{"id":103,"date":"2020-10-27T09:23:11","date_gmt":"2020-10-27T09:23:11","guid":{"rendered":"http:\/\/cdha.edu.vn\/cdha\/?p=103"},"modified":"2021-01-09T22:54:19","modified_gmt":"2021-01-09T15:54:19","slug":"ca-so-08","status":"publish","type":"post","link":"https:\/\/cdha.edu.vn\/cdha\/ca-so-08\/","title":{"rendered":"Ca s\u1ed1 08: U m\u1ea1ch gan kh\u00f4ng \u0111i\u1ec3n h\u00ecnh"},"content":{"rendered":"\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"CA 08\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/URX56rQNY98?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><figcaption>CA S\u1ed0 08: Bn kh\u00e1m s\u1ee9c kho\u1ebb, si\u00eau \u00e2m b\u1ee5ng l\u1ea7n \u0111\u1ea7u ti\u00ean: Sa: t\u1ed5n th\u01b0\u01a1ng t\u1ea1i gan p. Video: BS Nguy\u1ec5n \u0110\u00ecnh H\u1ed3<\/figcaption><\/figure>\n\n\n\n<p style=\"text-align: justify;\"><b>M\u00f4 t\u1ea3:<\/b><br \/>Gan ph\u1ea3i kho\u1ea3ng h\u1ea1 ph\u00e2n th\u00f9y V-VIII c\u00f3 t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng \u0111\u1eb7c, echo k\u00e9m, kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t,c\u00f3 vi\u1ec1n d\u00e0y t\u0103ng \u00e2m, b\u1edd kh\u00f4ng \u0111\u1ec1u, gi\u1edbi h\u1ea1n r\u00f5, t\u0103ng \u00e2m ph\u00eda sau, kh\u00f4ng th\u1ea5y b\u1eaft m\u00e0u, kt# 59x51mm.<br \/><br \/><b>K\u1ebft lu\u1eadn<\/b>: U gan ph\u1ea3i, g\u1ee3i \u00fd u m\u1ea1ch kh\u00f4ng \u0111i\u1ec3n h\u00ecnh.<br \/><b><br \/><\/b><b>\u0110\u1ec1 ngh\u1ecb<\/b>: Ch\u1ee5p CT b\u1ee5ng c\u00f3 c\u1ea3n quang.<br \/><br \/><b>K\u1ebft qu\u1ea3 CT<\/b>: U m\u1ea1ch.<br \/><br \/><b>L\u00fd thuy\u1ebft<\/b>: ca n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee5p CT ki\u1ec3m ch\u1ee9ng n\u00ean em \u0111\u0103ng l\u00ean \u0111\u00e2y \u0111\u1ec3 m\u1ecdi ng\u01b0\u1eddi h\u1ecdc cho vui th\u00f4i. Ch\u1ee9 th\u1ef1c ra u m\u1ea1ch kh\u00f4ng \u0111i\u1ec3n h\u00ecnh kh\u00f4ng c\u00f3 h\u00ecnh \u1ea3nh n\u00e0o \u0111\u1eb7c tr\u01b0ng c\u1ea3.<br \/><br \/><b>M\u1ed9t v\u00e0i \u0111i\u1ec1u l\u01b0u \u00fd v\u1ec1 u m\u1ea1ch:<\/b><\/p>\n<div style=\"text-align: justify;\">&#8211; X\u1ea3y ra \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i. N\u1eef : Nam # 5:1<\/div>\n<div style=\"text-align: justify;\">&#8211; \u0110i\u1ec3n h\u00ecnh (&lt;3cm):<\/div>\n<div style=\"text-align: justify;\">\n<ol>\n<li>Echo d\u00e0y \u0111\u1ed3ng nh\u1ea5t<\/li>\n<li>Gi\u1edbi h\u1ea1n r\u00f5<\/li>\n<li>T\u0103ng \u00e2m ph\u00eda sau: c\u00f3 th\u1ec3 th\u1ea5y nh\u01b0ng kh\u00f4ng th\u01b0\u1eddng xuy\u00ean v\u00e0 kh\u00f4ng \u0111\u1eb7c hi\u1ec7u.<\/li>\n<li>Kh\u00f4ng th\u1ea5y Doppler (do d\u00f2ng ch\u1ea3y trong n\u00f3 r\u1ea5t ch\u1eadm)<\/li>\n<\/ol>\n<div>&#8211; Kh\u00f4ng \u0111i\u1ec3n h\u00ecnh:<\/div>\n<\/div>\n<div style=\"text-align: justify;\">\n<ol>\n<li>Trung t\u00e2m kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t (c\u00f3 th\u1ec3 ch\u1ee9a ph\u1ea3n \u00e2m d\u1ea1ng h\u1ea1t ho\u1eb7c d\u1ea1ng d\u1ea3i)<\/li>\n<li>\u00a0B\u1edd c\u00f3 ph\u1ea3n \u00e2m, vi\u1ec1n d\u00e0y ho\u1eb7c m\u1ecfng (gi\u1ed1ng ca n\u00e0y)<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng l\u1edbn c\u00f3 khuynh h\u01b0\u1edbng kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t v\u00e0 