{"id":273883,"date":"2008-04-03T11:43:55","date_gmt":"2008-04-03T04:43:55","guid":{"rendered":"https:\/\/clients-previewhub.com\/hoanmy_wp\/xoan-thung-tinh-hoan\/"},"modified":"2025-11-08T19:23:45","modified_gmt":"2025-11-08T12:23:45","slug":"xoan-thung-tinh-hoan","status":"publish","type":"post","link":"https:\/\/clients-previewhub.com\/hoanmy_wp\/xoan-thung-tinh-hoan\/","title":{"rendered":"Xo\u1eafn Th\u1eebng Tinh Ho\u00e0n"},"content":{"rendered":"<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>2- Sinh b\u1ec7nh h\u1ecdc <\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">Tinh ho\u00e0n \u0111\u01b0\u1ee3c bao b\u1ecdc b\u1edfi m\u00e0ng bao tinh ho\u00e0n (tunica vaginalis), t\u1ea1o m\u1ed9t kho\u1ea3ng tr\u1ed1ng l\u1edbn h\u01a1n \u1edf 2\/3 ph\u00eda tr\u01b0\u1edbc c\u1ee7a tinh ho\u00e0n n\u01a1i c\u00e1c d\u1ecbch t\u1eeb nhi\u1ec1u ngu\u1ed3n kh\u00e1c nhau c\u00f3 th\u1ec3 d\u1ed3n \u0111\u1ebfn. M\u00e0ng bao tinh ho\u00e0n d\u00ednh v\u00e0o m\u1eb7t sau ngo\u00e0i c\u1ee7a tinh ho\u00e0n, khi\u1ebfn tinh ho\u00e0n \u00edt kh\u1ea3 n\u0103ng di chuy\u1ec3n trong b\u00ecu.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">\u1ede nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 m\u00e0ng bao tinh ho\u00e0n d\u00ednh cao b\u1ea5t th\u01b0\u1eddng, tinh ho\u00e0n c\u00f3 th\u1ec3 xoay t\u1ef1 do tr\u00ean th\u1eebng tinh trong m\u00e0ng bao tinh ho\u00e0n (xo\u1eafn tinh ho\u00e0n trong m\u00e0ng bao=intravaginal testicular torsion). B\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh n\u00e0y, g\u1ecdi l\u00e0 d\u1ea5u hi\u1ec7u b\u1ea5t th\u01b0\u1eddng c\u1ee7a qu\u1ea3 l\u1eafc chu\u00f4ng (the bell clapper deformity) d\u1eabn \u0111\u1ebfn tr\u1ee5c d\u00e0i c\u1ee7a tinh ho\u00e0n n\u1eb1m ngang thay v\u00ec theo tr\u1ee5c th\u1eb3ng c\u1ee7a c\u01a1 th\u1ec3.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">B\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh n\u00e0y hi\u1ec7n di\u1ec7n \u1edf kho\u1ea3ng 12% \u0111\u00e0n \u00f4ng, 40% trong s\u1ed1 \u0111\u00f3 c\u00f3 lu\u00f4n b\u1ea5t th\u01b0\u1eddng n\u00e0y \u1edf tinh ho\u00e0n b\u00ean kia. B\u1ea5t th\u01b0\u1eddng qu\u1ea3 l\u1eafc chu\u00f4ng (the bell clapper deformity) khi\u1ebfn tinh ho\u00e0n xoay tr\u00ean th\u1eebng tinh, g\u00e2y t\u1eafc t\u0129nh m\u1ea1ch v\u00e0 t\u1ee5 m\u00e1u, v\u1edbi h\u1ec7 qu\u1ea3 l\u00e0 thi\u1ebfu m\u00e1u \u0111\u1ed9ng m\u1ea1ch v\u00e0 ho\u1ea1i t\u1eed tinh ho\u00e0n. C\u00e1c b\u1eb1ng ch\u1ee9ng th\u1ef1c nghi\u1ec7m cho th\u1ea5y c\u1ea7n xo\u1eafn 720\u00b0 \u0111\u1ec3 g\u00e2y r\u1ed1i lo\u1ea1n l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u1edf \u0111\u1ed9ng m\u1ea1ch tinh ho\u00e0n v\u00e0 d\u1eabn \u0111\u1ebfn thi\u1ebfu m\u00e1u.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">\u1ede tr\u1ebb s\u01a1 sinh, tinh ho\u00e0n th\u01b0\u1eddng ch\u01b0a xu\u1ed1ng \u0111\u1ebfn b\u00ecu, n\u01a1i n\u00f3 s\u1ebd d\u00ednh v\u1edbi m\u00e0ng bao tinh ho\u00e0n. T\u00ednh di \u0111\u1ed9ng l\u00fac n\u00e0y c\u1ee7a tinh ho\u00e0n khi\u1ebfn n\u00f3 d\u1ec5 b\u1ecb xo\u1eafn (xo\u1eafn tinh ho\u00e0n ngo\u00e0i m\u00e0ng bao=extravaginal testicular torsion). Ngo\u00e0i ra, tinh ho\u00e0n kh\u00f4ng d\u00ednh \u0111\u1ea7y \u0111\u1ee7 v\u1edbi th\u00e0nh c\u1ee7a b\u00ecu th\u01b0\u1eddng x\u1ea3y ra \u1edf&nbsp; 7-10 ng\u00e0y \u0111\u1ea7u ti\u00ean c\u1ee7a cu\u1ed9c s\u1ed1ng.