![\"S\u00e0ng](\"\/\/yhoccongdong.org\/Documents\/2132_sang-loc-khiem-thinh.jpg\")
<\/p>\nKhi\u1ebfm th\u00ednh s\u01a1 sinh x\u1ea3y ra \u1edf t\u1ef7 l\u1ec7 1\/1000 \u0111\u1ebfn 1\/2000 tr\u1ebb s\u01a1 sinh, ri\u00eang trong nh\u00f3m tr\u1ebb c\u00f3 nguy c\u01a1 cao nh\u01b0 nh\u1eefng tr\u1ebb \u0111\u01b0\u1ee3c sinh ra t\u1eeb c\u00e1c b\u00e0 m\u1eb9 m\u1eafc m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd khi mang thai nh\u01b0 rubella, giang mai, herpes\u2026, nh\u1eefng tr\u1ebb c\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 ng\u01b0\u1eddi b\u1ecb \u0111i\u1ebfc, tr\u1ebb \u0111\u1ebb non ho\u1eb7c nh\u1eb9 c\u00e2n, c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a suy h\u00f4 h\u1ea5p sau \u0111\u1ebb, v\u00e0 ph\u1ea3i th\u00f4ng kh\u00ed h\u1ed7 tr\u1ee3 k\u00e9o d\u00e0i, tr\u1ebb b\u1ecb v\u00e0ng da do t\u0103ng bilirubin, vi\u00eam m\u00e0ng n\u00e3o v.v\u2026th\u00ec t\u1ef7 l\u1ec7 tr\u1ebb s\u01a1 sinh khi\u1ebfm th\u00ednh r\u1ea5t cao, t\u1eeb 1\/50 \u0111\u1ebfn 1\/25 tr\u1ebb s\u01a1 sinh. Theo m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u, t\u1ef7 l\u1ec7 \u0111i\u1ebfc \u1edf tr\u1ebb chi\u1ebfm t\u1eeb 1\/1000 \u0111\u1ebfn 5\/1000. Nh\u01b0 v\u1eady \u01b0\u1edbc t\u00ednh m\u1ed7i n\u0103m s\u1ebd c\u00f3 th\u00eam kho\u1ea3ng 5000 tr\u1ebb b\u1ecb \u0111i\u1ebfc m\u1edbi tr\u00ean kho\u1ea3ng 1 tri\u1ec7u tr\u1ebb \u0111\u01b0\u1ee3c sinh ra. <\/p>\n
Vi\u1ec7c ph\u00e1t hi\u1ec7n t\u00ecnh tr\u1ea1ng khi\u1ebfm th\u00ednh \u1edf tr\u1ebb th\u01b0\u1eddng r\u1ea5t mu\u1ed9n, \u0111a ph\u1ea7n sau 2 tu\u1ed5i n\u00ean vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u1ea3 \u0111i\u1ebfc v\u00e0 ng\u00f4n ng\u1eef \u0111\u1ec1u r\u1ea5t kh\u00f3 kh\u0103n. Tr\u1ebb khi\u1ebfm th\u00ednh th\u01b0\u1eddng ch\u1eadm n\u00f3i ho\u1eb7c kh\u00f4ng n\u00f3i \u0111\u01b0\u1ee3c, t\u1eeb \u0111\u00f3 d\u1eabn \u0111\u1ebfn ch\u1eadm ph\u00e1t tri\u1ec3n ng\u00f4n ng\u1eef v\u00e0 g\u00e2y kh\u00f3 kh\u0103n cho vi\u1ec7c h\u1ecdc t\u1eadp. S\u00e0ng l\u1ecdc th\u00ednh l\u1ef1c cho tr\u1ebb s\u01a1 sinh tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n v\u1ec1 nh\u00e0 s\u1ebd gi\u00fap ph\u00e1t hi\u1ec7n t\u1eeb r\u1ea5t s\u1edbm nh\u1eefng tr\u1ebb c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 th\u00ednh gi\u00e1c \u0111\u1ec3 k\u1ecbp th\u1eddi can thi\u1ec7p, \u0111i\u1ec1u n\u00e0y c\u00f3 \u00fd ngh\u0129a r\u1ea5t quan tr\u1ecdng v\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n ng\u00f4n ng\u1eef v\u00e0 kh\u1ea3 n\u0103ng n\u00f3i c\u1ee7a tr\u1ebb. Tr\u1ebb s\u01a1 sinh b\u1ecb khi\u1ebfm th\u00ednh n\u1ebfu \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n v\u00e0 can thi\u1ec7p s\u1edbm s\u1ebd c\u00f3 th\u1ec3 nghe, n\u00f3i, v\u00e0 ph\u00e1t tri\u1ec3n nh\u01b0 tr\u1ebb b\u00ecnh th\u01b0\u1eddng. <\/p>\n
<\/p>\n
