{"id":20944,"date":"2023-04-14T20:48:26","date_gmt":"2023-04-14T13:48:26","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20944"},"modified":"2023-04-17T15:45:06","modified_gmt":"2023-04-17T08:45:06","slug":"uc-che-men-chuyen-va-nhung-chi-dinh-trong-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/uc-che-men-chuyen-va-nhung-chi-dinh-trong-lam-sang\/","title":{"rendered":"\u1ee8c ch\u1ebf men chuy\u1ec3n v\u00e0 nh\u1eefng ch\u1ec9 \u0111\u1ecbnh trong l\u00e2m s\u00e0ng"},"content":{"rendered":"<p><strong>\u1ee8c ch\u1ebf men chuy\u1ec3n (UCMC) d\u1ea1ng angiotensin (Angiotensin-converting enzyme (ACE) inhibitors), t\u00e1c d\u1ee5ng tr\u1ef1c ti\u1ebfp l\u00ean h\u1ec7 RAA. L\u00e0 nh\u00f3m thu\u1ed1c h\u1ebft s\u1ee9c quan tr\u1ecdng m\u00e0 c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng c\u1ea7n n\u1eafm r\u00f5 trong th\u1ef1c h\u00e0nh \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tim m\u1ea1ch.<\/strong><\/p>\n<h2><strong>1.Suy tim<\/strong><\/h2>\n<p>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n trong suy tim:<\/p>\n<ul>\n<li>\u1ee8c ch\u1ebf t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a angiotensin v\u00e0\/ho\u1eb7c aldosterone tr\u00ean c\u00e1c c\u01a1 quan \u0111\u00edch nh\u01b0 tim, m\u1ea1ch m\u00e1u v\u00e0 th\u1eadn.<\/li>\n<li>\u0110i\u1ec1u ti\u1ebft h\u1ec7 th\u1ed1ng renin-angiotensin trong tim, m\u1ea1ch m\u00e1u v\u00e0 c\u00e1c c\u01a1 quan kh\u00e1c. Trong tim, h\u1ec7 th\u1ed1ng n\u00e0y c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n v\u00e0o vi\u1ec7c t\u00e1i c\u1ea5u tr\u00fac b\u1ec7nh l\u00fd d\u1eabn \u0111\u1ebfn nh\u1eefng \u1ea3nh h\u01b0\u1edfng x\u1ea5u \u0111\u1ebfn c\u1ea5u tr\u00fac v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a t\u00e2m th\u1ea5t.<\/li>\n<li>Gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c giao c\u1ea3m trung t\u00e2m v\u00e0 t\u0103ng c\u01b0\u1eddng \u0111\u00e1p \u1ee9ng giao c\u1ea3m v\u1edbi k\u00edch th\u00edch baroreceptor.<\/li>\n<li>C\u1ea3i thi\u1ec7n v\u00e0\/ho\u1eb7c b\u1ea3o t\u1ed5n tr\u01b0\u01a1ng l\u1ef1c \u0111\u1ed9ng m\u1ea1ch gi\u00fap gi\u1ea3m h\u1eadu g\u00e1nh th\u1ea5t tr\u00e1i, do \u0111\u00f3 g\u00f3p ph\u1ea7n c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng t\u00e2m thu v\u00e0\/ho\u1eb7c gi\u1ea3m ph\u00ec \u0111\u1ea1i v\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng.<\/li>\n<li>T\u0103ng n\u1ed3ng \u0111\u1ed9 kinin, quan tr\u1ecdng nh\u1ea5t l\u00e0 bradykinin, b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng kininase c\u1ee7a ACE.<\/li>\n<li>C\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng n\u1ed9i m\u00f4 d\u1eabn \u0111\u1ebfn c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng m\u1ea1ch m\u00e1u.