{"id":4253,"date":"2024-11-21T15:37:37","date_gmt":"2024-11-21T08:37:37","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&#038;p=4253"},"modified":"2025-06-29T18:26:25","modified_gmt":"2025-06-29T11:26:25","slug":"benh-an-ngoai-khoa-tien-phau","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-an-ngoai-khoa-tien-phau\/","title":{"rendered":"B\u1ec6NH \u00c1N NGO\u1ea0I KHOA (Ti\u1ec1n ph\u1eabu)"},"content":{"rendered":"<p>Sinh vi\u00ean th\u1ef1c hi\u1ec7n<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tr\u1ea7n Kh\u00e1nh Vy\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 MSSV: 116019303<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tr\u01b0\u01a1ng Th\u00fay Vy\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 MSSV: 116019387<\/p>\n<p><strong>I. H\u00c0NH CH\u00cdNH<\/strong><\/p>\n<p>H\u1ecd v\u00e0 t\u00ean BN: NGUY\u1ec4N T\u1ea4N C<\/p>\n<p>Tu\u1ed5i: 28 ( Sinh n\u0103m 1996 )<\/p>\n<p>Gi\u1edbi t\u00ednh: Nam<\/p>\n<p>\u0110\u1ecba ch\u1ec9: s\u1ed1 355, Ph\u01b0\u1eddng 3, qu\u1eadn G\u00f2 V\u1ea5p, th\u00e0nh ph\u1ed1 H\u1ed3 Ch\u00ed Minh<\/p>\n<p>Ngh\u1ec1 nghi\u1ec7p: t\u00e0i x\u1ebf xe m\u00e1y<\/p>\n<p>Li\u00ean l\u1ea1c: S\u0110T: 0945.562.xxx<\/p>\n<p>Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n: 02 gi\u1edd 18 ph\u00fat, ng\u00e0y 28\/09\/2024<\/p>\n<p>Ng\u00e0y gi\u1edd l\u00e0m b\u1ec7nh \u00e1n: 20 gi\u1edd 00 ph\u00fat, ng\u00e0y 01\/10\/2024<\/p>\n<p><strong>II. <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">L\u00dd DO V\u00c0O VI\u1ec6N<\/a>: <\/strong><\/p>\n<p>\u0110au + bi\u1ebfn d\u1ea1ng c\u1eb3ng tay (P)<\/p>\n<p><strong>III. <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">B\u1ec6NH S\u1eec<\/a><\/strong><\/p>\n<ol>\n<li><strong>Qu\u00e1 tr\u00ecnh b\u1ec7nh l\u00fd<\/strong><\/li>\n<\/ol>\n<p>B\u1ec7nh nh\u00e2n khai:<\/p>\n<p>C\u00e1ch nh\u1eadp vi\u1ec7n kho\u1ea3ng 4 gi\u1edd, b\u1ec7nh nh\u00e2n \u0111ang \u0111i\u1ec1u khi\u1ec3n xe m\u00e1y th\u00ec va ch\u1ea1m v\u1edbi xe m\u00e1y kh\u00e1c \u0111ang \u0111i ng\u01b0\u1ee3c chi\u1ec1u, c\u1eb3ng tay (P) c\u1ee7a b\u1ec7nh nh\u00e2n va ch\u1ea1m v\u1edbi \u0111\u1ea7u xe, ng\u00e3 nghi\u00eang ng\u01b0\u1eddi v\u1ec1 b\u00ean (T) 2 g\u1ed1i va ch\u1ea1m xu\u1ed1ng m\u1eb7t \u0111\u01b0\u1eddng, kh\u00f4ng va \u0111\u1eadp \u0111\u1ea7u, ng\u1ef1c, b\u1ee5ng, v\u00e0 c\u00e1c v\u00f9ng kh\u00e1c tr\u00ean c\u01a1 th\u1ec3. Sau ng\u00e3 b\u1ec7nh nh\u00e2n t\u1ec9nh, th\u1ea5y \u0111au ch\u00f3i v\u00e0 bi\u1ebfn d\u1ea1ng \u2153 d\u01b0\u1edbi c\u1eb3ng tay (P), \u0111au li\u00ean t\u1ee5c, t\u0103ng khi c\u1eed \u0111\u1ed9ng, kh\u00f4ng s\u1ea5p ng\u1eeda \u0111\u01b0\u1ee3c c\u1eb3ng tay, kh\u00f4ng v\u1ebft th\u01b0\u01a1ng v\u00f9ng c\u1eb3ng tay,\u00a0 2 g\u1ed1i x\u00e2y x\u00e1t kh\u00f4ng gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng, b\u1ec7nh nh\u00e2n d\u00f9ng tay (T) \u0111\u1ee1 l\u1ea5y tay (P) \u0111ang g\u1ea5p khu\u1ef7u \u00f4m s\u00e1t v\u00e0o th\u00e2n ng\u01b0\u1eddi, \u0111\u01b0\u1ee3c ng\u01b0\u1eddi d\u00e2n \u0111\u01b0a \u0111\u1ebfn b\u1ec7nh vi\u1ec7n qu\u1eadn T\u00e2n Ph\u00fa, t\u1ea1i \u0111\u00e2y b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ee5p <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/x-quang-trong-chan-thuong-chinh-hinh\/\">X-ray<\/a> c\u1eb3ng tay (P) th\u1eb3ng nghi\u00eang, x\u1eed tr\u00ed gi\u1ea3m \u0111au Paracetamol 500mg 1 vi\u00ean u\u1ed1ng v\u00e0 n\u1eb9p g\u1ed7 c\u1ed1 \u0111\u1ecbnh c\u1eb3ng tay (P) chuy\u1ec3n \u0111\u1ebfn khoa c\u1ea5p c\u1ee9u b\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>Trong qu\u00e1 tr\u00ecnh b\u1ec7nh, b\u1ec7nh nh\u00e2n , ti\u00eau ti\u1ec3u b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng: \u0111au \u0111\u1ea7u, \u0111au ng\u1ef1c, n\u00f4n, t\u00ea, d\u1ecb c\u1ea3m v\u00f9ng c\u1eb3ng tay (P).<\/p>\n<ol start=\"2\">\n<li><strong>T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp vi\u1ec7n:<\/strong><\/li>\n<\/ol>\n<p>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/p>\n<p>\u0110au 1\/3 d\u01b0\u1edbi c\u1eb3ng tay (P)<\/p>\n<p>h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay (P)<\/p>\n<p>\u2153 d\u01b0\u1edbi c\u1eb3ng tay (P): kh\u00f4ng v\u1ebft th\u01b0\u01a1ng , bi\u1ebfn d\u1ea1ng, s\u01b0ng b\u1ea7m nhi\u1ec1u<\/p>\n<p>\u00a0X\u00e2y x\u00e1t da 2 g\u1ed1i<\/p>\n<p>Sinh hi\u1ec7u:<\/p>\n<p>M\u1ea1ch: 84 l\u1ea7n\/ph\u00fat<\/p>\n<p>Huy\u1ebft \u00e1p: 120\/70 mmHg<\/p>\n<p>Nhi\u1ec7t \u0111\u1ed9: 37<sup>0<\/sup>OLD<\/p>\n<p>Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat<\/p>\n<ul>\n<li><strong>X\u1eed tr\u00ed t\u1ea1i c\u1ea5p c\u1ee9u: <\/strong><\/li>\n<\/ul>\n<p>SAT 1500UI TB<\/p>\n<p>C\u1ed1 \u0111\u1ecbnh b\u1eb1ng n\u1eb9p c\u00e1nh tay-b\u00e0n tay (P)<\/p>\n<ul>\n<li><strong>C\u1eadn l\u00e2m s\u00e0ng c\u1ea5p c\u1ee9u<\/strong>:<\/li>\n<\/ul>\n<p>T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi, nh\u00f3m m\u00e1u, \u0111\u00f4ng c\u1ea7m m\u00e1u, \u0111\u1ecbnh l\u01b0\u1ee3ng ethanol m\u00e1u, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3 (Na+, K+, Cl-), sinh ho\u00e1 m\u00e1u ( \u0111\u1ecbnh l\u01b0\u1ee3ng glucose, ure, creatinine, eGFR, AST,ALT), t\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u.