{"id":1558,"date":"2020-06-08T17:02:43","date_gmt":"2020-06-08T10:02:43","guid":{"rendered":"https:\/\/benhvienvietbi.vn\/en\/?p=1558"},"modified":"2021-04-22T08:52:40","modified_gmt":"2021-04-22T01:52:40","slug":"buong-trung-da-nang","status":"publish","type":"post","link":"https:\/\/benhvienvietbi.vn\/en\/buong-trung-da-nang\/","title":{"rendered":"BU\u1ed2NG TR\u1ee8NG \u0110A NANG"},"content":{"rendered":"\n

T\u1ed5ng quan<\/strong><\/p>\n\n\n\n

V\u00e0o n\u0103m 1935, H\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp b\u1edfi Stein v\u00e0 Leventhal tr\u00ean t\u1ea1p ch\u00ed H\u1ed9i s\u1ea3n ph\u1ee5 khoa Hoa K\u1ef3. Trong \u0111\u00f3 b\u00e1o c\u00e1o 7 tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n mang c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m v\u00f4 kinh, r\u1eadm l\u00f4ng, 2 bu\u1ed3ng tr\u1ee9ng to v\u1edbi nhi\u1ec1u nang nh\u1ecf v\u00e0 v\u1ecf \u0111\u1ec7m d\u00e0y. Qua nhi\u1ec1u n\u0103m nghi\u00ean c\u1ee9u, ng\u00e0y nay ng\u01b0\u1eddi ta \u0111\u00e3 hi\u1ec3u r\u00f5 h\u01a1n v\u1ec1 h\u1ed9i ch\u1ee9ng n\u00e0y.<\/p>\n\n\n\n

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H\u00ecnh 1: Ph\u00e2n bi\u1ec7t H\u1ed9i ch\u1ee9ng \u0111a nang<\/figcaption><\/figure>\n\n\n\n

H\u1ed9i ch\u1ee9ng\nbu\u1ed3ng tr\u1ee9ng \u0111a nang (Polycystic ovary syndrome: PCOS) l\u00e0 m\u1ed9t h\u1ed9i ch\u1ee9ng do r\u1ed1i\nlo\u1ea1n n\u1ed9i ti\u1ebft hay g\u1eb7p \u1edf nh\u1eefng ph\u1ee5 n\u1eef trong tu\u1ed5i sinh s\u1ea3n. B\u1ec7nh x\u1ea3y ra \u1edf n\u1eef gi\u1edbi\nk\u00e8m m\u1ed9t lo\u1ea1t c\u00e1c h\u1ed9i ch\u1ee9ng do c\u00f3 qu\u00e1 nhi\u1ec1u androgen (hormone nam gi\u1edbi) trong c\u01a1\nth\u1ec3. C\u00e1c h\u1ed9i ch\u1ee9ng bao g\u1ed3m: th\u01b0a kinh ho\u1eb7c v\u00f4 kinh, c\u01b0\u1eddng androgen v\u00e0 b\u1ea5t\nth\u01b0\u1eddng \u1edf bu\u1ed3ng tr\u1ee9ng. C\u1ee5 th\u1ec3, ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u00f3 th\u1ec3 t\u00edch tr\u1ee9ng to h\u01a1n ng\u01b0\u1eddi\nb\u00ecnh th\u01b0\u1eddng t\u1eeb 2\u20138 mm, s\u1ed1 l\u01b0\u1ee3ng tr\u1ee9ng nhi\u1ec1u nh\u01b0ng tr\u1ee9ng l\u1ea1i kh\u00f4ng ch\u00edn,\ntrong tr\u1ee9ng r\u1ed7ng n\u00ean kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng th\u1ee5 thai, bu\u1ed3ng tr\u1ee9ng c\u00f3 m\u1ed9t l\u1edbp v\u1ecf d\u00e0y\nkhi\u1ebfn cho c\u00e1c nang tr\u1ee9ng kh\u00f4ng th\u1ec3 ph\u00e1t tri\u1ec3n n\u00ean h\u00e0ng th\u00e1ng tr\u1ee9ng kh\u00f4ng ph\u00e1\n\u0111\u01b0\u1ee3c l\u1edbp v\u1ecf \u0111\u00f3, hi\u1ec7n t\u01b0\u1ee3ng ph\u00f3ng no\u00e3n s\u1ebd kh\u00f4ng x\u1ea3y ra. Do \u0111\u00f3, PCOS \u1ea3nh h\u01b0\u1edfng r\u1ea5t\nl\u1edbn t\u1edbi kh\u1ea3 n\u0103ng sinh s\u1ea3n c\u1ee7a ph\u1ee5 n\u1eef. Ngo\u00e0i ra, b\u1ec7nh c\u00f2n k\u00e8m theo m\u1ed9t s\u1ed1 b\u1ea5t\nth\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn nguy c\u01a1 tim m\u1ea1ch v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng typ 2.<\/p>\n\n\n\n

