{"id":151,"date":"2026-10-05T22:44:25","date_gmt":"2026-10-05T15:44:25","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/05\/dieu-tri-gay-lien-mau-chuyen-o-nguoi-cao-tuoi-chien-luoc-bao-ton-va-can-thiep\/"},"modified":"2026-10-05T22:44:25","modified_gmt":"2026-10-05T15:44:25","slug":"dieu-tri-gay-lien-mau-chuyen-o-nguoi-cao-tuoi-chien-luoc-bao-ton-va-can-thiep","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/05\/dieu-tri-gay-lien-mau-chuyen-o-nguoi-cao-tuoi-chien-luoc-bao-ton-va-can-thiep\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n \u1edf ng\u01b0\u1eddi cao tu\u1ed5i: Chi\u1ebfn l\u01b0\u1ee3c b\u1ea3o t\u1ed3n v\u00e0 can thi\u1ec7p"},"content":{"rendered":"<p>\u0110i\u1ec1u tr\u1ecb g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n \u1edf ng\u01b0\u1eddi cao tu\u1ed5i: Chi\u1ebfn l\u01b0\u1ee3c b\u1ea3o t\u1ed3n v\u00e0 can thi\u1ec7p<\/p>\n<p>G\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n (trochanteric hip fracture) l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng ch\u1ea5n th\u01b0\u01a1ng ph\u1ed5 bi\u1ebfn \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, th\u01b0\u1eddng \u0111\u01b0\u1ee3c xem nh\u01b0 d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o s\u1edbm c\u1ee7a s\u1ef1 suy y\u1ebfu c\u01a1 th\u1ec3. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ch\u1ec9 nh\u1eb1m m\u1ee5c \u0111\u00edch \u1ed5n \u0111\u1ecbnh g\u00e3y x\u01b0\u01a1ng m\u00e0 c\u00f2n ph\u1ea3i c\u00e2n nh\u1eafc \u0111\u1ebfn kh\u1ea3 n\u0103ng ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng v\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn tu\u1ed5i t\u00e1c.<\/p>\n<h2>\u0110\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n: Tu\u1ed5i sinh h\u1ecdc thay v\u00ec tu\u1ed5i chronologic<\/h2>\n<p>Trong qu\u1ea3n l\u00fd ch\u1ea5n th\u01b0\u01a1ng \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, ti\u00eau ch\u00ed x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n n\u00ean d\u1ef1a tr\u00ean tr\u1ea1ng th\u00e1i sinh h\u1ecdc h\u01a1n l\u00e0 tu\u1ed5i \u0111\u1eddi th\u1ef1c t\u1ebf. C\u00e1c nghi\u00ean c\u1ee9u ch\u1ec9 ra r\u1eb1ng, b\u1ea5t k\u1ec3 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn, trong khi thi\u1ebfu c\u00e1c th\u1eed nghi\u1ec7m so s\u00e1nh c\u00f3 k\u1ebf ho\u1ea1ch, ph\u01b0\u01a1ng ph\u00e1p t\u1ed1i \u01b0u cho g\u00e3y acetabular \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u1eabn \u0111ang g\u00e2y tranh lu\u1eadn [1]. Tuy nhi\u00ean, xu h\u01b0\u1edbng chung trong y h\u1ecdc hi\u1ec7n \u0111\u1ea1i l\u00e0 t\u1eadp trung v\u00e0o nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 s\u1ee9c kh\u1ecfe th\u1ec3 ch\u1ea5t t\u1ed1t h\u01a1n d\u00f9 \u0111\u00e3 gi\u00e0.