{"id":1062,"date":"2023-04-03T11:46:52","date_gmt":"2023-04-03T04:46:52","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&#038;p=1062"},"modified":"2023-04-02T12:00:02","modified_gmt":"2023-04-02T05:00:02","slug":"bong-gan","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/bong-gan\/","title":{"rendered":"Sprains"},"content":{"rendered":"<h2>\u0110\u1ecaNH NGH\u0128A<\/h2>\n<p>Bong g\u00e2n (Ti\u1ebfng anh l\u00e0 <a href=\"https:\/\/dictionary.cambridge.org\/dictionary\/english\/sprain\" target=\"_blank\" rel=\"noopener\">sprain<\/a>) l\u00e0 t\u1eeb ng\u1eef d\u00e2n gian (\u0111\u00e3 \u0111\u01b0\u1ee3c ng\u00e0nh Y Vi\u1ec7t Nam ch\u1ea5p nh\u1eadn l\u00e0 t\u1eeb ng\u1eef khoa h\u1ecdc) ch\u1ec9 c\u00e1c t\u1ed5n th\u01b0\u01a1ng (th\u01b0\u1eddng l\u00e0 k\u00edn) ch\u1ee7 y\u1ebfu c\u1ee7a c\u00e1c d\u00e2y ch\u1eb1ng gi\u1eef v\u1eefng kh\u1edbp. Th\u00f4ng th\u01b0\u1eddng c\u00f3 k\u00e8m theo t\u1ed5n th\u01b0\u01a1ng bao kh\u1edbp n\u00f3i chung. \u0110\u00f4i khi c\u00f3 th\u1ec3 th\u1ea5y c\u1ea3 t\u1ed5n th\u01b0\u01a1ng c\u00e1c c\u01a1 gi\u1eef v\u1eefng kh\u1edbp x\u01b0\u01a1ng t\u01b0\u01a1ng quan. Bong g\u00e2n ho\u00e0n to\u00e0n kh\u00f4ng c\u00f3 li\u00ean quan \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng g\u00e2n c\u01a1 \u0111\u01a1n thu\u1ea7n.<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" width=\"694\" height=\"346\" class=\"wp-image-1065 aligncenter\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1062-1.png\" alt=\"\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1062-1.png 694w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1062-1-300x150.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1062-1-18x9.png 18w\" sizes=\"(max-width: 694px) 100vw, 694px\" \/><\/p>\n<p style=\"text-align: center;\"><strong>H\u00ecnh 9.1. <\/strong>Bong g\u00e2n d\u00e2y ch\u1eb1ng m\u00e1c-s\u00ean v\u00e0 m\u00e1c-g\u00f3t [1]<\/p>\n<h2>C\u01a0 CH\u1ebe<\/h2>\n<p>Th\u01b0\u1eddng l\u00e0 ch\u1ea5n th\u01b0\u01a1ng gi\u00e1n ti\u1ebfp theo chi\u1ec1u h\u01b0\u1edbng v\u1eb7n xo\u1eafn ho\u1eb7c g\u1eadp g\u00f3c l\u00e0m khe kh\u1edbp b\u00ean \u0111\u1ed1i di\u1ec7n to\u00e1c r\u1ed9ng v\u00e0 d\u00e2y ch\u1eb1ng b\u1ecb k\u00e9o c\u0103ng qu\u00e1 m\u1ee9c m\u00e0 b\u1ecb th\u01b0\u01a1ng t\u00edch. C\u00f3 khi c\u01a1 ch\u1ebf ph\u1ee9c t\u1ea1p g\u1ed3m c\u1ea3 v\u1eb7n xo\u1eafn v\u00e0 g\u1eadp g\u00f3c. C\u00e1c d\u00e2y ch\u1eb1ng b\u1ecb c\u1eaft \u0111\u1ee9t kh\u00f4ng \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o bong g\u00e2n.<\/p>\n<h2>GI\u1ea2I PH\u1eaaU \u2013 SINH L\u00dd B\u1ec6NH VI TH\u1ec2 C\u1ee6A D\u00c2Y CH\u1eb0NG<\/h2>\n<p>Sau m\u1ed9t t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng ta th\u1ea5y di\u1ec5n bi\u1ebfn ba giai \u0111o\u1ea1n (theo Oakes):<\/p>\n<ul>\n<li>Giai \u0111o\u1ea1n vi\u00eam t\u1ea5y c\u1ea5p t\u00ednh, k\u00e9o d\u00e0i kho\u1ea3ng 72 gi\u1edd, th\u1ea5y c\u00f3 d\u1eadp v\u1ee1 c\u00e1c m\u1ea1ch m\u00e1u v\u00e0 s\u1ef1 ng\u1ea5m m\u00e1u ra t\u1ebf b\u00e0o.<\/li>\n<li>Giai \u0111o\u1ea1n ph\u1ee5c h\u1ed3i, di\u1ec5n ra t\u1eeb kho\u1ea3ng sau gi\u1edd 72 \u0111\u1ebfn 4 \u2013 6 tu\u1ea7n l\u1ec5, c\u00f3 s\u1ef1 t\u00edch t\u1ee5 collagen t\u1ea1i v\u00f9ng bong g\u00e2n.<\/li>\n<li>Giai \u0111o\u1ea1n t\u00e1i t\u1ea1o l\u1ea1i c\u00e1c d\u00e2y ch\u1eb1ng v\u00e0 c\u00e1c m\u00f4 kh\u00e1c, x\u1ea3y ra t\u1eeb tu\u1ea7n l\u1ec5 4 \u2013 6 sau ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ebfn 3 \u2013 6 th\u00e1ng [th\u1eadm ch\u00ed \u0111\u1ebfn 12 \u2013 16 th\u00e1ng, (theo Sisk)] l\u00e0 th\u1eddi k\u1ef3 t\u1ed5 ch\u1ee9c l\u1ea1i collagen v\u00e0 c\u01a1.