{"id":21596,"date":"2023-04-16T14:34:43","date_gmt":"2023-04-16T07:34:43","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21596"},"modified":"2023-04-17T12:42:08","modified_gmt":"2023-04-17T05:42:08","slug":"viem-teo-da-day-man-quan-ly-theo-khuyen-cao-esge-2019","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/viem-teo-da-day-man-quan-ly-theo-khuyen-cao-esge-2019\/","title":{"rendered":"Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n: Qu\u1ea3n l\u00fd theo khuy\u1ebfn c\u00e1o ESGE 2019"},"content":{"rendered":"<p><strong>Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u00a0hay c\u00f2n g\u1ecdi l\u00e0 vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n l\u00e0 m\u1ed9t h\u00ecnh th\u00e1i c\u1ee7a vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a nh\u00f3m b\u1ec7nh n\u00e0y l\u00e0 ngo\u00e0i h\u00ecnh \u1ea3nh th\u1ec3 hi\u1ec7n s\u1ef1 vi\u00eam m\u1ea1n t\u00ednh c\u00f2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng l\u00e0m thi\u1ec3u s\u1ea3n (teo) bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1 d\u00e0y, c\u00f3 th\u1ec3 b\u1ecb thay th\u1ebf b\u1eb1ng bi\u1ec3u m\u00f4 tr\u1ee5 c\u1ee7a ru\u1ed9t. Nh\u00f3m b\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nh\u1eefng bi\u1ebfn ch\u1ee9ng n\u1eb7ng \u00a0n\u1ec1 h\u01a1n, \u0111\u1eb7c bi\u1ec7t l\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y, n\u00ean c\u1ea7n c\u00f3 chi\u1ebfn l\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/strong><\/p>\n<h2>1. \u0110\u1ecbnh ngh\u0129a v\u00e0 ph\u00e2n lo\u1ea1i<\/h2>\n<p>Vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u0111\u01b0\u1ee3c chia l\u00e0m 03 d\u1ea1ng ch\u00ednh d\u1ef1a tr\u00ean nhi\u1ec1u y\u1ebfu t\u1ed1 nh\u01b0ng ch\u1ee7 y\u1ebfu l\u00e0 h\u00ecnh th\u00e1i t\u1ed5n th\u01b0\u01a1ng quan s\u00e1t b\u1eb1ng n\u1ed9i soi hay b\u1eb1ng gi\u1ea3i ph\u1eabu b\u1ec7nh h\u1ecdc. Vi\u00eam teo d\u1ea1 d\u00e0y c\u00f3 hai d\u1ea1ng b\u1ec7nh ch\u00ednh l\u00e0 Vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n do t\u1ef1 mi\u1ec5n v\u00e0 Vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n do m\u00f4i tr\u01b0\u1eddng. Hai d\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 kh\u00e1c bi\u1ec7t v\u1ec1 c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh sinh b\u1ec7nh v\u00e0 c\u1ea3 h\u00ecnh th\u00e1i l\u00e2m s\u00e0ng. Nh\u01b0ng trong r\u1ea5t nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, c\u00f3 s\u1ef1 ch\u1ed3ng l\u1ea5p hai d\u1ea1ng n\u00e0y tr\u00ean m\u00f4 b\u1ec7nh h\u1ecdc d\u1eabn \u0111\u1ebfn h\u00ecnh th\u00e1i l\u00e2m s\u00e0ng kh\u00f3 ph\u00e2n bi\u1ec7t.<\/p>\n<ul>\n<li><strong>Vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n do t\u1ef1 mi\u1ec5n (autoimmune metaplastic atrophic gastritis \u00a0&#8211; AMAG)<\/strong> &#8211; L\u00e0 d\u1ea1ng sang th\u01b0\u01a1ng thi\u1ec3u d\u01b0\u1ee1ng (hay c\u00f2n g\u1ecdi l\u00e0 teo) v\u00e0 chuy\u1ec3n s\u1ea3n c\u1ee7a bi\u1ec3u m\u00f4 d\u1ea1 d\u00e0y, \u0111\u1eb7c tr\u01b0ng l\u00e0 t\u1eadp trung \u1edf v\u00f9ng th\u00e2n v\u1ecb (corpus).