{"id":1944,"date":"2023-06-27T12:40:28","date_gmt":"2023-06-27T05:40:28","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&#038;p=1944"},"modified":"2023-07-31T17:52:06","modified_gmt":"2023-07-31T10:52:06","slug":"benh-ly-viem-bao-gan","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-ly-viem-bao-gan\/","title":{"rendered":"Tendonitis disease"},"content":{"rendered":"<h2><strong>1. GENERAL OBJECTIVES<\/strong><\/h2>\n<p>G\u00e2n l\u00e0 m\u1ed9t lo\u1ea1i m\u00f4 li\u00ean k\u1ebft, n\u1ed1i c\u01a1 b\u1eafp v\u1edbi x\u01b0\u01a1ng. Ch\u00fang gi\u00fap ki\u1ec3m so\u00e1t c\u00e1c h\u00e0nh \u0111\u1ed9ng nh\u01b0 ch\u1ea1y, nh\u1ea3y, c\u1ea7m n\u1eafm v\u00e0 n\u00e2ng \u0111\u1ee1. B\u00ean ngo\u00e0i g\u00e2n c\u00f3 m\u1ed9t l\u1edbp b\u1ea3o v\u1ec7 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 bao ho\u1ea1t d\u1ecbch g\u00e2n. Vai tr\u00f2 c\u1ee7a l\u1edbp bao l\u00e0 ti\u1ebft ra ho\u1ea1t d\u1ecbch \u0111\u1ec3 gi\u1eef cho g\u00e2n ho\u1ea1t \u0111\u1ed9ng tr\u01a1n tru. C\u00e1c t\u1ed5n th\u01b0\u01a1ng \u1edf g\u00e2n c\u00f3 th\u1ec3 khi\u1ebfn cho l\u1edbp bao ho\u1ea1t d\u1ecbch g\u00e2n g\u1eb7p v\u1ea5n \u0111\u1ec1. Khi \u0111\u00f3, ho\u1ea1t d\u1ecbch kh\u00f4ng \u0111\u01b0\u1ee3c t\u1ea1o ra ho\u1eb7c t\u1ea1o ra kh\u00f4ng \u0111\u1ee7 l\u01b0\u1ee3ng c\u1ea7n thi\u1ebft, g\u00e2y ra vi\u00eam v\u00e0 s\u01b0ng m\u00e0ng bao n\u00e0y. T\u00ecnh tr\u1ea1ng \u0111\u00f3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 vi\u00eam bao g\u00e2n. T\u00f9y theo v\u1ecb tr\u00ed b\u1ecb vi\u00eam m\u00e0 t\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi t\u00ean t\u01b0\u01a1ng \u1ee9ng, nh\u01b0 vi\u00eam bao g\u00e2n c\u1ed5 tay, vi\u00eam bao g\u00e2n <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ban-ngon-tay-gay-xuong-ban-tay\/\">ng\u00f3n tay<\/a>,\u2026<\/p>\n<p>C\u00f3 hai lo\u1ea1i vi\u00eam bao g\u00e2n ch\u00ednh l\u00e0: vi\u00eam bao g\u00e2n du\u1ed7i d\u1ea1ng (h\u1ed9i ch\u1ee9ng De Quervain), vi\u00eam bao g\u00e2n g\u1ea5p ng\u00f3n tay c\u00f2n g\u1ecdi l\u00e0 ng\u00f3n tay l\u00f2 xo.<\/p>\n<h2><strong>2. NGUY\u00caN NH\u00c2N<\/strong><\/h2>\n<ul>\n<li>T\u1ef1 mi\u1ec5n: vi\u00eam kh\u1edbp d\u1ea1ng n\u1ebfn, vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p<\/li>\n<li>R\u1ed1i lo\u1ea1n h\u1ec7 th\u1ed1ng: <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-ly-ban-chan-dai-thao-duong\/\">\u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/a>, <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/u-hat-tophi-o-benh-nhan-gout\/\">gout<\/a>, b\u1ec7nh l\u1eafng \u0111\u1ecdng calcium pyrophosphate, b\u1ec7nh l\u00fd tuy\u1ebfn gi\u00e1p,\u2026<\/li>\n<li>Tho\u00e1i h\u00f3a m\u1ea1n t\u00ednh<\/li>\n<li>Infection<\/li>\n<li>Nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 do v\u1eadn \u0111\u1ed9ng qu\u00e1 m\u1ee9c, b\u1ec7nh ngh\u1ec1 nghi\u1ec7p.