{"id":853,"date":"2021-08-31T09:17:33","date_gmt":"2021-08-31T02:17:33","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=853"},"modified":"2021-08-31T09:17:36","modified_gmt":"2021-08-31T02:17:36","slug":"u-quai-o-tre-em","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/u-quai-o-tre-em\/","title":{"rendered":"U qu\u00e1i \u1edf tr\u1ebb em"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>1. \u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/p>\n\n\n\n<ul><li>U qu\u00e1i l\u00e0 lo\u1ea1i u bao g\u1ed3m nhi\u1ec1u lo\u1ea1i t\u1ebf b\u00e0o c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb 3 l\u00e1 m\u1ea7m th\u1eddi k\u1ef3 ph\u00f4i thai. Kh\u1ed1i u c\u00f3 th\u1ec3 bao g\u1ed3m l\u00f4ng, t\u00f3c, r\u0103ng, x\u01b0\u01a1ng, tuy\u1ebfn gi\u00e1p\u2026<\/li><li>Nguy\u00ean nh\u00e2n c\u1ee7a u qu\u00e1i ch\u01b0a r\u00f5 r\u00e0ng nh\u1eefng gi\u1ea3 thuy\u1ebft \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn nhi\u1ec1u nh\u1ea5t l\u00e0 n\u00f3 c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb c\u00e1c t\u1ebf b\u00e0o m\u1ea7m nguy\u00ean th\u1ee7y.<\/li><li>M\u00f4 h\u1ecdc c\u1ee7a u qu\u00e1i c\u00f3 th\u1ec3 t\u1eeb l\u00e0nh t\u00ednh, bi\u1ec7t h\u00f3a t\u1ed1t (tr\u01b0\u1eddng th\u00e0nh) \u0111\u1ebfn \u00e1c t\u00ednh (ch\u01b0a tr\u01b0\u1edfng th\u00e0nh).<\/li><li>U qu\u00e1i tr\u01b0\u1edfng th\u00e0nh c\u00f3 th\u1ec3 l\u00e0 d\u1ea1ng nang, d\u1ea1ng \u0111\u1eb7c ho\u1eb7c h\u1ed7n h\u1ee3p.<\/li><li>75 \u2013 80% c\u00e1c lo\u1ea1i u qu\u00e1i th\u01b0\u1eddng g\u1eb7p \u1edf n\u1eef, ngo\u1ea1i tr\u1eeb u qu\u00e1i \u1edf tinh ho\u00e0n.<\/li><li>Nh\u1eefng lo\u1ea1i u qu\u00e1i th\u01b0\u1eddng g\u1eb7p<ul><li>U qu\u00e1i c\u00f9ng c\u1ee5t (57%)<\/li><li>U qu\u00e1i sinh h\u1ecdc (29%)<\/li><li>U qu\u00e1i trung th\u1ea5t (7%)<\/li><li>U qu\u00e1i sau ph\u00fac m\u1ea1c (4%)<\/li><li>U qu\u00e1i \u1edf c\u1ed5 (3%)<\/li><li>U qu\u00e1i trong s\u1ecd (3%)&#8230;<\/li><\/ul><\/li><li>Ph\u00e2n \u0111\u1ed9 u qu\u00e1i theo Gonzalez-Crussi<ul><li>0: tr\u01b0\u1edfng th\u00e0nh (l\u00e0nh t\u00ednh)<\/li><li>1: ch\u01b0a tr\u01b0\u1edfng th\u00e0nh, kh\u1ea3 n\u0103ng l\u00e0nh t\u00ednh<\/li><li>2: ch\u01b0a tr\u01b0\u1edfng th\u00e0nh, kh\u1ea3 n\u0103ng \u00e1c t\u00ednh<\/li><li>3: ch\u1eafc ch\u1eafn \u00e1c t\u00ednh<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>2. U qu\u00e1i c\u00f9ng c\u1ee5t<\/strong><\/p>\n\n\n\n<ul><li>U qu\u00e1i c\u00f9ng c\u1ee5t l\u00e0 lo\u1ea1i u th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u1edf \u0111\u1ed9 tu\u1ed5i s\u01a1 sinh, t\u1ea7n su\u1ea5t 1\/40.000-30.000 tr\u1ebb sinh ra s\u1ed1ng.