{"id":387,"date":"2026-10-11T17:57:47","date_gmt":"2026-10-11T10:57:47","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/hoi-chung-dai-chau-chay-keo-gian-va-tap-manh-co-mong\/"},"modified":"2026-10-11T17:57:47","modified_gmt":"2026-10-11T10:57:47","slug":"hoi-chung-dai-chau-chay-keo-gian-va-tap-manh-co-mong","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/hoi-chung-dai-chau-chay-keo-gian-va-tap-manh-co-mong\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng d\u1ea3i ch\u1eadu ch\u00e0y: K\u00e9o gi\u00e3n v\u00e0 t\u1eadp m\u1ea1nh c\u01a1 m\u00f4ng"},"content":{"rendered":"<h2>\u0110\u1ecbnh ngh\u0129a v\u00e0 \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng c\u1ee7a H\u1ed9i ch\u1ee9ng d\u1ea3i ch\u1eadu ch\u00e0y<\/h2>\n<p>H\u1ed9i ch\u1ee9ng d\u1ea3i ch\u1eadu ch\u00e0y (iliopsoas syndrome) l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng th\u01b0\u1eddng g\u1eb7p li\u00ean quan \u0111\u1ebfn s\u1ef1 k\u00edch ho\u1ea1t qu\u00e1 m\u1ee9c ho\u1eb7c \u0111au \u0111\u1edbn t\u1ea1i c\u00e1c c\u01a1 quanh h\u00f4ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u01a1 iliopsoas. T\u00ecnh tr\u1ea1ng n\u00e0y th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n do h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ee7a kh\u1edbp h\u00e1ng k\u1ebft h\u1ee3p v\u1edbi c\u01a1 h\u1ecdc b\u1ea5t th\u01b0\u1eddng khi di chuy\u1ec3n t\u1eeb t\u01b0 th\u1ebf n\u1eb1m sang ng\u1ed3i ho\u1eb7c \u0111\u1ee9ng.<\/p>\n<p>D\u1ef1a tr\u00ean t\u00e0i li\u1ec7u chuy\u00ean ng\u00e0nh v\u1ec1 ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh v\u00e0 ph\u1eabu thu\u1eadt [1], h\u1ed9i ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c x\u1eed l\u00fd \u0111\u00fang c\u00e1ch. C\u00e1c d\u1ea5u hi\u1ec7u c\u1ea3m gi\u00e1c b\u1ecb suy gi\u1ea3m nh\u01b0 kh\u00f4 da (anhidrosis), teo da v\u00e0 thu h\u1eb9p ng\u00f3n tay do teo th\u1ecbt b\u00e0n tay c\u0169ng l\u00e0 nh\u1eefng ch\u1ec9 s\u1ed1 gi\u00e1 tr\u1ecb trong ch\u1ea9n \u0111o\u00e1n thi\u1ebfu h\u1ee5t c\u1ea3m gi\u00e1c [1]. Tuy nhi\u00ean, c\u1ea7n ph\u00e2n bi\u1ec7t r\u00f5 r\u00e0ng gi\u1eefa c\u00e1c h\u1ed9i ch\u1ee9ng kh\u00e1c nhau nh\u01b0 h\u1ed9i ch\u1ee9ng \u1ed1ng c\u1ed5 tay hay h\u1ed9i ch\u1ee9ng d\u00e2y th\u1ea7n kinh ti\u1ec1n gi\u1eefa (anterior interosseous nerve syndrome) \u0111\u1ec3 \u00e1p d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n<h2>Nguy\u00ean t\u1eafc can thi\u1ec7p kh\u00f4ng ph\u1eabu thu\u1eadt: K\u00e9o gi\u00e3n v\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng<\/h2>\n<p>Khi\u1ebfn vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u cho h\u1ea7u h\u1ebft c\u00e1c t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh ho\u1eb7c h\u1ed9i ch\u1ee9ng c\u01a1 h\u1ecdc bao g\u1ed3m ph\u1eabu thu\u1eadt, nh\u01b0ng tr\u01b0\u1edbc \u0111\u00f3 c\u1ea7n th\u1eed nghi\u1ec7m c\u00e1c bi\u1ec7n ph\u00e1p b\u1ea3o t\u1ed3n. C\u00e1c li\u1ec7u ph\u00e1p v\u1eadt l\u00fd bao g\u1ed3m k\u00e9o gi\u00e3n v\u00e0 b\u00e0i t\u1eadp t\u0103ng c\u01b0\u1eddng c\u01a1 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ngay trong giai \u0111o\u1ea1n sau ph\u1eabu thu\u1eadt s\u1edbm [4].