{"id":185,"date":"2025-11-27T07:27:58","date_gmt":"2025-11-27T07:27:58","guid":{"rendered":"https:\/\/xuongkhopviet.vn\/?p=185"},"modified":"2025-11-27T07:28:01","modified_gmt":"2025-11-27T07:28:01","slug":"dau-lung-cap","status":"publish","type":"post","link":"https:\/\/xuongkhopviet.vn\/?p=185","title":{"rendered":"\u0110AU L\u01afNG C\u1ea4P"},"content":{"rendered":"\n

\u0110au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng<\/strong> hay c\u00f2n g\u1ecdi l\u00e0 \u0111au l\u01b0ng v\u00f9ng th\u1ea5p (Low back pain) l\u00e0 h\u1ed9i ch\u1ee9ng do \u0111au khu tr\u00fa trong kho\u1ea3ng t\u1eeb ngang m\u1ee9c L1 \u0111\u1ebfn n\u1ebfp l\u1eb1n m\u00f4ng (c\u00f3 th\u1ec3 \u1edf m\u1ed9t b\u00ean ho\u1eb7c c\u1ea3 hai b\u00ean), \u0111\u00e2y l\u00e0 m\u1ed9t h\u1ed9i ch\u1ee9ng x\u01b0\u01a1ng kh\u1edbp hay g\u1eb7p nh\u1ea5t trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. Kho\u1ea3ng 65-80% nh\u1eefng ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh trong c\u1ed9ng \u0111\u1ed3ng c\u00f3 \u0111au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng (CSTL) c\u1ea5p t\u00ednh ho\u1eb7c t\u1eebng \u0111\u1ee3t m\u1ed9t v\u00e0i l\u1ea7n trong cu\u1ed9c \u0111\u1eddi v\u00e0 kho\u1ea3ng 10% s\u1ed1 n\u00e0y b\u1ecb chuy\u1ec3n th\u00e0nh \u0111au CSTL m\u1ea1n t\u00ednh.<\/p>\n\n\n\n

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

NGUY\u00caN NH\u00c2N<\/strong>

1. \u0110au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng do nguy\u00ean nh\u00e2n c\u01a1 h\u1ecdc<\/strong>

Nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn do c\u0103ng gi\u00e3n c\u01a1, d\u00e2y ch\u1eb1ng c\u1ea1nh c\u1ed9t s\u1ed1ng qu\u00e1 m\u1ee9c; tho\u00e1i h\u00f3a \u0111\u0129a \u0111\u1ec7m c\u1ed9t s\u1ed1ng; tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m CSTL; tr\u01b0\u1ee3t th\u00e2n \u0111\u1ed1t s\u1ed1ng, d\u1ecb d\u1ea1ng th\u00e2n \u0111\u1ed1t s\u1ed1ng (c\u00f9ng h\u00f3a th\u1eaft l\u01b0ng 5, th\u1eaft l\u01b0ng h\u00f3a c\u00f9ng 1\u2026), lo\u00e3ng x\u01b0\u01a1ng nguy\u00ean ph\u00e1t…\u00a0Lo\u1ea1i n\u00e0y di\u1ec5n bi\u1ebfn l\u00e0nh t\u00ednh, chi\u1ebfm 90% s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111au CSTL.<\/p>\n\n\n\n


2. \u0110au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng do m\u1ed9t b\u1ec7nh to\u00e0n th\u00e2n (\u0110au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng \u201ctri\u1ec7u ch\u1ee9ng\u201d)<\/strong>

\u0110au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng l\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a m\u1ed9t trong c\u00e1c b\u1ec7nh kh\u1edbp m\u1ea1n t\u00ednh (Vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp, Vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p, lo\u00e3ng x\u01b0\u01a1ng); ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng t\u1ea1i c\u1ed9t s\u1ed1ng do nguy\u00ean nh\u00e2n nhi\u1ec5m khu\u1ea9n (vi\u00eam \u0111\u0129a \u0111\u1ec7m \u0111\u1ed1t s\u1ed1ng do vi khu\u1ea9n lao ho\u1eb7c vi khu\u1ea9n sinh m\u1ee7); do ung th\u01b0; do c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c (s\u1ecfi th\u1eadn, lo\u00e9t h\u00e0nh t\u00e1 tr\u00e0ng, b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng, u x\u01a1 tuy\u1ebfn ti\u1ec1n li\u1ec7t\u2026), t\u1ed5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng do ch\u1ea5n th\u01b0\u01a1ng…<\/p>\n\n\n\n

