{"id":97,"date":"2020-10-27T06:13:38","date_gmt":"2020-10-27T06:13:38","guid":{"rendered":"http:\/\/cdha.edu.vn\/cdha\/?p=97"},"modified":"2020-12-06T17:13:26","modified_gmt":"2020-12-06T10:13:26","slug":"ca-09","status":"publish","type":"post","link":"https:\/\/cdha.edu.vn\/cdha\/ca-09\/","title":{"rendered":"Ca 09: U m\u1ee1"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Kh\u1ed1i u ng\u1ef1c p \u0111\u00e3 l\u00e2u, ko \u0111au, to d\u1ea7n,=&gt; kh\u00e1m bs \u0111\u1ec3 pt=&gt; bs ch\u1ec9 \u0111\u1ecbnh sa:<\/p>\n\n\n\n<figure class=\"wp-block-embed-youtube wp-block-embed is-type-video is-provider-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Ca s\u1ed1 09\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/ed8_Xs8o2Fs?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><\/figure>\n\n\n\n<p style=\"text-align: justify;\"><b>K\u1ebft lu\u1eadn<\/b>: U m\u1ee1 trong m\u1ea1c c\u01a1 v\u00f9ng ng\u1ef1c<\/p>\n<p style=\"text-align: justify;\"><b>C\u0110PB:<\/b>\u00a0V\u00ec kh\u1ed1i u t\u0103ng d\u1ea7n k\u00edch th\u01b0\u1edbc n\u00ean ph\u1ea3i \u0111\u1eb7t ra c\u0111pb v\u1edbi Liposarcoma.<\/p>\n<p style=\"text-align: justify;\"><b>\u0110\u1ec1 ngh\u1ecb<\/b>: Ch\u1ee5p MRI c\u00f3 t\u01b0\u01a1ng ph\u1ea3n ho\u1eb7c sinh thi\u1ebft.<\/p>\n<p style=\"text-align: justify;\"><b>L\u00fd thuy\u1ebft U m\u1ee1<\/b>:<br \/>&#8211; L\u00e0 kh\u1ed1i u s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c ph\u1ed5 bi\u1ebfn nh\u1ea5t.<br \/>&#8211; C\u00f3 th\u1ec3 \u1edf trong m\u00f4 d\u01b0\u1edbi da, c\u01a1, ho\u1eb7c m\u00f4 m\u1ec1m s\u00e2u.<br \/>&#8211; Kh\u00f4ng \u0111au, di d\u1ed9ng, c\u00f3 th\u1ec3 \u0111\u00e8 \u00e9p \u0111\u01b0\u1ee3c.<br \/>&#8211; H\u00ecnh \u1ea3nh si\u00eau \u00e2m \u0111i\u1ec3n h\u00ecnh:<\/p>\n<ol style=\"text-align: justify;\">\n<li>Kh\u1ed1i \u0111\u1ed3ng nh\u1ea5t, t\u0103ng \u00e2m, \u0111\u1ed3ng \u00e2m ho\u1eb7c h\u01a1i gi\u1ea3m \u00e2m nh\u1eb9 so v\u1edbi l\u1edbp m\u1ee1.<\/li>\n<li>Gi\u1edbi h\u1ea1n r\u00f5, b\u00ean trong c\u00f3 nhi\u1ec1u v\u00e1ch g\u1ee3n s\u00f3ng gi\u1ed1ng nh\u01b0 m\u00f4 m\u1ee1.<\/li>\n<li>Kh\u00f4ng c\u00f3 h\u1ed3i \u00e2m ph\u1ee9c t\u1ea1p b\u00ean trong c\u0169ng nh\u01b0 kh\u00f4ng t\u0103ng sinh m\u1ea1ch.<\/li>\n<li>C\u00f3 th\u1ec3 c\u00f3 m\u1ea1ch m\u00e1u b\u0103ng qua.