{"id":28163,"date":"2023-04-25T17:43:05","date_gmt":"2023-04-25T10:43:05","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28163"},"modified":"2023-04-25T17:43:05","modified_gmt":"2023-04-25T10:43:05","slug":"chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n theo ICD-10"},"content":{"rendered":"

Ng\u1ee7 l\u00e0 m\u1ed9t tr\u1ea1ng th\u00e1i sinh l\u00fd b\u00ecnh th\u01b0\u1eddng c\u1ee7a c\u01a1 th\u1ec3 c\u00f3 t\u00ednh ch\u1ea5t chu k\u00ec 24 gi\u1edd \u0111\u00eam, trong \u0111\u00f3 to\u00e0n b\u1ed9 c\u01a1 th\u1ec3 \u0111\u01b0\u1ee3c ngh\u1ec9 ng\u01a1i, t\u1ea1m ng\u1eebng ho\u1ea1t \u0111\u1ed9ng tri gi\u00e1c v\u00e0 \u00fd th\u1ee9c, c\u00e1c c\u01a1 b\u1eafp gi\u00e3n m\u1ec1m, c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00f4 h\u1ea5p tu\u1ea7n ho\u00e0n ch\u1eadm l\u1ea1i. M\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 li\u00ean quan \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m sinh, trong \u0111\u00f3 b\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n \u01b0u th\u1ebf l\u00e0 kh\u00f4ng \u0111\u1ea3m b\u1ea3o v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng, ch\u1ea5t l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian ng\u1ee7 cho m\u1ed9t gi\u1ea5c ng\u1ee7 b\u00ecnh th\u01b0\u1eddng.<\/strong><\/p>\n

\"\"
M\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 li\u00ean quan \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m sinh<\/figcaption><\/figure>\n

1. Nguy\u00ean nh\u00e2n c\u1ee7a m\u1ea5t ng\u1ee7<\/b><\/h2>\n

M\u1ea5t ng\u1ee7 c\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau. Tuy nhi\u00ean, m\u1ea5t ng\u1ee7 c\u00f3 li\u00ean quan ch\u1ee7 y\u1ebfu \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m l\u00fd-x\u00e3 h\u1ed9i, trong \u0111\u00f3 nguy\u00ean nh\u00e2n c\u1ea3m x\u00fac l\u00e0 \u0111\u1ea7u ti\u00ean v\u00e0 c\u01a1 b\u1ea3n.<\/p>\n

D\u01b0\u1edbi \u0111\u00e2y l\u00e0 m\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n ch\u00ednh c\u1ee7a m\u1ea5t ng\u1ee7:<\/p>\n

