{"id":28043,"date":"2023-04-24T22:09:27","date_gmt":"2023-04-24T15:09:27","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28043"},"modified":"2023-04-24T22:09:27","modified_gmt":"2023-04-24T15:09:27","slug":"sieu-am-tim-trong-hep-van-dong-mach-chu","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/sieu-am-tim-trong-hep-van-dong-mach-chu\/","title":{"rendered":"Si\u00eau \u00e2m tim trong h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7"},"content":{"rendered":"

H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/a> c\u00f3 th\u1ec3 do tho\u00e1i ho\u00e1, th\u1ea5p tim, ho\u1eb7c do nguy\u00ean nh\u00e2n b\u1ea9m sinh. \u1ede giai \u0111o\u1ea1n mu\u1ed9n, khi t\u1ed5n th\u01b0\u01a1ng x\u01a1 h\u00f3a, v\u00f4i h\u00f3a n\u1eb7ng, vi\u1ec7c x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh kh\u00f3 kh\u0103n, ngay c\u1ea3 khi quan s\u00e1t tr\u1ef1c ti\u1ebfp trong ph\u0201u thu\u1eadt.<\/strong><\/p>\n

\"H\u1eb9p<\/p>\n

Si\u00eau \u00e2m h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/strong><\/p>\n

1.Gi\u1edbi thi\u1ec7u v\u1ec1 si\u00eau \u00e2m qua th\u00e0nh ng\u1ef1c.<\/h2>\n

M\u1eb7c d\u00f9 c\u00e1c k\u1ef9 thu\u1eadt C\u0110HA tim m\u1ea1ch m\u1edbi \u0111\u00e3 c\u00f3 nh\u1eefng ti\u1ebfn b\u1ed9 v\u01b0\u1ee3t b\u1eadc, si\u00eau \u00e2m tim v\u0201n l\u00e0 ph\u01b0\u01a1ng ph\u00e1p C\u0110HA quan tr\u1ecdng nh\u1ea5t trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. \u0110\u01b0\u1ee3c ph\u00e1t tri\u1ec3n b\u1edfi Edler v\u00e0 Herz g\u1ea7n n\u0103m th\u1eadp k\u1ef7 tr\u01b0\u1edbc, si\u00eau \u00e2m tim \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng th\u01b0\u1eddng quy trong l\u00e2m s\u00e0ng v\u00e0 \u0111\u00e3 ph\u00e1t tri\u1ec3n th\u00e0nh m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p tr\u1ef1c quan, d\u1ec5 hi\u1ec3u, d\u1ec5 th\u1ef1c h\u00e0nh, cho ph\u00e9p \u0111\u00e1nh gi\u00e1 nhanh ch\u00f3ng v\u00e0 c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n nhi\u1ec1u l\u1ea7n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 h\u00ecnh th\u00e1i v\u00e0 ch\u1ee9c n\u0103ng tim. \u0110\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ed9t c\u00e1ch ch\u00ednh x\u00e1c k\u1ebft qu\u1ea3 si\u00eau \u00e2m tim, y\u00eau c\u1ea7u \u0111\u1ea7u ti\u00ean l\u00e0 c\u1ea7n hi\u1ec3u r\u00f5 nh\u1eefng nguy\u00ean t\u1eafc v\u1eadt l\u00fd – c\u01a1 s\u1edf cho c\u00e1c ph\u01b0\u01a1ng th\u1ee9c k\u1ef9 thu\u1eadt kh\u00e1c nhau.<\/p>\n