<\/li><li>Th\u01b0\u1eddng g\u1eb7p \u1edf n\u1eef h\u01a1n nam, t\u1ec9 s\u1ed1 nam\/n\u1eef = 1\/3-4.<\/li><li>C\u00e1c b\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh k\u00e8m theo (15%): kh\u00f4ng h\u1eadu m\u00f4n, thi\u1ec3u s\u1ea3n x\u01b0\u01a1ng c\u00f9ng, t\u1eed cung \u00e2m \u0111\u1ea1o \u0111\u00f4i, c\u1ed9t s\u1ed1ng ch\u1ebb \u0111\u00f4i, tho\u00e1t v\u1ecb m\u00e0ng n\u00e3o t\u1ee7y\u2026<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"840\" height=\"199\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/u-quai-1.jpg\" alt=\"\" class=\"wp-image-866\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/u-quai-1.jpg 840w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/u-quai-1-300x71.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/u-quai-1-768x182.jpg 768w\" sizes=\"(max-width: 840px) 100vw, 840px\" \/><figcaption><strong>H\u00ecnh 1: U qu\u00e1i c\u00f9ng c\u1ee5t<\/strong><br><em>\u201cNgu\u1ed3n: Al-Salem, 2014\u201d.<\/em><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ph\u00e2n lo\u1ea1i<\/strong><em><\/em><\/p>\n\n\n\n<p>Theo Altman, chia l\u00e0m 4 nh\u00f3m (h\u00ecnh 2):<\/p>\n\n\n\n<ul><li>Lo\u1ea1i I (45,8%): U ch\u1ee7 y\u1ebfu n\u1eb1m ph\u00eda ngo\u00e0i, m\u1ed9t ph\u1ea7n nh\u1ecf b\u00ean trong tr\u01b0\u1edbc x\u01b0\u01a1ng c\u00f9ng.<\/li><li>Lo\u1ea1i II (34%): U n\u1eb1m c\u1ea3 b\u00ean trong v\u00e0 b\u00ean ngo\u00e0i, 2 ph\u1ea7n t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nhau.<\/li><li>Lo\u1ea1i III (8,6%): U n\u1eb1m ch\u1ee7 y\u1ebfu b\u00ean trong (v\u00f9ng b\u1ee5ng ch\u1eadu), ph\u1ea7n b\u00ean ngo\u00e0i v\u1eabn c\u00f2n nh\u00ecn th\u1ea5y.<\/li><li>Lo\u1ea1i IV (9,6%): U n\u1eb1m ho\u00e0n to\u00e0n b\u00ean trong, kh\u00f4ng th\u1ea5y u b\u00ean ngo\u00e0i.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"795\" height=\"296\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/u-quai-cung-cut-1.jpg\" alt=\"\" class=\"wp-image-867\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/u-quai-cung-cut-1.jpg 795w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/u-quai-cung-cut-1-300x112.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/08\/u-quai-cung-cut-1-768x286.jpg 768w\" sizes=\"(max-width: 795px) 100vw, 795px\" \/><figcaption><strong>H\u00ecnh 2: Ph\u00e2n lo\u1ea1i b\u01b0\u1edbu qu\u00e1i c\u00f9ng c\u1ee5t<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>X\u00e9t nghi\u1ec7m<\/strong><\/p>\n\n\n\n<ul><li>AFP, Beta HCG: t\u0103ng nghi ng\u1edd \u00e1c t\u00ednh.