TӘ1*48$17ẻ1++ẻ1+9,ầ0/Ӝ TUYӂ1&7&7521*9ơ1*2ơ, 1ѬӞC
1.1.1 TuQKKuQK bӋnh YLrPOӝ tuyӃn CTC WUrQWKӃ giӟi
9LrP Oӝ tuyӃn CTC Fy WrQ WLӃQJ $QK Oj &ervical Ectropion hay Cervical Ectopy hoһc Erosion Occurs ± QJKƭDOj[yL PzQ&7& Lӝ tuyӃn xҧy ra khi Fy Vӵ WKD\ÿәi cӫa nӝi tiӃt tӕ OjPlӝ YQJbiӇXP{WX\Ӄn UDErQQJRjL, NpRGjLYjRSKҫn kPÿҥo cӫa CTC [1] Theo thӕQJNrWӹ lӋ mҳc bӋnh Qj\ GDRÿӝng tӯ ÿӃn 50% ӣ phө nӳ [1,6], FyPһt ӣ 80% thanh thiӃXQLrQKRҥWÿӝQJWuQKGөc YjWӹ lӋ hiӋn mҳc VDXÿyJLҧm dҫn khi phө nӳ EѭӟFYjRÿӝ tuәLYj>@7X\QKLrQFiF\Ӄu tӕ OLrQTXDQÿӃn sӵ tiӃQKyDYjSKiKӫy cӫD&7&NK{QJÿѭӧF[iFÿӏQKU} BӣLYulӝ tuyӃn ÿѭӧc WuPWKҩy WKѭӡQJ[X\rQӣ FiFF{JiLYӏ WKjQKQLrQYjSKө nӳ mang thai 'Rÿy QyFyWKӇ WKD\ÿәi theo sӵ GDRÿӝng cӫa nӝi tiӃt tӕ [1] Khi nӗQJÿӝ hormone WăQJ Fy WKӇ NtFKKRҥt YQJbiӇX P{tuyӃn tӯ ErQ WURQJ ӕng CTC mӣ rӝQJUD ErQ ngojLYjWKD\WKӃ dҫQYQJELӇXP{OiW [6]
MӝWQJKLrQFӭu vӅ tӹ lӋ hiӋn mҳc ӣ Trung QuӕFÿmEiRFiRUҵng FyNKRҧng 43.2% phө nӳ mҳc bӋQKYLrPOӝ tuyӃn CTC trong sӕ nhӳQJQJѭӡi phө nӳ sӱ dөng dӏch vө kӃ hoҥFKKyDJLDÿuQK[5] MӝWQJKLrQFӭXNKiFYӅ nhӳng phө nӳ sӱ dөng thuӕF WUiQK WKDL ÿѭӡng uӕQJ 2&3V Yj dөng cө WUiQK WKDL (IUCDs) ӣ Benghazi, /LE\D FNJQJTXDQViWWKҩy rҵng YLrPOӝ tuyӃn CTC OjUӕi loҥn phө khoa phә biӃn nhҩt ӣ phө nӳQyFKLӃm khoҧng 54.9% [18]
Trong mӝWQJKLrQFӭu vӅ nhӳng phө nӳ tham gia WKăPNKiPWҥi SKzQJNKiP bӋQK Ok\ WUX\ӅQ TXD ÿѭӡQJ WuQK Gөc ӣ Hoa KǤ, bӋQK YLrP Oӝ tuyӃn CTC Fy OLrQ quan mұt thiӃW ÿӃn viӋc sӱ dөQJ FiF biӋQ SKiS WUiQK WKDL ÿѭӡng uӕQJ Yj QKLӉm Chlamydia [1,19] &KODP\GLDOjPӝt trong nhӳng bӋnh phә biӃn nhҩWOk\QKLӉm qua ÿѭӡQJ WuQK Gөc BӋnh nӃX NK{QJ ÿѭӧF ÿLӅu trӏ kӏp thӡL Fy WKӇ Jk\ WәQ WKѭѫQJ QJKLrPWUӑQJYjYƭQKYLӉn tӟLFѫTXDQVLQKVҧn cӫa nӳ giӟi, thұPFKtFyWKӇ dүn tӟi Y{VLQK&KODP\GLDJk\UDEӣi vi khuҭQÿһc biӋW&KODP\GLDNêVLQKEҳt buӝc trong tӃ EjRVӕQJFyKuQKFҫXFyNtFKWKѭӟc trung gian giӳa vi khuҭQYjYLU~W+ҫu hӃt
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 FiFWUѭӡng hӧp mҳF&KODP\GLDNK{QJFyWULӋu chӭng, tuy vұ\QyYүQkPWKҫPJk\ tәQWKѭѫQJFѫTXDQVLQKGөc cӫa QJѭӡi bӋnh
MӝW QJKLrQ Fӭu NKiF ӣ Thә 1Kƭ Ǥ cho thҩy Fy NKRҧng 14.7% phө nӳ sӱ dөng IUCDs FyEӋQKOêvӅ CTC TURQJÿy, vLrPOӝ tuyӃn Yj tiӃt dӏFKkPÿҥRFNJQJ ÿѭӧFWuPWKҩ\FDRKѫQÿiQJNӇ ӣ nhӳQJQJѭӡi sӱ dөng IUCDs so vӟi phө nӳ GQJ OCPs [20] MһFNKiF, YLrPOӝ tuyӃn FNJQJÿѭӧFWuPWKҩy tӯ ÿӃn 25% ӣ phө nӳ bӏ chҧ\PiXVDXVLQK>] 7KHRÿyciFWәQWKѭѫQJWLӅQXQJWKѭWKѭӡQJSKiWWULӇn tҥi vӏ WUtUDQKJLӟi giӳa biӇXP{OiWYj biӇXP{WX\ӃQ'RÿyYӅ mһWOêWKX\ӃWÿLӅu trӏ bӋQKYLrPOӝ tuyӃn CTC FyWKӇ chӭQJPLQKÿѭӧc khҧ QăQJFKӕng lҥi tӹ lӋ mҳc unJWKѭ&7& [22] Mӝt sӕ SKѭѫQJWKӭF ÿLӅu trӏ ÿm ÿѭӧc sӱ dөQJ FKR FiF WUѭӡng hӧp YLrPOӝ tuyӃn bao gӗm sӱ dөQJNKiQJVLQKÿ{QJPiXP{YLVyQJÿ{QJPiX bҵng laser, tia hӗng ngoҥi, thuӕc interferon-DOSKDÿӕWÿLӋn hoһc liӋXSKiSiSOҥnh [6,23-24]
1ăP LNHORPR 2ORODGH :ULJKW Yj Fӝng sӵ ÿm F{QJ Eӕ WUrQ %0& Research Notes mӝWQJKLrQFӭXÿѭӧc tiӃQKjQKYjRQăP± 2011 YjQJKLrQFӭu Qj\ ÿm ÿѭӧF SKr GX\Ӌt bӣi ӫ\ EDQ ÿҥR ÿӭc cӫa BӋnh viӋn Ĉҥi hӑc bang Lagos (LASUTH) 7URQJÿyEӋQKQKkQFyVӱ dөng dөng cө WUiQKWKDLÿѭӧc kiӇm tra CTC KӃt quҧ cho thҩ\FyWәng sӕ 79/628 bӋQKQKkQÿѭӧc kiӇm tra Fy dҩu hiӋu cӫa YLrPOӝ tuyӃQ&7&YjFKLӃm 12.QKѭWURQJEҧng 1.1 [9]
Sӵ FyPһt cӫDYLrPOӝ tuyӃn CTC Sӕ ca Tӹ lӋ phҫQWUăP
9LrPOӝ tuyӃQ&7&OjPӝt trong nhӳng QJX\rQQKkQ phә biӃn nhҩWÿӇ nhұp viӋn cӫa phө nӳ WURQJÿӝ tuәi tӯ 15 ÿӃn 44 tuәi1yFKLӃm khoҧQJOѭӧt nhұp viӋn WUrQ mӝWQăPӣ 6FRWODQGYjOѭӧt nhұp viӋQWUrQ mӝWQăPӣ $QKYj[ӭ
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 Wales 1JRjLUDPӝt sӕ phө nӳ NK{QJU}QJX\rQQKkQEӏ YLrPOӝ tuyӃn phҧi tiӃn KjQKÿLӅu trӏ ngoҥLWU~WKHR\rXFҫu cӫDEiFVƭ>1]
HiӋQWѭӧng chҧ\PiXVDXVLQKFNJQJOjPӝt trong nhӳng dҩu hiӋu cӫDYLrPOӝ tuyӃn Trong mӝWQJKLrQ Fӭu cӫa Daniel O Selo-2MHPH Yj Fӝng sӵ thӵc hiӋn tҥi BӋnh viӋQĈDNKRD6RXWKHQGSKtDÿ{QJQDPQѭӟc Anh TҥLÿk\EӋQKQKkQFy dҩu hiӋu chҧ\ PiX VDX VLQK ÿѭӧc tiӃQ KjQK VRL &7& NӃt quҧ Fy EӋQK QKkQ (chiӃm 43.5%) ÿѭӧc chҭQÿRiQOj YLrPOӝ tuyӃn [21]
9LrPOӝ tuyӃQFNJQJOLrQTXDQÿӃn nhiӅu loҥi bӋQKOk\WUX\ӅQTXDÿѭӡQJWuQK dөc bao gӗm bӋnh Chlamydia [4,10-11@ YLUXV Jk\ VX\ JLҧm miӉn dӏch ӣ QJѭӡi (Human immunodeficiency virus ± HIV) [11-12@ YLUXV X QK~ ӣ QJѭӡi (Human papilloma virus ± HPV) [13@7uQKWUҥQJYLrPOӝ tuyӃQÿӇ TXiOkXNK{QJÿLӅu trӏ FzQOjPӝt trong nhӳQJQJX\rQQKkQKjQJÿҫXJk\UDXQJWKѭ&7&
8QJWKѭ&7&OjPӝt trong nhӳng XQJWKѭSKә biӃn nhҩt ӣ phө nӳ WUrQWRjQWKӃ giӟi, ÿӭng thӭ WѭWURQJFiFORҥLXQJWKѭYj ÿӭng thӭ KDLWURQJFiFXQJWKѭSKө khoa vӅ tӹ lӋ mҳc phҧLFNJQJQKѭWӹ lӋ tӱ vong 8QJWKѭ&7& xҧy ra chӫ yӃu ӣ FiFTXӕc JLDÿDQJ SKiWWULӇn (chiӃm khoҧng 85%)QѫLYүQFzQ WKLӃXFiF FKѭѫQJWUuQKWҫm VRiW XQJ WKѭ Yj ÿLӅu kiӋQ Fѫ Vӣ vұt chҩt vүQ FzQ QKLӅu hҥn chӃ [1,14] 9jR QăP
&ѫTXDQ1JKLrQFӭX8QJWKѭ4Xӕc tӃ ѭӟFWtQKKjQJQăP FyNKRҧng 570000 WUѭӡng hӧp mҳFXQJWKѭ&7&Yj000 ca tӱ YRQJĈk\OjFăQEӋQKXQJWKѭÿѭӧc chҭQÿRiQSKә biӃn nhҩt ӣ 28 quӕFJLDYjOjQJX\rQQKkQKjQJÿҫXJk\Wӱ vong do XQJWKѭӣ 42 quӕc gia [25]
Theo thӕQJNrFӫa Tә chӭc Y tӃ ThӃ giӟL:+2YjR QăPmӛLQăPWUrQ thӃ giӟLFyWKrPNKRҧng 530WUѭӡng hӧp mҳFXQJWKѭ&7&FKLӃm khoҧng 7.5% tәng sӕ ca tӱ YRQJGRXQJWKѭӣ nӳ giӟi [14] 7X\QKLrQQӃXÿѭӧFSKiWKLӋn ӣ giai ÿRҥn sӟm, tӹ lӋ WLrQOѭӧng tӕt sau chҭQÿRiQQăPFyWKӇ ÿҥWÿӃQFzQ QӃu SKiWKLӋn trӉ YjRJLDLÿRҥn tӃ EjRXQJWKѭÿmGLFăQWKuWӹ lӋ Qj\JLҧm xuӕng chӍ FzQ 17% [14] TҥLFiFTXӕFJLDSKiWWULӇn viӋc tҫPVRiWXQJWKѭ&7&OjPӝt phҫQNK{QJ thӇ thiӃXWURQJFiFFKѭѫQJWUuQKFKăPVyFVӭc khӓe phө nӳ ĈLӇQKuQKQKѭӣ Hoa
KǤ, tҩt cҧ phө nӳ WURQJQKyPWXәLFyQJX\FѫWӯ 21 tuәi trӣ OrQÿӅXÿѭӧF\rXFҫu [pWQJKLӋPÿӏnh kǤ vӟi mӭFÿӝ tӕi thiӇXOjQăPQăPKRһFQăPPӝt lҫQW\
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 QKyPWXәLGRÿy tӹ lӋ mҳc bӋQKXQJWKѭCTC ӣ QѭӟFQj\FNJQJgiҧm xuӕng khoҧng 70% TҥLÒFWҩt cҧ phө nӳ WURQJÿӝ tuәi tӯ ÿӃn 70 tuәi ÿӅu bҳt buӝc thӵc hiӋn tҫPVRiWXQJWKѭCTC mӛLQăPPӝt lҫn 1KѭYұ\ÿӇ WăQJNKҧ QăQJFKӳa trӏ WKjQK F{QJYjNKҧ QăQJVӕQJFKRQJѭӡi bӋQKWKuYLӋc tҫPVRiWSKiWKLӋn sӟPQJX\FѫXQJ WKѭCTC QyLFKXQJYjEӋQKYLrPOӝ tuyӃQQyLULrQJOjY{FQJTXDQWUӑng
HiӋn nay, mӝWYjLNӻ thuұWVjQJOӑFXQJWKѭCTC WKѭӡQJÿѭӧc sӱ dөng trong OkPVjQJFyWKӇ kӃ ÿӃQQKѭ [pWQJKLӋm papilloma virus (HPV) FyQJX\FѫFDR ӣ QJѭӡL[pWQJKLӋm tӃ EjR3DSVPHDUVRLCTC YjNLӇm tra trӵc quan CTC bҵng acid acetic 3% ± 5% 9,$ Yj OXJRO 9,/, MӛL SKѭѫQJ SKiS ÿӅX Fynhӳng ѭX ÿLӇPYj QKѭӧF ÿLӇm cӫD QyW\YjR ÿLӅu kiӋQFѫVӣ vұt chҩt, mӭF ÿӝ bӋnh, khҧ QăQJWjLFKtQKFӫa bӋQKQKkQPjOӵa chӑn mӝWSKѭѫQJSKiSFKRSKKӧp
