{"id":383,"date":"2026-10-11T17:52:13","date_gmt":"2026-10-11T10:52:13","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/ung-dung-thiet-bi-bao-khop-va-dot-rf-trong-noi-soi-chinh-hinh\/"},"modified":"2026-10-11T17:52:13","modified_gmt":"2026-10-11T10:52:13","slug":"ung-dung-thiet-bi-bao-khop-va-dot-rf-trong-noi-soi-chinh-hinh","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/ung-dung-thiet-bi-bao-khop-va-dot-rf-trong-noi-soi-chinh-hinh\/","title":{"rendered":"\u1ee8ng d\u1ee5ng thi\u1ebft b\u1ecb b\u00e0o kh\u1edbp v\u00e0 \u0111\u1ed1t RF trong n\u1ed9i soi ch\u1ec9nh h\u00ecnh"},"content":{"rendered":"

Trong l\u0129nh v\u1ef1c ch\u1ec9nh h\u00ecnh n\u1ed9i soi, vi\u1ec7c l\u1ef1a ch\u1ecdn c\u00f4ng c\u1ee5 ch\u00ednh x\u00e1c l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 an to\u00e0n cho b\u1ec7nh nh\u00e2n. Hai thi\u1ebft b\u1ecb ph\u1ed5 bi\u1ebfn nh\u1ea5t hi\u1ec7n nay l\u00e0 m\u00e1y b\u00e0o kh\u1edbp (shaver) v\u00e0 h\u1ec7 th\u1ed1ng \u0111\u1ed1t b\u1eb1ng t\u1ea7n s\u1ed1 v\u00f4 tuy\u1ebfn (radiofrequency – RF). C\u00e1c t\u00e0i li\u1ec7u chuy\u00ean khoa c\u1eadp nh\u1eadt nh\u01b0 Campbell’s Operative Orthopaedics<\/em> \u0111\u00e3 m\u00f4 t\u1ea3 chi ti\u1ebft c\u00e1ch th\u1ee9c ho\u1ea1t \u0111\u1ed9ng c\u0169ng nh\u01b0 \u1ee9ng d\u1ee5ng c\u1ee7a hai thi\u1ebft b\u1ecb n\u00e0y trong c\u00e1c ph\u1eabu thu\u1eadt kh\u00e1c nhau [1], [6].<\/p>\n

Vai tr\u00f2 v\u00e0 c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a thi\u1ebft b\u1ecb RF v\u00e0 Shaver<\/h2>\n

B\u00ean c\u1ea1nh \u0111i\u1ec7n cao t\u1ea7n truy\u1ec1n th\u1ed1ng, c\u00e1c h\u1ec7 th\u1ed1ng mono v\u00e0 bipolar radiofrequency \u0111\u00e3 tr\u1edf th\u00e0nh l\u1ef1a ch\u1ecdn h\u00e0ng \u0111\u1ea7u nh\u1edd chi ph\u00ed th\u1ea5p h\u01a1n nh\u01b0ng v\u1eabn t\u1ea1o ra n\u0103ng l\u01b0\u1ee3ng nhi\u1ec7t t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi laser [1]. C\u01a1 ch\u1ebf c\u1ee7a thi\u1ebft b\u1ecb RF \u0111\u01a1n c\u1ef1c (monopolar) s\u1eed d\u1ee5ng t\u1ea5m ti\u1ebfp \u0111\u1ea5t \u0111\u1ec3 d\u1eabn n\u0103ng l\u01b0\u1ee3ng qua c\u01a1 th\u1ec3, trong khi thi\u1ebft b\u1ecb l\u01b0\u1ee1ng c\u1ef1c (bipolar) truy\u1ec1n n\u0103ng l\u01b0\u1ee3ng tr\u1ef1c ti\u1ebfp gi\u1eefa hai \u0111i\u1ec7n c\u1ef1c t\u1ea1i v\u1ecb tr\u00ed \u0111i\u1ec1u tr\u1ecb [6].<\/p>\n

