TÀI LIỆU HỘI THẢO TMH_clone

["(A): D\u1eef li\u1ec7u WBT b\u00ecnh th\u01b0\u1eddng \u1edf tr\u1ebb s\u01a1 sinh. \u0110\u1ed1i t\u01b0\u1ee3ng n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c s\u00e0ng l\u1ecdc TEOAE v\u00e0 k\u1ebft qu\u1ea3 b\u00ecnh th\u01b0\u1eddng. \u0110\u01b0\u1eddng cong 3D \u0111\u01b0\u1ee3c m\u00e3 h\u00f3a m\u00e0u, hi\u1ec3n th\u1ecb gi\u00e1 tr\u1ecb t\u1ed1t b\u1eb1ng m\u00e0u xanh lam (\u0111\u1ed9 h\u1ea5p thu cao) v\u00e0 gi\u00e1 tr\u1ecb \u0111\u1ed9 h\u1ea5p thu th\u1ea5p h\u01a1n ho\u1eb7c c\u00f3 b\u1ea5t th\u01b0\u1eddng b\u1eb1ng m\u00e0u \u0111\u1ecf.","(B): D\u1eef li\u1ec7u WBT t\u1eeb tr\u1ebb c\u00f3 k\u1ebft qu\u1ea3 s\u00e0ng l\u1ecdc TEOAE b\u1ea5t th\u01b0\u1eddng. \u0110\u01b0\u1eddng cong 3D \u0111\u01b0\u1ee3c m\u00e3 h\u00f3a m\u00e0u, hi\u1ec3n th\u1ecb c\u00e1c gi\u00e1 tr\u1ecb \u0111\u1ed9 h\u1ea5p thu th\u1ea5p h\u01a1n ho\u1eb7c c\u00f3 b\u1ea5t th\u01b0\u1eddng b\u1eb1ng m\u00e0u \u0111\u1ecf cam.","2.2. \u0110\u1ed9 h\u1ea5p thu v\u00e0 c\u00e1c ph\u00e9p \u0111o li\u00ean quan \u2022 C\u00f3 th\u1ec3 thu g\u1ecdn m\u1ed9t v\u00e0i t\u1ea7n s\u1ed1 v\u00e0 thu \u0111\u01b0\u1ee3c d\u1eef li\u1ec7u \u0111\u1ed9 h\u1ea5p thu tr\u00ean m\u1ed9t d\u1ea3i t\u1ea7n s\u1ed1 trung b\u00ecnh g\u1ecdi l\u00e0 nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 b\u0103ng r\u1ed9ng trung b\u00ecnh (wideband averaged tympanogram), c\u00f3 th\u1ec3 g\u1ee3i \u00fd c\u00e1c nghi ng\u1edd tr\u00ean l\u00e2m s\u00e0ng t\u1ed1t h\u01a1n \u0111\u1ed1i v\u1edbi tr\u1ebb s\u01a1 sinh kh\u1ecfe m\u1ea1nh v\u00e0 tr\u1ebb s\u01a1 sinh t\u1ea1i khoa NICU. \u2022 Kho\u1ea3ng trung b\u00ecnh c\u1ee7a WBT \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u1edf tr\u1ebb s\u01a1 sinh l\u00e0 t\u1eeb 800 \u0111\u1ebfn 2000 Hz, v\u00ec n\u00f3 \u0111\u01b0\u1ee3c t\u1ed1i \u01b0u h\u00f3a ph\u00f9 h\u1ee3p c\u00e1c b\u1ea5t th\u01b0\u1eddng truy\u1ec1n \u00e2m ME nh\u01b0 \u00e1p su\u1ea5t \u00e2m ME v\u00e0 tr\u00e0n d\u1ecbch ME. \u2022 Trong d\u1ea3i t\u1ea7n s\u1ed1 n\u00e0y, c\u00e1c b\u1ec7nh l\u00fd n\u00e0y t\u1ea1o ra \u0111\u1ed3 th\u1ecb 3D th\u1ec3 hi\u1ec7n s\u1ef1 kh\u00e1c bi\u1ec7t l\u1edbn v\u00e0 \u0111\u00e1ng k\u1ec3 gi\u1eefa tai b\u00ecnh th\u01b0\u1eddng v\u00e0 tai b\u1ea5t th\u01b0\u1eddng.","Nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 3D tai b\u00ecnh th\u01b0\u1eddng v\u00e0 nghe k\u00e9m d\u1eabn truy\u1ec1n","Nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 3D \u1edf tai (T) t\u1ed5n th\u01b0\u01a1ng \u1edf 4000Hz v\u00e0 tai (P) v\u1edbi nghe k\u00e9m h\u1ed7n h\u1ee3p","2.2. \u0110\u1ed9 h\u1ea5p thu v\u00e0 c\u00e1c ph\u00e9p \u0111o li\u00ean quan \u2022 Theo Interacoustics, kho\u1ea3ng trung b\u00ecnh c\u1ee7a WBT \u1edf ng\u01b0\u1eddi l\u1edbn \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh t\u1eeb 375 \u0111\u1ebfn 2000 Hz. \u2022 S\u1eed d\u1ee5ng d\u1eef li\u1ec7u WBT trung b\u00ecnh trong kho\u1ea3ng n\u00e0y, c\u00f3 th\u1ec3 ph\u00e2n bi\u1ec7t t\u1ed1t c\u00e1c ph\u1ea3n h\u1ed3i WBT gi\u1eefa tr\u1ebb em v\u00e0 ng\u01b0\u1eddi l\u1edbn. \u2022 Interacoustics \u0111\u1ec1 ngh\u1ecb l\u1ea5y trung b\u00ecnh d\u1eef li\u1ec7u WBT b\u1eaft \u0111\u1ea7u t\u1eeb 375 Hz v\u00e0 kh\u00f4ng ph\u1ea3i t\u1eeb 226 Hz, v\u00ec t\u1ea7n s\u1ed1 n\u00e0y kh\u00f4ng mang l\u1ea1i gi\u00e1 tr\u1ecb ph\u00e2n bi\u1ec7t cao.","2.2. \u0110\u1ed9 h\u1ea5p thu v\u00e0 c\u00e1c ph\u00e9p \u0111o li\u00ean quan \u2022 C\u00f3 th\u1ec3 thu \u0111\u01b0\u1ee3c th\u00f4ng tin v\u1ec1 \u0111\u1ed9 h\u1ea5p thu \u1edf t\u1ea7n s\u1ed1 c\u1ed9ng h\u01b0\u1edfng ME, t\u01b0\u01a1ng \u1ee9ng v\u1edbi t\u1ea7n s\u1ed1 m\u00e0 kh\u1ed1i l\u01b0\u1ee3ng v\u00e0 \u0111\u1ed9 c\u1ee9ng \u0111\u00f3ng g\u00f3p nh\u01b0 nhau v\u00e0o \u0111\u1ed9 h\u1ea5p thu (ph\u1ea3n h\u1ed3i \u1edf pha zero). T\u1ea7n s\u1ed1 c\u1ed9ng h\u01b0\u1edfng (resonance frequency) h\u1eefu \u00edch trong ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ea5t th\u01b0\u1eddng ME nh\u01b0 tr\u1eadt kh\u1edbp chu\u1ed7i x\u01b0\u01a1ng con ho\u1eb7c x\u01a1 tai. \u2022 \u0110\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh l\u00fd gi\u00e1n \u0111o\u1ea1n chu\u1ed7i x\u01b0\u01a1ng con ho\u1eb7c b\u1ec7nh l\u00fd kh\u00e1c hi\u1ec7n di\u1ec7n m\u1ed9t kh\u1ed1i u \u1edf ME, t\u1ea7n s\u1ed1 c\u1ed9ng h\u01b0\u1edfng c\u1ee7a tai gi\u1eefa c\u00f3 xu h\u01b0\u1edbng gi\u1ea3m. \u0110\u1ed1i v\u1edbi x\u01a1 tai, t\u1ea7n s\u1ed1 c\u1ed9ng h\u01b0\u1edfng t\u0103ng v\u1ecdt \u1edf c\u00e1c t\u1ea7n s\u1ed1 cao.","2.2. \u0110\u1ed9 h\u1ea5p thu v\u00e0 c\u00e1c ph\u00e9p \u0111o li\u00ean quan \u2022 Theo d\u00f5i t\u1ea7n s\u1ed1 c\u1ed9ng h\u01b0\u1edfng