{"id":339,"date":"2026-10-11T08:59:06","date_gmt":"2026-10-11T01:59:06","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/thay-khop-khuyu-toan-phan-cho-di-chung-chan-thuong-phuc-tap-khi-nao-can-nhac\/"},"modified":"2026-10-11T08:59:06","modified_gmt":"2026-10-11T01:59:06","slug":"thay-khop-khuyu-toan-phan-cho-di-chung-chan-thuong-phuc-tap-khi-nao-can-nhac","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/thay-khop-khuyu-toan-phan-cho-di-chung-chan-thuong-phuc-tap-khi-nao-can-nhac\/","title":{"rendered":"Thay kh\u1edbp khu\u1ef7u to\u00e0n ph\u1ea7n cho di ch\u1ee9ng ch\u1ea5n th\u01b0\u01a1ng ph\u1ee9c t\u1ea1p: khi n\u00e0o c\u00e2n nh\u1eafc?"},"content":{"rendered":"

Thay kh\u1edbp khu\u1ef7u to\u00e0n ph\u1ea7n<\/strong> l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn t\u00e1i t\u1ea1o d\u00e0nh cho m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p di ch\u1ee9ng ch\u1ea5n th\u01b0\u01a1ng ph\u1ee9c t\u1ea1p, khi kh\u1edbp b\u1ecb ph\u00e1 h\u1ee7y, \u0111au k\u00e9o d\u00e0i, m\u1ea5t v\u1eefng ho\u1eb7c kh\u00f4ng c\u00f2n kh\u1ea3 n\u0103ng ph\u1ee5c h\u1ed3i b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p b\u1ea3o t\u1ed3n kh\u1edbp. Tuy nhi\u00ean, \u0111\u00e2y kh\u00f4ng ph\u1ea3i l\u00e0 gi\u1ea3i ph\u00e1p \u00e1p d\u1ee5ng cho m\u1ecdi ng\u01b0\u1eddi b\u1ec7nh sau ch\u1ea5n th\u01b0\u01a1ng. \u0110\u00e1nh gi\u00e1 m\u00f4 m\u1ec1m, ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng, ch\u1ee9c n\u0103ng c\u01a1 v\u00e0 m\u1ee9c \u0111\u1ed9 ho\u1ea1t \u0111\u1ed9ng c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb [4][7].<\/p>\n

Thay kh\u1edbp khu\u1ef7u to\u00e0n ph\u1ea7n \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc trong t\u00ecnh hu\u1ed1ng n\u00e0o?<\/h2>\n

T\u00e0i li\u1ec7u chuy\u00ean ng\u00e0nh li\u1ec7t k\u00ea di ch\u1ee9ng sau ch\u1ea5n th\u01b0\u01a1ng \u1edf giai \u0111o\u1ea1n cu\u1ed1i<\/strong> l\u00e0 m\u1ed9t trong c\u00e1c ch\u1ec9 \u0111\u1ecbnh c\u1ee7a thay kh\u1edbp khu\u1ef7u. Nh\u1eefng bi\u1ec3u hi\u1ec7n th\u01b0\u1eddng khi\u1ebfn b\u00e1c s\u0129 c\u00e2n nh\u1eafc ph\u1eabu thu\u1eadt g\u1ed3m bi\u1ebfn d\u1ea1ng v\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng k\u00e8m \u0111au ho\u1eb7c m\u1ea5t v\u1eefng, c\u1ee9ng kh\u1edbp x\u01b0\u01a1ng hay x\u01a1 \u1edf t\u01b0 th\u1ebf ho\u1ea1t \u0111\u1ed9ng k\u00e9m, c\u0169ng nh\u01b0 t\u1ed5n th\u01b0\u01a1ng kh\u00f4ng th\u1ec3 t\u00e1i t\u1ea1o c\u1ee7a \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i [4].<\/p>\n

