{"id":20419,"date":"2023-04-14T20:18:51","date_gmt":"2023-04-14T13:18:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20419"},"modified":"2023-04-17T15:49:40","modified_gmt":"2023-04-17T08:49:40","slug":"viem-cot-song-dinh-khop-nguyen-nhan-va-chan-doan-theo-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/viem-cot-song-dinh-khop-nguyen-nhan-va-chan-doan-theo-bo-y-te\/","title":{"rendered":"Vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp: Nguy\u00ean nh\u00e2n v\u00e0 ch\u1ea9n \u0111o\u00e1n theo B\u1ed9 Y t\u1ebf"},"content":{"rendered":"

Vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp l\u00e0 m\u1ed9t b\u1ec7nh th\u1ea5p vi\u00eam \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u1ed5n th\u01b0\u01a1ng kh\u1edbp c\u00f9ng ch\u1eadu, c\u1ed9t s\u1ed1ng v\u00e0 c\u00e1c kh\u1edbp \u1edf chi d\u01b0\u1edbi, th\u01b0\u1eddng k\u00e8m theo vi\u00eam c\u00e1c \u0111i\u1ec3m b\u00e1m g\u00e2n. B\u1ec7nh ti\u1ebfn tri\u1ec3n ch\u1eadm song c\u00f3 xu h\u01b0\u1edbng d\u00ednh kh\u1edbp. B\u1ec7nh vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp c\u00f3 m\u1ed1i li\u00ean quan ch\u1eb7t ch\u1ebd v\u1edbi y\u1ebfu t\u1ed1 kh\u00e1ng nguy\u00ean ho\u00e0 h\u1ee3p m\u00f4 HLA-B27.<\/strong><\/p>\n

1. Nguy\u00ean nh\u00e2n<\/h2>\n

Nguy\u00ean nh\u00e2n c\u1ee7a b\u1ec7nh ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft r\u00f5 ho\u00e0n to\u00e0n. C\u00f3 hai \u0111\u1eb7c \u0111i\u1ec3m ch\u00ednh l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng vi\u00eam v\u00e0 x\u01a1 h\u00f3a, calci h\u00f3a<\/strong> c\u00e1c d\u00e2y ch\u1eb1ng, bao kh\u1edbp (\u0111\u1eb7c bi\u1ec7t t\u1ea1i v\u1ecb tr\u00ed c\u1ed9t s\u1ed1ng), c\u00e1c \u0111i\u1ec3m b\u00e1m g\u00e2n.<\/p>\n

Kh\u00e1ng nguy\u00ean ho\u00e0 h\u1ee3p m\u00f4 HLA-B27:<\/strong><\/em> g\u1eb7p trong 90<\/strong>% tr\u01b0\u1eddng h\u1ee3p, ngo\u00e0i ra c\u00f2n c\u00f3 th\u1ec3 c\u00f3 m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 gen kh\u00e1c v\u00e0 t\u00e1c nh\u00e2n nhi\u1ec5m khu\u1ea9n. Y\u1ebfu t\u1ed1 gia \u0111\u00ecnh chi\u1ebfm t\u1ef7 l\u1ec7 10%.<\/p>\n

Ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch:<\/strong> <\/em>S\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa y\u1ebfu t\u1ed1 gen v\u00e0 t\u00e1c nh\u00e2n nhi\u1ec5m khu\u1ea9n ban \u0111\u1ea7u \u1edf c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng n\u00e0y g\u00e2y ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch k\u00e9o d\u00e0i, c\u00f3 s\u1ef1 tham gia c\u1ee7a y\u1ebfu t\u1ed1 ho\u1ea1i t\u1eed u (TNF\u03b1).<\/p>\n

Ph\u1ea3n \u1ee9ng vi\u00eam:<\/strong><\/em> Ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch g\u00e2y ra m\u1ed9t chu\u1ed7i ph\u1ea3n \u1ee9ng vi\u00eam, c\u00f3 vai tr\u00f2 x\u00fac t\u00e1c c\u1ee7a c\u00e1c enzym nh\u01b0 cyclo-oxygenase (COX).<\/p>\n

