{"id":267,"date":"2025-11-27T15:11:45","date_gmt":"2025-11-27T15:11:45","guid":{"rendered":"https:\/\/xuongkhopviet.vn\/?p=267"},"modified":"2025-11-27T15:13:39","modified_gmt":"2025-11-27T15:13:39","slug":"hoi-chung-lo-tu-giac-vung-vai","status":"publish","type":"post","link":"https:\/\/xuongkhopviet.vn\/?p=267","title":{"rendered":"H\u1ed8I CH\u1ee8NG L\u1ed6 T\u1ee8 GI\u00c1C V\u00d9NG VAI"},"content":{"rendered":"\n

H\u1ed9i ch\u1ee9ng l\u1ed7 t\u1ee9 gi\u00e1c (Quadrilateral Space Syndrome \u2013 QSS) l\u00e0 t\u00ecnh tr\u1ea1ng ch\u00e8n \u00e9p th\u1ea7n kinh n\u00e1ch (axillary nerve) v\u00e0\/ho\u1eb7c \u0111\u1ed9ng m\u1ea1ch m\u0169 c\u00e1nh tay sau (posterior circumflex humeral artery \u2013 PCHA) khi ch\u00fang \u0111i qua khoang t\u1ee9 gi\u00e1c \u1edf vai.T\u00ecnh tr\u1ea1ng n\u00e0y g\u00e2y \u0111au vai, y\u1ebfu c\u01a1, v\u00e0 \u0111\u00f4i khi r\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u v\u00f9ng vai\u2013c\u00e1nh tay.<\/p>\n\n\n\n

\ud83d\udd0d 1. Gi\u1ea3i ph\u1eabu l\u1ed7 t\u1ee9 gi\u00e1c (quadrilateral space)<\/strong><\/p>\n\n\n\n

 Khoang t\u1ee9 gi\u00e1c \u0111\u01b0\u1ee3c gi\u1edbi h\u1ea1n b\u1edfi:<\/p>\n\n\n\n

 Tr\u00ean: C\u01a1 tr\u00f2n b\u00e9 (teres minor)<\/p>\n\n\n\n

 D\u01b0\u1edbi: C\u01a1 tr\u00f2n l\u1edbn (teres major)<\/p>\n\n\n\n

 Trong: C\u01a1 tam \u0111\u1ea7u \u2013 \u0111\u1ea7u d\u00e0i (long head of triceps)<\/p>\n\n\n\n

 Ngo\u00e0i: X\u01b0\u01a1ng c\u00e1nh tay (humerus)<\/p>\n\n\n\n

\u0110i qua khoang n\u00e0y :<\/p>\n\n\n\n

 Th\u1ea7n kinh n\u00e1ch (axillary nerve)<\/p>\n\n\n\n

 \u0110\u1ed9ng m\u1ea1ch m\u0169 c\u00e1nh tay sau (PCHA)<\/p>\n\n\n\n

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

\u26a0\ufe0f 2. Nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p<\/strong><\/p>\n\n\n\n

Ho\u1ea1t \u0111\u1ed9ng tay qu\u00e1 \u0111\u1ea7u k\u00e9o d\u00e0i (b\u01a1i, tennis, b\u00f3ng ch\u00e0y, leo n\u00fai).<\/p>\n\n\n\n

Ch\u1ea5n th\u01b0\u01a1ng vai, tr\u1eadt kh\u1edbp vai.<\/p>\n\n\n\n

Ph\u00ec \u0111\u1ea1i c\u01a1, m\u00f4 s\u1eb9o, u nang.<\/p>\n\n\n\n

D\u00e0y bao kh\u1edbp ho\u1eb7c x\u01a1 h\u00f3a do vi\u00eam.<\/p>\n\n\n\n

\u00a0\ud83d\udccc 3. Tri\u1ec7u ch\u1ee9ng<\/strong><\/p>\n\n\n\n

\u0110au \u00e2m \u1ec9 \u1edf m\u1eb7t sau\u2013b\u00ean vai, t\u0103ng khi n\u00e2ng tay ho\u1eb7c xoay ngo\u00e0i.<\/strong><\/p>\n\n\n\n

\u0110au c\u00f3 th\u1ec3 lan xu\u1ed1ng c\u00e1nh tay tr\u00ean,hi\u1ebfm khi lan qu\u00e1 khu\u1ef7u.<\/p>\n\n\n\n

\u0110au v\u1ec1 \u0111\u00eam, nh\u1ea5t l\u00e0 n\u1eb1m nghi\u00eang b\u00ean \u0111au.<\/p>\n\n\n\n

Y\u1ebfu, \u0111\u00f4i khi teo c\u01a1 delta v\u00e0 c\u01a1 tr\u00f2n b\u00e9.<\/strong><\/p>\n\n\n\n

Gi\u1ea3m,m\u1ea5t c\u1ea3m gi\u00e1c v\u00f9ng da n\u1eb1m b\u00ean ngo\u00e0i m\u1ecfm c\u00f9ng vai<\/strong><\/p>\n\n\n\n

