{"id":21913,"date":"2023-04-19T15:31:44","date_gmt":"2023-04-19T08:31:44","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21913"},"modified":"2023-04-19T15:41:31","modified_gmt":"2023-04-19T08:41:31","slug":"chan-doan-hen-phe-quan-theo-gina-2019","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/chan-doan-hen-phe-quan-theo-gina-2019\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n theo GINA 2019"},"content":{"rendered":"

Hen ph\u1ebf qu\u1ea3n (HPQ<\/a>) l\u00e0 m\u1ed9t b\u1ec7nh c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m l\u00e0 vi\u00eam m\u1ea1n t\u00ednh ni\u00eam m\u1ea1c ph\u1ebf qu\u1ea3n l\u00e0m t\u0103ng ph\u1ea3n \u1ee9ng c\u1ee7a ph\u1ebf qu\u1ea3n th\u01b0\u1eddng xuy\u00ean v\u1edbi nhi\u1ec1u t\u00e1c nh\u00e2n k\u00edch th\u00edch, d\u1eabn \u0111\u1ebfn co th\u1eaft lan to\u1ea3 c\u01a1 tr\u01a1n ph\u1ebf qu\u1ea3n. S\u1ef1 co th\u1eaft ph\u1ebf qu\u1ea3n kh\u00f4ng c\u1ed1 \u0111\u1ecbnh, th\u01b0\u1eddng c\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c t\u1ef1 nhi\u00ean ho\u1eb7c sau khi d\u00f9ng thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y s\u1ebd cung c\u1ea5p th\u00f4ng tin v\u1ec1 ch\u1ea9n \u0111o\u00e1n hen ph\u1ebfn qu\u1ea3n theo GINA 2019.<\/strong><\/p>\n

\"H\u00ecnh
H\u00ecnh \u1ea3nh minh h\u1ecda b\u1ec7nh nh\u00e2n hen ph\u1ebf qu\u1ea3n<\/figcaption><\/figure>\n

1. Ch\u1ea9n \u0111o\u00e1n<\/b><\/h2>\n

1.1. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/b><\/h3>\n

– Kh\u00f3 th\u1edf, kh\u00f2 kh\u00e8, th\u1edf r\u00edt, \u0111\u1eb7c bi\u1ec7t th\u00ec th\u1edf ra;<\/p>\n

– Th\u1eddi \u0111i\u1ec3m xu\u1ea5t hi\u1ec7n c\u01a1n kh\u00f3 th\u1edf: v\u1ec1 \u0111\u00eam, theo m\u00f9a, sau m\u1ed9t s\u1ed1 k\u00edch th\u00edch (c\u1ea3m c\u00fam, g\u1eafng s\u1ee9c, thay \u0111\u1ed5i th\u1eddi ti\u1ebft, kh\u00f3i b\u1ee5i);<\/p>\n

– Ti\u1ec1n s\u1eed c\u00f3 c\u01a1n kh\u00f3 th\u1edf ki\u1ec3u hen: ho kh\u1ea1c \u0111\u1eddm, kh\u00f3 th\u1edf, c\u00f2 c\u1eed, n\u1eb7ng ng\u1ef1c, nghe ph\u1ed5i c\u00f3 ran r\u00edt, ran ng\u00e1y;<\/p>\n

– Ti\u1ec1n s\u1eed b\u1ea3n th\u00e2n: vi\u00eam m\u0169i d\u1ecb \u1ee9ng, vi\u00eam k\u1ebft m\u1ea1c d\u1ecb \u1ee9ng, d\u1ecb \u1ee9ng thu\u1ed1c, th\u1ee9c \u0103n;<\/p>\n

– Ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 ng\u01b0\u1eddi m\u1eafc hen ph\u1ebf qu\u1ea3n v\u00e0\/ ho\u1eb7c c\u00e1c b\u1ec7nh d\u1ecb \u1ee9ng;<\/p>\n

– C\u1ea7n l\u01b0u \u00fd lo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c c\u00f3 tri\u1ec7u ch\u1ee9ng gi\u1ed1ng hen ph\u1ebf qu\u1ea3n nh\u01b0 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD), gi\u00e3n ph\u1ebf qu\u1ea3n, vi\u00eam ph\u1ebf qu\u1ea3n co th\u1eaft ….;<\/p>\n

