{"id":27083,"date":"2023-04-24T22:46:38","date_gmt":"2023-04-24T15:46:38","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27083"},"modified":"2023-04-24T22:46:38","modified_gmt":"2023-04-24T15:46:38","slug":"benh-crohn-trieu-chung-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/benh-crohn-trieu-chung-lam-sang\/","title":{"rendered":"B\u1ec7nh Crohn: Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng"},"content":{"rendered":"

C\u00e1c b\u1ec7nh ru\u1ed9t vi\u00eam l\u00e0 nh\u00f3m b\u1ec7nh l\u00fd vi\u00eam m\u1ea1n t\u00ednh \u1ea3nh h\u01b0\u1edfng l\u00ean \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. B\u1ec7nh ru\u1ed9t vi\u00eam c\u00f3 hai d\u1ea1ng ch\u00ednh l\u00e0 vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn. B\u1ec7nh Crohn c\u00f3 kh\u1edfi ph\u00e1t l\u00e2m s\u00e0ng r\u1ea5t \u0111a d\u1ea1ng, c\u00f3 th\u1ec3 cho tri\u1ec7u ch\u1ee9ng \u1edf \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u00e0 \u1edf c\u00e1c c\u01a1 quan n\u1eb1m ngo\u00e0i \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/strong><\/p>\n

1. \u0110\u1ecbnh ngh\u0129a b\u1ec7nh Crohn<\/h2>\n

B\u1ec7nh ru\u1ed9t vi\u00eam (inflammatory bowel disease \u2013 IBD) l\u00e0 nh\u00f3m b\u1ec7nh l\u00fd vi\u00eam m\u1ea1n t\u00ednh c\u1ee7a \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, c\u00f3 c\u01a1 ch\u1ebf b\u1ec7nh sinh r\u1ea5t ph\u1ee9c t\u1ea1p, nguy\u00ean nh\u00e2n v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ee9ng minh r\u00f5 r\u00e0ng. B\u1ec7nh ru\u1ed9t vi\u00eam g\u1ed3m c\u00f3 hai lo\u1ea1i ch\u00ednh l\u00e0 b\u1ec7nh Crohn (Crohn\u2019s disease – CD) v\u00e0 vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng (ulcerative colitis). B\u1ec7nh Crohn l\u00e0 d\u1ea1ng b\u1ec7nh vi\u00eam ru\u1ed9t c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng m\u1ecdi v\u1ecb tr\u00ed c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a, t\u1eeb khoang mi\u1ec7ng cho \u0111\u1ebfn l\u1ed7 h\u1eadu m\u00f4n. So v\u1edbi vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng, sang th\u01b0\u01a1ng c\u1ee7a b\u1ec7nh Crohn th\u01b0\u1eddng kh\u00f4ng li\u00ean t\u1ee5c (xen k\u1ebd gi\u1eefa nh\u1eefng \u0111o\u1ea1n sang th\u01b0\u01a1ng b\u1ec7nh l\u00fd v\u00e0 c\u00e1c \u0111o\u1ea1n ru\u1ed9t b\u00ecnh th\u01b0\u1eddng), t\u1eadp trung ch\u1ee7 y\u1ebfu \u1edf \u0111o\u1ea1n cu\u1ed1i c\u1ee7a ru\u1ed9t non v\u00e0 \u0111o\u1ea1n \u0111\u1ea7u \u0111\u1ea1i tr\u00e0ng. T\u1ed5n th\u01b0\u01a1ng ru\u1ed9t trong b\u1ec7nh Crohn th\u01b0\u1eddng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u1ea5t c\u1ea3 c\u00e1c l\u1edbp c\u1ee7a th\u00e0nh ru\u1ed9t.\u00a0<\/span><\/p>\n

B\u00e0i vi\u1ebft chi ti\u1ebft v\u1ec1 tri\u1ec7u ch\u1ee9ng, ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00e2n \u0111\u1ed9 b\u1ec7nh l\u00fd vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng c\u00f3 tr\u00ean chuy\u00ean trang VinmecDr.\u00a0<\/a><\/p>\n

2. Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh Crohn<\/h2>\n

T\u1ed5n th\u01b0\u01a1ng c\u1ee7a b\u1ec7nh Crohn th\u01b0\u1eddng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ru\u1ed9t non v\u00e0 \u0111o\u1ea1n \u0111\u1ea7u c\u1ee7a \u0111\u1ea1i tr\u00e0ng. Hi\u1ebfm khi CD \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn tr\u1ef1c tr\u00e0ng, nh\u01b0ng CD c\u00f3 kh\u1ea3 n\u0103ng \u1ea3nh h\u01b0\u1edfng m\u1ecdi v\u1ecb tr\u00ed c\u1ee7a h\u1ec7 ti\u00eau h\u00f3a. G\u1ea7n 80% b\u1ec7nh nh\u00e2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u1edf ru\u1ed9t non, trong \u0111\u00f3 kho\u1ea3ng \u0111a ph\u1ea7n l\u00e0 t\u1eadp trung \u1edf \u0111o\u1ea1n xa c\u1ee7a ru\u1ed9t non. G\u1ea7n m\u1ed9t n\u1eefa b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ea9n \u0111o\u00e1n CD v\u00e0 t\u1ed5n th\u01b0\u01a1ng \u1edf h\u1ed3i tr\u00e0ng v\u00e0 \u0111\u1ea1i tr\u00e0ng. Kho\u1ea3ng 30% b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng quanh h\u1eadu m\u00f4n. Kho\u1ea3ng t\u1eeb 5 \u0111\u1ebfn 15% b\u1ec7nh nh\u00e2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u1edf mi\u1ec7ng, d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng.<\/p>\n

\"Minh-hoa-trieu-chung-benh-Crohn\"
B\u1ec7nh Crohn c\u00f3 tri\u1ec7u ch\u1ee9ng kh\u1edfi ph\u00e1t \u0111a d\u1ea1ng<\/figcaption><\/figure>\n

V\u1ec1 di\u1ec5n ti\u1ebfn c\u1ee7a b\u1ec7nh, CD c\u00f3 th\u1ec3 di\u1ec5n ti\u1ebfn theo 02 con \u0111\u01b0\u1eddng t\u01b0\u01a1ng \u0111\u1ed1i ph\u00e2n bi\u1ec7t. M\u1ed9t l\u00e0 d\u1ea1ng di\u1ec5n ti\u1ebfn t\u1ea1o th\u00e0nh c\u00e1c l\u1ed7 r\u00f2, \u0111\u00e2y l\u00e0 d\u1ea1ng di\u1ec5n ti\u1ebfn b\u1ec7nh ph\u1ed5 bi\u1ebfn, th\u1ec3 hi\u1ec7n \u0111\u1eb7c tr\u01b0ng c\u1ee7a b\u1ec7nh l\u00e0 t\u1ed5n th\u01b0\u01a1ng t\u1ea5t c\u1ea3 c\u00e1c l\u1edbp c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a. D\u1ea1ng th\u1ee9 hai l\u00e0 d\u1ea1ng ti\u1ebfn tri\u1ec3n l\u00e0m ch\u00edt h\u1eb9p \u1ed1ng ti\u00eau h\u00f3a do qu\u00e1 tr\u00ecnh x\u01a1 h\u00f3a. T\u1ea1o th\u00e0nh c\u00e1c v\u1ecb tr\u00ed ch\u00edt h\u1eb9p do x\u01a1 h\u00f3a g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn l\u01b0u th\u00f4ng c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a c\u00f3 th\u1ec3 ch\u00ednh l\u00e0 tri\u1ec7u ch\u1ee9ng ch\u1ee7 y\u1ebfu c\u1ee7a d\u1ea1ng b\u1ec7nh n\u00e0y.<\/p>\n

\u0110\u1ed1i v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u1edf ru\u1ed9t non \u1edf d\u1ea1ng CD \u0111i\u1ec3n h\u00ecnh, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n nh\u01b0 m\u1ed9t tr\u01b0\u1eddng h\u01a1p t\u1eafc ru\u1ed9t non. Qu\u00e1 tr\u00ecnh b\u1ec7nh di\u1ec5n ti\u1ebfn \u00e2m th\u1ea7m l\u00e0m ch\u00edt h\u1eb9p l\u00f2ng \u1ed1ng ti\u00eau h\u00f3a g\u00e2y t\u1eafc, bi\u1ec3u hi\u1ec7n l\u00e0 nh\u1eefng \u0111\u1ee3t co th\u1eaft \u0111\u1ea1i tr\u00e0ng t\u00e1i di\u1ec5n, \u0111\u00f4i khi c\u00f3 th\u1ec3 k\u00e8m theo bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n. Tri\u1ec7u ch\u1ee9ng n\u00e0y th\u01b0\u1eddng tr\u1edf n\u00ean n\u1eb7ng n\u1ec1 h\u01a1i v\u1edbi ch\u1ebf \u0111\u1ed9 \u0103n nhi\u1ec1u x\u01a1 do kh\u1ed1i l\u01b0\u1ee3ng th\u1ee9c \u0103n \u0111\u1ebfn ch\u1ed7 ch\u00edt x\u1eb9p nhi\u1ec1u h\u01a1n. Th\u0103m kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 s\u1edd th\u1ea5y kh\u1ed1i c\u0103ng ho\u1eb7c \u0111au \u1edf ph\u1ea7n t\u01b0 d\u01b0\u1edbi ph\u1ea3i c\u1ee7a b\u1ee5ng. N\u1ebfu c\u00e1c qu\u00e1 tr\u00ecnh vi\u00eam di\u1ec5n ra d\u1eef d\u1ed9i, c\u00f3 th\u1ec3 c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u th\u1ec3 hi\u1ec7n t\u00ecnh tr\u1ea1ng vi\u00eam ru\u1ed9t nh\u01b0: ti\u00eau ph\u00e2n l\u1ecfng, ch\u00e1n \u0103n, s\u1ee5t c\u00e2n, s\u1ed1t nh\u1eb9.<\/p>\n

