{"id":22171,"date":"2023-04-17T17:35:26","date_gmt":"2023-04-17T10:35:26","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22171"},"modified":"2023-04-18T12:07:55","modified_gmt":"2023-04-18T05:07:55","slug":"cac-cach-danh-gia-benh-phoi-tac-nghen-man-tinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/cac-cach-danh-gia-benh-phoi-tac-nghen-man-tinh\/","title":{"rendered":"C\u00e1c c\u00e1ch \u0111\u00e1nh gi\u00e1 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh"},"content":{"rendered":"

B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD<\/a>) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd m\u00e3n t\u00ednh c\u1ee7a \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi s\u1ef1 t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng kh\u00ed qu\u1ea3n v\u00e0 c\u00e1c \u0111\u01b0\u1eddng ph\u1ed5i. \u0110\u00e2y l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn nh\u1ea5t tr\u00ean th\u1ebf gi\u1edbi v\u00e0 \u1ea3nh h\u01b0\u1edfng nghi\u00eam tr\u1ecdng \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n.\u00a0C\u00e1c c\u00e1ch \u0111\u00e1nh gi\u00e1 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng b\u1ec7nh, \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh v\u00e0 l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3.<\/strong><\/p>\n

\"C\u00e1c
C\u00e1c c\u00e1ch \u0111\u00e1nh gi\u00e1 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng b\u1ec7nh<\/figcaption><\/figure>\n

1. M\u1ee5c ti\u00eau c\u1ee7a \u0111\u00e1nh gi\u00e1 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/b><\/h2>\n

– M\u1ee5c ti\u00eau c\u1ee7a \u0111\u00e1nh gi\u00e1 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 h\u1ea1n ch\u1ebf c\u1ee7a lu\u1ed3ng kh\u00ed th\u1edf, \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh \u0111\u1ebfn t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u00e0 nguy c\u01a1 c\u00e1c bi\u1ebfn c\u1ed1 trong t\u01b0\u01a1ng lai gi\u00fap \u0111i\u1ec1u tr\u1ecb b\u1ec7nh hi\u1ec7u qu\u1ea3 h\u01a1n.<\/p>\n

– \u0110\u00e1nh gi\u00e1 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh d\u1ef1a tr\u00ean c\u00e1c kh\u00eda c\u1ea1nh sau: m\u1ee9c \u0111\u1ed9 t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf, m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a tri\u1ec7u ch\u1ee9ng v\u00e0 s\u1ef1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe v\u00e0 cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n, nguy c\u01a1 n\u1eb7ng c\u1ee7a b\u1ec7nh (ti\u1ec1n s\u1eed \u0111\u1ee3t c\u1ea5p\/n\u0103m tr\u01b0\u1edbc) v\u00e0 c\u00e1c b\u1ec7nh l\u00fd \u0111\u1ed3ng m\u1eafc.<\/p>\n

    \n
  • \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf: \u0110o l\u01b0u l\u01b0\u1ee3ng kh\u00ed th\u1edf, th\u01b0\u1edbc \u0111o kh\u00ed dung ph\u1ed5i, \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 kh\u00f3 th\u1edf v\u00e0 m\u1ee9c \u0111\u1ed9 t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf.<\/li>\n
  • \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a tri\u1ec7u ch\u1ee9ng v\u00e0 s\u1ef1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe v\u00e0 cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n: \u0110\u00e1nh gi\u00e1 c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 kh\u00f3 th\u1edf, ho, \u0111\u1eddm v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y nh\u01b0 \u0111i b\u1ed9, leo c\u1ea7u thang, v\u00e0 c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t kh\u00e1c.<\/li>\n
  • \u0110\u00e1nh gi\u00e1 nguy c\u01a1 n\u1eb7ng c\u1ee7a b\u1ec7nh: \u0110\u00e1nh gi\u00e1 ti\u1ec1n s\u1eed v\u1ec1 \u0111\u1ee3t c\u1ea5p v\u00e0 c\u00e1c b\u1ec7nh l\u00fd \u0111\u1ed3ng m\u1eafc \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nguy c\u01a1 c\u00e1c bi\u1ebfn ch\u1ee9ng.<\/li>\n
  • \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng t\u00e2m l\u00fd v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng: \u0110\u00e1nh gi\u00e1 t\u00e1c \u0111\u1ed9ng c\u1ee7a b\u1ec7nh \u0111\u1ebfn t\u00ecnh tr\u1ea1ng t\u00e2m l\u00fd v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n

    D\u1ef1a tr\u00ean k\u1ebft qu\u1ea3 c\u1ee7a \u0111\u00e1nh gi\u00e1 COPD, c\u00e1c chuy\u00ean gia s\u1ee9c kh\u1ecfe c\u00f3 th\u1ec3 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p nh\u1ea5t, bao g\u1ed3m s\u1eed d\u1ee5ng thu\u1ed1c, ph\u01b0\u01a1ng ph\u00e1p t\u1eadp th\u1ec3 d\u1ee5c v\u00e0 c\u00e1c bi\u1ec7n ph\u00e1p h\u1ed7 tr\u1ee3 kh\u00e1c \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng v\u00e0 nguy c\u01a1 c\u00e1c bi\u1ebfn ch\u1ee9ng.<\/p>\n