<\/p>\n<p>\u0110\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n, vi\u1ec7c x\u00e1c \u0111\u1ecbnh h\u1ecd c\u00f3 \u0111\u1ee7 ch\u1ee9c n\u0103ng \u0111\u1ec3 tham gia v\u00e0o qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t. C\u00e1c \u0111\u01b0\u1eddng d\u1eabn l\u00e2m s\u00e0ng trong b\u1ec7nh vi\u1ec7n n\u00ean \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111i\u1ec1u ki\u1ec7n n\u00e0y th\u00f4ng qua ki\u1ec3m tra sinh l\u00fd h\u1ecdc to\u00e0n di\u1ec7n b\u1edfi m\u1ed9t \u0111\u1ed9i ng\u0169 \u0111a ng\u00e0nh bao g\u1ed3m c\u1ea3 ph\u1eabu thu\u1eadt v\u00e0 chuy\u00ean khoa l\u00e3o khoa [2].<\/p>\n<h3>Di chuy\u1ec3n s\u1edbm v\u00e0 qu\u1ea3n l\u00fd \u0111au<\/h3>\n<p>M\u1ee5c ti\u00eau ch\u00ednh c\u1ee7a \u0111i\u1ec1u tr\u1ecb l\u00e0 cho ph\u00e9p di chuy\u1ec3n s\u1edbm m\u00e0 kh\u00f4ng ph\u1ee5 thu\u1ed9c qu\u00e1 m\u1ee9c v\u00e0o thu\u1ed1c gi\u1ea3m \u0111au. \u0110\u1ed1i v\u1edbi c\u00e1c g\u00e3y kh\u00f4ng d\u1ecbch v\u1ecb ho\u1eb7c d\u1ecbch v\u1ecb nh\u1eb9, b\u1eb1ng ch\u1ee9ng cho th\u1ea5y ch\u1ec9 kho\u1ea3ng 7% s\u1ebd d\u1ecbch v\u1ecb \u0111\u00e1ng k\u1ec3 sau n\u00e0y v\u00e0 94% s\u1ebd gi\u1eef \u0111\u01b0\u1ee3c kh\u1edbp h\u00e1ng t\u1ef1 nhi\u00ean sau 10 n\u0103m [1]. Do \u0111\u00f3, \u0111\u1ed1i v\u1edbi nh\u00f3m b\u1ec7nh nh\u00e2n n\u00e0y, ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb bao g\u1ed3m di chuy\u1ec3n s\u1edbm v\u00e0 mang tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3 m\u1ed9t ph\u1ea7n trong 8 tu\u1ea7n \u0111\u1ea7u ti\u00ean l\u00e0 h\u1ee3p l\u00fd. Kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh cho vi\u1ec7c c\u1ed1 \u0111\u1ecbnh ph\u1eabu thu\u1eadt d\u1ef1 ph\u00f2ng trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y.<\/p>\n<h2>Ch\u1ea9n \u0111o\u00e1n s\u1edbm c\u00e1c d\u1ea5u hi\u1ec7u suy y\u1ebfu<\/h2>\n<p>M\u1ed9t nh\u1eadn th\u1ee9c m\u1edbi quan tr\u1ecdng l\u00e0 g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c coi l\u00e0 d\u1ea5u hi\u1ec7u \u0111\u1ea7u ti\u00ean c\u1ee7a s\u1ef1 suy y\u1ebfu hi\u1ec7n h\u1eefu ho\u1eb7c ti\u1ec1m \u1ea9n \u1edf ng\u01b0\u1eddi tr\u00ean 50 tu\u1ed5i. Fracture n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem nh\u01b0 m\u1ed9t &#8220;fracture ch\u1ec9 s\u1ed1&#8221; (index fracture). T\u1eeb tu\u1ed5i 50, t\u1ef7 l\u1ec7 r\u1ee7i ro b\u1ecb g\u00e3y th\u1ee9 hai trong c\u01a1 th\u1ec3 g\u1ea7n \u0111\u00f3 g\u1ea5p \u0111\u00f4i \u0111\u1ed9c l\u1eadp v\u1edbi m\u1eadt \u0111\u1ed9 kho\u00e1ng ch\u1ea5t x\u01b0\u01a1ng [2].