2. C\u00e1c nguy\u00ean t\u1eafc v\u1eadt l\u00fd trong si\u00eau \u00e2m.<\/h2>\n

T\u1ea5t c\u1ea3 c\u00e1c d\u1ea1ng h\u00ecnh \u1ea3nh trong si\u00eau \u00e2m \u0111\u1ec1u d\u1ef1a tr\u00ean vi\u1ec7c t\u1ea1o ra c\u00e1c s\u00f3ng \u00e2m thanh c\u00f3 t\u1ea7n s\u1ed1 cao (>1 MHz) t\u1eeb \u0111\u1ea7u d\u00f2 c\u00f3 m\u1ed9t ho\u1eb7c nhi\u1ec1u tinh th\u1ec3 \u00e1p \u0111i\u1ec7n. D\u00f2ng \u0111i\u1ec7n truy\u1ec1n qua c\u00e1c tinh th\u1ec3 \u00e1p \u0111i\u1ec7n v\u00e0 truy\u1ec1n s\u00f3ng \u00e2m. Tinh th\u1ec3 \u00e1p \u0111i\u1ec7n \u0111\u00f3ng vai tr\u00f2 nh\u01b0 m\u1ed9t m\u00e1y thu, khi s\u00f3ng d\u1ed9i l\u1ea1i t\u1eeb c\u00e1c v\u1eadt th\u1ec3 c\u1ea3n \u00e2m (V\u00ed d\u1ee5: Th\u00e0nh c\u01a1 tim, van tim) l\u00e0m bi\u1ebfn d\u1ea1ng tinh th\u1ec3, t\u1eeb \u0111\u00f3 t\u1ea1o ra d\u00f2ng \u0111i\u1ec7n \u0111\u01b0\u1ee3c ghi nh\u1eadn theo th\u1eddi gian. V\u00ec v\u1eadn t\u1ed1c c\u1ee7a s\u00f3ng \u00e2m l\u00e0 kh\u00f4ng \u0111\u1ed5i, v\u1ecb tr\u00ed c\u1ee7a v\u1eadt th\u1ec3 (\u0111\u1ed9 ph\u00e2n gi\u1ea3i kh\u00f4ng gian) \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh d\u1ef1a v\u00e0o th\u1eddi gian t\u00edn hi\u1ec7u d\u1ed9i l\u1ea1i. Bi\u00ean \u0111\u1ed9 c\u1ee7a t\u00edn hi\u1ec7u d\u1ed9i l\u1ea1i d\u1ef1a tr\u00ean g\u00f3c t\u1edbi (c\u00e1c b\u1ec1 m\u1eb7t vu\u00f4ng g\u00f3c v\u1edbi ch\u00f9m si\u00eau \u00e2m s\u1ebd c\u00f3 c\u00e1c ch\u00f9m ph\u1ea3n x\u1ea1 m\u1ea1nh h\u01a1n) v\u00e0 giao di\u1ec7n c\u1ee7a c\u00e1c tr\u1edf kh\u00e1ng \u00e2m (s\u1ef1 kh\u00e1c bi\u1ec7t l\u1edbn h\u01a1n c\u00f3 th\u1ec3 x\u1ea3y ra t\u1ea1i th\u1ea5t tr\u00e1i \u1edf v\u00f9ng ti\u1ebfp x\u00fac gi\u1eefa m\u00e1u m\u00f4 d\u0201n \u0111\u1ebfn \u0111\u1ed9 ph\u1ea3n x\u1ea1 l\u1edbn h\u01a1n). C\u00e1c th\u00f4ng tin si\u00eau \u00e2m \u0111\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 sau \u0111\u00f3 l\u1eadp b\u1ea3n \u0111\u1ed3 hi\u1ec3n th\u1ecb v\u00e0 l\u01b0u tr\u1eef c\u00e1c \u0111i\u1ec3m \u1ea3nh.<\/p>\n

