{"id":22230,"date":"2023-04-16T18:07:53","date_gmt":"2023-04-16T11:07:53","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22230"},"modified":"2023-04-17T12:23:48","modified_gmt":"2023-04-17T05:23:48","slug":"phuc-hoi-chuc-nang-ho-hap-cho-benh-nhan-copd","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/phuc-hoi-chuc-nang-ho-hap-cho-benh-nhan-copd\/","title":{"rendered":"Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p cho b\u1ec7nh nh\u00e2n COPD"},"content":{"rendered":"

Theo H\u1ed9i L\u1ed3ng ng\u1ef1c Hoa K\u1ef3\/Hi\u1ec7p H\u1ed9i H\u00f4 h\u1ea5p ch\u00e2u \u00c2u 2013 \u201cPh\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p l\u00e0 m\u1ed9t can thi\u1ec7p to\u00e0n di\u1ec7n d\u1ef1a tr\u00ean s\u1ef1 l\u01b0\u1ee3ng gi\u00e1 c\u1ea9n th\u1eadn ng\u01b0\u1eddi b\u1ec7nh ti\u1ebfp theo sau l\u00e0 ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u1edbi t\u1eebng ng\u01b0\u1eddi b\u1ec7nh bao g\u1ed3m t\u1eadp v\u1eadn \u0111\u1ed9ng, gi\u00e1o d\u1ee5c s\u1ee9c kh\u1ecfe v\u00e0 thay \u0111\u1ed5i th\u00e1i \u0111\u1ed9 h\u00e0nh vi, \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf nh\u1eb1m c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng th\u1ec3 ch\u1ea5t v\u00e0 t\u00e2m l\u00fd c\u1ee7a b\u1ec7nh nh\u00e2n COPD v\u00e0 khuy\u1ebfn kh\u00edch tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i\u201d.<\/strong><\/p>\n

\"Ph\u1ee5c
Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p cho b\u1ec7nh nh\u00e2n COPD gi\u00fap c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh<\/figcaption><\/figure>\n

1. M\u1ee5c ti\u00eau ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p cho b\u1ec7nh nh\u00e2n COPD<\/b><\/h2>\n

Gi\u1ea3m tri\u1ec7u ch\u1ee9ng, c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng v\u00e0 gia t\u0103ng c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t v\u00e0 x\u00e3 h\u1ed9i trong \u0111\u1eddi s\u1ed1ng h\u00e0ng ng\u00e0y. Ch\u01b0\u01a1ng tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh mang l\u1ea1i nhi\u1ec1u l\u1ee3i \u00edch. (B\u1ea3ng 1)<\/p>\n

B\u1ea3ng 1. <\/b>Nh\u1eefng l\u1ee3i \u00edch c\u1ee7a ch\u01b0\u01a1ng tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p<\/p>\n\n\n\n\n\n\n
C\u1ea3i thi\u1ec7n kh\u00f3 th\u1edf, t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe v\u00e0 kh\u1ea3 n\u0103ng v\u1eadn \u0111\u1ed9ng \u1edf b\u1ec7nh nh\u00e2n \u1ed5n \u0111\u1ecbnh.<\/td>\nB\u1eb1ng ch\u1ee9ng lo\u1ea1i A<\/td>\n<\/tr>\n
Gi\u1ea3m nh\u1eadp vi\u1ec7n trong s\u1ed1 b\u1ec7nh nh\u00e2n v\u1eeba ra kh\u1ecfi \u0111\u1ee3t c\u1ea5p \u2264 4 tu\u1ea7n.<\/td>\nB\u1eb1ng ch\u1ee9ng lo\u1ea1i B<\/td>\n<\/tr>\n
Gi\u00e1o d\u1ee5c s\u1ee9c kh\u1ecfe \u0111\u01a1n thu\u1ea7n kh\u00f4ng \u0111em l\u1ea1i hi\u1ec7u qu\u1ea3.<\/td>\nB\u1eb1ng ch\u1ee9ng lo\u1ea1i C<\/td>\n<\/tr>\n
T\u1ef1 qu\u1ea3n l\u00fd b\u1ec7nh k\u00e8m trao \u0111\u1ed5i v\u1edbi nh\u00e2n vi\u00ean y t\u1ebf c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe, gi\u1ea3m nh\u1eadp vi\u1ec7n.<\/td>\nB\u1eb1ng ch\u1ee9ng lo\u1ea1i B<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

