{"id":351,"date":"2026-10-11T09:31:00","date_gmt":"2026-10-11T02:31:00","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/tap-luyen-duoi-nuoc-va-phuc-hoi-chuc-nang-sau-phau-thuat-khop\/"},"modified":"2026-10-11T09:31:00","modified_gmt":"2026-10-11T02:31:00","slug":"tap-luyen-duoi-nuoc-va-phuc-hoi-chuc-nang-sau-phau-thuat-khop","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/tap-luyen-duoi-nuoc-va-phuc-hoi-chuc-nang-sau-phau-thuat-khop\/","title":{"rendered":"T\u1eadp luy\u1ec7n d\u01b0\u1edbi n\u01b0\u1edbc v\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau ph\u1eabu thu\u1eadt kh\u1edbp"},"content":{"rendered":"<p>T\u1eadp luy\u1ec7n d\u01b0\u1edbi n\u01b0\u1edbc (th\u1ee7y tr\u1ecb li\u1ec7u) cho ng\u01b0\u1eddi thay kh\u1edbp: Nguy\u00ean t\u1eafc v\u00e0 ph\u01b0\u01a1ng ph\u00e1p<\/p>\n<p>Ph\u1eabu thu\u1eadt thay th\u1ebf kh\u1edbp (THA ho\u1eb7c TKA) mang l\u1ea1i hy v\u1ecdng l\u1edbn cho b\u1ec7nh nh\u00e2n, nh\u01b0ng k\u1ebft qu\u1ea3 cu\u1ed1i c\u00f9ng ph\u1ee5 thu\u1ed9c r\u1ea5t nhi\u1ec1u v\u00e0o quy tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng. M\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh t\u1eadp luy\u1ec7n khoa h\u1ecdc kh\u00f4ng ch\u1ec9 gi\u00fap kh\u00f4i ph\u1ee5c v\u1eadn \u0111\u1ed9ng m\u00e0 c\u00f2n h\u1ed7 tr\u1ee3 ng\u01b0\u1eddi b\u1ec7nh tr\u1edf l\u1ea1i cu\u1ed9c s\u1ed1ng \u0111\u1ed9c l\u1eadp nhanh ch\u00f3ng [1]. Trong \u0111\u00f3, th\u1ee7y tr\u1ecb li\u1ec7u (hydrotherapy) \u0111ang ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c ch\u00fa tr\u1ecdng nh\u1edd kh\u1ea3 n\u0103ng gi\u1ea3m t\u1ea3i tr\u1ecdng c\u01a1 th\u1ec3, cho ph\u00e9p th\u1ef1c hi\u1ec7n c\u00e1c b\u00e0i t\u1eadp v\u1eadn \u0111\u1ed9ng m\u00e0 kh\u00f4ng g\u00e2y \u00e1p l\u1ef1c l\u00ean kh\u1edbp m\u1edbi thay th\u1ebf.<\/p>\n<h2>Nguy\u00ean t\u1eafc an to\u00e0n v\u00e0 v\u1ecb tr\u00ed kh\u1edbp sau ph\u1eabu thu\u1eadt<\/h2>\n<p>M\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh ph\u1ee5c h\u1ed3i n\u00e0o \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn l\u00e0 ph\u1ed5 qu\u00e1t cho t\u1ea5t c\u1ea3 m\u1ecdi ca, nh\u01b0ng c\u00e1c nguy\u00ean t\u1eafc c\u01a1 b\u1ea3n v\u1ec1 t\u01b0 th\u1ebf kh\u1edbp v\u1eabn c\u1ea7n \u0111\u01b0\u1ee3c tu\u00e2n th\u1ee7 ch\u1eb7t ch\u1ebd \u0111\u1ec3 ng\u0103n ng\u1eeba bi\u1ebfn ch\u1ee9ng nh\u01b0 tr\u1eadt kh\u1edbp ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh [1]. Ngay sau khi l\u1ea5y m\u00ea v\u00e0 trong giai \u0111o\u1ea1n h\u1ed3i ph\u1ee5c c\u1ea3m gi\u00e1c, kh\u1edbp h\u00e1ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c gi\u1eef \u1edf v\u1ecb tr\u00ed abducted kho\u1ea3ng 15 \u0111\u1ed9. \u0110\u1ed1i v\u1edbi c\u00e1c ca ph\u1eabu thu\u1eadt s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt t\u00e1ch r\u1eddi (DAA), vi\u1ec7c s\u1eed d\u1ee5ng g\u1ed1i \u0111\u1ec7m l\u00e0 l\u1ef1a ch\u1ecdn thay th\u1ebf cho c\u00e1c thi\u1ebft b\u1ecb h\u00ecnh tam gi\u00e1c [1].