{"id":156,"date":"2026-10-06T11:01:23","date_gmt":"2026-10-06T04:01:23","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/06\/dut-day-chang-cheo-sau-chan-doan-hinh-anh-va-huong-xu-tri-theo-tai-lieu\/"},"modified":"2026-10-06T11:01:23","modified_gmt":"2026-10-06T04:01:23","slug":"dut-day-chang-cheo-sau-chan-doan-hinh-anh-va-huong-xu-tri-theo-tai-lieu","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/06\/dut-day-chang-cheo-sau-chan-doan-hinh-anh-va-huong-xu-tri-theo-tai-lieu\/","title":{"rendered":"\u0110\u1ee9t d\u00e2y ch\u1eb1ng ch\u00e9o sau: ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh v\u00e0 h\u01b0\u1edbng x\u1eed tr\u00ed theo t\u00e0i li\u1ec7u"},"content":{"rendered":"

\u0110\u1ee9t d\u00e2y ch\u1eb1ng ch\u00e9o sau<\/strong> l\u00e0 t\u1ed5n th\u01b0\u01a1ng c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 trong b\u1ed1i c\u1ea3nh ch\u1ea5n th\u01b0\u01a1ng g\u1ed1i, \u0111\u1eb7c bi\u1ec7t khi c\u00f3 nghi ng\u1edd t\u1ed5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p. C\u00e1c t\u00e0i li\u1ec7u \u0111\u01b0\u1ee3c cung c\u1ea5p t\u1eadp trung v\u00e0o h\u00ecnh \u1ea3nh MRI, t\u1ed5n th\u01b0\u01a1ng \u1edf tr\u1ebb em, tr\u1eadt kh\u1edbp g\u1ed1i v\u00e0 m\u1ed9t s\u1ed1 nguy\u00ean t\u1eafc ph\u1eabu thu\u1eadt. V\u00ec v\u1eady, b\u00e0i vi\u1ebft n\u00e0y ch\u1ec9 tr\u00ecnh b\u00e0y trong ph\u1ea1m vi nh\u1eefng th\u00f4ng tin c\u00f3 b\u1eb1ng ch\u1ee9ng t\u1eeb c\u00e1c \u0111o\u1ea1n t\u00e0i li\u1ec7u n\u00f3i tr\u00ean, kh\u00f4ng thay th\u1ebf cho th\u0103m kh\u00e1m tr\u1ef1c ti\u1ebfp.<\/p>\n

\u0110\u1ee9t d\u00e2y ch\u1eb1ng ch\u00e9o sau l\u00e0 g\u00ec?<\/h2>\n

D\u00e2y ch\u1eb1ng ch\u00e9o sau, th\u01b0\u1eddng vi\u1ebft t\u1eaft l\u00e0 PCL, \u0111\u01b0\u1ee3c nh\u1eadn di\u1ec7n tr\u00ean MRI \u1edf v\u00f9ng trong kh\u1edbp g\u1ed1i. H\u00ecnh \u1ea3nh r\u00e1ch PCL tr\u00ean m\u1eb7t ph\u1eb3ng \u0111\u1ee9ng d\u1ecdc c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n b\u1eb1ng t\u00edn hi\u1ec7u b\u1ea5t th\u01b0\u1eddng t\u0103ng l\u00ean trong c\u00e1c b\u00f3 s\u1ee3i b\u1ecb m\u1ea5t t\u1ed5 ch\u1ee9c<\/strong>, nh\u01b0 minh h\u1ecda trong t\u00e0i li\u1ec7u ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh ch\u1ec9nh h\u00ecnh [3][4].<\/p>\n

