb 150-250nm), c\u00e1c s\u1ee3i n\u00e0y kh\u00f4ng ch\u1ea1y song song m\u00e0 \u0111an ch\u00e9o nhau, t\u1ea1o th\u00e0nh nh\u1eefng s\u1ee3i c\u00f3 \u0111\u01b0\u1eddng k\u00ednh l\u1edbn h\u01a1n(l-20 micromet), c\u00e1c s\u1ee3i n\u00e0y t\u1eadp trung th\u00e0nh c\u00e1c b\u00f3 s\u1ee3i nh\u1ecf c\u00f3 k\u00edch th\u01b0\u1edbc 100-250 micromet. C\u00e1c b\u00f3 n\u00e0y c\u1ed5 m\u00f4 li\u00ean k\u1ebft ch\u1ee9a m\u1ea1ch m\u00e1u nu\u00f4i bao quanh. C\u00e1c b\u00f3 n\u00e0y t\u1eadp trung th\u00e0nh c\u00e1c b\u00f3 l\u1edbn h\u01a1n, ch\u00fang c\u00f3 th\u1ec3 \u0111i th\u1eb3ng t\u1eeb v\u1ecb tr\u00ed b\u00e1m \u0111\u00f9i \u0111\u1ebfn v\u1ecb tr\u00ed b\u00e1m ch\u1ea7y. To\u00e0n b\u1ed9 DCCT \u0111\u01b0\u1ee3c bao b\u1ecdc b\u1edfi m\u00f4 li\u00ean k\u1ebft c\u00f3 c\u1ea5u tr\u00fac t\u01b0\u01a1ng t\u1ef1 nh\u01b0ng d\u00e0y h\u01a1n l\u1edbp n\u1ed9i m\u00f4.<\/span><\/p>\n

T\u1ea1i v\u1ecb tr\u00ed b\u00e1m v\u00e0o x\u01b0\u01a1ng, c\u00e1c s\u1ee3i Collagen c\u1ee7a DCCT ho\u00e0 l\u1eabn v\u00e0o c\u00e1c s\u1ee3i Collagen c\u1ee7a v\u00f9ng x\u01b0\u01a1ng l\u00e2n c\u1eadn, s\u1ef1 chuy\u1ec3n \u0111\u1ed5i t\u1eeb m\u00f4 d\u00e2y ch\u1eb1ng \u0111\u00e0n h\u1ed3i sang m\u00f4 x\u01b0\u01a1ng c\u1ee9ng th\u00f4ng qua m\u1ed9t v\u00f9ng chuy\u1ec3n ti\u1ebfp \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o b\u1edfi m\u00f4 s\u1ee5n s\u1ee3i v\u00e0 m\u00f4 s\u1ee5n s\u1ee3i kho\u00e1ng h\u00f3a, t\u1ea1o th\u00e0nh 4 l\u1edbp t\u01b0\u01a1ng \u0111\u1ed1i r\u00f5 r\u1ec7t l\u00e0: c\u00e1c s\u1ee3i Collagen, v\u00f9ng s\u1ee5n kh\u00f4ng kho\u00e1ng, v\u00f9ng s\u1ee5n kho\u00e1ng h\u00f3a v\u00e0 m\u00f4 x\u01b0\u01a1ng d\u01b0\u1edbi s\u1ee5n.<\/span><\/p>\n