T\u1ed5n th\u01b0\u01a1ng kh\u1edbp:<\/strong> <\/em>hi\u1ec7n t\u01b0\u1ee3ng x\u01a1 c\u00e1c m\u00f4 s\u1ee5n ho\u1eb7c m\u00f4 x\u01b0\u01a1ng g\u00e2y h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng, c\u00f3 k\u00e8m s\u1ef1 ph\u00e1 h\u1ee7y kh\u1edbp.<\/p>\n

2. Ch\u1ea9n \u0111o\u00e1n vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp<\/h2>\n

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

\u2212 Tri\u1ec7u ch\u1ee9ng s\u1edbm nh\u1ea5t, th\u01b0\u1eddng l\u00e0 \u0111au t\u1ea1i c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng<\/strong> ho\u1eb7c v\u00f9ng l\u01b0ng-th\u1eaft l\u01b0ng<\/strong>. \u0110au ki\u1ec3u vi\u00eam, k\u00e8m theo hi\u1ec7n t\u01b0\u1ee3ng c\u1ee9ng c\u1ed9t s\u1ed1ng.<\/p>\n

\u2212 Vi\u00eam kh\u1edbp c\u00f9ng ch\u1eadu bi\u1ec3u hi\u1ec7n b\u1edfi hi\u1ec7n t\u01b0\u1ee3ng \u0111au t\u1ea1i v\u00f9ng m\u00f4ng, m\u1ed9t ho\u1eb7c hai b\u00ean.<\/p>\n

\u2212 Vi\u00eam kh\u1edbp: th\u1ec3 \u0111i\u1ec3n h\u00ecnh, th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n vi\u00eam c\u00e1c kh\u1edbp g\u1ed1c chi \u0111\u1ed1i x\u1ee9ng hai b\u00ean (kh\u1edbp h\u00e1ng, kh\u1edbp g\u1ed1i chi\u1ebfm 20%). \u0110\u00f4i khi giai \u0111o\u1ea1n s\u1edbm ch\u1ec9 bi\u1ec3u hi\u1ec7n vi\u00eam m\u1ed9t kh\u1edbp, l\u00fac n\u00e0y c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi vi\u00eam kh\u1edbp nhi\u1ec5m khu\u1ea9n, \u0111\u1eb7c bi\u1ec7t l\u00e0 lao kh\u1edbp.<\/p>\n

\u2212 Vi\u00eam c\u00e1c \u0111i\u1ec3m b\u00e1m t\u1eadn c\u1ee7a g\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t t\u1ea1i g\u00e2n Achilles, c\u00e2n gan ch\u00e2n. \u2212 Vi\u00eam k\u1ebft m\u1ea1c m\u1eaft v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng ti\u00eau h\u00f3a g\u1eb7p kho\u1ea3ng 5-10% (ti\u00eau ch\u1ea3y, \u0111au b\u1ee5ng, xu\u1ea5t huy\u1ebft).<\/p>\n

\"Viem-cot-song-dinh-khop\"
Vie\u0302m co\u0323\u0302t so\u0302\u0301ng di\u0301nh kho\u031b\u0301p<\/figcaption><\/figure>\n

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

\u2212 X\u00e9t nghi\u1ec7m m\u00e1u: c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u vi\u00eam nh\u01b0 t\u0103ng t\u1ed1c \u0111\u1ed9 l\u1eafng m\u00e1u, t\u0103ng CRP<\/p>\n

\u2212 Kh\u00e1ng nguy\u00ean ho\u00e0 h\u1ee3p m\u00f4 HLA-B27 d\u01b0\u01a1ng t\u00ednh \u1edf 80-90% b\u1ec7nh nh\u00e2n vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp.<\/p>\n

