,

.
BOYTE CONG HOA xA HOI cnu NGHiA VIET NAM
. . .
DQc l~p - TV do - H~nh phuc

86: 2212019/TT-BYT tt« N(>i,ngay 28 thang 8 ndm 2019

THONGTU
Quy djnh tY l~ phin tram tAn thirong CO' th~
sir dung trong giam djnh phap y, giam djnh phap y tam thin

Can ctr Ludt giam dinh tuphap s613120121QH13 ngay 20 thdng 6 ndm 2012;
Can cu Nghi dinh s6 7512017IND-CP ngay 20 thdng 6 ndm 2017 cua Chinh
phu quy dinh chuc nang, nhiem v¥, quyen han va co cdu t6 chuc cua B(>Y ti;
Thea ad nghi cua Cue truong Cue Quan If;Khdm, chua benh,
B(>truong B(>Y ti ban hanh Thong tu quy dinn tY I¢phdn tram t6n thuang
co thd sic dung trong gidm dinh phap y, giam dinh phdp y tam thdn.

Di~u 1. Ty l~ phin tram tAn thuong CO' th~

Ban hanh kern thea Thong tu nay bang tY 1~phan tram tim thirong co thS
hay t6n hai sire khoe sau day duoc gQi chung la ty 1~phAn tram t6n thuang ca
thS (sau day viSt t~t la ty 1~ % TTCT) sir d\mg trong giam dinh phap y, giam
dinh phap y tam thAn, bao g6m:
1. Bang 1: Ty 1~% TTCT do thuang tich sir d\mg trong giam dinh phap y;
2. Bang 2: Ty 1~% TTCT do b~nh, t~t sir dVng trong giam dinh phap y;
3. Bang 3: Ty 1~ % TTCT do di chUng r6i lo~n tam thAn va hanh vi sau
ch~n thuang, vSt thuang SQnao sir dVng trong giam dinh phap y tam thAn;
4. Bang 4: Ty 1~ % TTCT do b~nh r6i lo~n tam thAn va hanh vi sir dvng
trong giam dinh phap y.
Di~u 2. Nguyen t~c giam djnh
1. Giam dinh dS xac dinh ty 1~% TTCT phai duQ'c th\fc hi~n tren nguai cAn
.giam dinh, trir truang hqp duQ'cquy dinh t~i Khoan 2 Di8u nay.
2. Giam dinh dS xac dinh ty 1~% TTCT duQ'c th\fc hi~n tren h6 sa trong
truang hqp nguai cAn giam dinh da bi chSt ho~c bi m~t tich ho~c cac truang hqp
khac thea quy dinh cua phap lu~t.
Khi giam dinh tren h6 sa, ty l~ % TTCT duQ'cxac dinh (] muc th~p nh~t cua
khung tY l~ tuang Ung v6i cac tY 1~% TTCT.
3. Ty 1~% TTCT duQ'cxac dinh t~i thai diSm giam dinh.
_.
2

f)i~u 3. Nguyen t~c xac djnh tY l~ ph~n tram tAn thurrng CO'th~
1. T6ng ty l~ % TTCT cua mot ngiroi phai nho hon 100%.
2. M6i b(>phan co thS bi t6n thuong chi duoc tinh tY l~ % TTCT mot lfuI.
Truong hQ'Pb(>phan nay bi t6n thuong nhung gay bien chung, di clnrng sang b(>
phan thir hai da:duoc xac dinh thi tinh them tY l~ % TTCT do bien chirng, di chimg
a
t6n thuong b(>phan thir hai.
3. NSu nhieu TTCT hi trieu clnrng thuoc mot hoi clnrng hoac thuoc mot benh
da:duoc ghi trong cac Bang ty l~ % TTCT thi ty l~ % TTCT duoc xac dinh thea
h(>ichirng hoac thea benh do.
4. Khi tinh ty l~ % TTCT chi l~y dSn hai chfr s6 hang thap phan, o kSt qua
cu6i cung thi lam tron dS co t6ng ty l~ % TTCT la s6 nguyen (nSu s6 hang th?p
phan b~ng ho?c Ian hon 0,5 thi lam trcm s6 thanh 01 don YD.
5. Khi tinh ty l~ % TTCT cua m(>tb(>ph?n co thS co tinh ch~t d6i xUng, hi~p
d6ng chuc nang rna m(>tben bi t6n thuang ho?c b~nh ly co s~n da:duQ'cxac dinh,
thi tinh ca tY l~ % TTCT d6i vai b(>ph?n bi t6n thuong ho?c b~nh ly co s~n do.
Vi d\l: M(>tnguoi da: bi c~t th?n phai truac do, nSu Iftn nay bi ch~n thuang
phai c~t th?n trai thi tY l~ % TTCT duQ'ctinh la m~t ca hai th?n.
6. Khi giam dinh, can cu t6n thuong th\Ic tS va muc d(>anh huang cua t6n
thuang dSn cu(>cs6ng, nghS nghi~p cua nguoi c~n giam dinh, giam dinh vien danh
gia, xac dinh ty l~ % TTCT trong khung ty l~ tuang Ung vai Bang ty l~ % TTCT.
7. D6i vai cac b(>ph?n co thS da:bi m~t chuc nang, nay bi t6n thuong thi ty
l~ % TTCT duQ'ctinh b~ng 30% ty l~ % TTCT cua b(>ph?n do.
8. Truong hQ'Ptren cung m(>tnguoi c~n giam dinh rna vua phai giam dinh
phap y l~i vua phai giam dinh phap y tam th~n (theo quySt dinh trung c~u/yeu
c~u), thi t6 chuc giam dinh th\Ic hi~n giam dinh sau t6ng hQ'p (c(>ng) ty l~ %
TTCT cua nguoi c~n giam dinh thea phuong phap xac dinh ty l~ % TTCT quy
dinh t~i DiSu 4 Thong tu nay.
f)i~u 4. PhuO'ng phap xac dinh tY l~ ph~n tram tAn thuO'ng CO'th~
1. Vi~c xac dinh ty l~ % TTCT duQ'ctinh thea phuong phap c(>ngnhu sau:
T6ng ty l~ % TTCT = T1 + T2 + T3 +...+ Tn; trong do:
a) T1: DuQ'c xac dinh la ty l~ % TTCT cua TTCT thu nh~t (n~m trong
khung ty l~ cac TTCT duQ'c quy dinh t~i Thong tu nay).
b) T2: la ty l~ % cua TTCT thu hai:
T2 = (100 - T1) x tY l~ % TTCT thu 21100;
c) T3: la ty l~ % cua TTCT thu ba:
,
, . 3

T3 = (100-TI-T2) x tY l~ % TTCT thir 3/100;

d) Tn: la ty l~ % cua TTCT thir n:
Tn = {100-TI-T2-T3- ... -T(n-l)} x tY l~ % TTCT thir n/l00.
d) T6ng ty l~ % TTCT sau khi diroc lam tron s6la kSt qua cu6i cling.
2. Vi du:
a) M<)td6i tuong co nhi@ut6n thirong:
Ong Nguyen Van A duoc xac dinh co 03 t6n thuong:
- Cut 113gitra canh tay phai, khung ty I~ % TTCT tir 61 - 65%;
- Mu m~t trai chua khoet bo nhan cau, ty I~ % TTCT la 41%;
- Nghe kern trung binh hai tai rmrc d<)I, ty I~ % TTCT tir 21 - 25%.
Ap dung phirong phap neu tren, t6ng ty I~ % TTCT cua ong NguySn Van A
duoc tinh nhu sau:
- Tl = 63% (ty l~ % TTCT quy dinh tai Thong tir nay tir 61-65%, giam
dinh vien co thS danh gia, xac dinh ty I~ % TTCT la 61%, 620/0,63%, 64% hoac
65%. Vi du tnrong hop nay giam dinh vien l<1yty I~ TTCT la 63%).
- T2 = (100 - 63) x 411100 % = 15,17 %.
- T3: Nghe kern trung binh hai tai mire d<)I, ty I~ % TTCT duoc quy dinh
trong Thong tu nay tu 21% - 25%. Giam dinh vien co thS danh gia, xac dinh ty
l~ % TTCT trong khoang tu 21% dSn 25%. Vi d\l truemg hgp nay giam dinh
vien l&yty l~ % TTCT la 22%, thi ty l~ % TTCT clla ong A dugc tinh la:
T3 = (100 - 63 - 15,17) x 22/100 % = 4,80%

T6ng ty l~ % TTCT cua ong NguySn Van A la : 63% + 15,17 % + 4,80% =

82,97 %, lam tron s6 la 83%.
K@tlu~n: T6ng ty l~ % TTCT cua ong NguySn Van Ala 83%.
b) M<)tnguai cAn phai giam dinh t~i hai t6 chuc: (1) Giam dinh phap y va
(2) Giam dinh phap y tam thAn:
Ong NguySn Van B (ong B) da dugc t6 chuc giam dinh phap y giam dinh
vai k@tlu~n t6ng ty l~ % TTCT la 45% (Tl).
Sau do ong B dSn giam dinh t~i t6 chuc giam dinh phap y tam thAn, t6 chuc
nay kSt lu~n ty I~ % TTCT la Clla ong B la 37%, t6 chuc giam dinh phap y tam
th~n nay t6ng hgp t6ng ty l~ % TTCT cua ong B nhu sau:
Tl da dugc xac dinh la 45 %; T2 dugc xac dinh nhu sau:
T2 = (100 - 45) x 37/100 = 20,35 %.
T6ng ty l~ % TTCT clla ong B la = (Tl+T2).
 . ,
,.'
..
r
4

T6ng ty 1~% TTCT cua ong Nguyen Van B la: 45 % + 20,35 % = 65,35 %.
KSt luan: T6ng ty l~ % TTCT cua ong Nguyen Van B la 65 %.
Di~u 5. Hi~u Il!c thi hanh
Thong nr nay co hieu luc kS til ngay 01 thang 11 nam 2019.
Thong ttr s6 20/2014/TT-BYT ngay 12 thang 6 nam 2014 cua B(>tnrong
B(>Y tS quy dinh ty l~ t6n thuong ca thS sir dung trong giam dinh phap y, giam
dinh phap y tam th§.n hSt hieu lire kS til ngay Thong tu nay co hieu lire thi hanh,
Di~u 6. Di~u khoan chuyen ti~p
Nhirng tnrong hop vu viec xay ra tnroc ngay Thong tir nay co hieu lire, kS
ca yeu cau, trung c§.usau thai diem Thong tu nay co hieu hrc nhung su viec xay
ra tnroc ngay Thong tir co hieu hrc thi ap dung thea quy dinh cua Thong tu s6
20/2014/TT-BYT ngay 12 thang 6 nam 2014 cua B(>truang B(>Y tS.
Di~u 7. TB chrrc thl!C hi~n
1. Cvc Quan ly Kham, chua b~nh - B(>Y tS chiu trach nhi~m t6 chuc th\fc
hi~n Thong tu nay.
2. Chanh Van phong B(>,Chanh Thanh tra B(>,Cac Vv truOng, Cvc truang,
T6ng Cvc truang thu(>c B(>Y tS, Giam d6c Sa Y tS tinh, thanh ph6 tr\fc thu(>c
Trung uang, cac t6 chuc giam dinh phap y, phap y tam th§.n va cac ca quan, t6
chuc, ca nhfm co lien quan chiu trach nhi~m th\fc hi~n Thong tu nay.
Trong qua trinh th\fC hi~n, nSu co kho khan, vuang m~c, dS nghi cac ca
quan, t6 chuc, ca nhan phan anh kip thai vS B(>Y tS (evc Quan ly Kham, chua
b~nh) dS xem xet, giai quySt.l.

No'i nh(in: ?¥-----------

KT. ~<) TRl[ONG fr
- Uy ban vS cac v~n dS xa hOi cua Qu6c hOi, Uy THUTRUONG
ban tu phap (d€ giam sat);
- Van phong Chinh phil (Cong bao,
C6ng thong tin di~n til' CP);
- Vi~n Ki€m sat nhan dan t6i cao;
- Toa an nhan dan t6i cao;
- BQ TO' phap (C~ICKi€m tra van biin QPPL, Cl,IC
B6 trQ'tu phap);
- Cae BQ: Cong an, Qu6c phong;
- Bo. tnrcrnab (d€ bao cao)' ,
- Vi~n PYQG, Vi~n PYTTTW, Vi~n PYTTTW
Bien Hoa, C6ng TTDT BYT;
- Vi~n Phap y quan dQi, Vi~n KHHS BC)Cong an;
- Scr Y tS tinh/thilllh ph6 trl,l'cthuC)cTW;
- TTPY tinh/thanh ph6 tqlC thuC)cTW;
- TTPYTT kllU V~I'C tr~c thuC)cBYT;
- BQ Y tS: Cac Vl,I, Cl,IC,T6ng Cl,lC,Van phong BC),
Thanh tra BC)(d€ tl11,l'chi~n);
- LUll: VT, KCB, PC.
 BQYTE .
CONG HOA xA HOI. cnu NGHiA VIET NAM .
DQc l~p - Tl! do - H~nh phuc

Bang 1
TV L:¢ PHAN TRAM TON THUONG CO THE
DO THUONG TICH
(Kem thea Thong tu s6 22 ITT-BYT ngay 28 thang 8 ndm 2019
cua B(3truang B(3 Y ti)

Clurong 1
TV L:¢ PHAN TRAM TON THUONG CO THE
DO TON THUONG XUONG SQ vA H:¢ THAN KINH

Muc TAn thuon

I. .. !Q!! !h~~'!!~~~9'!!g~2
1. Me ho~c mat ban ngoai xuang S9
1. i. D~&~gl~i~hh~~~~hiSu d~it~ 3~~~t~6 ;<:u6~g 5-7
*?~qrig•~~~rih
1.2 ..........••.
·•••••••• • •••
h9.~.~
•••••
~hi~~ 4~{•ii~ri
•••• • •~••
•••~~•••••
·•··•·
••··••·•························
. 11 - 15
2. Nut, va xuong vom S9
2.1 ¢hi~~ ~~qrigri4j,
4~i yq 4~gi }~l~ , T.
8 - 10
2.2. Chieu dai duong mrt, va duoi 3cm, dien nao co 0 ton thuong 11 - 15
tuong tmg
2.3. . ... chiSu daiduong ~~t,~5t&3~~~d@~ Scm, dien nao ~66t6~ thirong 16 - 20
tuong irng
............................
,.........................................
.. . ? "? .

2.4. Chieu dai dirong nut, va tren Scm, dien nao co 0 ton thirong nrong 21 - 25
ling
*Ghi chu: Niu duong nut, vi)'Ian tir ~d~s9~~6~g~J~ S9:
- Tinh tY I¢ % TTCT thea kich thuoc duong nut, va.
- Ldy phdn uu thiltinh thea phdn Ibn hon/ldy tY I¢ % TTCT a
mu'c t6..:i.d,:.:a:;.: 1 .
va
, 4~i dirong !1~!,yq 4~<?'i? ~l~
......... . , T .
16 - 20
3.2. Chieu dai ducmg nUt, va du6i Scm, di~n nao co 0 ton thuang 21 - 25
tuang ung
3.3 ... chisud~iduang nut, va tu Scm tra len, di~n n~~·~6Et6~thuang 26 - 30
.........................
t~q!1g~!1g, .,
3.4 NUt, va nen S9 de l';li di chung ro nu6c nao tuy vao tai ho~c mlii 61 - 65
di~u kSt
4. Lun
4. 1. ~~!1 P~!1 !1gC?~i:x.~<!!1g~9~i~h ~h~<!~h<?~~9~9'!1g ~i!1h 4~<!i}~~ 8 - 10
4.2. Lun ban ngoai xuang S9 kich thu6c ho~c dUOng kinh du6i 3cm, 11 - 15
di~n nao co 6 t6n thuang tuang ung
 2

4.3. Lun ban ngoai xuong SQ kich thuoc hoac duong kinh til 3cm tro 16 - 20
..........
J~~~...9~~~El~<:>
<?~~~9~~h~9:~g~~~g~g .
4.4. Lun ca 2 ban xuong SQ kich thuoc hoac duong kinh duoi 3cm, 21 - 25
9~~g~~g<?~ ~h~~g tuongung 9~9~
4.5. Lun ca 2 ban xuong SQ kich thuoc hoac dirong kinh til 3cm tro 26 - 30
... l~~, 9i~~~~<:> <?~9 t9~ thuong ~~~g ~g ..
* Ghi chu:
- Muc I: Ndu dien ndo khong co 6 ton thuong tuong ung, tinh
bang tY !¢ % TTCT cua tbn thuong co kich thuac nho hon lidn kl

- Muc 1.4.4 va
1.4.5: Ndu ad phdU thudt nang xuong tun, tinh
bdng tY !¢ % TTCT cua t6n thuong co kich thuac nho han lidn kl

5. . .. Khuyetxuong SQ
..................................
~ ? ···········-7······· _........ . .,.............. . .

5.1 ~~q~':l§~gT
:I2~9·~g~i.~ kh':lY~~~~~<?J:P: 9 . , 16 - 20
5.2. 9
Duongkinh kh':lY~~~~ ~9:~h~ ~<?~!l9~~?<?El'l' 9~YP.h~P.Eh9r:g 26 - 30
5.3. 9
~_l!q~gJ~i.~h ~h':lY~~~~)~h9:~ ?gJ:P:9~~Jg<?~!l'9~XEh~EEh9~g . ?J: 35
5.4 ~~q~gl~i~h9~h':lY~~~~}g<?1)]~E,(y)~~,1~yp~~p.ph§~g , 41 - 45
* Ghi chu: Ml:lc I.5: Neu aay 6 khuyet chac ho¢c aU'9'cva bang
manh xuang ho¢c bling v(tt li¢u nhan t90, tinh bling tY !¢ % TTCT
......... S~(!tqf}!~l!C!'Ygqc?4l!~f}g~ff}b '!bi? ~(?,I'}U¢lyk¢: •
5.5. 0 khuyet SQ CU, bi chan thuang l~iphai rna r(>ngde xu ly: Tinh ty
l~ % TTCT cua ph~n rna them
II Gh~r.I.~9r.I.g~~g , ,m
1 9i~~ ~Ei 9~9i~ ,
~h~~ 99~g ~~<:> 1- 5
2. ~han d(>ngnao dielltri khongon dinh 6 - 10
.... * GhT~h~:M~;ji. Khid6~hgicikith(J~p~bidi¢~~a;tF6:······
III. <) khuy~t nao, A tAn thU'o'ng nao khong co di chu'ng ch.rc nang
he th~n kinh
...........................................................
_;( ,........ .. 1'........ .. ., "......... . _ .

1. () kllUyetho~c 9 to~thuO'ng n~o dUClllg kinh nh6 h01l2cJ:P: 21 - 25

2. . .••
····•·
•••
·•••••••. 9•••. •..h~.~.~
kh.~.y~,t •••••
~.••
,t~•.~.•.th~·qrig.•. ~.~~rig..•.liirih••••?~.l~.~.~.~
n~()•••. t~.••. ?~1)] ,........26 - 30 •.•
3. 0 khuyet ho~c 0 ton thuO'ng nao duang kinh Ian han 5cm den 31 - 35
10cm
··4.····.····..... 9~h~y~ih(?~~§jsriih_l!q~g~~<:>9~q~g~i~hl<!~hg~!9SJ:P: , 36 - 40
5. 0 khuyet ho~c 0 ton thuang nao thong ho~c gay bien doi hinh the 41
nao th~t
f····················································· ,.................................................................... 1································

6. Mau t1,1ngoai mang cung ho~c duoj mang cung da di, tri khong co 11 - 15
............................................
~i <?h~~g~h~~)~~ , ?

7. Mau t1,1ngoai mang cung ho~c du6i mang cung da dieu tri con 0 16 - 20
. ~i<?h~h9~g<?~ ~~<?h~p:g~h~~~i~ ,..... .. ,
8. Chay mau duai mang nh~n da dieu tri khong co di chung than 11 - 15
kinh
 3

9. Chan thuong, vet thuong nao gay ro dong - tinh mach khong gay 16 - 20
..................................................
~t~~frgg ~~fr~g~l!g............., . .. , .
10. Ton thuong nao co tir truce da on dinh sau do lai bi ton thuong:
Tinh ty l~ % TTCT cua t6n thuong moi
* Ghi chu: Muc 111:
- Cac t6n thuong con hinh anh t6n thuong tren chan doan hinh
anh thi duoc tinh ty I¢ % TTCT nhu tren.
- Nhiing tim thuong khong con hinh anh t6n thuong tren chan
doan hinh anh thi tinh tY I¢ % TTCT tai thai aidm giam dinh nhu
sau:
- Tit,muc 111.1 din 111.5:
+ Khong phai mo: 5 - 8%.
+ Phai mo: 11 - 15%.
- Tic muc 111.6 din 111.7:
+ Mau tu ngoai mang cimg: 5%.
+ Mau tu duoi mang cung: 8%.
- M1;lc 111.8: 8-10%.
- Niu nhi~u t6n thuong do 1lim tac dong gay ra, cong tY I¢ %
TTCT cua cdc tim thuong theo phuong phap cong tai Thong tu.
M6i t6n thuong aU9'c tinh tY I¢ % TTCT muc t6i thdu cua a
khung tY I¢ % TTCT
- Niu co nhi~u 6 t6n thuang trong nao a cac vi tri khac nhau thi
tinh t6ng auong kinh cac 6 t6n thuang c(JnRIgi.

21 - 25
2. Tir hai di v~t tro'len 26 - 30
V. TAn thu'o'ng nao gay di chtfng tAn thU'o'ng chtfC nang th~n
kinh
................. 1)'............. . _ ····················································r ? .

1. . . T<?~~~~·q9g.P~<?g~y ~i ~~frpg~<?pg~i~~ !~V<::

y~! 99
2. Li~t
2. 1. Li~t tu chi muc d(>nh~ 61 - 63
2.2. Li~t tu chi muc d(>vira 81 - 83
2.3 ~i~! ~fr<::~iEl!fr<::
92 9*pg . 93 - 95
2.4. . ~~~t9f!,:1pg~q( l~fr<::92 ~x _ . 36 - 40
2.5. ~~~~9f!~l!g~q~l~fr<:: 92 Y~'~ 61 - 63
2.6. ~i~!!lf!~l!g~qtl~fr<::42!l~~g 71 - 73
2.7. Ll~t ho~mto~mnua nguai 85
2.8. .. ~~~~~~~!~Yh<?*<::
~~i <::~~P}~fr~92~x .. 36 - 40
2.9. ~~~!~~~!~y~g~,? ~_~i '?~~!l ~~<? ~2y~~ .. ....................." .
61 - 63
2. 10... ~~~!~~i !~y ~g~<:: ~~~ <::~~9P:1fr'?921!*l!g 75 - 77
2.11. ~i~t_~g~~~<?~p~~i~~y~g*'?~~t'?~~~ ..................._
87 .

2.12. Li~t m(>ttay ho?c m(>tchan muc d(>nh~ 21 - 25

 4

2.13. ~~~~l!l9!~~Yh<?~~~9t~h.~1!1!l~~~2Yl!~.................. 36 - 40
2.14. . ~~~~l!l9~~~yh<?~~1l!9t~h~l!l!l~~ ~9 g~l!g.......... _... ? l ..~ 55
2.15. Liet hoan toan 111Qt tay hoac 111Qtcha11.. _ 61
Gizi~iz~:T~~:~~~ * Vi.9 tii~v.i.is. Lift cl~i tren thi lciy ty If %
da, li€t chi duoi thi ldy tj If % TT_C;T_t~ifh!~l}: ..
TTCT t6i ~g6~~gfr _ .
.. R6ii~~~ _ m ••••••• ••

3. . -_ '1' ,,, ,,..................................................................... .. 1) .

16 - 20
3.1. . M~t Y~l!~21!gl!g§!ll!g~~~~~ ~T9~~ l!l~~ ~91!h~
3.2. Mat v~n dong ngon ngu kieu Broca 111UC dQ vua 31 - 35
.............•................. "j' ............•............................ ,...............................................••••••.••.•....................•..•.•............. 1)••••••••.............................•.....•.•••••••..........•••••••.............••••..........•••••••••••..•...................•

3.3. . M~~Y~l!~91!gl!g§l! !lg~ 1~~~\l1?E9~~ 1l!~'~A91!~l!g . 41 - 45

3 .4. .. _M~~Y~l!~911gl!g§1111_g\t l~~~\l~T9~~muc ~9 E~! I!~l!g ... 51 - 55
3.5 . .........Matr v~n dong ngon ngir kieu Broca hoan toan 61
1) /) .

3.6. Mat hieu loi ···········'r·······

kieu .. Wernicke muc~91!h~ . 16 - 20
. .., .........•..•.... 1)........

3.7. Mat hieu loi kieu Wernicke rmrc ~9y~'a 31 - 35

......... .., 1)............................•...... /) .

3.8.. M~t hi~\llq~ k~~\l~~~l!i~~~l!l~~ ~9 ~~11g .

3.9. M~~hi~l:ll?·il~i~l:l~~E11i~J~~ll!~~ ~9E~! 11~l!g 51 - 55
3.10. Mat hieu lO'ikieu Wernicke muc oQhoan toal1 63
* Ghi chit: loan ngon ngii ca hai thi tinh ty If %
TTCT t6i thidu cua tung t6n thuong r6i cong theo phuong phap
C?{!r;g£9_LI~qrz_gf~~:
3.11. MatdQc 41 - 45
41 - 45
4. .. Q~~l!(k:l!§~g ~h~ yJ ~~~9y~g l!~~ l!g~:qi 31 - 35
5. Ton thuong ngo?i thap: Ap dVng ty l~ % TTCT rieng cho tung
... h~~Eh~"l!g:P~l'k~11~gl!'J)~~1!~9,Fl:lg .
5.1. Tonthuang ngo?ithap muc dQnhy 26 - 30
5.2. t§ri!li~'~g i~~~~9
6g~~L~h~l? y~~ 61 - 63
81 - 83
5.3 T~~~hl:l·<:)'l!g
11g9C;li
~h~prl1.~·~
~211~11g ..
5.4. . I~I! !0l:l'<?!lgl!ggC;li!h~Pll!~'~ ~9E~! f1~f1g ............................... 1··········
91 - 93
6. Ton thuang nao gay di chtmg ChtfCnang ca quan khac (thi l\Xc,
thinh l\Xc...) tinh theo ty l~ % TTCT cua ca quan tuang ling
VI. !?J:! !h':l'9'J:!g_!,lIY , ...
1. ...............•...
Ionthuang hoi phvc hoan toan ho?c gan nhu hoan toan 5-7
"1•...•........................................•...........................................••...................................... ? .

2. . I~11 !h\l'<?!lg!l:lY!.9~1!99)~i~l:l~hg~~ ~9';l~ .