1.1.2 7uQKKuQKEӋQKYLrPOӝ tuyӃn CTC WURQJQѭӟc Ӣ ViӋW1DPYLrPOӝ tuyӃn CTC OjbӋnh phө khoa NKiSKә biӃn ӣ nӳ giӟi Yj FyWӹ lӋ mҳc phҧi cao nhҩt hiӋQQD\Ĉӕi vӟi phө nӳ WURQJÿӝ tuәi sinh sҧnFăQEӋnh Qj\FKLӃm khoҧng 50ÿӃn 60% Tӹ lӋ Qj\VӁ WăQJOrQkhoҧng 60ÿӃn 80% ÿӕi vӟi nӳ giӟi tӯng xҧy ra quan hӋ WuQKGөc BҧQWKkQOӝ tuyӃQ&7&OjPӝt tәQWKѭѫQJ OjQKWtQKQKѭQJQyOҥLOjNKӣi nguӗn cӫa mӝt sӕ bӋnh phө khoa nguy hiӇPÿӗng thӡLFNJQJFKtQKOjQJX\rQQKkQJk\Y{VLQKKLӃm muӝQYjXQJWKѭ&7& [26-27] 9LrP Oӝ tuyӃn CTC dүQ ÿӃn hiӋn WѭӧQJ WăQJ WLӃt dӏFK WURQJ kP ÿҥo, Yu Yұy WURQJJLDLÿRҥQQj\&7& OjYӏ WUtѭDWKtFKFӫDFiFORҥi vi khuҭQQKѭWUQJURLkP ÿҥo, tҥp khuҭn, nҩm hay vi khuҭn lұu, vi khuҭQ FKODP\GLD YLUXV Jk\ Pөn rӝp, VLQKV{LYjSKiWWULӇn mҥnh Ĉk\OjFiFWiFQKkQFKtQKJk\YLrPCTCVDXÿy Jk\ YLrP nhiӉm QJѭӧFGzQJGүQÿӃn YLrPWҳFYzLWUӭQJYLrPWLӇXNKXQJYLrPQӝi mҥc tӱ cung, [26]
1KѭÿmQyLӣ WUrQYLrPOӝ tuyӃn CTC FyELӇu hiӋQOjWăQJWLӃt dӏFKkPÿҥo, ÿLӅXQj\ Jk\Fҧn trӣ WLQKWUQJÿLYjRJһp trӭQJ.K{QJFKӍ vұ\FăQEӋQKQj\FzQ khiӃQFKRÿӝ S+kPÿҥRWKD\ÿәi, khiӃQWLQKWUQJNKyVӕng khi vӯDYjRÿӃQkP ÿҥR Yj NKy JһS ÿѭӧc trӭQJ Ĉy Oj QJX\rQ QKkQ YLrP Oӝ tuyӃn CTC Fy WKӇ ҧnh Kѭӣng tӟi khҧ QăQJVLQKVҧQYjJk\Y{VLQKӣ phө nӳ Theo thӕQJNrtӹ lӋ phө nӳ mҳF Y{ VLQK KLӃm muӝQ GR YLrP Oӝ tuyӃQ &7& Oj KӃt quҧ Qj\ FKR WKҩy,
TӘ1* 48$1 &È& 3+ѬѪ1* 3+È3 &+Ҭ1 Ĉ2È1 %ӊ1+ 9,Ç0 /Ӝ TUYӂN CTC
1Jj\QD\Yӟi sӵ SKiWWULӇQNK{QJQJӯng cӫa khoa hӑc kӻ thuұWYjF{QJQJKӋ, FyQKLӅXSKѭѫQJSKiSNKiFQKDXhӛ trӧ chҭQÿRiQEӋQKOê&7&QyLFKXQJYjEӋnh YLrPOӝ tuyӃQQyLULrQJĈӕi vӟi chҭQÿRiQEӋQKOê&7&QKuQFKXQJ FiFSKѭѫQJ SKiS ÿѭӧFFKLDOjPKDLQKyPFKtQKOjQKyPSKѭѫQJSKiSGӵDWUrQWӃ EjRKӑFYj QKyPSKѭѫQJSKiSGӵDWUrQP{Kӑc7URQJÿyWӃ EjRKӑFOjSKѭѫQJSKiSVӱ dөng FiFNӃt quҧ [pWQJKLӋPP{WӃ EjRQKѭ: Pap Smear, ThinPrep Pap, HPV-'1$Yj WXkQWKHRFiFWLrXFKXҭQÿӇ [iFÿӏnh bӋQKOê7URQJNKLÿyKѭӟng tiӃp cұn tӯ cҩSÿӝ P{Kӑc sӱ dөng kӃt quҧ tӯ viӋFTXDQViWEӅ mһt CTC bҵQJFiFSKѭѫQJSKiSQKѭ: chөp ҧnh CTC, soi CTC, V,$ÿӇ ÿiQKJLiWuQKWUҥng bӋQKOê [31] Ĉӕi vӟi chҭn ÿRiQEӋQKYLrPOӝ tuyӃn CTC, hiӋn nay WURQJOkPVjQJ SKѭѫQJSKiS ÿѭӧc sӱ dөng phә biӃQOj soi CTC kӃt hӧp vӟi phӃt Lugol's iodine 3% - 5% (gӑi tҳWOjOXJRO tiӃp cұn theo cҩSÿӝ P{Kӑc [2]
6RL &7& Oj PӝW SKѭѫQJ SKiS ÿѭӧc GQJ ÿӇ SKiW KLӋn sӟP FiF YҩQ ÿӅ bҩt WKѭӡQJFiFEӋQKOê ӣ tӱ cung FNJQJQKѭXQJWKѭCTC&iFKVRLFyWKӇ bҵng mҳt WKѭӡng hoһc bҵng thiӃt bӏ soi FKX\rQGөng3KѭѫQJSKiSVRLCTC EҵQJPҳWWKѭӡQJWK{QJWKѭӡQJÿѭӧFiSGөng ӣ nhӳQJQѫLYQJVkXYQJ[Dnhӳng YQJFKѭDFy thiӃt bӏVRLGRÿLӅXNLӋQNLQKWӃFzQQKLӅXNKyNKăQ&KtQKYuVRLEҵng mҳWWKѭӡng Pjÿӝ nhҥy Yj ÿӝ ÿһc hiӋu cӫDSKѭѫQJSKiSQj\NK{QJFDR
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 6RL&7&EҵQJthiӃt bӏ soi kӻ thuұt sӕ KuQKOjGQJPӝt hӋ thӕQJPi\VRL Fyÿӝ SKyQJÿҥi tӯ ÿӃn 12 lҫn, FKRSKpSÿLӅu chӍQKU}QpWWӵ ÿӝng hoһc bҵng tay trong khoҧQJÿLӅu chӍnh tӯ 100mm - 800mm Mi\VRLCTC FyFҩXWU~FÿѫQJLҧQVӱ GөQJPӝt nguӗQiQKViQJNKҧNLӃQFyNKҧ QăQJSKyQJÿҥLKuQKҧQKFNJQJQKѭNӃW nӕi vӟLPjQKuQKPi\WtQKFKRSKpSKLӇQWKӏOѭXWUӳKuQK ҧQKYjLQUDWKjQKNӃW TXҧÿӇ OjPEҵng chӭng cho bӋQKQKkQѬXÿLӇPFӫDSKѭѫQJSKiSQj\Oj dӉ thӵc hiӋn, FKRKuQK ҧQKU}UjQJkӃt quҧ QKDQKFKyQJ trong thӡi gian thӵc 7X\QKLrQ QKѭӧFÿLӇm cӫDSKѭѫQJSKiSQj\OjYLӋc chҭQÿRiQFKӫ yӃu dӵDYjRNLQKQJKLӋm TXDQViWYjÿӑc ҧnh cӫDEiFVƭGRÿyYүQFzQWӗn tҥi yӃu tӕ chӫ TXDQYjVӵ VDLNKiF kӃt quҧ giӳDFiFEiFVƭYӟi QKDXWUrQFQJPӝt ca bӋnh
+uQK Thi͇t b͓ soi c͝ t͵ cung kͿ thu̵t s͙ KN-2200 [32]
Soi CTC kӃt hӧp phӃt Lugol KD\FzQ ÿѭӧc gӑLOjSKѭѫQJSKiS9,/, OjPӝt trong nhӳQJSKѭѫQJSKiSSKә biӃQÿѭӧc sӱ dөng ÿӇ [iFÿӏQKYQJOӝ tuyӃn CTC FNJQJQKѭFiFVDQJWKѭѫQJFyNKҧ QăQJJk\XQJWKѭ&7&7URQJÿy9,/,-9LVXDO,QVSHFWLRQ XVLQJ /XJROảV LRGLQH Oj SKѭѫQJ SKiS SKӃW &7& Eҵng dung dӏch Lugol 3% - YjTXDQViWEҵng mҳWWKѭӡng sӵ bҳWPjX cӫa LXJROWUrQEӅ mһt CTC
%uQK WKѭӡQJ &7& Fy PjX Kӗng nhҥt (KuQK A) QrQ viӋF SKkQ ELӋW YQJ YLrPOӝ tuyӃQFNJQJQKѭUDQKJLӟi giӳa biӇXP{OiWYjELӇu tuyӃQOjNK{QJU}UjQJ 7X\QKLrQ sau khi phӃt Lugol cҧ biӇXP{OiWEDQÿҫXEuQKWKѭӡng hoһFÿmFKX\Ӈn sҧQÿӅu biӃQÿәi WKjQKPjXQkXKRһFÿHQYӟi dung dӏch Lugol, trong khi biӇXP{ tuyӃn WKuNK{QJEҳWPjXvӟi dung dӏFKQj\ %rQFҥQKÿyEiӇXP{ÿDQJWURQJTXi WUuQKFKX\Ӈn sҧQWKѭӡQJNK{QJbӏ nhuӝm PjX vӟi Lugol hoһF Fy WKӇ nhuӝm mӝt phҫQĈһc biӋWFiFELӇXP{OiWFyGҩu hiӋu bҩWWKѭӡng sӁ NK{QJWKӇ nhuӝPPjX [33@ĈLӅXQj\Uҩt hӳXtFKWURQJYLӋFSKkQELӋWFiFNKXYӵc bӋQKOê WURQJYQJELӃn ÿәi phӭc tҥSWUrQEӅ mһt CTC Qua ÿyEiFVƭFyWKӇ dӉ GjQJSKkQÿӏnh r}UDQKJLӟi tiӃSJLiSJLӳa biӇXP{OiWFӫa cә QJRjLYjELӇXP{tuyӃn cӫa cә trong, FNJQJQKѭ dӉ GjQJNKRDQKYQJlӝ tuyӃn CTC KuQK% ÿӇ ÿѭDUDFiFÿiQKJLiYӅ mӭFÿӝ lӝ tuyӃQFNJQJQKѭSKiWÿӗ ÿLӅu trӏ WKtFKKӧp
+uQK ̪QK&7&WU˱ͣc (AYjVDXB) khi ph͇t Lugol
Thӱ nghiӋP9,/,ÿѭӧFÿiQKJLiӣ ҨQĈӝ&KkX3KLEҵQJVRL&7&YjJLҧi phүu bӋnh cho kӃt quҧ tӕW7X\QKLrQÿӝ nhҥ\Yjÿӝ ÿһc hiӋu cӫDSKѭѫQJSKiS9,/, FzQKҥn chӃ YjSKҧi can thiӋSKyDFKҩt trӵc tiӃSOrQFѫWKӇ7KrPYjRÿyFzQSKө thuӝc rҩt lӟQYjRFKҩWOѭӧng cӫa dung dӏch phӃWFNJQJQKѭNӻ thuұt thӵc hiӋn quy WUuQK>@%rQFҥQKÿyFҩXWU~F&7&Fӫa phө nӳ PmQNLQKFyELӇXP{OiWFyWKӇ NK{QJKRjQWRjQQKXӝm vӟi Lugol do teo biӇXP{'RÿyNKyQKұn thҩ\ÿѭӧFKuQK ҧQKELrQYQJOӝ tuyӃn U}UjQJNKLWKӵc hiӋQ9,/,FKRÿӕLWѭӧQJQj\
;pWYӅ Kѭӟng tiӃp cұn tӯ tӃ EjRWX\ÿmFyFiFKѭӟng dүn nhҵPVRViQKNӃt quҧ TXDQViWWUӵFTXDQÿӇ ÿѭDUDÿiQKJLiQKѭQJÿӝ FKtQK[iFYүn sӁ WKD\ÿәi theo ÿLӅu kiӋQQѫLTXDQViWÿӝ SKkQJLҧLKuQKҧQKiQKViQJ1KuQFKXQJSKѭѫQJSKiS
TӘNG QUAN Vӄ 3+ѬѪ1*3+ẩ3;Ӱ /ộҦ1+9ơ.Ӻ THUҰ73+ặ1 CӴC
TәQJTXDQSKѭѫQJSKiS[ӱ Oêҧnh
1Jj\QD\Yӟi sӵ SKiWWULӇn cӫDPi\WtQKYLӋc sӱ dөQJFiFNӻ thuұt xӱ OêKuQK ҧQKÿӇ QkQJFDRKLӋu quҧ WURQJFiFWKLӃt bӏ chҭQÿRiQÿROѭӡng bҵQJKuQKҧQKOj mӝt vҩQÿӅ thӡi sӵ OX{QÿѭӧFTXDQWkPYjSKiWWULӇn trong nhiӅXOƭQKYӵFQKѭ\WӃ, F{QJQJKӋ nano, khoa hӑc vұt liӋXô7URQJÿyNӻ thuұWSKkQYQJKuQKҧnh trong OƭQKYӵc kӻ thuұt y sinh ÿѭӧFFRLOjEѭӟc tiӅn xӱ OêTXDQWUӑng trong hҫu hӃWFiFKӋ thӕng xӱ Oêҧnh KӃt quҧ SKkQYQJWӕt sӁ JL~SFKRTXiWUuQKFKҭQÿRiQÿҥt hiӋu quҧ FDRKѫQQKҵm tiӃt kiӋm vӅ FKLSKtWKӡLJLDQFNJQJQKѭQJXӗQQKkQOӵF3KkQYQJ
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 ҧQK\VLQKOjWұp hӧSFiFSKkQÿRҥn bao gӗPFyWKӇ OjWRjQEӝ bӭc ҧnh hoһc tұp hӧp FiFÿѭӡQJELrQFKLӃt xuҩt tӯ KuQKҧQK&iFÿLӇm ҧQKWURQJFQJPӝWYQJFyÿһc WtQKWѭѫQJWӵ nhau vӅ PjXVҳFFѭӡQJÿӝ hoһc kӃt cҩX&iFYQJOkQFұQWKuNKiF QKDXÿiQJNӇ vӅ FiFÿһFWUѭQJQj\'ӵDYjRSKkQÿRҥQKuQKҧQKQJѭӡLWDFyWKӇ ÿӏnh vӏ ÿѭӧc vӏ WUtFӫa khӕi u hoһFYQJEӋQKOê[iFÿӏnh cҩXWU~FP{QJKLrQFӭu cҩX WU~F JLҧi phүu, nhұn diӋQ YkQ WD\ >@ ÿһc biӋW Oj Kӛ trӧ SKkQ YQJ EӋQK Oê WURQJKuQKҧnh CTC [36-37]
