{"id":28291,"date":"2023-04-25T20:40:56","date_gmt":"2023-04-25T13:40:56","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28291"},"modified":"2023-04-25T20:40:56","modified_gmt":"2023-04-25T13:40:56","slug":"tong-quan-chan-doan-va-dieu-tri-thalassemia","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/","title":{"rendered":"T\u1ed5ng quan ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Thalassemia"},"content":{"rendered":"

Thalassemia<\/a> l\u00e0 b\u1ec7nh l\u00fd di truy\u1ec1n, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n nguy\u00ean nh\u00e2n do s\u1ef1 bi\u1ebfn \u0111\u1ed5i gen\u00a0 t\u1ea1o chu\u1ed7i globin t\u1eeb \u0111\u00f3 l\u00e0m gi\u1ea3m hay kh\u00f4ng s\u1ea3n xu\u1ea5t s\u1ed1 l\u01b0\u1ee3ng chu\u1ed7i alpha hay chu\u1ed7i beta.\u00a0 \u00a0Kh\u00e1c v\u1edbi b\u1ec7nh hemoglobin: c\u0169ng l\u00e0 b\u1ec7nh di truy\u1ec1n nh\u01b0ng nguy\u00ean nh\u00e2n l\u00e0 do thay \u0111\u1ed5i c\u1ea5u tr\u00fac\u00a0 c\u1ee7a ph\u00e2n t\u1eed hemoglobin.<\/strong><\/p>\n

\"minh-hoa-Thalassemia\"<\/p>\n

1. Ph\u00e2n lo\u1ea1i thalassemia<\/strong><\/h2>\n
    \n
  • \n
      \n
    • Ph\u00e2n lo\u1ea1i kinh \u0111i\u1ec3n<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
        \n
      • \u03b1 Thalassemia: thi\u1ebfu h\u1ee5t gen t\u1ea1o chu\u1ed7i\u00a0 \u03b1 \u2192 gi\u1ea3m t\u1ed5ng h\u1ee3p chu\u1ed7i \u03b1<\/li>\n
      • \u03b2 Thalassemia: \u0111\u1ed9t bi\u1ebfn \u0111i\u1ec3m tr\u00ean c\u00e1c locus t\u1ea1o chu\u1ed7i \u03b2 \u2192 gi\u1ea3m t\u1ed5ng h\u1ee3p chu\u1ed7i \u03b2<\/li>\n<\/ul>\n
          \n
        • Ph\u00e2n lo\u1ea1i m\u1edbi<\/strong><\/li>\n<\/ul>\n

          – Thalassemia ph\u1ee5 thu\u1ed9c truy\u1ec1n m\u00e1u: Cooley, HbE th\u1ec3 n\u1eb7ng, alpha Thal th\u1ec3 n\u1eb7ng:<\/p>\n

          + Bi\u1ebfn ch\u1ee9ng li\u00ean quan truy\u1ec1n m\u00e1u, ch\u1eadm ph\u00e1t tri\u1ec3n t\u00e2m v\u1eadn, \u1ee9 s\u1eaft g\u00e2y suy tim, t\u1ed5n\u00a0 th\u01b0\u01a1ng gan, suy gan, r\u1ed1i lo\u1ea1n n\u1ed9i ti\u1ebft.<\/p>\n

          \u2212 Thalassemia kh\u00f4ng ph\u1ee5 thu\u1ed9c truy\u1ec1n m\u00e1u: beta Thal th\u1ec3 trung b\u00ecnh, HbE, Alpha thal th\u1ec3 trung b\u00ecnh:<\/p>\n

          + Ch\u1ec9 c\u1ea7n truy\u1ec1n m\u00e1u trong m\u1ed9t s\u1ed1 giai \u0111o\u1ea1n nh\u1ea5t \u0111\u1ecbnh nh\u01b0 c\u00f3 thai, cho con b\u00fa, d\u1eady th\u00ec,\u00a0 ph\u1eabu thu\u1eadt, nhi\u1ec5m tr\u00f9ng n\u1eb7ng\u2026<\/p>\n