\u2212 Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh:<\/p>\n

H\u00ecnh \u1ea3nh vi\u00eam kh\u1edbp c\u00f9ng ch\u1eadu:<\/em> <\/strong>tr\u00ean phim ch\u1ee5p Xquang th\u01b0\u1eddng quy:<\/p>\n

Giai \u0111o\u1ea1n 1: m\u1ea5t ch\u1ea5t kho\u00e1ng c\u1ee7a b\u1edd kh\u1edbp, khe kh\u1edbp c\u00f9ng ch\u1eadu r\u1ed9ng.<\/p>\n

Giai \u0111o\u1ea1n 2: h\u00ecnh \u1ea3nh b\u00e0o m\u00f2n, h\u00ecnh \u1ea3nh tem th\u01b0 \u1edf r\u00eca kh\u1edbp.<\/p>\n

Giai \u0111o\u1ea1n 3: \u0111\u1eb7c x\u01b0\u01a1ng \u1edf b\u1edd kh\u1edbp, d\u00ednh m\u1ed9t ph\u1ea7n kh\u1edbp c\u00f9ng- ch\u1eadu.<\/p>\n

Giai \u0111o\u1ea1n 4: d\u00ednh kh\u1edbp c\u00f9ng ch\u1eadu ho\u00e0n to\u00e0n.<\/p>\n

\u1ede giai \u0111o\u1ea1n s\u1edbm, khi Xquang th\u01b0\u1eddng quy ch\u01b0a ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c t\u1ed5n th\u01b0\u01a1ng, ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb khung ch\u1eadu gi\u00fap ch\u1ea9n \u0111o\u00e1n s\u1edbm vi\u00eam kh\u1edbp c\u00f9ng ch\u1eadu.<\/p>\n

\"khop-cung-chau\"
H\u00ecnh \u1ea3nh vi\u00eam kh\u1edbp c\u00f9ng ch\u1eadu
Ngu\u1ed3n: B\u1ec7nh vi\u1ec7n ST.BARTHOLOMEW’S, LONDON\/SCIENCE PHOTO LIBRARY<\/em><\/figcaption><\/figure>\n

H\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng:<\/strong> <\/em>\u1edf giai \u0111o\u1ea1n mu\u1ed9n, Xquang th\u01b0\u1eddng quy c\u00f3 th\u1ec3 th\u1ea5y h\u00ecnh \u1ea3nh<\/strong> x\u01a1 h\u00f3a c\u00e1c d\u00e2y ch\u1eb1ng<\/strong> b\u00ean ho\u1eb7c d\u00e2y ch\u1eb1ng tr\u01b0\u1edb<\/strong>c c\u1ed9t s\u1ed1ng, bi\u1ec3u hi\u1ec7n b\u1edfi c\u00e1c c\u1ea7u x\u01b0\u01a1ng, khi\u1ebfn c\u1ed9t s\u1ed1ng c\u00f3 h\u00ecnh c\u00e2y tre. C\u00f3 th\u1ec3 th\u1ea5y hi\u1ec7n t\u01b0\u1ee3ng x\u01a1 h\u00f3a c\u00e1c d\u00e2y ch\u1eb1ng li\u00ean gai<\/strong> (h\u00ecnh \u1ea3nh \u0111\u01b0\u1eddng ray xe l\u1eeda), c\u00f3 th\u1ec3 calci ho\u00e1 \u0111\u0129a \u0111\u1ec7m, t\u1ed5n th\u01b0\u01a1ng kh\u1edbp li\u00ean m\u1ea5u sau, t\u1ed5n th\u01b0\u01a1ng kh\u1edbp x\u01b0\u01a1ng s\u01b0\u1eddn \u0111\u1ed1t s\u1ed1ng. Ngo\u00e0i ra, c\u00f3 th\u1ec3 th\u1ea5y h\u00ecnh \u1ea3nh lo\u00e3ng x\u01b0\u01a1ng<\/strong>: h\u00ecnh \u1ea3nh t\u0103ng th\u1ea5u quang, \u0111\u1ed1t s\u1ed1ng cong l\u00f5m hai m\u1eb7t. \u0110\u00f4i khi (hi\u1ebfm g\u1eb7p) c\u00f3 h\u00ecnh \u1ea3nh g\u00e3y c\u1ea7u x\u01b0\u01a1ng \u0111\u1ed1t s\u1ed1ng ho\u1eb7c g\u00e3y cung sau. \u1ede giai \u0111o\u1ea1n s\u1edbm, t\u1ed5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n tr\u00ean c\u1ed9ng h\u01b0\u1edfng t\u1eeb.<\/p>\n

