{"id":35838,"date":"2023-06-29T17:00:10","date_gmt":"2023-06-29T10:00:10","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35838"},"modified":"2023-06-29T17:00:10","modified_gmt":"2023-06-29T10:00:10","slug":"ung-thu-gan-va-tac-dong-cua-che-do-an-uong-va-loi-song","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/29\/ung-thu-gan-va-tac-dong-cua-che-do-an-uong-va-loi-song\/","title":{"rendered":"Ung th\u01b0 gan v\u00e0 t\u00e1c \u0111\u1ed9ng c\u1ee7a ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng v\u00e0 l\u1ed1i s\u1ed1ng"},"content":{"rendered":"

Ung th\u01b0 gan (HepatoCellular Carcinoma – HCC) l\u00e0 m\u1ed9t kh\u1ed1i u ch\u00ednh c\u1ee7a gan th\u01b0\u1eddng ph\u00e1t tri\u1ec3n trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh gan m\u00e3n t\u00ednh, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc x\u01a1 gan do s\u1eed d\u1ee5ng r\u01b0\u1ee3u, nhi\u1ec5m vi-r\u00fat vi\u00eam gan B ho\u1eb7c C m\u00e3n t\u00ednh ho\u1eb7c gan nhi\u1ec5m m\u1ee1 kh\u00f4ng li\u00ean quan \u0111\u1ebfn r\u01b0\u1ee3u (NASH). HCC l\u00e0 nguy\u00ean nh\u00e2n th\u1ee9 t\u01b0 d\u1eabn \u0111\u1ebfn t\u1eed vong li\u00ean quan \u0111\u1ebfn ung th\u01b0 tr\u00ean to\u00e0n th\u1ebf gi\u1edbi.<\/strong><\/p>\n

 <\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng ung th\u01b0 gan<\/h2>\n

\u00a0Theo c\u01a1 s\u1edf d\u1eef li\u1ec7u GLOBOCAN c\u1ee7a T\u1ed5 ch\u1ee9c Y t\u1ebf Th\u1ebf gi\u1edbi, Ung th\u01b0 gan (UTG) l\u00e0 nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn t\u1eed vong do ung th\u01b0 t\u0103ng nhanh nh\u1ea5t t\u1ea1i Hoa K\u1ef3 . T\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t sau 5 n\u0103m sau c\u1ee7a b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh n\u00e0y v\u1eabn th\u1ea5p, ch\u1ec9 \u0111\u1ea1t 18%. UTG th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n mu\u1ed9n trong qu\u00e1 tr\u00ecnh b\u1ec7nh c\u1ee7a n\u00f3 v\u00ec hai l\u00fd do: kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng \u1edf b\u1ec7nh nh\u00e2n v\u1edbi b\u1ec7nh s\u1edbm v\u00e0 s\u1ef1 ch\u1ea7n ch\u1eeb c\u1ee7a m\u1ed9t s\u1ed1 b\u00e1c s\u0129 l\u00e2m s\u00e0ng trong vi\u1ec7c gi\u00e1m s\u00e1t b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao.<\/span><\/p>\n

Ch\u1ea9n \u0111o\u00e1n HCC \u1edf giai \u0111o\u1ea1n s\u1edbm th\u01b0\u1eddng kh\u00f3, \u0111\u00f2i h\u1ecfi s\u1eed d\u1ee5ng m\u1ed9t ho\u1eb7c nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh. M\u1ee5c ti\u00eau ch\u1ea9n \u0111o\u00e1n ung th\u01b0 gan hi\u1ec7n nay l\u00e0 ph\u00e1t hi\u1ec7n kh\u1ed1i u khi n\u00f3 c\u00f3 k\u00edch th\u01b0\u1edbc \u22642cm \u0111\u1ec3 c\u00f3 s\u1eb5n to\u00e0n b\u1ed9 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb. T\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t sau 5 n\u0103m c\u1ee7a b\u1ec7nh nh\u00e2n khi ph\u00e1t hi\u1ec7n kh\u1ed1i u \u1edf giai \u0111o\u1ea1n s\u1edbm v\u00e0 nh\u1eadn \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 l\u00ean \u0111\u1ebfn h\u01a1n 70%.<\/span><\/p>\n