    \n
  • Stress v\u00e0 c\u0103ng th\u1eb3ng: C\u00e1c t\u00ecnh hu\u1ed1ng c\u0103ng th\u1eb3ng v\u00e0 stress trong cu\u1ed9c s\u1ed1ng h\u00e0ng ng\u00e0y c\u00f3 th\u1ec3 l\u00e0m cho \u0111\u1ea7u \u00f3c kh\u00f4ng th\u1ec3 th\u01b0 gi\u00e3n v\u00e0 g\u00e2y ra m\u1ea5t ng\u1ee7.<\/li>\n
  • R\u1ed1i lo\u1ea1n t\u00e2m l\u00fd: C\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m l\u00fd, ch\u1eb3ng h\u1ea1n nh\u01b0 tr\u1ea7m c\u1ea3m, lo \u00e2u v\u00e0 r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n c\u00f3 th\u1ec3 g\u00e2y ra m\u1ea5t ng\u1ee7.<\/li>\n
  • Thay \u0111\u1ed5i th\u1eddi gian: S\u1ef1 thay \u0111\u1ed5i m\u00fai gi\u1edd, s\u1ef1 \u0111i\u1ec1u ch\u1ec9nh gi\u1edd \u0111\u00eam ng\u00e0y, chuy\u1ebfn bay d\u00e0i c\u00f9ng nhi\u1ec1u y\u1ebfu t\u1ed1 kh\u00e1c c\u00f3 th\u1ec3 l\u00e0m cho nh\u1ecbp sinh h\u1ecdc c\u1ee7a c\u01a1 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng v\u00e0 g\u00e2y ra m\u1ea5t ng\u1ee7.<\/li>\n
  • Sinh l\u00fd: C\u00e1c v\u1ea5n \u0111\u1ec1 sinh l\u00fd nh\u01b0 \u0111au nh\u1ee9c, kh\u00f3 th\u1edf, ti\u1ec3u \u0111\u00eam v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 kh\u00e1c c\u00f3 th\u1ec3 l\u00e0m cho ng\u01b0\u1eddi ta kh\u00f3 ng\u1ee7.<\/li>\n
  • Th\u00f3i quen s\u1ed1ng: Th\u00f3i quen s\u1ed1ng kh\u00f4ng l\u00e0nh m\u1ea1nh, ch\u1eb3ng h\u1ea1n nh\u01b0 u\u1ed1ng nhi\u1ec1u cafein, u\u1ed1ng r\u01b0\u1ee3u, h\u00fat thu\u1ed1c v\u00e0 th\u1ee9c khuya c\u00f3 th\u1ec3 g\u00e2y ra m\u1ea5t ng\u1ee7.<\/li>\n
  • M\u00f4i tr\u01b0\u1eddng s\u1ed1ng: M\u00f4i tr\u01b0\u1eddng s\u1ed1ng kh\u00f4ng thu\u1eadn l\u1ee3i, ch\u1eb3ng h\u1ea1n nh\u01b0 \u00e1nh s\u00e1ng m\u1ea1nh, ti\u1ebfng \u1ed3n v\u00e0 nhi\u1ec7t \u0111\u1ed9 kh\u00f4ng ph\u00f9 h\u1ee3p c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn vi\u1ec7c ng\u1ee7.<\/li>\n<\/ul>\n

    2. Ch\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n<\/b><\/h2>\n

    2.1 Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/b><\/h3>\n

    3.1.1. L\u00e2m s\u00e0ng: theo ICD-10<\/h4>\n

    B\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n v\u1ec1 vi\u1ec7c kh\u00f3 \u0111i v\u00e0o gi\u1ea5c ng\u1ee7, kh\u00f3 duy tr\u00ec gi\u1ea5c ng\u1ee7 ho\u1eb7c ng\u1ee7 kh\u00f4ng ngon gi\u1ea5c.<\/p>\n

    R\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 x\u1ea3y ra \u00edt nh\u1ea5t ba l\u1ea7n m\u1ed9t tu\u1ea7n trong v\u00f2ng \u00edt nh\u1ea5t m\u1ed9t th\u00e1ng.<\/p>\n

    R\u1ed1i l\u1ecdan gi\u1ea5c ng\u1ee7 g\u00e2y ra s\u1ef1 suy s\u1ee5p r\u00f5 n\u00e9t ho\u1eb7c l\u00e0m r\u1ed1i lo\u1ea1n ho\u1ea1t \u0111\u1ed9ng ch\u1ee9c n\u0103ng c\u00e1 nh\u00e2n trong cu\u1ed9c s\u1ed1ng h\u00e0ng ng\u00e0y.<\/p>\n

    Kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n th\u1ef1c t\u1ed5n nh\u01b0 m\u1ed9t b\u1ec7nh l\u00fd th\u1ea7n kinh ho\u1eb7c b\u1ec7nh n\u1ed9i khoa, kh\u00f4ng c\u00f3 r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng ch\u1ea5t t\u00e1c \u0111\u1ed9ng t\u00e2m th\u1ea7n ho\u1eb7c m\u1ed9t lo\u1ea1i thu\u1ed1c.<\/p>\n