<\/li><li>Si\u00eau \u00e2m: ch\u1ea9n \u0111o\u00e1n, \u0111\u00e1nh gi\u00e1 t\u01b0\u01a1ng quan gi\u1eefa u v\u00e0 c\u00e1c c\u01a1 quan xung quanh (b\u00e0ng quang, tr\u1ef1c tr\u00e0ng, ni\u1ec7u qu\u1ea3n).<\/li><li>CT\/ MRI b\u1ee5ng ch\u1eadu: ch\u1ea9n \u0111o\u00e1n, \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c v\u1ecb tr\u00ed u, m\u1ed1i t\u01b0\u01a1ng quan v\u1edbi c\u00e1c c\u01a1 quan kh\u00e1c, ph\u00e1t hi\u1ec7n di c\u0103n (gan), h\u1ea1ch sau ph\u00fac m\u1ea1c\u2026<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<p><strong><em>Ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc sanh<\/em><\/strong><\/p>\n\n\n\n<ul><li>U qu\u00e1i c\u00f9ng c\u1ee5t c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc sanh nh\u1edd v\u00e0o si\u00eau \u00e2m, nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u1ea7n theo d\u00f5i s\u00e1t trong thai k\u1ef3.<\/li><li>Xem x\u00e9t sanh m\u1ed5 n\u1ebfu c\u1ea7n thi\u1ebft.<\/li><\/ul>\n\n\n\n<p><strong><em>Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/em><\/strong><\/p>\n\n\n\n<ul><li>K\u1ebft h\u1ee3p kh\u00e1m l\u00e2m s\u00e0ng, x\u00e9t nghi\u1ec7m, h\u00ecnh \u1ea3nh h\u1ecdc<\/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>Ph\u1eabu thu\u1eadt c\u1eaft b\u01b0\u1edbu, x\u01b0\u01a1ng c\u1ee5t \u00b1 h\u00f3a tr\u1ecb t\u00f9y theo b\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng<\/li><li>Ph\u1eabu thu\u1eadt s\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t khi t\u00ecnh tr\u1ea1ng n\u1ed9i khoa cho ph\u00e9p v\u00e0 kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh kh\u00e1c. Nguy c\u01a1 \u00e1c t\u00ednh c\u1ee7a u t\u0103ng theo \u0111\u1ed9 tu\u1ed5i.<ul><li>S\u01a1 sinh (\u0111a s\u1ed1 l\u00e0nh t\u00ednh): ph\u1eabu thu\u1eadt c\u1eaft b\u01b0\u1edbu + x\u01b0\u01a1ng c\u1ee5t.<\/li><li>Ngo\u00e0i s\u01a1 sinh:<ul><li>AFP b\u00ecnh th\u01b0\u1eddng: ph\u1eabu thu\u1eadt c\u1eaft c\u01b0\u1edbu + x\u01b0\u01a1ng c\u1ee5t<\/li><li>AFP t\u0103ng: sinh thi\u1ebft \u00e0 h\u00f3a tr\u1ecb \u00e0 ph\u1eabu thu\u1eadt.<\/li><\/ul><\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ti\u00ean l\u01b0\u1ee3ng<\/strong><\/p>\n\n\n\n<ul><li>Ph\u1ee5 thu\u1ed9c v\u00e0o k\u1ebft qu\u1ea3 gi\u1ea3i ph\u1eabu b\u1ec7nh, tu\u1ed5i ph\u1eabu thu\u1eadt\u2026 N\u1ebfu u l\u00e0nh t\u00ednh, t\u1ec9 l\u1ec7 s\u1ed1ng c\u00f2n kh\u00e1 cao &gt; 90%.