{"id":20499,"date":"2023-04-22T09:16:26","date_gmt":"2023-04-22T02:16:26","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20499"},"modified":"2023-04-22T09:16:26","modified_gmt":"2023-04-22T02:16:26","slug":"viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/","title":{"rendered":"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng-b\u1ec7nh Crohn: \u0111i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o"},"content":{"rendered":"<p><strong>Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn l\u00e0 hai th\u1ec3 kinh \u0111i\u1ec3n c\u1ee7a b\u1ec7nh l\u00fd ru\u1ed9t vi\u00eam. \u0110\u00f3 l\u00e0 nh\u00f3m b\u1ec7nh l\u00fd vi\u00eam m\u1ea1n c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a c\u00f3 b\u1ec7nh nguy\u00ean ph\u1ee9c t\u1ea1p nh\u01b0 y\u1ebfu t\u1ed1 di truy\u1ec1n, thay \u0111\u1ed5i h\u1ec7 vi khu\u1ea9n ch\u00ed \u0111\u01b0\u1eddng ru\u1ed9t, y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng (nh\u01b0 h\u00fat thu\u1ed1c l\u00e1) v\u00e0 y\u1ebfu t\u1ed1 mi\u1ec5n d\u1ecbch. B\u1ec7nh Crohn \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 vi\u00eam xuy\u00ean th\u00e0nh, \u1ea3nh h\u01b0\u1edfng b\u1ea5t k\u1ef3 v\u1ecb tr\u00ed n\u00e0o c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a t\u1eeb mi\u1ec7ng t\u1edbi h\u1eadu m\u00f4n. Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng ch\u1ec9 l\u00e0 s\u1ef1 vi\u00eam c\u1ee7a ni\u00eam m\u1ea1c \u0111\u1ea1i tr\u00e0ng. \u0110\u00e3 c\u00f3 nhi\u1ec1u t\u1ed5 ch\u1ee9c khoa h\u1ecdc v\u1ec1 ti\u00eau h\u00f3a \u0111\u01b0a ra c\u00e1c khuy\u1ebfn c\u00e1o ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb nh\u00f3m b\u1ec7nh n\u00e0y. B\u00e0y vi\u1ebft n\u00e0y cung c\u1ea5p c\u00e1c \u0111i\u1ec3m m\u1edbi, ch\u00ednh y\u1ebfu t\u1eeb c\u00e1c khuy\u1ebfn c\u00e1o v\u1ec1 \u0111i\u1ec1u tr\u1ecb nh\u00f3m b\u1ec7nh l\u00fd ru\u1ed9t vi\u00eam (IBD).<\/strong><\/p>\n<h2>1. Ch\u1ebf \u0111\u1ed9 \u0103n cho ng\u01b0\u1eddi b\u1ec7nh vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn.<\/h2>\n<p>H\u1ed9i ti\u00eau h\u00f3a Anh (BSG) khuy\u1ebfn c\u00e1o r\u1eb1ng ng\u01b0\u1eddi b\u1ec7nh IBD c\u1ea7n ch\u1ebf \u0111\u1ed9 \u0103n ph\u1ea3i th\u00f5a m\u00e3n nhu c\u1ea7u dinh d\u01b0\u1ee1ng ri\u00eang bi\u1ec7t c\u1ee7a h\u1ecd; c\u1ea7n ph\u1ed1i h\u1ee3p v\u1edbi chuy\u00ean gia dinh d\u01b0\u1ee1ng trong \u0111i\u1ec1u tr\u1ecb. N\u1ebfu ch\u1ebf \u0111\u1ed9 \u0103n kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111\u1ee7, c\u1ea7n xem x\u00e9t nu\u00f4i \u0103n \u0111\u01b0\u1eddng mi\u1ec7ng ho\u1eb7c t\u0129nh m\u1ea1ch. Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n theo d\u00f5i hemoglobin, proteins, vitamins v\u00e0 \u0111i\u1ec7n gi\u1ea3i.<\/p>\n<p>Theo hi\u1ec7p h\u1ed9i ti\u00eau h\u00f3a th\u1ebf gi\u1edbi WGO,<\/p>\n<ul>\n<li>Ch\u1ebf \u0111\u1ed9 \u0103n gi\u1ea3m ch\u1ea5t x\u01a1 gi\u00fap gi\u1ea3m t\u1ea7n su\u1ea5t \u0111i c\u1ea7u.<\/li>\n<li>Ch\u1ebf \u0111\u1ed9 \u0103n gi\u00e0u ch\u1ea5t x\u01a1 c\u00f3 l\u1ee3i v\u1edbi vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng (UC) ch\u1ec9 t\u1ed5n th\u01b0\u01a1ng \u1edf tr\u1ef1c tr\u00e0ng v\u00e0 b\u00f3n &gt; ti\u00eau ch\u1ea3y.