Trong nh\u00f3m di ch\u1ee9ng ph\u1ee9c t\u1ea1p, thay kh\u1edbp c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem x\u00e9t sau khi c\u00e1c ph\u1eabu thu\u1eadt tr\u01b0\u1edbc \u0111\u00f3 th\u1ea5t b\u1ea1i. C\u00e1c g\u1ee3i \u00fd \u0111\u01b0\u1ee3c n\u00eau trong t\u00e0i li\u1ec7u g\u1ed3m \u0111au dai d\u1eb3ng k\u00e8m b\u1eb1ng ch\u1ee9ng h\u00ecnh \u1ea3nh cho th\u1ea5y h\u01b0 h\u1ecfng kh\u1edbp quay\u2013c\u00e1nh tay v\u00e0 c\u00e1nh tay\u2013tr\u1ee5, m\u1ea5t v\u1eefng, th\u1ea5t b\u1ea1i sau c\u1eaft ch\u1ecfm quay v\u00e0 c\u1eaft bao ho\u1ea1t d\u1ecbch, ho\u1eb7c m\u1ea5t x\u01b0\u01a1ng li\u00ean quan \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng hay nhi\u1ec5m tr\u00f9ng [7].<\/p>\n

Nh\u1eefng y\u1ebfu t\u1ed1 c\u1ea7n \u0111\u00e1nh gi\u00e1 tr\u01b0\u1edbc ph\u1eabu thu\u1eadt<\/h2>\n

1. M\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng v\u00e0 kh\u1edbp<\/h3>\n

Ph\u1eabu thu\u1eadt t\u00e1i t\u1ea1o c\u1ea7n h\u01b0\u1edbng t\u1edbi gi\u1ea3m \u0111au, \u0111\u1ed3ng th\u1eddi ph\u1ee5c h\u1ed3i v\u1eadn \u0111\u1ed9ng v\u00e0 \u0111\u1ed9 v\u1eefng c\u1ee7a khu\u1ef7u. V\u00ec v\u1eady, b\u00e1c s\u0129 ph\u1ea3i \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 ph\u00e1 h\u1ee7y c\u1ee7a c\u00e1c di\u1ec7n kh\u1edbp, t\u00ecnh tr\u1ea1ng m\u1ea5t x\u01b0\u01a1ng v\u00e0 kh\u1ea3 n\u0103ng c\u1ed1 \u0111\u1ecbnh implant. M\u1ed9t nguy\u00ean t\u1eafc khi l\u1ef1a ch\u1ecdn implant l\u00e0 b\u1ea3o t\u1ed3n t\u1ed1i \u0111a l\u01b0\u1ee3ng x\u01b0\u01a1ng c\u00f2n l\u1ea1i, t\u1ea1o \u0111\u01b0\u1ee3c s\u1ef1 c\u1ed1 \u0111\u1ecbnh l\u00e2u d\u00e0i, c\u00f3 b\u1ec1 m\u1eb7t kh\u1edbp b\u1ec1n v\u00e0 thu\u1eadn l\u1ee3i t\u01b0\u01a1ng \u0111\u1ed1i khi c\u1ea7n ph\u1eabu thu\u1eadt l\u1ea1i [2].<\/p>\n