– Kh\u1eb3ng \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n n\u1ebfu th\u1ea5y c\u01a1n hen ph\u1ebf qu\u1ea3n v\u1edbi c\u00e1c d\u1ea5u hi\u1ec7u \u0111\u1eb7c tr\u01b0ng:<\/p>\n

+ Ti\u1ec1n tri\u1ec7u: h\u1eaft h\u01a1i, s\u1ed5 m\u0169i, ng\u1ee9a m\u1eaft, ho khan, bu\u1ed3n ng\u1ee7…<\/p>\n

+ C\u01a1n kh\u00f3 th\u1edf: l\u00fac b\u1eaft \u0111\u1ea7u kh\u00f3 th\u1edf ch\u1eadm, \u1edf th\u00ec th\u1edf ra, c\u00f3 ti\u1ebfng c\u00f2 c\u1ee9 ng\u01b0\u1eddi kh\u00e1c c\u0169ng nghe \u0111\u01b0\u1ee3c, kh\u00f3 th\u1edf t\u0103ng d\u1ea7n, sau c\u00f3 th\u1ec3 kh\u00f3 th\u1edf nhi\u1ec1u, v\u00e3 m\u1ed3 h\u00f4i, n\u00f3i t\u1eebng t\u1eeb ho\u1eb7c ng\u1eaft qu\u00e3ng. C\u01a1n kh\u00f3 th\u1edf k\u00e9o d\u00e0i 5- 15 ph\u00fat, c\u00f3 khi h\u00e0ng gi\u1edd, h\u00e0ng ng\u00e0y. C\u01a1n kh\u00f3 th\u1edf gi\u1ea3m d\u1ea7n v\u00e0 k\u1ebft th\u00fac v\u1edbi ho v\u00e0 kh\u1ea1c \u0111\u1eddm. \u0110\u1eddm th\u01b0\u1eddng trong, qu\u00e1nh, d\u00ednh. Kh\u00e1m trong c\u01a1n hen th\u1ea5y c\u00f3 ran r\u00edt, ran ng\u00e1y lan to\u1ea3 2 ph\u1ed5i.<\/p>\n

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

\u0110o ch\u1ee9c n\u0103ng th\u00f4ng kh\u00ed ph\u1ed5i<\/b><\/p>\n

– Khi \u0111o v\u1edbi h\u00f4 h\u1ea5p k\u00fd:<\/p>\n

+ \u0110o ngo\u00e0i c\u01a1n: k\u1ebft qu\u1ea3 ch\u1ee9c n\u0103ng th\u00f4ng kh\u00ed (CNTK) ph\u1ed5i b\u00ecnh th\u01b0\u1eddng;<\/p>\n

+ Tr\u01b0\u1eddng h\u1ee3p \u0111o trong c\u01a1n: r\u1ed1i lo\u1ea1n th\u00f4ng kh\u00ed (RLTK) t\u1eafc ngh\u1ebdn ph\u1ee5c h\u1ed3i ho\u00e0n to\u00e0n v\u1edbi thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n: ch\u1ec9 s\u1ed1 FEV1\/FVC \u2265 75% sau h\u00edt 400\u03bcg salbutamol;<\/p>\n

– S\u1ef1 bi\u1ebfn \u0111\u1ed5i th\u00f4ng kh\u00ed \u0111o b\u1eb1ng l\u01b0u l\u01b0\u1ee3ng \u0111\u1ec9nh k\u1ebf: l\u01b0u l\u01b0\u1ee3ng \u0111\u1ec9nh (LL\u0110) t\u0103ng > 15% sau 30 ph\u00fat h\u00edt 400\u03bcg salbutamol. LL\u0110 bi\u1ebfn thi\u00ean h\u01a1n 20% gi\u1eefa l\u1ea7n \u0111o bu\u1ed5i s\u00e1ng v\u00e0 chi\u1ec1u c\u00e1ch nhau 12 gi\u1edd \u1edf ng\u01b0\u1eddi b\u1ec7nh d\u00f9ng thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n (ho\u1eb7c h\u01a1n 10% khi kh\u00f4ng d\u00f9ng thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n), ho\u1eb7c LL\u0110 gi\u1ea3m h\u01a1n 15% sau 6 ph\u00fat \u0111i b\u1ed9 ho\u1eb7c g\u1eafng s\u1ee9c.<\/p>\n

1.3. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/b><\/h3>\n

Hen ph\u1ebf qu\u1ea3n l\u00e0 b\u1ec7nh bi\u1ebfn \u0111\u1ed5i (kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t), \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u00ecnh tr\u1ea1ng vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh.<\/p>\n