<\/li><li>Tr\u1ebb d\u01b0\u1edbi 2 th\u00e1ng, t\u1ec9 l\u1ec7 \u00e1c t\u00ednh 7-10%; tr\u1ebb &gt; 2 th\u00e1ng, t\u1ec9 l\u1ec7 \u00e1c t\u00ednh c\u00f3 th\u1ec3 l\u00ean \u0111\u1ebfn 50%.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>T\u00e1i kh\u00e1m theo d\u00f5i<\/strong><\/p>\n\n\n\n<ul><li>Tr\u1ebb c\u1ea7n \u0111\u01b0\u1ee3c t\u00e1i kh\u00e1m theo d\u00f5i (kh\u00e1m l\u00e2m s\u00e0ng, kh\u00e1m tr\u1ef1c tr\u00e0ng, AFP, h\u00ecnh \u1ea3nh h\u1ecdc) theo l\u1ecbch h\u1eb9n v\u00ec u c\u00f3 nguy c\u01a1 t\u00e1i ph\u00e1t th\u1eadm ch\u00ed l\u00e0 u l\u00e0nh.<\/li><li>T\u1ec9 l\u1ec7 t\u00e1i ph\u00e1t u l\u00e0nh kho\u1ea3ng 10-20%, u \u00e1c kho\u1ea3ng 50%.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>3. U qu\u00e1i bu\u1ed3ng tr\u1ee9ng<\/strong><\/p>\n\n\n\n<ul><li>U qu\u00e1i bu\u1ed3ng tr\u1ee9ng l\u00e0 u th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong nh\u00f3m u t\u1ebf b\u00e0o m\u1ea7m c\u1ee7a bu\u1ed3ng tr\u1ee9ng (xem th\u00eam b\u00e0i u \u00e1c bu\u1ed3ng tr\u1ee9ng). Chi\u1ebfm 15 \u2013 20% u bu\u1ed3ng tr\u1ee9ng n\u00f3i chung.<\/li><li>U qu\u00e1i bu\u1ed3ng tr\u1ee9ng \u0111\u01b0\u1ee3c chia th\u00e0nh 3 nh\u00f3m<ul><li>U qu\u00e1i tr\u01b0\u1edfng th\u00e0nh<\/li><li>U qu\u00e1i ch\u01b0a tr\u01b0\u1edfng th\u00e0nh<\/li><li>U qu\u00e1i \u0111\u01a1n b\u00ec (Monodermal teratoma)<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><strong><em>U qu\u00e1i tr\u01b0\u1edfng th\u00e0nh<\/em><\/strong><\/p>\n\n\n\n<ul><li>L\u00e0 m\u1ed9t trong nh\u1eefng d\u1ea1ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a u t\u1ebf b\u00e0o m\u1ea7m<\/li><li>U qu\u00e1i tr\u01b0\u1edfng th\u00e0nh th\u01b0\u1eddng d\u1ea1ng nang hay c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 nang b\u00ec bu\u1ed3ng tr\u1ee9ng (xem th\u00eam b\u00e0i Nang bu\u1ed3ng tr\u1ee9ng)<\/li><li>\u0110a s\u1ed1 u qu\u00e1i tr\u01b0\u1eddng th\u00e0nh l\u00e0 l\u00e0nh t\u00ednh (98%), \u00e1c t\u00ednh (2%).<\/li><li>T\u1ec9 l\u1ec7 m\u1eafc 2 b\u00ean 10-15% tr\u01b0\u1eddng h\u1ee3p.<\/li><li>Th\u00e0nh ph\u1ea7n u qu\u00e1i tr\u01b0\u1edfng th\u00e0nh c\u00f3 th\u1ec3 bao g\u1ed3m nang d\u1ecbch, l\u00f4ng, t\u00f3c, ch\u1ea5t b\u00e3, r\u0103ng, x\u01b0\u01a1ng, s\u1ee5n\u2026<\/li><\/ul>\n\n\n\n<p><strong><em>U qu\u00e1i ch\u01b0a tr\u01b0\u1eddng th\u00e0nh<\/em><\/strong><\/p>\n\n\n\n<ul><li>Nh\u00ecn chung kh\u00e1 hi\u1ebfm g\u1eb7p. Th\u01b0\u1eddng ch\u1ec9 g\u1eb7p \u1edf tr\u1ebb em v\u00e0 ph\u1ee5 n\u1eef tr\u1ebb.