{"id":3885,"date":"2023-10-23T10:32:56","date_gmt":"2023-10-23T03:32:56","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=3885"},"modified":"2023-10-24T10:39:21","modified_gmt":"2023-10-24T03:39:21","slug":"benh-vien-nhan-dan-gia-dinh-trien-khai-ki-thuat-moi-dieu-tri-dau-chuyen-sau-cho-nguoi-benh-ung-thu","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=3885","title":{"rendered":"B\u1ec6NH VI\u1ec6N NH\u00c2N D\u00c2N GIA \u0110\u1ecaNH TRI\u1ec2N KHAI K\u0128 THU\u1eacT M\u1edaI: \u0110I\u1ec0U TR\u1eca \u0110AU CHUY\u00caN S\u00c2U CHO NG\u01af\u1edcI B\u1ec6NH UNG TH\u01af"},"content":{"rendered":"\n

K<\/strong>\u0129 thu\u1eadt m\u1edbi<\/strong> n\u00e0y s\u1eed d\u1ee5ng <\/strong>ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p n\u1ed9i m\u1ea1ch <\/strong>l\u00e0m <\/strong>t\u1eafc m\u1ea1ch nu\u00f4i kh\u1ed1i b\u01b0\u1edbu kh\u1ed1ng ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ung th\u01b0 sau \u0111\u00f3 di\u1ec7t \u0111\u00e1m r\u1ed1i th\u1ea7n kinh h\u1ea1 v\u1ecb nh\u1eb1m \u0111i\u1ec1u tr\u1ecb \u0111au cho <\/strong>ng\u01b0\u1eddi b\u1ec7nh <\/strong>ung th\u01b0. \u0110\u00e2y l\u00e0 k\u0129 thu\u1eadt x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u, chi ph\u00ed th\u1ea5p, th\u1eddi gian th\u1ef1c hi\u1ec7n th\u1ee7 thu\u1eadt nhanh, hi\u1ec7u qu\u1ea3 gi\u1ea3m \u0111au t\u1ee9c th\u00ec, k\u00e9o d\u00e0i, t\u1ec9 l\u1ec7 bi\u1ebfn ch\u1ee9ng v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 r\u1ea5t hi\u1ebfm khi x\u1ea3y ra nh\u1edd \u1ee9ng d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n h\u1ed7 tr\u1ee3 d\u1eabn \u0111\u01b0\u1eddng nh\u01b0 c\u1eaft l\u1edbp vi t\u00ednh \u0111a d\u00e3y, si\u00eau \u00e2m \u0111\u1ecbnh v\u1ecb, m\u00e1y ch\u1ee5p s\u1ed1 ho\u00e1 xo\u00e1 n\u1ec1n.<\/strong><\/p>\n\n\n\n

Ch\u1ecb V.N.T 47 tu\u1ed5i ng\u1ee5 t\u1ea1i TPHCM \u0111ang ph\u1ea3i chi\u1ebfn \u0111\u1ea5u v\u1edbi n\u1ed7i \u0111au \u0111\u1edbn do c\u0103n b\u1ec7nh ung th\u01b0 \u0111\u1ea1i tr\u00e0ng x\u00e2m l\u1ea5n lan \u0111\u1ebfn v\u00f9ng x\u01b0\u01a1ng ch\u1eadu g\u00e2y ra, c\u01a1n \u0111au ng\u00e0y m\u1ed9t t\u0103ng. M\u1eb7c d\u00f9 \u0111\u00e3 th\u1eed<\/a>\u00a0 \u0111i\u1ec1u tr\u1ecb ph\u1ed1i h\u1ee3p nhi\u1ec1u lo\u1ea1i thu\u1ed1c gi\u1ea3m \u0111au v\u00e0 th\u1eadm ch\u00ed l\u00e0 truy\u1ec1n morphin (m\u1ed9t d\u1ea1ng thu\u1ed1c gi\u1ea3m \u0111au li\u1ec1u m\u1ea1nh th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nh\u1eefng c\u01a1n \u0111au n\u1eb7ng) th\u00ec c\u01a1n \u0111au c\u1ee7a ch\u1ecb v\u1eabn kh\u00f4ng th\u1ec3 ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c trong nhi\u1ec1u ng\u00e0y qua. C\u01a1n \u0111au n\u00e0y lan ra t\u1eeb v\u00f9ng x\u01b0\u01a1ng ch\u1eadu v\u00e0 v\u00f9ng \u0111\u00e1y ch\u1eadu, khi\u1ebfn nh\u1eefng c\u00f4ng vi\u1ec7c \u0111\u01a1n gi\u1ea3n nh\u01b0 \u0111i v\u1ec7 sinh c\u0169ng tr\u1edf th\u00e0nh n\u1ed7i \u00e1m \u1ea3nh \u0111\u1ed1i v\u1edbi ch\u1ecb. C\u01a1n \u0111au th\u1eadm ch\u00ed c\u00f2n lan \u0111\u1ebfn \u0111\u00f9i v\u00e0 b\u1eafp ch\u00e2n, khi\u1ebfn ch\u1ecb T kh\u00f3 di chuy\u1ec3n. Ch\u1ecb nh\u1eadp b\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u1edbi v\u1ebb m\u1eb7t \u0111au \u0111\u1edbn, ki\u1ec7t qu\u1ec7 v\u00ec nhi\u1ec1u \u0111\u00eam m\u1ea5t ng\u1ee7 v\u00e0 \u0103n u\u1ed1ng k\u00e9m.<\/p>\n\n\n\n

