{"id":2064,"date":"2023-07-04T07:00:22","date_gmt":"2023-07-04T00:00:22","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&#038;p=2064"},"modified":"2023-07-31T18:28:37","modified_gmt":"2023-07-31T11:28:37","slug":"gay-xuong-benh-ly-khong-do-nguyen-nhan-ac-tinh","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-benh-ly-khong-do-nguyen-nhan-ac-tinh\/","title":{"rendered":"G\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd kh\u00f4ng do nguy\u00ean nh\u00e2n \u00e1c t\u00ednh"},"content":{"rendered":"<h2><strong>OUTLINE<\/strong><\/h2>\n<p><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-kin\/\">Fracture<\/a> b\u1ec7nh l\u00fd l\u00e0 x\u01b0\u01a1ng b\u1ecb g\u00e3y \u0111\u00e3 c\u00f3 b\u1ec7nh t\u1eeb tr\u01b0\u1edbc, g\u00e3y c\u00f3 th\u1ec3 x\u1ea3y ra t\u1ef1 nhi\u00ean ho\u1eb7c do m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng nh\u1eb9. \u0110\u1ed1i v\u1edbi x\u01b0\u01a1ng l\u00e0nh kh\u00f4ng b\u1ec7nh, kh\u00f4ng th\u1ec3 g\u00e3y x\u01b0\u01a1ng sau m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng nh\u1eb9. G\u00e3y x\u01b0\u01a1ng c\u00f3 th\u1ec3 x\u1ea3y ra sau ch\u1ea5n th\u01b0\u01a1ng v\u00e0i gi\u1edd ho\u1eb7c nhi\u1ec1u ng\u00e0y.<\/p>\n<p>C\u00f3 hai nh\u00f3m b\u1ec7nh g\u00e2y <a href=\"https:\/\/bsvothanhtoan.com\/en\/sach-chan-thuong-chinh-hinh\/\">g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd<\/a><\/p>\n<ul>\n<li>Nh\u00f3m b\u1ecb ung th\u01b0 n\u01a1i kh\u00e1c di c\u0103n v\u00e0o x\u01b0\u01a1ng nh\u01b0 ung th\u01b0 ph\u1ed5i, tuy\u1ebfn ti\u1ec1n li\u1ec7t, v\u00fa,\u2026 s\u1ebd \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp \u1edf m\u1ed9t b\u00e0i kh\u00e1c<\/li>\n<li>Nh\u00f3m ch\u00ednh c\u1ee7a g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd c\u00f3 nguy\u00ean nh\u00e2n kh\u00f4ng do \u00e1c t\u00ednh. X\u01b0\u01a1ng b\u1ecb u nang, b\u1ecb lo\u1ea1n d\u01b0\u1ee1ng g\u00e2y g\u00e3y x\u01b0\u01a1ng, khuy\u1ebft x\u01b0\u01a1ng sau m\u1ed5, sau ch\u1ea5n th\u01b0\u01a1ng, vi\u00eam nhi\u1ec5m tr\u00f9ng x\u01b0\u01a1ng, r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a, b\u1ec7nh nh\u00e2n n\u1eb1m li\u1ec7t gi\u01b0\u1eddng. Ng\u01b0\u1eddi gi\u00e0 b\u1ecb lo\u00e3ng x\u01b0\u01a1ng, g\u00e3y x\u01b0\u01a1ng sau ch\u1ea5n th\u01b0\u01a1ng nh\u1eb9, c\u0169ng \u0111\u01b0\u1ee3c xem l\u00e0 g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd do lo\u00e3ng x\u01b0\u01a1ng.<\/li>\n<\/ul>\n<p>C\u00e1c b\u1ec7nh n\u00e0y l\u00e0m x\u01b0\u01a1ng b\u1ecb y\u1ebfu, gi\u1ea3m \u0111\u00e0n h\u1ed3i n\u00ean d\u1ec5 b\u1ecb g\u00e3y.<\/p>\n<p>\u0110a s\u1ed1 c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd kh\u00f4ng do nguy\u00ean nh\u00e2n \u00e1c t\u00ednh tr\u00ean phim.<\/p>\n<p><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/x-quang-trong-chan-thuong-chinh-hinh\/\">X-ray<\/a>, tuy nhi\u00ean, c\u1ea7n ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c nguy\u00ean nh\u00e2n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb v\u00e0 gi\u1ea3m nguy c\u01a1 g\u00e3y x\u01b0\u01a1ng sau n\u00e0y.<\/p>\n<h2><strong>KH\u00c1M L\u00c2M S\u00c0NG V\u00c0 CH\u1ea8N \u0110O\u00c1N<\/strong><\/h2>\n<h3><strong>clinical<\/strong><\/h3>\n<p>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng gi\u1ed1ng nh\u01b0 g\u00e3y x\u01b0\u01a1ng b\u00ecnh th\u01b0\u01a1ng v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng s\u01b0ng \u0111au, b\u1ea7m t\u00edm, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng, l\u1ea1o x\u1ea1o x\u01b0\u01a1ng, bi\u1ebfn d\u1ea1ng chi, c\u1eed \u0111\u1ed9ng b\u1ea5t th\u01b0\u1eddng.<\/p>\n<p>Ngh\u0129 t\u1edbi g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd khi x\u01b0\u01a1ng g\u00e3y sau ch\u1ea5n th\u01b0\u01a1ng nh\u1eb9 ho\u1eb7c g\u00e3y t\u1ef1 nhi\u00ean.