{"id":574,"date":"2026-10-13T06:19:45","date_gmt":"2026-10-12T23:19:45","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/13\/noi-soi-khop-vai-dieu-tri-ket-khop-do-canxi-hoa-gan-chop-xoay\/"},"modified":"2026-10-13T06:19:45","modified_gmt":"2026-10-12T23:19:45","slug":"noi-soi-khop-vai-dieu-tri-ket-khop-do-canxi-hoa-gan-chop-xoay","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/13\/noi-soi-khop-vai-dieu-tri-ket-khop-do-canxi-hoa-gan-chop-xoay\/","title":{"rendered":"N\u1ed9i soi kh\u1edbp vai \u0111i\u1ec1u tr\u1ecb k\u1eb9t kh\u1edbp do canxi h\u00f3a g\u00e2n ch\u00f3p xoay"},"content":{"rendered":"

N\u1ed9i soi kh\u1edbp vai \u0111i\u1ec1u tr\u1ecb k\u1eb9t kh\u1edbp do canxi h\u00f3a g\u00e2n ch\u00f3p xoay<\/strong> th\u01b0\u1eddng \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc khi \u0111au k\u00e9o d\u00e0i, v\u1eadn \u0111\u1ed9ng vai b\u1ecb h\u1ea1n ch\u1ebf v\u00e0 c\u00e1c bi\u1ec7n ph\u00e1p kh\u00f4ng ph\u1eabu thu\u1eadt kh\u00f4ng c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng. Tuy nhi\u00ean, kh\u00f4ng ph\u1ea3i m\u1ecdi tr\u01b0\u1eddng h\u1ee3p c\u00f3 l\u1eafng \u0111\u1ecdng canxi \u0111\u1ec1u c\u1ea7n m\u1ed5. T\u00e0i li\u1ec7u chuy\u00ean m\u00f4n cho th\u1ea5y quy\u1ebft \u0111\u1ecbnh ph\u1eabu thu\u1eadt c\u1ea7n d\u1ef1a tr\u00ean di\u1ec5n ti\u1ebfn tri\u1ec7u ch\u1ee9ng, m\u1ee9c \u0111\u1ed9 \u0111au v\u00e0 \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n [1], [2], [4].<\/p>\n

Canxi h\u00f3a g\u00e2n ch\u00f3p xoay c\u00f3 th\u1ec3 g\u00e2y \u201ck\u1eb9t\u201d vai nh\u01b0 th\u1ebf n\u00e0o?<\/h2>\n

Canxi h\u00f3a g\u00e2n ch\u00f3p xoay, hay vi\u00eam g\u00e2n v\u00f4i h\u00f3a, l\u00e0 t\u00ecnh tr\u1ea1ng xu\u1ea5t hi\u1ec7n l\u1eafng \u0111\u1ecdng canxi trong g\u00e2n. Nguy\u00ean nh\u00e2n ch\u00ednh x\u00e1c ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh; m\u1ed9t s\u1ed1 gi\u1ea3 thuy\u1ebft cho r\u1eb1ng thi\u1ebfu oxy t\u1ea1i ch\u1ed7 v\u00e0 tho\u00e1i h\u00f3a m\u00f4 c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn qu\u00e1 tr\u00ecnh h\u00ecnh th\u00e0nh c\u00e1c \u1ed5 canxi [3].<\/p>\n

Trong giai \u0111o\u1ea1n canxi \u0111\u01b0\u1ee3c c\u01a1 th\u1ec3 h\u1ea5p thu, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 \u0111au nhi\u1ec1u, vi\u00eam v\u00e0 h\u1ea1n ch\u1ebf t\u1ea7m v\u1eadn \u0111\u1ed9ng vai. C\u00e1c bi\u1ec3u hi\u1ec7n n\u00e0y \u0111\u00f4i khi gi\u1ed1ng m\u1ed9t t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng c\u1ea5p, v\u00ec v\u1eady kh\u00f4ng n\u00ean t\u1ef1 k\u1ebft lu\u1eadn r\u1eb1ng \u0111au v\u00e0 kh\u00f3 c\u1eed \u0111\u1ed9ng ch\u1eafc ch\u1eafn l\u00e0 do \u201ck\u1eb9t kh\u1edbp\u201d c\u01a1 h\u1ecdc [3].<\/p>\n

