{"id":21497,"date":"2021-07-27T08:57:03","date_gmt":"2021-07-27T01:57:03","guid":{"rendered":"https:\/\/e1ship.com\/?p=21497"},"modified":"2021-08-09T14:33:21","modified_gmt":"2021-08-09T07:33:21","slug":"phau-thuat-dong-kinh-khang-thuoc","status":"publish","type":"post","link":"https:\/\/e1ship.com\/phau-thuat-dong-kinh-khang-thuoc.html","title":{"rendered":"PH\u1eaaU THU\u1eacT \u0110\u1ed8NG KINH KH\u00c1NG THU\u1ed0C"},"content":{"rendered":"<h2 style=\"text-align: justify;\"><strong>1. T\u1ed5ng quan<\/strong><\/h2>\n<p style=\"text-align: justify;\">\u0110\u00f4\u0323ng kinh cu\u0323c b\u00f4\u0323 kha\u0301ng thu\u00f4\u0301c l\u00e0 m\u1ed9t nh\u00f3m b\u1ec7nh l\u00fd ph\u1ee9c t\u1ea1p trong chuy\u00ean ng\u00e0nh th\u00e2\u0300n kinh, b\u1ec7nh \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u00e1c c\u01a1n \u0111\u1ed9ng kinh t\u00e1i ph\u00e1t dai d\u1eb3ng kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c kha\u0301ng \u0111\u1ed9ng kinh (k\u1ec3 c\u1ea3 ph\u1ed1i h\u1ee3p nhi\u1ec1u thu\u1ed1c kh\u00e1ng \u0111\u1ed9ng kinh li\u1ec1u cao) k\u00e8m theo m\u1ed9t t\u1ed5n th\u01b0\u01a1ng g\u00e2y \u0111\u1ed9ng kinh khu tr\u00fa t\u1ea1i m\u1ed9t ba\u0301n c\u1ea7u \u0111\u1ea1i n\u00e3o. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u tr\u00ean th\u1ebf gi\u1edbi \u0111\u00e3 cho th\u1ea5y \u0111\u1ed9ng kinh c\u1ee5c b\u1ed9 kh\u00e1ng thu\u1ed1c chi\u1ebfm t\u1eeb 15-25% t\u1ed5ng s\u1ed1 b\u1ec7nh nh\u00e2n m\u1eafc \u0111\u1ed9ng kinh v\u00e0 c\u00f3 t\u1edbi 60% b\u1ec7nh nh\u00e2n m\u1eafc \u0111\u1ed9ng kinh kh\u1edfi ph\u00e1t c\u1ee5c b\u1ed9 sau n\u00e0y s\u1ebd tr\u1edf th\u00e0nh \u0111\u1ed9ng kinh kh\u00e1ng thu\u1ed1c.<\/p>\n<p style=\"text-align: justify;\">C\u00e1c c\u01a1n \u0111\u1ed9ng kinh t\u00e1i ph\u00e1t kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t s\u1ebd g\u00e2y ra h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng nh\u01b0: thi\u1ebfu oxy n\u00e3o, ch\u1eadm, r\u1ed1i lo\u1ea1n ph\u00e1t tri\u1ec3n t\u00e2m th\u1ea7n &#8211; v\u1eadn \u0111\u1ed9ng, c\u00f3 th\u1ec3 g\u00e2y th\u01b0\u01a1ng t\u00edch, tai n\u1ea1n, nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng. Ngo\u00e0i ra b\u1ec7nh nh\u00e2n ph\u1ea3i ch\u1ecbu c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a vi\u1ec7c ph\u1ea3i s\u1eed d\u1ee5ng nhi\u1ec1u thu\u1ed1c kh\u00e1ng \u0111\u1ed9ng kinh \u0111\u1ed3ng th\u1eddi \u1edf li\u1ec1u cao v\u00e0 k\u00e9o d\u00e0i.