Do di\u1ec7n b\u00e1m c\u1ee7a DCCT v\u00e0o m\u00e2m ch\u00e0y r\u1ed9ng, gi\u1ed1ng “ch\u00e2n v\u1ecbt” v\u00e0 lan ra r\u1ea5t s\u00e1t b\u1edd tr\u01b0\u1edbc c\u1ee7a m\u00e2m ch\u00e0y v\u1edbi kho\u1ea3ng c\u00e1ch l\u00e0 10\u00ad14mm n\u00ean khi g\u1ed1i g\u1ea5p, d\u00e2y ch\u1eb1ng s\u1ebd b\u1ecb “k\u1eb9t” v\u00e0o khe li\u00ean l\u1ed3i c\u1ea7u, hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y g\u1ecdi l\u00e0 “k\u1eb9t sinh l\u00fd”(physical impingement). Nghi\u00ean c\u1ee9u k\u1ef9 c\u1ea5u tr\u00fac m\u00f4 h\u1ecdc c\u1ee7a v\u00f9ng n\u00e0y cho th\u1ea5y, v\u00f9ng n\u00e0y c\u00f3 c\u1ea5u tr\u00fac kh\u00e1c v\u1edbi c\u1ea5u tr\u00fac c\u00e1c ph\u1ea7n kh\u00e1c c\u1ee7a d\u00e2y ch\u1eb1ng. V\u00f9ng n\u00e0y kh\u00f4ng c\u00f3 m\u1ea1ch m\u00e1u, c\u00f3 nhi\u1ec1u t\u1ebf b\u00e0o g\u00e2n v\u00e0 c\u00e1c t\u1ebf b\u00e0o d\u1ea1ng s\u1ee5n. C\u1ea5u tr\u00fac n\u00e0y \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch l\u00e0 do t\u00ednh th\u00edch nghi ch\u1ee9c n\u0103ng c\u1ee7a d\u00e2y ch\u1eb1ng khi ch\u1ecbu c\u00e1c l\u1ef1c ti\u1ebfp x\u00fac t\u00e1i di\u1ec5n li\u00ean t\u1ee5c c\u1ee7a x\u01b0\u01a1ng v\u00e0o d\u00e2y ch\u1eb1ng<\/span><\/p>\n

2.3 M\u1ea1ch m\u00e1u v\u00e0 th\u1ea7n kinh c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc<\/strong><\/h3>\n

M\u1ea1ch m\u00e1u cung c\u1ea5p ch\u00ednh cho DCCT l\u00e0 c\u00e1c nh\u00e1nh c\u1ee7a \u0111\u1ed9ng m\u1ea1ch g\u1ed1i gi\u1eefa v\u00e0 nh\u1eefng nh\u00e1nh t\u1eadn c\u00f9ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch g\u1ed1i d\u01b0\u1edbi trong v\u00e0 \u0111\u1ed9ng m\u1ea1ch g\u1ed1i d\u01b0\u1edbi ngo\u00e0i. C\u00e1c nh\u00e1nh n\u00e0y cho c\u00e1c nh\u00e1nh n\u1eb1m trong l\u1edbp bao ho\u1ea1t d\u1ecbch quanh d\u00e2y ch\u1eb1ng v\u00e0 th\u00f4ng n\u1ed1i v\u1edbi nhau.<\/span><\/p>\n

\u00a0<\/span>DCCT nh\u1eadn nh\u1eefng nh\u00e1nh th\u1ea7n kinh \u0111\u1ebfn t\u1eeb th\u1ea7n kinh ch\u00e0y(l\u00e0 nh\u00e1nh kh\u1edbp sau c\u1ee7a th\u1ea7n kinh ch\u00e0y). C\u00e1c nh\u00e1nh n\u00e0y \u0111i c\u00f9ng c\u00e1c m\u1ea1ch m\u00e1u \u0111\u1ebfn d\u00e2y ch\u1eb1ng v\u00e0 t\u1eadn c\u00f9ng l\u00e0 c\u00e1c th\u1ee5 th\u1ec3 \u00e1p l\u1ef1c d\u1ea1ng th\u1ee5 th\u1ec3 Golgi. C\u00e1c th\u1ee5 th\u1ec3 th\u1ea7n kinh c\u1ee7a d\u00e2y ch\u1eb1ng g\u1ed3m 3 lo\u1ea1i ch\u00ednh: nh\u1eefng th\u1ee5 th\u1ec3 nh\u1eadn c\u1ea3m s\u1ef1 bi\u1ebfn d\u1ea1ng, chi\u1ebfm kho\u1ea3ng 1% di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t d\u00e2y ch\u1eb1ng, nh\u1eefng th\u1ee5 th\u1ec3 nh\u1ea1y c\u1ea3m v\u1edbi nh\u1eefng th\u00edch nghi nhanh(Ruffini) v\u00e0 nh\u1eefng th\u1ee5 th\u1ec3 nh\u1ea1y c\u1ea3m v\u1edbi nh\u1eefng th\u00edch nghi ch\u1eadm(Pacini) gi\u00fap \u00fd th\u1ee9c \u0111\u01b0\u1ee3c s\u1ef1 v\u1eadn \u0111\u1ed9ng, t\u01b0 th\u1ebf v\u00e0 g\u00f3c xoay. C\u00e1c th\u1ee5 th\u1ec3 n\u00e0y(Ruffini v\u00e0 Pacini) chi\u1ebfm nhi\u1ec1u nh\u1ea5t v\u00e0 \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong ki\u1ec3m so\u00e1t c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3 c\u1ee7a kh\u1edbp. Ngo\u00e0i ra c\u00f2n c\u00f3 r\u1ea5t \u00edt c\u00e1c th\u1ee5 th\u1ec3 c\u1ea3m gi\u00e1c \u0111au<\/span><\/p>\n