7\WKHR \rX Fҫu cө thӇ trong tӯQJQJKLrQ Fӭu, nhiӅu thuұWWRiQ SKkQ YQJ ҧnh bӅ mһW&7&NKiFQKDXÿmÿѭӧc sӱ dөQJ7URQJÿy, nәi bұWFyWKӇ kӇ ÿӃn mӝt sӕ QJKLrQ Fӭu vӅ thuұW WRiQ ÿiQK GҩX ÿѭӡng viӅn [38] tҥR WKjQK Pӝt phҫn mӅm tӵ ÿӝng xӱ Oêÿѭӧc mӝt sӕ Oѭӧng ҧQKOrQÿӃn 100000 bӭc ҧnh CTC tӯ FѫVӣ dӳ liӋu cӫa ViӋQ8QJWKѭ4Xӕc gia Hoa KǤ Hay thuұWWRiQÿDFҩSÿӝ nhұn dҥng vӃt trҳng (acetowhite), GQJWURQJQKұn diӋQFiFYӃWDFHWRZKLWHWUrQEӅ mһt CTC %rQFҥnh ÿy, mӝt sӕ thuұWWRiQNKiFFNJQJÿѭӧc sӱ dөng phә biӃQWURQJSKkQÿRҥn ҧnh y sinh QKѭ thuұWWRiQ2WVX, thuұt toiQ6XSSRUt Vector Machine (SVM)$FWLYH&RQWRXUYj K-meansô7URQJ ÿy WKXұW WRiQ 2WVX Yj -PHDQV NKi Qәi bұt vӟi khҧ QăQJ SKkQ ÿRҥn ҧnh vӅ WtQKKLӋu quҧ Yjÿӝ tin cұy [37]
K-PHDQVOjPӝt thuұWWRiQSKkQFөm phә biӃQÿѭӧc sӱ dөng phә biӃn trong kӻ thuұWSKkQFөm 7X\QKLrQPӝt sӕ hҥn chӃ cӫa K-mHDQVOjKLӋu quҧ cӫa thuұWWRiQ phө thuӝF YjRYLӋc chӑn sӕ QKyP SKҧL[iF ÿӏQKWUѭӟF Yj SKҧi thӵc hiӋn nhiӅu YzQJOһSWtQKWRiQNKRҧQJFiFKNKLVӕ cөP.YjGӳ liӋXSKkQFөm lӟn [39] Thuұt WRiQ2WVXOjPӝWSKѭѫQJSKiSSKkQ ÿRҥn dӵDWUrQQJѭӥQJWRjQFөFNKRDQKYQJ hiӋu quҧ FiFÿӕLWѭӧQJNKiFELӋt vӟi nӅn Trong SKkQÿRҥn ҧnh \VLQK2WVXWKѭӡng ÿѭӧc ӭng dөQJÿӇ SKkQÿRҥQYQJPjXÿӓFӫD PiXMһFGYұy, GRÿһFWtQKEӅ mһW&7&EuQKWKѭӡQJFyPjXKӗng nhҥWQrQFiFYӃWÿӓ cӫDPiXJҫQQKѭ NK{QJ WiFKELӋWU}Yӟi nӅn YQJ&7&EuQKWKѭӡng) 'Rÿy viӋF[iFÿӏQKQJѭӥQJ2WVXÿӇ SKkQÿRҥn FiFYQJÿӓFKRKuQKҧQK&7&NK{QJÿҥt hiӋu quҧ [40]
GҫQ ÿk\, trong mӝW F{QJ Eӕ cӫD %LQJ %DL Yj Fӝng sӵ YjR QăP , mӝt SKѭѫQJ SKiS SKkQ ÿRҥn KuQK ҧnh soi CTC mӟL ÿm ÿѭӧF SKiW WULӇn bҵQJ FiFK Vӱ dөng thuұWWRiQ.-means ÿӇ SKkQÿRҥQKuQKҧQKPjXӣ ÿӏnh dҥQJPjX+69 Trong
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 ÿyH (Hue) OjYQJPjX, S (Saturation) Ojÿӝ EmRKzDPjX YjV (9DOXHOjÿӝ ViQJ
Kӻ thuұWÿҫXWLrQsӱ dөQJQJѭӥQJÿӝ ViQJ41].
Tәng quan kӻ thuұWSKkQFӵc
Cөm tӯ ³iQK ViQJ SKkQ Fӵc´ WURQJ QKӳQJ QăP JҫQ ÿk\ Oj Pӝt trong nhӳng chӫ ÿӅ nhұQÿѭӧc sӵ TXDQWkPWӯ FiFQKjQJKLrQFӭXQKѭOjPӝWF{QJFө chҭQÿRiQ KuQKҧnh trong OƭQKYӵc y tӃ+uQKҧQKSKkQFӵc sӁ OjPӝt trong nhӳng ӭng dөng y tӃ ÿҫy hӭa hҽQWURQJWѭѫQJODLEӣi ÿk\OjSKѭѫQJSKiSNK{QJ[kPOҩQFKRSKpSOҩy KuQKҧQKPjNK{QJVӱ dөQJÿӃn chҩWKyDKӑc HuQKҧQKWKXÿѭӧc JL~S giҧPÿѭӧc ÿӝ FKyL ViQJ WUrQҧnh GRÿһFWtQKEӅ mһW&7&FyQKLӅu dӏch ӣ thӇ lӓng NhӳQJFKyLViQJQj\FyWKӇ Jk\Fҧn trӣ WURQJTXiWUuQKFKҭQÿRiQNguӗQViQJSKkQFӵc chӫ yӃu sӱ dөng nguӗQViQJWUҳQJQKѭ/(' hoһFÿqQKDORJHQFyJLiWKjQKUҿ YjWXәi thӑ OkX Nhӳng tiӃn bӝ gҫQÿk\WURQJKuQKҧQKSKkQFӵFJL~SFKRYLӋc giҧi phүXYj chҭQÿRiQP{PӝWFiFKQKDQKFKyQJYjFKtQK[iF 1y ÿyQJJySPӝWYDLWUzTXDQ trӑng trong sӵ SKiWWULӇn cӫD OƭQK Yӵc chҭQ ÿRiQ KuQK ҧnh .K{QJGӯng lҥi ӣ ÿyKuQKҧQKSKkQFӵFFzQFXQJFҩSÿѭӧFWtQKFKҩWErQWURQJFӫDP{PjPҳWWKѭӡng NKyFyWKӇ QKuQWKҩ\ÿѭӧc DӵDYjRWtQKFKҩWSKkQFӵFNKiFQKDXFӫDFiFP{VLQK hӑFNKiFQKDXÿӇ FyWKӇ WKXÿѭӧFKuQKҧQKSKkQFӵFYjKLӇn thӏ mӝWFiFKWUӵc quan ÿѭӧFFiFWtQKFKҩt cӫDP{7ӯ ÿyJL~SEiFVƭSKkQELӋWÿѭӧFYQJEӋQKYjYQJ
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 EuQKWKѭӡng bӣLYuӣ FiFYQJFKӭa nhӳQJP{EӋnh sӁ FyWtQKFKҩWSKkQFӵFNKiF so vӟLYQJEuQKWKѭӡng [37]
1KuQFKXQJӭng dөng cӫDiQKViQJSKkQFӵc trong thiӃt bӏ sRL&7&ÿӇ chҭn ÿRiQFiFEӋQKOLrQTXDQÿһc biӋWOjXQJWKѭCTC nhұQÿѭӧc sӵ TXDQWkPOӟn cӫa FiFQKjQJKLrQFӭu Mӝt trong nhӳQJQJKLrQFӭXPӟLQKҩWOjӭng dөQJiQKViQJ SKkQFӵFYjPDWUұQ0XHOOHUYjRWKLӃt bӏVRL&7&NKҧRViWVӵWѭѫQJWiFFӫDiQK ViQJSKkQFӵFÿӃQEӅPһWP{&7&YjQKLӅXQJKLrQFӭXNKiFFө thӇ QKѭ
- 1ăP-HUHP\9L]HWYjFӝQJVӵ ÿmQJKLrQFӭu vӅVӵWѭѫQJWiFFӫDiQK ViQJSKkQFӵFÿӕLYӟLP{ӭng dөng cӫDKuQKҧQKSKkQFӵc Mueller trong thiӃt bӏ soi CTC, cҧi tiӃn thiӃt bӏ soi CTC truyӅn thӕng bҵQJFiFKJҳQWKrPKӋ thӕQJSKiW
Yj SKkQ WtFK iQK ViQJ SKkQ Fӵc nhҵP WKX ÿѭӧF KuQK ҧQK SKkQ FӵF Yj PD WUұn Mueller TӯÿySKiWKLӋn sӵ WKD\ÿәi cӫDFiFVӧi collagen trong tӱ cung do sӵ SKiWWULӇn cӫa tәQWKѭѫQJWLӅQXQJWKѭ1JKLrQFӭXQj\ÿѭӧF F{QJEӕ Yj ÿăQJ WUrQWҥSFKt1DWXUH YjRQăP [42]
- 1ăP-HDQ5HKELQGHUYjFӝQJVӵÿmQJKLrQFӭXWUrQFiF&7&Fӫa bӋnh QKkQ VDX NKL FKӃW ÿӇ WKX KuQK ҧQK SKkQ FӵF Yj SKkQ ELӋW YQJ EӋQK WUrQ &7& nhҵm ӭng dөQJQJKLrQFӭXQj\YjROkPVjQJ>]
- 1ăP$QJHOR3LHUDQJHORYjFӝQJVӵÿmQJKLrQFӭXYӅKuQK ҧQKSKkQ cӵc cӫD&7&QKҵPSKkQELӋWFiFYQJEuQKWKѭӡQJYj&,1>]
- 1ăP:HQMLQJ/LYjFӝQJVӵÿmQJKLrQFӭXYӅYLӋFFKөSҧQKSKkQFӵF
&7&WUѭӟFYjVDXNKLSKӃWDFLGDFHWLFVDXÿyVӱGөQJFiFSKѭѫQJSKiS[ӱOêҧQK ÿӇÿiQKGҩXYQJDFHWRZKLWH [45]
%rQFҥnh viӋc sӱ dөQJKuQKҧnh SKkQFӵc, gҫQÿk\Pӝt sӕ kӻ thuұt quang phә YjKuQKҧnh quang hӑFFNJQJÿmÿѭӧFNKiPSKiYjNKDLWKiFQKLӅXKѫQ&iFÿһFWtQK quang hӑc cӫDP{QKѭKҩSWKөWiQ[ҥYjFiFWtQKFKҩWKXǤQKTXDQJÿѭӧF[HP[pW ÿӇ nghirQFӭXFiFWKD\ÿәi vӅ mһWKuQKWKiLYjWӃEjRKӑc Thұt vұy, nhӳQJWKD\ÿәi vӅ ÿһF WtQK Kҩp thө cӫD R[\ KHPRJORELQ R[\+E Yj GHR[\JHQ KHPRJORELQ(deoxyHb) sӁ OjPWKD\ÿәLWKjQKSKҫn phҧn xҥ khuӃFKWiQFӫDiQKViQJWӟi tӯ FiFP{&7& bӋQKOêYjP{ ung WKѭ 'RÿyKuQKҧQKÿDSKә tҥLFiFÿӍnh hҩp thө cӫa R[\+EYjGHR[\+EÿѭӧFQJKLrQFӭXÿӇ SKkQWtFKQKӳQJYQJFyVӵ chuyӇQÿәLP{
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 sang trҥQJWKiLiFWtQKĈLӅXQj\WҥRWKjQKWK{QJWLQTXDQWUӑng cho vӏ WUtVLQKWKLӃt
&7&YjSKiWKLӋn sӟPFiFEӋQKOêFNJQJQKѭXQJWKѭӣ CTC [46-48]
KhҧRViWÿһFWtQKKҩp thөWiQ[ҥ cӫDP{WҥLFiFSKә ÿһFWUѭQJÿѭӧF[HPOj mӝt kӻ thuұt xӱ Oêҧnh JL~S WăQJÿӝ WѭѫQJSKҧn cӫDFiFWKjQKSKҫn GѭӟLP{WUrQ KuQKҧnh cӫa mүu Kӻ thuұWQj\GӵDWUrQVӵ FKrQKOӋch trong viӋc hҩp thө FiFEѭӟc VyQJiQKViQJNKiFQKDXFӫDPiXÿӇ WtQKWRiQQӗQJÿӝ tұp trung cӫDFiFWKjQKSKҫn WUrQҧnh PKѭѫQJSKiS Qj\ÿmÿѭӧc sӱ dөng trong mӝt sӕ QJKLrQFӭu nhҵm tҥo ra mӝWF{QJFө JL~SFKҭQÿRiQVӟPFiFWK{QJWLQOLrQTXDQÿӃn bӋQKQKѭviӋFÿiQK JLiFiFWK{QJVӕ vӅ melanin YjQӗQJÿӝ R[\WURQJPiXVӵ WăQJJLҧPFѭӡQJÿӝ vӃt EDQÿӓ WUrQGDYjVҳc tӕ da [49-50] MӝWWURQJFiFQJKLrQFӭu vӅ kӻ thuұt xӱ Oêҧnh Qj\OjQJKLrQFӭu cӫD'LPLWULRV.DSVRNDO\YDVYjFiFFӝng sӵ WUrQGDÿѭӧFF{QJ bӕ QăP WUrQ Optics Express [51@ 3KѭѫQJ SKiS SKiW WULӇQ WKHR KѭӟQJ WăQJFѭӡQJFiFWKjQKSKҫQFKtQKFӫa da dӵDWUrQFiFKuQKҧnh SKkQFӵc ÿDEѭӟFVyQJNguӗQViQJ LED SKkQFӵc tuyӃQWtQKOҫQOѭӧt vӟLEDEѭӟFVyQJJӗm [DQKGѭѫQJ(Blue) vӟLEѭӟFVyQJQP, [DQKOi (Green) EѭӟFVyQJ530nm Yjÿӓ (Red) Eѭӟc VyQJQP FyFѭӡQJÿӝ ViQJFDR ÿѭӧc sӱ dөQJÿӇ thu nhұQKuQKҧnh cӫa da Tӯ KuQKҧQKWKXÿѭӧc, mӝt bӝ thuұWWRiQ[ӱ OêÿѭӧFiSGөQJÿӇ FKRUDWK{QJVӕ ÿӝ hҩp thө cӫa melanin, oxy hemoglobin Yjdeoxygen hemoglobin +uQK ҧQK WăQJ WѭѫQJ phҧQPiXJL~SNLӇPWUDYj[iFÿӏQKU}UjQJKuQKWKiLÿһc hiӋu cho tӯQJYQJPҥch PiX7ѭѫQJWӵFiFKuQKҧQKWăQJWѭѫQJSKҧn melanin cung cҩSFiFWK{QJWLQYӅ sӵ SKkQEӕ cӫDPHODQLQOLrQTXDQÿӃQFiFEӋQKOêYӅ da NhӳQJKuQh ҧQKQj\FXQJFҩp FiLQKuQWәQJTXiWYӅ YQJGDEӏ tәQWKѭѫQJQKӳQJYQJNK{QJWKҩ\ÿѭӧc bҵng mҳt WKѭӡng
