{"id":19701,"date":"2023-04-16T18:19:38","date_gmt":"2023-04-16T11:19:38","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19701"},"modified":"2023-04-17T12:22:42","modified_gmt":"2023-04-17T05:22:42","slug":"chan-doan-benh-xo-phoi-vo-can-theo-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/chan-doan-benh-xo-phoi-vo-can-theo-bo-y-te\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh x\u01a1 ph\u1ed5i v\u00f4 c\u0103n theo B\u1ed9 Y t\u1ebf"},"content":{"rendered":"<p><strong>X\u01a1 ph\u1ed5i v\u00f4 c\u0103n (IPF) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 m\u1ed9t d\u1ea1ng b\u1ec7nh ph\u1ed5i k\u1ebd x\u01a1 h\u00f3a, ti\u1ebfn tri\u1ec3n, m\u1ea1n t\u00ednh \u0111\u1eb7c hi\u1ec7u, kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n, x\u1ea3y ra ch\u1ee7 y\u1ebfu \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i v\u00e0 t\u1ed5n th\u01b0\u01a1ng gi\u1edbi h\u1ea1n \u1edf ph\u1ed5i. M\u1eb7c d\u00f9 t\u1ef7 l\u1ec7 m\u1eafc IPF kh\u00f4ng cao, nh\u01b0ng \u0111\u00f3 l\u00e0 m\u1ed9t g\u00e1nh n\u1eb7ng b\u1ec7nh l\u1edbn v\u1edbi ng\u01b0\u1eddi b\u1ec7nh, gia \u0111\u00ecnh v\u00e0 x\u00e3 h\u1ed9i. Ti\u00ean l\u01b0\u1ee3ng b\u1ec7nh x\u1ea5u, th\u1eddi gian s\u1ed1ng th\u00eam trung b\u00ecnh sau ch\u1ea9n \u0111o\u00e1n l\u00e0 2-3 n\u0103m, v\u1edbi chi ph\u00ed \u0111i\u1ec1u tr\u1ecb cao. V\u00ec v\u1eady, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1ec7nh l\u00e0 v\u00f4 c\u00f9ng quan tr\u1ecdng.<\/strong><\/p>\n<h2>1. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh x<strong>\u01a1 ph\u1ed5i v\u00f4 c\u0103n<\/strong><\/h2>\n<h3><b style=\"font-size: 16px;\">1.1. B\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng<\/b><\/h3>\n<p>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng trong IPF r\u1ea5t k\u00edn \u0111\u00e1o v\u00e0 kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. Tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a IPF l\u00e0 ho v\u00e0 kh\u00f3 th\u1edf. Kh\u1edfi ph\u00e1t tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 r\u1ea5t k\u00edn \u0111\u00e1o v\u00e0 xu\u1ea5t hi\u1ec7n tr\u01b0\u1edbc ch\u1ea9n \u0111o\u00e1n t\u1eeb 1-2 n\u0103m. B\u00ean c\u1ea1nh \u0111\u00f3, th\u01b0\u1eddng c\u00f3 t\u1ed5n th\u01b0\u01a1ng tr\u00ean phim ch\u1ee5p ph\u1ed5i tr\u01b0\u1edbc khi BN c\u00f3 tri\u1ec7u ch\u1ee9ng.<\/p>\n<p>C\u1ea7n khai th\u00e1c ti\u1ec1n s\u1eed b\u1ea3n th\u00e2n v\u00e0 gia \u0111\u00ecnh m\u1ed9t c\u00e1ch r\u1ea5t chi ti\u1ebft, t\u1ec9 m\u1ec9 \u0111\u1ec3 c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c y\u1ebfu t\u1ed1 nghi ng\u1edd CTD-ILD ho\u1eb7c HP. Khai th\u00e1c k\u1ef9 ti\u1ec1n s\u1eed ti\u1ebfp x\u00fac, ti\u1ec1n s\u1eed d\u00f9ng thu\u1ed1c m\u1ed9t c\u00e1ch chi ti\u1ebft l\u00e0 \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng, \u0111\u1ec3 c\u00f3 th\u1ec3 lo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh nh\u01b0 HP ho\u1eb7c c\u00e1c b\u1ec7nh ph\u1ed5i li\u00ean quan \u0111\u1ebfn ph\u01a1i nhi\u1ec5m ngh\u1ec1 nghi\u1ec7p, thu\u1ed1c ho\u1eb7c h\u00f3a x\u1ea1 tr\u1ecb.