    2. \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf<\/b><\/h2>\n

    B\u1ea3ng M\u1ee9c \u0111\u1ed9 t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf theo GOLD 2018<\/strong><\/p>\n\n\n\n\n\n\n\n
    \n

    Giai \u0111o\u1ea1n GOLD<\/b><\/p>\n<\/td>\n

    		\n

    Gi\u00e1 tr\u1ecb FEV<\/b>1\u00a0<\/sub><\/b>sau test h\u1ed3i ph\u1ee5c ph\u1ebf qu\u1ea3n<\/b><\/p>\n<\/td>\n<\/tr>\n

    \n

    Giai \u0111o\u1ea1n 1<\/p>\n<\/td>\n

    		FEV1\u00a0<\/sub>\u2265 80% tr\u1ecb s\u1ed1 l\u00fd thuy\u1ebft<\/td>\n<\/tr>\n
    \n

    Giai \u0111o\u1ea1n 2<\/p>\n<\/td>\n

    		50% \u2264 FEV1\u00a0<\/sub>< 80% tr\u1ecb s\u1ed1 l\u00fd thuy\u1ebft<\/td>\n<\/tr>\n
    \n

    Giai \u0111o\u1ea1n 3<\/p>\n<\/td>\n

    		30% \u2264 FEV1<\/sub>< 50% tr\u1ecb s\u1ed1 l\u00fd thuy\u1ebft<\/td>\n<\/tr>\n
    \n

    Giai \u0111o\u1ea1n 4<\/p>\n<\/td>\n

    		FEV1\u00a0<\/sub>< 30% tr\u1ecb s\u1ed1 l\u00fd thuy\u1ebft<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    3. \u0110\u00e1nh gi\u00e1 tri\u1ec7u ch\u1ee9ng v\u00e0 \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh<\/b><\/h2>\n

    C\u00f4ng c\u1ee5 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 tri\u1ec7u ch\u1ee9ng v\u00e0 s\u1ef1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh l\u00ean t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh:<\/p>\n

    – B\u1ed9 c\u00e2u h\u1ecfi s\u1eeda \u0111\u1ed5i c\u1ee7a H\u1ed9i \u0111\u1ed3ng nghi\u00ean c\u1ee9u y khoa Anh (mMRC): g\u1ed3m 5 c\u00e2u h\u1ecfi v\u1edbi \u0111i\u1ec3m cao nh\u1ea5t l\u00e0 4, \u0111i\u1ec3m c\u00e0ng cao th\u00ec m\u1ee9c \u0111\u1ed9 kh\u00f3 th\u1edf c\u00e0ng nhi\u1ec1u. mMRC < 2 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 \u00edt tri\u1ec7u ch\u1ee9ng, mMRC \u2265 2 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 nhi\u1ec1u tri\u1ec7u ch\u1ee9ng.<\/p>\n

    – B\u1ed9 c\u00e2u h\u1ecfi CAT g\u1ed3m 8 c\u00e2u h\u1ecfi, t\u1ed5ng \u0111i\u1ec3m 40, \u0111i\u1ec3m c\u00e0ng cao th\u00ec \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh t\u1edbi t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n c\u00e0ng l\u1edbn. CAT < 10 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a \u00edt tri\u1ec7u ch\u1ee9ng, \u00edt \u1ea3nh h\u01b0\u1edfng, CAT \u2265 10 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh nhi\u1ec1u. B\u1ed9 c\u00e2u h\u1ecfi n\u00e0y s\u1ebd c\u00e1c nh\u00e2n vi\u00ean y t\u1ebf \u0111\u00e1nh gi\u00e1 t\u00e1c \u0111\u1ed9ng c\u1ee7a b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh \u1ea3nh h\u01b0\u1edfng l\u00ean s\u1ee9c kh\u1ecfe v\u00e0 cu\u1ed9c s\u1ed1ng h\u00e0ng ng\u00e0y c\u1ee7a b\u1ec7nh nh\u00e2n. Nh\u00e2n vi\u00ean y t\u1ebf s\u1ebd s\u1eed d\u1ee5ng nh\u1eefng c\u00e2u tr\u1ea3 l\u1eddi c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 k\u1ebft qu\u1ea3 \u0111\u00e1nh gi\u00e1 \u0111\u1ec3 gi\u00fap h\u1ecd n\u00e2ng cao hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh.<\/span><\/p>\n