TRI\u1ec6U CH\u1ee8NG<\/strong>

– \u0110au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng do nguy\u00ean nh\u00e2n c\u01a1 h\u1ecdc<\/em><\/strong>

+ \u0110au CSTL do c\u0103ng gi\u00e3n d\u00e2y ch\u1eb1ng qu\u00e1 m\u1ee9c: \u0111au xu\u1ea5t hi\u1ec7n \u0111\u1ed9t ng\u1ed9t sau b\u00ea v\u1eadt n\u1eb7ng, sau ho\u1ea1t \u0111\u1ed9ng sai t\u01b0 th\u1ebf (lao \u0111\u1ed9ng ch\u00e2n tay k\u00e9o d\u00e0i, \u0111i gu\u1ed1c cao g\u00f3t\u2026), rung x\u00f3c do \u0111i xe \u0111\u01b0\u1eddng d\u00e0i, sau nhi\u1ec5m l\u1ea1nh ho\u1eb7c sau m\u1ed9t c\u1eed \u0111\u1ed9ng \u0111\u1ed9t ng\u1ed9t. \u0110au th\u01b0\u1eddng k\u00e8m theo co c\u1ee9ng kh\u1ed1i c\u01a1 c\u1ea1nh c\u1ed9t s\u1ed1ng, t\u01b0 th\u1ebf c\u1ed9t s\u1ed1ng b\u1ecb l\u1ec7ch v\u1eb9o m\u1ea5t \u0111\u01b0\u1eddng cong sinh l\u00fd, khi th\u1ea7y thu\u1ed1c \u1ea5n ng\u00f3n tay d\u1ecdc c\u00e1c m\u1ecfm gai sau ho\u1eb7c v\u00e0o khe li\u00ean \u0111\u1ed1t \u1edf hai b\u00ean c\u1ed9t s\u1ed1ng c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c \u0111i\u1ec3m \u0111au..C\u01a1n \u0111au c\u00f3 th\u1ec3 khi\u1ebfn b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u1ee9ng th\u1eb3ng \u0111\u01b0\u1ee3c,kh\u00f3 kh\u0103n khi di chuy\u1ec3n,v\u1eb7n m\u00ecnh,khi ngh\u1ec9 ng\u01a1i c\u01a1n \u0111au c\u00f3 th\u1ec3 gi\u1ea3m d\u1ea7n.

+ Tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng: th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n c\u1ee7a \u0111au th\u1ea7n kinh t\u1ecda. Ng\u01b0\u1eddi b\u1ec7nh \u0111au lan t\u1eeb c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng lan xu\u1ed1ng m\u00f4ng, ph\u00eda sau ngo\u00e0i \u0111\u00f9i, m\u1eb7t tr\u01b0\u1edbc b\u00ean c\u1eb3ng ch\u00e2n, m\u1eaft c\u00e1 ngo\u00e0i, qua mu ch\u00e2n t\u1edbi ng\u00f3n I n\u1ebfu b\u1ecb ch\u00e8n \u00e9p \u1edf L5. N\u1ebfu t\u1ed5n th\u01b0\u01a1ng \u1edf S1, \u0111au lan xu\u1ed1ng m\u1eb7t sau \u0111\u00f9i, c\u1eb3ng ch\u00e2n, g\u00e2n Achille, m\u1eaft c\u00e1 ngo\u00e0i qua b\u1edd ngo\u00e0i gan ch\u00e2n t\u1edbi ng\u00f3n V. \u0110\u00f4i khi c\u00f3 r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c n\u00f4ng: c\u1ea3m gi\u00e1c t\u00ea b\u00ec, ki\u1ebfn b\u00f2, kim ch\u00e2m\u2026 
<\/em><\/strong><\/p>\n\n\n\n

