{"id":2047,"date":"2022-07-05T13:11:22","date_gmt":"2022-07-05T06:11:22","guid":{"rendered":"https:\/\/ykhoataynguyen.com\/site\/?p=2047"},"modified":"2022-07-14T22:47:44","modified_gmt":"2022-07-14T15:47:44","slug":"de-cuong-bai-soan-phau-thuat-thuc-hanh-k14","status":"publish","type":"post","link":"https:\/\/ykhoataynguyen.com\/site\/de-cuong-bai-soan-phau-thuat-thuc-hanh-k14\/","title":{"rendered":"\u0110\u1ec1 c\u01b0\u01a1ng – B\u00e0i So\u1ea1n: Ph\u1eabu Thu\u1eadt Th\u1ef1c H\u00e0nh (K14)"},"content":{"rendered":"

C\u00e2u 1: K\u1ef9 thu\u1eadt kh\u00e2u n\u1ed1i \u1ed1ng ti\u00eau h\u00f3a<\/p>\n

1. C\u00e1c \u0111i\u1ec1u ki\u1ec7n c\u1ea7n c\u00f3 c\u1ee7a 1 \u0111\u01b0\u1eddng kh\u00e2u t\u1ed1t :- \u0110\u01b0\u1eddng kh\u00e2u ph\u1ea3i k\u00edn, trung b\u00ecnh 1cm 3 m\u0169i- \u0110\u01b0\u1eddng kh\u00e2u ph\u1ea3i ch\u1eafc, kh\u00f4ng b\u1ee5c ch\u1ec9. Ph\u1ee5 thu\u1ed9c v\u00e0o:+ T\u00ecnh tr\u1ea1ng nu\u00f4i d\u01b0\u1ee1ng c\u1ee7a th\u00e0nh ru\u1ed9t .+ T\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng c\u1ee7a ph\u1eabu thu\u1eadt+ K\u0129 thu\u1eadt kh\u00e2u c\u1ee7a KTV v\u00e0 kim ch\u1ec9 s\u1eed d\u1ee5ng* C\u00e1c ki\u1ec3u kh\u00e2u:- Kh\u00e2u v\u1eaft:+ \u01afu \u0111i\u1ec3m :Nhanh , k\u00edn , \u00e1p l\u1ef1c d\u00e0n \u0111\u1ec1u tr\u00ean \u0111\u01b0\u1eddng kh\u00e2u+ Nh\u01b0\u1ee3c \u0111i\u1ec3m:R\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u c\u1ee7a t\u1ed5 ch\u1ee9c g\u00e2y ph\u00f9 n\u1ec1, d\u1ec5 l\u00e0m h\u1eb9p kh\u1ea9u k\u00ednh, ch\u1eb7t qu\u00e1\u00e0 ho\u1ea1i t\u1eed , l\u1ecfng qu\u00e1 \u00e0 ch\u1ea3y m\u00e1u- Kh\u00e2u m\u0169i r\u1eddi :+ \u01afu \u0111i\u1ec3m:\u0110\u01b0\u1eddng kh\u00e2u m\u1ec1m m\u1ea1i, co d\u00e3n d\u1ec5 d\u00e0ng, kh\u00f4ng l\u00e0m h\u1eb9p kh\u1ea9u k\u00ednh \u1ed1ng ti\u00eau h\u00f3a, \u00edt g\u00e2u ph\u00f9 n\u1ec1 \u1edf \u0111\u01b0\u1eddng kh\u00e2u, kh\u00e2u d\u1ec5 \u1edf 2 kh\u1ea9u k\u00ednh c\u1ee7a ru\u1ed9t to nh\u1ecf kh\u00e1c nhau, kh\u00e2u \u0111\u01b0\u1ee3c \u1edf ph\u1eabu tr\u01b0\u1eddng h\u1eb9p v\u00e0 s\u00e2u+ Nh\u01b0\u1ee3c \u0111i\u1ec3m:M\u1ea5t nhi\u1ec1u th\u1eddi gian, \u00e1p l\u1ef1c kh\u00f4ng d\u00e0n \u0111\u1ec1u2. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e2u n\u1ed1i \u1ed1ng ti\u00eau h\u00f3a :* Ph\u01b0\u01a1ng ph\u00e1p kh\u00e2u 1 l\u1edbp: l\u00e0 1 l\u1ea7n kh\u00e2u- Kh\u00e2u c\u1ea7m m\u00e1u b\u1eb1ng c\u00e1c m\u0169i ch\u1eef X- Kh\u00e2u m\u0169i r\u1eddi- Kh\u00e2u l\u1edbp c\u01a1 v\u00e0 l\u1edbp d\u01b0\u1edbi ni\u00eam m\u1ea1c- Ni\u00eam m\u1ea1c l\u1ed9n v\u00e0o trong* Ph\u01b0\u01a1ng ph\u00e1p kh\u00e2u 2 l\u1edbp: l\u00e0 2 l\u1ea7n kh\u00e2u- L\u1edbp 1: Kh\u00e2u to\u00e0n th\u1ec3 , xuy\u00ean qua 4 l\u1edbp c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a c\u00f3 t\u00e1c d\u1ee5ng n\u1ed1i li\u1ec1n 2 m\u00e9p v\u00e0 c\u1ea7m m\u00e1u- L\u1edbp 2 : Kh\u00e2u thanh c\u01a1. T\u00e1c d\u1ee5ng v\u00f9i l\u1edbp kh\u00e2u to\u00e0n th\u1ec3+ \u01afu \u0111i\u1ec3m:\u0110\u01b0\u1eddng kh\u00e2u k\u00edn, kh\u00e2u nhanh n\u1ebfu l\u00e0 kh\u00e2u v\u1eaft, kh\u00f4ng \u0111\u00f2i h\u1ecfi nhi\u1ec1u v\u1ec1 k\u0129 thu\u1eadt+ Nh\u01b0\u1ee3c \u0111i\u1ec3m:D\u00e0y c\u1ed9m ph\u00f9 n\u1ec1 nhi\u1ec1u, d\u1ec5 l\u00e0m h\u1eb9p kh\u1ea9u k\u00ednh \u1ed1ng ti\u00eau h\u00f3a, d\u1ec5 nhi\u1ec5m khu\u1ea9n \u1edf khe gi\u1eefa 2 \u0111\u01b0\u1eddng kh\u00e2u<\/p>\n

C\u00e2u 2: K\u1ef9 thu\u1eadt c\u1eaft n\u1ed1i ru\u1ed9t<\/p>\n

1. C\u1eaft b\u1ecf 1 \u0111o\u1ea1n ru\u1ed9t* Ch\u1ec9 \u0111\u1ecbnh :- C\u00e1c v\u1ebft r\u00e1ch ngang ho\u1eb7c d\u1ecdc qu\u00e1 to kh\u00f4ng kh\u00e2u \u0111\u01b0\u1ee3c- Nhi\u1ec1u v\u1ebft th\u01b0\u01a1ng li\u1ec1n nhau tr\u00ean c\u00f9ng 1 \u0111o\u1ea1n ru\u1ed9t- T\u1ed5n thuong m\u1ea1ch m\u00e1u m\u1ea1c treo d\u1eabn \u0111\u1ebfn ho\u1ea1i t\u1eed ho\u1eb7c thi\u1ec3u d\u01b0\u1ee1ng ru\u1ed9t- C\u00e1c lo\u1ea1i u \u1edf ru\u1ed9t ho\u1eb7c m\u1ea1c treo c\u00f3 li\u00ean quan \u0111\u1ebfn ru\u1ed9t* K\u0129 thu\u1eadt:- D\u00f9ng 2 Clamp k\u1eb9p vu\u00f4ng g\u00f3c v\u1edbi tr\u1ee5c c\u1ee7a ru\u1ed9t- C\u1eaft m\u1ea1c treo ru\u1ed9t: c\u1eaft 1 \u0111o\u1ea1n ru\u1ed9t ng\u1eafn th\u00ec c\u1eaft m\u1ea1c treo theo b\u1edd c\u1ee7a ru\u1ed9t, c\u1eaft 1 \u0111o\u1ea1n ru\u1ed9t d\u00e0i th\u00ec c\u1eaft m\u1ea1c treo theo h\u00ecnh tam gi\u00e1c \u0111\u1ec9nh v\u1ec1 ph\u00eda m\u1ea1c treo, \u0111\u00e1y v\u1ec1 ph\u00eda b\u1edd c\u1ee7a ru\u1ed9t2. N\u1ed1i ru\u1ed9t t\u1eadn \u2013 t\u1eadn: L\u00e0 n\u1ed1i 2 m\u1eb7t t\u1eadn v\u1edbi nhau- \u0110\u1eb7t 2 Clamp k\u1eb9p ru\u1ed9t song song v\u1edbi nhau kh\u00e2u 2 m\u0169i \u1edf 2 \u0111\u1ea7u l\u00e0m c\u01a1 s\u1edf ,- Kh\u00e2u m\u00e9p sau tr\u01b0\u1edbc b\u1eb1ng c\u00e1c m\u0169i ch\u1ec9 r\u1eddi, c\u1eaft ch\u1ec9 m\u00e9p sau, ti\u1ebfp t\u1ee5c kh\u00e2u m\u00e9p tr\u01b0\u1edbc* \u01afu \u0111i\u1ec3m :H\u1ee3p sinh l\u00ed , l\u01b0u th\u00f4ng ti\u00eau h\u00f3a t\u1ed1t* Nh\u01b0\u1ee3c \u0111i\u1ec3m:Kh\u1ea9u k\u00ednh c\u1ee7a ru\u1ed9t ph\u1ea3i b\u1eb1ng nhauCh\u00fa \u00fd : kh\u00f4ng l\u00e0m h\u1eb9p kh\u1ea9u k\u00ednh c\u1ee7a ru\u1ed9t3. N\u1ed1i b\u00ean \u2013 b\u00ean: L\u00e0 n\u1ed1i 2 m\u1eb7t b\u00ean c\u1ee7a ru\u1ed9t v\u1edbi nhau,M\u1edf 1 l\u1ed7 th\u00f4ng \u1edf 2 b\u1edd t\u1ef1 do c\u1ee7a ru\u1ed9tNh\u01b0 n\u1ed1i: D\u1ea1 d\u00e0y \u2013 H\u1ed7ng tr\u00e0ng, H\u1ed7ng \u2013 H\u1ed3i tr\u00e0ng, H\u1ed3i \u2013 \u0110\u1ea1i tr\u00e0ng+ \u01afu \u0111i\u1ec3m:D\u1ec5 th\u1ef1c hi\u1ec7n, l\u00e0m \u0111\u01b0\u1ee3c \u1edf c\u00e1c \u1ed1ng ti\u00eau h\u00f3a to nh\u1ecf kh\u00e1c nhau, \u0111\u1ed9 r\u1ed9ng c\u1ee7a mi\u1ec7ng n\u1ed1i t\u00f9y \u00fd, th\u1ee7 thu\u1eadt \u0111\u01a1n gi\u1ea3n+ Nh\u01b0\u1ee3c \u0111i\u1ec3m:\u0110\u01b0\u1eddng \u0111i kh\u00f4ng sinh l\u00ed, d\u1ec5 t\u1ea1o th\u00e0nh t\u00fai c\u00f9ng, ph\u1ea3i \u0111\u00f3ng 2 \u0111\u1ea7u ru\u1ed9t * K\u0129 thu\u1eadt \u0111\u00f3ng \u0111\u1ea7u ru\u1ed9t tr\u00ean k\u1eb9p nghi\u1ec1n MayO: D\u00f9ng k\u1eb9p n\u00e0y k\u1eb9p ru\u1ed9t, c\u1eaft \u0111\u1ea7u ru\u1ed9t s\u00e1t v\u1edbi k\u1eb9p nghi\u1ec1n, l\u00e0m 1 \u0111\u01b0\u1eddng kh\u00e2u v\u1eaft tr\u00ean k\u1eb9p nghi\u1ec1n, bu\u1ed9c 2 \u0111\u1ea7u ch\u1ec9 l\u1ea1i v\u1edbi nhau, l\u00e0m 1 m\u0169i kh\u00e2u h\u00ecnh t\u00fai v\u00f9i \u0111\u01b0\u1eddng kh\u00e2u tr\u00ean .4.N\u1ed1it\u1eadn \u2013 b\u00ean:N\u1ed1i m\u1eb7t t\u1eadn v\u1edbi m\u1eb7t b\u00ean , ph\u1ea3i \u0111\u00f3ng 1 \u0111\u1ea7u ru\u1ed9t<\/p>\n

C\u00e2u 3: K\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt tho\u00e1t v\u1ecb b\u1eb9n<\/p>\n

I. Ph\u00e2n lo\u1ea1i tho\u00e1t v\u1ecb b\u1eb9n : c\u00f3 3 lo\u1ea1i+ Tho\u00e1t v\u1ecb xi\u00ean ngo\u00e0i: \u1ede h\u1ed1 b\u1eb9n ngo\u00e0i, \u1edf ngo\u00e0i \u0111\u1ed9ng m\u1ea1ch th\u01b0\u1ee3ng v\u1ecb, bao tho\u00e1t v\u1ecb n\u1eb1ng trong bao x\u01a1 chungChia l\u00e0m 2 lo\u1ea1i l\u00e0: Tho\u00e1t v\u1ecb b\u1ea9m sinh v\u00e0 Tho\u00e1t v\u1ecb m\u1eafc ph\u1ea3i<\/p>\n

\u00d8 Tho\u00e1t v\u1ecb b\u1ea9m sinh: do t\u1ed3n t\u1ea1i c\u1ee7a \u1ed1ng ph\u00fac tinh macjbao tho\u00e1t v\u1ecb n\u1eb1m trong bao x\u01a1 chung, th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb em, m\u1ed5 \u00edt t\u00e1i ph\u00e1t<\/p>\n

\u00d8 Tho\u00e1i v\u1ecb m\u1eafc ph\u1ea3i: do th\u00e0nh b\u1ee5ng y\u1ebfu c\u00f3 th\u1ec3 g\u1eb7p \u1edf 3 v\u1ecb tr\u00ed th\u1eb3ng, xi\u00ean ngo\u00e0i, xi\u00ean trong. L\u00e0 tho\u00e1t viij g\u1eb7p \u1edf ng\u01b0\u1eddi l\u1edbn v\u00e0 th\u01b0\u1eddng g\u1eb7p xi\u00ean ngo\u00e0i.<\/p>\n

+ Tho\u00e1t v\u1ecb th\u1eb3ng: \u1ede h\u1ed1 b\u1eb9n gi\u1eefa, n\u1eb1m gi\u1eefa \u0111\u1ed9ng m\u1ea1ch th\u01b0\u1ee3ng v\u1ecb v\u00e0 \u0111\u1ed9ng m\u1ea1ch r\u1ed1n. Bao tho\u00e1t v\u1ecb bi\u1ec7t l\u1eadp v\u1edbi th\u1eebng tinh+ Tho\u00e1t v\u1ecb xi\u00ean trong: V\u1ecb tr\u00ed \u1edf gi\u1eefa th\u1eebng x\u01a1 c\u1ee7a \u0111\u1ed9ng m\u1ea1ch r\u1ed1n v\u00e0 d\u00e2y ch\u1eb1ng u r\u1eafcII. C\u00e1c th\u00ec k\u1ef9 thu\u1eadt1. Th\u00ec 1 :+ R\u1ea1ch da d\u00e0i 10cm b\u1eaft \u0111\u1ea7u t\u1eeb gai mu theo \u0111\u01b0\u1eddng ph\u00e2n gi\u00e1c t\u1ea1o b\u1edfi b\u1edd ngo\u00e0i c\u01a1 th\u1eb3ng to v\u00e0 cung \u0111\u00f9i.+ R\u1ea1ch c\u01a1 ch\u00e9o to d\u00f9ng 2 k\u1eb9p Kocher k\u1eb9p v\u00e0o 2 m\u00e9p k\u00e9o ra 2 ph\u00eda.2. Th\u00ec 2 : T\u00ecm v\u00e0 r\u1ea1ch bao tho\u00e1t v\u1ecb:+ D\u00f9ng Farabeuf k\u00e9o g\u00e2n k\u1ebft h\u1ee3p l\u00ean tr\u00ean, th\u1ea5y bao x\u01a1 chung xu\u1ea5t hi\u1ec7n+ R\u1ea1ch bao x\u01a1 chung, ti\u1ebfp t\u1ee5c l\u00e0m n\u1ebfp ph\u00fac m\u1ea1c \u0111\u1ec3 m\u1edf bao tho\u00e1t v\u1ecb cho \u0111\u1ebfn c\u1ed5 bao,+ \u0110\u1ea9y ru\u1ed9t v\u00e0 m\u1ea1c n\u1ed1i ( n\u1ebfu c\u00f3) v\u00e0o trong \u1ed5 b\u1ee5ng qua l\u1ed7 tho\u00e1t v\u1ecb, \u0111\u1eb7t 1 Metcher \u0111\u1ec3 kh\u00f4ng cho ru\u1ed9t r\u01a1i xu\u1ed1ng d\u01b0\u1edbi.+ T\u00e1ch bao tho\u00e1t v\u1ecb kh\u1ecfi bao x\u01a1 chung b\u1eb1ng c\u00e1ch :D\u00f9ng ng\u00f3n tr\u1ecf c\u1ee7a b\u00e0n tay tr\u00e1i cho v\u00e0o \u0111\u00e1y c\u1ee7a bao tho\u00e1t v\u1ecb, ng\u00f3n tay tr\u1ecf c\u1ee7a b\u00e0n tay ph\u1ea3i qu\u1ea5n g\u1ea1c \u0111\u1ea9y bao tho\u00e1t v\u1ecb t\u00e1ch kh\u1ecfi bao x\u01a1 chung v\u00e0 c\u00e1c th\u00e0nh ph\u1ea7n trong bao x\u01a1 chung.* Ch\u00fa \u00fd: Kh\u00f4ng l\u00e0m t\u1ed5n th\u01b0\u01a1ng c\u00e1c th\u00e0nh ph\u1ea7n trong bao x\u01a1 chung, t\u0129nh m\u1ea1ch th\u1eebng tinh.3. Th\u00ec 3 : C\u1eaft v\u00e0 th\u1eaft bao tho\u00e1t v\u1ecb :+ Sau khi \u0111\u00e3 t\u00e1ch xong bao tho\u00e1t v\u1ecb \u0111\u1ebfn c\u1ed5 bao d\u00f9ng 1 s\u1ee3i ch\u1ec9 \u0111\u1ec3 th\u1eaft bao tho\u00e1t v\u1ecb ngay l\u1ed7 b\u1eb9n trong v\u00e0 c\u1eaft bao tho\u00e1t v\u1ecb \u1edf ph\u00eda d\u01b0\u1edbi hay treo c\u1ed5 bao tho\u00e1t v\u1ecb v\u00e0o g\u00e2n k\u1ebft h\u1ee3p.4. Th\u00ec 4 : Kh\u00e2u ph\u1ee5c h\u1ed3i th\u00e0nh b\u1ee5ng.+ Theo 2 ph\u01b0\u01a1ng ph\u00e1p: tr\u01b0\u1edbc th\u1eebng tinh v\u00e0 sau th\u1eebng tinh, ch\u1ee7 y\u1ebfu l\u00e0 kh\u00e2u g\u00e2n k\u1ebft h\u1ee3p v\u1edbi cung \u0111\u00f9i.* Ph\u01b0\u01a1ng ph\u00e1p kh\u00e2u tr\u01b0\u1edbc th\u1eebng tinh:Kh\u00e2u b\u00ecnh di\u1ec7n b\u1edd sau c\u1ee7a cung \u0111\u00f9i v\u1edbi g\u00e2n k\u1ebft h\u1ee3p \u0111\u00e2y l\u00e0 th\u00ec quan tr\u1ecdng, kh\u00e2u b\u1eb1ng c\u00e1c m\u0169i ch\u1ec9 r\u1eddi, sau \u0111\u00f3 kh\u00e2u b\u00ecnh di\u1ec7n th\u1ee9 2 c\u01a1 ch\u00e9o to v\u1edbi c\u01a1 ch\u00e9o to.* Ph\u01b0\u01a1ng ph\u00e1p kh\u00e2u sau th\u1eebng tinh :D\u00f9ng Farabeuf k\u00e9o nh\u1eb9 th\u1eebng tinh ra tr\u01b0\u1edbc lu\u1ed3n ch\u1ec9 kh\u00e2u cung \u0111\u00f9i v\u1edbi g\u00e2n k\u1ebft h\u1ee3p. Sau \u0111\u00f3 ti\u1ebfp t\u1ee5c kh\u00e2u b\u00ecnh di\u1ec7n th\u1ee9 2 c\u01a1 ch\u00e9o to v\u1edbi c\u01a1 ch\u00e9o to.III. Tho\u00e1t v\u1ecb b\u1ea9m sinh<\/p>\n

C\u00e1c th\u00ec ph\u1eabu thu\u1eadt gi\u1ed1ng nh\u01b0 tr\u00ean, ch\u1ec9 c\u1ea7n t\u00e1ch v\u00e0 m\u1edf bao tho\u00e1t v\u1ecb \u0111\u1ebfn c\u1ed5 bao, \u0111\u1ea9y ru\u1ed9t l\u00ean tr\u00ean. Kh\u00e2u c\u1ed5 bao tho\u00e1t v\u1ecb l\u1ea1i ho\u1eb7c l\u1ed9n 2 m\u00e9p bao tho\u00e1t v\u1ecb \u1edf g\u1ea7n c\u1ed5 \u0111\u00f3ng ph\u1ea7n m\u1ec1m<\/p>\n

IV. Tho\u00e1t v\u1ecb b\u1eb9n ngh\u1eb9t<\/p>\n

R\u1ea1ch da, c\u01a1, bao x\u01a1 xung quanh nh\u01b0 tr\u00ean. Khi m\u1edf bao tho\u00e1t v\u1ecb ch\u00fa \u00fd kh\u00f4ng l\u00e0m t\u1ed5n th\u01b0\u01a1ng c\u00e1c quai ru\u1ed9t v\u00ec c\u00e1c quai ru\u1ed9t c\u0103ng ph\u1ed3ng c\u00f3 d\u1ecbch xu\u1ea5t ti\u1ebft l\u00e0m n\u1ebfp ph\u00fac m\u1ea1c. \u0110\u1ec3 m\u1edf bao tho\u00e1t v\u1ecb dung fngosn tay c\u00e1i v\u00e0 ng\u00f3n 2-3 c\u00f3 \u0111\u1ec7m g\u1ea1c, gi\u1eef to\u00e0n b\u1ed9 th\u00e0nh ph\u1ea7n tho\u00e1t v\u1ecb, tay ph\u1ea3i c\u1ee7a ph\u1eabu thu\u1eadt vi\u00ean d\u00f9ng dao l\u1eadt ng\u1eeda l\u00ean ph\u00eda tr\u00ean c\u1eaft v\u00f2ng x\u01a1 c\u1ed5 bao tho\u00e1t v\u1ecb. Ki\u1ec3m tra to\u00e0n b\u1ed9 th\u00e0nh ph\u1ea7n trong bao tho\u00e1t v\u1ecb n\u1ebfu c\u00f3 t\u1ed5n th\u01b0\u01a1ng th\u00ec x\u1eed l\u00fd. C\u00e1c th\u00ec kh\u00e1c c\u0169ng m\u1ed5 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 tho\u00e1t v\u1ecb b\u1eb9n th\u01b0\u1eddng<\/p>\n

V. Tai bi\u1ebfn, bi\u1ebfn ch\u1ee9ng<\/p>\n

– T\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch \u0111\u00f9i<\/p>\n

– T\u1ed5n th\u01b0\u01a1ng th\u1eebng tinh<\/p>\n

– R\u1ea1ch v\u00e0o ru\u1ed9t trong khi m\u1ed5 bao tho\u00e1t v\u1ecb<\/p>\n

– G\u00e2y t\u1ee5 m\u00e1u, u m\u00e1u sau khi m\u1ed5<\/p>\n

– Nhi\u1ec5m tr\u00f9ng<\/p>\n

C\u00e2u 4: K\u1ef9 thu\u1eadt n\u1ed1i d\u1ea1 d\u00e0y – h\u1ed7ng tr\u00e0ng<\/p>\n

