{"id":19518,"date":"2023-04-17T20:12:00","date_gmt":"2023-04-17T13:12:00","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19518"},"modified":"2023-04-18T12:43:05","modified_gmt":"2023-04-18T05:43:05","slug":"tiep-can-viem-dai-trang-man-cap-nhat-tu-cac-khuyen-cao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/tiep-can-viem-dai-trang-man-cap-nhat-tu-cac-khuyen-cao\/","title":{"rendered":"Ti\u1ebfp c\u1eadn vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u1ea1n: c\u1eadp nh\u1eadt t\u1eeb c\u00e1c khuy\u1ebfn c\u00e1o"},"content":{"rendered":"

Vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u1ea1n ch\u1ee7 y\u1ebfu do c\u00e1c b\u1ec7nh l\u00fd vi\u00eam ru\u1ed9t (IBD), \u0111\u01b0\u1ee3c ngh\u0129 \u0111\u1ebfn khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 tri\u1ec7u ch\u1ee9ng ti\u00eau ph\u00e2n \u0111\u00e0m v\u00e0\/ho\u1eb7c m\u00e1u k\u00e9o d\u00e0i ho\u1eb7c t\u00e1i ph\u00e1t nhi\u1ec1u l\u1ea7n k\u00e8m \u0111au b\u1ee5ng v\u00e0 t\u0103ng t\u1ea7n su\u1ea5t \u0111i c\u1ea7u, \u0111\u1eb7c bi\u1ec7t \u1edf ng\u01b0\u1eddi tr\u1ebb. IBD l\u00e0 m\u1ed9t thu\u1eadt ng\u1eef \u0111\u1ec3 ch\u1ec9 2 b\u1ec7nh: vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng (UC) v\u00e0 b\u1ec7nh Crohn\u2019s (CD). Ngo\u00e0i IBD, vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u1ea1n t\u00ednh c\u00f2n c\u00f3 th\u1ec3 do lao ru\u1ed9t, vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u1ea1n do amib, nhi\u1ec5m Yersinia m\u1ea1n, vi\u00eam \u0111\u1ea1i tr\u00e0ng do C.difficile.<\/em> Do \u0111\u00f3 trong ti\u1ebfp c\u1eadn ng\u01b0\u1eddi b\u1ec7nh nghi vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u1ea1n, tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb theo h\u01b0\u1edbng IBD c\u1ea7n lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng t\u01b0\u01a1ng t\u1ef1.<\/strong><\/p>\n

1. \u0110\u1ecbnh ngh\u0129a v\u00e0 ph\u00e2n lo\u1ea1i vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng (UC).<\/strong>\u00a0<\/strong><\/h2>\n

UC l\u00e0 b\u1ec7nh l\u00fd vi\u00eam m\u1ea1n \u0111\u1eb7c tr\u01b0ng b\u1edfi vi\u00eam m\u1ea1n t\u00ednh ni\u00eam m\u1ea1c \u0111o\u1ea1n xa c\u1ee7a \u0111\u1ea1i tr\u00e0ng, \u1edf tr\u1ef1c tr\u00e0ng, sang th\u01b0\u01a1ng c\u00f3 th\u1ec3 lan \u0111\u1ebfn c\u00e1c \u0111o\u1ea1n tr\u00ean t\u00f9y kho\u1ea3ng c\u00e1ch. Th\u01b0\u1eddng c\u00f3 s\u01b0 kh\u00e1c bi\u1ec7t r\u00f5 gi\u1eefa ni\u00eam m\u1ea1c vi\u00eam v\u00e0 kh\u00f4ng vi\u00eam. \u0110i\u1ec3n h\u00ecnh, b\u1ec7nh nh\u00e2n UC c\u00f3 nhi\u1ec1u \u0111\u1ee3t t\u00e1i ph\u00e1t v\u00e0 lui b\u1ec7nh.<\/p>\n