Vi\u1ec7c s\u1eed d\u1ee5ng shaver k\u1ebft h\u1ee3p v\u1edbi \u0111\u1ea7u \u0111\u1ed1t RF cho ph\u00e9p th\u1ef1c hi\u1ec7n c\u00e1c thao t\u00e1c c\u1eaft v\u00e0 \u0111\u00f4ng c\u1ea7m m\u00e1u \u0111\u1ed3ng th\u1eddi. M\u1ed9t \u0111i\u1ec3m quan tr\u1ecdng trong v\u1eadn h\u00e0nh l\u00e0 c\u1ea7n lu\u00f4n gi\u1eef m\u0169i dao n\u1eb1m trong t\u1ea7m nh\u00ecn v\u00e0 ch\u1ec9 k\u00edch ho\u1ea1t quay khi c\u1eeda s\u1ed5 \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ecbnh v\u1ecb \u0111\u00fang [6]. \u0110\u1ed1i v\u1edbi c\u00e1c kh\u1edbp nh\u1ecf, m\u00e1y shaver \u0111\u1ed9ng c\u01a1 c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m t\u1ea3i c\u00f4ng s\u1ee9c cho b\u00e1c s\u0129 ph\u1eabu thu\u1eadt.<\/p>\n

\u1ee8ng d\u1ee5ng trong ph\u1eabu thu\u1eadt n\u1ed9i soi vai<\/h3>\n

Trong ph\u1eabu thu\u1eadt gi\u1ea3i ph\u00f3ng t\u00fai l\u1ec7 (bursitis) t\u1ea1i vai, quy tr\u00ecnh th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u b\u1eb1ng vi\u1ec7c x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed qua n\u1ed9i soi sau khi ti\u00eam t\u00ea. Sau \u0111\u00f3, b\u00e1c s\u0129 s\u1eed d\u1ee5ng shaver v\u00e0 thi\u1ebft b\u1ecb RF \u0111\u1ec3 l\u00e0m s\u1ea1ch m\u00f4 l\u1ec7 vi\u00eam v\u00e0 c\u00e1c d\u00e2y x\u01a1 [2]. Ti\u1ebfp theo, g\u00f3c tr\u00ean si\u00eau b\u00ean c\u1ee7a x\u01b0\u01a1ng \u0111\u00f2n \u0111\u01b0\u1ee3c l\u1ed9 ra b\u1eb1ng c\u00e1ch lo\u1ea1i b\u1ecf ph\u1ea7n m\u1ec1m b\u00e1m d\u00ednh b\u1eb1ng probe RF, tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n c\u1eaft b\u1ecf c\u00e1c nh\u00fa x\u01b0\u01a1ng th\u1eeba b\u1eb1ng shaver v\u00e0 b\u00faa n\u1ed9i soi t\u1ed1c \u0111\u1ed9 cao [2].<\/p>\n