N\u1ed1i d\u1ea1 d\u00e0y \u2013 h\u1ed7ng tr\u00e0ng l\u00e0 l\u00e0m 1 mi\u1ec7ng n\u1ed1i \u1edf dd v\u1edbi h\u1ed7ng tr\u00e0ng t\u1ea1o 1 \u0111\u01b0\u1eddng l\u01b0u th\u00f4ng ti\u00eau h\u00f3a m\u1edbi tr\u1ef1c ti\u1ebfp t\u1eeb d\u1ea1 d\u00e0y sang h\u1ed7ng tr\u00e0ng, kh\u00f4ng qua m\u00f4n v\u1ecb t\u00e1 tr\u00e0ng trong tr\u01b0\u1eddng h\u1ee3p h\u1eb9p m\u00f4n v\u1ecb m\u00e0 kh\u00f4ng \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n \u0111\u1ec3 c\u1eaft d\u1ea1 d\u00e0y.I. Ch\u1ec9 \u0111\u1ecbnh:+ H\u1eb9p m\u00f4n v\u1ecb do K ho\u1eb7c l\u00fd do n\u00e0o \u0111\u00f3 nh\u01b0ng kh\u00f4ng c\u1eaft d\u1ea1 d\u00e0y \u0111\u01b0\u1ee3c.+ H\u1eb9p m\u00f4n v\u1ecb do lo\u00e9t m\u00e0 t\u00ecnh tr\u1ea1ng to\u00e0n th\u00e2n ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng t\u1ea1i ch\u1ed7 kh\u00f4ng cho ph\u00e9p c\u1eaft d\u1ea1 d\u00e0y an to\u00e0n+ C\u1eaft d\u00e2y th\u1ea7n kinh X m\u00e0 kh\u00f4ng t\u1ea1o h\u00ecnh m\u00f4n v\u1ecb \u0111\u01b0\u1ee3c+ Kh\u00e2u l\u1ed7 th\u1ee7ng g\u00e2y ch\u00edt h\u1eb9p m\u00f4n v\u1ecb ho\u1eb7c h\u00e0nh t\u00e1 tr\u00e0ng kh\u00f4ng c\u00f3 \u0111i\u1ec1u ki\u1ec7n t\u1ea1o h\u00ecnh m\u00f4n v\u1ecbII. Nguy\u00ean t\u1eafc:+ \u0110o\u1ea1n h\u1ed7ng tr\u00e0ng \u0111\u1ecbnh n\u1ed1i ph\u1ea3i ng\u1eafn nh\u1ea5t , tr\u1ef1c ti\u1ebfp v\u00e0 g\u1ea7n d\u1ea1 d\u00e0y nh\u1ea5t+ Mi\u1ec7ng n\u1ed1i ph\u1ea3i \u1edf ch\u1ed7 th\u1ea5p nh\u1ea5t c\u1ee7a d\u1ea1 d\u00e0y+ L\u01b0u th\u00f4ng c\u1ee7a \u0111o\u1ea1n t\u00e1 tr\u00e0ng ph\u1ea3i qua \u0111\u01b0\u1ee3c d\u1ea1 d\u00e0y \u0111\u1ec3 trung h\u00f2a \u0111\u01b0\u1ee3c d\u1ecbch v\u1ecb \u1edf d\u1ea1 d\u00e0yIII. C\u00e1c ki\u1ec3u n\u1ed1i:1. N\u1ed1i d\u1ea1 d\u00e0y h\u1ed7ng tr\u00e0ng xuy\u00ean qua m\u1ea1c treo \u0111\u1ea1i tr\u00e0ng ngang v\u00e0o m\u1eb7t sau d\u1ea1 d\u00e0y.2. N\u1ed1i d\u1ea1 d\u00e0y h\u1ed7ng tr\u00e0ng xuy\u00ean qua m\u1ea1c treo \u0111\u1ea1i tr\u00e0ng ngang v\u00e0o m\u1eb7t tr\u01b0\u1edbc d\u1ea1 d\u00e0y.3. N\u1ed1i d\u1ea1 d\u00e0y h\u1ed7ng tr\u00e0ng kh\u00f4ng xuy\u00ean qua m\u1ea1c treo \u0111\u1ea1i tr\u00e0ng ngang v\u00e0o m\u1eb7t sau d\u1ea1 d\u00e0y.4. N\u1ed1i d\u1ea1 d\u00e0y h\u1ed7ng tr\u00e0ng kh\u00f4ng xuy\u00ean qua m\u1ea1c treo \u0111\u1ea1i tr\u00e0ng ngang v\u00e0o m\u1eb7t tr\u01b0\u1edbc d\u1ea1 d\u00e0y.IV. C\u00e1c th\u00ec k\u1ef9 thu\u1eadt : N\u1ed1i d\u1ea1 d\u00e0y h\u1ed7ng tr\u00e0ng xuy\u00ean qua m\u1ea1c treo \u0111\u1ea1i tr\u00e0ng ngang v\u00e0o m\u1eb7t sau d\u1ea1 d\u00e0y:T\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n: n\u1eb1m ng\u1eeda<\/p>\n

Th\u00ec 1:+ M\u1edf \u1ed5 b\u1ee5ng theo \u0111\u01b0\u1eddng tr\u1eafng gi\u1eefa tr\u00ean r\u1ed1n+ D\u00f9ng Farabeuf k\u00e9o th\u00e0nh b\u1ee5ng v\u1ec1 2 ph\u00eda ki\u1ec3m tra d\u1ea1 d\u00e0y v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng2. Th\u00ec 2 : T\u00ecm quai h\u1ed7ng tr\u00e0ng \u0111\u1ea7u ti\u00ean+ \u0110\u01b0a m\u1ea1c n\u1ed1i l\u1edbn l\u00ean tr\u00ean, PTV v\u00e0 ng\u01b0\u1eddi ph\u1ee5 c\u0103ng \u0111\u1ea1i tr\u00e0ng ngang+ PTV d\u00f9ng 1 ng\u00f3n tay lu\u1ed3n nh\u1eb9 theo m\u1eb7t d\u01b0\u1edbi MT\u0110TN xu\u1ed1ng t\u1eadn g\u1ed1c sang tr\u00e1i c\u1ed9t s\u1ed1ng m\u00f3c l\u00ean quai ru\u1ed9t \u0111\u1ea7u ti\u00ean : 1 \u0111\u1ea7u th\u00ec c\u1ed1 \u0111\u1ecbnh \u0111\u00f3 l\u00e0 g\u1ed1c Treiz, 1 \u0111\u1ea7u di \u0111\u1ed9ng+ Ch\u1ecdn ch\u1ed7 \u0111\u1ecbnh n\u1ed1i c\u00e1ch g\u00f3c Treiz 8cm \u0111\u00ednh 1 s\u1ee3i ch\u1ec9 l\u00e0m m\u1ed1c.3. Th\u00ec 3: T\u00ecm m\u1eb7t sau d\u1ea1 d\u00e0y+ \u0110\u01b0a m\u1ea1c n\u1ed1i l\u1edbn v\u1ec1 ph\u00eda l\u1ed3ng ng\u1ef1c+ N\u00e2ng \u0111\u1ea1i tr\u00e0ng ngang l\u00ean t\u00ecm ch\u1ed7 v\u00f4 m\u1ea1ch c\u1ee7a m\u1ea1c treo \u0111\u1ea1i tr\u00e0ng , r\u1ea1ch 1 \u0111\u01b0\u1eddng d\u00e0i 8-10cm+ Qua l\u1ed7 m\u1edf m\u1ea1c treo \u0111\u1ea1i tr\u00e0ng v\u00e0o h\u1eadu cung m\u1ea1c n\u1ed1i dung 2 k\u1eb9p Shaput c\u1eb7p v\u00e0o m\u1eb7t sau d\u1ea1 d\u00e0y ch\u1ed7 \u0111\u1ecbnh n\u1ed1i : 2 k\u1eb9p Shaput c\u00e1ch nhau 8cm , c\u00e1ch b\u1edd cong l\u1edbn 1,5cm , s\u00e1t m\u00f4n v\u1ecb+ D\u00f9ng 2 Clamp k\u1eb9p d\u1ea1 d\u00e0y \u1edf 2 \u0111\u1ea7u Shaput+ D\u00f9ng 2 Shaput k\u1eb9p quai h\u1ed7ng tr\u00e0ng n\u01a1i s\u1ee3i ch\u1ec9 l\u00e0m m\u1ed1c , 2 k\u1eb9p c\u00e1ch nhau 8cm d\u00f9ng Clam k\u1eb9p ru\u1ed9t \u1edf 2 \u0111\u1ea7u Shaput4. Th\u00ec 4: B\u00ean- B\u00ean hai l\u1edbp+ \u0110\u1eb7t 2 Clam song song v\u1edbi nhau , kh\u00e2u \u0111\u00ednh c\u1ed1 \u0111\u1ecbnh 2 \u0111\u1ea7u \u0111\u1ecbnh n\u1ed1i v\u1edbi nhau+ Kh\u00e2u 1 \u0111\u01b0\u1eddng kh\u00e2u v\u1eaft thanh c\u01a1 m\u00e9p sau b\u1eb1ng ch\u1ec9 kh\u00f4ng ti\u00eau t\u1eeb A \u0111\u1ebfn B v\u00e0 g\u00f3i ch\u1ec9 v\u00e0o g\u1ea1c+ D\u00f9ng dao r\u1ea1ch d\u1ea1 d\u00e0y v\u00e0 h\u1ed5ng tr\u00e0ng d\u00e0i 5-6cm ,c\u00e1ch \u0111\u01b0\u1eddng kh\u00e2u thanh c\u01a1 m\u1ed7i b\u00ean 0,5cm , c\u00e1ch 2 \u0111\u1ea7u m\u1ed7i b\u00ean 0,5cm+ Kh\u00e2u 1 \u0111\u01b0\u1eddng kh\u00e2u v\u1eaft to\u00e0n th\u1ec3 : M\u00e9p sau t\u1eeb A \u00e0 B r\u1ed3i ti\u1ebfp t\u1ee5c kh\u00e2u m\u00e9p tr\u01b0\u1edbc t\u1eeb B \u00e0 A b\u1eb1ng ch\u1ec9 Catgut+ L\u1ea5y ch\u1ec9 g\u00f3i trong g\u1ea1c ti\u1ebfp t\u1ee5c kh\u00e2u thanh c\u01a1 m\u00e9p tr\u01b0\u1edbc t\u1eeb B\u00e0 A v\u00f9i \u0111\u01b0\u1eddng kh\u00e2u to\u00e0n th\u1ec3+ Kh\u00e2u \u0111\u00ednh l\u1ed7 m\u1edf m\u1ea1c treo v\u00e0o d\u1ea1 d\u00e0y tr\u00ean mi\u1ec7ng n\u1ed1i , k\u00e9o m\u1ea1c n\u1ed1i v\u00e0 \u0111\u1ea1i tr\u00e0ng v\u00e0o \u1ed5 b\u1ee5ng r\u1ed1i \u0111\u1ed1ng \u1ed5 b\u1ee5ng 2 l\u1edbpV. Tai bi\u1ebfn v\u00e0 bi\u1ebfn ch\u1ee9ng:+ T\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch m\u1ea1c treo \u0111\u1ea1i tr\u00e0ng ngang g\u00e2y ho\u1ea1i t\u1eed \u0111\u1ea1i tr\u00e0ng r\u1ea5t nguy hi\u1ec3m+ Ch\u1ea3y m\u00e1u mi\u1ec7ng n\u1ed1i : bi\u1ec3u hi\u1ec7n : n\u00f4n ra m\u00e1u ho\u1eb7c h\u00fat d\u1ecbch d\u1ea1 d\u00e0y c\u00f3 m\u00e1u+ B\u1ee5c mi\u1ec7ng n\u1ed1i , t\u1eafc mi\u1ec7ng n\u1ed1i+ Lo\u00e9t mi\u1ec7ng n\u1ed1i , h\u1ed9i ch\u1ee9ng quai \u0111\u1ebfn<\/p>\n

C\u00e2u 5: K\u1ef9 thu\u1eadt m\u1edf kh\u00ed qu\u1ea3n<\/p>\n

1. Ch\u1ec9 \u0111\u1ecbnh :+ Tr\u1edf ng\u1ea1i \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean do c\u00e1c nguy\u00ean nh\u00e2n l\u00e0m c\u1ea3n tr\u1edf th\u00f4ng kh\u00ed t\u1eeb m\u0169i t\u1edbi thanh h\u1ea7u: V\u1ebft th\u01b0\u01a1ng v\u00f9ng m\u0169i, v\u1ebft th\u01b0\u01a1ng thanh qu\u1ea3n,D\u1ecb v\u1eadt \u0111\u01b0\u1eddng KQ, B\u1ec7nh b\u1ea1ch h\u1ea7u \u2026+ Nh\u1eefng t\u1ed5n th\u01b0\u01a1ng \u1ea3nh h\u01b0\u1edfng t\u1edbi trung khu h\u00f4 h\u1ea5p. L\u00e0m s\u1ef1 th\u00f4ng kh\u00ed b\u1ecb \u1ea3nh h\u01b0\u1edfng. C\u00e1c bi\u1ebfn ch\u1ee9ng sau m\u1ed5 nh\u01b0 u n\u00e3o, Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o, m\u00ea s\u00e2u, c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam m\u00e0ng n\u00e3o n\u1eb7ng \u1ea3nh h\u01b0\u1edfng t\u1edbi nh\u1ecbp h\u00f4 h\u1ea5p v\u1edbi s\u1ef1 xu\u1ea5t ti\u1ebft \u0111\u1eddm d\u00e3i.+ M\u1ed9t s\u1ed1 ph\u1eabu thu\u1eadt l\u1ed3ng ng\u1ef1c l\u00e0m \u1ea3nh h\u01b0\u1edfng t\u1edbi c\u00e1c c\u01a1 h\u00f4 h\u1ea5p v\u00e0 s\u1ef1 co gi\u00e3n c\u1ee7a ph\u1ebf nang nh\u01b0: C\u1eaft \u0111o\u1ea1n ph\u1ed5i, B\u00f3c t\u00e1ch m\u00e0ng ph\u1ed5i. Sau 1 s\u1ed1 ph\u1eabu thu\u1eadt \u1edf l\u1ed3ng ng\u1ef1c v\u00e0 trung th\u1ea5t, c\u01a1n vi\u00eam c\u1ea5p trong gi\u00e3n ph\u1ebf qu\u1ea3n g\u00e2y ng\u1ea1t th\u1edf n\u1eb7ng.<\/p>\n

Ngo\u00e0i ra ng\u01b0\u1eddi ta c\u00f2n \u00e1p d\u1ee5ng m\u1edf kh\u00ed qu\u1ea3n \u0111\u1ec3 d\u1ef1 ph\u00f2ng trong tr\u01b0\u1eddng h\u1ee3p di chuy\u1ec3n xa ti\u00ean l\u01b0\u1ee3ng s\u1ef1 ng\u1ea1t th\u1edf c\u00f3 th\u1ec3 x\u1ea3y ra, ho\u1eb7c \u0111\u1ec3 chu\u1ea9n b\u1ecb cho 1 ph\u1eabu thu\u1eadt l\u1edbn nh\u01b0 n\u1ed1i u h\u1ea1 h\u1ecdngII. K\u1ef9 thu\u1eadt :1. D\u1ee5ng c\u1ee5: Ngo\u00e0i c\u00e1c d\u1ee5ng c\u1ee5 th\u00f4ng th\u01b0\u1eddng c\u00f2n c\u1ea7n c\u00f3 Ca-nuyn.2. Chu\u1ea9n b\u1ecb:T\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n:+ B\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eefa, k\u00ea g\u1ed1i \u1edf c\u1ed5 v\u00e0 \u1edf vai, \u0111\u1ec3 c\u1ed5 ng\u1eeda+ Trong tr\u01b0\u1eddng h\u1ee3p c\u1ea5p c\u1ee9u \u00edt khi g\u00e2y t\u00ea, trong \u0111i\u1ec1u ki\u1ec7n cho ph\u00e9p c\u00f2 th\u1ec3 g\u00e2y t\u00ea t\u1ea1i ch\u1ed7.+ Ph\u1eabu thu\u1eadt vi\u00ean \u0111\u1ee9ng \u1edf b\u00ean ph\u1ea3i, ng\u01b0\u1eddi ph\u1ee5 \u0111\u1ee9ng \u1edf ph\u00eda tr\u00ean \u0111\u1ea7u b\u1ec7nh nh\u00e2n3. C\u00e1c th\u00ec ph\u1eabu thu\u1eadt:a. Th\u00ec 1:+ R\u1ea1ch da d\u00e0i 3-5cm, \u0111\u01b0\u1eddng r\u1ea1ch b\u1eaft \u0111\u1ea7u t\u1eeb b\u1edb d\u01b0\u1edbi s\u1ee5n nh\u1eabn.+ PTV l\u1ea5y ng\u00f3n tay c\u00e1i v\u00e0 ng\u00f3n tay gi\u1eefa c\u1ee7a b\u00e0n tay tr\u00e1i gi\u1eef l\u1ea5y s\u1ee5n nh\u1eabn , ng\u00f3n tr\u1ecf \u0111\u1ec3 \u1edf d\u01b0\u1edbi v\u00f2ng s\u1ee5n \u0111\u1ec3 l\u00e0m m\u1ed1c.+ R\u1ea1ch c\u00e1c l\u1edbp c\u00e2n c\u1ed5: C\u00e2n c\u1ed5 n\u00f4ng, c\u00e2n c\u1ed5 gi\u1eefa, qua c\u00e1c l\u1edbp c\u00e2n ta th\u1ea5y c\u00e1c v\u00f2ng s\u1ee5n kh\u00ed qu\u1ea3n xu\u1ea5t hi\u1ec7n . Banh r\u1ed9ng v\u1ebft m\u1ed5b. Th\u00ec 2: R\u1ea1ch kh\u00ed qu\u1ea3n :+ Ng\u00f3n tay tr\u1ecf trong qu\u00e1 tr\u00ecnh m\u1ed5 lu\u00f4n lu\u00f4n \u0111\u01b0a \u0111\u01b0\u1eddng kh\u00f4ng r\u1eddi kh\u00ed qu\u1ea3n.+ \u0110\u01b0\u1eddng r\u1ea1ch b\u1eaft \u0111\u1ea7u t\u1eeb s\u1ee5n th\u1ee9 2, ch\u1ecdc s\u00e2u 5mm, k\u00e9o d\u00e0i 1,5cm, khi kh\u00f4ng kh\u00ed v\u00e0o t\u1ea1o ra 1 ti\u1ebfng r\u00edt l\u00e0m cho b\u1ec7nh nh\u00e2n c\u00f3 ph\u1ea3n x\u1ea1 ho h\u1eaft ra, n\u00ean \u0111\u1ec3 tr\u00e1nh \u0111\u1eddm gi\u00e3i b\u1eafn ra ph\u1ea3i d\u00f9ng ng\u00f3n tr\u1ecf \u0111\u1ec3 b\u1ecbt \u0111\u01b0\u1eddng r\u1ea1ch kh\u00ed qu\u1ea3n l\u1ea1i. G\u1eb7p eo tuy\u1ebfn gi\u00e1p \u0111\u1ea9y xu\u1ed1ng d\u01b0\u1edbi ho\u1eb7c k\u1eb9p c\u1eaft gi\u1eefa hai k\u1eb9p Kocher.c. Th\u00ec 3 : L\u1eafp Ca-nuyn:+ Trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 banh 3 c\u1ea1nh cho v\u00e0o v\u1ebft r\u1ea1ch kh\u00ed qu\u1ea3n \u0111\u1ec3 l\u1eafp Ca-nuyn v\u00e0o.+ Tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 banh 3 c\u1ea1nh, ng\u01b0\u1eddi ta l\u1eafp n\u00f2ng Ca-nuyn v\u00e0o v\u1ecf Ca-nuyn, sau \u0111\u00f3 t\u1ef3 m\u00e9p ph\u1ea3i c\u1ee7a \u0111\u01b0\u1eddng r\u1ea1ch, n\u00e2ng m\u00e9p tr\u00e1i l\u00ean r\u1ed3i d\u1ef1ng \u0111\u1ee9ng Ca-nuyn v\u00e0 \u0111\u1ea9y Ca-nuyn xu\u1ed1ng d\u01b0\u1edbi. R\u00fat n\u00f2ng ra kh\u1ecfi v\u1ecf, l\u1eafp v\u00e0o trong v\u1ecf th\u00eam 1 v\u1ecf nh\u1ecf h\u01a1n, l\u1ea5y m\u00e1y h\u00fat qua ca-nuyn \u0111\u1ec3 h\u00fat \u0111\u1eddm gi\u00e3i.d. Th\u00ec 4 : Kh\u00e2u da:+ Kh\u00e2u b\u1edbt \u0111\u01b0\u1eddng r\u1ea1ch da, c\u1ed1 \u0111\u1ecbnh Ca-nuyn b\u1eb1ng c\u00e1ch bu\u1ed9c ra ph\u00eda sau c\u1ed5 ho\u1eb7c kh\u00e2u v\u00e0o da b\u00ean c\u1ea1nh c\u1ed5.<\/p>\n

Thay \u0111\u1ed5i k\u1ef9 thu\u1eadt<\/p>\n

C\u00f3 t\u00e1c gi\u1ea3 thay \u0111\u1ed5i \u0111\u01b0\u1eddng r\u1ea1ch kh\u00ed qu\u1ea3n nh\u1eb1m m\u1ee5c \u0111\u00edch cho canuyn v\u00e0o d\u1ec5 d\u00e0ng ho\u1eb7c \u0111\u01b0\u1eddng kh\u00ed qu\u1ea3n kh\u00f4ng tr\u00f9ng v\u1edbi \u0111\u01b0\u1eddng r\u1ea1ch da nh\u01b0: \u0111\u01b0\u1eddng r\u1ea1ch v\u00f2ng tr\u00f2n, r\u1ea1ch ch\u1eef U, r\u1ea1ch ch\u1eef th\u1eadp.4. Ch\u0103m s\u00f3c<\/p>\n

\u0110\u1ea3m b\u1ea3o s\u1ef1 th\u00f4ng kh\u00ed h\u1eb1ng ng\u00e0y t\u1ed1t b\u1eb1ng c\u00e1ch h\u00fat \u0111\u1eddn d\u00e3i cho b\u1ec7nh nh\u00e2n, trong tr\u01b0\u1eddng h\u1ee3p \u0111\u1eddm \u0111\u1eb7c c\u00f3 th\u1ec3 b\u01a1m 3-5ml huy\u1ebft thanh c\u00f3 pha kh\u00e1ng sinh, khaonrg 1-2\u2019 sau s\u1ebd h\u00fat \u0111\u1eddm d\u00e3i, cho b\u1ec7nh nh\u00e2n n\u1eb1m t\u01b0 th\u1ebf fowler.<\/p>\n

\u00d8 \u0110\u1ec3 b\u1ec7nh nh\u00e2n trong ph\u00f2ng \u1ea5m th\u00edch h\u1ee3p kho\u1ea3ng 15-20 \u0111\u1ed9, \u0111\u1eafp g\u1ea1c l\u00ean canuyn c\u00f3 t\u1ea9m d\u1ea7u gommenolee<\/p>\n

\u00d8 Ch\u1ed1ng nhi\u1ec5m tr\u00f9ng v\u00e0 ch\u1ed1ng lo\u00e9t t\u1ea1i ch\u1ed7 c\u0169ng nh\u01b0 lo\u00e9t to\u00e0n th\u00e2n: cho c\u00e1c lo\u1ea1i kh\u00e1ng sinh (d\u1ef1a v\u00e0o kh\u00e1ng sinh \u0111\u1ed3). T\u00f9y theo nguy\u00ean nh\u00e2n v\u00e0 k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb m\u00e0 r\u00fat canuyn. Th\u00f4ng th\u01b0\u1eddng ng\u00e0y th\u1ee9 7 r\u00fat canuyn; ch\u1ed1ng lo\u00e9t t\u1ea1i ch\u1ed7 b\u1eb1ng c\u00e1ch thay b\u0103ng s\u1ea1ch, ch\u1ed1ng lo\u00e9t to\u00e0n th\u00e2n b\u1eb1ng c\u00e1ch v\u1ec7 sinh v\u00e0 tr\u1edf l\u1eadt ng\u01b0\u1eddi b\u1ec7nh nh\u00e2n lu\u00f4n.<\/p>\n

5. Tai bi\u1ebfn v\u00e0 bi\u1ebfn ch\u1ee9ng:+ \u0110\u01b0\u1eddng r\u1ea1ch xi\u00ean sang m\u1eb7t b\u00ean+ Ch\u1ecdc th\u1ee7ng th\u1ef1c qu\u1ea3n do kh\u00f4ng l\u00e0m \u0111i\u1ec3m t\u1ef3 \u0111\u1ec3 l\u00e0m m\u1ed1c+ Ch\u1ea3y m\u00e1u: Trong khi m\u1edf kh\u00ed qu\u1ea3n c\u00f3 ch\u00e3y m\u00e1u c\u00f3 th\u1ec3 cho ca-nuyn to h\u01a1n n\u1ebfu kh\u00f4ng kh\u00e2u c\u1ea7m m\u00e1u+ Ng\u1ea1t th\u1edf do t\u1eaft \u0111\u1eddm gi\u00e3i+ Tr\u00e0n kh\u00ed v\u00e0 m\u00e1u v\u00e0o v\u00f9ng trung th\u1ea5t trong tr\u01b0\u1eddng h\u1ee3p m\u1edf kh\u00ed qu\u1ea3n th\u1ea5p+ Nhi\u1ec5m tr\u00f9ng k\u00e9o d\u00e0i c\u00f3 th\u1ec3 l\u00e0m h\u1eb9p kh\u00ed qu\u1ea3n do \u0111\u1eddm \u0111\u1ecdng \u1edf c\u00e1c g\u00f3c ch\u1ebft\u2026.<\/p>\n

+ trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y ng\u01b0\u1eddi ta n\u00f3i nhi\u1ec1u t\u1edbi r\u00f2 r\u1ec9 kh\u00ed – th\u1ef1c qu\u1ea3n sau khi m\u1edf kh\u00ed qu\u1ea3n, ch\u1ea3y m\u00e1u do lo\u00e9t, r\u00f2 th\u00e2n \u0110M c\u00e1nh tay \u0111\u1ea7u, ch\u1ea3y m\u00e1u do lo\u00e9t t\u1ea1i ch\u1ed7 c\u1ee7a kh\u00ed qu\u1ea3n<\/p>\n

C\u00e2u 6: K\u1ef9 thu\u1eadt m\u1ed5 ru\u1ed9t th\u1eeba<\/p>\n

I. K\u1ef9 thu\u1eadt m\u1ed5 vi\u00eam ru\u1ed9t th\u1eeba \u0111\u1ebfn s\u1edbm<\/p>\n

Ph\u1eabu thu\u1eadt vi\u00ean \u0111\u1ee9ng b\u00ean ph\u1ea3i, ng\u01b0\u1eddi ph\u1ee5 \u0111\u1ee9ng b\u00ean \u0111\u1ed1i di\u1ec7n, g\u00e2y m\u00ea ho\u1eb7c g\u00e2y t\u00ea1. Th\u00ec 1: M\u1edf \u1ed5 b\u1ee5ng:+ D\u00f9ng dao r\u1ea1ch \u0111\u01b0\u1eddng vu\u00f4ng g\u00f3c v\u1edbi \u0111\u01b0\u1eddng gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean b\u00ean ph\u1ea3i \u0111\u1ebfn r\u1ed1n \u1edf 1\/3 ngo\u00e0i (\u0111\u01b0\u1eddng Macburney)+ R\u1ea1ch v\u00e0 t\u00e1ch c\u01a1 ch\u00e9o l\u1edbn, ng\u01b0\u1eddi ph\u1ee5 d\u00f9ng farabeuf banh r\u1ed9ng v\u1ebft m\u1ed5 , t\u00e1ch c\u01a1 ch\u00e9o b\u00e9, c\u01a1 ngang b\u1ee5ng, trong c\u00f9ng l\u00e0 ph\u00fac m\u1ea1c.+ PTV d\u00f9ng k\u1eb9p ph\u1eabu t\u00edch, ng\u01b0\u1eddi ph\u1ee5 c\u1ea7m Kocher n\u00e2ng ph\u00fac m\u1ea1c, c\u1eaft ph\u00fac m\u1ea1c, d\u00f9ng Farabeuf banh r\u1ed9ng v\u1ebft m\u1ed5 (d\u00e0i 6-8cm)2. Th\u00ec 2 t\u00ecm ru\u1ed9t th\u1eeba:+ Ph\u1eabu thu\u1eadt vi\u00ean d\u00f9ng Metcher \u0111\u1ea9y ru\u1ed9t non v\u1ec1 ph\u00eda tr\u00e1i, th\u1ea5y manh tr\u00e0ng c\u00f3 d\u1ea3i c\u01a1 d\u1ecdc, l\u1ea7n xu\u1ed1ng d\u01b0\u1edbi th\u1ea5y ru\u1ed9t th\u1eeba.+ D\u00f9ng Kocher k\u00e9o ru\u1ed9t th\u1eeba ra ngo\u00e0i.3. Th\u00ec 3: K\u1eb9p v\u00e0 c\u1eaft \u0111\u1ed9ng m\u1ea1ch m\u1ea1c treo ru\u1ed9t th\u1eeba:+ PTV d\u00f9ng Kocher ch\u1ecdc th\u1ee7ng m\u1ea1c treo s\u00e1t g\u1ed1c ru\u1ed9t th\u1eeba, ng\u01b0\u1eddi ph\u1ee5 d\u00f9ng Kocher k\u1eb9p 2 s\u1ee3i ch\u1ec9 \u0111\u01b0a v\u00e0o: 1 s\u1ee3i bu\u1ed9c s\u00e1t g\u1ed1c ru\u1ed9t th\u1eeba, 1 s\u1ee3i bu\u1ed9c \u0111\u1ed9ng m\u1ea1ch m\u1ea1c treo ru\u1ed9t th\u1eeba.+ D\u00f9ng Kocher k\u1eb9p ph\u1ea7n ngo\u00e0i ru\u1ed9t th\u1eeba c\u1eaft m\u1ea1c treo v\u00e0 \u0111\u1ed9ng m\u1ea1ch ru\u1ed9t th\u1eeba4. Th\u00ec 4: N\u00e2ng ru\u1ed9t th\u1eeba l\u00ean:PTV kh\u00e2u m\u1ed9t m\u0169i h\u00ecnh t\u00fai quanh g\u1ed1c ru\u1ed9t th\u1eeba5. Th\u00ec 5: C\u1eaft g\u1ed1c ru\u1ed9t th\u1eeba:D\u00f9ng dao t\u1ea9m c\u1ed3n iode c\u1eaft ru\u1ed9t th\u1eeba, th\u1eaft m\u0169i kh\u00e2u h\u00ecnh t\u00fai l\u1ea1i v\u00f9i m\u1ecfm c\u1eaft v\u00e0o manh tr\u00e0ng.6. Th\u00ec 6: Ki\u1ec3m tra 70cm h\u1ed3i tr\u00e0ng:N\u1ebfu c\u00f3 t\u00fai th\u1eeba Meckell kh\u00f4ng, n\u1ebfu c\u00f3 th\u00ec x\u1eed tr\u00ed sau \u0111\u00f3 lau s\u1ea1ch \u1ed5 b\u1ee5ng.7. Th\u00ec 7: \u0110\u00f3ng \u1ed5 b\u1ee5ng:- Kh\u00e2u ph\u00fac m\u1ea1c (l\u1ed9n ra ngo\u00e0i, kh\u00e2u v\u1eaft, r\u1eddi ho\u1eb7c h\u00ecnh t\u00fai)- Kh\u00e2u c\u01a1 ngang v\u1edbi c\u01a1 ch\u00e9o b\u00e9 m\u1ed9t l\u1edbp- Kh\u00e2u c\u01a1 ch\u00e9o l\u1edbn – Kh\u00e2u da* Ch\u00fa \u00fd: Trong tr\u01b0\u1eddng h\u1ee3p ru\u1ed9t th\u1eeba qu\u1eb7t ng\u01b0\u1ee3c sau manh tr\u00e0ng: Sau khi t\u00ecm \u0111\u01b0\u1ee3c g\u1ed1c ru\u1ed9t th\u1eeba,th\u1eaft \u0111\u1ed9ng m\u1ea1ch m\u1ea1c treo ru\u1ed9t th\u1eeba, th\u1eaft g\u1ed1c ru\u1ed9t th\u1eeba, c\u1eaft g\u1ed1c ru\u1ed9t th\u1eeba v\u00e0 \u0111\u1ed9ng m\u1ea1ch, b\u00f3c t\u00e1ch t\u1eeb g\u1ed1c \u0111\u1ebfn ng\u1ecdn (c\u1eaft ru\u1ed9t th\u1eeba ng\u01b0\u1ee3c d\u00f2ng)<\/p>\n

8. Tai bi\u1ebfn<\/p>\n

– Ch\u1ea3y m\u00e1u do tu\u1ed9t ch\u1ec9 bu\u1ed9c \u0111\u1ed9ng m\u1ea1ch m\u1ea1c treo ru\u1ed9t th\u1eeba<\/p>\n

– Ch\u1ecdc th\u1ee7ng manh tr\u00e0ng<\/p>\n

– R\u00f2 manh tr\u00e0ng<\/p>\n

II. Bi\u1ebfn ch\u1ee9ng c\u1ee7a vi\u00eam ru\u1ed9t th\u1eeba \u0111\u1ebfn mu\u1ed9n<\/p>\n

a. \u0110\u00e1m qu\u00e1nh ru\u1ed9t th\u1eeba:<\/p>\n

Do ph\u1ea3n \u1ee9ng b\u1ea3o v\u1ec7 c\u1ee7a c\u01a1 th\u1ec3 m\u1ea1c n\u1ed1i \u0111\u1ebfn bao quanh ru\u1ed9t th\u1eeba , kh\u00f4ng can thi\u1ec7p b\u1eb1ng ph\u1eabu thu\u1eadt \u0111\u1ee3i tan \u0111\u00e1m qu\u00e1nh m\u1edbi m\u1ed5<\/p>\n

b. \u00c1p xe ru\u1ed9t th\u1eeba<\/p>\n

\u00d8 \u00c1p xe ru\u1ed9t th\u1eeba: t\u00f9y theo v\u1ecb tr\u00ed \u1ed5 \u00e1p xe, ch\u1ecdc h\u00fat v\u00e0o \u1ed5 \u00e1p xe \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh. M\u1ed5 r\u1ed9ng \u1ed5 \u00e1p xe d\u1eabn l\u01b0u m\u1ee7 ra ngo\u00e0i, kh\u00f4ng t\u00ecm v\u00e0 c\u1eaft ru\u1ed9t th\u1eeba ngay khi d\u1eabn l\u01b0u \u00e1p xe, \u0111\u1eb7t \u1ed1ng d\u1eabn l\u01b0u, d\u1eabn l\u01b0u m\u1ee7 ra ngo\u00e0i<\/p>\n

\u00d8 N\u1ebfu \u00e1p xe \u1edf v\u00f9ng th\u1eaft l\u01b0ng: \u0111\u01b0\u1eddng r\u1ea1ch d\u00e0i 10cm c\u00e1ch m\u00e0o ch\u1eadu 2cm, bu\u1ed9c c\u1eaft c\u00e1c m\u1ea1ch m\u00e1u \u1edf s\u00e2u m\u1edf \u1ed5 \u00e1p xe d\u1eabn l\u01b0u<\/p>\n

\u00d8 \u00c1p xe \u1edf v\u00f9ng ch\u1eadu h\u00f4ng b\u00e9: th\u1ee5t th\u00e1o, \u0111\u1eb7t th\u00f4ng ti\u1ec3u, d\u1eabn l\u01b0u theo \u0111\u01b0\u1eddng tr\u1ef1c tr\u00e0ng<\/p>\n

c. Ru\u1ed9t th\u1eeba v\u1ee1: G\u00e2y vi\u00eam ph\u00fac m\u1ea1c to\u00e0n th\u1ec3. M\u1edf b\u1ee5ng \u0111\u01b0\u1eddng tr\u1eafng gi\u1eefa d\u01b0\u1edbi r\u1ed1n, x\u1eed l\u00ed ru\u1ed9t th\u1eeba, r\u1eeda s\u1ea1ch \u1ed5 b\u1ee5ng \u0111\u1eb7t d\u1eabn l\u01b0u \u1edf t\u00fai c\u00f9ng douglas. \u0110\u00f3ng th\u00e0nh b\u1ee5ng.<\/p>\n

C\u00e2u 7: Ph\u01b0\u01a1ng ph\u00e1p x\u1eed l\u00fd v\u1ebft th\u01b0\u01a1ng m\u1ea1ch m\u00e1u<\/p>\n

* C\u00f3 2 ph\u01b0\u01a1ng ph\u00e1p : Th\u1eaft m\u1ea1ch m\u00e1u v\u00e0 kh\u00e2u ph\u1ee5c h\u1ed3i l\u01b0u th\u00f4ng m\u1ea1ch m\u00e1u .I. Th\u1eaft m\u1ea1ch m\u00e1u:+ \u01afu \u0111i\u1ec3m – C\u1ea7m m\u00e1u \u0111\u01b0\u1ee3c ngay kh\u00f4ng ch\u1ea3y m\u00e1u th\u1ee9 ph\u00e1t hay t\u1eaft m\u1ea1ch nh\u01b0 trong kh\u00e2u ph\u1ee5c h\u1ed3i l\u01b0u th\u00f4ng m\u1ea1ch m\u00e1u.- Ti\u1ebfn h\u00e0nh l\u1ea1i nhanh ch\u00f3ng, kh\u00f4ng \u0111\u00f2i h\u1ecfi k\u1ef9 thu\u1eadt v\u00e0 trang b\u1ecb ph\u1ee9c t\u1ea1p, ai c\u0169ng l\u00e0m \u0111\u01b0\u1ee3c c\u1ea3 \u1edf tuy\u1ebfn ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe ban \u0111\u1ea7u, nh\u1ea5t l\u00e0 \u0111\u1ed1i v\u1edbi m\u1ea1ch m\u00e1u nh\u1ecf.+ Nh\u01b0\u1ee3c \u0111i\u1ec3m :- Ch\u1ec9 \u00e1p d\u1ee5ng \u0111\u01b0\u1ee3c \u1edf nh\u1eefng c\u00f9ng c\u00f3 nhi\u1ec1u ngh\u00e0nh b\u00ean , v\u00f2ng n\u1ed1i , \u0111o\u1ea1n cu\u1ed1i c\u1ee7a chi1. Nh\u1eefng \u0111i\u1ec3m l\u01b0u \u00fd:+ T\u00e1ch b\u1ecf l\u1edbp v\u1ecf ngo\u00e0i \u0111\u1ec3 tr\u00e1nh xung d\u1eabn truy\u1ec1n v\u1ec1 v\u1eadn m\u1ea1ch. Tr\u01b0\u1edbc khi th\u1eaft v\u00e0 c\u1eaft gi\u1eefa 2 n\u00fat ch\u1ec9 n\u00ean \u0111\u1ec3 m\u1ecfm c\u1ee7a \u0111\u1ea7u m\u1ea1ch m\u00e1u d\u00e0i.+ Ch\u1ecdn \u0111i\u1ec3m th\u1eaft \u0111\u1ec3 tr\u00e1nh v\u00f9ng nguy hi\u1ec3m trong \u0111i\u1ec1u ki\u1ec7n cho ph\u00e9p v\u1ec1 gi\u1ea3i ph\u1ea9u.+ N\u00fat th\u1eaft ph\u1ea3i \u0111\u01b0\u1ee3c kh\u00e2u c\u00e0i v\u1edbi t\u1ed5 ch\u1ee9c xung quanh \u0111\u1ec3 l\u00e0m \u0111i\u1ec3m t\u1ef1a tr\u00e1nh m\u00e1u ch\u1ea3y th\u1ee9 ph\u00e1t.II. Kh\u00e2u ph\u1ee5c h\u1ed3i l\u01b0u th\u00f4ng m\u1ea1ch m\u00e1uNg\u01b0\u1eddi ta ch\u1ec9 ti\u1ebfn h\u00e0nh kh\u00e2u m\u1ea1ch m\u00e1u \u1edf nh\u1eefng n\u01a1i c\u00f3 trang b\u1ecb t\u1ed1t v\u00e0 \u0111i\u1ec1u ki\u1ec7n k\u1ef9 thu\u1eadt cho ph\u00e9p.1. Nguy\u00ean t\u1eafc:+ \u0110\u01b0\u1eddng kh\u00e2u ph\u1ea3i kh\u00e9p k\u00edn+ Kh\u00f4ng l\u00e0m h\u1eb9p kh\u1ea9u k\u00ednh c\u1ee7a m\u1ea1ch m\u00e1u+ \u0110\u01b0\u1eddng kh\u00e2u ph\u1ea3i \u0111\u1ec3 l\u1edbp n\u1ed9i m\u1ea1c l\u1ed9n ra ngo\u00e0i, tr\u00e1nh t\u1eafc m\u1ea1ch.2. \u0110i\u1ec1u ki\u1ec7n kh\u00e2u ph\u1ee5c h\u1ed3i:- V\u1ebft th\u01b0\u01a1ng \u0111\u1ebfn s\u1edbm, t\u01b0\u01a1ng \u0111\u1ed1i s\u1ea1ch, kh\u00f4ng b\u1ecb nhi\u1ec5m tr\u00f9ng.- C\u00e1c trang b\u1ecb v\u00e0 \u0111i\u1ec1u ki\u1ec7n k\u1ef9 thu\u1eadt cho ph\u00e9p, nh\u1ea5t l\u00e0 c\u00f3 b\u00e1c s\u1ef9 chuy\u00ean ng\u00e0nh l\u00e0m.3. C\u00e1ch th\u1ee9c ti\u1ebfn h\u00e0nh l\u00e0m: C\u00f3 3 c\u00e1ch:* Kh\u00e2u m\u1ea1ch m\u00e1u: \u0110\u1ed1i v\u1edbi m\u1ea1ch m\u00e1u l\u1edbn, t\u1ed5n th\u01b0\u01a1ng 1 ph\u1ea7n, r\u00e1ch g\u1ecdn v\u00e0 s\u1ea1ch. Kh\u00e2u b\u1eb1ng m\u0169i r\u1eddi ho\u1eb7c m\u0169i ch\u1eef U. Nh\u01b0ng ph\u1ea3i \u0111\u1ea3m b\u1ea3o nguy\u00ean t\u1eafc n\u00f3i tr\u00ean.* N\u1ed1i m\u1ea1ch m\u00e1u- M\u1ea1ch m\u00e1u \u0111\u1ee9t ho\u00e0n to\u00e0n hay t\u1ed5n th\u01b0\u01a1ng nham nh\u1edf c\u1ea7n c\u1eaft b\u1ecf \u0111\u1ec3 n\u1ed1i- Kh\u00e2u c\u00e1c \u0111i\u1ec3m m\u1ed1c c\u1ee7a 2 m\u00e9p r\u1ed3i gh\u00e9p 2 \u0111\u1ea7u v\u00e0o nhau \u0111\u1ec3 kh\u00e2u cho \u0111\u1ec1u<\/p>\n

Ngo\u00e0i ra, y\u00eau c\u1ea7u v\u1ec1 k\u1ef9 thu\u1eadt sau khi c\u1eaft l\u1ecdc xong, k\u00e9o 2 \u0111\u1ea7u m\u1ea1ch tr\u00e1nh b\u1ecb c\u0103ng \u0111\u1ec3 tr\u00e1nh b\u1ee5c \u0111\u01b0\u1eddng kh\u00e2u. G\u1eb7p khi m\u1ea1ch m\u00e1u b\u1ecb c\u0103ng ta ti\u1ebfn h\u00e0nh gh\u00e9p m\u1ea1ch m\u00e1u* Gh\u00e9p m\u1ea1ch m\u00e1u :- T\u1ed5n th\u01b0\u01a1ng hai \u0111\u1ea7u qu\u00e1 xa nhau- Ch\u1ea5t li\u1ec7u \u0111\u1ec3 gh\u00e9p : C\u00e1c t\u0129nh m\u1ea1ch t\u1ef1 th\u00e2n c\u1ee7a b\u1ec7nh nh\u00e2n , C\u00e1c \u0111\u1ed9ng m\u1ea1ch d\u1ef1 tr\u1eef \u0111\u1ec3 gh\u00e9p , \u1ed1ng nh\u00e2n t\u1ea1o : Silicone , Dacron ..<\/p>\n

K\u1ef9 thu\u1eadt kh\u00e2u b\u1eb1ng tay ho\u1eb7c b\u1eb1ng m\u00e1y. \u0110\u1ec3 \u0111\u1ea3m b\u1ea3o \u0111\u1ed9 ch\u00ednh x\u00e1c khi kh\u00e2u ng\u01b0\u1eddi ta s\u1eed d\u1ee5ng k\u00ednh hi\u1ec3n vi<\/p>\n

1. Ch\u0103m s\u00f3c sau m\u1ed5<\/p>\n

– Ch\u1ed1ng nhi\u1ec5m tr\u00f9ng: d\u00f9ng c\u00e1c thu\u1ed1c kh\u00e1ng sinh \u0111\u1eb7c hi\u1ec7u \u0111\u1ec3 ch\u1ed1ng nhi\u1ec5m tr\u00f9ng, tr\u00e1nh b\u1ee5c mi\u1ec7ng n\u1ed1i v\u00e0 g\u00e2y ch\u00e1y m\u00e1u th\u1ee9 ph\u00e1t ho\u1eb7c t\u1eafc m\u1ea1ch<\/p>\n

– Ch\u1ed1ng t\u1eafc m\u1ea1ch v\u00e0 co th\u1eaft m\u1ea1ch: b\u1eb1ng c\u00e1c thu\u1ed1c \u0111\u1eb7c hi\u1ec7u c\u1ee7a ch\u00fang<\/p>\n

Bi\u1ebfn ch\u1ee9ng- T\u1eafc m\u1ea1ch: Th\u01b0\u1eddng do nhi\u1ec5m tr\u00f9ng ho\u1eb7c k\u1ef9 thu\u1eadt kh\u00e2u kh\u00f4ng t\u1ed1t l\u00e0m h\u1eb9p l\u00f2ng m\u1ea1ch- Ch\u1ea3y m\u00e1u th\u1ee9 ph\u00e1t do b\u1ee5c mi\u1ec7ng n\u1ed1i- C\u1eaft c\u1ee5t: Sau khi n\u1ed1i b\u1ecb t\u1eafc; nh\u1ea5t l\u00e0 v\u00f2ng n\u1ed1i k\u00e9m \u1edf nh\u1eefng n\u01a1i c\u00f3 nhi\u1ec1u nguy hi\u1ec3m nh\u01b0 \u1ed1ng Hunte, v\u00f9ng khoeo\u2026<\/p>\n

C\u00e2u 8: C\u1eaft c\u1ee5t v\u00e0 th\u00e1o kh\u1edbp \u0111\u1ec3 h\u1edf<\/p>\n

I. Ch\u1ec9 \u0111\u1ecbnh :- Chi b\u1ecb d\u1eadp n\u00e1t nhi\u1ec1u, nguy\u00ean nh\u00e2n ch\u00ednh c\u1ee7a s\u1ed1c ch\u1ea5n th\u01b0\u01a1ng, m\u00e0:+ Kh\u1ea3 n\u0103ng \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n mong manh.+ Vi\u1ec7c h\u1ed3i sinh \u0111\u00e3 ti\u1ebfn h\u00e0nh nh\u01b0ng kh\u00f4ng c\u00f3 k\u1ebft qu\u1ea3<\/p>\n

Trong tr\u01b0\u1eddng h\u1ee3p tr\u00ean, c\u1eaft c\u1ee5t chi c\u1ea5p c\u1ee9u l\u00e0 1 bi\u1ec7n ph\u00e1p t\u00edch c\u1ef1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb s\u1ed1c, hy v\u1ecdng c\u1ee9u s\u1ed1ng \u0111\u01b0\u1ee3c BN- Chi b\u1ecb th\u01b0\u01a1ng c\u00f3 hu\u1ef7 ho\u1ea1i t\u1ed5 ch\u1ee9c r\u1ed9ng \u0111ang b\u1ecb nhi\u1ec5m tr\u00f9ng- Khi b\u1ecb ch\u1ea5n th\u01b0\u01a1ng n\u1eb7ng, b\u1ea9n, kh\u1ea3 n\u0103ng nhi\u1ec5m tr\u00f9ng kh\u00f4ng lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c sau khi c\u1eaft c\u1ee5t- N\u1eb7ng h\u01a1n v\u00e0 c\u1ea5p c\u1ee9u h\u01a1n l\u00e0 tr\u01b0\u1eddng h\u1ee3p ho\u1ea1i th\u01b0 sinh h\u01a1i.<\/p>\n

C\u1eaft c\u1ee5t trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p tr\u00ean l\u00e0 \u0111\u1ec3 lo\u1ea1i tr\u1eeb, kh\u1ed1ng ch\u1ebf nhi\u1ec5m tr\u00f9ng v\u00e0 \u0111\u1ec3 \u0111\u1ec1 ph\u00f2ng v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1ed1cII. K\u1ef9 thu\u1eadt :1. Y\u00eau c\u1ea7u k\u0129 thu\u1eadt+ Nhanh ch\u00f3ng ,nh\u1eb9 nh\u00e0ng,\u0111\u01a1n gi\u1ea3n+ M\u1ecfm c\u1ee5t gi\u1eef \u0111\u01b0\u1ee3c c\u00e0ng, d\u00e0i c\u00e0ng t\u1ed1t \u0111\u1ec3 khi s\u1eeda l\u1ea1i c\u00f3 \u0111i\u1ec1u ki\u1ec7n ch\u1ecdn \u0111\u01b0\u1ee3c chi\u1ec1u d\u00e0i c\u00f3 l\u1ee3i.+ C\u1eaft c\u1ee5t ngang khoanh gi\u00f2 l\u00e0 ki\u1ec3u c\u1eaft c\u1ee5t ph\u1ed5 bi\u1ebfn nh\u1ea5t.<\/p>\n