<\/li>\n<\/ul>\n<h2><strong>3. GI\u1ea2I PH\u1eaaU V\u00c0 SINH L\u00dd B\u1ec6NH<\/strong><\/h2>\n<ul>\n<li>H\u1ea7u h\u1ebft g\u00e2n \u0111\u01b0\u1ee3c bao m\u1ed9t ph\u1ea7n b\u1edfi bao g\u00e2n, m\u1ed9t s\u1ed1 g\u00e2n kh\u00f4ng c\u00f3 bao g\u00e2n nh\u01b0 g\u00e2n g\u00f3t<\/li>\n<li>G\u00e2n ch\u1ea1y trong m\u1ed9t \u0111\u01b0\u1eddng h\u1ea7m x\u01a1 x\u01b0\u01a1ng n\u1eb1m tr\u00ean v\u1ecf x\u01b0\u01a1ng \u0111\u01b0\u1ee3c bao b\u1ecdc b\u1edfi c\u1ea5u tr\u00fac nh\u01b0 r\u00f2ng r\u1ecdc v\u00e0 m\u1ea1c<\/li>\n<li>Vi\u00eam bao g\u00e2n l\u00e0 m\u1ed9t hi\u1ec7n t\u01b0\u1ee3ng do s\u1ef1 n\u1edf r\u1ed9ng c\u1ee7a g\u00e2n g\u1ea5p so v\u1edbi m\u1ea1c r\u00f2ng r\u1ecdc c\u1ee7a n\u00f3, d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng h\u1eb9p khi g\u00e2n tr\u01b0\u1ee3t qua g\u00e2y \u0111au, kh\u00f3a kh\u1edbp\u00a0<\/li>\n<li>Vi\u00eam h\u1eb9p \u1edf kh\u1edbp \u0111\u1ed1t b\u00e0n ng\u00f3n tay g\u1ecdi l\u00e0 ng\u00f3n tay l\u00f2 xo ho\u1eb7c ng\u00f3n tay c\u00f2 s\u00fang. Vi\u00eam h\u1eb9p g\u00e2n d\u1ea1ng d\u00e0i v\u00e0 du\u1ed7i ng\u1eafn ng\u00f3n c\u00e1i g\u1ecdi l\u00e0 vi\u00eam bao g\u00e2n De Quervain (ho\u1eb7c g\u1ecdi t\u1eaft l\u00e0 vi\u00eam bao g\u00e2n du\u1ed7i d\u1ea1ng)<\/li>\n<li>B\u1ea5t k\u1ec3 nguy\u00ean nh\u00e2n, c\u01a1 ch\u1ebf c\u1ee7a vi\u00eam bao g\u00e2n v\u1eabn l\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng vi\u00eam t\u1ea1i g\u00e2n v\u00e0 bao g\u00e2n. M\u1ee7, ph\u1ee9c h\u1ee3p mi\u1ec5n d\u1ecbch, c\u00e1c tinh th\u1ec3 l\u1eafng \u0111\u1ecdng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u00e0ng g\u00e2n, g\u00e2n g\u00e2y vi\u00eam v\u00e0 d\u00e0y l\u00ean c\u1ee7a g\u00e2n.<\/li>\n<\/ul>\n<h2><strong>4. CH\u1ea8N \u0110O\u00c1N<\/strong><\/h2>\n<p>C\u00e1c <a href=\"https:\/\/bsvothanhtoan.com\/en\/\">tri\u1ec7u ch\u1ee9ng<\/a> s\u1edbm c\u1ee7a vi\u00eam bao g\u00e2n g\u1ed3m:<\/p>\n<ul>\n<li>S\u01b0ng kh\u1edbp, \u0111au c\u00e1c kh\u1edbp<\/li>\n<li>\u1ea4n \u0111au v\u00f9ng bao g\u00e2n<\/li>\n<li>\u0110\u1ecf v\u00f9ng da b\u1ecb t\u1ed5n th\u01b0\u01a1ng<\/li>\n<li>C\u1ed9m d\u01b0\u1edbi da v\u00f9ng bao g\u00e2n t\u1ed5n th\u01b0\u01a1ng &#8211; S\u1ed1t trong tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng.<\/li>\n<\/ul>\n<p>C\u00e1c tri\u1ec7u ch\u1ee9ng mu\u1ed9n th\u01b0\u1eddng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn v\u1eadn \u0111\u1ed9ng kh\u1edbp nh\u01b0:<\/p>\n<ul>\n<li>Ng\u00f3n tay c\u00f2 s\u00fang<\/li>\n<li>Ti\u1ebfng b\u1eadt khi v\u1eadn \u0111\u1ed9ng ng\u00f3n tay<\/li>\n<li>C\u1ee9ng kh\u1edbp trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng h\u01a1n.