{"id":21919,"date":"2023-04-18T18:15:58","date_gmt":"2023-04-18T11:15:58","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21919"},"modified":"2023-04-19T11:34:55","modified_gmt":"2023-04-19T04:34:55","slug":"danh-gia-muc-do-nang-va-kiem-soat-hen-phe-quan-theo-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/danh-gia-muc-do-nang-va-kiem-soat-hen-phe-quan-theo-bo-y-te\/","title":{"rendered":"\u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u00e0 ki\u1ec3m so\u00e1t hen ph\u1ebf qu\u1ea3n theo B\u1ed9 Y t\u1ebf"},"content":{"rendered":"

Vi\u1ec7c \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u00e0 ki\u1ec3m so\u00e1t hen ph\u1ebf qu\u1ea3n theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y t\u1ebf l\u00e0 r\u1ea5t quan tr\u1ecdng, 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. N\u1ebfu \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi, hen ph\u1ebf qu\u1ea3n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t v\u00e0 gi\u1ea3m thi\u1ec3u t\u00e1c \u0111\u1ed9ng ti\u00eau c\u1ef1c \u0111\u1ebfn s\u1ee9c kh\u1ecfe v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/strong><\/p>\n

\"Vi\u1ec7c
Vi\u1ec7c \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u00e0 ki\u1ec3m so\u00e1t hen ph\u1ebf qu\u1ea3n r\u1ea5t quan tr\u1ecdng<\/figcaption><\/figure>\n

\u00a01. \u0110\u00e1nh gi\u00e1 \u0111\u1ed9 n\u1eb7ng c\u1ee7a hen ph\u1ebf qu\u1ea3n<\/b><\/h2>\n

– M\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a hen \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 h\u1ed3i c\u1ee9u t\u1eeb m\u1ee9c \u0111i\u1ec1u tr\u1ecb c\u1ea7n thi\u1ebft \u0111\u1ec3 ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng v\u00e0 \u0111\u1ee3t c\u1ea5p. \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 hen c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n khi ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng xuy\u00ean v\u1edbi thu\u1ed1c ki\u1ec3m so\u00e1t trong v\u00e0i th\u00e1ng:<\/p>\n

+\u00a0Hen nh\u1eb9 l\u00e0 hen \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eadc 1 ho\u1eb7c b\u1eadc 2, ngh\u0129a l\u00e0 ch\u1ec9 d\u00f9ng thu\u1ed1c ki\u1ec3m so\u00e1t khi c\u00f3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c \u0111i\u1ec1u tr\u1ecb v\u1edbi c\u00e1c thu\u1ed1c ki\u1ec3m so\u00e1t nh\u01b0 ICS li\u1ec1u th\u1ea5p, kh\u00e1ng th\u1ee5 th\u1ec3 leukotriene (LTRA) ho\u1eb7c chromone.<\/p>\n

+\u00a0Hen trung b\u00ecnh l\u00e0 hen \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eadc 3, v\u00ed d\u1ee5 nh\u01b0 v\u1edbi ICS\/LABA li\u1ec1u th\u1ea5p.<\/p>\n

+\u00a0Hen n\u1eb7ng l\u00e0 hen \u0111\u00f2i h\u1ecfi \u0111i\u1ec1u tr\u1ecb \u1edf b\u1eadc 4 ho\u1eb7c 5 \u0111\u1ec3 duy tr\u00ec s\u1ef1 ki\u1ec3m so\u00e1t ho\u1eb7c hen kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c d\u00f9 \u0111i\u1ec1u tr\u1ecb \u1edf m\u1ee9c n\u00e0y.<\/p>\n

2. \u0110\u00e1nh gi\u00e1 ki\u1ec3m so\u00e1t hen<\/b><\/h2>\n

Ki\u1ec3m so\u00e1t hen gi\u00fap h\u1ea1n ch\u1ebf, gi\u1ea3m \u1ea3nh h\u01b0\u1edfng c\u1ee7a hen c\u00f3 th\u1ec3 quan s\u00e1t th\u1ea5y \u0111\u01b0\u1ee3c tr\u00ean b\u1ec7nh nh\u00e2n do \u0111i\u1ec1u tr\u1ecb. Ki\u1ec3m so\u00e1t hen g\u1ed3m c\u00f3 hai v\u1ea5n \u0111\u1ec1: ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng v\u00e0 gi\u1ea3m y\u1ebfu t\u1ed1 nguy c\u01a1 l\u00e0m b\u1ec7nh x\u1ea5u h\u01a1n trong t\u01b0\u01a1ng lai.<\/p>\n