<\/p>\n<p>Kh\u00e1m th\u1ef1c th\u1ec3 th\u01b0\u1eddng th\u1ea5y ral n\u1ed5 \u1edf 2 \u0111\u00e1y ph\u1ed5i. M\u00f3ng tay khum, ng\u00f3n tay d\u00f9i tr\u1ed1ng g\u1eb7p \u1edf kho\u1ea3ng 50% NB. B\u00ean c\u1ea1nh \u0111\u00f3 c\u1ea7n kh\u00e1m to\u00e0n di\u1ec7n, t\u00ecm c\u00e1c tri\u1ec7u ch\u1ee9ng ngo\u00e0i ph\u1ed5i \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 ban tr\u00ean da hay c\u00e1c d\u1ea5u hi\u1ec7u c\u00f3 th\u1ec3 nghi ng\u1edd b\u1ec7nh ph\u1ed5i k\u1ebd c\u00f3 nguy\u00ean nh\u00e2n, v\u00ed d\u1ee5 nh\u01b0 CTD-ILD, \u0111\u1ec3 tr\u00e1nh b\u1ecf s\u00f3t ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc khi k\u1ebft lu\u1eadn l\u00e0 IPF.<\/p>\n<h3>1.2. C\u00e1c th\u0103m d\u00f2 ch\u1ea9n \u0111o\u00e1n<\/h3>\n<h4><b>1.2.1. Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh \u0111\u1ed9 ph\u00e2n gi\u1ea3i cao (HRCT)<\/b><\/h4>\n<p>H\u00ecnh th\u00e1i UIP l\u00e0 h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng \u0111\u1eb7c tr\u01b0ng c\u1ee7a IPF, trong \u0111\u00f3 h\u00ecnh \u1ea3nh t\u1ed5 ong l\u00e0 h\u00ecnh \u1ea3nh \u0111i\u1ec3n h\u00ecnh c\u1ee7a UIP.<\/p>\n<p>H\u00ecnh th\u00e1i UIP (usual interstitial pneumonia) l\u00e0 h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng \u0111\u1eb7c tr\u01b0ng c\u1ee7a x\u01a1 ph\u1ed5i v\u00f4 c\u0103n (idiopathic pulmonary fibrosis &#8211; IPF). H\u00ecnh th\u00e1i UIP \u0111\u01b0\u1ee3c mi\u00eau t\u1ea3 l\u00e0 bao g\u1ed3m v\u00f9ng ph\u1ed5i b\u1ecb x\u01a1 h\u00f3a v\u00e0 vi\u00eam xen k\u1ebd v\u1edbi v\u00f9ng ph\u1ed5i b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>Vi\u1ec7c ph\u00e1t hi\u1ec7n h\u00ecnh th\u00e1i UIP trong x\u01a1 ph\u1ed5i v\u00f4 c\u0103n l\u00e0 quan tr\u1ecdng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh IPF. Tuy nhi\u00ean, \u0111\u1ec3 \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c c\u1ea7n ph\u1ea3i k\u1ebft h\u1ee3p v\u1edbi l\u1ecbch s\u1eed b\u1ec7nh, k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng ph\u1ed5i v\u00e0 c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c \u0111\u1ec3 lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c c\u1ee7a t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i.