- Ac tinh hoa: bien chiing muon va it 4 Dieu trj
2. Chan doan Lam sang:
Lam sang:
- Thay doi toan than.
- Dau bung (quan hoac triidng bun g giam dau bang thuoc giam co that hay trung tien + dai tien).
- Phan mau do - den.
- Roi loan van dong mdi xuat hien.
- Hoi chiing triic trang (m ot dan, buot mot, dau tiic). - The co bien chiing: nhiem trung (dai trang phai), tac
ruot, thung, chay mau (dai trang trai)
Noi soi dai trang:
Nhin doi, gay me toan than, khong co dau hieu tac ruot. Chuan bi soi dai trang (uong thuoc Fortrans va co the che do an khong xd trong 3 ngay) soi triic trang (thut), kiem tra dong
mau kin can cat bang thong long nhiet. bien chiing hiem (1/1000, thung, chay mau).
Nhin thay khoi u.
- Danh gia: vi tri, kich thildc, lan toa ra xung quanh, ti'nh chat.
- Cho phep sinh thiet nhieu manh (> 10 manh, bd trong va chu vi).
- Kham xet toan bo khung dai trang polyp ket hdp 25%, u thanh dai trang 5%.
Chup K D T khi co tac ruot hay nghi ngd thung, khi noi soi dai trang khong toan bo.
Hinh khuyet bd khon g deu hoac hinh polyp. Hep tti m ot ben thanh dai trang khong deu, loet.
Phat hien sdm K dai true trang:
- Neu tien sii gia dinh K dai triic trang < 60 tuoi: noi soi dai trang / 5 nam bat dau til 45 tuoi.
- Tham tn ic trang hang nam til tuoi sau 50.
- Tim hong cau trong phan / 2 nam, neu (+) noi soi dai trang - 20% so triidng hdp phat hien adenem e > 1cm va 5% co adenocarcinom e.
Tham triic tran g:
- Phat hien khoi u neu ciic diidi khoi u cach cd that hau mon 8cm.
- Vi tri khoi u so vdi cd that.
- Danh gia khoi u (ranh gidi, bd va chieu cao). - Dac diem : loet hay loet sui.
- Xam lan vao vung tieu khung: khoi u co dinh tren
xUdng cung, xam lan vao tien liet tuyen hoac dinh tnic trang am dao.