<\/p>\n<p style=\"text-align: justify;\">Nh\u1edd c\u00e1c ti\u1ebfn b\u1ed9 v\u1ec1 th\u0103m d\u00f2 ch\u1ea9n \u0111o\u00e1n v\u00e0 can thi\u1ec7p \u0111i\u1ec1u tr\u1ecb, ng\u00e0y c\u00e0ng nhi\u1ec1u c\u00e1c b\u1ec7nh nh\u00e2n m\u1eafc \u0111\u1ed9ng kinh c\u1ee5c b\u1ed9 kh\u00e1ng thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u1eaft c\u01a1n ho\u1eb7c gi\u1ea3m c\u01a1n t\u1ed1i \u0111a b\u1eb1ng ph\u1eabu thu\u1eadt l\u1ea5y b\u1ecf t\u1ed5n th\u01b0\u01a1ng n\u00e3o g\u00e2y \u0111\u1ed9ng kinh.<\/p>\n<p style=\"text-align: justify;\">Tr\u00ean th\u1ebf gi\u1edbi,vi\u1ec7c ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb \u0111\u1ed9ng kinh c\u1ee5c b\u1ed9 kh\u00e1ng thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp, do nhi\u1ec1u t\u00e1c gi\u1ea3, cho k\u1ebft qu\u1ea3 \u0111\u00e1ng kh\u00edch l\u1ec7. Theo Stefano Francione v\u00e0 c\u1ed9ng s\u1ef1 cho th\u1ea5y sau ph\u1eabu thu\u1eadt c\u00f3 t\u1edbi 68% b\u1ec7nh nh\u00e2n h\u1ebft gi\u1eadt ho\u00e0n to\u00e0n, k\u00e8m theo s\u1ef1 c\u1ea3i thi\u1ec7n r\u00f5 r\u1ec7t v\u1ec1 ph\u00e1t tri\u1ec3n t\u00e2m th\u1ea7n -v\u1eadn \u0111\u1ed9ng.<\/p>\n<p style=\"text-align: justify;\">T\u1ea1i Vi\u1ec7t Nam, t\u1eeb n\u0103m 2010, B\u1ec7nh vi\u1ec7n Nhi Trung \u01b0\u01a1ng l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u00e3 \u00e1p d\u1ee5ng ph\u1eabu thu\u1eadt.<\/p>\n<h2 style=\"text-align: justify;\"><strong>2. C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y \u0111\u1ed9ng kinh c\u1ee5c b\u1ed9 kh\u00e1ng thu\u1ed1c \u1edf tr\u1ebb em<\/strong><\/h2>\n<p style=\"text-align: justify;\">B\u1ec7nh \u0111\u1ed9ng kinh \u1edf tr\u1ebb em c\u00f3 nhi\u1ec1u nguy\u00ean nh\u00e2n g\u00e2y ra :<\/p>\n<p>&#8211; C\u00e1c lo\u1ea1n s\u1ea3n v\u1ecf n\u00e3o: chi\u1ebfm 42%<\/p>\n<p>&#8211; C\u00e1c u l\u00e0nh t\u00ednh h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng: chi\u1ebfm 19%<\/p>\n<p>&#8211; Sau nhi\u1ec5m khu\u1ea9n h\u1ec7 TK trung \u01b0\u01a1ng\/tai bi\u1ebfn m\u1ea1ch n\u00e3o\/ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o: chi\u1ebfm 10%<\/p>\n<p>&#8211; M\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n kh\u00e1c (ph\u1ea3n \u1ee9ng t\u0103ng sinh m\u00f4 TK \u0111\u1ec7m, kh\u00f4ng t\u00ecm th\u1ea5y nguy\u00ean nh\u00e2n): 7%<\/p>\n<p>&#8211; X\u01a1 h\u00f3a h\u1ed3i h\u1ea3i m\u00e3: 6%<\/p>\n<p>&#8211; B\u1ec7nh x\u01a1 h\u00f3a c\u1ee7: 5%<\/p>\n<p>&#8211; U m\u00f4 th\u1eeba