<\/li>\n<\/ol>\n<p style=\"text-align: justify;\">&#8211; C\u00e1c ki\u1ec3u h\u00ecnh \u1ea3nh kh\u00e1c c\u1ee7a u m\u1ee1:<\/p>\n<figure style=\"width: 600px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/1.bp.blogspot.com\/-QOiKlGWD5rY\/Xm-N_FmuyyI\/AAAAAAAAA1Y\/YkauTxpAe5w1FKKqxScMF34L8SJoEUNRACLcBGAsYHQ\/s1600\/a.PNG\" alt=\"\" width=\"600\" height=\"400\" \/><figcaption class=\"wp-caption-text\">a: H\u00ecnh \u1ea3nh c\u1eaft d\u1ecdc m\u1ed9t kh\u1ed1i c\u00f3 th\u1ec3 \u0111\u00e8 \u00e9p \u0111\u01b0\u1ee3c v\u1edbi \u0111\u01b0\u1eddng k\u00ednh d\u1ecdc song song v\u1edbi m\u1eb7t da. Kh\u1ed1i u c\u00f3 b\u1edd r\u00f5, h\u01a1i t\u0103ng \u00e2m nh\u1eb9 so v\u1edbi m\u00f4 m\u1ee1 xung quanh. B\u00ean trong c\u00f3 nh\u1eefng \u0111\u01b0\u1eddng s\u1ecdc m\u1ea3nh song song v\u1edbi m\u1eb7t da.<\/figcaption><\/figure>\n<figure style=\"width: 720px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/1.bp.blogspot.com\/-DFcolvdfztE\/Xm-7gw5uDeI\/AAAAAAAAA18\/gE8Hnw4CGxYB8cBD6AooraL7yLS1dsfoACLcBGAsYHQ\/s1600\/bc.PNG\" alt=\"\" width=\"720\" height=\"405\" \/><figcaption class=\"wp-caption-text\">b, c: M\u1eb7t c\u1eaft d\u1ecdc m\u1ed9t kh\u1ed1i u m\u1ee1 s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c \u1edf m\u1eb7t trong \u0111\u00f9i, kh\u00f4ng c\u00f3 v\u1ecf bao (b) so v\u1edbi b\u00ean \u0111\u1ed1i di\u1ec7n b\u00ecnh th\u01b0\u1eddng (c).<\/figcaption><\/figure>\n<figure style=\"width: 773px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/1.bp.blogspot.com\/-9ygqi2elnAk\/Xm-8YBN0qwI\/AAAAAAAAA2E\/Q5ql4UzPQQkOdVtz2I42bqV_DXVGHJ79wCLcBGAsYHQ\/s1600\/d.PNG\" alt=\"\" width=\"773\" height=\"452\" \/><figcaption class=\"wp-caption-text\">d: h\u00ecnh \u1ea3nh c\u1eaft d\u1ecdc m\u1ed9t kh\u1ed1i u m\u1ee1 trong m\u1ea1c (intrafascia) cho th\u1ea5y m\u1ed9t kh\u1ed1i m\u1ee1 d\u1ea1ng th\u1ea5u k\u00ednh (hoa th\u1ecb) n\u1eb1m trong c\u00e2n c\u01a1. L\u01b0u \u00fd m\u1ea1c c\u01a1 (muscle fascia) b\u1ecb t\u00e1ch ra l\u00e0m 2 d\u1ea3i t\u0103ng \u00e2m (m\u0169i t\u00ean) bao quanh kh\u1ed1i u m\u1ee1.<\/figcaption><\/figure>\n<figure style=\"width: 545px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/1.bp.blogspot.com\/-R8eXfoxn4Ec\/Xm--Ts1rC8I\/AAAAAAAAA2g\/9qS2Z8IIJ-wGEKS5pSO2USJac0i0Yz09ACLcBGAsYHQ\/s1600\/e.PNG\" alt=\"\" width=\"545\" height=\"456\" \/><figcaption class=\"wp-caption-text\">e: h\u00ecnh \u1ea3nh c\u1eaft ngang c\u00e1nh tay tr\u00e1i m\u1ed9t b\u1ec7nh nh\u00e2n c\u00f3 kh\u1ed1i u m\u1ee1 m\u1ea1ch \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh cho th\u1ea5y m\u1ed9t kh\u1ed1i tr\u00f2n t\u0103ng \u00e2m v\u1edbi nh\u1eefng n\u1ed1t gi\u1ea3m \u00e2m b\u00ean trong.<\/figcaption><\/figure>\n<p style=\"text-align: justify;\"><strong>Liposcarcoma r\u1ea5t gi\u1ed1ng Lipoma<\/strong>. C\u1ea7n k\u1ebft h\u1ee3p v\u1edbi MRI c\u00f3 t\u01b0\u01a1ng ph\u1ea3n ho\u1eb7c sinh thi\u1ebft n\u1ebfu c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u kh\u00f4ng \u0111i\u1ec3n h\u00ecnh sau:<\/p>\n<ol style=\"text-align: justify;\">\n<li>H\u1ed3i \u00e2m ph\u1ee9c t\u1ea1p ho\u1eb7c t\u0103ng sinh m\u1ea1ch<\/li>\n<li>K\u00edch th\u01b0\u1edbc &gt; 5cm<\/li>\n<li>N\u1eb1m \u1edf trong l\u1edbp c\u01a1 s\u00e2u.