<\/p>\n<ol start=\"3\">\n<li><strong> Di\u1ec5n ti\u1ebfn b\u1ec7nh ph\u00f2ng:<\/strong><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<table width=\"624\">\n<tbody>\n<tr>\n<td width=\"168\">\n<p>Ng\u00e0y, gi\u1edd<\/p>\n<\/td>\n<td width=\"209\">\n<p>Di\u1ec5n ti\u1ebfn b\u1ec7nh<\/p>\n<\/td>\n<td width=\"247\">\n<p>To solve<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"168\">\n<p>28\/09\/2024<\/p>\n<p>6 gi\u1edd 50ph<\/p>\n<\/td>\n<td width=\"209\">\n<p>B\u1ec7nh nh\u00e2n t\u1ec9nh ti\u1ebfp x\u00fac t\u1ed1t<\/p>\n<p>sinh hi\u1ec7u \u1ed5n<\/p>\n<p>\u0110au c\u1eb3ng tay (P)<\/p>\n<p>h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay P<\/p>\n<p>m\u1ea1ch quay P b\u1eaft r\u00f5<\/p>\n<p>K+: 2.7<\/p>\n<\/td>\n<td width=\"247\">\n<p>\u00a0 Kali clorid 10% 1g\/10ml 2 \u1ed1ng<\/p>\n<p>\u00a0 Natri clorid 0.9% 500ml<\/p>\n<p>\u00a0 Magnesi sulfat 15% 1,5g\/10ml 3 \u1ed1ng<\/p>\n<p>\u00a0 pha chung TTM XX g\/ph<\/p>\n<p>&nbsp;<\/p>\n<p>\u00a0Paracetamol 500mg<\/p>\n<p>\u00a0 1v x 3 (u) (8g &#8211; 14g -20g)<\/p>\n<p>&nbsp;<\/p>\n<p>x\u00e9t nghi\u1ec7m l\u1ea1i \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3 sau truy\u1ec1n kali<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"168\">\n<p>28\/09\/2024<\/p>\n<p>8g30<\/p>\n<\/td>\n<td width=\"209\">\n<p>K+ 3.8<\/p>\n<\/td>\n<td width=\"247\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"168\">\n<p>29-30\/10\/2-2024<\/p>\n<\/td>\n<td width=\"209\">\n<p>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/p>\n<p>Sinh hi\u1ec7u \u1ed5n<\/p>\n<p>C\u00f2n \u0111au c\u1eb3ng tay ( P )<\/p>\n<p>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay ( P )<\/p>\n<p>M\u1ea1ch quay tay ( P ) \u0111\u1ec1u r\u00f5<\/p>\n<p>Kh\u00f4ng t\u00ea tay<\/p>\n<\/td>\n<td width=\"247\">\n<p>Paracetamol 500 mg<\/p>\n<p>1 vi\u00ean x 3 ( u\u1ed1ng ) ( 8g &#8211; 14g &#8211; 20g )<\/p>\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>T\u00ecnh tr\u1ea1ng hi\u1ec7n t\u1ea1i: 20 gi\u1edd 00 ph\u00fat, ng\u00e0y 01\/10\/2024<\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n c\u00f2n \u0111au 1\/3 d\u01b0\u1edbi c\u1eb3ng tay (P), \u0111\u00e1nh gi\u00e1 \u0111i\u1ec3m \u0111au VAS: 5\u0111<\/li>\n<li>c\u00f2n s\u01b0ng n\u1ec1 1\/3 d\u01b0\u1edbi c\u1eb3ng tay (P)<\/li>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay (P)<\/li>\n<li>Kh\u00f4ng t\u00ea tay<\/li>\n<\/ul>\n<ol>\n<li><strong>TI\u1ec0N S\u1eec<\/strong><\/li>\n<li><strong>B\u1ea3n th\u00e2n<\/strong><\/li>\n<\/ol>\n<ul>\n<li>Ngo\u1ea1i khoa: Ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay sau tai n\u1ea1n giao th\u00f4ng kho\u1ea3ng 10 n\u0103m tr\u01b0\u1edbc t\u1ea1i b\u1ec7nh vi\u1ec7n Gia \u0110\u1ecbnh<\/li>\n<li>N\u1ed9i khoa: Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n b\u1ec7nh l\u00fd n\u1ed9i khoa<\/li>\n<li>D\u1ecb \u1ee9ng: ch\u01b0a ghi nh\u1eadn ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng thu\u1ed1c, th\u1ee9c \u0103n.<\/li>\n<li>Th\u00f3i quen: u\u1ed1ng r\u01b0\u1ee3u bia kh\u00f4ng th\u01b0\u1eddng xuy\u00ean, kh\u00f4ng h\u00fat thu\u1ed1c l\u00e1.<\/li>\n<\/ul>\n<ol start=\"2\">\n<li><strong>Gia \u0111\u00ecnh<\/strong><\/li>\n<\/ol>\n<ul>\n<li>Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n b\u1ec7nh l\u00fd li\u00ean quan.<\/li>\n<\/ul>\n<ol>\n<li><strong>KH\u00c1M L\u00c2M S\u00c0NG ( 20 gi\u1edd 00 ph\u00fat ng\u00e0y 01\/10\/2024 )<\/strong><\/li>\n<li><strong>Kh\u00e1m t\u1ed5ng tr\u1ea1ng<\/strong><\/li>\n<\/ol>\n<ul>\n<li>B\u1ec7nh t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/li>\n<li>Da, ni\u00eam m\u1ea1c h\u1ed3ng<\/li>\n<li>Chi \u1ea5m, m\u1ea1ch quay \u0111\u1ec1u r\u00f5, CRT&lt;2s<\/li>\n<li>Tuy\u1ebfn gi\u00e1p kh\u00f4ng to<\/li>\n<li>H\u1ea1ch ngo\u1ea1i vi s\u1edd kh\u00f4ng ch\u1ea1m.