{"id":2650,"date":"2023-04-14T13:09:29","date_gmt":"2023-04-14T06:09:29","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2650"},"modified":"2023-04-14T15:02:58","modified_gmt":"2023-04-14T08:02:58","slug":"phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/","title":{"rendered":"Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp theo H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam 2023"},"content":{"rendered":"

\u1ede Vi\u1ec7t Nam, \u0111\u1ed3ng thu\u1eadn \u0111\u1ea7u ti\u00ean v\u1ec1 \u0111i\u1ec1u tr\u1ecb Hp (Helicobacter pylori) \u0111\u01b0\u1ee3c xu\u1ea5t b\u1ea3n n\u0103m 2012 v\u1edbi c\u00e1c khuy\u1ebfn c\u00e1o t\u1eadp trung v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb. Trong 10 n\u0103m qua, t\u1ec9 l\u1ec7 c\u00e1c ch\u1ee7ng Hp \u0111\u1ec1 kh\u00e1ng kh\u00e1ng sinh ph\u00e1t tri\u1ec3n kh\u00f4ng ng\u1eebng, v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y v\u1eabn l\u00e0 m\u1ed9t trong nh\u1eefng ung th\u01b0 th\u01b0\u1eddng g\u1eb7p v\u00e0 ch\u1ebft ng\u01b0\u1eddi \u1edf n\u01b0\u1edbc ta, v\u1edbi ph\u1ea7n l\u1edbn ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u1edf giai \u0111o\u1ea1n ti\u1ebfn tri\u1ec3n. Do \u0111\u00f3, c\u1eadp nh\u1eadt \u0111\u1ed3ng thu\u1eadn l\u00e0 m\u1ed9t nhu c\u1ea7u c\u1ea5p thi\u1ebft \u0111\u1ec3 h\u01b0\u1edbng d\u1eabn th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng.<\/strong>
\nC\u00f3 t\u1ed5ng c\u1ed9ng 27 khuy\u1ebfn c\u00e1o c\u1ee7a \u0111\u1ed3ng thu\u1eadn \u0111\u01b0\u1ee3c \u0111\u01b0a ra, k\u00e8m theo m\u1ee9c ch\u1ee9ng c\u1ee9, m\u1ee9c khuy\u1ebfn c\u00e1o v\u00e0 m\u1ee9c \u0111\u1ed3ng thu\u1eadn \u0111\u01b0\u1ee3c \u0111\u01b0a ra l\u1ea7n l\u01b0\u1ee3t.<\/strong><\/p>\n

1. Ch\u1ec9 \u0111\u1ecbnh v\u00e0 l\u1ef1a ch\u1ecdn test ch\u1ea9n \u0111o\u00e1n.<\/strong><\/h2>\n

Khuy\u1ebfn c\u00e1o 1.<\/strong> Trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng, x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m H. pylori ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi c\u00f3 \u00fd \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ti\u1ec7t tr\u1eeb. (M\u1ee9c ch\u1ee9ng c\u1ee9 th\u1ea5p, m\u1ee9c \u0111\u1ed9 khuy\u1ebfn c\u00e1o m\u1ea1nh).<\/p>\n

