{"id":18667,"date":"2023-04-12T00:16:28","date_gmt":"2023-04-11T17:16:28","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18667"},"modified":"2023-04-12T16:05:03","modified_gmt":"2023-04-12T09:05:03","slug":"chi-dinh-va-muc-tieu-dieu-tri-viem-gan-virus-c-man-tinh-cua-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/chi-dinh-va-muc-tieu-dieu-tri-viem-gan-virus-c-man-tinh-cua-bo-y-te\/","title":{"rendered":"H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C m\u1ea1n t\u00ednh theo B\u1ed9 Y t\u1ebf"},"content":{"rendered":"

Vi\u00eam gan virus C (HCV) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd gan c\u1ea5p t\u00ednh ho\u1eb7c m\u1ea1n t\u00ednh. B\u1ec7nh vi\u00eam gan C c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan v\u00e0 d\u1eabn \u0111\u1ebfn c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m. V\u00ec v\u1eady, ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb vi\u00eam gan virus C l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u1ed5n th\u01b0\u01a1ng c\u1ee7a gan v\u00e0 ng\u0103n ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng.<\/strong><\/p>\n

\"Ch\u1ec9
Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C t\u00f9y theo t\u1eebng nh\u00f3m \u0111\u1ed1i t\u01b0\u1ee3ng<\/figcaption><\/figure>\n

1. M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb<\/h2>\n

– Lo\u1ea1i tr\u1eeb HCV ra kh\u1ecfi c\u01a1 th\u1ec3 ng\u01b0\u1eddi b\u1ec7nh (\u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng vi r\u00fat b\u1ec1n v\u1eefng: t\u1ea3i l\u01b0\u1ee3ng HCV RNA d\u01b0\u1edbi ng\u01b0\u1ee1ng ph\u00e1t hi\u1ec7n (< 15 IU\/ml) \u1edf tu\u1ea7n th\u1ee9 12 sau khi k\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb, g\u1ecdi l\u00e0\u00a0SVR 12.<\/p>\n

– Ph\u00f2ng ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng v\u1ec1 gan v\u00e0 c\u00e1c b\u1ec7nh ngo\u00e0i gan li\u00ean quan \u0111\u1ebfn HCV bao g\u1ed3m vi\u00eam gan ti\u1ebfn tri\u1ec3n, x\u01a1 h\u00f3a gan, x\u01a1 gan, HCC, bi\u1ec3u hi\u1ec7n ngo\u00e0i gan n\u1eb7ng v\u00e0 t\u1eed vong.<\/p>\n

– D\u1ef1 ph\u00f2ng l\u00e2y nhi\u1ec5m HCV trong c\u1ed9ng \u0111\u1ed3ng.<\/p>\n

2. Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h2>\n

Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n vi\u00eam gan vi r\u00fat C m\u1ea1n t\u00ednh.<\/p>\n

3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h2>\n

3.1. <\/strong>\u0110\u1ed1i v\u1edbi ph\u00e1c \u0111\u1ed3 c\u00f3 c\u00e1c thu\u1ed1c kh\u00e1ng vi r\u00fat tr\u1ef1c ti\u1ebfp (Direct Acting Antivirals: DAA)<\/strong><\/h3>\n

– Tr\u1ebb < 3 tu\u1ed5i<\/p>\n

– Ph\u1ee5 n\u1eef c\u00f3 thai<\/p>\n

– Kh\u00f4ng s\u1eed d\u1ee5ng c\u00e1c DAA c\u00f9ng v\u1edbi thu\u1ed1c c\u00f3 t\u01b0\u01a1ng t\u00e1c g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb ho\u1eb7c g\u00e2y c\u00e1c bi\u1ebfn c\u1ed1 kh\u00f4ng mong mu\u1ed1n, t\u0103ng t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c<\/p>\n

3.2. <\/strong>\u0110\u1ed1i v\u1edbi ph\u00e1c \u0111\u1ed3 c\u00f3 ribavirin (RBV)<\/strong><\/h3>\n

– Qu\u00e1 m\u1eabn c\u1ea3m v\u1edbi RBV<\/p>\n

– Thi\u1ebfu m\u00e1u n\u1eb7ng (hemoglobin <8,5 g\/dL)<\/p>\n

– B\u1ec7nh v\u1ec1 huy\u1ebft s\u1eafc t\u1ed1 (b\u1ec7nh h\u1ed3ng c\u1ea7u h\u00ecnh li\u1ec1m ho\u1eb7c thalassemia)<\/p>\n

