{"id":378,"date":"2021-08-16T09:45:29","date_gmt":"2021-08-16T09:45:29","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=378"},"modified":"2021-08-17T16:52:17","modified_gmt":"2021-08-17T16:52:17","slug":"tui-thua-meckel","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/tui-thua-meckel\/","title":{"rendered":"T\u00fai th\u1eeba Meckel"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>T\u00fai<\/strong><strong> th\u1eeba Meckel l\u00e0 g\u00ec?<\/strong><\/p>\n\n\n\n<ul><li>Trong giai \u0111o\u1ea1n b\u00e0o thai, trong cu\u1ed1n r\u1ed1n c\u1ee7a thai nhi c\u00f3 nhi\u1ec1u c\u1ea5u tr\u00fac kh\u00e1c nhau bao g\u1ed3m m\u1ea1ch m\u00e1u cu\u1ed1ng r\u1ed1n, \u1ed1ng no\u00e3n ho\u00e0n v\u00e0 \u1ed1ng ni\u1ec7u r\u1ed1n\u2026 Ru\u1ed9t c\u1ee7a thai nhi th\u00f4ng n\u1ed1i v\u1edbi t\u00fai no\u00e3n ho\u00e0n qua \u1ed1ng no\u00e3n ho\u00e0n v\u00e0 c\u1ea5u tr\u00fac n\u00e0y s\u1ebd ti\u00eau bi\u1ebfn \u0111i khi tr\u1ebb \u0111\u01b0\u1ee3c sinh ra.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"678\" height=\"256\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/tui-thua-1.jpg\" alt=\"\" class=\"wp-image-383\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/tui-thua-1.jpg 678w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/tui-thua-1-300x113.jpg 300w\" sizes=\"(max-width: 678px) 100vw, 678px\" \/><figcaption><strong>H\u00ecnh 1: T\u00fai th\u1eeba Meckel\u2019s<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<ul><li>\u1ede kho\u1ea3ng 2% d\u00e2n s\u1ed1, \u1ed1ng no\u00e3n ho\u00e0n kh\u00f4ng ti\u00eau bi\u1ebfn ho\u00e0n to\u00e0n h\u00ecnh th\u00e0nh t\u00fai th\u1eeba Meckel\u2019s, \u0111a s\u1ed1 ho\u00e0n to\u00e0n kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh l\u00ed g\u00ec. M\u1ed9t s\u1ed1 \u00edt bi\u1ec3u hi\u1ec7n b\u1ec7nh n\u1eb7ng v\u00e0 c\u00f3 th\u1ec3 ph\u1ea3i can thi\u1ec7p ph\u1eabu thu\u1eadt.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Tri\u1ec7u ch\u1ee9ng<\/strong><\/p>\n\n\n\n<ul><li>N\u1ebfu ru\u1ed9t th\u00f4ng th\u01b0\u01a1ng ho\u00e0n to\u00e0n v\u1edbi th\u00e0nh b\u1ee5ng, ph\u00e2n c\u00f3 th\u1ec3 tho\u00e1t ra t\u1ea1i r\u1ed1n l\u00e0m vi\u00eam, \u01b0\u1edbt r\u1ed1n v\u00e0 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n d\u1ec5 d\u00e0ng.<\/li><li>N\u1ebfu ch\u1ec9 c\u00f3 d\u00e2y x\u01a1 ho\u1eb7c kh\u00f4ng d\u00ednh v\u1edbi th\u00e0nh b\u1ee5ng, bi\u1ebfn ch\u1ee9ng c\u1ee7a t\u00fai th\u1eeba Merckel\u2019s c\u00f3 th\u1ec3 g\u1ed3m nh\u1eefng tr\u01b0\u1eddng h\u1ee3p sau:<\/li><li>Bi\u1ec3u hi\u1ec7n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a t\u00fai th\u1eeba Meckel\u2019s l\u00e0 xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 (40-60%). Th\u01b0\u1eddng tr\u1ebb bi\u1ec3u hi\u1ec7n b\u1eb1ng nh\u1eefng d\u1ea5u hi\u1ec7u: \u0111i ti\u00eau ph\u00e2n \u0111en, h\u00f4i tanh. C\u00f3 th\u1ec3 ph\u00e2n \u0111\u1ecf t\u01b0\u01a1i n\u1ebfu ch\u1ea3y m\u00e1u l\u01b0\u1ee3ng nhi\u1ec1u.