<\/li>\n<\/ul>\n<figure id=\"attachment_1945\" aria-describedby=\"caption-attachment-1945\" style=\"width: 260px\" class=\"wp-caption aligncenter\"><img fetchpriority=\"high\" decoding=\"async\" class=\"size-full wp-image-1945\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture12.jpg\" alt=\"Picture12\" width=\"260\" height=\"195\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture12.jpg 260w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture12-16x12.jpg 16w\" sizes=\"(max-width: 260px) 100vw, 260px\" \/><figcaption id=\"caption-attachment-1945\" class=\"wp-caption-text\"><strong>Figure 9.1. <\/strong>Ng\u00f3n tay c\u00f2 s\u00fang<br \/>\n<em>(Ngu\u1ed3n: Khoa Ngo\u1ea1i Ch\u1ea5n th\u01b0\u01a1ng \u2013 Ch\u1ec9nh h\u00ecnh, B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t TP. HCM)<\/em><\/figcaption><\/figure>\n<p>Ph\u00e2n \u0111\u1ed9 ng\u00f3n tay c\u00f2 s\u00fang:<\/p>\n<ul>\n<li>\u0110\u1ed9 1: Ng\u00f3n tay c\u00f2 s\u00fang kh\u00f4ng th\u01b0\u1eddng xuy\u00ean<\/li>\n<li>\u0110\u1ed9 2: Ng\u00f3n tay c\u00f2 s\u00fang b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u1ef1 kh\u1eafc ph\u1ee5c<\/li>\n<li>\u0110\u1ed9 3: B\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 kh\u1eafc ph\u1ee5c, b\u1ecb kh\u00f3a kh\u1edbp t\u1ea1i v\u1ecb tr\u00ed du\u1ed7i ho\u1eb7c g\u1ea5p ng\u00f3n tay<\/li>\n<li>\u0110\u1ed9 4: Ng\u00f3n tay c\u00f2 s\u00fang v\u1edbi <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/co-rut-khop\/\">joint contracture<\/a> li\u00ean \u0111\u1ed1t xa<\/li>\n<\/ul>\n<p>Nghi\u1ec7m ph\u00e1p <a href=\"https:\/\/en.wikipedia.org\/wiki\/Norman_Finkelstein\" target=\"_blank\" rel=\"noopener\">Finkelstein<\/a>: d\u01b0\u01a1ng t\u00ednh g\u1ee3i \u00fd vi\u00eam bao g\u00e2n du\u1ed7i d\u1ea1ng.<\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n n\u1eafm tay th\u00e0nh n\u1eafm \u0111\u1ea5m, \u0111\u1ec3 ng\u00f3n c\u00e1i trong l\u00f2ng b\u00e0n tay, \u0111\u01b0a b\u00e0n tay nghi\u00eang tr\u1ee5, n\u1ebfu \u0111au m\u1eb7t quay c\u1ed5 tay l\u00e0 d\u01b0\u01a1ng t\u00ednh.<\/li>\n<\/ul>\n<figure id=\"attachment_1946\" aria-describedby=\"caption-attachment-1946\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" class=\"size-medium wp-image-1946\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture13-300x126.jpg\" alt=\"Picture13\" width=\"300\" height=\"126\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture13-300x126.jpg 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture13-18x8.jpg 18w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture13.jpg 326w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-1946\" class=\"wp-caption-text\"><strong>Figure 9.2.<\/strong> Nghi\u1ec7m ph\u00e1p Fin Kelstein. <em>Ngu\u1ed3n: https:\/\/orthoinfo.aaos.org\/en\/diseases&#8211;conditions\/ de-quervains-tendinosis\/<\/em><\/figcaption><\/figure>\n<p>\u00a0C\u1eadn l\u00e2m s\u00e0ng:<\/p>\n<ul>\n<li>X-quang c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n t\u00ecnh tr\u1ea1ng l\u1eafng \u0111\u1ecdng acid uric, t\u00ecnh tr\u1ea1ng tho\u00e1i h\u00f3a kh\u1edbp<\/li>\n<li>Si\u00eau \u00e2m c\u00f3 th\u1ec3 d\u00e0y d\u00ednh bao g\u00e2n, t\u1ee5 d\u1ecbch bao g\u00e2n<\/li>\n<li>C\u00e1c x\u00e9t nghi\u1ec7m m\u00e1u c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng, vi\u00eam kh\u1edbp,\u2026 &#8211; MRI \u0111\u00e1nh gi\u00e1 r\u00f5 h\u01a1n v\u1ec1 t\u00ecnh tr\u1ea1ng m\u00f4 m\u1ec1m t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<\/ul>\n<h2><strong>5. \u0110I\u1ec0U TR\u1eca<\/strong><\/h2>\n<p>For <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/viem-gan-calci-hoa-khop-vai\/\">vi\u00eam g\u00e2n<\/a> do nhi\u1ec5m tr\u00f9ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng, ph\u1eabu thu\u1eadt khi c\u1ea7n thi\u1ebft.