Khuy\u1ebfn c\u00e1o 2<\/strong>. Khuy\u1ebfn c\u00e1o ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m H. pylori \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi c\u00f3 c\u00e1c b\u1ec7nh l\u00fd sau (k\u00e8m theo m\u1ee9c ch\u1ee9ng c\u1ee9, m\u1ee9c khuy\u1ebfn c\u00e1o):
\n– Vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y (cao, m\u1ea1nh).
\n– Ti\u1ec1n s\u1eed lo\u00e9t d\u1ea1 d\u00e0y ch\u01b0a t\u1eebng th\u1eed Hp (cao, m\u1ea1nh).
\n– Kh\u00f3 ti\u00eau ch\u1ee9c n\u0103ng (dyspepsia) ch\u01b0a \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m (cao, m\u1ea1nh).
\n– Sang th\u01b0\u01a1ng ti\u1ec1n ung th\u01b0 (vi\u00eam teo d\u1ea1 d\u00e0y m\u1ea1n, lo\u1ea1n s\u1ea3n ru\u1ed9t, thi\u1ec3u s\u1ea3n d\u1ea1 d\u00e0y) (cao, m\u1ea1nh).
\n– Sau ph\u1eabu thu\u1eadt n\u1ed9i soi c\u1eaft ung th\u01b0 d\u1ea1 d\u00e0y giai \u0111o\u1ea1n s\u1edbm (cao, m\u1ea1nh).
\n– Lymphoma MALT bi\u1ec7t h\u00f3a th\u1ea5p (cao, m\u1ea1nh).
\n– Tr\u1ef1c h\u1ec7 th\u1ee9 nh\u1ea5t c\u1ee7a ng\u01b0\u1eddi m\u1eafc ung th\u01b0 d\u1ea1 d\u00e0y (cao, m\u1ea1nh).
\n– B\u1eaft \u0111\u1ea7u ho\u1eb7c s\u1eafp \u0111i\u1ec1u tr\u1ecb NSAID k\u00e9o d\u00e0i (cao, c\u00f3 \u0111i\u1ec1u ki\u1ec7n).
\n– C\u1ea7n \u0111i\u1ec1u tr\u1ecb aspirin li\u1ec1u th\u1ea5p k\u00e9o d\u00e0i (cao, c\u00f3 \u0111i\u1ec1u ki\u1ec7n).
\n– Tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n c\u1ea7n \u0111i\u1ec1u tr\u1ecb duy tr\u00ec l\u00e2u d\u00e0i b\u1eb1ng PPI (v\u1eeba, c\u00f3 \u0111i\u1ec1u ki\u1ec7n).
\n– Thi\u1ebfu m\u00e1u thi\u1ebfu s\u1eaft kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n (cao, c\u00f3 \u0111i\u1ec1u ki\u1ec7n).
\n– Ban xu\u1ea5t huy\u1ebft gi\u1ea3m ti\u1ec3u c\u1ea7u mi\u1ec5n d\u1ecbch (th\u1ea5p, c\u00f3 \u0111i\u1ec1u ki\u1ec7n).
\n– Ng\u01b0\u1eddi mu\u1ed1n \u0111i\u1ec1u tr\u1ecb ti\u1ec7t tr\u1eeb Hp sau khi gi\u1ea3i th\u00edch k\u0129 s\u1ef1 kh\u00f4ng c\u1ea7n thi\u1ebft (cao, c\u00f3 \u0111i\u1ec1u ki\u1ec7n).<\/p>\n

Khuy\u1ebfn c\u00e1o 3.<\/strong> B\u1ec7nh nh\u00e2n c\u00f3 kh\u00f3 ti\u00eau ch\u1ee9c n\u0103ng (dyspepsia) ch\u01b0a \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m tu\u1ed5i \u2265 35 v\u1edbi n\u1eef, ho\u1eb7c \u226540 v\u1edbi nam v\u00e0\/ho\u1eb7c k\u00e8m d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o n\u00ean \u0111\u01b0\u1ee3c n\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean. Ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m Hp tr\u00ean c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng n\u00e0y n\u00ean d\u1ef1a v\u00e0o c\u00e1c x\u00e9t nghi\u1ec7m c\u00f3 sinh thi\u1ebft. (V\u1eeba, m\u1ea1nh, 87.5%).<\/p>\n

Khuy\u1ebfn c\u00e1o 4.<\/strong> B\u1ec7nh nh\u00e2n c\u00f3 ch\u1ec9 \u0111\u1ecbnh th\u1eed Hp c\u00f3 n\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean, test urease nhanh n\u00ean \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay. (V\u1eeba, m\u1ea1nh, 100%).<\/p>\n