TS.BS L\u00ea B\u00e1 Th\u1ea3o – Tr\u01b0\u1edfng khoa T\u1ed5ng h\u1ee3p B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh, chuy\u00ean gia v\u1ec1 ho\u00e1 tr\u1ecb li\u1ec7u cho hay: \u201cD<\/em>\u00f9 c\u00f3 s\u1eb5n c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 hi\u1ec7n \u0111\u1ea1i nh\u01b0ng kh\u00f4ng d\u1ec5 \u0111\u1ec3 th\u1ef1c hi\u1ec7n ngay c\u00e1c li\u1ec7u tr\u00ecnh n\u00e0y trong khi ng\u01b0\u1eddi b\u1ec7nh c\u00f2n \u0111ang ch\u1ecbu \u0111\u1ef1ng \u0111au \u0111\u1edbn h\u00e0nh h\u1ea1<\/em> (h\u00f3a tr\u1ecb kh\u00f4ng th\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m c\u01a1n \u0111au ngay m\u00e0 c\u1ea7n c\u00f3 th\u1eddi gian t\u00e1c d\u1ee5ng)<\/em>.<\/em> <\/em>Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 c\u01a1n<\/em> \u0111au k\u00e9o d\u00e0i nhi\u1ec1u ng\u00e0y, m\u1ee9c \u0111\u1ed9 nhi\u1ec1u, \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa kh\u00f4ng hi\u1ec7u qu\u1ea3<\/em>. . Nguy\u00ean nh\u00e2n \u0111au do ung th\u01b0 c\u00f3 th\u1ec3 do kh\u1ed1i u x\u00e2m l\u1ea5n c\u01a1 quan l\u00e2n c\u1eadn, v\u00e0o x\u01b0\u01a1ng, th\u1ea7n kinh, \u2026; g\u00e2y c\u1ea3m gi\u00e1c \u0111au t\u0103ng d\u1ea7n, li\u00ean t\u1ee5c, dai d\u1eb3ng, \u0111i\u1ec1u n\u00e0y khi\u1ebfn ng\u01b0\u1eddi b\u1ec7nh m\u1ea5t ng\u1ee7 tri\u1ec1n mi\u00ean, t\u00e2m tr\u1ea1ng lo \u00e2u, bu\u1ed3n b\u1ef1c, ch\u00e1n n\u1ea3n, suy gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng, c\u01a1 th\u1ec3 suy ki\u1ec7t d\u1ea7n v\u00e0 d\u1eabn t\u1edbi nguy c\u01a1 t\u1eed vong s\u1edbm. Ng\u01b0\u1eddi b\u1ec7nh th\u01b0\u1eddng t\u00ecm \u0111\u1ebfn morphine – thu\u1ed1c gi\u1ea3m \u0111au c\u00f3 ch\u1ea5t g\u00e2y nghi\u1ec7n \u0111\u1ec3 gi\u1ea3i tho\u00e1t kh\u1ecfi c\u01a1n \u0111au, nh\u01b0ng v\u1ec1 l\u00e2u d\u00e0i s\u1ebd ph\u1ea3i t\u0103ng li\u1ec1u l\u01b0\u1ee3ng, hi\u1ec7u l\u1ef1c gi\u1ea3m \u0111au c\u1ee7a thu\u1ed1c r\u00fat ng\u1eafn d\u1ea7n v\u00e0 ng\u01b0\u1eddi b\u1ec7nh v\u1eabn ph\u1ea3i ch\u1ecbu \u0111\u1ef1ng \u0111au \u0111\u1edbn t\u00e1i ph\u00e1t. Do \u0111\u00f3 v<\/em>i\u1ec7c \u0111i\u1ec1u tr\u1ecb \u0111au ph\u1ea3i \u0111\u01b0\u1ee3c \u01b0u ti\u00ean h\u00e0ng \u0111\u1ea7u.<\/em>\u201d<\/em><\/p>\n\n\n\n