<\/li>\n<\/ul>\n<h3>Giai \u0111o\u1ea1n vi\u00eam t\u1ea5y c\u1ea5p t\u00ednh<\/h3>\n<p>Bi\u1ec3u hi\u1ec7n ch\u1ee7 y\u1ebfu b\u1eb1ng s\u1ef1 gi\u1eadp v\u1ee1 c\u00e1c m\u1ea1ch m\u00e1u nh\u1ecf, c\u00e1c h\u1ed3ng c\u1ea7u tho\u00e1t ra ngo\u00e0i m\u1ea1ch m\u00e1u v\u00e0 h\u00ecnh th\u00e0nh m\u00e1u c\u1ee5c c\u00f3 fibrin \u1edf v\u00f9ng bong g\u00e2n. Trong v\u00f2ng 36 gi\u1edd c\u00e1c b\u1ea1ch c\u1ea7u \u0111\u01a1n nh\u00e2n \u0111a h\u00ecnh d\u1ea1ng (polymorphonuclear monocytes) v\u00e0 c\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o (macrophage) \u0111\u01b0\u1ee3c huy \u0111\u1ed9ng \u0111\u1ebfn v\u00f9ng b\u1ecb ch\u1ea5n th\u01b0\u01a1ng. C\u00e1c d\u01b0\u1ee1ng b\u00e0o (mast cells) v\u00e0 c\u00e1c t\u1ebf b\u00e0o kh\u00e1c ph\u00f3ng th\u00edch histamin serotonin v\u00e0 prostaglandin, do \u0111\u00f3, g\u00e2y ra s\u1ef1 duy tr\u00ec v\u00e0 tho\u00e1t r\u00f2 r\u1ec9 m\u00e1u ra ngo\u00e0i m\u1ea1ch. Bao kh\u1edbp ph\u1ea3n \u1ee9ng b\u1eb1ng hi\u1ec7n t\u01b0\u1ee3ng vi\u00eam bao kh\u1edbp v\u00f4 tr\u00f9ng sau ch\u1ea5n th\u01b0\u01a1ng, nh\u01b0 \u0111\u00e3 tr\u00ecnh b\u00e0y \u1edf tr\u00ean.<\/p>\n<h3>Giai \u0111o\u1ea1n ph\u1ee5c h\u1ed3i<\/h3>\n<p>Bi\u1ec3u hi\u1ec7n b\u1eb1ng hi\u1ec7n t\u01b0\u1ee3ng vi\u00eam t\u1ea5y ti\u00eau huy\u1ebft. C\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o s\u1ebd ti\u00eau h\u1ee7y c\u00e1c t\u1ebf b\u00e0o ch\u1ebft, h\u1ed3ng c\u1ea7u v\u00e0 m\u00e1u c\u1ee5c. \u0110\u1ed3ng th\u1eddi xu\u1ea5t hi\u1ec7n c\u00e1c ch\u1ed3i m\u1ea1ch m\u00e1u, t\u1eeb \u0111\u00f3 m\u00e0 h\u00ecnh th\u00e0nh c\u00e1c vi huy\u1ebft qu\u1ea3n m\u1edbi v\u00e0 c\u00f3 s\u1ef1 v\u1eadn chuy\u1ec3n nguy\u00ean b\u00e0o s\u1ee3i (fibroblast). C\u00e1c s\u1ee3i collagen \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh (ti\u1ebfn tri\u1ec3n theo \u0111\u1ecbnh lu\u1eadt Wolf gi\u1ed1ng nh\u01b0 s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/cham-lanh-xuong-va-khong-lanh-xuong\/\">li\u1ec1n x\u01b0\u01a1ng<\/a> g\u00e3y) d\u1ea7n d\u1ea7n ph\u00ec \u0111\u1ea1i l\u00ean (t\u0103ng th\u00eam \u0111\u01b0\u1eddng k\u00ednh) v\u00e0 t\u0103ng d\u1ea7n c\u1ea3 s\u1ee9c ch\u1ecbu \u0111\u1ef1ng k\u00e9o c\u0103ng t\u1ed1i thi\u1ec3u v\u00e0 c\u0169ng sau th\u1eddi gian \u0111\u00f3 c\u00e1c s\u1ee3i collagen m\u1edbi ch\u1ecbu \u0111\u01b0\u1ee3c s\u1ef1 k\u00e9o c\u0103ng m\u00e0 kh\u00f4ng b\u1ecb \u0111\u1ee9t l\u1ea1i. \u1ede th\u1eddi k\u1ef3 n\u00e0y c\u00e1c s\u1ee3i collagen ch\u01b0a ph\u00e1t tri\u1ec3n theo s\u1ef1 \u0111\u1ecbnh h\u01b0\u1edbng c\u1ee7a s\u1ee9c k\u00e9o c\u0103ng.<\/p>\n<h3>Giai \u0111o\u1ea1n t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng v\u00e0 c\u00e1c m\u00f4 kh\u00e1c<\/h3>\n<p>Qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n c\u00e1c s\u1ee3i collagen ti\u1ebfp t\u1ee5c t\u1eeb t\u1eeb k\u00e9o d\u00e0i \u0111\u1ebfn 12 \u2013 18 th\u00e1ng m\u1edbi ho\u00e0n th\u00e0nh. L\u00fac n\u00e0y c\u00e1c s\u1ee3i collagen m\u1edbi ph\u00e1t tri\u1ec3n theo \u0111\u00fang h\u01b0\u1edbng c\u1ee7a s\u1ef1 k\u00e9o c\u0103ng. S\u1ef1 ph\u00e1t tri\u1ec3n collagen \u0111\u1ecbnh h\u01b0\u1edbng ph\u1ee5 thu\u1ed9c v\u00e0o s\u1ef1 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang quy c\u00e1ch n\u00f3i tr\u00ean. N\u1ebfu \u0111i\u1ec1u tr\u1ecb sai quy c\u00e1ch, c\u00e1c s\u1ee3i collagen s\u1ebd ph\u00e1t tri\u1ec3n l\u1ed9n x\u1ed9n, kh\u00f4ng \u0111\u1ecbnh h\u01b0\u1edbng s\u1ebd g\u00e2y s\u1eb9o d\u00ednh. C\u00e1c nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y cho th\u1ea5y t\u1eadp v\u1eadn \u0111\u1ed9ng th\u1eadn tr\u1ecdng, c\u00f3 h\u01b0\u1edbng d\u1eabn v\u00e0 c\u00f3 ki\u1ec3m so\u00e1t c\u0169ng nh\u01b0 ho\u1ea1t \u0111\u1ed9ng c\u01a1 h\u1ecdc (k\u00e9o c\u0103ng) t\u1ed1i thi\u1ebfu c\u00e1c d\u00e2y ch\u1eb1ng \u0111\u00fang th\u1eddi \u0111i\u1ec3m, s\u1ebd k\u00edch<\/p>\n<p>th\u00edch t\u1ed1t s\u1ef1 t\u1ed5ng h\u1ee3p v\u00e0 t\u00e1i t\u1ea1o c\u00e1c s\u1ee3i collagen c\u0169ng nh\u01b0 t\u0103ng c\u01b0\u1eddng s\u1ee9c ch\u1ecbu k\u00e9o c\u0103ng c\u1ee7a d\u00e2y ch\u1eb1ng.