{"id":2345,"date":"2023-09-24T12:00:39","date_gmt":"2023-09-24T05:00:39","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&p=2345"},"modified":"2024-12-24T15:11:17","modified_gmt":"2024-12-24T08:11:17","slug":"chan-doan-ton-thuong-sun-chem","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/chan-doan-ton-thuong-sun-chem\/","title":{"rendered":"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n t\u1ed5n th\u01b0\u01a1ng s\u1ee5n ch\u00eam"},"content":{"rendered":"

1. L\u00c2M S\u00c0NG<\/span><\/h3>\n

\u0110au khe kh\u1edbp g\u1ed1i<\/a>, tr\u00e0n d\u1ecbch kh\u1edbp g\u1ed1i, d\u1ea5u hi\u1ec7u k\u1eb9t kh\u1edbp v\u00e0 l\u1ee5c kh\u1ee5c trong kh\u1edbp, teo c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i, l\u00e0 nh\u1eefng d\u1ea5u hi\u1ec7u c\u01a1 n\u0103ng m\u00e0 b\u1ec7nh nh\u00e2n \u0111\u1ebfn kh\u00e1m nhi\u1ec1u \u1edf b\u1ec7nh vi\u1ec7n. C\u00e1c d\u1ea5u hi\u1ec7u n\u00e0y c\u00f9ng v\u1edbi h\u1ecfi ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng m\u1ed9t c\u00e1ch c\u1ea9n th\u1eadn, gi\u00fap cho ng\u01b0\u1eddi th\u1ea7y thu\u1ed1c \u0111\u1ecbnh h\u01b0\u1edbng ph\u1ed1i h\u1ee3p c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c \u0111\u1ec3 h\u01b0\u1edbng t\u1edbi ch\u1ea9n \u0111o\u00e1n th\u01b0\u01a1ng t\u1ed5n s\u1ee5n ch\u00eam<\/a>.<\/span><\/p>\n

1.1. \u0110au ch\u00f3i hay \u0111au khe kh\u1edbp khi \u1ea5n ng\u00f3n tay v\u00e0o kh\u1edbp g\u1ed1i<\/span><\/h3>\n

\"3.1\"<\/p>\n

\"3.1\"
H\u00ecnh 3.1. D\u1ea5u hi\u1ec7u \u1ea5n khe kh\u1edbp trong v\u00e0 ngo\u00e0i (Ngu\u1ed3n: R\u00e9paration M\u00e9niscale – Beaufils P 2004) [133]<\/figcaption><\/figure>\n

– B\u1ec7nh nh\u00e2n th\u01b0\u1eddng c\u1ea3m th\u1ea5y \u0111au ch\u00f3i ngay sau ch\u1ea5n th\u01b0\u01a1ng, k\u00e8m theo nghe th\u1ea5y ti\u1ebfng \u201cl\u1ee5c kh\u1ee5c\u201d trong kh\u1edbp.<\/span> C\u1ea3m gi\u00e1c \u0111au th\u01b0\u1eddng khu tr\u00fa ngay t\u1ea1i v\u1ecb tr\u00ed ch\u1ea5n th\u01b0\u01a1ng, c\u00f3 th\u1ec3 \u1edf ph\u00eda tr\u01b0\u1edbc hay \u1edf ph\u00eda sau v\u00e0 \u00edt lan ra xung quanh. Khai th\u00e1c k\u1ef9 \u0111i\u1ec3m \u0111au ch\u00f3i c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c v\u1ecb tr\u00ed s\u1ee5n ch\u00eam r\u00e1ch.<\/span><\/p>\n