GIҦI PHҮU CӘ TӰ CUNG
BiӇXP{OiW
+uQK C̭XWU~FP{K͕c cͯa bi͋XP{OiW>]
BiӇXP{OiWKD\FzQFyQKӳQJWrQJӑLNKiFQKѭOjELӇu P{Yҧy, biӇXP{OiW tҫng hay biӇX P{ Yҧ\ SKkQ Wҫng, WrQ WLӃng Anh cӫa Qy Oj 6TXDPRXV (SLWKHOLXP (SE) BiӇXP{OiWWURQJ&7&OjORҥi biӇXP{ Gj\ÿDOӟSYjFKӭa nhiӅu glycogen Ĉӝ Gj\ Fӫa biӇX P{ SKө thuӝF YjR ÿӝ tuәi cӫD QJѭӡi phө nӳ, tӹ lӋ hormone
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 estrogeQYjSURJHVWHURQHLӟp biӇXP{OiWFyQJXӗn gӕFKuQKWKjQKWURQJJLDLÿRҥn SK{LWKDLÿѭӧc gӑLOjELӇXP{OiWEDQÿҫu 1JRjLUDQyFzQFyWKӇ ÿѭӧFKuQKWKjQK mӟi do kӃt quҧ cӫDTXiWUuQKFKX\Ӈn sҧQOiWWURQJJLDLÿRҥn trѭӣQJWKjQKӢ ÿӝ tuәi sinh sҧn, biӇXP{OiWEDQÿҫXFyPjXKѫi hӗng, trong khi biӇXP{OiWKuQKWKjQKGR chuyӇn sҧQFyPjXWUҳng hӗng Lӟp biӇXP{Qj\Gj\PPJӗm tӯ 15 ± 20 lӟp [54-55@&iFOӟp tӃ EjRQj\ÿѭӧFSKkQWKjQKWҫng/lӟSFKtQKWKHRKuQKWKiLKӑc cӫa FK~QJQKѭKuQK
- Lӟp bӅ mһWĈk\OjOӟp tӃ EjRgӗm nhiӅu tӃ EjRWUѭӣQJWKjQKQKҩt cӫa lӟp biӇXP{ OiW&7& Gӗm 6 ± 8 lӟp tӃ EjRFyNtFKWKѭӟc lӟn nhҩWKuQKÿDJLiFÿѭӡng NtQKP ± PFyFKӭDJO\FRJHQ1KkQÿһc, nhӓ FyÿѭӡQJNtQKP ± P KuQKWUzQKRһc bҫu dөc TӃ Ejo dҽWQJX\rQVLQKFKҩt trong suӕt nhuӝPPjXNLӅm, FyPӭFÿӝ sӯQJKyDQKҽ .KiFYӟi tӃ EjRӣ FiFOӟSVkXWӃ EjREӅ mһWFyQKkQÿ{QJ YjQKӓ LӟSQj\WKѭӡQJWKD\ÿәLFyFKXNǤ Gѭӟi ҧQKKѭӣng cӫDFiFQӝi tiӃt buӗng trӭQJYj nӗQJÿӝ estrogen
- Lӟp tӃ EjRWUXQJJLDQOjOӟp tӃ EjRÿѭӧFSKiWWULӇn tӯ lӟp tӃ EjRFұQÿi\WӃ EjRGҽWKuQKÿDJLiFEjRWѭѫQJOӟn chӭa nhiӅXJO\FRJHQQKkQQKӓ WUzQÿӅXÿѭӡng NtQKP± PPjQJQKkQU}QKLӉm sҳc chҩt mӏn ӣ WUXQJWkPĈk\OjlӟSGj\ nhҩt gӗm 5 ± 10 lӟp, tӃ EjRKuQKEҫu dөc hoһFÿDJLiFQӕi vӟi nhau bҵng cҫXOLrQ EjR NtFK WKѭӟc 15P ± P &iF WӃ EjR [Xҩt hiӋQ U} UjQJ GR [Xҩt hiӋn sӵ tҥo NK{QJEjRFӫDPjQJWӃ EjRFKҩt &jQJOrQWUrQWKuWӹ lӋ QKkQVRYӟLEjRWѭѫQJFjQJ nhӓ&iFWӃ EjRӣ phҫQQ{QJNK{ng chӭDQKkQSKҷng vӟLKjPOѭӧQJJO\FRJHQWăQJ
- Lӟp tӃ EjRFұQÿi\*ӗm 3 ± 4 lӟp tӃ EjRKuQKWUzQÿӃn bҫu dөFNtFKWKѭӟc 15P ± PWѭѫQJÿӕLtWWӃ EjRFKҩW&yVӵ hiӋn diӋn cӫa cҫu nӝLEjRYjSKkQ EjRWѭѫQJWӵ QKѭӣ lӟSÿi\1KkQWUzQKRһc bҫu dөFÿѭӡQJNtQK± PFKLӃm mӝt khӕLOѭӧQJWѭѫQJÿѭѫQJEjRWѭѫQJ, QKkQWѭѫQJÿӕLWRѭDNLӅm NhiӉm sҳc thӇ nhӓ FKLDÿӅXWURQJQKkQ, hҥt nhiӉm sҳc mӏn, tӹ lӋ QKkQ- EjRWѭѫQJJҫn bҵng nhau Lӟp tӃ EjRFұQÿi\YjOӟSWUXQJJLDQFQJQKDXFҩu tҥRWKjQKlӟp gai
- Lӟp tӃ EjRÿi\*ӗm mӝt KjQJ tӃ EjRÿѫQKuQKWUzQKD\KuQKEҫu dөc nҵm ViWPjQJÿi\, che phӫ PjQJÿӋm, tӃ EjRQKӓ - QKkQWRѭDNLӅm, NtFKWKѭӟc 12P ±
P7Ӄ EjRWѭѫQJÿӕi nhӓEjRWѭѫQJtWQKkQWRU}FKLӃm gҫn hӃt tӃ EjRQKLӉm
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 sҳc chҩt mӏn 9QJ JLDR QKDX JLӳa biӇX P{ Yj FKҩt nӅQ WKѭӡQJ Oj ÿѭӡng thҷng 1KѭQJÿ{LNKLOjÿѭӡQJOѭӧQVyQJYӟi nhӳQJÿRҥn ngҳn cӫa chҩt nӅQQK{UD Wҥo WKjQKFiFQӃp gҩp 7URQJQKkQFyQKLӉm sҳc thӇ rҩt mӏQYjWLӇXQKkQU}
- 0jQJ ÿi\ SKkQ FiFK Oӟp biӇX P{ YӟL P{ OLrQ kӃW ErQ Gѭӟi, tҥR WKjQK Wӯ FROODJHQYjFiFVӧi protein
3KtDGѭӟi lӟSPjQJÿi\OjOӟSVWURPDQѫLFKӭa ciFPҥFKPiXFXQJFҩp cho biӇXP{EDRJӗPFiFPDRPҥch nhӓ nҵPVkXErQWURQJ&K~QJFyFiFPҥch trung chuyӇQSKkQQKiQKNpRGjLWӟi khoҧng mӝt phҫQEDÿӝ Gj\Fӫa biӇXP{%LӇXP{ OiWKRҥWÿӝQJQKѭPjQJOӑFPjTXDÿyFҧ iQKViQJWӟLYjiQKViQJSKҧn xҥ ÿӅu tҥo UDKuQKҧnh soi CTC cuӕLFQJ0jXÿӓ cӫDVWURPDÿѭӧc truyӅn trӣ lҥi vӟi sӵ ÿLӅu chӍQKW\WKXӝFYjRÿһFÿLӇPYjÿӝ Gj\Fӫa biӇXP{
1KuQFKXQJWӯ lӟSÿi\ÿӃn lӟp bӅ mһWFyVӵ JLDWăQJGҫn vӅ NtFKWKѭӟc tӃ EjR YjJLҧm vӅ NtFKWKѭӟFQKkQWӃ EjR&iFWӃ EjROӟSWUXQJJLDQYjOӟp bӅ mһWFyFKӭa nhiӅXJO\FRJHQÿk\FNJQJ OjQѫLEҳWPjXQkXVDXNKLSKӃt dung dӏFK/XJROĈLӅu Qj\FKRWKҩy sӵ sinh trѭӣQJYj SKiWWULӇQEuQKWKѭӡng cӫa biӇXP{OiW
Sӵ ÿiSӭng cӫa tӃ EjRELӇXP{Yӟi hormone sinh dөc xҧy ra ӣ phҫn CTC tiӃp [~FYӟLkPÿҥo Hormone HVWURJHQÿҧm nhұQYDLWUzWiLWҥROLrQWөc cӫa biӇXP{OiW trong viӋFWăQJVLQKELӇXP{WUѭӣQJWKjQKYjERQJWUyF1ӃXNK{QJFyHVWURJHQVӁ NK{QJGLӉn ra sӵ sinh trѭӣQJÿҫ\ÿӫ YjKuQKWKjQKJO\FRJHQ'Rÿyӣ phө nӳ sau PmQNLQKFiFWӃ EjRNK{QJVLQKWUѭӣng (ngoҥi trӯ lӟp cұQÿi\YjNK{QJWtFKONJ\ trong nhiӅu lӟp tӃ EjR.Ӄt quҧ OjELӇXP{WUӣ QrQPӓQJYjWHR7UrQNLӇm tra trӵc quan biӇX P{ [Xҩt hiӋn vӟL PjX QKӧt nhҥt, thѭӡQJ Fy FiF ÿLӇm xuҩt huyӃt dѭӟi QLrPPҥc do dӉ bӏ chҩn thѭѫng [54]
1KѭYұy, biӇXP{OiWFӫa cә QJRjL&7&Gj\FyQKLӅu lӟp YjKRҥWÿӝQJQKѭ mӝt bӝ lӑFFKRSKpSiQKViQJSKҧn xҥ YjiQKViQJWӟLFyWKӇ [X\rQTXD.KLVRLCTC, biӇXP{[Xҩt hiӋQPjXKӗng nhҥt hoһFÿӓ Thӵc chҩt lӟp biӇXP{NK{QJFyPjXYjFKҩt nӅQÿѭӧc nhuӝPPjXGRFKӭDFiFPҥFK PiXErQGѭӟL0jXÿӓ cӫa chҩt nӅQÿѭӧc truyӅn trӣ lҥLFKRQJѭӡLTXDQViWYӟLFiFELӃQÿәLW\WKXӝFYjRÿһc ÿLӇPYjÿӝ Gj\Fӫa biӇXP{
BiӇXP{WX\Ӄn
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 BiӇXP{WX\ӃQKD\FzQJӑLOjELӇXP{Fӝt/biӇXP{WUө, WrQWLӃng Anh cӫDQyOj
&ROXPQDU(SLWKHOLXP&(Ĉk\OjELӇXP{PӓQJÿѫQOӟp, chӍ chӭa mӝt lӟp duy nhҩWOjOӟSÿi\Yj chӭa chҩt nhҫy LӟSÿi\FKӭDFiFWӃ EjRKuQKWUө FDRP±
PUӝQJP± PKҥWQKkQQҵPGѭӟi gҫQPjQJQӅQQKѭKuQK&iFWӃ EjRFyVӕ Oѭӧng tӃ EjRFKҩt vӯa phҧLYjPӝWQKkQQKӓĈk\OjEӝ phұQNK{QJTXDQ ViWÿѭӧFNKLWKăPNKiP%rQGѭӟi lӟp tӃ EjRÿi\WKӍnh thoҧQJFyFiFWӃ EjRQKӓ, dҽWtWEjRWѭѫQJJӑLOjWӃ EjRGӵ trӳ [54-55]
+uQK C̭XWU~FP{K͕c cͯa bi͋XP{WX\͇n [54]
7K{QJWKѭӡng, biӇXP{WX\ӃQNK{QJEҵng phҷQJPjEӏ QpQYjRYjWҥRWKjQK nhiӅu nӃp gҩSQK{UDWURQJӕng CTC Nhӳng tӃ EjRWUө ÿѫQEjLWLӃt chҩt nhҫ\Yj nҵPVkXtrong FiFQӃp hoһFFiFKӕFĈLӅXQj\Jk\UDQKLӅu sӵ [kPQKұSYjRWURQJ chҩt nӅn CTC, tҥRUDFiFKӕc nhҫ\O}PVkXYjRErQWURQJQKѭKuQK&iFNKHJҩp VkXYjRNKRҧng 5mm ± PPWtQKWӯ bӅ mһt ӕng CTC CҩXWU~FQj\EDRJӗm FiF nӃp gҩSQLrPPҥFYjFiFWLӇXQDQJFyGҥng biӇXP{WUө dҥng hҥWNKLTXDQViW
+uQK 4 0{W̫ chi ti͇t c̭XWU~Fbi͋XP{WX\͇n [54]
'RÿһFWtQKEiӇXP{tuyӃn mӓng YjFyÿӝ trong suӕWFDRSKtD dѭӟi biӇXP{ tuyӃn FyPӝt mҥQJOѭӟi mao mҥFKSKiWWULӇn tӕWYjÿDQ[HQYӟLQKDX.KLTXDQViW
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 thҩ\FyPjXÿӓ do lӟp tӃ EjRÿѫQPӓQJFyPҥFKPiX cung cҩp cho biӇXP{WX\Ӄn nҵP QJD\ ErQ Gѭӟi PjQJ ÿi\ KuQK Ĉk\ FNJQJ FKtQK Oj Ot GR YQJ ELӇX P{ tuyӃQWKѭӡng xuҩt hiӋQPjXÿӓ thүPKѫQVRYӟLPjXFӫa biӇXP{OiWNKLTXDQViW bҵng mҳWWKѭӡng qua thiӃt bӏ soi CTC
+uQK 5 +uQK̫nh m̩FKPiXErQG˱ͣi bi͋XP{WUͭ [55].