Hai \u0111\u1eb7c \u0111i\u1ec3m c\u01a1 b\u1ea3n c\u1ee7a hen ph\u1ebf qu\u1ea3n<\/p>\n

– (1) B\u1ec7nh s\u1eed c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p nh\u01b0 th\u1edf kh\u00f2 kh\u00e8, kh\u00f3 th\u1edf, t\u1ee9c ng\u1ef1c v\u00e0 ho. C\u00e1c bi\u1ec3u hi\u1ec7n b\u1ec7nh bi\u1ebfn \u0111\u1ed5i theo th\u1eddi gian, m\u1ee9c \u0111\u1ed9 n\u1eb7ng, V\u00c0<\/p>\n

– (2) Gi\u1edbi h\u1ea1n lu\u1ed3ng kh\u00ed th\u1edf ra bi\u1ebfn \u0111\u1ed5i, \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh \u00edt nh\u1ea5t m\u1ed9t l\u1ea7n.<\/p>\n

<\/p>\n

L\u01b0u \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n tr\u00ean l\u00e2m s\u00e0ng theo GINA (2019)<\/b><\/p>\n

L\u01b0u \u00fd: Ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n n\u00ean d\u1ef1a tr\u00ean nh\u1eefng th\u00f4ng tin ghi nh\u1eadn c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb ki\u1ec3m so\u00e1t hen. Vi\u1ec7c kh\u1eb3ng \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n hen tr\u1edf n\u00ean kh\u00f3 h\u01a1n nhi\u1ec1u sau khi b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb ki\u1ec3m so\u00e1t.<\/p>\n

2. Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n<\/h2>\n

B\u1ea3ng: Nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m d\u00f9ng trong ch\u1ea9n \u0111o\u00e1n hen theo GINA (2019)<\/b><\/p>\n\n\n\n\n\n\n
1. Ti\u1ec1n s\u1eed c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p thay \u0111\u1ed5i<\/b><\/td>\n<\/tr>\n
C\u00e1c tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh l\u00e0 th\u1edf kh\u00f2 kh\u00e8, kh\u00f3 th\u1edf, n\u1eb7ng ng\u1ef1c v\u00e0 ho.<\/p>\n

– Ng\u01b0\u1eddi b\u1ecb hen th\u01b0\u1eddng c\u00f3 nhi\u1ec1u h\u01a1n m\u1ed9t trong c\u00e1c tri\u1ec7u ch\u1ee9ng n\u00eau tr\u00ean;<\/p>\n

– C\u00e1c tri\u1ec7u ch\u1ee9ng bi\u1ebfn \u0111\u1ed5i theo th\u1eddi gian v\u00e0 c\u01b0\u1eddng \u0111\u1ed9;<\/p>\n

– C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng x\u1ea3y ra ho\u1eb7c n\u1eb7ng h\u01a1n v\u00e0o ban \u0111\u00eam hay l\u00fac th\u1ee9c gi\u1ea5c;<\/p>\n

– C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng kh\u1edfi ph\u00e1t khi g\u1eafng s\u1ee9c, c\u01b0\u1eddi l\u1edbn, ti\u1ebfp x\u00fac c\u00e1c d\u1ecb nguy\u00ean hay kh\u00f4ng kh\u00ed l\u1ea1nh;<\/p>\n

– C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng x\u1ea3y ra ho\u1eb7c tr\u1edf n\u00ean x\u1ea5u \u0111i khi nhi\u1ec5m vi r\u00fat.<\/td>\n<\/tr>\n

2. B\u1eb1ng ch\u1ee9ng gi\u1edbi h\u1ea1n lu\u1ed3ng kh\u00ed th\u1edf ra bi\u1ebfn \u0111\u1ed5i<\/b><\/td>\n<\/tr>\n
– It nh\u1ea5t m\u1ed9t l\u1ea7n trong qu\u00e1 tr\u00ecnh ch\u1ea9n \u0111o\u00e1n c\u00f3 FEV1 th\u1ea5p, ghi nh\u1eadn t\u1ec9 l\u1ec7 FEV1\/FVC th\u1ea5p h\u01a1n gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng th\u1ea5p. T\u1ec9 l\u1ec7 FEV1\/FVC b\u00ecnh th\u01b0\u1eddng l\u1edbn h\u01a1n 0,75-0,80 \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn v\u00e0 h\u01a1n 0,85 \u0111\u1ed1i v\u1edbi tr\u1ebb em.<\/p>\n