<\/li>\n<li>T\u00e1c d\u1ee5ng tho\u00e1i gi\u1ea3m m\u1ea3ng x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch d\u1eabn \u0111\u1ebfn gi\u1ea3m nguy c\u01a1 nh\u1ed3i m\u00e1u c\u01a1 tim trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean. Thay \u0111\u1ed5i th\u00e0nh ph\u1ea7n protein c\u1ee7a c\u01a1 x\u01b0\u01a1ng, c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng t\u1eadp luy\u1ec7n. T\u00e1c d\u1ee5ng c\u00f3 l\u1ee3i \u0111\u1ed1i v\u1edbi \u0111\u1ed9 nh\u1ea1y insulin v\u00e0 ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft.<\/li>\n<\/ul>\n<h2><strong>2.T\u0103ng huy\u1ebft \u00e1p<\/strong><\/h2>\n<p>C\u01a1 ch\u1ebf ch\u00ednh c\u1ee7a thu\u1ed1c \u01afCMC trong h\u1ea1 huy\u1ebft \u00e1p l\u00e0 g\u00e2y gi\u00e3n m\u1ea1ch v\u00e0 t\u0103ng th\u1ea3i natri th\u00f4ng qua:<\/p>\n<ul>\n<li>\u1ee8c ch\u1ebf men chuy\u1ec3n h\u00f3a angiotensin I th\u00e0nh angiotensin II (ch\u1ea5t g\u00e2y gi\u1eef mu\u1ed1i v\u00e0 n\u01b0\u1edbc).<\/li>\n<li>Ng\u0103n c\u1ea3n gi\u00e1ng h\u00f3a bradykinin l\u00e0 ch\u1ea5t g\u00e2y gi\u00e3n m\u1ea1ch. N\u00f3i chung, thu\u1ed1c \u01afCMC c\u00f3 hi\u1ec7u qu\u1ea3 cao h\u01a1n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n da tr\u1eafng, k\u00e9m h\u01a1n \u1edf b\u1ec7nh nh\u00e2n da \u0111en v\u00e0 ng\u01b0\u1eddi l\u1edbn tu\u1ed5i.<\/li>\n<li>Thu\u1ed1c \u01afCMC th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u1ed1i h\u1ee3p v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u ho\u1eb7c ch\u1eb9n k\u00eanh canxi \u0111\u1ec3 cho hi\u1ec7u qu\u1ea3 h\u1ea1 huy\u1ebft \u00e1p t\u1ed1t h\u01a1n. V\u1edbi \u01b0u \u0111i\u1ec3m l\u00e0 kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn dung n\u1ea1p glucose v\u00e0 acid uric m\u00e1u ho\u1eb7c lipid m\u00e1u n\u00ean lo\u1ea1i thu\u1ed1c n\u00e0y ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u h\u01a1n trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.<\/li>\n<\/ul>\n<h2><strong>3. Sau nh\u1ed3i m\u00e1u c\u01a1 tim<\/strong><\/h2>\n<p>Thu\u1ed1c \u01afCMC l\u00e0m ch\u1eadm qu\u00e1 tr\u00ecnh t\u00e1i c\u1ea5u tr\u00fac th\u1ea5t tr\u00e1i v\u00e0 l\u00e0m gi\u1ea3m nguy c\u01a1 t\u00e1i nh\u1ed3i m\u00e1u c\u01a1 tim, do \u0111\u00f3 \u0111\u00e2y l\u00e0 thu\u1ed1c \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o h\u00e0ng \u0111\u1ea7u trong nh\u1ed3i m\u00e1u c\u01a1 tim c\u00f3 ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i gi\u1ea3m.<\/p>\n<p>N\u00ean b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng thu\u1ed1c \u01afCMC trong v\u00f2ng 24h \u0111\u1ea7u sau nh\u1ed3i m\u00e1u c\u01a1 tim, \u01b0u ti\u00ean h\u01a1n \u1edf \u0111\u1ed1i t\u01b0\u1ee3ng nguy c\u01a1 cao nh\u01b0: \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, nh\u1ed3i m\u00e1u c\u01a1 tim tr\u01b0\u1edbc r\u1ed9ng ho\u1eb7c nh\u1ecbp tim nhanh ho\u1eb7c suy ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i, do \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y h\u1ec7 th\u1ed1ng renin \u2013 angiotensin ho\u1ea1t \u0111\u1ed9ng m\u1ea1nh h\u01a1n. N\u1ebfu kh\u00f4ng th\u1ec3 s\u1eed d\u1ee5ng s\u1edbm th\u00ec b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng nh\u00f3m thu\u1ed1c n\u00e0y sau v\u00e0i ng\u00e0y.