Ranh giӟLOiWWUө
Ranh giӟL OiW WUө WrQ WLӃQJ $QK Oj 6TXDPRFROXPQDU -XQFWLRQ 6&- Oj YQJ ranh giӟi giӳa biӇXP{OiWFӫa cә QJRjLYjELӇXP{WUө hay biӇXP{WX\Ӄn cӫa cә trong 6&-OjPӝWÿѭӡng mӓQJÿѭӧc cҩXWKjQKGRVӵ NKiFQKDXYӅ ÿӝ cao cӫa tӃ EjROiWYjWӃ EjRWX\ӃQQKѭKuQK .KLTXDQViWEҵQJPi\ VRL&7&QyOjPӝt ÿѭӡng trҳng mӓQJQJăQJLӳa biӇXP{OiWPjXKӗQJYjELӇXP{tuyӃn PjXÿӓ
Phө thuӝFYjRFiF\Ӄu tӕ QKѭWXәi WiFVӵ WKD\ÿәi nӝi tiӃt tӕ - hormone, sӕ lҫn VLQKFRQGQJWKXӕc ngӯa thai uӕng hoһc mӝWYjLWuQKWUҥQJVLQKOêQKѭPDQJWKDL vӏ WUtFӫa ranh giӟLOiWWUө so vӟi lӛ QJRjL&7&WKD\ÿәLOLrQWөc theo suӕt cuӝc sӕng cӫa QJѭӡi phө nӳ Cө thӇ sӵ WKD\ÿәi vӏ WUt6&- theo tuәi diӉQUDQKѭVDX>]:
- KLEpJiLÿѭӧc sinh ra, ӣ JLDLÿRҥn WUѭӟc khi dұ\WKuKD\WXәi vӏ WKjQKQLrQ ranh giӟLOiWWUө ÿѭӧc gӑLOjUDQKJLӟLOiWWUө EDQÿҫu hay SCJ EDQÿҫXOjPӝWÿѭӡng nӕi giӳa biӇXP{tuyӃn YjELӇXP{OiWEDQÿҫu xuҩt hiӋn tӯ JLDLÿRҥQSK{LWKDLWURQJ tӱ FXQJ QKѭKuQKhuQK$ Trong suӕW JLDLÿRҥQQLrQWKLӃXYj EҳWÿҫu dұ\ WKu 6&-EDQÿҫu nҵPViWOӛ QJRjL&7&
+uQK 7 V͓ WUt cͯa ranh giͣLOiWWUͭ TXDFiFJLDLÿR̩n [2]
- KLEѭӟFYjRWXәi dұ\WKuYjKRҥWÿӝng sinh dөc, ÿһc biӋWOjJLDLÿRҥn mang thai, FѫTXDQVLQKGөc cӫDQJѭӡi phө nӳ bҳWÿҫu SKiWWULӇQGѭӟi sӵ ҧQKKѭӣng cӫa estrogen, Qy OjPFKR&7&Pӣ rӝQJYjӕQJ&7&NpRGjLUD4XiWUuQKQj\Gүn tӟi viӋc biӇXP{WX\Ӄn bӏ NpRQJѭӧFUDSKtDQJRjLcӫa lӛ QJRjL&7& YjJӑLOjOӝ tuyӃn
- 6DX NKL VLQK Fѫ WKӇ ngѭӡi phө nӳ xҧy ra sӵ WKD\ ÿәi nӝi tiӃt tӕ ÿӝt ngӝt, Oѭӧng estrogen giҧm xuӕQJOjP[Xҩt hiӋn ranh giӟLOiWWUө mӟi di chuyӇn vӅ SKtDOӛ QJRjL&7&QKѭhuQK&
- Ӣ gLDLÿRҥn bҳWÿҫu thӡi kǤ PmQNLQK, do thiӃu hөt estrogen, CTC thu nhӓ lҥi OjPFKR6&-Pӟi di chuyӇQYjRWURQJӕQJ&7&'RÿyYQJ6&-Pӟi Qj\NK{QJ FzQ TXDQViWÿѭӧFTXDWKăPNKiP(huQK'
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 Ranh giӟLOiWWUө WKD\ÿәi tҥRUDFiFUDQKJLӟLOiWWUө mӟi khi kPÿҥo vӟLS+FyWtQKDcid.KLÿy&7&WUҧi qua mӝWTXiWUuQKJӑLOjTXiWUuQKFKX\Ӈn sҧn biӇXP{OiW 4Xi WUuQK ELӃQ ÿәL Qj\ EҳW ÿҫu tӯ ranh giӟL OiW WUө EDQ ÿҫX Yj ÿL WKHR FKLӅu hѭӟng vӅ SKtDOӛ QJRjL&7&WURQJVXӕWJLDLÿRҥn sinh sҧQÿӃn thӡi kǤ PmQNLQK'o ÿyUDQKJLӟLOiWWUө nҵm ӣ nhiӅu vӏ WUtNKiFQKDXWUrQFә QJRjL&7&ĈLӅXQj\Gүn ÿӃn sӵ tiӃn triӇn cӫa biӇXP{OiWYjELӇXP{WX\Ӄn mӟi, bӣi lӁ ranh giӟLOiWWUө OjYӏ WUtWLӃSJLiSJLӳa hai loҥi biӇXP{Qj\ WUrQ cә QJRjL&7&
HiӋQWѭӧng chuyӇn sҧn biӇXP{OiW
+uQK 0{W̫ TXiWUuQKFKX\͋n s̫QWKjQKEL͋XP{OiW>]
HiӋQWѭӧng chuyӇn sҧn biӇXP{OiWFyWrQWLӃQJ$QKOj6TXDPRXV0HWDSODVLD, ÿk\OjKLӋQWѭӧng FiFWӃ EjRWX\Ӄn sau khi lӝ UDErQQJRjLGѭӟLP{LWUѭӡng pH acid kPÿҥo sӁ bӏ thay thӃ dҫn bӣi lӟp biӇX P{OiWFKX\Ӈn sҧn, hiӋQWѭӧQJQj\ JӑLOj chuyӇn sҧQĈk\OjJLDLÿRҥQFyVӵ biӃQÿәi tӯ dҥng biӇXP{WX\Ӄn sang biӇXP{OiWWURQJ YQJ FKX\Ӈn tiӃp cӫa CTC Nhӳng biӇX P{ Qj\ QҵP WURQJ YQJ WKѭӡng [X\rQELӃQÿәLYjUҩt nhҥy cҧm vӟi nhӳQJWKD\ÿәi cӫDP{LWUѭӡQJ[XQJTXDQKQyKhi biӇXP{tuyӃn lӝ WUrQEӅ mһt CTC OLrQWөc tiӃS[~FP{LWUѭӡng acid WURQJkP ÿҥRQyVӁ dҫQÿѭӧc thay thӃ bҵng biӇXP{OiWPӟL0{LWUѭӡng acid Qj\GүQÿӃn sӵ xuҩt hiӋn cӫDFiFWӃ EjRGӵ trӳ Kunh khӕLSKkQOӟSOjPWăQJVӕ Oѭӧng tӃ EjRGӵ trӳ YjGҫQSKiWWULӇQWKjQKELӇXP{OiW9Ӆ mһWKuQKWKiLFiFWӃ EjRGӵ trӳ Qj\JLӕng vӟLFiFWӃ EjRFѫEҧn cӫa biӇXP{OiWEDQÿҫu +uQKҧQKFiFWӃ EjROiWQRQVLQKVҧn
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 OLrQWөFÿӇ thay thӃ QJѭӧc trӣ lҥLYQJbiӇXP{WX\ӃQÿѭӧFP{Wҧ QKѭWURQJKuQK 2.8
Trong TXiWUuQKFKX\Ӈn sҧQFiFWӃ EjRVLQKV{LQҧy nӣ, biӋWKyDÿӇ KuQKWKjQK biӇXP{ÿDEjRYj NK{QJFyVӵ SKkQWҫng &iFWӃ EjRQj\FKѭDWUѭӣQJWKjQKQrQ FKѭDWҥRUDJO\FRJHQYjGRÿyNK{QJOjPQKXӝPPjXYӟi dung dӏch Lugol &jQJYӅ sau, biӇXP{OiW sӁ FjQJ WUѭӣQJWKjQKGҫn, NKLÿyOѭӧng glycogen bҳWÿҫXÿѭӧFKuQK WKjQK OjPPjX/XJROÿұm dҫQYjYLӋc bҳWPjXODQUӝQJUDKѫQ4XiWUuQKFKX\Ӈn sҧQWKѭӡng bҳWÿҫu ӣ ranh giӟLOiWWUө EDQÿҫXYjWLӃn triӇQKѭӟng tkPYӅ SKtDOӛ QJRjL&7&Ĉk\OjOêGRranh giӟLOiWWUө mӟLOX{QOX{Q WKD\ÿәLOLrQWөc trong suӕt thӡi kǤ hoҥWÿӝng chuyӇn sҧn xҧy ra
BҧQWKkQELrXP{OiWYӅ FѫEҧQFyOӟSFKtQKQKѭÿmWUuQKEj\ӣ WUrQGRÿy TXiWUuQKchuyӇn sҧn tӯ biӇXP{WX\ӃQQJѭӧc trӣ lҥLWKjQKELӇXP{OiW QKuQFKXQJVӁ bao gӗPJLDLÿRҥQQKѭVDX>54]:
- *LDLÿRҥn 1: Sӵ biӋWKyDFӫDFiFWӃ EjRGӵ trӳ Gѭӟi biӇXP{
- *LDLÿRҥQ&iFWӃ EjRFKѭDWUѭӣQJWKjQKSKkQFKLDYjWҥo ra 5 ± 6 lӟp tӃ EjRÿDGLӋn nhuӝPPjXÿӓQkQJFiFELӇXP{tuyӃn ra khӓLPjQJÿi\ QKѭKuQK 2.8
- *LDLÿRҥQ&iFWӃ EjROiWQRQFyÿӝ Gj\± 12 lӟSYjFK~QJEҳWÿҫu biӋt KyD
- *LDLÿRҥQ7URQJJLDLÿRҥQQj\WLӃp tөFFyVӵ NKiFELӋWFiFWӃ EjRGҫn sinh WUѭӣQJYjSKiWWULӇQWKjQKQKLӅu lӟSKѫQ
- *LDLÿRҥQĈӍnh ÿLӇPOjVӵ KuQKWKjQKFӫa 20 ± 30 lӟp tӃ EjROiWWUѭӣng WKjQKSKkQFKLDWKjQKÿӫ 5 tҫng tӃ EjRQKѭÿmQrXӣ phҫn 2.1.1
1KѭYұy, sau khi xҧy ra hiӋQWѭӧng chuyӇn sҧn biӇXP{OiWWUrQEӅ mһt CTC sӁ xuҩt hiӋn mӝt ranh giӟLOiWWUө mӟi KhoҧQJFiFKJLӳa ranh giӟLOiWWUө EDQÿҫXYj ranh giӟLOiWWUө mӟLQj\ÿѭӧc gӑLOjYQJFKX\Ӈn tiӃp
9QJ FKX\Ӈn tiӃS WrQ WLӃQJ $QK Oj 7UDQVIRUPDWLRQ ]RQH 7= ÿk\ Oj YQJ biӇXP{QҵPWUrQFә QJRjL&7&ÿmWUҧLTXDTXiWUuQKFKX\Ӈn sҧn biӇXP{OiWFyYӏ WUtQҵm giӳa ranh giӟLOiWWUө EDQÿҫXYjUDQKJLӟLOiWWUө mӟL9QJQj\GLFKX\Ӈn
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 WUrQ Fә QJRjL&7& ± nѫi biӇX P{tuyӃn ÿѭӧc thay thӃ bӣi biӇX P{OiW Pӟi (huQK 2.9)