2. C\u1eaft c\u1ee5t c\u1ea5p c\u1ee9u \u0111\u1ec3 h\u1edf ngang ki\u1ec3u khoanh gi\u00f2+ \u0110\u1eb7t garo ph\u00eda tr\u00ean ch\u1ed7 s\u1ebd c\u1eaft c\u1ee5t. Tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n \u0111\u01b0a \u0111\u1ebfn c\u1ea5p c\u1ee9u \u0111\u00e3 c\u00f3 garo th\u00ec \u0111\u1eb7t th\u00eam 1 garo th\u1ee9 2 v\u00e0 ti\u1ebfn h\u00e0nh c\u1eaft c\u1ee5t gi\u1eefa 2 garo+ C\u1eaft da v\u00e0 c\u00e2n ki\u1ec3u v\u00f2ng tr\u00f2n+ Khi da \u0111\u00e3 co c\u1eaft c\u01a1 ngay \u1edf m\u00e9p th\u1eb3ng v\u1edbi tr\u1ee5c c\u1ee7a x\u01b0\u01a1ng. V\u00ec l\u1edbp c\u01a1 n\u00f4ng c\u00f3 nhi\u1ec1u h\u01a1n l\u1edbp c\u01a1 s\u00e2u n\u00ean ph\u1ea3i c\u1eaft c\u01a1 nh\u1eb9 nh\u00e0ng, t\u1eeb t\u1eeb t\u1eebng l\u1edbp sao cho c\u00e1c c\u01a1 c\u00f3 \u0111\u1ee7 th\u1eddi gian co r\u00fat, \u0111\u1ec3 cu\u1ed1i c\u00f9ng c\u1ea3 l\u1edbp n\u00f4ng v\u00e0 l\u1edbp s\u00e2u co v\u1ec1 c\u00f9ng tr\u00ean m\u1ed9t ti\u1ebft di\u1ec7n+ C\u1eaft m\u00e0ng x\u01b0\u01a1ng theo v\u00f2ng tr\u00f2n n\u01a1i \u0111\u1ecbnh c\u01b0a x\u01b0\u01a1ng b\u1eb1ng dao s\u1eafc. R\u00f3c m\u00e0ng x\u01b0\u01a1ng \u1edf ph\u1ea7n d\u01b0\u1edbi. C\u01b0a x\u01b0\u01a1ng th\u1ea5p h\u01a1n ch\u1ed7 c\u1eaft m\u00e0ng x\u01b0\u01a1ng 5mm+ T\u00ecm th\u1eaft c\u00e1c m\u1ea1ch m\u00e1u+ \u0110\u1ed1i v\u1edbi c\u00e1c d\u00e2y th\u1ea7n kinh l\u1edbn th\u00ec ph\u1ea3i ti\u00ean Novocain 1% tr\u01b0\u1edbc khi ph\u1eabu t\u00edch v\u00e0 c\u1eaft l\u00ean cao+ H\u1eadu ph\u1eabu: Ph\u1ea3i k\u00e9o li\u00ean t\u1ee5c ph\u1ea7n m\u1ec1m c\u1ee7a m\u1ecfm c\u1ee5t \u0111\u1ec3 \u0111\u1ec1 ph\u00f2ng da co r\u00fat ng\u1eafn l\u1ea1i b\u1eb1ng d\u00ednh d\u00e1n v\u00e0o m\u1eb7t ngo\u00e0i c\u1ee7a m\u1ecfm c\u1ee5t ho\u1eb7c b\u1eb1ng c\u00e1c m\u0169i ch\u1ec9 kh\u00e2u v\u00e0o m\u00e9p da c\u1ee7a m\u1ecfm c\u1ee5t3. Thay \u0111\u1ed5i v\u00e0 k\u1ef9 thu\u1eadta. C\u1eaft v\u1ea1t da b\u1ea7u d\u1ee5c \u0111\u1ec3 h\u1edf:- Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p chi\u1ec1u d\u00e0i m\u1ecfm c\u1ee5t \u0111\u00e3 ng\u1eafn nh\u01b0ng th\u01b0\u01a1ng t\u1ed5n ph\u1ea7n m\u1ec1m cho ph\u00e9p ta c\u00f3 th\u1ec3 c\u1eaft da theo v\u1ea1t b\u1ea7u d\u1ee5c \u0111\u1ec3 v\u1ec1 sau c\u00f3 1 v\u1ea1t da c\u00f3 \u00edch cho vi\u1ec7c s\u1eeda l\u1ea1i m\u1ecfm c\u1ee5t \u1edf th\u00ec 2. Nh\u01b0ng c\u0169ng th\u1ea5y r\u00f5 b\u1ea5t l\u1ee3i c\u1ee7a v\u1ea1t da n\u00e0y l\u00e0 h\u1ea1n ch\u1ebf vi\u1ec7c d\u1eabn l\u01b0u n\u00ean c\u00f3 th\u1ec3 l\u1ed9n ng\u01b0\u1ee3c v\u1ea1c da l\u00ean m\u1ecfm c\u1ee5t, nh\u01b0ng ph\u1ea3i l\u01b0u \u00fd \u0111\u1eebng g\u1eadp th\u00e0nh g\u00f3c l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nu\u00f4i d\u01b0\u1ee1ng<\/p>\n

– K\u1ef9 thu\u1eadt: c\u1eaft da v\u00e0 c\u00e2n theo v\u1ea1t b\u1ea7u d\u1ee5c: c\u01b0a tr\u00ean tr\u01b0\u1edbc, c\u01b0a d\u01b0\u1edbi sau ho\u1eb7c ng\u01b0\u1ee3c l\u1ea1i t\u00f9y thu\u1ed9c v\u00e0o t\u00ecnh tr\u1ea1ng th\u01b0\u01a1ng t\u1ed5n t\u1ea1i ch\u1ed7. L\u00f3c da v\u00e0 c\u00e2n t\u1eeb c\u1ef1c th\u1ea5p k\u00e9o l\u1ed9n l\u00ean cao.<\/p>\n

C\u1eaft c\u01a1 v\u00e0 x\u01b0\u01a1ng nh\u01b0 k\u1ef9 thu\u1eadt c\u1eaft ki\u1ec3u khoanh gi\u00f2.b. C\u1eaft v\u1ea1t da kh\u00f4ng \u0111i\u1ec3n h\u00ecnh \u0111\u1ec3 h\u1edf :- L\u1ee3i d\u1ee5ng v\u1ea1t da l\u00e0nh c\u00f2n l\u1ea1i \u1edf v\u00f9ng c\u1eaft c\u1ee5t \u0111\u1ec3 s\u1eeda l\u1ea1i m\u1ecfm c\u1ee5t v\u1ec1 sau. V\u1ea1t da \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng c\u00f3 th\u1ec3 c\u00f3 h\u00ecnh d\u00e1ng b\u1ea5t k\u00ec nh\u01b0ng c\u00f3 gi\u00e1 tr\u1ecb trong vi\u1ec7c s\u1eeda l\u1ea1i m\u1ecfm c\u1ee5t, tr\u00e1nh \u0111\u01b0\u1ee3c 1 th\u1ee7 thu\u1eadt gh\u00e9p da c\u00f3 cu\u1ed1ng to\u00e0n ph\u1ea7n t\u1eeb xa \u0111\u1ebfn.<\/p>\n

– C\u1eaft c\u01a1 v\u00e0 c\u01b0a x\u01b0\u01a1ng nh\u01b0 ph\u1ea7n tr\u00ean<\/p>\n

– Sau khi c\u1eaft xongg kh\u00e2u d\u00ednh v\u1ea1t da l\u00ean tr\u00ean, l\u1ed9n l\u1edbp m\u1ee1 ra ngo\u00e0i \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o cho vi\u1ec7c d\u1eabn l\u01b0u \u0111\u01b0\u1ee3c t\u1ed1t.4. S\u1eeda l\u1ea1i m\u1ecfm c\u1ee5t \u0111\u1ec3 h\u1edf:S\u1eeda l\u1ea1i c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t khi BN c\u00f3 \u0111\u1ee7 ki\u1ec7n sau \u0111\u00e2y :+ To\u00e0n th\u00e2n \u1ed5n \u0111\u1ecbnh, t\u00ecnh tr\u1ea1ng chung t\u01b0\u01a1ng \u0111\u1ed1i kh\u00e1 l\u00e0 \u0111.ki\u1ec7n \u0111\u1ec3 ch\u1ed1ng \u0111\u1ee1 nhi\u1ec5m tr\u00f9ng v\u00e0 l\u00e0nh \u0111\u01b0\u1ee3c v\u1ebft kh\u00e2u+ T\u1ed5n th\u01b0\u01a1ng t\u1ea1i ch\u1ed7 \u1ed5n \u0111\u1ecbnh, h\u1ebft ph\u00f9 n\u1ec1, da l\u00e0nh l\u1eb7n, kh\u00f4ng vi\u00eam da, kh\u00f4ng c\u00f3 v\u1ea9y, \u0111\u1ea7u m\u1ecfm c\u1ee5t c\u00f3 t\u1ed5 ch\u1ee9c h\u1ea1t \u0111\u1ecf t\u01b0\u01a1i+ S\u1eeda m\u1ecfm c\u1ee5t: N\u1ebfu m\u1ecfm c\u1ee5t d\u00e0i th\u00ec t\u1ed1t nh\u1ea5t l\u00e0 c\u1eaft c\u1ee5t l\u1ea1i theo k\u1ef9 thu\u1eadt c\u1eaft c\u1ee5t \u0111\u00f3ng k\u00edn \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c chi\u1ec1u d\u00e0i l\u00fd t\u01b0\u1edfng+ N\u1ebfu chi\u1ec1u d\u00e0i m\u1ecfm c\u1ee5t \u0111\u00e3 ng\u1eafn, vi\u1ec7c c\u1eaft ng\u1eafn th\u00eam x\u01b0\u01a1ng l\u00e0 r\u1ea5t h\u1ea1n ch\u1ebf, ph\u1ea3i th\u1eadn tr\u1ecdng c\u00e2n nh\u1eafc – ch\u1ec9 n\u00ean kh\u00e2u da. N\u1ebfu thi\u1ebfu da th\u00ec chuy\u1ec3n v\u1ea1t da ho\u1eb7c v\u00e1 da c\u00f3 cu\u1ed1ng t\u1eeb xa \u0111\u1ebfn<\/p>\n

C\u00e2u 9: C\u1eaft c\u1ee5t v\u00e0 th\u00e1o kh\u1edbp \u0111\u00f3ng k\u00edn<\/p>\n

I. Ki\u1ebfn th\u1ee9c c\u01a1 b\u1ea3n trong k\u1ef9 thu\u1eadt c\u1eaft c\u1ee5t chi \u0111\u00f3ng k\u00edn:1. Ph\u1ea3i m\u1ed5 th\u1eadt v\u00f4 tr\u00f9ng<\/p>\n

Ng\u00e0y tr\u01b0\u1edbc m\u1ed5, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c t\u1eafm r\u1eeda k\u1ef9 to\u00e0n th\u00e2n v\u00e0 t\u1ea1i ch\u1ed7. Ng\u00e0y h\u00f4m sau m\u1ed5 ph\u1ea3i kh\u1eed tr\u00f9ng k\u1ef9 v\u00f9ng m\u1ed5.2. \u0110\u1eb7t garo:\u0110\u1eb7t garo ph\u00eda tr\u00ean \u0111\u1ec3 m\u1ed5 x\u1ebb \u0111\u01b0\u1ee3c s\u1ea1ch, d\u1ec5 th\u1ea5y l\u1ea1i ti\u1ebft ki\u1ec7m \u0111\u01b0\u1ee3c m\u00e1u cho b\u1ec7nh nh\u00e2n+ N\u1ebfu c\u1eaft c\u1ee5t chi v\u00ec b\u1ec7nh m\u1ea1ch m\u00e1u ngo\u1ea1i bi\u00ean th\u00ec garo c\u00f3 th\u1ec3 g\u00e2y tai bi\u1ebfn n\u00ean ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh+ \u0110\u1ec3 ti\u1ebft ki\u1ec7m m\u00e1u tr\u01b0\u1edbc khi \u0111\u1eb7t garo n\u00e2ng cao \u0111\u1ec1u chi 150 \u0111\u1ec3 d\u1ed3n m\u00e1u v\u1ec1 trung t\u00e2m. \u0110\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p l\u1edbn nh\u01b0 kh\u1edbp h\u00e1ng, kh\u1edbp vai t\u1ed1t nh\u1ea5t l\u00e0 th\u1eaft bu\u1ed9c c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn 2 ng\u00e0y tr\u01b0\u1edbc khi m\u1ed53. X\u1eed tr\u00ed da:Y\u00eau c\u1ea7u quan tr\u1ecdng l\u00e0 m\u1ecfm c\u1ee5t \u0111\u01b0\u1ee3c da che ph\u1ee7 t\u1ed1t, da ph\u1ea3i l\u00e0nh l\u1eb7n, \u0111\u01b0\u1ee3c nu\u00f4i d\u01b0\u01a1ng t\u1ed1t c\u00f3 c\u1ea3m gi\u00e1c b\u00ecnh th\u01b0\u1eddng+ V\u1ea1t da bao g\u1ed3m l\u1edbp m\u1ee1 d\u01b0\u1edbi da v\u00e0 c\u00f3 khi c\u1ea3 l\u1edbp c\u00e2n n\u00f4ng. Khi l\u1edbp m\u1ee1 d\u00e0y qu\u00e1 th\u00ec ch\u1ec9 c\u1ea7n l\u1ea5y m\u1ed9t l\u1edbp m\u1ecfng.+ Tr\u00e1nh \u0111\u1ec3 s\u1eb9o v\u00e0o ch\u1ed7 t\u1ef3, t\u1ef1a c\u1ee7a c\u00e1c m\u1ecfm c\u1ee5t l\u00ean chi gi\u1ea3. S\u1eb9o \u1edf \u0111\u00e1y m\u1ecfm c\u1ee5t kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i qua x\u01b0\u01a1ng. \u0110\u1ec3 tr\u00e1nh d\u00ednh v\u00e0o \u0111\u1ea7u x\u01b0\u01a1ng c\u00f3 th\u1ec3 \u0111\u1ec3 s\u1eb9o l\u1ec7ch ra ph\u00eda sau ho\u1eb7c ph\u00eda tr\u01b0\u1edbc n\u00ean th\u01b0\u1eddng dung hai v\u1ea1t tr\u01b0\u1edbc sau kh\u00f4ng b\u1eb1ng nhau.+ T\u00ednh chi\u1ec1u d\u00e0i c\u1ee7a v\u1ea1t da: T\u1ed5ng chi\u1ec1u d\u00e0i hai v\u1ea1t da b\u1eb1ng 3R ( R l\u00e0 b\u00e1n k\u00ednh tr\u01b0\u1edbc sau c\u1ee7a \u0111o\u1ea1n chi n\u01a1i c\u01b0a x\u01b0\u01a1ng) l\u00e0 \u0111\u1ee7. Nh\u01b0 v\u1eady t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi m\u1ed9t n\u1eeda chu vi (2\u03c0R\/2) v\u00e0 do \u0111\u00f3 3R# \u03c0R4. X\u1eed tr\u00ed c\u01a1:C\u1eaft g\u1ecdn t\u1eebng nh\u00e1t, nh\u1eb9 nh\u00e0ng kh\u00f4ng g\u00e2y \u0111\u1ee5ng gi\u1eadp v\u00e0 nham nh\u1edf \u0111\u1ec3 tr\u00e1nh nhi\u1ec5m tr\u00f9ng v\u00e0 hi\u1ec7n t\u01b0\u1ee3ng x\u01a1 h\u00f3a \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00ednh \u0111\u00e0n h\u1ed3i v\u00e0 sinh l\u1ef1c c\u1ee7a c\u01a1 v\u1ec1 sau.+ Ph\u1ea3i t\u00ednh sao cho l\u1edbp c\u01a1 n\u00f4ng v\u00e0 c\u01a1 sau sau khi c\u1eaft xong th\u00ec s\u1ebd co v\u1ec1 ngang v\u1edbi m\u1ee9c c\u1ee7a x\u01b0\u01a1ng. C\u00e1c c\u01a1 s\u00e2u b\u00e1m \u1edf \u0111\u1ea7u x\u01b0\u01a1ng th\u00ec ph\u1ea3i kh\u00e2u v\u00e0o m\u00e0ng x\u01b0\u01a1ng t\u1ea1o cho c\u01a1 c\u00f3 m\u1ed9t ch\u1ed7 b\u00e1m t\u1eadn m\u1edbi \u0111\u1ec3 v\u1eadn \u0111\u1ed9ng v\u00e0 \u0111i\u1ec1u khi\u1ec3n m\u1ecfm c\u1ee5t .5. C\u01b0a x\u01b0\u01a1ng:D\u00f9ng v\u00e9n c\u01a1 Percy v\u00e9n c\u01a1 l\u00ean v\u1ec1 ph\u00eda g\u1ed1c chi. D\u00f9ng dao c\u1eaft g\u1ecdn m\u00e0ng x\u01b0\u01a1ng; r\u00f3c m\u00e0ng x\u01b0\u01a1ng v\u1ec1 ph\u00eda ngo\u00e0i bi\u00ean. C\u01b0a x\u01b0\u01a1ng th\u1ea5p h\u01a1n m\u00e9p m\u00e0ng x\u01b0\u01a1ng 5mm6. X\u1eed tr\u00ed m\u1ea1ch m\u00e1u:\u0110\u1ed1i v\u1edbi c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn bu\u1ed9c hai n\u00fat cagut. C\u00e1c m\u1ea1ch m\u00e1u nh\u1ecf bu\u1ed9c m\u1ed9t n\u00fat . C\u1eaft ngang v\u1edbi t\u1ea7m c\u01b0a x\u01b0\u01a1ng7. X\u1eed tr\u00ed th\u1ea7n kinh:Nh\u1eb9 nh\u00e0ng ph\u1eabu t\u00edch l\u00ean cao, bu\u1ed9c m\u1ed9t n\u00fat ch\u1ec9 lanh v\u00e0 c\u1eaft \u1edf d\u01b0\u1edbi n\u00fat b\u1eb1ng giao s\u1eafc, ph\u1eabu t\u00edch l\u00ean cao nh\u1eb1m m\u1ee5c \u0111\u00edch v\u00f9i s\u00e2u m\u1ecfm c\u1ee5t th\u1ea7n kinh trong t\u1ed5 ch\u1ee9c l\u00e0nh, tr\u00e1nh \u0111\u01b0\u1ee3c u th\u1ea7n kinh ch\u1ed3i ra v\u00e0 \u0111\u1ea7u d\u00e2y th\u1ea7n kinh d\u00ednh v\u00e0o s\u1eb9o. \u0111\u1ed1i v\u1edbi c\u00e1c th\u1ea7n kinh l\u1edbn tr\u01b0\u1edbc khi k\u00e9o ph\u1eabu t\u00edch c\u1ea7n ph\u00f3ng b\u1ebf b\u1eb1ng Novocain 1% \u0111\u1ec3 tr\u00e1nh ph\u1ea3n x\u1ea1. Theo c\u1ed5 \u0111i\u1ec3n c\u00f2n ti\u00eam c\u1ed3n 900 v\u00e0o \u0111\u1ea7u d\u00e2y th\u1ea7n kinh \u0111\u1ec3 \u0111\u1ed1t c\u00e1c tr\u1ee5 tr\u1ee5c th\u1ea7n kinh8. B\u1ecf garo: C\u1ea7m m\u00e1u, \u0111i\u1ec1u tr\u1ec9nh l\u1ea1i m\u1ecfm c\u1ee5t9. Kh\u00e2u k\u00edn m\u1ecfm c\u1ee5t c\u00f3 \u0111\u1eb7t hai \u1ed1ng d\u1eabn l\u01b0u ra hai b\u00ean m\u1ecfm c\u1ee5tII. H\u1eadu ph\u1eabu:1. B\u0103ng \u00e9p m\u1ecfm c\u1ee5t : c\u00f3 t\u00e1c d\u1ee5ng : c\u1ea7m m\u00e1u v\u00e0 ch\u1ed1ng ph\u00f9 n\u1ec1. C\u00e1c v\u00f2ng b\u0103ng, \u00e9p t\u1eeb \u0111\u1ec9nh m\u1ecfm c\u1ee5t ng\u01b0\u1ee3c d\u1ea7n l\u00ean th\u00ec t\u1ed1t. Ng\u01b0\u1ee3c l\u1ea1i ch\u1ec9 qu\u1ea5n ch\u1eb7t \u0111\u01b0\u1ee3c m\u1ea5y v\u00f2ng \u1edf xa \u0111\u1ec9nh m\u1ecfm c\u1ee5t th\u00ec s\u1ebd c\u1ea3n tr\u1edf tu\u1ea7n ho\u00e0n s\u1ebd g\u00e2y ph\u00f9 n\u1ec1, m\u00e1u t\u1ee5 v\u00e0 d\u1ec5 b\u1ee5t \u0111\u01b0\u1eddng kh\u00e2u da.2. D\u1ef1 ph\u00f2ng t\u01b0 th\u1ebf x\u1ea5u : Sau m\u1ed5 b\u1ec7nh nh\u00e2n th\u00edch \u0111\u1ec3 chi \u1edf t\u01b0 th\u1ebf ch\u00f9n cho \u0111\u1ee1 \u0111au. C\u00e1c t\u01b0 th\u1ebf \u0111\u00f3 s\u1ebd d\u1eabn \u0111\u1ebfn co r\u00fat c\u01a1 l\u00e0m co g\u1ea5p c\u00e1c kh\u1edbp, nh\u1ea5t l\u00e0 \u1edf chi d\u01b0\u1edbi c\u00e1c t\u01b0 th\u1ebf \u0111\u00f3 s\u1ebd l\u00e0m c\u1ea3n tr\u1edf l\u1eafp chi gi\u1ea3.<\/p>\n

Trong th\u1eddi gian ch\u01b0a c\u00f3 chi gi\u1ea3 c\u1ea7n l\u01b0u \u00fd tr\u00e1nh c\u00e1c t\u01b0 th\u1ebf x\u1ea5u cho m\u1ecfm c\u1ee5t, l\u00e0m co r\u00fat c\u01a1 th\u00eam, c\u1ee5 th\u1ec3 nh\u01b0:+ \u0110\u1ed1i v\u1edbi m\u1ecfm c\u1ee5t \u0111\u00f9i tr\u00e1nh m\u1ecdi t\u01b0 th\u1ebf l\u00e0m g\u1ea5p v\u00e0 d\u00e3n kh\u1edbp h\u00e1ng+ \u0110\u1ed1i v\u1edbi m\u1ecfm c\u1ee5t c\u1eb3ng ch\u00e2n tr\u00e1nh m\u1ecdi t\u01b0 th\u1ebf l\u00e0m g\u1ea5p kh\u1edbp g\u1ed1i+ \u0110\u1ed1i v\u1edbi m\u1ecfm c\u1ee5t c\u1eb3ng tay tr\u00e1nh t\u01b0 th\u1ebf l\u00e0m g\u1ea5p kh\u1edbp khu\u1ef7uC\u00f3 th\u1ec3 b\u1ea5t \u0111\u1ed9ng t\u1ea1m th\u1eddi b\u1eb1ng b\u1ed9t \u0111\u1ec3 cho kh\u1edbp \u1edf tr\u00ean v\u00e0 m\u1ecfm c\u1ee5t du\u1ed7i 180 \u0111\u1ed93. \u1ed0ng d\u1eabn l\u01b0u \u0111\u1ec3 s\u00e2u, s\u00e1t x\u01b0\u01a1ng, h\u00fat li\u00ean t\u1ee5c, r\u00fat v\u00e0o ng\u00e0y 3 ho\u1eb7c 4 v\u00ec x\u01b0\u01a1ng r\u1ec9 m\u00e1u l\u00e2u h\u01a1n ph\u1ea7n m\u1ec1m4. Th\u1ec3 d\u1ee5c m\u1ecfm c\u1ee5t v\u00e0 d\u00e2y s\u1eb9o: N\u1ebfu kh\u00f4ng c\u00f3 nhi\u1ec5m tr\u00f9ng th\u00ec sau ng\u00e0y 5 c\u00f3 th\u1ec3 cho m\u1ecfm c\u1ee5t t\u1eadp v\u1eadn \u0111\u1ed9ng, t\u1eadp l\u00ean g\u00e2n c\u00e1c c\u01a1 quanh m\u1ecfm c\u1ee5t, t\u1eadp g\u1ea5p du\u1ed7i nh\u1eb9 c\u00e1c kh\u1edbp \u0111\u1ec3 ch\u1ed1ng co r\u00fat c\u01a1 v\u00e0 c\u0169ng l\u00e0m gi\u1ea3m ph\u00f9 n\u1ec1. sau khi c\u1eaft ch\u1ec9 ph\u1ea3i day \u0111\u1ec3 ch\u1ed1ng s\u1eb9o d\u00ednh5. L\u1eafp ch\u00e2n, tay gi\u1ea3 t\u1ea1m th\u1eddi: Khi v\u1ebft m\u1ed5 li\u1ec1n da n\u00ean l\u1eafp s\u1edbm ch\u00e2n tay gi\u1ea3 t\u1ea1m th\u1eddi \u0111\u1ec3 cho m\u1ecfm c\u1ee5t th\u00edch nghi s\u1edbm v\u00e0 th\u1ec3 d\u1ee5c li\u1ec7u ph\u00e1p ch\u1ed1ng teo c\u01a1,ch\u1ed1ng co r\u00fat, ch\u1ed1ng ph\u00f9 n\u1ec1. s\u1eed d\u1ee5ng chi gi\u1ea3 t\u1ea1m th\u1eddi l\u00e0 bi\u1ec7n ph\u00e1p th\u1ec3 d\u1ee5c t\u00edch c\u1ef1c v\u00e0 h\u1ee3p l\u00fd nh\u1ea5t<\/p>\n

