{"id":3662,"date":"2020-03-18T16:49:43","date_gmt":"2020-03-18T09:49:43","guid":{"rendered":"http:\/\/new.vientebaogoc.edu.vn\/?post_type=blog_post&p=1091"},"modified":"2024-11-24T07:58:42","modified_gmt":"2024-11-24T00:58:42","slug":"cay-ghep-te-bao-sun-tu-than","status":"publish","type":"post","link":"https:\/\/sci.edu.vn\/home\/blog\/2020\/03\/18\/cay-ghep-te-bao-sun-tu-than\/","title":{"rendered":"C\u1ea5y gh\u00e9p t\u1ebf b\u00e0o s\u1ee5n t\u1ef1 th\u00e2n"},"content":{"rendered":"\n

T\u1ed5n th\u01b0\u01a1ng s\u1ee5n kh\u1edbp (c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 t\u1ed5n th\u01b0\u01a1ng s\u1ee5n), ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ea3 s\u1ee5n v\u00e0 x\u01b0\u01a1ng b\u00ean d\u01b0\u1edbi (c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng kh\u1edbp), \u0111\u1ec1u kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng t\u1ef1 s\u1eeda ch\u1eefa v\u00e0 d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 g\u00e2y ra ch\u1ee9ng \u0111au kh\u1edbp v\u00e0 ch\u1ee9c n\u0103ng k\u00e9m.<\/p>\n\n\n\n

C\u00e1c t\u1ed5n th\u01b0\u01a1ng nh\u01b0 v\u1eady th\u01b0\u1eddng g\u1eb7p sau ch\u1ea5n th\u01b0\u01a1ng, v\u00e0 n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn vi\u00eam x\u01b0\u01a1ng kh\u1edbp. Kh\u1edbp \u0111\u1ea7u g\u1ed1i th\u01b0\u1eddng b\u1ecb \u1ea3nh h\u01b0\u1edfng nh\u1ea5t. B\u1ec7nh nh\u00e2n tr\u00ean 60 tu\u1ed5i b\u1ecb vi\u00eam x\u01b0\u01a1ng kh\u1edbp c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng ph\u1ea3i thay kh\u1edbp g\u1ed1i to\u00e0n ph\u1ea7n. Tuy nhi\u00ean, b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i ph\u1ea3i \u0111\u1ed1i m\u1eb7t v\u1edbi m\u1ed9t v\u1ea5n \u0111\u1ec1, \u0111\u00f3 l\u00e0 do kh\u1edbp thay th\u1ebf c\u00f3 tu\u1ed5i th\u1ecd h\u1ea1n ch\u1ebf, sau 10-15 n\u0103m b\u1ec7nh nh\u00e2n ph\u1ea3i thay kh\u1edbp m\u1edbi, khi n\u00e0y tu\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u00e3 l\u1edbn. \u0110\u1ed3ng th\u1eddi, khi thay kh\u1edbp g\u1ed1i l\u1ea7n th\u1ee9 hai ph\u1ea3i \u0111\u1ed1i m\u1eb7t v\u1edbi c\u00e1c k\u1ef9 thu\u1eadt ph\u1ee9c t\u1ea1p v\u00e0 kh\u00f3 kh\u0103n h\u01a1n nhi\u1ec1u so v\u1edbi thay kh\u1edbp l\u1ea7n \u0111\u1ea7u. <\/p>\n\n\n\n

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Quy tr\u00ecnh c\u1ea5y gh\u00e9p t\u1ebf b\u00e0o s\u1ee5n t\u1ef1 th\u00e2n <\/figcaption><\/figure>\n\n\n\n