          + Bi\u1ebfn ch\u1ee9ng huy\u1ebft kh\u1ed1i t\u1eafc m\u1ea1ch do t\u0103ng \u0111\u00f4ng g\u00e2y nh\u1ed3i m\u00e1u n\u00e3o, t\u0103ng \u00e1p ph\u1ed5i, nh\u1ed3i\u00a0 m\u00e1u c\u01a1 tim, nh\u1ed3i m\u00e1u h\u1ec7 t\u0129nh m\u1ea1ch c\u1eeda. C\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan truy\u1ec1n m\u00e1u, ch\u1eadm\u00a0 ph\u00e1t tri\u1ec3n t\u00e2m v\u1eadn, \u1ee9 s\u1eaft kh\u00f4ng nhi\u1ec1u b\u1eb1ng th\u1ec3 ph\u1ee5 thu\u1ed9c truy\u1ec1n m\u00e1u nh\u01b0ng n\u1ebfu theo\u00a0 d\u00f5i kh\u00f4ng t\u1ed1t th\u00ec c\u0169ng s\u1ebd g\u00e2y thi\u1ebfu m\u00e1u \u00e0 T\u1ea1o m\u00e1u ngo\u00e0i t\u1ee7y, bi\u1ebfn d\u1ea1ng x\u01b0\u01a1ng, gan\u00a0 l\u00e1ch to c\u00f3 th\u1ec3 tr\u1edf th\u00e0nh ph\u1ee5 thu\u1ed9c truy\u1ec1n m\u00e1u<\/p>\n

          2. T\u00f3m t\u1eaft sinh l\u00fd b\u1ec7nh<\/h2>\n

          \u2212 Gi\u1ea3m ho\u1eb7c kh\u00f4ng c\u00f3 t\u1ed5ng h\u1ee3p HbA ->\u2193MCHC & MCH ->nh\u01b0\u1ee3c s\u1eafc v\u00e0 h\u1ed3ng c\u1ea7u nh\u1ecf <\/em><\/strong><\/p>\n

          \u2212 S\u1ea3n xu\u1ea5t kh\u00f4ng \u0111\u1ee7 + Sinh h\u1ed3ng c\u1ea7u kh\u00f4ng hi\u1ec7u qu\u1ea3 + T\u00e1n huy\u1ebft->Thi\u1ebfu m\u00e1u<\/em><\/strong><\/p>\n

          \u00a0<\/em><\/strong>\u2212 \u2191t\u00e1n huy\u1ebft->\u2191 nhu c\u1ea7u c\u1ee7a ch\u1ee9c n\u0103ng th\u1ef1c b\u00e0o ->t\u0103ng sinh c\u00e1c th\u1ef1c b\u00e0o ->Gan l\u00e1ch to <\/em><\/strong><\/p>\n

          \u2212 B\u00f9 tr\u1eeb thi\u1ebfu m\u00e1u b\u1eb1ng c\u00e1ch t\u1ea1o m\u00e1u ngo\u00e0i t\u1ee7y \u1edf gan, l\u00e1ch ->Gan l\u00e1ch to <\/em><\/strong><\/p>\n

          \u2212 \u2191T\u1ed5ng h\u1ee3p h\u1ed3ng c\u1ea7u->t\u1ee7y x\u01b0\u01a1ng d\u00e3n r\u1ed9ng & v\u1ecf x\u01b0\u01a1ng s\u1ecd m\u1ecfng->v\u1ebb m\u1eb7t Thalassaemia <\/em><\/strong><\/p>\n

          \u2212 \u0110a h\u1ed3ng c\u1ea7u: T\u1ed5ng h\u1ed3ng c\u1ea7u t\u0103ng. Do ra ngo\u1ea1i bi\u00ean v\u1ee1 h\u1ebft tr\u01a1n, huy \u0111\u1ed9ng t\u1ee7y t\u1ea1o ra HC m\u1edbi\u00a0 nh\u01b0ng to\u00e0n HC b\u1ec7nh l\u00fd, tuy nhi\u00ean s\u1ed1 l\u01b0\u1ee3ng th\u00ec nhi\u1ec1u.<\/p>\n