v\u00f9ng d\u01b0\u1edbi \u0111\u1ed3i: 4%<\/p>\n<p>&#8211; H\u1ed9i ch\u1ee9ng Sturge Weber: 3%<\/p>\n<p>&#8211; C\u00e1c t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch n\u00e3o: 1%<\/p>\n<h2 style=\"text-align: justify;\"><strong>3. Vai tr\u00f2 c\u1ee7a \u0110i\u1ec7n n\u00e3o \u0111\u1ed3 trong \u0111i\u1ec1u tr\u1ecb \u0111\u1ed9ng kinh<\/strong><\/h2>\n<p>&#8211; Ch\u1ea9n \u0111o\u00e1n v\u1ecb tr\u00ed \u1ed5 \u0111\u1ed9ng kinh<\/p>\n<p>&#8211; Ch\u1ea9n \u0111o\u00e1n h\u1ed9i ch\u1ee9ng \u0111\u1ed9ng kinh, th\u1ec3 \u0111\u1ed9ng kinh (c\u1ee5c b\u1ed9 hay to\u00e0n th\u1ec3).<\/p>\n<p>&#8211; Ph\u00e1t hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng (c\u01a1n \u0111\u1ed9ng kinh) tr\u00ean l\u00e2m s\u00e0ng<\/p>\n<p style=\"text-align: justify;\">Ghi \u0111i\u1ec7n n\u00e3o \u0111\u1ed3 n\u1ed9i s\u1ecd (l\u1ea7n \u0111\u1ea7u ti\u00ean th\u1ef1c hi\u1ec7n t\u1ea1i Vi\u1ec7t Nam)<\/p>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-21500\" src=\"https:\/\/e1ship.com\/wp-content\/uploads\/2021\/07\/01.png\" alt=\"\" width=\"600\" height=\"390\" \/><\/p>\n<p style=\"text-align: justify;\">C\u00e1c \u0111i\u1ec7n c\u1ef1c n\u1ed9i s\u1ecd c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u1eb7t trong nhu m\u00f4 n\u00e3o, d\u01b0\u1edbi m\u00e0ng c\u1ee9ng, s\u1eed d\u1ee5ng \u0111\u1ec3 ghi v\u00e0 k\u00edch th\u00edch, cho ph\u00e9p \u0111\u00e1nh gi\u00e1 m\u1ed1i quan h\u1ec7 gi\u1eefa t\u1ed5n th\u01b0\u01a1ng \u0110K v\u00e0 v\u1ecf n\u00e3o ch\u1ee9c n\u0103ng.<\/p>\n<p style=\"text-align: justify;\">C\u00e1c l\u01b0\u1edbi d\u01b0\u1edbi m\u00e0ng c\u1ee9ng c\u00f3 th\u1ec3 ghi m\u1ed9t v\u00f9ng v\u1ecf n\u00e3o ti\u1ebfp gi\u00e1p l\u1edbn h\u01a1n v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng khi c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u0110K ti\u1ebfp gi\u00e1p v\u1edbi v\u1ecf n\u00e3o ch\u1ee9c n\u0103ng.<\/p>\n<p style=\"text-align: justify;\">T\u1eeb \u0111\u00f3 cho ph\u00e9p x\u00e2y d\u1ef1ng b\u1ea3n \u0111\u1ed3 c\u1ee7a v\u1ecf n\u00e3o v\u1eadn \u0111\u1ed9ng, c\u1ea3m gi\u00e1c c\u0169ng nh\u01b0 l\u1eadp b\u1ea3n \u0111\u1ed3 c\u00e1c khu v\u1ef1c ng\u00f4n ng\u1eef, ti\u1ebfp thu bi\u1ec3u c\u1ea3m v\u00e0 c\u0169ng c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh r\u00e3nh trung t\u00e2m. V\u00ec v\u1eady \u0111i\u1ec7n n\u00e3o \u0111\u1ed3 n\u1ed9i s\u1ecd l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 ch\u1ee9ng minh ho\u1eb7c b\u00e1c b\u1ecf v\u00f9ng kh\u1edfi ph\u00e1t c\u01a1n \u0111\u1ed9ng kinh \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t.