<\/li><li>Tr\u1ebb c\u00f3 th\u1ec3 b\u1ecb l\u1ed3ng ru\u1ed9t th\u1ee9 ph\u00e1t v\u00e0 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au b\u1ee5ng h\u01a1n, kh\u00f3c th\u00e9t, n\u00f4n \u00f3i. Ru\u1ed9t c\u00f3 th\u1ec3 xoay quanh d\u00e2y d\u00ednh l\u00ean th\u00e0nh b\u1ee5ng v\u00e0 g\u00e2y xo\u1eafn ru\u1ed9t, tr\u1ebb \u0111au nhi\u1ec1u, n\u00f4n \u00f3i, b\u1ee5ng ch\u01b0\u1edbng, c\u00f3 th\u1ec3 g\u00e2y ho\u1ea1i t\u1eed ru\u1ed9t.<\/li><li>T\u00fai th\u1eeba Meckel\u2019s b\u1ecb vi\u00eam cho tri\u1ec7u ch\u1ee9ng b\u1ec7nh g\u1ea7n gi\u1ed1ng v\u1edbi vi\u00eam ru\u1ed9t th\u1eeba v\u00e0 th\u01b0\u1eddng l\u00e0m nh\u1ea7m l\u1eabn. Ch\u1ec9 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n trung l\u00fac m\u1ed5.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<ul><li>C\u00f3 l\u1ebd vi\u1ec7c kh\u00e1m v\u00e0 h\u1ecfi b\u1ec7nh s\u1ef1 l\u00e0 quan tr\u1ecdng nh\u1ea5t. C\u00e1c c\u1eadn l\u00e2m s\u00e0ng nh\u01b0 si\u00eau \u00e2m, X Quang \u00edt c\u00f3 gi\u00e1 tr\u1ecb trong ch\u1ea9n \u0111o\u00e1n.<\/li><li>C\u00e1c k\u0129 thu\u1eadt kh\u00e1c nh\u01b0 ch\u1ee5p nh\u1ea5p nh\u00e1y \u0111\u1ed3, n\u1ed9i soi b\u1eb1ng camera con nh\u1ed9ng, ch\u1ee5p h\u00ecnh m\u1ea1ch m\u00e1u\u2026 \u00edt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng.<\/li><li>Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p kh\u00f3, n\u1ed9i soi \u1ed5 b\u1ee5ng th\u00e1m s\u00e1t c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u0110i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n<ul><li>\u0110i\u1ec1u tr\u1ecb b\u1eaft \u0111\u1ea7u b\u1eb1ng vi\u1ec7c h\u1ed3i s\u1ee9c cho tr\u1ebb: b\u00f9 n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i, truy\u1ec1n m\u00e1u n\u1ebfu c\u1ea7n. Chu\u1ea9n b\u1ecb c\u00e1c c\u1eadn l\u00e2m s\u00e0ng n\u1ebfu c\u1ea7n ph\u1eabu thu\u1eadt kh\u1ea9n nh\u01b0: huy\u1ebft \u0111\u1ed3, ch\u1ee9c n\u0103ng \u0111\u00f4ng m\u00e1u, ion \u0111\u1ed3.<\/li><li>Tr\u1ebb nh\u1eadp vi\u1ec7n v\u00ec xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a d\u01b0\u1edbi s\u1ebd \u0111\u01b0\u1ee3c h\u1eb9n l\u1ecbch n\u1ed9i soi b\u00e1n kh\u1ea9n ti\u00eau h\u00f3a d\u01b0\u1edbi v\u00e0 ch\u1ea9n \u0111o\u00e1n c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y xu\u1ea5t huy\u1ebft. N\u1ed9i soi ti\u00eau h\u00f3a d\u01b0\u1edbi c\u00f3 th\u1ec3 kh\u00f4ng th\u1ea5y \u0111\u01b0\u1ee3c t\u00fai th\u1eeba Meckel\u2019s nh\u01b0ng gi\u00fap lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c \u1edf ru\u1ed9t gi\u00e0.