{"id":605,"date":"2021-08-21T10:01:59","date_gmt":"2021-08-21T10:01:59","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=605"},"modified":"2021-08-21T10:02:10","modified_gmt":"2021-08-21T10:02:10","slug":"thoat-vi-hoanh-bam-sinh","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/thoat-vi-hoanh-bam-sinh\/","title":{"rendered":"Tho\u00e1t v\u1ecb ho\u00e0nh b\u1ea9m sinh"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>\u0110\u1ecbnh ngh\u0129a<\/strong><\/p>\n\n\n\n<p>Tho\u00e1t v\u1ecb ho\u00e0nh b\u1ea9m sinh bi\u1ec3u hi\u1ec7n b\u1edfi s\u1ef1 khi\u1ebfm khuy\u1ebft c\u1ee7a c\u01a1 ho\u00e0nh m\u00e0 qua \u0111\u00f3 m\u1ed9t ho\u1eb7c nhi\u1ec1u c\u01a1 quan trong \u1ed5 b\u1ee5ng nh\u01b0 ru\u1ed9t, d\u1ea1 d\u00e0y, l\u00e1ch, gan\u2026 chui l\u00ean l\u1ed3ng ng\u1ef1c. Tr\u1ebb tho\u00e1t v\u1ecb ho\u00e0nh b\u1ea9m sinh th\u01b0\u1eddng k\u00e8m v\u1edbi suy h\u00f4 h\u1ea5p \u1edf nhi\u1ec1u m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau (tr\u1ebb kh\u00f4ng th\u1edf hi\u1ec7u qu\u1ea3) v\u00ec ph\u1ed5i v\u00e0 m\u1ea1ch m\u00e1u ph\u1ed5i b\u00ean tho\u00e1t v\u1ecb ho\u00e0nh k\u00e9m ph\u00e1t tri\u1ec3n.<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>T\u1ea7n su\u1ea5t<\/strong><\/p>\n\n\n\n<ul><li>T\u1ef7 l\u1ec7 1\/2.000 \u2013 1\/5.000 tr\u1ebb sinh s\u1ed1ng<\/li><li>80% l\u00e0 tho\u00e1t v\u1ecb ho\u00e0nh \u1edf b\u00ean tr\u00e1i (khe Bochdalek), d\u01b0\u1edbi 5% l\u00e0 tho\u00e1t v\u1ecb ho\u00e0nh 2 b\u00ean, 15% l\u00e0 tho\u00e1t v\u1ecb b\u00ean ph\u1ea3i. M\u1ed9t s\u1ed1 hi\u1ebfm g\u1eb7p tho\u00e1t v\u1ecb ho\u00e0nh ph\u00eda tr\u01b0\u1edbc (qua khe Morgagni)<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Nguy\u00ean nh\u00e2n<\/strong><\/p>\n\n\n\n<p>Do y\u1ebfu t\u1ed1 b\u1ea9m sinh g\u00e2y khuy\u1ebft m\u1ed9t ph\u1ea7n hay to\u00e0n b\u1ed9 c\u01a1 ho\u00e0nh<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>D\u1ea5u hi\u1ec7u nh\u1eadn bi\u1ebft tr\u1ebb b\u1ecb tho\u00e1t v\u1ecb ho\u00e0nh?<\/strong><\/p>\n\n\n\n<ul><li>D\u1ea5u hi\u1ec7u suy h\u00f4 h\u1ea5p: th\u1edf nhanh, t\u00edm t\u00e1i, c\u00f3 th\u1ec3 x\u1ea3y ra s\u1edbm ngay sau sanh ho\u1eb7c v\u00e0i gi\u1edd sau sanh ho\u1eb7c x\u1ea3y ra mu\u1ed9n v\u1edbi t\u00ecnh tr\u1ea1ng vi\u00eam ph\u1ed5i t\u00e1i ph\u00e1t<\/li><li>Nghe ph\u1ed5i: ph\u1ebf \u00e2m gi\u1ea3m m\u1ed9t b\u00ean, ti\u1ebfng ru\u1ed9t trong l\u1ed3ng ng\u1ef1c<\/li><li>M\u1ecfm tim l\u1ec7ch ph\u1ea3i<\/li><li>B\u1ee5ng l\u00f5m<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>X\u00e9t nghi\u1ec7m h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<ul><li>X quang ph\u1ed5i c\u00f3 b\u00f3ng h\u01a1i d\u1ea1 d\u00e0y hay ru\u1ed9t trong l\u1ed3ng ng\u1ef1c, trung th\u1ea5t b\u1ecb \u0111\u1ea9y v\u1ec1 b\u00ean \u0111\u1ed1i di\u1ec7n, kh\u00f4ng th\u1ea5y v\u00f2m ho\u00e0nh.<\/li><li>X quang d\u1ea1 d\u00e0y c\u1ea3n quang: ch\u1ec9 \u0111\u1ecbnh trong tr\u01b0\u1eddng h\u1ee3p X quang ph\u1ed5i ch\u01b0a x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n. Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y th\u1ea5y thu\u1ed1c c\u1ea3n quang trong d\u1ea1 d\u00e0y, ru\u1ed9t n\u1eb1m trong l\u1ed3ng ng\u1ef1c.<\/li><li>Si\u00eau \u00e2m ng\u1ef1c b\u1ee5ng: th\u1ea5y h\u00ecnh \u1ea3nh m\u1ed9t s\u1ed1 c\u01a1 quan trong \u1ed5 b\u1ee5ng n\u1eb1m trong l\u1ed3ng ng\u1ef1c.<\/li><li>Si\u00eau \u00e2m tim: tim l\u1ec7ch ph\u1ea3i, \u0111\u00e1nh gi\u00e1 \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, t\u00ecm d\u1ecb t\u1eadt tim b\u1ea9m sinh ph\u1ed1i h\u1ee3p<\/li><li>Kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-1.jpg\" alt=\"\" class=\"wp-image-607\" width=\"351\" height=\"340\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-1.jpg 468w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-1-300x290.jpg 300w\" sizes=\"(max-width: 351px) 100vw, 351px\" \/><figcaption><strong>H\u00ecnh 1: H\u00ecnh \u1ea3nh ru\u1ed9t v\u00e0 d\u1ea1 d\u00e0y tr\u00ean ng\u1ef1c tr\u00e1i<\/strong><br><em>Ngu\u1ed3n: Newborn Surgery, 3<sup>rd<\/sup> Edition<\/em>.<\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>C\u00f3 c\u1ea7n ph\u1eabu thu\u1eadt hay kh\u00f4ng?<\/strong><\/p>\n\n\n\n<p>\u0110\u00e2y l\u00e0 m\u1ed9t d\u1ecb t\u1eadt b\u1ea9m sinh c\u1ea7n ph\u1ea3i ph\u1eabu thu\u1eadt.<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Th\u1eddi \u0111i\u1ec3m ph\u1eabu thu\u1eadt<\/strong><\/p>\n\n\n\n<ul><li>Kh\u00f4ng ph\u1ea3i l\u00e0 ph\u1eabu thu\u1eadt c\u1ea5p c\u1ee9u<\/li><li>\u0110\u00e2y l\u00e0 m\u1ed9t ph\u1eabu thu\u1eadt c\u00f3 tr\u00ec ho\u00e3n sau khi \u1ed5n \u0111\u1ecbnh l\u00e2m s\u00e0ng, kh\u00ed m\u00e1u v\u00e0 t\u00ecnh tr\u1ea1ng cao \u00e1p ph\u1ed5i<\/li><li>C\u00e1c b\u00e1c s\u0129 khoa h\u1ed3i s\u1ee9c, b\u00e1c s\u0129 g\u00e2y m\u00ea v\u00e0 b\u00e1c s\u0129 ph\u1eabu thu\u1eadt vi\u00ean s\u1ebd h\u1ed9i \u00fd v\u1edbi nhau \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh th\u1eddi \u0111i\u1ec3m ph\u1eabu thu\u1eadt t\u1ed1t nh\u1ea5t cho tr\u1ebb<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Chu\u1ea9n b\u1ecb tr\u01b0\u1edbc m\u1ed5<\/strong><\/p>\n\n\n\n<ul><li>\u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc m\u1ed5: m\u1ee9c \u0111\u1ed9 suy h\u00f4 h\u1ea5p, d\u1ecb t\u1eadt k\u00e8m theo (20%), vi\u00eam ph\u1ed5i, v\u00e0ng da, nhi\u1ec5m tr\u00f9ng huy\u1ebft\u2026<\/li><li>Gi\u1eef \u1ea5m<\/li><li>N\u1eb1m \u0111\u1ea7u cao 30<sup>0<\/sup>, nghi\u00eang b\u00ean tho\u00e1t v\u1ecb \u0111\u1ec3 gi\u1ea3m ch\u00e8n \u00e9p ph\u1ed5i.<\/li><li>Nh\u1ecbn b\u00fa, \u0111\u1eb7t \u1ed1ng th\u00f4ng d\u1ea1 d\u00e0y \u0111\u1ec3 gi\u1ea3m ch\u00e8n \u00e9p ph\u1ed5i do c\u0103ng d\u1ea1 d\u00e0y.<\/li><li>H\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p: ch\u1ec9 gi\u00fap th\u1edf b\u1eb1ng \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n, kh\u00f4ng gi\u00fap th\u1edf b\u1eb1ng m\u1eb7t n\u1ea1 v\u00ec kh\u00ed v\u00e0o \u0111\u01b0\u1eddng ti\u00eau h\u00f3a g\u00e2y ch\u00e8n \u00e9p ph\u1ed5i tr\u1ea7m tr\u1ecdng<\/li><li>Thi\u1ebft l\u1eadp \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch.<\/li><li>\u0110i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i, toan ki\u1ec1m, ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft.<\/li><li>Kh\u00e1ng sinh ch\u00edch t\u0129nh m\u1ea1ch<\/li><li>Ch\u00edch vitamin K1<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt<\/strong><\/p>\n\n\n\n<ul><li>C\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt n\u1ed9i soi hay m\u1ed5 m\u1edf<\/li><li>M\u1ee5c \u0111\u00edch: \u0111\u01b0a t\u1ea1ng tho\u00e1t v\u1ecb tr\u1edf l\u1ea1i \u1ed5 b\u1ee5ng v\u00e0 ph\u1ee5c h\u1ed3i c\u01a1 ho\u00e0nh. Vi\u1ec7c ph\u1ee5c h\u1ed3i c\u01a1 ho\u00e0nh c\u00f3 th\u1ec3 b\u1eb1ng c\u00e1c c\u00e1ch sau<ul><li>Kh\u00e2u l\u1ed7 tho\u00e1t v\u1ecb b\u1eb1ng ch\u1ec9 kh\u00f4ng tan<\/li><li>N\u1ebfu l\u1ed7 tho\u00e1t v\u1ecb kh\u00e1 l\u1edbn ho\u1eb7c khi\u1ebfm khuy\u1ebft c\u1ea3 c\u01a1 ho\u00e0nh: b\u00e1c s\u0129 ph\u1eabu thu\u1eadt vi\u00ean ph\u1ea3i s\u1eed d\u1ee5ng t\u1ea5m gh\u00e9p nh\u00e2n t\u1ea1o hay t\u1ef1 th\u00e2n nh\u01b0 c\u00e2n c\u01a1, v\u1ea1c c\u01a1 g\u1ea7n \u0111\u00f3 \u0111\u1ec3 thay th\u1ebf c\u01a1 ho\u00e0nh.<\/li><\/ul><\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-2.jpg\" alt=\"\" class=\"wp-image-608\" width=\"666\" height=\"275\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-2.jpg 888w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-2-300x124.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-2-768x317.jpg 768w\" sizes=\"(max-width: 666px) 100vw, 666px\" \/><figcaption><strong>H\u00ecnh 2: Mang ru\u1ed9t xu\u1ed1ng b\u1ee5ng v\u00e0 kh\u00e2u l\u1ea1i c\u01a1 ho\u00e0nh <\/strong><br><em>Ngu\u1ed3n: Pediatric Surgery Atlas, Springer<\/em>.<\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-3.jpg\" alt=\"\" class=\"wp-image-609\" width=\"324\" height=\"317\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-3.jpg 432w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/thoat-vi-hoanh-3-300x294.jpg 300w\" sizes=\"(max-width: 324px) 100vw, 324px\" \/><figcaption><strong>H\u00ecnh 3. Kh\u00e2u ph\u1ee5c h\u1ed3i c\u01a1 ho\u00e0nh b\u1eb1ng m\u1ea3nh gh\u00e9p <\/strong><br><em>Ngu\u1ed3n: Pediatric Surgery Atlas, Springer.<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u0103m s\u00f3c sau m\u1ed5<\/strong><\/p>\n\n\n\n<ul><li>Sau ph\u1eabu thu\u1eadt, b\u00e9 \u0111\u01b0\u1ee3c chuy\u1ec3n v\u1ec1 khoa h\u1ed3i s\u1ee9c<\/li><li>Gi\u1eef \u1ea5m, n\u1eb1m \u0111\u1ea7u cao, h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p<\/li><li>Nh\u1ecbn \u0103n \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, nu\u00f4i \u0103n t\u0129nh m\u1ea1ch ho\u00e0n to\u00e0n t\u1eeb 2 -3 ng\u00e0y, sau \u0111\u00f3 nu\u00f4i \u0103n \u0111\u01b0\u1eddng mi\u1ec7ng ho\u1eb7c qua th\u00f4ng d\u1ea1 d\u00e0y<\/li><li>Ki\u1ec3m tra kh\u00ed m\u00e1u 1 gi\u1edd sau m\u1ed5, v\u00e0 X quang ph\u1ed5i 6 gi\u1edd sau m\u1ed5.<\/li><li>\u0110i\u1ec1u tr\u1ecb cao \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n n\u1ebfu c\u00f3.