<\/p>\n<h2 style=\"text-align: justify;\"><strong>4. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng ph\u1eabu thu\u1eadt<\/strong><\/h2>\n<p style=\"text-align: justify;\">\u0110\u1ec3 ti\u1ebfn t\u1edbi ph\u1eabu thu\u1eadt, c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 g\u1ea7n nh\u01b0 theo \u0111\u00fang nh\u1eefng chu\u1ea9n m\u1ef1c hi\u1ec7n \u0111ang \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng t\u1ea1i c\u00e1c trung t\u00e2m l\u1edbn tr\u00ean th\u1ebf gi\u1edbi chuy\u00ean v\u1ec1 \u0111\u1ed9ng kinh kh\u00e1ng thu\u1ed1c\/ph\u1eabu thu\u1eadt \u0111\u1ed9ng kinh.<\/p>\n<p style=\"text-align: justify;\">Ph\u1eabu thu\u1eadt \u0111\u1ed9ng kinh t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi Trung \u01b0\u01a1ng \u0111\u1ea1t k\u1ebft qu\u1ea3 t\u1ed1t, \u00edt tai bi\u1ebfn c\u0169ng nh\u01b0 bi\u1ebfn ch\u1ee9ng. Ph\u1eabu thu\u1eadt l\u00e0 l\u1ef1a ch\u1ecdn c\u00f3 gi\u00e1 tr\u1ecb \u0111\u1ed1i v\u1edbi tr\u1ebb em b\u1ecb \u0111\u1ed9ng kinh kh\u00e1ng thu\u1ed1c, c\u00f3 k\u1ebft qu\u1ea3 t\u1ed1t trong m\u1ed9t s\u1ed1 l\u01b0\u1ee3ng \u0111\u00e1ng k\u1ec3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p.<\/p>\n<p style=\"text-align: justify;\">Ph\u1eabu thu\u1eadt \u0111\u1ed9ng kinh l\u00e0 c\u1eaft b\u1ecf ch\u1ecdn l\u1ecdc m\u1ed9t v\u00f9ng b\u1ec7nh l\u00fd c\u1ee7a b\u1ed9 n\u00e3o &#8211; v\u00f9ng sinh \u0111\u1ed9ng kinh. \u0110\u00e2y l\u00e0 m\u1ed9t ph\u1eabu thu\u1eadt \u0111\u00f2i h\u1ecfi r\u1ea5t nghi\u00eam ng\u1eb7t v\u1ec1 \u0111\u1ed9 ch\u00ednh x\u00e1c v\u00e0 \u0111\u1ed9 an to\u00e0n, ch\u1ec9 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf c\u00e1c trung t\u00e2m l\u1edbn chuy\u00ean s\u00e2u v\u1ec1 ngo\u1ea1i th\u1ea7n kinh v\u00e0 \u0111\u1ed9ng kinh<\/p>\n<p style=\"text-align: justify;\">Ngo\u00e0i c\u00e1c nguy\u00ean t\u1eafc c\u01a1 b\u1ea3n c\u1ee7a vi\u1ec7c c\u1eaft b\u1ecf \u0111\u1ec3 b\u1ea3o t\u1ed3n ranh gi\u1edbi c\u1ee7a n\u00e3o l\u00e0nh, vi\u1ec7c t\u00f4n tr\u1ecdng c\u00e1c m\u1eb7t ph\u1eb3ng gi\u1ea3i ph\u1eabu \u1edf c\u1ea3 v\u1ecf n\u00e3o s\u00e2u v\u00e0 b\u1ec1 ngo\u00e0i l\u00e0 \u0111i\u1ec1u c\u1ea7n thi\u1ebft. H\u01b0\u1edbng d\u1eabn h\u00ecnh \u1ea3nh h\u1ed7 tr\u1ee3 (navigation), k\u00ednh hi\u1ec3n vi, m\u00e1y h\u00fat si\u00eau \u00e2m (CUSA) gi\u00fap lo\u1ea1i b\u1ecf m\u00f4 ch\u00ednh x\u00e1c.