– Ph\u1ee5 n\u1eef c\u00f3 thai ho\u1eb7c kh\u00f4ng mu\u1ed1n d\u00f9ng c\u00e1c bi\u1ec7n ph\u00e1p tr\u00e1nh thai, ph\u1ee5 n\u1eef \u0111ang cho con b\u00fa, nam gi\u1edbi c\u00f3 b\u1ea1n t\u00ecnh \u0111ang mang thai<\/p>\n

4. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/strong><\/h2>\n

– Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n vi\u00eam gan vi r\u00fat C c\u1ea7n \u0111i\u1ec1u tr\u1ecb s\u1edbm, \u0111\u1eb7c bi\u1ec7t c\u00e1c tr\u01b0\u1eddng h\u1ee3p x\u01a1 h\u00f3a gan \u2265 F2, ng\u01b0\u1eddi b\u1ec7nh vi\u00eam gan vi r\u00fat C c\u00f3 bi\u1ec3u hi\u1ec7n ngo\u00e0i gan, ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ed3ng nhi\u1ec5m HIV\/HCV, ng\u01b0\u1eddi b\u1ec7nh nghi\u1ec7n ch\u00edch ma t\u00fay, ph\u1ee5 n\u1eef \u0111\u1ed9 tu\u1ed5i sinh \u0111\u1ebb mong mu\u1ed1n c\u00f3 thai,…<\/p>\n

– L\u1ef1a ch\u1ecdn ph\u00e1c \u0111\u1ed3 c\u00f3 c\u00e1c thu\u1ed1c DAA. T\u1ea1i c\u00e1c c\u01a1 s\u1edf y t\u1ebf kh\u00f4ng l\u00e0m \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m ki\u1ec3u gen n\u00ean s\u1eed d\u1ee5ng ph\u00e1c \u0111\u1ed3 c\u00f3 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u1edbi t\u1ea5t c\u1ea3 c\u00e1c ki\u1ec3u gen<\/p>\n

– D\u1ef1a v\u00e0o t\u00ecnh tr\u1ea1ng x\u01a1 gan, c\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, t\u01b0\u01a1ng t\u00e1c thu\u1ed1c v\u00e0 b\u1ec7nh \u0111i k\u00e8m \u0111\u1ec3 l\u1ef1a ch\u1ecdn c\u00e1c ph\u00e1c \u0111\u1ed3\u00a0(xem m\u1ee5c 3.2.5).<\/p>\n

– C\u00e1c ph\u00e1c \u0111\u1ed3 s\u1eed d\u1ee5ng thu\u1ed1c DAA th\u1ebf h\u1ec7 m\u1edbi, ch\u01b0a \u0111\u1ec1 c\u1eadp trong h\u01b0\u1edbng d\u1eabn n\u00e0y, c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem x\u00e9t, b\u1ed5 sung d\u1ef1a theo c\u00e1c h\u01b0\u1edbng d\u1eabn chuy\u00ean m\u00f4n c\u1ee7a T\u1ed5 ch\u1ee9c Y t\u1ebf th\u1ebf gi\u1edbi v\u00e0 c\u00e1c Hi\u1ec7p h\u1ed9i Gan m\u1eadt Ch\u00e2u \u00c1 Th\u00e1i B\u00ecnh D\u01b0\u01a1ng, Ch\u00e2u \u00c2u, Ch\u00e2u M\u1ef9 v\u00e0 theo c\u00e1c quy \u0111\u1ecbnh li\u00ean quan \u0111\u1ebfn s\u1eed d\u1ee5ng thu\u1ed1c t\u1ea1i Vi\u1ec7t Nam.<\/p>\n

– C\u00e1c tr\u01b0\u1eddng h\u1ee3p x\u01a1 gan m\u1ea5t b\u00f9 c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u1ea1i c\u00e1c c\u01a1 s\u1edf chuy\u00ean khoa tuy\u1ebfn t\u1ec9nh ho\u1eb7c trung \u01b0\u01a1ng.<\/p>\n

5<\/strong>. Chu\u1ea9n b\u1ecb \u0111i\u1ec1u tr\u1ecb<\/strong><\/h2>\n

5.1.<\/strong> \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh gan<\/strong><\/h3>\n

– \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng x\u01a1 h\u00f3a gan d\u1ef1a v\u00e0o c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00f4ng x\u00e2m l\u1ea5n. Ch\u1ea9n \u0111o\u00e1n x\u01a1 gan (F4) khi APRI \u2265 2 ho\u1eb7c FibroScan \u2265 12.5 kPa…(Ph\u1ee5 l\u1ee5c 1). Sinh thi\u1ebft gan khi c\u1ea7n thi\u1ebft.<\/p>\n

