{"id":25419,"date":"2023-04-23T22:53:40","date_gmt":"2023-04-23T15:53:40","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25419"},"modified":"2023-04-23T22:53:40","modified_gmt":"2023-04-23T15:53:40","slug":"benh-histeria-nguyen-nhan-chan-doan-va-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/benh-histeria-nguyen-nhan-chan-doan-va-dieu-tri\/","title":{"rendered":"B\u1ec7nh Histeria: Nguy\u00ean nh\u00e2n, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

R\u1ed1i lo\u1ea1n ph\u00e2n ly <\/a>\u00a0(Histeria) l\u00e0 b\u1ec7nh c\u1ea3nh m\u1ea5t m\u1ed9t ph\u1ea7n hay ho\u00e0n to\u00e0n s\u1ef1 h\u1ee3p nh\u1ea5t b\u00ecnh th\u01b0\u1eddng gi\u1eefa tr\u00ed nh\u1edb, qu\u00e1 kh\u1ee9, \u00fd th\u1ee9c v\u1ec1 \u0111\u1eb7c t\u00ednh c\u00e1 nh\u00e2n v\u1edbi nh\u1eefng c\u1ea3m gi\u00e1c tr\u1ef1c ti\u1ebfp v\u00e0 s\u1ef1 ki\u1ec3m so\u00e1t v\u1eadn \u0111\u1ed9ng c\u1ee7a c\u01a1 th\u1ec3. \u0110\u00e2y l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u00f3 li\u00ean quan ch\u1eb7t ch\u1ebd v\u1edbi sang ch\u1ea5n t\u00e2m l\u00fd v\u00e0 nh\u00e2n c\u00e1ch ng\u01b0\u1eddi b\u1ec7nh. X\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang c\u00e1ch l\u00e0 r\u1ea5t quan tr\u1ecdng v\u00ec b\u1ec7nh c\u00f3 th\u1ec3 g\u00e2y ra r\u1ea5t nhi\u1ec1u kh\u00f3 kh\u0103n cho b\u1ec7nh nh\u00e2n v\u00e0 gia \u0111\u00ecnh.<\/strong><\/p>\n

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Vi\u1ec7c x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Hysteria\u00a0\u0111\u00fang c\u00e1ch l\u00e0 r\u1ea5t quan tr\u1ecdng<\/figcaption><\/figure>\n

1. Nguy\u00ean nh\u00e2n c\u1ee7a b\u1ec7nh Histeria<\/b><\/h2>\n

Nh\u1eefng stress c\u00f3 th\u1ec3 g\u00e2y r\u1ed1i lo\u1ea1n ph\u00e2n ly \u0111\u00f3 l\u00e0 nh\u1eefng ho\u00e0n c\u1ea3nh xung \u0111\u1ed9t, nh\u1eefng v\u1ea5n \u0111\u1ec1 kh\u00f4ng gi\u1ea3i quy\u1ebft \u0111\u01b0\u1ee3c, nh\u1eefng m\u1ed1i quan h\u1ec7 ph\u1ee9c t\u1ea1p gi\u1eefa ng\u01b0\u1eddi v\u1edbi ng\u01b0\u1eddi ho\u1eb7c \u0111\u00f4i khi l\u00e0 c\u00e1c nhu c\u1ea7u t\u00e2m l\u00fd kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng t\u00e1c \u0111\u1ed9ng v\u00e0o t\u00e2m th\u1ea7n g\u00e2y ra c\u00e1c c\u1ea3m x\u00fac m\u1ea1nh, ph\u1ea7n l\u1edbn l\u00e0 c\u00e1c x\u00fac c\u1ea3m ti\u00eau c\u1ef1c nh\u01b0 lo l\u1eafng, bu\u1ed3n r\u1ea7u, t\u1ee9c gi\u1eadn, ghen tu\u00f4ng, th\u1ea5t v\u1ecdng\u2026<\/p>\n

R\u1ed1i lo\u1ea1n ph\u00e2n ly d\u1ec5 ph\u00e1t sinh \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 nh\u00e2n c\u00e1ch thu\u1ed9c lo\u1ea1i h\u00ecnh th\u1ea7n kinh ngh\u1ec7 s\u1ef9 y\u1ebfu.<\/p>\n