<\/li><li>Trong b\u1ec7nh c\u1ea3nh l\u1ed3ng ru\u1ed9t non, tr\u1ebb s\u1ebd \u0111\u01b0\u1ee3c b\u01a1m h\u01a1i th\u00e1o l\u1ed3ng c\u1ea5p c\u1ee9u. N\u1ebfu th\u00e0nh c\u00f4ng, tr\u1ebb s\u1ebd \u0111\u01b0\u1ee3c can thi\u1ec7p ph\u1eabu thu\u1eadt sau \u0111\u00f3. Ng\u01b0\u1ee3c l\u1ea1i n\u1ebfu th\u1ea5t b\u1ea1i, tr\u1ebb s\u1ebd \u0111\u01b0\u1ee3c chuy\u1ec3n m\u1ed5 ngay.<\/li><li>Vi\u00eam t\u00fai th\u1eeba th\u01b0\u1eddng \u0111\u01b0\u1ee3c m\u1ed5 c\u1ea5p c\u1ee9u, c\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c tr\u01b0\u1edbc m\u1ed5 hay ch\u1ec9 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n trong m\u1ed5.<\/li><li>Ph\u1eabu thu\u1eadt nh\u1eb1m m\u1ee5c \u0111\u00edch c\u1eaft b\u1ecf t\u00fai th\u1eeba v\u00e0 lo\u1ea1i b\u1ecf c\u00e1c tri\u1ec7u ch\u1ee9ng, bi\u1ebfn ch\u1ee9ng. \u0110\u1ea7u ti\u00ean, tr\u1ebb s\u1ebd \u0111\u01b0\u1ee3c n\u1ed9i soi \u1ed5 b\u1ee5ng th\u00e1m s\u00e1t h\u00ecnh d\u1ea1ng v\u00e0 v\u1ecb tr\u00ed c\u1ee7a t\u00fai th\u1eeba. N\u1ebfu ch\u00e2n tui th\u1eeba nh\u1ecf c\u00f3 th\u1ec3 s\u1ebd \u0111\u01b0\u1ee3c c\u1eaft ngay trong n\u1ed9i soi (h\u00ecnh 2). Ng\u01b0\u1ee3c l\u1ea1i n\u1ebfu ch\u00e2n t\u00fai th\u1eeba l\u1edbn, ho\u1eb7c kh\u00f3 kh\u0103n khi th\u1ef1c hi\u1ec7n qua n\u1ed9i soi, vi\u1ec7c c\u1eaft t\u00fai th\u1eeba s\u1ebd \u0111\u01b0\u1ee3c chuy\u1ec3n sang m\u1ed5 m\u1edf qua l\u1ed7 ch\u00e2n trocar (h\u00ecnh 3).<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"718\" height=\"332\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/tui-thua-2.jpg.png\" alt=\"\" class=\"wp-image-384\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/tui-thua-2.jpg.png 718w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/tui-thua-2.jpg-300x139.png 300w\" sizes=\"(max-width: 718px) 100vw, 718px\" \/><figcaption><strong>H\u00ecnh 2: N\u1ed9i soi c\u1eaft t\u00fai th\u1eeba Meckel\u2019s<\/strong><br><em>Ngu\u1ed3n: Ashcraft\u2019s Pediatric Surgery, 2010; Operative Pediatric Surgery 2013<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"656\" height=\"280\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/tui-thua-3.jpg\" alt=\"\" class=\"wp-image-385\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/tui-thua-3.jpg 656w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/tui-thua-3-300x128.jpg 300w\" sizes=\"(max-width: 656px) 100vw, 656px\" \/><figcaption><strong>H\u00ecnh 3: Chuy\u1ec3n m\u1ed5 m\u1edf c\u1eaft t\u00fai th\u1eeba Meckel\u2019s<\/strong><br><em>Ngu\u1ed3n: Operative