Thoai hoa cot song Nhung dieu can biet

Tags: BS Vo Van Thanh, A Benh, dieu can biet, Than Dot Song, gai cot song, duoi that lung, thoai hoa, dia dem, benh ly, chan doan, tu the, khac nhau, co, vung, moi


Thoai hoa cot song Nhung dieu can biet
Mot ca mo cot song
PGS. TS. BS Vo Van Thanh , truong khoa cot song A Benh vien Chan thuong chinh hinh TP.HCM, cho biet: Chung ta can phan biet thoai hoa cot song o co, lung hay that lung. O ba vung benh, tinh chat khac nhau. Luu y la o nhung vung nao co dia dem (co, lung, that lung) moi co van de thoai hoa cot song, con o vung xuong thieng (tu duoi that lung xuong - dinh thanh khoi, khong dia dem), xuong cut khong co thoai hoa cot song.

* Nguyen nhan chinh cua benh tu dau?

- Hien nay chung ta chua co mot thong ke chinh xac de noi ve ti le mac benh thoai hoa cot song, tuy nhien day la mot benh ly cot song rat pho bien, chiem khoang tren 60% benh ly chinh hinh cot song. Thuong sau tuoi 40 tro di, cang lon tuoi benh cang xay ra nhieu hon, co nhung nguoi thoat vi dia dem o tuoi 30-40,thoai hoa than dot song o tuoi 50-60. Nguyen nhan chinh la do su lao hoa.

Co the co nhung tac dong, yeu to khac nhau khien benh ly phat trien som hoac muon, nhu lao dong nang nhoc qua muc luc con tre, hoac su thieu van dong, khong huan luyen co bap (co bung, co that lung) de chiu luc, cac tu the sai cua co, lung, that lung trong sinh hoat hang ngay lam phat trien nhanh tien trinh lao hoa.

Thoai hoa cot song Nhung dieu can biet
PGS. TS. BS Vo Van Thanh
* Lam viec van phong ngoi nhieu co de mac benh?

- Nhung nguoi lao dong van phong nen ngoi tu the dung, phai co lung ghe tua va hoi nho ra ngay that lung, ngoi dau goi hoi cao hon hang mot chut la tot. Sau 45 phut den mot gio can lam nhung dong tac the duc nhe nhang.

Nguoi lai xe duong dai sau khoang hai gio phai nghi ngoi 10-15 phut de tap co co, co lung thi lam viec moi lau ben duoc.

Nhung nguoi buon ganh ban bung, khuan vac phai than trong, khong lam viec qua muc. Co nhung thanh nien y suc khuan vac 50-70kg la khong hop ly, chua ke tu the khong dung, nhung yeu to rui ro lam nang them tien trinh lao hoa. Lam nang sai tu the cung thuc day tien trinh thoai hoa cot song, thoai hoa dia dem tang len.

Tom lai, phai phong ngua bang cach biet tu the dung khi lam viec nang va lam viec thoi gian dai. Tuy giua ly thuyet va thuc hien tren thuc te co khoang cach, nhung chung ta can biet de tranh nhung dong tac sai.

* Thua bac si, doi voi hoc sinh lam the nao de co duoc tu the dung voi ban ghe hien nay?

- Phai co nhung kieu mau ban ghe phu hop tung lua tuoi khac nhau. Tre cao lon ma ngoi ban qua thap se bi veo cot song, nguoc lai be thap ma ban qua cao, phai nieng co dan den cac tu the co sai.

* Bac si co the gioi thieu mot so sai lam trong chan doan?

- Nhieu nguoi khi di kham benh cam theo phim X-quang va cho rang bi gai cot song nen gay dau. Day la mot sai lam trong chan doan. Nhung bieu hien gai cot song chi la mot trong cac trieu chung nghi den thoai hoa cot song giai doan som, nhung gai cot song khong phai la nguyen nhan chu yeu gay ra dau trong giai doan nay.

Van de chinh la phai chan doan cho duoc co hay khong co thoai hoa cot song. Can phai chan doan ro rang cac loai benh ly thoai hoa khac nhau (thoai than dot song, thoai hoa dia dem, thoai hoa khoi mau khop...), tang benh khac nhau (co, lung, that lung).

* Nhieu nguoi nghe quang cao va chi hang chuc trieu dong de dieu tri thoai hoa cot song voi phuong phap moi - giam ap bang laser. Day co phai la phuong phap toi uu?

- Hau nhu phuong phap giam ap bang laser khong nen ap dung cho cac benh ly thoai hoa cot song. Mot so it truong hop thoat vi dia dem nhe, chua pha rach day chang doc sau, co the duoc ap dung mot cach than trong phuong phap nay. Cac truong hop thoat vi dia dem nang gay dau than kinh toa, co bieu hien tren hinh anh cong huong tu (MRI) su xe rach day chang doc sau hay khoi thoat vi lot vao ong song thi chi dinh phau thuat it xam nhap la phu hop nhat.

* Co khi nao bi thoai hoa cot song ma bac si chan doan nham dau day than kinh toa, uong thuoc thoi gian dai khong khoi ?

- Dau than kinh toa chi la mot trieu chung cua nhieu nhom benh khac nhau: thoat vi dia dem, thoai hoa cot song, hep ong song that lung, viem re than kinh toa hay do buou chen ep vung that lung... Vi vay phai chan doan chinh xac. Neu chan doan ra nguyen nhan, can phau thuat thi phai tien hanh phau thuat moi giai quyet van de duoc.

Con neu la dang man tinh (benh ly thoai hoa khoi mau khop, benh ly hep ong song that lung, benh ly thoai hoa than dot song, loi dia dem...) moi dung thuoc lau dai truoc khi quyet dinh phau thuat.

* Neu den mot co so y te, bac si cho chup MRI ngay de chan doan, co hop ly khong ?

- Voi su tham kham lam sang can than va hinh anh X-quang thuong qui ro (neu duoc, nen chup X-quang thuong qui ky thuat so) da du huong den chan doan chinh xac co hay khong co thoai hoa cot song de bat dau huong dan dieu tri bao ton trong da so truong hop.

Chi khi nao benh nhan co cac trieu chung bieu hien benh ly re than kinh, benh ly tuy co hay lung moi nen chup MRI de quyet dinh huong dieu tri phau thuat. Khong nen cho chi dinh chup ngay MRI ma khong qua X-quang thuong qui neu khong thay cac trieu chung benh ly nang.

* Xin cam on bac si.

KIM SON

Viet Bao

Tìm hiểu: BS Vo Van Thanh, A Benh, dieu can biet, Than Dot Song, gai cot song, duoi that lung, thoai hoa, dia dem, benh ly, chan doan, tu the, khac nhau, co, vung, moi

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