{"id":27155,"date":"2023-04-25T01:19:21","date_gmt":"2023-04-24T18:19:21","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27155"},"modified":"2023-04-25T01:19:21","modified_gmt":"2023-04-24T18:19:21","slug":"benh-crohn-chan-doan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/benh-crohn-chan-doan\/","title":{"rendered":"B\u1ec7nh Crohn: Ch\u1ea9n \u0111o\u00e1n"},"content":{"rendered":"

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. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Crohn v\u00e0 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 b\u1ec7nh ch\u00ednh x\u00e1c l\u00e0 ti\u1ec1n \u0111\u1ec1 quan tr\u1ecdng \u0111\u1ec3 thi\u1ebft l\u1eadp ch\u1ebf \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh hi\u1ec7u qu\u1ea3 v\u00e0 an to\u00e0n.<\/strong><\/p>\n

1. \u0110\u1ecbnh ngh\u0129a v\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a 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 v\u00e0 vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng c\u00f3 c\u01a1 s\u1edf b\u1ec7nh sinh v\u00e0 h\u00ecnh \u1ea3nh l\u00e2m s\u00e0ng r\u1ea5t \u0111a d\u1ea1ng, \u0111\u00f4i khi d\u1ec5 ph\u00e2n bi\u1ec7t nh\u01b0ng \u0111\u00f4i khi c\u0169ng ch\u1ed1ng l\u1ea5p v\u1edbi nhau l\u00e0m cho c\u00f4ng t\u00e1c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c hai b\u1ec7nh n\u00e0y c\u00f3 nhi\u1ec1u th\u00e1ch th\u1ee9c.<\/span><\/p>\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. V\u1ec1 di\u1ec5n ti\u1ebfn c\u1ee7a b\u1ec7nh, CD c\u00f3 th\u1ec3 di\u1ec5n ti\u1ebfn theo 02, m\u1ed9t d\u1ea1ng di\u1ec5n ti\u1ebfn t\u1ea1o th\u00e0nh c\u00e1c l\u1ed7 r\u00f2, 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. \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\u1ee3p t\u1eafc ru\u1ed9t non – 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. 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. 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. \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. \u00cdt g\u1eb7p h\u01a1n l\u00e0 lo\u00e9t mi\u1ec7ng d\u1ea1ng \u00e1p-t\u01a1, nu\u1ed1t kh\u00f3, nu\u1ed1t \u0111au.<\/p>\n

Ngo\u00e0i c\u00e1c bi\u1ec3u hi\u1ec7n tr\u00ean, 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 nh\u01b0 \u1edf kh\u1edbp, da, m\u1eaft, h\u1ec7 ni\u1ec7u…<\/p>\n

B\u00e0i vi\u1ebft m\u00f4 t\u1ea3 chi ti\u1ebft tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh Crohn c\u00f3 tr\u00ean chuy\u00ean trang VinmecDr<\/a>.<\/p>\n

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

B\u1ec7nh Crohn \u0111\u01b0\u1ee3c g\u1ee3i \u00fd b\u1edfi c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a t\u00ecnh tr\u1ea1ng ru\u1ed9t vi\u00eam (\u0111au b\u1ee5ng, ti\u00eau l\u1ecfng, m\u1ec7t m\u1ecfi, s\u1ed1t nh\u1eb9, ch\u00e1n \u0103n) v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u li\u00ean quan r\u1ed1i lo\u1ea1n h\u1ea5p thu dinh d\u01b0\u1ee1ng (thi\u1ebfu m\u00e1u, thi\u1ebfu calcium, thi\u1ebfu vitamin D). Ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c th\u00e0nh l\u1eadp v\u1edbi c\u00e1c b\u1eb1ng ch\u1ee9ng h\u00ecnh \u1ea3nh h\u1ecdc, quan s\u00e1t \u0111\u1ea1i th\u1ec3 qua n\u1ed9i soi v\u00e0 gi\u1ea3i ph\u1eabu b\u1ec7nh h\u1ecdc. C\u00e1c d\u1ea5u hi\u1ec7u h\u00f3a sinh th\u01b0\u1eddng kh\u00f4ng d\u00f9ng \u0111\u01a1n \u0111\u1ed9c \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n m\u00e0 c\u00f3 gi\u00e1 tr\u1ecb trong theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd CD.<\/p>\n

