{"id":19715,"date":"2023-04-17T17:23:40","date_gmt":"2023-04-17T10:23:40","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19715"},"modified":"2023-04-18T12:18:20","modified_gmt":"2023-04-18T05:18:20","slug":"benh-phoi-ke-phuong-phap-dieu-tri-khong-dung-thuoc","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/benh-phoi-ke-phuong-phap-dieu-tri-khong-dung-thuoc\/","title":{"rendered":"B\u1ec7nh ph\u1ed5i k\u1ebd: Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00f4ng d\u00f9ng thu\u1ed1c"},"content":{"rendered":"<p><strong>B\u1ec7nh ph\u1ed5i k\u1ebd (interstitial lung disease &#8211; ILD) l\u00e0 m\u1ed9t b\u1ec7nh ph\u1ed5i m\u00e3n t\u00ednh r\u1ea5t ph\u1ed5 bi\u1ebfn, c\u00f3 ti\u1ec1m \u1ea9n nguy c\u01a1 g\u00e2y ra t\u1eed vong v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh ph\u1ed5i k\u1ebd nh\u1eb1m gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 ng\u0103n ch\u1eb7n s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh. C\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1ec7nh kh\u00f4ng d\u00f9ng thu\u1ed1c gi\u00fap c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh v\u00e0 h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p cho b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n<h2>1. H\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh ph\u1ed5i k\u1ebd<\/h2>\n<h3>1.1. \u0110i\u1ec1u tr\u1ecb th\u1edf oxy<\/h3>\n<h4>1.1.1. Cho \u0111\u1ee3t c\u1ea5p ILD:<\/h4>\n<p>+ Ch\u1ec9 \u0111\u1ecbnh: Khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 t\u00ecnh tr\u1ea1ng gi\u1ea3m oxy m\u00e1u nh\u01b0 SpO<sub>2<\/sub>\u00a0&lt; 90% ho\u1eb7c PaO<sub>2<\/sub> &lt; 60 mmHg.<\/p>\n<p>+ \u0110i\u1ec1u ch\u1ec9nh l\u01b0u l\u01b0\u1ee3ng oxy: \u0110i\u1ec1u ch\u1ec9nh l\u01b0u l\u01b0\u1ee3ng oxy \u0111\u1ec3 \u0111\u1ea1t m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb v\u1edbi SpO<sub>2<\/sub>\u00a0\u2265 90% ho\u1eb7c PaO<sub>2<\/sub> \u2265 60 mmHg. N\u1ebfu ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nguy c\u01a1 t\u0103ng CO<sub>2<\/sub>, m\u1ee5c ti\u00eau SpO<sub>2<\/sub>\u00a0ch\u1ec9 c\u1ea7n t\u1eeb 88-92%. D\u1ef1a v\u00e0o nhu c\u1ea7u oxy m\u00e0 \u0111i\u1ec1u ch\u1ec9nh n\u1ed3ng \u0111\u1ed9 oxy trong kh\u00ed h\u00edt v\u00e0o (FiO2) theo ph\u01b0\u01a1ng th\u1ee9c ph\u00f9 h\u1ee3p.<\/p>\n<figure id=\"attachment_21067\" aria-describedby=\"caption-attachment-21067\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-21067 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-922843276-612x612-1-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-922843276-612x612-1-300x200.