{"id":22821,"date":"2023-04-19T16:38:06","date_gmt":"2023-04-19T09:38:06","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22821"},"modified":"2023-04-20T16:34:37","modified_gmt":"2023-04-20T09:34:37","slug":"phac-do-dieu-tri-vi-khuan-lao-nhay-cam-voi-thuoc","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/phac-do-dieu-tri-vi-khuan-lao-nhay-cam-voi-thuoc\/","title":{"rendered":"Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n lao nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c"},"content":{"rendered":"

Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n lao nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb<\/a> \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o b\u1edfi B\u1ed9 Y t\u1ebf nh\u1eb1m \u0111i\u1ec1u tr\u1ecb b\u1ec7nh lao v\u00e0 ng\u0103n ng\u1eeba s\u1ef1 l\u00e2y lan c\u1ee7a b\u1ec7nh trong c\u1ed9ng \u0111\u1ed3ng. Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n lao nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c bao g\u1ed3m s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1ng lao \u0111\u1ec3 ti\u00eau di\u1ec7t vi khu\u1ea9n lao. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng k\u00e9o d\u00e0i t\u1eeb 6 \u0111\u1ebfn 9 th\u00e1ng ho\u1eb7c l\u00e2u h\u01a1n n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng thu\u1ed1c.<\/strong><\/p>\n

\"Ph\u00e1c
Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n lao nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o b\u1edfi B\u1ed9 Y t\u1ebf<\/figcaption><\/figure>\n

1. Ph\u00e1c \u0111\u1ed3 A<\/span><\/b>1<\/b>:\u00a02RHZE\/4RHE<\/b><\/span><\/h2>\n

\u25cb\u00a0<\/b>H\u01b0\u1edbng d\u1eabn:<\/span><\/b><\/p>\n

+\u00a0Giai \u0111o\u1ea1n t\u1ea5n c\u00f4ng k\u00e9o d\u00e0i 2 th\u00e1ng, g\u1ed3m 4 lo\u1ea1i thu\u1ed1c d\u00f9ng h\u00e0ng ng\u00e0y.<\/span><\/p>\n

+\u00a0Giai \u0111o\u1ea1n duy tr\u00ec k\u00e9o d\u00e0i 4 th\u00e1ng, g\u1ed3m 3 lo\u1ea1i thu\u1ed1c l\u00e0 R, H v\u00e0 E d\u00f9ng h\u00e0ng ng\u00e0y.<\/span><\/p>\n

\u25cb\u00a0<\/b>Ch\u1ec9 \u0111\u1ecbnh:\u00a0<\/span><\/b>cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh lao ng\u01b0\u1eddi l\u1edbn kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng kh\u00e1ng thu\u1ed1c.<\/span><\/p>\n

\u25cb\u00a0<\/b>Theo d\u00f5i – \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3<\/span><\/b><\/p>\n

2. Ph\u00e1c \u0111\u1ed3 <\/span><\/b>A2<\/b>: 2RHZE\/4RH<\/span><\/b><\/h2>\n

\u25cb\u00a0<\/b>H\u01b0\u1edbng d\u1eabn:<\/span><\/b><\/p>\n

+\u00a0Giai \u0111o\u1ea1n t\u1ea5n c\u00f4ng k\u00e9o d\u00e0i 2 th\u00e1ng, g\u1ed3m 4 lo\u1ea1i thu\u1ed1c d\u00f9ng h\u00e0ng ng\u00e0y.<\/span><\/p>\n

+\u00a0Giai \u0111o\u1ea1n duy tr\u00ec k\u00e9o d\u00e0i 4 th\u00e1ng, g\u1ed3m 2 lo\u1ea1i thu\u1ed1c l\u00e0 R v\u00e0 H d\u00f9ng h\u00e0ng ng\u00e0y.<\/span><\/p>\n

\u25cb\u00a0<\/b>Ch\u1ec9 \u0111\u1ecbnh:\u00a0<\/span><\/b>cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh lao tr\u1ebb em kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng kh\u00e1ng thu\u1ed1c.<\/span><\/p>\n