1.1. Ph\u00e2n lo\u1ea1i Montreal c\u1ee7a UC.<\/strong><\/h3>\n

Ph\u1ea1m vi:<\/p>\n

    \n
  • E1: vi\u00eam lo\u00e9t tr\u1ef1c tr\u00e0ng.<\/li>\n
  • E2: vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng tr\u00e1i (xa d\u00e2y ch\u1eb1ng l\u00e1ch).<\/li>\n
  • E3: lan r\u1ed9ng (g\u1ea7n d\u00e2y ch\u1eb1ng l\u00e1ch).<\/li>\n<\/ul>\n

    M\u1ee9c \u0111\u1ed9:<\/p>\n

      \n
    • S0: lui b\u1ec7nh l\u00e2m s\u00e0ng<\/li>\n
    • S1: UC nh\u1eb9.<\/li>\n
    • S2: UC trung b\u00ecnh.<\/li>\n
    • S3: UC n\u1eb7ng.<\/li>\n<\/ul>\n

      M\u00f4 h\u1ecdc: kh\u00f4ng c\u00f3 ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n UC. K\u1ebft h\u1ee3p: th\u1ea5m nh\u1eadp t\u01b0\u01a1ng b\u00e0o l\u1edbp \u0111\u00e1y, teo, m\u1ea5t c\u00e1c tuy\u1ebfn Lieberkuhn, b\u1edd nhung mao kh\u00f4ng \u0111\u1ec1u, m\u1ea5t l\u1edbp nh\u00e0y g\u1ee3i \u00fd UC trong b\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng ph\u00f9 h\u1ee3p.<\/p>\n

      1.2. Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n UC theo H\u1ed9i ti\u00eau h\u00f3a Nh\u1eadt 2021.<\/strong><\/h3>\n
        \n
      1. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng: ti\u00eau ph\u00e2n nh\u00e0y m\u00e1u k\u00e9o d\u00e0i\/t\u00e1i ph\u00e1t.<\/li>\n
      2. C\u1eadn l\u00e2m s\u00e0ng.<\/li>\n<\/ol>\n

        (1). N\u1ed9i soi: (a) ni\u00eam m\u1ea1c t\u1ed5n th\u01b0\u01a1ng lan t\u1ecfa, m\u1ea5t t\u00e2n sinh m\u1ea1ch, ni\u00eam m\u1ea1c th\u00f4. (b) nhi\u1ec1u sang th\u01b0\u01a1ng b\u00e0o m\u00f2n, lo\u00e9t ho\u1eb7c gi\u1ea3 polyp. (c) t\u1ed5n th\u01b0\u01a1ng li\u00ean t\u1ee5c t\u1edbi tr\u1ef1c tr\u00e0ng.<\/p>\n

        (2). Ch\u1ee5p c\u1ea3n quang barium. (a) thay \u0111\u1ed5i lan t\u1ecfa b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c d\u1ea1ng th\u00f4 ho\u1eb7c h\u1ea1t m\u1ecbn v\u00e0 (b) nhi\u1ec1u v\u1ebft b\u00e0o m\u00f2n, lo\u00e9t ho\u1eb7c gi\u1ea3 polyp.<\/p>\n

        3. M\u00f4 h\u1ecdc: trong giai \u0111o\u1ea1n ho\u1ea1t \u0111\u1ed9ng, th\u1ea5m nh\u1eadp t\u1ebf b\u00e0o vi\u00eam lan t\u1ecfa t\u1ea5t c\u1ea3 c\u00e1c l\u1edbp, \u00e1p xe tuy\u1ebfn, m\u1ea5t t\u1ebf b\u00e0o nh\u00e0y.<\/p>\n

        Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh khi \u0111\u1ee7 ti\u00eau chu\u1ea9n A, 1 ho\u1eb7c 2 c\u1ee7a B v\u00e0 C; 1 ho\u1eb7c 2 c\u1ee7a B v\u00e0 C tr\u00ean h\u01a1n 1 t\u00ecnh hu\u1ed1ng; ng\u01b0\u1eddi b\u1ec7nh c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u0111\u1ea1i th\u1ec3 v\u00e0 m\u00f4 h\u1ecdc, t\u1eeb m\u1eabu m\u00f4 ph\u1eabu thu\u1eadt\/t\u1eed thi\u1ebft.<\/p>\n

