{"id":26582,"date":"2023-04-22T19:09:11","date_gmt":"2023-04-22T12:09:11","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26582"},"modified":"2023-04-22T19:09:11","modified_gmt":"2023-04-22T12:09:11","slug":"tiem-botulinum-toxine-dieu-tri-loan-truong-luc-co-co","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/tiem-botulinum-toxine-dieu-tri-loan-truong-luc-co-co\/","title":{"rendered":"Ti\u00eam Botulinum Toxine \u0111i\u1ec1u tr\u1ecb lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5"},"content":{"rendered":"

Lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5 (Cervical dystonia<\/a>) l\u00e0 m\u1ed9t d\u1ea1ng r\u1ed1i lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 khu tr\u00fa, g\u00e2y ra t\u01b0 th\u1ebf b\u1ea5t th\u01b0\u1eddng kh\u00f4ng t\u1ef1 ch\u1ee7 c\u1ee7a \u0111\u1ea7u v\u00e0 c\u1ed5. B\u1ec7nh c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng n\u1ed5i tr\u1ed9i nh\u01b0: t\u01b0 th\u1ebf b\u1ea5t th\u01b0\u1eddng, co th\u1eaft c\u01a1 (spasm), rung gi\u1eadt ho\u1eb7c run ho\u1eb7c ph\u1ed1i h\u1ee3p c\u00e1c tri\u1ec7u ch\u1ee9ng. Ti\u00eam Botulinum toxine nh\u00f3m A (Dysport ho\u1eb7c Botox) v\u00e0o \u0111i\u1ec3m v\u1eadn \u0111\u1ed9ng c\u1ee7a c\u01a1 b\u1ecb r\u1ed1i lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c \u1edf c\u1ed5 hi\u1ec7n nay l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 l\u00e0m gi\u1ea3m tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh.<\/strong><\/p>\n

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Lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5 (Cervical dystonia<\/a>) l\u00e0 m\u1ed9t d\u1ea1ng r\u1ed1i lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 khu tr\u00fa<\/figcaption><\/figure>\n

1. Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/h2>\n

Ng\u01b0\u1eddi b\u1ec7nh b\u1ecb lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5, v\u1edbi c\u00e1c h\u00ecnh th\u00e1i kh\u00e1c nhau, ph\u1ee5 thu\u1ed9c v\u00e0o v\u1ecb th\u1ebf c\u1ee7a \u0111\u1ea7u ho\u1eb7c vai<\/p>\n

– Xoay \u0111\u1ea7u (rotatory).<\/p>\n

– Ng\u1eeda \u0111\u1ea7u ra sau (retrocollis).<\/p>\n

– Nghi\u00eang \u0111\u1ea7u sang b\u00ean (laterocollis).<\/p>\n

– C\u00fai \u0111\u1ea7u ra tr\u01b0\u1edbc (anterocollis).<\/p>\n

– Run lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u1ed5 (Dystonic head tremor).<\/p>\n

– Th\u1ec3 ph\u1ed1i h\u1ee3p (Complex torticollis).<\/p>\n

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

– Ng\u01b0\u1eddi b\u1ec7nh r\u1ed1i lo\u1ea1n nu\u1ed1t.<\/p>\n

– B\u1ec7nh l\u00fd to\u00e0n th\u00e2n n\u1eb7ng (nhi\u1ec5m khu\u1ea9n n\u1eb7ng, suy th\u1eadn\u2026).<\/p>\n

3. Chu\u1ea9n b\u1ecb<\/strong><\/h2>\n

Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n<\/strong><\/p>\n

– 01 b\u00e1c s\u0129 Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng c\u00f3 ch\u1ee9ng ch\u1ec9 ho\u1eb7c ch\u1ee9ng nh\u1eadn ti\u00eam thu\u1ed1c Botulinum toxin nh\u00f3m A.<\/p>\n

– 02 \u0111i\u1ec1u d\u01b0\u1ee1ng tr\u1ee3 gi\u00fap cho b\u00e1c s\u0129.<\/p>\n