2. Ch\u1ec9 \u0111\u1ecbnh v\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/b><\/h2>\n

2.1. Ch\u1ec9 \u0111\u1ecbnh:<\/h3>\n

Ch\u01b0\u01a1ng tr\u00ecnh ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p n\u00ean th\u1ef1c hi\u1ec7n \u1edf t\u1ea5t c\u1ea3 nh\u1eefng b\u1ec7nh nh\u00e2n COPD ngay c\u1ea3 \u1edf giai \u0111o\u1ea1n s\u1edbm. \u0110\u1eb7c bi\u1ec7t, ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p c\u1ea7n th\u1ef1c hi\u1ec7n \u0111\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau d\u00f9 \u0111\u00e3 \u0111\u01b0\u1ee3c d\u00f9ng thu\u1ed1c t\u1ed1i \u01b0u:<\/p>\n

– Kh\u00f3 th\u1edf v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh.<\/p>\n

– Ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng k\u00e9m, gi\u1ea3m t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe chung.<\/p>\n

– Kh\u00f3 kh\u0103n khi th\u1ef1c hi\u1ec7n c\u00e1c sinh ho\u1ea1t h\u00e0ng ng\u00e0y.<\/p>\n

– Lo \u00e2u, tr\u1ea7m c\u1ea3m.<\/p>\n

– Suy dinh d\u01b0\u1ee1ng.<\/p>\n

– T\u0103ng s\u1eed d\u1ee5ng d\u1ecbch v\u1ee5 y t\u1ebf (\u0111\u1ee3t c\u1ea5p v\u00e0 nh\u1eadp vi\u1ec7n nhi\u1ec1u, th\u0103m kh\u00e1m nhi\u1ec1u l\u1ea7n\u2026).<\/p>\n

– R\u1ed1i lo\u1ea1n trao \u0111\u1ed5i kh\u00ed bao g\u1ed3m h\u1ea1 oxy m\u00e1u.<\/p>\n

2.2. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/h3>\n

– C\u00f3 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ch\u1ec9nh h\u00ecnh ho\u1eb7c th\u1ea7n kinh c\u00f3 th\u1ec3 l\u00e0m h\u1ea1n ch\u1ebf kh\u1ea3 n\u0103ng \u0111i l\u1ea1i ho\u1eb7c ph\u1ed1i h\u1ee3p trong l\u00fac t\u1eadp v\u1eadn \u0111\u1ed9ng.<\/p>\n

– \u0110\u1ed9 kh\u00f3 th\u1edf mMRC \u2265 4.<\/p>\n

– C\u00f3 c\u00e1c b\u1ec7nh ph\u1ed1i h\u1ee3p nh\u01b0 b\u1ec7nh t\u00e2m th\u1ea7n, b\u1ec7nh tim m\u1ea1ch kh\u00f4ng \u1ed5n \u0111\u1ecbnh.<\/p>\n

3. \u0110\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n COPD tr\u01b0\u1edbc khi tham gia ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p<\/b><\/h2>\n

– \u0110o CNTK v\u00e0 ph\u00e2n nh\u00f3m ABCD theo GOLD.<\/p>\n

– \u0110\u00e1nh gi\u00e1 b\u1ec7nh \u0111\u1ed3ng m\u1eafc: tim m\u1ea1ch, c\u01a1 x\u01b0\u01a1ng kh\u1edbp, t\u00e2m th\u1ea7n kinh.<\/p>\n