Khi n\u00e0o n\u1ed9i soi kh\u1edbp vai \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc?<\/h2>\n

\u0110i\u1ec1u tr\u1ecb ban \u0111\u1ea7u th\u01b0\u1eddng kh\u00f4ng ph\u1eabu thu\u1eadt, g\u1ed3m ch\u01b0\u1eddm l\u1ea1nh t\u1eebng \u0111\u1ee3t, thu\u1ed1c ch\u1ed1ng vi\u00eam v\u00e0 trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 ti\u00eam thu\u1ed1c g\u00e2y t\u00ea t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i v\u00e0o khoang d\u01b0\u1edbi m\u1ecfm c\u00f9ng. Vai tr\u00f2 c\u1ee7a ti\u00eam corticosteroid v\u1eabn c\u00f2n g\u00e2y tranh lu\u1eadn v\u00ec c\u00f3 th\u1ec3 l\u00e0m k\u00e9o d\u00e0i giai \u0111o\u1ea1n \u0111au khi canxi \u0111ang \u0111\u01b0\u1ee3c h\u1ea5p thu [3].<\/p>\n

Ph\u1eabu thu\u1eadt ho\u1eb7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i soi c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem x\u00e9t khi xu\u1ea5t hi\u1ec7n m\u1ed9t hay nhi\u1ec1u y\u1ebfu t\u1ed1 sau:<\/p>\n

    \n
  • Tri\u1ec7u ch\u1ee9ng ti\u1ebfn tri\u1ec3n<\/strong> ho\u1eb7c \u0111au li\u00ean t\u1ee5c.<\/li>\n
  • C\u01a1n \u0111au \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c ho\u1ea1t \u0111\u1ed9ng sinh ho\u1ea1t h\u1eb1ng ng\u00e0y.<\/li>\n
  • Kh\u00f4ng c\u1ea3i thi\u1ec7n sau \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n ph\u00f9 h\u1ee3p [1], [2], [4].<\/li>\n<\/ul>\n

    Nh\u1eefng ti\u00eau ch\u00ed n\u00e0y kh\u00f4ng thay th\u1ebf cho th\u0103m kh\u00e1m tr\u1ef1c ti\u1ebfp. B\u00e1c s\u0129 c\u1ea7n \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng vai, m\u1ee9c \u0111\u1ed9 h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng v\u00e0 h\u00ecnh \u1ea3nh h\u1ecdc tr\u01b0\u1edbc khi ch\u1ec9 \u0111\u1ecbnh th\u1ee7 thu\u1eadt.<\/p>\n

    N\u1ed9i soi kh\u1edbp vai \u0111i\u1ec1u tr\u1ecb k\u1eb9t kh\u1edbp do canxi h\u00f3a g\u00e2n ch\u00f3p xoay \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ra sao?<\/h2>\n

    Khi \u0111\u00e3 c\u00f3 ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt, t\u00e0i li\u1ec7u \u01b0u ti\u00ean k\u1ef9 thu\u1eadt n\u1ed9i soi h\u01a1n m\u1ed5 m\u1edf [1], [4]. M\u1ee5c ti\u00eau ch\u00ednh l\u00e0 ti\u1ebfp c\u1eadn v\u00e0 lo\u1ea1i b\u1ecf \u1ed5 l\u1eafng \u0111\u1ecdng canxi trong g\u00e2n. Trong qu\u00e1 tr\u00ecnh n\u1ed9i soi, canxi c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u1ea5y b\u1ecf b\u1eb1ng d\u1ee5ng c\u1ee5 b\u00e0o c\u01a1 h\u1ecdc, th\u01b0\u1eddng g\u1ecdi l\u00e0 mechanical shaver [2].<\/p>\n

    Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, \u1ed5 canxi kh\u00f3 quan s\u00e1t tr\u1ef1c ti\u1ebfp qua n\u1ed9i soi. Si\u00eau \u00e2m \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong l\u00fac m\u1ed5 \u1edf m\u1ed9t s\u1ed1 b\u00e1o c\u00e1o nh\u1eb1m h\u1ed7 tr\u1ee3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed l\u1eafng \u0111\u1ecdng [2]. \u0110i\u1ec1u n\u00e0y cho th\u1ea5y vi\u1ec7c l\u1ef1a ch\u1ecdn d\u1ee5ng c\u1ee5 v\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ecbnh v\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1eb7c \u0111i\u1ec3m \u1ed5 canxi c\u0169ng nh\u01b0 \u0111\u00e1nh gi\u00e1 c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean.<\/p>\n

    C\u00f3 ph\u1ea3i l\u00fac n\u00e0o c\u0169ng c\u1ea7n n\u1ed9i soi ch\u1ea9n \u0111o\u00e1n?<\/h3>\n

    Kh\u00f4ng. T\u00e0i li\u1ec7u l\u01b0u \u00fd r\u1eb1ng n\u1ed9i soi ch\u1ea9n \u0111o\u00e1n th\u01b0\u1eddng quy nh\u00ecn chung kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb cho ng\u01b0\u1eddi b\u1ec7nh vi\u00eam g\u00e2n v\u00f4i h\u00f3a [1], [2], [4]. M\u1ed9t nguy\u00ean nh\u00e2n l\u00e0 b\u1ec7nh l\u00fd ph\u1ed1i h\u1ee3p \u1edf kh\u1edbp \u1ed5 ch\u1ea3o\u2013c\u00e1nh tay kh\u00f4ng th\u01b0\u1eddng g\u1eb7p trong nh\u00f3m n\u00e0y. Ngo\u00e0i ra, s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a \u1ed5 canxi kh\u00f4ng \u0111\u01b0\u1ee3c xem l\u00e0 l\u00e0m t\u0103ng nguy c\u01a1 r\u00e1ch g\u00e2n ch\u00f3p xoay; hai t\u00ecnh tr\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 xu\u1ea5t ph\u00e1t t\u1eeb c\u00e1c qu\u00e1 tr\u00ecnh kh\u00e1c nhau [2].<\/p>\n

    Khi n\u00e0o c\u1ea7n t\u1ea1o h\u00ecnh m\u1ecfm c\u00f9ng vai?<\/h2>\n

    T\u1ea1o h\u00ecnh m\u1ecfm c\u00f9ng vai, hay acromioplasty, kh\u00f4ng n\u00ean \u0111\u01b0\u1ee3c hi\u1ec3u l\u00e0 b\u01b0\u1edbc b\u1eaft bu\u1ed9c trong m\u1ecdi ca l\u1ea5y canxi. Theo t\u00e0i li\u1ec7u, th\u1ee7 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 b\u1eb1ng ch\u1ee9ng ch\u00e8n \u00e9p d\u01b0\u1edbi m\u1ecfm c\u00f9ng tr\u00ean \u0111\u00e1nh gi\u00e1 tr\u01b0\u1edbc m\u1ed5 [1], [2]. V\u00ec v\u1eady, ch\u1ec9 \u0111\u1ecbnh c\u1ea7n d\u1ef1a tr\u00ean bi\u1ec3u hi\u1ec7n v\u00e0 k\u1ebft qu\u1ea3 \u0111\u00e1nh gi\u00e1 c\u1ee5 th\u1ec3, thay v\u00ec \u00e1p d\u1ee5ng gi\u1ed1ng nhau cho t\u1ea5t c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