– \u0110au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng do m\u1ed9t b\u1ec7nh to\u00e0n th\u00e2n<\/em><\/strong>

Trong tr\u01b0\u1eddng h\u1ee3p \u0110au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng l\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a m\u1ed9t b\u1ec7nh to\u00e0n th\u00e2n, ng\u01b0\u1eddi b\u1ec7nh th\u01b0\u1eddng c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c k\u00e8m theo nh\u01b0: s\u1ed1t, d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng th\u01b0\u1eddng g\u1eb7p do nguy\u00ean nh\u00e2n nhi\u1ec5m khu\u1ea9n; g\u1ea7y, s\u00fat c\u00e2n nhanh, \u0111au ng\u00e0y c\u00e0ng t\u0103ng, kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c ch\u1ed1ng vi\u00eam gi\u1ea3m \u0111au th\u00f4ng th\u01b0\u1eddng l\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd nguy\u00ean nh\u00e2n l\u00e0 ung th\u01b0; tr\u01b0\u1eddng h\u1ee3p \u0111au th\u1eaft l\u01b0ng d\u1eef d\u1ed9i ng\u00e0y c\u00e0ng t\u0103ng k\u00e8m theo d\u1ea5u hi\u1ec7u s\u1ed1c (shock), da xanh thi\u1ebfu m\u00e1u n\u00ean nghi ng\u1edd ph\u00ecnh t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng\u2026Khi c\u00f3 d\u1ea5u hi\u1ec7u hi\u1ec7u ch\u1ec9 \u0111i\u1ec3m c\u1ee7a m\u1ed9t b\u1ec7nh to\u00e0n th\u00e2n li\u00ean quan \u0111\u1ebfn \u0111au v\u00f9ng th\u1eaft l\u01b0ng, th\u1ea7y thu\u1ed1c c\u1ea7n h\u01b0\u1edbng d\u1eabn ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ebfn c\u00e1c c\u01a1 s\u1edf chuy\u00ean khoa th\u1ef1c hi\u1ec7n c\u00e1c x\u00e9t nghi\u1ec7m, th\u0103m d\u00f2 chuy\u00ean s\u00e2u \u0111\u1ec3 t\u00ecm nguy\u00ean nh\u00e2n.

M\u1ed9t s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 nguy\u00ean nh\u00e2n do t\u00e2m l\u00fd: d\u1ea5u hi\u1ec7u \u0111au th\u1eaft l\u01b0ng xu\u1ea5t hi\u1ec7n sau c\u00e1c stress do \u00e1p l\u1ef1c c\u1ee7a t\u00e2m l\u00fd ho\u1eb7c lao \u0111\u1ed9ng th\u1ec3 l\u1ef1c qu\u00e1 s\u1ee9c, sau \u0111\u00f3 chuy\u1ec3n th\u00e0nh \u0111au th\u1eaft l\u01b0ng m\u1ea1n t\u00ednh dai d\u1eb3ng. Tuy nhi\u00ean, th\u1ea7y thu\u1ed1c c\u1ea7n lo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh th\u1ef1c th\u1ec3 g\u00e2y \u0111au th\u1eaft l\u01b0ng tr\u01b0\u1edbc khi ch\u1ea9n \u0111o\u00e1n \u0111au do nguy\u00ean nh\u00e2n t\u00e2m l\u00fd.<\/p>\n\n\n\n

C\u1eacN L\u00c2M S\u00c0NG<\/strong><\/p>\n\n\n\n

\u0110au c\u1ed9t s\u1ed1ng do nguy\u00ean nh\u00e2n c\u01a1 h\u1ecdc chi\u1ebfm \u0111\u1ebfn 90% c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111au th\u1eaft l\u01b0ng c\u1ea5p.Ph\u1ea7n l\u1edbn h\u00ecnh \u1ea3nh Xquang b\u00ecnh th\u01b0\u1eddng ho\u1eb7c c\u00f3 tho\u00e1i h\u00f3a,x\u00e9t nghi\u1ec7m y\u1ebfu t\u1ed1 vi\u00eam v\u00e0 canxi phospho trong m\u00e1u b\u00ecnh th\u01b0\u1eddng.MRI ch\u1ea9n \u0111o\u00e1n b\u1ec7nh l\u00fd \u0111\u0129a \u0111\u1ec7m n\u1ebfu nh\u01b0 c\u00f3 tri\u1ec7u ch\u1ee9ng ch\u00e8n \u00e9p r\u1ec5 th\u1ea7n kinh<\/p>\n\n\n\n