<\/li>\n<li>Gi\u1ea3m \u0111\u01b0\u1eddng trong th\u1ee9c \u0103n gi\u1ea3m tri\u1ec7u ch\u1ee9ng IBD (\u00edt ch\u1ee9ng c\u1ee9).<\/li>\n<li>Thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng v\u00e0 ch\u1ebf \u0111\u1ed9 \u0103n gi\u1ea3m vi\u00eam trong b\u1ec7nh Crohn (CD): ch\u1ebf \u0111\u1ed9 \u0103n l\u1ecfng, d\u1ea1ng c\u00f4ng th\u1ee9c ho\u1eb7c nh\u1ecbn \u0103n c\u00f3 th\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng t\u1eafc ngh\u1ebdn. Nu\u00f4i \u0103n \u0111\u01b0\u1eddng mi\u1ec7ng c\u00f3 th\u1ec3 l\u1ef1a ch\u1ecdn thay th\u1ebf corticosteroid th\u01b0\u1eddng quy, gi\u00fap lui b\u1ec7nh CD. B\u1ecf thu\u1ed1c l\u00e1 c\u00f3 l\u1ee3i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh Corhn. Gi\u1ea3m stress v\u00e0 qu\u1ea3n l\u00fd stress t\u1ed1t c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng CD.<\/li>\n<\/ul>\n<p>Theo h\u1ed9i ti\u00eau h\u00f3a Nh\u1eadt JSG, nu\u00f4i \u0103n \u0111\u01b0\u1eddng mi\u1ec7ng gi\u00fap lui b\u1ec7nh UC. Nu\u00f4i \u0103n t\u1ea1i nh\u00e0 gi\u00fap duy tr\u00ec lui b\u1ec7nh.<\/p>\n<p>H\u1ed9i ti\u00eau h\u00f3a Canada kh\u00f4ng khuy\u1ebfn c\u00e1o nu\u00f4i \u0103n \u0111\u01b0\u1eddng mi\u1ec7ng trong \u0111i\u1ec1u tr\u1ecb IBD, nh\u01b0ng m\u1ee9c ch\u1ee9ng c\u1ee9 th\u1ea5p.<\/p>\n<p>Hi\u1ec7p h\u1ed9i ti\u00eau h\u00f3a M\u1ef9 AGA khuy\u1ebfn c\u00e1o n\u00ean s\u1eed d\u1ee5ng ch\u1ebf \u0111\u1ed9 \u0103n kh\u00e1ng vi\u00eam cho ng\u01b0\u1eddi b\u1ec7nh IBD. \u0110\u00f3 l\u00e0 s\u1eed d\u1ee5ng probiotics, prebiotics, tr\u00e1nh lactose, b\u1ed9t m\u1ef3, c\u00e1c lo\u1ea1i \u0111\u01b0\u1eddng h\u00f3a h\u1ecdc, k\u1ebft h\u1ee3p nhi\u1ec1u lo\u1ea1i rau c\u1ee7 v\u00e0 ch\u1ea5t b\u00e9o l\u00e0nh m\u1ea1nh cho m\u1ed7i b\u1eefa \u0103n.<\/p>\n<h2>2. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn.<\/h2>\n<ul>\n<li>5-aminosalicylic acid (5-ASA) d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng l\u00e0 \u0111i\u1ec1u tr\u1ecb chu\u1ea9n cho nh\u00f3m b\u1ec7nh l\u00fd ru\u1ed9t vi\u00eam t\u1eeb th\u1ec3 nh\u1eb9 &#8211; v\u1eeba.<\/li>\n<li>BSG khuy\u1ebfn c\u00e1o li\u1ec1u 5-ASA 2 &#8211; 3\u2009g\/day \u0111\u1ed1i v\u1edbi IBD th\u1ec3 trung b\u00ecnh. N\u00ean k\u1ebft h\u1ee3p \u0111\u01b0\u1eddng u\u1ed1ng v\u1edbi b\u01a1m h\u1eadu m\u00f4n.<\/li>\n<li>WGO c\u0169ng khuy\u1ebfn c\u00e1o d\u00f9ng 5-ASA u\u1ed1ng v\u00e0 \u0111\u01b0\u1eddng t\u1ea1i ch\u1ed7 \u0111\u1ec3 \u0111\u1ea1t lui b\u1ec7nh v\u00e0 d\u00f9ng \u0111\u01b0\u1eddng t\u1ea1i ch\u1ed7 \u0111\u1ec3 duy tr\u00ec lui b\u1ec7nh.<\/li>\n<li>H\u1ed9i ti\u00eau h\u00f3a M\u1ef9 AGA ch\u1ec9 khuy\u1ebfn c\u00e1o d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng.<\/li>\n<li>H\u1ed9i ti\u00eau h\u00f3a Canada (CAG) khuy\u1ebfn c\u00e1o d\u00f9ng corticosteroid l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay ch\u1ee9 kh\u00f4ng ph\u1ea3i ASA.<\/li>\n<li>\u0110a s\u1ed1 c\u00e1c khuy\u1ebfn c\u00e1o \u0111\u1ec1u cho r\u1eb1ng l\u1ef1a ch\u1ecdn th\u1ee9 2 l\u00e0 corticosteroid n\u1ebfu th\u1ea5t b\u1ea1i v\u1edbi 5-ASA. Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u00a0budesonide v\u00e0 beclomethasone dipropionate \u0111\u01b0\u1eddng t\u1ea1i ch\u1ed7 \u0111\u1ec3 tr\u00e1nh t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n c\u1ee7a corticoid.<\/li>\n<li>B\u1ec7nh nh\u00e2n IBD trung b\u00ecnh &#8211; n\u1eb7ng c\u1ea7n u\u1ed1ng corticosteroid \u00edt nh\u1ea5t 6 &#8211; 8 tu\u1ea7n.<\/li>\n<\/ul>\n<h2>3. L\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb khi th\u1ea5t b\u1ea1i v\u1edbi 5-ASA.<\/h2>\n<p>\u0110\u00f3 l\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n c\u1ea7n duy tr\u00ec li\u1ec1u cao mesalazine ho\u1eb7c c\u1ea7n t\u1eeb \u00edt \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb corticoid\/n\u0103m v\u1eeba qua ho\u1eb7c l\u1ec7 thu\u1ed9c, kh\u00e1ng tr\u1ecb v\u1edbi corticoid. Khi \u0111\u00f3 c\u1ea7n th\u00eam 1 trong c\u00e1c thu\u1ed1c: thiopurine, anti-TNF, vedolizumab, ho\u1eb7c tofacitinib. L\u1ef1a ch\u1ecdn t\u00f9y thu\u1ed9c t\u00ednh s\u1eb5n c\u00f3, y\u1ebfu t\u1ed1 l\u00e2m s\u00e0ng, ch\u1ecdn l\u1ef1a c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, gi\u00e1 th\u00e0nh, tu\u00e2n th\u1ee7.<\/p>\n<h2>4. Ph\u1eabu thu\u1eadt.<\/h2>\n<p>Ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa ho\u1eb7c kh\u00f4ng dung n\u1ea1p t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c ho\u1eb7c c\u00f3 bi\u1ebfn ch\u1ee9ng \u0111e d\u1ecda t\u00ednh m\u1ea1ng.<\/p>\n<p>Ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn thay th\u1ebf cho \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa trong giai \u0111o\u1ea1n s\u1edbm c\u1ee7a b\u1ec7nh Crohn, v\u1edbi t\u1ed5n th\u01b0\u01a1ng khu tr\u00fa \u1edf m\u1ed9t \u0111o\u1ea1n ru\u1ed9t ng\u1eafn, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ea7u xa h\u1ed3i tr\u00e0ng.<\/p>\n<p>C\u00e1c khuy\u1ebfn c\u00e1o \u0111\u1ec1u \u0111\u1ed3ng thu\u1eadn cao r\u1eb1ng ng\u01b0\u1eddi b\u1ec7nh IBD c\u1ea7n ph\u1eabu thu\u1eadt trong m\u1ed9t giai \u0111o\u1ea1n n\u00e0o \u0111\u00f3 khi \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa th\u1ea5t b\u1ea1i, nh\u1eb1m ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng ho\u1eb7c ph\u1eabu thu\u1eadt \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng.<\/p>\n<p>Ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n: c\u1eaft \u0111\u1ea1i tr\u1ef1c tr\u00e0ng (k\u00e8m m\u1edf h\u1ed3i tr\u00e0ng ra da v\u0129nh vi\u1ec5n), n\u1ed1i h\u1ed3i tr\u00e0ng &#8211; h\u1eadu m\u00f4n, c\u1eaft \u0111o\u1ea1n ru\u1ed9t t\u1ed5n th\u01b0\u01a1ng (v\u1edbi ng\u01b0\u1eddi cao tu\u1ed5i).<\/p>\n<h2>5. \u0110i\u1ec1u tr\u1ecb thay th\u1ebf.<\/h2>\n<p>WGO v\u00e0 BSG \u0111\u1ec1 c\u1eadp m\u1ed9t s\u1ed1 bi\u1ec7n ph\u00e1p thay th\u1ebf nh\u01b0 s\u1eed d\u1ee5ng c\u1ea7n sa (marijuana), gh\u00e9p ph\u00e2n, d\u00f9ng probiotics v\u00e0 prebiotics.<\/p>\n<h2>6. M\u1ed9t s\u1ed1 l\u01b0u \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn theo c\u00e1c khuy\u1ebfn c\u00e1o.<\/h2>\n<h3>6.1. L\u01b0u \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 \u0111\u1ea1t lui b\u1ec7nh UC theo H\u1ed9i ti\u00eau h\u00f3a Nh\u1eadt B\u1ea3n.