2.1. Tonthuang non tuy khong ho~mtoan 36 - 40
·················1)"··································· .,......................................... ., .

2.2. Ton thuang non tuy toan bQ (mat dun giac vting day ch~u, roi lo?n 55
ca tron, khong li~t hai chi du6i)
................... "1........................•.............................•.......•.•.............................• ,............................................................................ .. ········1···············
....

2.3. ~~Y!h~~
I~!l ~hl!<:)'l!g ll!l!g ~9~~9? ~~~~kh9~~ ~gC;ll! . 96
2.4. ...1'911tb~'<!p'gWy p.~vc;JQ~P.l:J9)~~~~J~h9(l11h~gC;lP 97
2.5. ..I~11 ~hl:l·<:)'~1.g
~l:lY~9!g~l! ~9 ki~~)~Q~f1h 99C;l!l , . 99
2.6. Ton thuang nua tuy toan bQ (hQi ch(rng Brown - Sequard, tuy co 89
C4)
3. .T6n thuang tuy gay li~t dan thu~n: Ap dVng ty l~ % TTCT Mvc
 5

V.2.
4. f§~ •••~h.~~jig ••~~y.g~yrii.~~ ••••
. .......••.•••••• ~.~.~•••••
gi~~i~i~~ ••••
~~q~g •••4~rii~~y¥ri· •••••••
········
......
4.1. Ton thuong tuy gay giam cam giac (nong hoac sau) mot ben tir 26 - 30
.. ~&V~!ES! ~~~~g T ..

4.2. Ton thuong tuy gay mat hoan toan cam giac (nong hoac sau) mot 31 - 35
~~~!~~g¥~yS!~~~~g(q~<!t~9~~~~g~~~g\!~I?)
4.3. . I9~ !~~9..~g
!~yg~ygi.~,l.!l
cam gi~~(~<?~g
~g~~~~~)g~~~g~qi 3 1 - 35
4.4. Ton thuong tuy gay mat hoan toan dun giac (nong hoac sau) mra 45
nguoi
VII. .. !?~!h~·g..~gE~~~~~~9.!t~~ythA~ ~i~h .
1. . I9~!_h~9·~gX~!~~~~~~_h..... . ,................ N , . • . .

1.1. Ton thuong khong hoan toan mot re (khong tinh re co Ca, es, e6" 3-5
<::7~<::s" T~ ~g¥~II, T~ !~~!)~rEIg
~?, E~ ~~~g§I)"l.!l9!
~~~
1.2. Ton thuong hoan toan mot re (khong tinh re co e4, s, e6" e7, es" 9 e
rS nguc T1, rS that lung Ls, rS cling SI) mot ben
1.3 '6n thuong khong hoan toan mot trong cac . c6 Ca, es, e6" e7, 11 - 15
es , rS ng\l'c T 1 mQt ben
1.4. T6~ th~:;~g h;~~ t;~~~~Qttrong ca~~S: ~6 es, e6" e7, es" ~S 21 c~,
ng\l'c T 1 mQt ben
1.5. T6~ thu;:~~g iili6~g ho.1n to.1n mQt trong ca~ ~~rth~ti~'ng Ls, ~=r 16~26 ....
cling S 1 mQt ben
1.6. T6~thu;~gh;~~to.1n m(>ttrong ca~ l~Sth~tlung Ls, l'S ~~~g SI m(>t 26 - 30
ben
1.7. '9
!~~q~gJ9!<?~g~g~~ !9.~~~~<?i~gy'~(~9.E<?' 19~~~q!1~2~) .........
....61 - 65
87
1.8. .. I9~ !~~q~gh9.~~t?~~?~<?i~gl!~..............
..
2. ..
Ton thuO'ng dam roi than kinh mQt ben
: , , , ".""'., " ,._ " , , , "., ..,".,., .., ""'.""."""' .,. "',"'"'' '7 .

2.1. Ton thuO'ng khong ho.1n to~m dam roi than kinh co 11 - 15
2.2. .••••:t§rijh~~qrig ••h~.~.~•••~.~.~ri•~.~.riii9I.ihAriEt.rih~9,.......................................................
•• ., 21 - 25
2.3. Ton thuO'ng khong ho.1n to.1n dam roi than kinh canh tay - ton 26 - 30
!h~~~~! g~9;~ ..
!~!!9.'~g T <....... r .

2.4. Ton thuO'ng khong ho.1n to.1n dam roi than kinh canh tay - tOn 46 - 50
... !~!!q~g!h~~~~~!9~qi .. . , , ,..... . .
2.5. Ton thu'O'ng khong ho.1n to.1n dam roi than kinh canh tay - ton 51 - 55
thuO'ng than nh~t tren
......................•;;..............
. . .. . .....••.. , ..••................. ,.......... •... ...•. . • ••••• '? . .
. .
2.6. Ton thuO'l1g khong ho.1n to.1n dam roi than kinh canh tay - ton 46 - 50
... !~!!~g !h~~I?h~!~'I!q~
!~g~g T , . , .

2.7. Ton thuong khong ho.1n to.1n dam roi than kinh canh tay - ton 46 - 50
thuO'ng than nhi truac ngo.1i ...................................
, +.......... .
2.8. T6~ th~~a;~g iili6~gh;~~t;~~~d~;~;:6i thI~ki ;~i~
canb ta y - t6n 5 1 - 55
. !~!!()'~g
!h~~~~~~(;l1} .. . ,.......... ,............. . W T .

2.9. Ton thuO'ng ho.1n to.1n dam roi than kinh canh tay khong ton 65
thuO'ng ng.1nh ben
 6

2.1 O. I9l! thuong hg~l!~9~~4~~l'<?~ ~~y~~~ga,l!hg~l!

~h~l~l~~~h~~~!~ . 68
2.11. Ton thirong khong hoan toan dam roi that lung (co ton thuong 26 - 30
th~n kinh dui)
............................. \)" _ .,. .,.. .

2.12... 19~ ~hl!~~ghoan ~9~~4~~T<?~ ~h~~),l!~g _ . 41 - 45

2.13. ... -,
To~ ~ thuong khong hoan toan .,.dam roi cung
, , , , , " .
36 - 40
2. 14. I9~ ~hl!~l!ghoan ~9~~ 4~~roicung 61
3. Ion thuong day thfm 1(i~ln9t ben

~i-]it~~l~I~~~~i~
11 - 15
21 - 25
5-7
3 .4. .. I9l! ~!~l!~1~g hg~~ ~g~~~~y~h~l!~i~h ~~~l!y?:i ..... 11
3.5. Ton thuong khong hoan toan day than kinh diroi vai 5-7
f§~i••••
ih0·q~~g
3.6 ................••..••.. ••• .•.•. 4~y ••fh~ri•l~i.6E
E.~.~l! •• •4~.~·i
• •••••
y~.i·············· ~~~p
••. . 11
3 .7. 191)~hl!S?'~g)~<?~g h9~11~g~~,~~y!h~l1kinh ~gY'~~~i 7 - 10
3.8 I9l! ~hl!q~ghg~~ ~(?~~~~y!h~l!~~~hgg¥~A~L 11 - 15
3.9. I8~ ~h\!~~gh9~~~9~~IP:2~~~y~h~~kinh l~~~~~q~ . 7 - 10
3.10 I9l! ~hl!~~g)~<?~gh(?~~~(?~~ ~h~~~i~h ~g 16 - 20
3.11 19l! ~hl!~~gh9~~ ~(?~~~h~l1~il!h,IP:g . 31 - 35
3.12. 19~ thuongkhonghoan ~g~~th~~l~i~h~~ gL 11 - 15
3.13. I9~~h~·~l1gh9~l!~g~~~h~111~i~h ~(? gL . 26 - 30
.......................... H.·······

3.14. I91? ~h\l'~~g~~~h ~h~l!~~~hq~~y ..... 11 - 15

3.15. Ton thuong ban phan than kinh quay (do(;1n1/3 giua canh tay 26 - 30
tfnh ty l~% TTCT t6i da, dO(;1n113 du6i tinh ty l~% TTCT t6i
thiSu)
...................... '1 "."... . . ,""'" ,-.

3.16 19l! ~h~'~~gh()~l~~()~~~h~l1l~il~h q\l~y(4()?:111/}~T~11 ~~l?h!~y) 41 - 45

3.17. Ton thuang nhanh than kinh tr\l
...........................
'1 - , -- --.---_ , ,..................................................
. .
11 - 15
3 .18 . T9l! ~hl!~~gg~~ Eh~l1~h~;l1~i~h ~EV . 21 - 25
3.19. . I9~~hl!~~ghg~11 ~(?~~~h~~J~i~h~EV. 31 - 35
3.20. .. I9~ ~hl!~~g~~l1h ~h~l!~~~hg~l}~ . 11 - 15
3 .21 I9~ ~h\l'g~gg~~ph~~ ~h~H~il!hg~l}?:. 21 - 25
3.22. Ton "' thuong hoan tOc'm than
""
kinh gina
.......................... .•...........................................••.•...............................
- .......•...... .. ................................• •..••.•••••...............................
, , - - .
31 - 35
3.23. T9l! ~hl!~~gh()~~~()~~~h~l1l~il!hE~1~h~~ygi ~l'()~g . 11 - 15
3.24. ......19~ ~hl!(?'~g h(?~~t(?~~~h~~J~i~ ~~~g~~ygL~~~9~g................. 11 - 15
3.25. Ton thuang khong hoan toan than kinh hong be (day mong tren 11 - 15
. y~ ~~y ~??<?l!g ~~9D. .. , ...
3.26. Ton thuong hoan toan than kinh hong be (day mong tren va day 21 - 25
.....
lIl?I~g~\l:9>i) , .....
3.27. TOnth~ang)~()ng h()?ntoal1tb~~kinh~a qui sau 3-5
f§.~.•••
3 .28. ······· ~h.l!.~~g
••••••••••• •..
h(?~rij().~~~h~6••..
1~il1h~.~~~{~?:~..............
. . 7 - 10
3.29. I8~~hl!~~g~h~~h!h~11~~~hq~L _ . . _ .
11 - 15
3.30. T81~~hl!()'~gg~~Eh~~~h~?:~t~h ~~i . 21 - 25
3.31. Ton thuang hoan tot?mthan kinh dui 36 - 40
 7

3.32. Tontlurongkhong hoan toal'lth~nl(in11~\li - bi 3-5

]~~:::~~~~o~j&!%~h~t~=
~:~!:
Ti)rlthuang hoal1toal1than
3.35. kinh bit
7-9
7 - 10
16 - 20
3.36. T6~ th~~~giili6~gh~~~ i~~~th~~i~i~h sinh due - dui 6 - 10
3.37. ·T~~·.·.th.~q~g·
. ••h~·~~····t·~.~ri
••••
thIri··.l~i~h.··~i~h.··.dV~· •••.
~••••
4~i••·•·
••
·························
. 11 - 15
3.38. .t6ri th ~cyrigb~~ph~n th~ri kirih t~ . h9~g 26 - 30
3.39 T6~ th~O'ngh~an t~~n th~~ kinh h6~g to dean 113 giu'a dui d~~ 41 - 45
truoc dinh tram khoeo
3 .40. ..~?11.~hl!ang.h()~l~!()~~!h~l'll~il'lhh(')l'lg!()~()~l'l);:3 !T~11~~i 51
3 .41. . 1911 !hl!CYl'lg I1h~l1h!h~I1..~il1hh(')!1Kl~()~() I1g()~L 7 - 10
3.4 2. T0I1thll'0ng pa11ph~11thanld11h hi)ng l~()e() 11goai 16 - 20
3.43. I~11 thl!q~gh~ari t~~n·th~~l~il'lhhi)rig ~~~o 11g~~i 26 - 30
3.44. .
I61~thuqrig ~h~nh th~~ii~h hong khoeo t~~~g ·.
. ''''''? , '( .
6 - 10
19l'l !l1l!angP~l'lph~l'l~l1~p}~il'lh hi)l'lg)~()~()~T()11K 11 - 15
3 .45 .
3.46.
I8l'l...•
!b.~qrig•..
°
T 11thuong h()~ntoan than kinh hOngkhoeotr()ng
!h~ri•k~rih
4..............•••••••..••••••••• ••• .•••?9••••
iri9i •••• ~.~ri
••..•••
·••••••
,...................
21 - 25
......•••••••••••••..•..•.•••....
, .
4.1. T(,)nthll'()'ngkhol1g h()a11toan day than ki11hs9 so) 11 - 15
4.2. T6~ th ~'a~gh~~n t~~n d~y ihI~ l~i~h~9 s6 i .. 21 - 25
4.3. T6~th~~~gd~yth~~1~i~~9~6ii:Ti~hty l~ % TTCT thea M\1c
IV. T6n thuang chuc nang thi giac do t6n thuang th~n kinh chi
ph6i thi giac, Chuang t6n thuang Co' th~ do t6n thuang Co' quan
thi giac
4.4. .. I6~
thll'01~gl119tnhAnl1th~11kil1hSQs6 lIT 11 - 15
4.5 . 1§ri••••
ih.~.~g P.~ri••••
ph.~l'l••..
!~~.~? l(.i.l'll1
••••~.9i.tI! . ~.9•••.. 21 - 25
4.6 1911!hl!ang 11()~11 !()~1~!h~l'l1~il1h,?9 ?i) gI r 35
4.7. .. 1911 tl1l!ang)~<?l'lg11()~11 !()~l'l!h~l'l~i!;l1?9 ?i) IY ... 3-5
4.8. .
Ion thuang hoantoantl1an. ,"" kinh S9so.IV
. ..,............... .., . .. .
11 - 15
4.9. . 19l'l !1111'q~g~9~ 11h~l'lh!11~f!~i~ s2 ?i) Y T.
7 - 10
4.1 O. .. 18l'l !1111'9'~~g kh(')l'lg)?g~11 !()~l'l!l1~11)~i!;l1 s9 ?(')Y ... 16 - 20
4.11. Ton thuang hoan toan than kinh SQso V 31
4. 12. . ....I~~.··.t~.ll'~·~g···lili9rig
•••
h.~.~.~.··.i~.~ri
•••
·th·~~····i~i~h••·.~9
....
~.9.·.yI 5-7
4.13. t~~th~a~gE~a11 !O~riih~nki~ ~9S~ yI.
.... '1............ . . "
., .
16 - 20
4.14. 1i)n tl1l!CYI1g I1ha11htl1~I1ki11hsQsoyn 7 - 10
4.15. I 6~ thuang kh611g hoa11j()~nth~ri l~irihS9 ~6VII 16 - 20
4.16. I~ri tb~~'ng b()~rit()~ntb~f!1~iri~•S9 . s6 ·YII . 26 - 30
4.17. T6n thll'a~g th~n ki~h SQ~6 viiI~;6t b~n: Tinh ty l~ % TTCT
thea di chUng HQi chung TiSn dinh (Ml,lc XV.) ChuO'ng t6n
thuO'ng Co' th~ do t6n thuang xuang SQva h~ th~n kinh, va;ho~c
Nghe kern (M\1c I.1.) Chuang t6n thuO'ng Co' th~ do t6n thuang
Tai - MUi - HQng
4.18. T6~th~·~·~giili6ngho~~t~~~th~n kinh sQ·~6IX mQt ben 11 - 15
 8

4.19. Ton thuang hoan t()an thankiI1P s9 s~ 1)(' mot ben 21

4.20. . I§ri •••
ih~~g; •••
14i2rig.h9~ri•t9~ri.•.
•• ~h~I1 •1~i~h
• •••• ~.9••••
~.9.•••. ~ ~.~11. rii9~ 11 - 15
4.21. Ion thuong hoan toantpaI11(inpsQs6:)(, rr19t~~n 21
4.22. I 6ri..•.
th~·011g··
••
1¢6rig •••
ho~ri.·.t()~I1·
··th.~ri
.•·.l(i·~p
.• :)('I.·l~9t
....
~.en s9..•.~.6.... 11 - 15
4.23. . 1§r1 th~l'011gh9~11~()~11th~ri~{rip,~9i9 ~~I1 . . . X(l11?~ 21
4.24. I?11 thl:l'()'l1gI~~l1gp()~11!()~11th~I1I(i~h ~9 ~~ XII 1119t~~f1 21 - 25
4.25. Ton thuong hoan toan than kinh SQso XII mot ben 41
VIII. HQi chtrng bong buot: Ty l~ % TTCT duoc tinh bang ty l~ %
TTCT cua t6n thirong day th~n kinh tuong trng cong 10 - 15%
theo phuong phap cong tai Thong tu.
IX. HQi chung chi rna: Ty l~ % TTCT b~ng ty l~ % TTCT t6i thieu
cua cit doan chi 6' rmrc cit doan cao han li~n k~ voi t6n thuong
hien tai
X. U than kinh 0' mom cut: Ty l~ % TTCT bang ty l~ % TTCT Wi
thieu cua rmrc cit doan cao han li~n k~ voi t6n thuong hien tai
XI. HQi chtrng giao cam co (Hoi chung Claude Bernard - Horner) 31 - 35
XII. Rc3i loan cO' trim
1.
2. l)?i l~1:I
Kh6 O?lti~n
tiS~~oI1gtv
ti~n ~1l~.
.. ~~ngthu()'I1g)(llyel1
. .. 31 -- 35
31 35
...............................................•....••.•......................•.•.•...............•....•..•...................•
+................................ I
3. l?iq?i ti~n 55
4. D?i ti~~ ti~~i~hong tv ~h~ thu6'~g ~~yS~
(d~iiiSu ii~~ d~m dSj 61
XIII. Rc3i lo~n sinh d\lc
1. Li~t duang ...................•..............................................•.....................•......•.............................................•....................•.....................................................
··············1······································· .

1.1 Tu5i du6i 60

+ 31 - 35
...................................................................................
1.2 Tu61 tu 60 tr6' len 21 - 25
2. ... Gll'QI1g~ll:()'I1gE~I1
t~~ g~y 9~1l 41 - 45
3. Co c{mg am mon, am d?o 41 - 45
XIV yQ~g({i~h .,.... . , ,
l. De)ng kinh can co cung - co gi~t dien hinh dap ung dieu td tot 11 - 15
(1~6ngcoI1cantr~I11al11 saI1g)
2. De)~g i(i~h ~a~
co c&ng - ~o gi~i dis~hinh khong oap (mg oiSu tri 21 - 25
hi~n con can hiSm
3. De)ng kinh can co cling - co gi~t iSn hinh khong dap l:mg dil tri 31 - 35
hi~n con can thua
4. De)ng kinh can co cling - co gi~t iSn hinh khong dap l:mg oi ~ tri 61 - 63
hi~n con can mau ,
..........................•......................................................................................•..........................••.. .............•.....................................................................................•.....

De)ng kinh can co cling - co gi~t rSnhinh khong oap ung l~U tri 81 - 83
hi~n con can rAtmau .. . .
6. D~~g kinh can C\lC be) dan thu~~ dap ung di~u tri t6t (khong con 7 - 10
can tren l~m sang) . .
7. D~~g i~i~h~a~ ~\lC b~ th~I~ khong dap (mg oi~u tri con can cta~ 11 - 15
tren lam sang hiSm
 9

8. Dong kinh can C\1C bo dan thuan khong dap irng dieu tri con con 21 - 25
tren lamsimg thua
9. D~~g ki~ ~;~ ~v~
tr~n la111sang mau
b~d~~th~I~i2h6~g d~p6:~gdi~~tri con con 31 - 35

TO:·· DQ~g ki~h c~~ ~0~ b~d;~ th~~n khong dap Lrngdi~~ ~6~~;~ td 61 - 63
tren lam sang r~t mau
...11:···· D~~g ki~~h~~ ~~~ b~ph~chqp d~p~~g di~~ t~it6t(kh6~g· ~6~ iT = 15
con tren lam sang)
12. Dong kinh can C\1C be phirc hop khong dap ung d.~· tri con ccn 16 - 20
tren lam sang hiSm
13. Dong kinh con C\1C bQ phirc hop khong dap irng dieu tri con con 26 - 30
tren lam sang thua
14. Dong kinh can C\1C bQ phirc hop khong dap irng di tri con con 41 - 45
tren lam sang mau
15. Dong kinh can C\1C bQphirc hop khong dap ung dieu tri con con tren 66 - 70
lam sang r~t mau ............................................... 11····················································
.

16. Dong kinh con C\1C bQ toan .6 hoa thL},phat: Tinll ty I~ %

....
.. ~g~!l tb~ .
IIGI ~~~~9~g!~~l~h ,..............
. m,
17. DQng kinh co bien chung roi lo~mtam than, hanh vi: Tinh bang ty
l~ % TTCT dQng kinh cQng ty l~ % TTCT biSn chung r6i lo~n
tam th~n va hanh vi theo phuO'ng phap cQng t~i Thong tu.
xy. . !!{>i ~l~~~g~l~~<:!X~~(~TY!lg\l'()'~g?gg9~i yD
1. Muc dQ nh~ 21 - 25
2. Muc dQ viIa 41 - 45
3. M~~99!l~!lg 61 - 63
4. Muc dQ rat n~ng 81 - 83
XVI. Roi lo~n than kinh thu'C vat (ra mo hoi chan, tay)
........_ ? _..-.- ., , ........................•..........................
_ - - .

1. Anh 0u¢ng flhy ~en laod(>ng, sinh 11()?t 6 - 10

2. .....A~hh~6'~g ~&~dS~ 1~~dQ~g, ~i1~hh~~t 16 - 20
3. A~h h~:&~g~~~gdS~i~~ d~~g,~i~h h~?t 21 - 25
XVII. Ton thuo'ng h~ nao gay bi~n chtfng roi lo~n nQi tiet: Tinh ty l~
% TTCT thea quy dinh t~i Chuang Ty l~ ph~n tram t6n thuO'ng cO'
thS do t6n thuang h~ nQi tiSt
 10

Churrng 2

TV L~ PHAN TRAM TON THUONG CO THE

DO TON THUONG H~ TIM M~CH
Mue Tan thuong Ty Ie 0/0

I. Tan thuong tim

1. y~~_~~~~!?:g~h~~ ~it.P.:• . T

1.1 . .. ......~~ 4i~~ !ttph~l! thl!%~§~ 4i~, '?h~(;t'?~ 1?~~~ '?ht1:~g 31 - 35

1.2. Co bien clnrng noi khoa (loan nhip, suy tim, phinh hoac gia
phinh th~t...)
1.2.1. . S~y ti~; d~-iho~c~~~ ~6i10';1nnhip ti~ di~~ tri noi khoa ~6ksi
36 - 40
qua
'" ············
..··r······································ '\ ..

1.2.2. Suy tim d9 I kern cac roi loan nhip tim dieu tri n9i khoa khong
41 - 45
........
l~~~ ql!~ Eh~~ 4~t l!l~Y ~~<?nhip
l.2.3. Suy tim d9 II 41 - 45
l.2.4. S~yti~ d~Iii~~~ ~~~ ~6T10';1nnhip tim dib~ tri 119ikhoa khong
46 - 50
..... I~~~q':l~Eh~i 4~tl11~Y~~,<?~hjp
l.2.5. Suy tim d9 III hoac roi 10';1nnhip tim co chi dinh d~t may t';10
61 - 63
nhip
1.2.6. Suy tim d9 IV 71 - 73
2. . VStthua~g th~~ti~ph~~·thl!%t
2.1.·················
6~··di~h························
_...............................................
. 51 - 55
1····················································· , +
2.2. Co di chung: Cong voi ty l~ % TTCT cua di chung thea phuong
........................
Eh,~l?'?9~g~~LIh§~g~~r..... r

3. Roi 10';1nnhip tim sau chan thirong, vet thuong tim

.......................................................... " .....•.........................•••.•...........•••.•..•...........•........................... "1....••.•.....•.....•••••..•.••..•••• ? .

