{"id":28384,"date":"2023-04-25T20:39:16","date_gmt":"2023-04-25T13:39:16","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28384"},"modified":"2023-04-25T20:39:59","modified_gmt":"2023-04-25T13:39:59","slug":"tieu-chuan-chan-doan-va-dieu-tri-hoi-chung-than-hu","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/tieu-chuan-chan-doan-va-dieu-tri-hoi-chung-than-hu\/","title":{"rendered":"Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0"},"content":{"rendered":"

H\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0<\/a> (HCTH) l\u00e0 b\u1ec7nh c\u1ea7u th\u1eadn th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb em, \u0111a s\u1ed1 tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n, \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb corticoid, di\u1ec5n ti\u1ebfn m\u1ea1n t\u00ednh v\u1edbi c\u00e1c \u0111\u1ee3t t\u00e1i ph\u00e1t v\u00e0 t\u00e1i ph\u00e1t th\u01b0\u1eddng xuy\u00ean nh\u01b0ng \u00edt khi d\u1eabn t\u1edbi suy th\u1eadn m\u1ea1n. HCTH th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng t\u1ed1i thi\u1ec3u \u1edf c\u1ea7u th\u1eadn ho\u1eb7c nh\u1eefng t\u1ed5n th\u01b0\u01a1ng d\u00e0y v\u00e0 tho\u00e1i h\u00f3a m\u00e0ng \u0111\u00e1y c\u1ee7a mao m\u1ea1ch c\u1ea7u th\u1eadn. HCTH \u0111\u01a1n thu\u1ea7n nguy\u00ean ph\u00e1t nh\u1ea1y c\u1ea3m v\u1edbi Corticoides th\u01b0\u1eddng kh\u00f4ng c\u00f3 t\u0103ng huy\u1ebft \u00e1p, suy th\u1eadn v\u00e0 ti\u1ec3u m\u00e1u. M\u1ed9t s\u1ed1 l\u1edbn tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng \u0111\u1ec3 l\u1ea1i di ch\u1ee9ng \u1edf tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh.<\/strong><\/p>\n

\"hoi-chung-than-hu\"<\/p>\n

1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0<\/h2>\n

1.1. D\u1ef1a v\u00e0o l\u00e2m s\u00e0ng v\u00e0 c\u00e1c x\u00e9t nghi\u1ec7m th\u00f4ng th\u01b0\u1eddng.<\/strong><\/p>\n

C\u00e1c ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n: d\u1ef1a v\u00e0o c\u00e1c ti\u00eau chu\u1ea9n sau \u0111\u00e2y:<\/p>\n

– \u00a0Ph\u00f9.<\/p>\n

– \u00a0Protein ni\u1ec7u \u2265 3,5g\/24 gi\u1edd.<\/p>\n

– \u00a0Protein m\u00e1u <60g\/l, Albumin m\u00e1u < 30g\/l.<\/p>\n

– \u00a0Lipid m\u00e1u t\u0103ng tr\u00ean 900 mg%. Cholesterol m\u00e1u t\u0103ng tr\u00ean 250 mg% ho\u1eb7c<\/p>\n

tr\u00ean 6,5 mmol\/l.<\/p>\n

– \u0110i\u1ec7n di Protein m\u00e1u: Albumin gi\u1ea3m, t\u1ef7 l\u1ec7 A\/G < 1, Globulin: \u03b12 t\u0103ng, \u03b2 t\u0103ng.<\/p>\n

– \u00a0N\u01b0\u1edbc ti\u1ec3u c\u00f3 tr\u1ee5 m\u1ee1, tinh th\u1ec3 l\u01b0\u1ee1ng chi\u1ebft.<\/p>\n

Trong \u0111\u00f3 ti\u00eau chu\u1ea9n 2 v\u00e0 3 l\u00e0 b\u1eaft bu\u1ed9c.<\/p>\n

1.2. D\u1ef1a v\u00e0o c\u00e1c th\u0103m d\u00f2 ch\u1ee9c n\u0103ng v\u1ec1 th\u1eadn:<\/strong><\/p>\n

– H\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0 \u0111\u01a1n thu\u1ea7n: C\u00e1c ch\u1ee9c n\u0103ng th\u1eadn b\u00ecmh th\u01b0\u1eddng.<\/p>\n