Ph\u01b0\u01a1ng ti\u1ec7n<\/strong><\/p>\n

– M\u00e1y k\u00edch th\u00edch \u0111i\u1ec7n ho\u1eb7c m\u00e1y \u0111i\u1ec7n c\u01a1 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111i\u1ec3m v\u1eadn \u0111\u1ed9ng.<\/p>\n

– Kim k\u00edch th\u00edch \u0111i\u1ec7n – th\u1ea7n kinh hai n\u00f2ng, 21gauge – L.35mm : 01 chi\u1ebfc.<\/p>\n

– Thu\u1ed1c Botulinum toxine nh\u00f3m A (bi\u1ec7t d\u01b0\u1ee3c: Dysport 500UI ho\u1eb7c Botox 100 UI, \u2026).<\/p>\n

– B\u01a1m ti\u00eam 1 ml: 02 c\u00e1i.<\/p>\n

– N\u01b0\u1edbc mu\u1ed1i sinh l\u00fd 0.9% \u0111\u1ec3 pha thu\u1ed1c.<\/p>\n

– B\u00f4ng, c\u1ed3n s\u00e1t tr\u00f9ng 70o<\/sup> ho\u1eb7c Betadine.<\/p>\n

Ng\u01b0\u1eddi b\u1ec7nh<\/strong><\/p>\n

Gi\u1ea3i th\u00edch, h\u01b0\u1edbng d\u1eabn ng\u01b0\u1eddi b\u1ec7nh v\u00e0 ho\u00e0n th\u00e0nh th\u1ee7 t\u1ee5c tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n th\u1ee7 thu\u1eadt.<\/p>\n

H\u1ed3 s\u01a1 b\u1ec7nh \u00e1n<\/strong><\/p>\n

– Ho\u00e0n th\u00e0nh \u0111\u1ea7y \u0111\u1ee7, c\u00f3 ch\u1ea9n \u0111o\u00e1n, theo d\u00f5i b\u1ec7nh h\u1eb1ng ng\u00e0y.<\/p>\n

– X\u00e1c \u0111\u1ecbnh th\u1ec3 r\u1ed1i lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5: th\u1ec3 xoay \u0111\u1ea7u – th\u1ec3 nghi\u00eang sang b\u00ean – th\u1ec3 c\u00fai ra tr\u01b0\u1edbc – th\u1ec3 ng\u1ea3 ra sau ho\u1eb7c th\u1ec3 ph\u1ed1i h\u1ee3p.<\/p>\n

– \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5 theo thang \u0111i\u1ec3m Tsui ho\u1eb7c thang \u0111i\u1ec3m TWSTRS (Toronto Western Spasmodic Torticollis Rating Scale), \u0111\u00e1nh gi\u00e1 thang \u0111i\u1ec3m ch\u1ee9c n\u0103ng.<\/p>\n

– Ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng thu\u1ed1c.<\/p>\n

4. C\u00e1c b\u01b0\u1edbc ti\u1ebfn h\u00e0nh<\/strong><\/h2>\n

Th\u1eddi gian th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt: t\u1eeb 30 – 40 ph\u00fat.<\/p>\n

B\u01b0\u1edbc 1: <\/strong>ki\u1ec3m tra v\u00e0 kh\u00e1m x\u00e9t ng\u01b0\u1eddi b\u1ec7nh l\u1ea7n cu\u1ed1i tr\u01b0\u1edbc khi ti\u1ebfn h\u00e0nh th\u1ee7 thu\u1eadt, x\u00e1c \u0111\u1ecbnh c\u00e1c c\u01a1 lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u1ea7n \u0111i\u1ec1u tr\u1ecb. Ki\u1ec3m tra m\u1ea1ch, huy\u1ebft \u00e1p, nh\u1ecbp th\u1edf.<\/p>\n

B\u01b0\u1edbc 2: <\/strong>chu\u1ea9n b\u1ecb thu\u1ed1c v\u00e0 m\u00e1y k\u00edch th\u00edch \u0111i\u1ec7n<\/p>\n