\"8131
H\u00ecnh \u1ea3nh gai x\u01b0\u01a1ng do tho\u00e1i h\u00f3a \u0111\u1ed1t s\u1ed1ng th\u1eaft l\u01b0ng tr\u00ean Xquang<\/em><\/strong><\/figcaption><\/figure>\n\n\n\n

\u0110au c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng do b\u1ec7nh l\u00fd to\u00e0n th\u00e2n c\u1ea7n l\u00e0m x\u00e9t nghi\u1ec7m chuy\u00ean s\u00e2u t\u00f9y theo nguy\u00ean nh\u00e2n.<\/p>\n\n\n\n

\u0110I\u1ec0U TR\u1eca<\/strong><\/p>\n\n\n\n

– Ngh\u1ec9 ng\u01a1i tuy\u1ec7t \u0111\u1ed1i<\/p>\n\n\n\n

– Ch\u00e2m c\u1ee9u<\/p>\n\n\n\n

– Ch\u01b0\u1eddm l\u1ea1nh trong 72h \u0111\u1ea7u gi\u00fap gi\u1ea3m s\u01b0ng \u0111au nh\u1ea5t l\u00e0 \u0111au th\u1eaft l\u01b0ng c\u1ea5p sau ch\u1ea5n th\u01b0\u01a1ng,ng\u00e0y ch\u01b0\u1eddm 3 l\u1ea7n,m\u1ed7i l\u1ea7n 20 ph\u00fat<\/p>\n\n\n\n

– Ch\u01b0\u1eddm \u1ea5m sau 72h gi\u00fap gi\u00e3n c\u01a1,l\u01b0u th\u00f4ng m\u00e1u:ng\u00e0y ch\u01b0\u1eddm 3 l\u1ea7n,m\u1ed7i l\u1ea7n 20 ph\u00fat>ch\u01b0\u1eddm b\u1eb1ng t\u00fai ch\u01b0\u1eddm \u1ea5m ho\u1eb7c l\u1ea5y chai th\u1ee7y tinh \u0111\u1ef1ng n\u01b0\u1edbc 70 \u0111\u1ed9 b\u1ecdc v\u1ea3i r\u1ed3i ch\u01b0\u1eddm.<\/p>\n\n\n\n

– M\u00e1t xa:L\u1ef1c t\u00e1c \u0111\u1ed9ng t\u1eeb b\u00e0n tay l\u00ean l\u01b0ng c\u00f3 th\u1ec3 gi\u00fap ng\u01b0\u1eddi b\u1ec7nh l\u01b0u th\u00f4ng kinh m\u1ea1ch, kh\u00ed huy\u1ebft, th\u01b0 gi\u00e3n c\u1ed9t s\u1ed1ng, c\u01a1 v\u00e0 c\u00e1c d\u00e2y th\u1ea7n kinh, qua \u0111\u00f3 ch\u1eefa l\u00e0nh c\u00e1c t\u1ed5n th\u01b0\u01a1ng v\u00e0 c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng \u0111au nh\u1ee9c \u1edf l\u01b0ng. Massage ph\u00f9 h\u1ee3p cho ng\u01b0\u1eddi b\u1ec7nh \u0111au l\u01b0ng do l\u00e0m vi\u1ec7c qu\u00e1 s\u1ee9c, ng\u1ed3i sai t\u01b0 th\u1ebf, c\u0103ng c\u01a1.<\/p>\n\n\n\n

– Kh\u00f4ng d\u00f9ng r\u01b0\u1ee3u bia ch\u1ea5t k\u00edch th\u00edch,h\u1ea1n ch\u1ebf ch\u1ea5t b\u00e9o-ki\u1ec3m so\u00e1t c\u00e2n n\u1eb7ng<\/p>\n\n\n\n