d\u01b0\u1eddng nh\u01b0 l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ea7y h\u1ee9a h\u1eb9n \u0111\u1ec3 theo d\u00f5i ti\u1ebfn tri\u1ec3n l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh x\u01a1 tai. \u2022 C\u00f3 th\u1ec3 thu \u0111\u01b0\u1ee3c \u201cnh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 t\u1ea7n s\u1ed1 c\u1ed9ng h\u01b0\u1edfng\u201d (resonance frequency tympanogram), r\u1ea5t h\u1eefu \u00edch trong vi\u1ec7c ph\u00e2n bi\u1ec7t gi\u1eefa c\u00e1c b\u1ec7nh l\u00fd gi\u00e1n \u0111o\u1ea1n x\u01b0\u01a1ng con v\u00e0 m\u00e0ng nh\u0129 m\u1ecfng.","2.2. \u0110\u1ed9 h\u1ea5p thu v\u00e0 c\u00e1c ph\u00e9p \u0111o li\u00ean quan \u2022 T\u1eeb \u0111\u1ed3 th\u1ecb nh\u0129 l\u01b0\u1ee3ng 3D, c\u00f3 th\u1ec3 thu \u0111\u01b0\u1ee3c th\u00f4ng tin v\u1ec1 \u0111\u1ed9 h\u1ea5p thu t\u1ea1i m\u1ed9t t\u1ea7n s\u1ed1 c\u1ee5 th\u1ec3 \u0111\u01b0\u1ee3c \u0111o trong \u00e1p l\u1ef1c kh\u00f4ng kh\u00ed ho\u1eb7c \u00e1p l\u1ef1c tai gi\u1eefa. \u2022 \u0110\u1ed9 h\u1ea5p thu \u00e2m thanh (acoustic absorbance) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 t\u1ef7 l\u1ec7 gi\u1eefa n\u0103ng l\u01b0\u1ee3ng \u00e2m thanh \u0111\u01b0\u1ee3c h\u1ea5p thu (absorbed sound power) v\u00e0 n\u0103ng l\u01b0\u1ee3ng \u00e2m thanh \u0111\u01b0\u1ee3c ph\u00e1t ra (incident sound power). \u2022 C\u00e1c b\u1ec7nh l\u00fd \u0111\u01b0\u1ee3c theo d\u00f5i ho\u1eb7c \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n b\u1eb1ng ph\u01b0\u01a1ng th\u1ee9c n\u00e0y nh\u01b0: x\u01a1 tai, m\u00e0ng nh\u0129 m\u1ecfng, gi\u00e1n \u0111o\u1ea1n chu\u1ed7i x\u01b0\u01a1ng con, h\u1edf \u1ed1ng b\u00e1n khuy\u00ean, tr\u1ebb c\u00f3 \u00e1p su\u1ea5t \u00e2m tai gi\u1eefa v\u00e0 tr\u00e0n d\u1ecbch tai gi\u1eefa.","C\u00e1c d\u1ea1ng nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 th\u1ec3 hi\u1ec7n \u0111\u1ed9 h\u1ea5p thu c\u1ee7a c\u00e1c b\u1ec7nh l\u00fd tai gi\u1eefa kh\u00e1c nhau","2.2. \u0110\u1ed9 h\u1ea5p thu v\u00e0 c\u00e1c ph\u00e9p \u0111o li\u00ean quan \u2022 M\u1ed9t s\u1ed1 b\u00e0i b\u00e1o c\u00e1o ch\u1ec9 ra r\u1eb1ng \u0111\u1ed3 th\u1ecb c\u1ee7a nh\u0129 \u0111\u1ed3 h\u1ea5p thu cho ph\u00e9p ph\u00e2n bi\u1ec7t t\u1ed1t h\u01a1n gi\u1eefa c\u00e1c b\u1ec7nh v\u1ec1 tai gi\u1eefa so v\u1edbi ph\u01b0\u01a1ng ph\u00e1p \u0111o nh\u0129 l\u01b0\u1ee3ng truy\u1ec1n th\u1ed1ng. \u2022 C\u00f3 nh\u1eefng nh\u00f3m b\u1ec7nh nh\u00e2n m\u00e0 vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh \u00e1p su\u1ea5t trong tai c\u00f3 th\u1ec3 kh\u00f3 kh\u0103n. \u2022 V\u00ec v\u1eady, m\u1ed9t th\u1eed nghi\u1ec7m \u0111o \u0111\u1ed9 h\u1ea5p thu \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong \u0111i\u1ec1u ki\u1ec7n kh\u00f4ng \u0111i\u1ec1u ch\u1ec9nh \u00e1p su\u1ea5t s\u1ebd r\u1ea5t h\u1eefu \u00edch \u0111\u1ec3 theo d\u00f5i t\u00ecnh tr\u1ea1ng tai gi\u1eefa ngay sau khi ph\u1eabu thu\u1eadt, m\u00e0ng nh\u0129 th\u1ee7ng trong qu\u00e1 tr\u00ecnh t\u1ea7m so\u00e1t s\u1ee9c nghe \u1edf tr\u1ebb s\u01a1 sinh. \u2022 Trong m\u1ed9t v\u00e0i nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf \u00e1p l\u1ef1c kh\u00f4ng kh\u00ed \u0111\u00e3 ch\u1ee9ng minh c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n nh\u1eefng thay \u0111\u1ed5i ch\u1ee9c n\u0103ng tai gi\u1eefa \u0111\u00e1ng k\u1ec3 \u0111\u1ed1i v\u1edbi tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb nh\u1ecf.","2.2. \u0110\u1ed9 h\u1ea5p thu v\u00e0 c\u00e1c ph\u00e9p \u0111o li\u00ean quan Theo nghi\u00ean c\u1ee9u c\u1ee7a Groon v\u00e0 c\u1ed9ng s\u1ef1, cho th\u1ea5y nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1eb7t \u1ed1ng th\u00f4ng kh\u00ed: (i) \u0111\u1ed1i v\u1edbi b\u1ea5t k\u1ef3 l\u1ed7 th\u1ee7ng tr\u00ean m\u00e0ng nh\u0129 n\u00e0o l\u1edbn h\u01a1n 0,25 mm \u0111\u1ec1u g\u00e2y thay \u0111\u1ed5i \u0111\u1ed9 h\u1ea5p thu c\u00f3 th\u1ec3 l\u00ean \u0111\u1ebfn 10 kHz; (ii) \u1edf t\u1ea7n s\u1ed1 tr\u00ean 1kHz s\u1ef1 thay \u0111\u1ed5i \u0111\u1ed9 h\u1ea5p thu kh\u00f4ng th\u1ec3 d\u1ef1 \u0111o\u00e1n \u0111\u01b0\u1ee3c; (iii) c\u00e1c gi\u00e1 tr\u1ecb \u0111\u1ed9 h\u1ea5p thu ch\u1ee7 y\u1ebfu t\u0103ng \u1edf c\u00e1c d\u1ea3i t\u1ea7n s\u1ed1 th\u1ea5p h\u01a1n (0,1\u20130,2 v\u00e0 0,2\u20130,5 kHz).","2.2. \u0110\u1ed9 h\u1ea5p thu v\u00e0 c\u00e1c ph\u00e9p \u0111o li\u00ean quan \u2022 D\u1eef li\u1ec7u t\u1eeb Keefe v\u00e0 Simmons g\u1ee3i \u00fd r\u1eb1ng c\u00e1c ph\u00e9p \u0111o \u0111\u1ed9 h\u1ea5p thu, n\u1ebfu ch\u00fang \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u1edf m\u1ee9c \u00e1p su\u1ea5t cao nh\u1ea5t, s\u1ebd nh\u1ea1y h\u01a1n v\u1edbi c\u00e1c b\u1ec7nh l\u00fd v\u00e0 