<\/p>\n<h2>C\u00c1C Y\u1ebeU T\u1ed0 C\u1ed0 \u0110\u1ecaNH T\u0128NH V\u00c0 C\u00c1C Y\u1ebeU T\u1ed0 C\u1ed0 \u0110\u1ecaNH \u0110\u1ed8NG KH\u1edaP X\u01af\u01a0NG<\/h2>\n<p>Theo quan \u0111i\u1ec3m kinh \u0111i\u1ec3n th\u00ec d\u01b0\u1eddng nh\u01b0 ch\u1ec9 c\u00f3 c\u00e1c d\u00e2y ch\u1eb1ng l\u00e0m nhi\u1ec7m v\u1ee5 gi\u1eef v\u1eefng kh\u1edbp x\u01b0\u01a1ng.<\/p>\n<p>C\u00e1c ki\u1ebfn th\u1ee9c ng\u00e0y nay, nh\u1eadn \u0111\u1ecbnh c\u00f3 hai lo\u1ea1i y\u1ebfu t\u1ed1 gi\u1eef v\u1eefng kh\u1edbp:<\/p>\n<h3>C\u00e1c y\u1ebfu t\u1ed1 gi\u1eef v\u1eefng t\u0129nh (static stabilizers)<\/h3>\n<p>G\u1ed3m c\u00f3 c\u00e1c d\u00e2y ch\u1eb1ng c\u1ed5 \u0111i\u1ec3n. Ng\u00e0y nay th\u00eam c\u1ea3 bao kh\u1edbp v\u00e0 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 c\u00e1c d\u00e2y ch\u1eb1ng bao kh\u1edbp (capsular ligament).<\/p>\n<h3>C\u00e1c y\u1ebfu t\u1ed1 gi\u1eef v\u1eefng \u0111\u1ed9ng (dynamic stabilizers)<\/h3>\n<p>Bao g\u1ed3m c\u00e1c g\u00e2n, c\u01a1 bao quanh kh\u1edbp x\u01b0\u01a1ng.<\/p>\n<p>T\u1ea5t c\u1ea3 c\u00e1c y\u1ebfu t\u1ed1 n\u00e0y ho\u1ea1t \u0111\u1ed9ng \u0111\u1ed3ng b\u1ed9 \u0111\u1ec3 gi\u1eef v\u1eefng kh\u1edbp x\u01b0\u01a1ng v\u00e0 th\u01b0\u1eddng c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 c\u00f9ng c\u00f3 m\u1ed9t ch\u1ee9c n\u0103ng nh\u1ea5t \u0111\u1ecbnh gi\u1eef v\u1eefng kh\u1edbp. V\u00ed d\u1ee5: tr\u01b0\u1edbc kia kh\u00e1i ni\u1ec7m c\u1ed5 \u0111i\u1ec3n cho r\u1eb1ng ch\u1ec9 c\u00f3 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-day-chang-cheo\/\">d\u00e2y ch\u1eb1ng ch\u00e9o<\/a> tr\u01b0\u1edbc l\u00e0m nhi\u1ec7m v\u1ee5 c\u1ea3n gi\u1eef kh\u00f4ng cho m\u00e2m ch\u00e0y di chuy\u1ec3n ra tr\u01b0\u1edbc. Ng\u00e0y nay, c\u00e1c ki\u1ebfn th\u1ee9c cho th\u1ea5y nhi\u1ec1u y\u1ebfu t\u1ed1 tham gia l\u00e0m nhi\u1ec7m v\u1ee5 n\u00f3i tr\u00ean, bao g\u1ed3m:<\/p>\n<ul>\n<li>D\u00e2y ch\u1eb1ng <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-day-chang-cheo\/\">ch\u00e9o tr\u01b0\u1edbc<\/a><\/li>\n<li>B\u00f3 d\u00e2y ch\u1eb1ng bao kh\u1edbp tr\u01b0\u1edbc trong<\/li>\n<li>D\u1ea3i ch\u1eadu \u2013 ch\u00e0y<\/li>\n<li>C\u01a1 hai \u0111\u1ea7u \u0111\u00f9i<\/li>\n<li>S\u1eebng sau c\u1ee7a <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-day-chang-cheo\/\">s\u1ee5n ch\u00eam<\/a>.<\/li>\n<\/ul>\n<p>T\u1eeb \u0111\u00f3 quan ni\u1ec7m v\u1ec1 c\u00e1c t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng c\u0169ng c\u00f3 thay \u0111\u1ed5i kh\u00e1c quan ni\u1ec7m th\u00f4 s\u01a1 tr\u01b0\u1edbc kia. N\u1ebfu l\u00e0 bong g\u00e2n \u0111\u1ed9 3 hi\u1ebfm khi ch\u1ec9 l\u00e0 t\u1ed5n th\u01b0\u01a1ng \u0111\u01a1n thu\u1ea7n c\u1ee7a m\u1ed9t d\u00e2y ch\u1eb1ng kh\u00f4ng th\u00f4i. V\u00ec mu\u1ed1n l\u00e0m \u0111\u1ee9t ho\u00e0n to\u00e0n m\u1ed9t d\u00e2y ch\u1eb1ng n\u00e0o \u0111\u00f3 th\u00ec l\u00fac g\u00e2y v\u1eadn \u0111\u1ed9ng qu\u00e1 m\u1ee9c kh\u1edbp x\u01b0\u01a1ng c\u0169ng \u0111\u1ee7 \u0111\u1ec3 l\u00e0m c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c k\u1ebf c\u1eadn d\u00e2y ch\u1eb1ng \u0111\u00f3 b\u1ecb t\u1ed5n th\u01b0\u01a1ng \u1edf c\u00e1c m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau. Do \u0111\u00f3, c\u1ea7n ph\u1ea3i ch\u1ea9n \u0111o\u00e1n \u0111\u1ea7y \u0111\u1ee7 t\u1ea5t c\u1ea3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng m\u1edbi ph\u1ee5c h\u1ed3i t\u1ed1t \u0111\u01b0\u1ee3c.