{"id":13724,"date":"2025-09-15T16:33:54","date_gmt":"2025-09-15T16:33:54","guid":{"rendered":"https:\/\/vascularclinic.sg\/?p=13724"},"modified":"2025-09-30T15:34:05","modified_gmt":"2025-09-30T15:34:05","slug":"a-case-study-comparing-open-and-endovenous-therapy-for-varicose-veins","status":"publish","type":"post","link":"https:\/\/vascularclinic.sg\/vi\/a-case-study-comparing-open-and-endovenous-therapy-for-varicose-veins\/","title":{"rendered":"Nghi\u00ean c\u1ee9u tr\u01b0\u1eddng h\u1ee3p so s\u00e1nh ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb gi\u00e3n t\u0129nh m\u1ea1ch b\u1eb1ng ph\u1eabu thu\u1eadt m\u1edf v\u00e0 can thi\u1ec7p n\u1ed9i m\u1ea1ch"},"content":{"rendered":"
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G\u1ea7n \u0111\u00e2y, m\u1ed9t b\u1ec7nh nh\u00e2n nam 65 tu\u1ed5i \u0111\u1ebfn kh\u00e1m t\u1ea1i ph\u00f2ng kh\u00e1m c\u1ee7a t\u00f4i. \u00d4ng \u1ea5y \u0111\u1ebfn kh\u00e1m v\u1edbi tri\u1ec7u ch\u1ee9ng s\u01b0ng v\u00e0 \u0111au ng\u00e0y c\u00e0ng n\u1eb7ng \u1edf \u0111\u00f9i v\u00e0 b\u1eafp ch\u00e2n tr\u00e1i trong v\u00e0i th\u00e1ng qua. \u00d4ng c\u0169ng b\u1ecb gi\u00e3n t\u0129nh m\u1ea1ch \u1edf c\u00f9ng ch\u00e2n \u0111\u00f3 v\u00e0i n\u0103m nay v\u00e0 nh\u1eadn th\u1ea5y g\u1ea7n \u0111\u00e2y t\u00ecnh tr\u1ea1ng n\u00e0y tr\u1edf n\u00ean r\u00f5 r\u1ec7t h\u01a1n v\u00e0 nh\u1ee9c nh\u1ed1i khi \u0111\u1ee9ng v\u00e0 v\u1eadn \u0111\u1ed9ng. T\u1ea5t c\u1ea3 nh\u1eefng \u0111i\u1ec1u n\u00e0y \u0111\u00e3 \u1ea3nh h\u01b0\u1edfng \u0111\u00e1ng k\u1ec3 \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a \u00f4ng.<\/p>

Sau khi tr\u1ea3i qua qu\u00e1 tr\u00ecnh kh\u00e1m b\u1ec7nh s\u1eed k\u1ef9 l\u01b0\u1ee1ng, kh\u00e1m th\u1ef1c th\u1ec3 v\u00e0 si\u00eau \u00e2m Doppler m\u1ea1ch m\u00e1u v\u00f9ng ch\u00e2n tr\u00e1i, \u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc b\u1ec7nh van t\u0129nh m\u1ea1ch hi\u1ec3n d\u00e0i, d\u1eabn \u0111\u1ebfn m\u00e1u ch\u1ea3y ng\u01b0\u1ee3c v\u00e0o c\u00e1c t\u0129nh m\u1ea1ch gi\u00e3n \u1edf ch\u00e2n tr\u00e1i.<\/p>