Pediatric Surgery 2013<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<ul><li>Sau m\u1ed5 tr\u1ebb s\u1ebd ph\u1ea3i nh\u1ecbn \u0103n kho\u1ea3ng 2-3 ng\u00e0y, sau \u0111\u00f3 tr\u1ebb \u0111\u01b0\u1ee3c u\u1ed1ng n\u01b0\u1edbc \u0111\u01b0\u1eddng. Khi nhu \u0111\u1ed9ng ru\u1ed9t t\u00e1i l\u1eadp ho\u00e0n to\u00e0n tr\u1ebb c\u00f3 th\u1ec3 \u0103n u\u1ed1ng b\u00ecnh th\u01b0\u1eddng. Thay b\u0103ng v\u1ebft m\u1ed5 h\u1eb1ng ng\u00e0y, ch\u1ec9 tan s\u1ebd t\u1ef1 ti\u00eau.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Bi\u1ebfn<\/strong><strong> ch\u1ee9ng<\/strong><\/p>\n\n\n\n<ul><li>Nhi\u1ec5m tr\u00f9ng v\u1ebft m\u1ed5<\/li><li>Ch\u1ea3y m\u00e1u ra m\u1ed5<\/li><li>X\u00ec n\u01a1i kh\u00e2u n\u1ed1i \u1edf ru\u1ed9t<\/li><li>T\u1eafc ru\u1ed9t do d\u00ednh<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>T\u00e1i<\/strong><strong> kh\u00e1m<\/strong><\/p>\n\n\n\n<ul><li>T\u00e1i kh\u00e1m sau 1 tu\u1ea7n v\u00e0 c\u1eaft ch\u1ec9<\/li><li>T\u00e1i kh\u00e1m sau 1 th\u00e1ng, 6 th\u00e1ng ho\u1eb7c khi c\u00f3 g\u00ec l\u1ea1<\/li><\/ul>\n\n\n\n<p><strong><em>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/em><\/strong><\/p>\n\n\n\n<ul><li>Kurt P. Schropp et Carissa L. Garey (2010), Meckel\u2019s Diverticulum, Ashcraft\u2019s Pediatric Surgery, pp: 526-531<\/li><li>Spencer W Beasley (2013),Vitellointestinal (Omphalomesenteric) Duct Anomalies, Operative Pediatric Surgery, pp: 445-457<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>T\u00fai th\u1eeba Meckel l\u00e0 g\u00ec? Trong giai \u0111o\u1ea1n b\u00e0o thai, trong cu\u1ed1n r\u1ed1n c\u1ee7a thai nhi c\u00f3 nhi\u1ec1u c\u1ea5u tr\u00fac kh\u00e1c nhau bao g\u1ed3m m\u1ea1ch m\u00e1u cu\u1ed1ng r\u1ed1n, \u1ed1ng no\u00e3n ho\u00e0n v\u00e0 \u1ed1ng ni\u1ec7u r\u1ed1n\u2026 <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/tui-thua-meckel\/\" title=\"T\u00fai th\u1eeba Meckel\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":3,"featured_media":383,"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\/378"}],"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\/3"}],"replies":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/comments?post=378"}],"version-history":[{"count":3,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/378\/revisions"}],"predecessor-version":[{"id":440,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/378\/revisions\/440"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/383"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=378"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=378"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=378"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}