– \u0110i\u1ec1u d\u01b0\u1ee1ng pha lo\u00e3ng thu\u1ed1c Botulinum toxine v\u1edbi dung d\u1ecbch Natriclorua 0,9%. \u0110\u1ed9 pha lo\u00e3ng t\u00f9y theo k\u00edch th\u01b0\u1edbc c\u01a1, c\u01a1 c\u00e0ng l\u1edbn thu\u1ed1c n\u00ean pha lo\u00e3ng h\u01a1n \u0111\u1ec3 khuy\u1ebfch t\u00e1n v\u00e0 h\u1ea5p th\u1ee5 t\u1ed1t h\u01a1n. \u0110\u1ed1i v\u1edbi c\u00e1c c\u01a1 v\u00f9ng c\u1ed5, thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c pha v\u1edbi 1 ml NaCl 0.9% (t\u01b0\u01a1ng \u0111\u01b0\u01a1ng 50 UI Dysport \/0,1 ml ho\u1eb7c 10 UI Botox\/0,1 ml).<\/p>\n

– B\u00e1c s\u0129 chu\u1ea9n b\u1ecb m\u00e1y k\u00edch th\u00edch \u0111i\u1ec7n ho\u1eb7c m\u00e1y \u0111i\u1ec7n c\u01a1<\/p>\n

B\u01b0\u1edbc 3<\/strong>: s\u00e1t khu\u1ea9n t\u1ea1i ch\u1ed7 ti\u00eam b\u1eb1ng c\u1ed3n 70 \u0111\u1ed9 ho\u1eb7c Betadine.<\/p>\n

L\u01b0u \u00fd: n\u1ebfu s\u00e1t tr\u00f9ng b\u1eb1ng c\u1ed3n 70 \u0111\u1ed9, ph\u1ea3i ch\u1edd c\u1ed3n kh\u00f4 m\u1edbi \u0111\u01b0\u1ee3c \u0111\u00e2m kim.<\/p>\n

B\u01b0\u1edbc 4<\/strong>: x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c \u0111i\u1ec3m v\u1eadn \u0111\u1ed9ng c\u1ee7a c\u01a1 c\u1ea7n ti\u00eam,<\/p>\n

B\u01b0\u1edbc 5<\/strong>: ti\u1ebfn h\u00e0nh ti\u00eam.<\/p>\n

Ti\u00eam Botulinum toxine nh\u00f3m A v\u00e0o v\u1ecb tr\u00ed \u0111 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh (c\u01a1 v\u00e0 li\u1ec1u ti\u00eam theo b\u1ea3ng \u1edf d\u01b0\u1edbi).<\/p>\n

B\u01b0\u1edbc 6: <\/strong>Thu d\u1ecdn d\u1ee5ng c\u1ee5<\/p>\n

B\u1ea3ng 1<\/em><\/strong>: <\/em>Li\u1ec1u l\u01b0\u1ee3ng ti\u00eam v\u00e0 c\u01a1 ti\u00eam t\u00f9y thu\u1ed9c v\u00e0o ph\u00e2n lo\u1ea1i th\u1ec3 b\u1ec7nh<\/p>\n