<\/p>\n<p style=\"text-align: justify;\">Do v\u1eady, c\u1ea7n c\u00e2n nh\u1eafc k\u1ef9 t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3 khi ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt. Hi\u1ec7n nay c\u00e1c nh\u00e0 chuy\u00ean m\u00f4n cho r\u1eb1ng ph\u1eabu thu\u1eadt \u0111\u1ed9ng kinh \u1edf tr\u1ebb em n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t n\u1ebfu c\u00f3 ch\u1ec9 \u0111\u1ecbnh .<\/p>\n<p style=\"text-align: justify;\">Kh\u1ea3o s\u00e1t ILAE n\u0103m 2004 cho th\u1ea5y 81% ca ph\u1eabu thu\u1eadt \u0111\u1ed9ng kinh \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean b\u1ec7nh nhi, nh\u1eb1m ki\u1ec3m so\u00e1t c\u01a1n gi\u1eadt b\u1eb1ng lo\u1ea1i b\u1ecf c\u00e1c ph\u1ea7n c\u1ee7a n\u00e3o .<\/p>\n<p style=\"text-align: justify;\">\u1ede Vi\u1ec7t Nam hi\u1ec7n nay, B\u1ec7nh vi\u1ec7n Nhi Trung \u01b0\u01a1ng l\u00e0 \u0111\u01a1n v\u1ecb \u0111i \u0111\u1ea7u v\u00e0 c\u0169ng l\u00e0 duy nh\u1ea5t \u00e1p d\u1ee5ng ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb \u0110K c\u1ee5c b\u1ed9 kh\u00e1ng thu\u1ed1c v\u1edbi c\u00e1c b\u01b0\u1edbc ph\u00e1t tri\u1ec3n:<\/p>\n<p>&#8211; C\u1eaft h\u1ed3i h\u1ea3i m\u00e3 &amp; th\u00f9y th\u00e1i d\u01b0\u01a1ng (2010)<\/p>\n<p>&#8211; C\u1eaft th\u00f9y tr\u00e1n (2011)<\/p>\n<p>&#8211; C\u1eaft b\u00e1n c\u1ea7u gi\u1ea3i ph\u1eabu (2011)<\/p>\n<p>&#8211; C\u1eaft th\u00f9y \u0111\u1ec9nh (2013)<\/p>\n<p>&#8211; C\u1eaft t\u1ed5n th\u01b0\u01a1ng \u0111a th\u00f9y (2013)<\/p>\n<p>&#8211; C\u1eaft th\u1ec3 trai (2013)<\/p>\n<p>&#8211; C\u1eaft th\u00f9y ch\u1ea9m (2015)<\/p>\n<p>&#8211; C\u1eaft b\u00e1n c\u1ea7u ch\u1ee9c n\u0103ng \u201chemispherotomy\u201d (2016)<\/p>\n<p>&#8211; Ghi \u0111i\u1ec7n v\u1ecf n\u00e3o \u201cIntraOp ECoG\u201d (2017)<\/p>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-21501\" src=\"https:\/\/e1ship.com\/wp-content\/uploads\/2021\/07\/A-2.png\" alt=\"\" width=\"800\" height=\"522\" \/><\/p>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-21502 size-full\" src=\"https:\/\/e1ship.com\/wp-content\/uploads\/2021\/07\/A-3.jpg\" alt=\"\" width=\"800\" height=\"627\" \/><\/p>\n<p style=\"text-align: center;\"><strong>M\u1ed9t s\u1ed1 h\u00ecnh \u1ea3nh minh h\u1ecda b\u1ea5t th\u01b0\u1eddng tr\u00ean PET<\/strong><\/p>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-21503 