{"id":2071,"date":"2023-07-04T07:00:40","date_gmt":"2023-07-04T00:00:40","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&p=2071"},"modified":"2023-07-31T18:27:01","modified_gmt":"2023-07-31T11:27:01","slug":"trat-xuong-banh-che","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/trat-xuong-banh-che\/","title":{"rendered":"Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8"},"content":{"rendered":"

TR\u1eacT X\u01af\u01a0NG B\u00c1NH CH\u00c8 B\u1ea8M SINH<\/strong><\/h2>\n

T\u1ed5ng quan<\/strong><\/h3>\n

Tr\u1eadt kh\u1edbp x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh l\u00e0 m\u1ed9t d\u1ecb t\u1eadt hi\u1ebfm g\u1eb7p, bi\u1ec3u hi\u1ec7n nh\u01b0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng v\u00e0 khuy\u1ebft t\u1eadt trong th\u1eddi th\u01a1 \u1ea5u. Hai h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng \u0111\u00e3 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 trong y v\u0103n. M\u1ed9t h\u1ed9i ch\u1ee9ng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh ho\u1eb7c tr\u1eadt kh\u1edbp m\u1ed9t b\u00ean c\u1ed1 \u0111\u1ecbnh c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8, h\u1ed9i ch\u1ee9ng th\u1ee9 hai \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 theo th\u00f3i quen.<\/p>\n

Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh c\u00f3 th\u1ec3 x\u1ea3y ra nh\u01b0 m\u1ed9t t\u00ecnh tr\u1ea1ng tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 ra m\u1ed9t b\u00ean dai d\u1eb3ng v\u1edbi bi\u1ec3u hi\u1ec7n co g\u1ea5p g\u1ed1i v\u00e0 x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ecb d\u00ednh v\u00e0o m\u1ed9t b\u00ean v\u1edbi l\u1ed3i c\u1ea7u \u0111\u00f9i ho\u1eb7c nh\u01b0 m\u1ed9t s\u1ef1 tr\u1eadt kh\u1edbp kh\u00f4ng li\u00ean t\u1ee5c c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8. \u1ede h\u1ed9i ch\u1ee9ng sau, x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ecb tr\u1eadt ho\u00e0n to\u00e0n theo m\u1ed7i chu k\u1ef3 g\u1ea5p v\u00e0 du\u1ed7i c\u1ee7a g\u1ed1i v\u00e0 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 tr\u1eadt kh\u1edbp b\u1eaft bu\u1ed9c c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8, b\u1edfi v\u00ec b\u1ec7nh nh\u00e2n kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c t\u00ecnh tr\u1ea1ng tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 khi h\u1ecd di chuy\u1ec3n g\u1ed1i. Lo\u1ea1i tr\u1eadt kh\u1edbp b\u1ea9m sinh \u0111\u1ea7u ti\u00ean, l\u00e0 lo\u1ea1i c\u1ed1 \u0111\u1ecbnh, th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn c\u00e1c h\u1ed9i ch\u1ee9ng nh\u01b0 b\u1ec7nh kh\u1edbp v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt \u0111i\u1ec1u ch\u1ec9nh b\u1eb1ng c\u00e1ch gi\u1ea3i ph\u00f3ng m\u1ed9t b\u00ean v\u00e0 s\u1eafp x\u1ebfp l\u1ea1i x\u01b0\u01a1ng b\u00e1nh ch\u00e8. Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1eaft bu\u1ed9c c\u00f3 xu h\u01b0\u1edbng l\u00e0 m\u1ed9t b\u1ea5t th\u01b0\u1eddng lo\u1ea1n s\u1ea3n<\/a> ri\u00eang bi\u1ec7t v\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c dung n\u1ea1p t\u01b0\u01a1ng \u0111\u1ed1i t\u1ed1t. T\u00e1i c\u00e2n b\u1eb1ng x\u01b0\u01a1ng b\u00e1nh ch\u00e8 th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf \u0111\u1ed9 tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh v\u00ec \u00edt can thi\u1ec7p v\u00e0o ch\u1ee9c n\u0103ng h\u01a1n.<\/p>\n

L\u00e2m s\u00e0ng<\/strong><\/h3>\n

Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u1ed1 \u0111\u1ecbnh v\u00e0 tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1eaft bu\u1ed9c c\u00f3 hai bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng kh\u00e1c nhau nh\u01b0 \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y trong B\u1ea3ng 24.1<\/strong>.<\/p>\n

B\u1ea3ng 24.1<\/strong>. Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh<\/p>\n\n\n\n\n\n\n\n\n\n
Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u1ed1 \u0111\u1ecbnh<\/strong><\/td>\nTr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1eaft bu\u1ed9c<\/strong><\/td>\n<\/tr>\n
X\u01b0\u01a1ng b\u00e1nh ch\u00e8 tr\u1eadt ra m\u1ed9t b\u00ean v\u00e0 c\u1ed1 \u0111\u1ecbnh<\/td>\nX\u01b0\u01a1ng b\u00e1nh ch\u00e8 tr\u1eadt ra v\u00e0 n\u1eafn tr\u1eadt theo m\u1ed7i chu k\u1ef3 g\u1ea5p v\u00e0 du\u1ed7i c\u1ee7a g\u1ed1i<\/td>\n<\/tr>\n
Th\u01b0\u1eddng r\u00f5 r\u00e0ng \u1edf th\u1eddi th\u01a1 \u1ea5u<\/td>\nTh\u01b0\u1eddng xu\u1ea5t hi\u1ec7n t\u1eeb 5 \u0111\u1ebfn 10 tu\u1ed5i<\/td>\n<\/tr>\n
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    \n
  • C\u00f3 th\u1ec3 c\u00f3 m\u1ed9t h\u1ed9i ch\u1ee9ng c\u01a1 x\u01b0\u01a1ng kh\u1edbp<\/li>\n
  • Th\u01b0\u1eddng l\u00e0 b\u1ea5t th\u01b0\u1eddng \u0111\u1ed9c l\u1eadp k\u00e8m theo<\/li>\n<\/ul>\n<\/td>\n
\u00a0<\/td>\n<\/tr>\n
\n

Li\u00ean quan \u0111\u1ebfn ch\u1ee9ng co r\u00fat kh\u1edbp g\u1ed1i<\/a>\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n<\/td>\n

\n

T\u1ea7m v\u1eadn \u0111\u1ed9ng c\u1ee7a g\u1ed1i th\u01b0\u1eddng l\u00e0 b\u00ecnh th\u01b0\u1eddng<\/p>\n<\/td>\n<\/tr>\n