– \u0110\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng g\u1eafng s\u1ee9c b\u1eb1ng c\u00e1c nghi\u1ec7m ph\u00e1p \u0111i b\u1ed9.<\/p>\n

– SpO2\u00a0<\/sub>gi\u1ea3m > 4% sau g\u1eafng s\u1ee9c l\u00e0 c\u00f3 nguy c\u01a1 thi\u1ebfu oxy m\u00e1u khi g\u1eafng s\u1ee9c.<\/p>\n

– \u0110\u00e1nh gi\u00e1 s\u1ee9c c\u01a1 c\u1ee7a c\u00e1c c\u01a1 h\u00f4 h\u1ea5p v\u00e0 c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i.<\/p>\n

– \u0110\u00e1nh gi\u00e1 dinh d\u01b0\u1ee1ng (c\u00e2n n\u1eb7ng, kh\u1ed1i n\u1ea1c, % m\u1ee1…).<\/p>\n

– \u0110\u00e1nh gi\u00e1 lo \u00e2u, tr\u1ea7m c\u1ea3m…<\/p>\n

4. T\u1eadp v\u1eadn \u0111\u1ed9ng<\/b>\u00a0cho b\u1ec7nh nh\u00e2n COPD<\/b><\/h2>\n

L\u00e0 th\u00e0nh ph\u1ea7n ch\u1ee7 y\u1ebfu v\u00e0 b\u1eaft bu\u1ed9c c\u1ee7a ch\u01b0\u01a1ng tr\u00ecnh PHCN h\u00f4 h\u1ea5p v\u00e0 l\u00e0 c\u00e1ch t\u1ed1t nh\u1ea5t \u0111\u1ec3 c\u1ea3i thi\u1ec7n ho\u1ea1t \u0111\u1ed9ng c\u01a1 x\u01b0\u01a1ng \u1edf b\u1ec7nh nh\u00e2n BPTNMT.<\/p>\n

Ph\u01b0\u01a1ng th\u1ee9c t\u1eadp luy\u1ec7n\u00a0<\/b>bao g\u1ed3m t\u1eadp s\u1ee9c b\u1ec1n (endurance), t\u1eadp s\u1ee9c c\u01a1 (strenght), c\u00e1c b\u00e0i t\u1eadp c\u0103ng gi\u00e3n, t\u1eadp c\u01a1 h\u00f4 h\u1ea5p.<\/p>\n

– T\u1eadp s\u1ee9c b\u1ec1n: t\u1eadp chi d\u01b0\u1edbi nh\u1eb1m l\u00e0m kh\u1ecfe c\u00e1c c\u01a1 gi\u00fap \u0111i l\u1ea1i v\u00e0 c\u1ea3i thi\u1ec7n ho\u1ea1t \u0111\u1ed9ng tim ph\u1ed5i. T\u1eadp chi tr\u00ean gi\u00fap gi\u1ea3m b\u1edbt kh\u00f3 th\u1edf v\u00e0 gi\u1ea3m b\u1edbt nhu c\u1ea7u th\u00f4ng kh\u00ed trong c\u00e1c ho\u1ea1t \u0111\u1ed9ng d\u00f9ng tay.<\/p>\n

C\u00e1ch t\u1eadp: t\u1eadp chi d\u01b0\u1edbi: d\u00f9ng th\u1ea3m l\u0103n (kh\u1edfi \u0111\u1ea7u t\u1eeb 800m\/gi\u1edd, t\u0103ng d\u1ea7n cho \u0111\u1ebfn 5 km\/gi\u1edd ho\u1eb7c xe \u0111\u1ea1p l\u1ef1c k\u1ebf (kh\u1edfi \u0111\u1ea7u b\u1eb1ng 30 v\u00f2ng\/ph\u00fat) ho\u1eb7c \u0111i b\u1ed9 tr\u00ean m\u1eb7t ph\u1eb3ng. T\u1eadp chi tr\u00ean: d\u00f9ng m\u00e1y t\u1eadp tay c\u01a1 c\u00f4ng k\u1ebf (arm cycle ergometer), n\u00e2ng t\u1ea1 t\u1ef1 do ho\u1eb7c b\u1eb1ng \u0111\u00e0n h\u1ed3i.<\/p>\n