<\/p>\n<p>\u0110\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng ph\u1eabu thu\u1eadt ho\u1eb7c ti\u1ec1n ph\u1eabu thu\u1eadt, quy tr\u00ecnh th\u01b0\u1eddng bao g\u1ed3m:<\/p>\n<ul>\n<li><strong>K\u00e9o gi\u00e3n nh\u1eb9 nh\u00e0ng:<\/strong> C\u00e1c b\u00e0i t\u1eadp k\u00e9o gi\u00e3n th\u1ee5 \u0111\u1ed9ng b\u1eaft \u0111\u1ea7u kho\u1ea3ng 3 tu\u1ea7n sau ph\u1eabu thu\u1eadt v\u00e0 \u0111\u01b0\u1ee3c duy tr\u00ec cho \u0111\u1ebfn khi \u0111\u1ea1t \u0111\u01b0\u1ee3c ph\u1ea1m vi v\u1eadn \u0111\u1ed9ng \u0111\u1ea7y \u0111\u1ee7 [5].<\/li>\n<li><strong>T\u0103ng c\u01b0\u1eddng c\u01a1 b\u1eafp:<\/strong> Khi t\u00e1i th\u1ea7n kinh x\u1ea3y ra (th\u01b0\u1eddng \u1edf 2-4 th\u00e1ng), c\u00e1c b\u00e0i t\u1eadp co ng\u00f3n tay ch\u1ee7 \u0111\u1ed9ng b\u1eaft \u0111\u1ea7u. \u0110\u1ebfn 6-12 th\u00e1ng, c\u00e1c b\u00e0i t\u1eadp kh\u00e1ng l\u1ef1c \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n h\u00e0ng ng\u00e0y [5].<\/li>\n<li><strong>Luy\u1ec7n t\u1eadp s\u1ee9c m\u1ea1nh v\u00e0 ph\u1ea1m vi v\u1eadn \u0111\u1ed9ng:<\/strong> C\u00e1c k\u1ef9 thu\u1eadt v\u1eadt l\u00fd tr\u1ecb li\u1ec7u kh\u00e1c nhau \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 t\u0103ng c\u01b0\u1eddng s\u1ee9c m\u1ea1nh c\u01a1 v\u00e0 ph\u1ea1m vi v\u1eadn \u0111\u1ed9ng trong su\u1ed1t qu\u00e1 tr\u00ecnh. S\u1ee9c m\u1ea1nh c\u01a1 b\u1eafp \u1ed5n \u0111\u1ecbnh sau 2-3 n\u0103m sau c\u1ea5y gh\u00e9p [5].<\/li>\n<\/ul>\n<p>T\u01b0\u01a1ng t\u1ef1, \u0111\u1ed1i v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh ti\u1ec1n gi\u1eefa do ch\u1ea5n th\u01b0\u01a1ng xuy\u00ean th\u1ee7ng, s\u1eeda ch\u1eefa s\u01a1 c\u1ea5p \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb. Trong khi \u0111\u00f3, n\u1ebfu t\u00ecnh tr\u1ea1ng t\u00ea li\u1ec7t l\u00e0 t\u1ef1 ph\u00e1t, \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c \u01b0u ti\u00ean tr\u01b0\u1edbc, ch\u1ec9 th\u1ef1c hi\u1ec7n kh\u00e1m ph\u1eabu thu\u1eadt n\u1ebfu kh\u00f4ng c\u00f3 c\u1ea3i thi\u1ec7n l\u00e2m s\u00e0ng ho\u1eb7c EMG sau 12 tu\u1ea7n [7].<\/p>\n<h3>T\u00e1c \u0111\u1ed9ng c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 v\u00e0 c\u01a1 ch\u1ebf b\u1ec7nh sinh<\/h3>\n<p>M\u1eb7c d\u00f9 h\u1ed9i ch\u1ee9ng d\u1ea3i ch\u1eadu ch\u00e0y l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 ri\u00eang bi\u1ec7t, nh\u01b0ng nguy\u00ean t\u1eafc qu\u1ea3n l\u00fd ch\u1ea5n th\u01b0\u01a1ng do qu\u00e1 t\u1ea3i (overuse) \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng r\u1ed9ng r\u00e3i trong ch\u1ec9nh h\u00ecnh th\u1ec3 thao. V\u00ed d\u1ee5, c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 ch\u1ea5n th\u01b0\u01a1ng c\u1ea7u th\u1ee7 b\u00f3ng ch\u00e0y cho th\u1ea5y vi\u1ec7c vi ph\u1ea1m h\u01b0\u1edbng d\u1eabn c\u1ee7a Li\u00ean \u0111o\u00e0n B\u00f3ng ch\u00e0y Little League l\u00e0m t\u0103ng nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng c\u0103ng th\u1eb3ng m\u00e3n t\u00ednh \u1edf \u0111\u1ea7u g\u1ed1i gi\u1eefa v\u00e0 d\u00e2y \u0441\u0432\u044f\u0437 ch\u00e9o c\u00e1nh tay [2].