{"id":233,"date":"2026-10-10T18:10:00","date_gmt":"2026-10-10T11:10:00","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/10\/noi-soi-khop-goi-dieu-tri-hoi-chung-nep-gap-mang-hoat-dich\/"},"modified":"2026-10-10T18:10:00","modified_gmt":"2026-10-10T11:10:00","slug":"noi-soi-khop-goi-dieu-tri-hoi-chung-nep-gap-mang-hoat-dich","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/10\/noi-soi-khop-goi-dieu-tri-hoi-chung-nep-gap-mang-hoat-dich\/","title":{"rendered":"N\u1ed9i soi kh\u1edbp g\u1ed1i \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng n\u1ebfp g\u1ea5p m\u00e0ng ho\u1ea1t d\u1ecbch"},"content":{"rendered":"

N\u1ed9i soi kh\u1edbp g\u1ed1i \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng n\u1ebfp g\u1ea5p m\u00e0ng ho\u1ea1t d\u1ecbch<\/strong> th\u01b0\u1eddng t\u1eadp trung v\u00e0o vi\u1ec7c x\u00e1c \u0111\u1ecbnh n\u1ebfp g\u1ea5p c\u00f3 th\u1ef1c s\u1ef1 l\u00e0 t\u1ed5n th\u01b0\u01a1ng g\u00e2y tri\u1ec7u ch\u1ee9ng hay kh\u00f4ng, sau \u0111\u00f3 c\u1eaft b\u1ecf ph\u1ea7n n\u1ebfp g\u1ea5p b\u1ec7nh l\u00fd qua c\u00e1c c\u1ed5ng n\u1ed9i soi. T\u00e0i li\u1ec7u chuy\u00ean m\u00f4n nh\u1ea5n m\u1ea1nh c\u1ea7n kh\u1ea3o s\u00e1t kh\u1edbp m\u1ed9t c\u00e1ch c\u00f3 h\u1ec7 th\u1ed1ng \u0111\u1ec3 lo\u1ea1i tr\u1eeb nh\u1eefng b\u1ec7nh l\u00fd trong kh\u1edbp kh\u00e1c tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh c\u1eaft n\u1ebfp g\u1ea5p [4].<\/p>\n

N\u1ebfp g\u1ea5p m\u00e0ng ho\u1ea1t d\u1ecbch n\u00e0o c\u00f3 th\u1ec3 g\u00e2y v\u1ea5n \u0111\u1ec1?<\/h2>\n

N\u1ebfp g\u1ea5p m\u00e0ng ho\u1ea1t d\u1ecbch l\u00e0 c\u00e1c c\u1ea5u tr\u00fac n\u1eb1m quanh kh\u1edbp g\u1ed1i. H\u00ecnh minh h\u1ecda trong t\u00e0i li\u1ec7u ph\u00e2n bi\u1ec7t nhi\u1ec1u v\u1ecb tr\u00ed, trong \u0111\u00f3 n\u1ebfp g\u1ea5p ph\u00eda trong v\u00f9ng b\u00e1nh ch\u00e8 \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 c\u00f3 th\u1ec3 c\u00f3 t\u00ednh ch\u1ea5t g\u00e2y tri\u1ec7u ch\u1ee9ng, c\u00f2n m\u1ed9t s\u1ed1 n\u1ebfp g\u1ea5p kh\u00e1c th\u01b0\u1eddng kh\u00f4ng tri\u1ec7u ch\u1ee9ng [3]. V\u00ec v\u1eady, vi\u1ec7c nh\u00ecn th\u1ea5y n\u1ebfp g\u1ea5p tr\u00ean h\u00ecnh \u1ea3nh ho\u1eb7c trong qu\u00e1 tr\u00ecnh th\u0103m kh\u00e1m kh\u00f4ng t\u1ef1 \u0111\u1ed9ng \u0111\u1ed3ng ngh\u0129a v\u1edbi vi\u1ec7c c\u1ea7n ph\u1eabu thu\u1eadt.<\/p>\n

