{"id":21731,"date":"2023-04-15T22:02:53","date_gmt":"2023-04-15T15:02:53","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21731"},"modified":"2023-04-17T16:53:18","modified_gmt":"2023-04-17T09:53:18","slug":"tang-sinh-tan-sinh-tuy","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/tang-sinh-tan-sinh-tuy\/","title":{"rendered":"T\u0103ng sinh t\u00e2n sinh t\u1ee7y: Ph\u00e2n lo\u1ea1i v\u00e0 tri\u1ec7u ch\u1ee9ng b\u1ec7nh"},"content":{"rendered":"<p><strong>T\u00e2n sinh t\u0103ng sinh t\u1ee7y (Myeloproliferative neoplasms &#8211; MPNs) l\u00e0 m\u1ed9t nh\u00f3m b\u1ec7nh kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t x\u1ea3y ra \u1edf m\u1ee9c \u0111\u1ed9 t\u1ebf b\u00e0o g\u1ed1c \u0111a n\u0103ng, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 t\u0103ng s\u1ea3n xu\u1ea5t c\u00e1c t\u1ebf b\u00e0o m\u00e1u kh\u00f4ng ki\u1ec3m so\u00e1t. C\u00e1c t\u1ebf b\u00e0o n\u00e0y c\u00f3 kh\u1ea3 n\u0103ng bi\u1ec7t h\u00f3a v\u00e0 tr\u01b0\u1edfng th\u00e0nh g\u1ea7n nh\u01b0 b\u00ecnh th\u01b0\u1eddng. MPNs ph\u1ea3n \u1ea3nh \u0111i\u1ec3m n\u1ed5i b\u1eadt c\u1ee7a nh\u00f3m b\u1ec7nh n\u00e0y l\u00e0 thay \u0111\u1ed5i di truy\u1ec1n theo d\u00f2ng t\u1ebf b\u00e0o.<\/strong><\/p>\n<h2>1. Gi\u1edbi thi\u1ec7u<\/h2>\n<p>T\u00e2n sinh t\u0103ng sinh t\u1ee7y (MPNs), c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 b\u1ec7nh t\u0103ng sinh t\u1ebf b\u00e0o t\u1ee7y, l\u00e0 m\u1ed9t nh\u00f3m b\u1ec7nh l\u00fd ung th\u01b0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u1ee7y x\u01b0\u01a1ng, n\u01a1i s\u1ea3n xu\u1ea5t c\u00e1c t\u1ebf b\u00e0o m\u00e1u. MPNs g\u1ed3m c\u00e1c b\u1ec7nh l\u00fd sau \u0111\u00e2y:<\/p>\n<p>B\u1ec7nh b\u1ea1ch c\u1ea7u m\u1ea1n d\u00f2ng t\u1ee7y (Chronic myelogenous leukemia: CML)<\/p>\n<p><a href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/tim-hieu-ve-benh-da-hong-cau-nguyen-phat\/\">\u0110a h\u1ed3ng c\u1ea7u nguy\u00ean ph\u00e1t<\/a> (Polycythemia vera: PV)<\/p>\n<p>T\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t (Essential thrombocythemia: ET)<\/p>\n<p>X\u01a1 t\u1ee7y nguy\u00ean ph\u00e1t (Primary myelofibrosis: PMF)<\/p>\n<figure id=\"attachment_21742\" aria-describedby=\"caption-attachment-21742\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-21742 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/2-11-300x190.png\" alt=\"benh-bach-cau-man-dong-tuy-CML\" width=\"300\" height=\"190\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/2-11-300x190.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/2-11.png 592w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-21742\" class=\"wp-caption-text\">B\u1ec7nh B\u1ea1ch c\u1ea7u m\u1ea1n d\u00f2ng t\u1ee7y-CML<\/figcaption><\/figure>\n<h2>2. Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh t\u00e2n sinh t\u0103ng sinh t\u1ee7y<\/h2>\n<p>C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh t\u00f9y thu\u1ed9c v\u00e0o t\u1eebng lo\u1ea1i b\u1ec7nh. Tuy nhi\u00ean, c\u00e1c tri\u1ec7u ch\u1ee9ng chung bao g\u1ed3m s\u1ef1 m\u1ec7t m\u1ecfi, kh\u00f3 th\u1edf, xu\u1ea5t huy\u1ebft, \u0111au x\u01b0\u01a1ng v\u00e0 suy nh\u01b0\u1ee3c c\u01a1 th\u1ec3.