{"id":4879,"date":"2026-09-13T22:11:21","date_gmt":"2026-09-13T15:11:21","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=chuyen-de&p=4879"},"modified":"2026-09-13T22:13:09","modified_gmt":"2026-09-13T15:13:09","slug":"benh-an-khoa-ngoai-chan-thuong-chinh-hinh-mach-van-h","status":"publish","type":"chuyen-de","link":"https:\/\/bsvothanhtoan.com\/en\/chuyen-de\/benh-an-khoa-ngoai-chan-thuong-chinh-hinh-mach-van-h\/","title":{"rendered":"B\u1ec7nh \u00c1n Khoa Ngo\u1ea1i Ch\u1ea5n Th\u01b0\u01a1ng Ch\u1ec9nh H\u00ecnh M\u1ea1ch V\u0103n H."},"content":{"rendered":"

B\u1ec6NH \u00c1N KHOA NGO\u1ea0I CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH\u00a0<\/strong><\/p>\n

I. H\u00c0NH CH\u00cdNH\u00a0<\/strong><\/p>\n

– H\u1ecd v\u00e0 t\u00ean b\u1ec7nh nh\u00e2n: M\u1ea0CH V\u0102N H.\u00a0<\/p>\n

– Gi\u1edbi t\u00ednh: Nam\u00a0<\/p>\n

– N\u0103m sinh: 1992 (34 tu\u1ed5i)\u00a0<\/p>\n

– D\u00e2n t\u1ed9c: Kinh\u00a0<\/p>\n

– Ngh\u1ec1 nghi\u1ec7p: C\u00f4ng nh\u00e2n x\u00e2y d\u1ef1ng\u00a0<\/p>\n

– M\u00e3 s\u1ed1 BN: 26939521\u00a0<\/p>\n

– Thu\u1eadn chi: Tay (P), Ch\u00e2n (P)\u00a0<\/p>\n

– \u0110\u1ecba ch\u1ec9: X\u00e3 C\u00f4ng Ch\u00ednh, T\u1ec9nh Thanh H\u00f3a\u00a0<\/p>\n

– Ng\u00e0y, gi\u1edd nh\u1eadp vi\u1ec7n: 18 gi\u1edd 45 ph\u00fat, ng\u00e0y 21\/07\/2026\u00a0<\/p>\n

– Ng\u00e0y, gi\u1edd l\u00e0m b\u1ec7nh \u00e1n: 20 gi\u1edd, ng\u00e0y 21\/07\/2026\u00a0<\/p>\n

II. L\u00dd DO NH\u1eacP VI\u1ec6N: <\/strong><\/p>\n

\u0110au c\u00e1nh tay (T)<\/p>\n

III. B\u1ec6NH S\u1eec<\/a>\u00a0<\/strong><\/p>\n

B\u1ec7nh nh\u00e2n tr\u1ef1c ti\u1ebfp khai b\u1ec7nh:\u00a0<\/p>\n

C\u00e1ch nh\u1eadp vi\u1ec7n 4 gi\u1edd, khi \u0111ang l\u00e0m vi\u1ec7c t\u1ea1i c\u00f4ng tr\u00ecnh b\u1ec7nh nh\u00e2n tr\u01b0\u1ee3t ch\u00e2n ng\u00e3 t\u1eeb \u0111\u1ed9 cao kho\u1ea3ng 2 m\u00e9t xu\u1ed1ng n\u1ec1n \u0111\u1ea5t c\u1ee9ng. BN ng\u00e3 ch\u1ed1ng khu\u1ef7u tay (T) xu\u1ed1ng \u0111\u1ea5t trong t\u01b0 th\u1ebf khu\u1ef7u g\u1ea5p, kh\u00f4ng va \u0111\u1eadp v\u00f9ng \u0111\u1ea7u, ng\u1ef1c, b\u1ee5ng. Sau ng\u00e3, b\u1ec7nh nh\u00e2n t\u1ec9nh, \u0111au nh\u00f3i d\u1eef d\u1ed9i v\u00f9ng \u2153 gi\u1eefa c\u00e1nh tay (T), \u0111au li\u00ean t\u1ee5c, c\u01b0\u1eddng \u0111\u1ed9 9\/10, kh\u00f4ng lan, \u0111au t\u0103ng khi c\u1eed \u0111\u1ed9ng, gi\u1ea3m \u0111au khi d\u00f9ng tay (P) \u0111\u1ee1 tay (T), k\u00e8m s\u01b0ng n\u1ec1 c\u00e1nh tay (T), kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng hay tr\u1ea7y x\u01b0\u1edbc da, kh\u00f4ng t\u00ea v\u00f9ng c\u00e1nh tay, c\u1eb3ng tay, b\u00e0n tay. B\u1ec7nh nh\u00e2n kh\u00f4ng x\u1eed tr\u00ed g\u00ec, kh\u00f4ng n\u1eb9p c\u1ed1 \u0111\u1ecbnh, \u0111\u1ec3 t\u01b0 th\u1ebf tay (P) \u0111\u1ee1 tay (T) \u2192 Nh\u1eadp c\u1ea5p c\u1ee9u B\u1ec7nh vi\u1ec7n \u0110a khoa B\u00ecnh T\u00e2n, \u0111\u01b0\u1ee3c ch\u1ee5p X-Quang<\/a> x\u01b0\u01a1ng c\u00e1nh tay v\u00e0 s\u01a1 c\u1ee9u<\/a> c\u1ed1 \u0111\u1ecbnh t\u1ea1m b\u1eb1ng n\u1eb9p g\u1ed7 t\u1eeb 1\/3 gi\u1eefa c\u00e1nh tay \u0111\u1ebfn m\u1ecfm khu\u1ef7u \u2192 Chuy\u1ec3n C\u1ea5p c\u1ee9u B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t.\u00a0<\/p>\n

Trong qu\u00e1 tr\u00ecnh b\u1ec7nh, b\u1ec7nh nh\u00e2n t\u1ec9nh, kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng bu\u1ed3n n\u00f4n, kh\u00f4ng n\u00f4n, ti\u00eau ti\u1ec3u t\u1ef1 ch\u1ee7.\u00a0<\/p>\n

C\u1eadn l\u00e2m s\u00e0ng tuy\u1ebfn tr\u01b0\u1edbc t\u1ea1i B\u1ec7nh vi\u1ec7n \u0110a khoa B\u00ecnh T\u00e2n:\u00a0<\/p>\n

\"3\"
– H\u00e0nh ch\u00ednh:\u00a0<\/span><\/figcaption><\/figure>\n

+ H\u1ecd v\u00e0 t\u00ean: M\u1ea0CH V\u0102N H.\u00a0<\/p>\n

+ Gi\u1edbi t\u00ednh: Nam\u00a0<\/p>\n

+ Tu\u1ed5i: 34\u00a0<\/p>\n

+ Ng\u00e0y, gi\u1edd ch\u1ee5p: 16:09 21\/07\/2026. + T\u01b0 th\u1ebf ch\u1ee5p: Phim th\u1eb3ng.\u00a0<\/p>\n