Sau khi th\u0103m kh\u00e1m, \u0111\u00e1nh gi\u00e1 k\u0129 c\u00e0ng qua c\u00e1c x\u00e9t nghi\u1ec7m v\u00e0 h\u00ecnh \u1ea3nh ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh v\u00f9ng b\u1ee5ng ch\u1eadu, c\u00e1c b\u00e1c s\u0129 th\u1ed1ng nh\u1ea5t s\u1ebd th\u1ef1c hi\u1ec7n hai k\u0129 thu\u1eadt \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 v\u1eeba kh\u1ed1ng ch\u1ebf b\u01b0\u1edbu di c\u0103n, v\u1eeba gi\u1ea3i quy\u1ebft c\u01a1n \u0111au cho ch\u1ecb T. Ng\u00e0y 11\/10\/2023 ch\u1ecb T \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n can thi\u1ec7p t\u1eafc m\u1ea1ch kh\u1ed1i u v\u00e0 ng\u00e0y 14\/10\/2023 ch\u1ecb \u0111\u01b0\u1ee3c can thi\u1ec7p di\u1ec7t \u0111\u00e1m r\u1ed1i th\u1ea7n kinh h\u1ea1 v\u1ecb.<\/p>\n\n\n\n

TS.BS Nguy\u1ec5n \u0110\u00ecnh Lu\u00e2n, Tr\u01b0\u1edfng \u0111\u01a1n v\u1ecb X-quang can thi\u1ec7p \u2013 Ph\u00f3 tr\u01b0\u1edfng khoa Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh- B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft: \u201c<\/em>Ch\u1ecb T \u0111au \u0111\u1edbn do kh\u1ed1i ung th\u01b0 di c\u0103n v\u00f9ng h\u1ed1 ch\u1eadu tr\u00e1i. Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n k\u0129 thu\u1eadt can thi\u1ec7p n\u1ed9i m\u1ea1ch t\u1eafc m\u1ea1ch<\/em> b\u1eb1ng c\u00e1ch b\u01a1m c\u00e1c h\u1ea1t vi c\u1ea7u c\u1eaft ngu\u1ed3n<\/em> nu\u00f4i kh\u1ed1i b\u01b0\u1edbu<\/em> <\/em>\u0111\u1ec3 gi\u1ea3m \u0111au m\u1ed9t ph\u1ea7n v\u00e0 kh\u1ed1ng ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ung th\u01b0. K\u0129 thu\u1eadt \u0111i\u1ec1u tr\u1ecb th\u1ee9 2 \u0111\u00f3ng vai tr\u00f2 quy\u1ebft \u0111\u1ecbnh trong \u0111i\u1ec1u tr\u1ecb \u0111au \u0111\u01b0\u1ee3c \u00eakip th\u1ef1c hi\u1ec7n \u0111\u00f3 l\u00e0 k\u0129 thu\u1eadt di\u1ec7t \u0111\u00e1m r\u1ed1i th\u1ea7n kinh h\u1ea1 v\u1ecb.<\/em>\u201d<\/em><\/p>\n\n\n\n