<\/h3>\n<ul>\n<li>\u0110\u1ed1i v\u1edbi UC \u0111\u1ea1i tr\u00e0ng tr\u00e1i (kh\u00f4ng v\u01b0\u1ee3t qu\u00e1 \u0111\u1ea1i tr\u00e0ng sigma) \u0111i\u1ec1u tr\u1ecb b\u1eb1ng 5-ASA \u0111\u01b0\u1eddng u\u1ed1ng v\u00e0 b\u01a1m h\u1eadu m\u00f4n (d\u00f9ng \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c k\u1ebft h\u1ee3p).<\/li>\n<li>N\u1ebfu kh\u00f4ng \u0111\u00e1p \u1ee9ng, b\u01a1m h\u1eadu m\u00f4n steroid (kem budesonide).<\/li>\n<\/ul>\n<p>+ N\u1ebfu \u0111\u00e1p \u1ee9ng v\u00e0 lui b\u1ec7nh, \u0111i\u1ec1u tr\u1ecb duy tr\u00ec.<\/p>\n<p>+ N\u1ebfu kh\u00f4ng \u0111\u00e1p \u1ee9ng, prednisolone u\u1ed1ng 30 &#8211; 40mg\/ng\u00e0y cho \u0111\u1ebfn khi \u0111\u00e1p \u1ee9ng v\u00e0 lui b\u1ec7nh.<\/p>\n<p>+ N\u1ebfu ti\u1ebfp t\u1ee5c kh\u00f4ng \u0111\u00e1p \u1ee9ng, thu\u1ed9c 1 trong 2 t\u00ecnh hu\u1ed1ng: (1) th\u1ec3 ph\u1ee5 thu\u1ed9c steroid: th\u00eam azathioprine, 6-mercaptopurine; (2) th\u1ec3 kh\u00e1ng tr\u1ecb corticoid: l\u1ecdc t\u1ebf b\u00e0o m\u00e1u, tacrolimus, kh\u00e1ng TNF alpha (infliximab, adalimumab, golimumab), Tofacitinib, Vedolizumab.<\/p>\n<ul>\n<li>\u0110\u1ed1i v\u1edbi vi\u00eam tr\u1ef1c tr\u00e0ng, s\u1eed d\u1ee5ng \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c k\u1ebft h\u1ee3p 5-ASA u\u1ed1ng v\u00e0 5-ASA, steroid \u0111\u1eb7t h\u1eadu m\u00f4n. Kh\u00f4ng \u0111\u00e1p \u1ee9ng s\u1ebd b\u01a1m steroid.<\/li>\n<\/ul>\n<p>\u0110\u1ed1i v\u1edbi vi\u00eam \u0111\u1ea1i tr\u00e0ng to\u00e0n b\u1ed9, vi\u00eam \u0111\u1ea1i tr\u00e0ng ph\u1ea3i, ho\u1eb7c \u0111\u1ea1i tr\u00e0ng tr\u00e1i v\u01b0\u1ee3t qu\u00e1 \u0111o\u1ea1n sigma. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh giai \u0111o\u1ea1n ho\u1ea1t \u0111\u1ed9ng nh\u1eb9 &#8211; v\u1eeba d\u00f9ng 5-ASA \u0111\u01b0\u1eddng u\u1ed1ng \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c k\u1ebft h\u1ee3p b\u01a1m h\u1eadu m\u00f4n 5-ASA. Tr\u01b0\u1eddng h\u1ee3p th\u1ea5t b\u1ea1i s\u1eed d\u1ee5ng steroid (kem budesonide) b\u01a1m h\u1eadu m\u00f4n. C\u00e1c b\u01b0\u1edbc ti\u1ebfp theo c\u1ee7a l\u01b0u \u0111\u1ed3 t\u01b0\u01a1ng t\u1ef1 v\u1edbi vi\u00eam \u0111\u1ea1i tr\u00e0ng tr\u00e1i.<\/p>\n<h3>6.2. L\u01b0u \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb UC m\u1ee9c \u0111\u1ed9 n\u1eb7ng giai \u0111o\u1ea1n ho\u1ea1t \u0111\u1ed9ng.<\/h3>\n<ul>\n<li>V\u1edbi UC n\u1eb7ng, h\u1ed3i s\u1ee9c n\u1ed9i khoa b\u1ec7nh \u1ed5n. N\u1ebfu c\u00f3 ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt nh\u01b0 th\u1ee7ng ru\u1ed9t, xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a n\u1eb7ng, ph\u00ecnh \u0111\u1ea1i tr\u00e0ng \u0111\u1ed9c t\u1ed1 th\u00ec ch\u1ec9 \u0111\u1ecbnh m\u1ed5 c\u1ea5p c\u1ee9u<\/li>\n<li>N\u1ebfu kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt c\u00e1p c\u1ee9u, d\u00f9ng prednisolone 40 &#8211; 80 truy\u1ec1n t\u0129nh m\u1ea1ch, sau \u0111\u00f3 gi\u1ea3m li\u1ec1u r\u1ed3i d\u1eebng. N\u1ebfu kh\u00f4ng \u0111\u00e1p \u1ee9ng: ph\u1eabu thu\u1eadt.<\/li>\n<\/ul>\n<h3>6.3. \u0110i\u1ec1u tr\u1ecb lui b\u1ec7nh CD.<\/h3>\n<ul>\n<li>Th\u1ec3 nh\u1eb9 &#8211; v\u1eeba: steroid u\u1ed1ng, nu\u00f4i \u0103n \u0111\u01b0\u1eddng mi\u1ec7ng, 5-ASA.<\/li>\n<li>Th\u1ec3 v\u1eeba &#8211; n\u1eb7ng: steroid u\u1ed1ng v\u00e0 nu\u00f4i \u0103n \u0111\u01b0\u1eddng mi\u1ec7ng, k\u1ebft h\u1ee3p l\u1ecdc b\u1ea1ch c\u1ea7u.