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>3- T\u1ea7n Xu\u1ea5t<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>\u1ede M\u1ef9<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">T\u1ea7n xu\u1ea5t xo\u1eafn th\u1eebng tinh ho\u00e0n \u1edf ng\u01b0\u1eddi d\u01b0\u1edbi 25 tu\u1ed5i kho\u1ea3ng 1\/4000. Tinh ho\u00e0n tr\u00e1i th\u01b0\u1eddng b\u1ecb xo\u1eafn nhi\u1ec1u h\u01a1n. \u0110\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p xo\u1eafn th\u1eebng tinh ho\u00e0n \u1edf tr\u1ebb s\u01a1 sinh, 70% x\u1ea3y ra tr\u01b0\u1edbc khi sanh v\u00e0 30% sau khi sanh.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>4- T\u1eed vong\/B\u1ec7nh T\u1eadt<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">C\u1ea5p c\u1ee9u ni\u1ec7u khoa n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n nhanh ch\u00f3ng, chuy\u1ec3n ngay \u0111\u1ebfn khoa ni\u1ec7u v\u00e0 kh\u1ea9n tr\u01b0\u01a1ng \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 c\u1ee9u s\u1ed1ng tinh ho\u00e0n. T\u1ec9 l\u1ec7 c\u1ee9u s\u1ed1ng 100% g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c th\u00e1o xo\u1eafn trong v\u00f2ng 6 gi\u1edd k\u1ec3 t\u1eeb l\u00fac \u0111au; 20% n\u1ebfu sau 12 gi\u1edd; v\u00e0 0% s\u1ed1ng s\u00f3t n\u1ebfu th\u00e1o xo\u1eafn ti\u1ebfn h\u00e0nh sau 24 gi\u1edd.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>5- Gi\u1edbi T\u00ednh<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">Xo\u1eafn th\u1eebng tinh ho\u00e0n ch\u1ec9 x\u1ea3y ra \u1edf \u0111\u00e0n \u00f4ng.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>6- Tu\u1ed5i T\u00e1c<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">Xo\u1eafn th\u1eebng tinh ho\u00e0n th\u01b0\u1eddng x\u1ea3y ra \u1edf ng\u01b0\u1eddi d\u01b0\u1edbi 30 tu\u1ed5i, cao nh\u1ea5t trong kho\u1ea3ng 12-18 tu\u1ed5i. \u0110\u1ec9nh \u0111i\u1ec3m \u1edf 14 tu\u1ed5i, m\u1eb7c d\u00f9 m\u1ed9t \u0111\u1ec9nh \u0111i\u1ec3m ph\u1ee5 th\u1ea5p h\u01a1n c\u00f3 th\u1ec3 x\u1ea3y ra trong n\u0103m \u0111\u1ea7u ti\u00ean c\u1ee7a cu\u1ed9c \u0111\u1eddi.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>B- L\u00c2M S\u00c0NG<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>1- B\u1ec7nh S\u1eed<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>\u0110au nghi\u00eam tr\u1ecdng x\u1ea3y ra c\u1ea5p t\u00ednh \u1edf m\u1ed9t b\u00ean b\u00ecu.<\/li>\n<li>50% b\u1ecbnh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed nh\u1eefng \u0111\u1ee3t \u0111au tinh ho\u00e0n gi\u00e1n c\u00e1ch tr\u01b0\u1edbc \u0111\u00e2y sau \u0111\u00f3 t\u1ef1 kh\u1ecfi (xo\u1eafn v\u00e0 t\u1ef1 th\u00e1o xo\u1eafn).<\/li>\n<li>\u0110au c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t ch\u1eadm h\u01a1n, nh\u01b0ng&nbsp; kh\u00f4ng&nbsp; \u0111i\u1ec3n h\u00ecnh cho c\u01a1n \u0111au do xo\u1eafn tinh ho\u00e0n.