3.B\u1ec7nh nguy\u00ean<\/h2>\n

H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u00f3 th\u1ec3 do tho\u00e1i ho\u00e1, th\u1ea5p tim, ho\u1eb7c do nguy\u00ean nh\u00e2n b\u1ea9m sinh. \u1ede giai \u0111o\u1ea1n mu\u1ed9n, khi t\u1ed5n th\u01b0\u01a1ng x\u01a1 h\u00f3a, v\u00f4i h\u00f3a n\u1eb7ng, vi\u1ec7c x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh kh\u00f3 kh\u0103n, ngay c\u1ea3 khi quan s\u00e1t tr\u1ef1c ti\u1ebfp trong ph\u0201u thu\u1eadt. H\u1eb9p van \u0110M ch\u1ee7 n\u1eb7ng m\u1ea1n t\u00ednh th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi h\u00ecnh \u1ea3nh d\u00e0y \u0111\u1ed3ng t\u00e2m c\u00e1c th\u00e0nh th\u1ea5t tr\u00e1i do t\u0103ng h\u1eadu g\u00e1nh. Van \u0110M ch\u1ee7 hai l\u00e1 van: Th\u01b0\u1eddng c\u00f3 nhi\u1ec1u h\u00ecnh th\u00e1i, \u0111\u01b0\u1ee3c quan s\u00e1t t\u1ed1t nh\u1ea5t \u1edf m\u1eb7t c\u1eaft tr\u1ee5c ng\u1eafn ngang qua van \u0110M ch\u1ee7 tr\u00ean si\u00eau \u00e2m qua th\u00e0nh ng\u1ef1c. Th\u01b0\u1eddng quan s\u00e1t th\u1ea5y h\u00ecnh \u1ea3nh s\u1eb9o (\u201craphe”) tr\u00ean l\u00e1 van h\u1ee3p nh\u1ea5t, l\u00e0 di t\u00edch c\u1ee7a \u0111\u01b0\u1eddng x\u1ebb l\u00e1 van kh\u00f4ng ph\u00e1t tri\u1ec3n. C\u00f3 th\u1ec3 g\u1eb7p van \u0110M ch\u1ee7 m\u1ed9t l\u00e1 van \u1edf c\u00e1c b\u1ec7nh nh\u00e2n h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 r\u1ea5t s\u1edbm (\u1edf tu\u1ed5i v\u1ecb th\u00e0nh ni\u00ean) v\u1edbi h\u00ecnh \u1ea3nh li\u00ean t\u1ee5c c\u1ee7a c\u00e1c l\u00e1 van, m\u1ea5t \u0111i ranh gi\u1edbi c\u1ee7a c\u00e1c m\u00e9p van. Trong th\u00ec t\u00e2m thu, van m\u1edf d\u1ea1ng v\u00f2m l\u00e0 h\u00ecnh \u1ea3nh \u0111\u1eb7c tr\u01b0ng c\u1ee7a h\u1eb9p van \u0110M ch\u1ee7 b\u1ea9m sinh do b\u1ea5t th\u01b0\u1eddng s\u1ed1 l\u01b0\u1ee3ng c\u00e1c l\u00e1 van.<\/p>\n

H\u1eb9p van \u0110M ch\u1ee7 do tho\u00e1i h\u00f3a th\u01b0\u1eddng \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u b\u1eb1ng s\u1ef1 x\u01a1 h\u00f3a v\u00f2ng van (h\u1ea7u h\u1ebft \u1edf l\u00e1 kh\u00f4ng v\u00e0nh) v\u00e0 d\u1ea7n d\u1ea7n \u0111\u1ebfn th\u00e2n van, sau \u0111\u00f3 l\u00e0 b\u1edd van. Van d\u00e0y l\u00ean m\u00e0 kh\u00f4ng k\u00e8m theo thay \u0111\u1ed5i huy\u1ebft \u0111\u1ed9ng (kh\u00f4ng c\u00f3 t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i) th\u01b0\u1eddng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 van b\u1ecb x\u01a1 c\u1ee9ng.<\/p>\n

4. Huy\u1ebft \u0111\u1ed9ng<\/h2>\n

H\u1eb9p van \u0110M ch\u1ee7 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 gi\u1ea3m di\u1ec7n t\u00edch l\u1ed7 van d\u0201n \u0111\u1ebfn gi\u1ea3m c\u00f3 \u00fd ngh\u0129a l\u01b0u l\u01b0\u1ee3ng m\u00e1u qua l\u1ed7 van v\u00e0 bi\u1ec3u hi\u1ec7n b\u1eb1ng t\u0103ng ch\u00eanh \u00e1p qua van.<\/p>\n

Ch\u00eanh \u00e1p ph\u1ee5 thu\u1ed9c v\u00e0o l\u01b0u l\u01b0\u1ee3ng v\u00ec v\u1eady, trong tr\u01b0\u1eddng h\u1ee3p cung l\u01b0\u1ee3ng tim th\u1ea5p, h\u1eb9p van \u0111\u00e1ng k\u1ec3 nh\u01b0ng ch\u00eanh \u00e1p qua van ch\u1ec9 t\u0103ng nh\u1eb9 th\u00ec c\u1ea7n l\u00e0m si\u00eau \u00e2m tim g\u1eafng s\u1ee9c v\u1edbi dobutamine \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u00fang m\u1ee9c \u0111\u1ed9 h\u1eb9p.<\/p>\n