3. Gi\u1ea3i\u00a0 ph\u1eabu \u0111i\u1ec3m b\u00e1m v\u00e0o l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i<\/strong><\/h2>\n

V\u1ecb tr\u00ed b\u00e1m c\u1ee7a DCCT v\u00e0o ph\u1ea7n sau c\u1ee7a m\u1eb7t trong l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i, di\u1ec7n b\u00e1m \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 nh\u01b0 m\u1ed9t ph\u1ea7n c\u1ee7a h\u00ecnh tr\u00f2n v\u1edbi b\u1edd ph\u00eda tr\u01b0\u1edbc th\u1eb3ng v\u00e0 b\u1edd ph\u00eda sau cong l\u1ed3i. Kho\u1ea3ng c\u00e1ch t\u1eeb di\u1ec7n b\u00e1m n\u00e0y \u0111\u1ebfn m\u1eb7t s\u1ee5n c\u1ee7a l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i l\u00e0 2-3mm. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u kh\u00e1c th\u00ec cho k\u1ebft qu\u1ea3 l\u00e0 v\u1ecb tr\u00ed b\u00e1m c\u1ee7a DCCT v\u00e0o l\u1ed3i c\u1ea7u \u0111\u00f9i c\u00f3 h\u00ecnh ovan h\u01a1n v\u1edbi k\u00edch th\u01b0\u1edbc l\u00e0 d\u00e0i 18mm v\u00e0 r\u1ed9ng 11mm v\u00e0 v\u1ecb tr\u00ed b\u00e1m c\u1ee7a DCCT ra sau h\u01a1n v\u00e0 s\u00e1t v\u00e0o s\u1ee5n kh\u1edbp c\u1ee7a l\u1ed3i c\u1ea7u.<\/span><\/p>\n

\u00a0<\/span>M\u1ed9t m\u1ed1c gi\u1ea3i ph\u1eabu kh\u00e1c quan tr\u1ecdng m\u00e0 nhi\u1ec1u t\u00e1c gi\u1ea3 \u0111\u1ec1 c\u1eadp \u0111\u1ebfn khi m\u00f4 t\u1ea3 v\u1ecb tr\u00ed b\u00e1m c\u1ee7a DCCT v\u00e0o l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i l\u00e0 v\u1ecb tr\u00ed n\u00e0y n\u1eb1m ph\u00eda sau m\u1ed9t g\u1edd x\u01b0\u01a1ng nh\u1ecf g\u1ecdi l\u00e0 Resident\u2019s rigde v\u00e0 coi \u0111\u00e2y l\u00e0 m\u1ed1c gi\u1ea3i ph\u1eabu quan tr\u1ecdng trong vi\u1ec7c t\u1ea1o \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng \u0111\u00f9i. G\u1edd n\u00e0y l\u00e0 ch\u1ed7 nh\u00f4 l\u00ean hay v\u1ecb tr\u00ed thay \u0111\u1ed5i chi\u1ec1u cong c\u1ee7a khe li\u00ean l\u1ed3i c\u1ea7u, n\u1eb1m ngay tr\u01b0\u1edbc v\u1ecb tr\u00ed b\u00e1m c\u1ee7a DCCT v\u00e0 tr\u01b0\u1edbc b\u1edd ph\u00eda sau c\u1ee7a khe li\u00ean l\u1ed3i c\u1ea7u . S\u1ef1 kh\u00e1c nhau trong m\u00f4 t\u1ea3 v\u1ecb tr\u00ed b\u00e1m c\u1ee7a DCCT v\u00e0o l\u1ed3i c\u1ea7u x\u01b0\u01a1ng \u0111\u00f9i c\u0169ng ch\u1ec9 ch\u1ee9ng t\u1ecf s\u1ef1 \u0111a d\u1ea1ng v\u1ec1 h\u00ecnh th\u00e1i, \u0111i\u1ec1u n\u00e0y \u0111\u01b0\u1ee3c Phillip Colombet kh\u1eb3ng \u0111\u1ecbnh trong nghi\u00ean c\u1ee9u c\u1ee7a \u00f4ng.<\/span><\/p>\n