<\/li>\n<li><strong>Vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n do m\u00f4i tr\u01b0\u1eddng (environmental metaplastic atrophic gastritis &#8211; EMAG)<\/strong> &#8211; L\u00e0 d\u1ea1ng sang th\u01b0\u01a1ng thi\u1ec3u d\u01b0\u1ee1ng (hay c\u00f2n g\u1ecdi l\u00e0 teo) v\u00e0 chuy\u1ec3n s\u1ea3n ru\u1ed9t c\u1ee7a bi\u1ec3u m\u00f4 d\u1ea1 d\u00e0y, \u0111\u1eb7c tr\u01b0ng l\u00e0 ph\u00e2n b\u1ed1 c\u1ee7a sang th\u01b0\u01a1ng lan t\u1ecfa \u1edf c\u1ea3 hang v\u1ecb v\u00e0 th\u00e2n v\u1ecb.<\/li>\n<\/ul>\n<h2>2. Ch\u1ea9n \u0111o\u00e1n vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh<\/h2>\n<p>Vi\u00eam teo ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh d\u1ef1a tr\u00ean c\u00e1c b\u1eb1ng ch\u1ee9ng v\u1ec1 m\u00f4 b\u1ec7nh h\u1ecdc. Ph\u01b0\u01a1ng ph\u00e1p kh\u1ea3o s\u00e1t l\u1ef1a ch\u1ecdn \u01b0u ti\u00ean l\u00e0 n\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean c\u00f3 sinh thi\u1ebft. Ch\u1ec9 \u0111\u1ecbnh c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean c\u00f3 sinh thi\u1ebft xu\u1ea5t ph\u00e1t t\u1eeb nghi ng\u1edd vi\u00eam d\u1ea1 d\u00e0y qua c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng. Trong vi\u00eam teo ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y, do s\u1ef1 t\u1ed5n th\u01b0\u01a1ng g\u00e2y thi\u1ec3u d\u01b0\u1ee1ng v\u00e0 chuy\u1ec3n s\u1ea3n c\u1ee7a c\u00e1c t\u1ebf b\u00e0o ch\u1ee9c n\u0103ng chuy\u00ean bi\u1ec7t c\u1ee7a tuy\u1ebfn d\u1ea1 d\u00e0y c\u00f3 th\u1ec3 g\u00e2y gi\u1ea3m b\u00e0i ti\u1ebft m\u1ed9t s\u1ed1 s\u1ea3n ph\u1ea9m quan tr\u1ecdng nh\u01b0: axit d\u1ea1 d\u00e0y, pepsinogen v\u00e0 y\u1ebfu t\u1ed1 n\u1ed9i t\u1ea1i (intrinsic factor &#8211; c\u00f3 vai tr\u00f2 trong h\u1ea5p thu vitamin B12). M\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng chung hay ph\u1ed5 bi\u1ebfn c\u00f3 th\u1ec3 g\u1eb7p l\u00e0: \u0111au b\u1ee5ng th\u01b0\u1ee3ng v\u1ecb, kh\u00f3 ti\u00eau, ti\u00eau ch\u1ea3y, thi\u1ebfu m\u00e1u.<\/p>\n<p>Ph\u00e2n t\u00edch m\u00f4 b\u1ec7nh h\u1ecdc c\u00f2n cho ph\u00e9p \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9, qua \u0111\u00f3 ti\u00ean l\u01b0\u1ee3ng kh\u1ea3 n\u0103ng ung th\u01b0 h\u00f3a c\u1ee7a t\u1ed5n th\u01b0\u01a1ng chuy\u1ec3n s\u1ea3n. \u0110\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 c\u1ee7a t\u1ed5n th\u01b0\u01a1ng vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n tr\u00ean gi\u1ea3i ph\u1eabu b\u1ec7nh h\u1ecdc, c\u00f3 th\u1ec3 d\u00f9ng thang OLGA\/OLGIM \u0111\u1ec3 \u0111\u00e1nh gi\u00e1.