<\/li>\n<li>Xo\u1eafn c\u00f3 th\u1ec3 x\u1ea3y ra trong l\u00fac \u0111ang l\u00e0m vi\u1ec7c, c\u00f3 li\u00ean quan \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng, ho\u1eb7c x\u1ea3y ra trong khi ng\u1ee7 v\u00e0 c\u00f3 nh\u1eefng bi\u1ec3u hi\u1ec7n sau:\n<ul>\n<li>S\u01b0ng b\u00ecu<\/li>\n<li>Bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n (20-30%)<\/li>\n<li>\u0110au b\u1ee5ng (20-30%)<\/li>\n<li>S\u1ed1t (16%)<\/li>\n<li>Ti\u1ec3u l\u1eaft nh\u1eaft (4%)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>2- L\u00e2m S\u00e0ng<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>\u0110au tinh ho\u00e0n khi n\u1eafn; v\u1ecb tr\u00ed cao h\u01a1n tinh ho\u00e0n b\u00ean kia<\/li>\n<li>Tinh ho\u00e0n n\u1eb1m ngang<\/li>\n<li>S\u01b0ng ph\u00f9 tinh ho\u00e0n; ph\u00f9 to\u00e0n b\u1ed9 b\u00ecu<\/li>\n<li>B\u00ecu sung huy\u1ebft \u0111\u1ecf<\/li>\n<li>M\u1ea5t ph\u1ea3n x\u1ea1 th\u1eebng tinh c\u00f9ng b\u00ean<\/li>\n<li>Th\u01b0\u1eddng kh\u00f4ng b\u1edbt \u0111au khi n\u00e2ng b\u00ecu, (n\u00e2ng b\u00ecu c\u00f3 th\u1ec3 gi\u1ea3m \u0111au khi vi\u00eam m\u00e0o tinh ho\u00e0n = d\u1ea5u hi\u1ec7u Prehn)<\/li>\n<li>S\u1ed1t (kh\u00f4ng th\u01b0\u1eddng xuy\u00ean)<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>3- Nguy\u00ean Nh\u00e2n<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>B\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh; b\u1ea5t th\u01b0\u1eddng qu\u1ea3 l\u1eafc chu\u00f4ng (bell clapper deformity)<\/li>\n<li>Tinh ho\u00e0n kh\u00f4ng xu\u1ed1ng b\u00ecu \u0111\u1ea7y \u0111\u1ee7<\/li>\n<li>Ho\u1ea1t \u0111\u1ed9ng th\u01b0\u1eddng ng\u00e0y, sinh ho\u1ea1t t\u00ecnh d\u1ee5c<\/li>\n<li>Ch\u1ea5n th\u01b0\u01a1ng<\/li>\n<li>T\u1eadp luy\u1ec7n th\u1ec3 l\u1ef1c<\/li>\n<li>Ph\u1ea3n x\u1ea1 th\u1eebng tinh<\/li>\n<li>Kh\u00ed h\u1eadu l\u1ea1nh<\/li>\n<\/ul>\n<\/div>\n<p><strong>C- CH\u1ea8N \u0110O\u00c1N PH\u00c2N BI\u1ec6T<\/strong><\/p>\n<p>&#8211;&nbsp; Vi\u00eam ru\u1ed9t th\u1eeba c\u1ea5p<\/p>\n<p>&#8211;&nbsp; Vi\u00eam m\u00e0o tinh ho\u00e0n<\/p>\n<p>&#8211;&nbsp; Ho\u1ea1i t\u1eed Fournier<\/p>\n<p>&#8211;&nbsp; Tho\u00e1t v\u1ecb<\/p>\n<p>&#8211;&nbsp; Tr\u00e0n d\u1ecbch m\u00e0ng tinh ho\u00e0n<\/p>\n<p>&#8211;&nbsp; Vi\u00eam tinh ho\u00e0n<\/p>\n<p>&#8211;&nbsp; Vi\u00eam<a title=\"DifferentialsOtherProblemstobeConsidered\" name=\"DifferentialsOtherProblemstobeConsidered\"><\/a> ru\u1ed9t th\u1eeba tr\u1ebb em<\/p>\n<p><strong>C\u00e1c v\u1ea5n \u0111\u1ec1 kh\u00e1c<\/strong><\/p>\n<p>&#8211;&nbsp; V\u1ee1 tinh ho\u00e0n do ch\u1ea5n th\u01b0\u01a1ng<\/p>\n<p>&#8211;&nbsp; T\u1ee5 m\u00e1u tinh ho\u00e0n do ch\u1ea5n th\u01b0\u01a1ng<\/p>\n<p>&#8211;&nbsp; Xo\u1eafn c\u00e1c ph\u1ea7n ph\u1ee5 c\u1ee7a tinh ho\u00e0n<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>D- X\u00c9T NGHI\u1ec6M<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>1- Ph\u00f2ng X\u00e9t Nghi\u1ec7m<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u\n<ul>\n<li>Th\u01b0\u1eddng l\u00e0 b\u00ecnh th\u01b0\u1eddng.<\/li>\n<li>Hi\u1ec7n di\u1ec7n c\u1ee7a b\u1ea1ch c\u1ea7u \u1edf 30% b\u1ecbnh nh\u00e2n c\u00f3 xo\u1eafn tinh ho\u00e0n; do \u0111\u00f3 kh\u00f4ng n\u00ean d\u1ef1a tr\u00ean&nbsp; b\u1ea1ch c\u1ea7u \u0111\u1ec3 lo\u1ea1i tr\u1eeb ch\u1ea9n \u0111o\u00e1n.<\/li>\n<\/ul>\n<\/li>\n<li>C\u00f4ng Th\u1ee9c M\u00e1u: CTM b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng b\u1ea1ch c\u1ea7u c\u00f3 khi \u0111\u1ebfn&nbsp; 60% s\u1ed1 b\u1ecbnh nh\u00e2n xo\u1eafn tinh ho\u00e0n.