bi\u1ebfn ch\u1ee9ng ME. \u2022 V\u1ec1 m\u1eb7t ph\u00e2n t\u00edch, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 b\u00e1o c\u00e1o so s\u00e1nh c\u00e1c th\u1eed nghi\u1ec7m v\u1edbi \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u c\u1ed1 \u0111\u1ecbnh l\u00e0 0,90; \u0111\u1ed9 nh\u1ea1y l\u00e0 0,28 (\u0111\u1ed1i v\u1edbi \u0111\u1ed9 th\u00f4ng thu\u1eadn \u00e2m t\u0129nh \u0111\u01b0\u1ee3c b\u00f9 c\u1ef1c \u0111\u1ea1i \u1edf 226 Hz); 0,72 (\u0111\u1ed1i v\u1edbi WBT \u00e1p su\u1ea5t kh\u00f4ng kh\u00ed) v\u00e0 0,94 (\u0111\u1ed1i v\u1edbi WBT \u0111i\u1ec1u \u00e1p). \u2022 WBT \u0111i\u1ec1u \u00e1p ch\u00ednh x\u00e1c h\u01a1n trong vi\u1ec7c d\u1ef1 \u0111o\u00e1n nghe k\u00e9m d\u1eabn truy\u1ec1n v\u1edbi di\u1ec7n t\u00edch d\u01b0\u1edbi \u0111\u01b0\u1eddng cong ROC (receiver operating characteristic) l\u00e0 0,95.","2.3. Nh\u1eefng c\u1ea3i ti\u1ebfn trong \u0111o nh\u0129 l\u01b0\u1ee3ng \u2022 WBT c\u1ea3i ti\u1ebfn \u0111o nh\u0129 l\u01b0\u1ee3ng b\u1eb1ng c\u00e1ch t\u1ea1o ra nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 \u1edf c\u00e1c t\u1ea7n s\u1ed1 kh\u00e1c nhau. \u2022 Gi\u00e1 tr\u1ecb trung b\u00ecnh \u1edf ng\u01b0\u1eddi l\u1edbn l\u00e0 375-2000 Hz, nh\u01b0ng \u1edf tr\u1ebb s\u01a1 sinh l\u00e0 800-2000 Hz; s\u1eed d\u1ee5ng d\u1ea3i t\u1ea7n s\u1ed1 nh\u01b0 v\u1eady \u0111\u1ec3 ph\u00e1t hi\u1ec7n d\u1ecbch tai gi\u1eefa. \u2022 WBT \u00edt b\u1ecb nhi\u1ec5u v\u1edbi ti\u1ebfng \u1ed3n, do \u0111\u00f3 cho nh\u0129 \u0111\u1ed3 \u1ed5n \u0111\u1ecbnh ngay c\u1ea3 \u0111\u1ed1i v\u1edbi nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng \u1ed3n \u00e0o nh\u01b0 tr\u1ebb em. \u2022 M\u1ed9t nghi\u00ean c\u1ee9u so s\u00e1nh gi\u1eefa WBT \u1edf 1250 Hz v\u00e0 \u0111\u1ed9 th\u00f4ng thu\u1eadn t\u0129nh \u1edf 226 Hz cho th\u1ea5y WBT ph\u00e2n bi\u1ec7t t\u1ed1t nh\u1ea5t gi\u1eefa tai b\u00ecnh th\u01b0\u1eddng v\u00e0 tai b\u1ecb \u1ee9 d\u1ecbch.","2.3. Nh\u1eefng c\u1ea3i ti\u1ebfn trong \u0111o nh\u0129 l\u01b0\u1ee3ng \u2022 \u0110o nh\u0129 l\u01b0\u1ee3ng t\u1ea7n s\u1ed1 cao cho k\u1ebft qu\u1ea3 ch\u00ednh x\u00e1c h\u01a1n \u1edf tr\u1ebb nh\u1ecf v\u00e0 \u0111o nh\u0129 l\u01b0\u1ee3ng t\u1ea7n s\u1ed1 th\u1ea5p cho k\u1ebft qu\u1ea3 ch\u00ednh x\u00e1c h\u01a1n \u1edf tr\u1ebb l\u1edbn h\u01a1n. Tuy nhi\u00ean, t\u1ea7n s\u1ed1 t\u1ed1i \u01b0u ph\u00e1t hi\u1ec7n c\u00e1c b\u1ec7nh l\u00fd v\u1ec1 tai gi\u1eefa \u1edf tr\u1ebb t\u1eeb 4-8 th\u00e1ng tu\u1ed5i v\u1eabn ch\u01b0a r\u00f5 r\u00e0ng. \u2022 WBT t\u1ea1o ra nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 \u1edf c\u1ea3 226 v\u00e0 1000 Hz, cho ph\u00e9p c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng so s\u00e1nh th\u00f4ng s\u1ed1 t\u1ea7n s\u1ed1 th\u1ea5p v\u00e0 t\u1ea7n s\u1ed1 cao. \u2022 Nghi\u00ean c\u1ee9u c\u1ee7a Terzi v\u00e0 c\u1ed9ng s\u1ef1 ph\u00e1t hi\u1ec7n ra r\u1eb1ng t\u1ef7 l\u1ec7 h\u1ea5p thu (\u0111\u1ed9 h\u1ea5p thu trung b\u00ecnh 0,375-2 kHz) \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam tai gi\u1eefa \u1ee9 d\u1ecbch th\u1ea5p h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam tai gi\u1eefa \u0111\u01a1n thu\u1ea7n ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng.","3. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng 3.1. X\u01a1 tai (Otosclerosis) \u2022 X\u01a1 tai l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ME v\u00e0 g\u00e2y nghe k\u00e9m ti\u1ebfn tri\u1ec3n, x\u1ea3y ra ch\u1ee7 y\u1ebfu \u1edf ph\u1ee5 n\u1eef (\u0111\u1ed9 tu\u1ed5i ch\u1ee7 y\u1ebfu l\u00e0 20\u201330 tu\u1ed5i). \u2022 Trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p, b\u1ec7nh bi\u1ec3u hi\u1ec7n hai b\u00ean th\u00f4ng qua s\u1ef1 v\u00f4i h\u00f3a v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n b\u1ea5t th\u01b0\u1eddng c\u1ee7a x\u01b0\u01a1ng b\u00e0n \u0111\u1ea1p.","3.1. X\u01a1 tai (Otosclerosis) \u2022 \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb x\u01a1 tai, c\u00e1c ph\u00e9p \u0111o \u0111\u1ed9 h\u1ea5p thu c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 chi ti\u1ebft h\u01a1n \u0111\u1ed9 c\u1ee9ng c\u1ee7a h\u1ec7 th\u1ed1ng m\u00e0ng nh\u0129- x\u01b0\u01a1ng con. \u2022 Khi b\u1ec7nh ti\u1ebfn tri\u1ec3n, x\u01b0\u01a1ng b\u00e0n \u0111\u1ea1p ng\u00e0y c\u00e0ng c\u1ed1 \u0111\u1ecbnh tr\u00ean c\u1eeda s\u1ed5 b\u1ea7u d\u1ee5c, l\u00e0m cho vi\u1ec7c truy\u1ec1n \u00e2m qua ME r\u1ea5t kh\u00f3 kh\u0103n. \u2022 WBT cung c\u1ea5p th\u00f4ng tin chi ti\u1ebft v\u00e0 c\u1ee5 th\u1ec3 h\u01a1n v\u1ec1 h\u1ec7 th\u1ed1ng m\u00e0ng nh\u0129-x\u01b0\u01a1ng con v\u00e0 cho ph\u00e9p m\u1ed9t ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t x\u01a1 