\u1ede ng\u01b0\u1eddi c\u00f3 \u0111au v\u00f9ng tr\u01b0\u1edbc g\u1ed1i, n\u1ed9i soi c\u00f3 th\u1ec3 \u0111\u1ed3ng th\u1eddi ghi nh\u1eadn n\u1ebfp g\u1ea5p m\u00e0ng ho\u1ea1t d\u1ecbch v\u00e0 nh\u1eefng thay \u0111\u1ed5i kh\u00e1c nh\u01b0 t\u1ed5n th\u01b0\u01a1ng s\u1ee5n b\u00e1nh ch\u00e8. M\u1ed9t tr\u00edch \u0111o\u1ea1n nghi\u00ean c\u1ee9u trong t\u00e0i li\u1ec7u cho th\u1ea5y kh\u00f4ng n\u00ean ch\u1ec9 d\u1ef1a v\u00e0o h\u1ed9i ch\u1ee9ng \u0111au tr\u01b0\u1edbc g\u1ed1i \u0111\u1ec3 ch\u1ec9 \u0111\u1ecbnh n\u1ed9i soi, b\u1edfi tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng t\u01b0\u01a1ng \u1ee9ng v\u1edbi h\u00ecnh \u1ea3nh quan s\u00e1t \u0111\u01b0\u1ee3c khi n\u1ed9i soi [2]. \u0110\u00e2y l\u00e0 l\u00fd do quy\u1ebft \u0111\u1ecbnh can thi\u1ec7p c\u1ea7n d\u1ef1a tr\u00ean \u0111\u00e1nh gi\u00e1 t\u1ed5ng th\u1ec3, thay v\u00ec ch\u1ec9 d\u1ef1a v\u00e0o m\u1ed9t ph\u00e1t hi\u1ec7n \u0111\u01a1n l\u1ebb.<\/p>\n

N\u1ed9i soi kh\u1edbp g\u1ed1i \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng n\u1ebfp g\u1ea5p m\u00e0ng ho\u1ea1t d\u1ecbch \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n nh\u01b0 th\u1ebf n\u00e0o?<\/h2>\n

1. Kh\u1ea3o s\u00e1t to\u00e0n di\u1ec7n trong kh\u1edbp<\/h3>\n

Tr\u01b0\u1edbc khi c\u1eaft, ph\u1eabu thu\u1eadt vi\u00ean th\u1ef1c hi\u1ec7n n\u1ed9i soi ch\u1ea9n \u0111o\u00e1n c\u00f3 h\u1ec7 th\u1ed1ng \u0111\u1ec3 ki\u1ec3m tra c\u00e1c c\u1ea5u tr\u00fac trong kh\u1edbp v\u00e0 lo\u1ea1i tr\u1eeb b\u1ec7nh l\u00fd kh\u00e1c. N\u1ebfp g\u1ea5p \u0111\u01b0\u1ee3c xem l\u00e0 \u0111\u00e1ng ch\u00fa \u00fd khi c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m d\u00e0y, k\u00e9m \u0111\u00e0n h\u1ed3i, h\u00ecnh tr\u00f2n v\u00e0 m\u00e0u tr\u1eafng; trong b\u1ed1i c\u1ea3nh n\u00e0y, c\u1eaft n\u1ebfp g\u1ea5p qua n\u1ed9i soi \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m tri\u1ec7u ch\u1ee9ng [4].<\/p>\n

2. Quan s\u00e1t n\u1ebfp g\u1ea5p \u1edf nhi\u1ec1u g\u00f3c<\/h3>\n

T\u00e0i li\u1ec7u h\u01b0\u1edbng d\u1eabn quan s\u00e1t n\u1ebfp g\u1ea5p ph\u00eda trong b\u00e1nh ch\u00e8 b\u1eb1ng \u1ed1ng k\u00ednh 30 \u0111\u1ed9 qua c\u1ed5ng tr\u01b0\u1edbc ngo\u00e0i ti\u00eau chu\u1ea9n. Sau \u0111\u00f3, ph\u1eabu thu\u1eadt vi\u00ean c\u00f3 th\u1ec3 ki\u1ec3m tra m\u1eb7t tr\u00ean c\u1ee7a n\u1ebfp g\u1ea5p qua c\u1ed5ng tr\u00ean ngo\u00e0i \u0111\u1ec3 x\u00e1c nh\u1eadn th\u00eam t\u00ednh ch\u1ea5t b\u1ec7nh l\u00fd tr\u01b0\u1edbc khi c\u1eaft [4]. C\u00e1ch ti\u1ebfp c\u1eadn n\u00e0y nh\u1eb1m h\u1ea1n ch\u1ebf vi\u1ec7c x\u1eed tr\u00ed m\u1ed9t c\u1ea5u tr\u00fac ch\u1ec9 t\u00ecnh c\u1edd \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y nh\u01b0ng kh\u00f4ng ph\u1ea3i nguy\u00ean nh\u00e2n ch\u00ednh c\u1ee7a tri\u1ec7u ch\u1ee9ng.<\/p>\n

