{"id":20407,"date":"2023-04-14T17:54:13","date_gmt":"2023-04-14T10:54:13","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20407"},"modified":"2023-04-17T16:16:47","modified_gmt":"2023-04-17T09:16:47","slug":"ung-thu-dang-nang-cua-tuy-chan-doan-va-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/ung-thu-dang-nang-cua-tuy-chan-doan-va-dieu-tri\/","title":{"rendered":"Ung th\u01b0 d\u1ea1ng nang c\u1ee7a tu\u1ef5: ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

U nang tuy\u1ebfn t\u1ee5y<\/a> l\u00e0 b\u1ea5t th\u01b0\u1eddng, t\u00fai nang gi\u1ed1ng nh\u01b0 ch\u1ea5t l\u1ecfng tr\u00ean ho\u1eb7c b\u00ean trong tuy\u1ebfn t\u1ee5y. Ung th\u01b0 nang tu\u1ef5\u00a0 chi\u1ebfm kho\u1ea3ng 40-50% c\u00e1c lo\u1ea1i u nang tu\u1ef5<\/strong><\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng<\/h2>\n

1.1. Ung th\u01b0 nang nh\u1ea7y t\u1ee5y<\/span><\/h3>\n

– L\u00e0 d\u1ea1ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a ung th\u01b0 d\u1ea1ng nang c\u1ee7a t\u1ee5y.<\/span><\/p>\n

– Ung th\u01b0 nang nh\u1ea7y ch\u1ee9a t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 s\u1ea3n xu\u1ea5t mucin v\u00e0 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh m\u00f4 <\/span>h\u1ecdc b\u1eb1ng s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a nh\u1eefng t\u1ebf b\u00e0o gi\u00e0u mucin v\u00e0 ch\u1ea5t n\u1ec1n d\u1ea1ng bu\u1ed3ng tr\u1ee9ng.<\/span><\/p>\n

– Nhu\u1ed9m estrogen v\u00e0 progesterone d\u01b0\u01a1ng t\u00ednh h\u1ea7u h\u1ebft tr\u01b0\u1eddng h\u1ee3p. Th\u01b0\u1eddng g\u1eb7p \u1edf <\/span>n\u1eef tr\u1ebb, \u0111\u1ed9 tu\u1ed5i trung b\u00ecnh th\u01b0\u1eddng g\u1eb7p \u1edf ng\u0169 tu\u1ea7n, nam gi\u1edbi hi\u1ebfm g\u1eb7p.<\/span><\/p>\n

– Th\u01b0\u1eddng g\u1eb7p \u1edf th\u00e2n v\u00e0 \u0111u\u00f4i t\u1ee5y.<\/span><\/p>\n

– Th\u01b0\u01a1ng t\u1ed5n d\u1ea1ng nang n\u00e0y kh\u00f4ng th\u00f4ng v\u1edbi\u00a0 h\u1ec7 th\u1ed1ng \u1ed1ng tu\u1ef5 v\u00e0 gi\u1ea3i ph\u1eabu b\u1ec7nh ghi nh\u1eadn h\u00ecnh \u1ea3nh \u0111\u1eb7c tr\u01b0ng trong \u0111\u00f3 c\u00f3 m\u00f4 \u0111\u1ec7m c\u1ee7a bu\u1ed3ng tr\u1ee9ng.<\/p>\n

1.2. Ung th\u01b0 nang huy\u1ebft thanh<\/span><\/h3>\n

– So v\u1edbi ung th\u01b0 nang nh\u1ea7y, ung th\u01b0 nang huy\u1ebft thanh c\u00f3 h\u01b0\u1edbng ph\u00e1t tri\u1ec3n \u1edf \u0111\u1ea7u <\/span>t\u1ee5y v\u00e0 th\u01b0\u1eddng x\u1ea3y ra \u1edf d\u00e2n s\u1ed1 c\u00f3 tu\u1ed5i trung b\u00ecnh cao h\u01a1n. Th\u01b0\u1eddng l\u00e0 u l\u00e0nh t\u00ednh. Tri\u1ec7u ch\u1ee9ng li\u00ean quan k\u00edch th\u01b0\u1edbc kh\u1ed1i u (>4cm). B\u1ec7nh th\u01b0\u1eddng x\u1ea3y ra \u1edf ph\u1ee5 n\u1eef, th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u1edf \u0111\u1ea7u tu\u1ef5, v\u00e0 chi\u1ebfm 30% tr\u01b0\u1eddng h\u1ee3p u nang tu\u1ef5. U nang \u0111\u01b0\u1ee3c l\u00f3t b\u1edfi t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 kh\u1ed1i, nang c\u00f3 d\u1ecbch trong v\u00e0 n\u1ed3ng \u0111\u1ed9 CEA v\u00e0 amylase th\u1ea5p. Kh\u00f4ng n\u00ean ch\u1ec9 \u0111\u1ecbnh m\u1ed5 cho u nang tuy\u1ebfn thanh d\u1ecbch khi kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng.<\/span><\/p>\n