N\u1ebfu di\u1ec5n bi\u1ebfn c\u1ee7a m\u1ecfm c\u1ee5t t\u1ed1t, vi\u1ec7c luy\u1ec7n t\u1eadp \u0111\u01b0\u1ee3c th\u01b0\u1eddng xuy\u00ean th\u00ec kho\u1ea3ng sau hai th\u00e1ng sau m\u1ed5 th\u00ec hi\u1ec7n t\u01b0\u1ee3ng ph\u00f9 n\u1ec1 s\u1ebd h\u1ebft ho\u00e0n to\u00e0n. \u0110\u00f3 l\u00e0 th\u1eddi gian trung b\u00ecnh \u0111\u1ec3 l\u00e0m chi gi\u1ea3 ch\u00ednh th\u1ee9c<\/p>\n

C\u00e2u 10: M\u1edf v\u00e0 \u0111\u00f3ng th\u00e0nh b\u1ee5ng<\/p>\n

I. M\u1edf b\u1ee5ng<\/p>\n

1. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a m\u1ed9t \u0111\u01b0\u1eddng r\u1ea1ch n\u1ed1i<\/p>\n

– \u0110\u01b0\u1eddng \u0111\u00f3 \u0111i \u0111\u1ebfn c\u00e1c t\u1ea1ng c\u1ea7n can thi\u1ec7p<\/p>\n

– \u0110\u01b0\u1eddng r\u1ea1ch \u0111\u00f3 \u00edt l\u00e0m t\u1ed5n th\u01b0\u01a1ng \u0111\u1ebfn c\u00e1c m\u1ea1ch m\u00e1u, th\u1ea7n kinh, c\u01a1<\/p>\n

– \u0110\u01b0\u1eddng r\u1ea1ch \u0111\u00f3 c\u00f3 \u0111i\u1ec1u ki\u1ec7n \u0111\u1ec3 m\u1edf r\u1ed9ng th\u00eam<\/p>\n

– \u0110\u01b0\u1eddng r\u1ea1ch sau khi ph\u1ea9u thu\u1eadt ph\u1ea3i \u0111\u1ea3m b\u1ea3o ch\u1eafc, s\u1eb9o \u0111\u1eb9p<\/p>\n

2. C\u00e1c lo\u1ea1i \u0111\u01b0\u1eddng r\u1ea1ch<\/p>\n

a. \u0110\u01b0\u1eddng tr\u1eafng gi\u1eefa<\/p>\n

G\u1ed3m: tr\u00ean r\u1ed1n, d\u01b0\u1edbi r\u1ed1n, tr\u00ean v\u00e0 d\u01b0\u1edbi r\u1ed1n.<\/p>\n

– \u0110\u01b0\u1eddng n\u00e0y \u00edt l\u00e0m t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u, th\u1ea7n kinh, c\u01a1. \u0110\u01b0\u1eddng m\u1ed5 tr\u00ean r\u1ed1n v\u00e0o \u0111\u1ec3 c\u1eaft d\u1ea1 d\u00e0y, 1 ph\u1ea7n t\u00e1 tr\u00e0ng, t\u1ee5y, kh\u00e2u gan, c\u1eaft l\u00e1ch, \u1ed1ng m\u1eadt ch\u1ee7<\/p>\n

– \u0110\u01b0\u1eddng d\u01b0\u1edbi r\u1ed1n v\u00e0o b\u00e0ng quang, t\u1eed cung, 1 ph\u1ea7n ru\u1ed9t non, \u0111\u1ea1i tr\u00e0ng<\/p>\n

– \u0110\u01b0\u1eddng tr\u00ean v\u00e0 d\u01b0\u1edbi r\u1ed1n \u0111\u1ec3 ki\u1ec3m tra to\u00e0n b\u1ed9 \u1ed5 b\u1ee5ng<\/p>\n

b. C\u00e1c \u0111\u01b0\u1eddng r\u1ea1ch ch\u00e9o<\/p>\n

– R\u1ea1ch t\u1eeb trong ra ngo\u00e0i: ph\u1ea3i c\u1eaft c\u01a1, m\u1ea1ch m\u00e1u, th\u1ea7n kinh<\/p>\n

+ \u0110\u01b0\u1eddng r\u1ea1ch h\u1ea1 s\u01b0\u1eddn ph\u1ea3i \u0111\u1ec3 ph\u1eabu thu\u1eadt gan<\/p>\n

+ \u0110\u01b0\u1eddng r\u1ea1ch h\u1ea1 s\u01b0\u1eddn tr\u00e1i \u0111\u1ec3 ph\u1ea9u thu\u1eadt l\u00e1ch<\/p>\n

– R\u1ea1ch t\u1eeb ngo\u00e0i v\u00e0o trong:<\/p>\n

+ \u0110\u01b0\u1eddng r\u1ea1ch h\u1ed1 ch\u1eadu ph\u1ea3i (\u0110\u01b0\u1eddng Macburney) \u0111i v\u00e0o ru\u1ed9t th\u1eeba<\/p>\n

+ \u0110\u01b0\u1eddng r\u1ea1ch h\u1ed1 ch\u1eadu tr\u00e1i v\u00e0o \u0111\u1ea1i W<\/p>\n

c. C\u00e1c \u0111\u01b0\u1eddng r\u1ea1ch th\u1eb3ng b\u1edd ngo\u00e0i c\u01a1 th\u1eb3ng to<\/p>\n

d. C\u00e1c \u0111\u01b0\u1eddng r\u1ea1ch ngang: \u00edt s\u1eed d\u1ee5ng<\/p>\n

T\u00f3m l\u1ea1i: \u1edf v\u1ecb tr\u00ed c\u1ee7a m\u1ed7i t\u1ea1ng c\u00f3 1 \u0111\u01b0\u1eddng r\u1ea1ch t\u01b0\u01a1ng \u1ee9ng<\/p>\n

M\u1ed4 B\u1ee4NG THEO \u0110\u01af\u1edcNG TR\u1eaeNG GI\u1eeeA TR\u00caN R\u1ed0N<\/p>\n

1. T\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n<\/p>\n

B\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eeda, k\u00ea g\u1ed1i \u1edf l\u01b0ng<\/p>\n

2. Ph\u1eabu thu\u1eadt vi\u00ean<\/p>\n

\u0110\u1ee9ng b\u00ean ph\u1ea3i n\u1ea1n nh\u00e2n, ng\u01b0\u1eddi ph\u1ee5 \u0111\u1ee9ng b\u00ean \u0111\u1ed1i di\u1ec7n, ng\u01b0\u1eddi th\u1ee9 2 \u0111\u1ee9ng b\u00ean tr\u00e1i ph\u1eabu thu\u1eadt vi\u00ean<\/p>\n

3. V\u1ec7 sinh b\u1ec7nh nh\u00e2n, g\u00e2y m\u00ea ho\u1eb7c g\u00e2y t\u00ea<\/p>\n

4. K\u1ef9 thu\u1eadt<\/p>\n

v Th\u00ec 1: R\u1ea1ch da \u0111\u01b0\u1eddng b\u1eaft \u0111\u1ea7u t\u1eeb m\u0169i \u1ee9c theo \u0111\u01b0\u1eddng tr\u1eafng gi\u1eefa \u0111\u1ebfn r\u1ed1n l\u00fac kh\u1edfi \u0111\u1ea7u v\u00e0 k\u1ebft th\u00fac d\u1ef1ng \u0111\u1ee9ng m\u0169i dao.<\/p>\n

v Th\u00ec 2: R\u1ea1ch c\u00e2n theo \u0111\u01b0\u1eddng r\u1ea1ch da.<\/p>\n

v Th\u00ec 3: M\u1edf ph\u00fac m\u1ea1c: Ng\u01b0\u1eddi ph\u1ee5 d\u00f9ng kocher, ph\u1eabu thu\u1eadt vi\u00ean d\u00f9ng k\u1eb9p ph\u1eabu t\u00edch n\u00e2ng ph\u00fac m\u1ea1c l\u00ean d\u00f9ng dao r\u1ea1ch 3-5cm. Ph\u1eabu thu\u1eadt vi\u00ean v\u00e0 ng\u01b0\u1eddi ph\u1ee5 l\u1ea5y ng\u00f3n tay tr\u1ecf n\u00e2ng ph\u00fac m\u1ea1c l\u00ean tr\u00ean d\u00f9ng k\u00e9o c\u1eaft xu\u1ed1ng ph\u00eda d\u01b0\u1edbi. Ph\u1eabu thu\u1eadt vi\u00ean d\u00f9ng ng\u00f3n tr\u1ecf v\u00e0 ng\u00f3n tr\u1ecf n\u00e2ng ph\u00fac m\u1ea1c l\u00ean d\u00f9ng k\u00e9o c\u1eaft.<\/p>\n

\u0110\u00d3NG TH\u00c0NH B\u1ee4NG<\/p>\n

Theo ph\u01b0\u01a1ng ph\u00e1p: 1 l\u1edbp, 2 l\u1edbp, 3 l\u1edbp<\/p>\n

– \u0110\u00f3ng th\u00e0nh b\u1ee5ng 1 l\u1edbp: g\u1ed3m da, c\u00e2n, c\u01a1, ph\u00fac m\u1ea1c l\u00e0m 1 l\u1edbp kh\u00e2u b\u1eb1ng ch\u1ec9 kim lo\u1ea1i ho\u1eb7c ch\u1ec9 peclon.<\/p>\n

– \u0110\u00f3ng th\u00e0nh b\u1ee5ng 2 l\u1edbp: th\u01b0\u1eddng l\u00e0 \u0111\u01b0\u1eddng gi\u1eefa tr\u00ean r\u1ed1n<\/p>\n

\u00d8 L\u1edbp 1: kh\u00e2u c\u00e2n c\u01a1, ph\u00fac m\u1ea1c<\/p>\n

\u00d8 L\u1edbp 2: kh\u00e2u da<\/p>\n

– \u0110\u00f3ng th\u00e0nh b\u1ee5ng 3 l\u1edbp:<\/p>\n

\u00d8 L\u1edbp 1: Kh\u00e2u ph\u00fac m\u1ea1c b\u1eb1ng ch\u1ec9 catgut (ch\u1ec9 ti\u00eau)<\/p>\n

\u00d8 L\u1edbp 2: Kh\u00e2u c\u00e2n c\u01a1 b\u1eb1ng ch\u1ec9 peclon (ch\u1ec9 kh\u00f4ng ti\u00eau)<\/p>\n

\u00d8 L\u1edbp 3: Kh\u00e2u ch\u1ec9 kh\u00f4ng ti\u00eau (lin, l\u1ee5a, nilon)<\/p>\n

C\u00e2u 11: B\u1ed9c l\u1ed9 \u0111\u1ed9ng m\u1ea1ch<\/p>\n

1. Ch\u1ec9 \u0111\u1ecbnh<\/p>\n

\u00d8 \u0110\u1ec3 x\u1eed tr\u00ed th\u01b0\u01a1ng t\u1ed5n c\u1ee7a m\u1ea1ch m\u00e1u trong ch\u1ea5n th\u01b0\u01a1ng<\/p>\n

\u00d8 \u0110\u1ec3 x\u1eed tr\u00ed c\u00e1c di ch\u1ee9ng c\u1ee7a th\u01b0\u01a1ng t\u1ed5n m\u1ea1ch m\u00e1u nh\u01b0 ph\u1ed3ng \u0111\u1ed9ng m\u1ea1ch, ph\u1ed3ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch….<\/p>\n

\u00d8 \u0110\u1ec3 x\u1eed tr\u00ed c\u00e1c tr\u01b0\u1eddng h\u1ee3p t\u1eafc m\u1ea1ch, do huy\u1ebft kh\u1ed1i, do vi\u00eam t\u1eafc khu tr\u00fa<\/p>\n

\u00d8 \u0110\u1ec3 c\u1eaft m\u00e0ng l\u01b0\u1edbi th\u1ea7n kinh giao c\u1ea3m quanh \u0111\u1ed9ng m\u1ea1ch<\/p>\n

\u00d8 \u0110\u1ec3 c\u1ea7m m\u00e1u t\u1ea1m th\u1eddi \u1edf ph\u00eda tr\u00ean khi ti\u1ebfn h\u00e0nh 1 ph\u1eabu thu\u1eadt \u1edf 1 v\u00f9ng s\u00e2u c\u00f3 th\u1ec3 g\u1eb7p tai bi\u1ebfn ch\u1ea3y m\u00e1u trong v\u00f9ng m\u1ed5<\/p>\n

2. Nh\u1eefng \u0111i\u1ec3m c\u01a1 b\u1ea3n trong b\u1ed9c l\u1ed9 \u0111\u1ed9ng m\u1ea1ch<\/p>\n

a. V\u1ec1 gi\u1ea3i ph\u1ea9u<\/p>\n

– \u0110M c\u00f3 n\u01a1i b\u1eaft ngu\u1ed3n, 1 \u0111\u01b0\u1eddng \u0111i v\u00e0 n\u01a1i c\u00f9ng; \u0111\u01b0\u1eddng \u0111\u1ecbnh h\u01b0\u1edbng l\u00e0 \u0111\u01b0\u1eddng \u0111i c\u1ee7a \u0111\u1ed9ng m\u1ea1ch. D\u1ef1a tr\u00ean \u0111\u01b0\u1eddng \u0111\u1ecbnh h\u01b0\u1edbng \u0111\u1ec3 c\u00f3 \u0111\u01b0\u1eddng r\u1ea1ch da v\u00e0o \u0111\u1ed9ng m\u1ea1ch thu\u1eadn l\u1ee3i kh\u00f4ng b\u1ecb l\u1ea1c v\u00e0 \u00edt nguy hi\u1ec3m<\/p>\n

– D\u1ef1a tr\u00ean c\u00e1c m\u1ed1c, c\u00e1c li\u00ean quan tr\u1ef1c ti\u1ebfp v\u1edbi \u0111\u1ed9ng m\u1ea1ch ta tu\u1ea7n t\u1ef1 l\u1ea7n t\u1edbi \u0110M 1 c\u00e1ch d\u1ec5 d\u00e0ng v\u00e0 \u00edt nguy hi\u1ec3m. C\u00e1c m\u1ed1c c\u00f3 th\u1ec3 l\u00e0 c\u01a1 (c\u01a1 t\u00f9y h\u00e0nh) l\u00e1 c\u00e2n, d\u00e2y TK… Th\u00f4ng th\u01b0\u1eddng 1 \u0110M bao gi\u1edd c\u0169ng c\u00f3 c\u01a1 t\u00f9y h\u00e0nh, l\u00e0 m\u1ed1c qu\u00fd nh\u1ea5t, c\u01a1 n\u00e0y c\u00f3 th\u1ec3 theo su\u1ed1t \u0110M d\u1ecdc \u0111\u01b0\u1eddng \u0111i ho\u1eb7c c\u00f3 khi ch\u1ec9 qua 1 qu\u00e3ng c\u1ee7a \u0110M.<\/p>\n

– M\u1ed9t \u0110M l\u1edbn th\u00f4ng th\u01b0\u1eddng l\u00e0 tr\u1ee5c c\u1ee7a b\u00f3 m\u1ea1ch TK<\/p>\n

Khi b\u1ed9c l\u1ed9, ti\u1ebfn h\u00e0nh c\u00e1c thao t\u00e1c c\u1ea7n ch\u00fa \u00fd \u0111\u1ec3 tr\u00e1nh c\u00e1c TM b\u1ecb ch\u1ecdc th\u1ee7ng c\u0169ng nh\u01b0 c\u00e1c d\u00e2y TK d\u1ec5 b\u1ecb k\u00edch th\u00edch.<\/p>\n

C\u00e1c ngh\u00e0nh b\u00ean v\u00e0 c\u00e1c v\u00f2ng n\u1ed1i c\u1ee7a \u0110M gi\u00fap ta hi\u1ec3u \u0111\u01b0\u1ee3c s\u1ef1 t\u00e1i l\u1eadp m\u00e0ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 sau ki v\u00f2ng tu\u1ea7n ho\u00e0n b\u1ecb t\u1eaft. Kh\u00f4ng n\u1eafm \u0111\u01b0\u1ee3c \u0111i\u1ec1u n\u00e0y c\u00f3 khi l\u00e0m 1 vi\u1ec7c m\u00f9 qu\u00e1ng, kh\u00f4ng tr\u00e1nh \u0111\u01b0\u1ee3c v\u00f9ng nguy hi\u1ec3m, kh\u00f4ng ch\u1ecdn \u0111\u01b0\u1ee3c n\u01a1i an to\u00e0n \u0111\u1ec3 th\u1eaft \u0110M.<\/p>\n

b. C\u1ea5u tr\u00fac c\u1ee7a \u0111\u1ed9ng m\u1ea1ch: \u0110M c\u00f3 3 l\u1edbp:<\/p>\n

– L\u1edbp v\u1ecf \u00e1o hay ngo\u1ea1i m\u1ea1c: l\u1edbp n\u00e0y m\u1ecfng, ch\u1ee7 y\u1ebfu t\u1ed5 ch\u1ee9c x\u01a1 v\u00e0 m\u00e0ng l\u01b0\u1edbi th\u1ea7n kinh giao c\u1ea3m. R\u1ea5t d\u1ec5 b\u00f3c t\u00e1ch kh\u1ecfi l\u1edbp \u00e1o gi\u1eefa. Khi \u0110M b\u1ecb c\u1eaft \u0111\u1ee9t c\u00e1c l\u1edbp \u00e1o gi\u1eefa v\u00e0 trong co ch\u1ee5m nhi\u1ec1u. L\u1edbp ngo\u00e0i c\u00f3 \u00edt n\u00ean bao tr\u00f9m l\u00ean 2 l\u1edbp kia. Trong ph\u1eabu thu\u1eadt kh\u00e2u m\u1ea1ch m\u00e1u kh\u00f4ng ch\u00fa \u00fd b\u00f3c t\u00e1ch l\u1edbp \u00e1o v\u1ecf \u0111\u1ec3 n\u00f3 l\u1eabn v\u00e0o trong \u0111\u01b0\u1eddng kh\u00e2u th\u00ec \u0111\u00f3 l\u00e0 1 nguy\u00ean nh\u00e2n g\u00e2y huy\u1ebft kh\u1ed1i. Trong th\u1ee7 thu\u1eadt th\u1eaft \u0110M ph\u1ea3i th\u1eaft \u1edf d\u01b0\u1edbi l\u1edbp \u00e1o v\u1ecf \u0111\u1ec3 kh\u00f4ng th\u1eaft v\u00e0o m\u1ea1ng l\u01b0\u1edbi TK giao c\u1ea3m, c\u00e1c m\u00f4 trung gian, c\u00e1c TM v\u00e0 TK \u0111i k\u00e8m \u0110M.<\/p>\n

– L\u1edbp \u00e1o gi\u1eefa g\u1ed3m c\u00e1c th\u1edb c\u01a1, l\u00e0 l\u1edbp d\u00e0y nh\u1ea5t c\u1ee7a th\u00e0nh m\u1ea1ch. Khi m\u1ea1ch m\u00e1u b\u1ecb c\u1eaft \u0111\u1ee9t l\u1edbp n\u00e0y b\u1ecb co chun l\u1ea1i, thu h\u1eb9p kh\u1ea9u k\u00ednh \u0111\u1ea7u m\u1ea1ch m\u00e1u b\u1ecb \u0111\u1ee9t, h\u1ea1n ch\u1ebf \u0111\u01b0\u1ee3c s\u1ef1 ch\u1ea3y m\u00e1u hay c\u1ea7m m\u00e1u l\u1ea1i \u0111\u01b0\u1ee3c t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho s\u1ef1 h\u00ecnh th\u00e0nh m\u00e1u c\u1ee5c b\u1ecbt k\u00edn \u0111o\u1ea1n m\u1ea1ch<\/p>\n

– L\u1edbp \u00e1o trong n\u00e0y l\u00e1t \u1edf trong l\u00f2ng m\u1ea1ch. Trong ch\u1ea5n th\u01b0\u01a1ng l\u1edbp n\u00e0y d\u1ec5 b\u1ecb th\u01b0\u01a1ng t\u1ed5n s\u1ebd t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho vi\u1ec7c h\u00ecnh th\u00e0nh huy\u1ebft kh\u1ed1i l\u00e0m t\u1eafc \u0110M, n\u00ean khi c\u00f3 nghi ng\u1edd ph\u1ea3i m\u1edf \u0110M \u0111\u1ec3 th\u0103m d\u00f2<\/p>\n

3. K\u1ef9 thu\u1eadt b\u1ed9c l\u1ed9 \u0111\u1ed9ng m\u1ea1ch<\/p>\n

Tuy m\u1ed7i \u0110M c\u00f3 nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m ri\u00eang v\u1ec1 gi\u1ea3i ph\u1eabu, nh\u01b0ng \u0111\u1ec3 b\u1ed9c l\u1ed9 b\u1ea5t k\u1ef3 \u0110M n\u00e0o c\u0169ng ph\u1ea3i \u0111i nh\u1eefng b\u01b0\u1edbc gi\u1ed1ng nhau:<\/p>\n

– K\u1ebb \u0111\u01b0\u1eddng \u0111\u1ecbnh h\u01b0\u1edbng c\u1ee7a \u0110M<\/p>\n

– R\u1ea1ch da c\u00e2n theo tr\u1ee5c \u0111\u01b0\u1eddng \u0111\u1ecbnh h\u01b0\u1edbng<\/p>\n

– T\u00f9y c\u01a1 t\u00f9y h\u00e0nh, c\u00e1c m\u1ed1c \u0111\u1ec3 l\u1ea7n t\u1edbi \u0110M<\/p>\n

– B\u1ed9c l\u1ed9 l\u00e0 t\u00e1ch tr\u1ea7n \u0110M<\/p>\n

C\u00e2u 12: B\u1ed9c l\u1ed9 \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh<\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng:<\/p>\n

\u00b2 C\u00e1c \u0110M ch\u1ea1y d\u1ecdc theo 1 m\u00e1ng \u1edf v\u00f9ng c\u1ed5 tr\u01b0\u1edbc b\u00ean. \u0110\u01b0\u1eddng \u0111\u1ecbnh h\u01b0\u1edbng c\u1ee7a \u0110M l\u00e0 \u0111\u01b0\u1eddng n\u1ed1i li\u1ec1n t\u1eeb kh\u1edbp \u1ee9c \u0111\u00f2n \u0111\u1ebfn m\u1ecfm x\u01b0\u01a1ng ch\u1ee7m, t\u01b0\u01a1ng \u1ee9ng v\u1edbi b\u1edd tr\u01b0\u1edbc c\u01a1 \u1ee9c- \u0111\u00f2n – ch\u1ee7m, c\u01a1 t\u00f9y h\u00e0nh \u0110M<\/p>\n

\u00b2 \u0110M c\u1ea3nh g\u1ed1c \u1edf c\u1ed5 \u0111i t\u1eeb kh\u1edbp \u1ee9c \u0111\u00f2n theo h\u01b0\u1edbng m\u1ecfm x\u01b0\u01a1ng ch\u1ee7m \u0111\u1ec3 \u0111i l\u00ean, khi \u0111\u1ebfn b\u1edd s\u1ee5n gi\u00e1p, \u0110M ph\u00ecnh ra th\u00e0nh \u201ch\u00e0nh c\u1ea3nh\u201d v\u00e0 chia th\u00e0nh 2 ngh\u00e0nh c\u00f9ng: \u0110M c\u1ea3nh trong v\u00e0 \u0110M c\u1ea3nh ngo\u00e0i<\/p>\n

\u00b2 V\u00f2ng n\u1ed1i c\u1ee7a \u0110M c\u1ea3nh ngo\u00e0i r\u1ea5t phong ph\u00fa n\u00ean th\u1eaft \u0110M n\u00e0y \u00edt nguy hi\u1ec3m (th\u1eaft \u1edf qu\u00e3ng gi\u1eefa 2 ngh\u00e0nh b\u00ean \u0110M gi\u00e1p tr\u1ea1ng tr\u00ean & \u0110M l\u01b0\u1ee1i)<\/p>\n

\u00b2 Theo t\u00e0i li\u1ec7u Li\u00ean X\u00f4 c\u0169, t\u1ef7 l\u1ec7 t\u1eed vong khi th\u1eaft \u0110M c\u1ea3nh l\u00e0 kho\u1ea3ng 30%<\/p>\n

2. Nguy\u00ean t\u1eafc th\u1eaft \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh g\u1ed1c:<\/p>\n

\u00d8 L\u00fac b\u00f3c tr\u1ea7n \u0110M bao gi\u1edd c\u0169ng ph\u1ea3i c\u1eaft \u0111\u1ee9t h\u1eb3n c\u00e1c bao m\u1ea1ch \u0111\u1ec3 c\u1eaft \u0111\u1ee9t c\u00e1c th\u1edb giao c\u1ea3m, l\u00e0m cho \u0110M gi\u00e3n n\u1edf \u0111\u1ec3 b\u00f9 \u0111\u1eafp cho s\u1ef1 tu\u1ea7n ho\u00e0n n\u00e3o<\/p>\n