<\/p>\n<h2><strong>4.Thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n v\u1edbi b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh<\/strong><\/h2>\n<p>M\u1ed9t s\u1ed1 th\u1eed nghi\u1ec7m \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c l\u1ee3i \u00edch \u01b0u ti\u00ean c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf h\u1ec7 th\u1ed1ng renin-angiotensin (RAS) trong vi\u1ec7c gi\u1ea3m protein ni\u1ec7u, so v\u1edbi c\u00e1c thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c. Nh\u1eefng nghi\u00ean c\u1ee9u tr\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u1ef1a tr\u00ean quan s\u00e1t th\u1ea5y r\u1eb1ng: s\u1ef1 b\u00e0i ti\u1ebft protein thay \u0111\u1ed5i li\u00ean quan tr\u1ef1c ti\u1ebfp v\u1edbi \u00e1p l\u1ef1c n\u1ed9i m\u00f4 \u1edf \u0111\u1ed9ng v\u1eadt b\u1ecb b\u1ec7nh c\u1ea7u th\u1eadn c\u1ea5u tr\u00fac.<\/p>\n<p>Ngo\u00e0i vi\u1ec7c gi\u1ea3m \u00e1p l\u1ef1c n\u1ed9i b\u00e0o, m\u1ed9t lo\u1ea1t c\u00e1c c\u01a1 ch\u1ebf kh\u00e1c c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n l\u00e0m gi\u1ea3m ch\u1ea5t \u1ee9c ch\u1ebf RAS g\u00e2y ra b\u1edfi protein ni\u1ec7u. \u01afCMC c\u1ea3i thi\u1ec7n tr\u1ef1c ti\u1ebfp ch\u1ee9c n\u0103ng c\u1ee7a c\u1ea7u th\u1eadn, kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o s\u1ef1 thay \u0111\u1ed5i huy\u1ebft \u0111\u1ed9ng t\u1ea1i c\u1ea7u th\u1eadn.<\/p>\n<p>Nh\u1eefng ph\u00e1t hi\u1ec7n sau \u0111\u00e2y \u1ee7ng h\u1ed9 gi\u1ea3 thuy\u1ebft n\u00e0y: S\u1ef1 b\u00e0i ti\u1ebft protein gi\u1ea3m d\u1ea7n sau v\u00e0i tu\u1ea7n \u0111\u1ebfn v\u00e0i th\u00e1ng, trong khi \u0111\u00f3 t\u00e1c d\u1ee5ng huy\u1ebft \u0111\u1ed9ng c\u1ee7a \u01afCMC x\u1ea3y ra nhanh ch\u00f3ng v\u00e0 sau \u0111\u00f3 \u1ed5n \u0111\u1ecbnh. \u1ede chu\u1ed9t bi\u1ebfn \u0111\u1ed5i gen, s\u1ef1 bi\u1ec3u hi\u1ec7n qu\u00e1 m\u1ee9c c\u1ee7a th\u1ee5 th\u1ec3 angiotensin II (lo\u1ea1i 1) trong c\u00e1c t\u1ebf b\u00e0o s\u1ee3i c\u1ea7u th\u1eadn d\u1eabn \u0111\u1ebfn protein ni\u1ec7u \u0111\u00e1ng k\u1ec3 v\u00e0 x\u01a1 c\u1ee9ng c\u1ea7u th\u1eadn. Angiotensin II l\u00e0m gi\u1ea3m ch\u1ee9c n\u0103ng c\u1ee7a nephrin, m\u1ed9t protein th\u00e0nh ph\u1ea7n ch\u00ednh c\u1ee7a m\u1ea1ng l\u01b0\u1edbi t\u1ebf b\u00e0o c\u00f3 ch\u00e2n podocyte v\u00e0 l\u00e0 th\u00e0nh ph\u1ea7n quan tr\u1ecdng trong h\u00e0ng r\u00e0o l\u1ecdc c\u1ea7u th\u1eadn. Ng\u01b0\u1ee3c l\u1ea1i, ch\u1ee9c n\u0103ng