B\u00e0i vi\u1ebft n\u00e0y b\u00e0n v\u1ec1 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m y\u1ebfu t\u1ed1 nguy c\u01a1, l\u00e2m s\u00e0ng v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u01a1 b\u1ea3n c\u1ee7a ung th\u01b0 gan.<\/span><\/p>\n

1.1 C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1:<\/strong><\/p>\n

\u00a0<\/span>Ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng v\u00e0 l\u1ed1i s\u1ed1ng c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn nguy c\u01a1 m\u1eafc ung th\u01b0 gan. C\u00e1c y\u1ebfu t\u1ed1 sau \u0111\u00e2y c\u00f3 th\u1ec3 t\u0103ng nguy c\u01a1 m\u1eafc ung th\u01b0 gan:<\/span><\/p>\n

    \n
  1. \u00a0 <\/span>U\u1ed1ng r\u01b0\u1ee3u: U\u1ed1ng r\u01b0\u1ee3u c\u00f3 th\u1ec3 l\u00e0 y\u1ebfu t\u1ed1 ch\u00ednh g\u00e2y ung th\u01b0 gan, \u0111\u1eb7c bi\u1ec7t l\u00e0 vi\u1ec7c u\u1ed1ng nhi\u1ec1u r\u01b0\u1ee3u trong m\u1ed9t kho\u1ea3ng th\u1eddi gian d\u00e0i. Vi\u1ec7c u\u1ed1ng r\u01b0\u1ee3u c\u00e0ng nhi\u1ec1u, nguy c\u01a1 m\u1eafc ung th\u01b0 gan c\u00e0ng t\u0103ng.<\/span><\/li>\n
  2. \u00a0 <\/span>Ti\u00eau th\u1ee5 th\u1ef1c ph\u1ea9m kh\u00f4ng l\u00e0nh m\u1ea1nh: \u0102n nhi\u1ec1u th\u1ef1c ph\u1ea9m gi\u00e0u ch\u1ea5t b\u00e9o, \u0111\u01b0\u1eddng v\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m t\u1eeb \u0111\u1ed9ng v\u1eadt c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc ung th\u01b0 gan. Nh\u1eefng th\u1ef1c ph\u1ea9m n\u00e0y c\u0169ng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn b\u00e9o ph\u00ec, m\u1ed9t y\u1ebfu t\u1ed1 kh\u00e1c c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 ung th\u01b0 gan.<\/span><\/li>\n
  3. \u00a0 <\/span>Thi\u1ebfu ch\u1ea5t dinh d\u01b0\u1ee1ng: Thi\u1ebfu ch\u1ea5t dinh d\u01b0\u1ee1ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 vitamin A, C v\u00e0 E, c\u0169ng c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n l\u00e0m t\u0103ng nguy c\u01a1 ung th\u01b0 gan.<\/span><\/li>\n
  4. \u00a0 <\/span>B\u1ec7nh gan m\u1ea1n t\u00ednh: B\u1ec7nh gan m\u1ea1n t\u00ednh, ch\u1eb3ng h\u1ea1n nh\u01b0 vi\u00eam gan m\u00e3n t\u00ednh ho\u1eb7c x\u01a1 gan, c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 ung th\u01b0 gan.<\/span><\/li>\n
  5. \u00a0 <\/span>Ti\u1ebfp x\u00fac v\u1edbi c\u00e1c ch\u1ea5t \u0111\u1ed9c h\u1ea1i: Ti\u1ebfp x\u00fac v\u1edbi c\u00e1c ch\u1ea5t \u0111\u1ed9c h\u1ea1i, ch\u1eb3ng h\u1ea1n nh\u01b0 kim lo\u1ea1i n\u1eb7ng v\u00e0 h\u00f3a ch\u1ea5t, c\u0169ng c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 ung th\u01b0 gan.<\/span><\/li>\n<\/ol>\n

