Kh\u1ed1i u \u1edf ng\u00f3n tay tr\u1ebb em l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u00e2m s\u00e0ng ph\u1ee9c t\u1ea1p, \u0111\u00f2i h\u1ecfi s\u1ef1 ph\u00e2n bi\u1ec7t ch\u00ednh x\u00e1c gi\u1eefa c\u00e1c t\u1ed5n th\u01b0\u01a1ng l\u00e0nh t\u00ednh c\u00f3 xu h\u01b0\u1edbng t\u00e1i ph\u00e1t v\u00e0 c\u00e1c kh\u1ed1i u \u00e1c t\u00ednh ti\u1ec1m \u1ea9n. D\u1ef1a tr\u00ean t\u00e0i li\u1ec7u chuy\u00ean khoa v\u1ec1 ch\u1ec9nh h\u00ecnh, c\u00f3 m\u1ed9t s\u1ed1 lo\u1ea1i kh\u1ed1i u th\u01b0\u1eddng g\u1eb7p t\u1ea1i b\u00e0n tay v\u00e0 ng\u00f3n tay c\u1ee7a tr\u1ebb em c\u1ea7n \u0111\u01b0\u1ee3c l\u00e0m r\u00f5.<\/p>\n
Khi n\u00f3i \u0111\u1ebfn c\u00e1c kh\u1ed1i u \u1edf ng\u00f3n tay, ung th\u01b0 x\u01a1 m\u00e0ng g\u00e2n tr\u1ebb em l\u00e0 m\u1ed9t th\u1ef1c th\u1ec3 \u0111\u1eb7c bi\u1ec7t. \u0110\u00e2y l\u00e0 m\u1ed9t kh\u1ed1i u l\u00e0nh t\u00ednh nh\u01b0ng c\u00f3 t\u00ednh ch\u1ea5t x\u00e2m l\u1ea5n cao, th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n \u1edf l\u00f2ng b\u00e0n tay ho\u1eb7c c\u1ed5 tay c\u1ee7a tr\u1ebb em v\u00e0 ng\u01b0\u1eddi l\u1edbn tu\u1ed5i [1]. Kh\u1ed1i u n\u00e0y th\u01b0\u1eddng kh\u00f4ng \u0111au, di \u0111\u1ed9ng v\u00e0 nh\u1ecf h\u01a1n 4 cm, n\u1eb1m \u1edf m\u1eb7t tr\u01b0\u1edbc (volar) c\u1ee7a b\u00e0n tay, g\u1eafn li\u1ec1n v\u1edbi m\u00f4 li\u00ean k\u1ebft quanh g\u00e2n v\u00e0 d\u00e2y ch\u1eb1ng [1]. M\u1ed9t \u0111\u1eb7c \u0111i\u1ec3m quan tr\u1ecdng l\u00e0 tr\u00ean phim X-quang c\u00f3 th\u1ec3 th\u1ea5y c\u00e1c m\u1ea3ng canxi h\u00f3a trong kh\u1ed1i u m\u1ec1m, gi\u00fap ph\u00e2n bi\u1ec7t n\u00f3 v\u1edbi c\u00e1c kh\u1ed1i u nguy\u00ean ph\u00e1t kh\u00e1c [1].<\/p>\n
Kh\u00e1c v\u1edbi nhi\u1ec1u kh\u1ed1i u l\u00e0nh t\u00ednh kh\u00e1c, ung th\u01b0 x\u01a1 m\u00e0ng g\u00e2n tr\u1ebb em c\u00f3 xu h\u01b0\u1edbng t\u00e1i ph\u00e1t cao (kho\u1ea3ng 50% \u1edf tr\u1ebb nh\u1ecf) sau khi c\u1eaft b\u1ecf r\u00eca (marginal excision) [5]. Do \u0111\u00f3, nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb khuy\u1ebfn ngh\u1ecb l\u00e0 th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt c\u1eaft r\u1ed9ng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 t\u00e1i ph\u00e1t, trong khi v\u1eabn c\u1ed1 g\u1eafng b\u1ea3o t\u1ed3n ch\u1ee9c n\u0103ng c\u1ee7a chi [5].<\/p>\n