Khuy\u1ebfn c\u00e1o 5.<\/strong> Trong c\u00e1c test kh\u00f4ng x\u00e2m l\u1ea5n ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m Hp, test h\u01a1i th\u1edf urea n\u00ean \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay. (V\u1eeba, m\u1ea1nh, 100%).<\/p>\n

Khuy\u1ebfn c\u00e1o 6.<\/strong> C\u1ea7n \u0111\u1ea3m b\u1ea3o b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c test ch\u1ea9n \u0111o\u00e1n Hp kh\u00f4ng d\u00f9ng kh\u00e1ng sinh ho\u1eb7c bismuth trong v\u00f2ng 4 tu\u1ea7n ho\u1eb7c PPI trong v\u00f2ng 2 tu\u1ea7n tr\u01b0\u1edbc th\u1ef1c hi\u1ec7n. (V\u1eeba, m\u1ea1nh, 93.7%).<\/p>\n

Khuy\u1ebfn c\u00e1o 7.<\/strong> \u1ede b\u1ec7nh nh\u00e2n xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean c\u1ea5p, th\u1eed Hp b\u1eb1ng test urease nhanh v\u00e0 m\u00f4 h\u1ecdc c\u00f3 th\u1ec3 \u00e2m t\u00ednh gi\u1ea3. N\u1ebfu k\u1ebft qu\u1ea3 \u00e2m t\u00ednh, c\u00f3 th\u1ec3 x\u00e1c nh\u1eadn t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng b\u1eb1ng m\u1ed9t test kh\u00e1c \u0111\u1ed9 tin c\u1eady cao h\u01a1n sau khi xu\u1ea5t huy\u1ebft \u1ed5n \u0111\u1ecbnh. (V\u1eeba, m\u1ea1nh, 81.2%).<\/p>\n

2. Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ti\u1ec7t tr\u1eeb Hp.<\/strong><\/h2>\n

Khuy\u1ebfn c\u00e1o 8.<\/strong> M\u1ed9t ph\u00e1c \u0111\u1ed3 \u0111\u01b0\u1ee3c coi l\u00e0 hi\u1ec7u qu\u1ea3 v\u00e0 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o ch\u1ec9 khi t\u1ec9 l\u1ec7 ti\u1ec7t tr\u1eeb \u0111\u1ea1t \u00edt nh\u1ea5t 80% (intention to treat). L\u1ef1a ch\u1ecdn ph\u00e1c \u0111\u1ed3 theo \u0111\u1ed3ng thu\u1eadn d\u1ef1a v\u00e0o: (1) k\u1ebft qu\u1ea3 t\u1eeb c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng, (2) k\u1ebft qu\u1ea3 t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u ch\u1ea5t l\u01b0\u1ee3ng cao th\u1ef1c hi\u1ec7n \u1edf qu\u1ed1c gia kh\u00e1c, v\u00e0 (3) kinh nghi\u1ec7m c\u1ee7a chuy\u00ean gia t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng. (V\u1eeba, m\u1ea1nh, 96.8%).<\/p>\n

Khuy\u1ebfn c\u00e1o 9.<\/strong> T\u1ec9 l\u1ec7 \u0111\u1ec1 kh\u00e1ng \u0111\u01a1n \u0111\u1ed9c c\u1ee7a clarithromycin v\u00e0 metronidazole \u0111ang r\u1ea5t cao. T\u1ec9 l\u1ec7 \u0111\u1ec1 kh\u00e1ng c\u1ee7a amoxicillin v\u00e0 levofloxacin c\u0169ng \u0111ang t\u0103ng. Tuy nhi\u00ean, t\u1ec9 l\u1ec7 \u0111\u1ec1 kh\u00e1ng c\u1ee7a tetracycline v\u1eabn th\u1ea5p v\u00e0 duy tr\u00ec \u1ed5n \u0111\u1ecbnh. (V\u1eeba, m\u1ea1nh, 100%).<\/p>\n