    3.1.2. C\u1eadn l\u00e2m s\u00e0ng<\/h4>\n

    –\u00a0X\u00e9t nghi\u1ec7m m\u00e1u: huy\u1ebft h\u1ecdc, sinh ho\u00e1, vi sinh (HIV, VGB, VGC)<\/p>\n

    –\u00a0X\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u, x\u00e9t nghi\u1ec7m t\u00ecm ch\u1ea5t ma tu\u00fd, huy\u1ebft thanh ch\u1ea9n \u0111o\u00e1n giang mai\u2026<\/p>\n

    –\u00a0\u0110i\u1ec7n n\u00e3o \u0111\u1ed3, l\u01b0u huy\u1ebft n\u00e3o<\/p>\n

    –\u00a0\u0110a k\u00ed gi\u1ea5c ng\u1ee7<\/p>\n

    –\u00a0Tr\u1eafc nghi\u1ec7m t\u00e2m l\u00fd: nh\u00f3m tr\u1eafc nghi\u1ec7m t\u00e2m l\u00fd \u0111\u00e1nh gi\u00e1 r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 (PSQI\u2026), \u0111\u00e1nh gi\u00e1 tr\u1ea7m c\u1ea3m (Beck, Hamilton tr\u1ea7m c\u1ea3m\u2026), \u0111\u00e1nh gi\u00e1 lo \u00e2u (Zung, Hamilton lo \u00e2u\u2026), \u0111\u00e1nh gi\u00e1 nh\u00e2n c\u00e1ch (MMPI, EPI\u2026), \u2026<\/p>\n

    –\u00a0C\u00e1c x\u00e9t nghi\u1ec7m chuy\u00ean khoa kh\u00e1c x\u00e1c \u0111\u1ecbnh b\u1ec7nh l\u00fd k\u1ebft h\u1ee3p ho\u1eb7c lo\u1ea1i tr\u1eeb nguy\u00ean nh\u00e2n th\u1ef1c th\u1ec3:<\/p>\n

    –\u00a0\u0110i\u1ec7n t\u00e2m \u0111\u1ed3, XQ tim ph\u1ed5i, si\u00eau \u00e2m \u1ed5 b\u1ee5ng<\/p>\n

    –\u00a0CT, MRI…<\/p>\n

    2.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/b><\/h3>\n

    Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi m\u1ea5t ng\u1ee7 do nguy\u00ean nh\u00e2n th\u1ef1c t\u1ed5n nh\u01b0 m\u1ed9t b\u1ec7nh l\u00fd th\u1ea7n kinh ho\u1eb7c b\u1ec7nh n\u1ed9i khoa, do r\u1ed1i lo\u1ea1n s\u1eed d\u1ee5ng ch\u1ea5t t\u00e1c \u0111\u1ed9ng t\u00e2m th\u1ea7n ho\u1eb7c m\u1ed9t lo\u1ea1i thu\u1ed1c.<\/p>\n

    3. \u0110i\u1ec1u tr\u1ecb<\/b><\/h2>\n

    3.1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/b><\/h3>\n

    M\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n li\u00ean quan ch\u1ee7 y\u1ebfu \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m sinh, \u0111\u1eb7c bi\u1ec7t r\u1ed1i lo\u1ea1n c\u1ea3m x\u00fac l\u00e0 nh\u00e2n t\u1ed1 \u0111\u01b0\u1ee3c coi l\u00e0 nguy\u00ean ph\u00e1t. Do v\u00e2\u1ef5, trong \u0111i\u1ec1u tr\u1ecb c\u00f3 hai nh\u00f3m l\u1edbn: t\u00e2m l\u00fd (nh\u1eadn th\u1ee9c-h\u00e0nh vi) v\u00e0 d\u01b0\u1ee3c l\u00fd, hai nh\u00f3m n\u00e0y c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p v\u1edbi nhau.<\/p>\n