B\u1ea3ng 1. \u0110\u00e1nh gi\u00e1 vi\u1ec7c ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng v\u00e0 nguy c\u01a1 t\u01b0\u01a1ng lai<\/i><\/b><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
A. M\u1ee9c \u0111\u1ed9 ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng b\u1ec7nh hen<\/b><\/td>\n<\/tr>\n
4 tu\u1ea7n qua, b\u1ec7nh nh\u00e2n c\u00f3:<\/b><\/td>\n\n

Ki\u1ec3m so\u00e1t ho\u00e0n to\u00e0n<\/b><\/p>\n<\/td>\n

\n

Ki\u1ec3m so\u00e1t m\u1ed9t ph\u1ea7n<\/b><\/p>\n<\/td>\n

\n

Kh\u00f4ng ki\u1ec3m so\u00e1t<\/b><\/p>\n<\/td>\n<\/tr>\n

– Tri\u1ec7u ch\u1ee9ng ban ng\u00e0y >2 l\u1ea7n\/tu\u1ea7n?<\/p>\n

– B\u1ea5t k\u1ef3 \u0111\u00eam n\u00e0o th\u1ee9c gi\u1ea5c do hen?<\/p>\n

– C\u1ea7n thu\u1ed1c gi\u1ea3m tri\u1ec7u ch\u1ee9ng >2 l\u1ea7n\/tu\u1ea7n?<\/p>\n

– Gi\u1edbi h\u1ea1n b\u1ea5t k\u1ef3 ho\u1ea1t \u0111\u1ed9ng n\u00e0o do hen?<\/td>\n

C\u00f3 \u25a1 Kh\u00f4ng \u25a1<\/p>\n

C\u00f3 \u25a1 Kh\u00f4ng \u25a1<\/p>\n

C\u00f3 \u25a1 Kh\u00f4ng \u25a1<\/p>\n

C\u00f3 \u25a1 Kh\u00f4ng \u25a1<\/td>\n

\n

Kh\u00f4ng c\u00f3<\/p>\n<\/td>\n

\n

C\u00f3 1-2<\/p>\n<\/td>\n

\n

C\u00f3 3-4<\/p>\n<\/td>\n<\/tr>\n

B. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 d\u1eabn \u0111\u1ebfn k\u1ebft c\u1ee5c hen x\u1ea5u<\/b><\/td>\n<\/tr>\n
– \u0110\u00e1nh gi\u00e1 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 l\u00fac ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111\u1ecbnh k\u1ef3, \u0111\u1eb7c bi\u1ec7t v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n th\u01b0\u1eddng c\u00f3 \u0111\u1ee3t c\u1ea5p.<\/p>\n

– \u0110o FEV1\u00a0l\u00fac b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, sau 3-6 th\u00e1ng \u0111i\u1ec1u tr\u1ecb ki\u1ec3m so\u00e1t \u0111\u1ec3 ghi l\u1ea1i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p t\u1ed1t nh\u1ea5t, sau \u0111\u00f3 \u0111\u1ecbnh k\u1ef3 \u0111\u1ec3 li\u00ean t\u1ee5c \u0111\u00e1nh gi\u00e1 nguy c\u01a1.<\/td>\n<\/tr>\n

C\u00f3 tri\u1ec7u ch\u1ee9ng hen kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 quan tr\u1ecdng xu\u1ea5t hi\u1ec7n \u0111\u1ee3t c\u1ea5p<\/b><\/p>\n

C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 kh\u00e1c c\u00f3 th\u1ec3 thay \u0111\u1ed5i \u0111\u01b0\u1ee3c\u00a0<\/b>(th\u1eadm ch\u00ed \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 \u00edt tri\u1ec7u ch\u1ee9ng)\u00a0g\u00e2y \u0111\u1ee3t c\u1ea5p<\/b><\/p>\n

–\u00a0Thu\u1ed1c:\u00a0<\/i><\/b>ICS kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh; k\u00e9m tu\u00e2n th\u1ee7 ICS; k\u1ef9 thu\u1eadt h\u00edt kh\u00f4ng \u0111\u00fang; s\u1eed d\u1ee5ng SABA nhi\u1ec1u (t\u1ef7 l\u1ec7 t\u1eed vong t\u0103ng n\u1ebfu \u2265 1 b\u00ecnh 200 li\u1ec1u\/ th\u00e1ng, ho\u1eb7c nguy c\u01a1 nh\u1eadp vi\u1ec7n t\u0103ng n\u1ebfu d\u00f9ng \u2265 3 b\u00ecnh 200 li\u1ec1u\/ n\u0103m)<\/p>\n