– T\u1eadp s\u1ee9c c\u01a1: l\u1eadp \u0111i l\u1eadp l\u1ea1i nhi\u1ec1u l\u1ea7n c\u00f9ng m\u1ed9t \u0111\u1ed9ng t\u00e1c l\u00e0m gia t\u0103ng kh\u1ed1i c\u01a1 v\u00e0 s\u1ee9c c\u01a1 t\u1ea1i ch\u1ed7, n\u00ean v\u1eadn \u0111\u1ed9ng nh\u1ecbp nh\u00e0ng, t\u1ed1c \u0111\u1ed9 ki\u1ec3m so\u00e1t t\u1eeb ch\u1eadm \u0111\u1ebfn trung b\u00ecnh, k\u1ebft h\u1ee3p v\u1edbi h\u00edt v\u00e0o khi gi\u00e3n c\u01a1 v\u00e0 th\u1edf ra khi co c\u01a1. C\u00e1c c\u01a1 n\u00ean t\u1eadp: c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i, c\u01a1 tam \u0111\u1ea7u, c\u01a1 nh\u1ecb \u0111\u1ea7u, c\u01a1 Delta, c\u01a1 ng\u1ef1c l\u1edbn\u2026<\/p>\n

C\u00e1ch t\u1eadp: chi d\u01b0\u1edbi: \u0111\u1ea1p xe, n\u00e2ng ch\u00e2n, b\u0103ng \u0111\u00e0n h\u1ed3i, b\u01b0\u1edbc b\u1eadc thang, b\u00e0i t\u1eadp ng\u1ed3i \u0111\u1ee9ng\u2026; chi tr\u00ean: m\u00e1y t\u1eadp (kh\u1edfi \u0111\u1ea7u 50 v\u00f2ng\/ph\u00fat kh\u00f4ng kh\u00e1ng l\u1ef1c), n\u00e2ng t\u1ea1 t\u1ef1 do (kh\u1edfi \u0111\u1ea7u: 1\/4 kg – 1 kg), b\u0103ng \u0111\u00e0n h\u1ed3i, n\u00e9m b\u00f3ng\u2026 L\u1eadp l\u1ea1i 8 – 12 l\u1ea7n\/\u0111\u1ed9ng t\u00e1c x 1 – 3 \u0111\u1ee3t\/bu\u1ed5i t\u1eadp x 2 – 3 ng\u00e0y\/tu\u1ea7n.<\/p>\n

C\u00e1c b\u00e0i t\u1eadp c\u0103ng gi\u00e3n: c\u1ea3i thi\u1ec7n c\u00e1c b\u1ea5t th\u01b0\u1eddng v\u1ec1 t\u01b0 th\u1ebf v\u00e0 d\u00e1ng \u0111\u1ee9ng c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ho\u1ea1t \u0111\u1ed9ng h\u00f4 h\u1ea5p nh\u01b0 c\u1ee9ng c\u1ed9t s\u1ed1ng, l\u1ec7ch c\u1ed9t s\u1ed1ng, nh\u00f4 vai, l\u1ec7ch vai\u2026.; bao g\u1ed3m c\u1ea3 chi tr\u00ean l\u1eabn chi d\u01b0\u1edbi nh\u01b0 b\u1eafp tay, b\u1eafp ch\u00e2n, khoeo ch\u00e2n, c\u1ed5, vai\u2026<\/p>\n