    Nguy\u00ean t\u1eafc ch\u1ecdn thu\u1ed1c:<\/b><\/p>\n

    \u01afu ti\u00ean \u0111\u01a1n tr\u1ecb li\u1ec7u (ch\u1ecdn m\u1ed9t trong nh\u1eefng thu\u1ed1c li\u1ec7t k\u00ea \u1edf d\u01b0\u1edbi n\u1ebfu ch\u01b0a hi\u1ec7u qu\u1ea3 th\u00ec s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi m\u1ed9t thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m v\u00e0 m\u1ed9t thu\u1ed1c an th\u1ea7n kinh \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o nhi\u1ec1u h\u01a1n c\u1ea3).<\/p>\n

    Kh\u1edfi li\u1ec1u th\u1ea5p v\u00e0 t\u0103ng li\u1ec1u t\u1eeb t\u1eeb cho \u0111\u1ebfn khi c\u00f3 hi\u1ec7u qu\u1ea3. H\u1ea1n ch\u1ebf l\u1ea1m d\u1ee5ng nh\u00f3m gi\u1ea3i lo \u00e2u g\u00e2y nghi\u1ec7n.<\/p>\n

    3.2. S\u01a1 \u0111\u1ed3\/ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb<\/b><\/h3>\n

    Li\u1ec7u ph\u00e1p h\u00f3a d\u01b0\u1ee3c + li\u1ec7u ph\u00e1p t\u00e2m l\u00fd<\/p>\n

    3.3. \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3<\/b><\/h3>\n

    Li\u1ec7u ph\u00e1p t\u00e2m l\u00fd:\u00a0<\/b>C\u00e1c li\u1ec7u ph\u00e1p t\u00e2m l\u00fd ch\u1ee7 y\u1ebfu l\u00e0 gi\u00e1o d\u1ee5c ng\u01b0\u1eddi b\u1ec7nh ch\u00fa \u00fd v\u1ec7 sinh gi\u1ea5c ng\u1ee7 t\u1ed1t:<\/p>\n

    Ch\u1ec9 \u0111i ng\u1ee7 khi bu\u1ed3n ng\u1ee7<\/p>\n

    T\u1eadp th\u1ee9c ng\u1ee7 \u0111\u00fang gi\u1edd<\/p>\n

    H\u00e0ng s\u00e1ng ph\u1ea3i th\u1ee9c d\u1eady v\u00e0o m\u1ed9t gi\u1edd nh\u1ea5t \u0111\u1ecbnh, kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o th\u1eddi l\u01b0\u1ee3ng \u0111\u00e3 ng\u1ee7 \u0111\u00eam tr\u01b0\u1edbc<\/p>\n

    Kh\u00f4ng d\u00f9ng c\u00e0 ph\u00ea, thu\u1ed1c l\u00e1 \u0111\u1eb7c bi\u1ec7t v\u00e0o bu\u1ed5i t\u1ed1i<\/p>\n

    Thi\u1ebft l\u1eadp ch\u1ebf \u0111\u1ed9 t\u1eadp luy\u1ec7n th\u1ec3 d\u1ee5c th\u1ec3 thao h\u1eb1ng ng\u00e0y<\/p>\n

    Kh\u00f4ng u\u1ed1ng r\u01b0\u1ee3u v\u00ec r\u01b0\u1ee3u ph\u00e1 v\u1ee1 nh\u1ecbp th\u1ee9c ng\u1ee7<\/p>\n

    S\u1eed d\u1ee5ng k\u0129 thu\u1eadt th\u01b0 gi\u00e3n luy\u1ec7n t\u1eadp<\/p>\n

    Li\u1ec7u ph\u00e1p h\u00f3a d\u01b0\u1ee3c:<\/b><\/p>\n

    S\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c g\u00e2y ng\u1ee7, thu\u1ed1c gi\u1ea3i lo \u00e2u, thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m trong \u0111i\u1ec1u tr\u1ecb m\u1ea5t ng\u1ee7, v\u00ec m\u1ea5t ng\u1ee7 li\u00ean quan m\u1eadt thi\u1ebft v\u1edbi lo \u00e2u, tr\u1ea7m c\u1ea3m.<\/p>\n