c\u1ee7a nephrin \u0111\u01b0\u1ee3c t\u0103ng l\u00ean b\u1eb1ng li\u1ec7u ph\u00e1p \u01afCMC. S\u1ef1 gi\u1ea3m b\u00e0i ti\u1ebft protein g\u00e2y ra b\u1edfi c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf RAS (v\u00e0 m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p kh\u00e1c \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 d\u01b0\u1edbi \u0111\u00e2y) c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c gi\u1ea3m n\u1ed3ng \u0111\u1ed9 lipid huy\u1ebft thanh, c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m c\u1ea3 nguy c\u01a1 x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch to\u00e0n th\u00e2n v\u00e0 t\u1ed1c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh th\u1eadn.<\/p>\n<h3><strong>4.1<\/strong><strong>. B\u1ec7nh l\u00fd th\u1eadn kh\u00f4ng do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng <\/strong><\/h3>\n<p>C\u00e1c ch\u1ea5t \u01afCMC th\u01b0\u1eddng l\u00e0m gi\u1ea3m protein ni\u1ec7u kho\u1ea3ng 30% \u0111\u1ebfn 35% \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh kh\u00f4ng \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. T\u00e1c d\u1ee5ng gi\u1ea3m protein ni\u1ec7u l\u00e0 n\u1ed5i b\u1eadt nh\u1ea5t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang trong ch\u1ebf \u0111\u1ed9 \u0103n \u00edt natri ho\u1eb7c \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c l\u1ee3i ti\u1ec3u do s\u1ef1 suy gi\u1ea3m th\u1ec3 t\u00edch t\u01b0\u01a1ng \u0111\u1ed1i d\u1eabn \u0111\u1ebfn s\u1ef1 ph\u1ee5 thu\u1ed9c angiotensin II l\u1edbn h\u01a1n c\u1ee7a vi tu\u1ea7n ho\u00e0n c\u1ea7u th\u1eadn. Hi\u1ec7n kh\u00f4ng r\u00f5 li\u1ec1u thu\u1ed1c \u01afCMC gi\u00fap h\u1ea1 huy\u1ebft \u00e1p t\u1ed1i \u0111a c\u00f3 l\u00e0m gi\u1ea3m protein ni\u1ec7u t\u1ed1i \u01b0u hay kh\u00f4ng. Do \u0111\u00f3 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u1ea7n \u0111\u01b0\u1ee3c c\u00e1 th\u1ec3 h\u00f3a. Trong suy th\u1eadn ti\u1ebfn tri\u1ec3n, d\u00f9 do nguy\u00ean nh\u00e2n g\u00ec th\u00ec v\u1eabn lu\u00f4n c\u00f3 s\u1ef1 t\u0103ng n\u1ed3ng \u0111\u1ed9 creatinin huy\u1ebft thanh, gi\u1ea3m ch\u1ee9c n\u0103ng c\u1ea7u th\u1eadn v\u00e0 t\u0103ng protein ni\u1ec7u.<\/p>\n<p>Angiotensin II c\u00f3 th\u1ec3 \u0111\u00f3ng m\u1ed9t vai tr\u00f2 quy\u1ebft \u0111\u1ecbnh trong s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a t\u1ed5n th\u01b0\u01a1ng c\u1ea7u th\u1eadn v\u00e0 vi\u00eam c\u1ea7u th\u1eadn g\u00e2y ph\u00e1 h\u1ee7y c\u1ea7u th\u1eadn. C\u00e1c thu\u1ed1c \u01afCMC t\u1ea1o ra nh\u1eefng thay \u0111\u1ed5i c\u00f3 l\u1ee3i trong di\u1ec5n bi\u1ebfn c\u1ee7a suy th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i, m\u1eb7c d\u00f9 gi\u1ea3m huy\u1ebft \u00e1p t\u1ed1t c\u0169ng g\u00f3p ph\u1ea7n v\u00e0o k\u1ebft qu\u1ea3 n\u00e0y.