        \"\"
        H\u00ecnh n\u1ed9i soi c\u1ee7a vi\u00eam \u0111\u1ea1i tr\u00e0ng UC. Ngu\u1ed3n: Clin Endosc 2022; 55(4): 480-488.<\/figcaption><\/figure>\n

        2. Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n b\u1ec7nh vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u1ea1n Crohn.<\/strong><\/h2>\n

        Theo H\u1ed9i ti\u00eau h\u00f3a Nh\u1eadt: <\/strong><\/p>\n

        C\u00e1c d\u1ea5u hi\u1ec7u ch\u00ednh: <\/em><\/p>\n

          \n
        1. Lo\u00e9t theo chi\u1ec1u d\u1ecdc.<\/li>\n
        2. T\u1ed5n th\u01b0\u01a1ng d\u1ea1ng \u0111\u00e1 cu\u1ed9i.<\/li>\n
        3. U h\u1ea1t t\u1ebf b\u00e0o g\u1ed1c bi\u1ec3u m\u00f4 kh\u00f4ng t\u1ea1o khoang.<\/li>\n<\/ol>\n

          D\u1ea5u hi\u1ec7u th\u1ee9 ph\u00e1t: <\/em><\/p>\n

            \n
          1. V\u1ebft lo\u00e9t m\u1edf r\u1ed9ng, tr\u00f2n b\u1edd kh\u00f4ng \u0111\u1ec1u tr\u00ean \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/li>\n
          2. Sang th\u01b0\u01a1ng h\u1eadu m\u00f4n tr\u1ef1c tr\u00e0ng \u0111\u1eb7c tr\u01b0ng: n\u1ee9t h\u1eadu m\u00f4n, lo\u00e9t t\u1ea1o khoang, tr\u0129, \u00e1p xe quanh h\u1eadu m\u00f4n.<\/li>\n
          3. T\u1ed5n th\u01b0\u01a1ng d\u1ea1 d\u00e0y v\u00e0 t\u00e1 tr\u00e0ng \u0111\u1eb7c tr\u01b0ng: d\u1ea1ng c\u00e2y tre, l\u00fan d\u1ea1ng n\u1ed1t.<\/li>\n<\/ol>\n

            Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh n\u1ebfu: c\u00f3 d\u1ea5u hi\u1ec7u A v\u00e0 B; C v\u00e0 a ho\u1eb7c b; a v\u00e0 b v\u00e0 c.<\/p>\n

            \u1ede 5 \u2013 15% ng\u01b0\u1eddi b\u1ec7nh IBD, n\u1ed9i soi v\u00e0 m\u00f4 h\u1ecdc kh\u00f4ng ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c vi\u00eam \u0111\u1ea1i tr\u00e0ng Crohn v\u00e0 UC, v\u00e0 \u0111\u01b0\u1ee3c xem l\u00e0 IBD kh\u00f4ng x\u00e1c \u0111\u1ecbnh.<\/p>\n

            3. Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n IBD, UC v\u00e0 CD trong b\u1ec7nh c\u1ea3nh vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u1ea1n.<\/strong><\/h2>\n

            3.1. Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n IBD trong b\u1ec7nh c\u1ea3nh vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u1ea1n.<\/strong><\/h3>\n

            Ch\u1ea9n \u0111o\u00e1n IBD \u1edf ng\u01b0\u1eddi l\u1edbn c\u1ea7n th\u0103m kh\u00e1m l\u00e2m s\u00e0ng to\u00e0n di\u1ec7n v\u00e0 khai th\u00e1c b\u1ec7nh s\u01b0, ti\u1ec1n s\u1eed t\u1ec9 m\u1ec9. C\u1ea7n th\u1ef1c hi\u1ec7n nhi\u1ec1u x\u00e9t nghi\u1ec7m m\u00e1u, x\u00e9t nghi\u1ec7m ph\u00e2n, n\u1ed9i soi, sinh thi\u1ebft v\u00e0 h\u00ecnh \u1ea3nh h\u1ecdc gi\u00fap lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c v\u00e0 x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n.<\/p>\n