<\/p>\n<p>C\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u0103ng c\u01b0\u1eddng c\u00e1c y\u1ebfu t\u1ed1 gi\u1eef v\u1eefng kh\u00e1c \u0111\u1ec3 t\u0103ng hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng m\u1ed9t s\u1ed1 d\u00e2y ch\u1eb1ng nh\u1ea5t \u0111\u1ecbnh. V\u00ed d\u1ee5, \u0111\u1ed1i v\u1edbi \u0111\u1ee9t d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc, ngo\u00e0i vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ph\u1ee5c h\u1ed3i d\u00e2y ch\u1eb1ng \u0111\u00f3, ta c\u0169ng c\u00f3 th\u1ec3 t\u1eadp luy\u1ec7n t\u0103ng s\u1ee9c m\u1ea1nh c\u1ee7a c\u01a1 hai \u0111\u1ea7u \u0111\u00f9i v\u00e0 d\u1ea3i ch\u1eadu \u2013 ch\u00e0y (c\u0169ng l\u00e0 m\u1ed9t c\u01a1) \u0111\u1ec3 t\u0103ng th\u00eam hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n<h2>PH\u00c2N LO\u1ea0I<\/h2>\n<p>C\u00e1c t\u1ed5n th\u01b0\u01a1ng ch\u00ednh c\u1ee7a d\u00e2y ch\u1eb1ng v\u00e0 bao kh\u1edbp \u0111\u01b0\u1ee3c ph\u00e2n chia th\u00e0nh ba m\u1ee9c \u0111\u1ed9:<\/p>\n<ul>\n<li><em>Bong g\u00e2n \u0111\u1ed9 1: <\/em>l\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng ch\u1ec9 r\u00e1ch m\u1ed9t s\u1ed1 t\u1ed1i thi\u1ec3u c\u00e1c th\u1edb s\u1ee3i c\u1ee7a d\u00e2y ch\u1eb1ng, n\u00ean c\u00f3 khi \u0111\u01b0\u1ee3c coi l\u00e0 d\u00e2y ch\u1eb1ng ch\u1ec9 b\u1ecb d\u00e3n d\u00e0i ra th\u00f4i. T\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu coi nh\u01b0 kh\u00f4ng \u0111\u00e1ng k\u1ec3.<\/li>\n<li><em>Bong g\u00e2n \u0111\u1ed9 2: <\/em>c\u00f3 r\u00e1ch nhi\u1ec1u th\u1edb s\u1ee3i c\u1ee7a d\u00e2y ch\u1eb1ng h\u01a1n, n\u00ean c\u00f3 khi \u0111\u01b0\u1ee3c coi l\u00e0 r\u00e1ch d\u00e2y ch\u1eb1ng.<\/li>\n<li><em>Bong g\u00e2n \u0111\u1ed9 3: <\/em>d\u00e2y ch\u1eb1ng b\u1ecb \u0111\u1ee9t ho\u00e0n to\u00e0n m\u1ea5t s\u1ef1 li\u00ean t\u1ee5c v\u00e0 g\u00e2y t\u00ecnh tr\u1ea1ng ch\u00eanh v\u00eanh kh\u1edbp. C\u00f3 th\u1ec3 ch\u1ec9 \u0111\u1ee9t d\u00e2y ch\u1eb1ng thu\u1ea7n t\u00fay (th\u01b0\u1eddng c\u00f3 k\u00e8m theo r\u00e1ch ph\u1ea7n bao kh\u1edbp k\u1ebf c\u1eadn) ho\u1eb7c c\u00f3 khi l\u00e0m b\u1eadt m\u1ea3nh x\u01b0\u01a1ng \u1edf n\u01a1i b\u00e1m c\u1ee7a d\u00e2y ch\u1eb1ng \u1edf \u0111\u1ea7u tr\u00ean ho\u1eb7c d\u01b0\u1edbi. M\u1ee9c \u0111\u1ed9 n\u1eb7ng nh\u1ea5t c\u1ee7a bong g\u00e2n \u0111\u1ed9 3 s\u1ebd d\u1eabn \u0111\u1ebfn tr\u1eadt kh\u1edbp x\u01b0\u01a1ng. \u0110\u00f3 l\u00e0 t\u1ed5n th\u01b0\u01a1ng c\u1ee7a nhi\u1ec1u d\u00e2y ch\u1eb1ng v\u00e0 t\u1ed5n th\u01b0\u01a1ng r\u1ed9ng l\u1edbn \u1edf m\u1ed9t kh\u1edbp.<\/li>\n<\/ul>\n<p>\u0110\u1ed1i v\u1edbi bong g\u00e2n \u0111\u1ed9 1 v\u00e0 \u0111\u1ed9 2 c\u00e1c d\u00e2y ch\u1eb1ng v\u1eabn c\u00f2n gi\u1eef s\u1ef1 li\u00ean t\u1ee5c v\u00e0 ch\u01b0a g\u00e2y t\u00ecnh tr\u1ea1ng ch\u00eanh v\u00eanh kh\u1edbp.<\/p>\n<p><img decoding=\"async\" width=\"699\" height=\"222\" class=\"wp-image-1066 aligncenter\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1062-2.png\" alt=\"\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1062-2.png 699w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1062-2-300x95.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/04\/word-image-1062-2-18x6.png 18w\" sizes=\"(max-width: 699px) 100vw, 699px\" \/><\/p>\n<p style=\"text-align: center;\"><strong>H\u00ecnh 9.2. <\/strong>C\u00e1c m\u1ee9c \u0111\u1ed9 bong g\u00e2n [2]<\/p>\n<h2>C\u00c1C R\u1ed0I LO\u1ea0N K\u00c8M THEO<\/h2>\n<p>R\u1ed1i lo\u1ea1n th\u01b0\u1eddng g\u1eb7p l\u00e0 ch\u1ee9ng vi\u00eam bao kh\u1edbp v\u00f4 tr\u00f9ng sau ch\u1ea5n th\u01b0\u01a1ng, ki\u1ec3u vi\u00eam t\u1ea5y ph\u1ea3n \u1ee9ng c\u1ee7a bao ho\u1ea1t d\u1ecbch. Vi\u00eam t\u1ea5y bao kh\u1edbp sau ch\u1ea5n th\u01b0\u01a1ng c\u00f3 k\u00e8m theo tr\u00e0n d\u1ecbch \u1ed5 kh\u1edbp, bi\u1ec3u hi\u1ec7n l\u00e0m hai th\u1ec3:<\/p>\n<h3>Tr\u00e0n d\u1ecbch th\u1ec3 thanh d\u1ecbch<\/h3>\n<p>N\u01b0\u1edbc \u1ed5 kh\u1edbp c\u00f3 m\u00e0u v\u00e0ng chanh, trong v\u1eaft. D\u1ecbch kh\u1edbp c\u00f3 h\u00e0m l\u01b0\u1ee3ng albumin th\u1ea5p (3 \u2013 1%), g\u1ed3m ch\u1ee7 y\u1ebfu l\u00e0 d\u1ecbch th\u1ea5m (transudat). Soi k\u00ednh ph\u1ebft d\u1ecbch th\u1ea5y c\u00f3 m\u1ed9t \u00edt b\u1ea1ch c\u1ea7u.