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-922843276-612x612-1.jpg 612w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-21067\" class=\"wp-caption-text\">\u0110i\u1ec1u tr\u1ecb th\u1edf oxy l\u00e0 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p cho b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh ph\u1ed5i k\u1ebd<\/figcaption><\/figure>\n<h4>1.1.2. Cho suy h\u00f4 h\u1ea5p m\u1ea1n:<\/h4>\n<p>+ Ch\u1ec9 \u0111\u1ecbnh: trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p gi\u1ea3m oxy m\u00e1u khi ngh\u1ec9 ho\u1eb7c khi g\u1eafng s\u1ee9c. Ng\u01b0\u1ee1ng \u0111\u1ec3 xem x\u00e9t b\u1eaft \u0111\u1ea7u oxy d\u00e0i h\u1ea1n l\u00e0 SpO<sub>2<\/sub>\u00a0&lt; 88% (ho\u1eb7c PaO<sub>2<\/sub> &lt; 55mmHg) l\u00fac ngh\u1ec9. Oxy l\u01b0u \u0111\u1ed9ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 gi\u1ea3m oxy m\u00e1u khi g\u1eafng s\u1ee9c (SpO<sub>2\u00a0<\/sub>&lt; 88%) k\u00e8m v\u1edbi \u0111i\u1ec1u ki\u1ec7n SpO<sub>2<\/sub> t\u0103ng khi ng\u01b0\u1eddi b\u1ec7nh th\u1edf oxy l\u01b0u \u0111\u1ed9ng v\u00e0 ng\u01b0\u1eddi b\u1ec7nh gi\u1ea3m kh\u00f3 th\u1edf ho\u1eb7c t\u0103ng kh\u1ea3 n\u0103ng v\u1eadn \u0111\u1ed9ng (kho\u1ea3ng c\u00e1ch \u0111i b\u1ed9 6 ph\u00fat t\u0103ng \u2265 20-25% so v\u1edbi th\u1edf kh\u00ed tr\u1eddi). Oxy l\u01b0u \u0111\u1ed9ng cho ng\u01b0\u1eddi b\u1ec7nh ILD c\u00f3 gi\u1ea3m oxy m\u00e1u khi g\u1eafng s\u1ee9c s\u1ebd gi\u00fap gi\u1ea3m m\u1ee9c \u0111\u1ed9 kh\u00f3 th\u1edf, c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng v\u1eadn \u0111\u1ed9ng v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng cho ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n<p>+ \u0110i\u1ec1u ch\u1ec9nh l\u01b0u l\u01b0\u1ee3ng oxy: \u0111i\u1ec1u ch\u1ec9nh v\u1edbi bi\u1ec7n ph\u00e1p h\u1ed7 tr\u1ee3 oxy qua g\u1ecdng m\u0169i \u0111\u1ec3 \u0111\u1ea1t SpO<sub>2<\/sub> m\u1ee5c ti\u00eau t\u1eeb 88-92%. H\u01b0\u1edbng d\u1eabn ng\u01b0\u1eddi b\u1ec7nh c\u00e1ch \u0111i\u1ec1u ch\u1ec9nh l\u01b0u l\u01b0\u1ee3ng oxy \u0111\u1ec3 \u0111\u1ea1t SpO<sub>2<\/sub>\u00a0m\u1ee5c ti\u00eau nh\u1eb1m tr\u00e1nh gia t\u0103ng nhanh h\u01a1n n\u1eefa t\u00ecnh tr\u1ea1ng x\u01a1 ph\u1ed5i do d\u00f9ng oxy li\u1ec1u cao k\u00e9o d\u00e0i.