3.1. Pi§l! !l~i~9L~h<?(;t)~~tql!~ ~~ 41~h. 21 - 25

3.2. . Pi,~':l ~~J ~9i ~<?(;t 1~h2~g)~~~qy~ Eh~i ,?(;tl!thi~p
3.2.l. Ket qua tat 36 - 40
3.2.2. .....••.
·.•.••••••••••• ~~h h.~~g••. ~~!?:J~ K~i•q~~••••
h<?~t .••• hh9.rig•i9~
• !?:hr~.~•.••.
~~~ 51 - 55
3.3. . ~!l~Y~~<? ~NpYI~hy,~~~. ..
eh~i9~~ ... T
71
4. Viem mang ngoai tim co that, day dinh mang ngoai tim do chan
thuang, vSt thuung
4.1. ..... Dis~t~~f~~ikh~~h~~~ thu?t d';1ii<Stqua t~~';gd6i i61(50% ph~~ 31 - 35
:S EF < 60%)
4.2. .....•• K~iq~~E~~~h~
(~£ ~~q~ ?9~) 41 - 45
5. .... Tb~~g 111~~g!?:g<?~i!ilp '" ..... , r ...

5.1. ....Ih~~glp~~g~g<?~i !~lp ph~l! ~hl!%~451!~~~q\~~~§~ 8 - 10

5.2. Thung mang ngoai tim sau dieu tri co bien chung day dinh mang
ngoai tim ho~c viem mang ngoai tim: Tinh ty l~ % TTCT nhu
m\lc 1.4.
6. Di V?t mang ngoai tim
6.l. . Ch~~gi;; t~ibis~- 21 - 25
 11

6.2. C6 tai bi@; ph~i ph[i~thu~t

6.2. i: .•... g~!q~~t§!(~tj~·:?g§i~·qi~~) 36 - 40
6.2.2. ~~~ ql}~h51~'?h~(~f ~l!q~ ~Q~) 41 - 45
7. Di vat co tim, vach tim, buong tim, van tim
7.1. ······Ch~~g~yt~ibis;··································.................................................................. 41 - 45

7 .2. Q~yi~{~{~,~·(i~~:~~~h:~h?ii~~~ ~qi.{iri;I~~~

~hip~~~::J
7.2.1. .. ~~~ql}~ q~~l}yt 9~ ql~h ~l!~gq91... 61 - 63
7.2.2. Ket qua dieu tri han che,de doa tinh m~ng 81
...... "* Cizi ciz~:'- Cd~t6~tiz-;;;~~gJ ~~~i.3 dJ~i·~7~iu co suy tim thi
.....
,.., -
tinh?
tY l¢ % TTCT thea mire d(3suy tim a muc I.1. 2.
, , - , , , , , .

8. Ton thuong trung that

.••.••. y.~!••••
8. i··.·.......•••••••••••••..•...•.. Q.I••• ii~~g•ih.~i
,?~.~~.g _ ••• •kh9~g•••~.~.~ri
•• •~.~ ••• ~..l_ : ~ ? .
8.2 AI? ~~~~1}~g~h?~999i y~~ph~i c!i~~YL
8.2.1 ~~~q~~t9tl<b9~g'?9~i~l!~b~·I1g 31 - 35
8.2.2. C6 bien chirng: Cong voi ty l~ % TTCT cua m~ICtirong irng thea
phuong phap cong tai Thong tu
II. !c?~!~~'q~g~~~~
1. Phinh dong, tinh mach chu nguc, chu bung, hoac thong dong -
.........................................
g~h~P:~~h~hu
1.1 ~hl!~ph~':l~bl}~~ '" 31 - 35
1.2. ~~ ~i~~ '?h_t!~gy~'?9 '?hi ~i~hph?l} ~hl}~~
1.2.1. ... J5~~ql}~N~ rm T 51 - 55
1.2.2. ~~!_ql}~.h51~'?h~(~9~i~~'?h~g~P:2~'?9'ql}~~2 , _. 61 - 63
1.2.3. ~9 l~bi~l}~gl}YS<?:9~ 99~ ~i~ ~51I1g,'?9 ~hLc!il!h~P:91~i , 81
* Ghi chit: Neu ton thuong o' cac m~{c 1.2.2; 1.2.3 gay ton
th~l'Ongt(;mgphdi xu' If; ho(lc li¢t hai chi thi c(3ng vo'; tY I¢ %
_ ..TX;r:;TJl!.'c!_f!.gz!.f!.gr~~C!P~1!_C!T!gp~4I? Q(;_f!.gJ9z'T.hc?I'}gtl!··
2. Vet thuong m:;tch mau Ian (u(>ng m:;tch canh, u(>ng m:;tch duo-i

~l.===~~~~~L~~~~~~
2.1.1
2.1.2.
__
~_ ~~~_q1}~~9~~~~9~~ ~i~l}hi~I1~~~~51'?h .
Ket qua tuong uoi tot c6 thieu duo'ng nh~ cac cO'do d(>ng m:;tch
7 - 10
11 _ 15
chi ph6i m(>tuSn hai chi
........................................................ '1" , , ")1" •••••••••• ,••••• , '1 .

2.1.3. Ket qua tuO'ng uoi tOt c6 thieu ducyng nh~ cac cO'do u(>ng m:;tch 21 _ 25
.....................................
'?h}ph<?~~~~~~hi~~9:t~~................................ T

2.1.4 ~~~ql}~h51I1'?h~'?9~~~l}hi~~~~9Eglp2~~~~h~i~ht . 21- 25

2.1.5 ~5~~q~~ h~~ '?h~ '?9 ~}~1}bi~l! ~~g~g ~~.~~ '?hi !E9: 1~I1. 31 - 35
2.1.6. Ket qua xau phai xu' trf cat C\lt chi: Tinh ty l~ % TTCT theo
.....
. ... Pl-l,~l~ ~hi~~~~V~~ll'<!I1gt!I1g
2.2. Vet thuong u(>ng m:;tch canh, u(>ng m:;tch duai don, d(>ng m:;tch
.....~h~~, q2I1f?lP51'?ht~?~ ~51~g
2.2.1. ~hl!_?:'?9T9~19~~y~hl}Y~~q9~g 21 - 25
 12

2·:·2 .2······••••·•••••
····•.••••••••.••••• g~•.••
i~i
•••••
f~~.~
••.•
y¥h~yE~2g& ~..~g ~.~~F~ r . 41 - 45
2.2.3. C6 roi loan nang ve huyet dong gay bien chirng 6' cac co quan
I!gh ~.y~.~~ IIGI ~h~g~..~.'?<:I.iSh.~gg .
............ ~~A2gg lp_~.'?h'?h.~J?h<?}.:
3. Vet thuong cac mach mau cO' trung binh (dong mach 0- ding tay,
....................................................
~~!!~9:Y'~~gg'?h~g,l?~g ,~h~g)~~)~h~~g~}.............................. _
3.1. ................
Ket qua tot khong c6 bieu hien thieu rnau nuoi duang ben duoi
····························1······_······
,., ,•..............,. ..........................•........................................................
1j.........••••.............•.•............................................................................................................... " ••.•..••.•.......,...••.•.•.•.•........._..•..•.......•. ..••.. 4-6
3 .2. .. ~~i 19~9hyy§t 99gg g~y ~h~~~l ,?pi ~\r~ ~9l"lhY.
<:Il:1'Ql'l8 11 - 15
3 .3 . ~~i)g~g hYY§~99gg g~y ~h}~l:1 '?hiIP~~ ~9~~l:ll"lg
<:1':1:9'98 ()!9h 16 - 20
3.4. . ~<?i 19~9hyy~~~9gg8~y~hi~y <:I':1:Qg~
'?hilp~,? ~2g~gg T
21 - 25
4. H9i chtrng Wolkmann (co rut gan gap dai cac ng6n tay do thieu
mau sau sang chan, kern theo co cac dau hieu dau, phil nS, m~t
mach quay): Tinh ty l~ % TTCT cua cac ng6n bi ton thuong
theo quy dinh tai Chuong ton thuong co thS do t6n thuong h~
cO'- xuO'ng - kh6p.
5: IS!? i.h~9iig!f~~~~~h
(~~_h~~
g~~~~~Y~i
~h':1:qg,g,gh~lj
~h~~g)
5.1. Ton thuong tInh m?ch sau phau thu~t ph\lc hoi tOt (khong bi
gian tInh m?ch): Tinh b~ng 50% ty 1~% TTCT cua t6n thuO'ng
~21'lgIp~~h~':1:qgg~~g<!Mv'?g:?
.........................................
5.2. Gian tInh
5.2.1. Gian tInh
11 - 15
5.2.2. Phu va . lo?n dinh duo'ng, 10et 21 - 25
5:2:3: ~I~~~hl.!9gyi~~~~~g~ylg~~ _ _
31 - 35
6. Ghep m?ch cO' trung binh lay tInh m?ch lam d9ng m?ch (da bao
...........
89,IPg~g t~9 thg9'98Eh~l:1~hy~tl~y !Igh lp~~h)
6.1. Ket tOt ,
................................................... . 11 - 15
6.2. qua khong Tuy theo anh huo-ng dinh duO'ng tinh ty
1~,~IIGI~h~9 ~PV~ ~9g~h':1:9'g8~298 ~p~gh~~~'9'~g\rl,1g:
7. Vet thuO'ng d9ng m?ch, tInh m?ch chu da xu ly hi~n on dinh 51-55
 13

Chuong 3
TV Lit PHAN TRAM TON THUONG CO THE
. DO TON THUONG H:¢ HO HAp
Muc TAn thuong Ty Ie 0/0

I. • ••••••••••••••••••••••••••••
TAn thu'o'ng xu'o'ng .rc
".""." ••••", " ••••••-- " •••-- ••-.- ,•••••••••• _•••__._ ,........ .. ";•••••••••••••••••••••••••••••••••••••••••••• ,., ••••0.

1. . I~l'l !1'1l!q~g ~l!ql1gl'r~ ~q?!1'1~I~I1'~211g ~i~1199:l1g)211g ..1'lglf~ 6 - 10

2. ..I211 !l!tl'<:!l1g~1f<:!l1gl'r~ l?~~11<:I9:11g)211gl1glf~ ..... 11 - 15
* Chi
chu: Neu anh huong chtrc nang thi cong voi tY l¢ % TTCT
cua chuc nang co quan hi anh huang thea phuong phap cong tai
Thong tu.
II !c?l'l !1~_l!2·l'lg
:\:~'g:l'lg~~2·1'l, T ..

1:............................
Q~yI.!l9!~l!q~g~l!~'!1:1!l9! ~i~I.!l, ~~~ !2,!. 2
2. Gay mot, xirong siren mot,.•..•..•.••••••....................
.................................................................................... can xau
diem,,..........•......................................................................
, . ?,?
3 Q~y I.!l9! ~l!q~g ~l!9.:~!~ 1'1~~~i~l!l~Eq l~~.,~~~ ~2,! . ?,?
4. Gay mot xuong suon tir hai diem tro len, can xau 3,5
5. M~t doan hoac cit bo mot xuong siron 4. 5
* Chi chu:
- Ty l¢ % TTCT til' muc 11.2 din 11.5 dCitinh ca biin dang long
nguc.
- Ty l¢ % TTCT cua cdt xuong suon do phdu thudt ducc tinh
bang 50% tY l¢ % TTCT cua tim thuong xuong suon o' muc
tuong ung.
- Niu co anh huong chu'c nang ho hap thi c(5ngv6'i tY l¢ % TTCT
cua chuc nang ho hap bi anh huong thea phuong phap c(5ng tc;zi
Thong tu.
111. !?I'l !h~2'l'lg ~~I'lgp~c?t.............. '" "' .
l. Ton thuang mang phoi m<)t ben khong ph au thu~t ho~c co phau
3-5
.......... !1'1tl~~l11'1l!l1g)~~l1g ~~ I~LSi ~l!l'rl1g
2 PLy~~l!l~l1g p1'1~i ~(?'11~1'1~~l'l , 16 - 20
3. Di v~t
mang phoi gay bien chung day dinh mang phoi: Tinh ty l~
% TTCT thea t6n thuang mang ph6i di chung day dinh m{mg
Ph6i
........................................................... '1........ "".. . . ..
l)................... . . "f . . ····,f·..·..

4. Ton thuang mang phoi di chung day dinh mang phoi t(;li diem
thuO'ng tich ho~c t(;lidiSm d~n luu
1- 3
* Chi chu: C(5ng v6'i tY l¢ % TTCT 0' m~/c Ill.1, thea phu'O'ng
...... p~qp C?9.f}gJ9:z·T~?f}gf~': . . ,
5. Ton thuang mang phoi di chung day dinh mang phoi nh6 han
11 - 15
..................}/~9~~11 ~i<?h1?!9~Eh~}El!~·l'lg......................................................................................................
, .
6. Ton thuang mang phoi di chUng day dfnh mang phoi tir 114 di~n
tich m<)t phS truOng dSn nh6 han 112 di~n tich m<)t phS tnrang 16 - 20
l!9~~l1l'l¢ 1'1ql1J/4 9i~f1:t~~1'11'1~~Pl!~ !l:l!~I.'lg
 14
................................................................. ))............... . ...•.......... ···············································If······· ...•.............•. ·1·································,···············

7. Ton tlnrong mang phoi di clurng day dinh mang phoi ttl"bang 112
dien tich mot phe tnrong den bang dien tich mot ph~ tnrong 21 - 25
....... . h~~<?~~.l?~!1:g u+ c1~1!J?~l]g l/? ~i.~!:l~~<?hh~i ph~ ~~':!~1!g
8. Ton thuong rnang phoi di chung day dinh mang phoi Ian han 112 26 _ 30
. ~i~!1:~i<?hh~i gh~ ~E,:!q!:lgh9~<?J<!1]h<!!:lc:ii~~tfs:h .fl!2~ph~ tE~!ql!g
9. Can mang phoi sau tran khi, tran mau mangphoi
9. i.··················· Dis~t~i~6ikh~~ 6~ di~h . .
6 - 10
9.2. . Dis~lt~r ~'~i khoa kh6~g 6~ d{nh d~~dS~ day dinh mang ph6i~
Tinh ty l~ % TTCT thea t6n thuong mang phoi di clnrng day
dinh mang phoi
IV. . !~~
th,!9'~g phc?i.. " N N

1. Vet thuong nhu mo phoi khong phau thuat hoac c6 phau thuat
, 6 - 10
........................................................
~l.!.':!l]gl~§!1:g~~ 15l:i. c:ii. <?h~~g? . .
2. Di V?t dan thuan nhu mo phoi 16 - 20
3. Dr ~~tthi~h th~~~g gay h~ ~~mau· ho~~ ~6···~i~~t~~~gh6 h~p 31 - 35
ttmg d9t .
4. ........
T6~th~:~·~~g~hu ~~6ph6i~;~tbS~ c!iph~~thu?t c6 di cht.'rngday 16 _ 20
dil1h mangph6ictanthu~n .nha hanl/ 4 di~rltich m2t ph~.t~lrong~
5:· T6~th~:a~g ~u ~;6ph6i~~tbS~diph~~th~?t~6 di ~h~:ngd~y·
dinh mang ph6i dan thu~n tu b~ng 114 di~n tich m(>tph~ truong 21 _ 25
d~n nha han 112 di~n tich m(>t ph~ truong, ho~c nha h011 114
<:Ii~l!~~s:hh~i ph~ tl~~()·!1:g, N .

6. Ton thuang nhu mo phoi da phau thu~t c6 di cht.'mg day dinh

mang ph6i dan thu~n tu b~ng 112 di~n tich m(>tph~ trucmg d~n
26 - 30
b~ng di~n tich m(>t ph~ truOng, ho~c tu b~ng 114 d~n b~ng 112
.. .. <:Ii~~~~s:hh~i ph~ ~E,:!ql1g,. . N .

7. Ton thuang nhu mo phoi da phau thu?t c6 di chUng day dinh

mang ph6i dan thu~n Ian han di~n tich m(>tph~ truong, ho~c Ian 31 - 35
h~l! )/?
....... . ~i.~~~i<?hh~iph,~~E~()·l!g...... I , ..

8. ~l:!1P:§ Eh~i g~y ~YE~~ P]2~ c1~11

T~l1 ~h':!<!!1:g h(ii Eh~r: ~h0yph§L 26 - 30
9. .. T§,l! ~~,:!9:np~~ p]§ E~9i g~Y~YE ~~ ~~ph~~ ~h~y.ph§i ~l:<!J~!1: 31 - 35
10. M?s:~~ ph9Ll~h9~g c1i.~!!hi~h(ith<!~JE2~~h~yph9i) 21 - 25
11. M~ s:~~~~ ~E2~~h~YEh9i ~E~1~!1: 31 - 35
12. Mo cat toan b(>m(>tben phoi 61
V. . r?~!~~'!9:~g~hiq~~~, p,h~q':lA~... ,.
11 - 15
1. .........................................................
Ton thuang khi qu~m,phe quan dan thuan
;y ., _........ . , .

2. Ton thuang khi quan, phe quan gay kh6 th6, khong roi loc;m
gi9ng n6i, tiSng n6i va;ho~c khong r6i lo~n thong khi ph6i t~c 21 - 25
,..,
l1&h~!1:
h9~s:h9!:lh91? r T

.). Ton thuang khi quan, phe quan do~n trung that gay kh6 th6 va 26 _ 30
r6i lo~n gi9ng n6i, ti~ng n6i
••••••..•.•••••••••••. 1) , ,........ ?....... . .., .

4. .................
M9Ehy<? h§i !<hi ql:!~l],ph~ q~a~ s(il:!t911~h~l:!·C?:ng
~iq':l~l1,Eh~ 31. =??
 15

quan hoac sau cat thuy phoi

5. M6' khi_9win 3-5
VI
l.
!?~ (h':l'g'~g~()·h()~~h
Ton thuong co hoanh, khong
"'..................................................
phai can thiep phau thuat, khong
_
3-5
co ~i~nClllr!lg .. . .... .. . .
19!1••.•
th.~.<?Pg ....~.q•.•h9~~h .•ph~~ ••••.
2..........................•••.•.•••••.••.
3.
q~I.~
~.~~ •••tE~¥p •••ph.~~ ••.•~h.~.~i;•..•k~.i •• !9!......................................
.... 21 - 25
Ton thuong co hoanh phai can thiep, ket qua khong tot phai 26 _ 30
ph~u thuat lai hoac g~ day dinh man_g phoi
VII. B?tJ()~~!h§~g~~tph~~ T , ,

l. Rei loan thong khi phoi han che hoac tac nghen khong hoi phuc 11 _ 15
.................................
ll<?,~~ 119!l1l9'E~~~~9 ~llx T···· -r- •.. .,

2. Roi 10C;lnthong khi phoi han che hoac tac nghen khong hoi phuc 16 _ 20
......................................
h<?,~~119!l1l9E~~~~9 ~~~!lg9i~ ,......... 'v

3. Roi 10C;lnthong khi phoi han che hoac tac nghen khong hoi phuc 26 _ 30
hoac h6n hop rmrc de) nang
VIII. Tam ph~ man tinh
1. Mire de) 1: Co ~ hien tren lam sang (de) 1) va/hoac sieu am
tim va di~n tim binh thucmg 16 - 20
2. .. s~~g(d~l ~25~~/h~·~·~·
M6:~d~ 2: C6 biS~hi~~t~S~i~ll~ ~6bi~~
o6i hinh thai ho~c chuc nang tim phai tren sieu am tim; oi~n tim
binh thucmg va;ho~c co bi~n o6i tren oi~n tim, sieu am tim binh
31 - 35
thucmg
3: M~~ d~ 3~C6 bi€~ hi~n tren lam sang (oe) 3 tr6' len) va/ho~c co
bi~n o6i hinh thai, chuc nang tim phai tren sieu am tim va;ho~c 51 - 55
co bi~n o6i tren oi~n tim, sieu am tim binh thuCmg
s~~g
·M(;~d~ 4~ C6 bi@~hi¥~t~S~i~~; (d~ 45 ~~/h~~cco bi~~~d6i
4:·············································
hinh thai, chuc nang tim phai tren sieu am tim va;ho~c co bi~n 81
o6i tren oi~n tim.
 16

Chuong 4
TV Lt PHAN TRAM TON THUONG CO THE
DO TON THUONG Ht TIEU HOA

Mue TAn thuong Ty Ie 0/0

I. I~~ !hl1.'g'~g!h'!(.: q1:l~~ , ;;0

1. Khau 16 thung thirc quan mot den hai 10 khong gay di chirng anh
26 - 30
huang dSn an u6ng
2. . Kh~~ ·16 th~~g thvc t{f b~ 16· tl~6 is~kh6~g
q~~~ g~y di ch(!~g
31 - 35
- ~~~hh~~l!.g~~I!.~£l':l<?£lg - T , __

3. Khau 10 thung thuc quan gay di chtrng anh huong den an uong
(chi an duoc thirc an mem) 36 - 40
.................................., , ,..·················N·················~··················
,.., , , , , - - , , , "., 1) .

4. Khau 10 thung thuc quan co bien chung ro hoac hep phai 1110lai,
61 - 63
gay hypvTnh vi~n, chi an dlIQ'~ ch~t 1911g
5: Chit hyp th0:c q~~~ d~ ch~n· th~~ng phai mo thong da day vinh
71 - 73
y'i~l1 ~~ ~I!.':l9£lg (9.~ ~~<:) g9.~-r;~~EI!.§!h<?l1g95l <:i~y)
6. Chit hep thirc quan do chan thuong: Tuy thuoc mire d(> anh
huong den an u6ng tinh tYl~%TTGT thea m\lc 3ho~c 4
7. Chit hyp thv~ q~~~ d~ ch~~ th~~g ph~T ph~~ th~~~t t~; hinh
..............................................................
thy.'? q':l~l1, .
7 .1 !<;~!q':l~ !<?!. T- N
66 - 70 _

7.2. 73 - 75
!<;~!q~~~l~<?£lg,t<?!":~£lEh~~ l1!§ !h<?l!.g<:iC;l9~y...................................................
_
*
Ghi chit: Neu lay dc;zitdlng tc;zohinh thl/c quan thi tY l¢ %
TTCT tinh ca tY l¢ % TTCT cua cac phdu thu{tt lciy dc;zitdlng,
n6i, ghep_thl;l'cquem.
II. !?!1 !1~':I,C?'~g~~~~y
1. I<?l1 !h~<!£lgg~Y !h~l!.&9C;l<:l~y........ T

1.1. Thyl1gl1!9!hgJ~h~~)<?~~~1!!T~,)~<?l1gg~y~i,~119C;l£lg<:iC;lc1~Y. 26 - 30
1.2.
1.3. . thyrig4~ id;
Thyng ttl' ba 16tr6'IeIl d~xu·tri, khong gay bi~n dC;lngd~ day
~§ ~9~i~~ 4irig4i~~y . . 31 - 35
36 - 40
1.4 M§ !h<?l1g<:iC;l<:i~Y 36 - 40
1.4.1 M§!h<?£lg <:l5l<:l~Y!C;lEI!.!hS!i 16 - 20
1.4.2. M§ !h<?l!.g<:l5l<:l~YYI~ y'i~l!.. _ , 36 - 40
2. Th~11g c1C;l<:l~Y~~ ~l!!~~, ~~~q9 '?9 yj~~~)g¢!Eh~i 9.i.~':l!TL1!.9i.~<:)~ .
2.1. Thung d~ day dfl xu tri khong bien d~ng, sau d6 c6 loet phili
diSu tri n(>i khoa 6n dinh 31 - 35
2.2 Th~~gd~d~y(ji~~·t~Tc6bi~~ d~ng, sau d6 c610etph~idi@~; tri
n(>i khoa 6n dinh 41 - 45
2.3. Thung d~ day dfl xu tri, sau d6 c6 loet, chay l11au phili iSu tri
n(>ikhoa 46 - 50
 17

3. cii doan d~ d~ydo ~h~~thuo'~~g; s~~ph§u thuat khong viem

loet mieng noi, khong thieu mau
3.1. I9~!h~2·~gEh~~~~!h~~E~~~~~~i~~Y··.·...................
_............................................
46-~50
3.2 I~~!h~9:~gEh~~~~!~~ph~~!~~'t~~y ,.........................................................
51 - 55 T

4. Cat dean da day do chan thuong, sau mo vi em loet rnieng noi,

.................................................
!h!~~~~?l!I]~~g,,?~i ~~~l!!!LI]9~ ~g~
4.1. I9.p.!h~9·P.gEh~i '?~!l.~~~
P~~I]~~~? ~~y 55
4.2. . I~l~ thuongphai '?~!~~ph~~!l!~? ~~Y. T 56 - 60
5. Cat doan da day do chan thuong (Muc 3), co bien chirng phai 61 _ 65
.......p~~l}!hl!~!)?i ,. . ,
6. Cat toan bQ da day do ton thuong, t9-0 hinh da day bang ruot 66 _ 70
............. ~~I],'?s!!h~~91]g ~l!YI]hl,f2'?hg~,?~l!YI]h~2~p.hx v

7. Cat toan ~Q da day do ton thuong, t9-0 hinh da day bang ruot 71 _ 75
non, co the suy nhuoc vira
8. cii to~~ b~ d~ d~y do i6~ thuong, t9-0 hi~h d~ d~y b~~g ruot
non, co thS suy nhiroc n?n_g 81
III. !?~!h~·9.·~gE~9!~9.~.
1 I91]!h_L!qp'gg~y
!h~~g _
1.1 _ Ih~~g~~9!h2~~h~Ll§~~~\!!!L.. 26 - 30
1.2. Thung tir ba 16 tro len da: xu tri 31 - 35
2. . ·················T6~ih~o:~gph~i~~tdo~~~~~t~on
du6'i mQt met
................... ··························1··························· - , ;.;,;.;; , .

2. 1. ~~! ~g'tP. thl!9<;h?~g !!~I]g 36 - 40

2.2. Cat do?n thuQc hoi tl"ang 46 - 51
3. T6~thu:O:~gphii~~i b6 ~~~t~o~ d~it~~~~ 1~6i~6t;;6~6i lO9-n
......................................................................
tieu
,. hoa "'.--.. ..
- -

3.1. . ~~!~9?p.thl}9<;h8I]g~E~pg 46 - 51
3.2. Cat dO?nth1l9c hoitrang . 55 - 60
4. T6~ th~~ng ph~i c~i h6 h@t rUQt non co r6i lO9-ntieu hoa g~~ 81 _ 85
tr§m trc;mg, anh huc)'l'!Rn?ng n~ d~n dinh duo'ng
IV. .•.•••••••...•...................•••••••.••..••.••.•
TBn thu'O'ng dai trang
') ...............••••.••...•.•.••••••.......•••••.•.......•..•....••..••.. 41••••.•...•..••••••••••.•.••••.••.••••••••••••••••••..•••••••••••.• _••.•....•............•............•••..........•.•.•••••••••••.•.•................••.••.•...•.......•.........•.•. _ .

1. Ton thuang thung d9-i trang khong lam h~u mon nhan t9-0 vInh
vien
1. 1. Ih~l]g 1!l9! 19 ~~ ~~ ~!i 36 - 40
1.2. . Th~p'g!l!h~il.§!~"q)~1]
~~~\! !T( ~. 41 - 45
1.3. Thung d9-i trang da: xu tri nhung bi ro phai phau thu~t l?i nhung
46 - 50
•• .•. .....•.......
lillong phai c~t doan dai trang .
•••••......••. --••••...•.•....•••.•••• l}" ••••••••..•.•...•..•.........••••••••••••••.••••..•..•.•.••.••...........•.•.••••.•.••..•.. ~•••••••••..,. .•..•.••••• ~ _-_.. -.-.- •••••••...••...........•...••..•••••••••..•..•......•••.••••..••.•• -••.••••• --••.....•........••.....•.•..

2. Ton thuO'ng phai cat d?i trang, khong lam h~u mon nhan t9-0
vInh viSn
2.l. ctt d09-n d?i trang 46 - 50
2.2. •• ¢~iliy·~~~Lii~rigph~L 56 - 60
2.3. Cat nU'a d?i trang trai 61 - 65
?~4: _ ¢~ii9~ri~9:~~Lii~~~g 71 - 75
 18

3. aOl;U1dai trang phai lam hau man nhan tao VI

vien
3 .1. doan dai trang 61 - 65
3··:·2·.····.............................. Q~!~~:~~~Lii~~g
••••
p.h~i. 66 - 70
3.3. Cat mra dai trang trai 71 - 75
3.4. C~tt~~~b~ daitrang 81 - 85
V !c?~~h':l'(?'~g~EI!~
~~~~g. . s: .

1 Th~l!g t.Tlf~t.:~~g)~~~g l~~ h~':lll?~~ nhan t.~gyI0J) yi~0

1. 1. Ih~l!g IP.2t.l~ c:!~~\l; t.~i 36 - 40
1.2. nr hai 16 tro
len air tri xu 41 - 45
1.3. ... '
Thung
~ true trang air
,. tri nhung con bi ro keo dai
" , , ..
,."
xu
"' , ,., , .•..•.........--
-.,., -- .
46 - 51
2. T~n thuong phai cat true trang khong lam hau man nhan tao vinh
vien
.................................... ?....... . " " -v ..