    V\u00ec v\u1eady, \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 m\u1eafc ung th\u01b0 gan, b\u1ea1n n\u00ean duy tr\u00ec m\u1ed9t ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng l\u00e0nh m\u1ea1nh, bao g\u1ed3m nhi\u1ec1u rau v\u00e0 tr\u00e1i c\u00e2y, c\u00e1c lo\u1ea1i th\u1ef1c ph\u1ea9m gi\u00e0u ch\u1ea5t x\u01a1, ch\u1ea5t \u0111\u1ea1m v\u00e0 c\u00e1c lo\u1ea1i acid b\u00e9o kh\u00f4ng no. B\u1ea1n c\u0169ng n\u00ean h\u1ea1n ch\u1ebf ti\u00eau th\u1ee5 r\u01b0\u1ee3u v\u00e0 tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi c\u00e1c ch\u1ea5t \u0111\u1ed9c h\u1ea1i. \u0110\u1ed3ng th\u1eddi, vi\u1ec7c th\u1ef1c hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t th\u01b0\u1eddng xuy\u00ean v\u00e0 duy tr\u00ec m\u1ed9t l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh c\u0169ng c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m nguy c\u01a1 m\u1eafc ung th\u01b0 gan. N\u1ebfu b\u1ea1n c\u00f3 b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng n\u00e0o li\u00ean quan \u0111\u1ebfn gan, h\u00e3y tham kh\u1ea3o \u00fd ki\u1ebfn \u200b\u200bb\u00e1c s\u0129 \u0111\u1ec3 \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi.<\/span><\/p>\n

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

    1.2\u00a0 Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a ung th\u01b0 gan<\/strong><\/p>\n

    Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a ung th\u01b0 gan r\u1ea5t thay \u0111\u1ed5i t\u00f9y thu\u1ed9c v\u00e0o giai \u0111o\u1ea1n l\u00e2m s\u00e0ng v\u00e0 th\u1ec3 ung th\u01b0 gan. Hai h\u1ed9i ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p \u1edf giai \u0111o\u1ea1n cu\u1ed1i l\u00e0 h\u1ed9i ch\u1ee9ng suy t\u1ebf b\u00e0o gan v\u00e0 h\u1ed9i ch\u1ee9ng t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1eeda:<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Tri\u1ec7u ch\u1ee9ng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u; kh\u1ed1i u nh\u1ecf th\u01b0\u1eddng ch\u01b0a c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n nh\u1edd t\u1ea7m so\u00e1t.<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Th\u01b0\u1eddng g\u1eb7p nhi\u1ec1u tri\u1ec7u ch\u1ee9ng \u1edf giai \u0111o\u1ea1n tr\u1ec5, kho\u1ea3ng 2\/3 b\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n v\u00ec \u0111au b\u1ee5ng, kh\u00f3 th\u1edf, suy nh\u01b0\u1ee3c, gan to, v\u00e0ng da, c\u1ed5 tr\u01b0\u1edbng…,# 14% s\u1edd \u0111\u01b0\u1ee3c kh\u1ed1i u, c\u00f3 khi b\u00e1ng b\u1ee5ng, ph\u00f9 ch\u00e2n l\u00e0 tri\u1ec7u ch\u1ee9ng ban \u0111\u1ea7u …<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>\u0110au b\u1ee5ng nhi\u1ec1u khi c\u00f3 xu\u1ea5t huy\u1ebft trong u, hay u v\u1edf g\u00e2y\u00a0 xu\u1ea5t huy\u1ebft\u00a0 n\u1ed9i v\u00e0 s\u1ed1c m\u1ea5t m\u00e1u ( \u1edf nam xu\u1ea5t huy\u1ebft n\u1ed9i kh\u00f4ng do\u00a0 ch\u1ea5n th\u01b0\u01a1ng th\u01b0\u1eddng do UTG v\u1ee1.)<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>V\u00e0ng da khi c\u00f3 suy gan hay UTG ch\u00e8n \u00e9p \u0111\u01b0\u1eddng m\u1eadt; n\u1ebfu c\u00f3 x\u01a1 gan c\u00f3 th\u1ec3 c\u00f3 h\u1ed9i ch\u1ee9ng t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1eeda,\u00a0 xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a do v\u1ee1 gi\u00e3n t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n.<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>\u0110au h\u1ea1 s\u01b0\u1eddn ph\u1ea3i, c\u00f3 kh\u1ed1i u \u1edf th\u01b0\u1ee3ng v\u1ecb hay HSP (hay g\u1eb7p nh\u1ea5t).<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Suy ki\u1ec7t, ch\u00e1n \u0103n, s\u1ee5t c\u00e2n trong th\u1eddi gian ng\u1eafn (th\u01b0\u1eddng \u1edf giai \u0111o\u1ea1n to\u00e0n ph\u00e1t).<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>X\u01a1 gan c\u1ed5 tr\u01b0\u1edbng c\u00f3 th\u1ec3 t\u0103ng \u00e1p t\u0129nh m\u1ea1ch c\u1eeda .<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd nh\u1edd si\u00eau \u00e2m (giai \u0111o\u1ea1n ch\u01b0a tri\u1ec7u ch\u1ee9ng).<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>V\u00e0ng da v\u00e0 kh\u1ed1i u gan (suy gan hay t\u1eafc m\u1eadt do u ch\u00e8n \u00e9p).<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Xu\u1ea5t huy\u1ebft n\u1ed9i do UTG v\u1ee1 (b\u1ec7nh c\u1ea3nh c\u1ea5p c\u1ee9u).<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Di c\u0103n n\u1ed9i t\u1ea1ng: ph\u1ed5i, \u1ed5 b\u1ee5ng …<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>S\u1ed1t do UTG ho\u1ea1i t\u1eed hay h\u1ed9i ch\u1ee9ng c\u1eadn UT.<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>H\u00f4n m\u00ea gan (giai \u0111o\u1ea1n suy gan).<\/span><\/p>\n