<\/p>\n<h3>1.2. \u0110i\u1ec1u tr\u1ecb th\u1edf m\u00e1y<\/h3>\n<h4>1.2.1. Th\u1edf m\u00e1y kh\u00f4ng x\u00e2m nh\u1eadp:<\/h4>\n<p>+ Ch\u1ec9 \u0111\u1ecbnh: n\u00ean ch\u1ec9 \u0111\u1ecbnh s\u1edbm \u1edf m\u1ed9t s\u1ed1ng\u01b0\u1eddi b\u1ec7nh c\u00f3 SpO<sub>2<\/sub>\u00a0&lt; 90% ho\u1eb7c PaO<sub>2<\/sub> &lt; 60 mmHg d\u00f9 \u0111\u00e3 th\u1edf oxy qua g\u1ecdng m\u0169i ho\u1eb7c qua m\u1eb7t n\u1ea1, nh\u1ea5t l\u00e0 v\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u0111\u1ee3t b\u1ec7nh c\u1ea5p t\u00ednh do y\u1ebfu t\u1ed1 c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c v\u00ed d\u1ee5 nh\u01b0 b\u1ed9i nhi\u1ec5m . Th\u1edf m\u00e1y kh\u00f4ng x\u00e2m nh\u1eadp ban \u0111\u00eam \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho ng\u01b0\u1eddi b\u1ec7nh ILD c\u00f3 suy h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh t\u0103ng CO<sub>2<\/sub>\u00a0v\u00ec n\u00f3 gi\u00fap gi\u1ea3m PaCO<sub>2<\/sub>\u00a0v\u00e0 t\u0103ng PaO<sub>2<\/sub> ban ng\u00e0y.<\/p>\n<p>+ Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh: r\u1ed1i lo\u1ea1n tri gi\u00e1c ho\u1eb7c k\u00edch th\u00edch, r\u1ed1i lo\u1ea1n huy\u1ebft \u0111\u1ed9ng, ng\u01b0ng tim, PaO<sub>2<\/sub>\/FiO<sub>2<\/sub>\u00a0&lt; 100, tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i, thuy\u00ean t\u1eafc \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, ch\u1ea5n th\u01b0\u01a1ng v\u00f9ng m\u1eb7t.<\/p>\n<p>+ C\u00e0i \u0111\u1eb7t m\u00e1y th\u1edf: D\u00f9ng ki\u1ec3u th\u1edf BiPAP; \u0111i\u1ec1u ch\u1ec9nh EPAP, IPAP v\u00e0 FiO<sub>2<\/sub>\u00a0\u0111\u1ec3 PaO<sub>2<\/sub>\u00a0\u2265 60 mmHg. \u00c1p l\u1ef1c h\u1ed7 tr\u1ee3 n\u00ean \u2264 25 cmH<sub>2<\/sub>O \u0111\u1ec3 tr\u00e1nh ch\u1ea5n th\u01b0\u01a1ng ph\u1ed5i do m\u00e1y th\u1edf; EPAP n\u00ean \u2264 6-8 cmH<sub>2<\/sub>O \u0111\u1ec3 tr\u00e1nh tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i.<\/p>\n<h4>1.2.2. Th\u1edf m\u00e1y x\u00e2m nh\u1eadp:<\/h4>\n<p>+ Ch\u1ec9 \u0111\u1ecbnh: khi PaO<sub>2<\/sub>\u00a0v\u1eabn ch\u01b0a \u0111\u1ea1t \u2265 60 mmHg d\u00f9 \u0111\u00e3 th\u1edf oxy qua m\u1eb7t n\u1ea1 v\u1edbi FiO<sub>2<\/sub>\u00a0dao \u0111\u1ed9ng t\u1eeb 40-80% ho\u1eb7c \u0111\u00e3 th\u1edf m\u00e1y kh\u00f4ng x\u00e2m l\u1ea5n ho\u1eb7c \u0111\u00e3 th\u1edf HFNC; khi PaCO<sub>2<\/sub> &gt; 45 mmHg khi\u1ebfn pH &lt; 7,25-7,30 ho\u1eb7c NB thay \u0111\u1ed5i tri gi\u00e1c<\/p>\n<p>+ Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh: do t\u1ec9 l\u1ec7 t\u1eed vong cao \u1edf ng\u01b0\u1eddi b\u1ec7nh ILD c\u1ea7n h\u1ed7 tr\u1ee3 th\u1edf m\u00e1y x\u00e2m nh\u1eadp n\u00ean vi\u1ec7c quy\u1ebft \u0111\u1ecbnh chong\u01b0\u1eddi b\u1ec7nh th\u1edf m\u00e1y c\u1ea7n th\u1ea3o lu\u1eadn v\u1edbi ng\u01b0\u1eddi nh\u00e0 v\u1ec1 ti\u00ean l\u01b0\u1ee3ng. Y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn t\u1ef7 l\u1ec7 t\u1eed vong cao khi th\u1edf m\u00e1y x\u00e2m l\u1ea5n l\u00e0 c\u00f3 t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i tr\u01b0\u1edbc \u0111\u00f3, c\u00f3 t\u1ed5n th\u01b0\u01a1ng x\u01a1 lan r\u1ed9ng ho\u1eb7c c\u00f3 t\u1ed5n th\u01b0\u01a1ng UIP tr\u00ean HRCT.