size-full\" src=\"https:\/\/e1ship.com\/wp-content\/uploads\/2021\/07\/A-44.jpg\" alt=\"\" width=\"800\" height=\"495\" \/><\/p>\n<h2 style=\"text-align: justify;\"><strong>5. Quy tr\u00ecnh ph\u1eabu thu\u1eadt<\/strong><\/h2>\n<p>&#8211; Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n: b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ng\u1eebng thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh tr\u01b0\u1edbc ph\u1eabu thu\u1eadt 2 ng\u00e0y, v\u1ec7 sinh c\u01a1 th\u1ec3, c\u00e1c x\u00e9t nghi\u1ec7m c\u01a1 b\u1ea3n, kh\u00e1ng sinh d\u1ef1 ph\u00f2ng\u2026<\/p>\n<p>&#8211; X\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c v\u00f9ng \u0111\u1ed9ng kinh. Li\u00ean quan v\u1edbi v\u00f9ng ch\u1ee9c n\u0103ng, c\u00e1c b\u00f3 d\u1eabn truy\u1ec1n v\u00e0 h\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u.<\/p>\n<p>&#8211; R\u1ea1ch da, m\u1edf x\u01b0\u01a1ng, m\u1edf m\u00e0ng c\u1ee9ng (d\u1ef1a v\u00e0o h\u1ec7 th\u1ed1ng \u0111\u1ecbnh v\u1ecb Navigation)<\/p>\n<p>&#8211; L\u00e0m \u0111i\u1ec7n n\u00e3o \u0111\u1ed3 b\u1ec1 m\u1eb7t (h\u1ea1 li\u1ec1u thu\u1ed1c g\u00e2y m\u00ea, \u0111\u1ec3 xu\u1ea5t hi\u1ec7n s\u00f3ng \u0111\u1ed9ng kinh). H\u1ea1n ch\u1ebf d\u00f9ng manitol v\u00e0 thu\u1ed1c l\u1ee3i ti\u1ec3u trong m\u1ed5.<\/p>\n<p>&#8211; C\u1eaft b\u1ecf v\u00f9ng sinh \u0111\u1ed9ng kinh b\u1eb1ng dao \u0111i\u1ec7n l\u01b0\u1ee1ng c\u1ef1c, dao si\u00eau \u00e2m (CUSA) d\u01b0\u1edbi k\u00ednh hi\u1ec3n vi \u0111i\u1ec7n t\u1eed c\u00f3 k\u1ebft n\u1ed1i h\u1ec7 th\u1ed1ng \u0111\u1ecbnh v\u1ecb. X\u00e1c \u0111\u1ecbnh tr\u01b0\u1edbc ranh gi\u1edbi, tr\u00e1nh t\u1ed5n th\u01b0\u01a1ng c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn, c\u00e1c \u0111\u01b0\u1eddng d\u1eabn truy\u1ec1n v\u00e0 c\u00e1c v\u00f9ng ch\u1ee9c n\u0103ng.<\/p>\n<p>&#8211; L\u00e0m l\u1ea1i \u0111i\u1ec7n n\u00e3o \u0111\u1ed3 b\u1ec1 m\u1eb7t (xem h\u1ebft s\u00f3ng \u0111\u1ed9ng kinh)<\/p>\n<p>&#8211; C\u1ea7m m\u00e1u k\u1ef9 di\u1ec7n c\u1eaft b\u1eb1ng dao \u0111i\u1ec7n l\u01b0\u1ee1ng c\u1ef1c t\u1ea7n s\u1ed1 nh\u1ecf, keo sinh h\u1ecdc, ch\u1ea5t c\u1ea7m m\u00e1u (surgicell)<\/p>\n<p>&#8211; \u0110\u1eb7t d\u1eabn l\u01b0u n\u00e3o th\u1ea5t v\u00e0 d\u1eabn l\u01b0u \u00e1p l\u1ef1c \u1edf h\u1ed1 m\u1ed5<\/p>\n<p>&#8211; Kh\u00e2u ph\u1ee5c h\u1ed3i m\u00e0ng c\u1ee9ng b\u1eb1ng ch\u1ec9 Prolen 6\/0<\/p>\n<p>&#8211; Gh\u00e9p x\u01b0\u01a1ng b\u1eb1ng v\u00edt t\u1ef1 ti\u00eau ( Invis Locks)<\/p>\n<p>&#8211; Kh\u00e2u da v\u00e0 t\u1ed5 ch\u1ee9c d\u01b0\u1edbi da b\u1eb1ng ch\u1ec9 Vicril 5\/0.