<\/li><li>Ch\u0103m s\u00f3c v\u1ebft th\u01b0\u01a1ng m\u1ed7i ng\u00e0y v\u00e0 c\u1eaft ch\u1ec9 sau 07 ng\u00e0y.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Bi\u1ebfn ch\u1ee9ng<\/strong><\/p>\n\n\n\n<ul><li>Tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i, x\u1eb9p ph\u1ed5i<\/li><li>Nhi\u1ec5m tr\u00f9ng nh\u01b0 vi\u00eam ph\u1ed5i, nhi\u1ec5m tr\u00f9ng huy\u1ebft, nhi\u1ec5m tr\u00f9ng ti\u1ec3u\u2026<\/li><li>Tho\u00e1t v\u1ecb ho\u00e0nh t\u00e1i ph\u00e1t (5 \u2013 20%) c\u00e1c tr\u01b0\u1eddng h\u1ee3p tho\u00e1t v\u1ecb ho\u00e0nh b\u1ea9m sinh \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt n\u00f3i chung, v\u00e0 kho\u1ea3ng 30 % cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p d\u00f9ng m\u1ea3nh gh\u00e9p nh\u00e2n t\u1ea1o.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>T\u00e1i kh\u00e1m<\/strong><\/p>\n\n\n\n<p>Sau xu\u1ea5t vi\u1ec7n 1 tu\u1ea7n, 3 th\u00e1ng, 6 th\u00e1ng, 1 n\u0103m.<\/p>\n\n\n\n<p><strong><em>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/em><\/strong><\/p>\n\n\n\n<ul><li>Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Ngo\u1ea1i nhi B\u1ec7nh vi\u1ec7n Nhi \u0110\u1ed3ng 1- 2.<\/li><li>Prem Puri and Takashi Doi. Congenital Diaphragmatic Hernia. Newborn Surgery, 3<sup>rd<\/sup> Edition, 2011<\/li><li>Prem Puri. Congenital Diaphragmatic Hernia and Eventration. Pediatric Surgery Atlas, Springer, 2006.<\/li><li>KuoJen Tsao, MD, Kevin P.Lally,MD. Congenital Diaphragmatic Hernia and Eventration. Ashcraft\u2019s Pediatric Surgery, 5<sup>th<\/sup> Edition,2010.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u0110\u1ecbnh ngh\u0129a Tho\u00e1t v\u1ecb ho\u00e0nh b\u1ea9m sinh bi\u1ec3u hi\u1ec7n b\u1edfi s\u1ef1 khi\u1ebfm khuy\u1ebft c\u1ee7a c\u01a1 ho\u00e0nh m\u00e0 qua \u0111\u00f3 m\u1ed9t ho\u1eb7c nhi\u1ec1u c\u01a1 quan trong \u1ed5 b\u1ee5ng nh\u01b0 ru\u1ed9t, d\u1ea1 d\u00e0y, l\u00e1ch, gan\u2026 chui l\u00ean <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/thoat-vi-hoanh-bam-sinh\/\" title=\"Tho\u00e1t v\u1ecb ho\u00e0nh b\u1ea9m sinh\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":4,"featured_media":607,"comment_status":"open","ping_status":"open","sticky":false,"template":"template-full.php","format":"standard","meta":[],"categories":[4,18],"tags":[],"_links":{"self":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/605"}],"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\/4"}],"replies":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/comments?post=605"}],"version-history":[{"count":4,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/605\/revisions"}],"predecessor-version":[{"id":612,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/605\/revisions\/612"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/607"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=605"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=605"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=605"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}