T\u1ea5t c\u1ea3 tr\u1ebb s\u01a1 sinh b\u00ecnh th\u01b0\u1eddng ho\u1eb7c c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh l\u00fd \u0111\u1ec1u c\u1ea7n \u0111\u01b0\u1ee3c ki\u1ec3m tra th\u00ednh l\u1ef1c th\u00f4ng qua ch\u01b0\u01a1ng tr\u00ecnh s\u00e0ng l\u1ecdc khi\u1ebfm th\u00ednh. Do tr\u1ebb khi\u1ebfm th\u00ednh c\u00f3 th\u1ec3 c\u00f3 v\u1ebb ngo\u00e0i ho\u00e0n to\u00e0n b\u00ecnh th\u01b0\u1eddng n\u00ean vi\u1ec7c cho tr\u1ebb s\u00e0ng l\u1ecdc khi\u1ebfm th\u00ednh l\u00e0 bi\u1ec7n ph\u00e1p h\u1eefu hi\u1ec7u gi\u00fap ph\u00e1t hi\u1ec7n s\u1edbm nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u00f3 li\u00ean quan \u0111\u1ebfn th\u00ednh l\u1ef1c c\u1ee7a tr\u1ebb \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 can thi\u1ec7p s\u1edbm. <\/p>\n
\u0110\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 khi\u1ebfm th\u00ednh c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng m\u00e1y \u0111o th\u00ednh l\u1ef1c (audiometer) ho\u1eb7c s\u1eed d\u1ee5ng gi\u1ecdng n\u00f3i (voice test). C\u00f3 nhi\u1ec1u c\u1ea5p \u0111\u1ed9 hay m\u1ee9c \u0111\u1ed9 khi\u1ebfm th\u00ednh kh\u00e1c nhau. Ch\u00fang \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng \u0111\u01a1n v\u1ecb decibel (dB) khi \u0111\u1ec1 c\u1eadp \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 hay \u0111\u1ed9 l\u1edbn hay \u00e2m l\u01b0\u1ee3ng, ho\u1eb7c \u0111\u01a1n v\u1ecb Hertz (Hz) khi \u0111\u1ec1 c\u1eadp \u0111\u1ebfn \u0111\u1ed9 cao th\u1ea5p hay t\u1ea7n s\u1ed1 c\u1ee7a \u00e2m thanh ti\u1ebfng n\u00f3i. <\/p>\n
Khi\u1ebfm th\u00ednh \u0111\u01b0\u1ee3c chia l\u00e0m nhi\u1ec1u lo\u1ea1i kh\u00e1c nhau, g\u1ed3m khi\u1ebfm th\u00ednh do d\u1eabn truy\u1ec1n, khi\u1ebfm th\u00ednh do ti\u1ebfp nh\u1eadn \u1ed1c tai (khi\u1ebfm th\u00ednh do th\u1ea7n kinh c\u1ea3m nh\u1eadn: sensorineural hearing loss), khi\u1ebfm th\u00ednh do th\u1ea7n kinh th\u00ednh gi\u00e1c, khi\u1ebfm th\u00ednh h\u1ed7n h\u1ee3p. T\u00f9y theo khi\u1ebfm th\u00ednh lo\u1ea1i n\u00e0o m\u00e0 s\u1ebd kh\u00e1c nhau v\u1ec1 nguy\u00ean nh\u00e2n, m\u1ee9c \u0111\u1ed9 khi\u1ebfm th\u00ednh c\u0169ng nh\u01b0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb. <\/p>\n
\u0110\u1ed9 khi\u1ebfm th\u00ednh <\/strong> <\/td>\n| M\u00e1y \u0111o th\u00ednh l\u1ef1c <\/strong> <\/td>\n | Gi\u1ecdng n\u00f3i <\/strong> <\/td>\n | H\u01b0\u1edbng x\u1eed tr\u00ed <\/strong> <\/td>\n<\/tr>\n | Nh\u1eb9 <\/strong> <\/td>\n | 20 – 40 dB <\/td>\n | \n | – \u00a0Tr\u1ebb c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c ti\u1ebfng n\u00f3i nh\u01b0ng ch\u1ec9 l\u00e0\u00a0nh\u1eefng \u0111o\u1ea1n r\u1eddi r\u1ea1c. Nh\u1eefng t\u1eeb ng\u1eafn, ph\u1ea7n\u00a0cu\u1ed1i c\u1ee7a t\u1eeb v\u00e0 nh\u1eefng \u00e2m t\u1eeb kh\u00f4ng r\u00f5 th\u01b0\u1eddng \n | C\u00f3 th\u1ec3 d\u00f9ng m\u00e1y tr\u1ee3 th\u00ednh <\/p>\n<\/td>\n<\/tr>\n