    1.3\u00a0 C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Ch\u1ee9c n\u0103ng gan<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Ch\u1ee9c n\u0103ng \u0111\u00f4ng m\u00e1u (th\u1eddi gian Prothrombine).<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Ch\u1ee9c n\u0103ng t\u1ed5ng h\u1ee3p ( Albumin).<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Ch\u1ee9c n\u0103ng k\u1ebft h\u1ee3p Bilirubin …<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Ch\u1ea5t ch\u1ec9 th\u1ecb b\u01b0\u1edbu (tumour marker) :<\/span><\/p>\n

    AFP ( Alpha Fetoprotein ) kh\u00e1 \u0111\u1eb7c hi\u1ec7u \u0111\u1ec3 ph\u00e1t hi\u1ec7n s\u1edbm UTG hay u t\u00e1i ph\u00e1t ; AFP > 200ng\/m\u1ec9 trong 66-75% TH.<\/span><\/p>\n

    AFP \u0111\u1eb7c hi\u1ec7u trong kho\u1ea3ng 70-80% TH .<\/span><\/p>\n

    AFP thay \u0111\u1ed5i theo k\u00edch th\u01b0\u1edbc : 75% u >5cm c\u00f3 AFP > 100ng\/ml.<\/span><\/p>\n

    AFP (+) gi\u1ea3 trong VGSV c\u1ea5p, b\u1ec7nh gan m\u1ea1n, x\u01a1 gan, di c\u0103n gan …<\/span><\/p>\n