    4. \u0110\u00e1nh gi\u00e1 nguy c\u01a1 \u0111\u1ee3t c\u1ea5p<\/b><\/h2>\n

    D\u1ef1a v\u00e0o ti\u1ec1n s\u1eed \u0111\u1ee3t c\u1ea5p trong n\u0103m tr\u01b0\u1edbc (s\u1ed1 \u0111\u1ee3t c\u1ea5p v\u00e0 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a \u0111\u1ee3t c\u1ea5p). S\u1ed1 \u0111\u1ee3t c\u1ea5p\/n\u0103m: 0-1 (\u0111\u1ee3t c\u1ea5p nh\u1eb9 kh\u00f4ng ph\u1ea3i nh\u1eadp vi\u1ec7n, kh\u00f4ng s\u1eed d\u1ee5ng kh\u00e1ng sinh v\u00e0\/ho\u1eb7c corticosteroid) \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 nguy c\u01a1 th\u1ea5p. S\u1ed1 \u0111\u1ee3t c\u1ea5p \u2265 2 ho\u1eb7c c\u00f3 t\u1eeb 1 \u0111\u1ee3t c\u1ea5p n\u1eb7ng ph\u1ea3i nh\u1eadp vi\u1ec7n ho\u1eb7c \u0111\u1ee3t c\u1ea5p m\u1ee9c \u0111\u1ed9 trung b\u00ecnh ph\u1ea3i s\u1eed d\u1ee5ng kh\u00e1ng sinh v\u00e0\/ho\u1eb7c corticosteroid \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 nguy c\u01a1 cao.<\/p>\n

    5. \u0110\u00e1nh gi\u00e1 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh theo nh\u00f3m ABCD<\/b><\/h2>\n

    Ph\u00e2n nh\u00f3m ABCD ch\u1ee7 y\u1ebfu d\u1ef1a v\u00e0o:<\/p>\n

    + M\u1ee9c \u0111\u1ed9 tri\u1ec7u ch\u1ee9ng, \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh (mMRC, CAT).<\/p>\n

    + Nguy c\u01a1 \u0111\u1ee3t c\u1ea5p (ti\u1ec1n s\u1eed \u0111\u1ee3t c\u1ea5p\/n\u0103m, m\u1ee9c \u0111\u1ed9 n\u1eb7ng \u0111\u1ee3t c\u1ea5p).<\/p>\n

    <\/b><\/p>\n

    Bi\u1ec3u \u0111\u1ed3 <\/b>\u0110\u00e1nh gi\u00e1 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh theo nh\u00f3m ABCD (Theo GOLD 2018)<\/p>\n

    – B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/b>\u00a0nh\u00f3m A – Nguy c\u01a1 th\u1ea5p, \u00edt tri\u1ec7u ch\u1ee9ng:\u00a0<\/b>c\u00f3 0 – 1 \u0111\u1ee3t c\u1ea5p trong v\u00f2ng 12 th\u00e1ng qua (\u0111\u1ee3t c\u1ea5p kh\u00f4ng nh\u1eadp vi\u1ec7n v\u00e0 kh\u00f4ng ph\u1ea3i s\u1eed d\u1ee5ng kh\u00e1ng sinh, corticosteroid) v\u00e0 mMRC 0 – 1 ho\u1eb7c CAT < 10.<\/p>\n

    – B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/b>\u00a0nh\u00f3m B – Nguy c\u01a1 th\u1ea5p, nhi\u1ec1u tri\u1ec7u ch\u1ee9ng:\u00a0<\/b>c\u00f3 0 – 1 \u0111\u1ee3t c\u1ea5p trong v\u00f2ng 12 th\u00e1ng qua (\u0111\u1ee3t c\u1ea5p kh\u00f4ng nh\u1eadp vi\u1ec7n, kh\u00f4ng ph\u1ea3i s\u1eed d\u1ee5ng kh\u00e1ng sinh, corticosteroid) v\u00e0 mMRC \u2265 2 ho\u1eb7c \u0111i\u1ec3m CAT \u2265 10.<\/p>\n

    – B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/b>\u00a0nh\u00f3m C – Nguy c\u01a1 cao, \u00edt tri\u1ec7u ch\u1ee9ng:\u00a0<\/b>c\u00f3 \u2265 2 \u0111\u1ee3t c\u1ea5p trong v\u00f2ng 12 th\u00e1ng qua (ho\u1eb7c 1 \u0111\u1ee3t c\u1ea5p n\u1eb7ng ph\u1ea3i nh\u1eadp vi\u1ec7n ho\u1eb7c ph\u1ea3i \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n) v\u00e0 mMRC 0 – 1 ho\u1eb7c \u0111i\u1ec3m CAT <10.<\/p>\n

    – B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/b>\u00a0nh\u00f3m D – Nguy c\u01a1 cao, nhi\u1ec1u tri\u1ec7u ch\u1ee9ng:\u00a0<\/b>c\u00f3 \u2265 2 \u0111\u1ee3t c\u1ea5p trong v\u00f2ng 12 th\u00e1ng qua ho\u1eb7c 1 \u0111\u1ee3t c\u1ea5p ph\u1ea3i nh\u1eadp vi\u1ec7n v\u00e0 mMRC \u2265 2 ho\u1eb7c \u0111i\u1ec3m CAT \u2265 10.<\/p>\n

    Ch\u1ea9n \u0111o\u00e1n: B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh GOLD 1, 2, 3, 4; nh\u00f3m A, B, C, D<\/b><\/p>\n

    T\u00f3m l\u1ea1i, c\u00e1c c\u00e1ch \u0111\u00e1nh gi\u00e1 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 v\u00e0 t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n, t\u1eeb \u0111\u00f3 \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p nh\u1ea5t.<\/p>\n

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

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