\u00d4ng \u1ea5y t\u1eebng ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb gi\u00e3n t\u0129nh m\u1ea1ch \u1edf ch\u00e2n ph\u1ea3i c\u00e1ch \u0111\u00e2y 8 n\u0103m. Ca ph\u1eabu thu\u1eadt \u0111\u00f3 bao g\u1ed3m m\u1ed5 h\u1edf \u0111\u1ec3 th\u1eaft t\u0129nh m\u1ea1ch hi\u1ec3n th\u00f4ng qua m\u1ed9t v\u1ebft m\u1ed5 \u1edf h\u00e1ng, sau \u0111\u00f3 b\u00f3c t\u00e1ch to\u00e0n b\u1ed9 t\u0129nh m\u1ea1ch tr\u00ean \u0111\u00f9i th\u00f4ng qua m\u1ed9t v\u1ebft m\u1ed5 ri\u00eang \u1edf ph\u1ea7n \u0111\u00f9i d\u01b0\u1edbi. Tuy nhi\u00ean, ca ph\u1eabu thu\u1eadt \u0111\u00f3 \u0111\u00e3 \u0111\u1ec3 l\u1ea1i cho \u00f4ng \u1ea5y nhi\u1ec1u v\u1ebft b\u1ea7m t\u00edm v\u00e0 \u0111au nh\u1ee9c sau ph\u1eabu thu\u1eadt, c\u0169ng nh\u01b0 ch\u1ee9ng t\u00ea m\u1ea1n t\u00ednh \u1edf m\u1eb7t trong \u0111\u00f9i. Trong qu\u00e1 tr\u00ecnh t\u01b0 v\u1ea5n \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng gi\u00e3n t\u0129nh m\u1ea1ch hi\u1ec7n t\u1ea1i, \u00f4ng \u1ea5y r\u1ea5t lo l\u1eafng li\u1ec7u ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u01b0\u01a1ng t\u1ef1 c\u00f3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng hay kh\u00f4ng v\u00e0 li\u1ec7u \u00f4ng \u1ea5y c\u00f3 ph\u1ea3i \u0111\u1ed1i m\u1eb7t v\u1edbi nh\u1eefng bi\u1ebfn ch\u1ee9ng ti\u1ec1m \u1ea9n l\u00e2u d\u00e0i nh\u01b0 \u1edf ch\u00e2n ph\u1ea3i hay kh\u00f4ng.<\/p>

Sau khi \u0111\u01b0\u1ee3c tr\u1ea5n an v\u00e0 t\u01b0 v\u1ea5n, \u00f4ng \u0111\u00e3 tr\u1ea3i qua th\u1ee7 thu\u1eadt tri\u1ec7t t\u0129nh m\u1ea1ch n\u1ed9i m\u1ea1ch x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u \u0111\u1ed1i v\u1edbi t\u0129nh m\u1ea1ch hi\u1ec3n tr\u00e1i b\u1eb1ng c\u00e1ch k\u1ebft h\u1ee3p ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ed1t nhi\u1ec7t v\u00e0 x\u01a1 h\u00f3a b\u1eb1ng b\u1ecdt th\u00f4ng qua m\u1ed9t v\u1ebft ch\u00edch nh\u1ecf \u1edf c\u1eb3ng ch\u00e2n g\u1ea7n v\u00f9ng m\u1eaft c\u00e1 ch\u00e2n. Sau \u0111\u00f3, c\u00e1c t\u0129nh m\u1ea1ch gi\u00e3n r\u1ed9ng c\u1ee7a \u00f4ng \u0111\u00e3 \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf th\u00f4ng qua nhi\u1ec1u v\u1ebft r\u1ea1ch nh\u1ecf xung quanh v\u00f9ng \u0111\u00f9i v\u00e0 b\u1eafp ch\u00e2n. \u00d4ng \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n c\u00f9ng ng\u00e0y v\u00e0 2 tu\u1ea7n sau \u0111\u00f3, c\u00e1c v\u1ebft r\u1ea1ch \u0111\u00e3 l\u00e0nh v\u00e0 \u00f4ng kh\u00f4ng c\u00f2n tri\u1ec7u ch\u1ee9ng \u0111au, s\u01b0ng ho\u1eb7c t\u00ea, c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y v\u00e0 ch\u01a1i squash m\u00e0 kh\u00f4ng b\u1ecb \u0111au.<\/p>

Ph\u1eabu thu\u1eadt th\u1eaft t\u0129nh m\u1ea1ch hi\u1ec3n v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u1ed9i m\u1ea1ch (nh\u01b0 \u0111\u1ed1t laser ho\u1eb7c \u0111\u1ed1t s\u00f3ng cao t\u1ea7n) \u0111\u1ec1u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb gi\u00e3n t\u0129nh m\u1ea1ch, nh\u01b0ng ch\u00fang kh\u00e1c nhau \u0111\u00e1ng k\u1ec3 v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p v\u00e0 k\u1ebft qu\u1ea3. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u1ed9i m\u1ea1ch th\u01b0\u1eddng \u0111\u01b0\u1ee3c coi l\u00e0 \u00edt x\u00e2m l\u1ea5n h\u01a1n, th\u1eddi gian ph\u1ee5c h\u1ed3i nhanh h\u01a1n v\u00e0 \u00edt bi\u1ebfn ch\u1ee9ng h\u01a1n, trong khi ph\u1eabu thu\u1eadt th\u1eaft t\u0129nh m\u1ea1ch hi\u1ec3n, m\u1eb7c d\u00f9 hi\u1ec7u qu\u1ea3, nh\u01b0ng l\u1ea1i li\u00ean quan \u0111\u1ebfn th\u1eddi gian ph\u1ee5c h\u1ed3i l\u00e2u h\u01a1n v\u00e0 nguy c\u01a1 t\u00e1i ph\u00e1t cao h\u01a1n.<\/p>