<\/p>\n<p>Trong b\u1ec7nh b\u1ea1ch c\u1ea7u m\u1ea1n d\u00f2ng t\u1ee7y (CML), s\u1ef1 gia t\u0103ng qu\u00e1 m\u1ee9c t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u h\u1ea1t b\u00ean trong t\u1ee7y x\u01b0\u01a1ng, \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u00e1c tri\u1ec7u ch\u1ee9ng thi\u1ebfu m\u00e1u, t\u0103ng c\u00e1c giai \u0111o\u1ea1n b\u1ea1ch c\u1ea7u h\u1ea1t ch\u01b0a tr\u01b0\u1edfng th\u00e0nh trong m\u00e1u, th\u01b0\u1eddng k\u00e8m theo t\u0103ng ti\u1ec3u c\u1ea7u v\u00e0 l\u00e1ch to.<\/p>\n<p>Trong b\u1ec7nh \u0111a h\u1ed3ng c\u1ea7u nguy\u00ean ph\u00e1t (PV), s\u1ea3n xu\u1ea5t qu\u00e1 m\u1ee9c c\u00e1c t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u d\u1eabn \u0111\u1ebfn t\u0103ng huy\u1ebft \u00e1p v\u00e0 \u0111\u1ed9 nh\u1edbt c\u1ee7a m\u00e1u. C\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c c\u00f3 th\u1ec3 bao g\u1ed3m \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, kh\u00f3 th\u1edf v\u00e0 \u0111au th\u1eaft ng\u1ef1c.<\/p>\n<p>Trong b\u1ec7nh t\u0103ng ti\u1ec3u c\u1ea7u nguy\u00ean ph\u00e1t (ET), s\u1ef1 s\u1ea3n xu\u1ea5t qu\u00e1 m\u1ee9c c\u00e1c ti\u1ec3u c\u1ea7u d\u1eabn \u0111\u1ebfn r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u, bi\u1ec3u hi\u1ec7n b\u1edfi c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 xu\u1ea5t huy\u1ebft ho\u1eb7c huy\u1ebft kh\u1ed1i.<\/p>\n<p>Trong b\u1ec7nh x\u01a1 t\u1ee7y nguy\u00ean ph\u00e1t (PMF), s\u1ef1 t\u0103ng s\u1ea3n xu\u1ea5t c\u00e1c t\u1ebf b\u00e0o m\u00e1u d\u1eabn \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng v\u00e0 s\u1eb9o h\u00f3a t\u1ee7y x\u01b0\u01a1ng, g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 thi\u1ebfu m\u00e1u, \u0111au x\u01b0\u01a1ng, suy nh\u01b0\u1ee3c v\u00e0 nhi\u1ec5m tr\u00f9ng.<\/p>\n<p>C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh c\u00f3 th\u1ec3 g\u00e2y ra s\u1ef1 kh\u00f3 ch\u1ecbu v\u00e0 nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh<\/p>\n<h2>3. Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh t\u00e2n sinh t\u0103ng sinh t\u1ee7y<\/h2>\n<p>\u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh, c\u00e1c b\u00e1c s\u0129 th\u01b0\u1eddng s\u1eed d\u1ee5ng m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p ki\u1ec3m tra kh\u00e1c nhau. X\u00e9t nghi\u1ec7m m\u00e1u l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ef1 thay \u0111\u1ed5i c\u00e1c ch\u1ec9 s\u1ed1 m\u00e1u, bao g\u1ed3m \u0111\u1ebfm t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u, \u0111\u1ebfm ti\u1ec3u c\u1ea7u, \u0111\u1ebfm h\u1ed3ng c\u1ea7u v\u00e0 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan v\u00e0 th\u1eadn. X\u00e9t nghi\u1ec7m t\u1ee7y x\u01b0\u01a1ng l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 vi\u1ec7c s\u1ea3n xu\u1ea5t t\u1ebf b\u00e0o m\u00e1u t\u1ea1i t\u1ee7y x\u01b0\u01a1ng v\u00e0 ph\u00e1t hi\u1ec7n b\u1ec7nh l\u00fd t\u1ea1i t\u1ee7y x\u01b0\u01a1ng.