          3. L\u00e2m s\u00e0ng thalassemia<\/strong><\/h3>\n

          3.<\/strong>1. B\u1ec7nh s\u1eed: <\/strong><\/p>\n

          – Th\u1eddi gian b\u1eaft \u0111\u1ea7u ph\u00e1t hi\u1ec7n thi\u1ebfu m\u00e1u, di\u1ec5n ti\u1ebfn c\u1ee7a thi\u1ebfu m\u00e1u.<\/p>\n

          – Ti\u1ec1n c\u0103n :<\/p>\n

          \u2212 B\u1ec7nh l\u00fd: d\u1ec5 g\u00e3y x\u01b0\u01a1ng, s\u00e2u r\u0103ng (r\u0103ng d\u1ec5 b\u1ecb m\u00f2n c\u1ee5t). B\u1ec7nh l\u00fd t\u1eafc m\u1ea1ch<\/p>\n

          \u2212 S\u1ea3n khoa: m\u1eb9 kh\u00e1m thai c\u00f3 thi\u1ebfu m\u00e1u? C\u00f3 ph\u1ea3i truy\u1ec1n m\u00e1u trong l\u00fac mang thai kh\u00f4ng? (N\u1ebfu m\u1eb9 mang gen th\u00ec m\u1eb9 HC nh\u1ecf, nh\u01b0\u1ee3c s\u1eafc, trong qu\u00e1 tr\u00ecnh mang thai nhu c\u1ea7u m\u00e1u t\u0103ng, m\u1eb9 s\u1ebd ph\u1ea3i\u00a0 truy\u1ec1n m\u00e1u v\u00ec thi\u1ebfu m\u00e1u)<\/p>\n

          \u2212 Ti\u1ec1n c\u0103n dinh d\u01b0\u1ee1ng:<\/p>\n

          + \u0102n u\u1ed1ng -> c\u00f2i c\u1ecdc suy dinh d\u01b0\u1ee1ng<\/p>\n

          \u2219 + H\u1ed9i ch\u1ee9ng k\u00e9m h\u1ea5p thu (kh\u00f3 h\u1ea5p thu, \u0111\u1ea7y b\u1ee5ng, kh\u00f3 ti\u00eau) v\u00ec thalassemia thi\u1ebfu m\u00e1u, l\u00e0m\u00a0 gi\u1ea3m t\u01b0\u1edbi m\u00e1u c\u00e1c c\u01a1 quan trong \u0111\u00f3 c\u00f3 c\u1ea3 h\u1ec7 ti\u00eau h\u00f3a.<\/p>\n

          \u2212 T\u00e2m v\u1eadn: ch\u1eadm ph\u00e1t tri\u1ec3n th\u1ec3 ch\u1ea5t, v\u1eadn \u0111\u1ed9ng, t\u00e2m th\u1ea7n<\/p>\n

          \u2212 Gia \u0111\u00ecnh:<\/p>\n

          + C\u00f3 ai b\u1ec7nh l\u00fd m\u00e1u, c\u00f3 ai truy\u1ec1n m\u00e1u \u0111\u1ecbnh k\u00ec, c\u00f3 ai b\u1ecb t\u1eeb ch\u1ed1i hi\u1ebfn m\u00e1u?<\/p>\n

          + B\u1ed1 m\u1eb9 c\u00f3 \u0111\u01b0\u1ee3c l\u00e0m x\u00e9t nghi\u1ec7m t\u1ea7m so\u00e1t Thalassemia.<\/p>\n