2.1 I~~!h~q~gEh~i ~~!~~ ~2t.E9~~ !Ell.~!~~l!g 41 - 45

2.2. Ton thuong phai cat bo hoan toan true trang 56 - 60
3. T6~····thua~g····t~v~···t~~~g·····di~·{f·····t~:i·····~~ph~i····i·~~h~~
~~6~-·~hantao
vinh viSn
3 .1 . . I~~0g t.Ell.~tT~l!g~~f)~ll?h~l:l~~9 0h~~ t.51~
yIl!h '. 56 - 60
3.2. T~n thirong phai cat true trang co lam hau man nhan tao vinh
61 - 65
vien
4. thuong rach thanh co tieu hoa phai khau (khong thung
3-5

* Ghi chit: Truong h9P mc)' bl:fngchi khdu rach thanh ca thi
c9ng vui tY a
l¢ % TTCT Ml:fcX I.I thea phuong phap c9ng tc;zi
Than tu:.
VI
1.
I?~ ~~~'g'~gh~~~§~
Ton thuO'ng cO'that h$u man, ong h$u man air
T........ .

xu trf Ian aau,

, ,

16 - 20
......................................................
1~~~gg~YE<?!J9~t;~~i t.!~9 , , ,
2. Ton thuO'ng co that h$u man, ong h$u man air xu' tri Ian aau, co
~hfrl!gg~YE<?!~g~l!~~L!i~~ ~i
I~~.~~l! h()~~~~ ~~i t.i~l!
?~)~............................. 26 - 30
2.2 J??it.}~~)~~~g!¥~h~... , _ N
36 - 40
3. Ton thuO'ng cO' that h$u man, ong h$u man gay ro phai phau
thu$t l~i
3.1. 26 - 30
3.2. co 46 - 50
......................................................··········1

3.3. toan b9 h$u man va lam h$u man nhan tSlo 51 - 55

VII Tc?Jl_~~':I'<:)'~gg~~,,!!!~! , , _.........., r

1. . ~V3:g <:l~Pg':l~,c:!i~':l~TL~~<?!<?~~~t.:.8~2i l~()':ll~~!ql:l~!<?! . T. 5-9

2. Phau thu$t khau va gan ho?c phau thu$t ap xe gan sau chan
..........................
th~()·I.~g"y~t. t.h~q~g
2.1. Khau vet 31
 19

Rh.~·~.yq
2:2·. . .........•.••...•••••••••
g~~••h9~.~·ph~~!h~~!~P~.~~.~~•~2i
•• ••!h~.yg.~.~ . 31 - 35
2.3. Khau va gan hoac phau thuat ap xe cua hai thuygan 36 - 40
3. Cat bo gan
:3~l~ . :~~1?9~!l:2!Eh~1]~h~Yg~~p.h~Ah<?~~Eh~~~h~yJY 41 - 45
3.2. G~t.1?§~~9!E~ih~~~IP2~1]~~g(l~Eh~L 56
3.3. . G~~9N~~ h<?!l~P9~1]~(:lg(lI]Eh~i1
~9E§i1(?~1]
~h~~n~9gg(l1] 61 - 65
4. .... Qty.~!I]~lP~~~1]p1]h\l~§g(:l1] .
4.1. Chua gay tai bien 16 - 20
4.2. >hfi· thuat nhung khong 1.1: duoc di v~t va khong phai lam thu
31 - 35

~.~.i
....
thuat khac
5. '6n thuong tui m~t phai bo ~~i111%~ 31
6. ..........•••..•
.....•.•..•.•••••••• M§.•~~·
••••jy••
• §pg••• ~.h~••••••••
············
6.1. Ket qua tot 31 - 35
?:?~ ~~!q~~~§l]g!§! =r': 41 - 45
6.3. . gh~~ !h\l%!~~Jy§1]g~~! ~h~y~ ~~!1?§f!~~~~~ .. 61
7. Phau thuat noi tui mat - ru(>tI1onhay noi ong m~tru()t non 61
8. Ph~~th~~t·du&~g
;~~t~i~~l~~ do ~=6~~t;t~~l1'l~t
................. 71 - 73
VIII. !?~!h,!~~gJl}Y
1. I§l] ~h~<?!lg
tuyphaikhau
1.1. Khau duoi tuy 31 - 35
1.2. Khau than tuy 36 - 40
1.3. Khau d~u tuy 41 - 45
1.4. '6 thuong bao tVYphai khau: Tinh ty l~ % TTCT nhu khau
...................."
rach thanh ca 6ng tieu hoa
, ,.,'?', ,., ,., , , , ;.;;,:; ,.., '1' ", .

2 I91] ~h~<?!lg
ph~.~.ph~l}~hl}~~
I1?i§l]g~lt.y:~l}.2~PC?I]
. 51 - 55
3. I~l] ~h~~·9gEhNph~~r~hl}~~~~!!YY ...
3.1. Cat
, duoi t\lYket ,qua tOt ~ ,. _ .•..•..•..•....................................•........•......•...•...............
............................................•....... _ ..•.•............................................•••.•..•......................•...................•••...• -;;.;.:, ....................................................•....•.•...............•.•.•••.• .
41 - 45
3.2. Cat duoi t\lY bien chung ro phai phau thu~t l?i, dieu trj co kSt
61
.................
ql}~,~h~!T~l]~l~§l]g ~\lY,lp<?1]
3.3. Phau thu~t cat ta trang, dau t\lY
.................................................. ;.;,;;; _ 1" ,\" ~...... . .., .
71 - 75
3.4. Phau thu~t cat ta trang, dau t\lY anh huang nhieu den dinh
81
..........................
~~2:l]g,!h~.~~~1]gg~Y , T. '"

3.5. Phau thu~t cat ta trang, dau t\lY bien chung ro h~o dai sau phau
85
thu~t,
.. .,
................................................................•....- - - , nit g~y, suy mon .
di6u trj it k~t ~qua, th~ tr?ng
....•.....•.•............................................•...........................•........................................••.•....................
, -- , -- , --

4. Ghan thuang tVycti~~tri baC?t§n 16 - 20

5. l'-J(l~ggi(i~Y ~(l~~h~l]ih0.·~·l!g...•..... 26 - 30
6. Chan thuang t\lY anh huang chuc nang t\lY: Tinh thea ty l~ %
TTC~ a
m\lc V. Chuang t6n thuang ca th~ do t6n thuang h~
n(>itiet
IX. !9~!h~'g:~g ~~~~l, , .
1. J.=.)yng
d~p 1ach ~ieu tri bao tOn 5-7
2.•..•..•.•.
···•· I?ri .••. ~·~.~h,
~h~~.g..••• .•
•.••.••••..•••.•••••.•••.•••••.. yq•••••
~4~h;•••••
ph.~.~~
•••• 4i•.~~•••••
ih~.~i••••• y~P••..•.
ti.i••••. ~.~~•t~.9
••••~.l!9·~. 16 - 20
 20

lach
3. Cat ban phan lach 21 - 25
4. Cat lach toan bQ 31 - 35
x. . G~,5 tc?~J~lJ'9·~g~~~~~~~h~ti~~ ~9~ y , .

1. Phau thuat tham do 0 bung do ton thuong hoac lay di v~t (rno
me)
1.1. ..Ti~~l;
do don thu~~ h~~ci~yduoc di V?t trong 6 bung, khong
11 - 15
...........
Eh~i (;GlI1i~hi~Ey~() (;~(; (;()'q~(:1}?:"Eh~ ~9:I1g....
1.2. Khong lay diroc di V?t trong 0 bung va khong phai can thiep
16 - 20
........
y~() (;~s,(;()'q~GlI1;Ph~l~9:I1g r: T . . N

2. Sau phau thuat 0 bung, co bien clnrng dinh tac ruot., phai phau
thuat lai: Tinh bang ty I~ % TTCT cua muc X.l cong voi ty l~ %
...............................................
IIGIE.~.(;t.ph~~~h~~~ ..19:i..theophuong ph~p (;2I1g ~5liIh§I1g ..~\l' .
2.1 eh~l! ~hl!~~)5ligq c!~J:lh)~J:l ~h\l; I1h~~ . 21 - 25
2.2. Phau thuat lai gO' dinh Ian thir hai 31 - 35
2.3. ...........•••..•.••••••••.••...•• i~~j Rh~~•ih~.~i~.~.ig§
•• •••
4(~h•i~:
••••bGl~.l:ql.~I1 . ••••• ih~••• 41 - 45
3. eh~~ ~h~~~ ~\!~~i. ~§I1 ~hl:!()'I1gq I1?:9:(;I19i,Xr,~5l(;~l~~()
3.1. . Ih~l?:g ~5l(; ~~~()' I1?:5l(;I19i I1h1!I1g 1~9I1g t9I1 ~h\l'(),I1gI1?:9:(;h 3-5
3.2. Khau cam mau dan~ .. thuan
.....................................................................................................................................................................
21 - 25
3.3. Khau c&mmau va c~t mQt ph&n m:;tcn6i 31
* Ghi chu:Tru'ong h9P mc)'bl;lngchi xii' tri thung mt;lctreo, m9C
n6i thi c(mg vO'i tY l¢ % TTCT o' m~tCX 1. 1 thea phuong philp
............ q9,f}gt9.LThqf}gX1!~r ,
4. Ton thuang do vet thuang pha huy ca thanh bl,lng dan thuan,
phai ph~u thu?t tai t:;tol~i thanh bl,lng
4.1. Ph~u thu~t kSt qua t6t 21 - 25
4.2. Sau ph~u thu~t con sa I6i th~mh bl,lng 26 - 30
4.3. Sau ph~u thu~t con thoat vi thanh bl,lng 31 - 35
5. M6 tham do 6 bl,lngb~ng nQi soi 6 - 10
 21

Chuong 5

TV LE PHAN TRAM TON THUONG CO THE

DO TON THrrONG HE. TIET NIEU - SINH DUC
. - SAN KHOA .
Muc TAn thuong Ty Ie 0/0
I. TAn thU'o'ng than
......................... "1' , , " t " " ""
..,.".,, ,." ,..,',.,", ,..,",, ,.,, "., .

1. Chan thuong dung dap than dfl duoc dieu tri nQi khoa bao ton
...................................
~hl!Ci~~h hl!<!~g~h~~~~~g~h~~
1.1. M9t than
1.1.1. DQ 1 2-4
ILJ)=..:· D=)..QI =2 1 ~5- 7
.....•
: I
1.1.3. DQ 3 8 - 10
* Ghi chu: Trang truong h9P khong chia dc), tinh tY l¢ % TTCT
bang do 2.
1.2. Hai than: Cong ty l~ % TTCT cua tung than thea phuong phap
eQng t~i ThoIlg tu
2. ¢b~l!~h~<!.rigib~ri g~y ~<!.!~2 r~~A!
~h~~~~~g l!l9! than
2.1. Ih~~ g~~~iCibinh thirong, l<l19~g~~y!h~~ . 31 - 35
2.2 Than ben kia khong binh thirong va/hoac suy than: Cong voi ty
l~ % TTCT do benh cua than ben con lai thea phuong phap
~9~g !~LIh9~g !l! ..
3. Viern than, be than
3.1: . Chu~ ~6 bis~ ~h&~g 11 - 15
3.2. bis~ ~h~;g~ C~~g ~6it§i~% TTCT~~~ bis~
·····································C6 chirng thea
.......................................
Eh~·<!.~gEh~E~9~g~~AIh9~g~_I!. .
4. than man tinh Suy
4.l. doan I Giai 41 - 45
4.2. dean II Giai 61 - 65
4.3. dean IlIa Giai 71 - 75
4.4. doan lUg, IV (co chi diI1h chay than nhan tao)
Giai 85 - 90
5. . ···························¢h~riih.~·.~~g
..•!h~ri•••• ~9 ••••• ~h.~.p····························· . ph~i•••• ~~i
••••
5.1. G~~P<?~P.9t.Eh~~~h~~,!h~I1
~9~ l~~ Q}1!h~I!1!9·~g. 21 - 25
5.2. Cat., b6 ITIQtth~n,, th?n con l~i binh thuang.. .
..........................................,. .....•....................__
.. -.- --.-- - -.- - -- -.-- , ,.,
41 - 45
5.3. Cat b6 ITIQtphan th?n ho~e ITIQtth?n, th~n ben kia co b~nh:
CQng v6i ty l~ % TTCT do b~nh eua th?n ben kia thea phuong
. .. Eh~p~9~gt~LIh§~g!1! T

6. Di V?t trong th?n chua lay ra

6. i···:····••.••••••••• ••·..···Qi••• §••••
·••••·.••······•· ~2i ••• y.~t•••
ih~~?~h~~•••• ~h~~g. ~.I~ri
g~y••••. 11 - 15
6.2. Di v?t (; hai th?n, chua gay bien chung: CQng ty l~ % TTCT eua
tung th?n thea phuong phap cQng t~i Thong tu
 22

6.3. Di v~t & than gay bien chung: Cong voi ty l~ % TTCT cua bien
. '?h.~.~g!h~g ph':r.~g Ph.~l? ,?9~g !~i Ih§I!g!l:l' .
7. Mo thong than 15 - 17
8. Ghep than, .., chuc nang than duoc cai thien
. ..........•.••....•.••.•.•...•.........•.•...•.....•.....•................•....
.•.•..•.................................•.........•..........
' - - .
26 - 30
9. Khau vet thuang th~n
. M~tb~~···································.
9.1. 16 - 18
9.2. Hai ben: Cong ty l~ % TTCT cua tung ben thea phuong phap
cong tai Thong tu
II. I?~!h~'g·~g~J~~.q~~~
1. Ton thuong mQt~en
1. i:······· ~~ikh~~b~~t6~
Di~~t~~i
1 .1.1. I9.!.§I:tg'?9 ~~ '?h.':!n:g. 6 - 10
1.1.2. Co di chimg: Cong voi ty l~ % TTCT cua di chirng thea phucng
.............Ph.~P '?9~g~~i Ih(')~g!':r. . .
1.2. . I.=?i~l} tTiEh~l:l ~hl}~~khong '?9 9i '?h~'l)g
1.2.1 Mo noi soi 16 - 20
1.2.2. M<3ho 21 - 25
1.3. tri ph~ thuat co di chimg: Cong voi ty l~ % TTCT cua di
'?h.,:!~g!h~s>J2h':r.~~gph~p ,?9~g !~LIh.(')gg!1!
.................................................
lA. Di chirng ton thuang nieu quan: chit hep nieu quan, than u 31 - 35
...............•••
n tree, nhiem trung b~ than .
•... - _ ....••.....••••••••••••••••1) ;;••••••••••••••••••••••••••••••••••..••.............. , .•

1.5. . I~~ ~h':r.qn:gI:t~~l:lql:l~I:tph~i '?h.l:lY~~c:l9~g~~~~~~~l}

1.6 ~§~ ~}~l}q1:l~I:t:E1:l9~ . JI.: 15
1.7 ~~~ 9~l:ll:)~~l:lql:l~I:tE(:l~g<?~i~(:l 16 - 20
2. Ton thuang hai ben: CQng ty l~ % TTCT cua tung ben thea
..................... .
phua'l:)g
.
phap cQng
,
tliliThong
1'.......... .
tu . ,. .

*
Ghi chit: Tat ca cac ton thuong o' M1;lc lJ: Neu suy th¢in, co
c(mg vO'i tY l¢ % TTCT cua suy th¢in thea phuong philp c(mg tc;li
Thong tu.
III I?~Jll~~()'~g ~~~gq~::t~g , ,
1. Ton thuang bang quang dieu tri nQi khaa baa tOn chua co di 6 - 10
.................
.... '?h,~'~g , . ~..
2. Ton thuO'ng bang quang phai dieu tri phau thu~t chua co di 21 - 25
chung
3. ~6 thuO'ng bang quang co di chung: CQng v6'i ty l~ % TTCT di
.......................
. '?h,:!~g ~h~<?,phl:l:<?PgEh~E'?9~g!~i Ih§pg!1!
4. Ri '?h,:!l:)g!§~ ~h1!<?pg1?~n:gql:l9:~g
4.1. HQi chul:)gbangquangnho (dung tich du6'i 100mI) 31 - 35
4.2. B~~g,q~a~g, iili6~g ~hfr~d~·Q·~ ~~6'~ l~~ti~i~m saat bang ti~~; 36 - 40
qy~I!g(I:t1!<!'?~i~l}'?h.~Y~h.9gi9~li~I:t ~\l,?} ..
....................
4.3. T~<? hil:)h ~~~gql:l~I:tgI.p<!A . 41 - 45
4A. D?t d~n luu bang quang vlnh vi~n 56 - 60
 23

5. . PLy~~bangquang
~:::L.. }~~!i~§¥::~~i~ng
c~di<:~ ~ -2-6-= 30
5.l.2. Ph~u thuat c6 di chung: Cong voi ti l~ % TTCT cua di chtrng
thea phuong phap cong tai Thong tu

f;:1. =--- ~~~_t~E~~ngbanlL'lUang_ 6 - 10

5.2.2. .....................Phai
" '.. '.~."."
phau thuat,
"'.'.' ..
ket qua tot, khong c6 ~ichlmg .. .
-- - ,., , ,,, , , , ,., , " ,

5.2.2.1. Mo noi soi 11 - 15

M6 ho "'
5.2.2.2. ...................................................
' ., ,. . ". 16 - 20
5.2.3. Phai phau thuat, ket qua khong tot (khong lay duoc di V?t hoac 36 - 40
l~y khong het)
* Chi chit: Niu co
di chimg, cong voi ti l¢ % TTCT cua di
...................................................
qhz!'!gt~~?P~l!C?·'!:gp~4pq9'!gt9iT~c?,!gtl!:: ....._
6. yg, ~h~l~gl:J~P:g q~(l~g ~~ph~~ ~h~~~,.1~9J:lg(;<) di ..(;h~l~g
2:1: _ ~gg~~Eh~(;~~(; _ _ 21 - 25
6.2. IT9PgEh~(;~~~ 26 - 30
* Chi chit: Neu co di chung, cong voi ry l¢ % TTCT cua di
q~z!'!gt~~?,p~l!C!'!gp~4pq9'!gt9LIhc?'!gtl!:
7 G~t l:J~~~Eh~pl:J~P:gq~(lgg...... , , 41 - 45
8. Cat toan phan bang_quang va chuyen luu mroc tieu 81 - 85
IV.. !?!1 !~l!C?:~g~i~~ c.t.~C?
1. I9~!hl!<!P:gP:~~~~~g.. 'T
1.1. . ~i~~l yj J:l2ikhoaphuc h§i ~§~,)'h9gg (;<) ~L(;l1~P:g. 11 - 15
1.2. g8~i (;l1~,~gl1yErl~~~~~gEh~i1~gP:g119~(;(;(lI~ ~l1i~E~~9h}l}h
1.2.1. KH qua tot 31 - 35
1.2.2. Khong k:et qua 41 - 45
2. Ro ni~u dC;lo 16 - 20
3.
3 . 1. ~l1§p:g (;<) ~L(;h~J:lg 21 - 25
3.2. C6 di chung: C<)ng vai ty l~ % TTCT 6' m\lc l.2 thea phuong
phap c<)ng tC;liThong tu
V. !?~!J~~'C?'~g~~~g~~~~t.!l§~, T T

1. •••• ••
Iop:thli'ongtang
>j....
sinh mon dieu tri n<)i khoaket qua tOt
••••••••••....••••••••••..•......••••••••..., 1- 5 , ....•••••...................•••••.•..•••••••••••••••••.••...........•.••••••...•.•.•••..•...•.•••••••••••••••••.•••••..••••

2. Ton thuang tang sinh mon c6 bien chung ro bang quang - am

dC;lOhay ni~u dC;lO,tn!c trang
2.1 Ph~u thu~tkSt q~at6t ·······1f= 15

2.2.......•...•... Ph~~I!E~~ij~~iq~~Fh9hgj2! T 31 - 35
2.3. Daphau thu?thai Ian tro' len nhung khong ket qua 51 - 55
3. ... T6~th~:~g~; ~6~gh~~~6~~Apdv~g T6~ thuong ~\;~vI:
h?u man, Chuang Ty l~ ph~n tram t6n thuO'ng Co' thS do t6n
thuang h~ tieu h6a
 24

VI. . .
TAn thU'o'ng tinh hoan/buong tnrng
? , ~ , .

1. ..... I§? ~h':!qt1g}p~~~i.!1:hhc.>~~~ll§gg~rl!gg

1.1. M~~~P9~ph~g ~2~~~g _ . .6 - 10_ .

1.2. Mat hoan toan m2tben 16 - 20

1.3. M~t ca hai ben 36 - 40
2. . ~<? ~~~':!qt1gg~yt~c.>
~ighh9~g <?h~:~l~~gg ~iph ~igh
2.1. M9t ben 11 - 15
2.2. Hai ben 30 - 35
3. ii~~giri~i.~h~~
I~~i.h~~gg~yi.~~~~9~g ri~rig~{rihti~~g
3.1. M9t ben 16 - 20
3.2. Hai ben 31 - 35
4. . Q~ptirili E9~ri!~~2rig tTl!Pg, <?<)l~Eh~r~l!~l)g sirLhtil1h/siph trl!pg .
4.1. M9t ben
4.1.1. f):,~· tri noi khoa bao ton 1- 5
4.1.2. fj{¥~id~~rigpE~~ih~~!~h~rigj~~pg~~<~§ 6 - 10
4.2. Hai ben: Cong ty l~ % TTCT cua tung ben thea phuong phap
..... ~2gg~9:LIh§pg~,:!, . T

5. Dap tinh hoan/buong tnrng gay mat clnrc nang: Tinh ty l~ %

............
.. . Irgr !1:h':! ~~9 ~i.!1:h
hc.>~~!~~9gg~I:l!l)g
* Ghi chu: Tat ccl cdc ton thuong 0 m1:1C VI
- Tit 40 tuJi tro xuong: Cong them 50% tY I¢ % TTCT
- Tic 55 tuoi tro len (a6z' voi nii) va tic 65 tuoi tro len (a6i voi
nam): Trit 50% tY I¢ % TTCT
VII. ,,~t
. !~p !~ll'q~~~lI'g'~g
1 M~~
~p2~ph~peltl'9'pgy~~ T . 21 - 25
2. .. ~1!~1~9~Eh~rLel':!9'ggy~~~~ g§i l';li .
2.1 Kh§pg~<? eli ~hl!gg... _ 11 - 15
2.2. Co di chung: C9ng v6i ty l~ % TTCT cua di chung thea phuong
.................. ph~l?~2gg~';l~Ih§pg~~. ,.
3 ~~~ hc.>~p~c.>~!1: el~·qggy~~"~~ g§iJ51i
3.1 ~§!1:g~<? eli ~hl!rLg 21 - 25
3.2. Co di chung: C9ng v6i ty l~ % TTCT cua di ch(mg thea phuang
.. Eh~l? ~2gg ~';liIh§pg ~':! T m... .. . ~ .

4. UUt h02tll toan duang v~t, khong noi l~i dUQ'c,da: phau thu~t t(;to 31 - 35
. hir;h el':!9'pg.y~~~ .
5. Mat hoan toan duang v~t 36 - 40
6. . §y9el':!9'rLgy~t ..,
6.1. Kl;ong gay co keo duang v~t: Tinh ty l~ % TTCT nhu SyO phan
mem
6.2. g~y~9 ~¢9 el':!9'l)gy.~~ 11 - 15
7. 1:<?~el(;lel':!9'pgy~~Eh~i gh¢E el<:i.
7.1. Khong co di chung 11 - 15
 25

7.2. C6 di chimg: Cong voi ty l~ % TTCT cua di chung thea phuong

ph~p~2!l:gt.~LIh§~g~l! ,
8. Di clnrng ton thuong duong vat khong the thirc hien chirc nang 16 - 20
sinh due
9. ... ~~ <}~Yh~lp}?(;l8q~}
g~~
9.1. Khau l?huc hoi tot
.................................................................
" ~ * ;0;
, .....•.....•.•..•••.•.•••.• _............................................................ •
1- 5
9.2. Phuc hoi mot phan, de lai di clnrng (dau, quan h~ tinh d\IC kh6 6 - 10
khan) . , ~
........................................................
,. ....•.. .

* Ghi chu: Tat ca cdc ton thuong 0' muc VII

- Tie 40 tuoi tro xuong: Cong them 50% tY I¢ % TTCT.
- Tic 65 tuJi tro len: Trir 50% tY l¢ % TTCT.
VIII. !?~ !~~'g'~g!~'~~~g
1. Ton thuong thanh nr cung nhung chua thung, khong c6 di 16 - 20
chung

3.
I&~
2·. ······················•·· ~.g•!~
Tonthucmgtu
••..
•.·•.•...••.•••••••••••••• ~.~rig,~I~.~
~~ng
.•.iiLp.h~~~h.~.~~
~6di chirng
~.§!l:g~2<}~
(dinh buong
~h~g
ttl' cung.v.)
. 21
26
- 25
- 30
4. C~tis cu~g b~~ph~n . ..
31 - 35
5. Cat tir cung hoan toan 46 - 50
* Ghi chu: ca cdc tJn thuong 0' muc VIII nat
- Tir 40 tuJi tro xuong: Cong them 50% tY I¢ % TTCT.
- rtf 55 tuJi tro len: Trir 50% tY l¢ % TTCT.
IX. T~n..th ~'O'ng v~ (Nil gi6i)
1.
··T6~·th~r~g~6~n···~·6 .
1.1. MQt ben
1.1.1.. ....•. M~~~9iph~ri:Iyl~ ~II~I~~(;l~y()Eh~~~~~~~ph~l!h¥~9 ? ...
1.1.2. Mat toim bQ 11 - 13
1.2. Hai ben: CQng ty l~ % TTCT cua tung ben thea phuong phap
. ~9,!l:g~~i
Ih§gg~~
2. Ton thuong vu
2.1. MQt ben

•.•••••.•..............................•............................................................................•..••.•.........•.....•••••..................•••.••.......
, _ .
21 - 25
2.2. Hai ben: CQng ty l~ % TTCT cua tung ben theo phuong phap
..........................
~2pg~~LTh§g,g~l! , ..
* Ghi chu: Tat ca cac ton thuang a m~lCIX
- Tit 40 tuJi tro' xu6ng: C9ng 50% tY I¢ % TTCT.
- Tit 55 tu6i tro'len: Trir 50% tY I¢ % TTCT.
- T6n thuong vu nam gibi: Tinh tY l¢ % TTCT c~ta sr;;ophdn a
mJm nhan h¢ s6 3.
X.
1.
!~':I'.q~g
Ton thuong ffiQtben
T?~
~~g~~~!~~~/~~g~~~!E~:~g~y~i
!r:~'~g .

1. i:············· T6~th~';~giili6~gg§:y dUt, phvc·hbi t6t m

5-9
 26

1.2. I?~~hy9.·~gg~y.~~, ph~~ !h~~!p~~Ehy~h~i.~~~ N _

11 - 15
1.3. Ton thuong gay dirt, khong phau thuat hoac phau thuat khong 16 - 20
. phY~h<?i.~Y(2'~ r= , , .