<\/p>\n<p>Ngo\u00e0i ra, c\u00e1c b\u00e1c s\u1ef9 c\u0169ng s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh, bao g\u1ed3m si\u00eau \u00e2m, CT v\u00e0 MRI, \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng c\u1ee7a t\u1ee7y x\u01b0\u01a1ng v\u00e0 c\u00e1c c\u01a1 quan l\u00e2n c\u1eadn.<\/p>\n<p>Trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh t\u00e2n sinh t\u0103ng sinh t\u1ee7y, c\u00e1c b\u00e1c s\u1ef9 s\u1eed d\u1ee5ng m\u1ed9t lo\u1ea1t c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c nhau \u0111\u1ec3 ki\u1ec3m so\u00e1t vi\u1ec7c s\u1ea3n xu\u1ea5t t\u1ebf b\u00e0o m\u00e1u v\u00e0 ph\u00f2ng ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m. M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ki\u1ec3m so\u00e1t s\u1ea3n xu\u1ea5t t\u1ebf b\u00e0o m\u00e1u bao g\u1ed3m hydroxyurea, interferon v\u00e0 anagrelide. Ngo\u00e0i ra c\u0169ng c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u v\u00e0 kh\u00e1ng histamin \u0111\u1ec3 gi\u1ea3m thi\u1ec3u c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn \u0111\u00f4ng m\u00e1u v\u00e0 d\u1ecb \u1ee9ng.<\/p>\n<p>N\u1ebfu thu\u1ed1c kh\u00f4ng \u0111\u1ee7 hi\u1ec7u qu\u1ea3, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p n\u00e0y g\u1ed3m truy\u1ec1n m\u00e1u h\u1ed3ng c\u1ea7u kh\u1ed1i, truy\u1ec1n ti\u1ec3u c\u1ea7u. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p nghi\u00eam tr\u1ecdng, b\u00e1c s\u1ef9 c\u0169ng c\u00f3 th\u1ec3 xem x\u00e9t ph\u1eabu thu\u1eadt \u0111\u1ec3 lo\u1ea1i b\u1ecf c\u00e1c t\u1ebf b\u00e0o ung th\u01b0.<\/p>\n<h2>4. T\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang b\u1ec7nh t\u00e2n sinh t\u0103ng sinh t\u1ee7y<\/h2>\n<p>\u0110i\u1ec1u quan tr\u1ecdng \u0111\u1ea7u ti\u00ean l\u00e0 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c b\u1ec7nh. B\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng gi\u1ed1ng nhau v\u1edbi c\u00e1c lo\u1ea1i b\u1ec7nh kh\u00e1c nhau. Do \u0111\u00f3, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c l\u00e0 c\u1ea7n thi\u1ebft trong vi\u1ec7c \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3. Khi ch\u1ea9n \u0111o\u00e1n b\u1ec7nh \u0111\u01b0\u1ee3c \u0111\u1eb7t ra, c\u00e1c b\u00e1c s\u1ef9 c\u00f3 th\u1ec3 l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u1edbi t\u1eebng b\u1ec7nh nh\u00e2n.<\/p>\n<p>Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb \u0111\u00fang b\u1ec7nh c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p>Tuy nhi\u00ean, \u0111i\u1ec1u quan tr\u1ecdng nh\u1ea5t l\u00e0 vi\u1ec7c theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u00fang c\u00e1ch trong su\u1ed1t qu\u00e1 tr\u00ecnh b\u1ec7nh nh\u00e2n s\u1ed1ng. V\u00ec v\u1eady, vi\u1ec7c th\u1ef1c hi\u1ec7n c\u00e1c cu\u1ed9c ki\u1ec3m tra \u0111\u1ecbnh k\u1ef3 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a b\u1ec7nh l\u00e0 r\u1ea5t quan tr\u1ecdng. N\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang c\u00e1ch, b\u1ec7nh t\u00e2n sinh t\u0103ng sinh t\u1ee7y c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m, bao g\u1ed3m \u0111\u1ed9t qu\u1ef5, \u0111\u00f4ng m\u00e1u, v\u00e0 ung th\u01b0 t\u1ee7y x\u01b0\u01a1ng.