          \u25a3 Chung:<\/p>\n

          \u2212 Ti\u00eam ch\u1ee7ng: v\u00ec sau n\u00e0y c\u00f3 th\u1ec3 c\u1eaft l\u00e1ch n\u00ean c\u1ea7n h\u1ecfi v\u1ec1 c\u00e1c m\u0169i ti\u00eam ch\u1ee7ng, \u0111\u1eb7c bi\u1ec7t c\u00e1c m\u0169i: Ph\u1ebf c\u1ea7u, n\u00e3o m\u00f4 c\u1ea7u, Hib.<\/p>\n

          3.<\/strong>2. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng: <\/strong><\/p>\n

          – Thi\u1ebfu m\u00e1u m\u1ea1n: da xanh, ni\u00eam nh\u1ee3t, l\u00f2ng b\u00e0n tay nh\u1ee3t.<\/p>\n

          – T\u00e1n huy\u1ebft m\u1ea1n: v\u00e0ng da, gan l\u00e1ch to, da x\u1ea1m.<\/p>\n

          – Bi\u1ebfn d\u1ea1ng x\u01b0\u01a1ng: tr\u00e1nd\u00f4, m\u0169i t\u1eb9t, u tr\u00e1n, u \u0111\u1ec9nh.<\/p>\n

          – Ch\u1eadm ph\u00e1t tri\u1ec3n th\u1ec3 ch\u1ea5t: nh\u1eb9 c\u00e2n, th\u1ea5p b\u00e9, ch\u1eadm d\u1eady th\u00ec.<\/p>\n

          3<\/strong>.3 C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n

          – Huy\u1ebft \u0111\u1ed3: h\u1ed3ng c\u1ea7u nh\u1ecf, nh\u01b0\u1ee3c s\u1eafc.<\/p>\n

          – S\u1eaft huy\u1ebft thanhv\u00e0 Ferritine: b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng. Bilirubin gi\u00e1n ti\u1ebfp t\u0103ng. – \u0110i\u1ec7n di Hb (tr\u01b0\u1edbc khi truy\u1ec1n m\u00e1u).<\/p>\n

          4. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/strong><\/h2>\n

          D\u1ef1a v\u00e0o k\u1ebft qu\u1ea3 \u0111i\u1ec7n di Hb: HbA gi\u1ea3m , HbF t\u0103ng, HbA2 t\u0103ng, hi\u1ec7n di\u1ec7n HbE hay HbH.<\/p>\n

          – \u03b1 Thalassemia (th\u1ec3 HbH): <\/strong>HbA< 96%, hi\u1ec7n di\u1ec7n HbH v\u00e0 c\u00f3 th\u1ec3 c\u00f3 Hb Constant Spring. – \u03b2 Thalassemia (th\u1ec3 trung b\u00ecnh, n\u1eb7ng, \u0111\u1ed3ng h\u1ee3p t\u1eed): <\/strong>thi\u1ebfu m\u00e1u n\u1eb7ng, s\u1edbm, gan l\u00e1ch to. \u0110i\u1ec7n\u00a0 di Hb c\u00f3 HbA< 80%, HbF 20-100%.<\/p>\n

          – \u0392 Thalassemia (th\u1ec3 nh\u1eb9, d\u1ecb h\u1ee3p t\u1eed): <\/strong>kh\u00f4ng thi\u1ebfu m\u00e1u hay thi\u1ebfu m\u00e1u nh\u1eb9, kh\u00f4ng c\u00f3 gan l\u00e1ch\u00a0 to. \u0110i\u1ec7n di: HbA2 > 3,5%, HbF 5-15%<\/p>\n\n\n\n\n\n\n\n
          TH\u1ec2 B\u1ec6NH <\/strong><\/td>\nL\u00c2M S\u00c0NG <\/strong><\/td>\nC\u1eacN L\u00c2M\u00a0 <\/strong><\/p>\n

          S\u00c0NG<\/strong><\/td>\n

          		X\u1eec TR\u00cd<\/strong><\/td>\n<\/tr>\n
          \u03b1 Thalassemia<\/td>\nThi\u1ebfu m\u00e1u trung b\u00ecnh\/nh\u1eb9 Gan l\u00e1ch to<\/p>\n