<\/p>\n<h2>2. Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh ph\u1ed5i k\u1ebd<\/h2>\n<p>&#8211; C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p (PHCNHH) c\u00f3 hi\u1ec7u qu\u1ea3 c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng g\u1eafng s\u1ee9c v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng tr\u00ean to\u00e0n b\u1ed9 c\u00e1c ng\u01b0\u1eddi b\u1ec7nhb\u1ec7nh ph\u1ed5i k\u1ebd v\u00e0 c\u00f3 th\u1ec3 ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c ng\u01b0\u1eddi b\u1ec7nh c\u00f3 tri\u1ec7u ch\u1ee9ng khi g\u1eafng s\u1ee9c, b\u1ea5t k\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh ph\u1ed5i k\u1ebd lo\u1ea1i n\u00e0o.<\/p>\n<p>&#8211; Vi\u1ec7c ch\u1ec9 \u0111\u1ecbnh PHCNHH s\u1edbm c\u00f3 th\u1ec3 mang l\u1ea1i nhi\u1ec1u l\u1ee3i \u00edch h\u01a1n cho ng\u01b0\u1eddi b\u1ec7nh. Vi\u1ec7n Qu\u1ed1c gia v\u1ec1 n\u00e2ng cao s\u1ee9c kho\u1ebb v\u00e0 ch\u0103m s\u00f3c Anh (NICE) khuy\u1ebfn c\u00e1o \u0111\u00e1nh gi\u00e1 c\u00e1c ng\u01b0\u1eddi b\u1ec7nh x\u01a1 ph\u1ed5i v\u00f4 c\u0103n cho ch\u01b0\u01a1ng tr\u00ecnh PHCNHH \u1edf th\u1eddi \u0111i\u1ec3m ch\u1ea9n \u0111o\u00e1n b\u1ec7nh v\u00e0 l\u1eb7p l\u1ea1i m\u1ed7i 6-12 th\u00e1ng .<\/p>\n<p>&#8211; Ch\u01b0a c\u00f3 khuy\u1ebfn c\u00e1o \u0111\u1ed3ng thu\u1eadn v\u1ec1 kho\u1ea3ng th\u1eddi gian th\u1ef1c hi\u1ec7n PHCNHH l\u00fd t\u01b0\u1edfng cho ng\u01b0\u1eddi b\u1ec7nh ph\u1ed5i k\u1ebd. H\u01b0\u1edbng d\u1eabn c\u1ee7a Anh v\u1ec1 PHCNHH khuy\u1ebfn ngh\u1ecb ch\u01b0\u01a1ng tr\u00ecnh k\u00e9o d\u00e0i 6-12 tu\u1ea7n, nh\u01b0ng kh\u00f4ng c\u00f3 khuy\u1ebfn ngh\u1ecb c\u1ee5 th\u1ec3 cho b\u1ec7nh ph\u1ed5i k\u1ebd. M\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh PHCNHH d\u00e0i h\u01a1n c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 duy tr\u00ec c\u00e1c l\u1ee3i \u00edch .<\/p>\n<p>&#8211; C\u00e1c th\u00e0nh ph\u1ea7n c\u1ee7a m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p: theo ATS\/ERS: PHCNHH l\u00e0 s\u1ef1 can thi\u1ec7p to\u00e0n di\u1ec7n c\u1ee7a c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u1edbi ng\u01b0\u1eddi b\u1ec7nh, bao g\u1ed3m nh\u01b0ng kh\u00f4ng ch\u1ec9 gi\u1edbi h\u1ea1n \u1edf luy\u1ec7n t\u1eadp th\u1ec3 ch\u1ea5t (exercise training), gi\u00e1o d\u1ee5c s\u1ee9c kho\u1ebb v\u00e0 thay \u0111\u1ed5i h\u00e0nh vi. Trong \u0111\u00f3, luy\u1ec7n t\u1eadp th\u1ec3 ch\u1ea5t l\u00e0 m\u1ed9t