T\u01b0\u01a1ng quan v\u1ecb tr\u00ed b\u00e1m c\u1ee7a hai b\u00f3 c\u1ee7a DCCT c\u0169ng r\u1ea5t kh\u00e1c nhau, b\u00f3 tr\u01b0\u1edbc trong n\u1eb1m cao h\u01a1n v\u00e0 tr\u01b0\u1edbc h\u01a1n so v\u1edbi b\u00f3 sau ngo\u00e0i(t\u1ee9c l\u00e0 n\u1eb1m cao v\u00e0 s\u00e2u v\u1ec1 ph\u00eda khe li\u00ean l\u1ed3i c\u1ea7u \u0111\u00f9i khi g\u1ed1i g\u1ea5p). Kho\u1ea3ng c\u00e1ch t\u1eeb trung t\u00e2m c\u1ee7a b\u00f3 tr\u01b0\u1edbc trong \u0111\u1ebfn \u0111\u01b0\u1eddng li\u00ean l\u1ed3i c\u1ea7u v\u00e0o kho\u1ea3ng 5-6mm. Tr\u00ean m\u1eb7t th\u1eb3ng \u0111\u1ee9ng ngang, v\u1ecb tr\u00ed trung t\u00e2m c\u1ee7a b\u00f3 tr\u01b0\u1edbc trong t\u01b0\u01a1ng \u1ee9ng kho\u1ea3ng 10h30\u2019(\u0111\u1ed1i v\u1edbi b\u00ean ph\u1ea3i v\u00e0 lh30\u2019 \u0111\u1ed1i v\u1edbi b\u00ean tr\u00e1i).<\/span><\/p>\n

B\u00f3 sau ngo\u00e0i n\u1eb1m ph\u00eda tr\u01b0\u1edbc v\u00e0 d\u01b0\u1edbi so v\u1edbi b\u00f3 tr\u01b0\u1edbc trong, kho\u1ea3ng c\u00e1ch t\u1eeb tr\u1ecdng t\u00e2m c\u1ee7a b\u00f3 sau ngo\u00e0i \u0111\u1ebfn b\u1edd s\u1ee5n ph\u00eda d\u01b0\u1edbi c\u1ee7a l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i l\u00e0 kho\u1ea3ng 3mm. Tr\u00ean m\u1eb7t ph\u1eb3ng \u0111\u1ee9ng ngang, v\u1ecb tr\u00ed c\u1ee7a b\u00f3 sau ngo\u00e0i t\u01b0\u01a1ng \u1ee9ng l\u00e0 9h30\u2019 (\u0111\u1ed1i v\u1edbi b\u00ean ph\u1ea3i v\u00e0 2h3G\u2019 \u0111\u1ed1i v\u1edbi b\u00ean tr\u00e1i). Kho\u1ea3ng c\u00e1ch gi\u1eefa trung t\u00e2m c\u1ee7a hai b\u00f3 v\u00e0o kho\u1ea3ng 8-10mm m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 m\u00f4 t\u1ea3 k\u1ebft qu\u1ea3 c\u00f3 kh\u00e1c bi\u1ec7t m\u1ed9t ch\u00fat.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u00a04. Gi\u1ea3i ph\u1eabu \u0111i\u1ec3m b\u00e1m v\u00e0o m\u00e2m ch\u00e0y c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc<\/strong><\/h2>\n

