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Trường hợp lâm sàng: U cơ tuyến túi mật

Trường hợp lâm sàng: U cơ tuyến túi mật

20/11/2019 16:01:17 | 0 binh luận

Bệnh nhân nữ 37 tuổi, đi kiểm tra sức khỏe. Tiền căn: không có tiền căn bệnh lý Các xét nghiệm SGOT, SGPT, bilirubin, CTM, chức năng thận trong giới hạn bình thường
 Thai 18 tuần ở sừng chột của tử cung 1 sừng

Thai 18 tuần ở sừng chột của tử cung 1 sừng

15/06/2020 11:19:35 | 0 binh luận

A 18 WEEK OF GESTATIONAL AGE IN A NONCOMMUNICATING RUDIMENTARY HORN OF A UNICORNUATE UTERUS
Thai ngoài tử cung ở buồng trứng

Thai ngoài tử cung ở buồng trứng

15/06/2020 10:31:59 | 0 binh luận

Thai ngoài tử cung (TNTC) ở buồng trứng được mô tả đầu tiên bởi by Saint Maurice de Perigot vào năm 1682. TNTC ở buồng trứng là loại hiếm gặp nhất trong các thể TNTC với tần suất khoảng 1:3000-40.000 ca sinh sống và <3% các trường hợp TNTC [2]. TNTC ở buồng trứng có thể là thứ phát, do phôi làm tổ ở buồng trứng hoặc do thất bại trong việc thoát noãn. Bệnh cảnh lâm sàng của TNTC ở buồng trứng cũng tương tự như TNTC ở tai vòi: trễ kinh, đau bụng, ra huyết âm đạo bất thường, khối cạnh tử cung đau… Siêu âm chẩn đoán TNTC ở buồng trứng hiện nay vẫn là một thách thức vì hình ảnh trùng lấp khó phân biệt với TNTC ở tai vòi hay xuất huyết nang hoàng thể. Nội soi ổ bụng được xem là tiêu chuẩn vàng cho chẩn đoán và điều trị bệnh lý này. Từ khóa: Thai ngoài tử cung (ectopic pregnancy), thai ngoài tử cung ở buồng trứng (Ovarian ectopic pregnancy), nang hoàng thể (corpus luteum cyst)
Nhân một trường hợp chảy máu ổ bụng tự phát do tổn thương động mạch vị phải được chẩn đoán bằng chụp cắt lớp vi tính

Nhân một trường hợp chảy máu ổ bụng tự phát do tổn thương động mạch vị phải được chẩn đoán bằng chụp cắt lớp vi tính

31/03/2020 16:24:54 | 0 binh luận

Acute abdominal hemorrage by gastric atery aneurysm rupture- Case report SUMMARY We show the case of acute abdominal hemorrhage by gastric atery aneurysm rupture that was diagnosed and treated in Viet Tiep Hospital, Hai Phong. The female patient who was attended to hospital in acute lost blood volume. The patient was examined by US and abdominal CT scanner. The diagnosis was gastric atery aneurysm rupture. The patient was treated by surgery 4/5 gastroectomy because of gastric necrosis. In our experience, the large blood clot in lesser sac, increase arterial diameter and leak of contrast agent were suggested of diagnosis.
Đặc điểm lâm sàng, cận lâm sàng của các bệnh nhân ung thư tuyến giáp biệt hóa kháng I-131

Đặc điểm lâm sàng, cận lâm sàng của các bệnh nhân ung thư tuyến giáp biệt hóa kháng I-131

03/04/2020 16:45:03 | 0 binh luận

The clinical characteristics of rai refractory differentiated thyriod cancer SUMMARY Objectives: to determine clinical characteristics of RAI refractory differentiated thyroid carcinoma patients. Material and method s: 30 post-surgical and treated with I-131 differentiated thyroid carcinoma patients, diagnosed RAI refractory were enrolled in the study in 108 Military Centre Hospital from January 2017 to Jun 2017. Results : RAI refractory differentiated thyroid carcinoma has more frequently seen in middle aged, female patients (female to male ratio 3.2/1). Papillary and folicullar carcinoma represents 86.7% and 6.7% respectively. 40% of patients were in stage I and 53.4% in stage VI (AJCC7). The distant metastases were detected in 13.3% of patients. The median of time from initial diagnosis to RAI refractory were 21.5 months. I-131 treatment courses were 2.47 ± 1.13. The mean total dose was 301,8 mCi. 70% of the patients were in group I; 10% in group II and the rate of group III and IV were 6.7 and 13.3% respectively according to the ATA RAI refractory classification of DTC. 80% of patients had one RAI refractory lesion; 76.8% had metastasis in the neck lymph nodes and 16.7% had recurrent malignant lesions in the thyroid bed. Keywords : differentiated thyroid carcinoma, RAI refractory differentiated thyroid carcinoma.
Nhân một vài trường hợp điều trị viêm gân vôi hóa bằng chọc hút vôi dưới hướng dẫn siêu âm