V\u1eeba <\/strong> <\/td>\n | 41 – 60 dB <\/td>\n | \n | – \u00a0Tr\u1ebb c\u00f3 th\u1ec3 kh\u00f4ng nghe \u0111\u01b0\u1ee3c t\u1edbi 50% l\u1eddi n\u00f3i\u00a0c\u1ee7a ng\u01b0\u1eddi kh\u00e1c v\u00e0 th\u1eadm ch\u00ed c\u00f2n h\u01a1n n\u1eefa n\u1ebfu\u00a0ti\u1ebfng \u1ed3n xung quanh t\u0103ng l\u00ean. \n | C\u1ea7n d\u00f9ng m\u00e1y tr\u1ee3 th\u00ednh th\u01b0\u1eddng xuy\u00ean <\/p>\n<\/td>\n<\/tr>\n N\u1eb7ng <\/strong> <\/td>\n | 61 – 90 dB <\/td>\n | \n | – \u00a0Tr\u1ebb kh\u00f4ng nghe \u0111\u01b0\u1ee3c ph\u1ea7n l\u1edbn \u00e2m thanh ti\u1ebfng n\u00f3i. Ngo\u00e0i ra, c\u00e1c k\u1ef9 n\u0103ng n\u00f3i c\u00f3 th\u1ec3 kh\u00f4ng ph\u00e1t tri\u1ec3n \u0111\u01b0\u1ee3c n\u1ebfu \u00e2m thanh kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfch \u0111\u1ea1i nh\u1edd m\u00e1y tr\u1ee3 th\u00ednh v\u00e0 tr\u1ebb c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh ng\u00f4n ng\u1eef v\u00e0 tr\u1ecb li\u1ec7u v\u1ec1 ng\u00f4n ng\u1eef. \n | – \u00a0C\u1ea7n d\u00f9ng m\u00e1y tr\u1ee3 th\u00ednh th\u01b0\u1eddng xuy\u00ean. R\u1ea5t n\u1eb7ng <\/strong> <\/td>\n | 91 dB <\/td>\n | \n | – \u00a0Tr\u1ebb g\u1ea7n nh\u01b0 kh\u00f4ng nghe \u0111\u01b0\u1ee3c \u00e2m thanh g\u00ec c\u1ea3 (\u0111\u1eb7c bi\u1ec7t l\u00e0 l\u1eddi n\u00f3i). Kh\u1ea3 n\u0103ng n\u00f3i kh\u00f4ng th\u1ec3 ph\u00e1t tri\u1ec3n \u0111\u01b0\u1ee3c n\u1ebfu kh\u00f4ng d\u00f9ng m\u00e1y tr\u1ee3 th\u00ednh hay c\u1ea5y thi\u1ebft b\u1ecb tr\u1ee3 th\u00ednh \u1ed1c tai. \n | – \u00a0M\u00e1y m\u00e1y tr\u1ee3 th\u00ednh c\u00f3 th\u1ec3 gi\u00fap ph\u1ea7n n\u00e0o. Khi\u1ebfm th\u00ednh t\u1ea7n s\u1ed1 cao <\/strong> <\/td>\n | 1500 Hz\u20138000 Hz <\/td>\n | \n | – \u00a0Tr\u1ebb ch\u1ee7 y\u1ebfu kh\u00f4ng nghe \u0111\u01b0\u1ee3c nh\u1eefng \u00e2m thanh c\u00f3 t\u1ea7n s\u1ed1 cao v\u00e0 kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng nghe \u0111\u01b0\u1ee3c c\u00e1c ph\u1ee5 \u00e2m. \n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n | C\u00e1c nghi\u1ec7m ph\u00e1p \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 khi\u1ebfm th\u00ednh \u1edf tr\u1ebb nh\u1ecf? <\/h2>\n Nghi\u1ec7m ph\u00e1p h\u00e0nh vi <\/strong> <\/span> <\/p>\n C\u00e1c x\u00e9t nghi\u1ec7m h\u00e0nh vi \u0111\u01b0\u1ee3c d\u1ef1a tr\u00ean vi\u1ec7c t\u1ea1o ra hay quan s\u00e1t th\u1ea5y m\u1ed9t thay \u0111\u1ed5i trong h\u00e0nh vi khi ph\u1ea3n \u1ee9ng l\u1ea1i v\u1edbi \u00e2m thanh. C\u00e1c x\u00e9t nghi\u1ec7m n\u00e0y bao g\u1ed3m ph\u00e9p \u0111o th\u00ednh gi\u00e1c quan s\u00e1t h\u00e0nh vi (BOA: behavioral observation audiometry), ph\u00e9p \u0111o th\u00ednh gi\u00e1c t\u0103ng c\u01b0\u1eddng th\u1ecb gi\u00e1c (VRA: visual reinforcement audiometry) v\u00e0 ph\u00e9p \u0111o th\u00ednh gi\u00e1c b\u1eb1ng tr\u00f2 ch\u01a1i. <\/p>\n \u0110\u1ed1i v\u1edbi tr\u1ebb nh\u1ecf, b\u1ed1 m\u1eb9 ho\u1eb7c