3. C\u1eaft ph\u1ea7n n\u1ebfp g\u1ea5p b\u1ec7nh l\u00fd<\/h3>\n

N\u1ebfu n\u1ebfp g\u1ea5p \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 b\u1ec7nh l\u00fd, k\u1ef9 thu\u1eadt \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 c\u1eaft b\u1ecf m\u1ed9t ph\u1ea7n t\u01b0\u01a1ng \u0111\u1ed1i r\u1ed9ng thay v\u00ec ch\u1ec9 r\u1ea1ch \u0111\u01a1n thu\u1ea7n. K\u00e9o ho\u1eb7c k\u00ecm g\u1eafp \u0111\u01b0\u1ee3c \u0111\u01b0a qua c\u1ed5ng ph\u00f9 h\u1ee3p, b\u1eaft \u0111\u1ea7u t\u1eeb ph\u1ea7n tr\u00ean c\u1ee7a n\u1ebfp g\u1ea5p; t\u00e0i li\u1ec7u n\u00eau vi\u1ec7c l\u1ea5y b\u1ecf m\u1ed9t \u0111o\u1ea1n kho\u1ea3ng 1\u20132 cm v\u00e0 t\u1ea1o b\u1ec1 m\u1eb7t l\u00f5m \u0111\u1ebfn th\u00e0nh m\u00e0ng ho\u1ea1t d\u1ecbch [4]. M\u1ee5c ti\u00eau l\u00e0 lo\u1ea1i b\u1ecf ph\u1ea7n n\u1ebfp g\u1ea5p d\u00e0y, c\u0103ng ho\u1eb7c d\u1ec5 va ch\u1ea1m trong v\u1eadn \u0111\u1ed9ng c\u1ee7a kh\u1edbp.<\/p>\n

Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, sau khi chia n\u1ebfp g\u1ea5p, hai \u0111\u1ea7u c\u00f3 th\u1ec3 t\u00e1ch r\u1ed9ng do c\u1ea5u tr\u00fac n\u00e0y \u0111ang ch\u1ecbu l\u1ef1c c\u0103ng. N\u1ebfu c\u00f2n c\u00e1c d\u1ea3i m\u00e0ng ho\u1ea1t d\u1ecbch ho\u1eb7c ph\u1ea7n n\u1ebfp g\u1ea5p s\u00f3t l\u1ea1i, d\u1ee5ng c\u1ee5 c\u1eaft h\u00fat chuy\u00ean d\u1ee5ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 l\u00e0m s\u1ea1ch th\u00eam [1]. Tuy nhi\u00ean, t\u00e0i li\u1ec7u c\u0169ng l\u01b0u \u00fd tr\u00e1nh c\u1eaft m\u00e0ng ho\u1ea1t d\u1ecbch qu\u00e1 m\u1ea1nh v\u00ec \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u00ecnh tr\u1ea1ng vi\u00eam m\u00e0ng ho\u1ea1t d\u1ecbch sau m\u1ed5 [1].<\/p>\n

4. R\u1eeda s\u1ea1ch kh\u1edbp<\/h3>\n

Sau khi x\u1eed tr\u00ed, kh\u1edbp \u0111\u01b0\u1ee3c r\u1eeda v\u00e0 h\u00fat k\u1ef9 \u0111\u1ec3 lo\u1ea1i b\u1ecf m\u1ea3nh v\u1ee5n c\u00f2n l\u1ea1i [1]. \u0110\u00e2y l\u00e0 b\u01b0\u1edbc ho\u00e0n t\u1ea5t quy tr\u00ecnh \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 trong t\u00e0i li\u1ec7u k\u1ef9 thu\u1eadt, nh\u01b0ng c\u00e1c tr\u00edch \u0111o\u1ea1n \u0111\u01b0\u1ee3c cung c\u1ea5p kh\u00f4ng n\u00eau c\u1ee5 th\u1ec3 v\u1ec1 th\u1eddi gian ph\u1eabu thu\u1eadt, lo\u1ea1i g\u00e2y m\u00ea, l\u1ecbch t\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng ho\u1eb7c th\u1eddi \u0111i\u1ec3m tr\u1edf l\u1ea1i th\u1ec3 thao.<\/p>\n

\u0110i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n c\u00f3 vai tr\u00f2 g\u00ec?<\/h2>\n

