{"id":289,"date":"2021-08-15T08:33:30","date_gmt":"2021-08-15T08:33:30","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=289"},"modified":"2021-08-15T13:58:36","modified_gmt":"2021-08-15T13:58:36","slug":"viem-ruot-thua","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/viem-ruot-thua\/","title":{"rendered":"Vi\u00eam ru\u1ed9t th\u1eeba"},"content":{"rendered":"\n<h2><strong>Ru\u1ed9t th\u1eeba l\u00e0 g\u00ec v\u00e0 khi n\u00e0o ru\u1ed9t th\u1eeba b\u1ecb vi\u00eam?<\/strong><\/h2>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"496\" height=\"409\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/Screenshot-at-Aug-15-15-29-17.png\" alt=\"\" class=\"wp-image-290\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/Screenshot-at-Aug-15-15-29-17.png 496w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/Screenshot-at-Aug-15-15-29-17-300x247.png 300w\" sizes=\"(max-width: 496px) 100vw, 496px\" \/><figcaption><strong>H\u00ecnh 1: v\u1ecb tr\u00ed ru\u1ed9t th\u1eeba v\u00e0 h\u00ecnh \u1ea3nh ru\u1ed9t th\u1eeba<\/strong> <strong>vi\u00eam<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<ul><li>Ru\u1ed9t th\u1eeba l\u00e0 m\u1ed9t b\u1ed9 ph\u1eadn nh\u1ecf nh\u01b0 ng\u00f3n tay c\u00e1i n\u1eb1m \u1edf ph\u00eda d\u01b0\u1edbi b\u00ean ph\u1ea3i c\u1ee7a b\u1ee5ng (90% ru\u1ed9t th\u1eeba n\u1eb1m \u1edf h\u1ed1 ch\u1eadu ph\u1ea3i), c\u00f3 m\u1ed9t \u0111\u1ea7u b\u1ecbt k\u00edn, m\u1ed9t \u0111\u1ea7u th\u00f4ng v\u1edbi manh tr\u00e0ng (\u0111o\u1ea1n \u0111\u1ea7u ti\u00ean c\u1ee7a ru\u1ed9t gi\u00e0).<\/li><li>N\u1ebfu v\u00ec m\u1ed9t nguy\u00ean nh\u00e2n n\u00e0o \u0111\u00f3 l\u00e0m cho l\u00f2ng ru\u1ed9t th\u1eeba b\u1ecb t\u1eafc ngh\u1ebdn (do s\u1ecfi ph\u00e2n, do qu\u00e1 s\u1ea3n t\u1ed5 ch\u1ee9c lympho \u1edf th\u00e0nh ru\u1ed9t th\u1eeba, d\u1ecb v\u1eadt\u2026) s\u1ebd khi\u1ebfn cho ru\u1ed9t th\u1eeba s\u01b0ng l\u00ean t\u1ea1o th\u00e0nh ru\u1ed9t th\u1eeba vi\u00eam:<\/li><li>T\u1eafc ngh\u1ebdn trong l\u00f2ng ru\u1ed9t th\u1eeba l\u00e0 kh\u1edfi \u0111\u1ea7u c\u1ee7a vi\u00eam ru\u1ed9t th\u1eeba<\/li><li>Ph\u00ec \u0111\u1ea1i c\u00e1c nang b\u1ea1ch huy\u1ebft d\u01b0\u1edbi ni\u00eam m\u1ea1c (60%)<\/li><li>S\u1ecfi ph\u00e2n (35%)<\/li><li>V\u1eadt l\u1ea1, nhi\u1ec5m khu\u1ea9n (4%): h\u1ea1t nh\u1ecf tr\u00e1i c\u00e2y, Yersinia, Salmonella, Shigella; virus: s\u1edfi, th\u1ee7y \u0111\u1eadu; k\u00fd sinh tr\u00f9ng: giun \u0111\u0169a<\/li><li>Do b\u01b0\u1edbu th\u00e0nh ru\u1ed9t th\u1eeba hay th\u00e0nh manh tr\u00e0ng \u0111\u00e8 v\u00e0o (1%)<\/li><\/ul>\n\n\n\n<p><strong>Xu\u1ea5t \u0111\u1ed9<\/strong><\/p>\n\n\n\n<ul><li>Vi\u00eam ru\u1ed9t th\u1eeba c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i<\/li><li>Th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb 11-12 tu\u1ed5i<\/li><li>\u00cdt x\u1ea3y ra \u1edf tr\u1ebb nh\u1ecf h\u01a1n 5 tu\u1ed5i (5%), hi\u1ebfm