Do \u0111\u00f3, c\u00e1c k\u1ef9 thu\u1eadt nh\u1eb1m th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh t\u00e1i t\u1ea1o s\u1ee5n trong (hyaline) tr\u1edf n\u00ean r\u1ea5t h\u1ea5p d\u1eabn, v\u00ec ch\u00fang v\u1eeba gi\u00fap s\u1eeda ch\u1eefa m\u00f4, v\u1eeba cho ph\u00e9p b\u1ec7nh nh\u00e2n tr\u1ebb th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c c\u00e1c ho\u1ea1t \u0111\u1ed9ng sinh ho\u1ea1t tr\u01b0\u1edbc \u0111\u00f3. K\u1ef9 thu\u1eadt nh\u01b0 v\u1eady l\u00e0 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 k\u1ef9 thu\u1eadt c\u1ea5y t\u1ebf b\u00e0o s\u1ee5n t\u1ef1 th\u00e2n (ACI).<\/p>\n\n\n\n

ACI l\u00e0 m\u1ed9t quy tr\u00ecnh t\u01b0\u01a1ng \u0111\u1ed1i m\u1edbi, hi\u1ec7n \u0111\u1ea1i \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u1ed5n th\u01b0\u01a1ng to\u00e0n b\u1ed9 (xu\u1ed1ng x\u01b0\u01a1ng) s\u1ee5n kh\u1edbp. \u0110\u00e2y l\u00e0 k\u1ef9 thu\u1eadt \u0111\u1ec3 t\u00e1i t\u1ea1o s\u1ee5n trong trong m\u1ed9t khu v\u1ef1c b\u1ecb t\u1ed5n th\u01b0\u01a1ng ho\u1eb7c b\u1ecb h\u01b0 h\u1ecfng c\u1ee7a kh\u1edbp th\u00f4ng qua vi\u1ec7c c\u1ea5y gh\u00e9p c\u00e1c t\u1ebf b\u00e0o s\u1ee5n. K\u1ef9 thu\u1eadt n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i k\u1ec3 t\u1eeb khi n\u00f3 \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u v\u00e0o nh\u1eefng n\u0103m 1980. N\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c C\u1ee5c Qu\u1ea3n l\u00fd Th\u1ef1c ph\u1ea9m v\u00e0 D\u01b0\u1ee3c ph\u1ea9m Hoa K\u1ef3 ph\u00ea duy\u1ec7t cho \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u1ed5n th\u01b0\u01a1ng s\u1ee5n n\u1eb1m \u1edf cu\u1ed1i x\u01b0\u01a1ng \u0111\u00f9i. Ngo\u00e0i c\u00e1c kh\u1edbp kh\u00e1c c\u1ee7a c\u01a1 th\u1ec3, ACI c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n cho c\u00e1c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a x\u01b0\u01a1ng b\u00e1nh ch\u00e8 (\u0111\u1ea7u g\u1ed1i). ACI \u0111\u00e3 \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 l\u00e2u d\u00e0i tuy\u1ec7t v\u1eddi, c\u1ea3 v\u1ec1 s\u1eeda ch\u1eefa s\u1ee5n v\u00e0 gi\u00fap b\u1ec7nh nh\u00e2n tr\u1edf l\u1ea1i ho\u1ea1t \u0111\u1ed9ng nh\u01b0 tr\u01b0\u1edbc \u0111\u00f3. C\u1ea5y t\u1ebf b\u00e0o s\u1ee5n t\u1ef1 th\u00e2n l\u00e0 m\u1ed9t quy tr\u00ecnh ph\u1eabu thu\u1eadt hai giai \u0111o\u1ea1n.<\/p>\n\n\n\n