<\/p>\n<p>B\u1ec7nh nh\u00e2n b\u1ecb ch\u1ea5n th\u01b0\u01a1ng c\u00f3 nguy c\u01a1 cao nh\u1ea5t b\u1ecb g\u00e3y t\u00e1i ph\u00e1t trong 2 n\u0103m ti\u1ebfp theo. Do \u0111\u00f3, sau khi b\u1ecb g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c s\u00e0ng l\u1ecdc t\u1ea1i ph\u00f2ng ph\u00f2ng ng\u1eeba g\u00e3y x\u01b0\u01a1ng v\u1edbi \u0111o l\u01b0\u1eddng m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng (BMD), x\u00e9t nghi\u1ec7m m\u00e1u th\u00edch h\u1ee3p, \u0111\u00e1nh gi\u00e1 g\u00e3y \u0111\u1ed1t s\u1ed1ng v\u00e0 ph\u00e2n t\u00edch ng\u00e3 [4].<\/p>\n<h3>K\u1ebf ho\u1ea1ch ph\u1ee5c h\u1ed3i v\u00e0 qu\u1ea3n l\u00fd k\u1ef3 v\u1ecdng<\/h3>\n<p>Khuy\u1ebfn kh\u00edch k\u00edch th\u00edch ch\u1ee7 \u0111\u1ed9ng v\u00e0 l\u1eadp k\u1ebf ho\u1ea1ch ph\u1ee5c h\u1ed3i s\u1edbm l\u00e0 c\u1ea7n thi\u1ebft. Qu\u1ea3n l\u00fd k\u1ef3 v\u1ecdng cho b\u1ec7nh nh\u00e2n th\u01b0\u1eddng bao g\u1ed3m m\u1ed9t chu k\u1ef3 ph\u1ee5c h\u1ed3i t\u1eeb 6 \u0111\u1ebfn 12 th\u00e1ng sau g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n, k\u00e8m theo m\u1ed9t m\u1ee9c \u0111\u1ed9 t\u00e0n t\u1eadt c\u00f2n l\u1ea1i [2].<\/p>\n<h2>Gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 bi\u1ebfn ch\u1ee9ng<\/h2>\n<p>T\u1ef7 l\u1ec7 t\u1eed vong \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i b\u1ecb g\u00e3y h\u00e1ng l\u00e0 r\u1ea5t cao t\u1ea1i b\u1ea5t k\u1ef3 th\u1eddi \u0111i\u1ec3m n\u00e0o so v\u1edbi khi h\u1ecd b\u1ecb g\u00e3y. S\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a c\u0103ng th\u1eb3ng do ch\u1ea5n th\u01b0\u01a1ng v\u00e0 \u0111i\u1ec1u tr\u1ecb, c\u00f9ng v\u1edbi c\u00e1c b\u1ec7nh l\u00fd m\u00e3n d\u1ee5ng th\u01b0\u1eddng c\u00f3 m\u1eb7t trong qu\u1ea7n th\u1ec3 n\u00e0y \u0111\u01b0\u1ee3c quy cho t\u1ef7 l\u1ec7 t\u1eed vong cao [3]. C\u00e1c t\u00ecnh tr\u1ea1ng n\u00e0y c\u0169ng \u0111\u01b0\u1ee3c th\u1ea5y \u1edf b\u1ec7nh nh\u00e2n b\u1ecb g\u00e3y ch\u00e2n d\u01b0\u1edbi quanh kh\u1edbp g\u1ed1i gi\u1ea3 (periprosthetic distal femur fractures).<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb g\u00e3y x\u01b0\u01a1ng ph\u1ea3i t\u00ednh \u0111\u1ebfn c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng, nguy c\u01a1 ng\u00e3, c\u00e1c b\u1ec7nh l\u00fd k\u00e8m theo v\u00e0 kh\u1ea3 n\u0103ng mang tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3 c\u1ee7a x\u01b0\u01a1ng. G\u00e3y x\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t ch\u1ec9 s\u1ed1 ho\u1eb7c fracture c\u1ea3nh b\u00e1o. T\u1eeb tu\u1ed5i 50, t\u1ef7 l\u1ec7 r\u1ee7i ro b\u1ecb g\u00e3y th\u1ee9 hai trong c\u01a1 th\u1ec3 g\u1ea7n g\u1ea5p \u0111\u00f4i \u0111\u1ed9c l\u1eadp v\u1edbi m\u1eadt \u0111\u1ed9 kho\u00e1ng ch\u1ea5t x\u01b0\u01a1ng [2].