\u25cb\u00a0<\/b>Theo d\u00f5i – \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3<\/span><\/b><\/p>\n

3. Ph\u00e1c \u0111\u1ed3 <\/span><\/b>B1<\/b>: 2RHZE<\/span><\/b>\u00a0(S)<\/b>\/10RHE<\/span><\/b><\/h2>\n

\u25cb\u00a0<\/b>H\u01b0\u1edbng d\u1eabn:<\/span><\/b><\/p>\n

+\u00a0Giai \u0111o\u1ea1n t\u1ea5n c\u00f4ng k\u00e9o d\u00e0i 2 th\u00e1ng, g\u1ed3m 4 lo\u1ea1i thu\u1ed1c H, R, Z, E d\u00f9ng h\u00e0ng ng\u00e0y.<\/span><\/p>\n

+\u00a0Giai \u0111o\u1ea1n duy tr\u00ec k\u00e9o d\u00e0i 10 th\u00e1ng, g\u1ed3m 3 lo\u1ea1i thu\u1ed1c l\u00e0 R, H, E d\u00f9ng h\u00e0ng ng\u00e0y.<\/span><\/p>\n

\u25cb\u00a0<\/b>Ch\u1ec9 \u0111\u1ecbnh:\u00a0<\/span><\/b>lao m\u00e0ng n\u00e3o, lao x\u01b0\u01a1ng kh\u1edbp v\u00e0 lao h\u1ea1ch ng\u01b0\u1eddi l\u1edbn. \u0110i\u1ec1u tr\u1ecb lao m\u00e0ng n\u00e3o\u00a0<\/span>n\u00ean\u00a0s\u1eed d\u1ee5ng corticosteroid<\/span>\u00a0(dexamethasone ho\u1eb7c prednisolone) khi kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh\u00a0li\u1ec1u gi\u1ea3m d\u1ea7n trong\u00a0<\/span>th\u1eddi gian 6-8 tu\u1ea7n \u0111\u1ea7u ti\u00ean (tham kh\u1ea3o th\u00eam m\u1ee5c 4.8-s\u1eed d\u1ee5ng Corticosteroid trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p)\u00a0v\u00e0 d\u00f9ng Streptomycin\u00a0<\/span>(thay cho E)\u00a0trong giai \u0111o\u1ea1n t\u1ea5n c\u00f4ng.<\/span><\/p>\n

\u25cb\u00a0<\/b>Theo d\u00f5i – \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3<\/span><\/b><\/p>\n

4. Ph\u00e1c \u0111\u1ed3 B<\/span><\/b>2<\/b>: 2RHZE\/10RH<\/span><\/b><\/h2>\n

\u25cb\u00a0<\/b>H\u01b0\u1edbng d\u1eabn:<\/span><\/b><\/p>\n

+\u00a0Giai \u0111o\u1ea1n t\u1ea5n c\u00f4ng k\u00e9o d\u00e0i 2 th\u00e1ng, g\u1ed3m 4 lo\u1ea1i thu\u1ed1c H, R, Z, E d\u00f9ng h\u00e0ng ng\u00e0y.<\/span><\/p>\n

+\u00a0Giai \u0111o\u1ea1n duy tr\u00ec k\u00e9o d\u00e0i 10 th\u00e1ng, g\u1ed3m 2 lo\u1ea1i thu\u1ed1c l\u00e0 R, H d\u00f9ng h\u00e0ng ng\u00e0y.<\/span><\/p>\n

\u25cb\u00a0<\/b>Ch\u1ec9 \u0111\u1ecbnh:\u00a0<\/span><\/b>lao m\u00e0ng n\u00e3o, lao x\u01b0\u01a1ng kh\u1edbp v\u00e0 lao h\u1ea1ch tr\u1ebb<\/span>\u00a0<\/span>em.\u00a0\u0110i\u1ec1u tr\u1ecb lao m\u00e0ng n\u00e3o\u00a0<\/span>n\u00ean\u00a0s\u1eed d\u1ee5ng corticosteroid\u00a0<\/span>(dexamethasone ho\u1eb7c prednisolone)\u00a0li\u1ec1u gi\u1ea3m d\u1ea7n trong\u00a0<\/span>th\u1eddi gian 6-8 tu\u1ea7n \u0111\u1ea7u ti\u00ean (tham kh\u1ea3o th\u00eam m\u1ee5c 4.8-s\u1eed d\u1ee5ng Corticosteroid trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p)\u00a0v\u00e0 d\u00f9ng Streptomycin\u00a0<\/span>(thay cho E)\u00a0trong giai \u0111o\u1ea1n t\u1ea5n c\u00f4ng.<\/span><\/p>\n