<\/p>\n<p>&#8211; Duy tr\u00ec th\u1edf m\u00e1y t\u0103ng th\u00f4ng kh\u00ed t\u1ea1i khoa h\u1ed3i s\u1ee9c v\u00e0 cho BN t\u1ec9nh d\u1ea7n sau 24 gi\u1edd. X\u00e9t nghi\u1ec7m l\u1ea1i c\u00f4ng th\u1ee9c m\u00e1u, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3, kh\u00ed m\u00e1u \u2026<\/p>\n<p>&#8211; S\u1eed d\u1ee5ng l\u1ea1i thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh 48 gi\u1edd sau m\u1ed5 v\u1edbi li\u1ec1u nh\u01b0 tr\u01b0\u1edbc ph\u1eabu thu\u1eadt v\u00e0 gi\u1ea3m d\u1ea7n sau 2 tu\u1ea7n n\u1ebfu kh\u00f4ng c\u00f2n c\u01a1n gi\u1eadt<\/p>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-21506 size-full\" src=\"https:\/\/e1ship.com\/wp-content\/uploads\/2021\/07\/A-55.jpg\" alt=\"\" width=\"800\" height=\"596\" \/><\/p>\n<p style=\"text-align: justify;\">Ph\u1eabu thu\u1eadt \u0111\u1ed9ng kinh t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi Trung \u01b0\u01a1ng \u0111\u1ea1t k\u1ebft qu\u1ea3 t\u1ed1t, \u00edt tai bi\u1ebfn c\u0169ng nh\u01b0 bi\u1ebfn ch\u1ee9ng. Ph\u1eabu thu\u1eadt l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn c\u00f3 gi\u00e1 tr\u1ecb \u0111\u1ed1i v\u1edbi tr\u1ebb em b\u1ecb \u0111\u1ed9ng kinh kh\u00e1ng thu\u1ed1c, c\u00f3 k\u1ebft qu\u1ea3 t\u1ed1t trong m\u1ed9t s\u1ed1 l\u01b0\u1ee3ng \u0111\u00e1ng k\u1ec3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p ( &gt;70).<\/p>\n<div id=\"attachment_21507\" style=\"width: 610px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" aria-describedby=\"caption-attachment-21507\" class=\"wp-image-21507 size-full\" src=\"https:\/\/e1ship.com\/wp-content\/uploads\/2021\/07\/13-2.jpg\" alt=\"\" width=\"600\" height=\"947\" \/><p id=\"caption-attachment-21507\" class=\"wp-caption-text\">B\u00e1o c\u00e1o t\u1ea1i h\u1ed9i ngh\u1ecb ph\u1eabu thu\u1eadt th\u1ea7n kinh Th\u1ebf gi\u1edbi 2013 (Seoul- H\u00e0n qu\u1ed1c): \u201cEpilepsy Surgery in Vietnam: Initial Experiences at National Hospital of Pediatrics\u201d<\/p><\/div>\n<h2 style=\"text-align: justify;\"><strong>6. L\u00e0m vi\u1ec7c nh\u00f3m \u0111a chuy\u00ean khoa v\u1ec1 \u0111\u1ed9ng kinh kh\u00e1ng thu\u1ed1c v\u00e0 ph\u1eabu thu\u1eadt \u0111\u1ed9ng kinh<\/strong><\/h2>\n<p>&#8211; Th\u0103m d\u00f2 chuy\u00ean s\u00e2u tr\u01b0\u1edbc ph\u1eabu thu\u1eadt: \u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng, \u0111i\u1ec7n