– H\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0 kh\u00f4ng \u0111\u01a1n thu\u1ea7n: R\u1ed1i lo\u1ea1n c\u00e1c ch\u1ee9c n\u0103ng l\u1ecdc c\u1ee7a c\u1ea7u th\u1eadn,<\/p>\n

ch\u1ee9c n\u0103ng b\u00e0i ti\u1ebft v\u00e0 t\u00e1i h\u1ea5p thu c\u1ee7a \u1ed1ng th\u1eadn.<\/p>\n

1.3. Sinh thi\u1ebft th\u1eadn<\/strong><\/p>\n

– C\u00f3 gi\u00e1 tr\u1ecb r\u1ea5t l\u1edbn trong ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh t\u1ed5n th\u01b0\u01a1ng c\u1ee7a HCTH.<\/p>\n

– Gi\u00fap ph\u00e2n lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng trong HCTH m\u1ed9t c\u00e1ch ch\u00ednh x\u00e1c.<\/p>\n

– HCTH \u0111\u01a1n thu\u1ea7n \u1edf tr\u1ebb em 80% l\u00e0 t\u1ed5n th\u01b0\u01a1ng t\u1ed1i thi\u1ec3u.<\/p>\n

2. \u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0:<\/h2>\n

– T\u1ea5n c\u00f4ng: Prednisone 2 mg\/kg\/ng\u00e0y (max: 60 mg\/ng\u00e0y) trong 4 tu\u1ea7n.
\na) N\u1ebfu c\u00f3 \u0111\u00e1p \u1ee9ng: h\u1ebft ph\u00f9, \u0111\u1ea1m ni\u1ec7u \u00e2m t\u00ednh li\u00ean ti\u1ebfp trong 3 ng\u00e0y
\n– 8 tu\u1ea7n k\u1ebf: Prednisone 2 mg\/kg\/c\u00e1ch ng\u00e0y.
\n– 6 tu\u1ea7n k\u1ebf: Prednisone d\u00f9ng c\u00e1ch ng\u00e0y, gi\u1ea3m li\u1ec1u d\u1ea7n, m\u1ed7i tu\u1ea7n gi\u1ea3m 1\/6 li\u1ec1u cho \u0111\u1ebfn khi ng\u01b0ng thu\u1ed1c.
\nb) N\u1ebfu tr\u1ebb t\u00e1i ph\u00e1t trong qu\u00e1 tr\u00ecnh gi\u1ea3m li\u1ec1u:
\n– T\u00e1i ph\u00e1t kh\u00f4ng th\u01b0\u1eddng xuy\u00ean:
\n+ Prednisone 2 mg\/kg\/ng\u00e0y \u0111\u1ebfn khi \u0111\u1ea1m ni\u1ec7u \u00e2m t\u00ednh li\u00ean ti\u1ebfp trong 3 ng\u00e0y.
\n+ Prednisone 2 mg\/kg\/c\u00e1ch ng\u00e0y trong 8 tu\u1ea7n k\u1ebf.
\n– T\u00e1i ph\u00e1t th\u01b0\u1eddng xuy\u00ean v\u00e0 l\u1ec7 thu\u1ed9c Corticoid:
\n+ Prednisone 2 mg\/kg\/ng\u00e0y \u0111\u1ebfn khi \u0111\u1ea1m ni\u1ec7u \u00e2m t\u00ednh li\u00ean ti\u1ebfp trong 3 ng\u00e0y.
\n+ Prednisone 2 mg\/kg\/c\u00e1ch ng\u00e0y trong 8 tu\u1ea7n k\u1ebf.
\n+ Gi\u1ea3m d\u1ea7n li\u1ec1u Prednisone v\u00e0 duy tr\u00ec 0,5 \u2013 1 mg\/kg\/c\u00e1ch ng\u00e0y trong 6 \u2013 12 th\u00e1ng.