<\/p>\n<p>Vi\u1ec7c c\u1ed1 \u0111\u1ecbnh b\u1eb1ng d\u00e2y bu\u1ed9c c\u1ea7n th\u1ef1c hi\u1ec7n r\u1ea5t c\u1ea9n th\u1eadn \u0111\u1ec3 tr\u00e1nh g\u00e2y \u00e1p l\u1ef1c qu\u00e1 m\u1ee9c l\u00ean d\u00e2y th\u1ea7n kinh gai ch\u1eadu ngo\u00e0i (peroneal nerve) [1]. \u0110\u1ed3ng th\u1eddi, ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn ng\u1ed3i tr\u00ean gi\u01b0\u1eddng ho\u1eb7c gh\u1ebf trong t\u01b0 th\u1ebf b\u00e1n n\u1eb1m nghi\u00eang. S\u1eed d\u1ee5ng g\u1ed1i \u1edf gi\u1eefa hai \u0111\u00f9i gi\u00fap h\u1ea1n ch\u1ebf adduction v\u00e0 quay trong, c\u00f2n m\u1ed9t s\u1ed1 g\u1ed1i \u1edf ph\u1ea7n t\u1ef1a l\u01b0ng ng\u0103n ng\u1eeba qu\u00e1 \u0111\u1ed9 flexion c\u1ee7a kh\u1edbp [4].<\/p>\n<h2>Vai tr\u00f2 c\u1ee7a th\u1ee7y tr\u1ecb li\u1ec7u trong quy tr\u00ecnh ph\u1ee5c h\u1ed3i<\/h2>\n<p>Th\u1ee7y tr\u1ecb li\u1ec7u kh\u00f4ng ph\u1ea3i l\u00e0 ph\u01b0\u01a1ng ph\u00e1p duy nh\u1ea5t m\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c t\u00edch h\u1ee3p v\u00e0o k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb t\u1ed5ng th\u1ec3, \u0111\u1eb7c bi\u1ec7t trong c\u00e1c giai \u0111o\u1ea1n sau ph\u1eabu thu\u1eadt ph\u1ee9c t\u1ea1p ho\u1eb7c khi c\u1ea7n gi\u1ea3m t\u1ea3i tr\u1ecdng [2]. M\u1ed9t s\u1ed1 t\u00e0i li\u1ec7u ch\u1ec9 ra r\u1eb1ng vi\u1ec7c ti\u1ebfp t\u1ee5c v\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u00e0 th\u1ee7y tr\u1ecb li\u1ec7u trong v\u00f2ng 6 tu\u1ea7n sau giai \u0111o\u1ea1n b\u1ea3o v\u1ec7 kh\u00f4ng ch\u1ecbu tr\u1ecdng l\u01b0\u1ee3ng ban \u0111\u1ea7u l\u00e0 quan tr\u1ecdng \u0111\u1ec3 chu\u1ea9n b\u1ecb cho vi\u1ec7c mang tr\u1ecdng l\u01b0\u1ee3ng \u0111\u1ea7y \u0111\u1ee7 [6].<\/p>\n<p>L\u1ee3i \u00edch ch\u00ednh c\u1ee7a m\u00f4i tr\u01b0\u1eddng n\u01b0\u1edbc n\u1eb1m \u1edf kh\u1ea3 n\u0103ng t\u1ea1o l\u1ef1c \u0111\u1ea9y Archimedes, gi\u00fap gi\u1ea3m t\u1ea3i tr\u1ecdng l\u00ean kh\u1edbp xu\u1ed1ng kho\u1ea3ng 70-80%, cho ph\u00e9p ng\u01b0\u1eddi b\u1ec7nh th\u1ef1c hi\u1ec7n c\u00e1c b\u00e0i t\u1eadp t\u0103ng c\u01b0\u1eddng c\u01a1 v\u00e0 c\u1ea3i thi\u1ec7n th\u0103ng b\u1eb1ng m\u00e0 kh\u00f4ng lo g\u00e3y x\u01b0\u01a1ng ho\u1eb7c tr\u1eadt kh\u1edbp [1]. C\u00e1c ho\u1ea1t \u0111\u1ed9ng cardio trong n\u01b0\u1edbc nh\u01b0 b\u01a1i l\u1ed9i hay ch\u1ea1y d\u01b0\u1edbi n\u01b0\u1edbc (deep-water running) \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch \u0111\u1ec3 duy tr\u00ec s\u1ee9c m\u1ea1nh tim m\u1ea1ch khi ch\u01b0a th\u1ec3 di chuy\u1ec3n tr\u00ean m\u1eb7t \u0111\u1ea5t [5].