          Bi\u1ebfn d\u1ea1ng x\u01b0\u01a1ng \u00edt<\/td>\n

          		HC nh\u1ecf nh\u01b0\u1ee3c s\u1eafc<\/p>\n

          HbH 5 \u2013 30 %<\/td>\n

          		T\u00f9y di\u1ec5n ti\u1ebfn<\/td>\n<\/tr>\n
          \u03b2 Thalassemia<\/p>\n

          (th\u1ec3 nh\u1eb9\/d\u1ecb h\u1ee3p<\/p>\n

          t\u1eed)<\/td>\n

          		Kh\u00f4ng tri\u1ec7u ch\u1ee9ng<\/p>\n

          Thi\u1ebfu m\u00e1u v\u1eeba<\/td>\n

          		Hb> 10g\/dl<\/p>\n

          HC nh\u1ecf nh\u01b0\u1ee3c s\u1eafc<\/p>\n

          HbA2 > 3,5% HbF> 5%<\/td>\n

          		Kh\u00f4ng c\u1ea7n truy\u1ec1n m\u00e1u<\/td>\n<\/tr>\n
          \u03b2 Thalassemia<\/p>\n

          (th\u1ec3 trung gian)<\/td>\n

          		Thi\u1ebfu m\u00e1u nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh<\/td>\nHb 7 \u2013 10 g\/dl<\/td>\nT\u00f9y di\u1ec5n ti\u1ebfn<\/td>\n<\/tr>\n
          \u03b2 Thalassemia<\/p>\n

          (th\u1ec3 trung b\u00ecnh<\/p>\n

          hay n\u1eb7ng \/ \u0111\u1ed3ng h\u1ee3p t\u1eed)<\/td>\n

          		Thi\u1ebfu m\u00e1u s\u1edbm, n\u1eb7ng<\/p>\n

          Gan l\u00e1ch to nhi\u1ec1u<\/p>\n

          Bi\u1ebfn d\u1ea1ng x\u01b0\u01a1ng n\u1eb7ng<\/td>\n

          		Hb< 7 g\/dl<\/p>\n

          HC nh\u1ecf nh\u01b0\u1ee3c s\u1eafc, HC \u0111a s\u1eafc,\u00a0 HC bia, HC<\/p>\n

          nh\u00e2n<\/td>\n

          		C\u1ea7n truy\u1ec1n m\u00e1u<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

           <\/p>\n

           <\/p>\n\n\n\n\n
          <\/td>\n<\/td>\nHbF> 20-80%<\/td>\n<\/td>\n<\/tr>\n
          \u03b2 Thalassemia\/\u00a0 HbE<\/td>\nThi\u1ebfu m\u00e1u trung b\u00ecnh \u0111\u1ebfn n\u1eb7ng<\/p>\n

          Gan l\u00e1ch to<\/p>\n

          Bi\u1ebfn d\u1ea1ng x\u01b0\u01a1ng trung b\u00ecnh<\/td>\n

          		Hb< 10g\/dl<\/p>\n

          HC nh\u1ecf nh\u01b0\u1ee3c s\u1eafc, HC \u0111a s\u1eafc,\u00a0 HC bia, HC<\/p>\n

          nh\u00e2n<\/p>\n

          HbA1 < 80%<\/p>\n

          HbF> 20-80% HbA2\/E > 8%<\/td>\n

          		C\u1ea7n truy\u1ec1n m\u00e1u<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

           <\/p>\n

           <\/p>\n

          5. \u0110i\u1ec1u tr\u1ecb<\/h2>\n

          5.1 Nguy\u00ean t\u1eafc: <\/strong><\/p>\n

          – Truy\u1ec1n m\u00e1u<\/p>\n

          – Th\u1ea3i s\u1eaft<\/p>\n

          – \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3<\/p>\n

          – C\u1eaft l\u00e1ch khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh<\/p>\n