1.3. Ung th\u01b0 d\u1ea1ng nh\u00fa c\u1ee7a \u1ed1ng t\u1ee5y<\/span><\/h3>\n

– U nh\u00fa c\u1ee7a \u1ed1ng tu\u1ef5 chi\u1ebfm kho\u1ea3ng 25% kh\u1ed1i u d\u1ea1ng nang tu\u1ef5, c\u00f3 \u01b0u th\u1ebf nh\u1eb9 \u1edf nam gi\u1edbi.<\/p>\n

– B\u1ec7nh c\u00f3 th\u1ec3 c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 th\u00f4ng v\u1edbi h\u1ec7 th\u1ed1ng \u1ed1ng tu\u1ef5. \u0110\u1eb7c \u0111i\u1ec3m tr\u00ean ERCP l\u00e0 t\u1ed5n th\u01b0\u01a1ng lan to\u1ea3 c\u1ea3 tuy\u1ebfn tu\u1ef5, \u1ed1ng tu\u1ef5 gi\u00e3n v\u00e0 b\u00ean trong ch\u1ee9a d\u1ecbch nh\u1ea7y s\u1ec7t<\/p>\n

– D\u1ea1ng \u1ed1ng nh\u00e1nh: L\u00e0 d\u1ea1ng ung th\u01b0 ch\u1ec9 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nh\u1eefng \u1ed1ng nh\u00e1nh ngo\u1ea1i vi <\/span>t\u1ee5y c\u00f3 li\u00ean quan nh\u01b0ng kh\u00f4ng \u1ea3nh h\u01b0\u1edfng t\u1edbi \u1ed1ng t\u1ee5y ch\u00ednh, c\u00f3 th\u1ec3 khu tr\u00fa ho\u1eb7c \u0111a \u1ed5.<\/span><\/p>\n

– D\u1ea1ng \u1ed1ng ch\u00ednh: Ng\u01b0\u1ee3c l\u1ea1i v\u1edbi d\u1ea1ng \u1ed1ng nh\u00e1nh, d\u1ea1ng \u1ed1ng ch\u00ednh \u00e1m ch\u1ec9 s\u1ef1 d\u00e3n <\/span>nang b\u1ea5t th\u01b0\u1eddng c\u1ee7a \u1ed1ng t\u1ee5y ch\u00ednh v\u1edbi s\u1ef1 chuy\u1ec3n d\u1ea1ng tr\u1ee5 \u0111\u01a1n v\u00e0 d\u00e0y th\u00e0nh ti\u1ebft <\/span>nh\u1ea7y. Ung th\u01b0 d\u1ea1ng \u1ed1ng ch\u00ednh c\u00f3 th\u1ec3 khu tr\u00fa ho\u1eb7c lan t\u1ecfa. C\u00f3 30% – 50% \u0111\u00e3 ti\u1ebfn <\/span>tri\u1ec3n t\u1edbi ung th\u01b0 \u0103n lan \u1edf th\u1eddi \u0111i\u1ec3m nh\u1eadp vi\u1ec7n n\u00ean ph\u1eabu thu\u1eadt l\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ec1n t\u1ea3ng.<\/span><\/p>\n

– D\u1ea1ng h\u1ed7n h\u1ee3p: Bi\u1ec3u th\u1ecb d\u1ea1ng ung th\u01b0 \u1edf nh\u00e1nh ngo\u1ea1i bi\u00ean \u0103n lan t\u1edbi \u1ed1ng t\u1ee5y ch\u00ednh <\/span>\u1edf nhi\u1ec1u m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau, do \u0111\u00f3 g\u1ea7n gi\u1ed1ng v\u1edbi d\u1ea1ng \u1ed1ng ch\u00ednh, ph\u1eabu thu\u1eadt c\u1eaft u l\u00e0 <\/span>\u0111i\u1ec1u tr\u1ecb l\u1ef1a ch\u1ecdn.<\/span><\/p>\n