(Theo Reiner Benecke, Karen Frei v\u00e0 Cynthia L. Comella -2009)<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Th\u1ec3 b\u1ec7nh<\/strong><\/td>\nC\u01a1 ti\u00eam<\/strong><\/td>\nC\u00f9ng b\u00ean<\/strong><\/td>\n\u0110\u1ed1i b\u00ean<\/strong><\/td>\nLi\u1ec1u Botox (UI)<\/strong><\/td>\nLi\u1ec1u Dysport (UI)<\/strong><\/td>\n<\/tr>\n
Th\u1ec3 xoay c\u1ed5 (torticoilis)<\/td>\nC\u01a1 g\u1ed1i \u0111\u1ea7u v\u00e0 g\u1ed1i c\u1ed5<\/td>\nX<\/td>\n<\/td>\n50 \u2013 100<\/td>\n200 – 400<\/td>\n<\/tr>\n
C\u01a1 n\u00e2ng vai<\/td>\nX<\/td>\n<\/td>\n10 \u2013 25<\/td>\n40 – 100<\/td>\n<\/tr>\n
C\u01a1 \u1ee9c \u0111\u00f2n ch\u0169m<\/td>\n<\/td>\nX<\/td>\n20 \u2013 50<\/td>\n100 – 200<\/td>\n<\/tr>\n
C\u01a1 thang (b\u00f3 tr\u00ean)<\/td>\n<\/td>\nX<\/td>\n20 \u2013 50<\/td>\n80 – 200<\/td>\n<\/tr>\n
C\u01a1 b\u1eadc thang tr\u01b0\u1edbc v\u00e0 gi\u1eefa<\/td>\n<\/td>\nX<\/td>\n10 \u2013 20<\/td>\n40 – 80<\/td>\n<\/tr>\n
C\u01a1 b\u00e1n gai \u0111\u1ea7u v\u00e0 b\u00e1n gai c\u1ed5<\/td>\n<\/td>\nX<\/td>\n15 \u2013 30<\/td>\n60 – 120<\/td>\n<\/tr>\n
Th\u1ec3 nghi\u00eang \u0111\u1ea7u (laterocollis)<\/td>\nC\u01a1 \u1ee9c \u0111\u00f2n ch\u0169m<\/td>\nX<\/td>\n<\/td>\n20 \u2013 50<\/td>\n100 – 200<\/td>\n<\/tr>\n
C\u01a1 thang<\/td>\nX<\/td>\n<\/td>\n20 \u2013 50<\/td>\n80 – 200<\/td>\n<\/tr>\n
C\u01a1 g\u1ed1i \u0111\u1ea7u v\u00e0 g\u1ed1i c\u1ed5<\/td>\nX<\/td>\n<\/td>\n50 \u2013 100<\/td>\n200 – 400<\/td>\n<\/tr>\n
C\u01a1 b\u1eadc thang gi\u1eefa v\u00e0 sau<\/td>\nX<\/td>\n<\/td>\n10 \u2013 20<\/td>\n40 – 80<\/td>\n<\/tr>\n
Th\u1ec3 g\u1eadp \u0111\u1ea7u ra tr\u01b0\u1edbc* (anterocollis)<\/td>\nC\u01a1 \u1ee9c \u0111\u00f2n ch\u0169m<\/td>\nX<\/td>\nX<\/td>\n20 \u2013 50<\/td>\n100 – 200<\/td>\n<\/tr>\n
C\u01a1 b\u1eadc thang<\/td>\nX<\/td>\nX<\/td>\n10 \u2013 20<\/td>\n40 – 80<\/td>\n<\/tr>\n
Th\u1ec3 ng\u1eeda \u0111\u1ea7u ra sau* (retrocollis)<\/td>\nC\u01a1 n\u00e2ng vai<\/td>\nX<\/td>\nX<\/td>\n10 \u2013 25<\/td>\n40 – 100<\/td>\n<\/tr>\n
C\u01a1 g\u1ed1i \u0111\u1ea7u v\u00e0 g\u1ed1i c\u1ed5<\/td>\nX<\/td>\nX<\/td>\n50 \u2013 100<\/td>\n200 – 400<\/td>\n<\/tr>\n
C\u01a1 b\u00e1n gai \u0111\u1ea7u v\u00e0 b\u00e1n gai c\u1ed5<\/td>\nX<\/td>\nX<\/td>\n15 \u2013 30<\/td>\n60 – 120<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

– L\u01b0u \u00fd<\/em>: n\u1ebfu ti\u00eam c\u01a1 \u1edf c\u1ea3 hai b\u00ean, c\u1ea7n ph\u1ea3i gi\u1ea3m li\u1ec1u, c\u1ee5 th\u1ec3 nh\u01b0 sau<\/p>\n