<\/p>\n<p>Ngo\u00e0i ra UIP c\u00f3 th\u1ec3 k\u00e8m theo gi\u00e3n ph\u1ebf qu\u1ea3n co k\u00e9o, gi\u00e3n ti\u1ec3u ph\u1ebf qu\u1ea3n co k\u00e9o. D\u1ea1ng ph\u00e2n b\u1ed1 c\u1ee7a UIP \u0111i\u1ec3n h\u00ecnh l\u00e0 ngo\u1ea1i vi d\u01b0\u1edbi m\u00e0ng ph\u1ed5i v\u00e0 \u01b0u th\u1ebf ph\u00eda d\u01b0\u1edbi ph\u1ed5i, th\u01b0\u1eddng 2 b\u00ean ph\u1ed5i. Tuy nhi\u00ean, theo h\u01b0\u1edbng d\u1eabn c\u1ee7a ATS\/ERS\/JRS\/ALAT, UIP c\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n tr\u00ean HRCT g\u1ed3m c\u00e1c nh\u00f3m ph\u00e2n lo\u1ea1i nh\u01b0 trong b\u1ea3ng sau:<\/p>\n<p align=\"center\">B\u1ea3ng Ph\u00e2n lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng UIP tr\u00ean HRCT<\/p>\n<table border=\"0\" width=\"100%\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"17%\">\n<p align=\"center\"><b>UIP<\/b><\/p>\n<\/td>\n<td valign=\"top\" width=\"18%\">\n<p align=\"center\"><b>C\u00f3 th\u1ec3 UIP<\/b><\/p>\n<\/td>\n<td valign=\"top\" width=\"28%\">\n<p align=\"center\"><b>Kh\u00f4ng x\u00e1c \u0111\u1ecbnh UIP<\/b><\/p>\n<\/td>\n<td valign=\"top\" width=\"35%\">\n<p align=\"center\"><b>Ch\u1ea9n \u0111o\u00e1n kh\u00e1c<\/b><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"17%\">\u25cf\u01afu th\u1ebf \u0111\u00e1y v\u00e0 d\u01b0\u1edbi m\u00e0ng ph\u1ed5i<\/p>\n<p>\u25cfT\u1ed5n th\u01b0\u01a1ng t\u1ed5 ong c\u00f3 ho\u1eb7c kh\u00f4ng k\u00e8m theo gi\u00e3n ph\u1ebf qu\u1ea3n co k\u00e9o ngo\u1ea1i vi ho\u1eb7c gi\u00e3n ti\u1ec3u ph\u1ebf qu\u1ea3n<\/td>\n<td valign=\"top\" width=\"18%\">\u25cf\u01afu th\u1ebf \u0111\u00e1y v\u00e0 d\u01b0\u1edbi m\u00e0ng ph\u1ed5i<\/p>\n<p>\u25cfT\u1ed5n th\u01b0\u01a1ng l\u01b0\u1edbi k\u00e8m theo gi\u00e3n ph\u1ebf qu\u1ea3n co k\u00e9o ngo\u1ea1i vi ho\u1eb7c gi\u00e3n ti\u1ec3u ph\u1ebf qu\u1ea3n<\/p>\n<p>\u25cfC\u00f3 th\u1ec3 c\u00f3 h\u00ecnh \u1ea3nh k\u00ednh m\u1edd nh\u1eb9<\/td>\n<td valign=\"top\" width=\"28%\">\u25cf\u01afu th\u1ebf \u0111\u00e1y v\u00e0 d\u01b0\u1edbi m\u00e0ng ph\u1ed5i<\/p>\n<p>\u25cfL\u01b0\u1edbi kh\u00f4ng r\u00f5 r\u00e0ng; c\u00f3 th\u1ec3 c\u00f3 h\u00ecnh \u1ea3nh k\u00ednh m\u1edd nh\u1eb9 ho\u1eb7c bi\u1ebfn d\u1ea1ng c\u1ea5u tr\u00fac (\u201ch\u00ecnh th\u00e1i UIP s\u1edbm\u201d)<\/p>\n<p>\u25cf\u0110\u1eb7c \u0111i\u1ec3m HRCT v\u00e0\/ho\u1eb7c ph\u00e2n b\u1ed1 t\u1ed5n th\u01b0\u01a1ng kh\u00f4ng g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng \u0111\u1eb7c hi\u1ec7u (\u201ckh\u00f4ng x\u00e1c \u0111\u1ecbnh th\u1ef1c s\u1ef1\u201d)<\/td>\n<td valign=\"top\" width=\"35%\">\u25cfT\u1ed5n th\u01b0\u01a1ng g\u1ee3i \u00fd ch\u1ea9n \u0111o\u00e1n kh\u00e1c g\u1ed3m:<\/p>\n<p>\u25cfK\u00e9n. Th\u1ec3 kh\u1ea3m r\u00f5. \u01afu th\u1ebf h\u00ecnh \u1ea3nh k\u00ednh m\u1edd. \u0110a vi n\u1ed1t. N\u1ed1t trung t\u00e2m ti\u1ec3u th\u00f9y. N\u1ed1t \u0111\u01a1n \u0111\u1ed9c. Ph\u00e2n b\u1ed1 quanh ph\u1ebf qu\u1ea3n m\u1ea1ch m\u00e1u\/quanh b\u1ea1ch m\u1ea1ch\/ ph\u1ea7n tr\u00ean v\u00e0 gi\u1eefa ph\u1ed5i. C\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c: m\u1ea3ng m\u00e0ng ph\u1ed5i, gi\u00e3n th\u1ef1c qu\u1ea3n, h\u1ee7y