<\/p>\n<p>\u0110\u1ed1i v\u1edbi vi\u00eam g\u00e2n v\u00f4 khu\u1ea9n:<\/p>\n<ul>\n<li>Ch\u01b0\u1eddm \u0111\u00e1, k\u00ea cao tay<\/li>\n<li>S\u1eed d\u1ee5ng kh\u00e1ng vi\u00eam NSAID \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c corticoid ti\u00eam bao g\u00e2n n\u1ebfu kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c u\u1ed1ng<\/li>\n<li>N\u1eb9p c\u1ed1 \u0111\u1ecbnh t\u01b0 th\u1ebf kh\u00f4ng \u0111au<\/li>\n<\/ul>\n<p>N\u1eb9p, h\u1ea1n ch\u1ebf ho\u1ea1t \u0111\u1ed9ng, NSAID, corticoid cho k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb kh\u1ea3 quan tr\u00ean 50% s\u1ed1 ca m\u1eafc<\/p>\n<p>\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n, ph\u1eabu thu\u1eadt gi\u1ea3i ph\u00f3ng bao g\u00e2n mang l\u1ea1i hi\u1ec7u qu\u1ea3 th\u00e0nh c\u00f4ng h\u01a1n 90%.<\/p>\n<figure id=\"attachment_1947\" aria-describedby=\"caption-attachment-1947\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" class=\"size-medium wp-image-1947\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture14-300x151.jpg\" alt=\"Picture14\" width=\"300\" height=\"151\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture14-300x151.jpg 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture14-18x9.jpg 18w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture14.jpg 316w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-1947\" class=\"wp-caption-text\"><strong>H\u00ecnh 9.3.<\/strong> H\u00ecnh \u1ea3nh sau gi\u1ea3i ph\u00f3ng bao g\u00e2n du\u1ed7i d\u1ea1ng v\u1edbi g\u00e2n l\u1ed9 r\u00f5<br \/>\n<em>(Ngu\u1ed3n: https:\/\/www.youtube.com\/watch?v=1FG3I65rH-4, tr\u00edch d\u1eabn 20\/10\/2022)<\/em><\/figcaption><\/figure>\n<ol start=\"2\">\n<li style=\"list-style-type: none;\">\u00a0<\/li>\n<\/ol>","protected":false},"featured_media":2259,"comment_status":"open","ping_status":"closed","template":"","tags":[165],"chuyen-muc":[35],"class_list":["post-1944","bai-giang","type-bai-giang","status-publish","has-post-thumbnail","hentry","tag-viem-bao-gan","chuyen-muc-nhap-mon-chan-thuong-chinh-hinh"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/1944","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=1944"}],"version-history":[{"count":0,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/1944\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/2259"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=1944"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=1944"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=1944"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}