<\/li>\n<li>C\u00e1c proteins&nbsp; giai \u0111o\u1ea1n c\u1ea5p (C-reactive protein =CRP): T\u0103ng proteins giai \u0111o\u1ea1n c\u1ea5p CRP, \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 ph\u00e2n bi\u1ec7t b\u1ecbnh l\u00fd vi\u00eam (vi\u00eam m\u00e0o tinh ho\u00e0n=epididymitis) v\u1edbi c\u00e1c nguy\u00ean nh\u00e2n kh\u00f4ng vi\u00eam (xo\u1eafn tinh ho\u00e0n=testicular torsion) \u0111\u1ed1i v\u1edbi m\u1ed9t tr\u01b0\u1eddng h\u1ee3p \u0111au \u1edf b\u00ecu. Tuy nhi\u00ean k\u1ebft qu\u1ea3 c\u00f2n \u0111ang ti\u1ebfp t\u1ee5c \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 v\u00ec c\u1ee1 m\u1eabu nghi\u00ean c\u1ee9u ch\u01b0a \u0111\u1ee7 l\u1edbn \u0111\u1ec3 mang t\u00ednh thuy\u1ebft ph\u1ee5c.<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>2- Ch\u1ea9n \u0110o\u00e1n H\u00ecnh \u1ea2nh<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>Ch\u1ea9n \u0111o\u00e1n xo\u1eafn th\u1eebng tinh ho\u00e0n l\u00e0 m\u1ed9t ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng. Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh th\u01b0\u1eddng kh\u00f4ng c\u1ea7n thi\u1ebft. Vi\u1ec7c ch\u1ec9 \u0111\u1ecbnh ch\u00fang l\u00e0m t\u1ed1n k\u00e9m th\u1eddi gian qu\u00ed gi\u00e1 khi vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u01a1 b\u1ea3n l\u00e0 ph\u1eabu thu\u1eadt.<\/li>\n<li>N\u1ebfu ch\u1ea9n \u0111o\u00e1n kh\u00f4ng ch\u1eafc ch\u1eafn, c\u00f3 th\u1ec3 d\u00f9ng scan ph\u00f3ng x\u1ea1 (radionuclide scans) 2 tinh ho\u00e0n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn v\u00e0 ph\u00e2n bi\u1ec7t xo\u1eafn v\u1edbi c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c.\n<ul>\n<li>Scan b\u1ea5t th\u01b0\u1eddng&nbsp; \u1edf xo\u1eafn th\u1eebng tinh ho\u00e0n khi n\u00f3 ch\u1ee9ng minh \u0111\u01b0\u1ee3c c\u00f3 gi\u1ea3m h\u1ea5p thu \u1edf tinh ho\u00e0n b\u1ecb t\u1ed5n th\u01b0\u01a1ng, g\u1ee3i \u00fd cho th\u1ea5y kh\u00f4ng c\u00f3 m\u00e1u \u0111\u1ebfn b\u00ean xo\u1eafn.<\/li>\n<li>Scan ph\u00f3ng x\u1ea1 (Radionuclide scans) c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c \u0111\u1ebfn 90-100% \u0111\u1ec3 ph\u00e1t hi\u1ec7n l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn tinh ho\u00e0n.<\/li>\n<\/ul>\n<\/li>\n<li>Si\u00eau \u00e2m Doppler m\u00e0u ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c d\u00f9ng nhi\u1ec1u \u0111\u1ec3 ch\u1ee9ng minh l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn tinh ho\u00e0n v\u00e0 cung c\u1ea5p th\u00f4ng tin v\u1ec1 gi\u1ea3i ph\u1eabu h\u1ecdc c\u1ee7a b\u00ecu v\u00e0 c\u00e1c b\u1ea5t th\u01b0\u1eddng kh\u00e1c c\u1ee7a tinh ho\u00e0n. Si\u00eau \u00e2m Doppler m\u00e0u c\u00f3 \u0111\u1ed9 nh\u1ea1y 86%, \u0111\u1ed9 chuy\u00ean bi\u1ec7t 100%, v\u00e0 \u0111\u1ed9 ch\u00ednh x\u00e1c 97% \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n xo\u1eafn th\u1eebng tinh ho\u00e0n khi s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a d\u00f2ng m\u00e1u \u0111\u1ebfn tinh ho\u00e0n l\u00e0 ti\u00eau ch\u00ed&nbsp; duy nh\u1ea5t \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n.\n<ul>\n<li>Si\u00eau \u00e2m Doppler th\u00f4ng th\u01b0\u1eddng kh\u00f4ng ch\u00ednh x\u00e1c b\u1eb1ng Doppler m\u00e0u \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn tinh ho\u00e0n.<\/li>\n<li>Th\u1ea7y thu\u1ed1c c\u1ea5p c\u1ee9u n\u00ean \u0111\u01b0\u1ee3c hu\u1ea5n luy\u1ec7n t\u1ed1t \u0111\u1ec3 c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n si\u00eau \u00e2m t\u1ea1i gi\u01b0\u1eddng b\u1ec7nh, g\u00f3p ph\u1ea7n trong ch\u1ea9n \u0111o\u00e1n nhanh xo\u1eafn th\u1eebng tinh ho\u00e0n.