K\u0129 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng m\u00e1y c\u1eaft l\u1edbp vi t\u00ednh \u0111\u1ec3 \u0111\u1ecbnh v\u1ecb ch\u00ednh x\u00e1c \u0111\u00e1m r\u1ed1i th\u1ea7n kinh v\u00e0 d\u1eabn \u0111\u01b0\u1eddng cho b\u00e1c s\u0129 \u0111\u01b0a c\u00e1c kim nh\u1ecf ti\u1ebfp c\u1eadn v\u00e0o \u0111\u00fang v\u1ecb tr\u00ed. Sau \u0111\u00f3, m\u1ed9t l\u01b0\u1ee3ng thu\u1ed1c ph\u00f9 h\u1ee3p s\u1ebd \u0111\u01b0\u1ee3c b\u01a1m v\u00e0o c\u00e1c kim nh\u1ecf, thu\u1ed1c s\u1ebd t\u00e1c <\/p>\n\n\n\n

\u0111\u1ed9ng t\u1ee9c th\u00ec \u0111\u1ebfn th\u1ea7n kinh d\u1eabn truy\u1ec1n c\u1ea3m gi\u00e1c \u0111au v\u00e0 l\u00e0m tri\u1ec7t ti\u00eau c\u00e1c d\u1eabn truy\u1ec1n n\u00e0y.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

H\u00ecnh \u1ea3nh:<\/em><\/strong> kim d\u1eabn b\u01a1m thu\u1ed1c d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn c\u1ee7a m\u00e1y c\u1eaft l\u1edbp vi t\u00ednh<\/em><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

H\u00ecnh \u1ea3nh:<\/em><\/strong> <\/em>Ng\u01b0\u1eddi <\/em>b\u1ec7nh \u0111\u01b0\u1ee3c \u0111\u1ecbnh v\u1ecb v\u1ecb tr\u00ed ch\u00ednh x\u00e1c b\u1eb1ng m\u00e1y c\u1eaft l\u1edbp vi t\u00ednh \u0111a d\u00e3y<\/em><\/p>\n\n\n\n

Ch\u1ecb T k\u1ec3 l\u1ea1i, khi thu\u1ed1c v\u1eeba \u0111\u01b0\u1ee3c b\u01a1m v\u00e0o, ch\u1ecb c\u1ea3m th\u1ea5y m\u1ed9t c\u01a1n \u0111au tho\u00e1ng qua nh\u01b0ng nhanh ch\u00f3ng sau \u0111\u00f3, c\u01a1n \u0111au d\u1ecbu h\u1eb3n v\u00e0 bi\u1ebfn m\u1ea5t. L\u1ea7n \u0111\u1ea7u ti\u00ean sau nhi\u1ec1u ng\u00e0y d\u00e0i ch\u1ecbu \u0111\u1ef1ng \u0111au \u0111\u1edbn h\u00e0nh h\u1ea1, ch\u1ecb \u0111\u00e3 c\u00f3 th\u1ec3 xoay tr\u1edf ng\u01b0\u1eddi, \u0111\u1ee9ng d\u1eady \u0111i l\u1ea1i v\u00e0 t\u1eadn h\u01b0\u1edfng m\u1ed9t gi\u1ea5c ng\u1ee7 ngon. Ch\u1ecb r\u1ea5t b\u1ea5t ng\u1edd v\u1edbi hi\u1ec7u qu\u1ea3 t\u1ee9c th\u00ec c\u1ee7a \u0111i\u1ec1u tr\u1ecb, li\u1ec1u l\u01b0\u1ee3ng thu\u1ed1c gi\u1ea3m \u0111au c\u0169ng \u0111\u01b0\u1ee3c gi\u1ea3m d\u1ea7n v\u00e0 sau 48h, ch\u1ecb kh\u00f4ng c\u00f2n ph\u1ea3i s\u1eed d\u1ee5ng th\u00eam thu\u1ed1c gi\u1ea3m \u0111au. Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0y qu\u1ea3 th\u1ef1c \u0111\u00e3 l\u00e0m cho ch\u1ecb c\u1ea3m gi\u00e1c nh\u1eb9 nh\u00f5m c\u1ea3 v\u1ec1 th\u1ec3 x\u00e1c l\u1eabn tinh th\u1ea7n, ch\u1ecb T cho bi\u1ebft th\u00eam.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