<\/p>\n<p>H\u1ecfi v\u1ec1 ti\u1ec1n s\u1eed g\u00e3y x\u01b0\u01a1ng, c\u00e1c b\u1ec7nh l\u00fd chuy\u1ec3n h\u00f3a \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc \u0111\u00f3, th\u1ec3 tr\u1ea1ng b\u1ec7nh nh\u00e2n, ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng.<\/p>\n<figure id=\"attachment_2065\" aria-describedby=\"caption-attachment-2065\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img fetchpriority=\"high\" decoding=\"async\" class=\"size-medium wp-image-2065\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture8-1-300x179.png\" alt=\"Picture8\" width=\"300\" height=\"179\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture8-1-300x179.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture8-1-1024x612.png 1024w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture8-1-768x459.png 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture8-1-18x12.png 18w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture8-1.png 1086w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-2065\" class=\"wp-caption-text\"><strong>Figure 22.1.<\/strong> H\u00ecnh tr\u00e1i: u t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 (giant cell tumor); h\u00ecnh ph\u1ea3i: g\u00e3y x\u01b0\u01a1ng \u1edf b\u1ec7nh nh\u00e2n u t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3. <em>Ngu\u1ed3n: Robert T. Arnold, Marnix T. van Holsbeeck (2011), Best Cases from the AFIP: Necrotic Giant Cell Tumor of Bone Manifesting with Pathologic Fracture<\/em><\/figcaption><\/figure>\n<h3><strong>Subclinical<\/strong><\/h3>\n<p>Ch\u1ee5p X-quang gi\u00fap ch\u1ea9n \u0111o\u00e1n g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd.<\/p>\n<p>V\u1edbi c\u00e1c u nang l\u00e0nh t\u00ednh, th\u01b0\u1eddng l\u00e0 u t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3, x\u1ea3y ra tr\u00ean c\u00e1c \u0111\u1ea7u x\u01b0\u01a1ng \u0111\u00e3 \u0111\u00f3ng v\u1edbi h\u00ecnh \u1ea3nh ti\u00eau x\u01b0\u01a1ng \u0111\u1ed3ng nh\u1ea5t k\u00edch th\u01b0\u1edbc l\u1edbn, l\u1ec7ch t\u00e2m, ti\u1ebfp gi\u00e1p v\u1edbi m\u1eb7t kh\u1edbp, v\u1ecf x\u01b0\u01a1ng, b\u1edd r\u00f5 r\u00e0ng, kh\u00f4ng x\u01a1 c\u1ee9ng. Th\u01b0\u1eddng g\u1eb7p \u1edf \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng ch\u00e0y, m\u1ea5u chuy\u1ec3n l\u1edbn x\u01b0\u01a1ng \u0111\u00f9i, \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng \u0111\u00f9i, x\u01b0\u01a1ng c\u00e1nh ch\u1eadu, \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay,\u2026<\/p>\n<p><img decoding=\"async\" class=\"size-medium wp-image-2066\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture9-3-300x148.png\" alt=\"Picture9\" width=\"300\" height=\"148\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture9-3-300x148.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture9-3-1024x505.png 1024w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture9-3-768x379.png 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture9-3-1536x758.png 1536w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture9-3-2048x1010.png 2048w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture9-3-18x9.png 18w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<p><a href=\"https:\/\/vi.wikipedia.org\/wiki\/Ch%E1%BB%A5p_c%E1%BB%99ng_h%C6%B0%E1%BB%9Fng_t%E1%BB%AB\" target=\"_blank\" rel=\"noopener\">Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb<\/a> (MRI) c\u0169ng gi\u00fap ch\u1ea9n \u0111o\u00e1n c\u00e1c <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/u-xuong-va-phan-mem\/\">bone tumor<\/a> l\u00e0nh t\u00ednh.<\/p>\n<figure id=\"attachment_2067\" aria-describedby=\"caption-attachment-2067\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" class=\"size-medium wp-image-2067\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture10-2-300x248.png\" alt=\"Picture10\" width=\"300\" height=\"248\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture10-2-300x248.