<\/li>\n<li>\u0110au ho\u1eb7c t\u0103ng d\u1ea7n k\u00edch th\u01b0\u1edbc.<\/li>\n<\/ol>\n<p style=\"text-align: justify;\"><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/1.bp.blogspot.com\/-6oyM-fRx2x4\/Xm_AfnK26TI\/AAAAAAAAA2s\/ZiHXKcpyyOsZrUC22tzXQy0VI3BKLnS6wCLcBGAsYHQ\/s1600\/f.PNG\" alt=\"\" \/><\/p>\n<p style=\"text-align: justify;\">&#8211; M\u1ed9t c\u1ea1m b\u1eaby trong ch\u1ea9n \u0111o\u00e1n u m\u1ee1 l\u00e0 kh\u1ed1i tho\u00e1t v\u1ecb ch\u1ee9a m\u1ee1 c\u00f3 th\u1ec3 cho c\u00e1c h\u00ecnh \u1ea3nh ch\u1ed3ng ch\u00e9o v\u1edbi u m\u1ee1, nh\u01b0 h\u1ed3i \u00e2m gi\u1ed1ng l\u1edbp m\u1ee1 d\u01b0\u1edbi da v\u00e0 nh\u1eefng v\u00e1ch l\u01b0\u1ee3n s\u00f3ng. D\u1ef1a v\u00e0o v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu v\u00e0 s\u1ef1 di chuy\u1ec3n khi l\u00e0m nghi\u1ec7m ph\u00e1p Valsava \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n tho\u00e1t v\u1ecb.<\/p>\n<div style=\"text-align: justify;\">&#8211; Khi c\u00f3 h\u00ecnh \u1ea3nh u m\u1ee1 \u0111i\u1ec3n h\u00ecnh, theo d\u00f5i l\u00e2m s\u00e0ng \u0111\u1ecbnh k\u1ef3 \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb h\u01a1n l\u00e0 th\u1ef1c hi\u1ec7n th\u00eam c\u00e1c kh\u1ea3o s\u00e1t h\u00ecnh \u1ea3nh kh\u00e1c v\u00e0 sinh thi\u1ebft.\u00a0<\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n<div style=\"text-align: justify;\"><b>TR\u1ea2 L\u1edcI C\u00c2U H\u1eceI:<br \/>1. B\u01b0\u1edbu m\u1ee1 ca n\u00e0y n\u1eb1m \u1edf \u0111\u00e2u:\u00a0<\/b><br \/>&#8211; N\u00f3i l\u00e0 trong m\u00f4 m\u1ec1m d\u01b0\u1edbi da c\u0169ng \u0111\u01b0\u1ee3c, nh\u01b0ng ch\u00ednh x\u00e1c l\u00e0 trong m\u1ea1c c\u01a1. T\u1eeb fascia trong s\u00e1ch gi\u1ea3i ph\u1eabu c\u00e1c th\u1ea7y d\u1ecbch l\u00e0 m\u1ea1c. (c\u01a1 c\u0103ng m\u1ea1c \u0111\u00f9i : tensor fasciae latae muscle). U m\u1ee1 c\u00f3 nhi\u1ec1u v\u1ecb tr\u00ed v\u00e0 trong m\u1ea1c c\u01a1 c\u0169ng l\u00e0 m\u1ed9t v\u1ecb tr\u00ed hay g\u1eb7p.<br \/><br \/><b>2. C\u00f3 c\u1ea7n thi\u1ebft ph\u1ea3i ch\u1ee5p MRI c\u00f3 t\u01b0\u01a1ng ph\u1ea3n ho\u1eb7c sinh thi\u1ebft kh\u00f4ng?\u00a0<\/b><br \/>&#8211; C\u00d3, \u0111\u1ec3 ph\u00e2n bi\u1ec7t v\u1edbi Liposarcoma v\u00ec u t\u0103ng k\u00edch th\u01b0\u1edbc. N\u1ebfu u kh\u00f4ng t\u0103ng k\u00edch th\u01b0\u1edbc th\u00ec kh\u00f4ng c\u1ea7n. Ch\u1ec9 c\u00f3 MRI t\u01b0\u01a1ng ph\u1ea3n v\u00e0 sinh thi\u1ebft m\u1edbi ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c. (xem b\u1ea3ng \u1edf tr\u00ean)<br \/><b><br \/><\/b><b>3. U m\u1ea1ch gan th\u01b0\u1eddng x\u1ea3y ra \u1edf nam hay \u1edf n\u1eef nhi\u1ec1u h\u01a1n\u00a0<\/b><br \/>&#8211; \u1ede n\u1eef nhi\u1ec1u h\u01a1n. N\u1eef: Nam # 5:1<\/div>\n<div style=\"text-align: justify;\"><img decoding=\"async\" src=\"https:\/\/1.bp.blogspot.com\/-xjnY-ZLYa6k\/Xm_FQlJsxnI\/AAAAAAAAA3Y\/P1fBTSznwcMO265DlxRpnuujcRLkR24ywCLcBGAsYHQ\/s1600\/u%2Bmach.PNG\" alt=\"\" \/><\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n<div style=\"text-align: justify;\"><b>4. N\u1ed9i ti\u1ebft t\u1ed1 estrogen c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn u m\u1ea1ch gan kh\u00f4ng?\u00a0<\/b>&#8211; C\u00f3. Hemangioma c\u00f3 th\u1ec3 t\u0103ng k\u00edch th\u01b0\u1edbc trong thai k\u1ef3 ho\u1eb7c s\u1eed d\u1ee5ng estrogen.<\/div>\n<div style=\"text-align: justify;\"><img decoding=\"async\" src=\"https:\/\/1.bp.blogspot.com\/-0iMakRwhxiU\/Xm_FtcXxujI\/AAAAAAAAA3g\/7xJxdYRs90sxqnMKDoCGWDbq1jR1_sQ4wCLcBGAsYHQ\/s1600\/um2.PNG\" alt=\"\" \/><\/div>\n<div style=\"text-align: justify;\"><b>5. \u0110\u1eb7c \u0111i\u1ec3m m\u00f4 h\u1ecdc u m\u1ea1ch gan:\u00a0<\/b>&#8211; G\u1ed3m nh\u1eefng k\u00eanh m\u1ea1ch (ch\u1ee9a h\u1ed3ng c\u1ea7u) \u0111\u01b0\u1ee3c l\u00f3t b\u1edfi m\u1ed9t l\u1edbp t\u1ebf b\u00e0o n\u1ed9i m\u00f4 (m\u00e0u xanh), ng\u0103n c\u00e1ch v\u00e0 n\u00e2ng \u0111\u1ee1 b\u1edfi c\u00e1c v\u00e1ch x\u01a1 (m\u00e0u h\u1ed3ng). Trong c\u00e1c khoang m\u1ea1ch c\u00f3 th\u1ec3 c\u00f3 huy\u1ebft kh\u1ed1i.<\/div>\n<div><img decoding=\"async\" src=\"https:\/\/1.bp.blogspot.com\/-m_vCf26ojKU\/Xm_M3hU0bmI\/AAAAAAAAA4Y\/a4XWIE67oaIIG6t5Q6meXTfzvsLT1AZgQCLcBGAsYHQ\/s1600\/um4.PNG\" alt=\"\" \/><\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n<div style=\"text-align: justify;\">\u00a0<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Kh\u1ed1i u ng\u1ef1c p \u0111\u00e3 l\u00e2u, ko \u0111au, to d\u1ea7n,=&gt; kh\u00e1m bs \u0111\u1ec3 pt=&gt; bs ch\u1ec9 \u0111\u1ecbnh sa: K\u1ebft lu\u1eadn: U m\u1ee1 trong m\u1ea1c c\u01a1<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,5],"tags":[],"class_list":["post-97","post","type-post","status-publish","format-standard","hentry","category-phan-mem-cxk","category-sieu-am"],"_links":{"self":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/97","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=97"}],"version-history":[{"count":6,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/97\/revisions"}],"predecessor-version":[{"id":189,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/97\/revisions\/189"}],"wp:attachment":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/media?parent=97"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/categories?post=97"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/tags?post=97"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}