Vi\u1ec7c kh\u00e1m v\u00e0 ph\u00e1t hi\u1ec7n h\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft \u0111\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u00f4 sinh. Nhi\u1ec1u nghi\u00ean c\u1ee9u ch\u1ec9 ra r\u1eb1ng, PCOS x\u1ea3y ra \u1edf kho\u1ea3ng 5-10% ph\u1ee5 n\u1eef trong \u0111\u1ed9 tu\u1ed5i sinh s\u1ea3n. Theo Polson v\u00e0 c\u1ed9ng s\u1ef1 (1986), trong s\u1ed1 nh\u1eefng ph\u1ee5 n\u1eef kh\u1ecfe m\u1ea1nh kh\u00f4ng b\u1ecb v\u00f4 sinh th\u00ec t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh l\u00e0 22%. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p v\u00f4 sinh do kh\u00f4ng ph\u00f3ng no\u00e3n, nguy\u00ean nh\u00e2n do h\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang chi\u1ebfm t\u1edbi 75%.<\/p>\n\n\n\n

Khi ph\u1ee5 n\u1eef m\u1eb7c PCOS, l\u01b0\u1ee3ng hormone sinh d\u1ee5c nam l\u00e0 androgen trong c\u01a1 th\u1ec3 qu\u00e1 nhi\u1ec1u, l\u00e0m ng\u0103n c\u1ea3n s\u1ef1 r\u1ee5ng tr\u1ee9ng khi\u1ebfn tr\u1ee9ng ch\u1ee9a \u0111\u1ea7y trong nang tr\u1ee9ng nh\u01b0ng l\u1ea1i kh\u00f4ng th\u1ec3 ch\u00edn, tho\u00e1t ra v\u1ecf v\u00e0 r\u1ee5ng. Nhi\u1ec1u ng\u01b0\u1eddi m\u1eafc b\u1ec7nh n\u00e0y c\u00f3 bu\u1ed3ng tr\u1ee9ng gi\u00e3n r\u1ed9ng ch\u1ee9a c\u00e1c c\u1ee5m nang nh\u1ecf. N\u1ebfu nang tr\u1ee9ng kh\u00f4ng ph\u00e1t tri\u1ec3n b\u00ecnh th\u01b0\u1eddng v\u00e0 vi\u1ec7c r\u1ee5ng tr\u1ee9ng x\u1ea3y ra kh\u00f4ng \u0111\u00fang chu k\u00ec th\u00ec s\u1ebd d\u1eabn \u0111\u1ebfn s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng hormone nam v\u00e0 n\u1eef trong c\u01a1 th\u1ec3. \u0110a ph\u1ea7n ph\u1ee5 n\u1eef b\u1ecb bu\u1ed3ng tr\u1ee9ng \u0111a nang, c\u01a1 th\u1ec3 s\u1ebd ph\u1ea3n \u1ee9ng \u0111\u1ec1 kh\u00e1ng v\u1edbi insulin ng\u0103n qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a \u0111\u01b0\u1eddng. Nguy c\u01a1 m\u1eafc b\u1ec7nh tim m\u1ea1ch v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng typ 2 do \u0111\u00f3 c\u0169ng t\u0103ng cao.<\/p>\n\n\n\n

Nguy\u00ean nh\u00e2n<\/strong><\/h2>\n\n\n\n

PCOS do s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a\nc\u00e1c y\u1ebfu t\u1ed1 di truy\u1ec1n v\u00e0 m\u00f4i tr\u01b0\u1eddng. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 bao g\u1ed3m b\u00e9o ph\u00ec,\nkh\u00f4ng r\u00e8n luy\u1ec7n th\u1ec3 ch\u1ea5t, v\u00e0 ti\u1ec1n s\u1eed gia \u0111\u00ecnh \u0111\u00e3 t\u1eebng c\u00f3 ng\u01b0\u1eddi b\u1ecb b\u1ec7nh n\u00e0y.<\/p>\n\n\n\n