<\/p>\n<h3>Tr\u00e0n m\u00e1u \u1ed5 kh\u1edbp<\/h3>\n<p>N\u1ebfu bong g\u00e2n c\u00f3 k\u00e8m theo \u0111\u1ee9t m\u1ea1ch m\u00e1u. N\u01b0\u1edbc m\u00e1u tr\u1ed9n l\u1eabn v\u1edbi thanh d\u1ecbch. N\u1ebfu ch\u1ea3y m\u00e1u nhi\u1ec1u th\u00ec ch\u1ecdc d\u00f2 \u1ed5 kh\u1edbp ch\u1ec9 th\u1ea5y ho\u00e0n to\u00e0n m\u00e1u th\u00f4i. Ch\u1ec9 v\u00e0i gi\u1edd sau s\u1ebd xu\u1ea5t hi\u1ec7n vi\u00eam t\u1ea5y ti\u00eau m\u00e1u hay vi\u00eam t\u1ea5y ph\u1ee5c h\u1ed3i v\u1edbi \u0111\u1ee7 c\u00e1c d\u1ea5u hi\u1ec7u \u0111au nh\u1ee9c t\u1ef1 nhi\u00ean, s\u01b0ng n\u1ec1, n\u00f3ng \u0111\u1ecf \u1ed5 kh\u1edbp. Do \u0111au m\u00e0 kh\u1edbp co l\u1ea1i ph\u1ea3n \u1ee9ng \u1edf t\u01b0 th\u1ebf bi\u1ebfn d\u1ea1ng ch\u1ed1ng \u0111au. N\u1ebfu \u0111i\u1ec1u tr\u1ecb kh\u00f4ng \u0111\u00fang quy c\u00e1ch \u1edf bong g\u00e2n \u0111\u1ed9 2 ho\u1eb7c \u0111\u1ed9 3, vi\u00eam bao kh\u1edbp sau ch\u1ea5n th\u01b0\u01a1ng s\u1ebd tr\u1edf th\u00e0nh m\u1ea1n t\u00ednh, t\u1ed3n t\u1ea1i k\u00e9o d\u00e0i. Tuy d\u00e2y ch\u1eb1ng l\u00e0 m\u1ed9t c\u1ea5u tr\u00fac m\u1ec1m m\u1ea1i, nh\u01b0ng ph\u1ea3i r\u1ea5t ch\u1eafc kh\u1ecfe c\u00f3 chi\u1ec1u d\u00e0i h\u1ee3p l\u00fd \u0111\u1ec3 l\u00e0m nhi\u1ec7m v\u1ee5 h\u1ea1n ch\u1ebf c\u00e1c v\u1eadn \u0111\u1ed9ng kh\u1edbp kh\u00f4ng c\u1ea7n thi\u1ebft ho\u1eb7c v\u1eadn \u0111\u1ed9ng c\u00f3 h\u1ea1i. C\u00e1c d\u00e2y ch\u1eb1ng b\u1ecb r\u00e1ch (\u0111\u1ed9 2) ho\u1eb7c b\u1ecb \u0111\u1ee9t ho\u00e0n to\u00e0n (\u0111\u1ed9 3) c\u1ea7n ph\u1ea3i ph\u1ee5c h\u1ed3i c\u1ea3 chi\u1ec1u d\u00e0i nguy\u00ean th\u1ee7y (kh\u00f4ng \u0111\u01b0\u1ee3c d\u00e0i h\u01a1n) l\u1eabn c\u1ea3 \u0111\u1ed9 b\u1ec1n ch\u1eafc, ch\u1ecbu \u0111\u01b0\u1ee3c s\u1ee9c k\u00e9o c\u0103ng. N\u1ebfu kh\u00f4ng \u0111\u1ea1t y\u00eau c\u1ea7u ph\u1ee5c h\u1ed3i n\u00f3i tr\u00ean, khi v\u1eadn \u0111\u1ed9ng kh\u1edbp s\u1ebd ch\u00eanh v\u00eanh, g\u00e2y \u0111au nh\u1ee9c, k\u00e9o d\u00e0i vi\u00eam bao kh\u1edbp. \u0110\u00f3 l\u00e0 vi\u00eam bao kh\u1edbp v\u00f4 tr\u00f9ng m\u1ea1n t\u00ednh, kh\u1edbp s\u1ebd b\u1ecb gi\u1ea3m c\u01a1 n\u0103ng, kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng \u0111\u01b0\u1ee3c v\u00ec \u0111au v\u00e0 ch\u1eefa tr\u1ecb r\u1ea5t kh\u00f3 kh\u0103n.<\/p>\n<h2>CH\u1ea8N \u0110O\u00c1N<\/h2>\n<p>Ch\u1ea9n \u0111o\u00e1n d\u1ef1a v\u00e0o:<\/p>\n<ul>\n<li>H\u1ecfi <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">b\u1ec7nh s\u1eed<\/a><\/li>\n<li>C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng<\/li>\n<li>\u0110\u00f4i khi c\u00f3 h\u00ecnh \u1ea3nh <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/x-quang-trong-chan-thuong-chinh-hinh\/\">X-quang<\/a>, song kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o X-quang c\u0169ng gi\u00fap cho ch\u1ea9n \u0111o\u00e1n bong g\u00e2n.<\/li>\n<\/ul>\n<h3>B\u1ec7nh s\u1eed<\/h3>\n<p>Th\u01b0\u1eddng l\u00e0 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng \u0111i\u1ec3n h\u00ecnh g\u00e2y v\u1eb7n xo\u1eafn hay g\u1eadp g\u00f3c ho\u1eb7c c\u1ea3 hai.<\/p>\n<ul>\n<li>\u0110au ch\u00f3i \u201cnh\u01b0 \u0111i\u1ec7n gi\u1eadt\u201d khi b\u1ecb ch\u1ea5n th\u01b0\u01a1ng<\/li>\n<li>T\u00ea b\u00ec (h\u1ebft \u0111au) \u0111\u1ed9 m\u1ed9t v\u00e0i gi\u1edd<\/li>\n<li>\u0110au nh\u1ee9c tr\u1edf l\u1ea1i c\u00e0ng t\u0103ng, m\u1eb7c d\u00f9 kh\u1edbp \u0111\u00e3 \u0111\u01b0\u1ee3c <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/so-cuu-bat-dong-gay-xuong\/\">b\u1ea5t \u0111\u1ed9ng<\/a>. Nghe ti\u1ebfng \u201cr\u1eafc\u201d khi tai n\u1ea1n l\u00e0 \u0111\u1ee9t ho\u00e0n to\u00e0n d\u00e2y ch\u1eb1ng.