Khuy\u1ebfn c\u00e1o 10.<\/strong> K\u00e9m tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n ch\u00ednh d\u1eabn t\u1edbi ti\u1ec7t tr\u1eeb th\u1ea5t b\u1ea1i. D\u00e0nh th\u1eddi gian \u0111\u1ec3 t\u01b0 v\u1ea5n v\u00e0 gi\u1ea3i th\u00edch c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c trong ph\u00e1c \u0111\u1ed3 ti\u1ec7t tr\u1eeb c\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb v\u00e0 d\u1eabn t\u1edbi t\u0103ng t\u1ec9 l\u1ec7 ti\u1ec7t tr\u1eeb th\u00e0nh c\u00f4ng. (V\u1eeba, m\u1ea1nh, 96.8%).<\/p>\n

Khuy\u1ebfn c\u00e1o 11.<\/strong> B\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c gi\u00e1o d\u1ee5c b\u1ecf thu\u1ed1c l\u00e1 v\u00e0 r\u01b0\u1ee3u trong li\u1ec7u tr\u00ecnh ti\u1ec7t tr\u1eeb Hp \u0111\u1ec3 tr\u00e1nh l\u00e0m gi\u1ea3m hi\u1ec7u qu\u1ea3 ti\u1ec7t tr\u1eeb. (V\u1eeba, y\u1ebfu, 93.7%).<\/p>\n

Khuy\u1ebfn c\u00e1o 12.<\/strong> \u1ee8c ch\u1ebf ti\u1ebft acid t\u1ed1t l\u00e0 y\u1ebfu t\u1ed1 c\u1ed1t l\u00f5i quy\u1ebft \u0111\u1ecbnh hi\u1ec7u qu\u1ea3 c\u1ee7a ph\u00e1c \u0111\u1ed3 ti\u1ec7t tr\u1eeb Hp. (Cao, m\u1ea1nh, 96.8%).<\/p>\n

Khuy\u1ebfn c\u00e1o 13.<\/strong> Th\u1eddi gian t\u1ed1i \u01b0u c\u1ee7a c\u00e1c t\u1ea5t c\u1ea3 ph\u00e1c \u0111\u1ed3 ti\u1ec7t tr\u1eeb Hp trong \u0111\u1ed3ng thu\u1eadn l\u00e0 14 ng\u00e0y. (V\u1eeba, m\u1ea1nh, 93.7%).<\/p>\n

Khuy\u1ebfn c\u00e1o 14.<\/strong> L\u1ef1a ch\u1ecdn ph\u00e1c \u0111\u1ed3 ti\u1ec7t tr\u1eeb Hp \u0111\u1ea7u tay.
\nA \u2013 Ph\u00e1c \u0111\u1ed3 \u0111\u1ea7u tay l\u1ef1a ch\u1ecdn \u0111\u1ea7u ti\u00ean l\u00e0 PPI + Tetracycline+ Metronidazole + Bismuth (PTMB). (Cao, m\u1ea1nh, 100%).
\nB \u2013 Ph\u00e1c \u0111\u1ed3 thay th\u1ebf \u0111\u1ea7u tay l\u00e0 PPI + Amoxicillin+ Levofloxacin + Bismuth (PALB). (Th\u1ea5p, m\u1ea1nh, 84.4%).
\nC \u2013 Ph\u00e1c \u0111\u1ed3 3 thu\u1ed1c c\u00f3 clarithromycin kh\u00f4ng n\u00ean l\u1ef1a ch\u1ecdn do t\u1ec9 l\u1ec7 kh\u00e1ng thu\u1ed1c cao. (Cao, m\u1ea1nh, 96.8%).<\/p>\n

\"\"
L\u01b0u \u0111\u1ed3 l\u1ef1a ch\u1ecdn ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp. Ngu\u1ed3n: H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam.<\/figcaption><\/figure>\n