+uQK 0{W̫ YQJFKX\͋n ti͇p [33] Ӣ trҿ sѫ VLQK Yj WUҿ nhӓ, biӇu P{tuyӃn ErQ WURQJ &7& Fy [X Kѭӟng dӏch chuyӇQUDQJRjLWӯ lӛ CTC Theo thӡi gian, phө nӳ EѭӟFYjRÿӝ tuәi sinh sҧn, biӇu P{WX\Ӄn mӣ rӝQJUDErQQJRjLYj[kPOҩn bӅ mһWQJRjL&7& Ranh giӟi giӳa biӇu P{WX\ӃQYjELӇXP{OiWWURQJJLDLÿRҥQQj\ tѭѫng ӭng vӟi YQJ6&-EDQÿҫu Khi FyVӵ WKD\ÿәi nӝi tiӃt tӕ ErQWURQJFѫWKӇ FNJQJQKѭS+kPÿҥo trӣ QrQDcid KѫQ biӇXP{WX\Ӄn dҫQÿѭӧc thay thӃ QJѭӧc trӣ lҥi bӣi biӇXP{OiWÿӗng thӡLFNJQJWҥo ra ranh giӟi mӟi giӳa hai loҥi biӇXP{Qj\ÿѭӧc gӑLOj6&-Pӟi KhoҧQJFiFKJLӳa 6&-EDQÿҫXYj6&-PӟLOjnguӗn gӕc xuҩt hiӋQYQJFKX\Ӈn tiӃp TZ trong CTC CuӕLFQJ ӣ tuәi hұXPmQ NLQKYӟi sӵ suy giҧPHVWURJHQ OjP &7&FR OҥLYQJ chuyӇn tiӃp di chuyӇn tӯ tӯ YjVDXÿyKRjQWRjQWXӝWYjRWURQJӕng &7&YjNK{QJ czQQKuQWKҩ\NKLTXDQViW&7&Eҵng thiӃt bӏ soi CTC
7URQJTXiWUuQKFKX\Ӈn tiӃSQj\GѭӟLFiFQJX\rQQKkQNKiFQKDXQKѭYLrP nhiӉm, sӵ [kPQKұp cӫa vi khuҭQFyKҥi do sinh hoҥWWuQKGөFNK{QJOjQKPҥnh, SKiWKDLQKLӅu lҫn, sӱ dөQJFiFGӏch vө y tӃ GjQKFho phө NKRDNK{QJDQWRjQôFy thӇ khiӃQFKRTXiWUuQKFKX\Ӈn sҧn biӇXP{OiWNK{QJWUӑn vҽn 1JKƭDOjFiFELӇu P{WX\ӃQNK{QJÿѭӧc thay thӃ KRjQWRjQEӣi biӇXP{OiWĈLӅXQj\OjQJX\rQQKkQ xuҩt hiӋQFiFWӃ EjRGӏ sҧQKuQKQJD\WUrQYQJFKX\Ӈn tiӃpFiFWӃ EjRQj\Oj
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 FiFWӃ EjREҩWWKѭӡQJYjOjQJX\rQQKkQFӫDKjQJORҥWFiFEӋQKOêSKө khoa hiӋn nay Theo thӕQJNrKҫu hӃt ciFWiFQKkQJk\XQJWKѭYjÿDVӕ XQJWKѭ&7&WKѭӡng bҳWÿҫu tҥLYQJFKX\Ӈn tiӃS7=Yj ÿѭӧFSKkQUDOjPORҥi [33]:
- 9QJFKX\Ӈn tiӃp EuQKWKѭӡQJÿѭӧc tҥRWKjQKWӯ YQJFKX\Ӈn sҧn biӇXP{ OiWFKѭDWUѭӣQJWKjQKKRһFWUѭӣQJWKjQKYӟLFiFNKXYӵc can thiӋp hoһFFiF ÿҧo cӫa biӇu P{WX\ӃnNK{QJFyGҩu hiӋu cӫDXQJWKѭ&7&
- 9QJFKX\Ӈn tiӃp NK{QJÿLӇQKuQKOjNKLFiFWKD\ÿәi bҩWWKѭӡQJÿѭӧFQKuQ thҩ\WURQJYQJFKX\Ӈn tiӃpÿyOjGҩu hiӋu cӫDXQJWKѭ&7&
7K{QJWKѭӡng&7&EuQKWKѭӡng sӁ Fy pH dӏch kiӅm nhҽJLiWUӏ pH khoҧng tӯ
7 ± 7.5 DӏFK kP ÿҥo Fy WtQK DFLG nhҽ Yj WKD\ ÿәi tӯ 3.8 ± 4.6 nhӡ trӵc khuҭn 'RGHUOHLQFyWURQJkPÿҥo chuyӇQJO\FRJHQWKjQKDFLG ODFWLF0{LWUѭӡng acid tӵ QKLrQ Qj\ OLrQ TXDQ ÿӃQ Oѭӧng glycogen cӫD FiF ELӇX P{ OiW QLrP PҥF kP ÿҥo -
&7&Yj SKө thuӝF YjRVӵ chӃ tiӃt cӫa estrogen M{LWUѭӡQJS+Qj\FyNKҧ QăQJ JL~S bҧo vӋ QLrPPҥFkPÿҥo ± &7&Yj chӕQJWiFQKkQJk\EӋnh tӯ ErQQJRjL&7& [56]
9jRJLDLÿRҥQSKiWWULӇn, Gѭӟi ҧQKKѭӣng cӫa estrogen BiӇXP{OiWSKiWWULӇn Gj\OrQQKҩWOjOӟp tӃ EjRWUXQJJLDQJLDWăQJWtFKWUӳ nhiӅu glycogen, tҥRFKRkP ÿҥo mӝt P{LWUѭӡng pH FyWtQKDFLG BiӇXP{ tuyӃn ӣ JLDLÿRҥQWUѭӟc rөng trӭng, GѭӟLWiFGөng cӫDHVWURJHQOjPFKRWӃ EjRWX\Ӄn WăQJWLӃt chҩt nhҫy trong suӕWYj dai gӑLOjKX\Ӄt trҳQJVLQKOê/~FQj\Oӛ &7&KpPӣ, tҥRÿLӅu kiӋn thuұn lӧi cho WLQKWUQJGӉ GjQJ[kPQKұp Yjgһp trӭQJÿӇ thө tinh Ӣ gLDLÿRҥn chӃ tiӃt, Gѭӟi ҧQKKѭӣng cӫDSURJHVWHURQÿk\OjKRRFPRQӭc chӃ sӵ chӃ tiӃt chҩt nhҫy TӃ EjR ӣ biӇXP{WX\Ӄn sӁ giҧm tiӃt dӏFKOjPFKҩt nhҫ\tWÿL ÿөFYjÿһc lҥi Lӟp tӃ EjR ӣ biӇXP{ OiWFӫDkPÿҥRYj&7&VӁ mӓng dҫn NqPWKHR hiӋQWѭӧQJWUyFYҧy cӫa lӟp tӃ EjREӅ mһW/~FQj\Oӛ &7&ÿyQJOҥLQJăQFҧn sӵ [kPQKұp cӫDWLQKWUQJWUrQÿѭӡng sinh dөc nӳ 'RÿyKRRFPRQSURJHVWHURQFy WiFGөng JL~SWUiQKWKDL>]
Lӝ tuyӃQ&7&OjWuQKWUҥQJFiFWӃ EjRWӯ ErQWURQJFӫa ӕng CTC ± ÿѭӧc gӑLOj tӃ EjR ELӇXP{WX\Ӄn mӣ rӝQJUD ErQQJRjLSKҫQkPÿҥo cӫa CTC ± ÿѭӧc gӑLOj biӇXP{OiWKuQK[1-3] NKuQEҵng mҳWWKѭӡng, vӏ WUtOӝ tuyӃQNK{QJ FyELӇu P{OiWWҫQJWKD\YjRÿyFyQKLӅu nө nhӓPjXKӗQJÿұPKѫQVRYӟi biӇXP{OiWYj FyFKҩWQKj\ErQWUrQ Lӝ tuyӃQOjPӝWWuQKWUҥQJVLQKOêEuQKWKѭӡng phә biӃn ӣ nӳ giӟLÿһc biӋWOjSKө nӳ FyWKDLSKө nӳ ÿDQJGQJWKXӕc ngӯDWKDLOjPWăQJWәng OѭӧQJ HVWURJHQ WURQJ Fѫ WKӇ [4-5@ &iF WULӋu chӭQJ WK{QJ WKѭӡng bao gӗm hiӋn WѭӧQJWăQJWLӃt dӏFKWURQJkPÿҥo, ngӭDQJi\NKtKѭQKj\FyPLFKҧ\PiXkP ÿҥo, chҧ\PiXKұXP{QÿDXYQJFKұXô>@7UrQWKӵc tӃ, lӝ tuyӃQNK{QJSKҧi OjEӋQKNK{QJSKҧi OjXQJWKѭYjNK{QJҧQKKѭӣQJÿӃn khҧ QăQJVLQKVҧn cӫa phө nӳ MһFGYұy, lӝ tuyӃn CTC nӃXNK{QJÿѭӧFWKHRG}LYjÿLӅu trӏ kӏp thӡLOkXQJj\ sӁ dүQÿӃQWuQKWUҥQJYLrPQKLӉPÿѭӧc gӑLOjYLrPOӝ tuyӃn CTC
3KkQORҥi lӝ tuyӃn bao gӗm 2 loҥLFKtQKÿyOj
- Lӝ tuyӃn bҭm sinh: ÿk\OjWuQKWUҥng lӝ tuyӃn xҧy ra ӣ FiFEpJiLWӯ khi sinh ra GRFѭӡQJÿӝ HVWURJHQWURQJFѫWKӇ NKiFYӟLJLiWUӏ EuQKWKѭӡng, NK{QJGRVDQJ chҩQYjYLrP
- Lӝ tuyӃn mҳc phҧi: WuQKWUҥng lӝ tuyӃQQj\[ҧy ra do sang chҩQYLrPQKLӉm, WKDLQJKpQOjPnӝi tiӃt eVWURJHQWăQJ
9LrP Oӝ tuyӃQ &7& Oj WuQK WUҥng lӝ tuyӃQ WURQJ ÿy YQJ ELӇX P{ WX\Ӄn bӏ YLrPQKLӉm Bӣi vuFiFELӇXP{WX\Ӄn bӏ bӝc lӝ UDQJRjLQLrPPҥFQrQFiFWӃ EjR
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 Qj\dӉ bӏ YLrPQKLӉPGRYLWUQJGRQҩPGRNêVLQKWUQJKD\FiFWҥp khuҭn Ĉk\ OjPӝt bӋQKOêOjQKWtQKYjNKiSKә biӃn ӣ phө nӳÿһc biӋWOjSKө nӳ ViӋt Nam Khi mҳc bӋQKQj\FѫTXDQVLQKGөc sӁ WăQJWLӃt dӏFKkPÿҥRFyPjXYjQJ[DQKKRһc YjQJ QkX NqP WKHR PL K{L Yj Fy QKLӅu bӑW ĈLӅX Qj\ VӁ tҥR ÿLӅu kiӋQ FKR FiF virus, vi khuҭQQKѭFKODP\GLDYLNKXҭn lұXYLUXVJk\Pөn rӝSôSKiWWULӇn Khi sinh thiӃW YQJ Oӝ tuyӃn mҩt lӟp biӇX P{ OiW FKӫ yӃu tӃ EjR ELӇX P{ WX\Ӄn tiӃt nhҫy Khi chuyӇQ TXD JLDL ÿRҥQ YLrP Oӝ tuyӃQ YQJ Qj\ Fy QKLӅu bҥch cҫX ÿD QKkQYjO\PSKREjR [52,59]
9QJWiLWҥo cӫa lӝ tuyӃn ljYQJOӝ tuyӃQFNJWURQJÿybiӇXP{OiWFә QJRjL ODQ YjR thay thӃ Yj FKH SKӫ biӇX P{ WX\Ӄn nhҵP ÿӇ mһW QJRjL &7& WUӣ vӅ EuQK WKѭӡng Sӵ hӗi phөFQj\GLӉn ra theo KDLFѫFKӃ NKiFQKDXEDRJӗm sӵ WiLWҥo biӇu P{OiWSKiWWULӇn YjR SKӫ OrQELӇXP{tuyӃQYjVӵ WiLWҥo biӇXP{GRORҥn sҧn tӯ nhӳng tӃ EjRGӵ trӳ cӫa biӇXP{WX\Ӄn
4XiWUuQKWiLWҥo xҧ\UDQKDQKFKyQJWKXұn lӧi nӃXÿѭӧc chӕQJYLrPÿӕt diӋt tuyӃQ VDX ÿy ELӇX P{ OiW OҩQ iW KRjQ WRjQ ELӇX P{ WuyӃn TXi WUuQK WiL WҥR KRjQ WKjQK&7&WUӣ lҥLEuQKWKѭӡng, bҳWPjXÿӅu vӟi dung dӏch Lugol 1Jѭӧc lҥLTXi WUuQKWiLWҥo diӉn ra chұm, trong mӝt thӡLJLDQNpRGjLkhi gһp ÿLӅu kiӋQNK{QJWKXұn lӧi GRYLrPQKLӉPÿӕWFzQVyWQKLӅu tuyӃn, biӃQÿӝng nӝi tiӃt,ô KLÿyEiӇXP{ OiWNK{QJOҩQiWÿѭӧc biӇXP{WX\Ӄn QrQÿӇ lҥLYQJWiLWҥo di chӭQJOjQKWtQKQKѭ cӱa tuyӃn; ÿҧo tuyӃn ± mӝt hoһc nhiӅu miӋng tuyӃn bӏ biӇXP{OiWEDR[XQJTXDQK NK{QJSKӫ OrQWUrQWLӃp tөc chӃ tiӃt; hay nang Naboth ± GRFiFÿiPWX\Ӄn bӏ biӇu P{ OiW SKӫ OrQ QKѭQJ NK{QJ Eӏ diӋt, tiӃp tөc chӃ tiӃt nhҫy tҥR FiF QDQJ WX\Ӄn [52,59]