1.4. C\u00e1c u nang tu\u1ef5 hi\u1ebfm g\u1eb7p kh\u00e1c<\/h3>\n

C\u00e1c u nang tu\u1ef5 hi\u1ebfm g\u1eb7p kh\u00e1c (chi\u1ebfm 10%) bao g\u1ed3m: ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1ng nang, ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1ng t\u1ebf b\u00e0o t\u00fai, ung th\u01b0 ph\u00f4i d\u1ea1ng nang, u qu\u00e1i d\u1ea1ng nang v\u00e0 u m\u1ea1ch m\u00e1u. T\u1ea5t c\u1ea3 nh\u1eefng th\u01b0\u01a1ng t\u1ed5n ung th\u01b0 \u0111\u01b0\u1ee3c sinh thi\u1ebft tr\u01b0\u1edbc m\u1ed5 ho\u1eb7c nghi ng\u1edd ung th\u01b0 n\u00ean \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt tri\u1ec7t \u0111\u1ec3 n\u1ebfu c\u00f3 th\u1ec3.<\/p>\n

\"Ung<\/p>\n

2. CH\u1ea8N \u0110O\u00c1N<\/span><\/h2>\n

2.1. L\u00e2m s\u00e0ng<\/span><\/h3>\n

– Kho\u1ea3ng 50% b\u1ec7nh nh\u00e2n c\u00f3 \u0111au b\u1ee5ng m\u01a1 h\u1ed3, c\u00f3 20% b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed vi\u00eam <\/span>t\u1ee5y c\u1ea5p n\u00ean th\u01b0\u1eddng d\u1ec5 l\u1ea7m v\u1edbi nang gi\u1ea3 t\u1ee5y.<\/span><\/p>\n

– \u00cdt g\u1eb7p s\u1ee5t c\u00e2n, v\u00e0ng da t\u1eafc m\u1eadt.<\/span><\/p>\n

– Kh\u00e1m th\u1ea5y kh\u1ed1i u l\u1edbn, b\u1edd r\u00f5.<\/span><\/p>\n

2.2. C\u1eadn l\u00e2m s\u00e0ng<\/span><\/h3>\n

2.2.1. Ch\u1ee5p c\u1eaft l\u1edbp \u0111i\u1ec7n to\u00e1n (CT scan)<\/span><\/h4>\n

– Ung th\u01b0 nang nh\u1ea7y t\u1ee5y: nang \u0111\u01a1n \u0111\u1ed9c, c\u00f3 th\u1ec3 chia th\u00e0nh c\u00e1c ng\u0103n \u0111\u1ec1u bao quanh <\/span>b\u1edfi v\u00f2ng canxi h\u00f3a.<\/span><\/p>\n

– Ung th\u01b0 nang huy\u1ebft thanh: canxi h\u00f3a trung t\u00e2m v\u1edbi nh\u1eefng v\u00e1ch ng\u0103n ly t\u00e2m cho <\/span>h\u00ecnh \u1ea3nh ng\u00f4i sao g\u1eb7p t\u1eeb 10% \u0111\u1ebfn 20% b\u1ec7nh nh\u00e2n.<\/span><\/p>\n

2.2.2. Si\u00eau \u00e2m qua n\u1ed9i soi ti\u00eau h\u00f3a (EUS)<\/span><\/h4>\n

Si\u00eau \u00e2m qua n\u1ed9i soi ti\u00eau h\u00f3a<\/span> v\u00e0 ph\u00e2n t\u00edch d\u1ecbch nang \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong ch\u1ea9n \u0111o\u00e1n. \u0110\u1ed1i v\u1edbi <\/span>ung th\u01b0 nang nh\u1ea7y t\u1ee5y, FNA ch\u1ecdc h\u00fat ra d\u1ecbch nang gi\u00e0u mucin.<\/span><\/h4>\n

Si\u00eau \u00e2m qua n\u1ed9i soi ti\u00eau h\u00f3a <\/span>cho h\u00ecnh \u1ea3nh r\u00f5 <\/span>h\u01a1n CT scan.<\/span><\/h4>\n

2.2.3. Ch\u1ea5t ch\u1ec9 th\u1ecb ung th\u01b0<\/span><\/h4>\n

– CEA t\u0103ng cao(>192ng\/ml) v\u00e0 amylase th\u1ea5p, gi\u00fap ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c l\u00ean \u0111\u1ebfn <\/span>80%.<\/span><\/p>\n