<\/li><li>U th\u01b0\u1eddng d\u1ea1ng \u0111\u1eb7c, k\u00edch th\u01b0\u1edbc l\u1edbn, c\u00f3 xu\u1ea5t huy\u1ebft, ho\u1ea1i t\u1eed b\u00ean trong. \u0110a ph\u1ea7n l\u00e0 \u00e1c t\u00ednh, ph\u00e1t tri\u1ec3n nhanh, di c\u0103n r\u1ed9ng.<\/li><li>Th\u00e0nh ph\u1ea7n u qu\u00e1i ch\u01b0a tr\u01b0\u1eddng th\u00e0nh bao b\u1ed3m nh\u1eefng m\u00f4 \u0111ang bi\u1ec7t h\u00f3a c\u1ee7a x\u01b0\u01a1ng, s\u1ee5n, bi\u1ec3u m\u00f4, c\u01a1, th\u1ea7n kinh\u2026<\/li><li>U qu\u00e1i ch\u01b0a tr\u01b0\u1eddng th\u00e0nh \u0111\u01b0\u1ee3c ph\u00e2n th\u00e0nh 3 \u0111\u1ed9 d\u1ef1a tr\u00ean m\u1ee9c \u0111\u1ed9 ch\u01b0a tr\u01b0\u1edfng th\u00e0nh c\u1ee7a c\u00e1c m\u00f4 b\u00ean trong v\u00e0 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a bi\u1ec3u m\u00f4 th\u1ea7n kinh.<\/li><\/ul>\n\n\n\n<p><strong><em>U qu\u00e1i \u0111\u01a1n b\u00ec (Monodermal teratoma)<\/em><\/strong><\/p>\n\n\n\n<ul><li>Th\u01b0\u1eddng ch\u1ec9 ch\u1ee9a nh\u1eefng m\u00f4 c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb 1 trong 3 l\u00e1 m\u1ea7m (ngo\u1ea1i b\u00ec &#8211; trung b\u00ec \u2013 n\u1ed9i b\u00ec) th\u1eddi k\u1ef3 th\u00f4i thai (kh\u00e1c v\u1edbi 2 lo\u1ea1i u qu\u00e1i kia c\u00f3 th\u1ec3 ch\u1ee9a t\u1eeb c\u1ea3 3 l\u00e1 m\u1ea7m)<\/li><li>C\u00f3 th\u1ec3 g\u1eb7p \u1edf tr\u1ebb em v\u00e0 ng\u01b0\u1eddi l\u1edbn. C\u00f3 th\u1ec3 l\u00e0nh t\u00ednh ho\u1eb7c \u00e1c t\u00ednh.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/p>\n\n\n\n<ul><li>C\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd qua kh\u00e1m t\u1ed5ng qu\u00e1t, h\u00ecnh \u1ea3nh h\u1ecdc hay trong l\u00fac ph\u1eabu thu\u1eadt v\u00f9ng b\u1ee5ng (th\u01b0\u1eddng g\u1eb7p trong u qu\u00e1i tr\u01b0\u1edfng th\u00e0nh).<\/li><li>Nh\u1eefng tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p:<ul><li>\u0110au b\u1ee5ng: th\u01b0\u1eddng \u0111au \u00e2m \u1ec9 li\u00ean t\u1ee5c, t\u1eeb nh\u1eb9 t\u1edbi v\u1eeba; th\u01b0\u1eddng do xo\u1eafn ho\u1eb7c xu\u1ea5t huy\u1ebft.<\/li><li>B\u1ee5ng to l\u00ean ho\u1eb7c s\u1edd th\u1ea5y kh\u1ed1i \u1edf b\u1ee5ng,<\/li><li>Ch\u1ea3y m\u00e1u \u00e2m \u0111\u1ea1o b\u1ea5t th\u01b0\u1eddng (do r\u1ed1i lo\u1ea1n \u0111i\u1ec1u h\u00f2a hormone)<\/li><\/ul><\/li><li>Nh\u1eefng tri\u1ec7u ch\u1ee9ng \u00edt g\u1eb7p: bu\u1ed3n n\u00f4n, n\u00f4n \u00f3i, \u0111au l\u01b0ng, r\u1ed1i lo\u1ea1n \u0111i ti\u1ec3u\u2026<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n\n\n\n<ul><li>X\u00e9t nghi\u1ec7m: AFP, Beta HCG t\u0103ng nghi ng\u1edd \u00e1c t\u00ednh.