C\u00e1c b\u1ec7nh l\u00fd c\u01a1 th\u1ec3 nh\u01b0 nhi\u1ec5m khu\u1ea9n, nhi\u1ec5m \u0111\u1ed9c, ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o\u2026 n\u00f3i chung \u0111\u00f3 l\u00e0 c\u00e1c nh\u00e2n t\u1ed1 l\u00e0m suy y\u1ebfu h\u1ec7 th\u1ea7n kinh, gi\u1ea3m s\u00fat ho\u1ea1t \u0111\u1ed9ng c\u1ee7a v\u1ecf n\u00e3o v\u00e0 t\u0103ng c\u01b0\u1eddng ho\u1ea1t \u0111\u1ed9ng d\u01b0\u1edbi v\u1ecf c\u00f3 th\u1ec3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i ph\u00e1t sinh r\u1ed1i lo\u1ea1n ph\u00e2n ly.<\/p>\n

2. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Histeria<\/b><\/h2>\n

2.1 Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh: Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n ICD 10<\/b><\/h3>\n

2.1.1. L\u00e2m s\u00e0ng<\/h4>\n

(A). C\u00e1c n\u00e9t l\u00e2m s\u00e0ng bi\u1ec7t \u0111\u1ecbnh cho c\u00e1c r\u1ed1i lo\u1ea1n c\u00e1 nh\u00e2n trong ch\u01b0\u01a1ng F44. (Li\u1ec7t, run, m\u1ea5t \u0111\u1ee9ng m\u1ea5t \u0111i, m\u00f9, \u0111i\u1ebfc, c\u00e2m, t\u00ea b\u00ec, s\u1eefng s\u1edd, qu\u00ean, co gi\u1eadt, hi\u1ec7n t\u01b0\u1ee3ng b\u1ecb x\u00e2m nh\u1eadp\u2026)<\/p>\n

(B). Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a m\u1ed9t r\u1ed1i lo\u1ea1n c\u01a1 th\u1ec3 n\u00e0o c\u00f3 th\u1ec3 gi\u1ea3i th\u00edch c\u00e1c tri\u1ec7u ch\u1ee9ng.<\/p>\n

(C). B\u1eb1ng ch\u1ee9ng c\u00f3 nguy\u00ean nh\u00e2n t\u00e2m l\u00fd d\u01b0\u1edbi d\u1ea1ng k\u1ebft h\u1ee3p r\u00f5 r\u1ec7t v\u1ec1 th\u1eddi gian v\u1edbi s\u1ef1 ki\u1ec7n g\u00e2y sang ch\u1ea5n v\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 ho\u1eb7c c\u00e1c m\u1ed1i quan h\u1ec7 b\u1ecb r\u1ed1i lo\u1ea1n.<\/p>\n

2.1.2. C\u1eadn l\u00e2m s\u00e0ng<\/h4>\n

–\u00a0X\u00e9t nghi\u1ec7m m\u00e1u: huy\u1ebft h\u1ecdc, sinh ho\u00e1, vi sinh (HIV, VGB, VGC)<\/p>\n

–\u00a0X\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u, x\u00e9t nghi\u1ec7m t\u00ecm ch\u1ea5t ma tu\u00fd, huy\u1ebft thanh ch\u1ea9n \u0111o\u00e1n giang mai\u2026<\/p>\n

–\u00a0Tr\u1eafc nghi\u1ec7m t\u00e2m l\u00fd: nh\u00f3m tr\u1eafc nghi\u1ec7m \u0111\u00e1nh gi\u00e1 nh\u00e2n c\u00e1ch (MMPI, EPI\u2026), tr\u1eafc nghi\u1ec7m t\u00e2m l\u00fd \u0111\u00e1nh gi\u00e1 lo \u00e2u (Zung, Hamilton lo \u00e2u\u2026), \u0111\u00e1nh gi\u00e1 tr\u1ea7m c\u1ea3m (Beck, Hamilton tr\u1ea7m c\u1ea3m\u2026), \u0111\u00e1nh gi\u00e1 r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 ph\u1ed1i h\u1ee3p (PSQI\u2026) \u2026<\/p>\n