+ V\u1ecb tr\u00ed: Tay (T).\u00a0<\/p>\n

– Ti\u00eau chu\u1ea9n phim:\u00a0<\/p>\n

+ C\u01b0\u1eddng \u0111\u1ed9 tia \u0111\u1ee7 (ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c m\u00f4 m\u1ec1m, v\u1ecf x\u01b0\u01a1ng, tu\u1ef7 x\u01b0\u01a1ng) + L\u1ea5y \u0111\u1ee7 2 kh\u1edbp tr\u00ean v\u00e0 d\u01b0\u1edbi x\u01b0\u01a1ng g\u00e3y.\u00a0<\/p>\n

+ X-quang x\u01b0\u01a1ng c\u00e1nh tay th\u1eb3ng, thi\u1ebfu phim nghi\u00eang.\u00a0<\/p>\n

– M\u00f4 t\u1ea3:\u00a0<\/p>\n

+ H\u00ecnh th\u00e1i gi\u1ea3i ph\u1eabu: B\u00ecnh th\u01b0\u1eddng.\u00a0<\/p>\n

+ G\u00e3y \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T). K\u1ebft lu\u1eadn: G\u00e3y \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T).\u00a0<\/p>\n

T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp khoa C\u1ea5p c\u1ee9u B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t:\u00a0<\/strong><\/p>\n

– B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t\u00a0<\/p>\n

– Da v\u00e0 ni\u00eam m\u1ea1c h\u1ed3ng, kh\u00f4ng ph\u00f9\u00a0<\/p>\n

– Chi \u1ea5m, m\u1ea1ch quay ph\u1ea3i r\u00f5\u00a0<\/p>\n

– H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng tay tr\u00e1i\u00a0<\/p>\n

– Tim \u0111\u1ec1u\u00a0<\/p>\n

– Ph\u1ed5i kh\u00f4ng rale\u00a0<\/p>\n

– B\u1ee5ng m\u1ec1m\u00a0<\/p>\n

– Sinh hi\u1ec7u:\u00a0<\/p>\n

+ M\u1ea1ch: 75 l\u1ea7n\/ph\u00fat + Nhi\u1ec7t \u0111\u1ed9: 36,9 \u0111\u1ed9 C\u00a0<\/p>\n

+ Huy\u1ebft \u00e1p: 130\/70 mmHg + Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat + SpO2: 98% kh\u00ed tr\u1eddi\u00a0<\/p>\n

– C\u00e2n n\u1eb7ng: 80kg; Chi\u1ec1u cao: 170cm \u2192 BMI= 27,68 kg\/m2 (Th\u1ec3 tr\u1ea1ng b\u00e9o ph\u00ec \u0111\u1ed9 I theo IDI & WPRO)\u00a0<\/p>\n

Di\u1ec5n ti\u1ebfn b\u1ec7nh ph\u00f2ng:\u00a0<\/p>\n

Di\u1ec5n ti\u1ebfn b\u1ec7nh <\/p>\n

19h30 ph\u00fat, ng\u00e0y 21\/07\/2026C\u00e1nh tay tr\u00e1i s\u01b0ng n\u1ec1, bi\u1ebfn d\u1ea1ng v\u00e0 c\u1eed \u0111\u1ed9ng b\u1ea5t th\u01b0\u1eddng 1\/3 gi\u1eefa d\u01b0\u1edbi, b\u1ec7nh nh\u00e2n kh\u00f4ng du\u1ed7i ng\u00f3n tay<\/a> \u0111\u01b0\u1ee3c Chi \u1ea5m, m\u1ea1ch r\u00f5, \u0110M quay tay tr\u00e1i b\u1eaft \u0111\u01b0\u1ee3c, CRT < 2s<\/p>\n

Y l\u1ec7nh<\/p>\n

1. Sodium chloride 0,9% 0,9% – 500ml [ Natri clorid ]: 1 T\u00faiTruy\u1ec1n t\u0129nh m\u1ea1ch; xxx gi\u1ecdt\/ ph\u00fat; 21 gi\u1edd 2. Paracetamol 10mg\/ml 1000mg\/100ml<\/p>\n

IV.TI\u1ec0N S\u1eec <\/strong><\/p>\n

1. B\u1ea3n th\u00e2n\u00a0<\/p>\n

a. N\u1ed9i khoa:\u00a0<\/p>\n

– Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n n\u1ed9i khoa\u00a0<\/p>\n

b. Ngo\u1ea1i khoa:\u00a0<\/p>\n

– Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n ngo\u1ea1i khoa\u00a0<\/p>\n

c. Th\u00f3i quen:\u00a0<\/p>\n

– H\u00fat thu\u1ed1c l\u00e1: 10 g\u00f3i.n\u0103m\u00a0<\/p>\n

– R\u01b0\u1ee3u bia: Th\u1ec9nh tho\u1ea3ng\u00a0<\/p>\n

d. D\u1ecb \u1ee9ng\u00a0<\/p>\n

– Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n d\u1ecb \u1ee9ng thu\u1ed1c, th\u1ee9c \u0103n, latex,..\u00a0<\/p>\n

2. Gia \u0111\u00ecnh: Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n b\u1ec7nh l\u00fd li\u00ean quan.\u00a0<\/p>\n

V. L\u01af\u1ee2C QUA C\u00c1C C\u01a0 QUAN: <\/strong>(20 gi\u1edd 00 ph\u00fat, ng\u00e0y 21\/07\/2026, gi\u1edd th\u1ee9 4\u00a0c\u1ee7a b\u1ec7nh)\u00a0<\/p>\n

1. Tim m\u1ea1ch: kh\u00f4ng \u0111au ng\u1ef1c, kh\u00f4ng h\u1ed3i h\u1ed9p, kh\u00f4ng \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c.\u00a0<\/p>\n

2. H\u00f4 h\u1ea5p: kh\u00f4ng ho, kh\u00f4ng kh\u00f3 th\u1edf.\u00a0<\/p>\n

3. Ti\u00eau h\u00f3a: kh\u00f4ng \u0111au b\u1ee5ng, kh\u00f4ng bu\u1ed3n n\u00f4n, kh\u00f4ng n\u00f4n, ti\u00eau ph\u00e2n v\u00e0ng \u0111\u00f3ng\u00a0khu\u00f4n.\u00a0<\/p>\n

4. Th\u1eadn ni\u1ec7u: kh\u00f4ng ti\u1ec3u g\u1eaft\/ti\u1ec3u bu\u1ed1t, n\u01b0\u1edbc ti\u1ec3u v\u00e0ng trong.\u00a0<\/p>\n

5. Th\u1ea7n kinh: kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng t\u00ea tay ch\u00e2n.\u00a0<\/p>\n

6. C\u01a1 x\u01b0\u01a1ng kh\u1edbp: \u0111au gi\u1ea3m VAS 7\/10 k\u00e8m s\u01b0ng n\u1ec1 v\u00f9ng \u2153 gi\u1eefa c\u00e1nh tay (T),\u00a0kh\u00f4ng t\u00ea v\u00f9ng c\u00e1nh tay, c\u1eb3ng tay, b\u00e0n tay (T).\u00a0<\/p>\n