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>E- \u0110I\u1ec0U TR\u1eca<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>1- C\u1ea5p C\u1ee9u<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>Ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 chuy\u1ec3n nhanh \u0111\u1ebfn khoa Ti\u1ebft Ni\u1ec7u \u0111\u1ec3 l\u00e0 c\u1ea5p thi\u1ebft v\u00ec th\u1eddi gian l\u00e0 y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh \u0111\u1ec3 c\u1ee9u s\u1ed1ng tinh ho\u00e0n.<\/li>\n<li>Thu\u1ed1c gi\u1ea3m \u0111au nh\u1eb9 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng m\u1ed9t khi \u0111\u00e3 ch\u1ea9n \u0111o\u00e1n xo\u1eafn th\u1eebng tinh ho\u00e0n trong khi ch\u1edd c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c.<\/li>\n<li>M\u1ed9t s\u1ed1 B\u00e1c s\u0129 chuy\u00ean khoa kh\u00f4ng d\u00f9ng gi\u1ea3m \u0111au \u0111\u1ec3 k\u1ebft qu\u1ea3 tham kh\u00e1m kh\u00f4ng b\u1ecb sai l\u1ec7ch.<\/li>\n<li>Th\u1eed th\u00e1o xo\u1eafn b\u1eb1ng tay, n\u1ebfu th\u00e0nh c\u00f4ng, b\u1ecbnh nh\u00e2n s\u1ebd b\u1edbt \u0111au ngay. Th\u1ee7 thu\u1eadt th\u1ef1c hi\u1ec7n gi\u1ed1ng nh\u01b0 &#8220;m\u1edf m\u1ed9t cu\u1ed1n s\u00e1ch&#8221; khi ng\u01b0\u1eddi th\u1ea7y thu\u1ed1c \u0111\u1ee9ng \u1edf ph\u00eda 2 ch\u00e2n c\u1ee7a b\u1ecbnh nh\u00e2n<\/li>\n<li>\u0110a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p xo\u1eafn v\u00e0o ph\u00eda trong v\u00e0 h\u01b0\u1edbng v\u1ec1 \u0111\u01b0\u1eddng gi\u1eefa, do \u0111\u00f3 th\u00e1o xo\u1eafn b\u1eb1ng tay s\u1ebd xoay tinh ho\u00e0n ra ph\u00eda b\u00ean ngo\u00e0i.\n<ul>\n<li>V\u00ed d\u1ee5 n\u1ebfu nghi ng\u1edd xo\u1eafn th\u1eebng tinh ho\u00e0n ph\u1ea3i, th\u1ea7y thu\u1ed1c s\u1ebd \u0111\u1ee9ng \u0111\u1ed1i di\u1ec7n v\u1edbi b\u1ecbnh nh\u00e2n \u0111ang \u1edf t\u01b0 th\u1ebf \u0111\u1ee9ng ho\u1eb7c n\u1eb1m v\u00e0 c\u1ea7m tinh ho\u00e0n ph\u1ea3i c\u1ee7a b\u1ecbnh nh\u00e2n b\u1eb1ng 2 ng\u00f3n c\u00e1i v\u00e0 tr\u1ecf tr\u00e1i c\u1ee7a m\u00ecnh.<\/li>\n<li>Th\u1ea7y thu\u1ed1c xoay tinh ho\u00e0n c\u1ee7a b\u1ecbnh nh\u00e2n 180\u00b0 t\u1eeb trong ra ph\u00eda ngo\u00e0i .<\/li>\n<li>C\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i xoay tinh ho\u00e0n nh\u1eafc l\u1ea1i t\u1eeb 2-3 l\u1ea7n \u0111\u1ec3 th\u00e1o xo\u1eafn ho\u00e0n to\u00e0n v\u00e0 gi\u00fap b\u1ecbnh nh\u00e2n b\u1edbt \u0111au.<\/li>\n<li>Tr\u01b0\u1eddng h\u1ee3p tinh ho\u00e0n tr\u00e1i c\u1ee7a b\u1ecbnh nh\u00e2n b\u1ecb xo\u1eafn, th\u1ea7y thu\u1ed1c d\u00f9ng 2 ng\u00f3n c\u00e1i v\u00e0 tr\u1ecf ph\u1ea3i \u0111\u1ec3 xoay tinh ho\u00e0n t\u1eeb trong ra ph\u00eda ngo\u00e0i 180\u00b0.<\/li>\n<li>Th\u00e1o xo\u1eafn tinh ho\u00e0n b\u1eb1ng tay (manual detorsion) th\u00e0nh c\u00f4ng \u1edf 30-70% tr\u01b0\u1eddng h\u1ee3p.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>2- H\u1ed9i Ch\u1ea9n<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">N\u1ebfu ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng nghi xo\u1eafn th\u1eebng tinh ho\u00e0n, b\u1eaft bu\u1ed9c m\u1eddi h\u1ed9i ch\u1ea9n Ngo\u1ea1i Ni\u1ec7u s\u1edbm v\u00ec \u0111i\u1ec1u tr\u1ecb kinh \u0111i\u1ec3n l\u00e0 ph\u1eabu thu\u1eadt th\u00e1o xo\u1eafn v\u00e0 ph\u1eabu thu\u1eadt c\u1ed1 \u0111\u1ecbnh tinh ho\u00e0n (orchiopexy).