<\/li>\n<li>Sinh hi\u1ec7u:\n<ul>\n<li>M\u1ea1ch: 82 l\u1ea7n\/ph\u00fat<\/li>\n<li>Huy\u1ebft \u00e1p: 120\/80 mmHg<\/li>\n<li>Nhi\u1ec7t \u0111\u1ed9: 37<sup>0<\/sup>OLD<\/li>\n<li>Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat<\/li>\n<li>SpO2: 98%<\/li>\n<\/ul>\n<\/li>\n<li>C\u00e2n n\u1eb7ng: 62 Chi\u1ec1u cao: 1.65 m. BMI = 22.7 kg\/m<sup>2<\/sup> ( Th\u1ec3 tr\u1ea1ng trung b\u00ecnh theo IDI &amp; WPRO )<\/li>\n<\/ul>\n<ol start=\"2\">\n<li><strong>Kh\u00e1m tim m\u1ea1ch<\/strong><\/li>\n<\/ol>\n<ul>\n<li>L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf.<\/li>\n<li>M\u1ecfm tim \u1edf khoang li\u00ean s\u01b0\u1eddn IV, \u0111\u01b0\u1eddng trung \u0111\u00f2n T, di\u1ec7n \u0111\u1eadp 1x1cm<\/li>\n<li>Rung miu (-), Harzer (-)<\/li>\n<li>T1, T2 \u0111\u1ec1u r\u00f5, t\u1ea7n s\u1ed1 82 l\u1ea7n\/ph\u00fat.<\/li>\n<li>Kh\u00f4ng \u00e2m th\u1ed5i.<\/li>\n<\/ul>\n<ol start=\"3\">\n<li><strong>Kh\u00e1m h\u00f4 h\u1ea5p<\/strong><\/li>\n<\/ol>\n<ul>\n<li>Kh\u00f4ng co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5.<\/li>\n<li>Rung thanh \u0111\u1ec1u 2 b\u00ean.<\/li>\n<li>G\u00f5 trong kh\u1eafp ph\u1ed5i.<\/li>\n<li>R\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu 2 ph\u1ebf tr\u01b0\u1eddng.<\/li>\n<\/ul>\n<ol start=\"4\">\n<li><strong>Kh\u00e1m ti\u00eau h\u00f3a<\/strong><\/li>\n<\/ol>\n<ul>\n<li>B\u1ee5ng c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf<\/li>\n<li>Kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7.<\/li>\n<li>Kh\u00f4ng \u00e2m th\u1ed5i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng, nhu \u0111\u1ed9ng ru\u1ed9t 6 l\/p.<\/li>\n<li>G\u00f5 trong kh\u1eafp b\u1ee5ng.<\/li>\n<li>B\u1ee5ng m\u1ec1m, \u1ea5n kh\u00f4ng \u0111au, gan l\u00e1ch s\u1edd kh\u00f4ng ch\u1ea1m.<\/li>\n<\/ul>\n<ol start=\"5\">\n<li><strong> Kh\u00e1m c\u01a1 x\u01b0\u01a1ng kh\u1edbp<\/strong>:<\/li>\n<\/ol>\n<ol>\n<li><strong>Upper limb<\/strong><\/li>\n<\/ol>\n<p>B\u1ec7nh nh\u00e2n ng\u1ed3i, t\u01b0 th\u1ebf khu\u1ef7u g\u1ea5p 80 \u0111\u1ed9, \u0111eo n\u1eb9p c\u00e1nh &#8211; c\u1eb3ng- b\u00e0n tay (P) th\u00e1o n\u1eb9p ki\u1ec3m tra<\/p>\n<p><strong><u>NH\u00ccN<\/u><\/strong>:\u00a0 (Tay ph\u1ea3i)<\/p>\n<ul>\n<li>Kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng<\/li>\n<li>S\u01b0ng n\u1ec1 \u2153 d\u01b0\u1edbi c\u1eb3ng tay , kh\u00f4ng t\u1ee5 m\u00e1u<\/li>\n<li>Bi\u1ebfn d\u1ea1ng g\u1eadp g\u00f3c v\u1eb9o ngo\u00e0i \u2153 d\u01b0\u1edbi c\u1eb3ng tay ( P )<\/li>\n<li>\u0110\u1ea7u c\u00e1c <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ban-ngon-tay-gay-xuong-ban-tay\/\">ng\u00f3n tay<\/a> h\u1ed3ng.<\/li>\n<li>Kh\u00f4ng u c\u1ee5c, kh\u00f4ng c\u00f3 s\u1eb9o m\u1ed5 c\u0169<\/li>\n<\/ul>\n<p><strong><u>S\u1edc:<\/u><\/strong><\/p>\n<ul>\n<li>Chi \u1ea5m<\/li>\n<li>S\u1ee9c c\u01a1 hi\u1ec7n t\u1ea1i kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do b\u1ec7nh nh\u00e2n \u0111au<\/li>\n<li>S\u1edd \u0111\u01b0\u1ee3c c\u00e1c m\u1ed1c x\u01b0\u01a1ng: m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u ngo\u00e0i, m\u1ecfm khu\u1ef7u, ch\u1ecfm quay, m\u1ecfm tr\u00ean r\u00f2ng r\u1ecdc, m\u1ecfm tr\u00e2m tr\u1ee5, m\u1ecfm tr\u00e2m quay<\/li>\n<li>M\u1ecfm tr\u00e2m quay th\u1ea5p h\u01a1n m\u1ecfm tr\u00e2m tr\u1ee5 kho\u1ea3ng 1 cm<\/li>\n<li>\u0110M c\u00e1nh tay, \u0110M quay b\u1eaft r\u00f5 \u0111\u1ec1u 2 b\u00ean<\/li>\n<li>\u1ea4n \u0111au ch\u00f3i v\u00e0 s\u1edd c\u00f3 \u0111i\u1ec3m m\u1ea5t li\u00ean t\u1ee5c x\u01b0\u01a1ng quay v\u1ecb tr\u00ed m\u1ecfn tr\u00e2m quay l\u00ean 10 cm<\/li>\n<li>\u1ea4n \u0111au ch\u00f3i v\u00e0 s\u1edd c\u00f3 \u0111i\u1ec3m m\u1ea5t li\u00ean t\u1ee5c x\u01b0\u01a1ng tr\u1ee5 v\u1ecb tr\u00ed m\u1ecfm tr\u00e2m quay l\u00ean 8 cm<\/li>\n<li>Kh\u00e1m c\u1ea3m gi\u00e1c ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong><u>\u0110O:<\/u><\/strong> 2 tay<\/p>\n<p>Chu vi c\u1eb3ng tay: t\u1eeb m\u1ecfm tr\u00e2m quay l\u00ean 10cm<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 (T): 26cm<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 (P): 28cm<\/p>\n<p>Chi\u1ec1u d\u00e0i c\u1eb3ng tay<\/p>\n<table width=\"576\">\n<tbody>\n<tr>\n<td width=\"286\">\n<p>Length<\/p>\n<\/td>\n<td width=\"152\">\n<p>Tr\u00e1i<\/p>\n<\/td>\n<td width=\"138\">\n<p>Ph\u1ea3i<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"286\">\n<p>T\u01b0\u01a1ng \u0111\u1ed1i c\u1eb3ng tay = t\u01b0\u01a1ng \u0111\u1ed1i x\u01b0\u01a1ng quay<br \/>\n(m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u &#8211; m\u1ecfm tr\u00e2m quay)<\/p>\n<\/td>\n<td width=\"152\">\n<p>24cm<\/p>\n<\/td>\n<td width=\"138\">\n<p>23cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"286\">\n<p>tuy\u1ec7t \u0111\u1ed1i c\u1eb3ng tay = tuy\u1ec7t \u0111\u1ed1i x\u01b0\u01a1ng tr\u1ee5<br \/>\n(m\u1ecfm