7. C\u00e1c c\u01a1 quan kh\u00e1c: Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.\u00a0<\/p>\n

VI. KH\u00c1M L\u00c2M S\u00c0NG: <\/strong>(20 gi\u1edd 00 ph\u00fat, ng\u00e0y 21\/07\/2026)\u00a0<\/p>\n

1. T\u1ed5ng tr\u1ea1ng:\u00a0<\/p>\n

– B\u1ec7nh t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t\u00a0<\/p>\n

– Da v\u00e0 ni\u00eam m\u1ea1c m\u1eaft h\u1ed3ng\u00a0<\/p>\n

– Chi \u1ea5m, m\u1ea1ch quay b\u1eaft r\u00f5\u00a0<\/p>\n

– Sinh hi\u1ec7u:\u00a0<\/p>\n

+ M\u1ea1ch: 80 l\u1ea7n\/ph\u00fat + Huy\u1ebft \u00e1p: 130\/70 mmHg + Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat + Nhi\u1ec7t \u0111\u1ed9: 36.9 \u0111\u1ed9 C + SpO2: 99% kh\u00ed tr\u1eddi\u00a0<\/p>\n

– C\u00e2n n\u1eb7ng: 80kg, Chi\u1ec1u cao: 170cm \u2192 BMI 27,68 kg\/m2 (Th\u1ec3 tr\u1ea1ng B\u00e9o ph\u00ec \u0111\u1ed9\u00a0<\/p>\n

I theo IDI&WPRO)\u00a0<\/p>\n

– Kh\u00f4ng ph\u00f9 chi, kh\u00f4ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da.\u00a0<\/p>\n

2. Tim m\u1ea1ch:\u00a0<\/p>\n

– L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, kh\u00f4ng u, kh\u00f4ng v\u1ebft s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7,\u00a0<\/p>\n

kh\u00f4ng \u1ed5 \u0111\u1eadp b\u1ea5t th\u01b0\u1eddng.\u00a0<\/p>\n

– Di\u1ec7n \u0111\u1eadp m\u1ecfm tim 1 cm x 2 cm \u1edf li\u00ean s\u01b0\u1eddn V \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i.\u00a0<\/p>\n

– Tim \u0111\u1ec1u, t\u1ea7n s\u1ed1 80 l\u1ea7n\/ph\u00fat, T1, T2 \u0111\u1ec1u r\u00f5, kh\u00f4ng \u00e2m th\u1ed5i.\u00a0<\/p>\n

3. H\u00f4 h\u1ea5p:\u00a0<\/p>\n

– L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf, kh\u00f4ng co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5, kh\u00f4ng\u00a0<\/p>\n

u s\u1eb9o.\u00a0<\/p>\n

– Rung thanh \u0111\u1ec1u 2 b\u00ean.\u00a0<\/p>\n

– G\u00f5 trong 2 ph\u1ed5i.\u00a0<\/p>\n

– R\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu 2 ph\u1ebf tr\u01b0\u1eddng, kh\u00f4ng rale.\u00a0<\/p>\n

4. Ti\u00eau h\u00f3a:\u00a0<\/p>\n

– B\u1ee5ng c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169.\u00a0<\/p>\n

– Nhu \u0111\u1ed9ng ru\u1ed9t 5 l\u1ea7n\/ph\u00fat\u00a0<\/p>\n

– G\u00f5 trong\u00a0<\/p>\n

– B\u1ee5ng m\u1ec1m, \u1ea5n kh\u00f4ng \u0111au, kh\u00f4ng s\u1edd th\u1ea5y kh\u1ed1i u v\u00f9ng b\u1ee5ng, gan l\u00e1ch kh\u00f4ng s\u1edd\u00a0<\/p>\n

ch\u1ea1m\u00a0<\/p>\n

5. Th\u1eadn ni\u1ec7u:\u00a0<\/p>\n

– C\u1ea7u b\u00e0ng quang (-)\u00a0<\/p>\n

– Ch\u1ea1m th\u1eadn (-)\u00a0<\/p>\n

6. Th\u1ea7n kinh:\u00a0<\/p>\n

– C\u1ed5 m\u1ec1m\u00a0<\/p>\n

– Kh\u00f4ng d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb\u00a0<\/p>\n

7. C\u01a1 x\u01b0\u01a1ng kh\u1edbp:\u00a0<\/p>\n

Kh\u00e1m BN \u1edf t\u01b0 th\u1ebf ng\u1ed3i, th\u00e1o n\u1eb9p g\u1ed7, n\u01a1i kh\u00e1m \u0111\u1ee7 \u00e1nh s\u00e1ng, kh\u00e1m v\u00f9ng chi tr\u00ean.\u00a0<\/p>\n

– Nh\u00ecn:\u00a0<\/p>\n

+ Ch\u01b0a quan s\u00e1t \u0111\u01b0\u1ee3c bi\u1ebfn d\u1ea1ng v\u00f9ng c\u00e1nh tay, c\u1eb3ng tay 2 b\u00ean. + Kh\u00f4ng v\u1ebft th\u01b0\u01a1ng tr\u1ea7y x\u01b0\u1edbc, kh\u00f4ng b\u1ea7m da, kh\u00f4ng v\u1ebft s\u1eb9o m\u1ed5 c\u0169 + S\u01b0ng n\u1ec1 \u2153 gi\u1eefa c\u00e1nh tay tr\u00e1i\u00a0<\/p>\n

+ Da \u0111\u1ea7u ng\u00f3n tay h\u1ed3ng\u00a0<\/p>\n

+ T\u01b0 th\u1ebf b\u00e0n tay (T): “B\u00e0n tay r\u0169” \u2013 c\u1ed5 tay g\u1ea5p nh\u1eb9, c\u00e1c ng\u00f3n tay \u1edf t\u01b0 th\u1ebf\u00a0<\/p>\n

g\u1ea5p nh\u1eb9, kh\u00f4ng t\u1ef1 du\u1ed7i ch\u1ee7 \u0111\u1ed9ng \u0111\u01b0\u1ee3c.\u00a0<\/p>\n

– S\u1edd:\u00a0<\/p>\n

+ M\u1ea1ch quay 2 b\u00ean b\u1eaft r\u00f5, \u0111\u1ec1u + Chi \u1ea5m, CRT < 2 gi\u00e2y\u00a0<\/p>\n

+ S\u1edd c\u00e1c m\u1ed1c gi\u1ea3i ph\u1eabu: m\u1ecfm c\u00f9ng vai, l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay, m\u1ea5u\u00a0\u0111\u1ed9ng l\u1edbn, m\u1ecfm khu\u1ef7u, m\u1ecfm tr\u00e2m quay, m\u1ecfm tr\u00e2m tr\u1ee5 \u1edf chi tr\u00ean hai b\u00ean r\u00f5 r\u00e0ng\u00a0<\/p>\n

+ \u1ea4n \u0111au ch\u00f3i v\u00f9ng \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T) + D\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng (+) \u2153 gi\u1eefa c\u00e1nh tay (T)\u00a0<\/p>\n

+ Kh\u00f4ng \u0111au ti\u1ebfn tri\u1ec3n, kh\u00f4ng t\u00ea b\u00ec, kh\u00f4ng m\u1ea5t m\u1ea1ch, da ni\u00eam m\u1ea1c v\u00f9ng\u00a0c\u00e1nh tay, c\u1eb3ng tay v\u00e0 b\u00e0n tay h\u1ed3ng ch\u00e8n \u00e9p khoang<\/a>.Ch\u01b0a ghi nh\u1eadn d\u1ea5u hi\u1ec7u \u0111e d\u1ecda
\n– \u0110o:\u00a0<\/p>\n

+ Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i x\u01b0\u01a1ng c\u00e1nh tay (m\u1ecfm c\u00f9ng vai \u2192 m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u\u00a0ngo\u00e0i)\u00a0<\/p>\n