1.4 I?~ !h1!9.·~gg~y~~~,

kh~~g~h§phY~h§i 16 - 20
2. Ton thuong hai ben: Cong ty l~ % TTCT cua tung ben theo
ph1!q~gEh~E,<?9~g~~iIh~~g~y _
* Ghi chu:
Tat ca cac ton thuong muc X a
- Til'40 tu6i tra xuong: Cong 50% ty I¢ % TTCT
- Til' 55 tu6i tro len: Tril' 50% ry I¢ % TTCT
XI. Tan thurrng am ho, am dao
1. Ton thuong am ho, am dao khong gay bien dang, khong anh
hlJ.·q~g~h~~~~~g:I~ph ~yl~ ~ IrgI~hY ~Y()Eh~~Ip~}!l....
........................
2. I~~ ~hY9:~g~P.? h9, ~~!l~'ilgg~y ~~~p~~~g, ,
2.1. Khong anh huong clnrc nang: Tinh ty l~ % TTCT nhu SyO phan
1···········································
mem nhan h~ s6 3
2.2. . g§,~~h hyq~g ~b~~~~~g_ 16 - 20
3. Mat am V?t
3.1. M~t mot phan 6 - 10
3.2. M~t hoan toan 11 - 15
4. Mat moi Ian
4.1 Mot ben
4.1.1. M~t mot phan 1- 5
4.1.2. M~t ho~mtoan 6 - 10
4.2. Hai ben: C(>ngty l~ % TTCT cua tung ben thea phuong phap
c(>ngt';tiThong tu
5.··································
M~t~6Tb6
5.1. M(>tben
5.1.1. M~t m(>tphftn 1- 5
5.1.2. M~t hoan toan 6 - 10
5.2. Hai ben: C(>ngty l~ % TTCT cua tUng ben thea phuong phap
..............
.. ~9~g~51i
Ih§~fg ty ,
* Ghi chu: Tat ca cac ton thuang a ml;lcXI
- Til'40 tu6i trO'xu6ng: C9ng 50% ry I¢ % TTCT
- Til' 55 tu6i tro'len: Tru' 50% ry l¢ % TTCT
XII !?~~h1:l·C?:~g~~~Ish()~
1 I~~ ~hl!q~gg~y ~?(:l~~y!h:;ti.
1.1. Dieu tri bao tOIl ket qua tot 1- 5
1.2. Dis~ t~:ib~~t6~kh6~gkSt qua, phai dinh chi thai nghen (b6
................ !h~D:IiI1h!yJ~~IIgII1h~·!~~~hyq~gg~y~~y!h:;ti
2. . I~I1 ~hyq~gg~y ~~y.!h(:l~~!h(:li
~h§!J~~ ..
2.1. Bathang dftu 11 - 15
2.2. Ba thang gifra 16 - 20
 27

?}~ _ ~~t.h~~g,?~§.~ 21 - 25
3. Ton thirong gay de non
3.1. De non con song 16 - 20
3.2. De non con chet 31 - 35
XIII.
1.
!?~ !~y~~!!~~
!!~~'<:)'~g l!~!,(~i !~~h .
Ton thuong gay roi loan chirc nang va/hoac
rr •. N

bien doi giai phau 6 - 10

~hl!l)g)0.§~~'?~~ ~~~~t.~L
.............................................
2. Cat tuyen tien liet 11 - 15
3. C~t t~yS~tiS~ ii~t ~atui tinh
16 - 20
*GhT;h~.:Tdt;d;6;t6~ih~l:;ng 0 muc XIII
- Tit 40 tuJi tro xuong: Cong them 50% tY I¢ % TTCT
- Tit 65 tuJi tro len: Trit 50% tY I¢ % TTCT
XIV. !9,~ !h~'g'~g,biu
1. Mat m9t phan da biu khong kern theo giam clnrc nang, khong 3-5
.....
~~Lyjt.ELy~
~§~g~~t 9L~2~g,?~~
t.il)hhg~l) ..
2. Mat mot phan da biu, khong giam chirc nang tinh hoan nhimg 6 - 10
co kern theo sai vi tri hoac mat di dong tinh hoan
3. Mat toan b9 da biu hoac mat mot phan da biu can ghep tinh 16 - 20
hoan vao noi khac dS bao t6n chirc nang tinh hoan
* Ghi chu: Tat ca cac ton thuong 0' muc XIV
- Til'40 tuJi tro xuong: Cong 50% ty I¢ % TTCT
- Tit 65 tuJi tro len: Trit 50% tY l¢ % TTCT
 28

Chuong 6
TY LIt PHA.N TRAM TON THUONG CO THE
'DO TON THU'ONG Ht NOI TIET
Muc Ty Ie 0/0

I Tan thu'o'ng . tuy~n

., yen
.............•.......•......................•••..•••.•••..•
----_.................. -- , , ~ .,
...............................•..•..•..............................•.••...............................•.......••.•.• ---_. __ - ~................. .
1. T6n thuong tuyen yen, chua gay bien chung: Ap dung Chuang

~:l. _. 26 - 30
2.2. "E3:9~
~C:?';ll!~~~~
!?:~1)g~h~y.!~:~sY~
!~Y~I!y~1) . . .............. _ ..

2.2.1. Roi loan mot loai hormon 26 - 30

2.2.2. R6i io~nt{f'h~idS~ ba loai hormon
............................
,. ! , ~ , '1 .
41 - 45
2.2.3. Roi loan tir bon loai hormon tro len (roi IOC;ln
clnrc nang thuy 56 - 60
, ;, en)
2.3. .....~~fi~~~~~h~~l!~~~g t~~~;
b~ t~yS~ y~l; (~6TjO?~;~h{r~l;~~g ~~ 61 - 63
..... !ht!y!l"':l'q~y~!~t!Y~c:tI:l) , T ·················,1·································
I
* Ghi chit: Neudi chung ton thuong tuyen yen xciy ra truac tuoi
day thi, tY l¢ % TTCT duac cong 20% thea phuong phap cong
tai Thong tu:
II !?~
!h~·9·~g!~~~l!gi~p "r .

1~ . I§!?:~~!~'<!1)g
!~Y~I!gi~p ~~~c:tg~y ~~~l!~~~!lg
1.1. M(>tben 11 - 15
1.2. Hai ben: Cong ty l~ % TTCT cua tirng ben thea phuong phap
~9,1)g~~i
I~9.l!g!y. , . . . .
2 I§I! ~~~~c:?'1)g
~~y~!?:gi~pg~y~i~1)~~f!l!g .
2.1. Nhiern doc giap
2.1.1. Duoi lam sang 21 - 25
2.1.2. ~~~!l~~l!g(~~I!~~c:t~~9g~1~~Yc:tg~..j~1!~~~'l!g 31 - 35
2.1.3. Lam sang (benh Basedow) co bien chimg: Tinh ty l~ % TTCT
thea muc 2.1.2 va cong voi ty l~ % TTCT cua bi~n chung thea
.............. pht.I:c:?'!?:gI?h~p
~91!g!';liIh§l!g~':l'
2.2. Suy giap ........................................................... . .

2.2.1. §~ygi~p~<?~~t! 21 - 25
2.2.2. §\!ygi~pl!l~!~~{~~Yg~~PE9) . 31 - 35
2.3. . I91!~h~c:?!l&P~~L~~~!~y~!?:g~~p T N , . .

2.3 .1. G~~1:l!9!l?h~!?:~!l9~9~1!~~~~~1!~l!g!l!y~/1)g~~E

Y~I!QI!9il!h ).1 = )? .
2.3.2 G~~~g~1) !g~1!l!l9! ~~I!'~h~S!?:~1)g~~X~!?:gi~p";'~I!§1)9tl!h. 16 - 20
2.3.3. Cat hoan to<,mm(>tben va cat lTI(>tphan ben doi di~n, chtyc nang 21 - 25
~l!y~l!g}~Ey~I!,~~9i~T
..............
* Ghi chit: Neu co bien chung thi cr;5ngvo'i tY l¢ % TTCT cz,ta
.....................................
. p~~,,!0h0:!gJht!C!I?hl!:C(l}gph4p 09,!:gJ9J Thql'}gt1!~
 29

2.3.4. C~t ca hai ben 56 - 60

III !?~ ~~~lI'().~g
~lJ),'~~ ~~~ gt~p r

1 I9l!: ~hll'c!!1:g
~l}Y~!1:
~~l):gi~p~h\l'':lg~y ~i~l'l~h~!1:g . . .. ..
1.1. Mot ben 11 - 15
1.2. Hai ben: Tinh ty l~ % TTCT cua tung ben .~~cong thea phuong
.............................................
E~~P~2P:g!~iI4,9l):g~\l' f .

2. Ton thuang tuyen can giap gay suy chirc nang tuyen can giap 21 - 25
(bao gorn ca suy tu_y6nc~n giap sau phau thuat)
IV. I?~ t~lI'()·!!g!lJ),'~!!!~1I'9'.~g!~~~............................. T

1. I9l!:~h\l'~g~l}y~l):!h\l'2'P:g!h~l):9h\l'':lg~y~~~l):~h~p:g .
1.1. Mot ben
1····················································· , ,....................................................................................................
11 - 15
t································

1.2. Hai ben: Tinh ty l~ % TTCT cua tung ben r6i cong theo phuong
.................... EQ~P~2l):gt~iI~9l):g~\l' T

2. . I9l'l ~hll'~g !l}Y~I!thll'Cll'lg~h~l'lg~y ~i~l'l ~h(rl'lg

2.1. Suy thuong than
2.1.1 : th# ~~l?~rigi~i yqi. ~g~~~gi9 36 - 40
2. 1.2. Ib~J<h9!1:g9~P~!1:&yqLS()~i~9i9 61 - 63
2.2 I9!1:~hl}·C!P:gp.h~L~~~ ~l}y~l'l!h\l'2'P:g!h~l): .
2.2.1. Cat mot ben
2.2.1.1 Khong gay l~n clnrng 16 - 20
2.2.1.2· C6 g~y bis~ (j{{f~g:C~~g ~6i i§ i~% TTeT ~~~bis~~chung
~h~9Eh\l'ql'lgp.h~I?99!1:g~~i,Ih9!1:g~;r.
2.2.2.
2.2.2.1: Cat mot benva cat mot phan ben doi dien
Kh6~g·g~ybis~~h~;g········ .
26 - 30
2.2.2.2. C6 bi 6 chirng: Cong voi ty l~ % TTCT cua l6n chlrng theo
.. E~ll'C!!1:gp.h~p.
~9!1:g!~LIh9l'lg ~\l'
2.2.3. Cat ca hai ben
2.2.3.1. 'b< dap (rng t61 v6i Corticoid
······························"····if··
..·'..,'''''''',,· ..·· ,"',." , , , , ,., '", ..,.,..
65 - 68
2.2.3.2. The khong dap lmg v6i Corticoid 81 - 83
* Ghi chu: NE m& b1:lngtham do thi c9ng vO'itY l¢ % TTCT cua
m6 tham do 6 b1:lngthea phuong phap c9ng t(Ji Thong hr.
V. !?~!~lI'()·~g!lJy~!! !.1}.y...... T.

1. Ton thuang tuyen t\lY chua gay bien chUng dai thao ducmg:
Tinh ty l~ % TTCT theo quy dinh t~i Chuang t6n thuang Co' th~
do t6n thuang h~ tieu h6a
t<?ri•ih~qrig••••
2 ................................•.•••• •• i~y~.~,iyy•g.~y
••• •bj.•••~ri
• •~.h.~.!1:.g
... 4~i ~.h.~.()
4\l'q!1:g.
2.1 ~~i. ~h~()4l}·q!1:g~i~~~~l):g 21 - 25
2.2. Dai thao ducmg lam sang 41 - 45
VI. Tuy~n sinh d1).c (buang trfrng, tinh hoitn)
Tinh ty l~ % TTCT thea quy dinh t~i Chuang t6n thuong Co' th~
.......................
9() ~9!1: ~hl}'2'!1:g
h~..~}~~
.!1:i~l}
. ~ ~i!1:h~yg ~~~!1:
kb()':l·
 30

* Ghi chu: ivi~ h¢nh iY t~yin yen, tuyin giap, tuyi~ thuong
than, tuyen tuy, tuyen sinh due xay ra truac 16 tuJi thi ry l¢ %
TTCT duoc cong 20% thea phuong phap cong tai Thong tu:
 31

Churrng 7

TY L¢ PHAN TRAM TON THUONG CO THE

DO TONTHUONGCO-XUONG-KHOP

Nguyen t~c chung:

1. Tan thuong xurrng
- Gay xuong dai nhieu 6 tai mot xuong nSu khong ngan chi: Tinh ty l~ % TTCT
bang gay xirong can xAu khong ngan chi. NSu co ngan chi tinh ty l~ % TTCT bang
gay xuong can x:lu ngan chi.
- Me xuong, nut, ran xuong: Tinh ty l~ % TTCT 1 - 3%
- Gay xuong dai (; 113tren, 113giira, 113duoi: Tinh ty l~ % TTCT nhu gay than
xuong (khong chia doan).
- Ghep xuong: Ch6 lAyxuong tinh ty l~ % TTCT 3 - 5%.
- M:lt mot phan d6t ngon tay, d6t ngon chan thi tinh ty l~ % TTCT (; mire t6i
thiSu cua khung ty l~ % TTCT mAt d6t ngon tay, d6t ngon chan tuong ung.
- Cac t6n thuong xuong SQ, xuong ham mat, xuang suon va xuong ire duoc qui
dinh tai cac chuang rieng.
2. Dirt, tan thurrng gan co'
- Gan ngon van dong ngon, d6t ngon tay, chan:
+ N6i ph\lc h6i: Tinh ty l~ % TTCT s~o ph~n mSm.
+ N6i khong ph\lc h6i: Tinh ty l~ % TTCT thea h~n chS v~n dQng cac d~u chi va
s~o ph~n mSm.
- Gan ca v~n dQng ban tay, ban chan:
+ N6i ph\lc h6i: Tinh ty l~ % TTCT s~o ph~n mSm.
+ N6i khong ph\lc h6i: Tinh ty l~ % TTCT h~n chS v~n dQng khop c6 tay, chan
va s~o ph~n mSm.
- T6n thuang gan du6i va gan gAp: xSp ty l~ % TTCT nhu nhau.
3. Tan thuO'ng sl}n kho'p
- T6n thuang s\ln gay anh huang kh6p: Tinh ty l~ % TTCT thea muc dQ h~n chS
v~n dQng kh6'p.
a
- T6n thuang s\ln tiSp hQ'p tre em: Tinh ty l~ % TTCT nhu t6n thuang xuang.
4.TanthuO'ngh~nhVp
Trong trucmg hQ'pt6n thuang chi co nhiSu t6n thuang h6n hQ'pnhu m~ch mau,
th~n kinh, xuong, ca ... khi cQng cac ty l~ % TTCT theo phuang phap cQng t~i Thong
tu rna kSt qua cao han ty l~ % TTCT c~t C\lt do~n chi thi tinh ty l~ % TTCT b&ng
95% ty l~ % TTCT c~t c\lt do~n chi tuang ung.
 32

Muc TAn thuoug

I ~~'g'~g49~Y~~t.!t:)'~gl?~y~t ..
1. Gay xucmg don
l.i:··································c~~ii~~··t6-t;kh6~g~~hhu&~gdS~g~~·,~ac 6 - 10
l.2. ¢~h(i¥ri ~~~; g9, ~~rig Y~IY~ <f~~¥rih h~§rig 9~ri g~l!h, y.~~ 16 - 20
2 M~~995t.~~~ql!gg~y~hqpg~~~~9'l!g92.l! J§~ 20
3. Trat khop don - mom - ba 11 - 15
4. Trat khop uc - don 11 - 15
5. Trat khop cung don
5 .1. }\~~j~E!p ~~rig ~9.ri~{¥~ ~dkh9r······ . . 1- 3
5.2. Tr~t khqp clIng ct2.l!~gd~ tai phat 11 - 15
Q~y,•yq.•..
••• ~~9·rig.•..~.~..'!.~.~1~9.i.~~l!.49•••••
6............•••....•••••.•••••••••.... •• ~.h~~~h.~()·~.g.
6.1. Me xuong ba vai. 1- 3
6.2. Gay mom cung vai hoac mom qua 6 - 10
6.3. Q~y, yq h()*~ ~9)9 !~l:1Y~~q ~h~l!~~qrig . 6 - 10
6.4 Q~y,yqq~g~l}hl!g~l!g .. 11 - 15
6.5. Gay, va phan 0 khop vai
6.5. i: V56iili6p ~~ida~ ,
th~~~, ch6~~u~'~g ~~~ t~y 1~h6~g bit6~ 16 - 20
~h~<?:l'l.g ~~~gct~ J.5t.~h~l:1ql:1~~~ ~E~!l~§p y'~i
6.5.2. Va 0 khop kern ton thuong chom gay hau qua cirng, han khop
vai: Tinh ty l~ % TTCT nhu tfm thuong khop vai
II. Kho'p vai
1. Thao mot khap vai 71 - 73
·•·•·f9ri~h~9·rig
2 .•...••••••••••••
·•··
••
•.••••••
•• j~§P••••
••• y~i !P.9~~.~.l! , .
2. 1. Mfl'~ <19h5t.~~h~f~~~<19l!g!~~i~(~5t.p~~~ L~~/799~g!~~) 11 - 15
2.2. Muc dQ h?n che cac dQng tac rat nhieu, kelTI thea teo ca (h?n
21 - 25
~h~} ~?/Z 99~g!~~}
2.3. . Gfl'~g)~hqp'!~i g~l! h()~~ !()~~ 31 - 35
2.4. Gfl'l!g}~9P y~i hg~!;!g~l! .
2.4.1. Tu the thu~n: Tu the nghi (0°) 46 - 50
2.4.2. ·•·· •I~
•••••••••••
• ·•·· •• •••
~hrkh9rig.ih~.~ri.:•••••
~~ •••
ii~q~;~~.~.•••.
~.~.~.;••••
g;iq•••rig;~rig.·Y~!.~.l!~..~.(). 51 - 55
2.4.3 Ih~y 1~h9'P'!~~l!h~~ !5t.C? 16 - 20
2.5. Tr~t kh6p vai
2.5.i: T~~~tiili6p~~il;6·TdiS~·tri kh6i 3-5
2.5.2 T~~tiili&p~~i~fid@t~iph~t(khong con kha nang di~~1tri ho?c
21 - 25
,.., .....................................
cti~l}.~EL~h9~g~~!ql:1~),.............................................................................................
j.... . .

.). Viem khap vai do chan thuang gay h?n che v~n dQng khap:
Tinh thea ty l~ % TTCT h?n chS v~n dQng kh6p
III. Canh tay
l. Cl,lt lTIQtcc'mhtay
1. 1. fjub:~g ~~t173t~~~ 66 - 70
 33

·1.2 t?~~~&~~!
i/~gI~~~~iili!~yii§ ~~9~gN............................................ 61 - 65
2. ... Q~y ~~l! ~E~P~l!~pg ~~£lh!~y (t~ ~?phau ~h~~~!Eq)~I))
2.1. Va, tieu cham dau xuong canh tay hau qua han khop vai hoac 41 _ 45
...................
l~pg)i~pg,(~h\lPP.h}!P~ql!~pg~~~~JPh) .
2.2. Can lien tot, nhung co teo co va han che dong tac khop vai mire 21 _ 25
d9 vim
2.3. Ca~ii~~·~§~~t~;~~6~ita;dai~ai~~~~~htay;h~~~h{d9ng tac
31 - 35
.................................................
l~¢p y~iphi~l! ? '"

3. Gay than xuong canh tay mot ben duoi co phau thuat,
3 . i··: ...••••
·•·•· li~~i9,!;
••.••.•••••.••••••••••
~.~~ •• ••••
!iy.~•ih~~g;
•••• ••••
~.§~g••••
~.g~ri
•••
~,h}
•••••••••••
··· . 11 - 15
3 .2. G~P li~p~~l!?!E\l~h(!~)~~h"~§pg !?:g~p~hi 21 - 25
3.3. Can lien xau, truc lech, ngan chi
3.3. i. tig~ri4~q{~~ii.i··········································· .
26 - 30
3.3.2. Ng~l!!~?~!P!r:ql~p. , .. 31 - 35
3.4 G~Q~~':l,h~i ~~l!g~y chongnhau . 41 - 43
4.
.....................
- -
Gay dfiu duoi xuong canh tay mot ben
, , - , y "....... .. ,,- "'........ ,......... . - ~ .

4.1. Gay tren loi cau hoac gay giira hai lai cau, gay loi cau trong 21 _ 25
hoac 16i cfiu ngoai
4:2: G~y~h~: ~v~
4:1 ~hung can li~~ ~~~, di l~ch d~~ d~~hau qua
cirng, han khop khuyu: Tinh thea ty l~ % TTCT Ctla t6n thuang
...........................
)~h<!El~!1:ly':1, .., , T

4.3 ~~ h<?~~T:tQ l§i ~~':l~<?:Q !hl!~Q,)~91}g~£lhl!~<)·Qp

~§Q)~h¢'E 3-5
4.4. Me xuung dai (cac chi tren va chi du6i, chua den ang tuy ho?c 1- 3
d~n 6ng tuy nhung khang co bi~n chung)
* Ghi chu: Ndu co bidn chung viem tuy xuang: Tinh tY l¢ %
TTCT thea m¥c viem tuy xuang tgi Chuang Ty l¢ ph6n tram t6n
.........................................
Jb~:C!f}gqC!Jb4cjq'?~'!:h,r9:tqq'~~l:!C)?]g~k~(?p
5. . ~~! ~<?:tQ~l!C!Qg~~ph!~y t:t<?!h~Qhl~h¢'Pgi~
5.1 )~¢l?g~~~h~~ 31 - 35
5.2. Kh6p ia long 41 - 45
IV. G~~g!~yy~~h§·p~h':ly~J~y.
1. . Ih~<?1!!9!!~¢p l~l!Y':l 61
2. C\lt 1119tcaI)g tay
2. 1: t?~2~g~~t1/~ii¥~ , 56 - 60
2.2 ~~.<?'!lg~~!J/?gi9'~ ~Eg ~~9Qg 51 - 55
3. Q~yr.P.<)lP.~':lYl!~l!:<?!l:g~~\l .
3.1 g~y ~C!p~h~~l!~9I)gg~Y ~Qhhl!:gpgl~¢E T 6 - 10
3.2. Gay mom khuyu xuang tr\l gay h?u qua bien d?ng cling m9t

3.2.1.
3.2.2.
= ~i~~~]l
:Bi~ol1gI<ho~~gtrii5,Od€Tli~-
Cang tay gap - duai dugc trong khoang 45° den 90°
11 - 15
26 - 30
~.~~g.i.~yg~p.;
3.2.3 .••••••••••••••••••••••• ••••. ~~2~.t.i~~g
~.~.~.{
••• !ili.~.~~g
i~¥~•••• 4$~· .
Q~~~~.. 31 - 35
 34