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    \n
  • H\u1ea7u nh\u01b0 c\u00f3 bi\u1ec3u hi\u1ec7n ch\u1eadm ph\u00e1t tri\u1ec3n kh\u1ea3<\/li>\n
  • C\u00f3 th\u1ec3 dung n\u1ea1p t\u1ed1t v\u1edbi s\u1ef1 gi\u1ea3m ch\u1ee9c n\u0103ng nh\u1eb9 n\u0103ng \u0111i l\u1ea1i<\/li>\n<\/ul>\n<\/td>\n
\u00a0<\/td>\n<\/tr>\n
\n
    \n
  • Th\u1eddi \u0111i\u1ec3m can thi\u1ec7p ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 tr\u00ec ho\u00e3n \u0111\u1ebfn<\/li>\n
  • C\u1ea7n can thi\u1ec7p ph\u1eabu thu\u1eadt s\u1edbm khi b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng<\/li>\n<\/ul>\n<\/td>\n
\u00a0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Tr\u1ebb s\u01a1 sinh b\u1ecb tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 m\u1ed9t b\u00ean dai d\u1eb3ng c\u00f3 bi\u1ec3u hi\u1ec7n co g\u1ea5p g\u1ed1i v\u00e0 kh\u00f4ng s\u1edd th\u1ea5y x\u01b0\u01a1ng b\u00e1nh ch\u00e8 \u1edf ph\u00eda tr\u01b0\u1edbc x\u01b0\u01a1ng \u0111\u00f9i. Kh\u00f3 s\u1edd th\u1ea5y x\u01b0\u01a1ng b\u00e1nh ch\u00e8 gi\u1ea3m s\u1ea3n \u1edf v\u1ecb tr\u00ed c\u1ee7a n\u00f3. Ki\u1ec3m tra h\u00ecnh \u1ea3nh c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI) l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 ch\u1eafc ch\u1eafn v\u1ec1 v\u1ecb tr\u00ed c\u1ee7a s\u1ee5n x\u01b0\u01a1ng b\u00e1nh ch\u00e8.<\/p>\n

Tr\u1ebb b\u1ecb tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 m\u1ed9t b\u00ean c\u1ed1 \u0111\u1ecbnh c\u00f3 th\u1ec3 c\u00f3 bi\u1ec3u hi\u1ec7n ch\u1eadm ph\u00e1t tri\u1ec3n kh\u1ea3 n\u0103ng \u0111i l\u1ea1i ho\u1eb7c c\u00f3 d\u00e1ng \u0111i b\u1ea5t th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn ch\u1ee9ng co r\u00fat kh\u1edbp<\/a> g\u1ed1i. Th\u00f4ng th\u01b0\u1eddng, xoay ngo\u00e0i x\u01b0\u01a1ng ch\u00e0y c\u00f3 li\u00ean quan \u0111\u1ebfn co g\u1ea5p kh\u1edbp g\u1ed1i.<\/p>\n

Nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 m\u1ed9t h\u1ed9i ch\u1ee9ng c\u01a1 x\u01b0\u01a1ng kh\u1edbp k\u00e8m theo, trong \u0111\u00f3 tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh l\u00e0 m\u1ed9t \u0111\u1eb7c \u0111i\u1ec3m. Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh c\u00f3 th\u1ec3 x\u1ea3y ra hai b\u00ean nh\u01b0ng ph\u1ed5 bi\u1ebfn h\u01a1n l\u00e0 m\u1ed9t b\u00ean. Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a c\u00e1c h\u1ed9i ch\u1ee9ng sau: arthrogryposis, h\u1ed9i ch\u1ee9ng Larsen\u2019s, dyschondrosteosis, h\u1ed9i ch\u1ee9ng Rubinstein-Taybi, h\u1ed9i ch\u1ee9ng Down v\u00e0 h\u1ed9i ch\u1ee9ng nail patella. T\u00e1c gi\u1ea3 c\u0169ng \u0111\u00e3 th\u1ea5y tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh trong h\u1ed9i ch\u1ee9ng Ellis-Van Crevald v\u00e0 trong ch\u1ee9ng lo\u1ea1n d\u01b0\u1ee1ng x\u01b0\u01a1ng b\u00e1nh ch\u00e8.<\/p>\n

Kh\u00f4ng s\u1edd th\u1ea5y x\u01b0\u01a1ng b\u00e1nh ch\u00e8 \u1edf ph\u00eda tr\u01b0\u1edbc g\u1ed1i. B\u1eb1ng c\u00e1ch s\u1edd n\u1eafn c\u1ea9n th\u1eadn, ta c\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y x\u01b0\u01a1ng b\u00e1nh ch\u00e8 n\u1eb1m m\u1ed9t b\u00ean l\u1ed3i c\u1ea7u \u0111\u00f9i. X\u01b0\u01a1ng b\u00e1nh ch\u00e8 gi\u1ea3m \u0111\u00e0n h\u1ed3i, n\u1eb1m nghi\u00eang v\u00e0 kh\u00f4ng th\u1ec3 ph\u00e1t hi\u1ec7n b\u1eb1ng c\u00e1ch kh\u00e1m l\u00e2m s\u00e0ng \u0111\u01a1n thu\u1ea7n \u1edf h\u1ea7u h\u1ebft tr\u1ebb s\u01a1 sinh.<\/p>\n

Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1eaft bu\u1ed9c th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n sau khi tr\u1ebb b\u1eaft \u0111\u1ea7u t\u1eadp \u0111i v\u00e0 l\u00e0 m\u1ed9t b\u1ea5t th\u01b0\u1eddng n\u1ed5i b\u1eadt \u1edf ch\u1ed7 x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ecb tr\u1eadt ra trong m\u1ed7i chu k\u1ef3 g\u1ea5p v\u00e0 du\u1ed7i c\u1ee7a g\u1ed1i. Theo kinh \u0111i\u1ec3n, x\u01b0\u01a1ng b\u00e1nh ch\u00e8 l\u1ec7ch sang m\u1ed9t b\u00ean khi du\u1ed7i g\u1ed1i ho\u00e0n to\u00e0n v\u00e0 di chuy\u1ec3n theo h\u01b0\u1edbng u\u1ed1n. B\u1ec7nh nh\u00e2n b\u1ecb tr\u1eadt kh\u1edbp b\u1eaft bu\u1ed9c th\u01b0\u1eddng kh\u00f4ng b\u1ecb co r\u00fat, nh\u01b0ng h\u1ecd c\u00f3 c\u1ea3m gi\u00e1c b\u1ea5t \u1ed5n \u1edf g\u1ed1i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t m\u1ed9t c\u00e1ch \u0111\u00e1ng ng\u1ea1c nhi\u00ean. \u0110au kh\u00f4ng ph\u1ea3i l\u00e0 bi\u1ec3u hi\u1ec7n kh\u00f3 ch\u1ecbu trong th\u1eddi th\u01a1 \u1ea5u m\u00e0 l\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng v\u00e0 bi\u1ebfn d\u1ea1ng.<\/p>\n