\u25cf (P): 32 cm\u00a0<\/p>\n

\u25cf (T): 29 cm\u00a0<\/p>\n

\u21d2 Ng\u1eafn chi c\u00e1nh tay T 3 cm\u00a0<\/p>\n

+ Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i x\u01b0\u01a1ng c\u00e1nh tay (m\u1ea5u \u0111\u1ed9ng l\u1edbn \u2192 m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u\u00a0ngo\u00e0i)\u00a0<\/p>\n

\u25cf (P): 26 cm\u00a0<\/p>\n

\u25cf (T): 23 cm\u00a0<\/p>\n

\u21d2 Ng\u1eafn chi c\u00e1nh tay T 3 cm + \u0110o v\u00f2ng chi c\u00e1ch m\u1ecfm c\u00f9ng vai 10 cm.\u00a0<\/p>\n

\u25cf (P): 32 cm\u00a0<\/p>\n

\u25cf (T): 38 cm\u00a0<\/p>\n

– Kh\u00e1m v\u1eadn \u0111\u1ed9ng – th\u1ea7n kinh:\u00a0<\/p>\n

+ \u0110\u1ed9ng t\u00e1c ra tr\u01b0\u1edbc – ra sau, d\u1ea1ng – kh\u00e9p, xoay trong – xoay ngo\u00e0i c\u00e1nh tay\u00a0<\/p>\n

(T) kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do \u0111au nhi\u1ec1u. + Th\u1ea7n kinh quay<\/a>:\u00a0<\/p>\n

\u25cf V\u1eadn \u0111\u1ed9ng:\u00a0<\/p>\n

\u25cb M\u1ea5t du\u1ed7i c\u1ed5 tay, m\u1ea5t du\u1ed7i ng\u00f3n c\u00e1i v\u00e0 c\u00e1c ng\u00f3n b\u00e0n tay\u00a0<\/p>\n

(T).\u00a0<\/p>\n

\u25cb \u0110\u1ed9ng t\u00e1c du\u1ed7i khu\u1ef7u c\u00f2n th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c\u00a0<\/p>\n

\u25cf C\u1ea3m gi\u00e1c: B\u1ec7nh nh\u00e2n v\u1eabn c\u1ea3m gi\u00e1c \u0111au, s\u1edd n\u00f4ng r\u00f5 r\u1ec7t t\u1ea1i v\u00f9ng\u00a0k\u1ebd ng\u00f3n I – II mu tay (T). + Th\u1ea7n kinh tr\u1ee5<\/a>:\u00a0<\/p>\n

+ V\u1eadn \u0111\u1ed9ng g\u1ea5p c\u1ed5 tay, g\u1ea5p ng\u00f3n tay V, kh\u00e9p ng\u00f3n tay I b\u00ecnh\u00a0th\u01b0\u1eddng, kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u \u201cb\u00e0n tay vu\u1ed1t tr\u1ee5\u201d\u00a0<\/p>\n

+ C\u1ea3m gi\u00e1c \u0111au, s\u1edd n\u00f4ng m\u1eb7t l\u00f2ng v\u00e0 m\u1eb7t mu b\u00e0n tay c\u1ee7a ng\u00f3n IV,\u00a0V b\u00ecnh th\u01b0\u1eddng\u00a0<\/p>\n

+ Th\u1ea7n kinh gi\u1eefa<\/a>:\u00a0<\/p>\n

+ V\u1eadn \u0111\u1ed9ng g\u1ea5p c\u1ed5 tay; g\u1ea5p, d\u1ea1ng \u0111\u1ed1i ng\u00f3n I b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng c\u00f3\u00a0d\u1ea5u hi\u1ec7u \u201cb\u00e0n tay kh\u1ec9\u201d\u00a0<\/p>\n

+ C\u1ea3m gi\u00e1c \u0111au, s\u1edd n\u00f4ng m\u1eb7t l\u00f2ng ng\u00f3n I, II, III v\u00e0 m\u1eb7t mu b\u00e0n tay\u00a0c\u1ee7a ng\u00f3n II, III b\u00ecnh th\u01b0\u1eddng.\u00a0<\/p>\n

– S\u1ee9c c\u01a1:\u00a0<\/p>\n\n\n\n\n\n\n\n
\u00a0<\/td>\nG\u1ed1c chi<\/strong><\/td>\nNg\u1ecdn chi<\/strong><\/td>\n<\/tr>\n
Tay (T)<\/strong><\/td>\n– Ch\u01b0a th\u0103m kh\u00e1m \u0111\u01b0\u1ee3c do BN \u0111au<\/td>\n\u00a0<\/td>\n<\/tr>\n
Ch\u00e2n (T)<\/strong><\/td>\n5\/5<\/td>\n5\/5<\/td>\n<\/tr>\n
Tay (P)<\/strong><\/td>\n5\/5<\/td>\n5\/5<\/td>\n<\/tr>\n
Ch\u00e2n (P)<\/strong><\/td>\n5\/5<\/td>\n5\/5<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\n8. C\u00e1c c\u01a1 quan kh\u00e1c: Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng\u00a0<\/p>\n

VII. T\u00d3M T\u1eaeT B\u1ec6NH \u00c1N\u00a0<\/strong><\/p>\n

B\u1ec7nh nh\u00e2n nam, 34 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au v\u00f9ng c\u00e1nh tay T. Qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m l\u00e2m s\u00e0ng ghi nh\u1eadn:\u00a0<\/p>\n

– Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng:\u00a0<\/p>\n

+ \u0110au c\u00e1nh tay (T)\u00a0<\/p>\n

+ S\u01b0ng n\u1ec1 c\u00e1nh tay (T)\u00a0<\/p>\n

– Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3:\u00a0<\/p>\n

+ \u1ea4n \u0111au ch\u00f3i v\u00f9ng \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T) + D\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng (+) \u2153 gi\u1eefa c\u00e1nh tay (T)\u00a0<\/p>\n

– \u0110o:\u00a0<\/p>\n

+ Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i x\u01b0\u01a1ng c\u00e1nh tay (P): 32cm > (T): 29cm + Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i x\u01b0\u01a1ng c\u00e1nh tay (P): 26cm > (T): 23cm + \u0110o v\u00f2ng chi c\u00e1ch m\u1ecfm c\u00f9ng vai 10cm (P): 32cm < (T): 38cm\u00a0<\/p>\n

– Kh\u00e1m v\u1eadn \u0111\u1ed9ng:\u00a0<\/p>\n

+ M\u1ea5t du\u1ed7i c\u00e1c ng\u00f3n tay b\u00e0n tay (T) v\u00e0 ng\u00f3n c\u00e1i (T), m\u1ea5t du\u1ed7i c\u1ed5\u00a0<\/p>\n

tay (T).\u00a0<\/p>\n

– Ti\u1ec1n c\u0103n: ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n n\u1ed9i, ngo\u1ea1i khoa\u00a0<\/p>\n

VIII. \u0110\u1eb6T V\u1ea4N \u0110\u1ec0.\u00a0<\/strong><\/p>\n

– D\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng<\/a> \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (l\u1ea1o x\u1ea1o x\u01b0\u01a1ng, ng\u1eafn\u00a0chi)\u00a0<\/p>\n

– \u0110au + s\u01b0ng n\u1ec1 \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T).\u00a0<\/p>\n