<\/p>\n<p>T\u01b0\u01a1ng t\u1ef1, trong \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u1edbp vai kh\u00f4ng \u1ed5n \u0111\u1ecbnh theo nhi\u1ec1u chi\u1ec1u h\u01b0\u1edbng (multidirectional glenohumeral instability), ph\u1eabu thu\u1eadt ch\u1ec9 \u0111\u01b0\u1ee3c th\u1ea3o lu\u1eadn sau khi b\u1ec7nh nh\u00e2n \u0111\u00e3 ch\u1ee9ng minh th\u1ea5t b\u1ea1i v\u1edbi li\u1ec7u tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng k\u00e9o d\u00e0i t\u1eeb 6 \u0111\u1ebfn 12 th\u00e1ng [3]. \u0110i\u1ec1u n\u00e0y nh\u1ea5n m\u1ea1nh t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c ki\u00ean tr\u00ec t\u1eadp luy\u1ec7n v\u00e0 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng tr\u01b0\u1edbc khi c\u00e2n nh\u1eafc c\u00e1c bi\u1ec7n ph\u00e1p x\u00e2m l\u1ea5n.<\/p>\n<h2>K\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt v\u00e0 ch\u0103m s\u00f3c sau m\u1ed5<\/h2>\n<p>Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3 nh\u01b0 d\u1ecb t\u1eadt b\u1ea9m sinh c\u1ee7a x\u01b0\u01a1ng \u0111\u00f2n ho\u1eb7c c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 c\u1ed5, k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 bao g\u1ed3m gi\u1ea3i ph\u00f3ng c\u01a1 (v\u00ed d\u1ee5: gi\u1ea3i ph\u00f3ng c\u01a1 Sternocleidomastoid) th\u00f4ng qua c\u00e1c v\u1ebft c\u1eaft ng\u1eafn h\u1ea1n ch\u1ebf \u0111\u1ec3 tr\u00e1nh t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh [4]. \u0110\u1ed1i v\u1edbi gi\u1ea3 kh\u1edbp \u0111ai \u0111\u00f2n b\u1ea9m sinh, \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 kh\u00f4i ph\u1ee5c h\u00ecnh th\u00e1i b\u00ecnh th\u01b0\u1eddng v\u00e0 ng\u0103n ng\u1eeba c\u00e1c v\u1ea5n \u0111\u1ec1 ch\u1ee9c n\u0103ng ho\u1eb7c m\u1ea1ch m\u00e1u trong thanh thi\u1ebfu ni\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn [9].<\/p>\n<p>Ch\u0103m s\u00f3c sau ph\u1eabu thu\u1eadt \u0111\u00f3ng vai tr\u00f2 then ch\u1ed1t. Sau khi ph\u1eabu thu\u1eadt, kh\u00f4ng c\u1ea7n n\u1eb9p c\u1ed1 \u0111\u1ecbnh, cho ph\u00e9p v\u1eadn \u0111\u1ed9ng ph\u1ea1m vi ngay l\u1eadp t\u1ee9c c\u00f9ng v\u1edbi c\u00e1c b\u00e0i t\u1eadp k\u00e9o gi\u00e3n n\u1ed9i t\u1ea1i v\u00e0 t\u0103ng c\u01b0\u1eddng c\u01a1 b\u1eafp [6]. Ngo\u00e0i ra, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng d\u00e2y k\u00e9o \u0111\u1ea7u-h\u1ecdng ho\u1eb7c c\u1ed5 \u00e1o c\u1ed5 trong 6 \u0111\u1ebfn 12 tu\u1ea7n \u0111\u1ea7u ti\u00ean sau ph\u1eabu thu\u1eadt \u0111\u1ec3 h\u1ed7 tr\u1ee3 [4].<\/p>\n<p>\u0110\u1ed1i v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u1edbp vai m\u00e3n t\u00ednh ho\u1eb7c r\u00e1ch bao kh\u1edbp, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt ph\u1ed5 bi\u1ebfn bao g\u1ed3m d\u1ecbch chuy\u1ec3n bao kh\u1edbp d\u01b0\u1edbi (inferior capsular shift) ho\u1eb7c b\u00f3 ch\u1eb7t bao kh\u1edbp n\u1ed9i soi (arthroscopic capsular plication). Ph\u1eabu thu\u1eadt nhi\u1ec7t b\u00f3 bao kh\u1edbp kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb do li\u00ean quan \u0111\u1ebfn t\u1ef7 l\u1ec7 th\u1ea5t b\u1ea1i cao v\u00e0 tho\u00e1i h\u00f3a s\u1ee5n [8].