B\u00ean c\u1ea1nh c\u00e1c kh\u1ed1i u x\u01a1, m\u1ed9t lo\u1ea1i kh\u1ed1i u l\u00e0nh t\u00ednh kh\u00e1c th\u01b0\u1eddng g\u1eb7p l\u00e0 ung th\u01b0 t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 \u1edf m\u00e0ng g\u00e2n, c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 xanthoma [7]. \u0110\u00e2y l\u00e0 kh\u1ed1i u ch\u1eadm ph\u00e1t tri\u1ec3n, h\u00ecnh th\u00e0nh c\u00e1c \u0111\u00e1m \u0111\u00f4ng r\u1eafn b\u00ean c\u1ea1nh l\u00f2ng b\u00e0n tay. V\u1ec1 m\u1eb7t gi\u1ea3i ph\u1eabu b\u1ec7nh h\u1ecdc, n\u00f3 bao g\u1ed3m c\u00e1c t\u1ebf b\u00e0o s\u1ee3i, m\u00f4 li\u00ean k\u1ebft v\u00e0 c\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o ch\u1ee9a cholesterol c\u00f9ng t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 \u0111a nh\u00e2n [7].<\/p>\n
M\u1eb7c d\u00f9 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u00e0 l\u00e0nh t\u00ednh, kh\u1ed1i u n\u00e0y c\u00f3 th\u1ec3 t\u00e1i ph\u00e1t t\u1eeb 10% \u0111\u1ebfn 40% sau ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf [7]. \u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf v\u1eabn l\u00e0 ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7u qu\u1ea3 \u0111\u1ec3 ch\u1eefa kh\u1ecfi b\u1ec7nh. Tuy nhi\u00ean, vi\u1ec7c theo d\u00f5i ch\u1eb7t ch\u1ebd l\u00e0 c\u1ea7n thi\u1ebft do t\u1ef7 l\u1ec7 t\u00e1i ph\u00e1t \u0111\u00e1ng k\u1ec3.<\/p>\n
C\u1ea7n ph\u00e2n bi\u1ec7t r\u00f5 r\u00e0ng gi\u1eefa kh\u1ed1i u t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 \u1edf m\u00e0ng g\u00e2n v\u00e0 kh\u1ed1i u t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 \u1edf x\u01b0\u01a1ng, v\u00ec hai b\u1ec7nh n\u00e0y c\u00f3 h\u00e0nh vi sinh h\u1ecdc kh\u00e1c nhau [3]. Kh\u1ed1i u t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 \u1edf x\u01b0\u01a1ng r\u1ea5t hi\u1ebfm g\u1eb7p \u1edf b\u00e0n tay nh\u01b0ng khi x\u1ea3y ra th\u01b0\u1eddng t\u1ea1i c\u00e1c \u0111\u1ed1t ng\u00f3n tay cu\u1ed1i c\u00f9ng ho\u1eb7c x\u01b0\u01a1ng c\u1ed5 tay (nh\u01b0 x\u01b0\u01a1ng hamate). D\u00f9 l\u00e0 kh\u1ed1i u l\u00e0nh t\u00ednh, ch\u00fang l\u1ea1i c\u00f3 t\u00ednh x\u00e2m l\u1ea5n m\u1ea1nh v\u00e0 \u0111\u00e1p \u1ee9ng k\u00e9m v\u1edbi ph\u1eabu thu\u1eadt c\u1eaft r\u00eca, d\u1ec5 d\u00e0ng di c\u0103n [3].<\/p>\n
Do t\u00ednh ch\u1ea5t nguy hi\u1ec3m n\u00e0y, khi nghi ng\u1edd ung th\u01b0 t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 \u1edf x\u01b0\u01a1ng, b\u00e1c s\u0129 c\u1ea7n ch\u1ec9 \u0111\u1ecbnh ch\u1ee5p X-quang to\u00e0n th\u00e2n \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c \u1ed5 di c\u0103n ti\u1ec1m \u1ea9n. H\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i Campanacci \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n: t\u1eeb t\u1ed5n th\u01b0\u01a1ng c\u00f3 ranh gi\u1edbi r\u00f5 r\u00e0ng (Grade I) \u0111\u1ebfn m\u1ea5t l\u1edbp v\u1ecf x\u01b0\u01a1ng v\u00e0 x\u00e2m nh\u1eadp m\u00f4 m\u1ec1m (Grade III). Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf ph\u1ea7n x\u01b0\u01a1ng k\u00e8m gh\u00e9p x\u01b0\u01a1ng th\u01b0\u1eddng kh\u00f4ng \u0111\u1ee7, \u0111\u00f2i h\u1ecfi c\u00e1c bi\u1ec7n ph\u00e1p t\u00e1i t\u1ea1o ph\u1ee9c t\u1ea1p h\u01a1n [3].<\/p>\n