Ph\u00e2n \u0111\u1ed9<\/strong><\/h3>\n

Thu\u1eadt ng\u1eef tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh th\u00edch h\u1ee3p cho t\u00ecnh tr\u1ea1ng tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 m\u1ed9t b\u00ean li\u00ean t\u1ee5c ho\u1eb7c c\u1ed1 \u0111\u1ecbnh, c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u1ea1i ho\u1eb7c g\u1ea7n th\u1eddi \u0111i\u1ec3m sinh. Trong h\u1ed9i ch\u1ee9ng n\u00e0y, x\u01b0\u01a1ng b\u00e1nh ch\u00e8 kh\u00f4ng bao gi\u1edd n\u1eb1m\u00a0 trong r\u00e3nh \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng \u0111\u00f9i v\u00e0 lu\u00f4n lu\u00f4n n\u1eb1m nghi\u00eang v\u1ec1 m\u1ed9t b\u00ean v\u00ec s\u1ef1 co r\u00fat c\u1ee7a bao kh\u1edbp v\u00e0 s\u1ef1 k\u1ebft d\u00ednh d\u00e0y v\u1edbi d\u1ea3i ch\u1eadu ch\u00e0y.<\/p>\n

\u1ede nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1eaft bu\u1ed9c, nh\u1eefng chuy\u1ec3n \u0111\u1ed9ng b\u1ea5t th\u01b0\u1eddng c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8 kh\u00f4ng ph\u1ea3i l\u00e0 v\u1ea5n \u0111\u1ec1 c\u1ee7a b\u1ec7nh nh\u00e2n c\u0169ng kh\u00f4ng ph\u1ea3i l\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a m\u1ed9t th\u00f3i quen hay khu\u00f4n m\u1eabu t\u1ef1 nguy\u1ec7n. Thay v\u00e0o \u0111\u00f3, s\u1ef1 tr\u1eadt v\u00e0 n\u1eafn tr\u1eadt b\u1ea5t th\u01b0\u1eddng c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8 theo m\u1ed7i chu k\u1ef3 v\u1eadn \u0111\u1ed9ng l\u00e0 do gi\u1ea3i ph\u1eabu b\u1ec7nh h\u1ecdc t\u00e1c \u0111\u1ed9ng l\u00ean b\u1ec7nh nh\u00e2n. V\u00ec l\u00fd do n\u00e0y, thu\u1eadt ng\u1eef tr\u1eadt kh\u1edbp b\u1eaft bu\u1ed9c \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng h\u01a1n v\u00ec n\u00f3 m\u00f4 t\u1ea3 ch\u00ednh x\u00e1c h\u01a1n, th\u1ef1c t\u1ebf l\u00e0 b\u1ec7nh nh\u00e2n bu\u1ed9c ph\u1ea3i di chuy\u1ec3n x\u01b0\u01a1ng b\u00e1nh ch\u00e8 v\u00e0o v\u00e0 ra kh\u1ecfi v\u1ecb tr\u00ed b\u00ecnh th\u01b0\u1eddng c\u1ee7a n\u00f3 trong r\u00e3nh \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng \u0111\u00f9i b\u1ea5t c\u1ee9 khi n\u00e0o h\u1ecd g\u1ea5p ho\u1eb7c du\u1ed7i g\u1ed1i.<\/p>\n

Lo\u1ea1i th\u1ee9 ba c\u1ee7a lo\u1ea1n s\u1ea3n x\u01b0\u01a1ng b\u00e1nh ch\u00e8 ph\u1ed5 bi\u1ebfn h\u01a1n nhi\u1ec1u v\u00e0 g\u1eb7p \u1edf thanh thi\u1ebfu ni\u00ean. Lo\u1ea1i lo\u1ea1n s\u1ea3n n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 l\u1ec7ch kh\u1edbp. S\u1ef1 sai l\u1ec7ch l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 t\u0103ng tr\u01b0\u1edfng v\u00e0 ph\u00e1t tri\u1ec3n b\u1ea5t th\u01b0\u1eddng, l\u00e0m cho c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i b\u1ecb l\u1ec7ch sang m\u1ed9t b\u00ean. Lo\u1ea1i lo\u1ea1n s\u1ea3n c\u1ee7a kh\u1edbp ch\u00e8 \u0111\u00f9i l\u00e0 ph\u1ed5 bi\u1ebfn, nh\u01b0ng s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c th\u1ea3o lu\u1eadn trong b\u00e0i n\u00e0y. \u0110i\u1ec1u \u0111\u00e1ng quan t\u00e2m, t\u1eeb tr\u1eadt kh\u1edbp m\u1ed9t b\u00ean c\u1ed1 \u0111\u1ecbnh, \u0111\u1ebfn tr\u1eadt kh\u1edbp b\u1eaft bu\u1ed9c, tr\u1eadt kh\u1edbp kh\u00f4ng li\u00ean t\u1ee5c ho\u1eb7c t\u00e1i di\u1ec5n \u0111\u1ec1u x\u1ea3y ra \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng Down khi h\u1ecd \u0111\u01b0\u1ee3c kh\u00e1m theo nh\u00f3m.<\/p>\n

Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh<\/strong><\/h3>\n

X\u01b0\u01a1ng b\u00e1nh ch\u00e8 h\u00f3a th\u00e0nh x\u01b0\u01a1ng t\u1eeb 3 \u0111\u1ebfn 4 tu\u1ed5i, do \u0111\u00f3, kh\u00f4ng th\u1ec3 nh\u00ecn th\u1ea5y tr\u00ean phim ch\u1ee5p X-quang<\/a> th\u01b0\u1eddng \u1edf tr\u1ebb nh\u1ecf. Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb c\u00f3 th\u1ec3 cho th\u1ea5y x\u01b0\u01a1ng b\u00e1nh ch\u00e8 n\u1eb1m ngang v\u1edbi x\u01b0\u01a1ng \u0111\u00f9i trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 m\u1ed9t b\u00ean b\u1ea9m sinh v\u00e0 c\u00f3 gi\u00e1 tr\u1ecb trong ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m b\u1ec7nh l\u00fd \u1edf tr\u1ebb nh\u1ecf.<\/p>\n

M\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 \u0111\u00e3 s\u1eed d\u1ee5ng si\u00eau \u00e2m \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8. \u1ede ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh (CT) r\u1ea5t h\u1eefu \u00edch \u0111\u1ec3 th\u1ea5y s\u1ef1 li\u00ean k\u1ebft c\u1ee7a kh\u1edbp ch\u00e8 \u0111\u00f9i. CT c\u00f3 th\u1ec3 ghi l\u1ea1i s\u1ef1 li\u00ean k\u1ebft trong qu\u00e1 tr\u00ecnh du\u1ed7i g\u1ed1i \u0111\u1ebfn 15\u00b0, \u0111\u00e2y l\u00e0 ph\u1ea7n quan tr\u1ecdng nh\u1ea5t. H\u00ecnh \u1ea3nh \u1ea5n t\u01b0\u1ee3ng nh\u1ea5t l\u00e0 vi\u1ec7c s\u1eed d\u1ee5ng m\u1ed9t \u0111o\u1ea1n phim l\u1eb7p l\u1ea1i \u0111\u1ec3 hi\u1ec3n th\u1ecb m\u00f4 h\u00ecnh chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8, nh\u01b0ng \u0111\u00e2y l\u00e0 m\u1ed9t \u00e1p d\u1ee5ng h\u1ecdc thu\u1eadt \u0111\u1ec3 ph\u00e2n t\u00edch s\u1ef1 tr\u1eadt kh\u1edbp b\u1ea9m sinh c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8.<\/p>\n