3.2.4 .•••
······•·
••
·•••••••• g~P;•~.~.§I~.~2:~
¢.~~gi~y
•••• ••. ••ii?~g•~.?¥~g.·i~~~~!99°
•• den 150; 51 - 55
4. IE~t)~9E)~l})'l} c:~.
4.1. ]):~~kh¢pkhl})'l}~_i~l}~~Lkh9i 3-5
4.2 Ir~~J~9P khl})'l} c:~~~ ~~iEh~~ 11 - 15
4.3 Tr~~)~9P ql}~Y ~ tEY. g~~l}~rLkh§L 1- 3
5. Gay hai )(uang c~ng tay
5. i. Kh6~gii~~ ~~'~~g h~~~
~~~t doan xuong tao thanh khop gia hai

5.1.1. ~9Pg~~5?h~~ 26 - 30
5.1.2 ~¢Eg~~)9!l:g }L~ 35

~e~:TI~~re,¥~~:~~~~~~
...- - ~~
:~~
5.2. Can li~I1t6t tf\lcth~ng, clnrc nang cang tayg~n nhir binh thuong 11 - 15

~:!:-
5.5 ·X~~~g ~g~~ ·1~~1'6,~g
ii~~~I~~t~v~i~~h,~hi t~@~·····3c~~, ~~h dS~···
31 - 35
......................................
~h4'g p~!l:g~~p~ I1g~~C:~I1g~~yy~y~I1 ~9I1gc:~~)~9P c:9~~Y .
5.6. B6n dau xtrong gay dinh nhau, can x§.u, mat s§.p ngira cang tay,

~.~.~.~g
31 - 35
teo co
Q~y~~~
••.••
~.~~.{
6:····•·•••·•••...•.••••.••••..•.•••••
6.1.
·•••····•• ~.¥•h.~.i
.••• ••. •••• ~.~.~.g
~~y~.~~~§••••
~.~y
Han chS van dong khop c6 tay it va vua (1 den 2/5 dong tac c6
.
16 - 20
tay)
6:2·.··········.·················H~~~h{~~~d~~g··kh6p~6tay~hi~u (t~e~j d~~gt~~~6tay) 21 - 25
6.3. ¢~~gt~~p~§i~yi~i.E~~~ri~~g(9~) ?}.~25
6.4. ()xng kh6'P c6 tay tir thS g§.p ho?c ngua t6i da 31 - 35
6.5. ¢.~jjgj~§p~§.i~yi~ih~~~~j~L· ••··························........................
26 - 30

6.6 T~·~~)~9Pc:9!~Yg~~~~~LEh~~ )}.~ 15

6.7. Thoat vi bao ho~t dich kh6'p c6 tay anh hu6'ng v~n d<)ng kh6'p
1- 3
c:9!~y g, kh9I1g ~I1hh~9:!l:g~h~~~S'
6.8. Thoat vi bao ho~t dich kh6'p c6 tay anh hu6'ng v~n d<)ng khop
4-6
..............................................
<?9!~yI1hi~l}h<?~c: ~I1hh~q!l:g~h~~P:
lIlY
7. Gay thal1x~ang ql}ay
7.1. ..... c~~
ii~~t6t~ trvc th~ng, iili6~g~g~~chi, ChLl'Cnang c~ng tay
6 - 10
tuang d6i binh thuemg
7:2. w c~~ iis~ ~~~,t~~v~ i~~h h~~~~hibi~g~~··tr~t kh6'p quay - tr\l va
21 - 25
...... . h:t!l:c:h~<?h4'<? I1~!l:g~~p~!l:g~~ .
7.3. Kh6ng li~n xuang ho?c m§.t do~n xuang t~o thanh kh6'p gia

7.3.1. ~h~·Eg~~<?h~~ 11 - 15
7.3 .2. ~§EpL~J§I1g..........................................................................
; ; ?!.~?5
8. Gay dau tren xU'ong quay co di chUng gay h~n che v~n d<)ng gap 21 _ 25
 35

... ~d~6iiili&p id~~§~

~ih?~~hS~1p:~g~~~~~g tay, kern thea teo
cO'
9:.·.····· .••.•....Q~Y~~~ ~~qL?Cl:l·9·l!gql:l§.t)'(~~~~?~~!~::tl:l.: ...<==~11~?}
9.1 . !5.§~ql:l~r~~§.l:l~~L
!§~ , " 6 - 10
9.2. g~l! ~h§ Y~9: ~9P:g ~~p:g !§.ty,(?9 ~::t)' 11 - 15
1O g~y !h~p: ~~~g~TY? ,
10 .1. ~§~, ~~y~thang, c:hl!C:l!~l!g S~!1g !§.t)'1~91!g ~i ~l!h h~9!lg
<==§.t!l.li~p: 6 - 10
10.2. Can lien xau, true lech hoac hai dau gay dinh voi xuong quay 21 _ 25
..................................................
l~l:r! l:r!~~Shl!~p~l!g ~~p~ gg,lJ.:§.tC:~!1g~§.ty
10.3 . !5.h§gg l~§!.l.~~q!.l.gh9~C: l:!l.~~~9~P: ~~~g ~~9~h~p:h ~9:E g!~ _
10.3.1... !5.hqpg~~ c:h~~ 11 - 15
10.3.2. J~h9Pg~~19P:g.................................................................................................
, _ 1§_:20
11. Gay 1/3 tren xuong tru va trat khop dau tren xuong quay (gay
kiSu Monteggia) khong dS lai di chung
6 - 10
* Ghi chit: Niu a~ lai di chtmg cung khop khuyu: Tinh ty l¢ %
TTCT thea muc IV 3. +
2.............................................................................................................................................................................................................................................................. 1
12. Gay mom tram quay hoac tram tru khong anh huong van dong 6 - 10
khop c6 tay
* Ghi
chit: Niu anh huang v¢in a(mg kh&p cd tay, tinh tY l¢ %
TTCT thea muc a(5h{;mchi v¢in a(5ngkh6p.
V. ~~~!~yy~~h§'p£~!~y
1 Ih~g)~qpc:§!::tY~9~ ~§g, ~ . 52
2. C(mg khap co tay do chan thuO'ng (cac ngon tay van binh
...........................
~h~<?·gg) , . _
2.1. Co tay 0- tu the cO'nang (0°) _ 21 - 25
¢§.i~y~i~:!h{
••
2.2. ·••••••••••••••.•••••••••••
·•..•. g.~p.h9.~.~••••
6g~§.t••.i9L_9§.t ,.................... , . 31 - 35
2.3. Co tay 0- tu the khac (khong ph~ti tu the cO'nang ho~c gap, ngua 26 _ 30
t6i da)
3. Q~y,yq ?C~qp:g hg~c: !~~~ !'h<pc:g~qp ?C~~g = ~::tYl:r!9~~§!.l.
3.1 Pi c:hl!!.l.g~gh 0~§'1!~ i! ~§p ~9!.l.g t~c::l~<P C?9t§.ty 5-9
3.2. Gay cung khop co tay: Tinh ty l~ % TTCT thea m~lC V.2
Chl:l'qgg nay
4 g~y ~~q!.l.gr~~!.l. ~§.t)' ,
4.l. Gay m<)t den hai XUO'ilgban tay, khong h~n che chuc nang ban
6 - 10
......................................
t§.t)',gg99: ~~y........................................................................................ -T .

4.2. Gay m<)t den hai XUO'ilgban tay, co bien d~ng ho~c anh hu6'ng 11 _ 15
........ 9~1! ~hl!S 1!~r.l.g~~Q ~§.ty,gg9P: ~::tY.
4.3. . Q~X9:h}§1.} hqI1 0::ti ?C~g1!&Q~P:~(:t)' 16 - 20
4.4. Mat do~n xuO'ng cua nhieu xuO'ng ban tay (hai xuO'ng tro- len) 21 - 25
VI :Ng2~!~y .. . _
1. . <==l,l~
_(l:r!~!)I1~~-gI1g9g ~(:ty~~(:t~P:9~~~I1 ~(:ty
1.1 <==l,l~_(!!l~QI1~~gg91! ~(:ty. .--
47
_ .
 36

1.2. . E9l'lg IrlJ:9'l!g,h9P,

?<-lJ:(),l'lg
g~l! ~(:ly 50
2 ~y}(1!!~~2g§l! l!g9l'l ()~(:lJ!l.9~g~l]~(:ly
2.1. M~~l]g9l'lJY~g(:ll!g9l'l~~()
2.1.1. ..M~! ()~()l]g9l'lJ ~ Il ~ Ill ~JY()9l! l~i l'lg9l'lY2 .. 45
2.1.2. M~!()~() ngonI ~D ~ EI. ~Y«)9l'l)~~ ngon JY2. 43
2.1.3 M~~()~~l]g91]J~ n~JY ~ Y()9l'l1~i l'lg9l'lgD 43
2.1 .4. . M~! ()~()l'lg9l'lJ ~ rn ~)Y ~ Y ()9l'l1~L l]g2l'l I.D 43
2.2. . M~! ()~()l'l~9l'lJI. ~JD~ I.Y~Y~()91]1~Ll]g9rlD T .. 41
2.3. Vua bi mat bon ngon tay vira ton thuong (gay, khuyet. ..) tir mot
45 - 47
den ba xirong ban tay
3:·········· Cvt(~~t5b~~g6~t~y~ua mot ban tay
............................................ "}' , , " , .

3.1. .. M~! l'lg9l'lJ y~ h(:lLl'lg9l'l)~h~()

3.l.l. Mat cac I + II + III 41
3.l.2. I + II + IV 39
3.l.3. I+II+V 39
3.l.4. I + III + IV 37
3.l.5. I + III + V 35
35
3.2. ngon II va hai ngon khac (eon lai ng6n I)
.......................................................... ,... --.-_.-- , " ..

3.2.1. Mat cac II + III + IV 31

31
29
3.3. cac ngon III + IV + V _ _
................................................................................................. , .., ?...................................... . .
25
* Ghi chu: Neu mat ba ngon tay kern thea ton thuong xuong
ban tuong ung thi tY l¢ % TTCT duoc cong 4 - 6 % thea phuong
..................... l?~q:pC?9,f!gJ9Z' T~r?f!gtl!
4. Cut (mat) hai ngon tay cua mot ban tay
4. j.:.........••
····
••·..•·•·•••••• ~9t ••• M~i-.~g2~
••••
t••y.~••• ~g2~•~.~~
••• ...'.."
4. 1.1. M~~l]g9l!J y~ l'lg9l'l)I 35
4.1 .2. M~~l'lg91]) y~ l'lg9l'lPI. 33
4.1.3. Mat ngonlva ngonIV 32
4.1.4. M~t~g6~T~~~g6~V 31
4.2. . •...• ~g9~ •• M~i•• I~••••
y~••••
~~.2.!.
••••
~g9l'l ~~.~~.(!~~l'l.g2l'l.I.2.
4.2.l. Mat ngon II va ng6n III 25
4.2.2. M~i~g2~Ity~~g9~Iy 23
4.2.3 . . M~! l]g9l'l y~ l'lg9l! Y n 21
4.3. Mat ngon tay III va ngon IV
.................................................
jI .
19
4.4. ...... M~! ~!g91]!(:lYI.g y~ l!g91]Y 18
18
4.5. ~---~~~~f~i~~-~-k~;~h;;~J~-~~~~~-
ban tucrng Ung thi c(mg 2 - 4 % thea phuong phap crng t(1i
tu ......•..••....•.....••••.•.•.•...••....................................................•.................•......•...............•...•.••..•..•..•..•....•...•........•..............
 37

5. .. .. . th~·(?·flg'
. ~h~·(?'flgrfl9t
flg9flt[il'
5.1. Ngon I (ngon cai)
5 .1.1. C~~gi~h6Piie~d6t 6-8

~:::;:~M~~~~:~t,~kh~~llg6n
5 . 1.4. 9§.!flg9~!(9§.!h[ii)
cai ::::~
11 - 15
5.1.5. M~!~~9flflg9flJ(!h~(?kh~Pflg§fl=i?~fl).... 21 - 25
5 .1.6. M~~!~9flflg9fly.~~9!p.h~fl~l!<?'flgi?~flJ ?'?=:30
5 .2. t:!g9flg (flg9r.?
!~§)
5 .2.1 . ~fr.flgkh2:E9§.! ~~fl , 7.= 9
5.2.2 Gfr.flgIP9!kh§P1}~fl9~~ 3-5
5.2.3. Cung cac khop lien d()t 11 - 12
5.2.4. M~td6tb~································ 3-5
5.2.5. hai 2 va 3 6-8
5.2.6 !~9flflg9fl g (~h~<?kh<:!12
r: flg9.fl=~~fl) 11 - 15
5.2.7 M~!!r9fl flg9.flgy~t.P.:2!Eh~fl~l!qflg~~fl 16 - 20
5.3. Ngon III (ngon giua)
5.3. i: ~~·rigj~qp~<?<~
~~ri T 5-6
5.3.2. gfr.flg~9! kh2:p)i~fl9~!. 1- 3
5.3.3. "
Cirng cac khop lien dot
.". 'r . 7-9
5.3A.
.................................................................•
Mat dot ba
""1' , r .
....•.•.....................•••......•....
1- 3
5 .3 .5. M~! h[ii 9§.!flg<?~i(9§.!?y~}) 4-6
5.3.6. Mat tron ngon III (thao khop ngon - ban) 8 - 10
5.3.7. M~iii2~~g99.Y~~~9!ph~r.i~~9:rig~~rii~~g~~g·················
.. 11 - 15
5.4. t:!g9.flIY(flg91!A~(?
flh~fl).
5A.l. Cung khop ban - ngon 4-5
5.4.2. ~~~gr.ij2illi~p n~~
~§i 1- 3
5.4.3 ~~:flgS~~kh2:p)i~fl99! 6-8
5.4.4. M~!99!~~flg9flJy........... T 1- 3
5.4.5 M~~h[i!9()!flg<?~i~~[iflg9flJy(99!? y~}) 4-6
5A.6. Mat tron ngon IV 8 - 10
5 .4.7. . ~l!<?'flg
~~fl!Y9'flgfr.flg M~iii29.~g9~Y~iii9~ph~ri 11 - 15
5 .5. t:!g9.flY (flg9.fl![iY~!) . .
5 .5 .1. ..Gfr.flgl~h2:E 1?~P:= l]g9.fl, 3-4
5.5.2. . Gfr.flgJP9~kh2:pU~fl9~! .- -- .•..•...•...._
1 - ..2
_ -

5.5.3. G0}!gs~~)~9.'Pli~fl~9~ 5-6

5.5.4 M~~.99~~[i'flg§fly 1- 3
5.5.5 M~!A9!h[ii y~ ~[i,~g9flY 4-5
5.5.6. M~!.~r91~ flg9.flY(~h~9kh§Pl]g9fl =~~fl) 6-8
5 .5 .7. .M~t ~1:9~ flg9fly~ Ip9!ph~fl ~Y<?'flg
~~fltyqflgfr.flg 11 - 15
6. Cl,lt nhieu ngon tay cua hai ban tay: C9ng ty l~ % TTCT cua Cl,lt
~~l[i!lr~~gflg9fl ~h~(?phl!9'flgEh~p~9flg!~i Il!9flg ~lr
 38
,................... . .

7. Q~y,Y9'~ll'(?'P:gIP2~9.9. p:g<?p:
~9:Y
7.1. ~9~JP:g<?P:). 1 _?
_..

7.2. ~9~..~gg<?gJh<?~~..4§~J~~~P:g<?P:~~<? .. 2
7.3. Dot 2; 3 cac ngon khac 1
8. . <?94~~~Lph~~
I~..~! ~<!P gg<?p:~<:lY
8.1. Ngon I
8. 1. 1. ~h:<!E ~~g ~gg<?J:? 4-6
8.1.2. Khop lien d6t 2-4
8.2 Ng<?J:? n h(?~<?Jn
8.2.1 ~<?E~~P: ~~g<?~ 4-8
8.2.2. ~h<!Eli~g 9.9~g~J:? 2-4
8.2.3. Khop lien dot xa 1- 3
8.3 . Ng<?E~!Yh(?~<? y .. . ..
8.3.1. Khop ban - ngon
, " ~......................................•.......•.....•. .........................................•.....••.•••••..•................•..•..•..........................
", ~. 2-4
~:}:?:..- ...~h<!E)i.~P:49~g~J:? 2-4
8.3.3. Khop lien dot xa 1- 3
9. . Yi~lp)~h<!p~~p:~gg<?p:!(;lY~(;l~ ~hll'(?·l1g
9.1. Ngon I
9. 1.1. y~~~ ~<?P. 9~P:~pg<?J:? 5-7
9.1.2. Viem ~h<?Elien dot 3-5
9.2. Ngon II va III
9.2.1. . y~~!!l)~h<!E9~g~~g<?~ 3-5
9.2.2. "iem khap li~ndotgfm 2-4
9.2.3 ViS;~1~h6plie~d6t~a·········
1- 3
9.3. Ngon IV va V
9.3.1. Viem khop ban - ngon 1- 3
9.3.2. y{~~~ ~hqp'H¥p ~§!g~~ 1- 3
9.3.3. y~~~pJ~~p)~~P:9.§! ~'.l. 1
10. ~fr.p:gp:h:i~~~<!P l<!p:gh~~~~g T T ,

10.1. Cung khop vai va khop khuyu mot ben a tu the bat loi ve chirc
nang 51 - 55
10.2. Cling ca ba khop vai, khuyu, c6 t(;1)' 61
VII. Y~Jy~~h§'ph~~g
1. Ih~(? !P2~~<!ph~~g v 71 - 73
2 I~:~~I~<?P.h~P:g,)~~~q~~4i~~~rL
2.1. Tot 6 - 10
2.2 g~Y)9gg~h<?P.h~gg......... T 21 - 25
3. . Gfr.gg~P2~~<!J? h~gg ~<:l~~h~g thuong
3.1. Chi 6' tu the thang true
3.1.1. T~6dS~96°····························· 21 - 25
3.1.2. ro 0 den 60° 31 - 35
3.1.3. TlrOden30° 41 - 45
 39

3:2. GE(§~~!h~ Y~9.E9.~~g~p

3.2.1. Til' 0 den 90° 31 - 35
3.2.2. Til' 0 den 60° 41 - 45
3.2.3. ro 0 den 30° 46 - 50
4. . ~~1!g h<?~1!~g~l'l~9t kh9]? h~1!g ~(;l\l<?h~1!~hl!9'1!g 51 - 55
5. Ih~y.khqp.h~1!~l'lh~r.!~~<? . _ 21 - 25
6. ~h~1! ~hl!9'r.!g<!~l~~h~~ q~~ <?~r.!gh(;li;~(;lkhqp'l~1! <?hi9l!qi
6.1 ~~·r.!g~!l2~~~~ph~r.!gY~~9~kh~p~<?L . 61 - 65
6.2. ~~!1g~9t ~9Eg<?i y~ 1!l9~}~¢E <?<? <?h~1! 41 - 45
6.3. . ~~.!1g ~(;l~_<!P 1~!1(h~~g, g<?i), 66 - 70
6.4. . ~~'1!g ~(;lkhop hang, g<?Ly~<?<? chan . 61 - 65
7. .. ~\l~~9t dui
7.1. ~l!qr.!g § ~g~~g ~~~~ ~E~y~~)<!r.! .. ~%~ 68 - 69
7.2. Duong cat a 1/3 tren 67
7.3. ......••.•..•
¥?~qri& ~~~§ Q~g{~~~i§~~2rig ... 65
8. . ........... Q~y.<?8?Sl!9'r.!g9~i
8.1. Gay co xuong dui gay tieu chorn
..................................................
, Ij , ,..........................................................................................
. _ - .
51
8.2 Q~y<?<??Sl!qr.!g9~~J~<?r.!g~A~~<?h,~~ ,_ 31 - 35
8.3. Mat dean xuong hoac khong lien xirong tao thanh khop gia co
xuong dui
8.4. Khop g~~<?h~~ 41 - 45
8.5. . I5h<!p ~}~)9!1g)~<? ". 51
8.6. Q~y <?9 ?Sl!<?!l.g 9~i, 9~ Eh~y. !.~!y~!.
~h(;lYchom l!h~l! ~~(? . 35
9. Q~Y9~Y ~;~l!?Sl!9'r.!g. 9~L .
9.1. Can lien tot, true thang 26 - 30
9.2. c~~iis~~~~:t~~i~~h:~at~~~is~,· chiI1g~~ du6i 4cm, chilc
31 - 35
nang kh6p hang bi h~n chS
9.3 ......•••••••••••••.•.
·.••••••••••
G.~rij{.~.ri~~.~;••••
~i~~•••
l.~~h;~q ••• rihi~.~•••••
~.hi••• !.~.~.1!
4.<?1!l . ~~9
•••• lig.~.ri 41 - 45
10. Gay than xuang dui
10.1.···.... g~ri(i~ri~?,~~ ~i¥.~!h.~~g, <?h~<?Eh~~<?hL~l!1h!.hl!~g . 21 - 25
10.2. Can lien ,. xau, tn)c l~ch ..,
.................................•...•....................... ..•...•...............................•..•...•.•.•......................•......•.•............................ .
26 - 30
10.3. . ~(;ll!?S~~,~~v<?J~<?h, <?bipg~!14l!<!L4<?~ 31 - 35
10.4. ~(;ll!?S~\l,~EY<? J~<?h,<?hi1!g~!1!.~~!14<?1!!. 41 - 45
11. Q~y 9~Y 9l!<!~~y'<?'!1g9~i, .., .. , , T .. T .

11.1. Gay dau du6i xuong dui gan sat 16i cau sau c1ieutri ket qua tot,
11 - 15
.......................
1~h<?!1g,~phhl!~g Y~1!99!1&1~<!E&<?i, , .
11.2. Gay dau du6i xuang dui gan sat loi diu sau dieu tri c6 di chUng
h~n chS v~n d9ng kh6p g6i: Tinh ty l~ % TTCT thea cung kh6p
g6i
VIII. ~~~g ..~..~..~.~y~ }{~,2·pgc?i.....
1 Ih~g_1!!9!.~9E,g<?L TN - f
61
2. . y~t ~h~<?!l.g,<?h~1!~h~9'r.!gkhqp g<?A4~r.!9~r.!h~\l q~~ <?~!1gkhqE
 40

H·~ R~t~i~;_~~:1~50
2.4.
---
Cirng kh6p tu the 0°
l~:~~
36 - 40
~~~h~h.~
••••
~~•rii9••••
g.~~••• •••tili~~•~~i
3 . ··························
••••••••
~.~~..•• ••.••.••
q~.~.i9~•.....•.•......................................................
,...............................................
. 6 - 10
4. Chan thirong cat bo xuong banh che lam han che chirc nang
. ~<!pg<?i: Ii~h}y)~ ~ II<=!' !h~(?T\l~ynL~ .
........... . T

5. Gay hoac va lei cau xuong dui dan den hau qua han che van
. ~9.~gl~<P g<?~:Ii~!y l~ <yo,IIc:::I!h~91!l\l.~yUL~ .
6 I§~!h~·q~g~\l~~h~l!l~<?~h~~!hl!<?Pg~hqpg§i ..
6.l. g~~h~~0.;!l:~!~h§ ~~1!lh9*~g~yyi~~!l!!l':l~!i~ 16 - 20
6.2. Neu phai cat bo va co hau qua dinh khop goi: Tinh ty l~ %
TTCT thea rnuc VIIl,2
6.3.· C~tbo sun chS~;;~6bis~·chUngh~~ ~hr~~tph~~cir dong g~p~....... .
.............. ~~§i ~9Eg<?i~Ii~h !y)~ ~?ITgI~h~91!l\l~ Y!!L?
7. Pty~! lsJ;<pg§~ r:

7.1. Dj v~t nam trong bao khop hoac bao hoat dich anh huong it den 11 _ 15
.........................
~hl1~~~~g~9Eg<?L... .. T

7.2 12iy~!~~1!lY9~g~h~k!!<!pl~!!l~~~hl!§!lg~~~y~~~2~g, ~Ll':l(. 21 - 25

8 I§~!hl!(?·~&~~~~~Y~h~~gl~h<!pg§i..... .., , , ..
8.1 I2~~~~y ~h~l!.g~h~(?!~l!9·~hg*~~:;t':l~~'g~~i~~!l:Lphv~h§i !§~ , 11 - 15
8.2. But day chang cheo truac ho$.c sau duQ'c dieu tri ph\lc hoi 21 _ 25
khang t6t ho$.ckhang duQ'cdiSu tri
~~y•~h~~g
••• •••
~g9~~
••••
khqp~~~I~~•••
i~j.... h.~{.}9~
8. 3: ••·••••••••••••.•..•..•.••••••••••
~.~ •••• ••...........•..•..•••.•••.••••.
phY.~ •.,.•••••.•............................
6 - 10
8.4. BUt day chang ngoai kh6p da dieu tri ph\lc hoi khang tot ho$.c 11 _ 15
qi~~
.......................................
1~h§~g~l!2~ !~L
9. Ih:;tykh<P.g§} ~h~~!':l<? 11 - 15
1o. y.? )(l!?~g,~~~h~h~~T9~g~:;tg)~qp
10.1 C:::~~li~~!~!, ~~ !!l*~)~qp.kh§~ghg*~~!)~~h ~\!qL?!!l~!l 2-4
Canlien t§t, ~e ll$.~kh6p (lil~ch tr~n 5!!lll 5-7
10.2.
10.3. g_h~rigU¥~~~~~g.. . 8 - 10
10.4 M~~1!l2!Eha,~)(l!q~g~~~h~h~ 5-7
11. Tr~t kh6p gai
ii.i. . f~~~i)~qp
g§(lP9'C
~i~y yj ~h<?i , 3-5
11.2 I~:~~~qp.g§i. ~~i ~~~g~§~g9.i~~ !TL~~'g~ 8 - 10
12. C\lt ll9t cang chan
12.1. .
12.1.i.
kh6P
cvt 6 li3 t~€~,~s~
1~P~~2S~h~~gi~ g6i binh thucmg
.. 51
12.1.2. !5h§~g 1~p9.\!9·~~h~~gi.~ 55
12.2. C\lt (] 113 gifra ho$.cduai
12.2. i. ~~j~p~E~~g{~~L(~L~9! 41 - 45
12.2.2 !5h§~gl~p ~l!2~ ~h~~gi~ hg~~9.i~h~~gi~ ~~':l,kh9 46 - 50
 41

··1·3·.··· ·•••••.••Q~y.h.~~
•.....•..•••• ••~i~·~g~~~&
..~h~~ , .
13.1. Can lien tot, true
,." thang, khong ngan chi ,.... ,
............................................................................ ............••. .._-----
, " -.-._---.- , - , , . .
16 - 20
13.2 ~~~ ~':l.',<?~g~~':l.;
~~~ ~f~hh~i ~~<:Y~g,
!TY~1~C?h,C?9rlg~~~hi
13.2.1. ~hi ~g~~<:i~9'L~~l.p, _ . 21 - 25
13.2.2 ..... ~h~ ~g~~!~ ~c?!p~§p ~~9'L?C?lP 26 - 30
13.2.3. Chi ngan nr Scm tro len 31 - 35
14. M~!"~~~~
h~f~~~~g
~h~y.,
!p~~!~'? !h~~h khop gi~
14.1 Khopgiahaixuongchatchi pg~~ <:l':l.'qi
?c?lp 31 - 35
14.2. ~9'pgi~h~i~Ll'<?pgl§~g~C?hL~g~~!T§g?~!p . 41 - 45
15. Gay than xuong chay mot chan
.....................................................................................................................................................................................
, , '? .,...................... . '? ..

15.1. Gay than xirong chay bat ke doan nao, can tot, true thang, a 11 - 15
...... ~h§l.!g~g~~ chi .. r •. r:

15.2. Gay than xuong chay bat kc doan nao, can xau, true lech, co a
ngan chi
15.2.1. Chi~~g~~duai 2cm 16 - 20
15.2.2. Chi~g~~t&2~1;dS~ diroi 5cm 21 - 25
15.2.3 ...••••••••••••••• GEi•~g~~
•• •••
i~•••• iiqI¥~••••••••••••••••
$~~•••• ,••••••••••••••••••••••••••••••............................................
, ,. 26 - 30
15.3. Gay th~nxuangchay da lien nhung than xuong co 0 khuyet Ian 21 - 25
i6. _ M~!~~~~ ~~q~g ~E~y.!~~ !h~~h)~91? g{~ _ _
.16·X: _ ~hqpg}~~h~!. 21 - 25
16.2. ~hqpgi~l§~g 31 - 35
17. 9~{hg~~yg !p~!p,~h~y T

17.1. J?i.~':l.!~tphy.C?h§i!§!, lshqJ?g§L~§~g~(!pg 11 - 15

17.2. Di chUng cung kh6p goi ho~c han kh6p: Tinh thea ty l~ %
TTG.I ~~~ !<?p!h~<:ypg~qp g<?~ _
17.3 . ~g~g ~V~l§i. ~,4~l!9'~gC?l!~Y 6 - 10
18. ....
... g~y hg~~ ygJ§i ~~ !l~~qC? ~P~lpC?h~y 6 - 10
19. Gay than xuang mac m9t chan
......................................................................
7..·..·..·..· · .

19.1. Can tot 3- 5

19.2. ...................................................................
Can X~l '}', , ..
5-7
19.3. Gay kielIDuPlJytreI1{t1~lJ duai xuopg mac), cetPxau
19.3.1. I-i~~ ~h~~ ~h@~~~ d9~g 109'P c6 m •••••••••••••••••
••••••• •• ••• • • •• •••••••••••••••••••••••••

6 - 10
19.3.2. ¢9~h~~~L~~~jgl;Eqp····
_......................... , . II - 15
19.4. Va mat ca ngoai khong {mhhuang v?n d9ng khop co chan. 1- 3
* Ghi chu: Niu anh huang v4n d(mg khap c6 chan thi tinh thea
tf! {?_ ?1 TT9.T c:_~q q'!h ~1!<!,rt_gy9.rt_49,!g k~qp:
20. M~!~~9'pg l.P~c? _ _ _ ..
20.1. Mat toan b9 )(uong !pac 11 - 15
20.2 M~td~~~~~~~g~~~~······ 4-6
Gay xuang chi duai co di chung dili chi thi tinh
* Ghi chu: tY l¢
% TTCT nhu ngcin chi muc de)tuong ung.
IX. Ban chan va kho'p c8 chan
 42

1. .......
Ih~21~qp ~&~h~l?lIl9t !?~l? .. 45
2. Thao khop co chan hai ben: Cong ty l~ % TTCT cua tung ben
. !h~2 phl!<!l?gP?~P ~91?g!';lLIh<?pg!l! .
3. . I<?p... !!.l2!..!?~~.....
!h.l!.<:rPg}Il.~!.~A.!.~<?l?g
....
3.1. Eh<?pg ~ph hl!q~& ~<!P .... 6 - 10
3.2. . Q~yg~~g ~?qp~<? ~h~p:I~l?h !y ~~cy~II~I !h~<?!!.llJ~)~:§
~:}: . .. Iy~!!~qpg<?~h~p4~~l} !ti ~~9L ... 1- 3
4. Cat bo mra truce ban chan (thao khop cac xuong ban hay thu 35
!h~~! ~~~f~:;tp~) .. 1············ "" , .

5. Cat bo giira ban chan con de lai cho chong got (thu thuat 41
............
~h<?p~t!~BJg~t<:l h:;tyR~E<?g<?fn.............. . .
6. ~h~~ !hl!<!pg~qpf~9 chan <:l~~4~~ h~l}ql}~~~l?g ~<!p
6.1. . ~~l?g~9P q!l! !h~ g5;p~~g (Q~) .. T···
21
6.2 ~~1)g 1~9·Pg !l!!h~ !?~!)2}~.h<?~h~·~~~1)g~~h9·P~.<? ..~.h.~~. 31
6.3. .~(rpg~<!p~<?pgh<?~~ !<?~~Ch';lp~h~ y~p 49pgl~gp) 11 - 15
7. . ~(r!.&~~g9!(g~P 6~~ill~).
7.1. ~~Jl<?i)';li1,1~<?pgpg~~g~p . , . 11 - 15
7.2. .. . Q~p !?i p~~p ~~l}khi P8~? !?~p ~h~!l.~g~ y~ phr~ !tl:!gg . 21 - 25
7~~~. kq;<?~g~<?~)<;liI9P!h914~ ~<:r<:l~p~<?)<;l~!h~!!.l9!~Y~,9i}<;lLl~91~~ 26 - 30
8. ~~! !?9!<?~~!?9?Sl!<:rPgg9! 31 - 35
9. Q~y h<?~~y<:S: ~l!<:)'pgg9! . . .
9.1. Y<:S: ?Sl:!g~gg9!~<?~g ~~ hl:!~gy~;t 99!l.g . 6 - 10
9.2. ... Y<:S:!h~~ )S~<:rPgg9!~9,~~hhl!q~g 4~~ 4~)';l~1J~<? 49~g. 11 - 15
9.3. Gay goc Boehler (phan Thalamus cua xuong got) lam s~p vom 21 - 25
b~mchan, di lc;tikho va dau
10. C~t b6 xuong sen 26 - 30
11. . ..Q~y ~l!<?'J:1g ~~~l~lIl,g~!l.~h~~ l~!l.<:l<;l~g, 9i )';li ~91~~1'l 16 - 20
12. Q~y(y<:S: ?s~<:rPg!hl}Y~l? . . 6 - 10
13.
14. ......
g~~;~.g
... ~:~~~h!~~:~g·······~h6·······gifr~···ban
cha~·········d·~~········dS~
h~u qua
11 - 15

16 - 20
..................................
~~~g(h~p~?p !?~l?~h~~
15. Q~yh8~~H'1~! q<?';lPIIl9!~l!()·J:1gg~p ~0~g~J:1~h~"l i····.·······