– Ghi nh\u1eadn bi\u1ebfn \u0111\u1ed5i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p cao h\u01a1n \u1edf ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh. V\u00ed d\u1ee5:<\/p>\n

+ FEV1\u00a0t\u0103ng h\u01a1n 12% v\u00e0 200mL so v\u1edbi gi\u00e1 tr\u1ecb ban \u0111\u1ea7u (\u1edf tr\u1ebb em, >12% gi\u00e1 tr\u1ecb d\u1ef1 \u0111o\u00e1n) sau khi h\u00edt thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n. \u0110\u01b0\u1ee3c g\u1ecdi l\u00e0 \u201cgi\u00e3n ph\u1ebf qu\u1ea3n h\u1ed3i ph\u1ee5c\u201d.<\/p>\n

+ Trung b\u00ecnh h\u1eb1ng ng\u00e0y LL\u0110 thay \u0111\u1ed5i >10% (\u1edf tr\u1ebb em, >13%)<\/p>\n

+ FEV1 t\u0103ng h\u01a1n 12% v\u00e0 200mL so v\u1edbi gi\u00e1 tr\u1ecb ban \u0111\u1ea7u (\u1edf tr\u1ebb em, >12% gi\u00e1 tr\u1ecb d\u1ef1 \u0111o\u00e1n) sau 4 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c kh\u00e1ng vi\u00eam (ngo\u00e0i c\u00e1c \u0111\u1ee3t nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p)<\/p>\n

– S\u1ef1 thay \u0111\u1ed5i v\u01b0\u1ee3t m\u1ee9c c\u00e0ng l\u1edbn trong nhi\u1ec1u l\u1ea7n \u0111\u00e1nh gi\u00e1 th\u00ec vi\u1ec7c ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n c\u00e0ng ch\u1eafc ch\u1eafn h\u01a1n.<\/p>\n

– Vi\u1ec7c th\u0103m d\u00f2 n\u00ean \u0111\u01b0\u1ee3c l\u1eb7p l\u1ea1i trong khi c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng, v\u00e0o s\u00e1ng s\u1edbm hay sau khi s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n.<\/p>\n

– H\u1ed3i ph\u1ee5c ph\u1ebf qu\u1ea3n c\u00f3 th\u1ec3 kh\u00f4ng th\u1ea5y trong \u0111\u1ee3t c\u1ea5p n\u1eb7ng hay nhi\u1ec5m vi r\u00fat. N\u1ebfu h\u1ed3i ph\u1ee5c ph\u1ebf qu\u1ea3n kh\u00f4ng th\u1ea5y trong th\u0103m d\u00f2 ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p l\u1ea7n \u0111\u1ea7u, th\u00ec b\u01b0\u1edbc ti\u1ebfp theo ph\u1ee5 thu\u1ed9c v\u00e0o t\u00ednh c\u1ea5p b\u00e1ch c\u1ee7a l\u00e2m s\u00e0ng v\u00e0 s\u1ef1 s\u1eb5n c\u00f3 c\u1ee7a c\u00e1c th\u0103m d\u00f2 kh\u00e1c.<\/p>\n

– L\u00e0m th\u00eam c\u00e1c th\u0103m d\u00f2 kh\u00e1c \u0111\u1ec3 h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n, bao g\u1ed3m c\u1ea3 th\u1eed nghi\u1ec7m g\u00e2y co th\u1eaft ph\u1ebf qu\u1ea3n.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

3. C\u00e1c b\u01b0\u1edbc ti\u1ebfn h\u00e0nh \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n<\/h2>\n

– Khai th\u00e1c b\u1ec7nh s\u1eed v\u00e0 ti\u1ec1n s\u1eed gia \u0111\u00ecnh: th\u1eddi \u0111i\u1ec3m v\u00e0 c\u00e1ch kh\u1edfi ph\u00e1t c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p, ti\u1ec1n s\u1eed m\u1eafc c\u00e1c b\u1ec7nh d\u1ecb \u1ee9ng nh\u01b0 vi\u00eam m\u0169i d\u1ecb \u1ee9ng, ch\u00e0m c\u01a1 \u0111\u1ecba c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh ho\u1eb7c gia \u0111\u00ecnh<\/p>\n