\n+ N\u1ebfu li\u1ec1u Prednisone duy tr\u00ec cao > 1 mg\/kg\/c\u00e1ch ng\u00e0y hay 0,5 mg\/kg\/c\u00e1ch ng\u00e0y k\u00e8m theo bi\u1ebfn ch\u1ee9ng do d\u00f9ng corticoid k\u00e9o d\u00e0i nh\u01b0 Cushing n\u1eb7ng, cao huy\u1ebft \u00e1p, ti\u1ec3u \u0111\u01b0\u1eddng, xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a s\u1ebd ph\u1ed1i h\u1ee3p th\u00eam Cyclophosphamide 2,5 mg\/kg\/ng\u00e0y trong 8 \u2013 12 tu\u1ea7n v\u1edbi Prednisone li\u1ec1u th\u1ea5p + Th\u01b0\u1eddng sau c\u00e1c ph\u00e1c \u0111\u1ed3 tr\u00ean, b\u1ec7nh nh\u00e2n s\u1ebd b\u1edbt t\u00e1i ph\u00e1t. N\u1ebfu v\u1eabn t\u00e1i ph\u00e1t, s\u1ebd d\u00f9ng: Cyclosporine 5 mg\/kg\/ng\u00e0y trong 1 n\u0103m.
\n+ \u0110\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y, \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u1ed1t ti\u00ean l\u01b0\u1ee3ng n\u00ean ti\u1ebfn h\u00e0nh sinh thi\u1ebft th\u1eadn.
\nc) N\u1ebfu sau 4 tu\u1ea7n v\u1eabn ch\u01b0a \u0111\u00e1p \u1ee9ng Prednisone:
\n– Methylprednisone 1g\/1,73 m2 da\/ng\u00e0y (10 \u2013 15 mg\/kg\/ng\u00e0y) truy\u1ec1n t\u0129nh m\u1ea1ch 3 l\u1ea7n c\u00e1ch ng\u00e0y. N\u1ebfu sau 3 li\u1ec1u Methylprednisone v\u1eabn kh\u00f4ng \u0111\u00e1p \u1ee9ng sau 2 tu\u1ea7n (c\u00f2n ph\u00f9 v\u00e0 ho\u1eb7c \u0111\u1ea1m ni\u1ec7u d\u01b0\u01a1ng t\u00ednh), xem nh\u01b0 kh\u00e1ng corticoid \u00e0 sinh thi\u1ebft th\u1eadn.
\n– N\u1ebfu sang th\u01b0\u01a1ng t\u1ed1i thi\u1ec3u (MCD), t\u0103ng sinh trung m\u00f4 (MP), x\u01a1 h\u00f3a c\u1ee5c b\u1ed9 t\u1eebng ph\u1ea7n (FSGS):
\nCyclosporine 5 mg\/kg\/ng\u00e0y trong 6 th\u00e1ng \u2013 1 n\u0103m k\u00e8m
\nPrednisone 1 mg\/kg\/ng\u00e0y trong 1 th\u00e1ng \u0111\u1ea7u r\u1ed3i gi\u1ea3m li\u1ec1u c\u00f2n 1mg\/kg\/c\u00e1ch ng\u00e0y trong 6 th\u00e1ng ti\u1ebfp.
\nHo\u1eb7c: Cyclophosphamide 2,5 mg\/kg\/ng\u00e0y trong 12 tu\u1ea7n k\u00e8m Prednisone 1 mg\/kg\/ng\u00e0y trong 1 th\u00e1ng \u0111\u1ea7u r\u1ed3i gi\u1ea3m li\u1ec1u c\u00f2n 1 mg\/kg\/c\u00e1ch ng\u00e0y trong 6 th\u00e1ng ti\u1ebfp.
\n– N\u1ebfu sang th\u01b0\u01a1ng b\u1ec7nh c\u1ea7u th\u1eadn m\u00e0ng (MN):
\nTh\u00e1ng 1: Methylprednisolone 15 \u2013 30 mg\/kg\/ng\u00e0y x 3 li\u1ec1u (3 ng\u00e0y \u0111\u1ea7u) r\u1ed3i Prednisone 0,4 mg\/kg\/ng\u00e0y trong 27 ng\u00e0y ti\u1ebfp.
\nTh\u00e1ng 2: Chlorambucil 0,2 mg\/kg\/ng\u00e0y x 30 ng\u00e0y.<\/p>\n

L\u1eadp l\u1ea1i 3 \u0111\u1ee3t, xen k\u1ebd trong 6 th\u00e1ng.
\n– Sang th\u01b0\u01a1ng vi\u00eam c\u1ea7u th\u1eadn t\u0103ng sinh m\u00e0ng:<\/p>\n