D\u01b0\u1edbi \u0111\u00e2y, ch\u00fang t\u00f4i cung c\u1ea5p b\u1ea3n t\u00f3m t\u1eaft ng\u1eafn g\u1ecdn v\u00e0 so s\u00e1nh gi\u1eefa c\u00e1c y\u1ebfu t\u1ed1 sau: Ph\u1eabu thu\u1eadt n\u1ed9i m\u1ea1ch so v\u1edbi ph\u1eabu thu\u1eadt m\u1edf \u0111i\u1ec1u tr\u1ecb gi\u00e3n t\u0129nh m\u1ea1ch<\/a>:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Th\u1eaft v\u00e0 b\u00f3c t\u00e1ch t\u0129nh m\u1ea1ch hi\u1ec3n:<\/h3>

Th\u1ee7 t\u1ee5c<\/strong>:
Quy tr\u00ecnh n\u00e0y bao g\u1ed3m vi\u1ec7c r\u1ea1ch da \u1edf v\u00f9ng h\u00e1ng v\u00e0 c\u00f3 th\u1ec3 c\u1ea3 c\u00e1c v\u1ecb tr\u00ed kh\u00e1c d\u1ecdc theo ch\u00e2n \u0111\u1ec3 ti\u1ebfp c\u1eadn v\u00e0 bu\u1ed9c ch\u1ec9.
Th\u1eaft t\u0129nh m\u1ea1ch hi\u1ec3n, th\u01b0\u1eddng k\u00e8m theo \u0111\u00f3 l\u00e0 ph\u1eabu thu\u1eadt b\u00f3c t\u00e1ch (lo\u1ea1i b\u1ecf) t\u0129nh m\u1ea1ch.<\/p>

Hi\u1ec7u qu\u1ea3<\/strong>:
M\u1eb7c d\u00f9 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c lo\u1ea1i b\u1ecf tr\u00e0o ng\u01b0\u1ee3c \u1edf t\u0129nh m\u1ea1ch \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, c\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y t\u1ef7 l\u1ec7 t\u00e1i ph\u00e1t cao h\u01a1n.
so v\u1edbi c\u00e1c k\u1ef9 thu\u1eadt n\u1ed9i t\u0129nh m\u1ea1ch.<\/p>

S\u1ef1 h\u1ed3i ph\u1ee5c<\/strong>:
Th\u00f4ng th\u01b0\u1eddng, qu\u00e1 tr\u00ecnh h\u1ed3i ph\u1ee5c s\u1ebd k\u00e9o d\u00e0i h\u01a1n (1-3 tu\u1ea7n) v\u1edbi kh\u1ea3 n\u0103ng g\u00e2y \u0111au, b\u1ea7m t\u00edm v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c.
c\u00e1c hi\u1ec7u \u1ee9ng.<\/p>

Bi\u1ebfn ch\u1ee9ng<\/strong>:
C\u00f3 th\u1ec3 bao g\u1ed3m nhi\u1ec5m tr\u00f9ng, t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh v\u00e0 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u (DVT)<\/a>.<\/p>

C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u1ed9i t\u0129nh m\u1ea1ch \u2014 \u0111\u1ed1t nhi\u1ec7t, \u0111\u1ed1t b\u1eb1ng cyanoacrylate\/keo (CAG), \u0111\u1ed1t c\u01a1 h\u1ecdc k\u1ebft h\u1ee3p x\u01a1 h\u00f3a b\u1eb1ng b\u1ecdt (MOCA):<\/h3>

Th\u1ee7 t\u1ee5c<\/strong>:
M\u1ed9t ph\u01b0\u01a1ng ph\u00e1p x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u, trong \u0111\u00f3 nhi\u1ec7t \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng v\u00e0o t\u0129nh m\u1ea1ch (b\u1eb1ng laser ho\u1eb7c s\u00f3ng cao t\u1ea7n) \u0111\u1ec3 l\u00e0m t\u1eafc ngh\u1ebdn n\u00f3. Qu\u00e1 tr\u00ecnh n\u00e0y \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n th\u00f4ng qua m\u1ed9t v\u1ebft ch\u00edch nh\u1ecf, thay v\u00ec nh\u1eefng v\u1ebft r\u1ea1ch l\u1edbn.<\/p>