<\/p>\n<h2>H\u1ea1n ch\u1ebf c\u1ee7a t\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p>B\u00e0i vi\u1ebft n\u00e0y t\u1eadp trung v\u00e0o c\u00e1c nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean c\u00e1c ngu\u1ed3n t\u00e0i li\u1ec7u chuy\u00ean s\u00e2u v\u1ec1 ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh. M\u1ed9t s\u1ed1 kh\u00eda c\u1ea1nh nh\u01b0 chi ti\u1ebft k\u1ef9 thu\u1eadt c\u1ee5 th\u1ec3 c\u1ee7a t\u1eebng lo\u1ea1i n\u1ed9i c\u1ed1 \u0111\u1ecbnh hay so s\u00e1nh th\u1ed1ng k\u00ea d\u00e0i h\u1ea1n gi\u1eefa c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt kh\u00e1c nhau c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u01b0\u1ee3c bao qu\u00e1t \u0111\u1ea7y \u0111\u1ee7 do gi\u1edbi h\u1ea1n ph\u1ea1m vi c\u1ee7a c\u00e1c \u0111o\u1ea1n v\u0103n b\u1ea3n cung c\u1ea5p.<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<ul>\n<li>[1] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 2484<\/li>\n<li>[2] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 2733<\/li>\n<li>[3] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 2959<\/li>\n<li>[4] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 2733<\/li>\n<\/ul>\n<p><!-- aiwriter:947a5affd9a247cd876485f7 --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ng\u01b0\u1eddi cao tu\u1ed5i b\u1ecb g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n c\u1ea7n \u0111\u00e1nh gi\u00e1 to\u00e0n di\u1ec7n v\u1ec1 ch\u1ee9c n\u0103ng. C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y ph\u00e2n lo\u1ea1i theo \u0111\u1ed9 tu\u1ed5i sinh h\u1ecdc, \u01b0u ti\u00ean di \u0111\u1ed9ng s\u1edbm \u0111\u1ec3 duy tr\u00ec kh\u1edbp t\u1ef1 nhi\u00ean.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12],"tags":[],"class_list":["post-151","post","type-post","status-publish","format-standard","hentry","category-chi-duoi"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>\u0110i\u1ec1u tr\u1ecb g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n \u1edf ng\u01b0\u1eddi cao tu\u1ed5i: Chi\u1ebfn l\u01b0\u1ee3c b\u1ea3o t\u1ed3n v\u00e0 can thi\u1ec7p - BS NGUY\u1ec4N TH\u00c0NH LONG - BS C\u01a0 X\u01af\u01a0NG KH\u1edaP - CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/05\/dieu-tri-gay-lien-mau-chuyen-o-nguoi-cao-tuoi-chien-luoc-bao-ton-va-can-thiep\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u0110i\u1ec1u tr\u1ecb g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n \u1edf ng\u01b0\u1eddi cao tu\u1ed5i: Chi\u1ebfn l\u01b0\u1ee3c b\u1ea3o t\u1ed3n v\u00e0 can thi\u1ec7p - BS NGUY\u1ec4N TH\u00c0NH LONG - BS C\u01a0 X\u01af\u01a0NG KH\u1edaP - CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH\" \/>\n<meta property=\"og:description\" content=\"Ng\u01b0\u1eddi cao tu\u1ed5i b\u1ecb g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n c\u1ea7n \u0111\u00e1nh gi\u00e1 to\u00e0n di\u1ec7n v\u1ec1 ch\u1ee9c n\u0103ng. 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