V\u1edbi c\u00e1c th\u1ec3 b\u1ec7nh CD di\u1ec5n ti\u1ebfn t\u1ea1o th\u00e0nh c\u00e1c l\u1ed7 r\u00f2, bi\u1ec3u hi\u1ec7n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 c\u00e1c l\u1ed7 r\u00f2 xung quanh h\u1eadu m\u00f4n. Trong kho\u1ea3ng 1\/4 b\u1ec7nh nh\u00e2n CD, r\u00f2 h\u1eadu m\u00f4n l\u00e0 tri\u1ec7u ch\u1ee9ng kh\u1edfi ph\u00e1t \u0111\u1ea7u ti\u00ean c\u1ee7a b\u1ec7nh, \u0111i tr\u01b0\u1edbc c\u00e1c kh\u1edfi ph\u00e1t tr\u00ean \u0111\u01b0\u1eddng ti\u00eau h\u00f3a kh\u00e1c. Ngo\u00e0i c\u00e1c t\u1ed5n th\u01b0\u01a1ng r\u00f2, c\u00f3 th\u1ec3 quan s\u00e1t th\u1ea5y c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c nh\u01b0 n\u1ee9t, lo\u00e9t v\u00e0 h\u1eb9p h\u1eadu m\u00f4n. C\u00e1c \u0111\u01b0\u1eddng r\u00f2 v\u1edbi l\u1ed7 trong n\u1eb1m cao \u1edf \u0111o\u1ea1n tr\u1ef1c tr\u00e0ng c\u00f3 th\u1ec3 cho bi\u1ebfn ch\u1ee9ng th\u00e0nh c\u00e1c abscess s\u00e2u. C\u00e1c t\u1ed5n th\u01b0\u01a1ng ru\u1ed9t c\u1ee7a CD c\u00f3 th\u1ec3 g\u00e2y \u00a0r\u1ed1i lo\u1ea1n h\u1ea5p thu, d\u1eabn \u0111\u1ebfn ti\u00eau l\u1ecfng, ti\u00eau ph\u00e2n m\u1ee1, h\u1ea1 calci m\u00e1u, suy dinh d\u01b0\u1ee1ng v\u00e0 thi\u1ebfu m\u00e1u.<\/p>\n

\u0110\u1ed1i v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u1eb1m \u1edf c\u00e1c v\u1ecb tr\u00ed kh\u00f4ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a CD, kh\u1edfi ph\u00e1t th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 c\u00e1c b\u1ec7nh l\u00fd lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng kh\u00f4ng do vi khu\u1ea9n Helicobacter pylori. Ngo\u00e0i ra, c\u00e1c t\u1ed5n th\u01b0\u01a1ng ch\u00edt h\u1eb9p do x\u01a1 h\u00f3a n\u1eb1m \u1edf c\u00e1c v\u1ecb tr\u00ed kh\u00e1c c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a t\u1eafc ru\u1ed9t nh\u01b0 \u0111\u00e3 \u0111\u1ec1 c\u1eadp \u1edf tr\u00ean. C\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c kh\u1edfi ph\u00e1t ngo\u00e0i ru\u1ed9t non c\u1ee7a CD th\u01b0\u1eddng kh\u1edfi b\u1ec7nh \u1edf tu\u1ed5i tr\u1ebb h\u01a1n. Bi\u1ec3u hi\u1ec7n \u1edf mi\u1ec7ng c\u1ee7a CD c\u00f3 th\u1ec3 l\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng lo\u00e9t d\u1ea1ng \u00e1p-t\u01a1 g\u00e2y \u0111au \u1edf v\u00f9ng mi\u1ec7ng v\u00e0 n\u01b0\u1edbu. Bi\u1ec3u hi\u1ec7n \u1edf th\u1ef1c qu\u1ea3n c\u1ee7a CD c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t l\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng nu\u1ed1t \u0111au hay nu\u1ed1t kh\u00f3.<\/p>\n