3. \u0110I\u1ec0U TR\u1eca<\/span><\/h2>\n

3.1. Ung th\u01b0 nang nh\u1ea7y t\u1ee5y<\/span><\/h3>\n

– C\u1eaft t\u1ee5y l\u00e0 \u0111i\u1ec1u tr\u1ecb ti\u00eau chu\u1ea9n. T\u1ec9 l\u1ec7 s\u1ed1ng 5 n\u0103m v\u00e0o kho\u1ea3ng 50% \u0111\u1ebfn 60% sau khi <\/span>c\u1eaft t\u1ee5y.<\/span><\/p>\n

– C\u1eaft u: c\u1eaft th\u00e2n v\u00e0 \u0111u\u00f4i t\u1ee5y, c\u1eaft lu\u00f4n l\u00e1ch th\u00e0nh m\u1ed9t kh\u1ed1i, k\u1ebft h\u1ee3p v\u1edbi h\u00f3a tr\u1ecb v\u00e0 x\u1ea1 tr\u1ecb.<\/span><\/p>\n

– N\u1ebfu kh\u00f4ng c\u1eaft \u0111\u01b0\u1ee3c th\u00ec \u0111i\u1ec1u tr\u1ecb gi\u1ea3m \u0111au b\u1eb1ng ch\u00edch alcohol 50% v\u00e0o \u0111\u00e1m r\u1ed1i <\/span>th\u1ea7n kinh t\u1ea1ng.<\/span><\/p>\n

– M\u1ed9t nghi\u00ean c\u1ee9u g\u1ea7n d\u00e2y ghi nh\u1eadn ung th\u01b0 x\u00e2m l\u1ea5n tr\u00ean 17,5% c\u00e1c b\u1ec7nh ph\u1ea9m u nang nh\u1ea7y tu\u1ef5 \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt c\u00f3 li\u00ean quan k\u00edch th\u01b0\u1edbc kh\u1ed1i u (>4cm), l\u1edbn tu\u1ed5i >55, nghi\u00ean c\u1ee9u c\u0169ng ch\u1ec9 ra r\u1eb1ng nh\u1eefng u kh\u00f4ng x\u00e2m l\u1ea5n r\u1ea5t c\u00f3 th\u1ec3 l\u00e0 nh\u1eefng t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n ung th\u01b0. T\u1ec9 l\u1ec7 s\u1ed1ng 5 n\u0103m l\u00e0 100% \u1edf nh\u1eefng u nang kh\u00f4ng x\u00e2m l\u1ea5n v\u00e0 57% b\u1ec7nh nh\u00e2n u nang nh\u1ea7y \u00e1c t\u00ednh.<\/p>\n

– Do ph\u1eabu thu\u1eadt \u0111\u00e3 c\u1ea3i thi\u1ec7n r\u00f5 r\u00e0ng th\u1eddi gian s\u1ed1ng c\u00f2n cho b\u1ec7nh nh\u00e2n u nang nh\u1ea7y tr\u01b0\u1edbc khi ti\u1ebfn tri\u1ec3n th\u00e0nh ung th\u01b0 x\u00e2m l\u1ea5n v\u00e0 hi\u1ec3u r\u00f5 u tuy\u1ebfn nh\u1ea7y s\u1ebd chuy\u1ec3n th\u00e0nh ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn, n\u00ean t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n c\u00f3 u nang nh\u1ea7y x\u00e2m l\u1ea5n th\u00ec ph\u1eabu thu\u1eadt ch\u1ec9 c\u1ea7n c\u1eaft \u0111\u01a1n thu\u1ea7n, kh\u00f4ng c\u1ea7n ph\u1eabu thu\u1eadt tri\u1ec7t c\u0103n.<\/p>\n

3.2. Ung th\u01b0 nang huy\u1ebft thanh<\/span><\/h3>\n

Th\u01b0\u1eddng l\u00e0 u l\u00e0nh, ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt khi b\u1ec7nh nh\u00e2n c\u00f3 kh\u1ed1i u >4cm ho\u1eb7c ti\u1ebfn <\/span>tri\u1ec3n nhanh.<\/span><\/p>\n