          – Ch\u1ee7ng ng\u1eeba<\/p>\n

          5.2 Truy\u1ec1n m\u00e1u: <\/strong><\/p>\n

          – Ch\u1ec9 \u0111\u1ecbnh: khi Hb<7g\/dl<\/p>\n

          – Duy tr\u00ec Hb 9 \u2013 10 g\/dl<\/p>\n

          – Truy\u1ec1n 10-15ml\/kg h\u1ed3ng c\u1ea7u l\u1eafng\/l\u1ea7n trong 3-4 gi\u1edd (5ml\/kg\/gi\u1edd).<\/p>\n

          – Thi\u1ebfu m\u00e1u n\u1eb7ng (Hb< 5g\/dl) ho\u1eb7c suyt im: truy\u1ec1n 2ml\/kg\/gi\u1edd, Furosemide 1-2mg\/kg. – Kho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c l\u1ea7n truy\u1ec1n m\u00e1u # 4-6 tu\u1ea7n t\u00f9y theo m\u1ee9c \u0111\u1ed9 t\u00e1n huy\u1ebft. + T\u00e1n huy\u1ebft mi\u1ec5n d\u1ecbch th\u1ee9 ph\u00e1t do c\u01a1 th\u1ec3 t\u1ea1o kh\u00e1ng th\u1ec3 ch\u1ed1ng h\u1ed3ng c\u1ea7u cho: x\u1eed tr\u00ed: truy\u1ec1n h\u1ed3ng c\u1ea7u phenotype.<\/p>\n

          5.3 Th\u1ea3i s\u1eaft : <\/strong><\/p>\n

          – Ch\u1ec9 \u0111\u1ecbnh: khi Ferritine > 1000ng\/ml hay sau truy\u1ec1n m\u00e1u 10 \u2013 12 l\u1ea7n (\u1edf tr\u1ebb > 3 tu\u1ed5i) + Vi\u00ean u\u1ed1ng \u2013 Desferiprone :\u00a0 <\/em><\/strong><\/p>\n

          \u25aa Li\u1ec1u 75 mg\/kg\/ng\u00e0y chia 3-4 l\u1ea7n.<\/p>\n

          \u25aa Theo d\u00f5i huy\u1ebft \u0111\u1ed3 m\u1ed7i 3-4 tu\u1ea7n, Ferritine m\u1ed7i 3-4 th\u00e1ng<\/p>\n

          \u25aa Ng\u01b0ng thu\u1ed1c khi:<\/p>\n

          – Ferrintine< 1000 ng\/ml<\/p>\n

          – B\u1ea1chc\u1ea7u< 3000\/mm\u00b3, Neutrophile< 1000\/mm\u00b3, Ti\u1ec3u c\u1ea7u< 100000\/mm\u00b3 – Gi\u1ea3m ch\u1ee9c n\u0103ng gan th\u1eadn, \u0111au kh\u1edbp<\/p>\n

          + Truy\u1ec1n d\u01b0\u1edbi da \u2013 Desferrioxamine : <\/em><\/strong><\/p>\n

          \u25aa Desferal li\u1ec1u 25 \u2013 35 mg\/kg truy\u1ec1n d\u01b0\u1edbi da 8 \u2013 12 gi\u1edd\/\u0111\u00eam \u00d7 5 \u2013 6 \u0111\u00eam\/tu\u1ea7n 4. \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3: <\/strong><\/p>\n

          – Acid folic 5mg\/ng\u00e0y<\/p>\n

          – Calci D<\/p>\n

          – Vitamin E<\/p>\n

            \n
          1. C\u1eaft l\u00e1ch: <\/strong>kh\u00f4ng ph\u1ea3i \u0111i\u1ec1u tr\u1ecb tri\u1ec7t \u0111\u1ec3, c\u00f3 nhi\u1ec1u nguy c\u01a1<\/li>\n<\/ol>\n