<\/li><li>Si\u00eau \u00e2m b\u1ee5ng<\/li><li>CT scan b\u1ee5ng ch\u1eadu<\/li><li>Gi\u1ea3i ph\u1eabu b\u1ec7nh<\/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>U qu\u00e1i tr\u01b0\u1edfng th\u00e0nh (d\u1ea1ng nang): ph\u1eabu thu\u1eadt c\u1eaft b\u01b0\u1edbu b\u1ea3o t\u1ed3n m\u00f4 bu\u1ed3ng tr\u1ee9ng qua PTNS hay m\u1ed5 m\u1edf.<\/li><li>U qu\u00e1i \u00e1c t\u00ednh: ph\u1eabu thu\u1eadt c\u1eaft bu\u1ed3ng tr\u1ee9ng ch\u1ee9a b\u01b0\u1edbu, ph\u1ea7n ph\u1ee5, c\u1eaft m\u1ea1c n\u1ed1i l\u1edbn, sinh thi\u1ebft h\u1ea1ch v\u00f9ng, r\u1eeda \u1ed5 b\u1ee5ng l\u00e0m cell block. H\u00f3a tr\u1ecb k\u1ebft h\u1ee3p n\u1ebfu c\u1ea7n thi\u1ebft.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ti\u00ean l\u01b0\u1ee3ng v\u00e0 theo d\u00f5i<\/strong><\/p>\n\n\n\n<ul><li>T\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 l\u00e0nh \u00e1c c\u1ee7a u (xem th\u00eam b\u00e0i U \u00e1c bu\u1ed3ng tr\u1ee9ng v\u00e0 Nang bu\u1ed3ng tr\u1ee9ng).<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>4. U qu\u00e1i tinh ho\u00e0n<\/strong><\/p>\n\n\n\n<ul><li>T\u1ea7n xu\u1ea5t g\u1eb7p c\u1ee7a u qu\u00e1i tinh ho\u00e0n 2,1-2,5\/100.000 nam gi\u1edbi. T\u1ea7n su\u1ea5t g\u1eb7p tr\u01b0\u1edbc tu\u1ed5i d\u1eady th\u00ec 0,5-2\/100.000 tr\u1ebb.<\/li><li>U qu\u00e1i tr\u01b0\u1edfng th\u00e0nh chi\u1ebfm 14-27% u qu\u00e1i tinh ho\u00e0n.<\/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>Kh\u1ed1i c\u1ee9ng ch\u1eafc \u1edf b\u00ecu, kh\u00f4ng \u0111au, kh\u00f4ng th\u1ea5u quang (tr\u1eeb khi c\u00f3 k\u1ebft h\u1ee3p th\u1ee7y tinh m\u1ea1c)<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n\n\n\n<ul><li>X\u00e9t nghi\u1ec7m: AFP, Beta HCG, Testosteron, LDH. <\/li><li>Si\u00eau \u00e2m b\u1eb9n b\u00ecu. <\/li><li>XQ ng\u1ef1c<\/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>T\u00f9y theo lo\u1ea1i u, t\u00ednh ch\u1ea5t m\u00f4 h\u1ecdc, giai \u0111o\u1ea1n b\u1ec7nh m\u00e0 c\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p<ul><li>C\u1eaft u b\u1ea3o t\u1ed3n tinh ho\u00e0n<\/li><li>Ph\u1eabu thu\u1eadt c\u1eaft cao tinh ho\u00e0n \u00b1 h\u00f3a tr\u1ecb<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ti\u00ean l\u01b0\u1ee3ng v\u00e0 theo d\u00f5i<\/strong><\/p>\n\n\n\n<ul><li>Ti\u00ean l\u01b0\u1ee3ng t\u00f9y thu\u1ed9c v\u00e0o t\u00ecnh tr\u1ea1ng l\u00e0nh \u00e1c c\u1ee7a kh\u1ed1i u. Tr\u1ebb c\u1ea7n \u0111\u01b0\u1ee3c t\u00e1i kh\u00e1m v\u00e0 theo d\u00f5i theo h\u1eb9n sau xu\u1ea5t vi\u1ec7n.