– T\u1eadp c\u01a1 h\u00f4 h\u1ea5p: t\u1eadp v\u1eadn \u0111\u1ed9ng c\u01a1 h\u00f4 h\u1ea5p c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u00eam v\u00e0o b\u00e0i t\u1eadp v\u1eadn \u0111\u1ed9ng, gi\u00fap t\u0103ng c\u01b0\u1eddng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u01a1 h\u00f4 h\u1ea5p v\u00e0 gi\u1ea3m b\u1edbt kh\u00f3 th\u1edf trong sinh ho\u1ea1t h\u00e0ng ng\u00e0y. T\u1eadp c\u01a1 h\u00f4 h\u1ea5p ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1eb1ng ch\u1ee9ng ho\u1eb7c nghi ng\u1edd y\u1ebfu c\u01a1 h\u00f4 h\u1ea5p. D\u1ee5ng c\u1ee5 t\u1eadp c\u01a1 h\u00f4 h\u1ea5p l\u00e0 d\u1ee5ng c\u1ee5 nh\u1ecf g\u1ecdn, gi\u00fap ng\u01b0\u1eddi b\u1ec7nh t\u0103ng kh\u1ea3 n\u0103ng h\u00edt v\u00e0o. S\u1ed1 l\u1ea7n t\u1eadp trung b\u00ecnh: 30 l\u1ea7n\/15 ph\u00fat.<\/p>\n

C\u01b0\u1eddng \u0111\u1ed9 t\u1eadp luy\u1ec7n<\/b>: c\u1ea7n ph\u00f9 h\u1ee3p v\u1edbi \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh, m\u1ee9c \u0111\u1ed9 h\u1ea1n ch\u1ebf do tri\u1ec7u ch\u1ee9ng b\u1ec7nh, b\u1ec7nh l\u00fd \u0111i k\u00e8m v\u00e0 s\u1ef1 n\u0103ng \u0111\u1ed9ng c\u1ee7a t\u1eebng ng\u01b0\u1eddi b\u1ec7nh. Th\u01b0\u1eddng s\u1eed d\u1ee5ng c\u00e1c \u0111i\u1ec3m tri\u1ec7u ch\u1ee9ng \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh v\u00e0 duy tr\u00ec m\u1ee9c \u0111\u1ed9 v\u1eadn \u0111\u1ed9ng nh\u01b0<\/p>\n

– Thang \u0111i\u1ec3m Borg. \u0110i\u1ec3m Borg 4 – 6 l\u00e0 m\u1ee5c ti\u00eau th\u00edch h\u1ee3p khi luy\u1ec7n t\u1eadp.<\/p>\n

– Nh\u1ecbp tim trong l\u00fac t\u1eadp sao cho x\u1ea5p x\u1ec9 75% nh\u1ecbp tim t\u1ed1i \u0111a (NTT\u0110) theo c\u00f4ng th\u1ee9c:<\/p>\n

NTT\u0110 = 220 – tu\u1ed5i.<\/p>\n

C\u00e1c bi\u1ec7n ph\u00e1p h\u1ed7 tr\u1ee3<\/b>: \u0111\u1ec3 vi\u1ec7c t\u1eadp v\u1eadn \u0111\u1ed9ng c\u00f3 th\u1ec3 \u0111\u1ea1t hi\u1ec7u qu\u1ea3 t\u1ed1i \u01b0u:<\/p>\n

– Thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n tr\u01b0\u1edbc khi t\u1eadp v\u1eadn \u0111\u1ed9ng gi\u00fap c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng g\u1eafng s\u1ee9c.<\/p>\n