\"Vi\u00eam
Vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp (c\u1ed9t s\u1ed1ng h\u00ecnh c\u00e2y tre)<\/figcaption><\/figure>\n

Kh\u1edbp h\u00e1ng:<\/strong> <\/em>Th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n vi\u00eam c\u1ea3 hai b\u00ean. Bi\u1ec3u hi\u1ec7n vi\u00eam kh\u1edbp h\u00e1ng d\u1ec5 d\u00e0ng ph\u00e1t hi\u1ec7n tr\u00ean si\u00eau \u00e2m b\u1edfi hi\u1ec7n t\u01b0\u1ee3ng tr\u00e0n d\u1ecbch kh\u1edbp v\u00e0 \/ho\u1eb7c d\u00e0y m\u00e0ng ho\u1ea1t d\u1ecbch. T\u1ed5n th\u01b0\u1eddng tr\u00ean X quang th\u01b0\u1eddng quy bi\u1ec3u hi\u1ec7n b\u1edfi h\u00ecnh \u1ea3nh h\u1eb9p khe kh\u1edbp, \u0111\u00f4i khi c\u00f3 c\u00e1c h\u00ecnh b\u00e0o m\u00f2n \u0111\u1ed1i x\u1ee9ng qua khe kh\u1edbp (h\u00ecnh \u1ea3nh soi g\u01b0\u01a1ng), giai \u0111o\u1ea1n cu\u1ed1i th\u01b0\u1eddng c\u00f3 d\u00ednh kh\u1edbp.<\/p>\n

Vi\u00eam \u0111i\u1ec3m b\u00e1m g\u00e2n:<\/strong> <\/em>Vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t b\u1edfi bi\u1ec3u hi\u1ec7n ngo\u00e0i kh\u1edbp: vi\u00eam c\u00e1c \u0111\u1ea7u g\u00e2n t\u1ea1i v\u1ecb tr\u00ed b\u00e1m v\u00e0o x\u01b0\u01a1ng. V\u1ec1 l\u00e2m s\u00e0ng, b\u1ec7nh nh\u00e2n \u0111au t\u1ea1i c\u00e1c \u0111i\u1ec3m b\u00e1m t\u1eadn c\u1ee7a g\u00e2n, c\u00f3 \u0111i\u1ec3m \u0111au ch\u00f3i khi b\u1ea5m v\u00e0o c\u00e1c v\u1ecb tr\u00ed n\u00e0y. C\u00e1c tri\u1ec7u ch\u1ee9ng tr\u00ean si\u00eau \u00e2m: h\u00ecnh \u1ea3nh c\u00e1c g\u00e2n t\u0103ng \u00e2m, tr\u00e0n d\u1ecbch quanh g\u00e2n. H\u00ecnh \u1ea3nh X quang th\u01b0\u1eddng quy: \u0111\u00f4i khi th\u1ea5y hi\u1ec7n t\u01b0\u1ee3ng x\u01a1 c\u00e1c \u0111i\u1ec3m b\u00e1m t\u1eadn (gai x\u01b0\u01a1ng).<\/p>\n