2. M\u00f4 m\u1ec1m, c\u01a1 v\u00e0 th\u1ea7n kinh<\/h3>\n

Di ch\u1ee9ng ch\u1ea5n th\u01b0\u01a1ng th\u01b0\u1eddng \u0111i k\u00e8m s\u1eb9o, co r\u00fat, t\u1ed5n th\u01b0\u01a1ng c\u01a1 ho\u1eb7c bi\u1ebfn \u0111\u1ed5i gi\u1ea3i ph\u1eabu. Nh\u1eefng y\u1ebfu t\u1ed1 n\u00e0y c\u00f3 th\u1ec3 l\u00e0m ph\u1eabu thu\u1eadt v\u00e0 ph\u1ee5c h\u1ed3i kh\u00f3 kh\u0103n h\u01a1n. Ch\u1ee9c n\u0103ng c\u1ee7a h\u1ec7 c\u01a1 g\u1ea5p\u2013du\u1ed7i, t\u00ecnh tr\u1ea1ng m\u00f4 m\u1ec1m quanh khu\u1ef7u v\u00e0 kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 th\u1ea7n kinh tr\u1ee5 c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh [4]. Trong c\u00e1c ca ph\u1ee9c t\u1ea1p ho\u1eb7c ph\u1eabu thu\u1eadt l\u1ea1i, s\u1eb9o, co r\u00fat v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng k\u00e9m khi\u1ebfn vi\u1ec7c can thi\u1ec7p kh\u00f3 h\u01a1n; khi x\u1eed l\u00fd ph\u1ea7n th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay c\u1ee7a kh\u1edbp nh\u00e2n t\u1ea1o, c\u1ea7n \u0111\u1eb7c bi\u1ec7t l\u01b0u \u00fd v\u1ecb tr\u00ed g\u1ea7n c\u1ee7a th\u1ea7n kinh quay [6].<\/p>\n

3. Tu\u1ed5i v\u00e0 m\u1ee9c \u0111\u1ed9 ho\u1ea1t \u0111\u1ed9ng<\/h3>\n

Thay kh\u1edbp khu\u1ef7u cho di ch\u1ee9ng sau ch\u1ea5n th\u01b0\u01a1ng nh\u00ecn chung k\u00e9m thu\u1eadn l\u1ee3i h\u01a1n so v\u1edbi ch\u1ec9 \u0111\u1ecbnh trong vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p. T\u00e0i li\u1ec7u khuy\u1ebfn c\u00e1o th\u1eadn tr\u1ecdng \u1edf ng\u01b0\u1eddi tr\u1ebb v\u00e0 ho\u1ea1t \u0111\u1ed9ng nhi\u1ec1u, \u0111\u1eb7c bi\u1ec7t ng\u01b0\u1eddi d\u01b0\u1edbi 50 tu\u1ed5i, do nguy c\u01a1 bi\u1ebfn ch\u1ee9ng r\u1ea5t cao [2]. V\u00ec v\u1eady, mong mu\u1ed1n c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, c\u00f4ng vi\u1ec7c, nhu c\u1ea7u s\u1eed d\u1ee5ng tay v\u00e0 kh\u1ea3 n\u0103ng tu\u00e2n th\u1ee7 gi\u1edbi h\u1ea1n sau m\u1ed5 ph\u1ea3i \u0111\u01b0\u1ee3c trao \u0111\u1ed5i r\u00f5 tr\u01b0\u1edbc khi l\u1ef1a ch\u1ecdn.<\/p>\n

Hi\u1ec7u qu\u1ea3 v\u00e0 gi\u1edbi h\u1ea1n c\u1ee7a kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o<\/h2>\n

C\u00e1c b\u00e1o c\u00e1o d\u00e0i h\u1ea1n cho th\u1ea5y k\u1ebft qu\u1ea3 c\u1ee7a kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o c\u00f3 th\u1ec3 duy tr\u00ec trong nhi\u1ec1u n\u0103m, nh\u01b0ng \u0111\u1ed9 s\u1ed1ng c\u00f2n gi\u1ea3m d\u1ea7n theo th\u1eddi gian. M\u1ed9t c\u01a1 s\u1edf d\u1eef li\u1ec7u \u0111\u01b0\u1ee3c n\u00eau trong t\u00e0i li\u1ec7u ghi nh\u1eadn t\u1ef7 l\u1ec7 s\u1ed1ng c\u00f2n kho\u1ea3ng 90% sau 5 n\u0103m, 81% sau 10 n\u0103m, 71% sau 15 n\u0103m v\u00e0 61% sau 20 n\u0103m; c\u00e1c nghi\u00ean c\u1ee9u kh\u00e1c c\u0169ng cho th\u1ea5y k\u1ebft qu\u1ea3 20 n\u0103m kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t [5]. Nh\u1eefng con s\u1ed1 n\u00e0y kh\u00f4ng ph\u1ea3i ti\u00ean l\u01b0\u1ee3ng c\u00e1 nh\u00e2n, v\u00ec k\u1ebft qu\u1ea3 c\u00f2n ph\u1ee5 thu\u1ed9c nguy\u00ean nh\u00e2n, tu\u1ed5i, m\u1ee9c \u0111\u1ed9 ho\u1ea1t \u0111\u1ed9ng, ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng, m\u00f4 m\u1ec1m v\u00e0 lo\u1ea1i implant.<\/p>\n