V\u1ecb tr\u00ed b\u00e1m c\u1ee7a DCCT v\u00e0o m\u00e2m ch\u00e0y c\u00e1ch b\u1edd tr\u01b0\u1edbc m\u00e2m ch\u00e0y 10-14mm, k\u00e9o d\u00e0i v\u1ec1 ph\u00eda trong v\u00e0 n\u1eb1m ph\u00eda trong c\u1ee7a gai ch\u00e0y ngo\u00e0i. K\u00edch th\u01b0\u1edbc c\u1ee7a di\u1ec7n b\u00e1m tr\u00ean m\u1eb7t ph\u1eb3ng \u0111\u1ee9ng d\u1ecdc l\u00e0 10-13mm v\u00e0 tr\u00ean m\u1eb7t ph\u1eb3ng \u0111\u1ee9ng ngang l\u00e0 15-19mm (s\u1ef1 kh\u00e1c nhau t\u00f9y theo k\u00edch th\u01b0\u1edbc c\u01a1 th\u1ec3). Do DCCT x\u00f2e ra nh\u01b0 h\u00ecnh c\u00e1i qu\u1ea1t khi b\u00e1m v\u00e0o m\u00e2m ch\u1ea7y do \u0111\u00f3 di\u1ec7n b\u00e1m c\u1ee7a DCCT v\u00e0o m\u00e2m ch\u00e0y l\u1edbn h\u01a1n ti\u1ebft di\u1ec7n c\u1ee7a ph\u1ea7n th\u00e2n DCCT v\u00e0 l\u1edbn h\u01a1n di\u1ec7n b\u00e1m c\u1ee7a DCCT v\u00e0o l\u1ed3i c\u1ea7u \u0111\u00f9i, \u01b0\u1edbc t\u00ednh kho\u1ea3ng 120%. v\u1ec1 \u0111\u1ea1i th\u1ec3, b\u1edd sau c\u1ee7a DCCT c\u00e1ch b\u1edd tr\u01b0\u1edbc c\u1ee7a DCCS kho\u1ea3ng 6-7mm, tuy nhi\u00ean DCCS kh\u00f4ng ph\u1ea3i l\u00e0 t\u1ed5 ch\u1ee9c c\u1ee9ng n\u00ean kh\u00f4ng th\u1ec3 s\u1eed d\u1ee5ng l\u00e0m m\u1ed1c gi\u1ea3i ph\u1eabu \u0111\u01b0\u1ee3c. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u1edf l\u1ed3i c\u1ea7u \u0111\u00f9i, \u1edf m\u00e2m ch\u00e0y, c\u00f3 m\u1ed9t m\u1ed1c gi\u1ea3i ph\u1eabu \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 v\u00e0 c\u00f3 vai tr\u00f2 \u0111\u1ecbnh h\u01b0\u1edbng khi th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt n\u1ed9i soi, \u0111\u00f3 l\u00e0 “retro-eminence ridge” (vi\u1ebft t\u1eaft l\u00e0 RER). G\u1edd n\u00e0y n\u1eb1m ngay ph\u00eda tr\u01b0\u1edbc v\u1ecb tr\u00ed b\u00e1m c\u1ee7a DCCS v\u00e0o m\u00e2m ch\u00e0y.<\/span><\/p>\n