<\/li><\/ul>\n\n\n\n<p>(Tham kh\u1ea3o th\u00eam b\u00e0i U tinh ho\u00e0n)<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>5. U qu\u00e1i trung th\u1ea5t<\/strong><\/p>\n\n\n\n<ul><li>U qu\u00e1i trung th\u1ea5t kh\u00e1 hi\u1ebfm, chi\u1ebfm 8% u \u1edf v\u00f9ng trung th\u1ea5t, th\u01b0\u1eddng \u1edf trung th\u1ea5t tr\u01b0\u1edbc (xem th\u00eam b\u00e0i B\u01b0\u1edbu trung th\u1ea5t \u1edf tr\u1ebb em).<\/li><li>U qu\u00e1i trung th\u1ea5t th\u01b0\u1eddng l\u00e0nh t\u00ednh \u1edf tr\u1ebb em.<\/li><li>U qu\u00e1i trung th\u1ea5t th\u01b0\u1eddng kh\u00f4ng tri\u1ec7u ch\u1ee9ng, th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd qua ch\u1ee5p XQ ng\u1ef1c. Nh\u1eefng tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 g\u1eb7p \u0111au ng\u1ef1c, ho, kh\u00f3 th\u1edf, vi\u00eam ph\u1ed5i t\u00e1i ph\u00e1t, suy h\u00f4 h\u1ea5p (tr\u1ebb s\u01a1 sinh).<\/li><li><strong>\u0110i\u1ec1u tr\u1ecb<\/strong>: ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf u (c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n qua m\u1ed5 m\u1edf ho\u1eb7c m\u1ed5 n\u1ed9i soi) \u00b1 h\u00f3a tr\u1ecb. \u0110\u00e2y l\u00e0 ph\u1eabu thu\u1eadt t\u01b0\u01a1ng \u0111\u1ed1i ph\u1ee9c t\u1ea1p do v\u1ecb tr\u00ed v\u00e0 m\u1ed1i li\u00ean quan c\u1ee7a u g\u1ea7n v\u1edbi c\u00e1c c\u01a1 quan quan tr\u1ecdng (m\u1ea1ch m\u00e1u l\u1edbn tim, th\u1ea7n kinh, kh\u00ed ph\u1ebf qu\u1ea3n\u2026).<\/li><li><strong>Ti\u00ean l\u01b0\u1ee3ng v\u00e0 theo d\u00f5i<\/strong>: ti\u00ean l\u01b0\u1ee3ng kh\u00e1 t\u1ed1t n\u1ebfu u l\u00e0nh t\u00ednh, th\u1eadm ch\u00ed n\u1ebfu u \u00e1c t\u00ednh, t\u1ec9 l\u1ec7 s\u1ed1ng c\u00f2n c\u00f3 th\u1ec3 \u0111\u1ebfn 70% n\u1ebfu \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p. Tr\u1ebb c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i v\u00e0 t\u00e1i kh\u00e1m theo l\u1ecbch h\u1eb9n sau xu\u1ea5t vi\u1ec7n.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>6. U qu\u00e1i sau ph\u00fac m\u1ea1c<\/strong><\/p>\n\n\n\n<ul><li>Kh\u00e1 hi\u1ebfm g\u1eb7p, chi\u1ebfm 3,5-4% u qu\u00e1i \u1edf tr\u1ebb em.<\/li><li>\u0110a s\u1ed1 l\u00e0nh t\u00ednh<\/li><li>Th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb n\u1eef d\u01b0\u1edbi 1 tu\u1ed5i.<\/li><\/ul>\n\n\n\n<p><strong>Tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p<\/strong>: kh\u1ed1i l\u1edbn \u1edf b\u1ee5ng, th\u01b0\u1eddng b\u00ean tr\u00e1i, th\u01b0\u1eddng \u00edt g\u00e2y \u0111au b\u1ee5ng hay nh\u1eefng tri\u1ec7u ch\u1ee9ng kh\u00e1c.