H\u00ecnh \u1ea3nh:<\/em><\/strong> Ch\u1ecb T sau th\u1ee7 thu\u1eadt \u0111i\u1ec1u tr\u1ecb gi\u1ea3m \u0111au.<\/em><\/p>\n\n\n\n

Can thi\u1ec7p di\u1ec7t \u0111\u00e1m r\u1ed1i th\u1ea7n kinh \u0111i\u1ec1u tr\u1ecb \u0111au do ung th\u01b0 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng \u0111\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd ung th\u01b0 v\u00f9ng b\u1ee5ng tr\u00ean nh\u01b0 ung th\u01b0 gan, t\u1ee5y, th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y, t\u00fai m\u1eadt, th\u1eadn, \u2026 b\u1ecb \u0111au dai d\u1eb3ng v\u00f9ng b\u1ee5ng, l\u01b0ng c\u1ee5c b\u1ed9. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au nhanh ch\u00f3ng v\u00e0 l\u00e2u d\u00e0i h\u01a1n so v\u1edbi ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c n\u1ed9i khoa th\u00f4ng th\u01b0\u1eddng. \u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p gi\u1ea3m \u0111au hi\u1ec7u qu\u1ea3 v\u00e0 nh\u00e2n v\u0103n, gi\u00fap ng\u01b0\u1eddi b\u1ec7nh c\u00f3 cu\u1ed9c s\u1ed1ng t\u1ed1t \u0111\u1eb9p, l\u1ea1c quan v\u00e0 c\u00f3 \u0111\u1ed9ng l\u1ef1c h\u01a1n \u0111\u1ec3 chi\u1ebfn \u0111\u1ea5u v\u1edbi b\u1ec7nh t\u1eadt. \u0110\u1eb7c bi\u1ec7t chi ph\u00ed cho k\u1ef9 thu\u1eadt n\u00e0y kh\u00f4ng qu\u00e1 cao, ph\u00f9 h\u1ee3p v\u1edbi nhi\u1ec1u \u0111\u1ed1i t\u01b0\u1ee3ng ng\u01b0\u1eddi b\u1ec7nh kh\u00e1c nhau.<\/p>\n\n\n\n

B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh l\u00e0 c\u01a1 s\u1edf y t\u1ebf c\u00f4ng l\u1eadp, \u0111a khoa v\u1edbi nhi\u1ec1u chuy\u00ean khoa s\u00e2u v\u1ec1 ph\u1eabu thu\u1eadt, h\u1ed3i s\u1ee9c, ung th\u01b0, dinh d\u01b0\u1ee1ng, n\u1ed9i khoa, ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9, X-quang can thi\u1ec7p…Vi\u1ec7c ph\u1ed1i h\u1ee3p v\u1edbi nhi\u1ec1u chuy\u00ean khoa trong qu\u00e1 tr\u00ecnh s\u1ebd gi\u00fap ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe to\u00e0n di\u1ec7n, n\u00e2ng cao ch\u1ea5t l\u01b0\u1ee3ng \u0111i\u1ec1u tr\u1ecb<\/p>\n","protected":false},"excerpt":{"rendered":"

K\u0129 thu\u1eadt m\u1edbi n\u00e0y s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p n\u1ed9i m\u1ea1ch l\u00e0m t\u1eafc m\u1ea1ch nu\u00f4i kh\u1ed1i b\u01b0\u1edbu kh\u1ed1ng ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ung th\u01b0 sau \u0111\u00f3 di\u1ec7t \u0111\u00e1m r\u1ed1i th\u1ea7n kinh h\u1ea1 v\u1ecb nh\u1eb1m \u0111i\u1ec1u tr\u1ecb \u0111au cho ng\u01b0\u1eddi b\u1ec7nh ung th\u01b0. \u0110\u00e2y l\u00e0 k\u0129 thu\u1eadt x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u, chi ph\u00ed th\u1ea5p, 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