So v\u1edbi c\u00e1c b\u1ec7nh l\u00fd vi\u00eam kh\u1edbp, thay kh\u1edbp cho di ch\u1ee9ng sau ch\u1ea5n th\u01b0\u01a1ng th\u01b0\u1eddng c\u00f3 k\u1ebft qu\u1ea3 k\u00e9m thu\u1eadn l\u1ee3i h\u01a1n [2][5]. C\u00e1c v\u1ea5n \u0111\u1ec1 nh\u01b0 l\u1ecfng implant, nhi\u1ec5m tr\u00f9ng, m\u1ea5t x\u01b0\u01a1ng ho\u1eb7c th\u1ea5t b\u1ea1i c\u01a1 h\u1ecdc c\u00f3 th\u1ec3 d\u1eabn t\u1edbi ph\u1eabu thu\u1eadt s\u1eeda l\u1ea1i. Ph\u1eabu thu\u1eadt thay l\u1ea1i th\u01b0\u1eddng kh\u00f3 do s\u1eb9o, co r\u00fat v\u00e0 x\u01b0\u01a1ng y\u1ebfu; c\u00e1c ph\u01b0\u01a1ng \u00e1n c\u1ee9u v\u00e3n c\u00f3 th\u1ec3 bao g\u1ed3m thay implant kh\u00e1c, c\u1eaft b\u1ecf kh\u1edbp nh\u00e2n t\u1ea1o, t\u1ea1o h\u00ecnh xen k\u1ebd ho\u1eb7c h\u00e0n kh\u1edbp, t\u00f9y ho\u00e0n c\u1ea3nh [6].<\/p>\n

Khi n\u00e0o c\u1ea7n c\u00e2n nh\u1eafc ph\u01b0\u01a1ng \u00e1n kh\u00e1c?<\/h2>\n

N\u1ebfu implant kh\u00f4ng ph\u00f9 h\u1ee3p, b\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 c\u00e1c l\u1ef1a ch\u1ecdn kh\u00e1c. T\u1ea1o h\u00ecnh xen k\u1ebd b\u1eb1ng m\u00f4 c\u00e2n t\u1eebng \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 cho b\u1ec7nh nh\u00e2n tr\u1ebb, ho\u1ea1t \u0111\u1ed9ng, \u0111au nhi\u1ec1u do tho\u00e1i h\u00f3a giai \u0111o\u1ea1n cu\u1ed1i nh\u01b0ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0111\u1eb7t implant; ph\u01b0\u01a1ng ph\u00e1p n\u00e0y kh\u00f4ng t\u1ef1 t\u1ea1o \u0111\u1ed9 v\u1eefng n\u00ean kh\u00f4ng ph\u00f9 h\u1ee3p khi m\u1ea5t v\u1eefng l\u00e0 v\u1ea5n \u0111\u1ec1 ch\u00ednh [1]. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng n\u1eb7ng, nhi\u1ec5m tr\u00f9ng, th\u1ea5t b\u1ea1i kh\u1edbp nh\u00e2n t\u1ea1o ho\u1eb7c b\u1ec7nh l\u00fd kh\u1edbp kh\u00f4ng ph\u00f9 h\u1ee3p v\u1edbi thay kh\u1edbp, h\u00e0n kh\u1edbp khu\u1ef7u c\u0169ng n\u1eb1m trong nh\u00f3m th\u1ee7 thu\u1eadt c\u1ee9u v\u00e3n \u0111\u01b0\u1ee3c xem x\u00e9t [3].<\/p>\n