ng\u01b0\u1eddi tr\u1ef1c ti\u1ebfp ch\u0103m s\u00f3c l\u00e0 ng\u01b0\u1eddi c\u00f3 th\u1ec3 bi\u1ebft t\u1ed1t nh\u1ea5t kh\u1ea3 n\u0103ng nghe c\u1ee7a tr\u1ebb. \u1ede tr\u1ebb b\u00ecnh th\u01b0\u1eddng, \u1edf m\u1ed7i \u0111\u1ed9 tu\u1ed5i kh\u00e1c nhau s\u1ebd c\u00f3 nh\u1eefng \u0111\u00e1p \u1ee9ng \u00e2m thanh kh\u00e1c nhau \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 trong b\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y: <\/p>\n M\u1ed9t v\u00e0i d\u1ea5u hi\u1ec7u nh\u01b0 m\u1edf m\u1eaft, ch\u1edbp m\u1eaft <\/p>\n<\/td>\n<\/tr>\n Quay \u0111\u1ea7u ho\u1eb7c m\u1eaft nh\u00ecn theo h\u01b0\u1edbng ph\u00e1t \u00e2m thanh <\/p>\n<\/td>\n<\/tr>\n L\u1eafng nghe v\u00e0 t\u1ef1 ph\u00e1t ra c\u00e1c lo\u1ea1i \u00e2m t\u1eeb l\u1edbn \u0111\u1ebfn nh\u1ecf <\/p>\n<\/td>\n<\/tr>\n Bi\u1ebft t\u00ean m\u00ecnh v\u00e0 m\u1ed9t s\u1ed1 t\u1eeb, b\u1eaft \u0111\u1ea7u b\u1eadp b\u1eb9 n\u00f3i <\/p>\n<\/td>\n<\/tr>\n Bi\u1ebft ch\u1ec9 m\u1ed9t s\u1ed1 \u0111\u1ed3 v\u1eadt quen thu\u1ed9c khi \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u, bi\u1ebft n\u00f3i m\u1ed9t s\u1ed1 t\u1eeb \u0111\u01a1n gi\u1ea3n <\/p>\n<\/td>\n<\/tr>\n C\u00f3 th\u1ec3 nghe nh\u1eefng t\u1eeb r\u1ea5t nh\u1ecf v\u00e0 nh\u1eadn bi\u1ebft h\u01b0\u1edbng c\u1ee7a n\u00f3, c\u00f3 kh\u1ea3 n\u0103ng n\u00f3i nh\u1eefng c\u00e2u \u0111\u01a1n gi\u1ea3n <\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n C\u00e1c nghi\u1ec7m ph\u00e1p kh\u00e1ch quan <\/span> <\/span> <\/strong> <\/p>\n Nh\u1eefng nghi\u1ec7m ph\u00e1p n\u00e0y \u0111o \u0111\u00e1p \u1ee9ng c\u1ee7a m\u1ed9t b\u1ed9 ph\u1eadn c\u1ee5 th\u1ec3 trong h\u1ec7 th\u1ed1ng th\u00ednh gi\u00e1c v\u00e0 g\u1ea7n nh\u01b0 kh\u00f4ng c\u1ea7n tr\u1ebb ph\u1ea3i h\u1ee3p t\u00e1c. C\u00e1c nghi\u1ec7m ph\u00e1p n\u00e0y bao g\u1ed3m: <\/p>\n X\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng tai gi\u1eefa l\u00e0 m\u1ed9t x\u00e9t nghi\u1ec7m kh\u00e1ch quan kh\u00e1c nh\u1eb1m cung c\u1ea5p th\u00f4ng tin v\u1ec1 ch\u1ee9c n\u0103ng c\u1ee7a tai gi\u1eefa. <\/p>\n M\u00e1y tr\u1ee3 th\u00ednh l\u00e0 nh\u1eefng thi\u1ebft b\u1ecb khu\u1ebfch \u0111\u1ea1i \u00e2m thanh \u0111\u1ec3 ng\u01b0\u1eddi b\u1ecb khi\u1ebfm th\u00ednh c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c.M\u00e1y tr\u1ee3 th\u00ednh kh\u00f4ng ch\u1eefa \u0111\u01b0\u1ee3c t\u1eadt khi\u1ebfm th\u00ednh nh\u01b0ng c\u00f3 \u00edch cho ng\u01b0\u1eddi khi\u1ebfm th\u00ednh khi s\u1eed d\u1ee5ng. C\u00f3 hai lo\u1ea1i m\u00e1y tr\u1ee3 th\u00ednh d\u1ef1a tr\u00ean s\u1ef1 kh\u00e1c bi\u1ec7t trong k\u1ef9 thu\u1eadt ti\u1ebfp nh\u1eadn \u00e2m thanh: <\/p>\n M\u00e1y tr\u1ee3 th\u00ednh khu\u1ebfch \u00e2m \u0111\u1ed3ng b\u1ed9 <\/strong> : khu\u1ebfch \u00e2m \u0111\u1ed3ng b\u1ed9 m\u1ecdi \u00e2m thanh xung quanh, n\u00f3 nh\u01b0 m\u1ed9t c\u00e1i amply c\u00f3 nhi\u1ec7m