Tuy nhi\u00ean, ch\u1ec9 m\u1ed9t h\u00ecnh \u1ea3nh b\u1ea5t th\u01b0\u1eddng tr\u00ean MRI kh\u00f4ng n\u00ean \u0111\u01b0\u1ee3c t\u00e1ch r\u1eddi kh\u1ecfi b\u1ec7nh s\u1eed, th\u0103m kh\u00e1m v\u00e0 \u0111\u00e1nh gi\u00e1 c\u00e1c c\u1ea5u tr\u00fac kh\u00e1c c\u1ee7a kh\u1edbp g\u1ed1i. Nh\u1eefng \u0111o\u1ea1n t\u00e0i li\u1ec7u \u0111\u01b0\u1ee3c cung c\u1ea5p kh\u00f4ng m\u00f4 t\u1ea3 \u0111\u1ea7y \u0111\u1ee7 h\u1ec7 th\u1ed1ng tri\u1ec7u ch\u1ee9ng, ph\u00e2n \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng ho\u1eb7c ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng ri\u00eang cho m\u1ecdi tr\u01b0\u1eddng h\u1ee3p PCL.<\/p>\n

Vai tr\u00f2 c\u1ee7a MRI khi nghi ng\u1edd \u0111\u1ee9t d\u00e2y ch\u1eb1ng ch\u00e9o sau<\/h2>\n

MRI c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 ph\u00e1t hi\u1ec7n r\u00e1ch PCL v\u00e0 \u0111\u00e1nh gi\u00e1 c\u00e1c t\u1ed5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p trong kh\u1edbp g\u1ed1i. H\u00ecnh minh h\u1ecda trong t\u00e0i li\u1ec7u cho th\u1ea5y r\u00e1ch PCL \u0111\u01b0\u1ee3c kh\u1ea3o s\u00e1t tr\u00ean chu\u1ed7i xung \u0111\u1ee9ng d\u1ecdc, c\u00f3 \u1ee9c ch\u1ebf m\u1ee1 v\u00e0 m\u1eadt \u0111\u1ed9 proton; h\u00ecnh \u1ea3nh \u0111\u1eb7c tr\u01b0ng l\u00e0 t\u00edn hi\u1ec7u t\u0103ng b\u1ea5t th\u01b0\u1eddng b\u00ean trong c\u00e1c s\u1ee3i d\u00e2y ch\u1eb1ng b\u1ecb r\u1ed1i lo\u1ea1n [3].<\/p>\n

Ngo\u00e0i d\u00e2y ch\u1eb1ng, MRI c\u00f2n \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 kh\u1ea3o s\u00e1t nhi\u1ec1u v\u1ea5n \u0111\u1ec1 kh\u00e1c c\u1ee7a kh\u1edbp g\u1ed1i, g\u1ed3m t\u1ed5n th\u01b0\u01a1ng s\u1ee5n, d\u1eadp x\u01b0\u01a1ng, b\u1ec7nh l\u00fd m\u00e0ng ho\u1ea1t d\u1ecbch v\u00e0 g\u00e3y x\u01b0\u01a1ng k\u00edn \u0111\u00e1o [3]. \u0110i\u1ec1u n\u00e0y c\u00f3 \u00fd ngh\u0129a khi ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng ch\u1ec9 b\u1ecb r\u00e1ch PCL \u0111\u01a1n thu\u1ea7n m\u00e0 c\u00f2n c\u00f3 ch\u1ea5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p.<\/p>\n

T\u1ed5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p c\u1ea7n l\u01b0u \u00fd<\/h2>\n

Trong ch\u1ea5n th\u01b0\u01a1ng g\u1ed1i n\u1eb7ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c ki\u1ec3u g\u00e3y-tr\u1eadt kh\u1edbp, t\u1ed5n th\u01b0\u01a1ng PCL c\u00f3 th\u1ec3 \u0111i k\u00e8m t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng kh\u00e1c. M\u1ed9t t\u00e0i li\u1ec7u ghi nh\u1eadn c\u00e1c ki\u1ec3u t\u1ed5n th\u01b0\u01a1ng m\u00e2m ch\u00e0y do g\u00e3y-tr\u1eadt th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn d\u00e2y ch\u1eb1ng b\u00ean v\u00e0 d\u00e2y ch\u1eb1ng ch\u00e9o, trong \u0111\u00f3 PCL c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t c\u1ea5u tr\u00fac b\u1ecb t\u1ed5n th\u01b0\u01a1ng [2][7].<\/p>\n