\u0110i\u1ec3m c\u1ea7n trao \u0111\u1ed5i v\u1edbi b\u00e1c s\u0129<\/h2>\n
    \n
  • Nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y \u0111au v\u00e0 m\u1ea5t ch\u1ee9c n\u0103ng hi\u1ec7n nay l\u00e0 h\u01b0 kh\u1edbp, m\u1ea5t v\u1eefng, bi\u1ebfn d\u1ea1ng hay t\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m.<\/li>\n
  • L\u01b0\u1ee3ng x\u01b0\u01a1ng c\u00f2n l\u1ea1i c\u00f3 \u0111\u1ee7 \u0111\u1ec3 c\u1ed1 \u0111\u1ecbnh lo\u1ea1i implant d\u1ef1 ki\u1ebfn hay kh\u00f4ng.<\/li>\n
  • Ch\u1ee9c n\u0103ng th\u1ea7n kinh, c\u01a1 g\u1ea5p\u2013du\u1ed7i v\u00e0 t\u00ecnh tr\u1ea1ng da s\u1eb9o quanh khu\u1ef7u.<\/li>\n
  • M\u1ee9c \u0111\u1ed9 ho\u1ea1t \u0111\u1ed9ng sau m\u1ed5 c\u00f3 ph\u00f9 h\u1ee3p v\u1edbi c\u00e1c gi\u1edbi h\u1ea1n c\u1ee7a kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o hay kh\u00f4ng.<\/li>\n
  • N\u1ebfu kh\u1edbp nh\u00e2n t\u1ea1o th\u1ea5t b\u1ea1i, nh\u1eefng ph\u01b0\u01a1ng \u00e1n ph\u1eabu thu\u1eadt l\u1ea1i ho\u1eb7c c\u1ee9u v\u00e3n n\u00e0o c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc.<\/li>\n<\/ul>\n

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

    Thay kh\u1edbp khu\u1ef7u to\u00e0n ph\u1ea7n cho di ch\u1ee9ng ch\u1ea5n th\u01b0\u01a1ng ph\u1ee9c t\u1ea1p<\/strong> c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3i quy\u1ebft \u0111au, m\u1ea5t v\u1eefng v\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng \u1edf nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u0111\u01b0\u1ee3c ch\u1ecdn l\u1ecdc. D\u00f9 v\u1eady, ng\u01b0\u1eddi tr\u1ebb ho\u1ea1t \u0111\u1ed9ng nhi\u1ec1u, c\u00f3 m\u1ea5t x\u01b0\u01a1ng l\u1edbn, m\u00f4 m\u1ec1m k\u00e9m, ti\u1ec1n s\u1eed nhi\u1ec5m tr\u00f9ng ho\u1eb7c ch\u1ee9c n\u0103ng c\u01a1 kh\u00f4ng t\u1ed1t c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 \u0111\u1eb7c bi\u1ec7t th\u1eadn tr\u1ecdng. Quy\u1ebft \u0111\u1ecbnh cu\u1ed1i c\u00f9ng n\u00ean d\u1ef1a tr\u00ean th\u0103m kh\u00e1m chuy\u00ean khoa, h\u00ecnh \u1ea3nh h\u1ecdc, t\u00ecnh tr\u1ea1ng m\u00f4 m\u1ec1m v\u00e0 m\u1ee5c ti\u00eau s\u1eed d\u1ee5ng tay c\u1ee7a t\u1eebng ng\u01b0\u1eddi b\u1ec7nh; t\u00e0i li\u1ec7u n\u00e0y kh\u00f4ng thay th\u1ebf t\u01b0 v\u1ea5n tr\u1ef1c ti\u1ebfp ho\u1eb7c k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb c\u00e1 nh\u00e2n.<\/p>\n

    T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
      \n
    • [1] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 803<\/li>\n
    • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 817<\/li>\n
    • [3] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 820<\/li>\n
    • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 810<\/li>\n
    • [5] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 817<\/li>\n
    • [6] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 817<\/li>\n
    • [7] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 810<\/li>\n<\/ul>\n

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

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