{"id":21917,"date":"2023-04-20T10:57:48","date_gmt":"2023-04-20T03:57:48","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21917"},"modified":"2023-04-20T16:05:53","modified_gmt":"2023-04-20T09:05:53","slug":"chan-doan-benh-hen-phe-quan-o-mot-so-the-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/20\/chan-doan-benh-hen-phe-quan-o-mot-so-the-lam-sang\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh hen ph\u1ebf qu\u1ea3n \u1edf m\u1ed9t s\u1ed1 th\u1ec3 l\u00e2m s\u00e0ng"},"content":{"rendered":"

Hen ph\u1ebf qu\u1ea3n l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd h\u00f4 h\u1ea5p<\/a> m\u1ea1n t\u00ednh, g\u00e2y ra do vi\u1ec7c vi\u00eam v\u00e0 co th\u1eaft c\u00e1c \u0111\u01b0\u1eddng ph\u1ebf qu\u1ea3n, l\u00e0m gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng kh\u00ed v\u00e0o v\u00e0 ra kh\u1ecfi ph\u1ed5i. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n l\u00e0 r\u1ea5t quan tr\u1ecdng trong c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng kh\u00e1c nhau \u0111\u1ec3 gi\u00fap \u0111\u01b0a ra ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u00e0 gi\u00fap ng\u01b0\u1eddi b\u1ec7nh ki\u1ec3m so\u00e1t b\u1ec7nh t\u1ed1t h\u01a1n, gi\u1ea3m thi\u1ec3u c\u00e1c bi\u1ebfn ch\u1ee9ng v\u00e0 t\u00e1c \u0111\u1ed9ng ti\u00eau c\u1ef1c \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/strong><\/p>\n

\"Th\u1ec3
Th\u1ec3 hen ph\u1ebf qu\u1ea3n v\u1edbi ho l\u00e0 tri\u1ec7u ch\u1ee9ng duy nh\u1ea5t<\/figcaption><\/figure>\n

1. Hen ph\u1ebf qu\u1ea3n v\u1edbi ho l\u00e0 tri\u1ec7u ch\u1ee9ng duy nh\u1ea5t<\/b><\/h2>\n

Th\u1ec3 n\u00e0y \u0111\u1eb7c tr\u01b0ng b\u1edfi tri\u1ec7u ch\u1ee9ng ho, xu\u1ea5t hi\u1ec7n th\u00e0nh c\u01a1n, th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n khi thay \u0111\u1ed5i th\u1eddi ti\u1ebft, n\u1eeda \u0111\u00eam v\u1ec1 s\u00e1ng;<\/p>\n

Th\u1ec3 b\u1ec7nh n\u00e0y \u0111\u00f4i khi kh\u00f3 ch\u1ea9n \u0111o\u00e1n, do b\u1ec7nh nh\u00e2n th\u01b0\u1eddng \u0111\u1ebfn kh\u00e1m b\u1ec7nh khi kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, k\u1ebft qu\u1ea3 \u0111o ch\u1ee9c n\u0103ng th\u00f4ng kh\u00ed ph\u1ed5i b\u00ecnh th\u01b0\u1eddng. \u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh, c\u00f3 th\u1ec3 c\u1ea7n l\u00e0m test k\u00edch th\u00edch ph\u1ebf qu\u1ea3n, theo d\u00f5i dao \u0111\u1ed9ng l\u01b0u l\u01b0\u1ee3ng \u0111\u1ec9nh (LL\u0110) trong ng\u00e0y ho\u1eb7c c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb th\u1eed v\u1edbi thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n, ho\u1eb7c corticoid h\u00edt. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh hen ph\u1ebf qu\u1ea3n khi c\u00f3 test k\u00edch th\u00edch ph\u1ebf qu\u1ea3n d\u01b0\u01a1ng t\u00ednh.<\/p>\n

Khi ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n th\u1ec3 ho l\u00e0 tri\u1ec7u ch\u1ee9ng duy nh\u1ea5t: c\u1ea7n l\u01b0u \u00fd lo\u1ea1i tr\u1eeb m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd g\u00e2y c\u00e1c tri\u1ec7u ch\u1ee9ng ho k\u00e9o d\u00e0i nh\u01b0: h\u1ed9i ch\u1ee9ng ch\u1ea3y d\u1ecbch t\u1eeb m\u0169i sau, vi\u00eam xoang m\u1ea1n, tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n (GERD), r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng d\u00e2y thanh, vi\u00eam ph\u1ebf qu\u1ea3n t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan.<\/p>\n