15.1. Can lien tOt, ban chan khong bien dc;tng,khong 2tl1hhuo-ng den 3-5
. 9L9~J:1g ,..... . y .

15.2... J?~J:1~h~J:1p~~J:1 <:l'.l:J:1gy~!~qJ:1g'.l:i.q~J:1y~~~9.i.9~J:1gLI(;l(?99J:1g

. 11 - 15
16. Q~yh<?~~}Il~!9()';lJ:1J:1hi~l} ~l!<:),!l.g!?~!l.
~~?:!!.l9!g~J:1~h~"l ,
16.1. Gay hai xuong ban chan, can lien tot, ban chan khong bien 6 - 10
<:l';lJ:1g'.l~h<?"lg ~~hhl!9·!l.gq~!l.y~p' 99!l.g T

16.2. . Q~yh(;lL~l}'<:rPg q~!l.,~(;lp)i~!l.~~l} ll?~~!!.l~!q()';l~ll:;ti~l}'<?,l'lg

q~"l 16 - 20
16.3. Gay tren hai xuang ban ho~c mat doc;tnxuang lam ban chan 21 - 25
........................
!?i~J:1 <:l';l~gg~y,!~qJ:1g'.l:~l?ht~l} q~"lyi~~ 4i 9(r!l.g~}:;t() 99!l.g ....
17. . M~l?h <:lty~!"l~!!.ltE()"lg~~ ~gp ~<?~h~I'l(gh~y ~g9! ~~~!l.) 16 - 20
 43

18. C6~~hi~~manh di V?t nho &ph~~l;S~ gan ban chan hay gam
....... q ~~<!l~g~~~ '?h~~~~h h~~'~g ~~~ ~i li:l:i,1~<?~9~g .
18.1. Co duoi 10 manh 11 - 15
18.2. Co tir 10 rnanh tro len 16 - 20
19. Bong gan khop c6 chan diSu tri lau khong khoi 16 - 20
20. . vis~;1~h6p~6~h~~~;?~ti;;h~~~~h§:;;th~a~gtr?t khop, bong 16 - 20
gan c6 chan
X. Ngon chan
1. Cut nam ngon chan 26 - 30
2. Cvtb6~;;g6;;~h~~ . .
2.1. . Cvtb6~~g6~ii+iiI + IV + V (con lai ngon I) 16 - 20
2.2. . CVtb6~ ~g6~i+ii+iIi+ tv (~6~i~i~g6~ v) 21 - 25
2.3. ¢~i~§lirig~i1.f±I(±jtI± y(~§riI~Li1.g~i1.Iy) 21 - 25
2.4. G\l~~~~gg9~I =r.:P=r.:JY±Y{'?~~ li:l:i~g9~JID 21 - 25
3. Cut ba ngon chan
3. i: ¢vi~~i1.g~i1.iili~i1.g 1~~i1.g~~~i~g9~ chanI 11 - 15
3 .2. .... G\l~1?~ ~g9~ ~~<?~g
~9 '?9 ngon '?h~~J 16 - 20
4. Cut hai ngon chan
4.:!...:........ G\l~...?~g9~.Jg=r.:IY.h<?~'?..?.....
P:g9~...gI=r.:Yh<?i)i'?..?~g9~ .... =r.:
....
~y....y 6 - 10
4.2. G\l~~g9P:n Y~~9~~g9~ ~~'?(~~~P:g9P:'?h~P:D. .. JJ ~15
4.3. Gy.~P:g9P:'?h~P:JY~~9~~g9~~~'? 16 - 20
5. Cut ngon chan I 11 - 15
6. Cut mot , ngon chan khac
................................................................•••••.•..•... -\: .•.•........
3-5
7. Cut dot , ngoai cua mot ngon chan I (dau
~ ngon chan)
.................................................................•.•.•..••.•• , .•••.•.••.••....•......................................................................... .
6 - - 10
.

8. C=\ltdot ngoai ,?ua ngon chan khac (dau ngon chan) 1- 3

··.•••••••••••.••••• i1.g<?~~
9 ..••.•.•....•.•.•••••• ¢.~ih~~~.9~ ~.4.~iii.2ii1.g~i1.
••••
~h~i1.1ili.~~
•••••••
····· . 2·····~4
10.
10. i.··· Cung kh6'Pli~n
T~thS th~~~ dot ngo~cha111 .
3-5
10.2 T~tj~sb§:tTq~ 7-9
11. . ...... gl!~gl~hqp ,?~~~g9~ '?h~~J. , ~<?, ~ ~~~ 7-9
12. Cung kh6p dot - ban ho~c cac khap lien dot vai nhau cua mQt
ngon chan khac
l.?:):.... Gl!~gq~~~h~~h,l:l~~ , 1- 3
12.2. Cung a tu the bat 19i ve chuc nang 4-5
13. ········G~y~~a;;g~~td6t~g6~~h~~... 1
XI. . G'l~~,hc?~g . T ". ,

1. ~h1:lX~!~~<!~g'?h~1:l9<?
)~Y.x~<!~g~~ ~i~1:l~l·L.. 3-5
2. Q~y(yg}g~i <?h~l:l!~~q<?!T~~ . 6 - 10
Q~y(yg1~~<? '?h~~ ....
~.~.~g
3. 11 - 15
4. Gay (vo') mQt ben canh ch?u 16 - 20
5. . .....••.••••....•••.•.•.....•.•••
·•·
•.. Q.~y•(.y.9·)
••• ••••• ~.h~~•ki.~~••••
••• M~1.g.~~gi1.~
•.•••
~~i1.•••~~i1.1~~.<?1':h~~.~.g
'?h~1:l .
5.1.
1••••••••••••••••
Nam giai 31 - 35
 44

5.2. nu 41 - 45
5.3. Nguoi a d9 vi thanh nien hoac ngu()'i gi~ 41 - 45
6. .·······
••••
·••••••••••••
Q.~y••• rii.~~
¥•••rig9~(g~yi~•••• ••••
~~.{~~rig
••••
~.9•4~q{)
•• •••••.....
· . 16 - 20
7. .............
g~y nganh I]g::lp:g)(l:f(!p:gJIl\l
ben 11 - 15
..••.•..•..••..•.................................••..•..••...........................•.....................................................................................•.........................•...•..••••........
············1

Gay ca hai" ben 16 - 20

..
-- , ..
, , .

7.3. Nganhngoi muh()~cnganh~h~umu

mot ben 11 - 15
8. ...···········•·•·
•••
·g.~y•••
§ ~.h~9
••••
~.qph~rig•••••••..••••.............................................................
, ,.
8.1. Gay 0 chao khop hang (cung truce hoac sau) mo ket hop xirong
11 - 15
~~~!q\l~ !<?tIgl~l]g anh hl:fql]g Y~I] 99I'lg l<hqp h~l]g
8.2. Gay 6 chao khop hang ca cung truce l~n cung sau gay di lech,
21 - 25
. )~l!llc)l]g khop (9~!E~!)<h~p.... h.~.l1g)... ,
9. . ..g~y)(\l'(),pg~~I]g l<h~l]g !~I] !hl:f()'l]g!h~I'l)~il]h
..... 5-7
10. Gay xirong cut
........................ , " " - ,.. . ?....... . , .

10.1. Gay xuong cut khong ton thuong than "kinh

.............................. - ............................................•.....•,.............................................................................................................•...•...•.••..••................................... .
3-5
10.2. Gay )(uO'ng cut di .lech, gay dau khi ngoi 4-6
11. ······.··.·y.i.~l!l
.••• l~qp.••.•
~.~.pg
....
~h~~.••..
~..~~..••
~h~ri•••
~h~9·rig
••••••••
·····················
11.1. Mire 1-3
4-6
11.3. Mire dQ nang 11 - 13
XII. !?...!hl!~·...g ~}H~9...g ~h§...g g~y!~...!h':J.'~·...g !h~Il ~~...h
1. Ton thuang dot song C I (ho~c) C2 31 - 35
*Timthu:()ngnyr)rrz 13~q qr5t.C2tiryhnh1}·trjn t~1!::O'ngq?tC;2
2.
2.1.
...............•• y.i.~.1!l ~xP.,....
~~<?·P...•.
...4.irih.... ~.~~..•••
~~t••• 9()•.... th.~~~'lg.....·..•...•......•.....
Xyp, viem dinh mQt - hai d6t s6ng c6, dau vua, h<;tnchS mQt
~.9•.• ~.h.~.~j
~~.ri.g
.... ...
ph~n dQng tac c6 - d~u (g~p - du6i, nghieng trai, phai va xoay tu 31 - 35
0° dSn 20°)
2.2. .. X~p,~is~ di~ht~s~h~id6i~6~g~6;d~~~hi§~,i~6~g?id~~~~~ 41 - 45
991]g c6 d~\l (yen 20° a t~t c~ cac ..~Qng tac)
3. .. 19P ih~9'rig~9!~~rigJ~rig
~th~ti~rig ... .
3.1. Gay, Xyp than" mQt dot song , .,
.......................................•.....................................•••...............................................•.......•.•.•••...•.•••....•...•................ .
21 - 25
3 .2. g~y,)(xE~h~p ~~~ ~g~<?~~ 9~! ~§I'lg !Eq 1~I'l .
3.2.1. Xyp thaI] hai dot song 26 - 30
3.2.2. . g~P~~4~<~9rig·, 36 - 40
3 .2.3. ~xE !l~~p:~~ 9~! ~§p:g 41 - 45
4.
4.1. 6 - 10
4.2. 16 - 20
4.3. 26 - 30
5.
5.1. 3 -5
5.2. 11 - 15
 45
................. . , ,.
5.3 G~?~~~~g? q§~~§~g 21 - 25
6. '])l:!S!!than ?9~~9~g,}h9~~yt~? ~~l.P
6.1. ... ITl:!~ l.P9~§)~§~g ~§~~hl:!q~gth~~~~i~h 21 - 25
6.2. Truqt nhiSu t~ng kh6ng t6n thuang th~n kinh 31 - 35
I····
* Ghi chu:
- Niu gay tim thuong thdn kinh: Tinh theo tY l¢ % TTCT quy
dinh' tai Chuang Ty l¢ phdn tram t6n thuong Co' thi do t6n
thuong xuong S9 va
h¢ than kinh.
- T6n thuong xuong, neu co bidu hien loiing xuong kem theo
(loiing xuong do liet thdn kinh gay giam vdn dong, do c6 dinh
xuong keo dai, khong tinh lodng xuong do tuoi) thi cong 5-10%
th~(?phl!·q·r!gp~qpq9rzgt9LThqrzgtl!'~
7. Thoat vi rna dem da duoc dieu tri thuong gay tai phat, 6 - 10
XIII. Viern bao gan sao chan thuong: Tinh ty 1~% TTCT theo quy
dinh tai Chuang Ty l~ phan tram t6n thuong co thS do benh, t?t
ca - xuang - khop
 46

Churmg 8
TY L.¢ PHA.N TRAM TON THUONG CO THE
DO TON THU'ONG PHA.N MEM

Nguyen t~c:
1. Kich thurrc seo
+ SyO nho: Chieu dai duoi 3cm va chiSUrong duoi O,3cm.
+ SyO trung binh: Chieu dai tir 3cm d~n Scm va chiSu rong ttl' O,3cm d~n O,Scm.
+ SyO 16n: Chieu dai tren Scm va chiSu rong tren O,Scm.
+ N~u SyO co kich thuoc khong dat tieu chi chieu dai hoac chiSu rong thi tinh ty
1~% TTCT 6 mire nho han liSn kS.
(Vi du: Seo co chi~u deli tren 5cm nhung chi~u rong nho hon 0,5cm: Tinh tY l¢
% TTCT nhu seo trung binh).
2. Quy djnh v~ ty l~ % TTCT ella seo theo vitng co' th~
+ SyO phan mem vung mat: B~ng ty 1~% TTCT cua SyO v~t thuong phan mern
nhan h~ s6 3.
+ SyO phan mem vung c6: B~ng ty 1~% TTCT cua SyO v~t thuong phan mSm
nhan h~s6 2.
3. Seo do phfiu thuat, thu thu~t d~ xli' ly mQt bQ ph~n ho~c mQt vitng co' th~
bi tan thu'O'ng
+ SyO do ph~u thu~t, thll thu~t: Tinh ty 1~ % TTCT nhu SyO v~t thuO'ng ph§n
mSm (tru tru<mg hqp m6 tham do 6 bVng).
+ N~u SyO v~t thuang va SyO ph~u thu~t, thll thu~t trung nhau thl tinh kich thuac
mQt SyO va cho ty 1~% TTCT 6 muc t6i da eua khung.
, 4. V~t thU'o'ng chua li~n s~o: Tinh ty 1~ % TTCT nhu SyO v~t thuang ph§n
memo
5. S~ovitng niem m~c: T6n thuO'ng niem m~c phai khau d~ l~i SyO, duQ'ctinh ty
I~ % TTCT nhu SyO v~t thuO'ng ph§n mSm.
6. S~O gay anh hU'o'ng chu'c nang: DuQ'c danh gia b~ng lam sang va cac xet
nghi~m c~n lam sang (di~n cO', sieu am, v.v ... ).
 47

Muc TAn tlnrong

I. §~9Y~! !h~~:,?,~g
phA~ ~~~
1. SyO nho 1
2. SyO trung binh 2
3. Syolan 3
* Ghi chu: Teu anh huang chirc nang thi cong voi tY l¢ %
TTCT cua anh huang chuc nang theo phuong phap cong tai
Thong tu:
II. V~t thurrng lam d~p nat m~t nhi~u co' d~ lai seo rum dinh,
-;9~~9~~h h~'.§'~_g~h!~~~~~ -;h~-;~~~g-;~~~Q ph~~
1. SyO 0- vung ham mat, mat, mfii, tai: Da quy dinh 0- cac chuang
!~gl'lg (l'J:1g , T

2. SyO 6' vung co, co k60 lam han che cac dong tac quay, ngua, 11 _ 15
...............................................
l'lgh~~l'lg'?c?,~~~l'lg~l'lg~~~...................................................
_ ., ,
3. SyO 15m sau, kich thuoc Ion, co k60 do mat nhieu co nguc dien
tich 4 - 5 khoang lien suon hay co bung vung thuong vi lam 21 - 25
.. ~J:1h h':l'S!l'lgl'lhi~~ ~~l'l ~h(r~l'l~l'lgh§ h~p r , _

4. SyO 15m sau, kich thiroc to-n, dinh, co k60 do mat mot phan co 21 _25
P~l!~, ~5!~~i Yeli, ~'il~~h~ ~~g~9~g!?~ ~~~!~
................................................... t(1y' 'v-

5. SyO 15m Ian do mat mot phan Ian co nhi dau ho~c tam dau lam 16 _ 20
y~~. ~~l'lh!~y ~p'~.~_~9l'lhi~~, , ,
6. SyO kem thea dut don thuan co nhj dau ho~c tam dau da khau
" 5-7
......................................
J:19l'lh~l'lg
i S9l'l)~~PY,~~~~J:1h
!~YP!(r~ ~9J!
7. SyO him mat m9t phan co mong to 11 - 15
8. S~O l~~~~fit ~~0t phft~ co·t~· d~~··d~Ci~~~~·yS~ chan merc d9
nhi~u 16 - 20
9:····· - ··········s~oi~~~~th~od6td~th~fin·co:t&dft~1 dui c1~kh~~~6i nhung
, 6-8
con lam yeu chan muc d9 it
III. TAn thU'O'ng ph~m m~m (bao gAm ca gan ho~c can cO' ho~c
vitng kh6'p) gay h~n ch~ v~n dQng: Tinh ty l~ % TTCT cua
h'iln ch~ v~n d9ng khop va SyO v~t thuong ph~n m~m r6i c9ng
thea phuong phap c9ng t(;liThong tu
IV §~9~91~y.~~gh~p... , ,_ _
1. P~~l'l!~~h!~ J ~ ~i~l'l !~~h~q !h~ !T<?: ~Y§l'lg N 1
2. Di~n tich tren 1% di~n tich co the tro- len: CU them moi 1%
di~n tfch co thS thi c9ng them 1% ty l~ % TTCT
V. TAn thu'O'ng da khong d~ l~i St;O nhu'ng d~ I~i v~t bi~n d8i
rBi loan s~c tB da 0,5 - 1
VI. s~O do tai n~n giao thong ho~c do d~n ghem (ho~c do cung
mot loai hun_g_ khi gay nen) co tinh ch~t tu'o'ng ttr nhau,
 48

kich thurrc nho

1. S6 hrorig til 20 seo tro xuong: Tinh ty l~ % TTCT nhu sec v~t
...!h}:!q~gph~~
~~~~(My'?Jl . N

2. So luong til tren 20 seo tro len: Cir them moi 5 seo thi cong
them 1% ty l~ % TTCT
VII. !?iy~!ph~~~~~ ....
1. ......... ~?~9Ly~!~<?~g S29~'?hl!~g
1.1. I~5, 9Ly~t !ESr~~<?~g 1-5
1.2. Nhieu han 5 di V?t 6 - 10
2. V~tthu~gph&~-~~~c6IJ. di v?t gay anh huang clnrc nang,
chirc phan cua b(>phan chua di V?t: Tinh ty l~ % TTCT cua di
v?t va cua di clurng clnrc nang co quan b(>phan r6i cong thea
phuangphapc(>ngt~iThongtu
VIII.. !?I! !h~g'I!g~§l!g !~y, ~§l!g ~h~I! , , .
1. Ton thuong m(>tmong tay hoac mot rnong chan: 80i rnau, san
sui co v~n ngang, doc hoac viern quanh mong diSu tri khong 1
...... ~~!q~~h~y!~iph~!
2. Cvt, rvng m(>tmong tay ho~c m(>tmong chan 2
 49

Churmg 9
TY L~ PHAN TRAM TON THUONG CO THE
DO TON THUONG BONG

Nguyen t~c
- S((O a
bong chua 1iSn S((O: Cho ty 1~% TTCT mire t6i thiSu cua khung
- S((O bong anh huang th~m my la S((O c6 it nh~t mot trong cac dac diem sau: XO'
cling; dinh; 16ihoac 15m sau,
Moe TAn thU'o'ng Ty Ie 0/0
I. !h~~ ~Y.. . ..
§~g ~§r.I.g~h.§r.I.g~r.I.h.h~qr.I.g~~J'! ~i.~~}i~ty~ _ .
1. Dien tich tir 1% dien tich co the tro xuong
2. Di~~ti~hi6·~h;:~io/~di~~ti~h~;th6~C&them 1% dien tich co
thS thi cong them 1% ty l~% TTCT thea phuong phap cong tai
Thongtu
II. Seo o· cac vung da ho' khac gay r8i loan s~c t8 anh hurrng
.. ~~J'! !h~~ ~5T..................... ,
to'
T

1. Di~n tich 1% di§n ti~hcoth~tr6'xuong 2

2. . Di~~ ii~h i6~ h;~ 1% di~~ iich co th6: C& them 1% dien tich co
thS thi cong them 2% ty 1~% TTCT thea phuong phap cong tai
Thongtu
3. s~~~~~tben ~hit~@~g~yt6~thu;:~gih~~ kinh hoac anh huang
dt3nchirc nang van dong cua khop, tuy thea mire dQ anh huang:
Tinh thea ty l~ % TTCT quy dinh tai Chuong Ty l~ ph~n tram
t6n thuO'ng cO' thS do t6n thuO'ng xuO'ng SQ va h~ th~n kinh
valhoi;ic ChuO'ng Ty 1~ ph~n tram t6n thuO'ng cO' thS do t6n
!hl!<?pgh~ ~(?' ~ ~l!9'~g~)~h<P...,....
........................................ . ,
4. S((O mQt ben chi du6i, gay ton thuO'llg than kinh hoi;ic anh
huang dt3n chuc nang v~n dQng cua kh6p, tuy thea muc oQ anh
huang: Tinh thea ty l~ % TTCT quy dinh t'ili ChuO'ng Ty l~
ph~n tram t6n thuO'ng cO'thS do t6n thuO'ng xuO'ng SQ va h~ th~n
kinh valhoi;ic ChuO'llg Ty 1~ph~n tram t6n thuO'ng cO'thS do t6n
~~l!9Pg~ ~<P~
- ... .... !hl!9..~gh~ S<?'
5. S((Ovung tang sinh mon - sinh d\lc: Tuy thea muc dQ di chlmg
va anh huong dt3n cac bQ ph~n Ian c~n, tinh thea ty l~ % TTCT
quy dinh t'ili ChuO'ng Ty l~ ph~n tram t6n thuO'ng cO'thS do t6n
........................ ~i.~~
~hl!<?·~gh~ ~}~\l~~i~h 9V~~~~~kh9~............ _ .
6. S((O bong gay dinh ng6n tay ng6n chan dil ph~u thu~t anh
huang chuc nang: Tinh thea ty l~ % TTCT quy dinh t'ili
Chuong Ty l~ ph~n tram t6n thuO'ng cO'thS do t6n thuO'ng h~ cO'
- xuO'ng - kh6p
III. . §~g ~§~g~J'!h h!!<!r.I.g~tJ~~h.t!~,r.I.~_~g~~y~ ~h~~,~Y ..
1. ?y<:) y~gglP~!, ~<?g~YE<?i)g~~~~~!<?~PhhL!6'l1g.~h~I??lPY
 50

1.1. ....................
Dien tich duoi 1% dien tich co th~
,." " ",..,,,..,,,,.,,
.." , , "." , , " ".•.....
, i) .
6 - 10
1.2. Ri~Eltich tir 1% den duoi 3% dien tich co the 11 - 15
1.3. Di~n tich tir 3% dien tich~ath~ tro len 21
IV. .g~~
19~1l!r~1l "Y~llg~~g , , i.· ·..·..····.························

1 ~~~ y~! ~<?~!,

Y.~!X9~§P:g lien ~g~§L)g5l:p~~ph.~1!qpgy.~!:lg~xg 1 .

1.1 ~h.x{41!~g~i.P:h.y.~~)g~!~1!c!i?~~) 7-9

1.2. . y~~(41!9:p:gklnh Y~!,}<?~~~~?~~4~p: !g~~p). 16 - 18
1.3. Jg~~) .
~~pg(41!f!P:g~rpb y.~~19~~.t~~p: 21 - 25
2. Bong buot, seo loi, seo doi mau, seo viem: Tuy thea mire dQ
cong cho m6i seo 7 - 9% thea phuong phap cong tai Thong tu
* Ghi chu: NJu do nguyen nhdn thdn kinh thi tinh theo tY l¢ %
TTCT quy dinh tai Chuang Ty l¢ phdn tram tim thuong co thd
do t6n thuong xuong S9 va h¢ thdn kinh.
 51

Churrng 10
TY LE PHA.N TRAM TON THUONG CO THE
DO·TON THUONG CO QUAN THI GIAC

Muc TAn thuong Ty Ie 0/0

I. Khoet bo nhan cau 1 ben 51 - 55
II. Due nhan m~t do chfin thU'O'ng
.......................................................................... 1) : 'f ..

l. Chua mo: Can cir vao ket qua thi 19c, ap dung Muc XV. Ty l~ %
TTCT do giam thi 19c vi t6n thirong thirc th~ co quan thi giac va
~9!1g ~qi !9ro ~h~(?Eh~l'<?r:gEh~E~9l!g t51iTh9l!g tl!;
2. Da mo thay thuy tinh the nhan tao: Can cir vao ket qua thi 19c,
ap dung Muc XV. Ty l~ % TTCT do giarn thj 19c vi t6n thuong
thuc thS co quan thi giac va cong voi 10% thea phuong phap
cong tai Thong tu nhirng khong qua 41% mot mat,
III I?!!!~~:q~.g!!.g.~.~.!
!!.~.~ ~(~Q!.~~n
..!! <;.~
..
l. Ton thuong l~ dao
1. i..••••••••••••••.••••.•••• ~h.~.~~, , . ~~~h,~~I~
••••
~~9~E~~Bh~~ 7-9
1.2 ~~~h,~~ 1~S!51(?T9.~ph~~~h~~~,k~~
q~~~9~ 3-5
1.3. p~ph~~~h~~! k~~q~~kh9~g!9~. 11 - 15
?: §€(Oco keo ho mi 11 - 15
3. Syok6t ~~~~ ~~~l;i ~~t khong co keo ho mi: Tinh ty l~ %
TTCT nhu SyO vSt thuO'ng ph~n m~m
IV. TAn thu'O'ng chirc nang thi ghic do tAn thu'o'ng than kinh chi
...... pl!~i!l!jgi~,<;, , ,.
1. Mu nao chan thuong mQt mat hoi.}chai mat (ton thuO'ng trung
khu th~n kinh thi giac n~m 0 thuy ch~m dU9'Cxac dinh b~ng
ch~n doan hinh anh): Can ClrkSt qua thi 19c, ap dVng M\lC XV,
Ty l~ % TTCT do giam thi 19c vi t6n thuO'ng thgc thS cO'quan
thigi~c
2. Thi tr~&~g th~ h~p (d~ t6~ thu()'~g ~ii~~~~g .~h~~~tr~~g ~h~~.
thuO'ng)
.........................................................................................................
~ ···················.,.······· ·..······;r·········· .