            B\u1ec7nh s\u1eed v\u00e0 ti\u1ec1n s\u1eed: <\/strong><\/p>\n

              \n
            • H\u1ecfi v\u1ec1 tri\u1ec7u ch\u1ee9ng ti\u00eau ch\u1ea3y (\u0111\u00e0m, m\u00e1u), \u0111au b\u1ee5ng, n\u00f4n, s\u1ee5t c\u00e2n, c\u00e1c bi\u1ec3u hi\u1ec7n ngo\u00e0i ru\u1ed9t, d\u00f2, b\u1ec7nh quanh h\u1eadu m\u00f4n, s\u1ed1t.<\/li>\n
            • H\u1ecfi v\u1ec1 c\u00e1c tri\u1ec7u ch\u1ee9ng trong b\u1ea5t k\u1ef3 kho\u1ea3ng th\u1eddi gian n\u00e0o. C\u00e1c \u0111\u1ee3t b\u00f9ng ph\u00e1t b\u1ec7nh trong qu\u00e1 kh\u1ee9 c\u00f3 th\u1ec3 b\u1ecb b\u1ecf s\u00f3t.<\/li>\n
            • Th\u1eddi gian di\u1ec5n ra tri\u1ec7u ch\u1ee9ng, th\u1ee9c gi\u1ea5c ban \u0111\u00eam, sao l\u00e3ng c\u00f4ng vi\u1ec7c, ho\u1ea1t \u0111\u1ed9ng.<\/li>\n
            • Bi\u1ec3u hi\u1ec7n ngo\u00e0i ru\u1ed9t nh\u01b0 \u1edf kh\u1edbp, b\u1ec7nh nh\u00e3n c\u1ea7u, da, lo\u00e3ng x\u01b0\u01a1ng, g\u00e3y x\u01b0\u01a1ng, thuy\u00ean t\u1eafc.<\/li>\n
            • Y\u1ebfu t\u1ed1 t\u00e2m l\u00fd, stress c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t IBD.<\/li>\n
            • Ti\u1ec1n s\u1eed lao ho\u1eb7c ph\u01a1i nhi\u1ec5m lao.<\/li>\n
            • Du l\u1ecbch.<\/li>\n
            • Thu\u1ed1c: kh\u00e1ng sinh, NSAIDs, corticoid.<\/li>\n
            • Ti\u1ec1n s\u1eed gia \u0111\u00ecnh (IBD, b\u1ec7nh celiac, ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng, lao).<\/li>\n
            • H\u00fat thu\u1ed1c.<\/li>\n<\/ul>\n

              Kh\u00e1m l\u00e2m s\u00e0ng.<\/strong><\/p>\n

                \n
              • To\u00e0n th\u00e2n: tri gi\u00e1c, ni\u00eam nh\u1ea1t, suy m\u00f2n, ng\u00f3n tay d\u00f9i tr\u1ed1ng, dinh d\u01b0\u1ee1ng, m\u1ea1ch, huy\u1ebft \u00e1p, c\u00e2n n\u1eb7ng, chi\u1ec1u cao.<\/li>\n
              • B\u1ee5ng: kh\u1ed1i u, ch\u01b0\u1edbng, \u0111\u1ec1 kh\u00e1ng, b\u1ea5t th\u01b0\u1eddng nhu \u0111\u1ed9ng ru\u1ed9t (t\u1eafc ru\u1ed9t), gan to, s\u1eb9o m\u1ed5.<\/li>\n
              • V\u00f9ng quanh h\u1eadu m\u00f4n: g\u1edd da, r\u00e3nh n\u00fat, r\u00f2, \u00e1p xe.<\/li>\n
              • Bi\u1ec3u hi\u1ec7n ngo\u00e0i ru\u1ed9t: lo\u00e9t mi\u1ec7ng, b\u1ec7nh l\u00fd kh\u1edbp, vi\u00eam c\u1ee7ng m\u1ea1c, h\u1ed3ng ban d\u1ea1ng n\u00fat, ho\u1ea1i t\u1eed da, x\u01a1 chai \u0111\u01b0\u1eddng m\u1eadt nguy\u00ean ph\u00e1t.<\/li>\n<\/ul>\n