x\u01b0\u01a1ng \u0111\u00f2n, h\u1ea1ch to, tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i, d\u00e0y m\u00e0ng ph\u1ed5i\u2026<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h4>1.2.2. Sinh thi\u1ebft ph\u1ed5i:<\/h4>\n<p>Sinh thi\u1ebft ph\u1ed5i xuy\u00ean v\u00e1ch ph\u1ebf qu\u1ea3n \u00edt c\u00f3 vai tr\u00f2 ch\u1ea9n \u0111o\u00e1n do m\u1ea3nh sinh thi\u1ebft nh\u1ecf. H\u00ecnh th\u1ee9c sinh thi\u1ebft ph\u1ed5i \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o ph\u1ed5 bi\u1ebfn trong c\u00e1c h\u01b0\u1edbng d\u1eabn qu\u1ed1c t\u1ebf hi\u1ec7n nay l\u00e0 sinh thi\u1ebft ph\u1ed5i ph\u1eabu thu\u1eadt. \u0110\u1eb7c bi\u1ec7t l\u00e0 v\u1edbi s\u1ef1 ph\u1ed5 bi\u1ebfn h\u01a1n c\u1ee7a VATS (ph\u1eabu thu\u1eadt n\u1ed9i soi l\u1ed3ng ng\u1ef1c h\u1ed7 tr\u1ee3 b\u1eb1ng video &#8211; Video-assisted thoracoscopic surgery), vi\u1ec7c sinh thi\u1ebft ph\u1ed5i ph\u1eabu thu\u1eadt tr\u1edf n\u00ean d\u1ec5 d\u00e0ng h\u01a1n. Khi sinh thi\u1ebft, n\u00ean l\u1ea5y 2 &#8211; 3 m\u1ea3nh b\u1ec7nh ph\u1ea9m, \u1edf c\u00e1c th\u00f9y ph\u1ed5i kh\u00e1c nhau \u0111\u1ec3 t\u0103ng gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n[27]. Tuy nhi\u00ean v\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i n\u1eb7ng, \u0111\u00e3 suy gi\u1ea3m ch\u1ee9c n\u0103ng ph\u1ed5i ho\u1eb7c c\u00f3 b\u1ec7nh l\u00fd n\u1ec1n, c\u1ea7n c\u00e2n nh\u1eafc k\u1ef9 vi\u1ec7c sinh thi\u1ebft ph\u1ed5i ph\u1eabu thu\u1eadt v\u00ec c\u00e1c nguy c\u01a1 li\u00ean quan \u0111\u1ebfn ph\u1eabu thu\u1eadt. Vi\u1ec7c ch\u1ec9 \u0111\u1ecbnh sinh thi\u1ebft ph\u1ed5i ph\u1eabu thu\u1eadt c\u1ea7n \u0111\u01b0\u1ee3c th\u1ea3o lu\u1eadn b\u1edfi h\u1ed9i ch\u1ea9n \u0111a chuy\u00ean khoa (MDD).<\/p>\n<figure id=\"attachment_21384\" aria-describedby=\"caption-attachment-21384\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-21384 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1390116936-612x612-1-300x244.jpg\" alt=\"Sinh thi\u1ebft ph\u1ed5i l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n b\u1ec7nh x\u01a1 ph\u1ed5i v\u00f4 c\u0103n\" width=\"300\" height=\"244\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1390116936-612x612-1-300x244.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1390116936-612x612-1.jpg 612w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-21384\" class=\"wp-caption-text\">Sinh thi\u1ebft ph\u1ed5i l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n b\u1ec7nh x\u01a1 ph\u1ed5i v\u00f4 c\u0103n<\/figcaption><\/figure>\n<h4>1.2.3. M\u00f4 b\u1ec7nh h\u1ecdc:<\/h4>\n<p>T\u1ed5n th\u01b0\u01a1ng m\u00f4 b\u1ec7nh h\u1ecdc ch\u00ednh trong IPF l\u00e0 h\u00ecnh th\u00e1i UIP v\u1edbi s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a qu\u00e1 tr\u00ecnh x\u01a1 h\u00f3a d\u00e0y \u0111\u1eb7c, xen