    C\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m: Nh\u00f3m SSRI, SNRI, 3 v\u00f2ng, ho\u1eb7c nh\u00f3m kh\u00e1c<\/p>\n

    Ch\u1ecdn m\u1ed9t ho\u1eb7c hai ho\u1eb7c ba thu\u1ed1c trong s\u1ed1 c\u00e1c thu\u1ed1c sau:<\/b><\/i><\/p>\n

    Imipramin, li\u1ec1u 25 – 300 mg\/24 gi\u1edd<\/p>\n

    Amitriptylin, li\u1ec1u 25 – 300 mg\/24 gi\u1edd<\/p>\n

    Paroxetin, li\u1ec1u 20 – 80 mg\/24 gi\u1edd<\/p>\n

    Fluoxetin, li\u1ec1u10 – 80 mg\/24 gi\u1edd<\/p>\n

    Fluvoxamin, li\u1ec1u 50 – 300 mg\/24 gi\u1edd<\/p>\n

    Citalopram, li\u1ec1u 20 – 60 mg\/24 gi\u1edd<\/p>\n

    Escitalopram, li\u1ec1u10 – 20mg\/24 gi\u1edd<\/p>\n

    Sertralin, li\u1ec1u 50 – 200 mg\/24 gi\u1edd<\/p>\n

    Venlafaxin, li\u1ec1u 37,5 – 375 mg\/24 gi\u1edd<\/p>\n

    Mirtazapin, li\u1ec1u 15 – 60mg\/24 gi\u1edd<\/p>\n

    Nh\u00f3m thu\u1ed1c b\u00ecnh th\u1ea7n, gi\u1ea3i lo \u00e2u nh\u00f3m benzodiazepins: diazepam, lorazepam, bromazepam, alprazolam,\u2026 non-benzodiazepins: etifoxine HCL, sedanxio, zopiclon\u2026nh\u00f3m thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m: propanolol\u2026<\/p>\n

    C\u00e1c thu\u1ed1c an th\u1ea7n kinh: olanzapin, quetiapin\u2026<\/p>\n

    M\u1ed9t s\u1ed1 thu\u1ed1c kh\u00e1c \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7: melatonin \u2026<\/p>\n

    Nu\u00f4i d\u01b0\u1ee1ng t\u1ebf b\u00e0o th\u1ea7n kinh:\u00a0p<\/b>iracetam, ginkgo biloba, vinpocetin, choline alfoscerate, nicergoline, \u2026.<\/p>\n

    Thu\u1ed1c h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng gan, thu\u1ed1c t\u0103ng c\u01b0\u1eddng nh\u1eadn th\u1ee9c\u2026<\/p>\n

    Dinh d\u01b0\u1ee1ng: b\u1ed5 sung dinh d\u01b0\u1ee1ng, vitamine nh\u00f3m B v\u00e0 kho\u00e1ng ch\u1ea5t, ch\u1ebf \u0111\u1ed9 \u0103n d\u1ec5 ti\u00eau h\u00f3a (m\u1ec1m, nhi\u1ec1u x\u01a1), \u0111\u1ee7 vitamin v\u00e0 kho\u00e1ng ch\u1ea5t (hoa qu\u1ea3, \u2026.), tr\u00e1nh ch\u1ea5t k\u00edch th\u00edch, u\u1ed1ng \u0111\u1ee7 n\u01b0\u1edbc, nu\u00f4i d\u01b0\u1ee1ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch\u2026trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thi\u1ebft.<\/p>\n