– Th\u1edf oxy: \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n gi\u1ea3m b\u00e3o h\u00f2a oxy khi g\u1eafng s\u1ee9c, oxy gi\u00fap t\u0103ng kh\u1ea3 n\u0103ng g\u1eafng s\u1ee9c v\u00e0 gi\u1ea3m kh\u00f3 th\u1edf. \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n kh\u00f4ng h\u1ea1 oxy m\u00e1u khi g\u1eafng s\u1ee9c, oxy gi\u00fap gia t\u0103ng hi\u1ec7u qu\u1ea3 t\u1eadp s\u1ee9c b\u1ec1n. \u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n \u0111ang th\u1edf oxy d\u00e0i h\u1ea1n t\u1ea1i nh\u00e0 n\u00ean t\u0103ng l\u01b0u l\u01b0\u1ee3ng oxy khi v\u1eadn \u0111\u1ed9ng.<\/p>\n

– D\u1ee5ng c\u1ee5 h\u1ed7 tr\u1ee3 \u0111i l\u1ea1i: m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n n\u00ean s\u1eed d\u1ee5ng c\u00e1c d\u1ee5ng c\u1ee5 nh\u01b0 g\u1eady, khung \u0111\u1ea9y c\u00f3 b\u00e1nh xe (wheeled walking aid) v\u1edbi t\u01b0 th\u1ebf ch\u1ed3m ng\u01b0\u1eddi ra ph\u00eda tr\u01b0\u1edbc v\u1edbi \u0111i\u1ec3m t\u1ef1a \u1edf hai tay gi\u00fap gi\u1ea3m b\u1edbt kh\u00f3 th\u1edf v\u00e0 t\u0103ng kh\u1ea3 n\u0103ng g\u1eafng s\u1ee9c.<\/p>\n

– C\u00e1c ph\u01b0\u01a1ng ph\u00e1p t\u1eadp th\u1edf: bao g\u1ed3m th\u1edf ch\u00fam m\u00f4i, th\u1edf ra ch\u1ee7 \u0111\u1ed9ng, c\u00e1c t\u01b0 th\u1ebf \u0111\u1ed1i ph\u00f3 kh\u00f3 th\u1edf v\u00e0 c\u00e1ch ph\u1ed1i h\u1ee3p gi\u1eefa t\u1eadp th\u1edf v\u00e0 c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u01b0\u1eddng ng\u00e0y.<\/p>\n

– C\u00e1c k\u1ef9 thu\u1eadt l\u00e0m s\u1ea1ch ph\u1ebf qu\u1ea3n: bao g\u1ed3m ho h\u1eefu hi\u1ec7u, k\u1ef9 thu\u1eadt th\u1edf ra m\u1ea1nh (forced expiratory technique – FET, d\u1eabn l\u01b0u t\u01b0 th\u1ebf v\u00e0 v\u1ed7 rung.<\/p>\n

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

Theo H\u1ed9i L\u1ed3ng ng\u1ef1c Hoa K\u1ef3\/Hi\u1ec7p H\u1ed9i H\u00f4 h\u1ea5p ch\u00e2u \u00c2u 2013 \u201cPh\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p l\u00e0 m\u1ed9t can thi\u1ec7p to\u00e0n di\u1ec7n d\u1ef1a tr\u00ean s\u1ef1 l\u01b0\u1ee3ng gi\u00e1 c\u1ea9n th\u1eadn ng\u01b0\u1eddi b\u1ec7nh ti\u1ebfp theo sau l\u00e0 ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u1edbi t\u1eebng ng\u01b0\u1eddi b\u1ec7nh bao g\u1ed3m t\u1eadp v\u1eadn \u0111\u1ed9ng, gi\u00e1o d\u1ee5c s\u1ee9c […]<\/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":"\nPh\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p cho b\u1ec7nh nh\u00e2n COPD - Vinmec<\/title>\n<meta name=\"description\" content=\"Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb nh\u1eb1m c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng th\u1ec3 ch\u1ea5t v\u00e0 t\u00e2m l\u00fd c\u1ee7a b\u1ec7nh nh\u00e2n COPD v\u00e0 khuy\u1ebfn kh\u00edch ...\" \/>\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=\"Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p cho b\u1ec7nh nh\u00e2n COPD - 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