\u1ee8ng d\u1ee5ng trong ph\u1eabu thu\u1eadt kh\u1edbp g\u1ed1i<\/h3>\n

\u0110\u1ed1i v\u1edbi \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u1ed5n th\u01b0\u01a1ng s\u1ee5n x\u01b0\u01a1ng (osteocondritis), k\u1ef9 thu\u1eadt bao g\u1ed3m vi\u1ec7c n\u00e2ng v\u1ecb tr\u00ed c\u1eeda s\u1ed5 \u0111\u1ec3 quan s\u00e1t r\u00f5 h\u01a1n kho\u1ea3ng c\u00e1ch tr\u01b0\u1edbc. S\u1eed d\u1ee5ng shaver c\u01a1 kh\u00ed v\u00e0 thi\u1ebft b\u1ecb RF, b\u00e1c s\u0129 th\u1ef1c hi\u1ec7n gi\u1ea3i ph\u00f3ng kho\u1ea3ng c\u00e1ch tr\u01b0\u1edbc, lo\u1ea1i b\u1ecf c\u00e1c m\u1ea3nh v\u1ee5n v\u00e0 l\u00e0m s\u1ea1ch m\u1eb7t d\u1ed1c tr\u01b0\u1edbc c\u1ee7a x\u01b0\u01a1ng ch\u00e0y [4]. Vi\u1ec7c k\u00e9o c\u0103ng d\u00e2y ch\u1eb1ng b\u00e1nh ch\u00e8 gi\u00fap t\u1ea1o l\u1ef1c c\u0103ng, h\u1ed7 tr\u1ee3 qu\u00e1 tr\u00ecnh l\u00e0m s\u1ea1ch hi\u1ec7u qu\u1ea3 h\u01a1n.<\/p>\n

\u0110\u1ed1t nhi\u1ec7t trong \u0111i\u1ec1u tr\u1ecb di c\u0103n x\u01b0\u01a1ng<\/h2>\n

Beyond c\u00e1c ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh th\u00f4ng th\u01b0\u1eddng, k\u1ef9 thu\u1eadt \u0111\u1ed1t nhi\u1ec7t (thermal ablation) \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c qu\u1ea3n l\u00fd c\u00e1c kh\u1ed1i u x\u01b0\u01a1ng di c\u0103n. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p nh\u01b0 \u0111\u00f4ng l\u1ea1nh (cryoablation) v\u00e0 RF ablation \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i \u0111\u1ec3 g\u00e2y ch\u1ebft t\u1ebf b\u00e0o b\u1eb1ng c\u00e1ch l\u00e0m gi\u1ea3m ho\u1eb7c t\u0103ng nhi\u1ec7t \u0111\u1ed9 m\u1ee5c ti\u00eau [3], [9].<\/p>\n

RF ablation \u0111\u1eb7c bi\u1ec7t h\u1eefu \u00edch v\u00ec kh\u1ea3 n\u0103ng x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u v\u00e0 th\u1eddi gian \u0111i\u1ec1u tr\u1ecb nhanh (kho\u1ea3ng 15-20 ph\u00fat). Tuy nhi\u00ean, hi\u1ec7u qu\u1ea3 c\u1ee7a k\u1ef9 thu\u1eadt n\u00e0y ph\u1ee5 thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc kh\u1ed1i u (th\u01b0\u1eddng gi\u1edbi h\u1ea1n d\u01b0\u1edbi 3-5 cm) v\u00e0 v\u1ecb tr\u00ed [10]. C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y \u0111\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p thay th\u1ebf t\u1ed1t cho x\u1ea1 tr\u1ecb ngo\u00e0i ho\u1eb7c ph\u1eabu thu\u1eadt m\u1edf trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3, gi\u00fap ki\u1ec3m so\u00e1t \u0111au \u0111\u1edbn v\u00e0 ng\u0103n ng\u1eeba g\u00e3y x\u01b0\u01a1ng do b\u1ec7nh l\u00fd [9], [10].<\/p>\n

Thi\u1ebft b\u1ecb h\u1ed7 tr\u1ee3 v\u00e0 c\u00e1c k\u1ef9 thu\u1eadt li\u00ean quan<\/h2>\n

B\u00ean c\u1ea1nh shaver v\u00e0 RF, c\u00e1c thi\u1ebft b\u1ecb nh\u01b0 suture anchors (m\u00f3c neo ch\u1ec9) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong ph\u1eabu thu\u1eadt vai \u0111\u1ec3 c\u1ed1 \u0111\u1ecbnh g\u00e2n d\u00e2y ch\u1eb1ng m\u00e0 kh\u00f4ng c\u1ea7n t\u1ea1o h\u1ea7m x\u01b0\u01a1ng [8]. C\u00e1c m\u00f3c neo l\u00e0m b\u1eb1ng kim lo\u1ea1i ho\u1eb7c v\u1eadt li\u1ec7u ph\u00e2n h\u1ee7y sinh h\u1ecdc \u0111\u1ec1u c\u00f3 \u01b0u \u0111i\u1ec3m v\u1ec1 kh\u1ea3 n\u0103ng t\u01b0\u01a1ng th\u00edch sinh h\u1ecdc v\u00e0 cho ph\u00e9p ph\u1ee5c h\u1ed3i s\u1edbm.<\/p>\n