Prednisone 1 \u2013 2 mg\/kg\/c\u00e1ch ng\u00e0y v\u00e0 gi\u1ea3m d\u1ea7n trong v\u00f2ng 12 \u2013 24 th\u00e1ng.
\n– N\u1ebfu kh\u00f4ng sinh thi\u1ebft th\u1eadn \u0111\u01b0\u1ee3c, s\u1ebd d\u00f9ng:
\nPrednisone 1 \u2013 2 mg\/kg\/c\u00e1ch ng\u00e0y v\u00e0 gi\u1ea3m d\u1ea7n trong v\u00f2ng 12 \u2013 24 th\u00e1ng K\u00c8M Cyclophosphamide 2,5 mg\/kg\/ng\u00e0y ho\u1eb7c Cyclosporine 5 mg\/kg\/ng\u00e0y.<\/p>\n

3. \u0110i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng:<\/h2>\n

a) Ph\u00f9:
\n– H\u1ea1n ch\u1ebf mu\u1ed1i v\u00e0 n\u01b0\u1edbc trong giai \u0111o\u1ea1n ph\u00f9.
\n– H\u1ea1n ch\u1ebf d\u00f9ng l\u1ee3i ti\u1ec3u trong h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0. Ch\u1ec9 d\u00f9ng trong tr\u01b0\u1eddng h\u1ee3p ph\u00f9 n\u1eb7ng, b\u00e1ng b\u1ee5ng to, hay tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i nhi\u1ec1u g\u00e2y kh\u00f3 th\u1edf, ph\u00f9 ph\u1ed5i, n\u1ee9t da do ph\u00f9 hay ph\u00f9 \u0111i k\u00e8m v\u1edbi nhi\u1ec5m tr\u00f9ng n\u1eb7ng. Thu\u1ed1c l\u1ee3i ti\u1ec3u d\u00f9ng trong HCTH: Chlorothiazide,
\nSpironolactone, Furosemide.
\n– Truy\u1ec1n Albumine: khi albumin m\u00e1u gi\u1ea3m th\u1ea5p k\u00e8m ph\u00f9 nhi\u1ec1u \u0111e d\u1ecda ph\u00f9 ph\u1ed5i kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb corticoids, truy\u1ec1n t\u0129nh m\u1ea1ch Albumine 1g\/kg trong 2 \u2013 3 gi\u1edd, truy\u1ec1n k\u00e8m v\u1edbi Furosemide 1 mg\/kg TM. Trong v\u00e0 sau khi truy\u1ec1n ph\u1ea3i lu\u00f4n theo d\u00f5i d\u1ea5u hi\u1ec7u qu\u00e1 t\u1ea3i v\u00e0 \u0111\u00e1p \u1ee9ng l\u1ee3i ti\u1ec3u c\u1ee7a b\u1ec7nh nh\u00e2n. N\u1ebfu sau truy\u1ec1n \u0111\u00e1p \u1ee9ng
\nl\u1ee3i ti\u1ec3u kh\u00f4ng t\u1ed1t h\u01a1n, kh\u00f4ng truy\u1ec1n ti\u1ebfp.
\nb) Bi\u1ec7n ph\u00e1p h\u1ed7 tr\u1ee3 kh\u00e1c:
\n– Cho th\u00eam vitamin D v\u00e0 Calcium (do HCTH l\u00e0m gi\u1ea3m chuy\u1ec3n h\u00f3a vitamin D, d\u1eabn \u0111\u1ebfn gi\u1ea3m h\u1ea5p th\u1ee5 Ca \u1edf ru\u1ed9t, ngo\u00e0i ra c\u00f3 th\u1ec3 g\u00e2y c\u01b0\u1eddng tuy\u1ebfn c\u1eadn gi\u00e1p (t\u0103ng PTH) do feedback h\u1ea1 Ca m\u00e1u l\u00ean tuy\u1ebfn c\u1eadn gi\u00e1p).<\/p>\n

– Ch\u1ec9 c\u1ea7n \u0103n l\u1ea1t trong giai \u0111o\u1ea1n ph\u00f9.
\n– Tr\u1ebb c\u00f3 th\u1ec3 sinh ho\u1ea1t b\u00ecnh th\u01b0\u1eddng.<\/p>\n