Khuy\u1ebfn c\u00e1o 15:<\/strong> L\u1ef1a ch\u1ecdn ph\u00e1c \u0111\u1ed3 ti\u1ec7t tr\u1eeb Hp h\u00e0ng hai.
\nA \u2013 S\u1eed d\u1ee5ng ph\u00e1c \u0111\u1ed3 PTMB n\u1ebfu ch\u01b0a \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0 ph\u00e1c \u0111\u1ed3 \u0111\u1ea7u tay. (Cao, m\u1ea1nh, 100%).
\nB \u2013 S\u1eed d\u1ee5ng ph\u00e1c \u0111\u1ed3 PALB n\u1ebfu \u0111\u00e3 s\u1eed d\u1ee5ng ph\u00e1c \u0111\u1ed3 PTMB l\u00e0 ph\u00e1c \u0111\u1ed3 \u0111\u1ea7u tay. (Th\u1ea5p, m\u1ea1nh, 90.6%).<\/p>\n

Khuy\u1ebfn c\u00e1o 16.<\/strong> Ch\u1ecdn ph\u00e1c \u0111\u1ed3 c\u1ee9u v\u00e3n sau 2 l\u1ea7n ti\u1ec7t tr\u1eeb th\u1ea5t b\u1ea1i.
\nA \u2013 S\u1eed d\u1ee5ng PTMB n\u1ebfu ch\u01b0a \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. (V\u1eeba, m\u1ea1nh, 100%).
\nB \u2013 N\u1ebfu ph\u00e1c \u0111\u1ed3 PTMB \u0111\u00e3 \u0111\u01b0\u1ee3c d\u00f9ng, n\u00ean th\u1ef1c hi\u1ec7n kh\u00e1ng sinh \u0111\u1ed3. (Th\u1ea5p, m\u1ea1nh, 84.3%).<\/p>\n

Khuy\u1ebfn c\u00e1o 17.<\/strong> Kh\u00f4ng n\u00ean d\u00f9ng ph\u00e1c \u0111\u1ed3 ti\u1ec7t tr\u1eeb c\u00f3 rifabutin do t\u00ecnh h\u00ecnh lao kh\u00e1ng thu\u1ed1c ph\u1ee9c t\u1ea1p t\u1ea1i Vi\u1ec7t Nam. (R\u1ea5t th\u1ea5p, m\u1ea1nh, 87.5%).<\/p>\n

Khuy\u1ebfn c\u00e1o 18.<\/strong> Khi b\u1ec7nh nh\u00e2n tu\u00e2n th\u1ee7 t\u1ed1t v\u1edbi ph\u00e1c \u0111\u1ed3 th\u00edch h\u1ee3p nh\u01b0ng v\u1eabn ti\u1ec7t tr\u1eeb th\u1ea5t b\u1ea1i, n\u00ean xem l\u1ea1i li\u1ec7u ph\u00e1p ti\u1ec7t tr\u1eeb. B\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c th\u00f4ng tin v\u1ec1 k\u1ebf ho\u1ea1ch theo d\u00f5i v\u00e0 qu\u1ea3n l\u00fd \u0111\u1ebfn khi c\u00f3 ph\u00e1c \u0111\u1ed3 ti\u1ec7t tr\u1eeb m\u1edbi. (R\u1ea5t th\u1ea5p, y\u1ebfu, 81.2%).<\/p>\n

3. Th\u1eed Hp sau ti\u1ec7t tr\u1eeb.<\/strong><\/h2>\n

Khuy\u1ebfn c\u00e1o 19.<\/strong> N\u00ean th\u1eed l\u1ea1i t\u00ecnh tr\u1ea1ng nhi\u1ec5m Hp cho t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ti\u1ec7t tr\u1eeb. (Cao, m\u1ea1nh, 96.8%).<\/p>\n

Khuy\u1ebfn c\u00e1o 20.<\/strong> N\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf b\u1ec7nh nh\u00e2n c\u00f3 (1) lo\u00e9t d\u1ea1 d\u00e0y, (2) nghi ng\u1edd t\u1ed5n th\u01b0\u01a1ng \u00e1c t\u00ednh \u1edf d\u1ea1 d\u00e0y, (3) sang th\u01b0\u01a1ng ti\u1ec1n ung th\u01b0 c\u1ea7n \u0111\u00e1nh gi\u00e1 th\u00eam v\u1ec1 m\u1ee9c \u0111\u1ed9 v\u00e0 ph\u1ea1m vi x\u00e2m l\u1ea5n. (Cao, m\u1ea1nh, 96.8%).<\/p>\n