–\u00a0B\u1ec7nh \u0111\u1ed3ng m\u1eafc<\/i><\/b>: b\u00e9o ph\u00ec, vi\u00eam m\u0169i m\u1ea1n t\u00ednh, GERD, d\u1ecb \u1ee9ng th\u1ee9c \u0103n, lo l\u1eafng, tr\u1ea7m c\u1ea3m, c\u00f3 thai;<\/p>\n

–\u00a0Ph\u01a1i nhi\u1ec5m<\/i><\/b>: kh\u00f3i thu\u1ed1c; ti\u1ebfp x\u00fac v\u1edbi d\u1ecb nguy\u00ean; \u00f4 nhi\u1ec5m kh\u00f4ng kh\u00ed;<\/p>\n

– C\u00f3 c\u00e1c v\u1ea5n \u0111\u1ec1 nghi\u00eam tr\u1ecdng v\u1ec1 t\u00e2m l\u00fd hay \u0111\u1eddi s\u1ed1ng – kinh t\u1ebf<\/p>\n

–\u00a0Ch\u1ee9c n\u0103ng ph\u1ed5i<\/i><\/b>: FEV1 th\u1ea5p, \u0111\u1eb7c bi\u1ec7t n\u1ebfu < 60% d\u1ef1 \u0111o\u00e1n; bi\u1ebfn \u0111\u1ed5i nhi\u1ec1u;<\/p>\n

– M\u1ed9t s\u1ed1 x\u00e9t nghi\u1ec7m kh\u00e1c: t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan trong \u0111\u1eddm\/ m\u00e1u, t\u0103ng FENO<\/p>\n

Y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u1ed9c l\u1eadp quan tr\u1ecdng kh\u00e1c c\u1ee7a \u0111\u1ee3t c\u1ea5p g\u1ed3m:<\/b><\/p>\n

– \u0110\u00e3 \u0111\u01b0\u1ee3c \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n ho\u1eb7c nh\u1eadp khoa \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c do hen;<\/p>\n

– C\u00f3 1 ho\u1eb7c nhi\u1ec1u \u0111\u1ee3t c\u1ea5p n\u1eb7ng trong 12 th\u00e1ng qua;<\/td>\n

C\u00f3 m\u1ed9t ho\u1eb7c nhi\u1ec1u c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 l\u00e0m t\u0103ng nguy c\u01a1 \u0111\u1ee3t c\u1ea5p ngay c\u1ea3 khi c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t.<\/td>\n<\/tr>\n
Y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y gi\u1edbi h\u1ea1n lu\u1ed3ng kh\u00ed dai d\u1eb3ng\u00a0<\/b>bao g\u1ed3m: sinh non, sinh nh\u1eb9 c\u00e2n v\u00e0 t\u0103ng c\u00e2n nhi\u1ec1u khi m\u1edbi sinh; kh\u00f4ng \u0111i\u1ec1u tr\u1ecb ICS \u0111\u1ea7y \u0111\u1ee7; ti\u1ebfp x\u00fac v\u1edbi kh\u00f3i thu\u1ed1c l\u00e1, h\u00f3a ch\u1ea5t \u0111\u1ed9c h\u1ea1i, ph\u01a1i nhi\u1ec3m ngh\u1ec1 nghi\u1ec7p; FEV1\u00a0ban \u0111\u1ea7u th\u1ea5p; t\u0103ng ti\u1ebft nh\u1ea7y m\u1ea1n t\u00ednh; t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan trong \u0111\u1eddm ho\u1eb7c m\u00e1u<\/td>\n<\/tr>\n
Y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c g\u1ed3m:<\/b><\/p>\n

–\u00a0To\u00e0n th\u00e2n<\/i><\/b>: d\u00f9ng th\u01b0\u1eddng xuy\u00ean corticoid u\u1ed1ng (OCS); ICS li\u1ec1u cao v\u00e0\/ho\u1eb7c c\u00f3 ho\u1ea1t t\u00ednh m\u1ea1nh trong m\u1ed9t th\u1eddi gian d\u00e0i; d\u00f9ng k\u00e8m thu\u1ed1c \u1ee9c ch\u1ebf P450<\/p>\n

– T\u1ea1i ch\u1ed7: ICS li\u1ec1u cao v\u00e0\/ho\u1eb7c c\u00f3 ho\u1ea1t t\u00ednh m\u1ea1nh; k\u1ef9 thu\u1eadt h\u00edt k\u00e9m<\/td>\n<\/tr>\n

<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

2.1. Vai tr\u00f2 c\u1ee7a ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p trong theo d\u00f5i hen ph\u1ebf qu\u1ea3n<\/i><\/h3>\n