tai.","3.1. X\u01a1 tai (Otosclerosis) \u2022 Theo d\u1eef li\u1ec7u t\u1eeb Shahnaz v\u00e0 c\u1ed9ng s\u1ef1, s\u1ef1 thay \u0111\u1ed5i ch\u1ee7 y\u1ebfu \u0111\u1ed9 h\u1ea5p thu sau ph\u1eabu thu\u1eadt x\u01a1 tai l\u00e0 c\u00e1c gi\u00e1 tr\u1ecb h\u1ea5p thu gi\u1ea3m m\u1ea1nh v\u00e0 s\u00e2u trong kho\u1ea3ng t\u1eeb 700 \u0111\u1ebfn 1000 Hz. \u2022 \u0110\u1ed9 h\u1ea5p thu sau ph\u1eabu thu\u1eadt c\u0169ng t\u0103ng nh\u1eb9 th\u1ee9 ph\u00e1t \u1edf kho\u1ea3ng t\u1ea7n s\u1ed1 r\u1ed9ng h\u01a1n, gi\u1eefa 2000 v\u00e0 4000 Hz.","\u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a nh\u0129 \u0111\u1ed3 h\u1ea5p thu (thu \u0111\u01b0\u1ee3c b\u1eb1ng c\u00e1ch thu nh\u1ecf tr\u1ee5c \u00e1p su\u1ea5t trong nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 3D) c\u1ee7a m\u1ed9t b\u1ec7nh nh\u00e2n b\u1ecb x\u01a1 tai cho m\u1ed9t d\u1ea1ng nh\u0129 \u0111\u1ed3 h\u1ea5p thu \u0111i\u1ec3n h\u00ecnh. Gi\u00e1 tr\u1ecb \u0111\u1ed9 h\u1ea5p thu \u0111\u1ec9nh t\u0103ng v\u1ecdt \u1edf t\u1ea7n s\u1ed1 cao kho\u1ea3ng 2,8 kHz.","3.2. \u0110\u1ed9 th\u00f4ng thu\u1eadn \u1edf tr\u1ebb s\u01a1 sinh \u2022 S\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 nh\u1eefng thay \u0111\u1ed5i trong \u1ed1ng tai ngo\u00e0i di\u1ec5n ra nhanh ch\u00f3ng trong 6 th\u00e1ng \u0111\u1ea7u \u0111\u1eddi cho \u0111\u1ebfn khi \u0111\u1ea1t \u0111\u1ebfn k\u00edch th\u01b0\u1edbc ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh. \u2022 Trong s\u1ed1 c\u00e1c k\u1ebft qu\u1ea3 thu \u0111\u01b0\u1ee3c trong ch\u01b0\u01a1ng tr\u00ecnh t\u1ea7m so\u00e1t s\u1ee9c nghe \u1edf tr\u1ebb s\u01a1 sinh, c\u00f3 th\u1ec3 c\u00f3 nh\u1eefng k\u1ebft qu\u1ea3 d\u01b0\u01a1ng t\u00ednh gi\u1ea3 do s\u1ef1 kh\u00e1c bi\u1ec7t trong s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ea5u tr\u00fac tai \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u01a1 ch\u1ebf tr\u1edf kh\u00e1ng. \u2022 Do s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a n\u01b0\u1edbc \u1ed1i, trung m\u00f4 ph\u00e2n su ho\u1eb7c \u1ed1ng tai ngo\u00e0i c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng thay \u0111\u1ed5i t\u1ea1m th\u1eddi v\u1ec1 th\u00ednh gi\u00e1c. \u2022 Nh\u1eefng thay \u0111\u1ed5i n\u00e0y l\u00e0m t\u0103ng kh\u1ed1i l\u01b0\u1ee3ng, \u0111\u1ed9 c\u1ee9ng v\u00e0 tr\u1edf kh\u00e1ng c\u1ee7a h\u1ec7 th\u1ed1ng m\u00e0ng nh\u0129-x\u01b0\u01a1ng con v\u00e0 do \u0111\u00f3 l\u00e0m thay \u0111\u1ed5i tr\u1edf kh\u00e1ng c\u1ee7a tai gi\u1eefa v\u00e0 s\u1ef1 d\u1eabn truy\u1ec1n \u00e2m thanh.","3.2. \u0110\u1ed9 th\u00f4ng thu\u1eadn \u1edf tr\u1ebb s\u01a1 sinh \u2022 Khi m\u1edbi sinh, tai ngo\u00e0i v\u00e0 tai gi\u1eefa ch\u01b0a ph\u00e1t tri\u1ec3n ho\u00e0n ch\u1ec9nh. \u1ed0ng tai ngo\u00e0i \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o b\u1edfi m\u1ed9t l\u1edbp s\u1ee5n \u0111\u00e0n h\u1ed3i m\u1ecfng. \u2022 Trong \u0111o nh\u0129 l\u01b0\u1ee3ng kinh \u0111i\u1ec3n, \u0111\u01b0\u1eddng k\u00ednh c\u1ee7a \u1ed1ng tai ngo\u00e0i c\u00f3 th\u1ec3 t\u0103ng ho\u1eb7c gi\u1ea3m t\u00f9y thu\u1ed9c v\u00e0o \u00e1p su\u1ea5t \u0111\u01b0\u1ee3c b\u01a1m. Khi tr\u1ebb l\u1edbn l\u00ean, s\u1ef1 c\u1ed1t h\u00f3a c\u1ee7a \u1ed1ng tai ngo\u00e0i l\u00e0m t\u0103ng \u0111\u1ed9 c\u1ee9ng c\u1ee7a \u1ed1ng tai ngo\u00e0i. \u2022 Ngo\u00e0i ra chi\u1ec1u d\u00e0i c\u1ee7a \u1ed1ng tai ngo\u00e0i t\u0103ng d\u1ea7n, l\u00e0m gi\u1ea3m t\u1ea7n s\u1ed1 c\u1ed9ng h\u01b0\u1edfng c\u1ee7a \u1ed1ng tai ngo\u00e0i.","3.2. \u0110\u1ed9 th\u00f4ng thu\u1eadn \u1edf tr\u1ebb s\u01a1 sinh \u2022 M\u00e0ng nh\u0129 s\u1ebd gi\u1ea3m \u0111\u1ed9 d\u00e0y, t\u0103ng k\u00edch th\u01b0\u1edbc v\u00e0 thay \u0111\u1ed5i \u0111\u1ed9 nghi\u00eang c\u1ee7a n\u00f3. \u2022 Nh\u1eefng thay \u0111\u1ed5i c\u0169ng x\u1ea3y ra trong ME. D\u1eef li\u1ec7u t\u1eeb Proctor v\u00e0 Holborow cho th\u1ea5y v\u00f2i nh\u0129 c\u1ee7a tr\u1ebb s\u01a1 sinh ng\u1eafn h\u01a1n [30 mm] v\u00e0 g\u1ea7n nh\u01b0 n\u1eb1m ngang. \u2022 V\u00f2i nh\u0129 m\u1edf ra t\u1ed1t nh\u01b0ng \u0111\u00f3ng l\u1ea1i ch\u1eadm h\u01a1n, d\u1eabn \u0111\u1ebfn v\u00f2i nh\u0129 ho\u1ea1t \u0111\u1ed9ng k\u00e9m hi\u1ec7u qu\u1ea3. \u2022 V\u00f2i nh\u0129 ph\u00e1t tri\u1ec3n t\u1eeb t\u1eeb v\u1edbi chi\u1ec1u d\u00e0i t\u0103ng l\u00ean v\u00e0 d\u1ed1c h\u01a1n, ho\u00e0n ch\u1ec9nh l\u00fac 7 tu\u1ed5i. \u2022 \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 gi\u1ea3i th\u00edch l\u00fd do \u1edf tr\u1ebb nh\u1ecf c\u00f3 t\u1ef7 l\u1ec7 vi\u00eam tai gi\u1eefa li\u00ean quan \u0111\u1ebfn nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean cao h\u01a1n.","3.2. \u0110\u1ed9 th\u00f4ng thu\u1eadn \u1edf