* C\u01a1 \u1ee9c \u0111\u00f2n ch\u0169m: ch\u1ec9 c\u00f2n 50% li\u1ec1u b\u00ecnh th\u01b0\u1eddng (\u0111\u1ec3 ph\u00f2ng ng\u1eeba bi\u1ebfn ch\u1ee9ng kh\u00f3 nu\u1ed1t).<\/p>\n

* C\u00e1c c\u01a1 g\u1ed1i \u0111\u1ea7u v\u00e0 b\u00e1n gai \u0111\u1ea7u: ch\u1ec9 c\u00f2n 60% li\u1ec1u b\u00ecnh th\u01b0\u1eddng (\u0111\u1ec3 ph\u00f2ng ng\u1eeba y\u1ebfu c\u1ed5).<\/p>\n

B\u1ea3ng 2: <\/strong>T\u1ed5ng li\u1ec1u ti\u00eam<\/p>\n

(Theo Reiner Benecke, Karen Frei v\u00e0 Cynthia L. Comella -2009)<\/p>\n\n\n\n\n
\u0110i\u1ec3m Tsui<\/strong><\/td>\nT\u1ed5ng li\u1ec1u Botox<\/strong><\/td>\nT\u1ed5ng li\u1ec1u Dysport<\/strong><\/td>\n<\/tr>\n
12-15<\/p>\n

9-12<\/p>\n

6-9<\/p>\n

3-6<\/td>\n

200 UI<\/p>\n

150 – 200 UI<\/p>\n

100 – 150 UI<\/p>\n

80 – 120 UI<\/td>\n

800 UI<\/p>\n

600 – 800 UI<\/p>\n

400 – 600 UI<\/p>\n

320 – 480 UI<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

T\u1ed5ng li\u1ec1u m\u1ed7i l\u1ea7n ti\u00eam l\u00e0 500 – 1000 UI Dysport ho\u1eb7c 100 – 200 UI Botox t\u00f9y theo th\u1ec3 b\u1ec7nh v\u00e0 m\u1ee9c \u0111\u1ed9 b\u1ec7nh (theo ph\u00e2n lo\u1ea1i Tsui), \u0111\u1ed9 tu\u1ed5i, gi\u1edbi t\u00ednh, s\u1ed1 l\u01b0\u1ee3ng c\u01a1 \u0111\u01b0\u1ee3c ti\u00eam, th\u1ec3 tr\u1ea1ng v\u00e0 c\u00e2n n\u1eb7ng ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

B\u01b0\u1edbc 7<\/strong>: K\u1ebft th\u00fac: s\u00e1t tr\u00f9ng v\u1ecb tr\u00ed ti\u00eam, thu d\u1ecdn d\u1ee5ng c\u1ee5, d\u1eb7n d\u00f2 ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

5. Theo d\u00f5i v\u00e0 x\u1eed tr\u00ed tai bi\u1ebfn<\/strong><\/h2>\n

Theo d\u00f5i ng\u01b0\u1eddi b\u1ec7nh sau ti\u00eam \u0111\u1ebfn 48 gi\u1edd.<\/p>\n

Tai bi\u1ebfn v\u00e0 x\u1eed tr\u00ed:<\/b><\/p>\n

H\u1ea7u h\u1ebft c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 nh\u1eb9, ch\u1ec9 tho\u00e1ng qua v\u00e0 x\u1ea3y ra ch\u1ee7 y\u1ebfu trong v\u00e0i tu\u1ea7n \u0111\u1ea7u sau ti\u00eam, th\u01b0\u1eddng bi\u1ebfn m\u1ea5t trong v\u00f2ng 2 tu\u1ea7n. M\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ea7n x\u1eed tr\u00ed theo quy \u0111\u1ecbnh.<\/p>\n

– C\u00e1c ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn.<\/p>\n

– Nhi\u1ec5m tr\u00f9ng t\u1ea1i ch\u1ed7 ti\u00eam.<\/p>\n

– Ch\u1ea3y m\u00e1u t\u1ea1i ch\u1ed7 ti\u00eam.<\/p>\n

– Kh\u00f4 mi\u1ec7ng.<\/p>\n

– Nu\u1ed1t kh\u00f3: c\u00f3 th\u1ec3 x\u1ea3y ra khi ti\u00eam c\u01a1 \u1ee9c \u0111\u00f2n ch\u0169m c\u1ea3 hai b\u00ean.<\/p>\n

– Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean.<\/p>\n

– \u0110au c\u1ed5.<\/p>\n

– \u0110au \u0111\u1ea7u.<\/p>\n

– Y\u1ebfu c\u1ed5: c\u00f3 th\u1ec3 x\u1ea3y ra khi ti\u00eam c\u01a1 v\u00f9ng c\u1ed5 sau (c\u01a1 g\u1ed1i \u0111\u1ea7u v\u00e0 c\u01a1 b\u00e1n gai \u0111\u1ea7u) \u1edf c\u1ea3 hai b\u00ean.<\/p>\n

T\u00f3m l\u1ea1i, ti\u00eam Botulinum Toxine (Botox) l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 cho lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5 (cervical dystonia), gi\u00fap gi\u1ea3m s\u1ef1 co th\u1eaft c\u1ee7a c\u00e1c c\u01a1 trong v\u00f9ng c\u1ed5 v\u00e0 gi\u1ea3m tri\u1ec7u ch\u1ee9ng co c\u1ee9ng c\u1ed5 v\u00e0 \u0111au li\u00ean quan \u0111\u1ebfn b\u1ec7nh. Hi\u1ec7u qu\u1ea3 c\u1ee7a Botox k\u00e9o d\u00e0i t\u1eeb 3 \u0111\u1ebfn 6 th\u00e1ng v\u00e0 c\u00f3 th\u1ec3 ti\u00eam l\u1ea1i sau \u0111\u00f3. Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng Botox \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb co c\u1ee9ng c\u1ed5 c\u0169ng c\u00f3 m\u1ed9t s\u1ed1 r\u1ee7i ro v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 x\u1ea3y ra, bao g\u1ed3m \u0111au \u0111\u1ea7u, kh\u00f3 nu\u1ed1t, m\u1ec7t m\u1ecfi v\u00e0 kh\u00f3 th\u1edf. Vi\u1ec7c s\u1eed d\u1ee5ng Botox c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi c\u00e1c chuy\u00ean gia y t\u1ebf c\u00f3 chuy\u00ean m\u00f4n v\u00e0 kinh nghi\u1ec7m trong l\u0129nh v\u1ef1c n\u00e0y.<\/p>\n

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

Lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5 (Cervical dystonia) l\u00e0 m\u1ed9t d\u1ea1ng r\u1ed1i lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 khu tr\u00fa, g\u00e2y ra t\u01b0 th\u1ebf b\u1ea5t th\u01b0\u1eddng kh\u00f4ng t\u1ef1 ch\u1ee7 c\u1ee7a \u0111\u1ea7u v\u00e0 c\u1ed5. B\u1ec7nh c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng n\u1ed5i tr\u1ed9i nh\u01b0: t\u01b0 th\u1ebf b\u1ea5t th\u01b0\u1eddng, co th\u1eaft c\u01a1 (spasm), rung gi\u1eadt ho\u1eb7c run ho\u1eb7c […]<\/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":"\nTi\u00eam Botulinum Toxine \u0111i\u1ec1u tr\u1ecb lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5 - Vinmec<\/title>\n<meta name=\"description\" content=\"Lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5 (Cervical dystonia) l\u00e0 m\u1ed9t d\u1ea1ng r\u1ed1i lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 khu tr\u00fa, g\u00e2y ra t\u01b0 th\u1ebf b\u1ea5t th\u01b0\u1eddng kh\u00f4ng t\u1ef1 ch\u1ee7 c\u1ee7a \u0111\u1ea7u v\u00e0 c\u1ed5 ...\" \/>\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=\"Ti\u00eam Botulinum Toxine \u0111i\u1ec1u tr\u1ecb lo\u1ea1n tr\u01b0\u01a1ng l\u1ef1c c\u01a1 c\u1ed5 - 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