khi x\u1ea3y ra \u1edf tr\u1ebb nh\u1ecf h\u01a1n 1 tu\u1ed5i<\/li><li>Nam th\u01b0\u1eddng g\u1eb7p h\u01a1n n\u1eef (nam: 9%, n\u1eef: 7%)<\/li><\/ul>\n\n\n\n<p><strong>Tri\u1ec7u ch\u1ee9ng<\/strong><\/p>\n\n\n\n<ul><li>Tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a vi\u00eam ru\u1ed9t th\u1eeba l\u00e0 \u0111au v\u00f9ng b\u1ee5ng d\u01b0\u1edbi b\u00ean ph\u1ea3i (c\u00f2n g\u1ecdi l\u00e0 h\u1ed1 ch\u1eadu ph\u1ea3i). Ki\u1ec3u \u0111au c\u1ee7a vi\u00eam ru\u1ed9t th\u1eeba th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u \u1edf v\u00f9ng quanh r\u1ed1n tr\u01b0\u1edbc khi khu tr\u00fa \u1edf h\u1ed1 ch\u1eadu ph\u1ea3i. Tuy nhi\u00ean v\u1edbi tr\u1ebb em, \u0111i\u1ec3m \u0111au r\u1ea5t kh\u00f3 x\u00e1c \u0111\u1ecbnh v\u00ec tr\u1ebb \u0111a ph\u1ea7n g\u1eb7p b\u00e1c s\u0129 l\u00e0 s\u1ee3, k\u00eau kh\u00f3c, kh\u00f4ng mi\u00eau t\u1ea3 \u0111\u01b0\u1ee3c l\u00e0 \u0111au \u1edf \u0111\u00e2u, th\u1eadm ch\u00ed kh\u00e1m b\u1ee5ng ch\u1ed7 n\u00e0o c\u0169ng k\u00eau \u0111au. B\u00e9 th\u01b0\u1eddng n\u1eb1m y\u00ean v\u00e0 khi \u0111i th\u00ec lom khom \u0111\u1ec3 gi\u1ea3m \u0111au.<\/li><li>Tr\u1ebb b\u1ecb vi\u00eam ru\u1ed9t th\u1eeba th\u01b0\u1eddng c\u00f3 m\u00f4i kh\u00f4, l\u01b0\u1ee1i d\u01a1 bi\u1ec3u hi\u1ec7n t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng. Ph\u1ea7n l\u1edbn tr\u1ebb c\u00f3 s\u1ed1t nh\u1eb9, giao \u0111\u1ed9ng 38-38,5 \u0111\u1ed9 C nh\u01b0ng c\u00f3 khi tr\u1ebb kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng n\u00e0y, ch\u1ec9 khi \u0111o\u1ea1n ru\u1ed9t th\u1eeba vi\u00eam b\u1ecb v\u1ee1 th\u00ec m\u1edbi s\u1ed1t cao tr\u00ean 39 \u0111\u1ed9 C.<\/li><li>Ngo\u00e0i ra, b\u00e9 s\u1ebd c\u00f3 t\u00ecnh tr\u1ea1ng m\u1ec7t m\u1ecfi, ch\u00e1n \u0103n, b\u1ee5ng tr\u01b0\u1edbng do ru\u1ed9t b\u1ecb k\u00edch th\u00edch k\u00e8m theo bu\u1ed3n n\u00f4n, n\u00f4n \u00f3i. Ti\u00eau ch\u1ea3y c\u00f3 th\u1ec3 c\u00f3 ho\u1eb7c kh\u00f4ng, nh\u01b0ng n\u1ebfu c\u00f3 s\u1ebd l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng ch\u1ea9n \u0111o\u00e1n. Bi\u1ec3u hi\u1ec7n n\u00f4n v\u00e0 ti\u00eau ch\u1ea3y \u1edf tr\u1ebb vi\u00eam ru\u1ed9t th\u1eeba c\u0169ng d\u1ec5 b\u1ecb nh\u1ea7m v\u1edbi r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a.<\/li><\/ul>\n\n\n\n<p><strong>Quy tr\u00ecnh ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<ul><li>Th\u0103m kh\u00e1m v\u00e0 theo d\u00f5i di\u1ec5n ti\u1ebfn l\u00e2m s\u00e0ng l\u00e0 y\u1ebfu t\u1ed1 quan tr\u1ecdng nh\u1ea5t \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt.<\/li><li>H\u1ecfi b\u1ec7nh: \u0111au b\u1ee5ng b\u1eaft \u0111\u1ea7u khi n\u00e0o v\u00e0 di\u1ec5n ti\u1ebfn ra sao? Tri\u1ec7u ch\u1ee9ng \u0111i k\u00e8m l\u00e0 g\u00ec?<\/li><li>Kh\u00e1m l\u00e2m s\u00e0ng \u1ea5n \u0111au h\u1ed1 ch\u1eadu ph\u1ea3i r\u00f5 v\u00e0 c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n t\u00ecnh tr\u1ea1ng vi\u00eam nhi\u1ec5m lan t\u1ecfa trong \u1ed5 b\u1ee5ng.