tr\u1ebb s\u01a1 sinh \u2022 M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng ph\u1ea7n l\u1edbn s\u1ef1 thay \u0111\u1ed5i \u0111\u00e1ng k\u1ec3 c\u00e1c gi\u00e1 tr\u1ecb \u0111\u1ed9 h\u1ea5p thu b\u0103ng r\u1ed9ng x\u1ea3y ra trong 6 th\u00e1ng \u0111\u1ea7u \u0111\u1eddi, do s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a tai ngo\u00e0i v\u00e0 tai gi\u1eefa. \u2022 Trong giai \u0111o\u1ea1n n\u00e0y, \u0111\u1ed9 h\u1ea5p thu k\u00e9m \u1edf t\u1ea7n s\u1ed1 th\u1ea5p v\u00e0 t\u0103ng \u0111\u00e1ng k\u1ec3 \u1edf t\u1ea7n s\u1ed1 cao. \u2022 Sau kho\u1ea3ng th\u1eddi gian n\u00e0y, c\u00e1c k\u1ebft qu\u1ea3 c\u1ee7a ph\u00e9p \u0111o \u0111\u1ed9 h\u1ea5p thu b\u1eaft \u0111\u1ea7u g\u1ea7n v\u1edbi c\u00e1c gi\u00e1 tr\u1ecb c\u1ee7a ng\u01b0\u1eddi l\u1edbn.","\u2022 V\u00ed d\u1ee5 v\u1ec1 nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 b\u0103ng r\u1ed9ng trung b\u00ecnh \u1edf tr\u1ebb s\u01a1 sinh c\u00f3 ch\u1ee9c n\u0103ng ME b\u00ecnh th\u01b0\u1eddng v\u00e0 k\u1ebft qu\u1ea3 \u0111o TEOAE l\u00e0 PASS. \u2022 Cho th\u1ea5y \u0111\u01b0\u1eddng cong \u0111\u1ed9 h\u1ea5p thu trung b\u00ecnh tr\u1ebb s\u01a1 sinh \u0111i\u1ec3n h\u00ecnh (0,8\u20132,0 kHz), t\u1eeb tr\u1ebb c\u00f3 k\u1ebft qu\u1ea3 \u0111o TEOAE l\u00e0 PASS.","3.3. Th\u1ee7ng m\u00e0ng nh\u0129 (Tympanic perforations) \u2022 \u0110o nh\u0129 l\u01b0\u1ee3ng truy\u1ec1n th\u1ed1ng gi\u00fap ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c th\u1ee7ng m\u00e0ng nh\u0129 v\u00e0 \u0111ang \u0111\u1eb7t \u1ed1ng th\u00f4ng kh\u00ed, nh\u01b0ng n\u00f3 kh\u00f4ng cung c\u1ea5p th\u00f4ng tin v\u1ec1 tai gi\u1eefa. \u2022 T\u01b0\u01a1ng t\u1ef1, WBT c\u0169ng ph\u00e1t hi\u1ec7n c\u00e1c l\u1ed7 th\u1ee7ng ho\u1eb7c \u1ed1ng th\u00f4ng kh\u00ed. H\u01a1n n\u1eefa, WBT c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 theo d\u00f5i tr\u01b0\u1edbc\/sau \u0111\u1eb7t \u1ed1ng th\u00f4ng kh\u00ed. \u2022 M\u1ed9t l\u1ed7 th\u1ee7ng m\u00e0ng nh\u0129 l\u00e0m thay \u0111\u1ed5i s\u1ef1 h\u1ea5p thu n\u0103ng l\u01b0\u1ee3ng. Ngo\u00e0i ra, nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 v\u00e0 \u0111\u1ed3 th\u1ecb \u0111\u1ed9 h\u1ea5p thu c\u00f2n cung c\u1ea5p t\u00ecnh tr\u1ea1ng c\u1ee7a tai gi\u1eefa tr\u00ean t\u1ea5t c\u1ea3 d\u1ea3i t\u1ea7n s\u1ed1. \u2022 Tai th\u1ee7ng nh\u0129 cho \u0111\u1ed9 h\u1ea5p thu cao h\u01a1n \u1edf t\u1ea7n s\u1ed1 th\u1ea5p, \u0111i\u1ec1u \u0111\u00e1ng ng\u1ea1c nhi\u00ean l\u00e0 c\u00e1c l\u1ed7 th\u1ee7ng nh\u1ecf nh\u1ea5t l\u1ea1i c\u00f3 thay \u0111\u1ed5i l\u1edbn nh\u1ea5t.","Nh\u0129 l\u01b0\u1ee3ng 3D v\u1edbi th\u1ee7ng m\u00e0ng nh\u0129 + tr\u1eadt kh\u1edbp x\u01b0\u01a1ng con","3.4. Tr\u1eadt kh\u1edbp chu\u1ed7i x\u01b0\u01a1ng con (Ossicular chain disarticulation) \u2022 M\u00e0ng nh\u0129 m\u1ecfng v\u00e0 tr\u1eadt kh\u1edbp chu\u1ed7i x\u01b0\u01a1ng con c\u00f3 \u0111\u1ed9 th\u00f4ng thu\u1eadn cao t\u1ea1i t\u1ea7n s\u1ed1 226 Hz. \u2022 Tuy nhi\u00ean, kh\u00f4ng d\u1ec5 \u0111\u1ec3 ph\u00e2n bi\u1ec7t c\u00e1c b\u1ec7nh l\u00fd n\u00e0y b\u1eb1ng nh\u0129 l\u01b0\u1ee3ng \u0111\u1ed3 truy\u1ec1n th\u1ed1ng. \u2022 T\u1ea7n s\u1ed1 c\u1ed9ng h\u01b0\u1edfng gi\u00fap ph\u00e1t hi\u1ec7n s\u1ef1 m\u1ea5t li\u00ean t\u1ee5c chu\u1ed7i x\u01b0\u01a1ng con v\u1edbi \u0111\u1ec9nh h\u1ea5p thu gi\u1ea3m \u1edf v\u00f9ng t\u1ea7n s\u1ed1 th\u1ea5p h\u01a1n. \u2022 Khi m\u1ea5t li\u00ean t\u1ee5c chu\u1ed7i x\u01b0\u01a1ng con c\u00f3 th\u1ec3 th\u1ea5y \u0111\u1ed9 ph\u1ea3n h\u1ed3i khuy\u1ebft r\u00f5 \u1edf t\u1ea7n s\u1ed1 kho\u1ea3ng 400-800 Hz.","Nh\u0129 l\u01b0\u1ee3ng 3D v\u1edbi tr\u1eadt kh\u1edbp x\u01b0\u01a1ng con","3.5. H\u1edf \u1ed1ng b\u00e1n khuy\u00ean (Semicircular canal dehiscence-SCD) \u2022 Theo Nakajima v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 b\u00e1o c\u00e1o r\u1eb1ng \u0111\u1ed9 h\u1ea5p thu c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n h\u1edf \u1ed1ng b\u00e1n khuy\u00ean (SCD) v\u1edbi \u0111\u1ed9 nh\u1ea1y 92% v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 72%. \u2022 SCD cho h\u00ecnh \u1ea3nh khuy\u1ebft SCD tr\u00ean WBT. \u2022 \u0110\u00f3 l\u00e0 m\u1ed9t khuy\u1ebft \u1edf kho\u1ea3ng 1 kHz, nh\u1ecf h\u01a1n v\u00e0 kh\u00f4ng s\u00e2u nh\u01b0 khuy\u1ebft do gi\u00e1n \u0111o\u1ea1n x\u01b0\u01a1ng con.","3.6. Theo d\u00f5i sau m\u1ed5 \u2022 Sau ph\u1eabu thu\u1eadt tai, kh\u00f4ng d\u1ec5 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng tai gi\u1eefa, b\u1edfi v\u00ec l\u00fac n\u00e0y kh\u00f4ng th\u1ec3 t\u1ea1o \u00e1p l\u1ef1c l\u00ean m\u00e0ng nh\u0129. \u2022 WBT t\u1ea1o ra m\u1ed9t nh\u0129 \u0111\u1ed3 h\u1ea5p thu m\u00e0 kh\u00f4ng c\u1ea7n