Khi \u0111\u00e3 c\u00f3 ch\u1ea9n \u0111o\u00e1n hen, ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p r\u1ea5t h\u1eefu \u00edch v\u1edbi vai tr\u00f2 l\u00e0 m\u1ed9t ch\u1ec9 s\u1ed1 quan tr\u1ecdng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh c\u00e1c nguy c\u01a1 t\u01b0\u01a1ng lai. FEV1\u00a0th\u1ea5p l\u00e0 d\u1ea5u hi\u1ec7u d\u1ef1 b\u00e1o \u0111\u1ed9c l\u1eadp nguy c\u01a1 \u0111\u1ee3t c\u1ea5p, nh\u1ea5t l\u00e0 khi FEV1<\/sub>\u00a0< 60% d\u1ef1 \u0111o\u00e1n.<\/p>\n

Ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p c\u1ea7n \u0111\u01b0\u1ee3c \u0111o khi kh\u00e1m, ch\u1ea9n \u0111o\u00e1n b\u1ec7nh; sau 3-6 th\u00e1ng \u0111i\u1ec1u tr\u1ecb v\u00e0 \u0111\u1ecbnh k\u1ef3 sau \u0111\u00f3. H\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh nh\u00e2n khi \u0111\u00e3 \u1ed5n \u0111\u1ecbnh v\u1eabn c\u1ea7n \u0111\u01b0\u1ee3c \u0111o ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p \u0111\u1ecbnh k\u1ef3. Vi\u1ec7c \u0111o ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p n\u00ean \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh th\u01b0\u1eddng xuy\u00ean h\u01a1n v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao xu\u1ea5t hi\u1ec7n \u0111\u1ee3t c\u1ea5p, ho\u1eb7c gi\u1ea3m ch\u1ee9c n\u0103ng ph\u1ed5i.<\/p>\n

Khi \u0111\u00e3 c\u00f3 ch\u1ea9n \u0111o\u00e1n hen, theo d\u00f5i LL\u0110 ng\u1eafn h\u1ea1n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb, x\u00e1c \u0111\u1ecbnh hen tr\u1edf n\u1eb7ng. Sau \u0111i\u1ec1u tr\u1ecb ICS, LL\u0110 s\u1ebd \u0111\u1ea1t m\u1ee9c trung b\u00ecnh 2 tu\u1ea7n, v\u00e0 ti\u1ebfp t\u1ee5c t\u0103ng trong kho\u1ea3ng 3 th\u00e1ng. Theo d\u00f5i LL\u0110 d\u00e0i h\u1ea1n th\u01b0\u1eddng \u00e1p d\u1ee5ng trong hen n\u1eb7ng, tr\u00ean l\u00e2m s\u00e0ng, ch\u1ec9 s\u1ed1 LL\u0110 gi\u00fap h\u1ed7 tr\u1ee3 trong t\u01b0 v\u1ea5n ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

2.2. C\u00e1c \u0111\u00e1nh gi\u00e1 c\u1ea7n thi\u1ebft cho b\u1ec7nh nh\u00e2n hen kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t<\/i><\/h3>\n

H\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n \u0111\u1ea1t ki\u1ec3m so\u00e1t hen t\u1ed1t nh\u1edd \u0111i\u1ec1u tr\u1ecb \u0111\u00fang, tr\u00e1nh y\u1ebfu t\u1ed1 nguy c\u01a1, v\u00e0 kh\u00e1m \u0111\u1ecbnh k\u1ef3. Tuy nhi\u00ean, v\u1eabn c\u00f3 nhi\u1ec1u b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t hen ph\u1ebf qu\u1ea3n. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u0111\u00f3: c\u1ea7n ti\u1ebfn h\u00e0nh c\u00e1c th\u0103m d\u00f2 theo l\u01b0\u1ee3c \u0111\u1ed3 sau:<\/p>\n