\u00a0<\/span>Trong t\u01b0\u01a1ng quan hai b\u00f3 th\u00ec b\u00f3 tr\u01b0\u1edbc trong n\u1eb1m ph\u00eda tr\u01b0\u1edbc b\u00f3 sau ngo\u00e0i. T\u00e2m c\u1ee7a b\u00f3 tr\u01b0\u1edbc trong c\u00e1ch b\u1edd tr\u01b0\u1edbc c\u1ee7a m\u00e2m ch\u00e0y 13-17mm v\u00e0 th\u1eb3ng h\u00e0ng v\u1edbi s\u1eebng tr\u01b0\u1edbc c\u1ee7a s\u1ee5n ch\u00eam ngo\u00e0i . Kho\u1ea3ng c\u00e1ch t\u1eeb t\u00e2m c\u1ee7a b\u00f3 tr\u01b0\u1edbc trong \u0111\u1ebfn g\u1edd RER l\u00e0 17,5mm v\u00e0 kho\u1ea3ng c\u00e1ch gi\u1eefa t\u00e2m c\u1ee7a b\u00f3 tr\u01b0\u1edbc trong t\u1edbi t\u00e2m c\u1ee7a b\u00f3 sau ngo\u00e0i l\u00e0 8,4mm. Kho\u1ea3ng c\u00e1ch t\u1eeb t\u00e2m c\u1ee7a b\u00f3 sau trong \u0111\u1ebfn b\u1edd tr\u01b0\u1edbc c\u1ee7a m\u00e2m ch\u00e0y l\u00e0 20-25mm. Kho\u1ea3ng c\u00e1ch t\u1eeb b\u1edd sau c\u1ee7a DCCT \u0111\u1ebfn g\u1edd RER r\u1ea5t thay \u0111\u1ed5i do s\u1ef1 \u0111a d\u1ea1ng v\u1ec1 h\u00ecnh th\u00e1i gi\u1ea3i ph\u1eabu ch\u1ed7 b\u00e1m c\u1ee7a DCCT nh\u01b0ng nh\u1ecf nh\u1ea5t l\u00e0 7mm .<\/span><\/p>\n

V\u1ecb tr\u00ed c\u1ee7a ch\u1ed7 b\u00e1m DCCT v\u00e0o m\u00e2m ch\u00e0y tr\u00ean X quang \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh d\u1ef1a tr\u00ean \u0111\u01b0\u1eddng Amis Jacob. \u0110\u01b0\u1eddng n\u00e0y l\u00e0 \u0111\u01b0\u1eddng k\u1ebb t\u1eeb \u0111i\u1ec3m sau nh\u1ea5t c\u1ee7a m\u00e2m ch\u00e0y ngo\u00e0i v\u00e0 song song v\u1edbi m\u1eb7t m\u00e2m ch\u00e0y. D\u1ef1a tr\u00ean nh\u1eefng \u0111o \u0111\u1ea1c ch\u00ednh x\u00e1c th\u00ec t\u00e2m c\u1ee7a b\u00f3 tr\u01b0\u1edbc trong chi\u1ebfm 36% chi\u1ec1u d\u00e0i \u0111\u01b0\u1eddng Amis Jacob v\u00e0 t\u00e2m c\u1ee7a b\u00f3 sau ngo\u00e0i chi\u1ebfm 52% chi\u1ec1u d\u00e0i c\u1ee7a \u0111\u01b0\u1eddng n\u00e0y.<\/span><\/p>\n

Xem th\u00eam (Ch\u00e8n link n\u00e0y sau khi xu\u1ea5t b\u1ea3n): S\u01a1 l\u01b0\u1ee3c l\u1ecbch s\u1eed ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng<\/a><\/p>\n

Tags: #Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh, # Gi\u1ea3i ph\u1eabu, #D\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc kh\u1edbp g\u1ed1i,#Ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh d\u00e2y ch\u1eb1ng<\/strong><\/p>\n

T\u00e1c gi\u1ea3:<\/b> PGS.TS. Tr\u1ea7n Trung D\u0169ng, <\/span>Trung t\u00e2m Ch\u1ea5n th\u01b0\u01a1ng Ch\u1ec9nh h\u00ecnh v\u00e0 Y h\u1ecdc th\u1ec3 thao<\/span>, <\/span>B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c t\u1ebf Vinmec Times City.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

\u00a0Nh\u1eefng m\u00f4 t\u1ea3 gi\u1ea3i ph\u1eabu c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc kh\u1edbp g\u1ed1i (DCCT) \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong c\u00e1c t\u00e0i li\u1ec7u c\u1ee7a ng\u01b0\u1eddi Ai c\u1eadp c\u1ed5 \u0111\u1ea1i t\u1eeb 3000 n\u0103m Tr\u01b0\u1edbc C\u00f4ng Nguy\u00ean (TCN). 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