    H\u00ecnh \u1ea3nh h\u1ecdc:<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Si\u00eau \u00e2m (SA): c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n u gan > 1cm, ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c 92% u gan < 5cm.<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>SA c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c b\u1ec7nh l\u00fd \u0111i k\u00e8m nh\u01b0 x\u01a1 gan, t\u0103ng \u00e1p l\u1ef1c TM c\u1eeda (TALTMC), t\u1eafc TMC v\u00e0 TM gan do u …<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>\u0110i\u1ec7n to\u00e1n c\u1eaft l\u1edbp (CT-scan): l\u00e0 x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh \u0111\u01b0\u1ee3c ch\u1ecdn l\u1ef1a, CT c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n UTG #1 \\ cm, c\u00e1c di c\u0103n ngo\u00e0i gan, h\u1ea1ch \u1ed5 b\u1ee5ng, \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n, th\u1ec3 t\u00edch gan c\u00f2n l\u1ea1i…<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>C\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI): \u0111\u1ed9 ch\u00ednh x\u00e1c cao, h\u00ecnh \u1ea3nh \u0111i\u1ec3n h\u00ecnh. MRI gi\u00fap ph\u00e2n bi\u1ec7t UTG v\u1edbi u m\u1ea1ch m\u00e1u, n\u1ed1t t\u0103ng sinh, di c\u0103n gan …<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>\u00a0Ch\u1ee5p m\u1ea1ch m\u00e1u: l\u00e0 1 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh x\u00e2m l\u1ea5n (invasive) .UTG l\u00e0 u gi\u00e0u m\u1ea1ch m\u00e1u t\u00e2n sinh \u1edf th\u00ec \u0111\u1ed9ng m\u1ea1ch, v\u1ea3 c\u00f3 h\u00ecnh \u1ea3nh u c\u1ea3n quang th\u00ec t\u0129nh m\u1ea1ch.<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Ph\u00e1t hi\u1ec7n t\u1eafc t\u0129nh m\u1ea1ch ch\u1ee7, t\u0103ng sinh \u0111\u1ed9ng m\u1ea1ch nh\u1ecf. .th\u01b0\u1eddng \u1ee9ng d\u1ee5ng \u0111\u1ec3 t\u1eafc m\u1ea1ch (TACE).<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>\u00a0N\u1ed9i soi \u1ed5 b\u1ee5ng: \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n UTG v\u1ea3 c\u00e1c u kh\u00e1c, t\u00ecm di c\u0103n \u1ed5 b\u1ee5ng.<\/span><\/p>\n

    –<\/span>\u00a0 \u00a0 \u00a0 \u00a0 <\/span>Sinh thi\u1ebft kim: qua h\u01b0\u1edbng d\u1eabn c\u1ee7a SA hay CT, ch\u1ec9 \u0111\u1ecbnh gi\u1edbi h\u1ea1n khi ch\u01b0a ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c u l\u00e0nh hay \u00e1c.<\/span><\/p>\n

    \"ung-thu-gan\"<\/span><\/p>\n

    \u00a0 \u00a0 2.\u00a0 <\/strong><\/span>S\u01a1 l\u01b0\u1ee3c c\u00e1c ph\u01b0\u01a1ng ph\u00e1p trong \u0111i\u1ec1u tr\u1ecb UTG<\/strong><\/h2>\n

    C\u00f3 2 ph\u01b0\u01a1ng th\u1ee9c: ph\u1eabu thu\u1eadt v\u00e0 kh\u00f4ng ph\u1eabu thu\u1eadt.<\/span><\/p>\n

    C\u1eaft gan l\u00e0 \u0111i\u1ec1u tr\u1ecb ch\u1ecdn l\u1ef1a \u01b0u ti\u00ean, c\u00f3 ti\u00ean l\u01b0\u1ee3ng t\u1ed1t h\u01a1n h\u1eb3n.<\/span><\/p>\n

    2.1 Ph\u1eabu thu\u1eadt c\u1eaft gan :<\/strong><\/p>\n

    N\u0103m 1954 Couinaud m\u00f4 t\u1ea3 8 h\u1ea1 ph\u00e2n th\u00f9y gan d\u1ef1a tr\u00ean t\u0129nh m\u1ea1ch C\u1eeda v\u00e0 t\u0129nh m\u1ea1ch gan => c\u1eaft gan theo gi\u1ea3i ph\u1eabu.<\/span><\/p>\n

    \u00a0– Ch\u1ec9 \u0111\u1ecbnh : T\u00f9y thu\u1ed9c ch\u1ee9c n\u0103ng gan v\u00e0 th\u1ec3 t\u00edch gan c\u1eaft \u0111\u01b0\u1ee3c.<\/span><\/p>\n

    \u0110\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan b\u1eb1ng x\u1ebfp lo\u1ea1i Child-Pugh ; lo\u1ea1i A c\u1eaft gan l\u1edbn, lo\u1ea1i B c\u1eaft gan gi\u1edbi h\u1ea1n h\u1ea1 ph\u00e2n th\u00f9y, lo\u1ea1i c qu\u00e1 ch\u1ec9 \u0111\u1ecbnh .<\/span><\/p>\n