Tr\u1eadt kh\u1edbp g\u1ed1i l\u00e0 t\u00ecnh tr\u1ea1ng t\u01b0\u01a1ng \u0111\u1ed1i hi\u1ebfm nh\u01b0ng c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u01b0\u1ee3c nh\u1eadn ra n\u1ebfu kh\u1edbp t\u1ef1 n\u1eafn tr\u01b0\u1edbc khi ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c kh\u00e1m. Ch\u1ea9n \u0111o\u00e1n c\u00f3 th\u1ec3 kh\u00f3 h\u01a1n \u1edf ng\u01b0\u1eddi b\u00e9o ph\u00ec, ng\u01b0\u1eddi b\u1ecb \u0111a ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c tr\u01b0\u1eddng h\u1ee3p kh\u1edbp \u0111\u00e3 t\u1ef1 tr\u1edf v\u1ec1 v\u1ecb tr\u00ed [1]. \u0110\u00e1ng ch\u00fa \u00fd, kh\u00f4ng nh\u1eadn di\u1ec7n \u0111\u00fang tr\u1eadt kh\u1edbp g\u1ed1i c\u00f3 th\u1ec3 l\u00e0m b\u1ecf s\u00f3t t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch khoeo, d\u1eabn \u0111\u1ebfn bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng [5].<\/p>\n

    \n
  • C\u1ea7n \u0111\u00e1nh gi\u00e1 to\u00e0n b\u1ed9 kh\u1edbp g\u1ed1i thay v\u00ec ch\u1ec9 t\u1eadp trung v\u00e0o PCL.<\/li>\n
  • Trong ch\u1ea5n th\u01b0\u01a1ng n\u1eb7ng, ph\u1ea3i l\u01b0u \u00fd kh\u1ea3 n\u0103ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u v\u00e0 th\u1ea7n kinh.<\/li>\n
  • Vi\u1ec7c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o ki\u1ec3u t\u1ed5n th\u01b0\u01a1ng, m\u1ee9c \u0111\u1ed9 m\u1ea5t v\u1eefng v\u00e0 t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng ho\u1eb7c d\u00e2y ch\u1eb1ng \u0111i k\u00e8m.<\/li>\n<\/ul>\n

    Nguy\u00ean t\u1eafc x\u1eed tr\u00ed \u1edf tr\u1ebb em<\/h2>\n

    T\u00e0i li\u1ec7u v\u1ec1 ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh tr\u1ebb em \u0111\u01b0a ra h\u01b0\u1edbng ti\u1ebfp c\u1eadn ri\u00eang cho b\u1ec7nh nh\u00e2n ch\u01b0a tr\u01b0\u1edfng th\u00e0nh v\u1ec1 x\u01b0\u01a1ng. V\u1edbi t\u1ed5n th\u01b0\u01a1ng PCL \u0111\u01a1n thu\u1ea7n, ch\u1ec9 t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng v\u00e0 kh\u00f4ng c\u00f3 m\u1ea3nh x\u01b0\u01a1ng bong, t\u00e1c gi\u1ea3 \u01b0u ti\u00ean \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt b\u1eb1ng n\u1eb9p k\u1ebft h\u1ee3p v\u1eadt l\u00fd tr\u1ecb li\u1ec7u t\u1eadp trung v\u00e0o t\u0103ng c\u01b0\u1eddng c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i [6].<\/p>\n

    Ng\u01b0\u1ee3c l\u1ea1i, n\u1ebfu c\u00f3 m\u1ea3nh x\u01b0\u01a1ng bong di l\u1ec7ch, t\u00e0i li\u1ec7u \u01b0u ti\u00ean s\u1eeda ch\u1eefa s\u1edbm. M\u1ea3nh bong \u1edf v\u1ecb tr\u00ed b\u00e1m ph\u00eda \u0111\u00f9i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eeda ch\u1eefa qua n\u1ed9i soi v\u1edbi \u0111\u01b0\u1eddng h\u1ea7m x\u01b0\u01a1ng v\u00e0 c\u1ed1 \u0111\u1ecbnh b\u1eb1ng ch\u1ec9, \u0111\u1ed3ng th\u1eddi c\u1ea7n ch\u00fa \u00fd tr\u00e1nh t\u1ed5n th\u01b0\u01a1ng s\u1ee5n t\u0103ng tr\u01b0\u1edfng \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng \u0111\u00f9i. M\u1ea3nh bong \u1edf ph\u00eda m\u00e2m ch\u00e0y c\u00f3 th\u1ec3 kh\u00f3 ti\u1ebfp c\u1eadn h\u01a1n qua n\u1ed9i soi [6].<\/p>\n