2.l. Thitrucmg con khoang 300xung quanh diem co dinh

2.1. i···.·····.·.·.••.• fh.i••.•
ii~§·~gih~
••••
h~p§.iri.2!~~i
••••••••..............................................................
5-9
2. 1.~: IhL~~':l..~y!1g~h~h€(E <! h(;li p:~~~................................................ , , . 21 - 25
2.2. Thi trucmg con khoang 10°xung quanh diem co dinh
2.2.1. ·········M~t~~t ······21=25··
2.2.2. Hai m~t <» ~<>}
3. A i~ trung tam
3.1.
............................
'
AlTIdiS~~6'~~6t~~t
.,. ? ! ,
21 - 25
3.2. Am diem 6' hai mat 41 - 45
4. Ban manh (do t6n thuO'ng 0 giao thoa thi giac)
 52

4.1. ... ~~~~~~h y~~g!Q:9~2'.~~l!~ !1h!~(~hLIV'?~~l:ll?:g

~~~)
4. 1.1. . ~~l?:~~~h ,?~~g ~§~(ph~i hC?~~~~~i)_ ..... 26 - 30
4.l.2. Ban manh khac ben phia miii 21 - 25
4.1 .3. ~~l?:l~~l?:h~~'? ~§1!Ehi~ h~i !h~i ~~qI."lg . 61 - 63
4.1.4. Ban manh g6c 114 tren 11 - 15
4.l.5. Ban manh g6c 114 duoi 21 - 25
4.l.6. Ban manh ncanz tren 11 - 15
4.1.7. . ~~l!l~~I."lhI."lg~pg~l:l'<!L T
36 - 40
4.2. Ban manh kern thea mat thi luc trung tam mot ben hay ca hai
ben: Can cir vao k~t qua thi lire, ap dung Muc XV. Ty l~ %
TTCT do giam thi luc vi t6n thuong thuc the co quan thi giac
phl!l!g ~§i 9~ ~<?~g q\l~ ~)ro
5. Song thi
S~~gth!~~t~~t
5.1:························ . 11 - 15
"'
................................................................................................... .

5.2.. ?8I!g!hLh~Ll~~~ , . 21 - 25
6. . ~<?iJg~lI."l~.~.~g~~~y.~!~X'?hI."lghi~.~.pg!~~ , . 11 - 15
7. ?yp mi 1~9~l~~!(~g !<?I."l !hl!qI."lg~~yth~p ~~l!h~<?Ig) .
7.1. . _?yp l!l~1~fl'~99 '?h~I."lfl:~ q<?~p~fl: _ ..., _ 11 - 15
7.2. S\lP mi hoan toan che mat tam nhin: Can cir vao ket qua thi hrc,
ap dung Muc XV. Ty l~ % TTCT do giam thi lvc vi t6n thuO'ng
thvc thS cO' quan thi giac va c9ng v6i 10% thea phuO'ng phap
. .. . '?9Pg !~liI~<?I."lg~l:l' , T

8. Dinh mi cau khong con kha nang ph\lc hoi: Can Cll'vao ket qua
thi lvc, ap dl,lng M\lc XV. Ty l~ % TTCT do giam thi 19c vi t6n
thuO'ng th\l'c th6 cO'quan thi giac va C9ng v6i 10% thea phuong
....................
Eh~E'?9I."lg!,:;liIh<?I."lg~~ , .. ..... _
9.
9. i.
Li~t dieu tiet va li~t cO' co dong tu: .
M~tl;~t··················································
11 - 15
9.2. Hai mat 21 - 25
10. .. I3:l:lI."lg
g~~!~h~I."l'?~l:l,99:~ ~y~I."l
10.1. ~l:ll!g g}~! q l!l9! p:;~! . 5-9
10.2 ~yl!gg~~!9~h~it.E:~! ,.. ., T
11 - 15
11. Li~t m9t hay nhieu day than kinh v~n d9ng nhan cau (day so III
- nhanh v~n d9ng nhan c~u; s6 IV; s6 VI): Tinh ty I~ % TTCT
thea quy dinh t<;tiChuO'ng t6n thuO'ng cO' th~ do t6n thuong
xU()'l"lgs9 y~ h~th~n kinh
12.· T6n th~~ng ~hi~h i d~y th~~ ki~h;'6 V: Tinh ty l~ % TTCT
thea quy dinh t<;tiChuO'ng t6n thuO'ng cO' th6 do t6n thuO'ng
~~()'J:?g~9y~ h~!h~p l~iJ:?h. ..., f···································.

13. Viem giac m<;tc:Can cli vao ket qua thi lvc, ap d\lng M\lc XV.
Ty l~ % TTCT do giam thi lvc vi t6n thuO'ng th\l'c th6 cO'quan
thi giac. Ty l~ % TTCT do giam thi Ivc t6i da khong qua 41 %
 53

........... ~.~!y~.~<y~IIG.I~¥.y~J~
!P.2!~.~~5~2P:g -r ,......... . .

14. Teo day than kinh thi giac (day than kinh so II): Can cir vao ket
qua thi lire, ap dung Muc XV. Ty l~ % TTCT do giam thi luc vi
ton thuong thuc the co quan thi giac
V. TBn thirong vong mac
Can cir vao k~t qua thi lire, ap dung Muc XV. Ty l~ % TTCT do
giam thi l\IC vi ton thuong thuc the co quan thi giac
VI. §t;g gi~<;~~C;, C;~~g ~~<; ..
l. . §«(?gi~g l!lc,t~I~§l!g~l1hhy~l~gthj)\r~ i
5
2. SyO giac mac anh huang thi luc: Can cir vao ket qua thi lire, ap
dung Muc XV. Ty l~ % TTCT do giam thi luc vi t6n thuong
thuc th~ co quan thi giac va cong voi 5% thea phuong phap
..............
~21!g!c,t~Ih§l1g!~!1h~l1g~h§l!gq~~4.X~~2!!P.~! .
3. . §«(?~~l!g~c,t~ ~§l!g~l1hh~~l1g!ht)¥~ _ r-
2
4. SyO cung mac anh huang thi luc: Can cir vao ket qua thi l\IC, ap
d\lng M\lc XV. Ty l~ % TTCT do giam thi l\Ic vi t6n thuO'ng
th\Ic th~ cO' quan thi giac va c(>ng vai 2% theo phuang phap
c(>ng t:;liThong tu nhung khong qua 41 %
VII. Ton h~i moi trU'()'ugtr()ng su~t (thuy dich - thuy ti$ dich)
l. ·········chI~thu~·~g di··v~t~~i~h~~kh6~gthSiftyduqc
~h~~·~~~····~6~
g~y ~h~'l!g~~! !?Ll1bi~~9<?ggh()~~?~!
2. To chuc h6a dich kinh
M\lc VII: Can cu vao ~Stqua thi l\IC, ap d\lng Ml,lc XV. Ty l~ %
TTCT do giam thi l\Ic vi t6n thuO'ng th\Ic th~ cO'quan thi giac va
c(>ng vai 15% thea phuO'ng phap c(>ng t:;li Thong tu nhung
khong qua 41 %
VIII. Giam di~u van, so' anh sang, chay nU'o'c m~t va kich ll'llg m~t 3-5
IX Q~~pgi~<; ~~£
1. ~h2I1ggi~~!hL~¥~ . T 3-5
2. Giam thi l\Ic: Can cli vao ket qua thi l\IC, ap d\lng M\lc XV. Ty
l~ % TTCT do giam thi l\Ic vi t6n thuang th\Ic th~ cO' quan thi
giac
X. Di v~t trong nhun cfiu
Can cli vao k~t qua thi l\Ic, ap d\lng M\lc XV. Ty l~ % TTCT do
giam thi l\IC vi t6n thuO'ng th\Ic th~ cO' quan thi giac va c(>ng vai
10% thea phuO'ng phap c(>ng t:;li Thong tu nhung khong qua
41%
XI. Di vat sau nhun cfiu
Cin ~lf vao k~t qua thi l\IC, ap d\lng M\lc XV. Ty l~ % TTCT do
giam thi l\Ic vi t6n thuO'ng th\Ic th~ cO' quan thi giac va cQng vai
10% thea phuO'ng phap c(>ng t:;li Thong tu nhung khong qua
41%
 54

XII. D] v~t ti~n phong

Can cir vao ket qua thi lire, ap dung M\1c xv. Ty l~ % TTCT do
giarn thi luc vi t6n thuong co quan thi giac va cong 10% thea
phuong phap cong tai Thong nr nhimg khong qua 410/0
XIII. Y9'~,!9'~g9~~! .
1. v» xuong khong anh huang thjhlc 5-7
2. gh.~y.~.i
·········
.••••• •••• .••h9.S.~.~f
~.~~rig.ih.~.rih .•• ••...
·.······· . 8 - 10
3. R6 viem xuang thanh hoc mat + 11 - 1?
4. Co anh huang thi luc: Cong ty l~ % TTCT cua giam thi luc va ty
l~ % TTCT cua va xuong thea phuong phap cong tai Thong tir
XIV. .. ~~~~_~~!~~~~i~~~t?!~'!t?'.~g!~~~ _.. _ .
1. Glocom 3 - 5~
............... .

2. ...........
~v,~..~h.~.y
~~.~hi§~?4i~.~..~.~~,.~h\ly
..• ~i.~•••
ih~i~9~.•ph~~•••••...•..•
·,.......... 4-8
3. . !?i.~~<:l~~g
§ IP~~(!hV~~~!!.~~~g~':lh~}h~p/~~~~~':l~~~g,~~<?) 3 - 5
4. Gian dong nr do chan thuong va cac bat thuong khac ve dong nr 4-8
hoac mong mat
XV. TY LE % TTCT DO GIAM THI LUC vi TON THUONG THUC THE
. CO QUAN Till GIAc .
10/10 7/10 durri ST
Thi Il}'c SilO 4/10 3/10 2/10 1110 1120
8/10 6/10 1120 (-)
10/10 17 21 25 31 41
0 5 8 11 14
8/10
7/10 25 31 35 45
5 8 11 14 17 21
6/10
SilO 8 11 14 17 21 25 31 35 41 51

4/10 11 14 17 21 25 31 35 41 45 55

3/10 14 17 21 25 31 35 41 45 51 61

2/10 17 21 25 31 35 41 45 51 55 65

1110 21 25 31 35 41 45 51 55 61 71

1120 25 31 35 41 45 51 55 61 71 81
du·o·j 61 71 81 85
31 35 41 45 51 55
1120
ST(-) 41 45 51 55 61 65 71 81 85 87
,
- Giao diem cua 2 tr\lc tung - tr\lc hoanh la ty l~ % TTCT chung cua 2 mat do
gi~unthi It_Xc
(thi It_Xc
sau khi da duQ'cchinh kinh, cac muc dQ til giam r~t nhy d~n mu
tuy~t d6i).
 55

- Thi hrc cua m6i mat diroc biSu diSn tren 1 true (true tung hoac true hoanh)
phan ra cac dQ 8110 - 10/10 (binh thuong), 7110 - 6/10 (giam r~t nhe), 5110, 4110...
d~n ST am tinh.
- Trong tnrong hop thi lire duoc cho thea cac phuong phap khac nhau thi phai
quy d6i vS bang thap phan.
 56

Chiroug 11
TY LE PHAN TRAM TON THUONG CO THE
DOTONTHUONGRANG-HAM-M~T

Muc Tan thuo'na Ty Ie 0/0

I. Xll'O'ng ham, go rna, cung ti~p va kho'p thai du'o'ng - ham
,•••••••.••••••••••••••••••••••••••••••••••••.••••••••.•••••••••.•..............••••....••••.••••••••••....•.......... ';j...••••.•_••.•••..•••••.•..•....•••....••..•..•. ,•...••....•••..•...............•.•..••.•••••••••••••••.•••••••••••••.••••••••.••....••........•..•.....•..•..•.••••••.•• -....•••••••••••.•.............. -.••.-•••.•..•........

1. M~~l!(?'~gh~~, Y9' () <?h*~E~~g . 1- 3

2. Gay xuong ham tren; gay xuong ham duoi; gay xuong go rna,
8 - 10
.....<?l:l~g~~~p<?(;l~~<?~, kh()~g ~~ hl!<?Pg<?h~<?
~~~g . T ...

3. Gay xuong hall tren hoac xuong ham duoi can xau gay sai
21 - 25
khop c~n
4. ..... Q~y <?~~l!<?:~gh~~p:!E~~y~ ~~9.'~gh~~ 9l:l'~'i<?~1~
t.<? ..... r:
16 - 20
5. Gay ca xuang ham tren va xuong ham duoi can xau, gay sai
31 - 35
..........
I~hqPE~~...... ,..................
, ,
6. . Q~X~\l'<!l'lg~<? ~~, <?\l~g!~~p~~l'l~~\l g~y ~i~,~9C;l~g~~~ 16 - 20
7. Mat mot phan xuong ham tren hoac mot phan xuong ham duoi
31 - 35
til canh cao tro xuong (da:tinh ca ty l~ % TTCT mat rang)
..............................
, ".···················'c··,·······,·················
..···· ,",.," " "' .."" ,.,.,', ,,, ,.,..

8. Mat mot phan xuong ham tren va mot phan xuong ham duoi til
.. ~~~h <?~9.~~q ~l:l~~g(9~ ~i~ <?~~y)~(Yo IIGI El'l~!E~~g2 ..
8.1. Cling ben 41 - 45
8.2. Khac ben 51 - 55
9. . ? ~g.~~~9 ~l!9.·~g.h~!.!l.~~.~.~h9..~.<?
~.l!9.'~gh.~1P:9l!9'~ . 61
10. Ton thuang xuang ham, khap thai duang ham gay dinh khap
h~n chS ha mi~ng
10:1.··· f&i~5~~dS~j~~ 21 - 25
10.2. Duai 1,5cm 36 - 40
ii. .. -Khap gia x~~;g h~~h~y kh~ySt ~uang anh hu6';g d~~ ~h(;~- 26 - 30
nang nhai.
12: f~~tiili6:phamd~tai phM khong con kh~~~;gdi~~ tri 16 - 20
II. R~~g .
1. Rang vInh viSn
1. i M~~~~gdi~~t~fb~o t6~:fi~b~~g 50% ty l~ % TTCT C~~l;~t
rang
1.2. . h<?~<?g~y~h~~!.!l.9~r~l'l:g
1.2.l. ~ang elra, rang nanh (sol, 2, 3) 2
1.2.2. . R~~g h~~;~h6(~6 5)·· 4, . 1,5
1.2.3. R~~gh~~~i6;~66· .
. ?,?
1.2.4. Rang ham Ian s6 7 2
1.2.5 ~~!!gh~~~<? § . ...
1
1································I
1.3. Mat til 8 den 19 rang ca hai ham a 15 - 18
M~i ••• b.9••••
1.4.•••••••••••••..•.....• 1?9.i•h~1?h.?%~••••
••• t.9.~ri••••
1~.~i•••• ?Q•••••
~~l'lgt~q I..
~l'l q ~..~ h.a.ih~l!!. t~•••• 21 - 25
 57

1.5. ........
M~!t~~~!?9E~£lgh~Lh~~...... . 31
2. Rang sua: Tinh bang 50% ty 1~ % TTCT cua rang vinh vien
tuong img
III. . ." ' .",.............. . .. . f"..................... . ·······..·1·..········ .

1. Khuyet hong 100 a xung quanh hoc mieng, ton thuong miii, rna
nhung chua duoc phau thuat tao hinh lam tro ngai d~n an, uong, 51 - 55
noi
IV. ....._
Lufri
.

1. Seo hroi khong anh huang chirc nang

...........................
1 ················
, " "' , ,.............
. .
1- 5
6 - 10
2. . M.~!1~9~ph~!?:P,:h~.~.~~
..)~f!~,~~ h~.<!~g~~£l~~, £l.9i .
31 - 35
3. M.~!P?9~ £l~(;l~~£lh~LEh~£l!?(;l)~qi .. ., .
4. Mat ba phan tir hroi, ke tir duong gai chir "V" tro fa (con goc 51 - 55
hroi)
V. . ~h~·~·~g
!~~ h~~h2~g
!~y~~~~'~'<:~9t .
1. ~9£lgg~Y ~9 EJ:l~~£lg 3-5
2. .. _Q~y h~~q~~~9 ~~~~g 16 - 20
3. Gay ro keo dai 21 - 25
 58

Chirong 12

TY LIt PHAN TRAM TON THUONG CO THE

DO TON THUONG TAl - Min - HQNG
Mue TAn thurrng
I. Tai
2. .........
~gh~ ~~~!l:~2! !'.lL
2 .1. ~gh~ ~~~ l!hx ~2!!'.li . 3
2.2. . .~gh~ l~~~!Tl:lPg~11!hE1!9ttClL . 9
2.3. ~gh~~~~1!~l!gEP9!!Cli .... 11 - 15
2.4. ~gh~ )~~~!l: ql:l~l!~l!g1!l:2!!ClL 16 - 20
3. S((O thung rnang nhi hay S((O xo dinh mang nhi lam giam sire
. l!gl!~:Tiph !y l~~ TI~I!h~~ !P~'? ~2 nghe ~~!P .
.........................
4. Viem tai giira man tinh sau chan thuong gay ton thuong tai giira:
Tinh ty l~ % TTCT thea sire nghe va cong til 5 den 10% tuy thea
viem tai gitra mot ben hay hai ben, n~u co kern thea
cholesteatome cong til 11 d~n 15% thea phuong phap cong tai
.. Ih§l!g!~ .
5. Vet thuong vanh tai •••••••••••••••
* .

5.1. S((O vanh tai khong co rum 1- 3

5.2. . ....M~titha~i;3~~~ht~ih~i~
,. , ~ ~
seo co rum
........................................... "... . -,... . .
6 - 10
5.2 Mat tir 113 den 2/3 vanh tai. 11 - 15
t··········································

5.3.· M~t~~his~ han 2/3 dS~hoan t()~pl!1:2!Vanhtai 16 - 20

6. S~~6~gtai
...................................................• -1" -_.-•.........•...............

6.1. S((O ong tai mot ben khong gay hep: Tinh ty l~ % TTCT nhir S((O

J?h~p ~!1:~~P
....................................... T· .... T

6.2. .. §x(?J~~PhxE <?pg!'.l~Ip9! ~~l! (han '?h~~~ thanh) 3-6

6.3. Ong tai bi bit kin: Tinh ty l~ % TTCT thea mire dQ nghe kern mot
tai
6.4. On tai bi bit kin gay viem tai ngoai: Ty l~ % TTCT m\lc
~~?~
'?9Pg? :]~ ~h~(?l?h~qpgEh~p'?9Pg~~Llh§pg ~~
7. . yi?:~l:l:S!pg~.~~.§l!g~~ l..~.~~.~'?h~pg . 16 - 20
8. Va xuang da de l~i di chung: Ty l~ % TTCT m\lc 7 cQng ty l~ %
...... TI<;=I,?~(;l9i '?~~'l!~!h~()ph\l:qpgph~p '?9Pg!~i Ih<?pg ~~
*
Ghi chu: Neu ton thuang 2 ben, tinh tY I¢ % TTCT c~la tung
ben r6i c9nJ?thea phuong philp c9ng t(li Thong tu,
II. M~t~,~~~g
....
1. .. ~\ly~~~gL
1,1.. ~\lY~~ l!h§ ,h9!l)/4J~gL 5-9
1.2, ~\lY~! ~~~~l!g)/4 ~~P ~§ h'?'p}/?lPgi 11 - 15
1.3. . ~h\ly.~~.~~~.~pg)/.?~~P..!?~pg..?/4 ~gi . 21 - 25
...............................

1.4, ~hl:lY~!)qp hC!1!?/4 IpgA: 26 - 30

 59

2. ~h~~ih~~g)~!iliE~qiig~~iiihq
$~~~E~!E~p'j9rii~I(.4~ .. .
~:~:. §~~~7ti~~~6;fg~rr7~E ~~~~~
2.3. $~~~hi~h~ph~{19iPg~,~~hh~<!pg~h{~~~~ii~h<!.. 31 - 35
2.4. Seo bit hoan toan ca hai 10 mfii phai tho bang mieng 41 - 45
3. ~~{;y~~y~~hiig~iii
I§.iii4.~~gih~p.i~~I(g~y;~~p~~~g.~ht!ili
3.1. ~h§~g ~~h h,:!<!pg<!§~<?h~'?~~pg~h9.'....... 7-9
3.2. ....Ap~ h~:~·pg9§P ~h<!E~ E~t 11 - 15
4. ...Chan ~h~g'pg :>()9:pg
4 .1. !~~
y~ ~'~Ph9:Y ~h~~ :>()~pgh~~!lh()~'?:>()9:pg!~·~~)~h§l!.gSU!~<?h. 7-9
4.2. M~!1!l2~Eh~p h~Yy<! ~i)~'?h ~h~l!.h:>()~l!.gh~~ h()~<?:>()9:pg~t~p )J =) 5
4.3. Chan thuong phirc hop miii - sang (vo kin miii - sang - buorn):
Cong ty l~ % TTCT cac t6n thuong phoi h9P di kern cua cac co 36 - 40
.................................
qt.l.<:t,l!. kh~'? ~h~()ph~9:l!.g ph~p '?2Pg ~~iIh§pg ~~ .....
5. Chan thuong S9 - mat (tang tren, gitra, duoi): Cong ty l~ % TTCT
cua cac t6n thuong chirc nang lien quan (lay mire t6i thieu cua
)~ht.l.l!.g)~h~()ph~9:~& ph~P<?2Pg ~~~Ih§~g ~~
6. yi§l!l :>()9:~g~9:t.l. '?h~p th~9:Pg .
6.1. Viem dan xoang""
1····················································· ·1···································

6.1.1. MQt ben 6 - 10

6.1.2. Hai ben 11 - 15
6.2. Viem da xoang
6.2.1. MQt ben 16 - 20
6.2.2. Hai ben 26 - 30
6.3. Viem xoang con di V?t trong xoang (chua l~' ra duqc ho~c
m6 khong l~y ra duqc) ho~c c6 16 ro: Ty l~ % TTCT cua viem
xoang cQng 5% thea phuang phap cQng t?i Thong tu
III. !!9J:lg .. T ......, T 1···········································

1. SyO lam hyp h9ng, h? h9ng anh huang den nuot nhy (kh6 nuot 11 _ 15
ch~t d?c)
..........................................................................................................................................................
_........ . ,. ,. , 1 m •••••
••••••••••••••••••••••••••••••••••••·

2. SyO lam hyp h9ng, h? h9ng anh huang kh6 nuot (kh6 nuot chat 26 _ 30
...............
" ,...
long) ,...... . ··········································1·· .

3. An qua ong thong d? day (sonde) ho~c phai m6' thong d~ day
vinh vi@n do khong an duqc qua duo-ng h9ng (d§: tinh ca t6n 71 - 73
..........
~h~<?·~gh.9~g,h~h.99g1 ........ .
IV. !~~J:lhg~~J:l T.

1. Roi lo?n tieng n6i do ton thuang clla thanh quan - h9ng ho~c cac
ca vung c6
l.1. N6i kh6
1.1.1. N:~i}~~~!l~g<!2~h.y('?~~rig~ii5 . 16 - 20
1.1.2. N6i kh6 muc dQ vira (tung tieng) 26 - 30
1.1.3. E9I0i~rii~~~2~~~g(0i9~gi§i{~iigl
..... 41 - 45
 60
................
I' ~ - , " .

;:2.. -=Mli;~&~i~~~i~§~~~~~~~L
---61
2.1. ..~2~~~~g~9~gT 11 - 15
2.2. .......~~~ ~i?~gE9~i§~g .. - ~I ~..~.?.
2.3. ryr~~~_~§~g'm .. . .. _ 4! ~4?.
3. .. J:3.i?~ Jg~~ hi? h~p (~h~ ~hqthaph q\l~~) T . . .

3.1. ~h9 !hq~hx(<?h}~\l~!h~~~~~ h<?~~ q9~gg~~g~lJ.:<?} 26 - 30

3.2. ...... ~h9 !hqy~·~(!T\l~g l?i~h:kh2 !h<!~t.I~!h!~~l~hi g~~g~~'<?~hY) .... 46 - 50
3.3. . ~h9 !hq ~~~g (kh9 !hcY thuong ~l:lY§~~~§ <?~",~hi~ghi ~g<?'i) .. . 61 - 63
3.4. Kh6 tho nit nang, phai rna khi quan vinh vien 81
KT. BQ TRUONG
THUTRUONG

Nguy~n Vi~t Ti~n

 60

1.2: ~9.~g ~~I~~2~

ph~Lg{~~_f~~p
~~~gh~~h~h~~~~~ 61
2 ~<?iJg5l:~
g!2~g~.9L.(49
. !<?~.!hl!~g~2~!h~~ q':l.~~:4~y.!h~~) .
2.1 ~9~~~~gJ2~gT _ J) :J?
2.2 ~~~~<?~gX<?~~§~g 21 - 25
2.3. Mat tieng 41 - 45
3: _ ~9LI~~~h~h~p(kh~!hq!h~~hq~~~) T

3 .1 ~h9!hq.~hx..(.~hi.~~~!h~~~
~.~h9.5I:~q2~g
g~~g~.Y:~.)
. 26 - 30
3.2 ~.9 !hqy~~(!T':l~gl?i~h:~9 ~h.q~~.~~
..h~.~.~
~.ig~~g ~.~.~
~.hx2. 46 - 50
3.3. ~9 ~hq~~~g(~9 !hq~hl!~g~~y.§~~k.§ ~ghJ~gq~}
~~N~~ 61 - 63
3.4. Kh6 tho rat nang, phai rna khi quan vinh vien 81
KT. BO TRUONG ~
RUON