<\/li>\n<\/ul>\n<h3>C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng<\/h3>\n<p>Ph\u00f9 n\u1ec1 khu tr\u00fa, ph\u00f9 n\u1ebfu c\u00f3 s\u1edbm l\u00e0 bong g\u00e2n n\u1eb7ng. \u0110\u00f4i khi c\u00f3 k\u00e8m theo b\u1ea7m t\u00edm do m\u00e1u t\u1ee5 khu tr\u00fa \u1edf n\u01a1i d\u00e2y ch\u1eb1ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng, n\u1ebfu c\u00f3 th\u00ec d\u1ec5 cho ch\u1ea9n \u0111o\u00e1n. \u0110\u00f4i khi ch\u1ec9 l\u00e0 tr\u00e0n d\u1ecbch chung to\u00e0n kh\u1edbp.<\/p>\n<ul>\n<li>\u0110au: \u0111au t\u1ef1 nhi\u00ean c\u00f3 t\u00ednh ch\u1ea5t nh\u01b0 m\u00f4 t\u1ea3 \u1edf tr\u00ean. \u0110au kh\u00f3 ch\u1ecbu khi \u1ea5n v\u00e0o v\u00f9ng d\u00e2y ch\u1eb1ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng ho\u1eb7c \u0111au d\u1ecdc to\u00e0n b\u1ed9 d\u00e2y ch\u1eb1ng ho\u1eb7c ch\u1ec9 \u0111au ch\u00f3i khi \u1ea5n \u1edf n\u01a1i d\u00e2y ch\u1eb1ng b\u00e1m v\u00e0o x\u01b0\u01a1ng. \u0110au t\u0103ng l\u00ean khi ta l\u00e0m to\u00e1c khe kh\u1edbp b\u00ean ph\u00eda d\u00e2y ch\u1eb1ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<li>V\u1eadn \u0111\u1ed9ng to\u00e1c khe kh\u1edbp nhi\u1ec1u h\u01a1n so v\u1edbi b\u00ean l\u00e0nh s\u1ebd r\u00f5 r\u1ec7t n\u1ebfu l\u00e0 bong g\u00e2n \u0111\u1ed9 2, nh\u1ea5t l\u00e0 bong g\u00e2n \u0111\u1ed9 3. V\u00ed d\u1ee5: tr\u01b0\u1eddng h\u1ee3p c\u00f3 \u0111\u1ee9t <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-day-chang-ben\/\">d\u00e2y ch\u1eb1ng b\u00ean<\/a> ch\u00e0y (b\u00ean trong) <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">kh\u1edbp g\u1ed1i<\/a> n\u1ebfu ta l\u00e0m v\u1eadn \u0111\u1ed9ng d\u1ea1ng c\u1eb3ng ch\u00e2n (l\u00e0m to\u00e1c khe kh\u1edbp trong) ta th\u1ea5y bi\u1ebfn \u0111\u1ed9 l\u1edbn h\u01a1n so v\u1edbi b\u00ean l\u00e0nh l\u1eb7n.<\/li>\n<li>C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng c\u1ee7a vi\u00eam bao kh\u1edbp ch\u1ea5n th\u01b0\u01a1ng th\u1ea5y kh\u00e1 r\u00f5\n<ul>\n<li>Kh\u1edbp s\u01b0ng n\u1ec1<\/li>\n<li>S\u1edd bao kh\u1edbp th\u1ea5y d\u00e0y h\u01a1n b\u00ecnh th\u01b0\u1eddng, \u0111\u1ea7y d\u1ecbch l\u00e0m m\u1ea5t c\u00e1c h\u00f5m quanh kh\u1edbp, \u1ea5n \u0111au, h\u01a1i n\u00f3ng<\/li>\n<li>Ch\u1ecdc h\u00fat d\u1ecbch s\u1ebd x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c lo\u1ea1i tr\u00e0n d\u1ecbch.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>X-quang<\/h3>\n<p>Kh\u00f4ng ph\u1ea3i m\u1ecdi tr\u01b0\u1eddng h\u1ee3p bong g\u00e2n \u0111\u1ec1u c\u00f3 h\u00ecnh \u1ea3nh X-quang \u0111i\u1ec3n h\u00ecnh. X-quang ch\u1ec9 gi\u00fap cho ch\u1ea9n \u0111o\u00e1n \u1edf c\u00e1c tr\u01b0\u1eddng h\u1ee3p bong g\u00e2n sau \u0111\u00e2y:<\/p>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng \u1edf n\u01a1i b\u00e1m v\u00e0o x\u01b0\u01a1ng: X-quang cho th\u1ea5y h\u00ecnh m\u1ebb x\u01b0\u01a1ng ch\u1ee5p theo ki\u1ec3u th\u01b0\u1eddng quy.<\/li>\n<li>Bong g\u00e2n \u0111\u1ed9 3: ph\u1ea3i ch\u1ee5p \u1edf t\u01b0 th\u1ebf to\u00e1c khe kh\u1edbp b\u1eaft bu\u1ed9c (X-quang \u0111\u1ed9ng). G\u00e2y t\u00ea \u1ed5 kh\u1edbp cho h\u1ebft \u0111au, \u0111\u1ec3 \u1edf t\u01b0 th\u1ebf to\u00e1c khe kh\u1edbp b\u00ean ph\u00eda c\u00f3 \u0111\u1ee9t d\u00e2y ch\u1eb1ng khi ch\u1ee5p X-quang. Ch\u1ee5p b\u00ean kh\u1edbp \u0111\u1ed1i di\u1ec7n c\u0169ng v\u1edbi c\u00e1ch th\u1ee9c n\u00f3i tr\u00ean. M\u1ee9c \u0111\u1ed9 khe kh\u1edbp to\u00e1c r\u1ed9ng h\u01a1n so v\u1edbi b\u00ean l\u00e0nh s\u1ebd cho ph\u00e9p x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ch\u00eanh v\u00eanh c\u1ee7a kh\u1edbp.