Hi\u1ec7u qu\u1ea3<\/strong>:
C\u00e1c nghi\u00ean c\u1ee9u bao g\u1ed3m d\u1eef li\u1ec7u d\u00e0i h\u1ea1n (>10 n\u0103m) cho th\u1ea5y t\u1ef7 l\u1ec7 \u0111\u00f3ng t\u0129nh m\u1ea1ch cao (90-100%) v\u00e0 c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng.<\/p>

S\u1ef1 h\u1ed3i ph\u1ee5c<\/strong>:
Th\u00f4ng th\u01b0\u1eddng, qu\u00e1 tr\u00ecnh n\u00e0y di\u1ec5n ra nhanh h\u01a1n (ch\u1ec9 v\u00e0i ng\u00e0y thay v\u00ec v\u00e0i tu\u1ea7n), \u00edt \u0111au h\u01a1n v\u00e0 nhanh ch\u00f3ng tr\u1edf l\u1ea1i ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng.
c\u00e1c ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng.<\/p>

Bi\u1ebfn ch\u1ee9ng<\/strong>:
M\u1eb7c d\u00f9 nh\u00ecn chung an to\u00e0n h\u01a1n, nh\u01b0ng c\u00e1c bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 bao g\u1ed3m \u0111au, b\u1ea7m t\u00edm, t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh v\u00e0 c\u1ee5c m\u00e1u \u0111\u00f4ng.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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T\u00d3M T\u1eaeT SO S\u00c1NH GI\u1eeeA PH\u01af\u01a0NG PH\u00c1P \u0110I\u1ec0U TR\u1eca GI\u00c3N T\u0128NH M\u1ea0CH M\u1ede V\u00c0 PH\u01af\u01a0NG PH\u00c1P \u0110I\u1ec0U TR\u1eca GI\u00c3N T\u0128NH M\u1ea0CH<\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Ph\u1ea7n k\u1ebft lu\u1eadn<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u1ed9i m\u1ea1ch ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng trong \u0111i\u1ec1u tr\u1ecb gi\u00e3n t\u0129nh m\u1ea1ch do t\u00ednh ch\u1ea5t \u00edt x\u00e2m l\u1ea5n, th\u1eddi gian ph\u1ee5c h\u1ed3i nhanh h\u01a1n v\u00e0 hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi ph\u1eabu thu\u1eadt m\u1edf. Tuy nhi\u00ean, ph\u1eabu thu\u1eadt th\u1eaft t\u0129nh m\u1ea1ch v\u1eabn l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn kh\u1ea3 thi, \u0111\u1eb7c bi\u1ec7t trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i m\u1ea1ch kh\u00f4ng ph\u00f9 h\u1ee3p ho\u1eb7c trong c\u00e1c t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng c\u1ee5 th\u1ec3 m\u00e0 ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u01b0\u1ee3c \u01b0u ti\u00ean h\u01a1n. Vi\u1ec7c l\u1ef1a ch\u1ecdn gi\u1eefa hai ph\u01b0\u01a1ng ph\u00e1p n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n sau khi tham kh\u1ea3o \u00fd ki\u1ebfn c\u1ee7a b\u00e1c s\u0129 chuy\u00ean khoa m\u1ea1ch m\u00e1u c\u00f3 tr\u00ecnh \u0111\u1ed9, c\u00e2n nh\u1eafc c\u00e1c y\u1ebfu t\u1ed1 v\u00e0 s\u1edf th\u00edch c\u00e1 nh\u00e2n c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

Recently a 65 year old gentleman was seen in my clinic. He had presented with a few month history of worsening swelling and aching in his left lower thigh and calf. He also had dilated varicose veins in the same leg for a few years and noted it had become more prominent and throbbed with…<\/p>","protected":false},"author":1,"featured_media":13727,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[8],"tags":[],"featured-on":[],"class_list":["post-13724","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-doctors-column"],"acf":[],"yoast_head":"\nA Case Study Comparing Open and Endovenous Therapy for Varicose Veins - The Vascular & Endovascular Clinic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/vascularclinic.sg\/vi\/a-case-study-comparing-open-and-endovenous-therapy-for-varicose-veins\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A Case Study Comparing Open and Endovenous Therapy for Varicose Veins - The Vascular & Endovascular Clinic\" \/>\n<meta property=\"og:description\" content=\"Recently a 65 year old gentleman was seen in my clinic. 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