\"Picture1\"
H\u00ecnh 24.1.<\/strong> X-quang c\u1ee7a m\u1ed9t \u0111\u1ee9a tr\u1ebb 8 tu\u1ed5i b\u1ecb tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb.<\/figcaption><\/figure>\n

\u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt<\/strong><\/h3>\n

Ch\u1ec9 \u0111\u1ecbnh ch\u00ednh \u0111\u1ec3 ph\u1eabu thu\u1eadt \u0111i\u1ec1u ch\u1ec9nh tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh l\u00e0 kh\u00f4ng c\u00f3 ho\u1eb7c m\u1ea5t ch\u1ee9c n\u0103ng. Tr\u1ebb b\u1ecb tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 k\u00e9o d\u00e0i, b\u1eaft \u0111\u1ea7u \u0111i l\u1ea1i kh\u00f3 kh\u0103n. Do s\u1ef1 co r\u00fat v\u00e0 bi\u1ebfn d\u1ea1ng v\u1eb9o trong sau \u0111\u00f3, d\u00e1ng \u0111i kh\u00f4ng hi\u1ec7u qu\u1ea3 v\u00e0 v\u1ee5ng v\u1ec1 ngay c\u1ea3 khi \u0111\u1ee9a tr\u1ebb c\u00f3 th\u1ec3 \u0111i b\u1ed9. Tr\u1ebb b\u1ecb tr\u1eadt kh\u1edbp b\u1eaft bu\u1ed9c ph\u00e0n n\u00e0n v\u1ec1 vi\u1ec7c g\u1ed1i ph\u1ea3i nh\u01b0\u1eddng ch\u1ed7 ho\u1eb7c c\u1ea3m th\u1ea5y y\u1ebfu v\u00e0 kh\u00f4ng v\u1eefng. \u0110au th\u01b0\u1eddng l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng mu\u1ed9n h\u01a1n v\u00e0 c\u00f3 th\u1ec3 b\u00e1o tr\u01b0\u1edbc b\u1ec7nh tho\u00e1i h\u00f3a kh\u1edbp<\/a>. Nh\u1eefng bi\u1ebfn \u0111\u1ed5i tho\u00e1i h\u00f3a s\u1edbm \u1edf kh\u1edbp ch\u00e8 \u0111\u00f9i x\u1ea3y ra nh\u1ea5t qu\u00e1n \u1edf ng\u01b0\u1eddi l\u1edbn b\u1ecb tr\u1eadt kh\u1edbp m\u1ed9t b\u00ean c\u1ed1 \u0111\u1ecbnh kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb.<\/p>\n

Mang n\u1eb9p l\u00e0 m\u1ed9t bi\u1ec7n ph\u00e1p t\u1ea1m th\u1eddi \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u00ecnh tr\u1ea1ng tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1eaft bu\u1ed9c c\u00f3 \u00edt tri\u1ec7u ch\u1ee9ng nh\u01b0ng \u0111eo n\u1eb9p kh\u00f4ng hi\u1ec7u qu\u1ea3 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb d\u1ee9t \u0111i\u1ec3m.<\/p>\n

\u00a0K\u1ef9 thu\u1eadt m\u1ed5<\/strong><\/span><\/p>\n

\u0110\u01b0\u1eddng m\u1ed5 gi\u1eefa tr\u00ean x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u00f3 xu h\u01b0\u1edbng l\u00e0nh l\u1ea1i v\u1edbi nhi\u1ec1u s\u1eb9o t\u0103ng sinh \u1edf tr\u1ebb em h\u01a1n \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i. T\u00e1c gi\u1ea3 ch\u1ee7 tr\u01b0\u01a1ng r\u1ea1ch \u0111\u01b0\u1eddng m\u1ed5 qua kh\u1edbp g\u1ed1i tr\u01b0\u1edbc b\u00ean \u0111\u1ec3 s\u1eb9o kh\u00f4ng ch\u1ecbu \u00e1p l\u1ef1c tr\u1ef1c ti\u1ebfp v\u00e0o x\u01b0\u01a1ng b\u00e1nh ch\u00e8 trong giai \u0111o\u1ea1n h\u1eadu ph\u1eabu. V\u1ebft r\u1ea1ch ph\u1ea3i \u0111\u1ee7 d\u00e0i \u0111\u1ec3 l\u1ed9 ra m\u1ed9t ph\u1ea7n \u0111\u1ee7 c\u1ee7a c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i \u0111\u1ec3 n\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c li\u1ec1n l\u1ea1i. \u0110\u1ec3 b\u1ed9c l\u1ed9 t\u1ed1t \u1edf tr\u1ebb s\u01a1 sinh b\u1ecb tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh, v\u1ebft r\u1ea1ch c\u00f3 th\u1ec3 k\u00e9o d\u00e0i \u0111\u1ebfn n\u1eeda \u0111\u00f9i. D\u00e2y ch\u1eb1ng m\u1ed9t b\u00ean \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng b\u1eb1ng c\u00e1ch b\u00f3c t\u00e1ch c\u00e1c m\u00f4 s\u01a1 c\u00f3 th\u1ec3 k\u00e9o d\u00e0i d\u1ecdc theo v\u00e1ch ng\u0103n c\u01a1 b\u00ean. Bao kh\u1edbp b\u00ean trong v\u00e0 c\u00e1nh trong b\u00e1nh ch\u00e8 \u0111\u01b0\u1ee3c k\u00e9o d\u00e0i. Khi c\u00e1nh ngo\u00e0i b\u00e1nh ch\u00e8 \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng, c\u00e1nh trong b\u00e1nh ch\u00e8 s\u1ebd \u0111\u01b0\u1ee3c huy \u0111\u1ed9ng t\u1eeb b\u1ec1 m\u1eb7t tr\u01b0\u1edbc c\u1ee7a x\u01b0\u01a1ng \u0111\u00f9i b\u1eb1ng c\u00e1ch b\u00f3c t\u00e1ch s\u1eafc g\u1ecdn c\u1ea9n th\u1eadn, t\u00e1ch n\u00f3 ra kh\u1ecfi s\u1ee5n kh\u1edbp. C\u00e1nh trong b\u00e1nh ch\u00e8 \u0111\u01b0\u1ee3c k\u1ebft d\u00ednh v\u1edbi s\u1ee5n kh\u1edbp v\u00ec n\u00f3 n\u1eb1m tr\u00ean l\u1ed3i c\u1ea7u trong t\u01b0\u01a1ng t\u1ef1 nh\u01b0 m\u1ed9t chi\u1ebfc m\u0169 tr\u00f9m \u0111\u1ea7u.<\/p>\n