– \u0110\u00e1nh gi\u00e1 x\u01a1 gan c\u00f2n b\u00f9, m\u1ea5t b\u00f9 d\u1ef1a v\u00e0o ph\u00e2n lo\u1ea1i Child-Pugh: Child-Pugh A l\u00e0 x\u01a1 gan c\u00f2n b\u00f9, Child-Pugh B, C l\u00e0 x\u01a1 gan m\u1ea5t b\u00f9.<\/p>\n

5.2<\/strong>. \u0110\u00e1nh gi\u00e1 b\u1ec7nh l\u00fd \u0111i k\u00e8m<\/strong><\/h3>\n

Ng\u01b0\u1eddi b\u1ec7nh vi\u00eam gan vi r\u00fat C c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 c\u00e1c b\u1ec7nh l\u00fd \u0111i k\u00e8m nh\u01b0:<\/p>\n

– \u0110\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn v\u00e0 m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn<\/p>\n

– \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng \u0111\u1ed3ng nhi\u1ec5m vi r\u00fat vi\u00eam gan B, HIV<\/p>\n

– \u0110\u00e1nh gi\u00e1 c\u00e1c b\u1ec7nh tim m\u1ea1ch (r\u1ed1i lo\u1ea1n nh\u1ecbp tim), r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a (\u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, r\u1ed1i lo\u1ea1n lipid m\u00e1u, …)<\/p>\n

– \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng nghi\u1ec7n r\u01b0\u1ee3u<\/p>\n

5.3<\/strong>. \u0110\u00e1nh gi\u00e1 t\u01b0\u01a1ng t\u00e1c thu\u1ed1c<\/strong><\/h3>\n

\u0110\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c thu\u1ed1c v\u1edbi c\u00e1c thu\u1ed1c \u0111ang s\u1eed d\u1ee5ng nh\u01b0 thu\u1ed1c kh\u00e1ng HIV (antiretrovirals: ARV), thu\u1ed1c ch\u1ed1ng lao, thu\u1ed1c ch\u1ed1ng co gi\u1eadt, thu\u1ed1c \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n nh\u1ecbp tim, thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton…(Ph\u1ee5 l\u1ee5c 5)<\/p>\n

5.4<\/strong>. C\u00e1c x\u00e9t nghi\u1ec7m<\/strong><\/h3>\n

– C\u00e1c x\u00e9t nghi\u1ec7m khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb v\u00e0 theo d\u00f5i \u0111i\u1ec1u tr\u1ecb vi\u00eam gan vi r\u00fat C (Ph\u1ee5 l\u1ee5c 2).<\/p>\n

– X\u00e9t nghi\u1ec7m ki\u1ec3u gen HCV khi s\u1eed d\u1ee5ng c\u00e1c ph\u00e1c \u0111\u1ed3 kh\u00f4ng \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c t\u1ea5t c\u1ea3 c\u00e1c ki\u1ec3u gen v\u00e0\/ho\u1eb7c \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 t\u1eebng th\u1ea5t b\u1ea1i \u0111i\u1ec1u tr\u1ecb vi\u00eam gan vi r\u00fat C. Nh\u1eefng c\u01a1 s\u1edf l\u00e0m \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m ki\u1ec3u gen HCV th\u00ec c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb.<\/p>\n

– \u0110\u1ed1i v\u1edbi ph\u1ee5 n\u1eef trong tu\u1ed5i sinh \u0111\u1ebb ho\u1eb7c nghi ng\u1edd c\u00f3 thai c\u1ea7n x\u00e9t nghi\u1ec7m th\u1eed thai.<\/p>\n

– C\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c theo ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng.<\/p>\n

5.5<\/strong>. T\u01b0 v\u1ea5n tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb<\/strong><\/h3>\n

– Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb, hi\u1ec7u qu\u1ea3 c\u1ee7a \u0111i\u1ec1u tr\u1ecb, t\u00e1c d\u1ee5ng ph\u1ee5, kh\u1ea3 n\u0103ng t\u00e1i nhi\u1ec5m HCV<\/p>\n

– Nguy c\u01a1 HCC \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 \u0111\u1ed9 x\u01a1 h\u00f3a gan \u2265 F3<\/p>\n

– Kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c thu\u1ed1c DAA v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c v\u00e0 y\u00eau c\u1ea7u ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i th\u00f4ng b\u00e1o cho th\u1ea7y thu\u1ed1c c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n tr\u01b0\u1edbc v\u00e0 trong khi \u0111i\u1ec1u tr\u1ecb vi\u00eam gan vi r\u00fat C bao g\u1ed3m c\u1ea3 th\u1ef1c ph\u1ea9m ch\u1ee9c n\u0103ng<\/p>\n

– Tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb<\/p>\n

– Tr\u00e1nh \u0111\u1ed3 u\u1ed1ng c\u00f3 c\u1ed3n (r\u01b0\u1ee3u, bia…)<\/p>\n

– T\u01b0 v\u1ea5n d\u1ef1 ph\u00f2ng t\u00e1i nhi\u1ec5m v\u00e0 d\u1ef1 ph\u00f2ng l\u00e2y nhi\u1ec5m HCV<\/p>\n

– T\u01b0 v\u1ea5n s\u1eed d\u1ee5ng bi\u1ec7n ph\u00e1p tr\u00e1nh thai trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb thu\u1ed1c DAA \u0111\u1ed1i v\u1edbi c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh v\u00e0 b\u1ea1n t\u00ecnh. Trong tr\u01b0\u1eddng h\u1ee3p s\u1eed d\u1ee5ng ribavirin ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p tr\u00e1nh thai cho \u0111\u1ebfn 6 th\u00e1ng sau khi k\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb<\/p>\n

T\u00f3m l\u1ea1i, ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb vi\u00eam gan virus C l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u1ed5n th\u01b0\u01a1ng c\u1ee7a gan v\u00e0 ng\u0103n ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb \u0111\u00fang c\u00e1ch v\u00e0 \u0111\u1ea7y \u0111\u1ee7 s\u1ebd gi\u00fap b\u1ec7nh nh\u00e2n gi\u1eef \u0111\u01b0\u1ee3c ch\u1ee9c n\u0103ng gan v\u00e0 t\u0103ng ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng. Ngo\u00e0i ra, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u0169ng gi\u00fap gi\u1ea3m nguy c\u01a1 l\u00e2y nhi\u1ec5m virus HCV t\u1eeb b\u1ec7nh nh\u00e2n sang ng\u01b0\u1eddi kh\u00e1c, g\u00f3p ph\u1ea7n gi\u1ea3m thi\u1ec3u t\u1ed5n th\u1ea5t cho c\u1ed9ng \u0111\u1ed3ng.<\/p>\n

\u0110\u1ec3 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ea1i vi\u1ec7n, Qu\u00fd kh\u00e1ch vui l\u00f2ng b\u1ea5m s\u1ed1\u00a0HOTLINE<\/strong><\/a>\u00a0ho\u1eb7c \u0111\u1eb7t l\u1ecbch tr\u1ef1c ti\u1ebfp\u00a0T\u1ea0I \u0110\u00c2Y<\/strong><\/a>. T\u1ea3i v\u00e0 \u0111\u1eb7t l\u1ecbch kh\u00e1m t\u1ef1 \u0111\u1ed9ng tr\u00ean\u00a0\u1ee9ng d\u1ee5ng MyVinmec<\/a> \u0111\u1ec3 qu\u1ea3n l\u00fd, theo d\u00f5i l\u1ecbch v\u00e0 \u0111\u1eb7t h\u1eb9n m\u1ecdi l\u00fac m\u1ecdi n\u01a1i ngay tr\u00ean \u1ee9ng d\u1ee5ng.\u00a0 https:\/\/youtu.be\/sJAOMNkNpz8<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

Vi\u00eam gan virus C (HCV) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd gan c\u1ea5p t\u00ednh ho\u1eb7c m\u1ea1n t\u00ednh. B\u1ec7nh vi\u00eam gan C c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan v\u00e0 d\u1eabn \u0111\u1ebfn c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m. V\u00ec v\u1eady, ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb vi\u00eam gan virus C l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u1ed5n th\u01b0\u01a1ng c\u1ee7a gan v\u00e0 […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"\nH\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C m\u1ea1n t\u00ednh theo B\u1ed9 Y t\u1ebf<\/title>\n<meta name=\"description\" content=\"M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C l\u00e0 lo\u1ea1i tr\u1eeb HCV ra kh\u1ecfi c\u01a1 th\u1ec3 ng\u01b0\u1eddi b\u1ec7nh (\u0111\u1ea1t \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng vi r\u00fat b\u1ec1n v\u1eefng, t\u1ea3i l\u01b0\u1ee3ng HCV RNA < 15 IU\/ml ...\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta 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