5. Si\u00eau \u00e2m tim ch\u1ea9n \u0111o\u00e1n<\/h2>\n
    \n
  • \u0110\u00e1nh gi\u00e1 bi\u00ean \u0111\u1ed9 m\u1edf van \u0110M ch\u1ee7, d\u1ea5u hi\u1ec7u van m\u1edf d\u1ea1ng v\u00f2m. Van \u0110M ch\u1ee7 3 l\u00e1 van v\u1edbi 1 l\u00e1 van m\u1edf ho\u00e0n to\u00e0n (\u00e1p s\u00e1t g\u1ed1c \u0110M ch\u1ee7) g\u1ee3i \u00fd kh\u00f4ng c\u00f3 h\u1eb9p van.<\/li>\n
  • \u0110\u00e1nh gi\u00e1 s\u1ed1 l\u01b0\u1ee3ng c\u00e1c l\u00e1 van, t\u00ednh ch\u1ea5t c\u00e1c l\u00e1 van.<\/li>\n
  • \u0110o ch\u00eanh \u00e1p t\u1ed1i \u0111a v\u00e0 ch\u00eanh \u00e1p trung b\u00ecnh qua van b\u1eb1ng Doppler li\u00ean t\u1ee5c. Gi\u00e1 tr\u1ecb ch\u00eanh \u00e1p trung b\u00ecnh \u0111\u00e1ng tin c\u1eady h\u01a1n <\/strong>trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 h\u1eb9p.<\/li>\n
  • Khi \u0111o ch\u00eanh \u00e1p \u201c\u0111\u1ec9nh – \u0111\u1ec9nh\u201d trong th\u00f4ng tim th\u0103m d\u00f2 huy\u1ebft \u0111\u1ed9ng, c\u00e1c k\u1ebft qu\u1ea3 \u0111o \u00e1p l\u1ef1c thu \u0111\u01b0\u1ee3c th\u01b0\u1eddng kh\u00f4ng \u0111\u1ed3ng th\u1eddi v\u1edbi nhau, ch\u00eanh \u00e1p n\u00e0y th\u01b0\u1eddng kh\u00f4ng t\u01b0\u01a1ng quan <\/strong>v\u1edbi ch\u00eanh \u00e1p \u0111o \u0111\u01b0\u1ee3c tr\u00ean si\u00eau \u00e2m Doppler.<\/li>\n
  • V\u1eadn t\u1ed1c t\u1ed1i \u0111a qua van > 2,5 m\/s (ch\u00eanh \u00e1p t\u1ed1i \u0111a > 25 mmHg <\/strong>) g\u1ee3i \u00fd c\u00f3 h\u1eb9p van \u0110M ch\u1ee7.<\/li>\n
  • Cung l\u01b0\u1ee3ng tim t\u0103ng ho\u1eb7c h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u00e1ng k\u1ec3 s\u1ebd l\u00e0m t\u0103ng l\u01b0u l\u01b0\u1ee3ng m\u00e1u v\u00e0 ch\u00eanh \u00e1p qua van nh\u01b0ng kh\u00f4ng t\u01b0\u01a1ng \u1ee9ng v\u1edbi di\u1ec7n t\u00edch l\u1ed7 van <\/strong>.<\/li>\n<\/ul>\n

    Ch\u1ec9 s\u1ed1 v\u1eadn t\u1ed1c Doppler (DVI – Doppler velocity index) l\u00e0 t\u1ef7 l\u1ec7 c\u1ee7a v\u1eadn t\u1ed1c d\u00f2ng ch\u1ea3y t\u1ea1i \u0110RTT (\u0111o b\u1eb1ng Doppler xung)\/ v\u1eadn t\u1ed1c qua van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 (\u0111o b\u1eb1ng Doppler li\u00ean t\u1ee5c). Ch\u1ec9 s\u1ed1 n\u00e0y lo\u1ea1i b\u1ecf \u0111\u01b0\u1ee3c sai s\u1ed1 trong ph\u00e9p \u0111o \u0110RTT, \u0111\u1ed9c l\u1eadp v\u1edbi cung l\u01b0\u1ee3ng tim . C\u00e1c khuy\u1ebfn c\u00e1o chung:<\/p>\n

      \n
    • DVI > 0,5: h\u1eb9p nh\u1eb9<\/li>\n
    • DVI 0,25 – 0,5: h\u1eb9p v\u1eeba DVI < 0,25: h\u1eb9p kh\u00edt<\/li>\n
    • \u0110o \u0111\u01b0\u1eddng k\u00ednh \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i th\u1ea5p h\u01a1n th\u1ef1c t\u1ebf<\/li>\n
    • Kh\u00f4ng \u0111o \u0111\u01b0\u1ee3c \u0111\u1ed9 ch\u00eanh \u00e1p qua \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i \u1edf g\u00f3c \u2264 30<\/strong>\u00b0 <\/strong>so v\u1edbi h\u01b0\u1edbng d\u00f2ng ch\u1ea3y.<\/li>\n<\/ul>\n