G\u00e2n b\u00e1nh ch\u00e8 th\u01b0\u1eddng ch\u00e8n b\u1ea5t th\u01b0\u1eddng sang b\u00ean ngo\u00e0i. \u1ede tr\u1ebb s\u01a1 sinh, kh\u1ed1i ch\u00e8n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u1ecbch chuy\u1ec3n v\u00e0o trong b\u1eb1ng c\u00e1ch t\u00e1ch m\u1ea1nh kh\u1ed1i ch\u00e8n ra kh\u1ecfi s\u1ee5n ch\u00eam<\/a> v\u00e0 \u0111\u1ecbnh h\u00ecnh l\u1ea1i n\u00f3 \u1edf \u0111\u01b0\u1eddng gi\u1eefa c\u1ee7a \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng ch\u00e0y. G\u00e2n c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i ng\u1eafn. G\u00e2n \u0111\u01b0\u1ee3c k\u00e9o d\u00e0i b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p Z-plasty ho\u1eb7c Z-Y. Vi\u1ec7c k\u00e9o d\u00e0i \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf \u0111\u1ea7u g\u1ea7n x\u01b0\u01a1ng b\u00e1nh ch\u00e8 th\u00f4ng qua c\u00e1c s\u1ee3i g\u00e2n c\u1ee7a c\u01a1 khi ch\u00fang ch\u00e8n v\u00e0o x\u01b0\u01a1ng b\u00e1nh ch\u00e8.<\/p>\n

C\u00e1c m\u00f4 m\u1ec1m d\u00ednh b\u00ean ngo\u00e0i v\u00e0 trong x\u01b0\u01a1ng b\u00e1nh ch\u00e8 \u0111\u00f2i h\u1ecfi s\u1ef1 c\u00e2n b\u1eb1ng. Bao kh\u1edbp \u0111\u01b0\u1ee3c m\u1edf gi\u1ea3i ph\u00f3ng b\u00ean ngo\u00e0i v\u00e0 \u0111\u01b0\u1ee3c u\u1ed1n v\u00e0o trong. V\u1ea1t b\u00ean trong \u0111\u01b0\u1ee3c n\u00e2ng l\u00ean v\u00e0 kh\u00e2u v\u00e0o tr\u01b0\u1edbc x\u01b0\u01a1ng b\u00e1nh ch\u00e8. \u0110\u01b0\u1eddng kh\u00e2u th\u01b0\u1eddng n\u1eb1m d\u1ecdc theo m\u00e9p ngo\u00e0i c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8, v\u00ec v\u1ea1t k\u00e9o d\u00e0i h\u1ebft c\u1ee1 qua x\u01b0\u01a1ng b\u00e1nh ch\u00e8 l\u00e0m t\u00e2m x\u01b0\u01a1ng \u1edf \u0111\u01b0\u1eddng gi\u1eefa b\u00ean d\u01b0\u1edbi v\u1ea1t c\u00e1nh trong b\u00e1nh ch\u00e8.<\/p>\n

\u1ede b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, c\u1ea7n s\u1eeda ch\u1eefa c\u00e1nh trong b\u00e1nh ch\u00e8 cho vi\u1ec7c u\u1ed1n v\u00e0o trong. Chuy\u1ec3n g\u00e2n c\u01a1 b\u00e1n g\u00e2n v\u00e0o x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p Galeazzi gi\u00fap t\u0103ng c\u01b0\u1eddng l\u1ef1c b\u00ean trong v\u00e0 di chuy\u1ec3n ph\u1ea7n m\u1ec1m \u0111\u1ea7u xa \u0111\u1ebfn \u0111\u01b0\u1eddng gi\u1eefa. U\u1ed1n v\u00e0o ki\u1ec3u Krogius kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 duy tr\u00ec s\u1ef1 n\u1eafn tr\u1eadt \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y. G\u00e2n c\u01a1 b\u00e1n g\u00e2n \u0111\u01b0\u1ee3c t\u00e1ch ra qua m\u1ed9t v\u1ebft r\u1ea1ch nh\u1ecf ph\u00eda sau t\u1ea1i \u0111i\u1ec3m b\u00e1m t\u1eadn c\u1ee7a n\u00f3 v\u00e0 \u0111\u01b0\u1ee3c g\u1eafn \u1edf xa so v\u1edbi pes anserinus (\u0111i\u1ec3m b\u00e1m c\u1ee7a g\u00e2n c\u01a1 ch\u00e2n ng\u1ed7ng). Sau \u0111\u00f3, \u0111\u1ea7u g\u1ea7n c\u1ee7a g\u00e2n \u0111\u01b0\u1ee3c \u0111\u1ecbnh tuy\u1ebfn l\u1ea1i tr\u00ean x\u01b0\u01a1ng b\u00e1nh ch\u00e8 th\u00f4ng qua m\u1ed9t k\u00eanh x\u01b0\u01a1ng \u0111\u1ec3 cung c\u1ea5p m\u1ed9t l\u1ef1c xa v\u00e0 v\u00e0o b\u00ean trong c\u00f3 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c t\u0103ng c\u01b0\u1eddng v\u00e0o b\u00ean trong c\u1ee7a c\u00e1c l\u1ef1c t\u00e1c \u0111\u1ed9ng l\u00ean x\u01b0\u01a1ng b\u00e1nh ch\u00e8.<\/p>\n