<\/li><li>C\u1eadn l\u00e2m s\u00e0ng:<\/li><li>X\u00e9t nghi\u1ec7m m\u00e1u c\u00f3 th\u1ec3 th\u1ea5y b\u1ea1ch c\u1ea7u t\u0103ng tr\u00ean 10.000\/mm3 v\u1edbi \u0111a nh\u00e2n trung t\u00ednh chi\u1ebfm \u01b0u th\u1ebf.<\/li><li>Si\u00eau \u00e2m b\u1ee5ng c\u00f3 th\u1ec3 th\u1ea5y \u0111\u01b0\u1eddng k\u00ednh ru\u1ed9t th\u1eeba l\u1edbn h\u01a1n 6mm, s\u1ecfi ph\u00e2n trong l\u00f2ng ru\u1ed9t th\u1eeba v\u00e0 m\u1ed9t s\u1ed1 d\u1ea5u ch\u1ec9 \u0111i\u1ec3m kh\u00e1c<\/li><li>MRI ho\u1eb7c CTscan b\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p kh\u00f3 ch\u1ea9n \u0111o\u00e1n khi b\u1ec7nh nhi c\u00f3 b\u1ec7nh n\u1ec1n hay b\u1ec7nh ph\u1ed1i h\u1ee3p.<\/li><\/ul>\n\n\n\n<p><strong>C\u00e1ch th\u1ee9c \u0111i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n<p><strong><em>Tr\u01b0\u1edbc m\u1ed5<\/em><\/strong><\/p>\n\n\n\n<ul><li>Vi\u00eam ru\u1ed9t th\u1eeba ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng: kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng 1 li\u1ec1u tr\u01b0\u1edbc r\u1ea1ch da 30 ph\u00fat v\u00e0 kh\u00f4ng nh\u1eafc l\u1ea1i sau m\u1ed5<\/li><li>Vi\u00eam ru\u1ed9t th\u1eeba \u0111\u00e3 c\u00f3 bi\u1ebfn ch\u1ee9ng: kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng \u0111\u01b0\u1eddng to\u00e0n th\u00e2n cho c\u1ea3 Gram \u00e2m v\u00e0 y\u1ebfm kh\u00ed<\/li><\/ul>\n\n\n\n<p><strong><em>Ph\u1eabu thu\u1eadt<\/em><\/strong><em><\/em><\/p>\n\n\n\n<ul><li>M\u1ed5 m\u1edf ho\u1eb7c m\u1ed5 n\u1ed9i soi<\/li><li>Vi\u00eam ru\u1ed9t th\u1eeba ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng: ph\u1eabu thu\u1eadt c\u1eaft ru\u1ed9t th\u1eeba<\/li><li>Vi\u00eam ph\u00fac m\u1ea1c khu tr\u00fa: c\u1eaft ru\u1ed9t th\u1eeba, lau ho\u1eb7c r\u1eeda b\u1ee5ng<\/li><li>Vi\u00eam ph\u00fac m\u1ea1c to\u00e0n th\u1ec3: c\u1eaft ru\u1ed9t th\u1eeba, r\u1eeda b\u1ee5ng, c\u00f3 ho\u1eb7c kh\u00f4ng d\u1eabn l\u01b0u t\u00f9y tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3.<\/li><li>\u00c1p xe ru\u1ed9t th\u1eeba: d\u1eabn l\u01b0u \u1ed5 \u00e1p xe, c\u00f3 th\u1ec3 c\u1eaft ru\u1ed9t th\u1eeba n\u1ebfu t\u00ecm th\u1ea5y.<\/li><\/ul>\n\n\n\n<p><strong><em>Ch\u0103m s\u00f3c sau m\u1ed5<\/em><\/strong><\/p>\n\n\n\n<ul><li>S\u1edbm cho tr\u1ebb t\u1eadp v\u1eadn \u0111\u1ed9ng tr\u1edf l\u1ea1i \u0111\u1ec3 tr\u00e1nh bi\u1ebfn ch\u1ee9ng d\u00ednh ru\u1ed9t, v\u00e0 s\u1edbm c\u00f3 nhu \u0111\u1ed9ng ru\u1ed9t.