1.Y\u1ebfu t\u1ed1 di truy\u1ec1n:<\/strong> kh\u1ea3 n\u0103ng b\u1ecb ng\u01b0\u1eddi b\u1ec7nh b\u1ecb m\u1eafc bu\u1ed3ng tr\u1ee9ng \u0111a nang s\u1ebd cao n\u1ebfu m\u1eb9 ho\u1eb7c ch\u1ecb\/ em g\u00e1i trong gia \u0111\u00ecnh c\u0169ng b\u1ecb m\u1eafc b\u1ec7nh. Hi\u1ec7n v\u1ea5n \u0111\u1ec1 \u0111\u1ed9t bi\u1ebfn gen g\u00e2y h\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. <\/p>\n\n\n\n

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

2<\/strong>. D\u01b0 th\u1eeba insulin:<\/strong> Insulin l\u00e0 m\u1ed9t lo\u1ea1i hormone \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t trong c\u00e1c t\u1ebf b\u00e0o tuy\u1ebfn t\u1ee5y cho ph\u00e9p s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng (glucose), cung c\u1ea5p n\u0103ng l\u01b0\u1ee3ng ch\u00ednh c\u1ee7a c\u01a1 th\u1ec3. N\u1ebfu c\u00f3 \u0111\u1ec1 kh\u00e1ng insulin, kh\u1ea3 n\u0103ng s\u1eed d\u1ee5ng insulin m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3 b\u1ecb suy gi\u1ea3m. C\u01a1 th\u1ec3 c\u1ea7n n\u0103ng l\u01b0\u1ee3ng t\u1ea1o feedback ng\u01b0\u1ee3c khi\u1ebfn tuy\u1ebfn t\u1ee5y ti\u1ebft insulin nhi\u1ec1u h\u01a1n \u0111\u1ec3 chuy\u1ec3n h\u00f3a cho c\u00e1c t\u1ebf b\u00e0o. Insulin d\u01b0 th\u1eeba \u0111\u01b0\u1ee3c cho l\u00e0 \u0111\u1ea9y m\u1ea1nh s\u1ea3n xu\u1ea5t androgen c\u1ee7a bu\u1ed3ng tr\u1ee9ng. S\u1ef1 gia t\u0103ng s\u1ea3n xu\u1ea5t androgen c\u00f3 th\u1ec3 c\u1ea3n tr\u1edf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a nang tr\u1ee9ng, m\u1ea5t c\u00e2n b\u1eb1ng hormone sinh d\u1ee5c trong c\u01a1 th\u1ec3, l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng r\u1ee5ng tr\u1ee9ng c\u1ee7a bu\u1ed3ng tr\u1ee9ng.<\/p>\n\n\n\n

3<\/strong>. Ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng:<\/strong> B\u1eefa \u0103n c\u00f3 qu\u00e1 nhi\u1ec1u tinh b\u1ed9t c\u0169ng c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra h\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang. Ngo\u00e0i ra ch\u1ebf \u0111\u1ed9 luy\u1ec7n t\u1eadp th\u1ec3 d\u1ee5c v\u00e0 l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh c\u0169ng c\u00f3 t\u00e1c \u0111\u1ed9ng t\u1edbi vi\u1ec7c ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh. <\/p>\n\n\n\n

Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n\nh\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang<\/strong><\/h2>\n\n\n\n

H\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang (PCOS) l\u00e0 m\u1ed9t\nt\u1eadp h\u1ee3p c\u1ee7a nhi\u1ec1u tri\u1ec7u ch\u1ee9ng k\u1ebft h\u1ee3p. Do v\u1eady, kh\u00f4ng c\u00f3 m\u1ed9t ti\u00eau chu\u1ea9n \u0111\u01a1n l\u1ebb\nn\u00e0o c\u00f3 \u0111\u1ee7 gi\u00e1 tr\u1ecb cho ch\u1ea9n \u0111o\u00e1n. C\u00e1c r\u1ed1i lo\u1ea1n hay b\u1ec7nh l\u00fd kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 c\u00f3\nc\u00e1c tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng t\u1ef1 c\u1ea7n \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb nh\u01b0 c\u00e1c lo\u1ea1i u ch\u1ebf ti\u1ebft androgen,\nt\u0103ng s\u1ea3n tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn b\u1ea9m sinh, h\u1ed9i ch\u1ee9ng Cushing,\u2026<\/p>\n\n\n\n

