{"id":881,"date":"2021-09-02T17:16:28","date_gmt":"2021-09-02T10:16:28","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=881"},"modified":"2021-09-02T17:16:33","modified_gmt":"2021-09-02T10:16:33","slug":"chan-thuong-than-o-tre-em","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/chan-thuong-than-o-tre-em\/","title":{"rendered":"Ch\u1ea5n th\u01b0\u01a1ng th\u1eadn \u1edf tr\u1ebb em"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>\u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/p>\n\n\n\n<ul><li>L\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u ni\u1ec7u nhi khoa, th\u01b0\u1eddng g\u1eb7p trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u0111a ch\u1ea5n th\u01b0\u01a1ng.<\/li><li>Ch\u1ea5n th\u01b0\u01a1ng th\u1eadn th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong t\u1ed5n th\u01b0\u01a1ng h\u1ec7 ni\u1ec7u sinh d\u1ee5c \u1edf tr\u1ebb em.<\/li><li>Chi\u1ebfm 10% trong ch\u1ea5n th\u01b0\u01a1ng b\u1ee5ng k\u00edn.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ph\u00e2n \u0111\u1ed9<\/strong><\/p>\n\n\n\n<p>B\u1ea3ng ph\u00e2n \u0111\u1ed9 ch\u1ea5n th\u01b0\u01a1ng th\u1eadn theo AAST (b\u1ea3ng 1) c\u00f3 5 \u0111\u1ed9 v\u1edbi h\u00ecnh \u1ea3nh minh h\u1ecda (h\u00ecnh 1)<\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong>B\u1ea3ng 1: Ph\u00e2n \u0111\u1ed9 ch\u1ea5n th\u01b0\u01a1ng th\u1eadn<\/strong><\/p>\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\/09\/chan-thuong-than-1-1024x397.jpg\" alt=\"\" class=\"wp-image-885\" width=\"512\" height=\"199\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/chan-thuong-than-1-1024x397.jpg 1024w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/chan-thuong-than-1-300x116.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/chan-thuong-than-1-768x298.jpg 768w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/chan-thuong-than-1.jpg 1073w\" sizes=\"(max-width: 512px) 100vw, 512px\" \/><\/figure><\/div>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\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\/09\/chan-thuong-than-2-1-1024x508.jpg\" alt=\"\" class=\"wp-image-890\" width=\"580\" height=\"287\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/chan-thuong-than-2-1-1024x508.jpg 1024w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/chan-thuong-than-2-1-300x149.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/chan-thuong-than-2-1-768x381.jpg 768w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/chan-thuong-than-2-1.jpg 1070w\" sizes=\"(max-width: 580px) 100vw, 580px\" \/><figcaption><strong>H\u00ecnh 1: Ph\u00e2n \u0111\u1ed9 ch\u1ea5n th\u01b0\u01a1ng th\u1eadn<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<ul><li>H\u1ecfi \u0111\u00e1nh gi\u00e1 k\u0129 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng, th\u1eddi gian v\u00e0 m\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n: v\u1eadt nh\u1ecdn, v\u1eadt t\u00f9, tai n\u1ea1n giao th\u00f4ng, t\u00e9 cao, sinh ho\u1ea1t.<\/li><li>Ti\u1ec1n s\u1eed b\u1ea5t th\u01b0\u1eddng v\u1ec1 b\u1ec7nh l\u00fd th\u1eadn s\u1eb5n c\u00f3: th\u1eadn \u1ee9 n\u01b0\u1edbc, th\u1eadn \u0111a nang, s\u1ecfi th\u1eadn, th\u1eadn \u0111\u00f4i, u th\u1eadn\u2026<\/li><li>Tri\u1ec7u ch\u1ee9ng: \u0111au b\u1ee5ng v\u00f9ng h\u00f4ng l\u01b0ng, t\u00ecnh tr\u1ea1ng m\u1ea5t m\u00e1u c\u1ea5p, ti\u1ec3u m\u00e1u, b\u00e0ng quang c\u0103ng trong nh\u1eefng ch\u1ea5n th\u01b0\u01a1ng n\u1eb7ng.