khu\u1ef7u &#8211; m\u1ecfm tr\u00e2m tr\u1ee5)<\/p>\n<\/td>\n<td width=\"152\">\n<p>23cm<\/p>\n<\/td>\n<td width=\"138\">\n<p>22cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"286\">\n<p>tuy\u1ec7t \u0111\u1ed1i x\u01b0\u01a1ng quay<\/p>\n<p>(ch\u1ecfm quay &#8211; m\u1ecfm tr\u00e2m quay)<\/p>\n<\/td>\n<td width=\"152\">\n<p>23cm<\/p>\n<\/td>\n<td width=\"138\">\n<p>22cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"286\">\n<p>t\u01b0\u01a1ng \u0111\u1ed1i x\u01b0\u01a1ng tr\u1ee5<\/p>\n<p>(m\u1ecfm tr\u00ean r\u00f2ng r\u1ecdc &#8211; m\u1ecfm tr\u00e2m tr\u1ee5)<\/p>\n<\/td>\n<td width=\"152\">\n<p>24cm<\/p>\n<\/td>\n<td width=\"138\">\n<p>23cm<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>\u00a0<strong>Conclusion<\/strong>: chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i tuy\u1ec7t \u0111\u1ed1i c\u1ee7a c\u1eb3ng tay, x\u01b0\u01a1ng quay x\u01b0\u01a1ng tr\u1ee5 b\u00ean (P) ng\u1eafn h\u01a1n b\u00ean (T) 1cm<\/p>\n<p><strong><u>V\u1eacN \u0110\u1ed8NG:<\/u><\/strong><\/p>\n<ul>\n<li>C\u00e1c ng\u00f3n tay (P) c\u1eed \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng<\/li>\n<li>Kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c s\u1ea5p ng\u1eeda c\u1eb3ng tay (P)<\/li>\n<li>C\u1ed5 tay (P) h\u1ea1n ch\u1ebf g\u1ea5p, du\u1ed7i, nghi\u00eang quay, nghi\u00eang tr\u1ee5 do \u0111au<\/li>\n<\/ul>\n<ol>\n<li><strong>Lower extremities<\/strong><\/li>\n<\/ol>\n<ul>\n<li>X\u00e2y x\u00e1t 2 \u0111\u1ea7u g\u1ed1i k\u00edch th\u01b0\u1edbc 4x4cm<\/li>\n<li>V\u1eadn \u0111\u1ed9ng chi d\u01b0\u1edbi trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng, s\u1ee9c c\u01a1 2 ch\u00e2n 5\/5<\/li>\n<\/ul>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <strong><u>C\u1ea2M GI\u00c1C<\/u><\/strong><\/p>\n<ul>\n<li>Kh\u00f4ng t\u00ea<\/li>\n<\/ul>\n<ol start=\"6\">\n<li><strong> Kh\u00e1m c\u00e1c c\u01a1 quan kh\u00e1c:<\/strong> Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/li>\n<li><strong>T\u00d3M T\u1eaeT B\u1ec6NH \u00c1N<\/strong><\/li>\n<\/ol>\n<p>B\u1ec7nh nh\u00e2n nam, 28 tu\u1ed5i v\u00e0o vi\u1ec7n v\u00ec \u0111au + bi\u1ebfn d\u1ea1ng \u2153 d\u01b0\u1edbi c\u1eb3ng tay (P) sau tai n\u1ea1n giao th\u00f4ng ng\u00e0y th\u1ee9 4. Qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m l\u00e2m s\u00e0ng ghi nh\u1eadn:<\/p>\n<p>D\u1ea5u ch\u1ee9ng g\u00e3y 2 x\u01b0\u01a1ng c\u1eb3ng tay (P)<\/p>\n<ul>\n<li>Sure sign <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-kin\/\">fracture<\/a><\/li>\n<li>Bi\u1ebfn d\u1ea1ng: g\u1eadp g\u00f3c \u2153 d\u01b0\u1edbi c\u1eb3ng tay (P), s\u1edd c\u00f3 \u0111i\u1ec3m m\u1ea5t li\u00ean t\u1ee5c 2 x\u01b0\u01a1ng c\u1eb3ng tay, chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i, tuy\u1ec7t \u0111\u1ed1i c\u1eb3ng tay (P) ng\u1eafn h\u01a1n (T)<\/li>\n<li>D\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng<\/li>\n<li>\u1ea4n \u0111au ch\u00f3i \u2153 d\u01b0\u1edbi c\u1eb3ng tay (P)<\/li>\n<li>S\u01b0ng n\u1ec1 1\/3 d\u01b0\u1edbi c\u1eb3ng tay (P).<\/li>\n<li>C\u1ed5 tay (P) h\u1ea1n ch\u1ebf g\u1ea5p du\u1ed7i.<\/li>\n<li>kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c s\u1ea5p ng\u1eeda c\u1eb3ng tay (P) do \u0111au<\/li>\n<li>C\u00e1c d\u1ea5u ch\u1ee9ng c\u00f3 gi\u00e1 tr\u1ecb kh\u00e1c<\/li>\n<li>Kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng v\u00f9ng c\u1eb3ng tay(P)<\/li>\n<li>Kh\u00f4ng t\u00ea b\u00ec, c\u1ea3m gi\u00e1c c\u1eb3ng b\u00e0n tay (P) b\u00ecnh th\u01b0\u1eddng<\/li>\n<li>C\u00e1c ng\u00f3n tay c\u1eed \u0111\u1ed9ng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng<\/li>\n<li>M\u1ea1ch quay b\u1eaft \u0111\u1ec1u r\u00f5 2 b\u00ean<\/li>\n<li>Tay \u1ea5m<\/li>\n<li><strong>CH\u1ea8N \u0110O\u00c1N S\u01a0 B\u1ed8<\/strong><\/li>\n<\/ul>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-kin\/\">Closed fracture<\/a> 1\/3 d\u01b0\u1edbi 2 x\u01b0\u01a1ng c\u1eb3ng tay (P) sau tai n\u1ea1n giao th\u00f4ng ng\u00e0y 4, hi\u1ec7n t\u1ea1i ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng.<\/p>\n<ul>\n<li><strong>BI\u1ec6N LU\u1eacN CH\u1ea8N \u0110O\u00c1N<\/strong><\/li>\n<\/ul>\n<ol>\n<li><strong> V\u1ec1 b\u1ec7nh ch\u00ednh:<\/strong><\/li>\n<\/ol>\n<p><strong>&#8211;<\/strong> B\u1ec7nh nh\u00e2n nam, 28 tu\u1ed5i, v\u00e0o vi\u1ec7n v\u00ec l\u00fd do \u0111au, bi\u1ebfn d\u1ea1ng v\u00f9ng c\u1eb3ng tay (P) do tai n\u1ea1n giao th\u00f4ng , tr\u00ean l\u00e2m s\u00e0ng c\u00f3 d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng (bi\u1ebfn d\u1ea1ng c\u1eb3ng tay P, s\u1edd th\u1ea5y c\u00f3 \u0111i\u1ec3m m\u1ea5t li\u00ean t\u1ee5c x\u01b0\u01a1ng quay v\u00e0 x\u01b0\u01a1ng tr\u1ee5, chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i, tuy\u1ec7t \u0111\u1ed1i c\u1eb3ng tay ( P ) ng\u1eafn h\u01a1n\u00a0 ( T )) v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn nh\u01b0 \u0111au, s\u01b0ng n\u1ec1 , h\u1ea1n ch\u1ebf c\u1eed \u0111\u1ed9ng c\u1eb3ng tay (P) n\u00ean ngh\u0129 \u0111\u1ebfn t\u00ecnh tr\u1ea1ng g\u00e3y 2 x\u01b0\u01a1ng c\u1eb3ng tay (P) tr\u00ean b\u1ec7nh nh\u00e2n n\u00e0y. \u1ede v\u1ecb tr\u00ed ch\u1ea5n th\u01b0\u01a1ng kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng th\u00f4ng \u1ed5 g\u00e3y ra ngo\u00e0i n\u00ean g\u00e3y x\u01b0\u01a1ng n\u00e0y l\u00e0 g\u00e3y k\u00edn.<\/p>\n<ol>\n<li><strong> V\u1ec1 nguy\u00ean nh\u00e2n v\u00e0 c\u01a1 ch\u1ebf:<\/strong><\/li>\n<\/ol>\n<p>B\u1ec7nh nh\u00e2n b\u1ecb g\u00e3y x\u01b0\u01a1ng t\u1ea1i v\u1ecb tr\u00ed b\u1ecb \u0111\u1ea7u xe \u0111\u1ed1i di\u1ec7n t\u00f4ng tr\u1ef1c ti\u1ebfp v\u00e0o n\u00ean ngh\u0129 \u0111\u1ebfn nguy\u00ean nh\u00e2n g\u00e3y x\u01b0\u01a1ng do c\u01a1 ch\u1ebf ch\u1ea5n tr\u01b0\u01a1ng tr\u1ef1c ti\u1ebfp. Do b\u1ec7nh nh\u00e2n nam, tr\u1ebb tu\u1ed5i, kh\u00f4ng h\u00fat thu\u1ed1c, kh\u00f4ng s\u1eed d\u1ee5ng r\u01b0\u1ee3u bia th\u01b0\u1eddng xuy\u00ean, kh\u00f4ng m\u1eafc b\u1ec7nh n\u1ec1n \u0111i k\u00e8m n\u00ean\u00a0 \u00edt ngh\u0129 \u0111\u1ebfn g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd.<\/p>\n<ol>\n<li><strong> V\u1ec1 bi\u1ebfn ch\u1ee9ng<\/strong><\/li>\n<\/ol>\n<p>To\u00e0n th\u00e2n:<\/p>\n<ul>\n<li>S\u1ed1c do \u0111au v\u00e0 m\u1ea5t m\u00e1u:<\/li>\n<\/ul>\n<p>Su\u1ed1t qu\u00e1 tr\u00ecnh b\u1ec7nh BN t\u1ec9nh t\u00e1o, ti\u1ebfp x\u00fac t\u1ed1t, sinh hi\u1ec7u \u1ed5n \u0111\u1ecbnh, ch\u1ec9 s\u1ed1 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/da-chan-thuong-choang-chan-thuong\/\">stunned<\/a> (CSC) &lt; 1, ch\u1ee9c n\u0103ng t\u01b0\u1edbi m\u00e1u ngo\u1ea1i vi t\u1ed1t, \u0111i\u1ec3m \u0111au \u1edf m\u1ee9c trung b\u00ecnh VAS 5\u0111\u00a0 n\u00ean c\u00f3 th\u1ec3 th\u1ea5y tr\u00ean b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u00e3 kh\u00f4ng x\u1ea3y ra t\u00ecnh tr\u1ea1ng s\u1ed1c do \u0111au v\u00e0 m\u1ea5t m\u00e1u.<\/p>\n<ul>\n<li>T\u1eafc m\u1ea1ch do m\u1ee1 :<\/li>\n<\/ul>\n<p>B\u1ec7nh nh\u00e2n KH\u00d4NG c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 thu\u1eadn l\u1ee3i c\u1ee7a t\u1eafc m\u1ea1ch do m\u1ee1 nh\u01b0:<\/p>\n<ul>\n<li>G\u00e3y th\u00e2n c\u00e1c x\u01b0\u01a1ng d\u00e0i l\u1edbn.<\/li>\n<li>G\u00e3y nhi\u1ec1u x\u01b0\u01a1ng, ho\u1eb7c c\u00f3 nhi\u1ec1u m\u00f4 gi\u1eadp n\u00e1t<\/li>\n<li>C\u00f3 k\u00e8m bi\u1ebfn ch\u1ee9ng s\u1ed1c.<\/li>\n<li>C\u00f3 b\u1ec7nh \u1edf ph\u1ed5i<\/li>\n<\/ul>\n<p>Kh\u00e1m l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n : Kh\u00f4ng ho, kh\u00f4ng kh\u00f3 th\u1edf, kh\u00f4ng \u0111au ng\u1ef1c, da ni\u00eam m\u1ea1c h\u1ed3ng, kh\u00f4ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da, nh\u1ecbp tim \u0111\u1ec1u r\u00f5 n\u00ean ch\u01b0a ngh\u0129 \u0111\u1ebfn bi\u1ebfn ch\u1ee9ng t\u1eafc m\u1ea1ch ph\u1ed5i do m\u1ee1 tr\u00ean b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n<p>T\u1ea1i ch\u1ed5:<\/p>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u, th\u1ea7n kinh:<\/li>\n<\/ul>\n<p>Th\u0103m kh\u00e1m hi\u1ec7n t\u1ea1i b\u1ec7nh nh\u00e2n: Kh\u00f4ng t\u00ea b\u00ec, c\u1ea3m gi\u00e1c n\u00f4ng s\u00e2u b\u00ecnh th\u01b0\u1eddng c\u00e1c ng\u00f3n tay ( P ) c\u1eed \u0111\u1ed9ng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng; tay ( P ) \u1ea5m,\u00a0 m\u1ea1ch quay b\u1eaft r\u00f5 n\u00ean tr\u00ean b\u1ec7nh nh\u00e2n n\u00e0y kh\u00f4ng ph\u00e1t hi\u1ec7n bi\u1ebfn ch\u1ee9ng t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u v\u00e0 th\u1ea7n kinh.<\/p>\n<ul>\n<li>Syndrome <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/hoi-chung-chen-ep-khoang\/\">cavity compression<\/a>:<\/li>\n<\/ul>\n<p>B\u1ec7nh nh\u00e2n \u0111au v\u00f9ng c\u1eb3ng tay (P) nh\u01b0ng \u0111au kh\u00f4ng t\u0103ng d\u1ea7n, c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c gi\u1ea3m \u0111au, k\u00e8m theo kh\u00f4ng c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u ch\u00e8n \u00e9p m\u1ea1ch m\u00e1u v\u00e0 th\u1ea7n kinh \u0111\u00e3 tr\u00ecnh b\u00e0y \u1edf tr\u00ean n\u00ean kh\u00f4ng ngh\u0129 \u0111\u1ebfn h\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p khoang tr\u00ean b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n<p>Hi\u1ec7n t\u1ea1i b\u1ec7nh nh\u00e2n ch\u01b0a c\u00f3 bi\u1ec3u hi\u1ec7n c\u1ee7a c\u00e1c bi\u1ebfn ch\u1ee9ng sau g\u00e3y x\u01b0\u01a1ng. Tuy nhi\u00ean, c\u1ea7n theo d\u00f5i li\u00ean t\u1ee5c \u0111\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 x\u1eed tr\u00ed k\u1ecbp th\u1eddi khi c\u00f3 bi\u1ebfn ch\u1ee9ng x\u1ea3y ra.