<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>F- THU\u1ed0C MEN<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">D\u00f9ng thu\u1ed1c gi\u1ea3m \u0111au th\u1eadn tr\u1ecdng sau khi \u0111\u00e3 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c xo\u1eafn th\u1eebng tinh ho\u00e0n. M\u1ed9t s\u1ed1 b\u00e1c s\u0129 chuy\u00ean khoa Ni\u1ec7u kh\u00f4ng d\u00f9ng gi\u1ea3m \u0111au \u0111\u1ec3 vi\u1ec7c \u0111\u00e1nh gi\u00e1 v\u00e0 th\u0103m kh\u00e1m \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c, kh\u00e1ch quan<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>Thu\u1ed1c gi\u1ea3m \u0111au:<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>Morphine sulfate <\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">&#8211; Ng\u01b0\u1eddi l\u1edbn: Kh\u1edfi \u0111\u1ea7u: 0.1 mg\/kg IV\/IM\/SC. Duy tr\u00ec: 5-20 mg\/70 kg IV\/IM\/SC m\u1ed7i 4 gi\u1edd<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">&#8211; S\u01a1 sinh: 0.05-0.2 mg\/kg\/ li\u1ec1u IV\/IM\/SC m\u1ed7i 2-4gi\u1edd d\u00f9ng khi c\u1ea7n thi\u1ebft; kh\u00f4ng v\u01b0\u1ee3t qu\u00e1 15 mg\/li\u1ec1u<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">&#8211; Tr\u1ebb em: 0.1-0.2 mg\/kg\/ li\u1ec1u IV\/IM\/SC m\u1ed7i 2-4gi\u1edd d\u00f9ng khi c\u1ea7n thi\u1ebft.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\">Tr\u00e1nh d\u00f9ng khi t\u1ee5t huy\u1ebft \u00e1p, suy h\u00f4 h\u1ea5p, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n, t\u00e1o b\u00f3n, b\u00ed ti\u1ec3u; d\u00f9ng c\u1ea9n th\u1eadn trong tr\u01b0\u1eddng h\u1ee3p&nbsp; flutter nh\u0129 v\u00e0 c\u00e1c nh\u1ecbp nhanh tr\u00ean th\u1ea5t v\u00ec morphin gi\u1ea3i ph\u1ebf v\u1ecb (vagolytic) v\u00e0 t\u0103ng \u0111\u00e1p \u1ee9ng nh\u1ecbp th\u1ea5t.<\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>G- THEO D\u00d5I<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>1- Chuy\u1ec3n vi\u1ec7n<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>Chuy\u1ec3n b\u1ec7nh nh\u00e2n ngay n\u1ebfu kh\u00f4ng c\u00f3 chuy\u00ean khoa ngo\u1ea1i Ni\u1ec7u.<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>2- Bi\u1ebfn Ch\u1ee9ng<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>Ho\u1ea1i t\u1eed tinh ho\u00e0n<\/li>\n<li>M\u1ea5t tinh ho\u00e0n<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng<\/li>\n<li>V\u00f4 sinh th\u1ee9 ph\u00e1t do m\u1ea5t tinh ho\u00e0n<\/li>\n<li>Bi\u1ebfn d\u1ea1ng tinh ho\u00e0n<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>3- Ti\u00ean L\u01b0\u1ee3ng<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>N\u1ebfu \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n s\u1edbm, t\u1ec9 l\u1ec7 c\u1ee9u s\u1ed1ng tinh ho\u00e0n c\u00f3 th\u1ec3 \u0111\u1ea1t 100% . Ph\u1eabu thu\u1eadt c\u1ed1 \u0111\u1ecbnh tinh ho\u00e0n (orchiopexy) kh\u00f4ng \u0111\u1ea3m b\u1ea3o s\u1ebd kh\u00f4ng x\u1ea3y ra xo\u1eafn th\u1eebng tinh ho\u00e0n sau n\u00e0y, d\u00f9 c\u00f3 gi\u1ea3m t\u1ec9 l\u1ec7 t\u00e1i xo\u1eafn.<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>4- H\u01b0\u1edbng D\u1eabn B\u1ec7nh Nh\u00e2n<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>C\u1ea7n h\u01b0\u1edbng d\u1eabn ng\u01b0\u1eddi nh\u00e0 v\u00e0 b\u1ea3n th\u00e2n b\u1ec7nh nh\u00e2n nh\u1eadn bi\u1ebft s\u1edbm c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a xo\u1eafn th\u1eebng tinh ho\u00e0n.<\/li>\n<li>C\u1ea7n h\u01b0\u1edbng d\u1eabn b\u1ec7nh nh\u00e2n n\u1eafm v\u1eefng c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c c\u00f3 th\u1ec3 g\u00e2y \u0111au tinh ho\u00e0n (vi\u00eam tinh ho\u00e0n do bi\u1ebfn ch\u1ee9ng quai b\u1ecb, vi\u00eam m\u00e0o tinh ho\u00e0n v.v.)