4. \u0110i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng:<\/h2>\n

a) Nhi\u1ec5m tr\u00f9ng:
\n– Tr\u01b0\u1edbc khi d\u00f9ng kh\u00e1ng sinh, ph\u1ea3i c\u1ea5y m\u00e1u, c\u1ea5y d\u1ecbch m\u00e0ng b\u1ee5ng v\u00e0 c\u00e1c d\u1ecbch c\u01a1 th\u1ec3 kh\u00e1c:
\n– Kh\u00e1ng sinh ban \u0111\u1ea7u trong vi\u00eam ph\u00fac m\u1ea1c nguy\u00ean ph\u00e1t: Cefotaxim 150 \u2013 200 mg\/kg\/ng\u00e0y TM chia 4 l\u1ea7n trong 10 ng\u00e0y v\u00e0 Gentamycine 5 mg\/kg\/ng\u00e0y TB.
\nb) T\u0103ng \u0111\u00f4ng:
\n– Ch\u00fa \u00fd ph\u00f2ng ng\u1eeba c\u00e1c y\u1ebfu t\u1ed1 thu\u1eadn l\u1ee3i cho t\u0103ng \u0111\u00f4ng: t\u00ecnh tr\u1ea1ng gi\u1ea3m th\u1ec3 t\u00edch, l\u1ee3i ti\u1ec3u, c\u1ea9n th\u1eadn khi l\u1ea5y m\u00e1u t\u0129nh m\u1ea1ch (tr\u00e1nh l\u1ea5y m\u00e1u t\u0129nh m\u1ea1ch \u0111\u00f9i), t\u00ecnh tr\u1ea1ng b\u1ea5t \u0111\u1ed9ng.
\n– Khi c\u00f3 huy\u1ebft kh\u1ed1i \u00e0 \u0111i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00e1ng \u0111\u00f4ng.<\/p>\n

5. Theo d\u00f5i v\u00e0 t\u00e1i kh\u00e1m:<\/h2>\n

– H\u1eb9n t\u00e1i kh\u00e1m m\u1ed7i 2 \u2013 4 tu\u1ea7n.
\n– Theo d\u00f5i: \u0111\u1ea1m ni\u1ec7u 24 gi\u1edd, ho\u1eb7c t\u1ef7 l\u1ec7 \u0111\u1ea1m ni\u1ec7u\/creatinine ni\u1ec7u,
\nt\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c.<\/p>\n

6. Ti\u1ebfn tri\u1ec3n v\u00e0 ti\u00ean l\u01b0\u1ee3ng<\/h2>\n

C\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng x\u1ea3y ra: n\u1ebfu \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi \u0111i\u1ec1u tr\u1ecb, HCTH c\u00f3 th\u1ec3 lui b\u1ec7nh v\u00e0 kh\u1ecfi<\/p>\n

h\u1eb3n ho\u00e0n to\u00e0n. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, b\u1ec7nh t\u00e1i ph\u00e1t nhi\u1ec1u \u0111\u1ee3t, nhi\u1ec1u n\u0103m li\u1ec1n r\u1ed3i<\/p>\n

lui b\u1ec7nh ho\u1eb7c chuy\u1ec3n sang suy th\u1eadn<\/p>\n

– Tu\u1ed5i.<\/p>\n

– Th\u1ec3 b\u1ec7nh: \u0111\u01a1n thu\u1ea7n, kh\u00f4ng \u0111\u01a1n thu\u1ea7n<\/p>\n

– Th\u01b0\u01a1ng t\u1ed5n gi\u1ea3i ph\u1ea9u b\u1ec7nh c\u1ee7a HCTH.<\/p>\n","protected":false},"excerpt":{"rendered":"

H\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0 (HCTH) l\u00e0 b\u1ec7nh c\u1ea7u th\u1eadn th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb em, \u0111a s\u1ed1 tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n, \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb corticoid, di\u1ec5n ti\u1ebfn m\u1ea1n t\u00ednh v\u1edbi c\u00e1c \u0111\u1ee3t t\u00e1i ph\u00e1t v\u00e0 t\u00e1i ph\u00e1t th\u01b0\u1eddng xuy\u00ean nh\u01b0ng \u00edt khi d\u1eabn t\u1edbi suy th\u1eadn m\u1ea1n. HCTH th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n t\u1ed5n […]<\/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":"\nTi\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0 - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0 (HCTH) l\u00e0 b\u1ec7nh c\u1ea7u th\u1eadn th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb em, \u0111a s\u1ed1 tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n, \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb corticoid\" \/>\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=\"Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0 - 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