\u00d8 Ph\u1ea3i bu\u1ed9c r\u1ea5t ch\u1eadm, t\u1eeb t\u1eeb, \u00edt nh\u1ea5t l\u00e0 10\u2019. Plama ch\u1ee7 tr\u01b0\u01a1ng d\u00f9ng c\u00e1c d\u1ea3i c\u00e2n \u0111\u1ec3 bu\u1ed9c t\u1eeb t\u1eeb cho \u0111\u1ebfn khi \u0110M \u1edf ph\u1ea7n tr\u00ean kh\u00f4ng \u0111\u1eadp n\u1eefa th\u00ec th\u00f4i<\/p>\n

Khi \u0110M c\u1ea3nh g\u1ed1c b\u1ecb th\u1eaft, \u0110M c\u1ea3nh ngo\u00e0i s\u1ebd nh\u1eadn m\u00e1u qua c\u00e1c v\u00f2ng n\u1ed1i \u0111\u1ec3 r\u1ed3i l\u1ed9i ng\u01b0\u1ee3c d\u00f2ng v\u1ec1 \u0110M c\u1ea3nh g\u1ed1c \u0111\u01b0a t\u1edbi \u0110M c\u1ea3nh trong. Khi \u0110M c\u1ea3nh trong b\u1ecb th\u1eaft th\u00ec ngu\u1ed3n m\u00e1u n\u00e0y kh\u00f4ng c\u00f2n n\u1eefa, b\u1edfi th\u1ebf th\u1eaft \u0110M c\u1ea3nh trong nguy hi\u1ec3m h\u01a1n th\u1eaft \u0110M c\u1ea3nh g\u1ed1c<\/p>\n

3. Ch\u1ec9 \u0111\u1ecbnh:<\/p>\n

– V\u1ebft th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch \u1edf v\u00f9ng \u0111\u1ea7u m\u1eb7t c\u1ed5.<\/p>\n

– Ch\u1ea3y m\u00e1u m\u0169i, ch\u1ea3y m\u00e1u sau c\u1eaft amydal k\u00e9o d\u00e0i sau khi \u0111\u00e3 s\u1eed d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p c\u1ea7m m\u00e1u th\u00f4ng th\u01b0\u1eddng kh\u00f4ng c\u00f3 k\u1ebft qu\u1ea3, ch\u1ea3y m\u00e1u trong ung th\u01b0 mi\u1ec7ng l\u01b0\u1ee1i.<\/p>\n

– Th\u1eaft d\u1ef1 ph\u00f2ng trong c\u00e1c ph\u1eabu thu\u1eadt l\u1edbn \u1edf \u0111\u1ea7u m\u1eb7t c\u1ed5: Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf x\u01b0\u01a1ng h\u00e0m tr\u00ean, c\u1eaft ung th\u01b0 l\u01b0\u1ee1i, ung th\u01b0 tuy\u1ebfn mang tai, u x\u01a1 v\u00f2m m\u0169i h\u1ecdng\u2026<\/p>\n

4. K\u1ef9 thu\u1eadt:<\/p>\n

4.1. Chu\u1ea9n b\u1ecb d\u1ee5ng c\u1ee5:<\/p>\n

G\u1ed3m b\u1ed9 ph\u1eabu thu\u1eadt ph\u1ea7n m\u1ec1m: dao m\u1ed5, k\u00e9o th\u1eb3ng, k\u00e9o cong, banh Farabeuf, b\u00f3c t\u00e1ch, \u1ed1ng th\u00f4ng l\u00f2ng m\u00e1ng, k\u1eb9p Kocher c\u00f3 m\u1ea5u v\u00e0 kh\u00f4ng c\u00f3 m\u1ea5u, d\u1ee5ng c\u1ee5 lu\u1ed3n ch\u1ec9.<\/p>\n

4.2. V\u00f4 c\u1ea3m:G\u00e2y t\u00ea khu v\u1ef1c.G\u00e2y m\u00ea.<\/p>\n

4.4. K\u1ef9 thu\u1eadt:<\/p>\n

B\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eeda, c\u1ed5 h\u01a1i du\u1ed7i, c\u00f3 l\u00f3t g\u1ed1i d\u01b0\u1edbi vai, m\u1eb7t quay sang b\u00ean \u0111\u1ed1i di\u1ec7n.Th\u1ea7y thu\u1ed1c \u0111\u1ee9ng b\u00ean m\u1ed5, ph\u1ee5 m\u1ed5 \u0111\u1ee9ng \u0111\u1ed1i di\u1ec7n.<\/p>\n

Th\u00ec 1: R\u1ea1ch da theo b\u1edd tr\u01b0\u1edbc c\u01a1 \u1ee9c \u0111\u00f2n ch\u0169m, d\u00e0i 8- 10 cm, b\u1eaft \u0111\u1ea7u ph\u00eda tr\u00ean \u1edf sau g\u00f3c x\u01b0\u01a1ng h\u00e0m 1cm ph\u00eda d\u01b0\u1edbi t\u1edbi ngang s\u1ee5n nh\u1eabn.<\/p>\n

D\u01b0\u1edbi l\u1edbp da s\u1ebd c\u1eaft c\u01a1 b\u00e1m da c\u1ed5, c\u00f3 th\u1ec3 g\u1eb7p TM c\u1ea3nh ngo\u00e0i, c\u00f3 th\u1ec3 k\u00e9o ra ho\u1eb7c c\u1eaft, nh\u1eadn r\u00f5 c\u01a1 \u1ee9c – \u0111\u00f2n – ch\u0169m.<\/p>\n

Th\u00ec 2: R\u1ea1ch bao c\u01a1 \u1ee9c- \u0111\u00f2n – ch\u0169m, t\u00ecm b\u1edd tr\u01b0\u1edbc c\u1ee7a c\u01a1 \u0111\u1ec3 b\u00f3c t\u00e1ch m\u1eb7t sau c\u01a1 r\u1ed3i ding Farabeuf k\u00e9o ra ngo\u00e0i s\u1ebd g\u1eb7p t\u0129nh m\u1ea1ch c\u1ea3nh trong, d\u00f9ng Farabeuf th\u1ee9 2 m\u00f3c k\u00e9o g\u00f3c tr\u00ean c\u1ee7a \u0111\u01b0\u1eddng m\u1ed5 \u0111\u1ec3 t\u00ecm c\u01a1 nh\u1ecb th\u00e2n.<\/p>\n

Th\u00ec 3: T\u00ecm c\u1ee9 \u0111i\u1ec3m chu\u1ea9n, tam gi\u00e1c Farabeuf \u0111\u01b0\u1ee3c t\u1ea1o b\u1edfi t\u0129nh m\u1ea1ch c\u1ea3nh \u1edf ph\u00eda sau, ch\u1ea1c ba t\u0129nh m\u1ea1ch gi\u00e1p l\u01b0\u1ee1i m\u1eb7t \u1edf ph\u00eda d\u01b0\u1edbi, c\u01a1 nh\u1ecb th\u00e2n \u1edf ph\u00eda tr\u00ean. D\u00e2y 12 n\u1eb1m v\u1eaft ngang s\u00e1t \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh ngo\u00e0i v\u00e0 \u0111\u1ed9ng m\u1ea1ch n\u00e0y n\u1eb1m trong tam gi\u00e1c Farabeuf.<\/p>\n

Th\u00ec 4: T\u00ecm b\u1ed9c l\u1ed9 \u0111\u00f4ng m\u1ea1ch c\u1ea3nh ngo\u00e0i, sau khi x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed \u0111\u1ed9ng m\u1ea1ch, ding b\u00f3c t\u00e1ch b\u1ed9c l\u1ed9 b\u1edd tr\u01b0\u1edbc c\u1ee7a t\u0129nh m\u1ea1ch c\u1ea3nh, b\u00f3c v\u00e9n t\u0129nh m\u1ea1ch gi\u00e1p l\u01b0\u1ee1i m\u1eb7t \u0111\u1ec3 b\u1ed9c l\u1ed9 \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh ngo\u00e0i v\u1edbi nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m:<\/p>\n

+ C\u00f3 nh\u1ecbp \u0111\u1eadp<\/p>\n

+ C\u00f3 nh\u00e1nh b\u00ean: \u0110\u1ed9ng m\u1ea1ch gi\u00e1p, \u0111\u1ed9ng m\u1ea1nh l\u01b0\u1ee1i, \u0111\u1ed9ng m\u1ea1ch m\u1eb7t.<\/p>\n

Th\u00ec 5: Th\u1eaft \u0111\u1ed9ng m\u1ea1ch: t\u00e1ch tr\u1ea7n v\u00e0 b\u1ed9c l\u1ed9 \u0111\u1ed9ng m\u1ea1ch v\u1edbi c\u00e1c nh\u00e1nh, d\u00f9ng c\u00e1i lu\u1ed3n ch\u1ec9 cong lu\u1ed3n d\u01b0\u1edbi \u0111\u1ed9ng m\u1ea1ch t\u1eeb sau ra trr\u01b0\u1edbc v\u00e0 th\u1eaft gi\u1eefa \u0111\u1ed9ng gi\u00e1p v\u00e0 \u0111\u1ed9ng m\u1ea1ch l\u01b0\u1ee1i (ch\u00fa \u00fd th\u1eaft 2 ch\u1ec9).<\/p>\n

Th\u00ec 6: Kh\u00e2u v\u1ebft m\u1ed5 hai l\u1edbp, s\u00e2u b\u1eb1ng ch\u1ec9 catgut v\u00e0 n\u00f4ng b\u1eb1ng ch\u1ec9 lin. C\u00f3 th\u1ec3 \u0111\u1eb7t d\u1eabn l\u01b0u ho\u1eb7c kh\u00f4ng.<\/p>\n

5. H\u1eadu ph\u1eabu.<\/p>\n

– Kh\u00e1ng sinh.<\/p>\n

– C\u1eaft ch\u1ec9 sau 7-10 ng\u00e0y.<\/p>\n

C\u00e2u 13: C\u1eaft c\u1ee5t \u0111\u00f9i<\/p>\n

1. Chi\u1ec1u d\u00e0i c\u1ee7a m\u1ecfm c\u1ee5tChi\u1ec1u d\u00e0i l\u00fd t\u01b0\u1edfng c\u1ee7a m\u1ecfm c\u1ee5t \u0111\u00f9i l\u00e0 \u0111i\u1ec3m gi\u1eefa \u0111\u00f9i \u0111\u1ebfn ch\u1ed7 n\u1ed1i 1\/3 gi\u1eefa v\u00e0 d\u01b0\u1edbi. T\u00ednh t\u1eeb b\u1edd tr\u00ean m\u1ea5u chuy\u1ec3n l\u1edbn xu\u1ed1ng th\u00ec chi\u1ec1u d\u00e0i \u0111\u00f3 kho\u1ea3ng 25cm- 30cm. C\u1eaft c\u1ee5t cao h\u01a1n m\u1ecfm c\u1ee5t c\u00e0ng ng\u1eafn th\u00ec vi\u1ec7c l\u1eafp chi gi\u1ea3 s\u1ebd kh\u00f3 h\u01a1n, ch\u1ee9c n\u0103ng c\u0169ng s\u1ebd k\u00e9m \u0111i. T\u1eeb 1\/3 tr\u00ean tr\u1edf l\u00ean c\u1ea7n ph\u1ea3i ti\u1ebft ki\u1ec7m x\u01b0\u01a1ng c\u0169ng nh\u01b0 ph\u1ea7n m\u1ec1m, \u0111\u1ec3 tang them chi\u1ec1u d\u00e0i cho m\u1ecfm c\u1ee5t khi c\u1ea7n thi\u1ebft v\u00e1 da m\u00e0 kh\u00f4ng c\u1eaft ng\u1eafn b\u1edbt x\u01b0\u01a1ng v\u1eabn c\u00f2n h\u01a1n l\u00e0 th\u00e1o kh\u1edbp hang v\u1ec1 ch\u00e2n gi\u1ea3 th\u00ec b\u1ea5t k\u1ef3 m\u1ecfm c\u1ee5t n\u00e0o, ngay c\u1ea3 th\u00e1o kh\u1edbp hang c\u0169ng \u0111\u1ec1u l\u1eafp \u0111\u01b0\u1ee3c chi gi\u1ea3, t\u1ea5t nhi\u00ean ch\u1ea5t l\u01b0\u1ee3ng ch\u00e2n gi\u1ea3 kh\u00f4ng ph\u1ea3i nh\u01b0 nhau.K\u1ef9 thu\u1eadt c\u1eaft c\u1ee5t \u0111\u00f9i gi\u1eefa 1\/3 gi\u1eefa2. \u0110\u01b0\u1eddng r\u1ea1ch daR\u1ea1ch da v\u1ea1t tr\u01b0\u1edbc b\u1eaft \u0111\u1ea7u t\u1eeb m\u1ed9t \u0111i\u1ec3m tr\u00ean \u0111\u01b0\u1eddng gi\u1eefa m\u1eb7t trong \u0111\u00f9i cao h\u01a1n 5 c\u01b0a x\u01b0\u01a1ng 2cm; r\u1ea1ch xu\u1ed1ng d\u01b0\u1edbi, ra tr\u01b0\u1edbc v\u00f2ng l\u00ean tr\u00ean \u0111\u1ec3 c\u00f3 chi\u1ec1u d\u00e0i c\u1ee5t b\u1eb1ng 2R ti\u1ebfp t\u1ee5c \u0111i ra m\u1eb7t ngo\u00e0i \u0111\u00f9i, l\u00ean tr\u00ean k\u1ebft th\u00fac \u1edf \u0111i\u1ec3m \u0111\u1ed1i x\u1ee9ng v\u1edbi \u0111i\u1ec3m \u0111\u1ea7u c\u1ee7a \u0111\u01b0\u1eddng r\u1ea1ch.R\u1ea1ch n\u1ed1i hai \u0111i\u1ec3m \u0111\u1ed1i x\u1ee9ng \u0111\u00f3 \u0111\u1ec3 c\u00f3 v\u1ea1t da t\u01b0\u01a1ng t\u1ef1 \u1edf ph\u00eda sau, c\u00f3 \u0111\u1ed9 d\u00e0i R. L\u00f3c 3 v\u1ea1t da c\u00f3 c\u1ea3 c\u00e2n l\u00ean tr\u00ean ngang v\u1edbi t\u1ea7m c\u01b0a x\u01b0\u01a1ng.3. X\u1eed tr\u00ed c\u01a1: C\u1eaft ngang c\u00e1c c\u01a1 \u1edf v\u1ea1t tr\u01b0\u1edbc, r\u1ed3i v\u1ea1t sau, th\u1ea5p h\u01a1n m\u1ee9c c\u1ee7a x\u01b0\u01a1ng 1,5cm. \u0110\u1ec3 khi c\u1eaft xong c\u01a1 co v\u1ec1 ngang t\u1ea7m c\u1ee7a x\u01b0\u01a1ng.N\u1ebfu mu\u1ed1n d\u00f9ng l\u1edbp c\u00e2n- c\u01a1 m\u1ecfng \u0111\u1ec3 b\u1ecdc \u0111\u1ea7u m\u1ecfm c\u1ee5t th\u00ec c\u1eaft c\u01a1 t\u1ee9 \u0111\u1ea7u theo \u0111\u01b0\u1eddng r\u1ea1ch da, sau \u0111\u00f3, b\u00f3c m\u1ed9t l\u1edbp c\u01a1 d\u00e0y \u0111\u1ed9 kho\u1ea3ng 1,5cm theo b\u1ec1 r\u1ed9ng c\u1ee7a v\u1ea1t da tr\u01b0\u1edbc, v\u1ea1t ph\u00eda sau c\u0169ng l\u00e0m t\u01b0\u01a1ng t\u1ef1. C\u00e1c ph\u1ea7n c\u00f2n l\u1ea1i th\u00ec c\u1eaft th\u1ea5p h\u01a1n m\u1ee9c c\u01a1 x\u01b0\u01a1ng 1,5cmN\u1ebfu d\u00f9ng c\u01a1 \u0111\u1ed9n \u0111\u1ea7u m\u1ecfm c\u1ee5t th\u00ec c\u1eaft c\u01a1 \u1edf m\u00e9p \u0111\u00e1 \u0111\u00e3 co r\u00fat theo h\u01b0\u1edbng ch\u00e9o 45 \u0111\u1ed9 v\u1ec1 ph\u00eda g\u1ed1c ch\u1ec9 \u0111\u1ec3 \u0111\u1ebfn ch\u1ed7 \u0111\u1ecbnh c\u01b0a x\u01b0\u01a1ng.4. C\u01b0a x\u01b0\u01a1ng:D\u00f9ng \u0111\u0129a v\u00e9n c\u01a1 Percy v\u00e9n g\u1ecdn c\u01a1 l\u00ean tr\u00ean. C\u1eaft m\u00e0ng x\u01b0\u01a1ng v\u00f2ng quanh x\u01b0\u01a1ng. B\u00f3c m\u00e0ng x\u01b0\u01a1ng v\u1ec1 ph\u00eda d\u01b0\u1edbi. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a x\u01b0\u01a1ng \u0111\u00f9i l\u00e0 c\u00f3 \u0111\u01b0\u1eddng r\u00e1p \u1edf ph\u00eda sau; kh\u00fac chi b\u1ecb c\u1eaft b\u1ecf l\u1ea1i n\u1eb7ng n\u00ean khi c\u01b0a c\u00f3 2 \u0111i\u1ec1u ki\u1ec7n ph\u1ea3i l\u01b0u \u00fd:- Tho\u1ea1t ti\u00ean c\u01b0a th\u1ea5p h\u01a1n \u1edf m\u00e0ng x\u01b0\u01a1ng 5mm t\u1eeb tr\u01b0\u1edbc ra sau, \u0111\u1ebfn khi s\u1eafp \u0111\u1ee9t \u0111\u1ed5i h\u01b0\u1edbng t\u1eeb trong ra ngo\u00e0i.- Tr\u1ee3 th\u1ee7 th\u1ee9 hai ph\u1ea3i \u0111\u1ee1 l\u1ea5y \u0111\u1ea7u chi, \u0111\u1ec3 tr\u00e1nh m\u1ebb x\u01b0\u1edbc \u0111\u1ea7u x\u01b0\u01a1ng, nguy\u00ean nh\u00e2n g\u00e2y ra gai s\u1eb9o \u1edf \u0111\u1ea7u x\u01b0\u01a1ng.5. X\u1eed tr\u00ed m\u1ea1ch m\u00e1u th\u1ea7n kinhT\u00ecm b\u00f3 m\u1ea1ch \u0111\u00f9i n\u00f4ng \u1edf trong \u1ed1ng Hunter. Bu\u1ed9c ri\u00eang \u0111\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch b\u1eb1ng hai n\u00fat ch\u1ec9 catgut chrome ho\u1eb7c b\u1eb1ng m\u1ed9t m\u0169i catgut v\u00e0 1 s\u1edfi ch\u1ec9 lanh kh\u00e2u xuy\u00ean m\u1ea1ch \u1edf ph\u00eda d\u01b0\u1edbi.T\u00ecm d\u00e2y th\u1ea7n kinh h\u00f4ng to \u1edf ph\u00eda tr\u01b0\u1edbc kh\u1ed1i c\u01a1 \u1ee5 ng\u1ed3i c\u1eb3ng ch\u00e2n (c\u01a1 b\u00e1n g\u00e2n, b\u00e1n m\u1ea1c) nh\u1eb9 nh\u00e0ng ph\u1eabu t\u00edch l\u00ean th\u1eadt cao sau khi \u0111\u00e3 phong b\u1ebf Novocain 1%. Bu\u1ed9c ch\u1ec9 lanh v\u00e0 d\u00f9ng dao c\u1eaft g\u1ecdn th\u1ea7n kinh \u0111\u1ec3 m\u1ecfm c\u1ee5t th\u1ea7n kinh t\u1ee5t s\u00e2u v\u00e0o trong l\u1edbp c\u01a1.6. \u0110i\u1ec1u ch\u1ec9nh l\u1ea1i m\u1ecfm c\u1ee5tTh\u00e1o garo, ti\u1ebfp t\u1ee5c c\u1ea7m m\u00e1u s\u1eeda l\u1ea1i c\u00e1c v\u1ea1t c\u01a1 v\u00e0 v\u1ea1t da sau khi \u0111\u00e3 \u01b0\u1edbm th\u1eed7. Kh\u00e2u m\u1ecfm c\u1ee5tC\u00e1c l\u1edbp c\u01a1 s\u00e2u \u1edf v\u00f9ng n\u00e0y \u0111\u00e3 b\u00e1m v\u00e0o x\u01b0\u01a1ng, kh\u00f4ng c\u1ea7n thi\u1ebft ph\u1ea3i kh\u00e2u; kh\u00e2u l\u1edbp c\u01a1 n\u00f4ng v\u00e0o l\u1edbp s\u00e2u. N\u1ebfu d\u00f9ng c\u01a1 \u0111\u1ed9n \u1edf \u0111\u1ea7u m\u1ecfm c\u1ee5t th\u1ec9 kh\u00e2u theo t\u1eebng l\u1edbp, kh\u00e2u c\u00e1c c\u01a1 ph\u00eda tr\u01b0\u1edbc v\u00e0o c\u01a1 ph\u00eda sau. Nh\u1ea5t thi\u1ebft ph\u1ea3i \u0111\u1eb7t \u1ed1ng d\u1eabn l\u01b0u; \u0111\u1eb7t 2 \u1ed1ng cao su s\u00e1t x\u01b0\u01a1ng, m\u1ed7i chi\u1ebfc d\u1eabn l\u01b0u ra m\u1ed7i g\u00f3c c\u1ee7a v\u1ea1t da. Tr\u01b0\u1edfng h\u1ee3p d\u00f9ng c\u01a1 \u0111\u1ed9n m\u1ecfm c\u1ee5t th\u00ec 1 \u1ed1ng cao su \u0111\u1eb7t s\u00e1t x\u01b0\u01a1ng, 1 \u1ed1ng \u0111\u1eb7t d\u01b0\u1edbi da. Kh\u00e2u da b\u1eb1ng c\u00e1c m\u0169i r\u1eddi.8. S\u0103n s\u00f3c sau m\u1ed5:<\/p>\n

Gi\u1ed1ng nh\u01b0 trong c\u1eaft c\u1ee5t c\u1eb3ng ch\u00e2n. Ch\u00fa \u00fd h\u1ed3i sinh ch\u1ed1ng s\u1ed1c.<\/p>\n

C\u00e2u 14: M\u1edf th\u00f4ng b\u00e0ng quang<\/p>\n

1. Ch\u1ec9 \u0111\u1ecbnh<\/p>\n

M\u1edf th\u00f4ng b\u00e0ng quang trong tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thi\u1ebft, b\u1ec7nh nh\u00e2n kh\u00f4ng t\u1ef1 ti\u1ec3u \u0111\u01b0\u1ee3c th\u01b0\u1eddng do 1 s\u1ed1 nguy\u00ean nh\u00e2n:<\/p>\n

– \u0110\u1ee9t ni\u1ec7u \u0111\u1ea1o<\/p>\n

– S\u1ecfi b\u00e0ng quang k\u1eb9t \u1edf c\u1ed5 b\u00e0ng quang, \u1edf ni\u1ec7u \u0111\u1ea1o<\/p>\n

– U x\u01a1 ti\u1ec1n li\u1ec7t tuy\u1ebfn<\/p>\n

– Ung th\u01b0 c\u1ed5 b\u00e0ng quang<\/p>\n

– H\u1eb9p t\u1eafc ni\u1ec7u \u0111\u1ea1o<\/p>\n

– T\u1ed5n th\u01b0\u01a1ng TKTW \u1edf t\u1ee7y s\u1ed1ng<\/p>\n

– T\u1ed5n th\u01b0\u01a1ng ngo\u1ea1i vi (h\u1ed9i ch\u1ee9ng \u0111u\u00f4i ng\u1ef1a)<\/p>\n

– M\u1edf th\u00f4ng b\u00e0ng quang c\u00f2n \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho 1 s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec3 chu\u1ea9n b\u1ecb cho 1 th\u1ee7 thu\u1eadt ti\u1ebfp theo<\/p>\n

2. K\u1ef9 thu\u1eadt<\/p>\n

Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n: BN n\u1eb1m ng\u1eeda, ph\u1eabu thu\u1eadt vi\u00ean \u0111\u1ee9ng \u1edf b\u00ean tr\u00e1i, ng\u01b0\u1eddi ph\u1ee5 \u0111\u1ee9ng \u1edf b\u00ean \u0111\u1ed1i di\u1ec7n.<\/p>\n

S\u00e1t tr\u00f9ng v\u00f9ng m\u1ed5, g\u00e2y t\u00ea t\u1ea1i ch\u1ed7, g\u00e2y t\u00ea t\u1ee7y s\u1ed1ng ho\u1eb7c g\u00e2y m\u00ea<\/p>\n