<\/p>\n<p>C\u00e1c n\u1ed9i dung c\u1ee5 th\u1ec3 v\u1ec1 \u0111\u1eb7c \u0111i\u1ec3m d\u1ecbch t\u1ec5, m\u00f4 b\u1ec7nh h\u1ecdc, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111\u00e1nh gi\u00e1 theo OLGA\/OLGIM c\u1ee7a AMAG v\u00e0 EMAG \u0111\u00e3 c\u00f3 tr\u00ean chuy\u00ean trang <a href=\"https:\/\/vinmecdr.com\/\">https:\/\/VinmecDr.com\/<\/a><\/p>\n<figure style=\"width: 377px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/th.bing.com\/th\/id\/OIG.TKoxve1Gxz1GqOxYRuo_?pid=ImgGn\" alt=\"Minh-hoa-viem-da-day-man\" width=\"377\" height=\"377\" \/><figcaption class=\"wp-caption-text\">Minh h\u1ecda tri\u1ec7u ch\u1ee9ng vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh<\/figcaption><\/figure>\n<h2>3. Qu\u1ea3n l\u00fd vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh<\/h2>\n<p>Chi\u1ebfn l\u01b0\u1ee3c qu\u1ea3n l\u00fd c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n ph\u1ee5 thu\u1ed9c r\u1ea5t nhi\u1ec1u v\u1edbi m\u1ee9c \u0111\u1ed9 c\u1ee7a t\u1ed5n th\u01b0\u01a1ng thi\u1ec3u d\u01b0\u1ee1ng (hay teo) ho\u1eb7c chuy\u1ec3n s\u1ea3n t\u1ea1i th\u00e2n v\u1ecb (corpus) v\u00e0 hang v\u1ecb (antrum). M\u1ee9c \u0111\u1ed9 n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng thang OLGA\/OLGIM t\u01b0\u01a1ng \u1ee9ng cho t\u1ed5n th\u01b0\u01a1ng teo hay chuy\u1ec3n s\u1ea3n ru\u1ed9t.<\/p>\n<p>Qu\u1ea3n l\u00fd vi\u00eam teo ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh, theo hi\u1ec7p h\u1ed9i N\u1ed9i soi Ti\u00eau h\u00f3a Ch\u00e2u \u00c2u (ESGE) n\u0103m 2019 c\u00f3 m\u1ed9t s\u1ed1 \u0111i\u1ec3m \u0111\u00e1ng l\u01b0u t\u00e2m nh\u01b0 sau:<\/p>\n<ul>\n<li>N\u00ean bao g\u1ed3m ch\u1ea9n \u0111o\u00e1n Hp khi l\u1ea5y m\u1eabu sinh thi\u1ebft d\u1ea1 d\u00e0y trong l\u1ea7n \u0111\u1ea7u n\u1ed9i soi \u0111\u00e1nh gi\u00e1 vi\u00eam teo d\u1ea1 d\u00e0y m\u1ee9c \u0111\u1ed9 n\u1eb7ng.<\/li>\n<li>N\u00ean \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 vi\u00eam d\u1ea1 d\u00e0y b\u1eb1ng sinh b\u1ec7nh h\u1ecdc theo h\u01b0\u1edbng d\u1eabn c\u1ee7a OLGA v\u00e0 OLGIM.<\/li>\n<li>\u1ede b\u1ec7nh nh\u00e2n c\u00f3 lo\u1ea1i s\u1ea3n nh\u01b0ng ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c t\u1ed5n th\u01b0\u01a1ng tr\u00ean n\u1ed9i soi, n\u1ed9i soi l\u1ea1i l\u1eadp t\u1ee9c \u0111\u00e1nh gi\u00e1 b\u1eb1ng m\u1eaft hay v\u1edbi thu\u1ed1c nhu\u1ed9m. N\u1ebfu kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c t\u1ed5n th\u01b0\u01a1ng , sinh thi\u1ebft \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 l\u1ea1i v\u00e0 n\u1ed9i soi ki\u1ec3m tra l\u1ea1i n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong v\u00f2ng 6 th\u00e1ng (n\u1ebfu lo\u1ea1n s\u1ea3n m\u1ee9c \u0111\u1ed9 cao) ho\u1eb7c 12 th\u00e1ng (n\u1ebfu lo\u1ea1n s\u1ea3n m\u1ee9c \u0111\u1ed9 th\u1ea5p) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/li>\n<li>B\u1ec7nh nh\u00e2n vi\u00eam teo nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh (OLGA\/OLGIM giai \u0111o\u1ea1n I\/II) kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh n\u1ed9i soi ki\u1ec3m tra l\u1ea1i.