    4. Ti\u00ean l\u01b0\u1ee3ng v\u00e0 bi\u1ebfn ch\u1ee9ng<\/b><\/h2>\n

    C\u1ea7n \u0111\u1ec1 ph\u00f2ng v\u00e0 tr\u00e1nh c\u00e1c bi\u1ebfn ch\u1ee9ng do:<\/p>\n

    Ph\u00e1t hi\u1ec7n mu\u1ed9n, \u0111i\u1ec1u tr\u1ecb kh\u00f4ng k\u1ecbp th\u1eddi, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn lo \u00e2u v\u00e0 tr\u1ea7m c\u1ea3m. Bi\u1ebfn ch\u1ee9ng c\u1ee7a vi\u1ec7c l\u1ea1m d\u1ee5ng thu\u1ed1c gi\u1ea3i lo \u00e2u<\/p>\n

    5. Ph\u00f2ng b\u1ec7nh m\u1ea5t ng\u1ee7<\/b><\/h2>\n
      \n
    • Tr\u00e1nh c\u00e1c c\u0103ng th\u1eb3ng t\u00e2m l\u00fd m\u1ea1nh trong cu\u1ed9c s\u1ed1ng<\/li>\n
    • Ch\u1ee7 \u0111\u1ed9ng gi\u1ea3i quy\u1ebft nh\u1eefng sang ch\u1ea5n t\u00e2m l\u00fd c\u00e1 nh\u00e2n c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y ra r\u1ed1i lo\u1ea1n c\u1ea3m x\u00fac lo \u00e2u tr\u1ea7m c\u1ea3m ho\u1eb7c c\u00e1c r\u1ed1i lo\u1ea1n li\u00ean quan \u0111\u1ebfn stress.<\/li>\n
    • Ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1edbm c\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m sinh nguy\u00ean nh\u00e2n g\u00e2y r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7<\/li>\n
    • C\u1ea7n thi\u1ebft l\u1eadp ch\u1ebf \u0111\u1ed9 l\u00e0m vi\u1ec7c, ngh\u1ec9 ng\u01a1i, luy\u1ec7n t\u1eadp h\u1ee3p l\u00fd, khoa h\u1ecdc<\/li>\n
    • Tr\u00e1nh l\u00e0m vi\u1ec7c qu\u00e1 m\u1ee9c v\u00e0 kh\u00f4ng d\u00f9ng thu\u1ed1c, c\u00e1c ch\u1ea5t k\u00edch th\u00edch th\u1ea7n kinh trung \u01b0\u01a1ng<\/li>\n<\/ul>\n