b\u01a1m \u00e1p l\u1ef1c. \u2022 Do \u0111\u00f3 t\u00ecnh tr\u1ea1ng tai gi\u1eefa c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 ngay sau khi ph\u1eabu thu\u1eadt.","3.7. C\u00e1c b\u1ec7nh l\u00fd kh\u00e1c \u2022 Pitaro v\u00e0 c\u1ed9ng s\u1ef1 cho th\u1ea5y ph\u1ea3n h\u1ed3i \u00e2m \u1edf tr\u1ebb m\u1edbi sinh t\u0103ng r\u00f5 r\u1ec7t khi 70-80% \u0111\u01b0\u1eddng k\u00ednh \u1ed1ng tai ngo\u00e0i \u0111\u01b0\u1ee3c b\u1ecbt k\u00edn. \u2022 C\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 gi\u1eefa c\u00e1c \u0111\u01b0\u1eddng cong ph\u1ea3n h\u1ed3i n\u0103ng l\u01b0\u1ee3ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng Down v\u1edbi b\u1ec7nh l\u00fd tai gi\u1eefa. \u2022 Pucci v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 s\u1eed d\u1ee5ng WBT \u0111\u1ec3 l\u00fd gi\u1ea3i \u0111\u1ed9 h\u1ea5p thu \u1edf tr\u1ebb s\u01a1 sinh ti\u1ebfp x\u00fac v\u1edbi kh\u00f3i h\u00fat thu\u1ed1c th\u1ee5 \u0111\u1ed9ng trong th\u1eddi k\u1ef3 mang thai. \u2022 \u0110\u1ed9 h\u1ea5p thu \u1edf t\u1ea7n s\u1ed1 th\u1ea5p th\u00ec th\u1ea5p h\u01a1n \u0111\u1ed9 h\u1ea5p thu \u1edf t\u1ea7n s\u1ed1 cao \u1edf c\u1ea3 \u00e1p su\u1ea5t kh\u00f4ng kh\u00ed v\u00e0 \u00e1p su\u1ea5t cao nh\u1ea5t, nh\u01b0ng kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 gi\u1eefa nh\u00f3m ti\u1ebfp x\u00fac v\u00e0 kh\u00f4ng ti\u1ebfp x\u00fac. \u2022 Voss v\u00e0 c\u1ed9ng s\u1ef1 b\u00e1o c\u00e1o r\u1eb1ng WBT c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 theo d\u00f5i s\u1ef1 thay \u0111\u1ed5i \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.","4. K\u1ebft lu\u1eadn \u2022 WBT cung c\u1ea5p th\u00f4ng tin v\u1ec1 \u0111\u1ed9 h\u1ea5p thu v\u00e0 t\u1ea1o ra nh\u0129 \u0111\u1ed3 c\u00f3 gi\u00e1 tr\u1ecb v\u1ec1 tai gi\u1eefa. \u2022 WBT c\u00f3 gi\u00e1 tr\u1ecb l\u00e2m s\u00e0ng khi \u0111\u00e1nh gi\u00e1 \u1ee9 d\u1ecbch tai gi\u1eefa \u1edf tr\u1ebb s\u01a1 sinh, x\u01a1 tai, tr\u1eadt kh\u1edbp x\u01b0\u01a1ng con v\u00e0 th\u1ee7ng m\u00e0ng nh\u0129; n\u00f3 c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 theo d\u00f5i sau m\u1ed5. \u2022 WBT kh\u00e1 h\u1eefu \u00edch \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c b\u1ec7nh l\u00fd tai gi\u1eefa kh\u00e1c. \u2022 Trong c\u00e1c ph\u00f2ng th\u00ed nghi\u1ec7m nghi\u00ean c\u1ee9u, WBT c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c b\u1ec7nh l\u00fd tai gi\u1eefa th\u1ec3 \u1ea9n. \u2022 WBT s\u1ebd ng\u00e0y c\u00e0ng tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn trong ph\u00f2ng kh\u00e1m v\u00e0 ph\u00f2ng th\u00ed nghi\u1ec7m nghi\u00ean c\u1ee9u.","","VAI TR\u00d2 CH\u1ed0NG PH\u00d9 N\u1ec0 C\u1ee6A KH\u00c1NG VI\u00caM ENZYME T\u00c1C \u0110\u1ed8NG \u0110\u1ebeN HI\u1ec6U QU\u1ea2 \u0110I\u1ec0U TR\u1eca B\u1ec6NH L\u00dd TAI M\u0168I H\u1eccNG TS.BS NGUY\u1ec4N TRI\u1ec0U VI\u1ec6T TR\u01af\u1edeNG BM TAI M\u0168I H\u1eccNG","N\u1ed8I DUNG 1 T\u1ed4NG QUAN V\u1ec0 VI\u00caM 2 THU\u1ed0C CH\u1ed0NG PH\u00d9 N\u1ec0 DO VI\u00caM ENZYME 3 VI\u00caM TRONG TAI M\u0168I H\u1eccNG 4 C\u00c1C CA L\u00c2M S\u00c0NG","T\u1ed4NG QUAN V\u1ec0 VI\u00caM","\u0110\u1ecaNH NGH\u0128A VI\u00caM \u2022 Hi\u1ec7n nay, vi\u00eam \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh nh\u01b0 l\u00e0 m\u1ed9t nh\u00f3m c\u1ee7a c\u00e1c ph\u1ea3n \u1ee9ng thay \u0111\u1ed5i ph\u1ee9c t\u1ea1p \u0111\u1ed1i v\u1edbi t\u1ed5n th\u01b0\u01a1ng m\u00f4 ti\u00ean ph\u00e1t \u0111\u01b0\u1ee3c g\u00e2y ra do \u0111\u1ed9c t\u1ed1, m\u1ed9t s\u1ed1 t\u00e1c nh\u00e2n m\u00f4i tr\u01b0\u1eddng, ch\u1ea5n th\u01b0\u01a1ng, s\u1eed d\u1ee5ng thu\u1ed1c qu\u00e1 li\u1ec1u hay nhi\u1ec5m khu\u1ea9n. \u2022 M\u1ed9t s\u1ed1 ph\u1ea3n \u1ee9ng n\u00e0y l\u00e0 c\u00f3 l\u1ee3i trong l\u00e0m l\u00e0nh v\u1ebft th\u01b0\u01a1ng v\u00e0 ki\u1ec3m so\u00e1t nhi\u1ec5m khu\u1ea9n hay b\u1ec7nh l\u00fd trong c\u00e1c t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd m\u1ea1n t\u00ednh. http:\/\/www.ncbi.nlm.nih.gov\/pubmedhealth\/PMH0072482\/","Vi\u00eam c\u1ea5p hay m\u1ea1n . Vi\u00eam c\u1ea5p kh\u1edfi ph\u00e1t nhanh trong v\u00e0i ph\u00fat hay v\u00e0i gi\u1edd, th\u01b0\u1eddng kh\u1ecfi trong v\u00e0i ng\u00e0y, c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ea5u hi\u1ec7u kinh \u0111i\u1ec3n, v\u00e0 c\u00f3 th\u1ea9m nhu\u1eadn t\u1ebf b\u00e0o ti\u00ean ph\u00e1t l\u00e0 neutrophils. . Vi\u00eam m\u1ea1n kh\u1edfi ph\u00e1t ch\u1eadm v\u00e0i ng\u00e0y, h\u00e0ng n\u0103m, \u00edt c\u00e1c tri\u1ec7u ch\u1ee9ng kinh \u0111i\u1ec3n, v\u00e0 th\u1ea9m nhu\u1eadn t\u1ebf b\u00e0o ti\u00ean ph\u00e1t l\u00e0 monocytes\/macrophages and lymphocytes. Chronic exposure to toxic chemicals