N\u1ebfu s\u1ef1 co r\u00fat kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh ho\u00e0n to\u00e0n b\u1eb1ng c\u00e1c thao t\u00e1c n\u00e0y, gi\u1ea3i ph\u00f3ng ph\u00eda sau \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh. B\u1ed9c l\u1ed9 ph\u00eda sau th\u01b0\u1eddng l\u00e0 c\u1ea7n thi\u1ebft trong tr\u1eadt kh\u1edbp b\u1ea9m sinh, nh\u01b0ng kh\u00f4ng ph\u1ea3i trong tr\u1eadt kh\u1edbp b\u1eaft bu\u1ed9c. C\u00e1c g\u00e2n khoeo d\u00e0i ra theo h\u00ecnh ch\u1eef Z v\u00e0 bao kh\u1edbp sau \u0111\u01b0\u1ee3c t\u00e1ch ra. \u0110\u1ec3 k\u00e9o d\u00e0i g\u00e2n c\u01a1 khoeo, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng hai \u0111\u01b0\u1eddng r\u1ea1ch d\u1ecdc, m\u1ed9t \u0111\u01b0\u1eddng ngang g\u1ed1i sau trong v\u00e0 m\u1ed9t \u0111\u01b0\u1eddng ngang g\u1ed1i sau ngo\u00e0i. Th\u00f4ng qua \u0111\u01b0\u1eddng r\u1ea1ch sau ngo\u00e0i v\u00e0 b\u1ea3o v\u1ec7 d\u00e2y th\u1ea7n kinh m\u00e1c chung, qu\u00e1 tr\u00ecnh gi\u1ea3i ph\u00f3ng bao kh\u1edbp \u0111\u01b0\u1ee3c ho\u00e0n th\u00e0nh sau khi huy \u0111\u1ed9ng \u0111\u1ea7u b\u00ean ngo\u00e0i c\u1ee7a c\u01a1 b\u1ee5ng ch\u00e2n t\u1eeb x\u01b0\u01a1ng \u0111\u00f9i. B\u00f3 m\u1ea1ch khoeo \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 b\u1eb1ng c\u00e1ch ph\u1eabu t\u00edch trong m\u1ed9t m\u1eb7t ph\u1eb3ng tr\u1ef1c ti\u1ebfp tr\u00ean bao kh\u1edbp sau.<\/p>\n

TR\u1eacT X\u01af\u01a0NG B\u00c1NH CH\u00c8 M\u1eaeC PH\u1ea2I<\/strong><\/h2>\n

T\u1ed5ng quan<\/strong><\/h3>\n

Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 (hay c\u00f2n g\u1ecdi tr\u1eadt kh\u1edbp ch\u00e8 \u2013 \u0111\u00f9i) chi\u1ebfm kho\u1ea3ng 2 \u2013 3% c\u00e1c ca ch\u1ea5n th\u01b0\u01a1ng g\u1ed1i. Th\u01b0\u01a1ng t\u1ed5n n\u00e0y th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng ng\u01b0\u1eddi tr\u1ebb tu\u1ed5i, ph\u1ee5 n\u1eef v\u1ecb th\u00e0nh ni\u00ean v\u00e0 v\u1eadn \u0111\u1ed9ng vi\u00ean. T\u1ec9 l\u1ec7 m\u1eafc b\u1ec7nh \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 5,8\/100.000 nh\u01b0ng c\u00f3 th\u1ec3 cao t\u1edbi 29\/100.000 \u1edf \u0111\u1ed9 tu\u1ed5i v\u1ecb th\u00e0nh ni\u00ean [2]. Tr\u1eadt kh\u1edbp c\u1ea5p t\u00ednh c\u00f3 xu h\u01b0\u1edbng x\u1ea3y ra t\u01b0\u01a1ng \u0111\u1ed1i b\u1eb1ng nhau \u1edf nam v\u00e0 n\u1eef. Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong th\u1eadp k\u1ef7 th\u1ee9 hai v\u00e0 th\u1ee9 ba c\u1ee7a cu\u1ed9c \u0111\u1eddi.<\/p>\n

M\u1ea5t v\u1eefng x\u01b0\u01a1ng b\u00e1nh ch\u00e8 l\u00e0 m\u1ed9t lo\u1ea1t c\u00e1c t\u00ecnh tr\u1ea1ng kh\u00e1c nhau, t\u1eeb tr\u1eadt nh\u1eb9 kh\u00f4ng th\u01b0\u1eddng tr\u1ef1c cho \u0111\u1ebfn tr\u1eadt ho\u00e0n to\u00e0n th\u01b0\u1eddng tr\u1ef1c. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n bi\u1ebfn d\u1ea1ng r\u00f5 r\u00e0ng v\u00e0 kh\u00f4ng th\u1ec3 du\u1ed7i g\u1ed1i. T\u1ec9 l\u1ec7 tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 t\u00e1i di\u1ec5n sau khi tr\u1eadt b\u00e1nh ch\u00e8 l\u1ea7n \u0111\u1ea7u v\u00e0o kho\u1ea3ng 15 \u2013 60% [1]. Trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p, tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n v\u1edbi v\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u00e0 n\u1eb9p g\u1ed1i, ngo\u1ea1i tr\u1eeb tr\u01b0\u1eddng h\u1ee3p g\u00e3y x\u01b0\u01a1ng<\/a> b\u00e1nh ch\u00e8 \u0111i k\u00e8m ho\u1eb7c c\u00e1c \u0111\u1ee3t t\u00e1i ph\u00e1t c\u1ea7n can thi\u1ec7p ph\u1eabu thu\u1eadt.<\/p>\n

Nguy\u00ean nh\u00e2n<\/strong><\/h3>\n

Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u1ea5p t\u00ednh th\u01b0\u1eddng x\u1ea3y ra do ch\u1ea5n th\u01b0\u01a1ng, th\u01b0\u1eddng sau ch\u1ea5n th\u01b0\u01a1ng v\u1eb7n xo\u1eafn, kh\u00f4ng tr\u1ef1c ti\u1ebfp v\u1edbi g\u1ed1i ho\u1eb7c do l\u1ef1c t\u00e1c \u0111\u1ed9ng m\u1ea1nh tr\u1ef1c ti\u1ebfp v\u00e0o gi\u1eefa g\u1ed1i. M\u1ed9t c\u01a1 ch\u1ebf th\u01b0\u1eddng g\u1eb7p g\u00e2y tr\u1eadt b\u00e1nh ch\u00e8 l\u00e0 m\u00e2m ch\u00e0y xoay ngo\u00e0i v\u1edbi b\u00e0n ch\u00e2n c\u1ed1 \u0111\u1ecbnh tr\u00ean s\u00e0n. Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00f3i chung c\u00f3 d\u00e2y ch\u1eb1ng l\u1ecfng l\u1ebbo. Tuy nhi\u00ean, nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y h\u1ea7u h\u1ebft c\u00f3 xu h\u01b0\u1edbng t\u00e1i ph\u00e1t tr\u1eadt nh\u1eb9 x\u01b0\u01a1ng b\u00e1nh ch\u00e8 tr\u00e1i ng\u01b0\u1ee3c v\u1edbi t\u00ecnh tr\u1ea1ng tr\u1eadt kh\u1edbp ho\u00e0n to\u00e0n.<\/p>\n