– M\u1ea5t du\u1ed7i c\u00e1c ng\u00f3n tay b\u00e0n tay (T) v\u00e0 ng\u00f3n c\u00e1i (T) v\u00e0 c\u1ed5 tay (T)\u00a0<\/p>\n

IX.CH\u1ea8N \u0110O\u00c1N S\u01a0 B\u1ed8:\u00a0<\/strong><\/p>\n

G\u00e3y k\u00edn<\/a> \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T) gi\u1edd th\u1ee9 4 do tai n\u1ea1n lao \u0111\u1ed9ng bi\u1ebfn ch\u1ee9ng li\u1ec7t th\u1ea7n kinh<\/a> quay \/Th\u1ec3 tr\u1ea1ng b\u00e9o ph\u00ec \u0111\u1ed9 I theo IDI & WPRO.\u00a0<\/p>\n

X. BI\u1ec6N LU\u1eacN L\u00c2M S\u00c0NG\u00a0<\/strong><\/p>\n

B\u1ec7nh nh\u00e2n nam, 34 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au c\u00e1nh tay (T), ngh\u0129 G\u00e3y k\u00edn \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T) bi\u1ebfn ch\u1ee9ng li\u1ec7t th\u1ea7n kinh quay v\u00ec:\u00a0<\/p>\n

– G\u00e3y x\u01b0\u01a1ng c\u00e1nh tay<\/a> (T):\u00a0<\/p>\n

+ C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng: B\u1ec7nh nh\u00e2n ng\u00e3 t\u1eeb \u0111\u1ed9 cao 2m ch\u1ed1ng khu\u1ef7u tay tr\u00e1i\u00a0<\/p>\n

\u1edf t\u01b0 th\u1ebf g\u1ea5p khu\u1ef7u \u2192 C\u01a1 ch\u1ebf truy\u1ec1n l\u1ef1c gi\u00e1n ti\u1ebfp: L\u1ef1c d\u1ed3n n\u00e9n d\u1ecdc tr\u1ee5c\u00a0truy\u1ec1n t\u1eeb m\u1ecfm khu\u1ef7u l\u00ean th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay g\u00e2y g\u00e3y x\u01b0\u01a1ng + D\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng:\u00a0<\/p>\n

\u25cf C\u00f3 l\u1ea1o x\u1ea1o x\u01b0\u01a1ng t\u1ea1i v\u00f9ng c\u00e1nh tay (T).\u00a0<\/p>\n

\u25cf Bi\u1ebfn d\u1ea1ng \/ Ng\u1eafn chi:\u00a0<\/p>\n

\u25cb Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i v\u00e0 t\u01b0\u01a1ng \u0111\u1ed1i c\u1ee7a x\u01b0\u01a1ng c\u00e1nh tay (T) ng\u1eafn h\u01a1n b\u00ean (P) 3 cm (T\u01b0\u01a1ng \u0111\u1ed1i: 29cm v\u1edbi 32 cm; Tuy\u1ec7t \u0111\u1ed1i: 23 cm v\u1edbi 26 cm). + D\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn:\u00a0<\/p>\n

\u25cf B\u1ec7nh nh\u00e2n \u0111au ch\u00f3i 1\/3 gi\u1eefa c\u00e1nh tay (T), s\u01b0ng n\u1ec1 (v\u00f2ng chi c\u00e1ch\u00a0m\u1ecfm c\u00f9ng vai 10cm t\u0103ng l\u00ean 38 cm so v\u1edbi 32 cm b\u00ean l\u00e0nh), gi\u1ea3m\u00a0v\u1eadn \u0111\u1ed9ng c\u01a1 n\u0103ng c\u00e1nh tay tr\u00e1i.\u00a0<\/p>\n

– V\u1ecb tr\u00ed g\u00e3y: d\u1ef1a tr\u00ean \u0111i\u1ec3m \u1ea5n \u0111au ch\u00f3i nh\u1ea5t v\u00e0 v\u00f9ng s\u01b0ng n\u1ec1 \u0111o\u1ea1n 1\/3 gi\u1eefa x\u01b0\u01a1ng\u00a0c\u00e1nh tay.<\/p>\n

– G\u00e3y k\u00edn: Kh\u00e1m l\u00e2m s\u00e0ng ghi nh\u1eadn to\u00e0n b\u1ed9 da v\u00f9ng c\u00e1nh tay, c\u1eb3ng tay (T) l\u00e0nh\u00a0l\u1eb7n, kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng, kh\u00f4ng tr\u1ea7y x\u01b0\u1edbc, kh\u00f4ng c\u00f3 s\u1ef1 th\u00f4ng th\u01b0\u01a1ng gi\u1eefa \u1ed5\u00a0g\u00e3y v\u1edbi m\u00f4i tr\u01b0\u1eddng b\u00ean ngo\u00e0i.\u00a0<\/p>\n

– V\u1ec1 bi\u1ebfn ch\u1ee9ng:\u00a0<\/p>\n

+ T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh quay (T): B\u1ec7nh nh\u00e2n xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng th\u1ea7n\u00a0kinh chi ph\u1ed1i ngay sau ch\u1ea5n th\u01b0\u01a1ng: m\u1ea5t du\u1ed7i c\u1ed5 tay, m\u1ea5t du\u1ed7i ng\u00f3n c\u00e1i v\u00e0 c\u00e1c ng\u00f3n tay c\u00f2n l\u1ea1i (T) (d\u1ea5u hi\u1ec7u “b\u00e0n tay r\u0169”). C\u01a1 ch\u1ebf: Th\u1ea7n kinh quay \u0111i trong r\u00e3nh th\u1ea7n kinh quay s\u00e1t x\u01b0\u01a1ng \u1edf 1\/3 gi\u1eefa v\u00e0 1\/3 d\u01b0\u1edbi x\u01b0\u01a1ng c\u00e1nh tay, do \u0111\u00f3 g\u00e3y v\u1ecb tr\u00ed n\u00e0y r\u1ea5t d\u1ec5 g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh quay do ch\u00e8n \u00e9p, c\u0103ng d\u00e3n ho\u1eb7c b\u1ecb \u0111\u1ee9t\/k\u1eb9t v\u00e0o \u1ed5 g\u00e3y.\u00a0<\/p>\n

+ T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: kh\u00e1m kh\u00f4ng ghi nh\u1eadn c\u00f3 d\u1ea5u hi\u1ec7u thi\u1ebfu m\u00e1u\u00a0nu\u00f4i ng\u1ecdn chi: M\u1ea1ch quay (T) b\u1eaft r\u00f5, \u0111\u1ec1u, CRT < 2 gi\u00e2y, da \u0111\u1ea7u ng\u00f3n h\u1ed3ng, chi \u1ea5m.\u00a0<\/p>\n

+ Kh\u00f4ng \u0111au ti\u1ebfn tri\u1ec3n, kh\u00f4ng t\u00ea b\u00ec, kh\u00f4ng m\u1ea5t m\u1ea1ch, da ni\u00eam m\u1ea1c v\u00f9ng\u00a0c\u00e1nh tay, c\u1eb3ng tay v\u00e0 b\u00e0n tay h\u1ed3ng ch\u00e8n \u00e9p khoang. Ch\u01b0a ghi nh\u1eadn d\u1ea5u hi\u1ec7u \u0111e d\u1ecda<\/p>\n

\u0110\u1ec1 ngh\u1ecb CLS: X-quang x\u01b0\u01a1ng c\u00e1nh tay (T) th\u1eb3ng nghi\u00eang.\u00a0<\/p>\n