2. B\u1ec7nh hen ngh\u1ec1 nghi\u1ec7p<\/b><\/h2>\n

T\u1ea5t c\u1ea3 nh\u1eefng b\u1ec7nh nh\u00e2n hen ph\u1ebf qu\u1ea3n kh\u1edfi ph\u00e1t \u1edf tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh \u0111\u1ec1u c\u1ea7n \u0111\u01b0\u1ee3c h\u1ecfi v\u1ec1:<\/p>\n

– T\u00ecnh tr\u1ea1ng ph\u01a1i nhi\u1ec5m ngh\u1ec1 nghi\u1ec7p;<\/p>\n

– B\u1ec7nh hen c\u00f3 tr\u1edf n\u00ean t\u1ed1t h\u01a1n khi tr\u00e1nh xa c\u00f4ng vi\u1ec7c kh\u00f4ng;<\/p>\n

– Trong x\u1eed tr\u00ed: c\u1ea7n c\u00f3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh s\u1edbm v\u00e0 lo\u1ea1i tr\u1eeb ph\u01a1i nhi\u1ec5m ngh\u1ec1 nghi\u1ec7p c\u00e0ng nhanh c\u00e0ng t\u1ed1t.<\/p>\n

3. <\/b>Hen \u1edf p<\/b>h\u1ee5 n\u1eef mang thai<\/b><\/h2>\n

Trong th\u1eddi k\u1ef3 thai ngh\u00e9n, t\u00ecnh tr\u1ea1ng ki\u1ec3m so\u00e1t hen c\u00f3 th\u1ec3 thay \u0111\u1ed5i, do \u0111\u00f3 c\u1ea7n h\u1ecfi v\u1ec1 b\u1ec7nh hen cho t\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef mang thai v\u00e0 d\u1ef1 \u0111\u1ecbnh mang thai, v\u00e0 khuy\u1ebfn c\u00e1o v\u1ec1 t\u1ea7m quan tr\u1ecdng c\u1ee7a \u0111i\u1ec1u tr\u1ecb hen v\u00ec s\u1ee9c kh\u1ecfe c\u1ea3 m\u1eb9 v\u00e0 b\u00e9. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 th\u1ec3 kh\u00f3 kh\u0103n h\u01a1n so v\u1edbi nh\u1eefng ng\u01b0\u1eddi kh\u00e1c do nhi\u1ec1u y\u1ebfu t\u1ed1 kh\u00e1c nhau c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng t\u1ef1, v\u00ed d\u1ee5 nh\u01b0 kh\u00f3 th\u1edf do t\u00e1c \u0111\u1ed9ng c\u1ee7a thai nhi l\u00ean c\u00e1c c\u01a1 quan trong ng\u1ef1c. Do \u0111\u00f3, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c hen ph\u1ebf qu\u1ea3n \u1edf ph\u1ee5 n\u1eef mang thai c\u1ea7n s\u1ef1 tinh t\u1ebf v\u00e0 th\u1eadn tr\u1ecdng, v\u00e0 c\u00f3 th\u1ec3 y\u00eau c\u1ea7u s\u1ef1 h\u1ee3p t\u00e1c gi\u1eefa c\u00e1c chuy\u00ean gia v\u1ec1 s\u1ea3n ph\u1ee5 khoa v\u00e0 h\u00f4 h\u1ea5p.<\/p>\n

4. Hen \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i<\/b><\/h2>\n

hen ph\u1ebf qu\u1ea3n c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0111\u1ea7y \u0111\u1ee7 \u1edf ng\u01b0\u1eddi gi\u00e0, do nh\u1eadn th\u1ee9c k\u00e9m, do \u0111\u1ecbnh ki\u1ebfn r\u1eb1ng kh\u00f3 th\u1edf l\u00e0 b\u00ecnh th\u01b0\u1eddng \u1edf ng\u01b0\u1eddi gi\u00e0, do thi\u1ebfu t\u1eadp th\u1ec3 d\u1ee5c, hay gi\u1ea3m ho\u1ea1t \u0111\u1ed9ng. B\u1ec7nh hen c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n qu\u00e1 m\u1ee9c do nh\u1ea7m l\u1eabn v\u1edbi kh\u00f3 th\u1edf do suy tim tr\u00e1i hay b\u1ec7nh tim do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9.<\/p>\n