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

      Ng\u1ee7 l\u00e0 m\u1ed9t tr\u1ea1ng th\u00e1i sinh l\u00fd b\u00ecnh th\u01b0\u1eddng c\u1ee7a c\u01a1 th\u1ec3 c\u00f3 t\u00ednh ch\u1ea5t chu k\u00ec 24 gi\u1edd \u0111\u00eam, trong \u0111\u00f3 to\u00e0n b\u1ed9 c\u01a1 th\u1ec3 \u0111\u01b0\u1ee3c ngh\u1ec9 ng\u01a1i, t\u1ea1m ng\u1eebng ho\u1ea1t \u0111\u1ed9ng tri gi\u00e1c v\u00e0 \u00fd th\u1ee9c, c\u00e1c c\u01a1 b\u1eafp gi\u00e3n m\u1ec1m, c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00f4 h\u1ea5p tu\u1ea7n ho\u00e0n ch\u1eadm l\u1ea1i. M\u1ea5t ng\u1ee7 kh\u00f4ng […]<\/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":"\nCh\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n theo ICD-10 - Vinmec<\/title>\n<meta name=\"description\" content=\"M\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 li\u00ean quan \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m sinh, trong \u0111\u00f3 b\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n \u01b0u th\u1ebf l\u00e0 kh\u00f4ng \u0111\u1ea3m b\u1ea3o v\u1ec1 ...\" \/>\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=\"Ch\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n theo ICD-10 - Vinmec\" \/>\n<meta property=\"og:description\" content=\"M\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 li\u00ean quan \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m sinh, trong \u0111\u00f3 b\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n \u01b0u th\u1ebf l\u00e0 kh\u00f4ng \u0111\u1ea3m b\u1ea3o v\u1ec1 ...\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-25T10:43:05+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1332798293-612x612-1-300x200.jpg\" \/>\n<meta name=\"author\" content=\"mitkaka mitkaka\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"mitkaka mitkaka\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 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\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/\",\"name\":\"Ch\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n theo ICD-10 - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-25T10:43:05+00:00\",\"dateModified\":\"2023-04-25T10:43:05+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/afa83c897f17e0b5f69265f912e0572c\"},\"description\":\"M\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 li\u00ean quan \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m sinh, trong \u0111\u00f3 b\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n \u01b0u th\u1ebf l\u00e0 kh\u00f4ng \u0111\u1ea3m b\u1ea3o v\u1ec1 ...\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Ch\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n theo ICD-10\"}]},{\"@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\/afa83c897f17e0b5f69265f912e0572c\",\"name\":\"mitkaka mitkaka\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/0.gravatar.com\/avatar\/f102cd9b17e5dabdddda292eb3a7dd3d?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/0.gravatar.com\/avatar\/f102cd9b17e5dabdddda292eb3a7dd3d?s=96&d=mm&r=g\",\"caption\":\"mitkaka mitkaka\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/mitkaka2009mitkaka2009gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Ch\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n theo ICD-10 - Vinmec","description":"M\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 li\u00ean quan \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m sinh, trong \u0111\u00f3 b\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n \u01b0u th\u1ebf l\u00e0 kh\u00f4ng \u0111\u1ea3m b\u1ea3o v\u1ec1 ...","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":"Ch\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n theo ICD-10 - Vinmec","og_description":"M\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 li\u00ean quan \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m sinh, trong \u0111\u00f3 b\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n \u01b0u th\u1ebf l\u00e0 kh\u00f4ng \u0111\u1ea3m b\u1ea3o v\u1ec1 ...","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/","og_site_name":"Vinmec","article_published_time":"2023-04-25T10:43:05+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/istockphoto-1332798293-612x612-1-300x200.jpg"}],"author":"mitkaka mitkaka","twitter_card":"summary_large_image","twitter_misc":{"Written by":"mitkaka mitkaka","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/","name":"Ch\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n theo ICD-10 - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-25T10:43:05+00:00","dateModified":"2023-04-25T10:43:05+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/afa83c897f17e0b5f69265f912e0572c"},"description":"M\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7 li\u00ean quan \u0111\u1ebfn c\u00e1c nh\u00e2n t\u1ed1 t\u00e2m sinh, trong \u0111\u00f3 b\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n \u01b0u th\u1ebf l\u00e0 kh\u00f4ng \u0111\u1ea3m b\u1ea3o v\u1ec1 ...","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-mat-ngu-khong-thuc-ton-theo-icd-10\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Ch\u1ea9n \u0111o\u00e1n m\u1ea5t ng\u1ee7 kh\u00f4ng th\u1ef1c t\u1ed5n theo ICD-10"}]},{"@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\/afa83c897f17e0b5f69265f912e0572c","name":"mitkaka mitkaka","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/0.gravatar.com\/avatar\/f102cd9b17e5dabdddda292eb3a7dd3d?s=96&d=mm&r=g","contentUrl":"http:\/\/0.gravatar.com\/avatar\/f102cd9b17e5dabdddda292eb3a7dd3d?s=96&d=mm&r=g","caption":"mitkaka mitkaka"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/mitkaka2009mitkaka2009gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/28163"}],"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\/5"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=28163"}],"version-history":[{"count":5,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/28163\/revisions"}],"predecessor-version":[{"id":28169,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/28163\/revisions\/28169"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=28163"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=28163"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=28163"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}