3.3. Ung th\u01b0 d\u1ea1ng nh\u00fa c\u1ee7a \u1ed1ng t\u1ee5y<\/span><\/h3>\n

– D\u1ea1ng \u1ed1ng ch\u00ednh c\u00f3 kh\u1ea3 n\u0103ng ung th\u01b0 l\u00ean \u0111\u1ebfn 50%, c\u1ea7n \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt. T\u1ed5n th\u01b0\u01a1ng \u1ed1ng tu\u1ef5 ch\u00ednh th\u01b0\u1eddng ch\u1ee9a nhi\u1ec1u nguy c\u01a1 ho\u00e1 \u00e1c v\u00ec v\u1eady c\u0169ng n\u00ean ph\u1eabu thu\u1eadt v\u1edbi th\u1ec3 h\u1ed7n h\u1ee3p. D\u1ea1ng \u1ed1ng nh\u00e1nh 70% kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n x\u00e2m l\u1ea5n.<\/p>\n

– Khi ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf c\u1ea7n tu\u00e2n theo \u0111\u00fang ti\u00eau chu\u1ea9n ung th\u01b0 h\u1ecdc (Ph\u1eabu thu\u1eadt Whipple ho\u1eb7c c\u1eaft th\u00e2n-\u0111u\u00f4i tu\u1ef5)<\/span><\/p>\n

– D\u1ea1ng \u1ed1ng nh\u00e1nh ch\u1ec9 c\u1eaft t\u1eadp trung \u1edf sang th\u01b0\u01a1ng n\u00ean ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt th\u01b0\u1eddng <\/span>kh\u00e1 r\u00f5 r\u00e0ng: c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, k\u00edch th\u01b0\u1edbc >3cm, nhi\u1ec1u n\u1ed1t nh\u1ecf tr\u00ean th\u00e0nh.<\/span><\/p>\n

– D\u1ea1ng \u1ed1ng ch\u00ednh kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c m\u1ee9c \u0111\u1ed9 \u0103n lan trong <\/span>\u1ed1ng t\u1ee5y, nhi\u1ec1u nh\u00e0 ph\u1eabu thu\u1eadt khuy\u1ebfn c\u00e1o c\u1eaft b\u00e1n ph\u1ea7n ph\u1ea3i v\u00ec u th\u01b0\u1eddng n\u1eb1m \u1edf \u0111\u1ea7u <\/span>t\u1ee5y, vi\u1ec7c c\u1eaft b\u00e1n ph\u1ea7n c\u0169ng gi\u00fap lo\u1ea1i tr\u1eeb b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng khi c\u1eaft t\u1ee5y to\u00e0n ph\u1ea7n.<\/span><\/p>\n

– T\u1ec9 l\u1ec7 s\u1ed1ng c\u00f2n c\u1ee7a ung th\u01b0 d\u1ea1ng nh\u00fa \u1ed1ng t\u1ee5y cao h\u01a1n r\u00f5 r\u1ec7t so v\u1edbi <\/span>adenocarcinoma \u1ed1ng t\u1ee5y.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

U nang tuy\u1ebfn t\u1ee5y l\u00e0 b\u1ea5t th\u01b0\u1eddng, t\u00fai nang gi\u1ed1ng nh\u01b0 ch\u1ea5t l\u1ecfng tr\u00ean ho\u1eb7c b\u00ean trong tuy\u1ebfn t\u1ee5y. Ung th\u01b0 nang tu\u1ef5\u00a0 chi\u1ebfm kho\u1ea3ng 40-50% c\u00e1c lo\u1ea1i u nang tu\u1ef5 1. \u0110\u1ea1i c\u01b0\u01a1ng 1.1. Ung th\u01b0 nang nh\u1ea7y t\u1ee5y – L\u00e0 d\u1ea1ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a ung th\u01b0 d\u1ea1ng nang c\u1ee7a t\u1ee5y. – Ung […]<\/p>\n","protected":false},"author":15,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[3],"yoast_head":"\nUng th\u01b0 d\u1ea1ng nang c\u1ee7a tu\u1ef5: ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"Ung th\u01b0 nang tu\u1ef5 chi\u1ebfm kho\u1ea3ng 40-50% c\u00e1c lo\u1ea1i u nang c\u1ee7a tu\u1ef5. \u0110i\u1ec1u tr\u1ecb ph\u1ee9c t\u1ea1p tu\u1ef3 theo m\u00f4 b\u1ec7nh h\u1ecdc v\u00e0 m\u1ee9c \u0111\u1ed9 x\u00e2m l\u1ea5n.\" \/>\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=\"Ung th\u01b0 d\u1ea1ng nang c\u1ee7a tu\u1ef5: ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - 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