Cӱa tuyӃQYjÿҧo tuyӃn ljnhӳQJYQJKҽp hoһc rӝng cӫa biӇXP{WX\Ӄn FzQVyWOҥLWURQJYQJELӇXP{OiWWLӃp tөc chӃ tiӃt chҩt nhҫy NhiӅu cӱa tuyӃn kӃt hӧp lҥi vӟi mӝt sӕ tuyӃQFzQVyWOҥLWURQJYQJELӇXP{OiWPӟi phөc hӗi tҥRWKjQKÿҧo tuyӃn 1DQJ1DERWKOjhiӋQWѭӧng biӇXP{ OiWFKHSKӫ biӇXP{ tuyӃQQKѭQJFKѭD diӋWÿѭӧc biӇXP{tuyӃn ӣ GѭӟLQrQFiFtuyӃn vүn tiӃp tөc chӃ tiӃt chҩt nhҫy tҥo WKjQKQDQJ1DQJFyNtFKWKѭӟc to nhӓ NKiFQKDXPjXWURQJWUҳQJÿөc hoһFYjQJ nhҥWWUrQEӅ mһWFyWKӇ FyFiFPҥFKPiXWURQJQDQJFKӭa dӏch nhҫy do biӇXP{
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 tuyӃn chӃ tiӃt %rQFҥQKÿyFzQFyPӝt sӕ ciFWәQWKѭѫQJNKiFtWJһp KѫQ QKѭQJFҫn ÿLӅu trӏ QKѭSRO\S &7&X[ѫ&7&Oҥc nӝi mҥc tӱ cung, VLPjRJjô [52,59] 7\YjRWӯQJJLDLÿRҥn, triӋu chӭQJOkPVjQJFӫa bӋnh YLrPOӝ tuyӃn FyWKӇ NKiF QKDX 0ӝt sӕ dҩu hiӋX ÿLӇQ KuQK Fy WKӇ kӇ ÿӃQ QKѭ Oj UD NKt Kѭ QKҫ\ ÿөc, YjQJ.KLÿһt mӓ vӏWTXDQViWWKҩy mҩWÿLELӇXP{OiWQKҹQEyQJ7UrQEӅ mһt CTC FzQWKҩ\FyQKLӅu nө nhӓ, thүPPjX7X\QKLrQYLӋFSKkQELӋWYj[iFÿӏnh ranh giӟi giӳa PjXÿӓ thүPYQJOӝ tuyӃQWUrQPjXKӗng nhҥWYQJEuQKWKѭӡQJOjÿLӅu NKyNKăQĈӇ khҳc phөFWuQKWUҥQJQj\WURQJOkPVjQJVRL&7&NӃt hӧp E{LDFLG acetic 3% - 5% ÿѭӧc sӱ dөQJ ÿӇ TXDQ ViW YQJ YLrP Oӝ tuyӃQ Fy Gҥng QKuQ QKѭ ³FKPQKR´ hay kӃt hӧp phӃt LXJROYQJYLrPOӝ tuyӃQNK{QJEҳWPjXYӟi dung dӏFKQj\GRSKҫn lӟn lӟp tӃ EjRQj\ÿmPҩWÿLJO\FRJHQ
Ҧnh kӻ thuұt sӕ
ҦQKNӻWKXұWVӕKD\ҧQKVӕGLJLWDOOjWұp hӧp hӳu hҥQFiFÿLӇm ҧnh vӟi mӭc [iPSKKӧSGQJÿӇ P{Wҧ ҧnh gҫn vӟi ҧnh thұt Ĉk\OjGҥng ҧQKÿѭӧFOѭXWUӳ WUrQFiFWKLӃt bӏ kӻ thuұt sӕÿѭӧc tҥo ra bҵQJFiFKELӃQÿәi rӡi rҥFWK{QJWLQKuQKҧnh OLrQWөFWKjQKWtQKLӋu rӡi rҥFWK{QJTXDSKpSOҩy mүX3KpSOҩy mүu sӁ rӡi rҥFKyDFiF JLiWUӏ OLrQWөc tӟL FiF JLiWUӏ rӡi rҥc gҫn nhҩt Sӕ ÿLӇm ҧQKJL~S[iF ÿӏQKÿӝ SKkQJLҧi cӫa ҧnh ҦQKFyÿӝ SKkQJLҧi FjQJFDRWKuFjQJWKӇ hiӋQU}QpWFiFÿһc ÿLӇm cӫa tҩm ҧQKFjQJOjPFKRWҩm ҧnh trӣ QrQWKӵFYjVҳFQpWKѫQҦQKVӕÿѭӧFFKLDOjPEDORҥLҧQKQKӏSKkQҧQK[iPYjҧQKPjX>]
- ҦQKQKӏSKkQJLiWUӏ[iPFӫDWҩWFҧFiFÿLӇPҧQKFKӍQKұQKRһF1JKƭD OjPӛLÿLӇPҧQKWURQJҧQKQKӏSKkQÿѭӧFELӇXGLӉQEӣLELW
- ҦQK[iPJLiWUӏ[iPQҵPWURQJNKRҧQJWӯ ÿӃQPӛLÿLӇPҧQKWURQJ ҧQK[iPÿѭӧFELӇXGLӉQEӣLE\WH Mӝt pixel trong ҧQK[iPFyÿһFWUѭQJFѫEҧn OjWӑDÿӝ 2 chiӅu cӫDQyWUrQEӭc ҧQKYjJLiWUӏ FѭӡQJÿӝ tҥi vӏ WUtWѭѫQJӭng ± gӑLOj mӭF[iP0ӭF[iPFӫa mӝt pixel thӇ hiӋQFѭӡQJÿӝ ViQJFӫDQyYjÿѭӧFJiQEҵng mӝt con sӕ nҵm trong mӝt khoҧQJ[iFÿӏnh gӑLOjWKDQJPӭF[iP
- ҦQKPjXҧQKPjXWKHROêWKX\ӃWFӫD7KRPDVOjҧQKWәKӧSWӯPjXFѫEҧQ 55HG**UHHQ%%OXHYjWKѭӡQJWKXQKұQWUrQFiFGmLEăQJWҫQJNKiFQKDX 9ӟLҧQKPjXFiFKELӇXGLӉQFNJQJWѭѫQJWӵQKѭҧQKÿHQWUҳQJFKӍNKiFOjFiFVӕWҥL PӛLSKҫQWӱFӫDPDWUұQ1JѭӡLWDGQJE\WHÿӇP{WҧPӭFPjXNKLÿyFiFJLiWUӏ PjXOj 2 8x3 = 2 24 = WULӋXPjX
So vӟi ҧQKWtQKLӋXOLrQWөc (analog), ҧnh kӻ thuұt sӕ FyQKӳng ѭXÿLӇPYѭӧt trӝLQKѭFyWKӇ hiӇn thӏ QJD\WUrQWKLӃt bӏ PjNK{QJFҫQWUiQJUӱa phim, dӉ GjQJOѭX trӳ, truyӅn tҧi Yjÿһc biӋWOjFyWKӇ dӉ GjQJ[ӱ OêWUrQPi\WtQK ĈL͋ m ̫ nh ĈLӇm ҧnh KD\ SL[HO Oj Pӝt phҫn tӱ cӫa ҧnh sӕ tҥi toҥ ÿӝ (x, y) vӟL ÿӝ [iP hoһFPjXQKҩWÿӏnhÿk\OjÿѫQYӏ FѫEҧn (nhӓ nhҩt) cӫa ҧnh sӕ Mӛi bӭc ҧQKÿѭӧc tҥRWKjQKEҵQJFiFWKjQKSKҫQÿѫQYӏ cӫa ҧnh Pixel thӇ hiӋQJLiWUӏ FѭӡQJÿӝ rӡi rҥc cӫDÿLӇm ҧQKWURQJNK{QJJLDQ.tFKWKѭӟFYjNKRҧQJFiFKJLӳDFiFÿLӇm ҧQKÿy ÿѭӧc chӑQWKtFKKӧp sao cho mҳWQJѭӡi cҧm nhұn sӵ OLrQWөc vӅ NK{QJJLDQYjPӭc [iPKRһFPjXFӫa ҧnh sӕ gҫQQKѭҧnh thұt Mӝt bӭc ҧQKFjQJFyQKLӅXSL[HOWKu FjQJWU{QJFyYҿ OLrQWөFFjQJU}QpWYjFKLWLӃW0ӛLSL[HOÿѭӧFÿһFWUѭQJEӣi mӝt hay nhiӅXWK{QJVӕ ÿӇ thӇ hiӋQFѭӡQJÿӝ hoһFPjXVҳc nhҩWÿӏnh Ĉ͡ SKkQJL̫ i ĈӝSKkQJLҧL5HVROXWLRQFӫDҧQKOjPұWÿӝÿLӇPҧQKÿѭӧFҩQÿӏQKWUrQPӝW ҧQKVӕÿѭӧFKLӇQWKӏKD\Vӕ Oѭӧng pi[HOWUrQPӝWÿѫQYӏ chiӅXGjLSL[HOSHULQFK 33,.tFKWKѭӟc mӝt bӭc ҧQKÿѭӧFWtQKEҵng sӕ pixel chiӅXQJDQJYjFKLӅu dӑF7KHRÿӏQKQJKƭDNKRҧQJFiFKJLӳDFiFÿLӇPҧQKSKҧLÿѭӧFFKӑQVDRFKRPҳWQJѭӡLYүQWKҩ\VӵOLrQWөFFӫDҧQK9LӋFOӵDFKӑQNKRҧQJFiFKWKtFKKӧSWҥRQrQPӝWPұW
LUҰ19Ă17+Ҥ&6ƬNguyӉn Ngӑc QuǤnh ± 1870331 ÿӝSKkQ EӕÿyFKtQK OjÿӝSKkQ JLҧLÿѭӧFSKkQ EӕWKHRWUөF [Yj \WURQJNK{QJ JLDQFKLӅX+uQK thӇ hiӋQFiFҧQKWѭѫQJWӵ QKѭQJFyÿӝ SKkQJLҧLNKiFQKDX 7KHRÿyKuQKҧQKFyÿӝ SKkQJLҧLFjQJFDRVӁ cho ҧQKFjQJU}QpWYjQJѭӧc lҥi
+uQK+uQK̫nh vͣLFiFÿ͡ SKkQJL̫i NKiFQKDX
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.K{QJ JLDQ PjX Oj QKӳQJ SKѭѫQJ SKiS ÿӏQK OѭӧQJ PjX VҳF ÿѭӧc thiӃt lұp F{QJWKӭc mӝWFiFKNKRDKӑc HӋ thӕQJNK{QJJLDQPjXFKRSKpSPӛLPjXÿѭӧc [iFÿӏnh theo sӕ hӑc, bҵQJFiFKÿyWDFyWKӇ chӑQYjOһp lҥi nhӳQJPjXQjRÿyWKұt FKtQK[iF>]
7URQJNK{QJJLDQPjX5*%Wҩt cҧ FiFPjXEҩt kǤ ÿѭӧc thӇ hiӋQWK{QJTXDWә hӧp tuyӃQWtQKFӫDEDPjXFѫEҧQOjÿӓ (R, viӃt tҳt cӫa RHG[DQKOiFk\*YLӃt tҳc cӫa GUHHQYj [DQKGѭѫQJ%YLӃt tҳt cӫa Blue) Ba trөF PjXYX{QJJyF Yӟi nhau tӯQJÿ{LPӝt MӛLSL[HOWUrQҧQKPjXFy tӑDÿӝ WKD\YuQKѭҧQK[iPWӑa ÿӝ thӭ ba thӇ hiӋQNrQKPjXWUrQPӛi thang, mӭFPjXWѭѫQJӭQJFyJLiWUӏ tӯ ÿӃn
2 n -1 MӛLJLiWUӏ R, G, B sӁ ÿѭӧc biӇu diӉn bӣi sӕ ELWWK{QJWKѭӡng 8 bits (0 ± 255)
ҦQKSKkQFӵc
ҦQKSKkQFӵFOjҧQKÿѭӧc chөp GѭӟLiQKViQJSKkQFӵFÈQKViQJSKkQFӵFOj iQKViQJÿѭӧc lӑc qua ktQKOӑFSKkQFӵc KuQK7URQJÿyNtQKOӑFSKkQFӵc OjPӝt bӝ lӑc quang hӑFFKRiQKViQJFySKkQFӵc nhҩWÿӏQKÿLTXDYjQJăQFKһn iQK ViQJ Fy SKkQ FӵF NKiF 1y Fy WKӇ chuyӇQ ÿәi mӝt FKP iQK ViQJ SKkQ Fӵc NK{QJ[iFÿӏnh hoһc hӛn hӧSWKjQKPӝWFKPYӟLSKkQFӵFÿѭӧF[iFÿӏQKU}&iF loҥi phә biӃn cӫD FiF FӵF OjSKkQ Fӵc thҷng Yj SKkQ FӵF WUzQ3KkQFӵF ÿѭӧc sӱ dөng trong nhiӅu kӻ thuұt quang hӑc, FiFF{QJFө YjFiFEӝ lӑFSKkQFӵc ÿѭӧc ӭng dөng trong nhiӃp ҧQKYjF{QJQJKӋ PjQKuQKWLQKWKӇ lӓng