<\/li>\n<\/ul>\n<h3>C\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI)<\/h3>\n<p>X\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u1ee5 th\u1ec3 t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng bao kh\u1edbp. Ch\u1ea9n \u0111o\u00e1n ph\u1ea3i x\u00e1c \u0111\u1ecbnh r\u00f5:<\/p>\n<ul>\n<li>C\u00f3 bong g\u00e2n c\u1ee7a d\u00e2y ch\u1eb1ng n\u00e0o (hay c\u1ee7a c\u00e1c d\u00e2y ch\u1eb1ng n\u00e0o)<\/li>\n<li>M\u1ee9c \u0111\u1ed9 c\u1ee7a bong g\u00e2n<\/li>\n<li>C\u00e1c t\u1ed5n th\u01b0\u01a1ng k\u00e8m theo (<a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-kin\/\">g\u00e3y x\u01b0\u01a1ng<\/a>, tr\u00e0n kh\u1edbp,&#8230;) th\u00ec m\u1edbi x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u00e1ch \u0111i\u1ec1u tr\u1ecb \u0111\u00fang \u0111\u1eafn \u0111u\u1ee3c.<\/li>\n<\/ul>\n<h2>\u0110I\u1ec0U TR\u1eca<\/h2>\n<p>\u0110i\u1ec1u tr\u1ecb nh\u1eb1m hai m\u1ee5c \u0111\u00edch:<\/p>\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb vi\u00eam t\u1ea5y c\u1ea5p t\u00ednh sau ch\u1ea5n th\u01b0\u01a1ng<\/li>\n<li>Ph\u1ee5c h\u1ed3i v\u00e0 t\u00e1i t\u1ea1o c\u00e1c d\u00e2y ch\u1eb1ng (v\u00e0 c\u00e1c c\u01a1) b\u1ecb th\u01b0\u01a1ng. Nh\u01b0 v\u1eady, \u0111\u1ed1i v\u1edbi bong g\u00e2n \u0111\u1ed9 1 ch\u1ec9 ph\u1ea3i \u0111i\u1ec1u tr\u1ecb vi\u00eam c\u1ea5p t\u00ednh sau ch\u1ea5n th\u01b0\u01a1ng l\u00e0 \u0111\u1ee7, v\u00ec t\u1ed5n th\u01b0\u01a1ng gi\u1ea3i ph\u1eabu d\u00e2y ch\u1eb1ng coi nh\u01b0 kh\u00f4ng \u0111\u00e1ng k\u1ec3. Ng\u01b0\u1ee3c l\u1ea1i, \u0111\u1ed1i v\u1edbi bong g\u00e2n \u0111\u1ed9 2 ho\u1eb7c \u0111\u1ed9 3 ph\u1ea3i th\u1ef1c hi\u1ec7n \u0111\u1ea7y \u0111\u1ee7 c\u1ea3 hai y\u00eau c\u1ea7u. N\u1ebfu \u0111i\u1ec1u tr\u1ecb ph\u1ee5c h\u1ed3i v\u00e0 t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng kh\u00f4ng t\u1ed1t th\u00ec vi\u00eam t\u1ea5y bao kh\u1edbp s\u1ebd th\u00e0nh m\u1ea1n t\u00ednh v\u00e0 t\u1ed3n t\u1ea1i v\u0129nh vi\u1ec5n.<\/li>\n<\/ul>\n<h3>\u0110i\u1ec1u tr\u1ecb vi\u00eam bao kh\u1edbp c\u1ea5p t\u00ednh<\/h3>\n<ul>\n<li>M\u1ee5c \u0111\u00edch l\u00e0 h\u1ea1n ch\u1ebf ch\u1ea3y m\u00e1u \u1edf m\u1ee9c \u0111\u1ed9 th\u1ea5p nh\u1ea5t, nh\u1edd v\u1eady m\u00e0 h\u1ea1n ch\u1ebf \u0111\u01b0\u1ee3c s\u1ef1 h\u00ecnh th\u00e0nh ph\u00f9 n\u1ec1 do tho\u00e1t m\u00e1u ra ngo\u00e0i m\u1ea1ch v\u00e0 ch\u1ed1ng \u0111au nh\u1ee9c. C\u1ee5 th\u1ec3 l\u00e0:<\/li>\n<li>C\u00e1c \u0111i\u1ec1u n\u00ean l\u00e0m:\n<ul>\n<li>+ \u0110\u1ec3 v\u00f9ng chi c\u00f3 bong g\u00e2n n\u1eb1m y\u00ean<\/li>\n<li>+ Ch\u01b0\u1eddm \u0111\u00e1 l\u1ea1nh (n\u1ebfu kh\u00f4ng c\u00f3 th\u00ec ch\u01b0\u1eddm n\u01b0\u1edbc l\u1ea1nh) gi\u00e1n c\u00e1ch nhau 20 \u2013 30 ph\u00fat, trong 4 gi\u1edd li\u1ec1n sau ch\u1ea5n th\u01b0\u01a1ng<\/li>\n<li>+ B\u0103ng \u00e9p li\u00ean t\u1ee5c \u00edt nh\u1ea5t 48 gi\u1edd<\/li>\n<li>+ K\u00ea cao chi b\u1ecb th\u01b0\u01a1ng \u0111\u1ec3 k\u00edch th\u00edch l\u01b0u th\u00f4ng t\u0129nh m\u1ea1ch thu\u1eadn l\u1ee3i v\u00e0 l\u00e0m ti\u00eau h\u00fat nhanh ch\u00f3ng m\u00e1u t\u1ee5.<\/li>\n<li>+ D\u00f9ng c\u00e1c thu\u1ed1c ch\u1ed1ng vi\u00eam nh\u01b0 c\u00e1c lo\u1ea1i thu\u1ed1c phong b\u1ebf, ch\u1ed1ng ti\u1ebft prostaglandin (nh\u01b0 Indomethacine, ibuprofen,\u2026) ngay sau khi b\u1ecb ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c ch\u1eadm nh\u1ea5t trong v\u00f2ng 24 gi\u1edd \u0111\u1ec3 h\u1ea1n ch\u1ebf h\u00ecnh th\u00e0nh ph\u00f9 n\u1ec1<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>C\u00e1c bi\u1ec7n ph\u00e1p n\u00f3i tr\u00ean, nh\u1ea5t l\u00e0 ch\u01b0\u1eddm \u0111\u00e1 l\u1ea1nh, s\u1ebd l\u00e0m h\u1ebft \u0111au nhanh ch\u00f3ng.