<\/p>\n<ul>\n<li>Tr\u1eadt kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi;<\/li>\n<li>B\u1ec7nh nh\u00e2n g\u00e3y \u2153 d\u01b0\u1edbi c\u1eb3ng tay c\u00f3 nguy c\u01a1 tr\u1eadt kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi d\u00f9 kh\u00e1m b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111au hay s\u01b0ng n\u1ec1 v\u00f9ng c\u1ed5 tay, m\u1ecfm tr\u00e2m quay v\u00e0 m\u1ecfm tr\u00e2m tr\u1ee5 s\u1edd d\u01b0\u1edbi da kh\u00f4ng bi\u1ebfn d\u1ea1ng \u1ea5n kh\u00f4ng \u0111au tuy nhi\u00ean s\u1ea5p ng\u1eeda c\u1eb3ng tay v\u00e0 g\u1ea5p du\u1ed7i nghi\u00ean c\u1ed5 tay b\u1ec7nh nh\u00e2n kh\u00f4ng l\u00e0m \u0111\u01b0\u1ee3c do \u0111au n\u00ean kh\u00f4ng th\u1ec3 lo\u1ea1i tr\u1eeb.<\/li>\n<\/ul>\n<ol>\n<li><strong> V\u1ec1 h\u1ea1 Kali m\u00e1u tr\u00ean b\u1ec7nh nh\u00e2n<\/strong><\/li>\n<\/ol>\n<p>Kali m\u00e1u v\u00e0o vi\u1ec7n l\u00e0 2.7 mmol\/l, kh\u00f4ng c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a h\u1ea1 kali m\u00e1u n\u00ean ph\u00e2n lo\u1ea1i h\u1ea1 kali m\u00e1u m\u1ee9c \u0111\u1ed9 trung b\u00ecnh ch\u01b0a bi\u1ebfn ch\u1ee9ng, ngh\u0129 nguy\u00ean nh\u00e2n do ch\u1ebf \u0111\u1ed9 \u0103n ngh\u00e8o kali v\u00ec b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 b\u1ec7nh n\u1ec1n, kh\u00f4ng s\u1eed d\u1ee5ng thu\u1ed1c g\u00e2y nguy c\u01a1 h\u1ea1 kali m\u00e1u, sau \u0111i\u1ec1u tr\u1ecb hi\u1ec7n kali m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n l\u00e0 3.8 mmol\/l.<\/p>\n<p><strong>\u0110\u1ec0 NGH\u1eca C\u1eacN L\u00c2M S\u00c0NG<\/strong><\/p>\n<ol>\n<li><strong>C\u1eadn l\u00e2m s\u00e0ng ch\u1ea9n \u0111o\u00e1n<\/strong><\/li>\n<\/ol>\n<p>X-quang th\u1eb3ng, nghi\u00eang x\u01b0\u01a1ng c\u1eb3ng tay (P). (\u0111\u00e3 th\u1ef1c hi\u1ec7n)<\/p>\n<p>&nbsp;<\/p>\n<ol start=\"2\">\n<li><strong>C\u1eadn l\u00e2m s\u00e0ng ti\u1ec1n ph\u1eabu<\/strong><\/li>\n<\/ol>\n<ul>\n<li>T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi<\/li>\n<li>Nh\u00f3m m\u00e1u<\/li>\n<li>Sinh h\u00f3a m\u00e1u: AST, ALT, glucose, ure, creatinine<\/li>\n<li>Ion \u0111\u1ed3 ( Na, K, Cl )<\/li>\n<li>Bilan \u0111\u00f4ng c\u1ea7m m\u00e1u ( aPTT, TQ, TL, INR )<\/li>\n<li>T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u<\/li>\n<li>ECG<\/li>\n<li>X quang ng\u1ef1c th\u1eb3ng<\/li>\n<\/ul>\n<ol start=\"3\">\n<li><strong>K\u1ebft qu\u1ea3 c\u1eadn l\u00e2m s\u00e0ng ( \u0111\u00e3 c\u00f3 )<\/strong><\/li>\n<li><strong>C\u00f4ng th\u1ee9c m\u00e1u: <\/strong><\/li>\n<\/ol>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 RBC: 7.6 K\/uL<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 RBC : 5.35 M\/uL<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 PLT: 247 K\/uL<\/p>\n<p>\u00ae C\u00f4ng th\u1ee9c m\u00e1u n\u1eb1m trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng<\/p>\n<ol>\n<li><strong><strong>X-quang x\u01b0\u01a1ng c\u1eb3ng tay (P) th\u1eb3ng, nghi\u00eang<\/strong><\/strong><br \/>\n<figure id=\"attachment_4255\" aria-describedby=\"caption-attachment-4255\" style=\"width: 1729px\" class=\"wp-caption alignnone\"><img fetchpriority=\"high\" decoding=\"async\" class=\"size-full wp-image-4255\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/tien-phau.jpg\" alt=\"Ti\u1ec1n Ph\u1eabu\" width=\"1729\" height=\"2048\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/tien-phau.jpg 1729w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/tien-phau-253x300.jpg 253w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/tien-phau-865x1024.jpg 865w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/tien-phau-768x910.jpg 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/tien-phau-1297x1536.jpg 1297w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/tien-phau-10x12.jpg 10w\" sizes=\"(max-width: 1729px) 100vw, 1729px\" \/><figcaption id=\"caption-attachment-4255\" class=\"wp-caption-text\">Ti\u1ec1n Ph\u1eabu<\/figcaption><\/figure>\n<\/li>\n<\/ol>\n<p><strong>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 <\/strong>\u0110\u1ecdc phim:<\/p>\n<ul>\n<li>Th\u1ee7 t\u1ee5c h\u00e0nh ch\u00ednh:<\/li>\n<li>H\u1ecd v\u00e0 t\u00ean BN: NGUY\u1ec4N T\u1ea4N C, nam, 28 tu\u1ed5i<\/li>\n<li>Ng\u00e0y th\u00e1ng n\u0103m ch\u1ee5p: 27\/09\/2024<\/li>\n<li>T\u01b0 th\u1ebf phim: phim th\u1eb3ng, nghi\u00eang<\/li>\n<li>V\u1ecb tr\u00ed: c\u1eb3ng tay ( P )<\/li>\n<li>Ti\u00eau chu\u1ea9n phim<\/li>\n<li>C\u01b0\u1eddng \u0111\u1ed9 tia \u0111\u1ee7<\/li>\n<li>\u0110\u1ee7 phim th\u1eb3ng v\u00e0 nghi\u00eang.