– Gi\u1ea3i th\u00edch nguy\u00ean nh\u00e2n \u0111au khi s\u1ee5n ch\u00eam b\u1ecb th\u01b0\u01a1ng t\u1ed5n cho \u0111\u1ebfn nay v\u1eabn ch\u01b0a r\u00f5 r\u00e0ng. Theo De Palma A.F. khi ph\u1ea7n n\u1ec1n s\u1ee5n ch\u00eam b\u1ecb th\u01b0\u01a1ng t\u1ed5n c\u00f3 th\u1ec3 r\u00e1ch bao kh\u1edbp ho\u1eb7c c\u00f9ng v\u1edbi l\u1ef1c ch\u1ea5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 g\u00e2y gi\u00e3n ho\u1eb7c \u0111\u1ee9t d\u00e2y ch\u1eb1ng b\u00ean<\/a>, l\u00fac \u0111\u00f3 s\u1ebd g\u00e2y c\u1ea3m gi\u00e1c \u0111au cho b\u1ec7nh nh\u00e2n <\/span>[61]<\/span>. Tuy nhi\u00ean, trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng v\u00e0 bao kh\u1edbp ph\u1ed1i h\u1ee3p ho\u1eb7c ph\u1ea7n r\u00eca s\u1ee5n ch\u00eam, v\u1ecb tr\u00ed kh\u00f4ng c\u00f3 m\u1ea1ch m\u00e1u v\u00e0 th\u1ea7n kinh th\u00ec nguy\u00ean nh\u00e2n g\u00e2y \u0111au kh\u00f4ng gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c.<\/span><\/p>\n

1.2. K\u1eb9t kh\u1edbp<\/span><\/h3>\n

– L\u00e0 d\u1ea5u hi\u1ec7u th\u01b0\u1eddng g\u1eb7p trong th\u01b0\u01a1ng t\u1ed5n s\u1ee5n ch\u00eam, nh\u01b0ng kh\u00f4ng ph\u1ea3i l\u00e0 d\u1ea5u hi\u1ec7u \u0111\u1eb7c hi\u1ec7u.<\/span><\/p>\n

– K\u1eb9t kh\u1edbp c\u00f3 th\u1ec3 g\u1eb7p trong b\u1ec7nh l\u00fd s\u1ee5n ch\u00eam h\u00ecnh \u0111\u0129a, chu\u1ed9t kh\u1edbp, sai kh\u1edbp x\u01b0\u01a1ng b\u00e1nh ch\u00e8<\/a>, c\u00e1c b\u1ec7nh l\u00fd s\u1ee5n kh\u1edbp ho\u1eb7c hi\u1ebfm g\u1eb7p h\u01a1n l\u00e0 trong b\u1ec7nh l\u00fd qu\u00e1 ph\u00e1t d\u00e2y ch\u1eb1ng Hoffa <\/span>[101]<\/span>.<\/span><\/p>\n

– Tuy nhi\u00ean, tr\u01b0\u1edbc b\u1ec7nh nh\u00e2n c\u00f3 d\u1ea5u hi\u1ec7u k\u1eb9t kh\u1edbp sau ch\u1ea5n th\u01b0\u01a1ng m\u00e0 kh\u00f4ng c\u00f3 h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng tr\u00ean phim X-quang<\/a>, \u0111i\u1ec1u \u0111\u1ea7u ti\u00ean n\u00ean ngh\u0129 \u0111\u1ebfn l\u00e0 t\u1ed5n th\u01b0\u01a1ng s\u1ee5n ch\u00eam, m\u00e0 \u0111i\u1ec3n h\u00ecnh l\u00e0 t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng quai x\u00e1ch.<\/span><\/p>\n