\u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh l\u00fd CD, c\u1ea7n b\u1eaft \u0111\u1ea7u b\u1eb1ng khai th\u00e1c b\u1ec7nh s\u1eed m\u1ed9t c\u00e1ch k\u1ef9 l\u01b0\u1ee1ng. C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ea7n \u0111\u01b0\u1ee3c khai th\u00e1c \u0111\u1ea7y \u0111\u1ee7 thu\u1ed9c t\u00ednh, \u0111\u1eb7c bi\u1ec7t l\u00e0 m\u1ee9c \u0111\u1ed9 v\u00e0 th\u1eddi gian kh\u1edfi ph\u00e1t c\u1ee7a ch\u00fang. Ngo\u00e0i ra, qu\u00e1 tr\u00ecnh h\u1ecfi b\u1ec7nh c\u0169ng c\u1ea7n ch\u00fa tr\u1ecdng v\u00e0o khai th\u00e1c s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 v\u00e0 c\u00e1c g\u1ee3i \u00fd gi\u00fap lo\u1ea1i tr\u1eeb c\u00e1c ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t kh\u00e1c. C\u1ea7n ch\u00fa tr\u1ecdng khai th\u00e1c ti\u1ec1n s\u1eed du l\u1ecbch, ch\u1ebf \u0111\u1ed9 thu\u1ed1c \u0111\u00e3 v\u00e0 \u0111ang d\u00f9ng, l\u1ecbch s\u1eed can thi\u1ec7p ngo\u1ea1i khoa v\u00f9ng b\u1ee5ng, ch\u1ebf \u0111\u1ed9 \u0103n v\u00e0 th\u1eadm ch\u00ed l\u00e0 li\u00ean quan \u0111\u1ebfn c\u00e1c ho\u1ea1t \u0111\u1ed9ng t\u00ecnh d\u1ee5c. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00f3 li\u00ean quan c\u1ea7n khai th\u00e1c l\u00e0: ti\u1ec1n s\u1eed h\u00fat thu\u1ed1c l\u00e1, ti\u1ec1n s\u1eed nhi\u1ec5m tr\u00f9ng ti\u00eau h\u00f3a, ti\u1ec1n s\u1eed gia \u0111\u00ecnh m\u1eafc CD hay ung th\u01b0 \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/p>\n

C\u00e1c d\u1ea5u hi\u1ec7u c\u1eadn l\u00e2m s\u00e0ng \u1ee7ng h\u1ed9 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Crohn:<\/p>\n

    \n
  • C\u00f4ng th\u1ee9c m\u00e1u: thi\u1ebfu m\u00e1u h\u1ed3ng c\u1ea7u to do thi\u1ebfu vitamin B12<\/li>\n
  • T\u0103ng CRP, t\u1ed1c \u0111\u1ed9 m\u00e1u l\u1eafng: cho th\u1ea5y s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a ph\u1ea3n \u1ee9ng vi\u00eam trong c\u01a1 th\u1ec3<\/li>\n
  • \u0110\u1ecbnh l\u01b0\u1ee3ng lactoferrin v\u00e0 calprotectin trong ph\u00e2n: kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng th\u01b0\u1eddng quy trong ch\u1ea9n \u0111o\u00e1n nh\u01b0ng c\u00f3 th\u1ec3 gi\u00fap ph\u00e2n bi\u1ec7t c\u00e1c b\u1ec7nh l\u00fd ru\u1ed9t vi\u00eam v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n c\u01a1 n\u0103ng c\u1ee7a \u0111\u01b0\u1eddng ru\u1ed9t<\/li>\n<\/ul>\n

    Tr\u00ean c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n h\u00ecnh \u1ea3nh h\u1ecdc, m\u1ed9t s\u1ed1 d\u1ea5u hi\u1ec7u c\u00f3 gi\u00e1 tr\u1ecb trong ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Crohn nh\u01b0:<\/p>\n