C\u00e1c th\u00ec ph\u1eabu thu\u1eadt:<\/p>\n

a. Th\u00ec 1<\/p>\n

R\u1ea1ch th\u00e0nh b\u1ee5ng: r\u1ea1ch da b\u1eaft \u0111\u1ea7u t\u1eeb b\u1edd tr\u00ean kh\u1edbp mu theo \u0111\u01b0\u1eddng tr\u1eafng gi\u1eefa d\u00e0i 6-8cm, t\u00e1ch gi\u1eefa 2 c\u01a1 th\u1eb3ng to th\u1ea5y c\u00e2n r\u1ed1n tr\u01b0\u1edbc b\u00e0ng quang. M\u1edf c\u00e2n r\u1ed1n tr\u01b0\u1edbc b\u00e0ng quang, d\u00f9ng ng\u00f3n tr\u1ecf qu\u1ea5n g\u1ea1c \u0111\u1ea9y c\u00e2n r\u1ed1n tr\u01b0\u1edbc b\u00e0ng quang l\u00ean ph\u00eda tr\u00ean c\u00f9ng v\u1edbi t\u00fai c\u00f9ng ph\u00fac m\u1ea1c, d\u00f9ng metcher ch\u00e8n v\u00e0 farabeuf k\u00e9o l\u00ean tr\u00ean.<\/p>\n

b. Th\u00ec 2<\/p>\n

T\u00ecm b\u00e0ng quang: nh\u1eadn bi\u1ebft b\u00e0ng quang b\u1edfi 2 TM tr\u01b0\u1edbc b\u00e0ng quang, c\u00e1c th\u1edb c\u01a1 d\u1ecdc v\u00e0 \u0111\u1ed9 r\u1eafn ch\u1eafc c\u1ee7a b\u00e0ng quang ho\u1eb7c d\u00f9ng b\u01a1m ti\u00eam ch\u1ecdc h\u00fat c\u00f3 n\u01b0\u1edbc ti\u1ec3u<\/p>\n

c. Th\u00ec 3<\/p>\n

M\u1edf b\u00e0ng quang: d\u00f9ng 2 k\u1eb9p shaput ho\u1eb7c kh\u00e2u 2 s\u1ee3i ch\u1ec9 \u1edf m\u1eb7t tr\u01b0\u1edbc b\u00e0ng quang k\u00e9o b\u00e0ng quang s\u00e1t tr\u01b0\u1edbc th\u00e0nh b\u1ee5ng, dao r\u1ea1ch v\u00e0o b\u00e0ng quang d\u00e0i 3-4cm, d\u00f9ng m\u00e1y \u0111\u1ec3 h\u00fat h\u1ebft n\u01b0\u1edbc ti\u1ec3u<\/p>\n

d. Th\u00ec 4<\/p>\n

\u0110\u00e1nh gi\u00e1 v\u00e0 gi\u1ea3i quy\u1ebft t\u1ed5n th\u01b0\u01a1ng: ph\u1eabu thu\u1eadt vi\u00ean d\u00f9ng ng\u00f3n tr\u1ecf tay ph\u1ea3i cho v\u00e0o b\u00e0ng quang l\u1ea5y s\u1ecfi, ki\u1ec3m tra ni\u00eam m\u1ea1c, c\u1ed5 b\u00e0ng quang v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u1edf b\u00e0ng quang, kh\u00e2u t\u1ed5n th\u01b0\u01a1ng \u1edf b\u00e0ng quang…<\/p>\n

e. Th\u00ec 5: Kh\u00e2u b\u00e0ng quang:<\/p>\n

– B\u00e0ng quang kh\u00f4ng nhi\u1ec5m tr\u00f9ng, n\u01b0\u1edbc ti\u1ec3u trong, ni\u00eam m\u1ea1c b\u00e0ng quang b\u00ecnh th\u01b0\u1eddng: Kh\u00e2u b\u00e0ng quang m\u0169i r\u1eddi b\u1eb1ng ch\u1ec9 catgut, \u0111\u1eb7t sonde ni\u1ec7u \u0111\u1ea1o d\u1eabn l\u01b0u n\u01b0\u1edbc ti\u1ec3u<\/p>\n

– B\u00e0ng quang b\u1ecb nhi\u1ec5m tr\u00f9ng, n\u01b0\u1edbc ti\u1ec3u \u0111\u1ee5c, ni\u00eam m\u1ea1c b\u00e0ng quang ph\u00f9 n\u1ec1 ho\u1eb7c c\u00f3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u1edf b\u00e0ng quang ho\u1eb7c c\u00e1c b\u1ec7nh l\u00fd v\u1edbi ch\u1ec9 \u0111\u1ecbnh m\u1edf th\u00f4ng b\u00e0ng quang \u0111\u1ec3 d\u1eabn l\u01b0u th\u00ec \u0111\u1eb7t 1 sonde pezze qua v\u1ebft m\u1ed5 b\u00e0ng quang, kh\u00e2u v\u1ebft m\u1ed5 b\u00e0ng quang b\u1eb1ng ch\u1ec9 m\u0169i r\u1eddi.<\/p>\n

– Kh\u00e2u d\u00ednh b\u00e0ng quang b\u1eb1ng v\u00e0o c\u00e1c l\u1edbp c\u01a1 c\u1ee7a th\u00e0nh b\u1ee5ng, \u0111\u1eb7t \u1ed1ng d\u1eabn l\u01b0u v\u00e0o khoang Retzius, kh\u00e2u c\u00e1c l\u1edbp l\u1ea1i v\u1edbi nhau, kh\u00e2u da.<\/p>\n

3. Tai bi\u1ebfn<\/p>\n

M\u1edf nh\u1ea7m v\u00e0o ph\u00fac m\u1ea1c x\u1eed tr\u00ed kh\u00e2u l\u1ea1i tr\u01b0\u1edbc khi m\u1edf b\u00e0ng quang<\/p>\n

– Nhi\u1ec5m tr\u00f9ng khoang retzius<\/p>\n

– R\u00f2 k\u00e9o d\u00e0i<\/p>\n

Ch\u0103m s\u00f3c sau m\u1ed5: N\u1ed1i \u1ed1ng d\u1eabn l\u01b0u v\u00e0o t\u00fai ch\u1ea5t d\u1ebbo ho\u1eb7c l\u1ecd th\u1ee7y tinh. N\u1ebfu c\u00f3 ch\u1ea3y m\u00e1u ho\u1eb7c c\u00f3 m\u1ee7 th\u00ec s\u00fac r\u1eeda h\u00e0ng ng\u00e0y. Th\u00f4ng th\u01b0\u1eddng r\u00fat \u1ed1ng d\u1eabn l\u01b0u sau 7-8 ng\u00e0y.<\/p>\n

C\u00e2u 15: M\u1edf m\u00e0ng ph\u1ed5i<\/p>\n

1. Ch\u1ec9 \u0111\u1ecbnh:M\u1edf m\u00e0ng ph\u1ed5i nh\u1eb1m c\u00e1c m\u1ee5c \u0111\u00edch sau:- D\u1eabn l\u01b0u m\u1ee7 trong vi\u00eam m\u00e0ng ph\u1ed5i m\u1ee7, d\u1eabn l\u01b0u m\u00e1u trong ch\u1ea5n th\u01b0\u01a1ng v\u00e0 v\u1ebft th\u01b0\u01a1ng l\u1ed3ng ng\u1ef1c.- H\u00fat h\u01a1i cho ph\u1ed5i n\u1edf ra trong tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i, \u0111\u1ec3 gi\u00fap cho l\u1ed5 th\u1ee7ng c\u00f3 th\u1ec3 t\u1ef1 b\u1ecbt l\u1ea1i \u0111\u01b0\u1ee3c v\u00e0 tr\u00e1nh \u0111\u01b0\u1ee3c c\u00e1c t\u00fai c\u1eb7n m\u00e0ng ph\u1ed5i sau n\u00e0y.- Hi\u1ec7n nay nh\u1edd c\u00f3 kh\u00e1ng sinh n\u00ean ch\u1ec9 \u0111\u1ecbnh c\u1ee7a th\u1ee7 thu\u1eadt m\u1edf m\u00e0ng ph\u1ed5i thu h\u1eb9p l\u1ea1i r\u1ea5t nhi\u1ec1u.2. Nguy\u00ean t\u1eafc chung cho c\u00e1c lo\u1ea1i m\u1edf m\u00e0ng ph\u1ed5i:- Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n: T\u1ed1t nh\u1ea5t l\u00e0 ch\u1ee5p ho\u1eb7c chi\u1ebfu ph\u1ed5i \u0111\u1ec3 bi\u1ebft r\u00f5 t\u00fai m\u1ee7 v\u00e0 m\u1ed1c \u0111\u1ecbnh m\u1edf m\u00e0ng ph\u1ed5i, ch\u1ecdc h\u00fat th\u0103m d\u00f2 tr\u01b0\u1edbc, ph\u1ea3i l\u00e0m \u1edf ph\u00f2ng m\u1ed5.- Ch\u1ecdn n\u01a1i m\u1edf m\u00e0ng ph\u1ed5i: Theo c\u1ed5 \u0111i\u1ec3n, m\u1edf m\u00e0ng ph\u1ed5i ph\u1ea3i ch\u1ecdn \u1edf ch\u1ed7 th\u1ea5p nh\u1ea5t, v\u00ec m\u1ee7 v\u00e0 m\u00e1u \u1ee9 \u0111\u1ecdng \u1edf ch\u1ed7 th\u1ea5p nh\u1ea5t, nh\u01b0 v\u1eady d\u1eabn l\u01b0u m\u1edbi t\u1ed1t.- Hi\u1ec7n nay ng\u01b0\u1eddi ta \u0111\u00e3 bi\u1ebft \u00e1p d\u1ee5ng l\u1ef1c h\u00edt v\u00e0o v\u00e0 th\u1edf ra, c\u00f3 t\u00e1c d\u1ee5ng nh\u01b0 m\u1ed9t c\u00e1i b\u01a1m, c\u00f3 th\u1ec3 \u0111\u1ea9y m\u1ee7 ra ngo\u00e0i. Trong qu\u00e1 tr\u00ecnh d\u1eabn l\u01b0u \u1edf m\u00e0ng ph\u1ed5i thu h\u1eb9p, m\u00e0ng ph\u1ed5i d\u00ednh l\u1ea1i l\u00e0m cho \u1ed1ng cao su b\u1ecb g\u1eadp, do \u0111\u00f3 ch\u1ed7 d\u1eabn l\u01b0u th\u1ea5p nh\u1ea5t l\u00fac ban \u0111\u1ea7u t\u1ed1t, v\u1ec1 sau tr\u1edf n\u00ean x\u1ea5u ( ch\u1ed7 th\u1ea5p nh\u1ea5t l\u00e0 kho\u1ea3ng li\u00ean s\u01b0\u1eddn X v\u00e0 XI \u1edf sau l\u01b0ng)- Nh\u01b0ng hi\u1ec7n nay ng\u01b0\u1eddi ta th\u01b0\u1eddng ch\u1ecdn \u0111i\u1ec3m giao nhau kho\u1ea3ng li\u00ean s\u01b0\u1eddn th\u1ee9 VIII v\u00e0 l\u1ea1i.3. K\u1ef9 thu\u1eadt:C\u00f3 2 lo\u1ea1i m\u1edf m\u00e0ng ph\u1ed5i:a. M\u1edf m\u00e0ng ph\u1ed5i qua kho\u1ea3ng li\u00ean s\u01b0\u1eddnb. M\u1edf m\u00e0ng ph\u1ed5i c\u00f3 c\u1eaft x\u01b0\u01a1ng s\u01b0\u1eddn- Ngo\u00e0i ra c\u00f2n c\u00f3 lo\u1ea1i m\u1edf m\u00e0ng ph\u1ed5i r\u1ed9ng c\u1eaft nhi\u1ec1u x\u01b0\u01a1ng s\u01b0\u1eddn, lo\u1ea1i n\u00e0y v\u1eeba d\u1eabn l\u01b0u v\u1eeba c\u00f3 t\u00ednh ch\u1ea5t th\u0103m d\u00f2.3.1. M\u1edfm\u00e0ng ph\u1ed5i t\u1ed1i thi\u1ec3u- D\u1ee5ng c\u1ee5: Troca l\u00e0 1 \u1ed1ng kim lo\u1ea1i g\u1ed3m 4 c\u1ee1 \u0111\u01b0\u1eddng k\u00ednh 7, 8, 10, 12mm, c\u00f3 1 c\u00e1i n\u00f2ng b\u1eb1ng kim lo\u1ea1i \u0111\u1ea7u h\u00ecnh tr\u00f2n h\u01a1i t\u00f9 \u0111\u1ec3 kh\u00f4ng l\u00e0m th\u1ee7ng ph\u1ed5i khi ch\u1ecdc d\u00f2<\/p>\n

+ 1 \u1ed1ng d\u1eabn l\u01b0u b\u1eb1ng cao su, x\u00f4ng nelaton, ho\u1eb7c x\u00f4ng Pezzer…<\/p>\n

+ 1 d\u00e2y cao su d\u00e0i 1m<\/p>\n

+ 1 l\u1ecd th\u1ee7y tinh c\u00f3 chia \u0111\u1ed9 t\u1eeb 500-1000ml<\/p>\n

– T\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n: b\u1ec7nh nh\u00e2n ng\u1ed3i quay l\u01b0ng v\u1ec1 ph\u00eda ph\u1eabu thu\u1eadt vi\u00ean<\/p>\n

– Tr\u1eeb \u0111au b\u1eb1ng g\u00e2y t\u00ea novocain 0,5%<\/p>\n

– C\u00e1c th\u00ec ti\u1ebfn h\u00e0nh:* Th\u00ec 1: G\u1ea7y t\u00ea v\u00e0 r\u1ea1ch da d\u00e0i 1cm, ch\u1ecdc troca qua kho\u1ea3ng li\u00ean s\u01b0\u1eddn, \u0111\u1ec3 tr\u00e1nh c\u00e1c m\u1ea1ch m\u00e1u v\u00e0 th\u1ea7n kinh, khi c\u1ea7m tr\u00f4 ca v\u1eeba ch\u1ecdc v\u1eeba xoay, \u0111\u1ec3 kh\u1ecfi ch\u1ecdc xuy\u00ean v\u00e0o trong ng\u1ef1c.* Th\u00ec 2: Lu\u1ed3n \u1ed1ng d\u1eabn l\u01b0u v\u00e0o \u1ed5 m\u00e0ng ph\u1ed5i l\u1ea5y 1 k\u1eb9p kocher k\u1eb9p \u0111\u1ea7u ngo\u00e0i \u1ed1ng d\u1eabn l\u01b0u, sau \u0111\u00f3 lu\u1ed3n qua tr\u00f4 ca v\u00e0o trong \u1ed5 m\u00e0ng ph\u1ed5i, r\u00fat t\u1eeb t\u1eeb trocar a v\u00e0 l\u1ea5y k\u1eb9p \u1ed1ng cao su s\u00e1t da, \u0111\u1ed3ng th\u1eddi m\u1edf k\u1eb9p Kocher \u1edf ngo\u00e0i r\u00fat h\u1eb3n trocar a* Th\u00ec 3: Kh\u00e2u c\u1ed1 \u0111\u1ecbnh \u1ed1ng cao su b\u1eb1ng s\u1ee3i ch\u1ec9 lanh v\u00e0 kh\u00e2u ph\u1ea7n m\u1ec1m th\u00e0nh ng\u1ef1c l\u1ea1i.- Thay \u0111\u1ed5i k\u1ef9 thu\u1eadt: N\u1ebfu kh\u00f4ng c\u00f3 troca, sau khi g\u00e2y t\u00ea dung dao r\u1ea1ch t\u1eeb t\u1eeb qua da v\u00e0 c\u01a1, \u0111i s\u00e1t b\u1edd tr\u00ean c\u1ee7a x\u01b0\u01a1ng s\u01b0\u1eddn v\u00e0o \u1ed5 m\u00e0ng ph\u1ed5i, qua \u0111\u00f3 dung k\u1eb9p Kocher cong c\u1eb7p \u1ed1ng d\u1eabn l\u01b0u \u0111\u1ea9y v\u00e0o \u1ed5 m\u00e0ng ph\u1ed5i ( c\u00f2n c\u00e1c \u0111\u1ed9ng t\u00e1c kh\u00e2u l\u00e0m nh\u01b0 tr\u00ean).3.2. M\u1edf m\u00e0ng ph\u1ed5i c\u00f3 c\u1eaft \u0111o\u1ea1n x\u01b0\u01a1ng s\u01b0\u1eddn- \u00c1P d\u1ee5ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 m\u1ee7 \u0111\u1eb7c v\u00f3n l\u1ea1i, qua kho\u1ea3ng li\u00ean s\u01b0\u1eddn kh\u00f4ng th\u1ec3 d\u1eabn l\u01b0u \u0111\u01b0\u1ee3c.K\u1ef9 thu\u1eadt: Sau khi c\u1eaft \u0111o\u1ea1n x\u01b0\u01a1ng s\u01b0\u1eddn 3-5cmR\u1ea1ch m\u00e0ng ph\u1ed5i ngay tr\u00ean \u0111o\u1ea1n x\u01b0\u01a1ng s\u01b0\u1eddn \u0111\u00e3 c\u1eaft, dung k\u1eb9p Kocher banh r\u1ed9ng v\u1ebft r\u1ea1ch, ho\u1eb7c cho m\u1ed9t ng\u00f3n tay tr\u1ecf v\u00e0o l\u1ea5p m\u1ee7 \u0111\u1ecdng, sau \u0111\u00f3 \u0111\u1eb7t \u1ed1ng d\u1eabn l\u01b0u to, kh\u00e2u k\u00edn c\u00e1c l\u1edbp c\u01a1 da v\u00e0 c\u1ed1 \u0111\u1ecbnh \u1ed1ng d\u1eabn l\u01b0u b\u1eb1ng c\u00e1c m\u0169i ch\u1ec9 lanh.4. H\u1ec7 th\u1ed1ng d\u1eabn l\u01b0u<\/p>\n

15-20\u2019 h\u00fat 1 l\u1ea7n v\u1edbi \u00e1p l\u1ef1c v\u1eeba ph\u1ea3i, ho\u1eb7c d\u1eabn l\u01b0u v\u00e0o b\u00ecnh n\u01b0\u1edbc qua h\u1ec7 th\u1ed1ng k\u00edn<\/p>\n

5. Ch\u0103m s\u00f3c sau khi d\u1eabn l\u01b0u<\/p>\n

v N\u1eb1m theo t\u01b0 th\u1ebf n\u1eeda n\u1eb1m n\u1eeda ng\u1ed3i<\/p>\n

v Theo d\u00f5i l\u01b0\u1ee3ng m\u1ee7, m\u00e1u ra h\u00e0ng ng\u00e0y<\/p>\n

v T\u1eadp cho b\u1ec7nh nh\u00e2n th\u1ed5i \u1ed1ng cao su \u0111\u1ec3 ph\u1ed5i n\u1edf ra<\/p>\n

v Khi m\u1ee7 v\u00e0 m\u00e1u h\u1ebft ch\u1ea3y, to\u00e0n th\u00e2n t\u1ed1t s\u1ebd h\u1ebft s\u1ed1t, l\u00fac \u0111\u00f3 r\u00fat \u1ed1ng d\u1eabn l\u01b0u ra, b\u0103ng ch\u1eb7t v\u1ebft th\u01b0\u01a1ng l\u1ea1i<\/p>\n

C\u00e2u 16: C\u1eaft \u0111o\u1ea1n x\u01b0\u01a1ng s\u01b0\u1eddn<\/p>\n

1. Ch\u1ec9 \u0111\u1ecbnh:- L\u00e0 giai \u0111o\u1ea1n \u0111\u1ea7u ti\u00ean \u0111\u1ec3 ti\u1ebfn h\u00e0nh c\u00e1c th\u1ee7 thu\u1eadt trong l\u1ed3ng ng\u1ef1c- Trong tr\u01b0\u1eddng h\u1ee3p th\u1ee7 thu\u1eadt v\u1ec1 th\u1eadn kh\u00f3, ta c\u00f3 th\u1ec3 c\u1eaft 1 \u0111\u1ebfn 2 x\u01b0\u01a1ng s\u01b0\u1eddn XII, XII.2. K\u1ef9 thu\u1eadt:*Th\u00ec 1: R\u1ea1ch c\u00e1c ph\u1ea7n m\u1ec1m- \u0110\u01b0\u1eddng r\u1ea1ch d\u00e0i kho\u1ea3ng 3cm- 10cm song song h\u01b0\u1edbng \u0111i c\u1ee7a c\u00e1c x\u01b0\u01a1ng s\u01b0\u1eddn, d\u00e0i hay ng\u1eafn thay \u0111\u1ed5i t\u00f9y theo c\u1ee7a th\u1ee7 thu\u1eadt.- N\u1ebfu c\u1eaft nhi\u1ec1u x\u01b0\u01a1ng s\u01b0\u1eddn c\u00f9ng m\u1ed9t l\u00fac ta c\u00f3 th\u1ec3 r\u1ea1ch da th\u00e0nh m\u1ed9t v\u1ea1t ph\u1ea7n m\u1ec1m, h\u00ecnh th\u1ec3 thay \u0111\u1ed5i t\u00f9y theo s\u1ed1 l\u01b0\u1ee3ng c\u00e1c x\u01b0\u01a1ng s\u01b0\u1eddn \u0111\u1ecbnh c\u1eaft.* Th\u00ec 2: T\u00e1ch m\u00e0ng s\u01b0\u1eddn ra kh\u1ecfi x\u01b0\u01a1ng s\u01b0\u1eddn.a. R\u1ea1ch m\u00e0ng x\u01b0\u01a1ngTa d\u00f9ng ng\u00f3n tr\u1ecf v\u00e0 ng\u00f3n c\u00e1i c\u1ee7a tay tr\u00e1i, c\u1ed1 \u0111\u1ecbnh b\u1edd tr\u00ean v\u00e0 b\u1edd d\u01b0\u1edbi c\u1ee7a x\u01b0\u01a1ng s\u01b0\u1eddn, d\u00f9ng dao r\u1ea1ch dung \u0111\u01b0\u1eddng ch\u00ednh gi\u1eefa m\u1eb7t ngo\u00e0i c\u1ee7a x\u01b0\u01a1ng s\u01b0\u1eddn, r\u1ea1ch m\u00e0ng x\u01b0\u01a1ng theo \u0111\u00fang chi\u1ec1u d\u00e0i \u0111o\u1ea1n x\u01b0\u01a1ng \u0111\u1ecbnh c\u1eaft.b. T\u00e1ch m\u00e0ng x\u01b0\u01a1ngT\u00e1ch m\u1eb7t ngo\u00e0i c\u1ee7a m\u00e0ng x\u01b0\u01a1ng, ta d\u00f9ng tu\u1ed1t s\u01b0\u1eddn th\u1eb3ng doujin t\u00e1ch nh\u1eb9 t\u1eeb sau ra tr\u01b0\u1edbc ra sau \u0111\u1ec3 l\u1ed9 h\u1eb3n 2 m\u00e9p c\u1ee7a m\u00e0ng x\u01b0\u01a1ng cho \u0111\u1ebfn t\u1eadn b\u1edd tr\u00ean v\u00e0 b\u1edd d\u01b0\u1edbi c\u1ee7a x\u01b0\u01a1ng s\u01b0\u1eddnc. T\u00e1ch b\u1edd tr\u00ean v\u00e0 b\u1edd d\u01b0\u1edbi c\u1ee7a m\u00e0ng x\u01b0\u01a1ngL\u1ea5y m\u1ed9t c\u00e1i tu\u1ed1t s\u01b0\u1eddn doujin cong t\u00e1ch b\u1edd tr\u00ean v\u00e0 b\u1edd d\u01b0\u1edbi c\u1ee7a x\u01b0\u01a1ng s\u01b0\u1eddn, ch\u00fa \u00fd h\u01b0\u1edbng \u0111i c\u1ee7a c\u01a1 li\u00ean s\u01b0\u1eddn.- B\u1edd tr\u00ean c\u1ee7a x\u01b0\u01a1ng t\u00e1ch t\u1eeb sau ra tr\u01b0\u1edbc- B\u1edd d\u01b0\u1edbi c\u1ee7a x\u01b0\u01a1ng t\u00e1ch t\u1eeb tr\u01b0\u1edbc ra sau- Trong c\u00e1c thao t\u00e1c ph\u1ea3i l\u00e0m nh\u1eb9 nh\u00e0ng, kh\u00f4ng \u0111\u1ec3 cho tu\u1ed1t s\u01b0\u1eddn tr\u01b0\u1ee3t v\u00e0o trong l\u00e0m r\u00e1ch m\u00e0ng ph\u1ed5id. T\u00e1ch m\u1eb7t sau c\u1ee7a m\u00e0ng x\u01b0\u01a1ng s\u01b0\u1eddn- D\u00f9ng m\u1ed9t c\u00e1i tu\u1ed1t s\u01b0\u1eddn cong, t\u00e1ch m\u1eb7t sau c\u1ee7a x\u01b0\u01a1ng s\u01b0\u1eddn t\u1eeb 1-2cm, \u0111\u1ea7u c\u1ee7a c\u00e1i tu\u1ed1t s\u01b0\u1eddn s\u00e1t v\u1edbi m\u1eb7t x\u01b0\u01a1ng \u0111\u1ec3 kh\u1ecfi ch\u1ea1m v\u00e0o m\u00e0ng ph\u1ed5i- Sau \u0111\u00f3 ta lu\u1ed3n m\u1ed9t c\u00e1i tu\u1ed1t s\u01b0\u1eddn Doyen \u00f4m l\u1ea5y x\u01b0\u01a1ng s\u01b0\u1eddn t\u1eeb t\u1eeb l\u00e1ch nh\u1eb9 nh\u00e0ng ra ph\u00eda tr\u01b0\u1edbc, r\u1ed3i t\u1eeb tr\u01b0\u1edbc ra sau \u0111\u1ec3 b\u00f3c t\u00e1ch m\u00e0ng x\u01b0\u01a1ng s\u01b0\u1eddn r\u1eddi kh\u1ecfi m\u1eb7t trong r\u1ea5t d\u1ec5 d\u00e0ng, kh\u00f4ng g\u00e2y t\u1ed5n th\u01b0\u01a1ng \u0111\u1ebfn m\u1ea1ch m\u00e1u v\u00e0 TK.* Th\u00ec 3: C\u1eaft x\u01b0\u01a1ng s\u01b0\u1eddn: D\u00f9ng dao c\u1eaft s\u01b0\u1eddn, khi t\u00e1ch m\u00e0ng x\u01b0\u01a1ng \u0111\u1ebfn \u0111\u00e2u c\u1eaft x\u01b0\u01a1ng s\u01b0\u1eddn \u0111\u1ebfn \u0111\u00f3, c\u1eaft ph\u00eda sau r\u1ed3i \u0111\u1ebfn c\u1eaft ph\u00eda tr\u01b0\u1edbc, \u0111\u01b0\u1eddng c\u1eaft vu\u00f4ng g\u00f3c v\u1edbi tr\u1ee5c c\u1ee7a x\u01b0\u01a1ng s\u01b0\u1eddn.* C\u1ea7n ch\u00fa \u00fd: Khi r\u1ea1ch m\u00e0ng x\u01b0\u01a1ng, b\u00f3c t\u00e1ch m\u00e0ng x\u01b0\u01a1ng th\u01b0\u1eddng hay ch\u1ea3y m\u00e1u, d\u00f9ng huy\u1ebft thanh \u1ea5m oxy gi\u00e0 \u0111\u1eafp v\u00e0o \u0111o\u1ea1n x\u01b0\u01a1ng s\u01b0\u1eddn \u0111\u00e3 c\u1eaft \u0111o\u1ea1n sau \u00edt ph\u00fat m\u00e1u c\u1ea7m l\u1ea1i. N\u1ebfu c\u00f2n ch\u1ea3y kh\u00e2u c\u1ea7m m\u00e1u.<\/p>\n