<\/li>\n<li>K\u00edch th\u01b0\u1edbc phim:<\/li>\n<\/ul>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Phim th\u1eb3ng: l\u1ea5y \u0111\u1ee7 c\u1ea3 2 kh\u1edbp tr\u00ean v\u00e0 d\u01b0\u1edbi v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng, \u0111\u1ee7 r\u1ed9ng l\u1ea5y \u0111\u01b0\u1ee3c c\u1ea3 b\u00f3ng ph\u1ea7n m\u1ec1m.<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Phim nghi\u00eang: ch\u1ec9 l\u1ea5y \u0111\u01b0\u1ee3c kh\u1edbp d\u01b0\u1edbi v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng, l\u1ea5y \u0111\u01b0\u1ee3c c\u1ea3 b\u00f3ng ph\u1ea7n m\u1ec1m.<\/p>\n<ul>\n<li>\u0110\u1ecdc t\u1ed5n th\u01b0\u01a1ng:<\/li>\n<li>X\u01b0\u01a1ng g\u00e3y: x\u01b0\u01a1ng quay v\u00e0 x\u01b0\u01a1ng tr\u1ee5 ( P )<\/li>\n<li>V\u1ecb tr\u00ed g\u00e3y: \u2153 d\u01b0\u1edbi x\u01b0\u01a1ng quay v\u00e0 x\u01b0\u01a1ng tr\u1ee5<\/li>\n<li>\u0110\u01b0\u1eddng g\u00e3y: g\u00e3y ch\u00e9o x\u01b0\u01a1ng quay v\u00e0 x\u01b0\u01a1ng tr\u1ee5<\/li>\n<li>Di l\u1ec7ch:<\/li>\n<\/ul>\n<p>X\u01b0\u01a1ng tr\u1ee5: di l\u1ec7ch sang b\u00ean ngo\u00e0i, m\u1ee9c \u0111\u1ed9 di l\u1ec7ch 1 th\u00e2n x\u01b0\u01a1ng, di l\u1ec7ch ch\u1ed3ng ng\u1eafn kho\u1ea3ng 1 cm, di l\u1ec7ch g\u1eadp g\u00f3c m\u1edf ra tr\u01b0\u1edbc &lt; 30 \u0111\u1ed9, di l\u1ec7ch xoay<\/p>\n<p>X\u01b0\u01a1ng quay: di l\u1ec7ch sang b\u00ean ngo\u00e0i, m\u1ee9c \u0111\u1ed9 di l\u1ec7ch \u00bd th\u00e2n x\u01b0\u01a1ng, di l\u1ec7ch ch\u1ed3ng ng\u1eafn kho\u1ea3ng 1cm, kh\u00f4ng c\u00f3 di l\u1ec7ch g\u1eadp g\u00f3c, kh\u00f4ng c\u00f3 di l\u1ec7ch xoay<\/p>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng k\u00e8m theo: tr\u1eadt kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi. Kh\u1ed1i x\u01b0\u01a1ng v\u00f9ng c\u1ed5 tay b\u1edd x\u01b0\u01a1ng li\u00ean t\u1ee5c, kh\u00f4ng n\u1ee9t g\u00e3y.<\/li>\n<\/ul>\n<p>\u00ae <strong>Conclusion<\/strong>: G\u00e3y k\u00edn 1\/3 d\u01b0\u1edbi 2 x\u01b0\u01a1ng c\u1eb3ng tay ( P ) nh\u00f3m A3.3 theo OTA. Tr\u1eadt kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi<\/p>\n<p>&nbsp;<\/p>\n<ol>\n<li><strong>CH\u1ea8N \u0110O\u00c1N X\u00c1C \u0110\u1ecaNH<\/strong><\/li>\n<\/ol>\n<p>G\u00e3y k\u00edn 1\/3 d\u01b0\u1edbi 2 x\u01b0\u01a1ng c\u1eb3ng tay (P) nh\u00f3m A3.3 theo OTA \u2013 tr\u1eadt kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi sau tai n\u1ea1n giao th\u00f4ng ng\u00e0y 4,hi\u1ec7n t\u1ea1i ch\u01b0a bi\u1ebfn ch\u1ee9ng<\/p>\n<ol>\n<li><strong> TREATMENT<\/strong><\/li>\n<li><strong>H\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb<\/strong><\/li>\n<\/ol>\n<ul>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/so-cuu-bat-dong-gay-xuong\/\">Motionless<\/a> t\u1ea1m th\u1eddi x\u01b0\u01a1ng g\u00e3y<\/li>\n<li>Pain relief<\/li>\n<li>Ph\u1ee5c h\u1ed3i gi\u1ea3i ph\u1eabu<\/li>\n<li>Theo d\u00f5i c\u00e1c bi\u1ebfn ch\u1ee9ng<\/li>\n<\/ul>\n<ol start=\"2\">\n<li><strong>Specific treatment<\/strong><\/li>\n<\/ol>\n<ul>\n<li>Ti\u1ebfp t\u1ee5c \u0111eo n\u1eb9p c\u00e1nh &#8211; c\u1eb3ng &#8211; b\u00e0n tay (P)<\/li>\n<li>Paracetamol 500mg<\/li>\n<\/ul>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0 1 vi\u00ean \u00a0x 3 ( u\u1ed1ng ) (8g- 14g &#8211; 20g)<\/p>\n<ul>\n<li>Ph\u1eabu thu\u1eadt ch\u01b0\u01a1ng tr\u00ecnh k\u1ebft h\u1ee3p x\u01b0\u01a1ng<\/li>\n<\/ul>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0 Ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt KHX<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; BN g\u00e3y k\u00edn \u2153 d\u01b0\u1edbi 2 x\u01b0\u01a1ng c\u1eb3ng tay di l\u1ec7ch \u0111\u00e1ng k\u1ec3, v\u00f9ng 1\/3 d\u01b0\u1edbi m\u1ea1ch m\u00e1u nu\u00f4i k\u00e9m k\u00e8m v\u1edbi b\u1ec7nh nh\u00e2n tr\u1ebb \u0111ang trong \u0111\u1ed9 tu\u1ed5i lao \u0111\u1ed9ng c\u1ea7n gi\u00fap b\u1ec7nh nh\u00e2n h\u1ed3i ph\u1ee5c s\u1edbm \u0111\u1ec3 quay l\u1ea1i c\u00f4ng vi\u1ec7c n\u00ean \u01b0u ti\u00ean ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p x\u01b0\u01a1ng \u1edf b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 V\u1ec1 ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt<\/p>\n<p>Hi\u1ec7n nay c\u00f3 2 ph\u01b0\u01a1ng ph\u00e1p KHX \u1edf BN g\u00e3y x\u01b0\u01a1ng c\u1eb3ng tay l\u00e0 \u0111inh n\u1ed9i tu\u1ef7 (\u0111inh Rush) v\u00e0 KHX b\u1eb1ng n\u1eb9p v\u00edt.