<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>H- TH\u00d4NG TIN KH\u00c1C<\/strong><\/p>\n<div align=\"justify\"><\/div>\n<p align=\"justify\"><strong>1- Ph\u00e1p l\u00fd<\/strong><\/p>\n<div align=\"justify\">\n<ul>\n<li>Thi\u1ebfu s\u00f3t trong nh\u1eadn \u0111\u1ecbnh m\u1ed9t c\u1ea5p c\u1ee9u ngo\u1ea1i ni\u1ec7u<\/li>\n<li>Ch\u1eadm tr\u1ec5 trong h\u1ed9i ch\u1ea9n v\u1edbi khoa Ni\u1ec7u<\/li>\n<li>Ch\u1ea9n \u0111o\u00e1n sai v\u1edbi vi\u00eam m\u00e0o tinh ho\u00e0n<\/li>\n<li>Th\u00e1o xo\u1eafn kh\u00f4ng tr\u1ecdn v\u1eb9n (kh\u00f4ng \u0111\u1ee7 720\u00b0)<\/li>\n<\/ul>\n<\/div>\n<p align=\"justify\"><strong>2- H\u00ecnh \u1ea2nh Minh Ho\u1ea1:<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>C\u01a1 quan sinh d\u1ee5c nam: Tinh ho\u00e0n (Testis)<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>H\u00ecnh \u1ea3nh b\u00ecnh th\u01b0\u1eddng (T) v\u00e0 h\u00ecnh \u1ea3nh xo\u1eafn th\u1eebng tinh ho\u00e0n (P)<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>C\u1ea5u tr\u00fac tinh ho\u00e0n b\u00ecnh th\u01b0\u1eddng<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Xo\u1eafn th\u1eebng tinh ho\u00e0n<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>H\u00ecnh \u1ea3nh si\u00eau \u00e2m m\u00e0u xo\u1eafn th\u1eebng tinh ho\u00e0n T<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>H\u00ecnh \u1ea3nh si\u00eau \u00e2m m\u00e0u xo\u1eafn th\u1eebng tinh ho\u00e0n P<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Xo\u1eafn th\u1eebng tinh ho\u00e0n<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Ph\u1eabu thu\u1eadt c\u1ed1 \u0111\u1ecbnh tinh ho\u00e0n (orchiopexy)<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Tinh ho\u00e0n b\u00ecnh th\u01b0\u1eddng<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Xo\u1eafn th\u1eebng tinh ho\u00e0n T<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Ph\u1eabu thu\u1eadt c\u1ed1 \u0111\u1ecbnh tinh ho\u00e0n (orchiopexy)<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Ph\u1eabu thu\u1eadt c\u1ed1 \u0111\u1ecbnh tinh ho\u00e0n (orchiopexy)<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>BS \u0110\u1ed2NG NG\u1eccC KHANH &#8211; &nbsp;BV \u0110a Khoa Ho\u00e0n M\u1ef9 S\u00e0i G\u00f2n. <\/strong><\/p>\n<p><a title=\"References\" name=\"References\"><\/a><a title=\"section~References\" name=\"section~References\"><\/a><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n<ul>\n<li>Timothy J Rupp, MD, FACEP. Testicular Torsion<\/li>\n<li>Baker LA, Sigman D, Mathews RI, et al.&nbsp;An analysis of clinical outcomes using color doppler testicular ultrasound for testicular torsion.&nbsp;<em>Pediatrics<\/em>.&nbsp;Mar&nbsp;2000;105(3 Pt 1):604-7.&nbsp;.<\/li>\n<li>Blaivas M, Sierzenski P, Lambert M.&nbsp;Emergency evaluation of patients presenting with acute scrotum using bedside ultrasonography.&nbsp;<em>Acad Emerg Med<\/em>.&nbsp;Jan&nbsp;2001;8(1):90-3.&nbsp;.<\/li>\n<li>Blank BH, Goldsmith G, Schneider RE.&nbsp;Recognizing a testicular emergency.&nbsp;<em>Patient Care<\/em>.&nbsp;1997;31(13):117-35.<\/li>\n<li>Brenner JS, Ojo A.&nbsp;Evaluation of scrotal pain or swelling in children and adolescents. UpToDate [web site].&nbsp;2006.<\/li>\n<li>Brenner JS, Ojo A.