phtfdng phap can lam sang khac nhtf sieu am, choc do o bung va dac biet nhd noi soi kiem tra.
- Dieu tri GXC: 80% dieu tri bao ton, 20% dieu tri b in g can thiep ngoai khoa nhUng cUc ky kho khan: keo lien tuc, co dinh ngoai va ket hdp xtfdng.
2. CO CHE CHAN THUONG VA PHAN LOAI
2.1. Nhac lai giai p h iu cua xtfdng chau (hinh 21.1)
- Xtfdng chau la mot xtfdng ldn cua cd the, khung xUdng chac, cac day chang khdp mu (phfa trtfdc) va day chang chau cung (phia sau) rat khoe.
- Xtfdng chau dtfdc cau tao bdi 3 xtfdng: xtfdng ngoi, xtfdng mu va xtfdng chau chung tao nen khung chau.
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- O khdp hang (o co'i) chia xtfdng chau ra 2 phan la cung trtfdc va cung sau + Xtfdng mu d phia trtfdc bao ve cac tang d tieu khung
+ Phan chau va xtfdng ngoi phia sau ngoai va phia sau tao nen mot khung chau vtfng chac
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+ O coi co hom khdp va 2 cot tru: cot tru trtfdc (cot chau mu, di qua phan trtfdc hom) va cot tru sau (cot chau ngoi, di qua phaa~sau hom).
Hinh 21.1. Giai ph iu khung chau (3 xi/dng tao nen khung chau)
2.2. Cd che' chan thifdng: Hieu dtidc cd che chan thUdng l i het stic quan trong giup hieu dtidc thtidng ton va dtia ra quyet dinh dieu tri dung din. hieu dtidc thtidng ton va dtia ra quyet dinh dieu tri dung din.
Cac cd che chin thtidng nhti sau:
• Ltfc tac dong trtfdc-sau: bi ep giita 2 toa tau, gitfa 2 oto...
- ThUdng ton rat nang ca cung trtfdc va cung sau
— Neu ltfc tac dong vao xtfdng mu se gay 4 nganh cua xtfdng mu
- Neu ltfc tac dong vao gai chau trtfdc tren thi khung chau se md ra nhtf quyen sach (hinh 21.2) kem theo toac khcip mu va toac hai khdp cung chau lam xoay mot nUa khung chau hay ca hai ben.
— Khi ltfc tac dong vao canh chau thi gay phoi hdp cac nganh xtfdng mu, toac khdp mu, gay ca xtfdng cting va xtfdng chau. Gay canh xtfdng cung (gay kieu V oillem ier (hinl*21.3), gay 2 nganh ngoi-m u, chau-m u va gay canh chau cting ben lam meo khung chau (gay kieu M algaigne hinh 21.4)
Hinh 21.2. Gay bijfa khung chau (kieu md quyen s&ch) Toac khdp cung -chau vd khdp mu
Hinh 21.3. Gay kieu Voillemier
(Phfa tri/dc: gay 2 nganh. Phia sau: gay cung chau)
Hinh 21.4. Gay Malgaigne
(Gay 2 nganh va canh chau cung ben di lech di len)
• Co ch i' ep ben: do tai nan giao thong, do bi ep vao tubng...
- Da phan la gay nhe, gay viing (hinh 21.5)
— Hay gap gay gap cac nganh cua cung trtfdc hoac cung sau
Hinh 21.5. Gay mot phan xtfdng chau (Gay vtfng)
• Ca c h e e p doc
- Thtfdng gap sau khi bi nga, dui thuc len khung cMu, gay nen gay xtfdng mu, toac khdp cung ch$u, gay xtfdng cung, gay canh chau. Loai nay rat khong viing. toac khdp cung ch$u, gay xtfdng cung, gay canh chau. Loai nay rat khong viing.
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