<\/li>\n<li>B\u1ec7nh nh\u00e2n chuy\u1ec3n s\u1ea3n ru\u1ed9t \u1edf m\u1ed9t v\u1ecb tr\u00ed nh\u01b0ng ti\u1ec1n s\u1eed giai \u0111\u1ecbnh g\u1ee3i \u00fd ung th\u01b0 d\u1ea1 d\u00e0y, ho\u1eb7c chuy\u1ec3n s\u1ea3n kh\u00f4ng ho\u00e0n to\u00e0n hay vi\u00eam d\u1ea1 d\u00e0y do Hp tr\u01b0\u1eddng di\u1ec5n, n\u1ed9i soi \u0111\u00e1nh gi\u00e1 v\u00e0 sinh thi\u1ebft ki\u1ec3m tra \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o th\u1ef1c hi\u1ec7n trong 3 n\u0103m.<\/li>\n<li>B\u1ec7nh nh\u00e2n vi\u00eam teo giai \u0111o\u1ea1n n\u1eb7ng (teo n\u1eb7ng hay chuy\u1ec3n s\u1ea3n ru\u1ed9t n\u1eb7ng \u1edf c\u1ea3 2 v\u1ecb tr\u00ed th\u00e2n v\u1ecb v\u00e0 hang v\u1ecb, OLGA v\u00e0 OLGIM giai \u0111o\u1ea1n III\/IV) n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i b\u1eb1ng n\u1ed9i soi m\u1ed7i 3 n\u0103m<\/li>\n<li>B\u1ec7nh nh\u00e2n vi\u00eam teo giai \u0111o\u1ea1n n\u1eb7ng c\u00f9ng v\u1edbi ti\u1ec1n s\u1eed gia \u0111\u00ecnh g\u1ee3i \u00fd ung th\u01b0 d\u1ea1 d\u00e0y n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i b\u1eb1ng n\u1ed9i soi t\u00edch c\u1ef1c h\u01a1n (m\u1ed7i 1 \u0111\u1ebfn 2 n\u0103m sau khi ch\u1ea9n \u0111o\u00e1n).<\/li>\n<li>B\u1ec7nh nh\u00e2n v\u1edbi vi\u00eam teo d\u1ea1 d\u00e0y t\u1ef1 mi\u1ec5n c\u00f3 th\u1ec3 c\u00f3 l\u1ee3i \u00edch n\u1ebfu theo d\u00f5i m\u1ed7i 3 \u0111\u1ebfn 5 n\u0103m.<\/li>\n<li>\u1ede nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n nh\u01b0ng kh\u00f4ng teo ni\u00eam m\u1ea1c, di\u1ec7t tr\u1eeb Hp c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn tho\u00e1i tri\u1ec3n c\u1ee7a sang th\u01b0\u01a1ng vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n, gi\u1ea3m nguy c\u01a1 ung th\u01b0 h\u00f3a, teo ni\u00eam m\u1ea1c.<\/li>\n<li>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh chuy\u1ec3n s\u1ea3n ru\u1ed9t, di\u1ec7t tr\u1eeb Hp c\u00f3 v\u1ebb kh\u00f4ng l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 nguy c\u01a1 ung th\u01b0 d\u1ea1 d\u00e0y, nh\u01b0ng gi\u1ea3m vi\u00eam v\u00e0 teo ni\u00eam m\u1ea1c trong ng\u1eafn h\u1ea1n, do v\u1eady c\u0169ng c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc \u00e1p d\u1ee5ng.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u00a0hay c\u00f2n g\u1ecdi l\u00e0 vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n s\u1ea3n l\u00e0 m\u1ed9t h\u00ecnh th\u00e1i c\u1ee7a vi\u00eam d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a nh\u00f3m b\u1ec7nh n\u00e0y l\u00e0 ngo\u00e0i h\u00ecnh \u1ea3nh th\u1ec3 hi\u1ec7n s\u1ef1 vi\u00eam m\u1ea1n t\u00ednh c\u00f2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng l\u00e0m thi\u1ec3u s\u1ea3n (teo) bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1 d\u00e0y, [&hellip;]<\/p>\n","protected":false},"author":37,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n: Qu\u1ea3n l\u00fd theo khuy\u1ebfn c\u00e1o ESGE 2019<\/title>\n<meta name=\"description\" content=\"Vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n t\u00ednh \u00a0hay c\u00f2n g\u1ecdi l\u00e0 vi\u00eam teo d\u1ea1 d\u00e0y chuy\u1ec3n 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