1.3. Tr\u00e0n m\u00e1u kh\u1edbp g\u1ed1i<\/span><\/h3>\n

– L\u00e0 d\u1ea5u hi\u1ec7u h\u1eb1ng \u0111\u1ecbnh nh\u1ea5t trong t\u1ed5n th\u01b0\u01a1ng s\u1ee5n ch\u00eam. Tuy nhi\u00ean, c\u1ea7n ph\u00e2n bi\u1ec7t r\u00f5 t\u00ednh \u0111\u1eb7c tr\u01b0ng c\u1ee7a tr\u00e0n m\u00e1u kh\u1edbp g\u1ed1i trong th\u01b0\u01a1ng t\u1ed5n s\u1ee5n ch\u00eam v\u1edbi th\u01b0\u01a1ng t\u1ed5n d\u00e2y ch\u1eb1ng. Trong t\u1ed5n th\u01b0\u01a1ng s\u1ee5n ch\u00eam, tr\u00e0n m\u00e1u kh\u1edbp g\u1ed1i th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n mu\u1ed9n, th\u01b0\u1eddng l\u00e0 ng\u00e0y th\u1ee9 hai sau ch\u1ea5n th\u01b0\u01a1ng trong khi trong ch\u1ea5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng th\u01b0\u1eddng l\u00e0 ngay trong nh\u1eefng gi\u1edd \u0111\u1ea7u. Tuy nhi\u00ean, theo Triliat A., trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng m\u1ea1nh, t\u1ed5n th\u01b0\u01a1ng s\u1eebng sau c\u1ee7a s\u1ee5n ch\u00eam k\u00e8m theo c\u00f3 r\u00e1ch bao kh\u1edbp ph\u00eda sau, d\u1ecbch kh\u1edbp k\u00e8m theo m\u00e1u t\u1ee5 s\u1ebd ch\u1ea3y ra ngo\u00e0i kh\u1edbp v\u00e0 n\u1eb1m t\u1ea1i t\u1ed5 ch\u1ee9c d\u01b0\u1edbi da <\/span>[75]<\/span>.<\/span><\/p>\n

– Ch\u1ecdc h\u00fat v\u00e0 \u0111\u00e1nh gi\u00e1 t\u00ecnh ch\u1ea5t m\u00e1u t\u1ee5 trong kh\u1edbp c\u00f3 gi\u00e1 tr\u1ecb trong ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t c\u00e1c th\u01b0\u01a1ng t\u1ed5n t\u1ea1i kh\u1edbp g\u1ed1i. Theo Noyes F.R, trong t\u1ed5n th\u01b0\u01a1ng s\u1ee5n ch\u00eam, m\u00e1u t\u1ee5 th\u01b0\u1eddng l\u1eabn v\u1edbi huy\u1ebft thanh, c\u00f3 m\u00e0u trong. Trong t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng l\u00e0 d\u1ecbch m\u00e1u \u0111\u01a1n thu\u1ea7n, c\u00f2n n\u1ebfu d\u1ecbch m\u00e1u c\u00f3 l\u1eabn v\u00e1ng m\u1ee1 l\u00e0 c\u00f3 t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng k\u00e8m theo <\/span>[118]<\/span>.<\/span><\/p>\n

1.4. C\u00e1c nghi\u1ec7m ph\u00e1p l\u00e2m s\u00e0ng<\/span><\/h3>\n

– C\u00e1c nghi\u1ec7m ph\u00e1p l\u00e2m s\u00e0ng \u0111\u00e1nh gi\u00e1 th\u01b0\u01a1ng t\u1ed5n s\u1ee5n ch\u00eam \u0111\u1ec1u d\u1ef1a tr\u00ean nguy\u00ean t\u1eafc d\u1ecbch chuy\u1ec3n c\u1ee7a s\u1ee5n ch\u00eam trong qu\u00e1 tr\u00ecnh g\u1ea5p, du\u1ed7i g\u1ed1i v\u00e0 d\u1ea5u hi\u1ec7u \u0111au c\u1ee7a r\u00e1ch s\u1ee5n ch\u00eam<\/a> khi b\u1ecb \u0111\u00e8, \u00e9p ho\u1eb7c c\u00f3 ngo\u1ea1i l\u1ef1c t\u00e1c \u0111\u1ed9ng v\u00e0o.<\/span><\/p>\n

– C\u00f3 nhi\u1ec1u nghi\u1ec7m ph\u00e1p nh\u01b0ng nh\u00ecn chung c\u00f3 th\u1ec3 chia th\u00e0nh nh\u1eefng nh\u00f3m nh\u01b0 sau:<\/span><\/p>\n

1.4.1. <\/span>\u0110i\u1ec3m \u1ea5n \u0111au khu tr\u00fa<\/span><\/strong><\/p>\n