<\/li>\n<li>N\u1eb7ng &#8211; nguy k\u1ecbch: nh\u1eadp vi\u1ec7n, nu\u00f4i \u0103n t\u0129nh m\u1ea1ch, steroid t\u0129nh m\u1ea1ch, h\u1ed9i ch\u1ea9n ph\u1eabu thu\u1eadt vi\u00ean.<\/li>\n<li>N\u1ebfu xu\u1ea5t hi\u1ec7n bi\u1ebfn ch\u1ee9ng nh\u01b0 xu\u1ea5t huy\u1ebft, th\u1ee7ng, abscess, t\u1eafc ru\u1ed9t, ung th\u01b0 h\u00f3a th\u00ec ph\u1eabu thu\u1eadt.<\/li>\n<li>N\u1ebfu \u0111\u1ea1t lui b\u00eanh, \u0111i\u1ec1u tr\u1ecb duy tr\u00ec.<\/li>\n<li>N\u1ebfu ph\u1ee5 thu\u1ed9c ho\u1eb7c kh\u00e1ng tr\u1ecb corticosteroid, x\u1eed tr\u00ed nh\u01b0 l\u01b0u \u0111\u1ed3 UC.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/p>\n<div class=\"highwire-cite-title\">British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults<\/div>\n<p>Okobi OE, Udoete IO, Fasehun OO, Okobi T, Evbayekha EO, Ekabua JJ, Elukeme H, Ebong IL, Ajayi OO, Olateju IV, Taiwo A, Anaya IC, Omole JA, Nkongho MB, Ojinnaka U, Ajibowo AO, Ogbeifun OE, Ugbo OO, Okorare O, Akinsola Z, Olusoji RA, Amanze IO, Nwafor JN, Ukoha NA, Elimihele TA. A Review of Four Practice Guidelines of Inflammatory Bowel Disease. Cureus. 2021 Aug 3;13(8):e16859.<\/p>\n<p>Nakase, H., Uchino, M., Shinzaki, S.\u00a0<i>et al.<\/i>\u00a0Evidence-based clinical practice guidelines for inflammatory bowel disease 2020.\u00a0<i>J Gastroenterol<\/i>\u00a0<b>56<\/b>, 489\u2013526 (2021).<\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/cac-trieu-chung-cua-viem-loet-dai-trang\/\">C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng<\/a><\/p>\n<div class=\"share\"><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn l\u00e0 hai th\u1ec3 kinh \u0111i\u1ec3n c\u1ee7a b\u1ec7nh l\u00fd ru\u1ed9t vi\u00eam. \u0110\u00f3 l\u00e0 nh\u00f3m b\u1ec7nh l\u00fd vi\u00eam m\u1ea1n c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a c\u00f3 b\u1ec7nh nguy\u00ean ph\u1ee9c t\u1ea1p nh\u01b0 y\u1ebfu t\u1ed1 di truy\u1ec1n, thay \u0111\u1ed5i h\u1ec7 vi khu\u1ea9n ch\u00ed \u0111\u01b0\u1eddng ru\u1ed9t, y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng (nh\u01b0 h\u00fat thu\u1ed1c l\u00e1) v\u00e0 [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng-b\u1ec7nh Crohn: \u0111i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn l\u00e0 hai th\u1ec3 kinh \u0111i\u1ec3n c\u1ee7a IBD. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ch\u00ednh l\u00e0 5-ASA v\u00e0 steroid k\u1ebft h\u1ee3p ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng.\" \/>\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=\"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng-b\u1ec7nh Crohn: \u0111i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn l\u00e0 hai th\u1ec3 kinh \u0111i\u1ec3n c\u1ee7a IBD. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ch\u00ednh l\u00e0 5-ASA v\u00e0 steroid k\u1ebft h\u1ee3p ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-22T02:16:26+00:00\" \/>\n<meta name=\"author\" content=\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/\",\"name\":\"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng-b\u1ec7nh Crohn: \u0111i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-22T02:16:26+00:00\",\"dateModified\":\"2023-04-22T02:16:26+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e\"},\"description\":\"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn l\u00e0 hai th\u1ec3 kinh \u0111i\u1ec3n c\u1ee7a IBD. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ch\u00ednh l\u00e0 5-ASA v\u00e0 steroid k\u1ebft h\u1ee3p ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng-b\u1ec7nh Crohn: \u0111i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e\",\"name\":\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g\",\"caption\":\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/meogods1234gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng-b\u1ec7nh Crohn: \u0111i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o - Vinmec","description":"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn l\u00e0 hai th\u1ec3 kinh \u0111i\u1ec3n c\u1ee7a IBD. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ch\u00ednh l\u00e0 5-ASA v\u00e0 steroid k\u1ebft h\u1ee3p ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng-b\u1ec7nh Crohn: \u0111i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o - Vinmec","og_description":"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn l\u00e0 hai th\u1ec3 kinh \u0111i\u1ec3n c\u1ee7a IBD. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ch\u00ednh l\u00e0 5-ASA v\u00e0 steroid k\u1ebft h\u1ee3p ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/","og_site_name":"Vinmec","article_published_time":"2023-04-22T02:16:26+00:00","author":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/","name":"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng-b\u1ec7nh Crohn: \u0111i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-22T02:16:26+00:00","dateModified":"2023-04-22T02:16:26+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e"},"description":"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn l\u00e0 hai th\u1ec3 kinh \u0111i\u1ec3n c\u1ee7a IBD. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ch\u00ednh l\u00e0 5-ASA v\u00e0 steroid k\u1ebft h\u1ee3p ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/viem-loet-dai-trang-benh-crohn-dieu-tri-theo-khuyen-cao\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng-b\u1ec7nh Crohn: \u0111i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e","name":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g","contentUrl":"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g","caption":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/meogods1234gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/20499"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/69"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=20499"}],"version-history":[{"count":3,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/20499\/revisions"}],"predecessor-version":[{"id":26213,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/20499\/revisions\/26213"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=20499"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=20499"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=20499"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}