Quy tr\u00ecnh \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng k\u1ef9 thu\u1eadt n\u1ed9i soi trong v\u00f2ng ch\u01b0a \u0111\u1ea7y 30 ph\u00fat. B\u00e1c s\u0129 ph\u1eabu thu\u1eadt s\u1ebd thu m\u1ed9t m\u1ea3nh s\u1ee5n kh\u1edbp nh\u1ecf t\u1eeb \u0111\u1ea7u g\u1ed1i b\u1ec7nh nh\u00e2n. Sinh thi\u1ebft s\u1ee5n n\u00e0y sau \u0111\u00f3 \u0111\u01b0\u1ee3c g\u1eedi \u0111\u1ebfn ph\u00f2ng th\u00ed nghi\u1ec7m \u0111\u1ec3 x\u1eed l\u00fd b\u1eb1ng enzyme nh\u1eb1m ph\u00e2n l\u1eadp c\u00e1c t\u1ebf b\u00e0o ti\u1ec1n th\u00e2n t\u1ea1o s\u1ee5n. \u0110\u00e2y l\u00e0 c\u00e1c t\u1ebf b\u00e0o s\u1ea3n xu\u1ea5t s\u1ee5n c\u1ee7a c\u01a1 th\u1ec3. Sau \u0111\u00f3, c\u00e1c t\u1ebf b\u00e0o ti\u1ec1n th\u00e2n t\u1ea1o s\u1ee5n s\u1ebd \u0111\u01b0\u1ee3c nu\u00f4i t\u0103ng sinh v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng v\u00e0 g\u1eedi l\u1ea1i cho b\u00e1c s\u0129 ph\u1eabu thu\u1eadt kho\u1ea3ng 6 \u0111\u1ebfn 8 tu\u1ea7n sau \u0111\u00f3 \u0111\u1ec3 c\u1ea5y gh\u00e9p.<\/p>\n\n\n\n

Quy tr\u00ecnh th\u1ee9 hai l\u00e0 ph\u1eabu thu\u1eadt. Ph\u1eabu thu\u1eadt l\u00e0 m\u1ed9t quy tr\u00ecnh m\u1edf, theo \u0111\u00f3 m\u1ed9t mi\u1ebfng v\u00e1 nh\u1ecf \u0111\u01b0\u1ee3c kh\u00e2u tr\u00ean v\u00f9ng s\u1ee5n kh\u1edbp b\u1ecb khi\u1ebfm khuy\u1ebft. C\u00e1c t\u1ebf b\u00e0o s\u1ee5n \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e2n l\u1eadp v\u00e0 nu\u00f4i t\u0103ng sinh s\u1ed1 l\u01b0\u1ee3ng sau \u0111\u00f3 \u0111\u01b0\u1ee3c ti\u00eam b\u00ean d\u01b0\u1edbi mi\u1ebfng v\u00e1 n\u00e0y. T\u1ea1i \u0111\u00e2y, ch\u00fang d\u00ednh v\u00e0o \u0111\u1ea7u g\u1ed1i b\u1ec7nh nh\u00e2n \u0111\u1ec3 t\u1ea1o th\u00e0nh c\u00e1i g\u1ecdi l\u00e0 s\u1ee5n gi\u1ed1ng nh\u01b0 hyaline v\u00e0 gi\u1ed1ng nh\u01b0 s\u1ee5n kh\u1edbp t\u1ef1 nhi\u00ean. Sau khi c\u1ea5y gh\u00e9p, b\u1ec7nh nh\u00e2n b\u1ecb gi\u1edbi h\u1ea1n m\u1ed9t kho\u1ea3ng th\u1eddi gian kh\u00f4ng \u0111\u01b0\u1ee3c mang v\u00e1ch n\u1eb7ng trong t\u1ed1i \u0111a 8 tu\u1ea7n. Trong th\u1eddi gian n\u00e0y, vi\u1ec7c v\u1eadt l\u00fd tr\u1ecb li\u1ec7u \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng \u0111\u1ed1i v\u1edbi ho\u1ea1t \u0111\u1ed9ng c\u1ee7a \u0111\u1ea7u g\u1ed1i v\u00e0 c\u00e1c ho\u1ea1t \u0111\u1ed9ng t\u0103ng c\u01b0\u1eddng kh\u00e1c theo ch\u1ec9 \u0111\u1ecbnh.\u001cB\u00e1c s\u0129 c\u0169ng c\u00f3 th\u1ec3 \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng m\u00e1y v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng li\u00ean t\u1ee5c (CPM) \u0111\u1ec3 c\u1ea3i thi\u1ec7n hi\u1ec7u qu\u1ea3 c\u1ea5y gh\u00e9p. Quay tr\u1edf l\u1ea1i c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao nh\u1eb9 th\u01b0\u1eddng \u0111\u01b0\u1ee3c cho ph\u00e9p v\u00e0o kho\u1ea3ng 6 th\u00e1ng v\u00e0 tr\u1edf l\u1ea1i c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao \u0111\u1ea7y \u0111\u1ee7 trong kho\u1ea3ng t\u1eeb 9 \u0111\u1ebfn 12 th\u00e1ng sau khi l\u00e0m th\u1ee7 thu\u1eadt d\u1ef1a tr\u00ean s\u1ef1 ph\u1ee5c h\u1ed3i c\u1ee7a b\u1ec7nh nh\u00e2n. T\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng chung c\u1ee7a ACI l\u00e0 kho\u1ea3ng 85% trong vi\u1ec7c cho ph\u00e9p b\u1ec7nh nh\u00e2n quay tr\u1edf l\u1ea1i c\u00e1c ho\u1ea1t \u0111\u1ed9ng m\u00e0 kh\u00f4ng b\u1ecb \u0111au.<\/p>\n\n\n\n