      \n
    • N\u1ed9i soi \u0111\u1ea1i tr\u00e0ng: \u0110\u1ed1i v\u1edbi b\u1ec7nh CD, n\u1ed9i soi \u0111\u1ea1i tr\u00e0ng – h\u1ed3i tr\u00e0ng c\u00f3 sinh thi\u1ebft l\u00e0 ph\u01b0\u01a1ng ti\u1ec7n ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh CD \u0111\u1ea7u tay. D\u1ea5u hi\u1ec7u gi\u00fap nh\u1eadn di\u1ec7n CD tr\u00ean n\u1ed9i soi g\u1ed3m: v\u1ebft tr\u1ee3t, v\u1ebft lo\u00e9t tr\u00ean ni\u00eam m\u1ea1c, ph\u00f9 n\u1ec1 ni\u00eam m\u1ea1c, h\u00ecnh \u1ea3nh l\u00e1t \u0111\u00e1 v\u00e0 h\u1eb9p l\u00f2ng \u1ed1ng ti\u00eau h\u00f3a. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a t\u1ed5n th\u01b0\u01a1ng trong CD l\u00e0 c\u00e1c sang th\u01b0\u01a1ng kh\u00f4ng li\u00ean t\u1ee5c – xen k\u1ebd c\u00e1c v\u00f9ng t\u1ed5n th\u01b0\u01a1ng v\u00e0 c\u00e1c v\u00f9ng ni\u00eam m\u1ea1c l\u00e0nh l\u1eb7n. Tr\u1ef1c tr\u00e0ng kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u gi\u00fap ph\u00e2n bi\u1ec7t CD v\u00e0 vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng.<\/li>\n<\/ul>\n
      \"noi-soi-dai-trang-la-phuong-phap-su-dung-nhieu-trong-chan-doan-benh-crohn\"
      N\u1ed9i soi \u0111\u1ea1i tr\u00e0ng l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u trong ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Crohn<\/figcaption><\/figure>\n
        \n
      • N\u1ed9i soi ti\u00eau h\u00f3a tr\u00ean: c\u00f3 th\u1ec3 gi\u00fap ph\u00e1t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a b\u1ec7nh CD kh\u1edfi ph\u00e1t t\u1ea1i nh\u1eefng v\u1ecb tr\u00ed kh\u00f4ng \u0111i\u1ec3n h\u00ecnh, v\u1edbi nh\u1eefng h\u00ecnh nh\u01b0 l\u00e0 vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng, ch\u00edt h\u1eb9p th\u1ef1c qu\u1ea3n, r\u00f2 c\u00e1c v\u1ecb tr\u00ed trong \u1ed1ng ti\u00eau h\u00f3a.<\/li>\n
      • Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI): c\u1ed9ng h\u01b0\u1edfng t\u1eeb c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c v\u00e0 an to\u00e0n cao h\u01a1n so v\u1edbi CT trong ch\u1ea9n \u0111o\u00e1n CD. C\u00f3 th\u1ec3 th\u1ea5y h\u00ecnh \u1ea3nh vi\u00eam ru\u1ed9t v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a CD, qua \u0111\u00f3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 v\u00e0 s\u1ef1 lan r\u1ed9ng c\u1ee7a b\u1ec7nh CD.<\/li>\n<\/ul>\n

        C\u00f3 kh\u00e1 nhi\u1ec1u b\u1ec7nh l\u00fd c\u00f3 th\u1ec3 cho h\u00ecnh \u1ea3nh l\u00e2m s\u00e0ng gi\u1ed1ng v\u1edbi CD t\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 v\u00e0 th\u1eddi gian b\u1ec7nh, m\u1ed9t s\u1ed1 ch\u1ea9n \u0111o\u00e1n c\u1ea7n \u0111\u01b0\u1ee3c ch\u00fa tr\u1ecdng ph\u00e2n bi\u1ec7t v\u1edbi CD g\u1ed3m:<\/p>\n

          \n
        • Vi\u00eam lo\u00e9t \u0111\u1ea1i tr\u00e0ng<\/li>\n
        • Vi\u00eam t\u00fai th\u1eeba \u0111\u1ea1i tr\u00e0ng<\/li>\n
        • Vi\u00eam \u0111\u1ea1i tr\u00e0ng nhi\u1ec5m khu\u1ea9n<\/li>\n
        • H\u1ed9i ch\u1ee9ng ru\u1ed9t k\u00edch th\u00edch<\/li>\n
        • B\u1ea5t dung n\u1ea1p lactose<\/li>\n<\/ul>\n

           <\/p>\n

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

          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. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Crohn v\u00e0 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 b\u1ec7nh ch\u00ednh […]<\/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: Ch\u1ea9n \u0111o\u00e1n - Vinmec<\/title>\n<meta name=\"description\" content=\"Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Crohn v\u00e0 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 b\u1ec7nh ch\u00ednh x\u00e1c l\u00e0 ti\u1ec1n \u0111\u1ec1 quan tr\u1ecdng \u0111\u1ec3 thi\u1ebft l\u1eadp ch\u1ebf \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh hi\u1ec7u qu\u1ea3 v\u00e0 an to\u00e0n.\" \/>\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: Ch\u1ea9n \u0111o\u00e1n - 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