<\/p>\n<ul>\n<li>C\u00e1c \u0111i\u1ec1u c\u1ea7n tr\u00e1nh kh\u00f4ng \u0111\u01b0\u1ee3c l\u00e0m:\n<ul>\n<li>+ Kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u1eafp n\u00f3ng (b\u1ea5t k\u1ef3 b\u1eb1ng c\u00e1ch n\u00e0o), \u00edt nh\u1ea5t trong v\u00f2ng 42 \u2013 78 gi\u1edd \u0111\u1ea7u sau ch\u1ea5n th\u01b0\u01a1ng. V\u00ec n\u00f3ng c\u0169ng l\u00e0m d\u1ecbu \u0111au, n\u00ean nhi\u1ec1u ng\u01b0\u1eddi th\u01b0\u1eddng m\u1eafc sai l\u1ea7m. N\u00f3ng s\u1ebd l\u00e0m d\u00e3n m\u1ea1ch v\u00e0 c\u0169ng l\u00e0m t\u0103ng s\u1ef1 tho\u00e1t m\u00e1u ra ngo\u00e0i m\u1ea1ch v\u00e0 l\u00e0m t\u0103ng ph\u00f9 n\u1ec1<\/li>\n<li>+ Kh\u00f4ng \u0111\u01b0\u1ee3c cho b\u1ec7nh nh\u00e2n u\u1ed1ng r\u01b0\u1ee3u, c\u0169ng l\u00e0 th\u1ee9 l\u00e0m d\u00e3n m\u1ea1ch<\/li>\n<li>+ Kh\u00f4ng \u0111\u01b0\u1ee3c ti\u00eam c\u00e1c thu\u1ed1c t\u00ea, lo\u1ea1i steroid, hyaluronidase ho\u1eb7c h\u1ed7n h\u1ee3p c\u00e1c ch\u1ea5t \u0111\u00f3 v\u00e0o v\u00f9ng bong g\u00e2n v\u00ec c\u00e1c thu\u1ed1c n\u00f3i tr\u00ean, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c steroid, c\u00f3 th\u1ec3 l\u00e0m ch\u1eadm s\u1ef1 ph\u1ee5c h\u1ed3i collagen (theo nghi\u00ean c\u1ee9u c\u1ee7a Oakes). N\u1ebfu ti\u1ebfn h\u00e0nh k\u00e9m v\u00f4 tr\u00f9ng l\u1ea1i d\u1ec5 g\u00e2y nhi\u1ec5m tr\u00f9ng<\/li>\n<li>+ Kh\u00f4ng \u0111\u01b0\u1ee3c xoa b\u00f3p, t\u1eadp v\u1eadn \u0111\u1ed9ng v\u00f9ng b\u1ecb bong g\u00e2n \u1edf giai \u0111o\u1ea1n vi\u00eam t\u1ea5y c\u1ea5p t\u00ednh. L\u00e0m nh\u01b0 v\u1eady ch\u1ec9 g\u00e2y th\u00eam t\u1ed5n th\u01b0\u01a1ng, l\u00e0m ch\u1ea3y m\u00e1u v\u00e0 ph\u00f9 n\u1ec1 th\u00eam.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>\u0110i\u1ec1u tr\u1ecb ph\u1ee5c h\u1ed3i v\u00e0 t\u00e1i t\u1ea1o c\u00e1c d\u00e2y ch\u1eb1ng<\/h3>\n<p>C\u00e1ch t\u1ed1t nh\u1ea5t \u0111\u1ec3 c\u00e1c d\u00e2y ch\u1eb1ng b\u1ecb r\u00e1ch ho\u1eb7c \u0111\u1ee9t ph\u1ee5c h\u1ed3i l\u00e0 k\u00e9o cho c\u00e1c \u0111o\u1ea1n \u0111\u1ee9t \u00e1p s\u00e1t l\u1ea1i nhau \u0111\u1ec3 ph\u1ee5c h\u1ed3i \u0111\u01b0\u1ee3c \u0111\u00fang chi\u1ec1u d\u00e0i nguy\u00ean th\u1ee7y v\u00e0 b\u1ea5t \u0111\u1ed9ng b\u1ea3o v\u1ec7 ch\u1eebng n\u00e0o d\u00e2y ch\u1eb1ng c\u00f2n ch\u01b0a li\u1ec1n v\u1eefng. Nh\u01b0 v\u1eady, \u0111\u1ed1i v\u1edbi bong g\u00e2n \u0111\u1ed9 2 ch\u1ec9 c\u1ea7n \u0111\u01a1n thu\u1ea7n b\u1ea5t \u0111\u1ed9ng b\u1ea3o v\u1ec7 \u0111\u1ee7 th\u1eddi gian (4 \u2013 6 tu\u1ea7n l\u1ec5). \u0110\u1ed1i v\u1edbi bong g\u00e2n \u0111\u1ed9 3 t\u1ed1t nh\u1ea5t l\u00e0 ph\u1eabu thu\u1eadt s\u1edbm kh\u00e2u l\u1ea1i d\u00e2y ch\u1eb1ng v\u00e0 b\u1ea5t \u0111\u1ed9ng \u0111\u1ee7 th\u1eddi gian. Ch\u1ec9 \u0111\u01b0\u1ee3c cho t\u1eadp v\u1eadn \u0111\u1ed9ng s\u1edbm (sau 2 \u2013 4 tu\u1ea7n l\u1ec5 sau m\u1ed5) n\u1ebfu \u0111\u01b0\u1ee3c k\u1ef9 thu\u1eadt vi\u00ean v\u1eadt l\u00fd c\u00f3 tr\u00ecnh \u0111\u1ed9 v\u00e0 kinh nghi\u1ec7m h\u01b0\u1edbng d\u1eabn v\u00e0 ki\u1ec3m so\u00e1t, l\u00e0m c\u00e1c v\u1eadn \u0111\u1ed9ng t\u1ed1i thi\u1ec3u v\u00e0 th\u1eadn tr\u1ecdng. N\u1ebfu l\u00e0m \u0111\u01b0\u1ee3c nh\u01b0 v\u1eady s\u1ef1 t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng c\u00e0ng t\u1ed1t h\u01a1n.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"featured_media":1067,"comment_status":"open","ping_status":"closed","template":"","tags":[86,79],"chuyen-muc":[35],"class_list":["post-1062","bai-giang","type-bai-giang","status-publish","has-post-thumbnail","hentry","tag-bong-gan","tag-day-chang","chuyen-muc-nhap-mon-chan-thuong-chinh-hinh"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/1062","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang"}],"about":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/types\/bai-giang"}],"replies":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/comments?post=1062"}],"version-history":[{"count":0,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/1062\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/1067"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=1062"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=1062"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=1062"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}