    – T\u1eafc TMC ch\u00ednh hay nh\u00e1nh ch\u00ednh khi b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1eaft gan .<\/span><\/p>\n

    2.2 \u0110i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt;<\/strong><\/p>\n

    -Thuy\u00ean t\u1eafc m\u1ea1ch h\u00f3a tr\u1ecb (TACE) :<\/span><\/p>\n

    Ch\u1ec9 \u0111\u1ecbnh : UTG kh\u00f4ng c\u1eaft \u0111\u01b0\u1ee3c<\/span><\/p>\n

    \u00a0Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh : Bilirubin > 3mg%; Bil >2mg% ch\u1ec9 l\u00e0m TACE 1-2 h\u1ea1 ph\u00e2n th\u00f9y.<\/span><\/p>\n

    K\u1ef9 thu\u1eadt: lu\u1ed3n Catheter t\u1eeb \u0111\u1ed9ng m\u1ea1ch \u0111\u00f9i l\u00ean \u0111\u1ebfn \u0111\u1ed9ng m\u1ea1ch\u00a0 gan,v\u00e0o \u0111\u1ed9ng m\u1ea1ch HPT ; sau \u0111\u00f3 b\u01a1m h\u1ed7n h\u1ee3p Lipiodol, thu\u1ed1c tr\u1ecb UTG, sau c\u00f9ng l\u00e0 gelfoam cube \u0111\u1ec3 l\u00e0m t\u1eafc m\u1ea1ch .<\/span><\/p>\n

    – Ch\u00edch c\u1ed3n qua da (PEI):<\/span><\/p>\n

    . Ch\u1ec9 \u0111\u1ecbnh: s\u1ed1 l\u01b0\u1ee3ng u = 3, u < 3cm .<\/span><\/p>\n

    . Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh: BN kh\u00f4ng h\u1ee3p t\u00e1c, r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u .<\/span><\/p>\n

    . K\u1ef9 thu\u1eadt: qua SA d\u00f9ng kim 22G ch\u00edch 2-5 ml c\u1ed3n tuy\u1ec7t \u0111\u1ed1i v\u00e0o u, ch\u00edch l\u1eadp l\u1ea1i c\u00e1ch nhi\u1ec1u ng\u00e0y .<\/span><\/p>\n

    . Bi\u1ebfn ch\u1ee9ng: s\u1ed1t, \u0111au b\u1ee5ng do d\u00f2 alcool \u1ed5 b\u1ee5ng .<\/span><\/p>\n

    Xem th\u00eam: C\u00e1c giai \u0111o\u1ea1n c\u1ee7a x\u01a1 gan<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

    Ung th\u01b0 gan (HepatoCellular Carcinoma – HCC) l\u00e0 m\u1ed9t kh\u1ed1i u ch\u00ednh c\u1ee7a gan th\u01b0\u1eddng ph\u00e1t tri\u1ec3n trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh gan m\u00e3n t\u00ednh, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc x\u01a1 gan do s\u1eed d\u1ee5ng r\u01b0\u1ee3u, nhi\u1ec5m vi-r\u00fat vi\u00eam gan B ho\u1eb7c C m\u00e3n t\u00ednh ho\u1eb7c gan nhi\u1ec5m m\u1ee1 kh\u00f4ng li\u00ean quan \u0111\u1ebfn […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[],"yoast_head":"\nUng th\u01b0 gan v\u00e0 t\u00e1c \u0111\u1ed9ng c\u1ee7a ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng v\u00e0 l\u1ed1i s\u1ed1ng - Vinmec<\/title>\n<meta name=\"description\" content=\"Ung th\u01b0 gan (HepatoCellular Carcinoma - HCC) l\u00e0 m\u1ed9t kh\u1ed1i u ch\u00ednh c\u1ee7a gan th\u01b0\u1eddng ph\u00e1t tri\u1ec3n trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh gan m\u00e3n t\u00ednh\" \/>\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=\"Ung th\u01b0 gan v\u00e0 t\u00e1c \u0111\u1ed9ng c\u1ee7a ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng v\u00e0 l\u1ed1i s\u1ed1ng - 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