<\/p>\n<ul>\n<li>Tuy nhi\u00ean \u0111inh n\u1ed9i tu\u1ef7 th\u01b0\u1eddng \u00e1p d\u1ee5ng \u1edf g\u00e3y x\u01b0\u01a1ng tr\u1ebb em v\u00e0 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ho\/\">open fracture<\/a> \u1edf ng\u01b0\u1eddi l\u1edbn, nh\u01b0\u1ee3c \u0111i\u1ec3m l\u00e0 kh\u00f4ng ch\u1ed1ng \u0111\u01b0\u1ee3c di l\u1ec7ch xoay, \u0111\u1eb7t l\u1ea1i gi\u1ea3i ph\u1eabu kh\u00f3 kh\u0103n trong g\u00e3y x\u01b0\u01a1ng c\u00f3 di l\u1ec7ch nhi\u1ec1u, n\u00ean th\u01b0\u1eddng ph\u1ea3i <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/bo-bot\/\">cast<\/a> t\u0103ng c\u01b0\u1eddng th\u00eam 4-6 tu\u1ea7n.<\/li>\n<li>\u1ede ph\u01b0\u01a1ng ph\u00e1p KHX n\u1eb9p v\u00edt \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho g\u00e3y c\u1ea3 2 x\u01b0\u01a1ng c\u1eb3ng tay, \u01b0u \u0111i\u1ec3m c\u1ed1 \u0111\u1ecbnh v\u1eefng ch\u1eafc \u0111\u01b0\u1ee3c m\u1ecdi di l\u1ec7ch, \u0111\u1eb7t l\u1ea1i x\u01b0\u01a1ng v\u1ec1 \u0111\u00fang gi\u1ea3i ph\u1eabu \u0111\u1ea3m b\u1ea3o ch\u1ee9c n\u0103ng s\u1ea5p ng\u1eeda c\u1eb3ng tay sau n\u00e0y v\u00e0 b\u1ec7nh nh\u00e2n nhanh v\u1eadn \u0111\u1ed9ng s\u1edbm.<\/li>\n<\/ul>\n<p>Do \u0111\u00f3, \u1edf b\u1ec7nh nh\u00e2n n\u00e0y ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p KHX b\u1eb1ng n\u1eb9p v\u00edt<\/p>\n<ul>\n<li>CSC III \u2013 BT01 C\u01a1m<\/li>\n<li>Theo d\u00f5i sinh hi\u1ec7u, m\u1ea1ch, nhi\u1ec7t \u0111\u1ed9, huy\u1ebft \u00e1p, nh\u1ecbp th\u1edf \/ 24 gi\u1edd<\/li>\n<\/ul>\n<ol>\n<li><strong>TI\u00caN L\u01af\u1ee2NG<\/strong><\/li>\n<\/ol>\n<p>&#8211; Ti\u00ean l\u01b0\u1ee3ng g\u1ea7n: kh\u00e1<\/p>\n<p>B\u1ec7nh nh\u00e2n ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p x\u01b0\u01a1ng c\u1eb3ng tay. Trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh c\u00f3 th\u1ec3 g\u1eb7p bi\u1ebfn ch\u1ee9ng g\u00e2y t\u00ea &#8211; g\u00e2y m\u00ea. B\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i, ch\u01b0a ghi nh\u1eadn ti\u1ec1n s\u1eed n\u1ed9i khoa tr\u01b0\u1edbc \u0111\u00e2y, g\u00e3y k\u00edn x\u01b0\u01a1ng c\u1eb3ng tay c\u00f3 di l\u1ec7ch \u0111\u00e1ng k\u1ec3 ( sang b\u00ean, g\u1eadp g\u00f3c, ch\u1ed3ng ng\u1eafn) tuy nhi\u00ean hi\u1ec7n t\u1ea1i ch\u01b0a ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh m\u1ea1ch m\u00e1u n\u00ean ti\u00ean l\u01b0\u1ee3ng g\u1ea7n \u1edf b\u1ec7nh nh\u00e2n l\u00e0 kh\u00e1<\/p>\n<p>&#8211; Ti\u00ean l\u01b0\u1ee3ng xa: Kh\u00e1<\/p>\n<p>B\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i, kh\u00f4ng b\u1ec7nh n\u1ec1n hay b\u1ec7nh l\u00fd c\u01a1 x\u01b0\u01a1ng kh\u1edbp k\u00e8m theo n\u00ean ti\u00ean l\u01b0\u1ee3ng <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/cham-lanh-xuong-va-khong-lanh-xuong\/\">bone healing<\/a> t\u1ed1t, nhanh; b\u1ec7nh nh\u00e2n c\u1ea7n t\u1eadp v\u1eadn \u0111\u1ed9ng s\u1edbm nh\u1eb1m tr\u00e1nh teo c\u01a1 c\u1ee9ng kh\u1edbp, <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/phuc-hoi-chuc-nang-benh-nhan-cut-chi\/\">Rehabilitation<\/a> v\u1eadn \u0111\u1ed9ng c\u1ee7a c\u1eb3ng tay (P) sau n\u00e0y.Tuy nhi\u00ean, c\u1ea7n theo d\u00f5i th\u00eam t\u00ecnh tr\u1ea1ng li\u1ec1n x\u01b0\u01a1ng v\u00e0 can x\u01b0\u01a1ng l\u1ec7ch x\u1ea5u, g\u00e3y l\u1ea1i sau th\u00e1o n\u1eb9p tr\u00ean b\u1ec7nh nh\u00e2n.<\/p>\n<ol>\n<li><strong>PREVENTIVE<\/strong><\/li>\n<\/ol>\n<ul>\n<li>V\u1ebft th\u01b0\u01a1ng sau m\u1ed5 c\u1eaft ch\u1ec9 sau 10 &#8211; 14 ng\u00e0y<\/li>\n<li>Dinh d\u01b0\u1ee1ng \u0111\u1ea7y \u0111\u1ee7, h\u1ee3p l\u00fd, b\u1ed5 xung th\u1ef1c ph\u1ea9m gi\u00e0u canxi<\/li>\n<li>T\u1eadp v\u1eadn \u0111\u1ed9ng s\u1edbm \u0111\u1ec3 tr\u00e1nh h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng s\u1ea5p ng\u1eeda.<\/li>\n<li>T\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau m\u1ed5<\/li>\n<li>T\u00e1i kh\u00e1m \u0111\u00fang h\u1eb9n<\/li>\n<\/ul>","protected":false},"featured_media":4256,"comment_status":"open","ping_status":"closed","template":"","tags":[],"chuyen-muc":[188],"class_list":["post-4253","bai-giang","type-bai-giang","status-publish","has-post-thumbnail","hentry","chuyen-muc-benh-an-mau"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4253","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=4253"}],"version-history":[{"count":3,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4253\/revisions"}],"predecessor-version":[{"id":4622,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4253\/revisions\/4622"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/4256"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=4253"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=4253"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=4253"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}