<\/li><li>Kh\u00e1m \u0111\u00e1nh gi\u00e1: t\u1ed5ng tr\u1ea1ng, t\u00ecnh tr\u1ea1ng s\u1ed1c m\u1ea5t m\u00e1u, v\u1ebft th\u01b0\u01a1ng t\u1eeb b\u00ean ngo\u00e0i (n\u1ebfu nguy\u00ean nh\u00e2n do v\u1eadt \u0111\u00e2m v\u00e0o) v\u00e0 ch\u00fa \u00fd ch\u1ea5n th\u01b0\u01a1ng c\u00e1c t\u1ea1ng kh\u00e1c \u0111i k\u00e8m: s\u1ecd n\u00e3o, chi, l\u1ed3ng ng\u1ef1c v\u00e0 t\u1ea1ng trong \u1ed5 b\u1ee5ng.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>M\u1ed9t s\u1ed1 x\u00e9t nghi\u1ec7m c\u1ea7n l\u00e0m?<\/strong><\/p>\n\n\n\n<ul><li>C\u00f4ng th\u1ee9c m\u00e1u, ch\u1ee9c n\u0103ng th\u1eadn, ch\u1ee9c n\u0103ng \u0111\u00f4ng c\u1ea7m m\u00e1u.<\/li><li>X\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u.<\/li><li>Si\u00eau \u00e2m b\u1ee5ng th\u01b0\u1eddng quy c\u1ea7n l\u00e0m khi c\u00f3 ch\u1ea5n th\u01b0\u01a1ng b\u1ee5ng k\u00edn: th\u1ef1c hi\u1ec7n nhanh, \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c th\u01b0\u01a1ng t\u1ed5n v\u00e0 c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c \u0111i k\u00e8m.<\/li><li>Ch\u1ee5p CTscan b\u1ee5ng c\u1ea3n quang khi nghi ng\u1edd ch\u1ea5n th\u01b0\u01a1ng th\u1eadn: v\u1ebft th\u01b0\u01a1ng b\u1ee5ng do v\u1eadt s\u1eafc nh\u1ecdn, tai n\u1ea1n giao th\u00f4ng, t\u00e9 cao tr\u00ean 4-5m, \u0111\u1ee5ng gi\u1eadp khi ch\u01a1i th\u1ec3 thao, ch\u1ea5n th\u01b0\u01a1ng c\u00f3 k\u00e8m g\u00e3y x\u01b0\u01a1ng s\u01b0\u1eddn, c\u1ed9t s\u1ed1ng, x\u01b0\u01a1ng ch\u1eadu\u2026<\/li><li>Ch\u00fa \u00fd c\u1ea7n ti\u1ebfn h\u00e0nh Ctscan ng\u1ef1c v\u00e0 s\u1ecd n\u00e3o \u0111\u1ed3ng th\u1eddi n\u1ebfu c\u00f3 nghi ng\u1edd ch\u1ea5n th\u01b0\u01a1ng c\u00e1c t\u1ea1ng \u0111i k\u00e8m<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u0110i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n<p><strong>Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb chung<\/strong><\/p>\n\n\n\n<ul><li>C\u1ea5p c\u1ee9u ngay khi t\u00ecnh tr\u1ea1ng nguy k\u1ecbch, ch\u1ed1ng s\u1ed1c m\u1ea5t m\u00e1u, do \u0111au (n\u1ebfu c\u00f3).<\/li><li>\u0110i\u1ec1u tr\u1ecb c\u00e1c t\u1ed5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p.<\/li><li>\u0110i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng t\u1ea1i th\u1eadn.<\/li><\/ul>\n\n\n\n<p><strong>\u0110i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n<\/strong><\/p>\n\n\n\n<p>H\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n:<\/p>\n\n\n\n<ul><li>Chia c\u00e1c t\u1ed5n th\u01b0\u01a1ng do ch\u1ea5n th\u01b0\u01a1ng th\u1eadn th\u00e0nh nh\u1eb9 (\u0111\u1ed9 I, II, III) th\u01b0\u1eddng s\u1ebd c\u00f3 t\u00ecnh tr\u1ea1ng huy\u1ebft \u0111\u1ed9ng h\u1ecdc (H\u0110H) \u1ed5n \u0111\u1ecbnh.<\/li><li>Ch\u1ea5n th\u01b0\u01a1ng th\u1eadn \u0111\u1ed9 IV, V kh\u00f4ng k\u00e8m c\u00e1c th\u01b0\u01a1ng t\u1ed5n kh\u00e1c, k\u00e8m theo t\u00ecnh tr\u1ea1ng H\u0110H \u1ed5n \u0111\u1ecbnh.<\/li><\/ul>\n\n\n\n<p><strong>Khi n\u00e0o ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt th\u00e1m s\u00e1t<\/strong><\/p>\n\n\n\n<ul><li>Ch\u1ea5n th\u01b0\u01a1ng t\u1eeb \u0111\u1ed9 IV, V c\u00f3 H\u0110H kh\u00f4ng \u1ed5n \u0111\u1ecbnh.<\/li><li>Ch\u1ea5n th\u01b0\u01a1ng th\u1eadn k\u00e8m c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c ph\u1ed1i h\u1ee3p kh\u00f4ng \u1ed5n \u0111\u1ecbnh khi \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa.<\/li><li>T\u1ed5n th\u01b0\u01a1ng \u0111\u1ebfn c\u00e1c m\u1ea1ch m\u00e1u: t\u1eafc m\u1ea1ch, \u0111\u1ee9t m\u1ea1ch m\u00e1u, ti\u1ec3u m\u00e1u k\u00e9o d\u00e0i ho\u1eb7c v\u1ee1 th\u1eadn b\u1ec7nh l\u00fd: \u1ee9 n\u01b0\u1edbc&#8230;<\/li><\/ul>\n\n\n\n<p><strong>Nguy\u00ean t\u1eafc ph\u1eabu thu\u1eadt<\/strong><\/p>\n\n\n\n<ul><li>H\u1ed3i s\u1ee9c n\u1ed9i khoa tr\u01b0\u1edbc khi can thi\u1ec7p ngo\u1ea1i khoa, \u0111\u00f4i khi v\u1eeba h\u1ed3i s\u1ee9c v\u1eeba ph\u1eabu thu\u1eadt trong t\u00ecnh tr\u1ea1ng n\u1eb7ng t\u1ed5n th\u01b0\u1edbng \u0111\u1ebfn c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn.<\/li><li>X\u1eed l\u00ed t\u1ed5n th\u01b0\u01a1ng t\u1ea1i th\u1eadn v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p.<\/li><li>C\u1eaft th\u1eadn n\u1ebfu t\u1ed5n th\u01b0\u01a1ng qu\u00e1 n\u1eb7ng ho\u1eb7c \u0111\u1ee9t r\u1eddi cu\u1ed1ng th\u1eadn.<\/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>Kh\u1ed1i \u00e1p xe th\u1eadn.<\/li><li>T\u1ee5 d\u1ecbch nhi\u1ec5m tr\u00f9ng ho\u1eb7c t\u1ee5 n\u01b0\u1edbc ti\u1ec3u<\/li><li>Nhi\u1ec5m tr\u00f9ng.<\/li><li>R\u00f2 h\u1ec7 ni\u1ec7u.<\/li><li>Teo th\u1eadn<\/li><li>T\u0103ng huy\u1ebft \u00e1p, suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Theo d\u00f5i v\u00e0 t\u00e1i kh\u00e1m<\/strong><\/p>\n\n\n\n<ul><li>Theo d\u00f5i ti\u1ec3u m\u00e1u trong 1 th\u00e1ng \u0111\u1ea7u.<\/li><li>T\u00e1i kh\u00e1m: 1 tu\u1ea7n, 1 th\u00e1ng, 3 th\u00e1ng, 6 th\u00e1ng.<\/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>L\u00ea T\u1ea5n S\u01a1n, L\u00ea Nguy\u1ec5n Y\u00ean (2018), \u201c Ch\u1ea5n th\u01b0\u01a1ng th\u1eadn \u1edf tr\u1ebb em\u201d. Ngo\u1ea1i nhi l\u00e2m s\u00e0ng, Nh\u00e0 xu\u1ea5t b\u1ea3n Y H\u1ecdc. tr.112-116.<\/li><li>Casale A.J. (2010), \u201cUrinary tract trauma\u201d, Pediatric Urology, 2nd edi, pp. 720-728.<\/li><li>Husmann D.A. (2016), \u201cPediatric genitourinary trauma\u201d, Campbell-Walsh Urolory, 11th edi, pp. 3538-3549.<\/li><li>Moore E.E. (2017), \u201cInjury scoring scale\u201d, The American Association for the surgery of Trauma.<\/li><li>Summerton&nbsp; D.J. (2014), \u201cGuidelines on Urological Trauma\u201d, European Association of Urology, pp. 9-12.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u0110\u1ea1i c\u01b0\u01a1ng L\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u ni\u1ec7u nhi khoa, th\u01b0\u1eddng g\u1eb7p trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u0111a ch\u1ea5n th\u01b0\u01a1ng. Ch\u1ea5n th\u01b0\u01a1ng th\u1eadn th\u01b0\u1eddng g\u1eb7p nh\u1ea5t trong t\u1ed5n th\u01b0\u01a1ng h\u1ec7 ni\u1ec7u sinh d\u1ee5c \u1edf tr\u1ebb em. Chi\u1ebfm <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/chan-thuong-than-o-tre-em\/\" title=\"Ch\u1ea5n th\u01b0\u01a1ng th\u1eadn \u1edf tr\u1ebb em\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":4,"featured_media":895,"comment_status":"open","ping_status":"open","sticky":false,"template":"template-full.php","format":"standard","meta":[],"categories":[4,8],"tags":[],"_links":{"self":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/881"}],"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=881"}],"version-history":[{"count":7,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/881\/revisions"}],"predecessor-version":[{"id":894,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/881\/revisions\/894"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/895"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=881"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=881"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=881"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}