Ngoai c ac tai bien, bien chting c h u n g c ua phau thuat noi soi, phau thuat noi soi trong dieu tri chira ngoai tir c u n g co mot so c ac bien churng dac trirng sau:
1. D i e u tri, b a o ton
- C h a y ma u : c h a y m a u di en rau b a m t ro n g va sau m o da n toi pha i cdt voi trurng.
- C han t h u o n g voi trurng: do p h au t huat vien thieu k in h n g h i e m . + L a m thiing voi trung, m a c treo voi trurng.
+ Voi trurng bi r a c h q u a r ong.
+ K e p va ke o n h i e u g a y t6n t h u o n g 2 m e p voi trurng. + D o t dien c a m m a u r ong.
- Sot t6 clitic rau thai tai voi trting, c a c n g u y e n b a o n uoi tiep tuc p h a t trien tao t ha nh khoi tu huye t. Bien chting n a y c h i e m k h o a n g 5 % ( P o u l y va c o n g sir - 1986, C h a p r o n va c o n g sir - 1991).
- D o voi trting: lien q u a n d en dot dien h o a c d u o n g ra ch q u a dai.
2. D i e u tri triet de
- C h a y m a u c o the x a y ra t ro n g luc g o d i nh , c a m m a u k h o n g tot, t6n t h u o n g m a c h m a u m a c treo voi trting, c a c n h a n h noi g i u a d o n g m a c h b u o n g trting va d o n g m a c h tu c u n g .
- C h a n t h u o n g c a c c o q u a n k h a c khi c o d in h khoi c h u a voi r uot, t h a n h c h a u ...
- Ton t h u o n g ruot do dot die n, khi c o d i n h va c h a y m a u nhi6u.
- Cdt bo b u o n g trting do d in h vi sai vi d inh h o a c c a m m a u voi v a n g t r o n g luc c h a y m a u nhiSu.
- C ac n g u y e n b a o n uo i sot lai, p h a t trien vao 6 b u n g do de roi c a c m a n h rau thai, hut k h o n g sach. Bien cht ing n a y c h i e m k h o a n g 0 , 5 % ( D u b u i s s o n - 1990).
V II- KET LUAN
N g a y nay, p ha u t hu at noi soi la m o t p h u o n g p h a p d u o c lira c h o n d e d i e u tri c h u a n goai tu c u n g voi n h i e u uu die’m d a d u o c k h d n g d i nh . T u y n h i e n , p h a u t hua t vien c a n n d m v u n g c a c chi di nh va c h o n g chi d i n h c u a tting p h u o n g p ha p, c a n tuan thu c a c q u y tac c o b an , dd t r a n h c a c tai b ie n , b i e n c h t i n g c u a pha u thuat.
TAI LIEU THAM KHAO1. M - A Bruhat, G . M a g e , J - L . P o u l y , H . M a n h e s , M . C a n i s , A . W a t t i e z - 1. M - A Bruhat, G . M a g e , J - L . P o u l y , H . M a n h e s , M . C a n i s , A . W a t t i e z - C o e l i o s c o p i e o p e ra t oi re . M e d s i / M c G r a w - Hill Paris 1989. 133 - 152. 2. C h a u - s u on - L a p a r o s c o p i c m a n a g e m e n t o f E c t o p i c p r e g n a n c y . J. o f R e p r o d u c t i v e M e d e c i n e 1993. 8 4 9 - 852. 3. G . C a p r o n . J - L P o u l y , M . M a n h e s , G . M a g e , M . Ca r i s , A . W a t t i e z , S.Bassil, M - A B r u h a t - L a g r o s s e s s e e xt r a - ut e r i n e : t e c h i n i q u e o p e r a t o i r e , r es ul tat s , s trategie du t r a i t e m e n t c hi r u r gi c a l . L a C h i ru g i e . A b d o m i n o - p e l v i e n n e par c o e l i o s c o p i e . S p r i n ge r - ve rla g Paris 1992, 29 - 42.
4. De C h e r n e y , M - P D i a m o n d - L a p a r o s c o p i c S a l p i n g o s t o m y for e c t o p i c p r e g n a n c y . O b s t e t g y n e c o l . 1987, 70, 9 4 8 - 950.
5. W R . M e y e r , A H D e c h e r n e y - L a p a r o s c o p i c t r e a t m e n t o f e c t o p i c p r e g n a n c y . C lin ic al obs t et r ic s and g y n a e c o l o g y . I n t e r n a t i o n n a l p ra c ti se a n d r e s e a r c h . Bai lliere Ti ndall 1989 V o l u m 3. 583 - 594.
6. M e n c a g l i s , A. W a t t i e z - M a n u a l o f g y n e c o l o g i c a l l a p a r o s c o p i c s u r g e r y . L a p a r o s c o p i c m a n a g e r m e n t o f e c t o p i c p r e g a n c y . E n d o p r e s s T u t t l i n g e n
1998 38 - 43.
7. J - L P ou l y , C. C h a p r o n , A. W a t t i e z - E c t o p i c p r e g n a n c y . E n d o s c o p i c s u r g e r y for g y n a e c o l o g i s t . W B S a u n d e r s c o m p a n y Ltd. 1993. 105 - 112.
NOI SOI DIEU TR| VO SINH TAC VOI TRUNG
L e T h a n h Ky
Noi soi chain d o a n da dirge V i e n B V B M T S S thuc hi en tir t h a p k y 7 0, c o n phau t huat noi soi de di eu tri vo sinh m oi d u g c ap d u n g va p h a t t r i en tu t h a n g 1 / 1996.
N h u c h u n g ta d a biet, de c o thai d u g c phai c o n h u n g di eu k i e n n h a t d in h nhu:
- Q u a trinh tao gi ao tir p ha i bi nh t h u o n g c u a c a 2 v g c h o n g - D u o n g di ciia gi ao tir k h o n g bi t ro ngai
- C o c he thu tinh va lam to phai binh t h u o n g
- Lo ai trir n g u y e n n h a n do ng uo i c h o n g , P T N S c o the’ giai q u y e t d u g c m o t so n g u y e n n h a n ciia n g u o i v g nhu:
1. Sir tac n g h e n c u a voi trirng
- T i c t hu c sir t ro n g l ong voi t r ung
- D o loa t h a n h tui bit g a y t i c h o a c ur n u o c
- T i e do bi c a c m a n g d in h b a o lai h oa c lam c h o voi trufng g a p g a y
2. N h u n g t r uo n g h o p co roi loan p h o n g n o a n n g u v c n n h a n do b u o n g trurng
- U n a n g b u o n g trirng - B uon g t r u n g d a n a n g
i- c h i d;n h
Tat ca c a c t r u o n g h g p n g u y e n n h a n do voi trirng
Nghi n g d h o a c d a c h dn d o a n b u o n g trurng da n a n g h o a c u b u o n g trurng C ac t r u o n g h g p vo sinh k h o n g ro n g u y e n n h a n , d ie u tri k h o n g ket q u a