–\u00a0C\u00e1c x\u00e9t nghi\u1ec7m x\u00e1c \u0111\u1ecbnh b\u1ec7nh l\u00fd k\u1ebft h\u1ee3p ho\u1eb7c lo\u1ea1i tr\u1eeb nguy\u00ean nh\u00e2n th\u1ef1c th\u1ec3 tu\u1ef3 theo tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a r\u1ed1i lo\u1ea1n ph\u00e2n ly:<\/p>\n

–\u00a0\u0110i\u1ec7n n\u00e3o \u0111\u1ed3, l\u01b0u huy\u1ebft n\u00e3o<\/p>\n

–\u00a0\u0110i\u1ec7n t\u00e2m \u0111\u1ed3, XQ tim ph\u1ed5i, si\u00eau \u00e2m \u1ed5 b\u1ee5ng, si\u00eau \u00e2m tuy\u1ebfn gi\u00e1p<\/p>\n

–\u00a0X\u00e9t nghi\u1ec7m hormon tuy\u1ebfn gi\u00e1p<\/p>\n

–\u00a0CT, MRI…<\/p>\n

–\u00a0Ngo\u00e0i ra c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c chuy\u00ean khoa kh\u00e1c \u0111\u1ec3 ch\u1ec9 \u0111\u1ecbnh th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t.<\/p>\n

2.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/b><\/h3>\n

–\u00a0C\u00e1c b\u1ec7nh th\u1ea7n kinh n\u1ed9i khoa: Vi\u00eam n\u00e3o, xu\u1ea5t huy\u1ebft n\u00e3o, h\u1ed9i ch\u1ee9ng Guillain \u2013 Barre (vi\u00eam \u0111a r\u1ec5 v\u00e0 d\u00e2y th\u1ea7n kinh nguy\u00ean ph\u00e1t), c\u00e1c b\u1ec7nh l\u00fd v\u1ec1 c\u01a1: nh\u01b0\u1ee3c c\u01a1, vi\u00eam \u0111a c\u01a1…, c\u00e1c tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh s\u1edbm c\u1ee7a AIDS, x\u01a1 c\u1ee9ng r\u1ea3i r\u00e1c.<\/p>\n

–\u00a0R\u1ed1i lo\u1ea1n d\u1ea1ng c\u01a1 th\u1ec3<\/p>\n

–\u00a0R\u1ed1i lo\u1ea1n gi\u1ea3 b\u1ec7nh<\/p>\n

–\u00a0C\u01a1n co gi\u1eadt \u0111\u1ed9ng kinh<\/p>\n

3. \u0110i\u1ec1u tr\u1ecb <\/b>b\u1ec7nh Histeria<\/b><\/h2>\n

3.1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/b><\/h3>\n

R\u1ed1i lo\u1ea1n ph\u00e2n ly l\u00e0 b\u1ec7nh t\u00e2m sinh n\u00ean trong \u0111i\u1ec1u tr\u1ecb li\u1ec7u ph\u00e1p t\u00e2m l\u00fd c\u00f3 vai tr\u00f2 quan tr\u1ecdng.<\/p>\n

B\u01b0\u1edbc \u0111\u1ea7u ti\u00ean trong \u0111i\u1ec1u tr\u1ecb l\u00e0 ph\u1ea3i lo\u1ea1i b\u1ecf tri\u1ec7u ch\u1ee9ng b\u1eb1ng li\u1ec7u ph\u00e1p gi\u1ea3i th\u00edch h\u1ee3p l\u00fd k\u1ebft h\u1ee3p \u00e1m th\u1ecb.<\/p>\n

Sau \u0111\u00f3 c\u1ea7n \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng t\u00e1i di\u1ec5n b\u1ec7nh b\u1eb1ng c\u00e1c li\u1ec7u ph\u00e1p t\u00e2m l\u00ed h\u01b0\u1edbng t\u1edbi nh\u00e2n c\u00e1ch nh\u01b0 li\u1ec7u ph\u00e1p t\u00e2m l\u00ed nh\u00f3m, th\u01b0 gi\u00e3n luy\u1ec7n t\u1eadp, li\u1ec7u ph\u00e1p nh\u1eadn th\u1ee9c, v\u1eadn \u0111\u1ed9ng tr\u1ecb li\u1ec7u, ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u\u2026<\/p>\n

R\u1ed1i lo\u1ea1n ph\u00e2n ly th\u01b0\u1eddng k\u00e8m theo tr\u1ea7m c\u1ea3m, lo \u00e2u<\/p>\n