B\u00ean c\u1ea1nh \u0111\u00f3, c\u00e1c b\u1ea5t th\u01b0\u1eddng v\u1ec1 m\u1eb7t gi\u1ea3i ph\u1eabu nh\u01b0 ch\u1ee9ng lo\u1ea1n s\u1ea3n x\u01b0\u01a1ng b\u00e1nh ch\u00e8 v\u00e0 lo\u1ea1n s\u1ea3n di\u1ec7n b\u00e1nh ch\u00e8 c\u0169ng c\u00f3 th\u1ec3 khi\u1ebfn ng\u01b0\u1eddi b\u1ec7nh b\u1ecb tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8. T\u00ecnh tr\u1ea1ng l\u1ecfng l\u1ebbo c\u00e1c d\u00e2y ch\u1eb1ng th\u01b0\u1eddng th\u1ea5y \u1edf ph\u1ee5 n\u1eef ho\u1eb7c th\u1ee9 ph\u00e1t sau c\u00e1c r\u1ed1i lo\u1ea1n m\u00f4 li\u00ean k\u1ebft nh\u01b0 h\u1ed9i ch\u1ee9ng Marfan ho\u1eb7c Ehlers-Danlos, l\u00e0m t\u0103ng nguy c\u01a1 tr\u1eadt kh\u1edbp n\u00f3i chung.<\/p>\n

Tr\u1eadt kh\u1edbp th\u01b0\u1eddng tr\u1ef1c \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u00ecnh tr\u1ea1ng tr\u1eadt kh\u1edbp kh\u00f4ng \u0111au m\u1ed7i khi g\u1ea5p g\u1ed1i, th\u01b0\u1eddng l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 c\u0103ng b\u1ea5t th\u01b0\u1eddng c\u01a1 r\u1ed9ng ngo\u00e0i v\u00e0 d\u1ea3i ch\u1eadu ch\u00e0y.<\/p>\n

Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 b\u1ea9m sinh c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra, th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng Down. \u0110\u00e2y l\u00e0 h\u1ec7 qu\u1ea3 do x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf k\u1ebft h\u1ee3p v\u1edbi c\u1ea5u tr\u00fac l\u1ed3i c\u1ea7u b\u1ecb gi\u1ea3m s\u1ea3n v\u00e0 th\u01b0\u1eddng c\u1ea7n can thi\u1ec7p ph\u1eabu thu\u1eadt \u0111\u1ec3 gi\u1ea3m t\u1ec9 l\u1ec7 t\u00e1i ph\u00e1t.<\/p>\n

Sinh l\u00fd b\u1ec7nh<\/strong><\/h3>\n

Kh\u1edbp g\u1ed1i l\u00e0 n\u01a1i giao nhau c\u1ee7a x\u01b0\u01a1ng ch\u00e0y, x\u01b0\u01a1ng l\u1ed3i c\u1ea7u \u0111\u00f9i v\u00e0 x\u01b0\u01a1ng b\u00e1nh ch\u00e8. Khi g\u1ea5p du\u1ed7i g\u1ed1i, x\u01b0\u01a1ng b\u00e1nh ch\u00e8 s\u1ebd tr\u01b0\u1ee3t tr\u00ean m\u1eb7t kh\u1edbp l\u1ed3i c\u1ea7u \u0111\u00f9i. \u1ede hai \u0111\u1ea7u x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u00f3 g\u00e2n t\u1ee9 \u0111\u1ea7u thu\u1ed9c nh\u00f3m c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i n\u1eb1m \u1edf x\u01b0\u01a1ng \u0111\u00f9i v\u00e0 g\u00e2n b\u00e1nh ch\u00e8 b\u00e1m v\u00e0o l\u1ed3i c\u1ee7 ch\u00e0y \u1edf x\u01b0\u01a1ng m\u00e2m ch\u00e0y; khi chuy\u1ec3n \u0111\u1ed9ng g\u1ed1i, h\u1ec7 th\u1ed1ng c\u00e1c g\u00e2n v\u00e0 d\u00e2y ch\u1eb1ng s\u1ebd gi\u1eef cho x\u01b0\u01a1ng b\u00e1nh ch\u00e8 kh\u00f4ng b\u1ecb l\u1ec7ch ra ngo\u00e0i. Khi ch\u1ea5n th\u01b0\u01a1ng x\u1ea3y ra do va ch\u1ea1m l\u1ef1c m\u1ea1nh v\u00e0 \u0111\u1ed9t ng\u1ed9t \u1edf g\u1ed1i ho\u1eb7c ho\u1ea1t \u0111\u1ed9ng sai t\u01b0 th\u1ebf, x\u01b0\u01a1ng b\u00e1nh ch\u00e8 s\u1ebd tr\u01b0\u1ee3t ra kh\u1ecfi r\u00e3nh d\u1ecdc c\u1ee7a kh\u1edbp g\u1ed1i, g\u00e2y ra t\u00ecnh tr\u1ea1ng tr\u1eadt kh\u1edbp b\u00e1nh ch\u00e8 \u0111\u00f9i.<\/p>\n

C\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i v\u00e0 g\u00e2n x\u01b0\u01a1ng b\u00e1nh ch\u00e8 k\u1ebft h\u1ee3p v\u1edbi nhau t\u1ea1o th\u00e0nh m\u1ed9t g\u00f3c Q. G\u00f3c Q \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng g\u00f3c h\u1ee3p b\u1edfi hai \u0111\u01b0\u1eddng th\u1eb3ng: \u0111\u01b0\u1eddng v\u1ebd t\u1eeb gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean qua \u0111i\u1ec3m gi\u1eefa x\u01b0\u01a1ng b\u00e1nh ch\u00e8 v\u00e0 \u0111\u01b0\u1eddng v\u1ebd t\u1eeb \u0111i\u1ec3m gi\u1eefa x\u01b0\u01a1ng b\u00e1nh ch\u00e8 qua l\u1ed3i c\u1ee7 ch\u00e0y. G\u00f3c Q b\u00ecnh th\u01b0\u1eddng \u1edf n\u1eef kho\u1ea3ng 18o<\/sup>, cao h\u01a1n, \u1edf nam kho\u1ea3ng 14o<\/sup>. G\u1ed1i \u1edf ph\u1ee5 n\u1eef v\u1eb9o ra ngo\u00e0i nhi\u1ec1u h\u01a1n, \u0111\u00e2y l\u00e0 l\u00fd do tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u00f3 xu h\u01b0\u1edbng g\u1eb7p nhi\u1ec1u h\u01a1n \u1edf n\u1eef gi\u1edbi. S\u1ed1 \u0111o g\u00f3c Q \u0111o \u0111\u01b0\u1ee3c l\u1edbn h\u01a1n b\u00ecnh th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn s\u1ef1 m\u1ea5t kh\u1ea3 n\u0103ng c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8.<\/p>\n

