Bao ho\u1ea1t d\u1ecbch (hay c\u00f2n g\u1ecdi l\u00e0 nang Baker) l\u00e0 m\u1ed9t t\u00fai m\u1ee7 ch\u1ee9a d\u1ecbch kh\u1edbp n\u1eb1m trong kh\u00f4ng gian popliteal, ph\u00eda sau \u0111\u1ea7u g\u1ed1i. \u1ede tr\u1ebb em, t\u00ecnh tr\u1ea1ng n\u00e0y x\u1ea3y ra kh\u00e1 ph\u1ed5 bi\u1ebfn v\u00e0 chi\u1ebfm kho\u1ea3ng 33% \u0111\u1ebfn 50% c\u00e1c ca b\u1ec7nh so v\u1edbi ng\u01b0\u1eddi l\u1edbn [3]. M\u1eb7c d\u00f9 th\u01b0\u1eddng \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 ngo\u1ea1i khoa \u0111\u01a1n gi\u1ea3n, nh\u01b0ng \u1edf l\u1ee9a tu\u1ed5i nhi khoa, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c v\u00e0 x\u1eed l\u00fd \u0111\u00fang c\u00e1ch l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 tr\u00e1nh nh\u1ea7m l\u1eabn v\u1edbi c\u00e1c kh\u1ed1i u ho\u1eb7c nhi\u1ec5m tr\u00f9ng [3] [4].<\/p>\n
Tr\u00e1i v\u1edbi quan ni\u1ec7m sai l\u1ea7m r\u1eb1ng nang Baker ch\u1ec9 x\u1ea3y ra do tho\u00e1i h\u00f3a kh\u1edbp (th\u01b0\u1eddng g\u1eb7p \u1edf ng\u01b0\u1eddi l\u1edbn), \u1edf tr\u1ebb em nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ebfu l\u00e0 c\u00e1c b\u1ec7nh l\u00fd n\u1ed9i khoa ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng g\u00e2y vi\u00eam m\u00e0ng ho\u1ea1t d\u1ecbch [1] [3]. Kho\u1ea3ng m\u1ed9t ph\u1ea7n ba \u0111\u1ebfn m\u1ed9t n\u1eeda s\u1ed1 ca nang Baker \u1edf tr\u1ebb em kh\u00f4ng c\u00f3 th\u00f4ng tin v\u1ec1 nguy\u00ean nh\u00e2n r\u00f5 r\u00e0ng, v\u00e0 trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, ch\u00fang \u0111\u01b0\u1ee3c coi l\u00e0 v\u1ea5n \u0111\u1ec1 th\u1ee9 ph\u00e1t c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i m\u00e0 kh\u00f4ng c\u1ea7n can thi\u1ec7p ngay l\u1eadp t\u1ee9c [1].<\/p>\n
Nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t li\u00ean quan \u0111\u1ebfn c\u00e1c b\u1ec7nh l\u00fd n\u1ed9i khoa nh\u01b0 vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p ho\u1eb7c r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a. C\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u1edbp nh\u01b0 r\u00e1ch s\u1ee5n ch\u00eam c\u0169ng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u00edch t\u1ee5 d\u1ecbch v\u00e0 h\u00ecnh th\u00e0nh nang Baker, \u0111\u1eb7c bi\u1ec7t khi kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb tri\u1ec7t \u0111\u1ec3 [4].<\/p>\n
Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n nang Baker \u1edf tr\u1ebb em \u0111\u00f2i h\u1ecfi s\u1ef1 ph\u00e2n bi\u1ec7t k\u1ef9 l\u01b0\u1ee1ng gi\u1eefa c\u00e1c kh\u1ed1i u l\u00e0nh t\u00ednh (nh\u01b0 lipoma, xanthoma), kh\u1ed1i u \u00e1c t\u00ednh ho\u1eb7c c\u00e1c t\u00ecnh tr\u1ea1ng vi\u00eam nhi\u1ec5m nh\u01b0 \u00e1p-xe pyogenic [3]. Do \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p h\u00ecnh \u1ea3nh h\u1ecdc l\u00e0 b\u1eaft bu\u1ed9c tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt lo\u1ea1i b\u1ecf.<\/p>\n
S\u01a1 c\u1ee9u ch\u1ea9n \u0111o\u00e1n th\u01b0\u1eddng d\u1ef1a tr\u00ean k\u1ef9 thu\u1eadt soi s\u00e1ng nang (trans-illumination), tuy nhi\u00ean \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh ch\u1eafc ch\u1eafn v\u00e0 lo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c, si\u00eau \u00e2m ho\u1eb7c ch\u1ee5p MRI l\u00e0 c\u00e1c c\u00f4ng c\u1ee5 \u01b0u vi\u1ec7t [3]. \u0110\u1eb7c bi\u1ec7t, ch\u1ee5p MRI kh\u00f4ng ch\u1ec9 gi\u00fap x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed c\u1ee7a nang m\u00e0 c\u00f2n c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n ra c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u1edbp n\u1ed9i b\u1ed9 li\u00ean quan nh\u01b0 s\u1ee5n ch\u00eam r\u00e1ch hay tho\u00e1i h\u00f3a kh\u1edbp tr\u01b0\u1edbc \u0111\u00f3 [4].<\/p>\n