k\u1ebd g\u00e2y thay \u0111\u1ed5i c\u1ea5u tr\u00fac m\u00f4 ph\u1ed5i, d\u1eabn \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng t\u1ed5 ong, c\u00f9ng v\u1edbi c\u00e1c \u1ed5 nguy\u00ean b\u00e0o s\u1ee3i, xen k\u1ebd gi\u1eefa v\u00f9ng x\u01a1 v\u00e0 v\u00f9ng m\u00f4 \u00edt t\u1ed5n th\u01b0\u01a1ng h\u01a1n. Ph\u00e2n b\u1ed1 t\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p d\u01b0\u1edbi m\u00e0ng ph\u1ed5i v\u00e0 v\u00f9ng m\u00f4 ph\u1ed5i quanh v\u00e1ch. X\u00e2m nh\u1eadp vi\u00eam th\u01b0\u1eddng nh\u1eb9.<\/p>\n<p>Ngo\u00e0i ra m\u00f4 b\u1ec7nh h\u1ecdc c\u00f2n gi\u00fap lo\u1ea1i tr\u1eeb c\u00e1c ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t nh\u01b0 vi\u00eam ph\u1ed5i t\u0103ng c\u1ea3m, vi\u00eam ph\u1ed5i t\u1ed5 ch\u1ee9c h\u00f3a, vi\u00eam ph\u1ed5i k\u1ebd c\u1ea5p t\u00ednh, b\u1ee5i ph\u1ed5i, sarcoidosis\u2026<\/p>\n<h4>1.2.4. N\u1ed9i soi ph\u1ebf qu\u1ea3n:<\/h4>\n<p>H\u00ecnh \u1ea3nh n\u1ed9i soi ph\u1ebf qu\u1ea3n kh\u00f4ng c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m \u0111\u1eb7c hi\u1ec7u v\u1edbi IPF. Tuy nhi\u00ean, vi\u1ec7c x\u00e9t nghi\u1ec7m d\u1ecbch r\u1eeda ph\u1ebf qu\u1ea3n ph\u1ebf nang (BAL) c\u00f3 th\u1ec3 gi\u00fap lo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh ph\u1ed5i k\u1ebd kh\u00e1c. Khi t\u1ed5n th\u01b0\u01a1ng x\u01a1 ph\u1ed5i tr\u00ean HRCT chi\u1ebfm \u01b0u th\u1ebf, kh\u00f4ng khuy\u1ebfn c\u00e1o n\u1ed9i soi ph\u1ebf qu\u1ea3n.<\/p>\n<h3>1.2.5. C\u00e1c th\u0103m d\u00f2 kh\u00e1c:<\/h3>\n<p>C\u00e1c th\u0103m d\u00f2 kh\u00e1c nh\u01b0 \u0111o ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p, \u0111i\u1ec7n tim, si\u00eau \u00e2m tim, c\u00e1c x\u00e9t nghi\u1ec7m m\u00e1u kh\u00f4ng c\u00f3 vai tr\u00f2 trong ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh IPF, nh\u01b0ng gi\u00fap \u0111\u00e1nh gi\u00e1 to\u00e0n di\u1ec7n NB v\u00e0 theo d\u00f5i \u0111i\u1ec1u tr\u1ecb.<\/p>\n<h2>2. Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n b\u1ec7nh x<strong>\u01a1 ph\u1ed5i v\u00f4 c\u0103n<\/strong><\/h2>\n<p>C\u1ea7n nghi ng\u1edd IPF \u1edf nh\u1eefng BN tr\u00ean 60 tu\u1ed5i, c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, c\u00f3 t\u1ed5n th\u01b0\u01a1ng x\u01a1 ph\u1ed5i 2 b\u00ean tr\u00ean HRCT, kh\u00e1m ph\u1ed5i c\u00f3 ral n\u1ed5 2 b\u00ean.<\/p>\n<p>Ch\u1ea9n \u0111o\u00e1n IPF c\u00f3 th\u1ec3 theo c\u00e1c b\u01b0\u1edbc trong l\u01b0u \u0111\u1ed3 sau:<\/p>\n<figure style=\"width: 554px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/thuvienphapluat.vn\/doc2htm\/00556557_files\/image053.jpg\" alt=\"L\u01b0u \u0111\u1ed3 ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n IPF\" width=\"554\" height=\"531\" \/><figcaption class=\"wp-caption-text\">L\u01b0u \u0111\u1ed3 ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n