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture10-2-1024x845.png 1024w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture10-2-768x634.png 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture10-2-15x12.png 15w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/06\/Picture10-2.png 1162w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-2067\" class=\"wp-caption-text\"><strong>H\u00ecnh 22.3.<\/strong> (<strong>A<\/strong>) G\u00e3y x\u01b0\u01a1ng do u nang ph\u00ecnh m\u1ea1ch tr\u00ean phim X-quang. (<strong>B<\/strong>): H\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng v\u00f9ng h\u00e0nh x\u01b0\u01a1ng kh\u00f4ng c\u00f3 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-kin-mo-mem\/\">t\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m<\/a> tr\u00ean MRI.<\/figcaption><\/figure>\n<p>Ch\u1ee5p DEXA gi\u00fap ch\u1ea9n \u0111o\u00e1n lo\u00e3ng x\u01b0\u01a1ng.<\/p>\n<p>X\u00e9t nghi\u1ec7m calci, phospho, phosphatase, cortisol,\u2026 trong m\u00e1u ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ec7nh r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a. B\u1ec7nh nh\u00e2n lo\u00e3ng x\u01b0\u01a1ng c\u00f3 ch\u1ec9 s\u1ed1 x\u00e9t nghi\u1ec7m b\u00ecnh th\u01b0\u1eddng. B\u1ec7nh nhuy\u1ec5n x\u01b0\u01a1ng c\u00f3 calci m\u00e1u gi\u1ea3m, phosphotase ki\u1ec1m huy\u1ebft thanh t\u0103ng, phospho ni\u1ec7u t\u0103ng. B\u1ec7nh nh\u00e2n b\u1ecb c\u01b0\u1eddng ph\u00f3 gi\u00e1p tr\u1ea1ng nguy\u00ean ph\u00e1t c\u00f3 calci m\u00e1u t\u0103ng, phosphotase t\u0103ng.<\/p>\n<h3><strong>Implementing the quadrants<\/strong><\/h3>\n<p>Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1eb1ng sinh thi\u1ebft x\u01b0\u01a1ng.<\/p>\n<h3><strong>THE PRINCIPLES OF TREATMENT<\/strong><\/h3>\n<p>C\u00e1c b\u1ec7nh nh\u01b0 lo\u00e3ng x\u01b0\u01a1ng do kh\u00f4ng v\u1eadn \u0111\u1ed9ng, lo\u00e3ng x\u01b0\u01a1ng sau m\u00e3n kinh, c\u01b0\u1eddng ph\u00f3 gi\u00e1p tr\u1ea1ng c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1c thu\u1ed1c lo\u00e3ng x\u01b0\u01a1ng, thu\u1ed1c n\u1ed9i ti\u1ebft t\u1ed1.<\/p>\n<p>C\u00e1c b\u1ec7nh nh\u01b0 t\u1ea1o x\u01b0\u01a1ng b\u1ea5t to\u00e0n, <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/loan-san-xo-xuong\/\">dysplasia<\/a> x\u01a1 nhi\u1ec1u \u1edf b\u1ec7nh x\u01b0\u01a1ng h\u00f3a \u0111\u00e1, lo\u00e3ng x\u01b0\u01a1ng b\u1ec7nh <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/loan-san-xo-xuong\/\">Paget<\/a>, <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/viem-xuong-tuy\/\">arthritis<\/a> d\u1ea1ng th\u1ea5p, b\u1ec7nh Gaucher th\u00ec kh\u00f4ng ch\u1eefa \u0111\u01b0\u1ee3c.<\/p>\n<p>Ph\u1ea7n l\u1edbn c\u00e1c u x\u01b0\u01a1ng l\u00e0nh t\u00ednh c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb kh\u1ecfi v\u1edbi n\u1ea1o v\u00e0 gh\u00e9p x\u01b0\u01a1ng x\u1ed1p t\u1ef1 th\u00e2n. M\u1ed9t s\u1ed1 \u00edt ph\u1ea3i c\u1eaft \u0111o\u1ea1n nh\u01b0 u t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3 giai \u0111o\u1ea1n n\u1eb7ng. M\u1ed9t s\u1ed1 \u00edt c\u00f3 th\u1ec3 t\u1ef1 l\u00e0nh kh\u00f4ng c\u1ea7n m\u1ed5 nh\u01b0 u nang \u0111\u01a1n \u0111\u1ed9c nh\u1ecf.<\/p>","protected":false},"featured_media":2289,"comment_status":"open","ping_status":"closed","template":"","tags":[44,181],"chuyen-muc":[61],"class_list":["post-2064","bai-giang","type-bai-giang","status-publish","has-post-thumbnail","hentry","tag-gay-xuong","tag-khong-ac-tinh","chuyen-muc-benh-ly"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/2064","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=2064"}],"version-history":[{"count":0,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/2064\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/2289"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=2064"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=2064"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=2064"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}