\u0110\u1ea0I C\u01af\u01a0NG V\u1ec0 C\u1eaeT C\u1ee4T CHI<\/p>\n

1. Y\u00eau c\u1ea7u<\/p>\n

Kh\u00f4ng ch\u1ec9 lo\u1ea1i b\u1ecf 1 \u0111o\u1ea1n chi mang b\u1ec7nh c\u00f3 th\u1ec3 nguy h\u1ea1i \u0111\u1ebfn t\u00ednh m\u1ea1ng b\u1ec7nh nh\u00e2n, ho\u1eb7c chi b\u1ecb d\u1ecb d\u1ea1ng l\u00e0m c\u1ea3n tr\u1edf sinh ho\u1ea1t c\u1ee7a ch\u1ee7 chi m\u00e0 c\u00f2n c\u00f3 y\u00eau c\u1ea7u quan tr\u1ecdng h\u01a1n n\u1eefa l\u00e0 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho b\u1ec7nh nh\u00e2n mang \u0111\u01b0\u1ee3c chi gi\u1ea3 ho\u1ea1t \u0111\u1ed9ng t\u1ed1t, tr\u1edf l\u1ea1i cu\u1ed9c s\u1ed1ng lao \u0111\u1ed9ng c\u00e0ng binfht h\u01b0\u1eddng c\u00e0ng t\u1ed1t.<\/p>\n

M\u1ed9t m\u1ecfm c\u1ee5t t\u1ed1t ph\u1ea3i \u0111\u1ea3m b\u00e0o:<\/p>\n

\u00d8 M\u1ecfm c\u1ee5t ph\u1ea3i l\u00e0nh l\u1eb7n ngh\u0129a l\u00e0 \u0111\u01b0\u1ee3c nu\u00f4i d\u01b0\u1ee1ng t\u1ed1t, kh\u00f4ng \u0111au, c\u1ea3m gi\u00e1c b\u00ecnh th\u01b0\u1eddng; s\u1eb9o nh\u1ecf, kh\u00f4ng d\u00ednh, di \u0111\u1ed9ng t\u1ed1t, c\u01a1 kh\u1ecfe, s\u0103n ch\u1eafc, teo \u00edt, kh\u1edbp ph\u00eda tr\u00ean ho\u1ea1t \u0111\u1ed9ng t\u1ed1t. Khi m\u1ecfm c\u1ee5t x\u1ea5u, kh\u00f4ng mang \u0111\u01b0\u1ee3c chi gi\u1ea3 c\u1ea7n ph\u1ea3i s\u1eeda l\u1ea1i.<\/p>\n

\u00d8 M\u1ecfm c\u1ee5t c\u00f3 chi\u1ec1u d\u00e0i th\u00edch \u0111\u00e1ng l\u00e0 m\u1ecfm c\u1ee5t c\u00f3 c\u00e1nh tay \u0111\u00f2n \u0111\u1ee7 kh\u1ecfe, s\u1eed d\u1ee5ng chi gi\u1ea3 kh\u00f4ng b\u1ecb v\u01b0\u1edbng, kh\u00f4ng b\u1ecb h\u1ea1n ch\u1ebf. Ph\u1ee5 thu\u1ed9c v\u00e0o v\u1ecb tr\u00ed, t\u00ecnh tr\u1ea1ng t\u1ed5n th\u01b0\u01a1ng c\u1ee7a chi n\u00ean kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o ph\u1eabu thu\u1eadt vi\u00ean c\u0169ng ch\u1ecdn \u0111\u01b0\u1ee3c chi\u1ec1u d\u00e0i l\u00fd t\u01b0\u1edfng, nh\u01b0ng v\u1eabn ph\u1ea3i l\u1eafp v\u00e0 s\u1eed d\u1ee5ng chi gi\u1ea3 th\u00ec g\u1ecdi l\u00e0 chi\u1ec1u d\u00e0i c\u00f3 \u00edch. Khi m\u1ecfm c\u1ee5t qu\u00e1 ng\u1eafn ho\u1eb7c qu\u00e1 d\u00e0i l\u00e0m c\u1ea3n tr\u1edf l\u1eafp v\u00e0 s\u1eed d\u1ee5ng chi gi\u1ea3 th\u00ec g\u1ecdi l\u00e0 chi\u1ec1u d\u00e0i kh\u00f3 s\u1eed d\u1ee5ng.<\/p>\n

2. K\u1ef9 thu\u1eadt c\u1eaft c\u1ee5t ngo\u00e0i t\u00ecnh tr\u1ea1ng th\u01b0\u01a1ng t\u1ed5n, b\u1ec7nh t\u1eadt c\u00f2n ph\u1ee5 thu\u1ed9c v\u00e0o 1 s\u1ed1 y\u1ebfu t\u1ed1 kh\u00e1c:<\/p>\n

– L\u1ee9a tu\u1ed5i: c\u1eaft c\u1ee5t \u1edf tr\u1ebb con, \u1edf ng\u01b0\u1eddi gi\u00e0<\/p>\n

– Lo\u1ea1i b\u1ec7nh y\u00eau c\u1ea7u c\u1eaft c\u1ee5t chi<\/p>\n

– Ho\u00e0n c\u1ea3nh KT-XH, \u0111i\u1ec1u ki\u1ec7n sinh ho\u1ea1t t\u01b0\u01a1ng lai c\u0169ng nh\u01b0 nguy\u1ec7n v\u1ecdng c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u1ec3 ch\u1ec9 \u0111\u1ecbnh, l\u1ef1a ch\u1ecdn v\u1ecb tr\u00ed c\u1eaft c\u1ee5t v\u00e0 chi ti\u1ebft v\u1ec1 k\u1ef9 thu\u1eadt.<\/p>\n

3. Ph\u00e2n lo\u1ea1i<\/p>\n

v C\u1eaft c\u1ee5t c\u1ea5p c\u1ee9u \u0111\u1ec3 h\u1edf: y\u00eau c\u1ea7u ca ph\u1eabu thu\u1eadt l\u00e0 \u0111\u1ec3 c\u1ee9u s\u1ed1ng t\u00ednh m\u1ea1ng b\u1ec7nh nh\u00e2n. B\u1eaft bu\u1ed9c ph\u1eabu thu\u1eadt vi\u00ean ph\u1ea3i ti\u1ebfn h\u00e0nh nhanh v\u00e0 \u0111\u01a1n gi\u1ea3n. Y\u00eau c\u1ea7u m\u1ecfm c\u1ee5t mang \u0111\u01b0\u1ee3c chi gi\u1ea3 tr\u1edf th\u00e0nh th\u1ee9 y\u1ebfu, s\u1ebd ho\u00e0n ch\u1ec9nh \u0111\u01b0\u1ee3c khi t\u1ea1i ch\u1ed7 c\u0169ng nh\u01b0 to\u00e0n th\u00e2n b\u1ec7nh nh\u00e2n \u0111\u00e3 \u1ed5n \u0111\u1ecbnh<\/p>\n

v C\u1eaft c\u1ee5t \u0111\u00f3ng k\u00edn: \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n theo k\u1ebf ho\u1ea1ch, ti\u1ebfn h\u00e0nh th\u1eadn tr\u1ecdng c\u00f3 c\u00e2n nh\u1eafc, c\u00f3 t\u00ednh ch\u00ednh x\u00e1c, \u0111\u1ea3m b\u1ea3o c\u00e1c ti\u00eau chu\u1ea9n \u0111\u1ec3 l\u1eafp chi gi\u1ea3<\/p>\n

4. Sinh l\u00fd c\u1ee7a m\u1ecfm c\u1ee5t<\/p>\n

v Thay \u0111\u1ed5i c\u1ee7a da:<\/p>\n

\u00fc Hi\u1ec7n t\u01b0\u1ee3ng co r\u00fat: ngay khi ta c\u1eaft \u0111\u1ee9t da \u0111\u00e3 th\u1ea5y da co r\u00fat v\u1ec1 chi\u1ec1u d\u00e0i, \u0111\u1ed9 co r\u00fat n\u00e0y ph\u1ee5 thu\u1ed9c v\u00e0o t\u1eebng v\u00f9ng. V\u00f9ng da m\u1ecfng, di \u0111\u1ed9ng s\u1ebd co r\u00fat nhi\u1ec1u h\u01a1n \u1edf m\u1eb7t ngo\u00e0i, m\u1eb7t du\u1ed7i.<\/p>\n

\u00fc Hi\u1ec7n t\u01b0\u1ee3ng r\u1ed1i lo\u1ea1n dinh d\u01b0\u1ee1ng: bao gi\u1edd c\u0169ng c\u00f3 ph\u00f9 n\u1ec1, b\u1eaft \u0111\u1ea7u t\u1eeb ng\u00e0y 1 v\u00e0 cao nh\u1ea5t \u1edf ng\u00e0y 3, r\u1ed3i gi\u1ea3m d\u1ea7n v\u00e0 ti\u1ebfn t\u1edbi l\u00e0nh s\u1eb9o. Di\u1ec5n bi\u1ebfn b\u1ea5t th\u01b0\u1eddng s\u1ebd x\u1ea3y ra khi \u0111\u01b0\u1eddng kh\u00e2u c\u0103ng, da b\u1ecb \u0111\u1ee5ng d\u1eadp. Ho\u1eb7c thi\u1ebfu s\u1ef1 ch\u0103m s\u00f3c t\u00ecnh tr\u1ea1ng ph\u00f9 n\u1ec1 s\u1ebd k\u00e9o d\u00e0i l\u00e0m da b\u1ecb bi\u1ebfn \u0111\u1ed5i m\u00e0u s\u1eafc, n\u1eb7ng h\u01a1n s\u1ebd d\u1eabn t\u1edbi lo\u00e9t.<\/p>\n

v C\u01a1: Hi\u1ec7n t\u01b0\u1ee3ng co r\u00fat x\u1ea3y ra s\u1edbm c\u0169ng nh\u01b0 \u1edf da. C\u01a1 n\u00e0o b\u00e1m v\u00e0o th\u00e2n x\u01b0\u01a1ng s\u1ebd b\u1ecb co r\u00fat \u00edt, v\u00ec v\u1eady c\u01a1 \u1edf n\u00f4ng co r\u00fat nhi\u1ec1u h\u01a1n c\u01a1 \u1edf s\u00e2u. Th\u1eddi gian \u0111\u1ea7u c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng ph\u00f9 n\u1ec1 v\u00e0 r\u1ed1i lo\u1ea1n dinh d\u01b0\u1ee1ng nh\u01b0 \u1edf da. Khi hi\u1ec7n t\u01b0\u1ee3ng ph\u00f9 n\u1ec1 gi\u1ea3m th\u00ec th\u1ea5y r\u00f5 hi\u1ec7n t\u01b0\u1ee3ng teo c\u01a1. N\u1ebfu do ch\u1ea5n th\u01b0\u01a1ng g\u00e2y \u0111\u1ee5ng d\u1eadp tr\u01b0\u1edbc trong m\u1ed5 th\u00ec c\u00f3 th\u1ec3 d\u1eabn t\u1edbi hi\u1ec7n t\u01b0\u1ee3ng x\u01a1 h\u00f3a l\u00e0m gi\u1ea3m t\u00ednh \u0111\u00e0n h\u1ed3i v\u00e0 sinh l\u1ef1c c\u1ee7a c\u01a1.<\/p>\n

v M\u1ea1ch m\u00e1u: C\u00e1c m\u1ea1ch m\u00e1u teo nh\u1ecf d\u1ea7n do \u0111\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn vi\u1ec7c t\u01b0\u1edbi m\u00e1u nu\u00f4i d\u01b0\u1ee1ng m\u1ecfm c\u1ee5t<\/p>\n

v Th\u1ea7n kinh: Da, c\u01a1, m\u1ea1ch m\u00e1u \u0111\u1ec1u b\u1ecb co ng\u1eafn teo nh\u1ecf; ng\u01b0\u1ee3c l\u1ea1i tr\u1ee5 tr\u1ee5c th\u1ea7n kinh th\u00ec m\u1ecdc d\u00e0i ra. N\u1ebfu x\u1eed tr\u00ed kh\u00f4ng t\u1ed1t c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n u th\u1ea7n kinh v\u1ec1 sau g\u00e2y \u0111au cho m\u1ecfm c\u1ee5t<\/p>\n

v X\u01b0\u01a1ng: \u1edf ng\u01b0\u1eddi \u0111\u00e3 h\u1ebft tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh trong tu\u1ea7n \u0111\u1ea7u ti\u00ean s\u1ebd xu\u1ea5t hi\u1ec7n hi\u1ec7n t\u01b0\u1ee3ng m\u1ea5t ch\u1ea5t v\u00f4 \u1edf m\u1ecfm c\u1ee5t x\u01b0\u01a1ng, d\u1ea7n d\u1ea7n tr\u1edf n\u00ean x\u1ed1p v\u00e0 teo nh\u1ecf. \u1ede tr\u1ebb con x\u01b0\u01a1ng v\u1eabn ti\u1ebfp t\u1ee5c ph\u00e1t tri\u1ec3n v\u1ec1 chi\u1ec1u d\u00e0i. \u0110\u1ebfn l\u00fac x\u01b0\u01a1ng ch\u00f2i ra ngo\u00e0i ph\u1ea3i s\u1eeda l\u1ea1i m\u1ecfm c\u1ee5t=>ti\u1ebft ki\u1ec7m ph\u1ea7n m\u1ec1m<\/p>\n

5. D\u1ee5ng c\u1ee5 ri\u00eang trong c\u1eaft c\u1ee5t<\/p>\n

\u00fc Dao: Lo\u1ea1i dao t\u1eeb 15-20cm, 1 con dao c\u00f3 s\u00f3ng d\u00e0y, kh\u1ecfe \u0111\u1ec3 th\u00e1o kh\u1edbp nh\u1ea5t l\u00e0 kh\u1edbp nh\u1ecf<\/p>\n

\u00fc C\u01b0a: c\u01b0a c\u00e1c x\u01b0\u01a1ng nh\u1ecf. C\u01b0a khung kh\u1ecfe h\u01a1n \u0111\u1ec3 c\u01b0a c\u00e1c x\u01b0\u01a1ng l\u1edbn<\/p>\n

\u00fc K\u00ecm c\u1eaft x\u01b0\u01a1ng, g\u1eb7m x\u01b0\u01a1ng: c\u1eaft c\u00e1c x\u01b0\u01a1ng nh\u1ecf ho\u1eb7c g\u1eb7m s\u1eeda \u0111\u1ea7u x\u01b0\u01a1ng<\/p>\n

\u00fc R\u00f3c x\u01b0\u01a1ng v\u00e0 n\u1ea1o x\u01b0\u01a1ng<\/p>\n

\u00fc D\u0169a<\/p>\n

\u00fc \u0110\u0129a v\u00e9n c\u01a1 percy, ho\u1eb7c 1 vu\u00f4ng v\u1ea3i c\u00f3 2-3 d\u1ea3i<\/p>\n

Nh\u1eefng \u0111i\u1ec1u c\u01a1 b\u00e0n \u0111\u1ec3 x\u1eed l\u00fd v\u1ebft th\u01b0\u01a1ng m\u1ea1ch m\u00e1u<\/p>\n

1. \u0110\u01b0\u1eddng r\u1ea1ch \u0111\u1ec3 \u0111i v\u00e0o m\u1ea1ch m\u00e1u<\/p>\n

Trong tr\u01b0\u1eddng h\u1ee3p cho ph\u00e9p th\u00ec r\u1ea1ch theo \u0111\u01b0\u1eddng \u0111\u1ecbnh h\u01b0\u1edbng c\u1ee7a \u0110M \u0111i. Khi t\u1ed5n th\u01b0\u01a1ng qu\u00e1 r\u1ed9ng th\u00ec \u0111\u01b0\u1eddng r\u1ea1ch ph\u1ea3i d\u1ef1a v\u00e0o m\u1ed1i li\u00ean quan v\u1ec1 ph\u1eabu t\u00edch tr\u00ean \u0111\u01b0\u1eddng \u0111\u1ecbnh h\u01b0\u1edbng \u0111\u1ec3 t\u00ecm \u0110M, \u0110M b\u1ecb \u0111\u1ee9t b\u1ecb co l\u1ea1i t\u1ee5t v\u00e0o trong s\u00e2u, \u0111\u01b0\u1eddng r\u1ea1ch c\u0169ng c\u1ea7n ph\u1ea3i t\u00f4n tr\u1ecdng c\u00e1c ngh\u00e0nh b\u00ean v\u00e0 ngh\u00e0nh n\u1ed1i g\u00e2y \u1ea3nh h\u01b0\u1edfng t\u1edbi ch\u1ee9c n\u0103ng ph\u00eda d\u01b0\u1edbi c\u1ee7a chi.<\/p>\n

2. Gi\u1ea3i quy\u1ebft t\u1ed5n th\u01b0\u01a1ng ph\u1ea7n m\u1ec1m<\/p>\n

Ph\u1ea3i ti\u1ebfn h\u00e0nh c\u1eaft l\u1ecdc h\u1ebft t\u1ed5 ch\u1ee9c d\u1eadp n\u00e1t c\u1ee7a ph\u1ea7n m\u1ec1m nh\u01b0 da v\u00e0 c\u01a1. \u0110\u1ed1i v\u1edbi da, n\u1ebfu thi\u1ebfu da th\u00ec v\u1ec1 sau ti\u1ebfn h\u00e0nh gh\u00e9p da, ho\u1eb7c \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o cho l\u01b0u th\u00f4ng m\u1ea1ch m\u00e1u t\u1ed1t c\u1ea7n \u0111\u01b0\u1ee3c quay v\u1ea1t da (nh\u01b0ng v\u1eabn ph\u1ea3i \u0111\u1ea3m b\u1ea3o nguy\u00ean t\u1eafc v\u1ebft th\u01b0\u01a1ng h\u1edf kh\u00f4ng kh\u00e2u k\u00edn). \u0110\u1ed1i v\u1edbi c\u01a1 c\u0169ng ph\u1ea3i l\u1ea5y h\u1ebft t\u1ed5 ch\u1ee9c m\u00f9n n\u00e1t, th\u01b0\u1eddng th\u00ec ng\u01b0\u1eddi ta c\u1eaft cho \u0111\u1ebfn l\u00fac r\u1edbm m\u00e1u l\u00e0 \u0111\u01b0\u1ee3c. N\u1ebfu \u0111i\u1ec1u ki\u1ec7n cho ph\u00e9p th\u00ec l\u00e0m \u0111i\u1ec1m sinh l\u00fd c\u01a1 khi h\u1edf s\u1ebd gi\u1ea3i quy\u1ebft \u0111\u01b0\u1ee3c kh\u00e2u da \u1edf th\u00ec 2: kh\u00e2u ho\u1eb7c gh\u00e9p da<\/p>\n

3. Ki\u1ec3m tra nh\u1eadn x\u00e9t th\u01b0\u01a1ng t\u1ed5n \u0111\u1ec3 c\u00f3 th\u00e1i \u0111\u1ed9 x\u1eed tr\u00ed<\/p>\n

M\u1ea1ch m\u00e1u c\u00f3 th\u1ec3 b\u1ecb th\u01b0\u01a1ng t\u1ed5n d\u01b0\u1edbi d\u1ea1ng \u0111\u1ee9t 1 ph\u1ea7n hay \u0111\u1ee9t to\u00e0n ph\u1ea7n. N\u1ebfu kh\u00f4ng x\u1eed tr\u00ed s\u1ebd d\u1eabn t\u1edbi t\u1eed vong. N\u1ebfu \u0111\u01b0\u1ee3c s\u01a1 c\u1ee9u t\u1ed1t nh\u01b0: g\u1ea3o b\u0103ng \u00e9p, th\u00ec k\u1ebft qu\u1ea3 ph\u1eabu thu\u1eadt s\u1ebd t\u1ed1t. C\u0169ng c\u00f3 khi \u0111\u01b0\u1ee3c t\u1ef1 c\u1ea7m m\u00e1u b\u1edfi c\u00e1c c\u1ee5c m\u00e1u \u0111\u00f4ng \u1edf nh\u1eefng m\u1ea1ch m\u00e1u trung b\u00ecnh v\u00e0 nh\u1ecf, nh\u1ea5t l\u00e0 nh\u1eefng n\u01a1i c\u00f3 ph\u1ea7n c\u01a1 d\u00e0y che ph\u1ee7. Th\u01b0\u01a1ng t\u1ed5n c\u0169ng c\u00f3 th\u1ec3 \u1edf d\u1ea1ng \u0111\u1ee5ng d\u1eadp, \u1ea3nh h\u01b0\u1edfng t\u1edbi l\u1edbp n\u1ed9i m\u1ea1c g\u00e2y co th\u1eaft m\u1ea1ch ho\u1eb7c t\u1eafc m\u1ea1ch.<\/p>\n","protected":false},"excerpt":{"rendered":"

C\u00e2u 1: K\u1ef9 thu\u1eadt kh\u00e2u n\u1ed1i \u1ed1ng ti\u00eau h\u00f3a 1. C\u00e1c \u0111i\u1ec1u ki\u1ec7n c\u1ea7n c\u00f3 c\u1ee7a 1 \u0111\u01b0\u1eddng kh\u00e2u t\u1ed1t :- \u0110\u01b0\u1eddng kh\u00e2u ph\u1ea3i k\u00edn, trung b\u00ecnh 1cm 3 m\u0169i- \u0110\u01b0\u1eddng kh\u00e2u ph\u1ea3i ch\u1eafc, kh\u00f4ng b\u1ee5c ch\u1ec9. Ph\u1ee5 thu\u1ed9c v\u00e0o:+ T\u00ecnh tr\u1ea1ng nu\u00f4i d\u01b0\u1ee1ng c\u1ee7a th\u00e0nh ru\u1ed9t .+ T\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng c\u1ee7a ph\u1eabu thu\u1eadt+ …<\/p>\n","protected":false},"author":10,"featured_media":2202,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[42,49],"tags":[],"class_list":["post-2047","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-mon-ky-nang","category-phau-thuat-thuc-hanh"],"_links":{"self":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2047","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/comments?post=2047"}],"version-history":[{"count":2,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2047\/revisions"}],"predecessor-version":[{"id":2318,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2047\/revisions\/2318"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media\/2202"}],"wp:attachment":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media?parent=2047"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=2047"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=2047"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}