2.3. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp<\/h3>\n

K\u1ebft h\u1ee3p tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, h\u00ecnh \u1ea3nh vi\u00eam kh\u1edbp c\u00f9ng ch\u1eadu tr\u00ean X quang th\u01b0\u1eddng quy (ho\u1eb7c tr\u00ean c\u1ed9ng h\u01b0\u1edfng t\u1eeb n\u1ebfu nghi ng\u1edd ch\u1ea9n \u0111o\u00e1n m\u00e0 bi\u1ec3u hi\u1ec7n tr\u00ean X quang th\u01b0\u1eddng quy ch\u01b0a r\u00f5 r\u00e0ng) v\u00e0 n\u1ebfu c\u00f3 th\u1ec3, n\u00ean x\u00e9t nghi\u1ec7m HLA-B27. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp d\u1ef1a v\u00e0o ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n New York s\u1eeda \u0111\u1ed5i n\u0103m 1984<\/strong> g\u1ed3m c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u00e0 X quang.<\/p>\n

Ti\u00eau chu\u1ea9n l\u00e2m s\u00e0ng (\u00edt nh\u1ea5t c\u00f3 m\u1ed9t y\u1ebfu t\u1ed1): <\/strong><\/em><\/p>\n

\u2212 \u0110au th\u1eaft l\u01b0ng 3 th\u00e1ng tr\u1edf l\u00ean, c\u1ea3i thi\u1ec7n khi luy\u1ec7n t\u1eadp, kh\u00f4ng gi\u1ea3m khi ngh\u1ec9.<\/p>\n

\u2212 H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng c\u1ea3 t\u01b0 th\u1ebf c\u00fai v\u00e0 nghi\u00eang.<\/p>\n

\u2212 Gi\u1ea3m \u0111\u1ed9 gi\u00e3n l\u1ed3ng ng\u1ef1c (d\u01b0\u1edbi ho\u1eb7c b\u1eb1ng 2,5 cm).<\/p>\n

Ti\u00eau chu\u1ea9n X quang:<\/strong><\/em><\/p>\n

    \n
  • Vi\u00eam kh\u1edbp c\u00f9ng ch\u1eadu giai \u0111o\u1ea1n \u2265 2, n\u1ebfu bi\u1ec3u hi\u1ec7n vi\u00eam c\u1ea3 hai b\u00ean.<\/li>\n
  • Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh khi c\u00f3 ti\u00eau chu\u1ea9n X quang v\u00e0 \u00edt nh\u1ea5t m\u1ed9t y\u1ebfu t\u1ed1 thu\u1ed9c ti\u00eau chu\u1ea9n l\u00e2m s\u00e0ng.<\/li>\n<\/ul>\n

    \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp \u1edf Vi\u1ec7t Nam th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n vi\u00eam c\u00e1c kh\u1edbp g\u1ed1c chi s\u1edbm (kh\u1edbp h\u00e1ng, kh\u1edbp g\u1ed1i) v\u00e0 r\u1ea7m r\u1ed9, trong khi bi\u1ec3u hi\u1ec7n t\u1ea1i c\u1ed9t s\u1ed1ng k\u00edn \u0111\u00e1o. Do v\u1eady, c\u1ea7n khai th\u00e1c k\u1ef9 c\u00e1c tri\u1ec7u ch\u1ee9ng t\u1ea1i c\u1ed9t s\u1ed1ng, khi c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd ch\u1ea9n \u0111o\u00e1n, c\u1ea7n ch\u1ee5p X quang kh\u1edbp c\u00f9ng ch\u1eadu v\u00e0 x\u00e9t nghi\u1ec7m HLAB27. Tr\u01b0\u1eddng h\u1ee3p ch\u01b0a c\u00f3 bi\u1ec3u hi\u1ec7n tr\u00ean phim X quang th\u01b0\u1eddng quy, c\u1ea7n ch\u1ec9 \u0111\u1ecbnh ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb khung ch\u1eadu ho\u1eb7c c\u1ed9t s\u1ed1ng, c\u00f3 vai tr\u00f2 r\u1ea5t quan tr\u1ecdng trong ch\u1ea9n \u0111o\u00e1n s\u1edbm.<\/p>\n