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

M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p gi\u1ea3m t\u01b0\u1edbi m\u00e1u khi \u0111\u01b0a tay qu\u00e1 \u0111\u1ea7u.<\/p>\n\n\n\n

 Tri\u1ec7u ch\u1ee9ng d\u1ec5 nh\u1ea7m v\u1edbi vi\u00eam xoay kh\u1edbp vai, vi\u00eam g\u00e2n c\u01a1 tr\u00ean gai, ho\u1eb7c ch\u00e8n \u00e9p th\u1ea7n kinh tr\u00ean vai.<\/p>\n\n\n\n

\ud83e\uddea 4. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n

 Kh\u00e1m l\u00e2m s\u00e0ng: \u0111au khi d\u1ea1ng tay, xoay ngo\u00e0i. Hornblower sign (+)<\/strong><\/p>\n\n\n\n

 MRI: lo\u1ea1i tr\u1eeb r\u00e1ch g\u00e2n, ph\u00e1t hi\u1ec7n teo c\u01a1 delta\/teres minor.<\/p>\n\n\n\n

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

Tho\u00e1i h\u00f3a m\u1ee1 C\u01a1 delta v\u00e0 c\u01a1 tr\u00f2n b\u00e9 trong h\u1ed9i ch\u1ee9ng l\u1ed7 t\u1ee9 gi\u00e1c<\/em><\/strong><\/p>\n\n\n\n

 Si\u00eau \u00e2m Doppler: \u0111\u00e1nh gi\u00e1 \u0111\u1ed9ng m\u1ea1ch PCHA.<\/p>\n\n\n\n

 EMG: x\u00e1c \u0111\u1ecbnh t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh n\u00e1ch.<\/p>\n\n\n\n

 Test phong b\u1ebf th\u1ea7n kinh n\u00e1ch gi\u00fap x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n.<\/p>\n\n\n\n

\ud83e\ude7a 5. \u0110i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n

\u0110i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n (\u0111a s\u1ed1 hi\u1ec7u qu\u1ea3):<\/p>\n\n\n\n

 Ngh\u1ec9 c\u00e1c ho\u1ea1t \u0111\u1ed9ng qu\u00e1 \u0111\u1ea7u.<\/p>\n\n\n\n

 V\u1eadt l\u00fd tr\u1ecb li\u1ec7u: Gi\u00e3n c\u01a1 tr\u00f2n l\u1edbn,tr\u00f2n b\u00e9,tam \u0111\u1ea7u. T\u0103ng s\u1ee9c m\u1ea1nh g\u00e2n ch\u00f3p xoay v\u00e0 c\u01a1 \u1ed5n \u0111\u1ecbnh vai.<\/p>\n\n\n\n

 Thu\u1ed1c gi\u1ea3m \u0111au \u2013 kh\u00e1ng vi\u00eam (n\u1ebfu c\u1ea7n).<\/p>\n\n\n\n

 Ti\u00eam corticosteroid t\u1ea1i khoang t\u1ee9 gi\u00e1c (ch\u1ec9 khi tri\u1ec7u ch\u1ee9ng k\u00e9o d\u00e0i).<\/p>\n\n\n\n

 Ph\u1eabu thu\u1eadt (hi\u1ebfm, khi b\u1ea3o t\u1ed3n kh\u00f4ng hi\u1ec7u qu\u1ea3 4\u20136 th\u00e1ng):<\/p>\n\n\n\n

 Gi\u1ea3i ph\u00f3ng khoang t\u1ee9 gi\u00e1c:Lo\u1ea1i b\u1ecf m\u00f4 x\u01a1, nang, u ch\u00e8n \u00e9p.<\/p>\n\n\n\n

\ud83e\udded 6. Ti\u00ean l\u01b0\u1ee3ng<\/strong><\/p>\n\n\n\n

N\u1ebfu \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 t\u1eadp ph\u1ee5c h\u1ed3i \u0111\u00fang, \u0111a s\u1ed1 b\u1ec7nh nh\u00e2n h\u1ed3i ph\u1ee5c t\u1ed1t v\u00e0 tr\u1edf l\u1ea1i ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao b\u00ecnh th\u01b0\u1eddng.<\/p>\n","protected":false},"excerpt":{"rendered":"

H\u1ed9i ch\u1ee9ng l\u1ed7 t\u1ee9 gi\u00e1c (Quadrilateral Space Syndrome \u2013 QSS) l\u00e0 t\u00ecnh tr\u1ea1ng ch\u00e8n \u00e9p th\u1ea7n kinh n\u00e1ch (axillary nerve) v\u00e0\/ho\u1eb7c \u0111\u1ed9ng m\u1ea1ch m\u0169 c\u00e1nh tay sau (posterior circumflex humeral artery \u2013 PCHA) khi ch\u00fang \u0111i qua khoang t\u1ee9 gi\u00e1c \u1edf vai.T\u00ecnh tr\u1ea1ng n\u00e0y g\u00e2y \u0111au vai, y\u1ebfu c\u01a1, v\u00e0 \u0111\u00f4i khi r\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u v\u00f9ng vai\u2013c\u00e1nh tay.<\/p>\n","protected":false},"author":1,"featured_media":268,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center 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