Ph\u1ea7n t\u00e0i li\u1ec7u v\u1ec1 n\u1ebfp g\u1ea5p m\u00e0ng ho\u1ea1t d\u1ecbch li\u1ec7t k\u00ea m\u1ed9t s\u1ed1 bi\u1ec7n ph\u00e1p b\u1ea3o t\u1ed3n nh\u01b0 ti\u00eam t\u1ea1i ch\u1ed7 v\u00e0 tr\u00e1nh duy tr\u00ec t\u01b0 th\u1ebf g\u1ea5p g\u1ed1i k\u00e9o d\u00e0i [4]. Vi\u1ec7c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb c\u1ea7n \u0111\u01b0\u1ee3c c\u00e1 th\u1ec3 h\u00f3a sau khi b\u00e1c s\u0129 \u0111\u00e1nh gi\u00e1 nguy\u00ean nh\u00e2n \u0111au, m\u1ee9c \u0111\u1ed9 \u1ea3nh h\u01b0\u1edfng v\u1eadn \u0111\u1ed9ng v\u00e0 kh\u1ea3 n\u0103ng c\u00f3 b\u1ec7nh l\u00fd kh\u00e1c trong kh\u1edbp.<\/p>\n

Nh\u1eefng gi\u1edbi h\u1ea1n c\u1ea7n l\u01b0u \u00fd<\/h2>\n
    \n
  • Kh\u00f4ng ph\u1ea3i m\u1ecdi n\u1ebfp g\u1ea5p m\u00e0ng ho\u1ea1t d\u1ecbch \u0111\u1ec1u g\u00e2y tri\u1ec7u ch\u1ee9ng ho\u1eb7c c\u1ea7n c\u1eaft b\u1ecf [3].<\/li>\n
  • \u0110au tr\u01b0\u1edbc g\u1ed1i kh\u00f4ng n\u00ean \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u01a1n \u0111\u1ed9c l\u00e0m ch\u1ec9 \u0111\u1ecbnh n\u1ed9i soi [2].<\/li>\n
  • N\u1ed9i soi c\u1ea7n bao g\u1ed3m kh\u1ea3o s\u00e1t c\u00f3 h\u1ec7 th\u1ed1ng \u0111\u1ec3 lo\u1ea1i tr\u1eeb t\u1ed5n th\u01b0\u01a1ng kh\u00e1c trong kh\u1edbp [4].<\/li>\n
  • T\u00e0i li\u1ec7u \u0111\u01b0\u1ee3c cung c\u1ea5p ch\u01b0a m\u00f4 t\u1ea3 \u0111\u1ea7y \u0111\u1ee7 nguy c\u01a1, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, ch\u0103m s\u00f3c sau m\u1ed5 v\u00e0 k\u1ebft qu\u1ea3 l\u00e2u d\u00e0i ri\u00eang cho h\u1ed9i ch\u1ee9ng n\u00e0y.<\/li>\n<\/ul>\n

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

    N\u1ed9i soi kh\u1edbp g\u1ed1i \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng n\u1ebfp g\u1ea5p m\u00e0ng ho\u1ea1t d\u1ecbch ch\u1ee7 y\u1ebfu g\u1ed3m kh\u1ea3o s\u00e1t to\u00e0n b\u1ed9 kh\u1edbp, x\u00e1c nh\u1eadn n\u1ebfp g\u1ea5p c\u00f3 t\u00ednh ch\u1ea5t b\u1ec7nh l\u00fd, c\u1eaft b\u1ecf ph\u1ea7n t\u1ed5n th\u01b0\u01a1ng ph\u00f9 h\u1ee3p v\u00e0 r\u1eeda s\u1ea1ch kh\u1edbp. Do kh\u00f4ng ph\u1ea3i m\u1ecdi n\u1ebfp g\u1ea5p \u0111\u1ec1u g\u00e2y \u0111au, ch\u1ec9 \u0111\u1ecbnh n\u00ean \u0111\u01b0\u1ee3c \u0111\u01b0a ra sau \u0111\u00e1nh gi\u00e1 chuy\u00ean khoa v\u00e0 lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c. Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n trao \u0111\u1ed5i tr\u1ef1c ti\u1ebfp v\u1edbi b\u00e1c s\u0129 v\u1ec1 l\u1ee3i \u00edch, nguy c\u01a1 v\u00e0 k\u1ebf ho\u1ea1ch ph\u1ee5c h\u1ed3i c\u1ee5 th\u1ec3, v\u00ec nh\u1eefng n\u1ed9i dung n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y \u0111\u1ea7y \u0111\u1ee7 trong c\u00e1c \u0111o\u1ea1n t\u00e0i li\u1ec7u hi\u1ec7n c\u00f3.<\/p>\n

    T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
      \n
    • [1] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3078<\/li>\n
    • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2765<\/li>\n
    • [3] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2751<\/li>\n
    • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3078<\/li>\n<\/ul>\n

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