                X\u00e9t nghi\u1ec7m:<\/strong><\/p>\n

                  \n
                • Ph\u00e2n: Soi c\u1ea5y ph\u00e2n. Th\u1eed C. difficile. Th\u1eed m\u00e1u \u1ea9n ho\u1eb7c b\u1ea1ch c\u1ea7u ph\u00e2n. Lactoferrin, antitrypsin. Calprotectin.<\/li>\n
                • M\u00e1u: c\u00f4ng th\u1ee9c m\u00e1u, m\u00e1u l\u1eafng, CRP. \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3 m\u00e1u, albumin, ferritin, calcium, magnesium, vitamin B12.\u00a0 Ferritin c\u00f3 th\u1ec3 t\u0103ng ho\u1eb7c b\u00ecnh th\u01b0\u1eddng n\u1ebfu thi\u1ebfu s\u1eaft n\u1eb7ng. T\u1ea7m so\u00e1t HIV, HBV.<\/li>\n<\/ul>\n

                  H\u00ecnh \u1ea3nh h\u1ecdc v\u00e0 n\u1ed9i soi.<\/strong><\/p>\n

                    \n
                  • X quang b\u1ee5ng kh\u00f4ng chu\u1ea9n b\u1ecb: gi\u00fap quy\u1ebft \u0111\u1ecbnh c\u00f3 vi\u00eam \u0111\u1ea1i tr\u00e0ng kh\u00f4ng v\u00e0 m\u1ee9c \u0111\u1ed9. Khi nghi ng\u1edd t\u1eafc ho\u1eb7c th\u1ee7ng ru\u1ed9t. Lo\u1ea1i tr\u1eeb ph\u00ecnh \u0111\u1ea1i tr\u00e0ng.<\/li>\n
                  • Ch\u1ee5p barium \u0111\u1ed1i quang k\u00e9p: kh\u00f4ng khuy\u1ebfn cho ca n\u1eb7ng, x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1eddng r\u00f2, \u0111\u00e1nh gi\u00e1 tr\u01b0\u1edbc m\u1ed5.<\/li>\n
                  • N\u1ed9i soi: \u0111\u00e1nh gi\u00e1 v\u1ebft lo\u00e9t, vi\u00eam, ch\u1ea3y m\u00e1u, h\u1eb9p. Sinh thi\u1ebft nhi\u1ec1u ch\u1ed7 \u0111\u1ea1i tr\u00e0ng v\u00e0 t\u1eadn h\u1ed3i tr\u00e0ng. \u1ede ca n\u1eb7ng c\u00f3 th\u1ec3 g\u00e2y th\u1ee7ng.<\/li>\n
                  • \u0110\u00e1nh gi\u00e1 lo\u1ea1n s\u1ea3n sau 8 n\u0103m m\u1eafc.<\/li>\n<\/ul>\n

                    3.2. Ph\u00e2n bi\u1ec7t UC v\u00e0 CD trong vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u1ea1n<\/strong><\/h3>\n

                    C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a UC: <\/strong><\/p>\n

                      \n
                    • Ti\u00eau ch\u1ea3y th\u1ec3 t\u00edch ph\u00e2n nh\u1ecf, t\u0103ng c\u1ea3m gi\u00e1c m\u1eafc \u0111i c\u1ea7u. Ti\u00eau ch\u1ea3y m\u00e1u chi\u1ebfm \u01b0u th\u1ebf.<\/li>\n
                    • N\u1ed9i soi v\u00e0 h\u00ecnh \u1ea3nh: Vi\u00eam th\u01b0\u1ee3ng m\u00f4 lan t\u1ecfa. C\u00f3 t\u1ed5n th\u01b0\u01a1ng \u1edf tr\u1ef1c tr\u00e0ng. C\u00f3 m\u1ed9t v\u00e0i vi\u1ebft b\u00e0o m\u00f2n, lo\u00e9t. Ch\u1ea3y m\u00e1u t\u1ef1 ph\u00e1t.<\/li>\n
                    • M\u00f4 h\u1ecdc: vi\u00eam ni\u00eam m\u1ea1c v\u00e0 d\u01b0\u1edbi ni\u00eam lan t\u1ecfa.<\/li>\n<\/ul>\n