Tuy nhi\u00ean, H\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang \u0111\u01b0\u1ee3c \u0111\u1ecbnh h\u01b0\u1edbng khi b\u1ec7nh nh\u00e2n c\u00f3 2 trong 3 ti\u00eau chu\u1ea9n sau:<\/p>\n\n\n\n

1.R\u1ed1i lo\u1ea1n ph\u00f3ng no\u00e3n hay kh\u00f4ng ph\u00f3ng no\u00e3n.<\/p>\n\n\n\n

2. C\u01b0\u1eddng androgen \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1eb1ng c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2n s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng. <\/p>\n\n\n\n

3. Xu\u1ea5t hi\u1ec7n h\u00ecnh \u1ea3nh bu\u1ed3ng tr\u1ee9ng \u0111a nang tr\u00ean si\u00eau \u00e2m.<\/p>\n\n\n\n\n\n

C\u00e1c \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng<\/strong><\/h2>\n\n\n\n

1.R\u1ed1i lo\u1ea1n ph\u00f3ng no\u00e3n\/kh\u00f4ng ph\u00f3ng no\u00e3n<\/strong><\/p>\n\n\n\n

Trong h\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang, r\u1ed1i lo\u1ea1n kinh nguy\u1ec7t c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e0 thi\u1ec3u kinh (chu k\u00ec kinh nguy\u1ec7t >35 ng\u00e0y ho\u1eb7c c\u00f3 kinh <8 l\u1ea7n\/ n\u0103m) ho\u1eb7c v\u00f4 kinh (kh\u00f4ng c\u00f3 kinh >6 th\u00e1ng). Vi\u1ec7c r\u1ee5ng tr\u1ee9ng c\u00f3 th\u1ec3 l\u00e0 kh\u00f4ng th\u01b0\u1eddng xuy\u00ean ho\u1eb7c ho\u00e0n to\u00e0n kh\u00f4ng x\u1ea3y ra. Kho\u1ea3ng 90% ph\u1ee5 n\u1eef thi\u1ec3u kinh c\u00f3 h\u00ecnh \u1ea3nh bu\u1ed3ng tr\u1ee9ng \u0111a nang tr\u00ean si\u00eau \u00e2m.<\/p>\n\n\n\n

2. C\u01b0\u1eddng androgen<\/strong><\/p>\n\n\n\n

R\u1eadm l\u00f4ng<\/strong><\/p>\n\n\n\n

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

M\u1ed9t trong nh\u1eefng bi\u1ec3u hi\u1ec7n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a c\u01b0\u1eddng androgen l\u00e0 r\u1eadm l\u00f4ng. Thang \u0111i\u1ec3m Ferriman \u2013 Gallway c\u1ea3i ti\u1ebfn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1ng gi\u00e1 t\u00ecnh tr\u1ea1ng r\u1eadm l\u00f4ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh. C\u00f3 kho\u1ea3ng 92% ph\u1ee5 n\u1eef r\u1eadm long c\u00f3 h\u00ecnh \u1ea3nh bu\u1ed3ng tr\u1ee9ng \u0111a nang tr\u00ean si\u00eau \u00e2m. Tuy nhi\u00ean, khi \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 l\u01b0u \u00fd m\u1ed9t s\u1ed1 v\u1ea5n \u0111\u1ec1 nh\u01b0: (i) r\u1eadm long c\u00f3 th\u1ec3 l\u00e0 do y\u1ebfu t\u1ed1 v\u1ec1 di truy\u1ec1n hay ch\u1ee7ng t\u1ed9c; (ii) ch\u01b0a c\u00f3 tr\u1ecb s\u1ed1 tham kh\u1ea3o c\u1ee7a d\u00e2n s\u1ed1 b\u00ecnh th\u01b0\u1eddng; (iii) \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng r\u1eadm l\u00f4ng v\u1eabn c\u00f2n r\u1ea5t ch\u1ee7 quan; (iv) h\u1ec7 th\u1ed1ng \u0111\u00e1nh gi\u00e1 chu\u1ea9n Ferriman-Gallway ch\u01b0a \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng nh\u01b0 m\u1ed9t ti\u00eau chu\u1ea9n trong l\u00e2m s\u00e0ng.<\/p>\n\n\n\n