t\u1ea1o s\u1eb9o \u1edf trung t\u00e2m (s\u1eb9o collagen v\u00f4i h\u00f3a ho\u1eb7c c\u00e1c khoang m\u1ea1ch l\u1edbn ho\u1eb7c c\u1ea3 hai)<\/li>\n<li>C\u00f3 th\u1ec3 gi\u1ea3m \u00e2m tr\u00ean n\u1ec1n gan nhi\u1ec5m m\u1ee1. Th\u1eadm ch\u00ed gan ko nhi\u1ec5m m\u1ee1 c\u0169ng th\u1ea5y gi\u1ea3m \u00e2m (gi\u1ed1ng ca n\u00e0y)<\/li>\n<\/ol>\n&#8211; M\u1ed9t v\u00e0i t\u1ed5n th\u01b0\u01a1ng \u00e1c t\u00ednh kh\u00e1c c\u0169ng cho h\u00ecnh \u1ea3nh r\u1ea5t gi\u1ed1ng u m\u1ea1ch. N\u00ean ph\u1ea3i th\u1ef1c hi\u1ec7n th\u00eam c\u00e1c k\u1ef9 thu\u1eadt kh\u00e1c (CT c\u1ea3n quang, MRI, SPECT th\u1eadm ch\u00ed sinh thi\u1ebft gan qua da) \u1edf b\u1ec7nh nh\u00e2n:<\/div>\n<div>\n<ol style=\"text-align: justify;\">\n<li>\u0110\u00e3 bi\u1ebft c\u00f3 b\u1ec7nh \u00e1c t\u00ednh,\u00a0<\/li>\n<li>T\u0103ng nguy c\u01a1 ung th\u01b0 gan, b\u1ea5t th\u01b0\u1eddng x\u00e9t ch\u1ee9c n\u0103ng gan, c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u1ec1 gan<\/li>\n<li>H\u00ecnh th\u00e1i si\u00eau \u00e2m b\u1ea5t th\u01b0\u1eddng<\/li>\n<\/ol>\n<div style=\"text-align: justify;\">Nh\u00ecn chung, k\u1ebft h\u1ee3p 2 kh\u1ea3o s\u00e1t \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n u m\u1ea1ch l\u00e0 an to\u00e0n.<\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n<div style=\"text-align: justify;\"><b>T\u00c0I LI\u1ec6U<\/b><br \/>1.\u00a0<a href=\"https:\/\/drive.google.com\/open?id=1_FAfM7nc_TMFuMCXJ8fAe5ZIPbFZcXGn\" target=\"_blank\" rel=\"noopener noreferrer\">U m\u1ea1ch gan (Rumack)<\/a><\/div>\n<div style=\"text-align: justify;\">2. <a href=\"https:\/\/www.ultrasoundcases.info\/atypical-hemangiomas-234\/\" target=\"_blank\" rel=\"noopener noreferrer\">Atypical-hemangiomas-234\/<\/a><\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n<div style=\"text-align: justify;\"><b>TR\u1ea2 L\u1edcI C\u00c2U H\u1eceI:<\/b><\/div>\n<div style=\"text-align: justify;\"><b>1. \u0110\u00e2y c\u00f3 ph\u1ea3i l\u00e0 t\u1ed5n th\u01b0\u01a1ng echo d\u00e0y kh\u00f4ng?<\/b><\/div>\n<div>&#8211; \u0110\u00e2y l\u00e0 t\u1ed5n th\u01b0\u01a1ng\u00a0<b>echo k\u00e9m<\/b>, v\u00ec n\u00f3 t\u1ed1i h\u01a1n m\u00f4 gan xung quanh.<br \/>\n<div class=\"separator\" style=\"text-align: justify;\"><a href=\"https:\/\/1.bp.blogspot.com\/-3IA2IVuVwEo\/XmaCGo36sHI\/AAAAAAAAA0g\/4YRn7xIjP-8HDIfH370e1P37sv4GBDSAgCLcBGAsYHQ\/s1600\/Untitled.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/1.bp.blogspot.com\/-3IA2IVuVwEo\/XmaCGo36sHI\/AAAAAAAAA0g\/4YRn7xIjP-8HDIfH370e1P37sv4GBDSAgCLcBGAsYHQ\/s320\/Untitled.png\" width=\"320\" height=\"232\" border=\"0\" data-original-height=\"354\" data-original-width=\"487\" \/><\/a><\/div>\n<div class=\"separator\" style=\"text-align: justify;\"><b>2. C\u1ea7n l\u00e0m th\u00eam x\u00e9t nghi\u1ec7m g\u00ec \u0111\u1ec3 ph\u00e2n bi\u1ec7t Adenoma v\u1edbi Hemangioma:<\/b><\/div>\n<div class=\"separator\" style=\"text-align: justify;\">&#8211; Ch\u1ee5p CT c\u1ea3n quang, SPECT, MRI ho\u1eb7c sinh thi\u1ebft gan qua da.<\/div>\n<div class=\"separator\" style=\"text-align: justify;\">\u00a0<\/div>\n<div class=\"separator\" style=\"text-align: justify;\"><b>3. M\u1ed9t s\u1ed1 ch\u1ed7 gi\u1ea3m \u00e2m b\u00ean trong t\u1ed5n th\u01b0\u01a1ng m\u00f4 t\u1ea3 sao?