                      C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a CD.<\/strong><\/p>\n

                        \n
                      • L\u00e2m s\u00e0ng: Ti\u00eau ch\u1ea3y k\u00e8m \u0111au b\u1ee5ng v\u00e0 suy dinh d\u01b0\u1ee1ng. Kh\u1ed1i u \u1edf b\u1ee5ng. T\u1ed5n th\u01b0\u01a1ng quanh h\u1eadu m\u00f4n.<\/li>\n
                      • N\u1ed9i soi v\u00e0 m\u00f4 h\u1ecdc: t\u1ed5n th\u01b0\u01a1ng xuy\u00ean th\u00e0nh kh\u00f4ng li\u00ean t\u1ee5c, sang th\u01b0\u01a1ng kh\u00f4ng \u0111\u1ed1i x\u1ee9ng. \u1ea2nh h\u01b0\u1edfng h\u1ed3i tr\u00e0ng v\u00e0 \u0111\u1ea1i tr\u00e0ng ph\u1ea3i. D\u1ea1ng \u0111\u00e1 cu\u1ed9i. V\u1ebft lo\u00e9t d\u1ecdc, khe n\u1ee9t s\u00e2u.<\/li>\n
                      • M\u00f4 h\u1ecdc: vi\u00eam t\u1ea1o m\u00f4 h\u1ea1t.<\/li>\n<\/ul>\n

                        3.3. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t IBD.<\/strong><\/h3>\n
                          \n
                        • V\u1edbi UC: c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi vi\u00eam \u0111\u1ea1i tr\u00e0ng c\u1ea5p t\u1ef1 kh\u1ecfi, vi\u00eam \u0111\u1ea1i tr\u00e0ng amib, nhi\u1ec5m s\u00e1n m\u00e1ng, CD, ung th\u01b0 \u0111\u1ea1i tr\u00e0ng, h\u1ed9i ch\u1ee9ng ru\u1ed9t k\u00edch th\u00edch. Lao ru\u1ed9t, b\u1ec7nh l\u00fd ru\u1ed9t do NSAID. Vi\u00eam \u0111\u1ea1i tr\u00e0ng nhi\u1ec5m tr\u00f9ng, thi\u1ebfu m\u00e1u \u0111\u1ea1i tr\u00e0ng, vi\u00eam do tia x\u1ea1, Henoch Schonlein.<\/li>\n
                        • V\u1edbi CD: lao ru\u1ed9t, b\u1ec7nh Behcet, UC, b\u1ec7nh l\u00fd ru\u1ed9t do NSAID, h\u1ed9i ch\u1ee9ng ru\u1ed9t k\u00edch th\u00edch, b\u1ec7nh Celiac. Thi\u1ebfu m\u00e1u \u0111\u1ea1i tr\u00e0ng, vi\u00eam vi th\u1ec3, vi\u00eam tia x\u1ea1, vi\u00eam t\u00fai th\u1eeba, do NSAID, lymphoma ru\u1ed9t v\u00e0 K.<\/li>\n<\/ul>\n

                          3.4. C\u1ea7n lo\u1ea1i tr\u1eeb lao ru\u1ed9t tr\u01b0\u1edbc khi ch\u1ea9n \u0111o\u00e1n IBD. <\/strong><\/h3>\n

                          Tri\u1ec7u ch\u1ee9ng trong lao theo th\u1ee9 t\u1ef1: s\u1ed1t, \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y; CD: \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y, s\u1ed1t. Lao di\u1ec5n ti\u1ebfn tuy\u1ebfn t\u00ednh, CD t\u00e1i ph\u00e1t v\u00e0 lui b\u1ec7nh.<\/p>\n

                           <\/p>\n

                          T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/p>\n

                          World Gastroenterology Organisation Global Guidelines<\/p>\n

                          Inflammatory Bowel Disease.<\/p>\n

                          British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults<\/p>\n

                          Nakase, H., Uchino, M., Shinzaki, S. et al. Evidence-based clinical practice guidelines for inflammatory bowel disease 2020. J Gastroenterol 56, 489\u2013526 (2021).<\/p>\n","protected":false},"excerpt":{"rendered":"

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