– Kh\u00e1m th\u1ef1c th\u1ec3: ph\u00e1t hi\u1ec7n ti\u1ebfng ran r\u00edt, ran ng\u00e1y th\u00ec th\u1edf ra khi nghe ph\u1ed5i ho\u1eb7c c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a b\u1ec7nh l\u00fd m\u1eafc k\u00e8m nh\u01b0 vi\u00eam m\u0169i d\u1ecb \u1ee9ng ho\u1eb7c polyp m\u0169i.<\/p>\n

– \u0110o h\u00f4 h\u1ea5p k\u00fd \u0111\u1ec3 ghi nh\u1eadn gi\u1edbi h\u1ea1n lu\u1ed3ng kh\u00ed th\u1edf ra dao \u0111\u1ed9ng<\/p>\n

– C\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c:<\/p>\n

+\u00a0Test k\u00edch th\u00edch ph\u1ebf qu\u1ea3n: d\u00f9ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ef1 t\u0103ng t\u00ednh ph\u1ea3n \u1ee9ng c\u1ee7a \u0111\u01b0\u1eddng th\u1edf. C\u00e1c t\u00e1c nh\u00e2n k\u00edch th\u00edch bao g\u1ed3m methacholine h\u00edt, histamine, v\u1eadn \u0111\u1ed9ng, t\u0103ng th\u00f4ng kh\u00ed t\u1ef1 \u00fd v\u1edbi CO2<\/sub>\u00a0m\u00e1u b\u00ecnh th\u01b0\u1eddng ho\u1eb7c mannitol h\u00edt.<\/p>\n

+\u00a0Th\u1eed nghi\u1ec7m d\u1ecb \u1ee9ng: test l\u1ea9y da ho\u1eb7c \u0111\u1ecbnh l\u01b0\u1ee3ng n\u1ed3ng \u0111\u1ed9 immunoglobulin E (lgE) \u0110\u1eb7c hi\u1ec7u trong huy\u1ebft thanh v\u1edbi c\u00e1c d\u1ecb nguy\u00ean h\u00f4 h\u1ea5p th\u00f4ng th\u01b0\u1eddng \u0111\u1ec3 ph\u00e1t hi\u1ec7n t\u00ecnh tr\u1ea1ng qu\u00e1 m\u1eabn v\u1edbi c\u00e1c d\u1ecb nguy\u00ean n\u00e0y.<\/p>\n

+ \u0110o n\u1ed3ng \u0111\u1ed9 Oxit Nitric trong kh\u00ed th\u1edf ra (FENO).<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o : Ph\u00e1c \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n hen GINA (2019)<\/p>\n","protected":false},"excerpt":{"rendered":"

Hen ph\u1ebf qu\u1ea3n (HPQ) l\u00e0 m\u1ed9t b\u1ec7nh c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m l\u00e0 vi\u00eam m\u1ea1n t\u00ednh ni\u00eam m\u1ea1c ph\u1ebf qu\u1ea3n l\u00e0m t\u0103ng ph\u1ea3n \u1ee9ng c\u1ee7a ph\u1ebf qu\u1ea3n th\u01b0\u1eddng xuy\u00ean v\u1edbi nhi\u1ec1u t\u00e1c nh\u00e2n k\u00edch th\u00edch, d\u1eabn \u0111\u1ebfn co th\u1eaft lan to\u1ea3 c\u01a1 tr\u01a1n ph\u1ebf qu\u1ea3n. S\u1ef1 co th\u1eaft ph\u1ebf qu\u1ea3n kh\u00f4ng c\u1ed1 \u0111\u1ecbnh, th\u01b0\u1eddng c\u00f3 th\u1ec3 h\u1ed3i […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[3],"yoast_head":"\nCh\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n theo GINA 2019 - Vinmec<\/title>\n<meta name=\"description\" content=\"Hen ph\u1ebf qu\u1ea3n (HPQ) l\u00e0 m\u1ed9t b\u1ec7nh c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m l\u00e0 vi\u00eam m\u1ea1n t\u00ednh ni\u00eam m\u1ea1c ph\u1ebf qu\u1ea3n l\u00e0m t\u0103ng ph\u1ea3n \u1ee9ng c\u1ee7a ph\u1ebf qu\u1ea3n th\u01b0\u1eddng xuy\u00ean v\u1edbi nhi\u1ec1u t\u00e1c ...\" \/>\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=\"Ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n theo GINA 2019 - 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