    Hi\u1ec7u qu\u1ea3 v\u00e0 gi\u1edbi h\u1ea1n th\u00f4ng tin hi\u1ec7n c\u00f3<\/h2>\n

    M\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 \u0111\u01b0\u1ee3c t\u00e0i li\u1ec7u tr\u00edch d\u1eabn b\u00e1o c\u00e1o k\u1ebft qu\u1ea3 t\u1ed1t \u1edf kho\u1ea3ng 90% ng\u01b0\u1eddi b\u1ec7nh sau l\u1ea5y \u1ed5 canxi b\u1eb1ng n\u1ed9i soi; c\u00e1c nghi\u00ean c\u1ee9u theo d\u00f5i trung h\u1ea1n c\u0169ng ghi nh\u1eadn k\u1ebft qu\u1ea3 t\u1ed1t \u0111\u01b0\u1ee3c duy tr\u00ec theo th\u1eddi gian [2]. \u0110\u00e2y l\u00e0 k\u1ebft qu\u1ea3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o trong t\u00e0i li\u1ec7u, kh\u00f4ng ph\u1ea3i cam k\u1ebft cho t\u1eebng c\u00e1 nh\u00e2n.<\/p>\n

    C\u00e1c \u0111o\u1ea1n t\u00e0i li\u1ec7u \u0111\u01b0\u1ee3c cung c\u1ea5p t\u1eadp trung v\u00e0o ch\u1ec9 \u0111\u1ecbnh, nguy\u00ean t\u1eafc k\u1ef9 thu\u1eadt v\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a n\u1ed9i soi l\u1ea5y canxi. Ch\u00fang kh\u00f4ng tr\u00ecnh b\u00e0y \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 c\u00e1c b\u01b0\u1edbc g\u00e2y m\u00ea, nguy c\u01a1 bi\u1ebfn ch\u1ee9ng, ch\u01b0\u01a1ng tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau m\u1ed5 ho\u1eb7c th\u1eddi \u0111i\u1ec3m tr\u1edf l\u1ea1i lao \u0111\u1ed9ng. Ng\u01b0\u1eddi b\u1ec7nh n\u00ean trao \u0111\u1ed5i tr\u1ef1c ti\u1ebfp v\u1edbi b\u00e1c s\u0129 ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh \u0111\u1ec3 \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch c\u00e1c n\u1ed9i dung n\u00e0y tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh.<\/p>\n

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

    N\u1ed9i soi kh\u1edbp vai l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u01b0\u1ee3c \u01b0u ti\u00ean khi canxi h\u00f3a g\u00e2n ch\u00f3p xoay g\u00e2y \u0111au li\u00ean t\u1ee5c, tri\u1ec7u ch\u1ee9ng ti\u1ebfn tri\u1ec3n ho\u1eb7c kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n. Ph\u1eabu thu\u1eadt ch\u1ee7 y\u1ebfu nh\u1eb1m l\u1ea5y b\u1ecf \u1ed5 canxi; n\u1ed9i soi ch\u1ea9n \u0111o\u00e1n th\u01b0\u1eddng quy kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb, c\u00f2n t\u1ea1o h\u00ecnh m\u1ecfm c\u00f9ng vai ch\u1ec9 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc khi c\u00f3 b\u1eb1ng ch\u1ee9ng ch\u00e8n \u00e9p d\u01b0\u1edbi m\u1ecfm c\u00f9ng. Ch\u1ea9n \u0111o\u00e1n v\u00e0 ch\u1ec9 \u0111\u1ecbnh c\u1ea7n \u0111\u01b0\u1ee3c c\u00e1 th\u1ec3 h\u00f3a sau th\u0103m kh\u00e1m v\u00e0 \u0111\u00e1nh gi\u00e1 h\u00ecnh \u1ea3nh ph\u00f9 h\u1ee3p.<\/p>\n

    T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
      \n
    • [1] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2843<\/li>\n
    • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2843<\/li>\n
    • [3] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3216<\/li>\n
    • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2843<\/li>\n<\/ul>\n

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