<\/p>\n<h2>K\u1ebft lu\u1eadn<\/h2>\n<p>Qu\u1ea3n l\u00fd h\u1ed9i ch\u1ee9ng d\u1ea3i ch\u1eadu ch\u00e0y \u0111\u00f2i h\u1ecfi m\u1ed9t ti\u1ebfp c\u1eadn \u0111a chi\u1ec1u, k\u1ebft h\u1ee3p gi\u1eefa can thi\u1ec7p ph\u1eabu thu\u1eadt khi c\u1ea7n thi\u1ebft v\u00e0 t\u1eadp trung m\u1ea1nh v\u00e0o c\u00e1c bi\u1ec7n ph\u00e1p ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng nh\u01b0 k\u00e9o gi\u00e3n v\u00e0 t\u0103ng c\u01b0\u1eddng c\u01a1 b\u1eafp. T\u00e0i li\u1ec7u chuy\u00ean ng\u00e0nh ch\u1ec9 ra r\u1eb1ng vi\u1ec7c ki\u00ean tr\u00ec v\u1edbi li\u1ec7u tr\u00ecnh kh\u00f4ng ph\u1eabu thu\u1eadt trong th\u1eddi gian d\u00e0i (6-12 th\u00e1ng) c\u00f3 th\u1ec3 tr\u00e1nh \u0111\u01b0\u1ee3c c\u00e1c th\u1ee7 thu\u1eadt x\u00e2m l\u1ea5n [3].<\/p>\n<p>H\u01a1n n\u1eefa, nguy\u00ean t\u1eafc chung trong ch\u1ec9nh h\u00ecnh l\u00e0 c\u1ea7n lo\u1ea1i tr\u1eeb c\u00e1c h\u1ed9i ch\u1ee9ng th\u1ea7n kinh kh\u00e1c th\u00f4ng qua ki\u1ec3m tra d\u1eabn truy\u1ec1n th\u1ea7n kinh tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh ph\u1eabu thu\u1eadt [7]. Vi\u1ec7c k\u1ebft h\u1ee3p gi\u00e1o d\u1ee5c cho b\u1ec7nh nh\u00e2n, gia \u0111\u00ecnh v\u00e0 hu\u1ea5n luy\u1ec7n vi\u00ean c\u00f9ng v\u1edbi s\u1ef1 can thi\u1ec7p v\u1eadt l\u00fd tr\u1ecb li\u1ec7u \u0111\u00fang th\u1eddi \u0111i\u1ec3m l\u00e0 ch\u00eca kh\u00f3a \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 t\u1ed1i \u01b0u m\u00e0 kh\u00f4ng c\u1ea7n \u0111\u1ebfn c\u00e1c bi\u1ec7n ph\u00e1p ph\u1eabu thu\u1eadt ph\u1ee9c t\u1ea1p.<\/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 3873<\/li>\n<li>[2] Rockwood and Green&#x27;s Fractures in Children, 9th Edition, 2020, trang 956<\/li>\n<li>[3] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 1305<\/li>\n<li>[4] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 1459<\/li>\n<li>[5] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 3934<\/li>\n<li>[6] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 3873<\/li>\n<li>[7] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 3874<\/li>\n<li>[8] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 1305<\/li>\n<li>[9] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 1460<\/li>\n<\/ul>\n<p><!-- aiwriter:799b2392eea74db48b74b6cc --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ph\u00e2n t\u00edch quy tr\u00ecnh \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng d\u1ea3i ch\u1eadu ch\u00e0y bao g\u1ed3m c\u00e1c k\u1ef9 thu\u1eadt k\u00e9o gi\u00e3n, ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng v\u00e0 b\u00e0i t\u1eadp t\u0103ng c\u01b0\u1eddng c\u01a1 b\u1eafp d\u1ef1a tr\u00ean t\u00e0i li\u1ec7u chuy\u00ean ng\u00e0nh 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":[12],"tags":[],"class_list":["post-387","post","type-post","status-publish","format-standard","hentry","category-chi-duoi"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - 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