XI.\u0110\u1ec0 NGH\u1eca C\u1eacN L\u00c2M S\u00c0NG <\/strong><\/p>\n

1. C\u1eadn l\u00e2m s\u00e0ng ch\u1ea9n \u0111o\u00e1n:\u00a0<\/p>\n

– XQ x\u01b0\u01a1ng c\u00e1nh tay th\u1eb3ng nghi\u00eang.\u00a0<\/p>\n

2. C\u1eadn l\u00e2m s\u00e0ng theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb:\u00a0<\/p>\n

– C\u00f4ng th\u1ee9c m\u00e1u\u00a0<\/p>\n

– \u0110\u00f4ng c\u1ea7m m\u00e1u\u00a0<\/p>\n

– Sinh ho\u00e1 m\u00e1u (AST, ALT, ure, creatinine, glucose)\u00a0<\/p>\n

– \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3\u00a0<\/p>\n

– T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u 10 th\u00f4ng s\u1ed1\u00a0<\/p>\n

– X-quang ng\u1ef1c th\u1eb3ng\u00a0<\/p>\n

XII. K\u1ebeT QU\u1ea2 C\u1eacN L\u00c2M S\u00c0NG <\/strong><\/p>\n

1. Xquang x\u01b0\u01a1ng c\u00e1nh tay th\u1eb3ng nghi\u00eang.\u00a0<\/p>\n\n\n\n\n
\n

\"11\"<\/p>\n<\/td>\n

\n

\"22\"<\/p>\n<\/td>\n<\/tr>\n

\n

M\u00f4 t\u1ea3:<\/p>\n

– H\u00e0nh ch\u00ednh:<\/p>\n

+ H\u1ecd v\u00e0 t\u00ean: M\u1ea0CHV\u0102N H.<\/p>\n

+ Gi\u1edbi t\u00ednh: Nam<\/p>\n

+ Tu\u1ed5i: 34<\/p>\n

+ Ng\u00e0y, gi\u1edd ch\u1ee5p: 21:0121\/07\/2026.<\/p>\n

+ T\u01b0 th\u1ebf ch\u1ee5p: Phimth\u1eb3ng nghi\u00eang.<\/p>\n

+ V\u1ecb tr\u00ed: C\u00e1nh tay (T)<\/p>\n

– Ti\u00eau chu\u1ea9n phim:<\/p>\n

+ C\u01b0\u1eddng \u0111\u1ed9 tia \u0111\u1ee7 (ph\u00e2nbi\u1ec7t \u0111\u01b0\u1ee3c m\u00f4 m\u1ec1m, v\u1ecf x\u01b0\u01a1ng, tu\u1ef7 x\u01b0\u01a1ng)<\/p>\n

+ L\u1ea5y \u0111\u1ee7 2 kh\u1edbp tr\u00ean v\u00e0 d\u01b0\u1edbi x\u01b0\u01a1ng g\u00e3y.<\/p>\n

+ X-quang x\u01b0\u01a1ng c\u00e1nhtay th\u1eb3ng, phim nghi\u00eang.<\/p>\n

– M\u00f4 t\u1ea3:<\/p>\n

+ H\u00ecnh th\u00e1i gi\u1ea3i ph\u1eabu:B\u00ecnh th\u01b0\u1eddng<\/p>\n

+ V\u1ecb tr\u00ed: G\u00e3y \u2153 gi\u1eefax\u01b0\u01a1ng c\u00e1nh tay<\/p>\n

+ \u0110\u01b0\u1eddng g\u00e3y: ph\u1ee9c t\u1ea1p,c\u00f3 m\u1ea3nh c\u00e1nh b\u01b0\u1edbm v\u00e0 c\u00f3 v\u1ee1 c\u00e1nh b\u01b0\u1edbm<\/p>\n

+ Di l\u1ec7ch g\u1eadp g\u00f3c m\u1edf v\u00e0otrong v\u00e0 sang b\u00ean.<\/p>\n

+ M\u00f4 m\u1ec1m: c\u00f3 h\u00ecnh \u1ea3nhb\u00f3ng m\u1edd m\u00f4 m\u1ec1m s\u01b0ng n\u1ec1 l\u1edbn xung quanh v\u1ecb tr\u00ed \u1ed5 g\u00e3y. Kh\u00f4ng ghi nh\u1eadn d\u1ecb v\u1eadt c\u1ea3n quang hay kh\u00ed trong m\u00f4 m\u1ec1m+ Kh\u1edbp: ch\u01b0a th\u1ea5y d\u1ea5uhi\u1ec7u tr\u1eadt kh\u1edbp hay g\u00e3y x\u01b0\u01a1ng ph\u1ea1m kh\u1edbp k\u00e8m theo<\/p>\n

K\u1ebft lu\u1eadn: G\u00e3y \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T) g\u00e3y ph\u1ee9c t\u1ea1p ph\u00e2n \u0111\u1ed9 B3 theo AO.<\/p>\n<\/td>\n

\n

M\u00f4 t\u1ea3:<\/p>\n

– H\u00e0nh ch\u00ednh:<\/p>\n

+ H\u1ecd v\u00e0 t\u00ean: M\u1ea0CH V\u0102NH.<\/p>\n

+ Gi\u1edbi t\u00ednh: Nam+ Tu\u1ed5i: 34<\/p>\n

+ Ng\u00e0y, gi\u1edd ch\u1ee5p: 21:0121\/07\/2026.<\/p>\n

+ T\u01b0 th\u1ebf ch\u1ee5p: Phimth\u1eb3ng.<\/p>\n

+ V\u1ecb tr\u00ed: C\u00e1nh tay (T)<\/p>\n

– Ti\u00eau chu\u1ea9n phim:<\/p>\n

+ C\u01b0\u1eddng \u0111\u1ed9 tia \u0111\u1ee7 (ph\u00e2nbi\u1ec7t \u0111\u01b0\u1ee3c m\u00f4 m\u1ec1m, v\u1ecf x\u01b0\u01a1ng, tu\u1ef7 x\u01b0\u01a1ng)<\/p>\n

+ L\u1ea5y \u0111\u1ee7 2 kh\u1edbp tr\u00ean v\u00e0 d\u01b0\u1edbi x\u01b0\u01a1ng g\u00e3y.<\/p>\n

+ X-quang x\u01b0\u01a1ng c\u00e1nhtay th\u1eb3ng, phim th\u1eb3ng<\/p>\n

– M\u00f4 t\u1ea3:<\/p>\n

+ H\u00ecnh th\u00e1i gi\u1ea3i ph\u1eabu:B\u00ecnh th\u01b0\u1eddng<\/p>\n

+ V\u1ecb tr\u00ed: G\u00e3y \u2153 gi\u1eefax\u01b0\u01a1ng c\u00e1nh tay<\/p>\n

+ \u0110\u01b0\u1eddng g\u00e3y: ph\u1ee9c t\u1ea1p,c\u00f3 m\u1ea3nh c\u00e1nh b\u01b0\u1edbm v\u00e0 c\u00f3 v\u1ee1 c\u00e1nh b\u01b0\u1edbm<\/p>\n

+ Di l\u1ec7ch g\u1eadp g\u00f3c m\u1edf v\u00e0otrong v\u00e0 sang b\u00ean.<\/p>\n