Nguy\u00ean t\u1eafc ch\u1ecdn thu\u1ed1c:<\/b><\/p>\n

\u01afu ti\u00ean \u0111\u01a1n tr\u1ecb li\u1ec7u (ch\u1ecdn m\u1ed9t trong nh\u1eefng thu\u1ed1c li\u1ec7t k\u00ea \u1edf d\u01b0\u1edbi n\u1ebfu ch\u01b0a hi\u1ec7u qu\u1ea3 th\u00ec s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi m\u1ed9t thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m v\u00e0 m\u1ed9t thu\u1ed1c an th\u1ea7n kinh \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o nhi\u1ec1u h\u01a1n c\u1ea3).<\/p>\n

Kh\u1edfi li\u1ec1u th\u1ea5p v\u00e0 t\u0103ng li\u1ec1u t\u1eeb t\u1eeb cho \u0111\u1ebfn khi c\u00f3 hi\u1ec7u qu\u1ea3. H\u1ea1n ch\u1ebf l\u1ea1m d\u1ee5ng nh\u00f3m gi\u1ea3i lo \u00e2u g\u00e2y nghi\u1ec7n.<\/p>\n

3.2. S\u01a1 \u0111\u1ed3\/ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb: <\/b><\/h3>\n

Li\u1ec7u ph\u00e1p h\u00f3a d\u01b0\u1ee3c+li\u1ec7u ph\u00e1p t\u00e2m l\u00fd<\/p>\n

C\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m:\u00a0<\/b>Ch\u1ecdn m\u1ed9t ho\u1eb7c hai ho\u1eb7c ba thu\u1ed1c trong s\u1ed1 c\u00e1c thu\u1ed1c sau:<\/b><\/p>\n

Nh\u00f3m SSRI, SNRI, 3 v\u00f2ng, ho\u1eb7c nh\u00f3m kh\u00e1c:<\/p>\n

Imipramin, li\u1ec1u 150-300 mg\/24 gi\u1edd<\/p>\n

Amitriptylin, li\u1ec1u150-300 mg\/24 gi\u1edd<\/p>\n

Paroxetin, li\u1ec1u 20-80 mg\/24 gi\u1edd<\/p>\n

Fluoxetin, li\u1ec1u10-80 mg\/24 gi\u1edd<\/p>\n

Fluvoxamin, li\u1ec1u 50-300 mg\/24 gi\u1edd<\/p>\n

Citalopram, li\u1ec1u 20-60 mg\/24 gi\u1edd<\/p>\n

Escitalopram, li\u1ec1u10-20 mg\/24 gi\u1edd<\/p>\n

Sertralin, li\u1ec1u 50 – 200 mg\/24 gi\u1edd<\/p>\n

Venlafaxin, li\u1ec1u 37,5 – 375 mg\/24 gi\u1edd<\/p>\n

Mirtazapin, li\u1ec1u 15 – 60 mg\/ 24 gi\u1edd<\/p>\n

C\u00e1c thu\u1ed1c gi\u1ea3i lo \u00e2u:\u00a0<\/b>Ch\u1ecdn m\u1ed9t ho\u1eb7c hai ho\u1eb7c ba thu\u1ed1c trong s\u1ed1 c\u00e1c thu\u1ed1c sau:<\/b><\/p>\n

Thu\u1ed1c gi\u1ea3i lo \u00e2u g\u00e2y ng\u1ee7 nh\u00f3m Benzodiazepin:<\/b><\/p>\n

Diazepam, li\u1ec1u 5 – 20 mg\/24 gi\u1edd<\/p>\n

Lorazepam: 2 – 6 mg\/24 gi\u1edd<\/p>\n

Bromazepam: 6-12mg\/24 gi\u1edd<\/p>\n

Alprazolam: 1 – 4 mg\/24 gi\u1edd\u2026<\/p>\n

Non-benzodiazepins: etifoxine HCL, sedanxio, zopiclon\u2026<\/p>\n

Nh\u00f3m thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m: propanolol\u2026<\/p>\n