    Khi n\u00e0o c\u1ea7n \u0111\u00e1nh gi\u00e1 chuy\u00ean khoa?<\/h2>\n

    Ng\u01b0\u1eddi c\u00f3 ch\u1ea5n th\u01b0\u01a1ng g\u1ed1i k\u00e8m bi\u1ebfn d\u1ea1ng, \u0111au v\u00e0 s\u01b0ng r\u00f5, ho\u1eb7c nghi ng\u1edd tr\u1eadt kh\u1edbp c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 y t\u1ebf s\u1edbm. T\u00e0i li\u1ec7u nh\u1ea5n m\u1ea1nh r\u1eb1ng ch\u1ea9n \u0111o\u00e1n tr\u1eadt kh\u1edbp g\u1ed1i ph\u1ea3i \u0111i k\u00e8m nh\u1eadn di\u1ec7n nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch khoeo [1][5]. V\u1edbi tr\u1ebb em, vi\u1ec7c ph\u00e2n bi\u1ec7t r\u00e1ch d\u00e2y ch\u1eb1ng \u0111\u01a1n thu\u1ea7n v\u1edbi bong m\u1ea3nh x\u01b0\u01a1ng di l\u1ec7ch c\u00f3 vai tr\u00f2 quan tr\u1ecdng v\u00ec hai t\u00ecnh hu\u1ed1ng n\u00e0y c\u00f3 \u0111\u1ecbnh h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb kh\u00e1c nhau [6].<\/p>\n

    K\u1ebft lu\u1eadn<\/h2>\n

    \u0110\u1ee9t d\u00e2y ch\u1eb1ng ch\u00e9o sau c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c nh\u1eadn di\u1ec7n tr\u00ean MRI b\u1eb1ng c\u00e1c thay \u0111\u1ed5i b\u1ea5t th\u01b0\u1eddng trong c\u1ea5u tr\u00fac s\u1ee3i d\u00e2y ch\u1eb1ng. Tuy nhi\u00ean, \u0111\u00e1nh gi\u00e1 c\u1ea7n \u0111\u1eb7t trong to\u00e0n c\u1ea3nh ch\u1ea5n th\u01b0\u01a1ng, v\u00ec PCL c\u00f3 th\u1ec3 \u0111i k\u00e8m t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng kh\u00e1c, g\u00e3y-tr\u1eadt kh\u1edbp ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh-m\u1ea1ch m\u00e1u. \u1ede tr\u1ebb ch\u01b0a tr\u01b0\u1edfng th\u00e0nh v\u1ec1 x\u01b0\u01a1ng, t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng \u0111\u01a1n thu\u1ea7n v\u00e0 bong m\u1ea3nh x\u01b0\u01a1ng di l\u1ec7ch c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u1eed tr\u00ed kh\u00e1c nhau. C\u00e1c th\u00f4ng tin \u0111\u01b0\u1ee3c cung c\u1ea5p ch\u01b0a \u0111\u1ee7 \u0111\u1ec3 tr\u00ecnh b\u00e0y \u0111\u1ea7y \u0111\u1ee7 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb cho ng\u01b0\u1eddi l\u1edbn, ti\u00eau ch\u00ed ph\u1eabu thu\u1eadt \u1edf t\u1eebng m\u1ee9c \u0111\u1ed9 r\u00e1ch ho\u1eb7c ch\u01b0\u01a1ng tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng chi ti\u1ebft.<\/p>\n

    T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
      \n
    • [1] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2743<\/li>\n
    • [2] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 3118<\/li>\n
    • [3] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 192<\/li>\n
    • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 192<\/li>\n
    • [5] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2743<\/li>\n
    • [6] Rockwood and Green's Fractures in Children, 9th Edition, 2020, trang 1701<\/li>\n
    • [7] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 3118<\/li>\n<\/ul>\n

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