M\u1ee5n<\/strong><\/p>\n\n\n\n

Nhi\u1ec1u nghi\u00ean c\u1ee9u cho th\u1ea5y kho\u1ea3ng 75% ph\u1ee5 n\u1eef b\u1ecb m\u1ee5n c\u00f3 h\u00ecnh \u1ea3nh bu\u1ed3ng tr\u1ee9ng \u0111a nang tr\u00ean si\u00eau \u00e2m. V\u00ec th\u1ebf m\u1ee5n tr\u1ee9ng c\u00e1 c\u0169ng \u0111\u01b0\u1ee3c xem x\u00e9t nh\u01b0 l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u c\u1ee7a c\u01b0\u1eddng Androgen. Tuy nhi\u00ean trong c\u00e1c nghi\u00ean c\u1ee9u, t\u1ea7n xu\u1ea5t ch\u00ednh x\u00e1c c\u1ee7a c\u01b0\u1eddng androgen \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 m\u1ee5n tr\u1ee9ng c\u00e1 r\u1ea5t kh\u00e1c nhau.<\/p>\n\n\n\n

H\u00f3i \u0111\u1ea7u ki\u1ec3u nam gi\u1edbi<\/strong><\/p>\n\n\n\n

D\u1ea5u hi\u1ec7u h\u00f3i \u0111\u1ea7u r\u1ee5ng t\u00f3c \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u b\u1edfi di truy\u1ec1n, v\u00ec \u00edt \u0111\u01b0\u1ee3c quan t\u00e2m. Tuy nhi\u00ean n\u00f3 c\u0169ng kh\u00e1 ph\u1ed5 bi\u1ebfn trong b\u1ec7nh bu\u1ed3ng tr\u1ee9ng \u0111a nang.<\/p>\n\n\n\n

B\u00e9o ph\u00ec<\/strong><\/p>\n\n\n\n

Kho\u1ea3ng 30-50% ph\u1ee5 n\u1eef m\u1eafc PCOS b\u1ecb b\u00e9o ph\u00ec. B\u00e9o ph\u00ec \u1edf ng\u01b0\u1eddi m\u1eafc PCOS th\u01b0\u1eddng theo ki\u1ec3u trung t\u00e2m, th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng ch\u1ec9 s\u1ed1 BMI, ch\u1ec9 s\u1ed1 v\u00f2ng b\u1ee5ng hay t\u1ec9 s\u1ed1 eo (WHR) v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c bi\u1ec3u hi\u1ec7n r\u00f5 \u1edf ng\u01b0\u1eddi Ch\u00e2u \u00c2u v\u00e0 M\u1ef9. BMI >23kg\/m2 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 th\u1eeba c\u00e2n v\u00e0 >25 kg\/m2 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 b\u00e9o ph\u00ec. Ch\u1ec9 s\u1ed1 v\u00f2ng b\u1ee5ng >80 cm hay WHR >0.28-0.85 \u0111\u01b0\u1ee3c xem l\u00e0 b\u00e9o ph\u00ec ki\u1ec3u trung t\u00e2m (WHO, 2000). Nguy\u00ean nh\u00e2n c\u1ee7a v\u1ea5n \u0111\u1ec1 n\u00e0y l\u00e0 do r\u1ed1i lo\u1ea1n trong qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng ph\u00e2n b\u1ed1 m\u1ee1 kh\u00f4ng \u0111\u1ed3ng \u0111\u1ec1u. <\/strong><\/p>\n\n\n\n\n\n

C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n\n\n\n

V\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a y h\u1ecdc hi\u1ec7n \u0111\u1ea1i th\u00ec vi\u1ec7c ch\u1ea9n \u0111o\u00e1n c\u01b0\u1eddng androgen c\u00e0ng \u0111\u01b0\u1ee3c tin c\u1eady. Vi\u1ec7c \u0111\u1ecbnh l\u01b0\u1ee3ng c\u00e1c hormone li\u00ean quan \u0111\u1ebfn c\u01b0\u1eddng androgen nh\u01b0 n\u1ed3ng \u0111\u1ed9 testosterone to\u00e0n ph\u1ea7n v\u00e0 t\u1ef1 do, t\u1ef7 l\u1ec7 LH\/FSH,\u2026 t\u1ecf ra ng\u00e0y c\u00e0ng h\u1eefu \u00edch trong vi\u1ec7c n\u00e2ng cao ch\u1ea5t l\u01b0\u1ee3ng ch\u1ea9n \u0111o\u00e1n h\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang.<\/p>\n\n\n\n