Ngo\u00e0i c\u00e1c bi\u1ec3u hi\u1ec7n do c\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u1eb1m tr\u00ean \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, tri\u1ec7u ch\u1ee9ng b\u1ec7nh Crohn c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t \u1edf c\u00e1c c\u01a1 quan ngo\u00e0i h\u1ec7 ti\u00eau h\u00f3a, c\u00f3 th\u1ec3 k\u1ec3 \u0111\u1ebfn nh\u01b0:<\/p>\n

    \n
  • \u0110au kh\u1edbp v\u00e0 vi\u00eam kh\u1edbp: c\u00e1c d\u1ea1ng b\u1ec7nh l\u00fd ru\u1ed9t vi\u00eam th\u01b0\u1eddng c\u00f3 th\u1ec3 g\u00e2y vi\u00eam kh\u1edbp nh\u01b0ng kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng ph\u00e1 h\u1ee7y kh\u1edbp, t\u1ea7n su\u1ea5t g\u1eb7p c\u00f3 th\u1ec3 l\u00ean \u0111\u1ebfn 20%.<\/li>\n
  • C\u00e1c t\u1ed5n th\u01b0\u01a1ng da: c\u0169ng gi\u1ed1ng nh\u01b0 vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng, CD c\u00f3 th\u1ec3 cho h\u00ecnh \u1ea3nh kh\u1edfi ph\u00e1t tr\u00ean da l\u00e0 c\u00e1c h\u1ed3ng ban d\u1ea1ng n\u1ed1t ho\u1eb7c vi\u00eam da m\u1ee7 ho\u1ea1i th\u01b0.<\/li>\n
  • Vi\u00eam x\u01a1 \u0111\u01b0\u1eddng m\u1eadt nguy\u00ean ph\u00e1t: x\u1ea3y ra trong kho\u1ea3ng 5% b\u1ec7nh nh\u00e2n CD<\/li>\n
  • S\u1ecfi th\u1eadn: do s\u1ef1 r\u1ed1i lo\u1ea1n h\u1ea5p thu m\u1ee1, calcium v\u00e0 oxalate , c\u00e1c b\u1ec7nh nh\u00e2n CD c\u00f3 nguy c\u01a1 b\u1ecb s\u1ecfi th\u1eadn d\u1ea1ng calcium oxalate<\/li>\n
  • Gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng: do r\u1ed1i lo\u1ea1n h\u1ea5p thu calcium v\u00e0 vi\u1ec7c s\u1eed d\u1ee5ng glucocorticoid trong \u0111i\u1ec1u tr\u1ecb, c\u00e1c b\u1ec7nh nh\u00e2n CD c\u00f3 nguy c\u01a1 gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng tr\u1ea7m tr\u1ecdng.<\/li>\n<\/ul>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    C\u00e1c b\u1ec7nh ru\u1ed9t vi\u00eam l\u00e0 nh\u00f3m b\u1ec7nh l\u00fd vi\u00eam m\u1ea1n t\u00ednh \u1ea3nh h\u01b0\u1edfng l\u00ean \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. B\u1ec7nh ru\u1ed9t vi\u00eam c\u00f3 hai d\u1ea1ng ch\u00ednh l\u00e0 vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng v\u00e0 b\u1ec7nh Crohn. B\u1ec7nh Crohn c\u00f3 kh\u1edfi ph\u00e1t l\u00e2m s\u00e0ng r\u1ea5t \u0111a d\u1ea1ng, c\u00f3 th\u1ec3 cho tri\u1ec7u ch\u1ee9ng \u1edf \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u00e0 \u1edf c\u00e1c c\u01a1 […]<\/p>\n","protected":false},"author":37,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[],"yoast_head":"\nB\u1ec7nh Crohn: Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh Crohn c\u00f3 kh\u1edfi ph\u00e1t l\u00e2m s\u00e0ng r\u1ea5t \u0111a d\u1ea1ng, c\u00f3 th\u1ec3 cho tri\u1ec7u ch\u1ee9ng \u1edf \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u00e0 \u1edf c\u00e1c c\u01a1 quan n\u1eb1m ngo\u00e0i \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.\" \/>\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 Crohn: Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng - 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