\u25cb\u00a0<\/b>Theo d\u00f5i – \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3<\/span><\/b><\/p>\n

L\u01b0u \u00fd:<\/i><\/b><\/p>\n

\u25cb \u0110\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n lao \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u00e0 t\u00e1i ph\u00e1t, th\u1ea5t b\u1ea1i, \u0111i\u1ec1u tr\u1ecb l\u1ea1i sau b\u1ecf tr\u1ecb, ti\u1ec1n s\u1eed \u0111i\u1ec1u tr\u1ecb kh\u00e1c, kh\u00f4ng r\u00f5 ti\u1ec1n s\u1eed \u0111i\u1ec1u tr\u1ecb (nguy c\u01a1 kh\u00e1ng thu\u1ed1c) –<\/b>\u00a0Kh\u00f4ng \u00e1p d\u1ee5ng ph\u00e1c \u0111\u1ed3 II nh\u01b0 tr\u01b0\u1edbc \u0111\u00e2y\u00a0<\/b>m\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c l\u00e0m x\u00e9t nghi\u1ec7m Xpert – N\u1ebfu k\u1ebft qu\u1ea3 Xpert c\u00f3 vi khu\u1ea9n lao kh\u00f4ng kh\u00e1ng R (xem s\u01a1 \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n lao kh\u00e1ng thu\u1ed1c-Ph\u1ee5 l\u1ee5c 2.1) c\u1ea7n ch\u1ec9 \u0111\u1ecbnh ph\u00e1c \u0111\u1ed3 A ho\u1eb7c ph\u00e1c \u0111\u1ed3 B c\u0103n c\u1ee9 v\u00e0o v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng (ph\u1ed5i, ngo\u00e0i ph\u1ed5i), \u0111\u1ed9 tu\u1ed5i (ng\u01b0\u1eddi l\u1edbn, tr\u1ebb em).<\/p>\n

\u25cb Trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb P\u0110 A, P\u0110 B n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng \u00e2m h\u00f3a<\/b>\u00a0(sau giai \u0111o\u1ea1n t\u1ea5n c\u00f4ng) ho\u1eb7c th\u1ea5t b\u1ea1i (sau 5 th\u00e1ng \u0111i\u1ec1u tr\u1ecb) c\u1ea7n \u0111\u01b0\u1ee3c ki\u1ec3m tra vi\u1ec7c tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb, c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng h\u1ea5p thu thu\u1ed1c v\u00e0 l\u00e0m x\u00e9t nghi\u1ec7m Xpert v\u00e0\/ ho\u1eb7c nu\u00f4i c\u1ea5y \u0111\u1eddm l\u00e0m kh\u00e1ng sinh \u0111\u1ed3 v\u1edbi thu\u1ed1c lao h\u00e0ng 1 (t\u00f9y ngu\u1ed3n l\u1ef1c v\u00e0 th\u1ec3 b\u1ec7nh).\u00a0<\/b>C\u0103n c\u1ee9 v\u00e0o k\u1ebft qu\u1ea3 kh\u00e1ng R \u0111\u1ec3 ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p<\/p>\n

+ N\u1ebfu k\u1ebft qu\u1ea3 kh\u00e1ng R:<\/i><\/b><\/p>\n

\u25cb<\/b>\u00a0\u01afu ti\u00ean thu nh\u1eadn v\u00e0o ph\u00e1c \u0111\u1ed3 ng\u1eafn h\u1ea1n (P\u0110 C) n\u1ebfu \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n:<\/p>\n