&nbsp;Causes of scrotal pain in children and adolescents. UpToDate [web site].&nbsp;2006.<\/li>\n<li>Caesar RE, Kaplan GW.&nbsp;Incidence of the bell-clapper deformity in an autopsy series.&nbsp;<em>Urology<\/em>.&nbsp;Jul&nbsp;1994;44(1):114-6.&nbsp;.<\/li>\n<li>Cattolica EV, Karol JB, Rankin KN, Klein RS.&nbsp;High testicular salvage rate in torsion of the spermatic cord.&nbsp;<em>J Urol<\/em>.&nbsp;Jul&nbsp;1982;128(1):66-8.&nbsp;.<\/li>\n<li>Cattolica EV.&nbsp;Preoperative manual detorsion of the torsed spermatic cord.&nbsp;<em>J Urol<\/em>.&nbsp;May&nbsp;1985;133(5):803-5.<\/li>\n<li>Doehn C, Fornara P, Kausch I, et al.&nbsp;Value of acute-phase proteins in the differential diagnosis of acute scrotum.&nbsp;<em>Eur Urol<\/em>.&nbsp;Feb&nbsp;2001;39(2):215-21.<\/li>\n<li>Dogra V, Bhatt S.&nbsp;Acute painful scrotum.&nbsp;<em>Radiol Clin North Am<\/em>.&nbsp;Mar&nbsp;2004;42(2):349-63.<\/li>\n<li>Eyre RC.&nbsp;Evaluation of the acute scrotum in adults. UpToDate [web site].<\/li>\n<li>Flanigan RC, DeKernion JB, Persky L.&nbsp;Acute scrotal pain and swelling in children: a surgical emergency.&nbsp;<em>Urology<\/em>.&nbsp;Jan&nbsp;1981;17(1):51-3.&nbsp;.<\/li>\n<\/ul>\n<ul>\n<li>Kadish HA, Bolte RG.&nbsp;A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendages.&nbsp;<em>Pediatrics<\/em>.&nbsp;Jul&nbsp;1998;102(1 Pt 1):73-6.<\/li>\n<li>McCollough M, Sharieff GQ.&nbsp;Abdominal surgical emergencies in infants and young children.&nbsp;<em>Emerg Med Clin North Am<\/em>.&nbsp;Nov&nbsp;2003;21(4):909-35.<\/li>\n<li>Schwab R.&nbsp;Acute scrotal pain requires quick thinking and plan of action.&nbsp;<em>Emerg Med Rep<\/em>.&nbsp;1992;13(2):11-7.<\/li>\n<li>Wan J, Bloom DA.&nbsp;Genitourinary problems in adolescent males.&nbsp;<em>Adolesc Med<\/em>.&nbsp;Oct&nbsp;2003;14(3):717-31, viii..<\/li>\n<li>Weber DM, Rosslein R, Fliegel C.&nbsp;Color Doppler sonography in the diagnosis of acute scrotum in boys.&nbsp;<em>Eur J Pediatr Surg<\/em>.&nbsp;Aug&nbsp;2000;10(4):235-41.&nbsp;.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2- Sinh b\u1ec7nh h\u1ecdc Tinh ho\u00e0n \u0111\u01b0\u1ee3c bao b\u1ecdc b\u1edfi m\u00e0ng bao tinh ho\u00e0n (tunica vaginalis), t\u1ea1o m\u1ed9t kho\u1ea3ng tr\u1ed1ng l\u1edbn h\u01a1n \u1edf 2\/3 ph\u00eda tr\u01b0\u1edbc c\u1ee7a tinh ho\u00e0n n\u01a1i c\u00e1c d\u1ecbch t\u1eeb nhi\u1ec1u ngu\u1ed3n kh\u00e1c nhau c\u00f3 th\u1ec3 d\u1ed3n \u0111\u1ebfn. M\u00e0ng bao tinh ho\u00e0n d\u00ednh v\u00e0o m\u1eb7t sau ngo\u00e0i c\u1ee7a tinh ho\u00e0n, khi\u1ebfn tinh [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1249],"tags":[],"class_list":["post-273883","post","type-post","status-publish","format-standard","hentry","category-tin-tuc-y-te"],"acf":[],"_links":{"self":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/273883","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/comments?post=273883"}],"version-history":[{"count":1,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/273883\/revisions"}],"predecessor-version":[{"id":311114,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/273883\/revisions\/311114"}],"wp:attachment":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/media?parent=273883"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/categories?post=273883"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/tags?post=273883"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}