<\/p>\n<h3>M\u1ee5c ti\u00eau c\u1ee5 th\u1ec3 c\u1ee7a t\u1eadp luy\u1ec7n d\u01b0\u1edbi n\u01b0\u1edbc<\/h3>\n<p>M\u1ee5c ti\u00eau c\u1ed1t l\u00f5i c\u1ee7a m\u1ecdi ch\u01b0\u01a1ng tr\u00ecnh ph\u1ee5c h\u1ed3i, bao g\u1ed3m c\u1ea3 th\u1ee7y tr\u1ecb li\u1ec7u, l\u00e0 kh\u00f4i ph\u1ee5c ch\u1ee9c n\u0103ng v\u00e0 v\u1eadn \u0111\u1ed9ng [3]. \u0110\u1ed1i v\u1edbi kh\u1edbp h\u00e1ng, vi\u1ec7c b\u1ea3o v\u1ec7 s\u1eeda ch\u1eefa c\u01a1 d\u01b0\u1edbi \u0111\u00f2n (subscapularis) l\u00e0 \u01b0u ti\u00ean h\u00e0ng \u0111\u1ea7u trong c\u00e1c ca thay th\u1ebf gi\u1ea3i ph\u1eabu ch\u00ednh x\u00e1c [3]. Th\u1ee7y tr\u1ecb li\u1ec7u gi\u00fap ng\u01b0\u1eddi b\u1ec7nh t\u1eadp luy\u1ec7n c\u00e1c nh\u00f3m c\u01a1 n\u00e0y m\u1ed9t c\u00e1ch an to\u00e0n h\u01a1n so v\u1edbi t\u1eadp tr\u00ean c\u1ea1n.<\/p>\n<p>B\u00ean c\u1ea1nh \u0111\u00f3, ph\u1ee5c h\u1ed3i bao g\u1ed3m c\u1ea3 vi\u1ec7c t\u0103ng c\u01b0\u1eddng c\u1ea3m gi\u00e1c (proprioception), c\u00e2n b\u1eb1ng v\u00e0 k\u1ef9 thu\u1eadt \u0111i b\u1ed9. C\u00e1c b\u00e0i t\u1eadp v\u1eadn \u0111\u1ed9ng d\u01b0\u1edbi n\u01b0\u1edbc th\u01b0\u1eddng \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 ph\u00e1t tri\u1ec3n s\u1ee9c m\u1ea1nh, s\u1ee9c b\u1ec1n v\u00e0 c\u00f4ng su\u1ea5t c\u01a1 b\u1eafp tr\u01b0\u1edbc khi chuy\u1ec3n sang c\u00e1c b\u00e0i t\u1eadp th\u1ec3 thao chuy\u00ean bi\u1ec7t [5].<\/p>\n<h2>H\u1ea1n ch\u1ebf c\u1ee7a t\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p>C\u1ea7n l\u01b0u \u00fd r\u1eb1ng c\u00e1c ngu\u1ed3n t\u00e0i li\u1ec7u cung c\u1ea5p ch\u1ee7 y\u1ebfu t\u1eadp trung v\u00e0o nguy\u00ean t\u1eafc chung c\u1ee7a ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh v\u00e0 quy tr\u00ecnh ph\u1ee5c h\u1ed3i sau m\u1ed5 thay kh\u1edbp h\u00e1ng\/khu\u1ef7u \u0111\u1ea7u g\u1ed1i, c\u0169ng nh\u01b0 m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1eb7c bi\u1ec7t nh\u01b0 r\u00e1ch g\u00e2n Achilles ho\u1eb7c g\u00e3y x\u01b0\u01a1ng [1-5]. T\u00e0i li\u1ec7u kh\u00f4ng \u0111\u1ec1 c\u1eadp chi ti\u1ebft v\u1ec1 c\u00e1c ch\u1ec9 \u0111\u1ecbnh c\u1ee5 th\u1ec3 cho th\u1ee7y tr\u1ecb li\u1ec7u trong t\u1eebng lo\u1ea1i b\u1ec7nh l\u00fd kh\u1edbp ri\u00eang l\u1ebb (nh\u01b0 vi\u00eam x\u01b0\u01a1ng kh\u1edbp hay tho\u00e1i h\u00f3a) m\u00e0 ch\u1ec9 nh\u1ea5n m\u1ea1nh v\u00e0o nguy\u00ean t\u1eafc ph\u1ee5c h\u1ed3i chung sau ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh. Do \u0111\u00f3, \u00e1p d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh b\u1edfi b\u00e1c s\u0129 chuy\u00ean khoa d\u1ef1a tr\u00ean t\u00ecnh tr\u1ea1ng c\u1ee5 th\u1ec3 c\u1ee7a t\u1eebng b\u1ec7nh nh\u00e2n.