n\u00e3o video, test th\u1ea7n kinh-t\u00e2m l\u00fd, ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh n\u00e3o chuy\u00ean s\u00e2u<\/p>\n<p>&#8211; H\u1ed9i ch\u1ea9n to\u00e0n nh\u00f3m: b\u00e1c s\u0129 n\u1ed9i th\u1ea7n kinh, ngo\u1ea1i th\u1ea7n kinh,ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh, chuy\u00ean gia \u0111i\u1ec7n n\u00e3o, chuy\u00ean gia t\u00e2m l\u00ed, gi\u1ea3i ph\u1eabu b\u1ec7nh.<\/p>\n<p>&#8211; Ph\u1eabu thu\u1eadt: Ngo\u1ea1i th\u1ea7n kinh, g\u00e2y m\u00ea \u2013 h\u1ed3i s\u1ee9c trong ph\u1eabu thu\u1eadt<\/p>\n<p>&#8211; Ch\u0103m s\u00f3c sau ph\u1eabu thu\u1eadt: h\u1ed3i s\u1ee9c, ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng\u2026<\/p>\n<p>&#8211; Theo d\u00f5i d\u00e0i h\u1ea1n sau ph\u1eabu thu\u1eadt (\u22656 th\u00e1ng)<\/p>\n<h2 style=\"text-align: justify;\"><strong>7. H\u1ed9i ch\u1ea9n, h\u1ee3p t\u00e1c qu\u1ed1c t\u1ebf<\/strong><\/h2>\n<p style=\"text-align: justify;\">11 chuy\u00ean gia, 5 n\u01b0\u1edbc:<\/p>\n<p>&#8211; \u00dd: Prof. Lo Russo; Dr. Stefano Francione; Prof. Roberta Maria Cilio<\/p>\n<p>&#8211; \u00dac: Dr. Simon Harvey<\/p>\n<p>&#8211; Ph\u00e1p: Prof. Olivier Delalande; Prof. Pierre Jallon<\/p>\n<p>&#8211; M\u1ef9: Dr. Prakash Kotagal; Dr. Gowda; Dr. Bui Cuong ; Dr. Khan Jawad; <strong>COA Epilepsy team<\/strong> (Dr. Brandon Rocque, Prof. Pongkiat K, Mr. Donald T. King)<\/p>\n<p>&#8211; Canada: Prof. Dang Khoa Nguyen, Director of Canadian League Against Epilepsy<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>1. T\u1ed5ng quan \u0110\u00f4\u0323ng kinh cu\u0323c b\u00f4\u0323 kha\u0301ng thu\u00f4\u0301c l\u00e0 m\u1ed9t nh\u00f3m b\u1ec7nh l\u00fd ph\u1ee9c t\u1ea1p trong chuy\u00ean ng\u00e0nh th\u00e2\u0300n kinh, b\u1ec7nh \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u00e1c c\u01a1n \u0111\u1ed9ng kinh t\u00e1i ph\u00e1t dai d\u1eb3ng kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c kha\u0301ng \u0111\u1ed9ng kinh (k\u1ec3 c\u1ea3 ph\u1ed1i h\u1ee3p nhi\u1ec1u thu\u1ed1c kh\u00e1ng \u0111\u1ed9ng kinh li\u1ec1u cao) k\u00e8m [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":21942,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[180],"tags":[],"class_list":["post-21497","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-dich-vu-noi-bat"],"yoast_head":"\n<title>PH\u1eaaU THU\u1eacT \u0110\u1ed8NG KINH KH\u00c1NG THU\u1ed0C | BV 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