Khuy\u1ebfn c\u00e1o 21.<\/strong> \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ti\u1ec7t tr\u1eeb Hp nh\u01b0ng kh\u00f4ng c\u1ea7n n\u1ed9i soi \u0111\u00e1nh gi\u00e1 l\u1ea1i, n\u00ean ch\u1ecdn test h\u01a1i th\u1edf urea \u0111\u1ec3 x\u00e1c nh\u1eadn ti\u1ec7t tr\u1eeb th\u00e0nh c\u00f4ng hay th\u1ea5t b\u1ea1i. (Cao, m\u1ea1nh, 100%).<\/p>\n

4. D\u1ef1 ph\u00f2ng t\u00e1i nhi\u1ec5m v\u00e0 theo d\u00f5i sau ti\u1ec7t tr\u1eeb.<\/strong><\/h2>\n

Khuy\u1ebfn c\u00e1o 22.<\/strong> Hp l\u00e0 vi khu\u1ea9n c\u00f3 kh\u1ea3 n\u0103ng l\u00e2y t\u1eeb ng\u01b0\u1eddi sang ng\u01b0\u1eddi, \u0111\u1eb7c bi\u1ec7t gi\u1eefa c\u00e1c th\u00e0nh vi\u00ean trong gia \u0111\u00ecnh, qua \u0111\u01b0\u1eddng mi\u1ec7ng-mi\u1ec7ng, ph\u00e2n \u2013 mi\u1ec7ng v\u00e0 c\u00e1c d\u1ee5ng c\u1ee5 y t\u1ebf. (Cao, m\u1ea1nh, 100%).<\/p>\n

Khuy\u1ebfn c\u00e1o 23.<\/strong> T\u00e1i nhi\u1ec5m v\u00e0 b\u00f9ng ph\u00e1t Hp tr\u1edf l\u1ea1i th\u01b0\u1eddng g\u1eb7p \u1edf Vi\u1ec7t Nam. (th\u1ea5p, m\u1ea1nh, 90.6%).<\/p>\n

Khuy\u1ebfn c\u00e1o 24.<\/strong> Gi\u00e1o d\u1ee5c v\u00e0 n\u00e2ng cao nh\u1eadn th\u1ee9c c\u1ed9ng \u0111\u1ed3ng v\u1ec1 ngu\u1ed3n l\u00e2y v\u00e0 \u0111\u01b0\u1eddng l\u00e2y c\u1ee7a Hp c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m nguy c\u01a1 nhi\u1ec5m trong c\u1ed9ng \u0111\u1ed3ng. (V\u1eeba, m\u1ea1nh, 93.7%).<\/p>\n

Khuy\u1ebfn c\u00e1o 25<\/strong>. V\u1edbi b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ec9 \u0111\u1ecbnh n\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean v\u00e0 th\u1ef1c hi\u1ec7n test Hp c\u00f3 sinh thi\u1ebft, lu\u00f4n c\u1ea7n \u0111\u00e1nh gi\u00e1 s\u1ef1 hi\u1ec7n di\u1ec7n, m\u1ee9c \u0111\u1ed9 v\u00e0 ph\u1ea1m vi c\u1ee7a t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n ung th\u01b0. (V\u1eeba, m\u1ea1nh, 96.8%).<\/p>\n

Khuy\u1ebfn c\u00e1o 26.<\/strong> T\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n c\u00f3 teo d\u1ea1 d\u00e0y n\u1eb7ng v\u00e0 lan t\u1ecfa ho\u1eb7c lo\u1ea1n s\u1ea3n ru\u1ed9t ho\u1eb7c lo\u1ea1n s\u1ea3n d\u1ea1 d\u00e0y ru\u1ed9t ch\u01b0a \u0111\u1ecbnh type c\u1ee5 th\u1ec3 n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i b\u1eb1ng n\u1ed9i soi sau ti\u1ec7t tr\u1eeb Hp. (V\u1eeba, m\u1ea1nh, 100%).<\/p>\n