and environmental agents such as cigarette smoke can cause chronic inflammation.","Bi\u1ec3u hi\u1ec7n VI\u00caM Bi\u1ec3u hi\u1ec7n t\u1ea1i ch\u1ed7: 6 1. Gi\u00e3n m\u1ea1ch v\u00e0 t\u0103ng tu\u1ea7n ho\u00e0n m\u00e1u t\u1edbi ch\u1ed7 vi\u00eam (g\u00e2y ra \u0111\u1ecf, n\u00f3ng) 2. Tho\u00e1t d\u1ecbch v\u00e0 protein huy\u1ebft t\u01b0\u01a1ng kh\u1ecfi l\u00f2ng m\u1ea1ch (g\u00e2y ra s\u01b0ng ph\u00f9) 3. Di tr\u00fa v\u00e0 th\u00e2m nhi\u1ec5m b\u1edfi c\u00e1c lo\u1ea1i b\u1ea1ch c\u1ea7u (ch\u1ee7 y\u1ebfu l\u00e0 b\u1ea1ch c\u1ea7u trung t\u00ednh) Bi\u1ec3u hi\u1ec7n to\u00e0n th\u00e2n: 4. S\u1ed1t (do t\u0103ng mediator \u1edf n\u00e3o) 5. T\u0103ng b\u1ea1ch c\u1ea7u (k\u00edch th\u00edch t\u1ee7y x\u01b0\u01a1ng) 6. T\u0103ng s\u1ea3n xu\u1ea5t c\u00e1c ch\u1ea5t trung gian (mediator) (k\u00edch th\u00edch gan) CHAPTER 2 \u2013 Inflammation and repair. Targeted Therapy available online at studentconsult.com","\u00dd NGH\u0128A C\u1ee6A VI\u00caM \u2022 C\u00e1c giai \u0111o\u1ea1n ch\u00ednh \u2022 Th\u00e2m nhi\u1ec5m b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n, lympho b\u00e0o \u2022 Th\u00e2m nhi\u1ec5m b\u1ea1ch c\u1ea7u \u0111\u01a1n nh\u00e2n \uf0e0 \u0111\u1ea1i th\u1ef1c b\u00e0o \u2022 Ph\u00f3ng th\u00edch h\u00f3a ch\u1ea5t h\u01b0\u1edbng \u0111\u1ed9ng \u2022 M\u1ee5c \u0111\u00edch \u2022 H\u00e0ng r\u00e0o ng\u0103n ch\u1eb7n nhi\u1ec5m tr\u00f9ng \u2022 D\u1ecdn s\u1ea1ch v\u00f9ng t\u1ed5n th\u01b0\u01a1ng \u2022 T\u1ea1o m\u00f4i tr\u01b0\u1eddng thu\u1eadn l\u1ee3i cho kh\u1edfi ph\u00e1t l\u00e0nh th\u01b0\u01a1ng \u2022 \u00dd ngh\u0129a: ph\u1ea3n \u1ee9ng sinh l\u00fd t\u1ef1 nhi\u00ean b\u1ea3o v\u1ec7 c\u01a1 th\u1ec3","\uf0d8 Khi V\u00f9ng TMH b\u1ecb t\u1ea5n c\u00f4ng b\u1edfi c\u00e1c t\u00e1c nh\u00e2n k\u00edch th\u00edch th\u00ec m\u00f4 t\u1ebf b\u00e0o \u0111\u1ec1u b\u1ecb h\u01b0 h\u1ea1i. T\u1eeb khi b\u1ecb t\u1ea5n c\u00f4ng \u0111\u1ebfn khi \u0111\u01b0\u1ee3c ch\u1eefa l\u00e0nh, c\u01a1 th\u1ec3 tr\u1ea3i qua 4 giai \u0111o\u1ea1n: THAY \u0110\u1ed4I T\u1ebe B\u00c0O T\u0102NG SINH T\u00c1I T\u1ea0O HUY\u1ebeT \u0110\u1ed8NG Giai \u0111o\u1ea1n b\u1ea1ch c\u1ea7u Giai \u0111o\u1ea1n t\u0103ng sinh Giai \u0111o\u1ea1n t\u00e1i t\u1ea1o Giai \u0111o\u1ea1n c\u1ea7m m\u00e1u D\u00e3n m\u1ea1ch l\u00e0m t\u0103ng t\u00ednh C\u00f3 s\u1ef1 t\u0103ng sinh t\u1ebf b\u00e0o Gi\u00fap kh\u00f4i ph\u1ee5c l\u1ea1i t\u00ednh C\u00e1c t\u00e1c nh\u00e2n \u0111\u1ed9c h\u1ea1i x\u00e2m th\u1ea5m th\u00e0nh m\u1ea1ch t\u1ea1o bi\u1ec3u m\u00f4, m\u00f4 li\u00ean k\u1ebft, to\u00e0n v\u1eb9n v\u00e0 ch\u1ee9c n\u0103ng \u0111i\u1ec1u ki\u1ec7n b\u1ea1ch c\u1ea7u tho\u00e1t mao m\u1ea1ch. Nguy\u00ean b\u00e0o c\u1ee7a m\u00f4(4). nh\u1eadp m\u00f4. C\u01a1 th\u1ec3 \u0111\u00e1p \u1ee9ng m\u1ea1ch d\u1ecdn d\u1eb9p v\u1eadt th\u1ec3 l\u1ea1 s\u1ee3i* \u2013 nguy\u00ean li\u1ec7u b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p co bao g\u1ed3m c\u1ee5c m\u00e1u \u0111\u00f4ng, ch\u00ednh li\u00ean quan \u0111\u1ebfn m\u1ea1ch m\u00e1u \uf0e0 t\u1ea1o c\u1ee5c m\u00e1u m\u1ea3nh m\u00f4 ch\u1ebft \u2026 Giai y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng (3)\u2026 \u0111\u00f4ng, ng\u0103n ch\u1eb7n s\u1ef1 l\u00e2y lan \u0111o\u1ea1n n\u00e0y c\u1ea7n l\u01b0\u1ee3ng oxy th\u00eam c\u1ee7a t\u00e1c nh\u00e2n \u0111\u1ed9c h\u1ea1i cao(2). \uf0e0 gi\u1edbi h\u1ea1n v\u00f9ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng(1). => Vi\u00eam l\u00e0 ph\u1ea3n \u1ee9ng c\u00f3 l\u1ee3i, n\u1ebfu d\u1eadp t\u1eaft vi\u00eam s\u1ebd l\u00e0m cho qu\u00e1 tr\u00ecnh t\u0103ng sinh v\u00e0 t\u00e1i t\u1ea1o m\u00f4 t\u1ebf b\u00e0o kh\u00f4ng x\u1ea3y ra, m\u00f4 t\u1ebf b\u00e0o l\u00e2u l\u00e0nh. (1) https:\/\/www.bsmu.by\/downloads\/kafedri\/k_pat_anatom\/stud\/1-4_Inflammation.pdf (2,3,4) https:\/\/www.physio-pedia.com\/Soft_Tissue_Healing","\uf0d8 Ph\u1ea3i t\u1ea1o \u0111i\u1ec1u ki\u1ec7n th\u00f4ng tho\u00e1ng tu\u1ea7n ho\u00e0n t\u1ea1i v\u00f9ng t\u1ed5n th\u01b0\u01a1ng \u0111\u1ec3 vi\u1ec7c th\u1ef1c b\u00e0o x\u1ea3y ra nhanh ch\u00f3ng \u2022 D\u1ecdn d\u1eb9p t\u00e1c nh\u00e2n k\u00edch th\u00edch g\u00e2y t\u1ed5n th\u01b0\u01a1ng \u2022 D\u1ecdn d\u1eb9p c\u00e1c mediator, c\u00e1c t\u1ebf b\u00e0o g\u00e2y vi\u00eam c\u1ea5p \u2022 D\u1ecdn d\u1eb9p c\u00e1c t\u1ebf b\u00e0o ch\u1ebft, t\u1ebf b\u00e0o t\u1ed5n th\u01b0\u01a1ng \u2013 m\u1ea5t ch\u1ee9c n\u0103ng","H\u1eacU QU\u1ea2 C\u1ee6A VI\u00caM Vi\u00eam Ph\u00f9 n\u1ec1 Ph\u00f9 n\u1ec1 qu\u00e1 m\u1ee9c v\u00e0 k\u00e9o d\u00e0i g\u00e2y phi\u1ec1n ph\u1ee9c cho BN, g\u00e2y \u1ee9 d\u1ecbch t\u0103ng nguy c\u01a1 nhi\u1ec5m tr\u00f9ng \u1ee8 \u0111\u1ecdng