Ph\u1eabu thu\u1eadt khoan gi\u1ea3m \u00e1p trong ho\u1ea1i t\u1eed v\u00f4 khu\u1ea9n ch\u1ecfm x\u01b0\u01a1ng \u0111\u00f9i<\/p>\n
Ph\u1eabu thu\u1eadt khoan gi\u1ea3m \u00e1p (core decompression) l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ho\u1ea1i t\u1eed v\u00f4 khu\u1ea9n ch\u1ecfm x\u01b0\u01a1ng \u0111\u00f9i (ONFH), \u0111\u1eb7c bi\u1ec7t \u1edf c\u00e1c b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y nh\u1eb1m m\u1ee5c \u0111\u00edch l\u00e0m gi\u1ea3m \u00e1p l\u1ef1c n\u1ed9i s\u1ee5n v\u00e0 c\u1ea3i thi\u1ec7n tu\u1ea7n ho\u00e0n m\u00e1u t\u1ea1i v\u00f9ng t\u1ed5n th\u01b0\u01a1ng.<\/p>\n
Ph\u1eabu thu\u1eadt khoan gi\u1ea3m \u00e1p ch\u1ee7 y\u1ebfu \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng theo ph\u00e2n lo\u1ea1i Ficat giai \u0111o\u1ea1n I ho\u1eb7c II nh\u1ecf, t\u1eadp trung \u1edf trung t\u00e2m ch\u1ecfm x\u01b0\u01a1ng \u0111\u00f9i. C\u00e1c \u1ee9ng vi\u00ean l\u00fd t\u01b0\u1edfng th\u01b0\u1eddng l\u00e0 ng\u01b0\u1eddi tr\u1ebb, kh\u00f4ng b\u00e9o ph\u00ec v\u00e0 kh\u00f4ng s\u1eed d\u1ee5ng corticosteroid [2]. \u0110\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh ti\u1ebfn tri\u1ec3n h\u01a1n (giai \u0111o\u1ea1n III), hi\u1ec7u qu\u1ea3 c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y gi\u1ea3m \u0111\u00e1ng k\u1ec3 v\u00e0 c\u1ea7n c\u00e2n nh\u1eafc c\u00e1c li\u1ec7u ph\u00e1p thay th\u1ebf [2].<\/p>\n
Vi\u1ec7c x\u00e1c \u0111\u1ecbnh giai \u0111o\u1ea1n b\u1ec7nh r\u1ea5t quan tr\u1ecdng. Nghi\u00ean c\u1ee9u cho th\u1ea5y t\u1ef7 l\u1ec7 s\u1ee5p \u0111\u1ed5 ch\u1ecfm x\u01b0\u01a1ng \u0111\u00f9i \u1edf cao h\u01a1n 85% trong c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng thu\u1ed9c giai \u0111o\u1ea1n Ficat I ho\u1eb7c II sau 2 n\u0103m n\u1ebfu kh\u00f4ng can thi\u1ec7p [1]. M\u1ed9t y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng quan tr\u1ecdng l\u00e0 di\u1ec7n t\u00edch t\u1ed5n th\u01b0\u01a1ng; khi g\u00f3c ho\u1ea1i t\u1eed t\u1ed5ng h\u1ee3p v\u01b0\u1ee3t qu\u00e1 190 \u0111\u1ed9, s\u1ee5p \u0111\u1ed5 c\u00f3 th\u1ec3 x\u1ea3y ra, trong khi c\u00e1c tr\u01b0\u1eddng h\u1ee3p k\u1ebft h\u1ee3p l\u1edbn h\u01a1n 240 \u0111\u1ed9 lu\u00f4n d\u1eabn \u0111\u1ebfn s\u1ee5p \u0111\u1ed5 v\u00e0 tho\u00e1i h\u00f3a kh\u1edbp ti\u1ebfn tri\u1ec3n [1]. T\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng t\u1ed1t nh\u1ea5t th\u01b0\u1eddng th\u1ea5y \u1edf b\u1ec7nh nh\u00e2n d\u01b0\u1edbi 55 tu\u1ed5i v\u1edbi t\u1ed5n th\u01b0\u01a1ng nh\u1ecf h\u01a1n 30% di\u1ec7n t\u00edch ch\u1ecfm x\u01b0\u01a1ng \u0111\u00f9i [3].<\/p>\n
M\u1ee5c ti\u00eau c\u1ee7a ph\u1eabu thu\u1eadt bao g\u1ed3m gi\u1ea3m \u00e1p l\u1ef1c n\u1ed9i s\u1ee5n, c\u1eaft b\u1ecf m\u00f4 ho\u1ea1i t\u1eed (sequestrum) v\u00e0 \u0111i\u1ec1n khuy\u1ebft khuy\u1ebft b\u1eb1ng gh\u00e9p x\u01b0\u01a1ng \u0111\u1ec3 h\u1ed7 tr\u1ee3 b\u1ec1 m\u1eb7t d\u01b0\u1edbi s\u1ee5n [4]. M\u1ed9t trong nh\u1eefng k\u1ef9 thu\u1eadt ph\u1ed5 bi\u1ebfn l\u00e0 k\u1ef9 thu\u1eadt \u0111\u01b0\u1eddng khoan l\u00f5i ti\u00eau chu\u1ea9n (<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
H\u01b0\u1edbng d\u1eabn chi ti\u1ebft v\u1ec1 ph\u1eabu thu\u1eadt khoan gi\u1ea3m \u00e1p (core decompression) cho ho\u1ea1i t\u1eed x\u01b0\u01a1ng \u0111\u00f9i theo ph\u00e2n lo\u1ea1i Ficat giai \u0111o\u1ea1n I v\u00e0 II, bao g\u1ed3m ch\u1ec9 \u0111\u1ecbnh, k\u1ef9 thu\u1eadt th\u1ef1c hi\u1ec7n v\u00e0 ch\u0103m s\u00f3c v\u1ebft th\u01b0\u01a1ng.<\/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-608","post","type-post","status-publish","format-standard","hentry","category-chi-duoi"],"yoast_head":"\n