Khuy\u1ebfn c\u00e1o 27.<\/strong> T\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n thi\u1ec3u s\u1ea3n d\u1ea1 d\u00e0y ph\u00e1t hi\u1ec7n qua sinh thi\u1ebft theo s\u01a1 \u0111\u1ed3 n\u00ean \u0111\u01b0\u1ee3c n\u1ed9i soi \u0111\u00e1nh gi\u00e1 l\u1ea1i s\u1eed d\u1ee5ng n\u1ed9i soi h\u00ecnh \u1ea3nh t\u01b0\u01a1ng ph\u1ea3n \u0111\u1ec3 ki\u1ec3m so\u00e1t v\u00e0 \u0111i\u1ec1u tr\u1ecb. (Th\u1ea5p, m\u1ea1nh, 87.5%).<\/p>\n

Nhi\u1ec5m Hp l\u00e0 m\u1ed9t nhi\u1ec5m khu\u1ea9n ph\u1ed5 bi\u1ebfn \u1edf Vi\u1ec7t Nam v\u00e0 ng\u00e0y c\u00e0ng t\u0103ng nhanh t\u1ea7n su\u1ea5t \u0111\u1ec1 kh\u00e1ng kh\u00e1ng sinh. Ung th\u01b0 d\u1ea1 d\u00e0y l\u00e0 u \u00e1c ph\u1ed5 bi\u1ebfn \u1edf n\u01b0\u1edbc ta v\u00e0 c\u00f3 th\u1ec3 x\u1ea3y ra ngay c\u1ea3 khi ti\u1ec7t tr\u1eeb th\u00e0nh c\u00f4ng Hp. \u0110\u1ed3ng thu\u1eadn n\u00e0y \u0111\u01b0a ra c\u00e1c khuy\u1ebfn c\u00e1o v\u1ec1 \u0111i\u1ec1u tr\u1ecb ti\u1ec7t tr\u1eeb v\u00e0 chi\u1ebfn l\u01b0\u1ee3c theo d\u00f5i sau ti\u1ec7t tr\u1eeb Hp t\u1ea1i Vi\u1ec7t Nam.<\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong>
\nVietnam Association of Gastroenterology (VNAGE) consensus on the management of Helicobacter pylori infection
\nhttps:\/\/www.vinmec.com\/vi\/ung-buou-xa-tri\/thong-tin-suc-khoe\/tam-soat-vi-khuan-hp-phong-ung-thu-da-day-nhu-nao\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