<\/p>\n\n\n\n<p><strong>C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n\n\n\n<ul><li>X\u00e9t nghi\u1ec7m m\u00e1u: AFP, betaHCG\u2026<\/li><li>XQ, si\u00eau \u00e2m.<\/li><li>CT scan: ch\u1ea9n \u0111o\u00e1n, \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n, l\u00ean k\u1ebf ho\u1ea1ch ph\u1eabu thu\u1eadt.<\/li><\/ul>\n\n\n\n<p><strong>\u0110i\u1ec1u tr\u1ecb<\/strong>: ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf u \u00b1 h\u00f3a tr\u1ecb.<\/p>\n\n\n\n<p><strong>Ti\u00ean l\u01b0\u1ee3ng v\u00e0 theo d\u00f5i<\/strong>: nh\u00ecn chung ti\u00ean l\u01b0\u1ee3ng kh\u00e1 t\u1ed1t do \u0111a s\u1ed1 u l\u00e0 l\u00e0nh t\u00ednh. Tr\u1ebb c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i v\u00e0 t\u00e1i kh\u00e1m theo l\u1ecbch h\u1eb9n sau xu\u1ea5t vi\u1ec7n.<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong><em>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/em><\/strong><\/p>\n\n\n\n<ul><li>Laberge J.M., Puligandla P.S., and Shaw K. (2020), <em>Teratomas, Dermoids, and Other Soft Tissue Tumors<\/em>, Holcomb and Ashcraft\u2019s Pediatric Surgery, 7th Ed, Elsevier, pp. 1066 \u2013 1081<\/li><li>Al-Salem A.H (2014), <em>Teratoma<\/em>, An illustrated guide to pediatric surgery, Springer, pp. 491-503.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>1. \u0110\u1ea1i c\u01b0\u01a1ng U qu\u00e1i l\u00e0 lo\u1ea1i u bao g\u1ed3m nhi\u1ec1u lo\u1ea1i t\u1ebf b\u00e0o c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb 3 l\u00e1 m\u1ea7m th\u1eddi k\u1ef3 ph\u00f4i thai. Kh\u1ed1i u c\u00f3 th\u1ec3 bao g\u1ed3m l\u00f4ng, t\u00f3c, r\u0103ng, x\u01b0\u01a1ng, <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/u-quai-o-tre-em\/\" title=\"U qu\u00e1i \u1edf tr\u1ebb em\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":4,"featured_media":862,"comment_status":"open","ping_status":"open","sticky":false,"template":"template-full.php","format":"standard","meta":[],"categories":[4,21],"tags":[],"_links":{"self":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/853"}],"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=853"}],"version-history":[{"count":7,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/853\/revisions"}],"predecessor-version":[{"id":872,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/853\/revisions\/872"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/862"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=853"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=853"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=853"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}