3. H\u00ecnh \u1ea3nh bu\u1ed3ng tr\u1ee9ng \u0111a nang tr\u00ean si\u00eau \u00e2m<\/strong><\/p>\n\n\n\n

L\u00e0 bu\u1ed3ng tr\u1ee9ng c\u00f3 s\u1ef1\nhi\u1ec7n di\u1ec7n c\u1ee7a #12 nang no\u00e3n c\u00f3 k\u00edch th\u01b0\u1edbc 2-9mm tr\u00ean m\u1ed9t m\u1eb7t c\u1eaft, c\u00f3 th\u1ec3 k\u00e8m\ntheo s\u1ef1 t\u0103ng th\u1ec3 t\u00edch c\u1ee7a bu\u1ed3ng tr\u1ee9ng (>10ml).<\/p>\n\n\n\n

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

Khi \u0111\u00e1nh gi\u00e1 h\u00ecnh \u1ea3nh bu\u1ed3ng tr\u1ee9ng \u0111a nang c\u1ea7n l\u01b0u \u00fd m\u1ed9t s\u1ed1 \u0111\u1eb7c \u0111i\u1ec3m sau:<\/p>\n\n\n\n

-\u0110\u1eb7c \u0111i\u1ec3m ph\u00e2n b\u1ed1 c\u1ee7a c\u00e1c nang \u1edf v\u00f9ng ngo\u1ea1i vi bu\u1ed3ng tr\u1ee9ng, s\u1ef1 t\u0103ng th\u1ec3 t\u00edch v\u00e0 \u0111\u1ed9 d\u00e0y c\u1ee7a m\u00f4 \u0111\u1ec7m bu\u1ed3ng tr\u1ee9ng tr\u00ean si\u00eau \u00e2m. Ch\u1ec9 m\u1ed9t bu\u1ed3ng tr\u1ee9ng th\u1ecfa y\u00eau c\u1ea7u c\u0169ng \u0111\u1ee7 \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh bu\u1ed3ng tr\u1ee9ng \u0111a nang.<\/p>\n\n\n\n

-Ng\u01b0\u1eddi ph\u1ee5 n\u1eef kh\u00f4ng s\u1eed d\u1ee5ng thu\u1ed1c ng\u1eeba thai, thu\u1ed1c k\u00edch th\u00edch bu\u1ed3ng tr\u1ee9ng \u00edt nh\u1ea5t kho\u1ea3ng 3 th\u00e1ng tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n\n\n\n

-N\u1ebfu c\u00f3 1 nang >10mm tr\u00ean bu\u1ed3ng tr\u1ee9ng th\u00ec ti\u1ebfn h\u00e0nh th\u1ef1c hi\u1ec7n si\u00eau \u00e2m l\u1ea1i v\u00e0o k\u00ec sau.<\/p>\n\n\n\n

-Th\u1eddi \u0111i\u1ec3m si\u00eau \u00e2m v\u00e0o ng\u00e0y 3-5 c\u1ee7a chu k\u00ec. Nh\u1eefng ng\u01b0\u1eddi v\u00f4 kinh hay th\u01b0a kinh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c si\u00eau \u00e2m b\u1ea5t k\u00ec th\u1eddi \u0111i\u1ec3m n\u00e0o hay v\u00e0o ng\u00e0y 3-5 sau khi g\u00e2y ra huy\u1ebft \u00e2m \u0111\u1ea1i b\u1eb1ng progestin.<\/p>\n\n\n\n