ACI \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng cho nh\u1eefng b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111au kh\u1edbp v\u00e0 s\u01b0ng, li\u00ean quan \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng kh\u1edbp s\u1ee5n.<\/p>\n\n\n\n

T\u1ea1i Vi\u1ec7t Nam, ch\u01b0a th\u1ea5y c\u00f3 c\u00f4ng b\u1ed1 n\u00e0o v\u1ec1 vi\u1ec7c th\u1ef1c hi\u1ec7n li\u1ec7u ph\u00e1p n\u00e0y trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd v\u1ec1 s\u1ee5n kh\u1edbp. <\/p>\n\n\n\n

Ngu\u1ed3n:<\/p>\n\n\n\n

https:\/\/cartilage.org\/patient\/about-cartilage\/cartilage-repair\/autologous-chondrocyte-implantation-aci<\/a><\/p>\n\n\n\n

https:\/\/www.ortho.wustl.edu\/content\/Patient-Care\/2888\/Services\/Sports-Medicine\/Overview\/Knee\/Autologous-Chondrocyte-Implantation.aspx<\/a><\/p>\n\n\n\n

Ph\u1ea1m V\u0169 T\u1ed5ng h\u1ee3p v\u00e0 d\u1ecbch<\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

T\u1ed5n th\u01b0\u01a1ng s\u1ee5n kh\u1edbp (c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 t\u1ed5n th\u01b0\u01a1ng s\u1ee5n), ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng c\u1ea3 s\u1ee5n v\u00e0 x\u01b0\u01a1ng b\u00ean d\u01b0\u1edbi (c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng kh\u1edbp), \u0111\u1ec1u kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng t\u1ef1 s\u1eeda ch\u1eefa v\u00e0 d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 g\u00e2y ra ch\u1ee9ng \u0111au kh\u1edbp v\u00e0 ch\u1ee9c n\u0103ng k\u00e9m. C\u00e1c t\u1ed5n th\u01b0\u01a1ng nh\u01b0 v\u1eady […]<\/p>\n","protected":false},"author":293,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"","jetpack_seo_html_title":"","jetpack_seo_noindex":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[161],"tags":[],"class_list":["post-3662","post","type-post","status-publish","format-standard","hentry","category-ban-tin"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/posts\/3662","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/users\/293"}],"replies":[{"embeddable":true,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/comments?post=3662"}],"version-history":[{"count":1,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/posts\/3662\/revisions"}],"predecessor-version":[{"id":4491,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/posts\/3662\/revisions\/4491"}],"wp:attachment":[{"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/media?parent=3662"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/categories?post=3662"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/tags?post=3662"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}