*Ti\u00eau chu\u1ea9n thu nh\u1eadn:<\/p>\n

\u2022 Lao kh\u00e1ng R, ch\u01b0a c\u00f3 ti\u1ec1n s\u1eed d\u00f9ng thu\u1ed1c lao h\u00e0ng hai c\u00f3 trong ph\u00e1c \u0111\u1ed3 ho\u1eb7c d\u00f9ng d\u01b0\u1edbi 1 th\u00e1ng.<\/p>\n

* Ti\u00eau chu\u1ea9n lo\u1ea1i tr\u1eeb:<\/p>\n

\u2022 C\u00f3 b\u1eb1ng ch\u1ee9ng kh\u00e1ng ho\u1eb7c kh\u00f4ng c\u00f3 hi\u1ec7u l\u1ef1c v\u1edbi 1 thu\u1ed1c trong ph\u00e1c \u0111\u1ed3, tr\u1eeb H c\u00f3 l\u01b0u \u00fd ri\u00eang:<\/p>\n

\u25aa \u0110\u1eb7c bi\u1ec7t l\u01b0u \u00fd lo\u1ea1i kh\u1ecfi ph\u00e1c \u0111\u1ed3 n\u1ebfu kh\u00e1ng Fluoroquinolones. Th\u1eddi gian c\u00f3 k\u1ebft qu\u1ea3 MTB si\u00eau kh\u00e1ng LPA c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t, t\u1ed1i \u0111a kh\u00f4ng v\u01b0\u1ee3t qu\u00e1 1 th\u00e1ng t\u1eeb l\u00fac g\u1eedi m\u1eabu \u0111\u1ebfn l\u00fac nh\u1eadn \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3.<\/p>\n

\u25aa \u0110\u1ed1i v\u1edbi H: N\u1ebfu kh\u00e1ng H do \u0111\u1ed9t bi\u1ebfn \u1edf m\u1ed9t trong 2 v\u1ecb tr\u00ed ho\u1eb7c\u00a0inhA<\/i>, ho\u1eb7c\u00a0KatG<\/i>\u00a0v\u1eabn c\u00f3 th\u1ec3 ch\u1ec9 \u0111\u1ecbnh ph\u00e1c \u0111\u1ed3. N\u1ebfu kh\u00e1ng do \u0111\u1ed9t bi\u1ebfn \u0111\u1ed3ng th\u1eddi c\u1ea3 Kat G v\u00e0 inhA th\u00ec lo\u1ea1i tr\u1eeb kh\u1ecfi ph\u00e1c \u0111\u1ed3<\/p>\n

\u2022 C\u00f3 t\u1ed5n th\u01b0\u01a1ng r\u1ed9ng \u1edf ph\u1ed5i ho\u1eb7c lao ngo\u00e0i ph\u1ed5i nghi\u00eam tr\u1ecdng, lao ngo\u00e0i ph\u1ed5i ph\u1ee9c t\u1ea1p<\/p>\n

\u2022 C\u00f3 thai ho\u1eb7c cho con b\u00fa<\/p>\n

\u2022 Ng\u01b0\u1eddi m\u1eabn c\u1ea3m v\u1edbi b\u1ea5t k\u1ef3 thu\u1ed1c n\u00e0o trong ph\u00e1c \u0111\u1ed3, kh\u00f4ng dung n\u1ea1p thu\u1ed1c ho\u1eb7c c\u00f3 nguy c\u01a1 ng\u1ed9 \u0111\u1ed9c thu\u1ed1c (t\u01b0\u01a1ng t\u00e1c thu\u1ed1c)<\/p>\n

\u2022 B\u1ec7nh nh\u00e2n c\u00f3 kho\u1ea3ng QTc \u2265 500 ms tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3<\/p>\n

\u2022 B\u1ec7nh nh\u00e2n c\u00f3 men gan cao g\u1ea5p 3-4 l\u1ea7n m\u1ee9c b\u00ecnh th\u01b0\u1eddng<\/p>\n