v\u1ee5 l\u00e0m to l\u00ean c\u00e1c ti\u1ebfng \u0111\u1ed9ng m\u1ed9t c\u00e1ch \u0111\u1ed3ng b\u1ed9. Do \u0111\u00f3, n\u1ebfu ng\u01b0\u1eddi khi\u1ebfm th\u00ednh \u0111eo m\u00e1y n\u00e0y \u1edf n\u01a1i \u1ed3n \u00e0o s\u1ebd nghe \u0111\u1ee7 m\u1ecdi ti\u1ebfng \u0111\u1ed9ng do \u00e2m thanh kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ecdn l\u1ecdc, d\u1eabn \u0111\u1ebfn c\u00f3 th\u1ec3 kh\u00f4ng nghe \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c \u00e2m thanh c\u1ea7n nghe. <\/p>\n M\u00e1y tr\u1ee3 th\u00ednh k\u1ef9 thu\u1eadt s\u1ed1: <\/strong> ra \u0111\u1eddi theo s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00f4ng ngh\u1ec7 \u0111i\u1ec7n t\u1eed . N\u00f3 c\u00f3 th\u1ec3 ph\u00e2n l\u1ecdc \u0111\u01b0\u1ee3c c\u00e1c \u00e2m thanh ra t\u1eebng lo\u1ea1i.M\u00e1y \u0111\u01b0\u1ee3c l\u1eadp tr\u00ecnh \u0111\u1ec3 \u0111em l\u1ea1i nh\u1eefng \u00e2m thanh c\u1ea7n nghe \u1edf nh\u1eefng v\u1ecb tr\u00ed v\u00e0 ho\u00e0n c\u1ea3nh kh\u00e1c nhau. M\u00e1y v\u1eabn c\u00f3 t\u00ednh n\u0103ng khu\u1ebfch \u00e2m nh\u01b0 m\u00e1y khu\u1ebfch \u00e2m \u0111\u1ed3ng b\u1ed9 nh\u01b0ng c\u00f3 th\u00eam \u01b0u \u0111i\u1ec3m l\u00e0 ch\u1ecdn l\u1ecdc \u00e2m thanh, h\u1ea1n ch\u1ebf hi\u1ec7n t\u01b0\u1ee3ng d\u1ed9i \u00e2m, v\u00e0 lo\u1ea1i b\u1ecf c\u00e1c \u00e2m thanh ch\u00f3i tai \u0111\u1ec3 ng\u01b0\u1eddi khi\u1ebfm th\u00ednh c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c t\u1ed1t nh\u1ea5t. Ngo\u00e0i ra, m\u00e1y c\u00f2n c\u00f3 th\u1ec3 k\u1ebft n\u1ed1i v\u1edbi c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n nghe nh\u00ecn kh\u00e1c m\u00e0 kh\u00f4ng c\u1ea7n d\u00e2y d\u1eabn nh\u01b0 \u0111i\u1ec7n tho\u1ea1i di \u0111\u1ed9ng, m\u00e1y nghe nh\u1ea1c Mp3, Mp4, tivi, radio\u2026 <\/p>\n C\u1ea5y \u1ed1c tai \u0111\u00f4i khi c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 tai \u0111i\u1ec7n t\u1eed, thi\u1ebft b\u1ecb tr\u1ee3 th\u00ednh \u1ed1c tai l\u00e0 m\u1ed9t thi\u1ebft b\u1ecb th\u00ednh gi\u00e1c \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 t\u1ea1o ra c\u00e1c c\u1ea3m gi\u00e1c \u00e2m thanh h\u1eefu \u00edch b\u1eb1ng c\u00e1ch d\u00f9ng c\u00e1c xung \u0111i\u1ec7n k\u00edch th\u00edch c\u00e1c d\u00e2y th\u1ea7n kinh b\u00ean trong ph\u1ea7n tai trong.Thi\u1ebft b\u1ecb n\u00e0y \u0111\u01b0\u1ee3c c\u1ea5y b\u1eb1ng c\u00e1ch ph\u1eabu thu\u1eadt, th\u00edch h\u1ee3p cho ng\u01b0\u1eddi khi\u1ebfm th\u00ednh n\u1eb7ng ho\u1eb7c r\u1ea5t n\u1eb7ng. <\/p>\n Hi\u1ec7n nay, t\u1ea1i Vi\u1ec7t Nam, s\u00e0ng l\u1ecdc khi\u1ebfm th\u00ednh \u1edf tr\u1ebb s\u01a1 sinh \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u1ef1a v\u00e0o nghi\u1ec7m ph\u00e1p \u0111o \u00e2m \u1ed1c tai (OAE) v\u00e0 nghi\u1ec7m ph\u00e1p \u0111o \u0111\u00e1p \u1ee9ng th\u00ednh gi\u00e1c th\u00e2n n\u00e3o (ABR). <\/p>\n Khi c\u00f3 \u00e2m thanh t\u1eeb ngo\u00e0i t\u00e1c \u0111\u1ed9ng v\u00e0o \u1ed1c tai (n\u1eb1m \u1edf tai trong), \u1ed1c tai s\u1ebd c\u00f3 ph\u1ea3n \u1ee9ng b\u1eb1ng c\u00e1ch ph\u00e1t ra nh\u1eefng \u00e2m thanh r\u1ea5t nh\u1ecf. Ngu\u1ed3n g\u1ed1c c\u1ee7a nh\u1eefng \u00e2m thanh n\u00e0y l\u00e0 do s\u1ef1 rung \u0111\u1ed9ng c\u1ee7a nh\u1eefng t\u1ebf b\u00e0o c\u00f3 tua \u1edf b\u00ean trong \u1ed1c tai khi b\u1ecb k\u00edch th\u00edch b\u1edfi \u00e2m thanh b\u00ean ngo\u00e0i. \u00c2m thanh ph\u00e1t ra do s\u1ef1 rung \u0111\u1ed9ng c\u1ee7a nh\u1eefng t\u1ebf b\u00e0o c\u00f3 tua n\u00e0y g\u1ecdi l\u00e0 \u00e2m \u1ed1c tai (OAE). N\u0103m 1977 David Kemp \u1ee9ng d\u1ee5ng \u0111o \u00e2m \u1ed1c tai \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng c\u1ee7a \u1ed1c tai. \u0110\u1ebfn nay, \u1ee9ng d\u1ee5ng \u0111o \u00e2m \u1ed1c tai \u0111\u1ec3 ph\u00e1t hi\u1ec7n \u0111i\u1ebfc \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i tr\u00ean kh\u1eafp th\u1ebf gi\u1edbi, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ec3 s\u00e0ng l\u1ecdc khi\u1ebfm th\u00ednh \u1edf tr\u1ebb s\u01a1 sinh do ph\u01b0\u01a1ng ph\u00e1p \u0111o \u00e2m \u1ed1c tai c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c \u0111\u1ebfn 80-85 %. Ngo\u00e0i ra, m\u00e1y \u0111o nh\u1ecf g\u1ecdn, c\u00e1ch th\u1ef1c hi\u1ec7n \u0111\u01a1n gi\u1ea3n, kh\u00f4ng g\u00e2y \u0111au cho tr\u1ebb, cho k\u1ebft qu\u1ea3 trong th\u1eddi gian ng\u1eafn. <\/span> <\/p>\n Tuy nhi\u00ean, \u0111o \u00e2m \u1ed1c tai ch\u1ec9 gi\u00fap ph\u00e1t hi\u1ec7n nh\u1eefng tr\u01b0\u1eddng h\u1ee3p khi\u1ebfm th\u00ednh do t\u1ed5n th\u01b0\u01a1ng \u1ed1c tai, s\u1ebd c\u00f3 kho\u1ea3ng 15% tr\u01b0\u1eddng h\u1ee3p khi\u1ebfm th\u00ednh sau \u1ed1c tai (do t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh th\u00ednh gi\u00e1c) s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p n\u00e0y. <\/p>\n \u0110\u1ec3 th\u1ef1c hi\u1ec7n \u0111o \u00e2m \u1ed1c tai, \u0111\u00f2i h\u1ecfi ph\u1ea3i c\u00f3 m\u00f4i tr\u01b0\u1eddng y\u00ean t\u0129nh, bao g\u1ed3m c\u1ea3 ph\u00f2ng \u0111\u00e1nh gi\u00e1 v\u00e0 tr\u1ebb, do v\u1eady tr\u1ebb th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111o khi \u0111ang ng\u1ee7 y\u00ean. <\/p>\n H\u00ecnh:\u00a0M\u00e1y \u0111o \u00e2m \u1ed1c tai (OAE) <\/em> <\/p>\n \u0110o \u0111\u00e1p \u1ee9ng th\u00ednh gi\u00e1c th\u00e2n n\u00e3o (ABR) hay c\u00f2n g\u1ecdi l\u00e0 \u0111o \u0111i\u1ec7n th\u1ebf \u0111\u00e1p \u1ee9ng th\u00ednh gi\u00e1c th\u00e2n n\u00e3o, l\u00e0 ph\u01b0\u01a1ng ph\u00e1p quan tr\u1ecdng trong \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng sau \u1ed1c tai. Nghi\u1ec7m ph\u00e1p n\u00e0y \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng c\u1ee7a d\u00e2y th\u1ea7n kinh th\u00ednh gi\u00e1c (d\u00e2y th\u1ea7n kinh VIII) v\u00e0 th\u00e2n n\u00e3o v\u1edbi k\u00edch th\u00edch \u00e2m thanh th\u00f4ng qua c\u00e1c \u0111i\u1ec7n c\u1ef1c \u0111\u1eb7t \u1edf tr\u00e1n, b\u1ec1 m\u1eb7t hai x\u01b0\u01a1ng ch\u0169m v\u00e0 g\u00e1y c\u1ee7a tr\u1ebb. K\u00edch th\u00edch \u00e2m thanh l\u00e0 c\u00e1c ti\u1ebfng \u201cclick\u201d v\u1edbi c\u01b0\u1eddng \u0111\u1ed9 35dB \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o tai tr\u1ebb qua ch\u1ee5p tai.