            – Ch\u1ec9 \u0111\u1ecbnh :<\/p>\n

            + Truy\u1ec1n HCL qu\u00e1 225 \u2013 250 ml\/kg\/n\u0103m, kho\u1ea3ng c\u00e1ch gi\u1eefa 2 l\u1ea7n truy\u1ec1n m\u00e1u< 3 tu\u1ea7n, hay\u00a0 kh\u1ed1i l\u01b0\u1ee3ng truy\u1ec1n t\u0103ng g\u1ea5p \u0111\u00f4i.<\/p>\n

            + L\u00e1ch to qu\u00e1 r\u1ed1n (\u0111\u1ed9 IV)<\/p>\n

            + Tr\u1ebb \u2265 6 tu\u1ed5i (gi\u1ea3m nguy c\u01a1n hi\u1ec5mtr\u00f9ng)<\/p>\n

            – Sau c\u1eaft l\u00e1ch :<\/p>\n

            + Kh\u00e1ng sinh ph\u00f2ng ng\u1eeba \u0111\u1ebfn n\u0103m 16 tu\u1ed5i : Penicillin 250mg\/vi\u00eanu\u1ed1ng 2 l\u1ea7n\/ng\u00e0y, hay\u00a0 Erythromycin 250mg m\u1ed7i ng\u00e0y.<\/p>\n

            + T\u0103ng ti\u1ec3u c\u1ea7u: Aspirin li\u1ec1u th\u1ea5p<\/p>\n

            5.4 Ch\u1ee7ng ng\u1eeba: <\/strong>ch\u1ee7ng ng\u1eeba Vi\u00eam gan si\u00eau vi B, Streptococcus pneumonia, Hemophilus influenza type B, Neisseria meningitides tr\u01b0\u1edbc c\u1eaft l\u00e1ch 2-4 tu\u1ea7n, l\u1eb7p l\u1ea1i sau m\u1ed7i 5 n\u0103m. 7. <\/strong><\/p>\n

            5.5. Gh\u00e9p t\u1ee7y ph\u00f9 h\u1ee3p HLA: <\/strong>bi\u1ec7n ph\u00e1p hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb.<\/p>\n

            5.6 T\u00e1i kh\u00e1m : <\/strong><\/p>\n

            – 4-6 tu\u1ea7n sau truy\u1ec1n m\u00e1u.<\/p>\n

            – C\u00e2n n\u1eb7ng, chi\u1ec1u cao, Ferrintinem\u1ed7i 6 th\u00e1ng.<\/p>\n

            – T\u1ed5ng k\u1ebft truy\u1ec1n m\u00e1u, Ferritine sau m\u1ed7i 12 th\u00e1ng.<\/p>\n

            T\u00c0I LI\u1ec6U THAM KH\u1ea2O:<\/p>\n

            B\u1ec7nh vi\u1ec7n Nhi \u0110\u1ed3ng 1 \u2013 Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb Huy\u1ebft h\u1ecdc<\/p>\n","protected":false},"excerpt":{"rendered":"