M\u1ed9t \u0111i\u1ec3m \u0111\u1eb7c bi\u1ec7t \u1edf tr\u1ebb em l\u00e0 nang Baker hi\u1ebfm khi th\u00f4ng tr\u1ef1c ti\u1ebfp v\u1edbi kh\u1edbp g\u1ed1i, kh\u00e1c v\u1edbi ng\u01b0\u1eddi l\u1edbn n\u01a1i c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u1edbp n\u1ed9i khoa th\u01b0\u1eddng ph\u1ed5 bi\u1ebfn v\u00e0 c\u00f3 th\u1ec3 t\u00e1i ph\u00e1t n\u1ebfu kh\u00f4ng \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n g\u1ed1c r\u1ec5 [1] [4].<\/p>\n
\u0110\u1ed1i v\u1edbi tr\u1ebb em, xu h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb \u01b0u ti\u00ean l\u00e0 qu\u1ea3n l\u00fd b\u1ea3o t\u1ed3n (conservative management). Nhi\u1ec1u nang Baker \u1edf tr\u1ebb em c\u00f3 th\u1ec3 t\u1ef1\u6d88\u9000 ho\u1eb7c \u1ed5n \u0111\u1ecbnh khi nguy\u00ean nh\u00e2n g\u00e2y vi\u00eam \u0111\u00e3 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t [1]. Do \u0111\u00f3, ph\u01b0\u01a1ng ph\u00e1p h\u00fat d\u1ecbch d\u01b0\u1edbi si\u00eau \u00e2m ch\u1ec9 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n khi ch\u1ea9n \u0111o\u00e1n ch\u1eafc ch\u1eafn v\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng t\u1ee9c th\u1eddi.<\/p>\n
Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf nang Baker th\u01b0\u1eddng kh\u00f4ng ph\u1ea3i l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u1ea7u ti\u00ean cho tr\u1ebb em tr\u1eeb khi c\u00f3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u1eb7c bi\u1ec7t nh\u01b0 nang to g\u00e2y ch\u00e8n \u00e9p m\u1ea1ch m\u00e1u, ho\u1eb7c khi can thi\u1ec7p b\u1ea3o t\u1ed3n th\u1ea5t b\u1ea1i [1]. C\u00e1c k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt ti\u00eau chu\u1ea9n trong ng\u01b0\u1eddi l\u1edbn (nh\u01b0 ti\u1ebfp c\u1eadn h\u1eadu b\u00ean hay Meyerding v\u00e0 Van Demark) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng nh\u01b0ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh ph\u00f9 h\u1ee3p v\u1edbi gi\u1ea3i ph\u1eabu c\u1ee7a tr\u1ebb \u0111\u1ec3 tr\u00e1nh t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh v\u00e0 m\u1ea1ch m\u00e1u [2] [4].<\/p>\n
Trong khi \u0111\u00f3, c\u00e1c ca nang Baker do ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p th\u01b0\u1eddng \u0111\u00f2i h\u1ecfi x\u1eed l\u00fd tri\u1ec7t \u0111\u1ec3 nguy\u00ean nh\u00e2n g\u00e2y vi\u00eam m\u00e0ng ho\u1ea1t d\u1ecbch k\u00e8m theo c\u1eaft b\u1ecf nang, v\u00ec \u0111\u00e2y l\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 th\u1ee9 ph\u00e1t ph\u1ee9c t\u1ea1p h\u01a1n [1] [4].<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Bao ho\u1ea1t d\u1ecbch (nang Baker) \u1edf tr\u1ebb em th\u01b0\u1eddng do c\u00e1c v\u1ea5n \u0111\u1ec1 kh\u1edbp g\u00e2y ra. B\u00e0i vi\u1ebft gi\u1ea3i th\u00edch nguy\u00ean nh\u00e2n, ch\u1ea9n \u0111o\u00e1n b\u1eb1ng si\u00eau \u00e2m\/MRI v\u00e0 ph\u01b0\u01a1ng \u00e1n can thi\u1ec7p khi c\u1ea7n thi\u1ebft.<\/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-604","post","type-post","status-publish","format-standard","hentry","category-chi-duoi"],"yoast_head":"\n