\u0110\u00e1p \u1ee9ng c\u1ee7a m\u1ed7i tr\u1ebb s\u1ebd \u0111\u01b0\u1ee3c so s\u00e1nh v\u1edbi k\u1ebft qu\u1ea3 b\u00ecnh th\u01b0\u1eddng \u0111\u00e3 \u0111\u01b0\u1ee3c c\u00e0i \u0111\u1eb7t s\u1eb5n trong m\u00e1y, v\u00e0 \u0111\u01b0a ra k\u1ebft qu\u1ea3 \u201c\u0111\u1ea1t\u201d ho\u1eb7c \u201cnghi ng\u1edd\u201d.Tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd s\u1ebd c\u1ea7n l\u00e0m th\u00eam c\u00e1c nghi\u1ec7m ph\u00e1p kh\u00e1ch quan kh\u00e1c. <\/span> <\/p>\n H\u00ecnh:\u00a0S\u00e0ng l\u1ecdc khi\u1ebfm th\u00ednh \u1edf tr\u1ebb s\u01a1 sinh b\u1eb1ng \u0111o \u0111\u00e1p \u1ee9ng th\u00ednh l\u1ef1c th\u00e2n n\u00e3o (Ngu\u1ed3n \u1ea3nh:\u00a0chaodontuonglai.vn) <\/em> <\/p>\n Nghi\u1ec7m ph\u00e1p n\u00e0y kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi ti\u1ebfng \u0111\u1ed9ng trong ph\u00f2ng \u0111o, tuy nhi\u00ean \u0111i\u1ec7n c\u1ef1c c\u00f3 th\u1ec3 b\u1ecb nhi\u1ec5u do ho\u1ea1t \u0111\u1ed9ng c\u1ee7a h\u1ec7 c\u01a1. V\u00ec v\u1eady, khi ti\u1ebfn h\u00e0nh \u0111o \u1edf tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb nh\u1ecf, th\u01b0\u1eddng l\u00e0m l\u00fac tr\u1ebb \u0111ang ng\u1ee7. <\/p>\n M\u1ee5c ti\u00eau c\u1ee7a ch\u01b0\u01a1ng tr\u00ecnh s\u00e0ng l\u1ecdc khi\u1ebfm th\u00ednh qu\u1ed1c gia l\u00e0 s\u00e0ng l\u1ecdc cho 100% tr\u1ebb sinh \u1edf b\u1ec7nh vi\u1ec7n tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n ho\u1eb7c v\u00e0o kho\u1ea3ng 1 th\u00e1ng tu\u1ed5i. S\u00e0ng l\u1ecdc \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf c\u1ea3 hai tai c\u1ee7a tr\u1ebb. <\/p>\n Ch\u00fa \u00fd <\/strong> <\/span> <\/span> <\/p>\n –\u00a0 L\u1ea5y \u0111\u1ea7u d\u00f2 ra v\u00e0 ki\u1ec3m tra xem c\u00f3 g\u00ec trong \u1ed1ng tai c\u1ee7a tr\u1ebb kh\u00f4ng. <\/p>\n –\u00a0 Thay \u0111\u1ed5i \u0111\u1ea7u d\u00f2 n\u1ebfu th\u1ea5y c\u1ea7n thi\u1ebft <\/p>\n –\u00a0 Lau ch\u00f9i \u0111\u1ea7u d\u00f2 n\u1ebfu th\u1ea5y c\u1ea7n thi\u1ebft. <\/p>\n –\u00a0 \u0110\u1eb7t l\u1ea1i \u0111\u1ea7u d\u00f2 v\u00e0 \u0111o l\u1ea1i. <\/p>\n 2. Kh\u00f4ng n\u00ean s\u00e0ng l\u1ecdc tr\u01b0\u1edbc 12 gi\u1edd sau sinh, n\u00ean th\u1ef1c hi\u1ec7n s\u00e0ng l\u1ecdc trong kho\u1ea3ng th\u1eddi gian t\u1eeb 24 – 72 gi\u1edd sau sinh. <\/p>\n 3. N\u1ebfu tr\u1ebb xu\u1ea5t vi\u1ec7n tr\u01b0\u1edbc 12 gi\u1edd sau sinh c\u1ea7n th\u1ef1c hi\u1ec7n s\u00e0ng l\u1ecdc khi tr\u1ebb xu\u1ea5t vi\u1ec7n, n\u1ebfu tr\u1ebb kh\u00f4ng \u0111\u1ea1t, c\u1ea7n h\u1eb9n tr\u1ebb quay l\u1ea1i sau 2 tu\u1ea7n \u0111\u1ec3 th\u1ef1c hi\u1ec7n s\u00e0ng l\u1ecdc l\u1ea7n th\u1ee9 \u00a0hai. <\/p>\n 4. Th\u1ef1c hi\u1ec7n sau khi tr\u1ebb \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00fa \u0111\u1ec3 t\u0103ng c\u01a1 h\u1ed9i tr\u1ebb ng\u1ee7 khi th\u1ef1c hi\u1ec7n c\u00e1c nghi\u1ec7m ph\u00e1p. <\/p>\n 5. \u1ede tr\u1ebb m\u1ed5 \u0111\u1ebb, ph\u1ea3i \u0111\u1ee3i \u00edt nh\u1ea5t l\u00e0 24 gi\u1edd \u0111\u1ec3 cho \u1ed1ng tai \u0111\u01b0\u1ee3c s\u1ea1ch m\u1edbi th\u1ef1c hi\u1ec7n l\u1ea7n s\u00e0ng l\u1ecdc \u0111\u1ea7u ti\u00ean. <\/p>\n 6. N\u1ebfu s\u00e0ng l\u1ecdc khi\u1ebfm th\u00ednh 12 \u2013 24 gi\u1edd sau sinh s\u1ebd l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 d\u01b0\u01a1ng t\u00ednh sai. <\/p>\n 7..N\u1ebfu s\u00e0ng l\u1ecdc b\u1eb1ng nghi\u1ec7m ph\u00e1p \u0111o \u00e2m \u1ed1c tai, t\u1ef7 l\u1ec7 d\u01b0\u01a1ng t\u00ednh sai gi\u1ea3m d\u1ea7n trong 4 ng\u00e0y \u0111\u1ea7u sau sinh. <\/p>\n 8. N\u1ebfu tr\u1ebb b\u1ecb \u201cnghi ng\u1edd\u201d trong l\u1ea7n s\u00e0ng l\u1ecdc \u0111\u1ea7u ti\u00ean: <\/p>\n a. N\u1ebfu s\u00e0ng l\u1ecdc l\u1ea7n hai b\u1eb1ng \u0111o \u00e2m \u1ed1c tai OAE: ph\u1ea3i \u0111\u1ee3i 12 gi\u1edd tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n l\u1ea7n hai. <\/span> <\/p>\n b. N\u1ebfu s\u00e0ng l\u1ecdc l\u1ea7n hai b\u1eb1ng \u0111o \u0111\u00e1p \u1ee9ng th\u00ednh gi\u00e1c th\u00e2n n\u00e3o ABR: ph\u1ea3i \u0111\u1ee3i v\u00e0i gi\u1edd tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n l\u1ea7n hai. <\/span> <\/p>\n 9. Th\u1eddi gian s\u00e0ng l\u1ecdc cho m\u1ed7i tr\u1ebb c\u00f3 th\u1ec3 thay \u0111\u1ed5i t\u1eeb 3 \u2013 6 ph\u00fat t\u00f9y thu\u1ed9c v\u00e0o lo\u1ea1i thi\u1ebft b\u1ecb v\u00e0 s\u1ef1 h\u1ee3p t\u00e1c c\u1ee7a tr\u1ebb. <\/p>\n 10. C\u00e2n nh\u1eafc vi\u1ec7c th\u1ef1c hi\u1ec7n s\u00e0ng l\u1ecdc \u1edf tr\u1ebb c\u00f3 tu\u1ed5i thai d\u01b0\u1edbi 34 tu\u1ea7n. <\/span> <\/p>\n 11. N\u1ebfu tr\u1ebb \u0111ang \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh, tr\u1ebb v\u1eabn n\u00ean \u0111\u01b0\u1ee3c s\u00e0ng l\u1ecdc khi\u1ebfm th\u00ednh tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n. <\/span> <\/p>\n 12. N\u1ebfu tr\u1ebb b\u1ecb t\u0103ng bilirubin m\u00e1u: cho ph\u00e9p th\u1ef1c hi\u1ec7n s\u00e0ng l\u1ecdc n\u1ebfu tr\u1ebb \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng chi\u1ebfu \u0111\u00e8n. <\/span> <\/p>\n 13. S\u00e0ng l\u1ecdc l\u1ea1i trong th\u00e1ng \u0111\u1ea7u: <\/span> <\/p>\n C\u00e1m \u01a1n b\u00e1c s\u0129 <\/span> BS.L\u00ea Thanh Nh\u00e3 Uy\u00ean <\/a> \u0111\u00e3 chia s\u1ebb b\u00e0i vi\u1ebft n\u00e0y \u200b <\/span> <\/p>\n |
![\"M\u00e1y](\"\/\/yhoccongdong.org\/Documents\/2131_may-do-am-oc-tai-(oae).jpg\")
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