5. Hen \u1edf ng\u01b0\u1eddi h\u00fat thu\u1ed1c v\u00e0 nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 t\u1eebng h\u00fat thu\u1ed1c<\/b><\/h2>\n

C\u00f3 th\u1ec3 g\u1eb7p c\u1ea3 hen ph\u1ebf qu\u1ea3n, COPD, ho\u1eb7c ch\u1ed3ng l\u1ea5p hen-COPD (ACO), \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng ng\u01b0\u1eddi h\u00fat thu\u1ed1c l\u00e1 v\u00e0 ng\u01b0\u1eddi gi\u00e0. B\u1ec7nh s\u1eed, ki\u1ec3u h\u00ecnh c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 c\u00e1c ghi nh\u1eadn trong ti\u1ec1n s\u1eed b\u1ec7nh c\u00f3 th\u1ec3 gi\u00fap ph\u00e2n bi\u1ec7t hen ph\u1ebf qu\u1ea3n v\u1edbi gi\u1edbi h\u1ea1n lu\u1ed3ng kh\u00ed c\u1ed1 \u0111\u1ecbnh trong COPD. Tr\u01b0\u1eddng h\u1ee3p ch\u1ea9n \u0111o\u00e1n kh\u00f4ng ch\u1eafc ch\u1eafn: c\u1ea7n chuy\u1ec3n s\u1edbm b\u1ec7nh nh\u00e2n \u0111\u1ebfn kh\u00e1m c\u00e1c chuy\u00ean gia, ho\u1eb7c c\u00e1c c\u01a1 s\u1edf kh\u00e1m, \u0111i\u1ec1u tr\u1ecb chuy\u00ean khoa.<\/p>\n

6.\u0110\u00e1nh gi\u00e1 hen ph\u1ebf qu\u1ea3n<\/b><\/h2>\n

T\u1eadn d\u1ee5ng m\u1ecdi c\u01a1 h\u1ed9i \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u1ea7y \u0111\u1ee7 khi b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n, \u0111\u1eb7c bi\u1ec7t khi c\u00f3 tri\u1ec7u ch\u1ee9ng hay sau m\u1ed9t \u0111\u1ee3t c\u1ea5p g\u1ea7n \u0111\u00e2y, c\u0169ng nh\u01b0 khi b\u1ec7nh nh\u00e2n y\u00eau c\u1ea7u k\u00ea \u0111\u01a1n thu\u1ed1c. Ngo\u00e0i ra, ph\u1ea3i l\u1eadp k\u1ebf ho\u1ea1ch ki\u1ec3m tra \u0111\u1ecbnh k\u1ef3 t\u1ed1i thi\u1ec3u m\u1ed7i n\u0103m m\u1ed9t l\u1ea7n.<\/p>\n

B\u1ea3ng C\u00e1c n\u1ed9i dung c\u1ea7n \u0111\u00e1nh gi\u00e1 \u1edf b\u1ec7nh nh\u00e2n hen ph\u1ebf qu\u1ea3n<\/b><\/p>\n\n\n\n\n\n\n\n\n\n
1. \u0110\u00e1nh gi\u00e1 \u0111\u1ed9 n\u1eb7ng c\u1ee7a hen ph\u1ebf qu\u1ea3n<\/b><\/td>\n<\/tr>\n
2. Ki\u1ec3m so\u00e1t hen – \u0110\u00e1nh gi\u00e1 c\u1ea3 vi\u1ec7c ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng v\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1<\/b><\/td>\n<\/tr>\n
– \u0110\u00e1nh gi\u00e1 vi\u1ec7c ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng trong v\u00f2ng 4 tu\u1ea7n qua<\/p>\n

– X\u00e1c \u0111\u1ecbnh c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 kh\u00e1c d\u1eabn \u0111\u1ebfn k\u1ebft c\u1ee5c x\u1ea5u;<\/p>\n

– \u0110o ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, 3-6 th\u00e1ng sau v\u00e0 \u0111\u1ecbnh k\u1ef3, v\u00ed d\u1ee5 h\u00e0ng n\u0103m<\/td>\n<\/tr>\n