+ M\u00f4 m\u1ec1m: c\u00f3 h\u00ecnh \u1ea3nh b\u00f3ng m\u1edd m\u00f4 m\u1ec1m s\u01b0ng n\u1ec1 l\u1edbn xung quanh v\u1ecb tr\u00ed \u1ed5 g\u00e3y. Kh\u00f4ng ghi nh\u1eadn d\u1ecb v\u1eadt c\u1ea3n quang hay kh\u00ed trong m\u00f4 m\u1ec1m<\/p>\n

+ Kh\u1edbp: ch\u01b0a th\u1ea5y d\u1ea5uhi\u1ec7u tr\u1eadt kh\u1edbp hay g\u00e3y x\u01b0\u01a1ng ph\u1ea1m kh\u1edbp k\u00e8m theo<\/p>\n

K\u1ebft lu\u1eadn: G\u00e3y \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T) g\u00e3y ph\u1ee9c t\u1ea1p ph\u00e2n \u0111\u1ed9 B3 theo AO.<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

2. CTM (22h09\u2019 21\/07\/2026)\u00a0<\/strong><\/p>\n

\"Hinh<\/p>\n

\n\u2192 Nh\u1eadn x\u00e9t:\u00a0<\/p>\n

– WBC: 15.0 K\/uL (T\u0103ng cao) v\u1edbi NEU#: 10.05 K\/uL (T\u0103ng). T\u00ecnh tr\u1ea1ng t\u0103ng b\u1ea1ch c\u1ea7u \u01b0u th\u1ebf Neutrophil n\u00e0y kh\u00f4ng ph\u1ea3i l\u00e0 ph\u1ea3n \u1ee9ng nhi\u1ec5m\u00a0tr\u00f9ng (do b\u1ec7nh nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng gi\u1edd th\u1ee9 4, kh\u00f4ng s\u1ed1t, kh\u00f4ng c\u00f3 v\u1ebft\u00a0th\u01b0\u01a1ng h\u1edf). Ngh\u0129 nhi\u1ec1u \u0111\u00e2y l\u00e0 ph\u1ea3n \u1ee9ng \u0111\u00e1p \u1ee9ng vi\u00eam c\u1ea5p t\u00ednh c\u1ee7a c\u01a1 th\u1ec3\u00a0sau ch\u1ea5n th\u01b0\u01a1ng c\u01a1 h\u1ecdc n\u0103ng l\u01b0\u1ee3ng cao v\u00e0 d\u1eadp n\u00e1t m\u00f4 m\u1ec1m quanh \u1ed5 g\u00e3y.\u00a0<\/p>\n

– HGB: 15.6 g\/dL, HCT: 46.4%: C\u00e1c ch\u1ec9 s\u1ed1 d\u00f2ng h\u1ed3ng c\u1ea7u trong gi\u1edbi h\u1ea1n\u00a0b\u00ecnh th\u01b0\u1eddng, ch\u01b0a ghi nh\u1eadn d\u1ea5u hi\u1ec7u m\u1ea5t m\u00e1u c\u1ea5p \u0111\u00e1ng k\u1ec3 hay c\u00f4 \u0111\u1eb7c\u00a0m\u00e1u n\u1eb7ng.\u00a0<\/p>\n

– PLT: 204 K\/uL: Ti\u1ec3u c\u1ea7u trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng, \u0111\u1ea3m b\u1ea3o ch\u1ee9c\u00a0n\u0103ng \u0111\u00f4ng m\u00e1u ban \u0111\u1ea7u.\u00a0<\/p>\n

3. Sinh ho\u00e1 m\u00e1u (21h33 21\/07\/2026)\u00a0<\/strong><\/p>\n

\"Hinh<\/p>\n

\n\u2192 Nh\u1eadn x\u00e9t:\u00a0<\/p>\n

– Men gan: AST (GOT): 55.8 U\/L (t\u0103ng nh\u1eb9), ALT (GPT): 104 U\/L (t\u0103ng g\u1ea5p\u00a02 l\u1ea7n b\u00ecnh th\u01b0\u1eddng). ALT v\u00e0 AST t\u0103ng nh\u1eb9 c\u00f3 th\u1ec3 do nh\u1eefng nguy\u00ean nh\u00e2n\u00a0sau: gan nhi\u1ec5m m\u1ee1 tr\u00ean c\u01a1 \u0111\u1ecba b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec, ch\u01b0a lo\u1ea1i tr\u1eeb b\u1ec7nh l\u00fd vi\u00eam\u00a0gan si\u00eau vi.\u00a0<\/p>\n

– Ch\u1ee9c n\u0103ng th\u1eadn & \u0110i\u1ec7n gi\u1ea3i: Creatinine: 76.7 \u00b5mol\/L, eGFR: 116.21\u00a0ml\/ph\u00fat\/1.73m\u00b2, Na+: 135.5 mmol\/L, K+: 3.74 mmol\/L, Cl-: 102.6 mmol\/L. T\u1ea5t c\u1ea3 \u0111\u1ec1u trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng, ch\u1ee9c n\u0103ng l\u1ecdc c\u1ee7a th\u1eadn t\u1ed1t, kh\u00f4ng c\u00f3 r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i.\u00a0<\/p>\n

XIII. CH\u1ea8N \u0110O\u00c1N X\u00c1C \u0110\u1ecaNH:<\/strong>
\nG\u00e3y k\u00edn \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay (T) B3 theo AO gi\u1edd th\u1ee9 4 do tai n\u1ea1n lao \u0111\u1ed9ng bi\u1ebfn ch\u1ee9ng li\u1ec7t th\u1ea7n kinh quay\/Th\u1ec3 tr\u1ea1ng b\u00e9o ph\u00ec \u0111\u1ed9 I theo IDI & WPRO.<\/p>\n

XIV. H\u01af\u1edaNG \u0110I\u1ec0U TR\u1eca<\/p>\n

<\/strong>– Ph\u1eabu thu\u1eadt c\u1ea5p c\u1ee9u do b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ebfn ch\u1ee9ng li\u1ec7t th\u1ea7n kinh quay.\u00a0<\/p>\n

– Ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p x\u01b0\u01a1ng c\u00e1nh tay (T) b\u1eb1ng n\u1eb9p v\u00edt do BN c\u00f3 ch\u1ec9 \u0111\u1ecbnh: g\u00e3y nhi\u1ec1u m\u1ea3nh, bi\u1ebfn ch\u1ee9ng t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh quay.\u00a0<\/p>\n

– Th\u00e1m s\u00e1t v\u00e0 gi\u1ea3i ph\u00f3ng th\u1ea7n kinh quay (T): ph\u1eabu thu\u1eadt m\u1ed5 m\u1edf k\u1ebft h\u1ee3p x\u01b0\u01a1ng\u00a0k\u1ebft h\u1ee3p v\u1edbi th\u00e1m s\u00e1t tr\u1ef1c ti\u1ebfp th\u1ea7n kinh quay l\u00e0 ch\u1ec9 \u0111\u1ecbnh b\u1eaft bu\u1ed9c tr\u00ean b\u1ec7nh\u00a0nh\u00e2n n\u00e0y do:\u00a0<\/p>\n

+ M\u1eabu g\u00e3y B3 m\u1ea5t v\u1eefng (c\u00f3 m\u1ea3nh r\u1eddi, g\u1eadp g\u00f3c).\u00a0<\/p>\n