<\/p>\n<h2>5. K\u1ebft lu\u1eadn<\/h2>\n<p>K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u cho th\u1ea5y b\u1ec7nh t\u00e2n sinh t\u0103ng sinh t\u1ee7y l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ung th\u01b0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ee9c n\u0103ng c\u1ee7a t\u1ee7y x\u01b0\u01a1ng, n\u01a1i s\u1ea3n xu\u1ea5t c\u00e1c t\u1ebf b\u00e0o m\u00e1u. B\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, m\u1ec7t m\u1ecfi, v\u00e0 nhi\u1ec1u tri\u1ec7u ch\u1ee9ng kh\u00e1c li\u00ean quan \u0111\u1ebfn \u0111\u00f4ng m\u00e1u v\u00e0 thi\u1ebfu m\u00e1u, g\u00e2y \u1ea3nh h\u01b0\u1edfng ti\u00eau c\u1ef1c \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p>Trong t\u01b0\u01a1ng lai, nghi\u00ean c\u1ee9u v\u1ec1 b\u1ec7nh t\u00e2n sinh t\u0103ng sinh t\u1ee7y s\u1ebd gi\u00fap ch\u00fang ta hi\u1ec3u r\u00f5 h\u01a1n v\u1ec1 c\u01a1 ch\u1ebf ph\u00e1t tri\u1ec3n c\u1ee7a b\u1ec7nh, t\u1eeb \u0111\u00f3 t\u00ecm ra c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb m\u1edbi hi\u1ec7u qu\u1ea3 h\u01a1n. Tuy nhi\u00ean, \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n hi\u1ec7n t\u1ea1i, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang v\u1eabn l\u00e0 ch\u00eca kh\u00f3a \u0111\u1ec3 gi\u1ea3m thi\u1ec3u c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>T\u00e2n sinh t\u0103ng sinh t\u1ee7y (Myeloproliferative neoplasms &#8211; MPNs) l\u00e0 m\u1ed9t nh\u00f3m b\u1ec7nh kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t x\u1ea3y ra \u1edf m\u1ee9c \u0111\u1ed9 t\u1ebf b\u00e0o g\u1ed1c \u0111a n\u0103ng, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 t\u0103ng s\u1ea3n xu\u1ea5t c\u00e1c t\u1ebf b\u00e0o m\u00e1u kh\u00f4ng ki\u1ec3m so\u00e1t. C\u00e1c t\u1ebf b\u00e0o n\u00e0y c\u00f3 kh\u1ea3 n\u0103ng bi\u1ec7t h\u00f3a v\u00e0 tr\u01b0\u1edfng th\u00e0nh g\u1ea7n nh\u01b0 b\u00ecnh [&hellip;]<\/p>\n","protected":false},"author":70,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>T\u0103ng sinh t\u00e2n sinh t\u1ee7y: Ph\u00e2n lo\u1ea1i v\u00e0 tri\u1ec7u ch\u1ee9ng b\u1ec7nh - Vinmec<\/title>\n<meta name=\"description\" content=\"T\u00e2n sinh t\u0103ng sinh t\u1ee7y (MPNs) l\u00e0 m\u1ed9t nh\u00f3m b\u1ec7nh l\u00fd ung th\u01b0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u1ee7y x\u01b0\u01a1ng, n\u01a1i s\u1ea3n xu\u1ea5t c\u00e1c t\u1ebf b\u00e0o m\u00e1u\" \/>\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=\"T\u0103ng sinh t\u00e2n sinh t\u1ee7y: Ph\u00e2n lo\u1ea1i v\u00e0 tri\u1ec7u ch\u1ee9ng b\u1ec7nh - 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