<\/p>\n<h2>K\u1ebft lu\u1eadn<\/h2>\n<p>T\u1eadp luy\u1ec7n d\u01b0\u1edbi n\u01b0\u1edbc l\u00e0 m\u1ed9t c\u00f4ng c\u1ee5 h\u1eefu \u00edch trong h\u00e0nh tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau ph\u1eabu thu\u1eadt thay kh\u1edbp. Khi k\u1ebft h\u1ee3p v\u1edbi c\u00e1c bi\u1ec7n ph\u00e1p b\u1ea3o v\u1ec7 t\u01b0 th\u1ebf kh\u1edbp \u0111\u00fang quy \u0111\u1ecbnh v\u00e0 ch\u01b0\u01a1ng tr\u00ecnh v\u1eadt l\u00fd tr\u1ecb li\u1ec7u b\u00e0i b\u1ea3n, n\u00f3 g\u00f3p ph\u1ea7n quan tr\u1ecdng gi\u00fap ng\u01b0\u1eddi b\u1ec7nh l\u1ea5y l\u1ea1i kh\u1ea3 n\u0103ng v\u1eadn \u0111\u1ed9ng \u0111\u1ed9c l\u1eadp. Tuy nhi\u00ean, vi\u1ec7c \u00e1p d\u1ee5ng c\u1ea7n tu\u00e2n th\u1ee7 nghi\u00eam ng\u1eb7t c\u00e1c h\u01b0\u1edbng d\u1eabn chuy\u00ean m\u00f4n v\u1ec1 th\u1eddi \u0111i\u1ec3m kh\u1edfi \u0111\u1ed9ng v\u00e0 c\u01b0\u1eddng \u0111\u1ed9 t\u1eadp luy\u1ec7n \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n t\u1ed1i \u0111a cho k\u1ebft qu\u1ea3 ph\u1eabu thu\u1eadt [1].<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<ul>\n<li>[1] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 365<\/li>\n<li>[2] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 1485<\/li>\n<li>[3] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 757<\/li>\n<li>[4] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 365<\/li>\n<li>[5] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2952<\/li>\n<li>[6] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 1485<\/li>\n<\/ul>\n<p><!-- aiwriter:20ebae1327f94158acba068a --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Th\u1ee7y tr\u1ecb li\u1ec7u l\u00e0 ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 \u0111\u1ec3 ph\u1ee5c h\u1ed3i v\u1eadn \u0111\u1ed9ng v\u00e0 ch\u1ee9c n\u0103ng sau ph\u1eabu thu\u1eadt. B\u00e0i vi\u1ebft t\u1ed5ng h\u1ee3p c\u00e1c nguy\u00ean t\u1eafc an to\u00e0n, th\u1eddi gian kh\u1edfi \u0111\u1ed9ng v\u00e0 m\u1ee5c ti\u00eau t\u1eadp luy\u1ec7n d\u1ef1a tr\u00ean t\u00e0i li\u1ec7u chu\u1ea9n ch\u1ec9nh h\u00ecnh.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[],"class_list":["post-351","post","type-post","status-publish","format-standard","hentry","category-thay-khop"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>T\u1eadp luy\u1ec7n d\u01b0\u1edbi n\u01b0\u1edbc v\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau ph\u1eabu thu\u1eadt kh\u1edbp - 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\/11\/tap-luyen-duoi-nuoc-va-phuc-hoi-chuc-nang-sau-phau-thuat-khop\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"T\u1eadp luy\u1ec7n d\u01b0\u1edbi n\u01b0\u1edbc v\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau ph\u1eabu thu\u1eadt kh\u1edbp - 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=\"Th\u1ee7y tr\u1ecb li\u1ec7u l\u00e0 ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 \u0111\u1ec3 ph\u1ee5c h\u1ed3i v\u1eadn \u0111\u1ed9ng v\u00e0 ch\u1ee9c n\u0103ng sau ph\u1eabu thu\u1eadt. 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