\u1ede Vi\u1ec7t Nam, \u0111\u1ed3ng thu\u1eadn \u0111\u1ea7u ti\u00ean v\u1ec1 \u0111i\u1ec1u tr\u1ecb Hp (Helicobacter pylori) \u0111\u01b0\u1ee3c xu\u1ea5t b\u1ea3n n\u0103m 2012 v\u1edbi c\u00e1c khuy\u1ebfn c\u00e1o t\u1eadp trung v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb. Trong 10 n\u0103m qua, t\u1ec9 l\u1ec7 c\u00e1c ch\u1ee7ng Hp \u0111\u1ec1 kh\u00e1ng kh\u00e1ng sinh ph\u00e1t tri\u1ec3n kh\u00f4ng ng\u1eebng, v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y v\u1eabn l\u00e0 m\u1ed9t […]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"\nPh\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp theo H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam 2023 - Vinmec<\/title>\n<meta name=\"description\" content=\"Hp kh\u00e1ng thu\u1ed1c kh\u00f4ng ng\u1eebng t\u0103ng v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y l\u00e0 m\u1ed9t ung th\u01b0 th\u01b0\u1eddng g\u1eb7p, ch\u1ebft ng\u01b0\u1eddi. 27 khuy\u1ebfn c\u00e1o \u0111\u01b0\u1ee3c \u0111\u01b0a ra g\u1ed3m bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb Hp.\" \/>\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\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp theo H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam 2023 - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Hp kh\u00e1ng thu\u1ed1c kh\u00f4ng ng\u1eebng t\u0103ng v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y l\u00e0 m\u1ed9t ung th\u01b0 th\u01b0\u1eddng g\u1eb7p, ch\u1ebft ng\u01b0\u1eddi. 27 khuy\u1ebfn c\u00e1o \u0111\u01b0\u1ee3c \u0111\u01b0a ra g\u1ed3m bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb Hp.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-14T06:09:29+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-14T08:02:58+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/fmed-09-1065045-g002-1-300x164.jpg\" \/>\n<meta name=\"author\" content=\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/\",\"name\":\"Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp theo H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam 2023 - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-14T06:09:29+00:00\",\"dateModified\":\"2023-04-14T08:02:58+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e\"},\"description\":\"Hp kh\u00e1ng thu\u1ed1c kh\u00f4ng ng\u1eebng t\u0103ng v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y l\u00e0 m\u1ed9t ung th\u01b0 th\u01b0\u1eddng g\u1eb7p, ch\u1ebft ng\u01b0\u1eddi. 27 khuy\u1ebfn c\u00e1o \u0111\u01b0\u1ee3c \u0111\u01b0a ra g\u1ed3m bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb Hp.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp theo H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam 2023\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e\",\"name\":\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g\",\"caption\":\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/meogods1234gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp theo H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam 2023 - Vinmec","description":"Hp kh\u00e1ng thu\u1ed1c kh\u00f4ng ng\u1eebng t\u0103ng v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y l\u00e0 m\u1ed9t ung th\u01b0 th\u01b0\u1eddng g\u1eb7p, ch\u1ebft ng\u01b0\u1eddi. 27 khuy\u1ebfn c\u00e1o \u0111\u01b0\u1ee3c \u0111\u01b0a ra g\u1ed3m bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb Hp.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp theo H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam 2023 - Vinmec","og_description":"Hp kh\u00e1ng thu\u1ed1c kh\u00f4ng ng\u1eebng t\u0103ng v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y l\u00e0 m\u1ed9t ung th\u01b0 th\u01b0\u1eddng g\u1eb7p, ch\u1ebft ng\u01b0\u1eddi. 27 khuy\u1ebfn c\u00e1o \u0111\u01b0\u1ee3c \u0111\u01b0a ra g\u1ed3m bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb Hp.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/","og_site_name":"Vinmec","article_published_time":"2023-04-14T06:09:29+00:00","article_modified_time":"2023-04-14T08:02:58+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/fmed-09-1065045-g002-1-300x164.jpg"}],"author":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n","Est. reading time":"8 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/","name":"Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp theo H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam 2023 - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-14T06:09:29+00:00","dateModified":"2023-04-14T08:02:58+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e"},"description":"Hp kh\u00e1ng thu\u1ed1c kh\u00f4ng ng\u1eebng t\u0103ng v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y l\u00e0 m\u1ed9t ung th\u01b0 th\u01b0\u1eddng g\u1eb7p, ch\u1ebft ng\u01b0\u1eddi. 27 khuy\u1ebfn c\u00e1o \u0111\u01b0\u1ee3c \u0111\u01b0a ra g\u1ed3m bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb Hp.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/phac-do-dieu-tri-hp-hoi-tieu-hoa-viet-nam-2023\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Hp theo H\u1ed9i ti\u00eau h\u00f3a Vi\u1ec7t Nam 2023"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e","name":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g","contentUrl":"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g","caption":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/meogods1234gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/2650"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/69"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=2650"}],"version-history":[{"count":11,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/2650\/revisions"}],"predecessor-version":[{"id":20686,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/2650\/revisions\/20686"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=2650"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=2650"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=2650"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}