+ Th\u1ec3 tr\u1ea1ng b\u00e9o ph\u00ec (BMI = 27.68) khi\u1ebfn vi\u1ec7c b\u00f3 b\u1ed9t<\/a>\/\u0111ai ch\u1ee9c n\u0103ng kh\u00f3\u00a0duy tr\u00ec n\u1eafn ch\u1ec9nh v\u00e0 d\u1ec5 th\u1ea5t b\u1ea1i.\u00a0<\/p>\n

+ C\u1ea7n lo\u1ea1i tr\u1eeb nguy c\u01a1 d\u00e2y th\u1ea7n kinh quay b\u1ecb k\u1eb9t\/k\u1eb9p v\u00e0o gi\u1eefa c\u00e1c m\u1ea3nh\u00a0g\u00e3y.\u00a0<\/p>\n

– Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng<\/a> s\u1edbm v\u00e0 ph\u00f2ng ng\u1eeba bi\u1ebfn ch\u1ee9ng c\u1ee9ng kh\u1edbp\/co r\u00fat c\u01a1.\u00a0<\/p>\n

XV. TI\u00caN L\u01af\u1ee2NG.\u00a0<\/strong><\/p>\n

1. Ti\u00ean l\u01b0\u1ee3ng g\u1ea7n: D\u00e8 d\u1eb7t.\u00a0<\/p>\n

– Nguy c\u01a1 bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn ph\u1eabu thu\u1eadt: nhi\u1ec5m tr\u00f9ng v\u1ebft m\u1ed5, bi\u1ebfn ch\u1ee9ng\u00a0t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh th\u1ee9 ph\u00e1t, bi\u1ebfn ch\u1ee9ng li\u00ean quan trong qu\u00e1 tr\u00ecnh g\u00e2y m\u00ea.\u00a0<\/p>\n

2. Ti\u00ean l\u01b0\u1ee3ng xa: D\u00e8 d\u1eb7t\u00a0<\/p>\n

– D\u00f9 \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt th\u00e1m s\u00e1t v\u00e0 gi\u1ea3i ph\u00f3ng th\u1ea7n kinh quay nh\u01b0ng v\u1eabn c\u1ea7n r\u1ea5t\u00a0nhi\u1ec1u th\u1eddi gian d\u00e0i \u0111\u1ec3 ph\u1ee5c h\u1ed3i.\u00a0<\/p>\n

– N\u1ebfu d\u00e2y th\u1ea7n kinh b\u1ecb d\u1eadp n\u00e1t n\u1eb7ng ho\u1eb7c \u0111\u1ee9t, c\u00f3 nguy c\u01a1 \u0111\u1ec3 l\u1ea1i di ch\u1ee9ng “b\u00e0n\u00a0tay r\u0169” v\u0129nh vi\u1ec5n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn sinh ho\u1ea1t h\u00e0ng ng\u00e0y v\u00e0 quay l\u1ea1i l\u00e0m vi\u1ec7c.\u00a0<\/p>\n

– V\u1ecb tr\u00ed g\u00e3y 1\/3 gi\u1eefa c\u00e1nh tay, ph\u00e2n \u0111\u1ed9 B3 theo AO (\u0111\u01b0\u1eddng g\u00e3y ph\u1ee9c t\u1ea1p, v\u1ee1\u00a0m\u1ea3nh c\u00e1nh b\u01b0\u1edbm) l\u00e0 lo\u1ea1i g\u00e3y c\u00f3 \u0111\u1ed9 m\u1ea5t v\u1eefng cao, nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng m\u00e0ng\u00a0x\u01b0\u01a1ng v\u00e0 h\u1ec7 th\u1ed1ng c\u1ea5p m\u00e1u nu\u00f4i t\u1ea1i ch\u1ed7 l\u1edbn d\u1eabn \u0111\u1ebfn nguy c\u01a1 kh\u1ea3 n\u0103ng ch\u1eadm\u00a0li\u1ec1n x\u01b0\u01a1ng<\/a>.\u00a0<\/p>\n

XVI. THEO D\u00d5I SAU M\u1ed4\u00a0<\/strong><\/p>\n

– Theo d\u00f5i sinh hi\u1ec7u sau m\u1ed5: m\u1ea1ch, nh\u1ecbp th\u1edf, nhi\u1ec7t \u0111\u1ed9, huy\u1ebft \u00e1p\u00a0<\/p>\n

– T\u1ea1i v\u1ecb tr\u00ed v\u1ebft m\u1ed5 & d\u1eabn l\u01b0u: theo d\u00f5i d\u1ecbch th\u1ea5m b\u0103ng; ghi nh\u1eadn m\u00e0u s\u1eafc\/s\u1ed1\u00a0l\u01b0\u1ee3ng d\u1ecbch d\u1eabn l\u01b0u\u00a0<\/p>\n

– \u0110\u00e1nh gi\u00e1 th\u1ea7n kinh – m\u1ea1ch m\u00e1u tay (T)\u00a0<\/p>\n

+ M\u1ea1ch m\u00e1u: b\u1eaft m\u1ea1ch quay (T), CRT, \u0111\u1ed9 \u1ea5m\/m\u00e0u s\u1eafc ng\u1ecdn chi (T)\u00a0<\/p>\n

+ Th\u1ea7n kinh quay (T): \u0110\u00e1nh gi\u00e1 c\u1ea3m gi\u00e1c k\u1ebd ng\u00f3n I\u2013II mu tay v\u00e0 d\u1ea5u hi\u1ec7u “b\u00e0n tay r\u0169” (du\u1ed7i c\u1ed5 tay, du\u1ed7i ng\u00f3n I v\u00e0 c\u00e1c ng\u00f3n) \u0111\u1ec3 ghi nh\u1eadn ti\u1ebfn tri\u1ec3n h\u1ed3i ph\u1ee5c.\u00a0<\/p>\n

– V\u1ebft th\u01b0\u01a1ng sau m\u1ed5 c\u1eaft ch\u1ec9 sau 10 \u2013 14 ng\u00e0y\u00a0<\/p>\n

– Thu\u1ed1c kh\u00e1ng sinh, gi\u1ea3m \u0111au, ph\u1ee5c h\u1ed3i th\u1ea7n kinh\u00a0<\/p>\n

– Dinh d\u01b0\u1ee1ng \u0111\u1ea7y \u0111\u1ee7, h\u1ee3p l\u00fd, b\u1ed5 xung th\u1ef1c ph\u1ea9m gi\u00e0u canxi\u00a0<\/p>\n

– T\u1eadp v\u1eadn \u0111\u1ed9ng s\u1edbm\u00a0<\/p>\n

– T\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng sau m\u1ed5\u00a0<\/p>\n

– T\u00e1i kh\u00e1m \u0111\u00fang h\u1eb9n<\/p>\n","protected":false},"featured_media":4880,"comment_status":"open","ping_status":"open","template":"","tags":[],"chuyen-muc":[188],"class_list":["post-4879","chuyen-de","type-chuyen-de","status-publish","has-post-thumbnail","hentry","chuyen-muc-benh-an-mau"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/4879","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de"}],"about":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/types\/chuyen-de"}],"replies":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/comments?post=4879"}],"version-history":[{"count":8,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/4879\/revisions"}],"predecessor-version":[{"id":4894,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/4879\/revisions\/4894"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/4880"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=4879"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=4879"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=4879"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}