\u0110i\u1ec1u\ntr\u1ecb<\/strong><\/h2>\n\n\n\n
\"\"<\/figure>\n\n\n\n

Hi\u1ec7n nay ch\u01b0a c\u00f3 ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u cho bu\u1ed3ng tr\u1ee9ng \u0111a nang. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng nh\u1eafm t\u1edbi m\u1ee5c \u0111\u00edch l\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng c\u01b0\u1eddng androgen hay \u0111i\u1ec1u tr\u1ecb v\u00f4 sinh. N\u1ebfu \u1edf b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 nhu c\u1ea7u c\u00f3 con, c\u00f3 th\u1ec3 d\u00f9ng m\u1ed9t s\u1ed1 thu\u1ed1c n\u1ed9i ti\u1ebft \u0111\u1ec3 l\u00e0m gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a h\u1ed9i ch\u1ee9ng n\u00e0y nh\u01b0 kinh kh\u00f4ng \u0111\u1ec1u, r\u1eadm l\u00f4ng, r\u1ee5ng t\u00f3c, r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a,\u2026 hay ng\u0103n ng\u1eeba s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a m\u1ed9t s\u1ed1 nguy c\u01a1 l\u00e2u d\u00e0i sau n\u00e0y. Tuy nhi\u00ean, sau khi ng\u01b0ng s\u1eed d\u1ee5ng thu\u1ed1c, c\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 s\u1ebd tr\u1edf l\u1ea1i nh\u01b0 ban \u0111\u1ea7u. N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 nhu c\u1ea7u \u0111i\u1ec1u tr\u1ecb v\u00f4 sinh: D\u00f9ng m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c k\u00edch th\u00edch s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a nang no\u00e3n nh\u01b0 Clomiphene Citrate, Metformine, Gonadotrophine. T\u00f9y theo t\u00ecnh tr\u1ea1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh m\u00e0 b\u00e1c s\u0129 \u0111\u01b0a ra c\u00e1c ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p. Ngo\u00e0i ra duy tr\u00ec l\u1ed1i s\u1ed1ng kh\u1ecfe m\u1ea1nh v\u00e0 luy\u1ec7n t\u1eadp th\u1ec3 d\u1ee5c gi\u1ea3m c\u00e2n c\u0169ng \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong hi\u1ec7u qu\u1ea3 c\u1ee7a ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb. B\u00ean c\u1ea1nh \u0111\u00f3 c\u0169ng c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p m\u1ed5 n\u1ed9i soi \u0111\u1ed1t \u0111i\u1ec3m tr\u00ean b\u1ec1 m\u1eb7t bu\u1ed3ng tr\u1ee9ng. \u0110\u1eb7c bi\u1ec7t hi\u1ec7n nay c\u00f2n c\u00f3 r\u1ea5t nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb v\u00f4 sinh ti\u00ean ti\u1ebfn mang l\u1ea1i hi\u1ec7u qu\u1ea3 cao nh\u01b0: th\u1ee5 tinh nh\u00e2n t\u1ea1o, th\u1ee5 tinh trong \u1ed1ng nghi\u1ec7m, ti\u00eam tinh tr\u00f9ng v\u00e0o t\u01b0\u01a1ng b\u00e0o no\u00e3n, tr\u01b0\u1edfng th\u00e0nh tr\u1ee9ng non,\u2026<\/p>\n","protected":false},"excerpt":{"rendered":"

T\u1ed5ng quan V\u00e0o n\u0103m 1935, H\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp b\u1edfi Stein v\u00e0 Leventhal tr\u00ean t\u1ea1p ch\u00ed H\u1ed9i s\u1ea3n ph\u1ee5 khoa Hoa K\u1ef3. Trong \u0111\u00f3 b\u00e1o c\u00e1o 7 tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n mang c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m v\u00f4 kinh, r\u1eadm l\u00f4ng, 2 bu\u1ed3ng tr\u1ee9ng to v\u1edbi nhi\u1ec1u nang nh\u1ecf […]<\/p>\n","protected":false},"author":3,"featured_media":739,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[90,22,94],"tags":[],"class_list":["post-1558","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nguyen-nhan-vo-sinh","category-vo-sinh-hiem-muon","category-vo-sinh-do-buong-trung-da-nang"],"acf":[],"yoast_head":"\nBU\u1ed2NG TR\u1ee8NG \u0110A NANG - VIET \u2013 BI SPECIALIZED HOSPITAL IN ANDROLOGY AND INFERTILITY<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/benhvienvietbi.vn\/en\/buong-trung-da-nang\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"BU\u1ed2NG TR\u1ee8NG \u0110A NANG - VIET \u2013 BI SPECIALIZED HOSPITAL IN ANDROLOGY AND INFERTILITY\" \/>\n<meta property=\"og:description\" content=\"T\u1ed5ng quan V\u00e0o n\u0103m 1935, H\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp b\u1edfi Stein v\u00e0 Leventhal tr\u00ean t\u1ea1p ch\u00ed H\u1ed9i s\u1ea3n ph\u1ee5 khoa Hoa K\u1ef3. 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