b\u1ec7nh x\u01a1 ph\u1ed5i v\u00f4 c\u0103n<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p align=\"center\">B\u1ea3ng Ch\u1ea9n \u0111o\u00e1n IPF d\u1ef1a v\u00e0o k\u1ebft h\u1ee3p HRCT v\u00e0 m\u00f4 b\u1ec7nh h\u1ecdc<\/p>\n<table border=\"1\" width=\"100%\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td colspan=\"2\" rowspan=\"2\" width=\"31%\">\n<p align=\"center\"><b>NGHI NG\u1edc IPF<\/b><\/p>\n<\/td>\n<td colspan=\"4\" width=\"68%\">\n<p align=\"center\"><b>M\u00d4 B\u1ec6NH H\u1eccC<\/b><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"19%\">\n<p align=\"center\"><b>UIP<\/b><\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\"><b>C\u00f3 th\u1ec3 UIP<\/b><\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\"><b>Kh\u00f4ng x\u00e1c\u00a0<\/b><b>\u0111\u1ecbnh UIP<\/b><\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\"><b>Ch\u1ea9n \u0111o\u00e1n\u00a0<\/b><b>kh\u00e1c<\/b><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"4\" width=\"10%\">\n<p align=\"center\"><b>HRCT<\/b><\/p>\n<\/td>\n<td width=\"20%\">\n<p align=\"center\"><b>UIP<\/b><\/p>\n<\/td>\n<td width=\"19%\">\n<p align=\"center\">IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">Kh\u00f4ng ph\u1ea3i IPF<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"20%\">\n<p align=\"center\"><b>C\u00f3 th\u1ec3 UIP<\/b><\/p>\n<\/td>\n<td width=\"19%\">\n<p align=\"center\">IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">C\u00f3 th\u1ec3 IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">Kh\u00f4ng ph\u1ea3i IPF<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"20%\">\n<p align=\"center\"><b>Kh\u00f4ng x\u00e1c<\/b>\u00a0<b>\u0111\u1ecbnh UIP<\/b><\/p>\n<\/td>\n<td width=\"19%\">\n<p align=\"center\">IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">C\u00f3 th\u1ec3 IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">Kh\u00f4ng x\u00e1c\u00a0\u0111\u1ecbnh IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">Kh\u00f4ng ph\u1ea3i IPF<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"20%\">\n<p align=\"center\"><b>Ch\u1ea9n \u0111o\u00e1n<\/b>\u00a0<b>kh\u00e1c<\/b><\/p>\n<\/td>\n<td width=\"19%\">\n<p align=\"center\">C\u00f3 th\u1ec3 IPF\/ Kh\u00f4ng ph\u1ea3i IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">Kh\u00f4ng ph\u1ea3i IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">Kh\u00f4ng ph\u1ea3i IPF<\/p>\n<\/td>\n<td width=\"16%\">\n<p align=\"center\">Kh\u00f4ng ph\u1ea3i IPF<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2><\/h2>\n<p>&#8211; Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n IPF c\u1ea7n th\u1ecfa m\u00e3n:<\/p>\n<ul>\n<li>1. Lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n \u0111\u00e3 bi\u1ebft kh\u00e1c c\u1ee7a ILD (v\u00ed d\u1ee5: t\u00ednh ch\u1ea5t gia \u0111\u00ecnh, ph\u01a1i nhi\u1ec5m ngh\u1ec1 nghi\u1ec7p, m\u00f4i tr\u01b0\u1eddng, thu\u1ed1c, h\u00f3a x\u1ea1 tr\u1ecb, b\u1ec7nh h\u1ec7 th\u1ed1ng\u2026), v\u00e0<\/li>\n<li>2. C\u00f3 h\u00ecnh th\u00e1i t\u1ed5n th\u01b0\u01a1ng UIP tr\u00ean HRCT ho\u1eb7c<\/li>\n<li>3. S\u1ef1 k\u1ebft h\u1ee3p h\u00ecnh th\u00e1i UIP tr\u00ean HRCT v\u00e0 m\u00f4 b\u1ec7nh h\u1ecdc n\u1ebfu sinh thi\u1ebft ph\u1ed5i<\/li>\n<\/ul>\n<p>B\u1ec7nh x\u01a1 ph\u1ed5i v\u00f4 c\u0103n l\u00e0 m\u1ed9t b\u1ec7nh ph\u1ed5i m\u00e3n t\u00ednh hi\u1ebfm g\u1eb7p, \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t d\u1ea1ng vi\u00eam ph\u1ed5i t\u1ef1 mi\u1ec5n d\u1ecbch. B\u1ec7nh n\u00e0y g\u00e2y t\u1ed5n th\u01b0\u01a1ng v\u00e0 x\u01a1 h\u00f3a c\u00e1c m\u00f4 li\u00ean k\u1ebft trong ph\u1ed5i, d\u1eabn \u0111\u1ebfn gi\u1ea3m kh\u1ea3 n\u0103ng h\u00f4 h\u1ea5p v\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng ph\u1ed5i. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh x\u01a1 ph\u1ed5i v\u00f4 c\u0103n m\u1ed9t c\u00e1ch ch\u00ednh x\u00e1c l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft, gi\u00fap qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n k\u1ecbp th\u1eddi v\u00e0 hi\u1ec7u qu\u1ea3.<\/p>\n<p><iframe loading=\"lazy\" title=\"Ung th\u01b0 ph\u1ed5i c\u00f3 d\u1ec5 nh\u1ea7m v\u1edbi c\u00e1c b\u1ec7nh h\u00f4 h\u1ea5p kh\u00e1c?| BS Nguy\u1ec5n Th\u1ecb Thanh Huy\u1ec1n, BV Vinmec Times City\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/VVrx61LxQYw?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe><\/p>\n","protected":false},"excerpt":{"rendered":"<p>X\u01a1 ph\u1ed5i v\u00f4 c\u0103n (IPF) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 m\u1ed9t d\u1ea1ng b\u1ec7nh ph\u1ed5i k\u1ebd x\u01a1 h\u00f3a, ti\u1ebfn tri\u1ec3n, m\u1ea1n t\u00ednh \u0111\u1eb7c hi\u1ec7u, kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n, x\u1ea3y ra ch\u1ee7 y\u1ebfu \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i v\u00e0 t\u1ed5n th\u01b0\u01a1ng gi\u1edbi h\u1ea1n \u1edf ph\u1ed5i. M\u1eb7c d\u00f9 t\u1ef7 l\u1ec7 m\u1eafc IPF kh\u00f4ng cao, nh\u01b0ng \u0111\u00f3 l\u00e0 m\u1ed9t g\u00e1nh n\u1eb7ng [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh x\u01a1 ph\u1ed5i v\u00f4 c\u0103n theo B\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"X\u01a1 ph\u1ed5i v\u00f4 c\u0103n (IPF) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 d\u1ea1ng b\u1ec7nh ph\u1ed5i k\u1ebd x\u01a1 h\u00f3a, ti\u1ebfn tri\u1ec3n, m\u1ea1n t\u00ednh \u0111\u1eb7c hi\u1ec7u, kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n, x\u1ea3y ra ch\u1ee7 y\u1ebfu \u1edf ...\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh x\u01a1 ph\u1ed5i v\u00f4 c\u0103n theo B\u1ed9 Y t\u1ebf - 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