Nhân một vài trường hợp điều trị viêm gân vôi hóa bằng chọc hút vôi dưới hướng dẫn siêu âm

05/12/2019 10:11:45 | 0 binh luận

Report of several cases of treatment of calcific tendonitis by aspiration under ultrasound guidance SUMMARY Calcific tendonitis is a common disease caused by the deposition of canxi hydroxyapatite crystals in the tendons. The disease can occur in all tendons in the body and also in the ligaments, but the most common sites are the tendons of rotator cuffs , tendons around great trochanter, tendons around elbow joints, wrists... Normally, there is no pain. However, as calcification resorption occurs because the body releases enzymes that resolve calcification, patients develop severe and persistent pain. In terms of diagnosis, clinical symptoms are quite difficult to distinguish from other causes of musculoskeletal pain, but diagnostic imaging is easy with methods such as radiography, ultrasound, computer tomography, resonance imaging... On the treatment side, medical therapy is the first-line treatment with nonsteroidal anti-inflammatory painkillers. However, in fact, we found that there are many cases of persistant pain that resistant to NSAIDS drugs, because the calcific deposits are quite large (size up to 1-2 cm) so that the calcification resorption process persists for a long time. Percutaneous aspiration of calcification under ultrasound guidance is a minimally invasive treatment that reduces the progression of the disease due to nearly completely calcific aspiration. This technique is quite easy to implement and can be widely disseminated. We have also performed this technique for some patients diagnosed with calcific tendonitis at Hanoi Medical University Hospital and had achieve good clinical efficacy.
Hiệu quả bước đầu điều trị nhân nóng tuyến giáp bằng phương pháp đốt sóng cao tần

Hiệu quả bước đầu điều trị nhân nóng tuyến giáp bằng phương pháp đốt sóng cao tần

17/03/2020 16:23:44 | 0 binh luận

Initial effectiveness of radiofrequency ablation of the autonomously functioning thyroid nodules SUMMARY Objective: Some patients with autonomously functioning thyroid nodules (AFTN) are not suitable for surgery or radioiodine therapy. Therefore, minimally invasive alternative treatments, such as ethanol ablation or radiofrequency ablation (RFA), are necessary. Methods: This study included seven patients (7 toxic and 10 pretoxic patients; male to female ratio = 1:7.5; mean age, 46.47 ± 13 (range, 22–66) years) who were not eligible for surgery or radioiodine therapy. All of the patients showed hot nodule with suppression of normal thyroid gland in 99mTc pertechnetate scintigraphy. RFA was performed using a 18 gauge internally cooled electrode. Nodule volume, thyroid function, scintigraphy, symptom score (visual analogue scale, 0–10cm), cosmetic grading score (4 point scale), and complications were evaluated before treatment and at 1, 3, 6 months follow-up. Results: Mean volume of the index nodule was 13.07 ± 8.44 (range, 2.2–35.5) mL. After RFA, The volume reduction at 1month, 3 months, 6 months follow up was 42.77 % , 63. % và 78.3 % . Initial mean T3, FT4, and TSH were 2.59 ± 1.19nmol/L, 16.3 ± 5.78pmol/L, and 0.101 ± 0.178 mU/mL, respectively. A significant improvement of mean T3, FT4, and TSH were observed after 1month (T3: 2.18 ± 0.753 nmol/L, p = 0.001; FT4: 14.78 ± 2.86 pmol/L, p = 0.026; TSH: 1.464 ± 0.844 mU/mL, p = 0.001), after 6 months (T3: 2.07 ± 0.614 nmol/L, p = 0.012; FT4: 15.12 ± 2.0 pmol/L, p = 0.001; TSH: 1.269 ± 0.398 mU/ mL, p < 0.001). After ablation, 16 patients became a cold or normal scan and one patient uptake similar normal thyroid tissue. After 6 months, the mean symptom was reduced from 3.47 ± 1.9 to 0.12± 3.32 (p = 0.001) and cosmetic grading score was reduced from từ 3.59 ± 1.1 tới 1.41± 0.712 (p = 0.712) (p <0.001). No major complications were encountered. Conclusions: RFA was effective and safe for treating autonomously functioning benign thyroid nodules and it might be recommended for treating hot benign thyroid nodules as the first-line treatment
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