C\u00e1c y\u1ebfu t\u1ed1 b\u1ea5t th\u01b0\u1eddng gi\u1ea3i ph\u1eabu li\u00ean quan \u0111\u1ebfn s\u1ef1 tr\u1eadt kh\u1edbp b\u00e1nh ch\u00e8 nh\u01b0 x\u01b0\u01a1ng b\u00e1nh ch\u00e8 \u0111\u1ea9y l\u00ean cao, lo\u1ea1n s\u1ea3n x\u01b0\u01a1ng b\u00e1nh ch\u00e8 hay thi\u1ec3u s\u1ea3n x\u01b0\u01a1ng \u0111\u00f9i. S\u1ef1 b\u1ea5t th\u01b0\u1eddng v\u1ec1 m\u1eb7t gi\u1ea3i ph\u1eabu c\u1ee7a kh\u1edbp x\u01b0\u01a1ng b\u00e1nh ch\u00e8 khi\u1ebfn nguy c\u01a1 tr\u1eadt kh\u1edbp cao h\u01a1n.<\/p>\n

Kh\u00e1m l\u00e2m s\u00e0ng<\/strong><\/h3>\n

B\u1ec7nh nh\u00e2n th\u01b0\u1eddng m\u00f4 t\u1ea3 \u0111au v\u00e0 bi\u1ebfn d\u1ea1ng g\u1ed1i sau m\u1ed9t ch\u1ea5n th\u01b0\u01a1ng gi\u00e1n ti\u1ebfp hay m\u1ed9t va ch\u1ea1m tr\u1ef1c tri\u1ebfp v\u00e0o m\u1eb7t tr\u01b0\u1edbc hay gi\u1eefa g\u1ed1i, c\u00f3 th\u1ec3 nghe m\u1ed9t ti\u1ebfng \u201cb\u1ed1p\u201d k\u00e8m v\u1edbi t\u00ecnh tr\u1ea1ng s\u01b0ng t\u1ea5y. C\u00e1c tri\u1ec7u ch\u1ee9ng t\u1ed3i t\u1ec7 h\u01a1n khi g\u1eadp g\u1ed1i, qu\u1ef3 hay \u0111i l\u1ea1i.<\/p>\n

Th\u0103m kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 ghi t\u1ee5 d\u1ecbch hay t\u1ee5 m\u00e1u kh\u1edbp g\u1ed1i v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u0111i k\u00e8m \u1edf x\u01b0\u01a1ng \u0111\u00f9i, x\u01b0\u01a1ng ch\u00e0y v\u00e0 d\u00e2y ch\u1eb1ng kh\u1edbp g\u1ed1i. S\u1edd n\u1eafn \u1edf tr\u00ean, d\u01b0\u1edbi, gi\u1eefa v\u00e0 hai b\u00ean x\u01b0\u01a1ng b\u00e1nh ch\u00e8 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 v\u1ecb tr\u00ed \u0111au, v\u1eadn \u0111\u1ed9ng g\u1eadp du\u1ed7i. S\u1edd b\u00e1nh ch\u00e8 l\u1ec7ch h\u1eb3n ra ph\u00eda ngo\u00e0i, kh\u00f4ng c\u00f2n n\u1eb1m \u1edf gi\u1eefa g\u1ed1i. \u0110\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng ch\u00e9o<\/a> v\u00e0 d\u00e2y ch\u1eb1ng b\u00ean<\/a> kh\u00f4ng n\u00ean b\u1ecf s\u00f3t.<\/p>\n

\u1ede ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng, x\u01b0\u01a1ng b\u00e1nh ch\u00e8 c\u00f3 th\u1ec3 l\u1ec7ch sang b\u00ean 25 \u2013 50% chi\u1ec1u ngang c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8. Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p tr\u1eadt t\u00e1i h\u1ed3i, s\u1ef1 l\u1ec7ch sang b\u00ean n\u00e0y c\u00f3 th\u1ec3 nhi\u1ec1u h\u01a1n. \u0110\u1eb7t g\u1ed1i b\u1ec7nh nh\u00e2n th\u1ea3 l\u1ecfng g\u1eadp 20 \u2013 30 \u0111\u1ed9, x\u01b0\u01a1ng b\u00e1nh ch\u00e8 \u0111\u01b0\u1ee3c \u0111\u1ea9y sang m\u1ed9t b\u00ean. Nghi\u1ec7m ph\u00e1p d\u01b0\u01a1ng t\u00ednh khi b\u1ec7nh nh\u00e2n e ng\u1ea1i hay s\u1ee3 h\u00e3i khi th\u1ef1c hi\u1ec7n.<\/p>\n

\"Picture2\"
H\u00ecnh 24.2.<\/strong> Tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 [1]<\/figcaption><\/figure>\n

X-quang kh\u1edbp g\u1ed1i tr\u01b0\u1edbc \u2013 sau l\u00e0 ph\u01b0\u01a1ng ti\u1ec7n \u0111\u1ea7u tay ti\u1ebfp c\u1eadn m\u1ed9t b\u1ec7nh nh\u00e2n nghi ng\u1edd t\u1ed5n th\u01b0\u01a1ng kh\u1edbp b\u00e1nh ch\u00e8 c\u1ea5p t\u00ednh. X-quang gi\u00fap ph\u00e1n \u0111o\u00e1n s\u1ef1 di l\u1ec7ch, g\u00e3y x\u01b0\u01a1ng \u0111i k\u00e8m, m\u1ea5t v\u1eefng kh\u1edbp. C\u00e1c ph\u01b0\u01a1ng ti\u1ec7n cao c\u1ea5p h\u01a1n c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng l\u00e0 ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh (CT) hay MRI. Trong \u0111\u00f3, MRI r\u1ea5t h\u1eefu \u00edch trong vi\u1ec7c xem x\u00e9t c\u00e1c c\u1ea5u tr\u00fac d\u00e2y ch\u1eb1ng, m\u00f4 m\u1ec1m c\u1ee7a g\u1ed1i, vai tr\u00f2 c\u1ee7a MRI c\u00e0ng r\u00f5 r\u00e0ng h\u01a1n v\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p tr\u1eadt x\u01b0\u01a1ng b\u00e1nh ch\u00e8 t\u00e1i h\u1ed3i. Trong tr\u01b0\u1eddng h\u1ee3p tr\u1eadt kh\u1edbp ho\u00e0n to\u00e0n, MRI th\u01b0\u1eddng c\u00f3 m\u1ed9t m\u00f4 h\u00ecnh b\u1ea7m t\u00edm \u0111\u1eb7c tr\u01b0ng c\u1ee7a x\u01b0\u01a1ng \u0111\u00f9i b\u00ean v\u00e0 x\u01b0\u01a1ng b\u00e1nh ch\u00e8 gi\u1eefa. H\u00ecnh \u1ea3nh n\u00e0y r\u1ea5t h\u1eefu \u00edch trong vi\u1ec7c ch\u1ea9n \u0111o\u00e1n t\u1ed5n th\u01b0\u01a1ng s\u1ee5n kh\u1edbp \u1edf m\u1eb7t gi\u1eefa, d\u1ef1 b\u00e1o nguy c\u01a1 tr\u1eadt b\u00e1nh ch\u00e8 t\u00e1i di\u1ec5n.<\/p>\n

Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/h3>\n