    2.4. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h3>\n

    \u2212 Vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp th\u1ec3 c\u1ed9t s\u1ed1ng:<\/strong><\/em> c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi b\u1ec7nh Forestier. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh n\u00e0y l\u00e0 c\u00f3 x\u01a1 h\u00f3a d\u00e2y ch\u1eb1ng quanh \u0111\u1ed1t s\u1ed1ng, c\u00f3 c\u1ea7u x\u01b0\u01a1ng song kh\u00f4ng c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng vi\u00eam. Ngo\u00e0i ra, c\u00e1c c\u1ea7u x\u01b0\u01a1ng trong b\u1ec7nh Forestier th\u01b0\u1eddng th\u00f4, kh\u00f4ng thanh m\u1ea3nh nh\u01b0 trong b\u1ec7nh vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp.<\/p>\n

    \"tang-tao-xuong-lan-toa-nguyen-phat\"
    T\u0103ng t\u1ea1o x\u01b0\u01a1ng lan t\u1ecfa nguy\u00ean ph\u00e1t<\/figcaption><\/figure>\n

    \u2212 Vi\u00eam c\u1ed9t s\u1ed1ng th\u1ec3 ph\u1ed1i h\u1ee3p:<\/strong><\/em> \u0111\u00f4i khi giai \u0111o\u1ea1n s\u1edbm tri\u1ec7u ch\u1ee9ng vi\u00eam t\u1ea1i kh\u1edbp ch\u1ec9 bi\u1ec3u hi\u1ec7n t\u1ea1i m\u1ed9t kh\u1edbp duy nh\u1ea5t. R\u1ea5t hay g\u1eb7p vi\u00eam t\u1ea1i kh\u1edbp h\u00e1ng m\u1ed9t b\u00ean. Tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi lao kh\u1edbp h\u00e1ng.<\/p>\n

    T\u00f3m l\u1ea1i, \u0111\u00e2y l\u00e0 b\u1ec7nh l\u00fd di\u1ec5n ti\u1ebfn ch\u1eadm song c\u00f3 xu h\u01b0\u1edbng d\u00ednh kh\u1edbp v\u00e0 g\u00e2y \u0111au, l\u00e0m suy gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng b\u1ec7nh nh\u00e2n, c\u1ea7n \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n s\u1edbm nh\u1eb1m \u0111\u01b0a ra h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n

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

    Vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp l\u00e0 m\u1ed9t b\u1ec7nh th\u1ea5p vi\u00eam \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u1ed5n th\u01b0\u01a1ng kh\u1edbp c\u00f9ng ch\u1eadu, c\u1ed9t s\u1ed1ng v\u00e0 c\u00e1c kh\u1edbp \u1edf chi d\u01b0\u1edbi, th\u01b0\u1eddng k\u00e8m theo vi\u00eam c\u00e1c \u0111i\u1ec3m b\u00e1m g\u00e2n. B\u1ec7nh ti\u1ebfn tri\u1ec3n ch\u1eadm song c\u00f3 xu h\u01b0\u1edbng d\u00ednh kh\u1edbp. B\u1ec7nh vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp c\u00f3 m\u1ed1i li\u00ean quan ch\u1eb7t […]<\/p>\n","protected":false},"author":10,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[29,33],"tags":[3],"yoast_head":"\nVi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp: Nguy\u00ean nh\u00e2n v\u00e0 ch\u1ea9n \u0111o\u00e1n theo B\u1ed9 Y t\u1ebf<\/title>\n<meta name=\"description\" content=\"Vi\u00eam c\u1ed9t s\u1ed1ng d\u00ednh kh\u1edbp l\u00e0 m\u1ed9t b\u1ec7nh th\u1ea5p vi\u00eam, ti\u1ebfn tri\u1ec3n ch\u1eadm song c\u00f3 xu h\u01b0\u1edbng d\u00ednh kh\u1edbp. 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