3. C\u00f3 b\u1ec7nh \u0111\u1ed3ng m\u1eafc kh\u00f4ng<\/b><\/td>\n<\/tr>\n
– Bao g\u1ed3m: vi\u00eam m\u0169i, vi\u00eam m\u0169i xoang, tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n (GERD), b\u00e9o ph\u00ec, h\u1ed9i ch\u1ee9ng ng\u01b0ng th\u1edf khi ng\u1ee7, tr\u1ea7m c\u1ea3m, lo \u00e2u.<\/p>\n

– B\u1ec7nh \u0111\u1ed3ng m\u1eafc n\u00ean c\u1ea7n \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n v\u00ec ch\u00fang c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n l\u00e0m t\u0103ng c\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p, xu\u1ea5t hi\u1ec7n \u0111\u1ee3t c\u1ea5p v\u00e0 l\u00e0m gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng.<\/p>\n

\u0110i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed3ng m\u1eafc c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n c\u1ea3i thi\u1ec7n ki\u1ec3m so\u00e1t hen.<\/td>\n<\/tr>\n

4. V\u1ea5n \u0111\u1ec1 \u0111i\u1ec1u tr\u1ecb<\/b><\/td>\n<\/tr>\n
– Ghi l\u1ea1i \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 h\u1ecfi v\u1ec1 t\u00e1c d\u1ee5ng ph\u1ee5<\/p>\n

– Quan s\u00e1t b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng b\u00ecnh x\u1ecbt v\u00e0 ki\u1ec3m tra k\u1ef9 thu\u1eadt c\u1ee7a h\u1ecd<\/p>\n

– Th\u1ea3o lu\u1eadn c\u1edfi m\u1edf v\u00e0 \u0111\u1ed3ng c\u1ea3m v\u1ec1 tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb<\/p>\n

– Ki\u1ec3m tra b\u1ec7nh nh\u00e2n c\u00f3 b\u1ea3ng k\u1ebf ho\u1ea1ch h\u00e0nh \u0111\u1ed9ng cho hen<\/p>\n

– H\u1ecfi ng\u01b0\u1eddi b\u1ec7nh v\u1ec1 th\u00e1i \u0111\u1ed9 v\u00e0 m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb \u0111\u1ed1i v\u1edbi b\u1ec7nh hen c\u1ee7a h\u1ecd<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

T\u00f3m l\u1ea1i, ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u00fap b\u00e1c s\u0129 \u0111\u01b0a ra ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u00e0 gi\u00fap ng\u01b0\u1eddi b\u1ec7nh ki\u1ec3m so\u00e1t b\u1ec7nh t\u1ed1t h\u01a1n. Trong tr\u01b0\u1eddng h\u1ee3p hen ph\u1ebf qu\u1ea3n kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng nh\u01b0 suy h\u00f4 h\u1ea5p v\u00e0 vi\u00eam ph\u1ed5i. Do \u0111\u00f3, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb hen ph\u1ebf qu\u1ea3n k\u1ecbp th\u1eddi l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u c\u00e1c t\u00e1c \u0111\u1ed9ng ti\u00eau c\u1ef1c \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

Hen ph\u1ebf qu\u1ea3n l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh, g\u00e2y ra do vi\u1ec7c vi\u00eam v\u00e0 co th\u1eaft c\u00e1c \u0111\u01b0\u1eddng ph\u1ebf qu\u1ea3n, l\u00e0m gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng kh\u00ed v\u00e0o v\u00e0 ra kh\u1ecfi ph\u1ed5i. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n hen ph\u1ebf qu\u1ea3n l\u00e0 r\u1ea5t quan tr\u1ecdng trong c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng kh\u00e1c nhau \u0111\u1ec3 gi\u00fap \u0111\u01b0a ra ph\u00e1c […]<\/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 b\u1ec7nh hen ph\u1ebf qu\u1ea3n \u1edf m\u1ed9t s\u1ed1 th\u1ec3 l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh hen ph\u1ebf qu\u1ea3n l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh, g\u00e2y ra do vi\u1ec7c vi\u00eam v\u00e0 co th\u1eaft c\u00e1c \u0111\u01b0\u1eddng ph\u1ebf qu\u1ea3n, l\u00e0m gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng kh\u00ed v\u00e0o v\u00e0 ra kh\u1ecfi ...\" \/>\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 b\u1ec7nh hen ph\u1ebf qu\u1ea3n \u1edf m\u1ed9t s\u1ed1 th\u1ec3 l\u00e2m s\u00e0ng - 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