C\u00e1c an th\u1ea7n kinh<\/b>: olanzapin, quetiapin, sulpirid\u2026<\/p>\n

Nu\u00f4i d\u01b0\u1ee1ng t\u1ebf b\u00e0o th\u1ea7n kinh: piracetam, ginkgo biloba, vinpocetin, choline alfoscerate, nicergoline, \u2026.<\/p>\n

Thu\u1ed1c h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng gan, thu\u1ed1c t\u0103ng c\u01b0\u1eddng nh\u1eadn th\u1ee9c\u2026<\/p>\n

Dinh d\u01b0\u1ee1ng: b\u1ed5 sung dinh d\u01b0\u1ee1ng, vitamine nh\u00f3m b v\u00e0 kho\u00e1ng ch\u1ea5t, ch\u1ebf \u0111\u1ed9 \u0103n d\u1ec5 ti\u00eau h\u00f3a (m\u1ec1m, nhi\u1ec1u x\u01a1), \u0111\u1ee7 vitamin v\u00e0 kho\u00e1ng ch\u1ea5t (hoa qu\u1ea3, \u2026.), tr\u00e1nh ch\u1ea5t k\u00edch th\u00edch, u\u1ed1ng \u0111\u1ee7 n\u01b0\u1edbc, nu\u00f4i d\u01b0\u1ee1ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch\u2026trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thi\u1ebft.<\/p>\n

4. Ti\u00ean l\u01b0\u1ee3ng v\u00e0 bi\u1ebfn ch\u1ee9ng<\/b><\/h2>\n

R\u1ed1i lo\u1ea1n ph\u00e2n ly c\u00f3 ti\u00ean l\u01b0\u1ee3ng t\u1ed1t n\u1ebfu b\u1ec7nh kh\u1edfi ph\u00e1t c\u1ea5p t\u00ednh, li\u00ean quan tr\u1ef1c ti\u1ebfp \u0111\u1ebfn sang ch\u1ea5n t\u00e2m l\u00fd, kh\u00f4ng c\u00f3 c\u00e1c b\u1ec7nh l\u00fd n\u1ed9i khoa, th\u1ea7n kinh v\u00e0 t\u00e2m th\u1ea7n k\u00e8m theo.<\/p>\n

6. Ph\u00f2ng b\u1ec7nh<\/b><\/p>\n

B\u1ed3i d\u01b0\u1ee1ng nh\u00e2n c\u00e1ch.<\/p>\n

R\u00e8n luy\u1ec7n kh\u1ea3 n\u0103ng th\u00edch nghi cao v\u1edbi m\u00f4i tr\u01b0\u1eddng.<\/p>\n

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

R\u1ed1i lo\u1ea1n ph\u00e2n ly \u00a0(Histeria) l\u00e0 b\u1ec7nh c\u1ea3nh m\u1ea5t m\u1ed9t ph\u1ea7n hay ho\u00e0n to\u00e0n s\u1ef1 h\u1ee3p nh\u1ea5t b\u00ecnh th\u01b0\u1eddng gi\u1eefa tr\u00ed nh\u1edb, qu\u00e1 kh\u1ee9, \u00fd th\u1ee9c v\u1ec1 \u0111\u1eb7c t\u00ednh c\u00e1 nh\u00e2n v\u1edbi nh\u1eefng c\u1ea3m gi\u00e1c tr\u1ef1c ti\u1ebfp v\u00e0 s\u1ef1 ki\u1ec3m so\u00e1t v\u1eadn \u0111\u1ed9ng c\u1ee7a c\u01a1 th\u1ec3. \u0110\u00e2y l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u00f3 li\u00ean […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nB\u1ec7nh Histeria: Nguy\u00ean nh\u00e2n, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"R\u1ed1i lo\u1ea1n ph\u00e2n ly \u00a0(Histeria) l\u00e0 b\u1ec7nh c\u1ea3nh m\u1ea5t m\u1ed9t ph\u1ea7n hay ho\u00e0n to\u00e0n s\u1ef1 h\u1ee3p nh\u1ea5t b\u00ecnh th\u01b0\u1eddng gi\u1eefa tr\u00ed nh\u1edb, qu\u00e1 kh\u1ee9, \u00fd th\u1ee9c v\u1ec1 \u0111\u1eb7c t\u00ednh c\u00e1 ...\" \/>\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=\"B\u1ec7nh Histeria: Nguy\u00ean nh\u00e2n, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - 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