th\u00e0nh ph\u1ea7n thi\u1ebft y\u1ebfu c\u1ee7a PHCNHH, bao g\u1ed3m luy\u1ec7n t\u1eadp t\u0103ng c\u01b0\u1eddng s\u1ee9c m\u1ea1nh v\u00e0 s\u1ee9c b\u1ec1n (resistance and endurance training); c\u00e1c th\u00e0nh ph\u1ea7n ngo\u00e0i t\u1eadp luy\u1ec7n trong PHCNHH c\u00f3 th\u1ec3 bao g\u1ed3m gi\u00e1o d\u1ee5c s\u1ee9c kho\u1ebb, h\u1ed7 tr\u1ee3 t\u00e2m l\u00fd v\u00e0 li\u1ec7u ph\u00e1p dinh d\u01b0\u1ee1ng, c\u00f9ng v\u1edbi nh\u1eefng b\u00e0i t\u1eadp h\u00e0nh vi s\u1ebd gi\u00fap qu\u1ea3n l\u00fd b\u1ec7nh ph\u1ed5i k\u1ebd t\u1ed1i \u01b0u. Vi\u1ec7c \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 c\u0169ng l\u00e0 m\u1ed9t th\u00e0nh ph\u1ea7n thi\u1ebft y\u1ebfu c\u1ee7a ch\u01b0\u01a1ng tr\u00ecnh PHCNHH \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh hi\u1ec7u qu\u1ea3 c\u1ee7a ch\u01b0\u01a1ng tr\u00ecnh.<\/p>\n<p>Vi\u1ec7c ng\u0103n ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh ph\u1ed5i k\u1ebd l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u00e1c \u0111\u1ed9ng c\u1ee7a b\u1ec7nh tr\u00ean s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a h\u1ecd. Ngo\u00e0i ra, vi\u1ec7c gi\u1ea3m thi\u1ec3u ti\u1ebfp x\u00fac v\u1edbi c\u00e1c ch\u1ea5t \u0111\u1ed9c h\u1ea1i v\u00e0 d\u1eebng h\u00fat thu\u1ed1c l\u00e1 c\u0169ng l\u00e0 c\u00e1ch hi\u1ec7u qu\u1ea3 nh\u1ea5t \u0111\u1ec3 ng\u0103n ng\u1eeba s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a b\u1ec7nh ph\u1ed5i k\u1ebd.<\/p>\n<p>Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n<p><iframe loading=\"lazy\" title=\"Ph\u1ed5i c\u00f3 nhi\u1ec7m v\u1ee5 g\u00ec?\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/7TI32KxCWSk?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>B\u1ec7nh ph\u1ed5i k\u1ebd (interstitial lung disease &#8211; ILD) l\u00e0 m\u1ed9t b\u1ec7nh ph\u1ed5i m\u00e3n t\u00ednh r\u1ea5t ph\u1ed5 bi\u1ebfn, c\u00f3 ti\u1ec1m \u1ea9n nguy c\u01a1 g\u00e2y ra t\u1eed vong v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh ph\u1ed5i k\u1ebd nh\u1eb1m gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 ng\u0103n ch\u1eb7n s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh. [&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>B\u1ec7nh ph\u1ed5i k\u1ebd: Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00f4ng d\u00f9ng thu\u1ed1c - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh ph\u1ed5i k\u1ebd (ILD) l\u00e0 m\u1ed9t b\u1ec7nh ph\u1ed5i m\u00e3n t\u00ednh r\u1ea5t ph\u1ed5 bi\u1ebfn, c\u00f3 ti\u1ec1m \u1ea9n nguy c\u01a1 g\u00e2y ra t\u1eed vong. 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