<\/li><li>Kh\u00e1ng sinh \u0111i\u1ec1u tr\u1ecb ti\u1ebfp t\u1ee5c \u00edt nh\u1ea5t 5-7 ng\u00e0y sau m\u1ed5 v\u00e0 khi l\u00e2m s\u00e0ng \u1ed5n \u0111\u1ecbnh trong vi\u00eam ru\u1ed9t th\u1eeba c\u00f3 bi\u1ebfn ch\u1ee9ng<\/li><li>\u0102n u\u1ed1ng l\u1ea1i sau 6 gi\u1edd \u0111\u1ed1i v\u1edbi vi\u00eam ru\u1ed9t th\u1eeba ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng<\/li><li>Vi\u00eam ph\u00fac m\u1ea1c to\u00e0n th\u1ec3 \u0103n u\u1ed1ng l\u1ea1i sau khi c\u00f3 nhu \u0111\u1ed9ng ru\u1ed9t<\/li><li>D\u1eabn l\u01b0u c\u1ea7n \u0111\u01b0\u1ee3c r\u00fat s\u1edbm sau 48 gi\u1edd v\u00e0 kh\u00f4ng n\u00ean l\u01b0u qu\u00e1 5 ng\u00e0y<\/li><\/ul>\n\n\n\n<p><strong>Bi\u1ebfn ch\u1ee9ng<\/strong><\/p>\n\n\n\n<ul><li>Nhi\u1ec5m tr\u00f9ng: v\u1ebft m\u1ed5, \u00e1p xe t\u1ed3n l\u01b0u<\/li><li>Ch\u1ea3y m\u00e1u sau ph\u1eabu thu\u1eadt<\/li><li>B\u1ee5c g\u1ed1c ru\u1ed9t th\u1eeba<\/li><li>T\u1eafc ru\u1ed9t<\/li><\/ul>\n\n\n\n<p><strong>T\u00e1i kh\u00e1m<\/strong><\/p>\n\n\n\n<ul><li>Sau 1 tu\u1ea7n xu\u1ea5t vi\u1ec7n<\/li><li>Sau xu\u1ea5t vi\u1ec7n n\u1ebfu b\u1ec7nh nh\u00e2n \u0111au b\u1ee5ng, b\u1ee5ng tr\u01b0\u1edbng, n\u00f4n \u00f3i th\u00ec, s\u1ed1t cao\u2026 ph\u1ea3i nh\u1eadp vi\u1ec7n ngay.<\/li><\/ul>\n\n\n\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n\n\n\n<ul><li>Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh vi\u1ec7n Nhi \u0110\u1ed3ng 1- 2<\/li><li>B\u1ec7nh h\u1ecdc ngo\u1ea1i khoa ti\u00eau h\u00f3a \u2013 B\u00f4 m\u00f4n ngo\u1ea1i \u2013 \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TP.HCM<\/li><li>Ashcraft\u2019s Pediatric Surgery 5e (2010)<\/li><li>Operative Pediatric Surgery 2<sup>nd<\/sup> McGraw-Hill (2014)<\/li><li>Arnold G. Coran Appendicitis, Pediatric Surgery, seventh edition<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Ru\u1ed9t th\u1eeba l\u00e0 m\u1ed9t b\u1ed9 ph\u1eadn nh\u1ecf nh\u01b0 ng\u00f3n tay c\u00e1i n\u1eb1m \u1edf ph\u00eda d\u01b0\u1edbi b\u00ean ph\u1ea3i c\u1ee7a b\u1ee5ng (90% ru\u1ed9t th\u1eeba n\u1eb1m \u1edf h\u1ed1 ch\u1eadu ph\u1ea3i), c\u00f3 m\u1ed9t \u0111\u1ea7u b\u1ecbt k\u00edn, m\u1ed9t \u0111\u1ea7u th\u00f4ng v\u1edbi manh tr\u00e0ng (\u0111o\u1ea1n \u0111\u1ea7u ti\u00ean c\u1ee7a ru\u1ed9t gi\u00e0). <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/viem-ruot-thua\/\" title=\"Vi\u00eam ru\u1ed9t th\u1eeba\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":2,"featured_media":290,"comment_status":"open","ping_status":"open","sticky":false,"template":"template-full.php","format":"standard","meta":[],"categories":[4,20],"tags":[],"_links":{"self":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/289"}],"collection":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/comments?post=289"}],"version-history":[{"count":1,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/289\/revisions"}],"predecessor-version":[{"id":291,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/289\/revisions\/291"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/290"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=289"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=289"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=289"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}