B\u1ea3ng 2. C\u00e1c \u0111\u00e1nh gi\u00e1 c\u1ea7n thi\u1ebft cho hen kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t<\/i><\/b><\/p>\n\n\n\n
Quan s\u00e1t b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng \u1ed1ng h\u00edt. Trao \u0111\u1ed5i v\u1ec1 tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb v\u00e0 nh\u1eefng kh\u00f3 kh\u0103n khi s\u1eed d\u1ee5ng<\/b><\/td>\nSo s\u00e1nh k\u1ef9 thu\u1eadt h\u00edt v\u1edbi b\u1ea3ng ki\u1ec3m d\u1ee5ng c\u1ee5 h\u00edt. \u0110i\u1ec1u ch\u1ec9nh c\u00e1c b\u01b0\u1edbc d\u00f9ng sai; ki\u1ec3m tra l\u1ea1i th\u01b0\u1eddng xuy\u00ean. C\u1ea7n \u0111\u1ed3ng c\u1ea3m khi th\u1ea3o lu\u1eadn v\u1edbi b\u1ec7nh ng\u01b0\u1eddi v\u1ec1 nh\u1eefng kh\u00f3 kh\u0103n khi tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u2193<\/b><\/p>\n\n\n\n
X\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n hen<\/b><\/td>\nN\u1ebfu ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p b\u00ecnh th\u01b0\u1eddng khi \u0111ang c\u00f3 tri\u1ec7u ch\u1ee9ng, xem x\u00e9t gi\u1ea3m n\u1eeda li\u1ec1u ICS v\u00e0 ki\u1ec3m tra l\u1ea1i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p sau 2-3 tu\u1ea7n.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u2193<\/b><\/p>\n\n\n\n
Lo\u1ea1i b\u1ecf c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1. \u0110\u00e1nh gi\u00e1 v\u00e0 ki\u1ec3m so\u00e1t c\u00e1c b\u1ec7nh \u0111\u1ed3ng m\u1eafc<\/b><\/td>\nKi\u1ec3m tra c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 hay nguy\u00ean nh\u00e2n nh\u01b0 h\u00fat thu\u1ed1c, thu\u1ed1c ch\u1eb9n beta, ch\u1ed1ng vi\u00eam kh\u00f4ng steroid (NSAID), ti\u1ebfp x\u00fac d\u1ecb nguy\u00ean. Ki\u1ec3m tra b\u1ec7nh \u0111\u1ed3ng m\u1eafc nh\u01b0 vi\u00eam m\u0169i, b\u00e9o ph\u00ec, tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y-th\u1ef1c qu\u1ea3n (GERD), tr\u1ea7m c\u1ea3m\/lo l\u1eafng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u2193<\/b><\/p>\n\n\n\n
Xem x\u00e9t t\u0103ng b\u1eadc \u0111i\u1ec1u tr\u1ecb<\/b><\/td>\nXem x\u00e9t t\u0103ng b\u1eadc \u0111i\u1ec1u tr\u1ecb cho m\u1ee9c \u0111i\u1ec1u tr\u1ecb k\u1ebf ti\u1ebfp. S\u1eed d\u1ee5ng chia s\u1ebb quy\u1ebft \u0111\u1ecbnh v\u00e0 c\u00e2n nh\u1eafc l\u1ee3i \u00edch v\u00e0 nguy c\u01a1 ti\u1ec1m \u1ea9n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u2193<\/b><\/p>\n\n\n\n
Tham kh\u1ea3o \u00fd ki\u1ebfn chuy\u00ean gia hay c\u00e1c trung t\u00e2m chuy\u00ean \u0111i\u1ec1u tr\u1ecb hen n\u1eb7ng<\/b><\/td>\nN\u1ebfu hen v\u1eabn kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t sau 3-6 th\u00e1ng \u0111i\u1ec1u tr\u1ecb theo b\u1eadc 4, tham kh\u1ea3o \u00fd ki\u1ebfn chuy\u00ean gia. Tham kh\u1ea3o s\u1edbm h\u01a1n n\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng hen n\u1eb7ng hay nghi ng\u1edd v\u1ec1 ch\u1ea9n \u0111o\u00e1n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

T\u00f3m l\u1ea1i, \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u00e0 \u0111\u00e1nh gi\u00e1 ki\u1ec3m so\u00e1t 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.<\/p>\n

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

Vi\u1ec7c \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u00e0 ki\u1ec3m so\u00e1t hen ph\u1ebf qu\u1ea3n theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y t\u1ebf l\u00e0 r\u1ea5t quan tr\u1ecdng, 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. N\u1ebfu \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi, hen ph\u1ebf qu\u1ea3n […]<\/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":"\n\u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u00e0 ki\u1ec3m so\u00e1t hen ph\u1ebf qu\u1ea3n theo B\u1ed9 Y t\u1ebf<\/title>\n<meta name=\"description\" content=\"\u00a0Vi\u1ec7c \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng v\u00e0 ki\u1ec3m so\u00e1t hen ph\u1ebf qu\u1ea3n theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y t\u1ebf l\u00e0 r\u1ea5t quan tr\u1ecdng, gi\u00fap b\u00e1c s\u0129 \u0111\u01b0a ra ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ph\u00f9 ...\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" 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