HiӋn nay, NtQK SKkQ Fӵc KD\ FzQ JӑL Oj NtQK SRODUL]HGvӟL WtQK QăQJ FKӕng FKyLWӕWJL~SQJăQFKһQiQKViQJSKҧn chiӃXÿһc biӋWQKѭPһWQѭӟc Ĉk\FNJQJOjOê GRPjNtQKSKkQFӵFÿѭӧc sӱ dөQJWURQJFiFP{KuQKWKLӃt bӏ Pi\VRL&7&'Rÿһc WtQKEӅ mһW&7&WKѭӡQJFyQKLӅu dӏch ӣ thӇ lӓQJKuQKҧQKWKXÿѭӧFWKѭӡng FKyL ViQJĈLӅXÿyGүQÿӃn viӋc xӱ Oêҧnh trӣ QrQNKyNKăQNKLNK{QJWKӇ lӑc nhiӉu hӃt FiFYQJFKyLQj\Ĉӗng thӡLFzQOjQJX\rQQKkQJk\UDQKӳng chҭQÿRiQVDLNKL nhҫm lүn ÿk\OjYQJELӃQÿәi bҩWWKѭӡQJKD\YQJFyGҩu hiӋu bӋQKOê
.K{QJ Gӯng lҥi ӣ ÿy KuQK ҧQK SKkQ FӵF FzQ FXQJ FҩS ÿѭӧF WtQK FKҩW ErQ trong cӫDP{PjPҳWWKѭӡQJNKyFyWKӇ QKuQWKҩ\ÿѭӧc DӵDYjRWtQKFKҩWSKkQFӵc NKiFQKDXFӫDFiFP{VLQKKӑFNKiFQKDXFK~QJWDFyWKӇ WKXÿѭӧFKuQKҧQKSKkQ cӵFYjKLӇn thӏ mӝWFiFK trӵc quan FiFWtQKFKҩt cӫD P{7ӯ ÿyKӛ trӧ SKkQELӋt ÿѭӧFYQJEӋQKYjYQJEuQKWKѭӡng bӣLYuӣ FiFYQJFKӭa nhӳQJP{EӋnh sӁ FyWtQKFKҩWSKkQFӵFNKiFVRYӟLYQJEuQKWKѭӡng
Khӱ nhiӉu
NhiӉu KD\FzQJӑLOjQRLVHOjWKXұt ngӳ trong ҧnh sӕ chӍ hiӋQWѭӧng bӭc ҧnh WKXÿѭӧFNK{QJJLӕng vӟi thӵc tӃ1JX\rQQKkQFӫa nhiӉXOj do xҧy ra nhӳng sai lӋFK Jk\UD EӣL P{LWUѭӡQJErQ QJRjLGRFҧm biӃn thu nhұQGRFiF \Ӄu tӕ ngүu QKLrQô 1KLӉX OjP PҩW PiW KRһF Jk\ VDL OӋFK WK{QJ WLQ WKӵF GR ÿy VӁ OjP ҧnh KѭӣQJÿӃn viӋFÿiQKJLiKD\[ӱ OêҧQK9uWKӃ QJRjLYLӋc hҥn chӃ nhiӉu trong viӋc thu nhұn ҧQKQJѭӡLWDFzQVӱ dөQJFiFWKXұWWRiQ[ӱ OêÿӇ loҥi bӓ hoһFOjPJLҧm WiF ÿӝng cӫa nhiӉX WUѭӟc khi thӵc hiӋQ FiF WKXұW WRiQ [ӱ Oê ҧQK NKiF Mӝt sӕ SKѭѫQJ SKiS NKӱ nhiӉX Fy WKӇ kӇ ÿӃQ QKѭ NKӱ nhiӉX WUrQ PLӅQ NK{QJ JLDQ NKӱ nhiӉXWUrQPLӅn tҫn sӕ, lҩ\WUXQJEuQK0ӝt sӕ SKѭѫQJSKiSNKӱ nhiӉu sӱ dөng mһt nҥ ÿӇ [pWWӯQJYQJÿӇ xӱ OêWKD\YuWRjQEӭc ҧnh
Mһt nҥ Oj Pӝt ma trұQFy KuQKGҥQJYj FiF WK{QJVӕ ÿѭӧc chӑQWUѭӟF ÿѭӧc GQJÿӇ WUѭӧt qua tҩt cҧ FiFSL[HOWUrQҧQK*LiWUӏ cӫa tӯng pixel cӫa ҧQKVDXNKLÿL qua bӝ lӑc sӁ ÿѭӧFWtQKGӵDWUrQFiFSL[HOFQJQҵPWUrQPһt nҥ NKLWUѭӧt tӟi pixel ÿy&iFÿLӇm mһt nҥ NK{QJWKӇ WUѭӧWTXDÿѭӧFYuFyQKӳQJÿLӇm nҵPWUrQPһt nҥ nҵPQJRjLҧnh tҥLÿLӇPÿyFyWKӇ ÿѭӧc giҧi quyӃt bҵng mӝt trong nhӳQJFiFKQKѭ bӓ qua nhӳQJÿLӇPÿyFKӍ sӱ dөQJFiFÿLӇm nҵPWUrQPһt nҥ QKѭQJYүn nҵPWUrQ ҧnh, sӱ dөQJ FiF Pһt nҥ NKiF Wҥi nhӳQJ ÿLӇP ÿy 7\ YjR FiFK WtQK WRiQ JLi WUӏ pixel mӟLWUrQPһt nҥWDFyWKӇ FyQKӳng bӝ lӑFNKiFQKDXQKѭEӝ lӑFWUXQJEuQKYj bӝ lӑc trung vӏ
7ăQJFѭӡng ҧnh KD\WăQJWѭѫQJSKҧn ҧnh OjTXiWUuQKQkQJFDRFKҩWOѭӧng bӭc ҧQKÿӇ giҧi quyӃWFiFYҩQÿӅ QKѭҧnh bӏ mӡ, ҧnh TXiViQJKD\TXiWӕLWѭѫQJphҧn TXiWKҩpôOjPҧQKKѭӟQJÿӃn viӋFÿiQKJLiKRһFÿӃQFiFEѭӟc xӱ OờWLӃp theo Khӱ nhiӉXFNJQJOjPӝWEѭӟFJL~SWăQJFѭӡng ҧnh
7ăQJFѭӡQJÿӝ WѭѫQJSKҧQOjSKpS[ӱ OêWUrQҧQKOjPWăQJVӵ NKiFELӋt giӳa nhӳQJ ÿLӇm tӕL Yj QKӳQJ ÿLӇP ViQJ 0ӝt sӕ SKѭѫQJ SKiS WăQJ FѭӡQJ ÿӝ WѭѫQJ phҧQFyWKӇ kӇ ÿӃQQKѭWKD\ÿәi phҥm vi dҧLFѭӡQJÿӝ ViQJ, WKD\ÿәi qua cӱa sӕ FѭӡQJÿӝ ViQJCө thӇ QKѭVDX
- 7KD\ÿәi phҥm vi dҧLFѭӡQJÿӝ ViQJ: ljTXiWUuQKWUҧLFiFJLiWUӏ FѭӡQJÿӝ ViQJVDQJPӝt khoҧng mӟLĈӝ ViQJFӫDFiFÿLӇm cyFѭӡQJÿӝ thҩp nhҩWWUrQҧnh sӁ ÿѭӧc thӇ hiӋn bҵQJÿӝ ViQJFӫDPjXÿHQWX\ӋWÿӕLÿӝ ViQJFӫDFiFÿLӇPFyFѭӡng ÿӝ cao nhҩt sӁ ÿѭӧc thӇ hiӋn bҵQJFѭӡQJÿӝ cӫDPjXWUҳng tuyӋWÿӕLĈӝ ViQJFӫa FiFÿLӇPFzQOҥi sӁ ÿѭӧc thӇ hiӋn bҵng mӝWFѭӡQJÿӝ sao cho tӹ lӋ cӫDFѭӡQJÿӝ Qj\ÿӃQFѭӡQJÿӝ ÿHQWX\ӋWÿӕLYjWUҳng tuyӋWÿӕi bҵng vӟi tӹ lӋ FѭӡQJÿӝ EDQÿҫu so vӟLÿLӇm tӕi nhҩWYjViQJQKҩWEDQÿҫu
- 7KD\ÿәi qua cӱa sә FѭӡQJÿӝ ViQJ: ljELӃQÿәLWRjQEӝ FiFSL[HOFӫa bӭc ҧQKWKjQKPӝWJLiWUӏ NKiFWK{QJTXDPӝt KjPVӕFyWKӇ OjKjPWX\ӃQWtQKKRһc phi tuyӃn
3KkQYQJKD\SKkQÿRҥQKuQKҧQKQyLFKXQJYjKuQKҧnh y tӃ QyLULrQJOjPӝt TXiWUuQKTXDQWUӑQJWURQJSKkQWtFKKuQKҧQKYjӭng dөng thӏ JLiFPi\WtQK3KkQ ÿRҥn ҧnh Oj FKLDKuQKҧQKWKjQKPӝt sӕ phҫQWiFKUӡLQKDXÿӇ FiFÿLӇm ҧnh trong mӛi phҫQFy ÿӝ WѭѫQJÿӗQJFDR Yj FiF ÿLӇm ҧnh giӳD FiF SKҫQ NKiF QKDX Fy ÿӝ WѭѫQJSKҧQFDR9uYLӋFSKiWKLӋQYQJEҩWWKѭӡQJWUrQҧQK&7&OjPӝt nhiӋm vө quan trӑQJWURQJSKkQWtFKKuQKҧQKGRÿyFiFQKjQJKLrQFӭXÿDQJWuPNLӃPFiF thuұWWRiQSKkQÿRҥQFKtQK[iFWLrXWӕQtWWKӡLJLDQKѫQ7X\QKLrQQӃXSKkQÿRҥn NK{QJKLӋu quҧ YjFiFÿһFWtQKFyOLrQTXDQNK{QJWKӇ ÿѭӧFWUtFK[Xҩt tӯ khu vӵc TXDQWkPFyWKӇ sӁ dүQÿӃn dӵ ÿRiQVDL
PKѭѫQJ SKiS SKkQ YQJ ҧnh dӵD WUrQ FѭӡQJ ÿӝ ÿLӇm ҧQK ÿӇ SKkQ FKLD ҧnh WKjQKYQJNKiFQKDXWKHRF{QJ thӭc (2.1) ݃ሺݔǡ ݕሻ ൌ ൜ͳ݊ዅݑ݂ሺݔǡ ݕሻ ൏ ܶ Ͳ݊ዅݑ݂ሺݔǡ ݕሻ ܶሺʹǤͳሻ 7URQJÿy7OjQJѭӥng, IOjҧnh cҫQSKkQQJѭӥQJYj [\OjWӑDÿӝ 2 chiӅu cӫa ҧnh cҫQSKkQQJѭӥQJI[\OjJLiWUӏ FѭӡQJÿӝ pixel cӫa ҧnh cҫQSKkQQJѭӥng tҥi tӑDÿӝ [\JOjҧnh sau SKkQQJѭӥQJJ[\OjJLiWUӏ FѭӡQJÿӝ pixel cӫa ҧnh sau SKkQQJѭӥng tҥi tӑDÿӝ (x,y) ViӋFSKkQQJѭӥQJFyWhӇ ÿѭӧc mӣ rӝng cho viӋFWiFK nhiӅX KѫQ YQJ WK{QJ TXD YLӋc lҩy nhiӅX QJѭӥng hoһc lҩ\ QJѭӥng nhiӅu lҫn 1JѭӥQJ7FyWKӇ ÿѭӧc chӑn trong dҧLFѭӡQJÿӝ hoһFÿѭӧFWtQKWӵ ÿӝng dӵDWUrQ
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[1] Tran Van Tien, Nguyen Ngoc Quynh, Le Huynh Duc, Phan Ngoc Khuong Cat and Huynh Quang Linh ³'HWHFWLRQ DQG ORFDOL]DWLRQ RI WKH KHPRJORELQ DQG FROODJHQGLVWULEXWLRQRIWKHXWHULQHFHUYL[XVLQJFURVVSRODUL]HGLPDJH´Journal of Innovative Optical Health, vol 12, no 4, pp 1942006, Jun 2019
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Duong ³0RGHORIFROSRVFRS\XVLQJSRODUL]HGOLJKWDQGHIIHFWLYHHDUO\´Science & Technology DevelopmentJournal, vol 20, no K2, 2017
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Quynh, Ly Cao Duong ³0RGHORIFROSRVFRS\XVLQJSRODUL]HGOLJKWDQGHIIHFWLYH HDUO\´ISEPM, Ho Chi Minh, 2017
Phө lөc 2: Danh mөc giҧLWKѭӣng:
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