      C\u00e1c th\u00f4ng s\u1ed1 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/p>\n

      \u00a0<\/strong><\/p>\n\n\n\n\n\n\n\n\n
      \u00a0<\/strong><\/p>\n

      \u0110\u1eb7c \u0111i\u1ec3m<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      Nh\u1eb9<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      V\u1eeba<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      N\u1eb7ng<\/strong><\/td>\n<\/tr>\n

      \u00a0<\/strong><\/p>\n

      V\u1eadn t\u1ed1c t\u1ed1i \u0111a qua van \u0110M ch\u1ee7 (m\/s)<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      2,6 – 2,9<\/td>\n

      		\u00a0<\/strong><\/p>\n

      3,0 – 4,0<\/td>\n

      		\u00a0<\/strong><\/p>\n

      > 4,0<\/td>\n<\/tr>\n

      \u00a0<\/strong><\/p>\n

      Ch\u00eanh \u00e1p trung b\u00ecnh (AHA) (mmHg)<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      < 20<\/td>\n

      		\u00a0<\/strong><\/p>\n

      20 – 40<\/td>\n

      		\u00a0<\/strong><\/p>\n

      > 40<\/td>\n<\/tr>\n

      \u00a0<\/strong><\/p>\n

      Ch\u00eanh \u00e1p trung b\u00ecnh (ESC) (mmHg)<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      < 30<\/td>\n

      		\u00a0<\/strong><\/p>\n

      30 – 50<\/td>\n

      		\u00a0<\/strong><\/p>\n

      > 50<\/td>\n<\/tr>\n

      \u00a0<\/strong><\/p>\n

      Di\u1ec7n t\u00edch l\u1ed7 van (cm2)<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      > 1,5<\/td>\n

      		\u00a0<\/strong><\/p>\n

      1,0 – 1,5<\/td>\n

      		\u00a0<\/strong><\/p>\n

      < 1,0<\/td>\n<\/tr>\n

      \u00a0<\/strong><\/p>\n

      Di\u1ec7n t\u00edch l\u1ed7 van hi\u1ec7u ch\u1ec9nh (cm2\/m2)<\/strong><\/td>\n

      		\u00a0<\/strong><\/p>\n

      > 0,85<\/td>\n

      		\u00a0<\/strong><\/p>\n

      0,6 – 0,85<\/td>\n

      		\u00a0<\/strong><\/p>\n

      < 0,6<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

        \n
      • \u0110\u00e1nh gi\u00e1 c\u00e1c h\u1eadu qu\u1ea3 c\u1ee7a h\u1eb9p van \u0110M ch\u1ee7 : Gi\u00e3n \u0110M ch\u1ee7 l\u00ean sau h\u1eb9p, d\u00e0y th\u00e0nh th\u1ea5t tr\u00e1i, gi\u00e3n bu\u1ed3ng th\u1ea5t tr\u00e1i, ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i…<\/li>\n
      • \u0110\u00e1nh gi\u00e1 c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u0111i k\u00e8m: H\u1eb9p eo \u0110M ch\u1ee7, m\u1ee9c \u0111\u1ed9 h\u1eb9p h\u1edf c\u00e1c van tim kh\u00e1c…<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

        H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u00f3 th\u1ec3 do tho\u00e1i ho\u00e1, th\u1ea5p tim, ho\u1eb7c do nguy\u00ean nh\u00e2n b\u1ea9m sinh. \u1ede giai \u0111o\u1ea1n mu\u1ed9n, khi t\u1ed5n th\u01b0\u01a1ng x\u01a1 h\u00f3a, v\u00f4i h\u00f3a n\u1eb7ng, vi\u1ec7c x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh kh\u00f3 kh\u0103n, ngay c\u1ea3 khi quan s\u00e1t tr\u1ef1c ti\u1ebfp trong ph\u0201u thu\u1eadt. Si\u00eau \u00e2m h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[88,33],"tags":[],"yoast_head":"\nSi\u00eau \u00e2m tim trong h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 - Vinmec<\/title>\n<meta name=\"description\" content=\"Si\u00eau \u00e2m tim trong h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 v\u1ea5n \u0111\u1ec1 quan trong trong b\u1ec7nh l\u00fd h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. 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