– S\u1eed d\u1ee5ng thu\u1ed1c: thu\u1ed1c gi\u1ea3m \u0111au,thu\u1ed1c kh\u00e1ng vi\u00eam nonsteroid,thu\u1ed1c gi\u1ea3m \u0111au th\u1ea7n kinh nh\u01b0 gabapentin,pregabalin,c\u00e1c thu\u1ed1c gi\u00e3n c\u01a1.B\u1ec7nh nh\u00e2n \u0111au l\u01b0ng nghi\u00eam tr\u1ecdng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00e2m l\u00fd v\u00e0 gi\u1ea5c ng\u1ee7 ho\u1eb7c \u0111au l\u01b0ng do c\u0103ng th\u1eb3ng c\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c tr\u1ea7m c\u1ea3m nh\u01b0 amitriptylin 25 mg.<\/p>\n\n\n\n

Ti\u00eam corticoid c\u1ea1nh c\u1ed9t s\u1ed1ng ho\u1eb7c ti\u00eam m\u1ecfm gai n\u1ebfu \u0111i\u1ec1u tr\u1ecb thu\u1ed1c k\u00e9m \u0111\u00e1p \u1ee9ng,ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111em l\u1ea1i hi\u1ec7u qu\u1ea3 r\u00f5 r\u1ec7t.<\/p>\n\n\n\n

– Ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111au th\u1eaft l\u01b0ng do tho\u00e1t v\u1ecb \u0111\u0129a \u0111\u1ec7m ho\u1eb7c k\u00e8m tr\u01b0\u1ee3t \u0111\u1ed1t s\u1ed1ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa t\u00edch c\u1ef1c trong ba th\u00e1ng nh\u01b0ng kh\u00f4ng \u0111\u1ea1t hi\u1ec7u qu\u1ea3, \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p \u0111au nhi\u1ec1u, c\u00f3 d\u1ea5u hi\u1ec7u \u00e9p r\u1ec5 n\u1eb7ng (teo c\u01a1 nhanh, r\u1ed1i lo\u1ea1n c\u01a1 tr\u00f2n, r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c).<\/p>\n\n\n\n

PH\u00d2NG B\u1ec6NH<\/strong><\/p>\n\n\n\n

    \n
  • Duy tr\u00ec th\u00f3i quen r\u00e8n luy\u1ec7n th\u1ec3 ch\u1ea5t m\u1ed7i ng\u00e0y \u0111\u1ec3 t\u0103ng \u0111\u1ed9 ch\u1eafc kh\u1ecfe v\u00e0 linh ho\u1ea1t cho h\u1ec7 c\u01a1 x\u01b0\u01a1ng kh\u1edbp.B\u01a1i l\u1ed9i h\u00e0ng tu\u1ea7n l\u00e0 m\u00f4n th\u1ec3 thao r\u1ea5t c\u00f3 \u00edch cho c\u1ed9t s\u1ed1ng.<\/li>\n\n\n\n
  • \u0110\u1ea3m b\u1ea3o ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng c\u00e2n \u0111\u1ed1i.<\/li>\n\n\n\n
  • H\u1ea1n ch\u1ebf t\u00ecnh tr\u1ea1ng l\u00e0m vi\u1ec7c v\u00e0 v\u1eadn \u0111\u1ed9ng g\u1eafng s\u1ee9c, \u0111\u1eb7c bi\u1ec7t l\u00e0 ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed \u0111au l\u01b0ng c\u1ea5p.<\/li>\n\n\n\n
  • \u0110\u1ea3m b\u1ea3o t\u01b0 th\u1ebf \u0111\u00fang trong lao \u0111\u1ed9ng, h\u1ecdc t\u1eadp, t\u1eadp th\u1ec3 d\u1ee5c th\u1ec3 thao.<\/li>\n\n\n\n
  • Lu\u00f4n kh\u1edfi \u0111\u1ed9ng tr\u01b0\u1edbc khi v\u1eadn \u0111\u1ed9ng m\u1ea1nh, ch\u01a1i th\u1ec3 thao.<\/li>\n\n\n\n
  • B\u1ecf h\u00fat thu\u1ed1c l\u00e1.<\/li>\n\n\n\n
  • H\u1ea1n ch\u1ebf mang gi\u00e0y cao g\u00f3t.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

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