B\u00ean c\u1ea1nh c\u00e1c lo\u1ea1i \u0111\u00e3 n\u00eau, c\u00f2n c\u00f3 nhi\u1ec1u kh\u1ed1i u l\u00e0nh t\u00ednh kh\u00e1c nh\u01b0 lipoma (u m\u1ee1), lipoblastoma, ho\u1eb7c c\u00e1c kh\u1ed1i u th\u1ea7n kinh nh\u01b0 neurofibroma [2]. M\u1ed9t s\u1ed1 kh\u1ed1i u n\u00e0y c\u00f3 th\u1ec3 l\u00e0 \u0111a trung t\u00e2m, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nhi\u1ec1u ng\u00f3n tay c\u00f9ng l\u00fac. V\u00ed d\u1ee5, m\u1ed9t s\u1ed1 d\u1ea1ng u x\u01a1 c\u00f3 th\u1ec3 t\u00e1i ph\u00e1t \u1edf 60% b\u1ec7nh nh\u00e2n sau khi c\u1eaft r\u00eca n\u1ebfu ch\u1ec9 th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt \u0111\u01a1n gi\u1ea3n m\u00e0 kh\u00f4ng x\u1eed l\u00fd tri\u1ec7t \u0111\u1ec3 v\u00f9ng x\u00e2m l\u1ea5n [4].<\/p>\n
Ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c ph\u1ee5 thu\u1ed9c v\u00e0o vi\u1ec7c k\u1ebft h\u1ee3p gi\u1eefa kh\u00e1m l\u00e2m s\u00e0ng v\u00e0 c\u00e1c ph\u01b0\u01a1ng th\u1ee9c h\u00ecnh \u1ea3nh h\u1ecdc. MRI l\u00e0 c\u00f4ng c\u1ee5 quan tr\u1ecdng \u0111\u1ec3 ph\u00e2n bi\u1ec7t kh\u1ed1i u m\u1ec1m v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c, \u0111\u1eb7c bi\u1ec7t khi c\u1ea7n \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 x\u00e2m nh\u1eadp c\u1ee7a m\u00f4 m\u1ec1m ho\u1eb7c s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a canxi h\u00f3a [6]. Vi\u1ec7c sinh thi\u1ebft (biopsy) th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh tr\u01b0\u1edbc ph\u1eabu thu\u1eadt l\u1edbn \u0111\u1ec3 x\u00e1c nh\u1eadn ch\u1ea9n \u0111o\u00e1n, tr\u00e1nh nh\u1ea7m l\u1eabn gi\u1eefa ung th\u01b0 t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 \u1edf x\u01b0\u01a1ng v\u00e0 c\u00e1c kh\u1ed1i u nh\u01b0 enchondroma [3].<\/p>\n
Vi\u1ec7c hi\u1ec3u bi\u1ebft v\u1ec1 \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a t\u1eebng lo\u1ea1i kh\u1ed1i u gi\u00fap b\u00e1c s\u0129 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p, c\u00e2n b\u1eb1ng gi\u1eefa vi\u1ec7c ki\u1ec3m so\u00e1t b\u1ec7nh l\u00fd v\u00e0 b\u1ea3o t\u1ed3n ch\u1ee9c n\u0103ng v\u1eadn \u0111\u1ed9ng cho tr\u1ebb em.<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
B\u00e0i vi\u1ebft gi\u1ea3i th\u00edch c\u00e1c kh\u1ed1i u l\u00e0nh t\u00ednh nh\u01b0 nang x\u01b0\u01a1ng, vi\u00eam tuy\u1ebfn tu\u1ef7 v\u00e0 ung th\u01b0 t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 t\u1ea1i ng\u00f3n tay tr\u1ebb em. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh v\u00e0 ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-476","post","type-post","status-publish","format-standard","hentry","category-chi-tren"],"yoast_head":"\n