<\/b><\/div>\n<div class=\"separator\" style=\"text-align: justify;\">&#8211; BS ghi l\u00e0 echo\u00a0<b>k\u00e9m kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t<\/b>.\u00a0<\/div>\n<div class=\"separator\" style=\"text-align: justify;\">&#8211; Th\u1ea7y Tr\u1ecdng v\u00e0 th\u1ea7y Kho\u00e1ng c\u00f3 n\u00f3i r\u1eb1ng: N\u1ebfu b\u00ean trong t\u1ed5n th\u01b0\u01a1ng c\u00f3 echo tr\u1ed1ng (d\u1ecbch) th\u00ec m\u00f4 t\u1ea3 l\u00e0 echo h\u1ed7n h\u1ee3p. T\u1eeb &#8220;h\u1ed7n h\u1ee3p&#8221; ch\u1ec9 d\u00e0nh cho t\u1ed5n th\u01b0\u01a1ng c\u00f3 c\u1ea3 th\u00e0nh ph\u1ea7n \u0111\u1eb7c v\u00e0 nang, n\u1ebfu to\u00e0n \u0111\u1eb7c h\u1ebft (ch\u1ed7 echo d\u00e0y, ch\u1ed7 echo k\u00e9m nh\u01b0ng v\u1eabn 100% l\u00e0 \u0111\u1eb7c) th\u00ec d\u00f9ng t\u1eeb kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t.\u00a0<\/div>\n<div class=\"separator\" style=\"text-align: justify;\">&#8211; Hi\u1ec7n gi\u1edd r\u1ea5t nhi\u1ec1u bs d\u00f9ng l\u1ed9n x\u1ed9n t\u1eeb &#8220;h\u1ed7n h\u1ee3p&#8221; \u0111\u1ec3 ch\u1ec9 c\u00e1c t\u1ed5n th\u01b0\u01a1ng &#8220;kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t&#8221; n\u00ean kh\u00f4ng bi\u1ebft m\u1ed9t c\u00e1i sai l\u00e2u ng\u00e0y \u0111\u00e3 tr\u1edf th\u00e0nh c\u00e1i \u0111\u00fang ch\u01b0a (gi\u1ed1ng nh\u01b0 AFI kh\u00f4ng c\u1ea7n \u0111\u01a1n v\u1ecb).<\/div>\n<div class=\"separator\" style=\"text-align: justify;\">\u00a0<\/div>\n<div class=\"separator\" style=\"text-align: justify;\"><b>4. T\u1ed5n th\u01b0\u01a1ng n\u00e0y c\u00f3 s\u1eb9o trung t\u00e2m hay kh\u00f4ng?<\/b><\/div>\n<div class=\"separator\" style=\"text-align: justify;\">&#8211; H\u00ecnh \u1ea3nh n\u00e0y kh\u00f4ng gi\u1ed1ng s\u1eb9o trung t\u00e2m \u0111i\u1ec3n h\u00ecnh.\u00a0<\/div>\n<div class=\"separator\" style=\"text-align: justify;\">\u00a0<\/div>\n<div class=\"separator\" style=\"text-align: justify;\">\u00a0<\/div>\n<div class=\"separator\" style=\"text-align: justify;\">\u00a0<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>M\u00f4 t\u1ea3:Gan ph\u1ea3i kho\u1ea3ng h\u1ea1 ph\u00e2n th\u00f9y V-VIII c\u00f3 t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng \u0111\u1eb7c, echo k\u00e9m, kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t,c\u00f3 vi\u1ec1n d\u00e0y t\u0103ng \u00e2m, b\u1edd kh\u00f4ng \u0111\u1ec1u,<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,5],"tags":[46,23,47,22],"class_list":["post-103","post","type-post","status-publish","format-standard","hentry","category-bung-tq","category-sieu-am","tag-gan-mat","tag-hemangioma","tag-tieu-hoa","tag-u-mach-gan"],"_links":{"self":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/103","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/comments?post=103"}],"version-history":[{"count":5,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/103\/revisions"}],"predecessor-version":[{"id":320,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/103\/revisions\/320"}],"wp:attachment":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/media?parent=103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/categories?post=103"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/tags?post=103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}