Trong b\u1ed1i c\u1ea3nh h\u00ecnh \u1ea3nh y t\u1ebf, cu\u1ed9n RF (RF coils) l\u00e0 th\u00e0nh ph\u1ea7n thi\u1ebft y\u1ebfu c\u1ee7a h\u1ec7 th\u1ed1ng MRI \u0111\u1ec3 truy\u1ec1n s\u00f3ng v\u00e0 thu t\u00edn hi\u1ec7u. C\u00e1c cu\u1ed9n chuy\u00ean d\u1ee5ng \u0111\u1eb7t g\u1ea7n v\u00f9ng m\u00f4 c\u1ea7n ch\u1ee5p gi\u00fap t\u0103ng ch\u1ea5t l\u01b0\u1ee3ng h\u00ecnh \u1ea3nh so v\u1edbi cu\u1ed9n c\u01a1 th\u1ec3 m\u1eb7c \u0111\u1ecbnh [5], [11]. Ngo\u00e0i ra, c\u00e1c k\u1ef9 thu\u1eadt h\u1ed7 tr\u1ee3 ph\u1eabu thu\u1eadt nh\u01b0 d\u1eabn \u0111\u01b0\u1eddng b\u1eb1ng C-arm ho\u1eb7c robot c\u0169ng \u0111ang ph\u00e1t tri\u1ec3n \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o \u0111\u1ed9 ch\u00ednh x\u00e1c khi c\u1eaft b\u1ecf kh\u1ed1i x\u01b0\u01a1ng (osteotomy) [7].<\/p>\n

T\u1ed5ng quan l\u1ea1i, vi\u1ec7c k\u1ebft h\u1ee3p gi\u1eefa thi\u1ebft b\u1ecb c\u01a1 h\u1ecdc (shaver\/burr) v\u00e0 n\u0103ng l\u01b0\u1ee3ng nhi\u1ec7t (RF) c\u00f9ng v\u1edbi c\u00e1c k\u1ef9 thu\u1eadt h\u1ed7 tr\u1ee3 hi\u1ec7n \u0111\u1ea1i \u0111ang \u0111\u1ecbnh h\u00ecnh l\u1ea1i ti\u00eau chu\u1ea9n ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh. M\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng th\u1ed1ng k\u00ea c\u1ee5 th\u1ec3 v\u1ec1 t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng tuy\u1ec7t \u0111\u1ed1i trong v\u0103n b\u1ea3n cung c\u1ea5p, nh\u01b0ng c\u00e1c nguy\u00ean t\u1eafc v\u1eadn h\u00e0nh v\u00e0 ch\u1ec9 d\u1eabn \u0111\u00e3 \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y r\u00f5 r\u00e0ng \u0111\u1ec3 h\u01b0\u1edbng d\u1eabn th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng [1], [2], [4].<\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
    \n
  • [1] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3011<\/li>\n
  • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3221<\/li>\n
  • [3] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 894<\/li>\n
  • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 1495<\/li>\n
  • [5] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 242<\/li>\n
  • [6] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3011<\/li>\n
  • [7] Osteotomies around the Knee, 1st Edition, 2008, trang 276<\/li>\n
  • [8] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3011<\/li>\n
  • [9] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 894<\/li>\n
  • [10] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 895<\/li>\n
  • [11] Rockwood and Green's Fractures in Adults, 10th Edition, 2025, trang 242<\/li>\n<\/ul>\n

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