T\u1eafc ngh\u1ebdn","VAI TR\u00d2 CH\u1ed0NG PH\u00d9 N\u1ec0 C\u1ee6A KH\u00c1NG VI\u00caM ENZYME","THU\u1ed0C CH\u1ed0NG PH\u00d9 N\u1ec0 DO VI\u00caM ENZYME (Proteases) \uf0d8 L\u00e0 c\u00e1c thu\u1ed1c enzyme ly gi\u1ea3i protein d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c ch\u1ee9ng ph\u00f9 n\u1ec1 do vi\u00eam \uf0d8 Gi\u00fap c\u1ea3i thi\u1ec7n \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd vi\u00eam nhi\u1ec5m TMH nh\u01b0 gi\u1ea3m \u0111au, tho\u00e1t d\u1ecbch \u1ee9 \u0111\u1ecdng, khai th\u00f4ng tu\u1ea7n ho\u00e0n m\u00e1u gi\u00fap t\u0103ng t\u00ednh th\u1ea5m c\u1ee7a kh\u00e1ng sinh v\u00e0o m\u00f4 v\u00e0 t\u1ea1o \u0111i\u1ec7u ki\u1ec7n thu\u1eadn l\u1ee3i cho qu\u00e1 tr\u00ecnh l\u00e0nh th\u01b0\u01a1ng V\u00ed d\u1ee5: Alphachymotrypsin, trypsin, papain, bromelain\u2026","VAI TR\u00d2 C\u1ee6A ENZYME TRONG VI\u00caM \u2022 T\u1ea1i v\u00f9ng c\u00f3 vi\u00eam nhi\u1ec5m, men gi\u00fap t\u0103ng t\u00ednh th\u1ea5m th\u00e0nh m\u1ea1ch, thu h\u00fat c\u00e1c b\u1ea1ch c\u1ea7u h\u1ea1t v\u00e0 t\u1ea1o m\u00f4 h\u1ea1t \u2022 Tr\u00ean l\u00e2m s\u00e0ng men gi\u00fap ch\u1ed1ng ph\u00f9 n\u1ec1 , gi\u00fap t\u00e1i h\u1ea5p thu d\u1ecbch t\u1ea1i m\u00f4 vi\u00eam sau ch\u1ea5n th\u01b0\u01a1ng ,ph\u1eabu thu\u1eadt , vi\u00eam kh\u1edbp ,vi\u00eam xoang v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng ph\u00f9 n\u1ec1 kh\u00e1c do vi\u00eam nhi\u1ec5m","THU\u1ed0C ENZYME CH\u1ed0NG PH\u00d9 N\u1ec0 PH\u00c2N LO\u1ea0I Proteases Ngu\u1ed3n g\u1ed1c \u0111\u1ed9ng v\u1eadt Ngu\u1ed3n g\u1ed1c th\u1ef1c v\u1eadt Ngu\u1ed3n g\u1ed1c vi sinh Trypsin, Chymotrypsin Bromelain Serratiopeptidase Papain Streptokinase Streptonordase Protease ngu\u1ed3n g\u1ed1c t\u1eeb Aspergillus http:\/\/www.vrp.com\/physical-performance\/unizyme-introducing-improved-non-animal-derived-anti-inflammatory Grob D., Proteolytic Enzymes, The Journal of General Physiology, 1946","CH\u1ed0NG PH\u00d9 N\u1ec0 DO VI\u00caM ENZYME 15 C\u1eaft ng\u1eafn chu\u1ed7i polypeptide h\u1ed7 tr\u1ee3 qu\u00e1 tr\u00ecnh d\u1ecdn d\u1eb9p, gi\u1ea3m ph\u00f9 n\u1ec1 do Vi\u00eam C\u00c1C H\u00d3A CH\u1ea4T TRUNG GIAN C\u1ee6A Trypsin and chymotrypsin each VI\u00caM C\u00d3 NGU\u1ed2N G\u1ed0C PROTEIN cleave the protein at different points \u2022 H\u1ea6U H\u1ebeT C\u00c1C H\u00d3A CH\u1ea4T TRUNG GIAN C\u1ee6A VI\u00caM L\u00c0 C\u00c1C PROTEIN \u2022 H\u1ec7 th\u1ed1ng b\u1ed5 th\u1ec3 \u2022 H\u1ec7 th\u1ed1ng \u0111\u00f4ng m\u00e1u \u2022 H\u1ec7 th\u1ed1ng kinin (bradykinin) \u2022 H\u1ec7 th\u1ed1ng ti\u00eau s\u1ee3i huy\u1ebft \u2022 H\u1ec7 th\u1ed1ng h\u00f3a \u1ee9ng \u0111\u1ed9ng: c\u00f3 tr\u00ean 50 lo\u1ea1i \u2022 C\u00e1c cytokine ti\u1ec1n vi\u00eam \u2022 \u0110\u1eb7c bi\u1ec7t 3 trong s\u1ed1 c\u00e1c cytokine n\u00e0y c\u00f3 ho\u1ea1t t\u00ednh \u0111\u1eb7c tr\u01b0ng r\u00f5 r\u00e0ng: IL-1, IL-6, TNF-a [tumor necrosis factor alpha]","Ch\u1ed1ng vi\u00eam d\u1ea1ng enzym (PROTEASES) 1 6 C\u1eaft ng\u1eafn chu\u1ed7i polypeptide h\u1ed7 tr\u1ee3 qu\u00e1 tr\u00ecnh d\u1ecdn d\u1eb9p, gi\u1ea3m ph\u00f9 n\u1ec1 do vi\u00eam TRYPSIN CHYMOTRYPSIN CARBOXYPOLYPEPTIDASE PEPTIDASE http:\/\/www.tutorvista.com\/biology\/digestive-enzyme-protease; http:\/\/wellnessadvocate.com\/?ata=706 Elsevier. Guyton & Hall: Textbook of Medical Physiology 11e \u2013 www.studentconsult.com","VAI TR\u00d2 C\u1ee6A TRIPSIN:CHYMOTRYPSIN TRONG S\u1eecA CH\u1eeeA T\u1ed4N TH\u01af\u01a0NG M\u00d4 VI\u00caM H\u1ed7 tr\u1ee3 qu\u00e1 tr\u00ecnh t\u00e1i t\u1ea1o m\u00f4, l\u00e0m s\u1ea1ch v\u1ebft th\u01b0\u01a1ng \u2022 H\u1ed7 tr\u1ee3 ho\u1ea1t \u0111\u1ed9ng th\u1ef1c b\u00e0o \u2022 Khai th\u00f4ng tu\u1ea7n ho\u00e0n t\u1ea1i v\u00f9ng vi\u00eam Trypsin\/chymotrypsin trong m\u00f4 t\u1ed5n th\u01b0\u01a1ng \u2022 Kh\u00f4ng ng\u0103n c\u1ea3n t\u1ed5ng h\u1ee3p nguy\u00ean b\u00e0o s\u1ee3i \u0110\u1ed1i kh\u00e1ng v\u1edbi plasmin Duy tr\u00ec ho\u1ea1t l\u1ef1c a1- Ch\u1ed1ng oxy h\u00f3a Gi\u1ea3m m\u1ea5t \u0111i albumin v\u00e0 T\u0103ng th\u1ef1c b\u00e0o trong g\u1eafn k\u1ebft v\u1edbi a1- antitrypsin trong th\u1eddi prealbumin atitrypsin v\u00e0 a2- gian d\u00e0i h\u01a1n Gi\u1ea3m nguy c\u01a1 shock Ng\u0103n ng\u1eeba vi\u00eam macroglobulin do m\u1ea5t d\u1ecbch nhi\u1ec5m Gi\u1ea3m tho\u00e1i gi\u00e1n m\u00f4 Plasmin duy tr\u00ec ho\u1ea1t ch\u1ebft do protease \u0111\u1ed9ng ly gi\u1ea3i s\u1ee3i t\u01a1 Gi\u1ea3m vi\u00eam, ROS, huy\u1ebft stress Kh\u00f4i ph\u1ee5c tu\u1ea7n ho\u00e0n t\u1ea1i ch\u1ed7 Gi\u1ea3m s\u01b0ng n\u1ec1 \u0110\u1ea9y nhanh ti\u1ebfn tr\u00ecnh l\u00e0nh th\u01b0\u01a1ng Dilip Shah , Kushal Mital - The Role of Trypsin:Chymotrypsin in Tissue Repair - 2017 20"]