\u2022\u00a0B\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c v\u00e0 th\u1ea7n kinh ngo\u1ea1i vi<\/span><\/p>\n

\u2022 Tr\u1ebb em d\u01b0\u1edbi 6 tu\u1ed5i<\/p>\n

\u25cb Tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n thu nh\u1eadn v\u00e0o ph\u00e1c \u0111\u1ed3 ng\u1eafn h\u1ea1n (P\u0110 C), c\u00f3 th\u1ec3 chuy\u1ec3n sang ph\u00e1c \u0111\u1ed3 d\u00e0i h\u1ea1n<\/p>\n

+ N\u1ebfu k\u1ebft qu\u1ea3 kh\u00f4ng kh\u00e1ng R:<\/i><\/b><\/p>\n

\u25cb K\u1ebft qu\u1ea3 Xpert (lao ph\u1ed5i, lao m\u00e0ng n\u00e3o) kh\u00f4ng kh\u00e1ng R: Ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb v\u00e0 l\u00e0m XN nu\u00f4i c\u1ea5y, KS\u0110 h\u00e0ng 1 (LPA ho\u1eb7c KS\u0110 truy\u1ec1n th\u1ed1ng) \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh ph\u00e1c \u0111\u1ed3 c\u00e1 nh\u00e2n<\/p>\n

\u25cb K\u1ebft qu\u1ea3 nu\u00f4i c\u1ea5y, KS\u0110 h\u00e0ng 1 (lao ngo\u00e0i ph\u1ed5i kh\u00e1c) kh\u00f4ng kh\u00e1ng R: \u0110i\u1ec1u ch\u1ec9nh ph\u00e1c \u0111\u1ed3 c\u00e1 nh\u00e2n c\u0103n c\u1ee9 v\u00e0o k\u1ebft qu\u1ea3 KS\u0110 h\u00e0ng 1 \u0111\u1ed1i v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c R.<\/p>\n

\u25cb\u00a0Trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb P\u0110 A, P\u0110 B n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng dung n\u1ea1p<\/b>\u00a0th\u00ec \u0111i\u1ec1u ch\u1ec9nh ph\u00e1c \u0111\u1ed3 c\u00e1 nh\u00e2n ph\u00f9 h\u1ee3p (ph\u1ed1i h\u1ee3p thu\u1ed1c theo nguy\u00ean t\u1eafc n\u00eau t\u1ea1i m\u1ee5c 1.1 – nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb lao. C\u00f3 th\u1ec3 th\u00f4ng qua H\u1ed9i \u0111\u1ed3ng \u0111i\u1ec1u tr\u1ecb t\u1ea1i c\u01a1 s\u1edf ho\u1eb7c tuy\u1ebfn Trung \u01b0\u01a1ng, Mi\u1ec1n n\u1ebfu c\u1ea7n thi\u1ebft)<\/p>\n

T\u00f3m l\u1ea1i, vi\u1ec7c s\u1eed d\u1ee5ng ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n lao nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 ng\u0103n ng\u1eeba s\u1ef1 l\u00e2y lan c\u1ee7a b\u1ec7nh trong c\u1ed9ng \u0111\u1ed3ng. Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng lao c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng, do \u0111\u00f3 vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c ph\u1ea3i \u0111\u01b0\u1ee3c gi\u00e1m s\u00e1t ch\u1eb7t ch\u1ebd b\u1edfi c\u00e1c chuy\u00ean gia y t\u1ebf.<\/p>\n

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

Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n lao nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o b\u1edfi B\u1ed9 Y t\u1ebf nh\u1eb1m \u0111i\u1ec1u tr\u1ecb b\u1ec7nh lao v\u00e0 ng\u0103n ng\u1eeba s\u1ef1 l\u00e2y lan c\u1ee7a b\u1ec7nh trong c\u1ed9ng \u0111\u1ed3ng. Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n lao nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c bao g\u1ed3m s\u1ef1 k\u1ebft […]<\/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\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n lao nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c - Vinmec<\/title>\n<meta name=\"description\" content=\"Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n lao nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o b\u1edfi B\u1ed9 Y t\u1ebf. 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