            Thalassemia l\u00e0 b\u1ec7nh l\u00fd di truy\u1ec1n, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n nguy\u00ean nh\u00e2n do s\u1ef1 bi\u1ebfn \u0111\u1ed5i gen\u00a0 t\u1ea1o chu\u1ed7i globin t\u1eeb \u0111\u00f3 l\u00e0m gi\u1ea3m hay kh\u00f4ng s\u1ea3n xu\u1ea5t s\u1ed1 l\u01b0\u1ee3ng chu\u1ed7i alpha hay chu\u1ed7i beta.\u00a0 \u00a0Kh\u00e1c v\u1edbi b\u1ec7nh hemoglobin: c\u0169ng l\u00e0 b\u1ec7nh di truy\u1ec1n nh\u01b0ng nguy\u00ean nh\u00e2n l\u00e0 do thay \u0111\u1ed5i […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[15,33],"tags":[],"yoast_head":"\nT\u1ed5ng quan ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Thalassemia - Vinmec<\/title>\n<meta name=\"description\" content=\"Thalassemia l\u00e0 b\u1ec7nh l\u00fd di truy\u1ec1n, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n do gi\u1ea3m hay kh\u00f4ng s\u1ea3n xu\u1ea5t s\u1ed1 l\u01b0\u1ee3ng chu\u1ed7i alpha hay chu\u1ed7i beta.\" \/>\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=\"T\u1ed5ng quan ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Thalassemia - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Thalassemia l\u00e0 b\u1ec7nh l\u00fd di truy\u1ec1n, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n do gi\u1ea3m hay kh\u00f4ng s\u1ea3n xu\u1ea5t s\u1ed1 l\u01b0\u1ee3ng chu\u1ed7i alpha hay chu\u1ed7i beta.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-25T13:40:56+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/b2965bd3-f48e-4c63-b7a5-407d9d7f290e-1-300x300.jpg\" \/>\n<meta name=\"author\" content=\"Dai Tran Van\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dai Tran Van\" \/>\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\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/\",\"name\":\"T\u1ed5ng quan ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Thalassemia - Vinmec\",\"isPartOf\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-25T13:40:56+00:00\",\"dateModified\":\"2023-04-25T13:40:56+00:00\",\"author\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2\"},\"description\":\"Thalassemia l\u00e0 b\u1ec7nh l\u00fd di truy\u1ec1n, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n do gi\u1ea3m hay kh\u00f4ng s\u1ea3n xu\u1ea5t s\u1ed1 l\u01b0\u1ee3ng chu\u1ed7i alpha hay chu\u1ed7i beta.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"T\u1ed5ng quan ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Thalassemia\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"https:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2\",\"name\":\"Dai Tran Van\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g\",\"caption\":\"Dai Tran Van\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/tranvandai2791995gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"T\u1ed5ng quan ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Thalassemia - Vinmec","description":"Thalassemia l\u00e0 b\u1ec7nh l\u00fd di truy\u1ec1n, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n do gi\u1ea3m hay kh\u00f4ng s\u1ea3n xu\u1ea5t s\u1ed1 l\u01b0\u1ee3ng chu\u1ed7i alpha hay chu\u1ed7i beta.","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":"T\u1ed5ng quan ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Thalassemia - Vinmec","og_description":"Thalassemia l\u00e0 b\u1ec7nh l\u00fd di truy\u1ec1n, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n do gi\u1ea3m hay kh\u00f4ng s\u1ea3n xu\u1ea5t s\u1ed1 l\u01b0\u1ee3ng chu\u1ed7i alpha hay chu\u1ed7i beta.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/","og_site_name":"Vinmec","article_published_time":"2023-04-25T13:40:56+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/b2965bd3-f48e-4c63-b7a5-407d9d7f290e-1-300x300.jpg"}],"author":"Dai Tran Van","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Dai Tran Van","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/","name":"T\u1ed5ng quan ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Thalassemia - Vinmec","isPartOf":{"@id":"https:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-25T13:40:56+00:00","dateModified":"2023-04-25T13:40:56+00:00","author":{"@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2"},"description":"Thalassemia l\u00e0 b\u1ec7nh l\u00fd di truy\u1ec1n, \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n do gi\u1ea3m hay kh\u00f4ng s\u1ea3n xu\u1ea5t s\u1ed1 l\u01b0\u1ee3ng chu\u1ed7i alpha hay chu\u1ed7i beta.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tong-quan-chan-doan-va-dieu-tri-thalassemia\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"T\u1ed5ng quan ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Thalassemia"}]},{"@type":"WebSite","@id":"https:\/\/noithathoaphat.in\/ctv\/#website","url":"https:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2","name":"Dai Tran Van","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g","contentUrl":"http:\/\/1.gravatar.com\/avatar\/104f3ddcb78816cdc9f1340c38ade413?s=96&d=mm&r=g","caption":"Dai Tran Van"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/tranvandai2791995gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/28291"}],"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\/16"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=28291"}],"version-history":[{"count":4,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/28291\/revisions"}],"predecessor-version":[{"id":28297,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/28291\/revisions\/28297"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=28291"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=28291"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=28291"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}