<\/p>\n<h3><strong>4.2<\/strong><strong>. B\u1ec7nh l\u00fd th\u1eadn do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng <\/strong><\/h3>\n<p>Trong b\u1ec7nh th\u1eadn do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, thu\u1ed1c \u01afCMC l\u00e0m gi\u1ea3m protein ni\u1ec7u, ph\u00f2ng ng\u1eeba x\u01a1 c\u1ee9ng c\u1ea7u th\u1eadn ti\u1ebfn tri\u1ec3n v\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn. Thu\u1ed1c \u01afCMC ph\u00f2ng ng\u1eeba ti\u1ebfn tri\u1ec3n b\u1ec7nh th\u1eadn \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u1ea3 type 1 v\u00e0 type 2, t\u1eeb m\u1ee9c nh\u1eb9 sang m\u1ee9c trung b\u00ecnh, t\u1eeb trung b\u00ecnh sang m\u1ee9c n\u1eb7ng, v\u00e0 m\u1ee9c n\u1eb7ng sang b\u1ec7nh th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i.<\/p>\n<p>Thu\u1ed1c \u01afCMC l\u00e0m tr\u00ec ho\u00e3n xu\u1ea5t hi\u1ec7n microalbumin ni\u1ec7u, \u0111\u00e2y l\u00e0 d\u1ea5u hi\u1ec7u \u0111\u1ea7u ti\u00ean trong qu\u00e1 tr\u00ecnh ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh l\u00fd c\u1ea7u th\u1eadn, c\u00f3 th\u1ec3 g\u00e2y t\u1eed vong. C\u00e1c thu\u1ed1c \u01afCMC \u0111\u00e3 c\u00f3 nghi\u00ean c\u1ee9u tr\u00ean b\u1ec7nh l\u00fd th\u1eadn do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng: captopril (FDA c\u00f4ng nh\u1eadn), perindopril, ramipril, lisinopril.<\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/\" target=\"_blank\" rel=\"nofollow noopener\"><b>B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c t\u1ebf Vinmec<\/b><\/a>\u00a0 c\u00f3 \u0111\u1ed9i ng\u0169 d\u01b0\u1ee3c s\u0129 d\u01b0\u1ee3c l\u00e2m s\u00e0ng v\u00e0 \u0111\u01b0a h\u1ec7 th\u1ed1ng m\u00e1y m\u00f3c, thi\u1ebft b\u1ecb hi\u1ec7n \u0111\u1ea1i \u0111\u1ea1t chu\u1ea9n v\u00e0o c\u00f4ng t\u00e1c th\u0103m kh\u00e1m, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u1ee8c ch\u1ebf men chuy\u1ec3n (UCMC) d\u1ea1ng angiotensin (Angiotensin-converting enzyme (ACE) inhibitors), t\u00e1c d\u1ee5ng tr\u1ef1c ti\u1ebfp l\u00ean h\u1ec7 RAA. L\u00e0 nh\u00f3m thu\u1ed1c h\u1ebft s\u1ee9c quan tr\u1ecdng m\u00e0 c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng c\u1ea7n n\u1eafm r\u00f5 trong th\u1ef1c h\u00e0nh \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tim m\u1ea1ch. 1.Suy tim C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n trong [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":20923,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u1ee8c ch\u1ebf men chuy\u1ec3n v\u00e0 nh\u1eefng ch\u1ec9 \u0111\u1ecbnh trong l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"\u1ee8c ch\u1ebf men chuy\u1ec3n v\u00e0 nh\u1eefng ch\u1ec9 \u0111\u1ecbnh trong l\u00e2m s\u00e0ng l\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c quan t\u00e2m. 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