{"id":29186,"date":"2023-05-06T22:14:34","date_gmt":"2023-05-06T15:14:34","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29186"},"modified":"2023-05-06T22:16:52","modified_gmt":"2023-05-06T15:16:52","slug":"chien-luoc-xu-ly-va-phong-ngua-ctsn-nhe-vua-va-nang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/chien-luoc-xu-ly-va-phong-ngua-ctsn-nhe-vua-va-nang\/","title":{"rendered":"Chi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 ph\u00f2ng ng\u1eeba CTSN nhe\u0323, v\u01b0\u0300a va\u0300 n\u0103\u0323ng"},"content":{"rendered":"
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Chi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 ph\u00f2ng ng\u1eeba <\/strong>ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o<\/strong><\/a> (CTSN) l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u c\u00e1c r\u1ee7i ro v\u00e0 h\u1ea1n ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o – m\u1ed9t v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u00e2\u0301n \u0111\u00ea\u0300 v\u1ec1 ch\u1ee9c n\u0103ng v\u00e0 s\u1ee9c kh\u1ecfe.<\/p>\n

Chi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o bao g\u1ed3m vi\u1ec7c \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng, gi\u1eef cho b\u1ec7nh nh\u00e2n \u1ed5n \u0111\u1ecbnh v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng. \u0110\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p nghi\u00eam tr\u1ecdng h\u01a1n, ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 gi\u1eef cho c\u1ea5u tr\u00fac s\u1ecd v\u00e0 n\u00e3o \u1ed5n \u0111\u1ecbnh h\u01a1n v\u00e0 gi\u1ea3m thi\u1ec3u s\u1ef1 t\u1ed5n th\u01b0\u01a1ng.<\/p>\n

Ph\u00f2ng ng\u1eeba ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o l\u00e0 m\u1ed9t ph\u1ea7n r\u1ea5t quan tr\u1ecdng c\u1ee7a chi\u1ebfn l\u01b0\u1ee3c n\u00e0y. C\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba bao g\u1ed3m \u0111eo m\u0169 b\u1ea3o hi\u1ec3m khi tham gia c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao ho\u1eb7c lao \u0111\u1ed9ng c\u00f3 nguy c\u01a1 ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o, gi\u1ea3m thi\u1ec3u c\u00e1c t\u00e1c \u0111\u1ed9ng c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng trong c\u00e1c tai n\u1ea1n giao th\u00f4ng, v\u00e0 \u0111\u1ea3m b\u1ea3o m\u00f4i tr\u01b0\u1eddng l\u00e0m vi\u1ec7c v\u00e0 h\u1ecdc t\u1eadp an to\u00e0n \u0111\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 ch\u1ea5n th\u01b0\u01a1ng.<\/p>\n

Ba\u0300i vi\u00ea\u0301t tham kha\u0309o t\u01b0\u0300 ta\u0300i li\u00ea\u0323u ban ha\u0300nh theo Quy\u1ebft \u0111\u1ecbnh s\u1ed1 5623 \/Q\u0110-BYT ng\u00e0y 21\/9\/2018 c\u1ee7a B\u1ed9 tr\u01b0\u1edfng B\u1ed9 Y t\u1ebf.\u00a0<\/em><\/p>\n

\"Ch\u00e2\u0301n
Chi\u00ea\u0301n l\u01b0\u01a1\u0323c x\u01b0\u0309 ly\u0301 va\u0300 pho\u0300ng ng\u01b0\u0300a ch\u00e2\u0301n th\u01b0\u01a1ng so\u0323 na\u0303o<\/figcaption><\/figure>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

1. Chi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 ph\u00f2ng ng\u1eeba \u0111\u00f4\u0301i v\u01a1\u0301i CTSN Nh\u1eb9<\/strong><\/h2>\n

B\u00ean c\u1ea1nh c\u00f3 \u0111i\u1ec3m s\u1ed1 Thang \u0111i\u1ec3m H\u00f4n m\u00ea Glasgow (GCS) t\u1eeb13-15, m\u1ed9t CTSN c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u00e0 nh\u1eb9 n\u1ebfu m\u1ea5t \u00fd th\u1ee9c v\u00e0\/ho\u1eb7c l\u00fa l\u1eabn v\u00e0 m\u1ea5t \u0111\u1ecbnh h\u01b0\u1edbng ng\u1eafn h\u01a1n 30 ph\u00fat.<\/p>\n

Trong khi k\u1ebft qu\u1ea3 ch\u1ee5p MRI v\u00e0 CT th\u01b0\u1eddng l\u00e0 b\u00ecnh th\u01b0\u1eddng, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 c\u00f3 nh\u1eefng v\u1ea5n \u0111\u1ec1 v\u1ec1 nh\u1eadn th\u1ee9c nh\u01b0 l\u00e0 nh\u1ee9c \u0111\u1ea7u, suy ngh\u0129 kh\u00f3 kh\u0103n, c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tr\u00ed nh\u1edb, ch\u00fa \u00fd k\u00e9m, thay \u0111\u1ed5i t\u00e2m tr\u1ea1ng v\u00e0 th\u1ea5t v\u1ecdng. Nh\u1eefng t\u1ed5n th\u01b0\u01a1ng n\u00e0y th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c ch\u00fa \u00fd \u0111\u1ebfn.<\/p>\n

Cho d\u00f9 lo\u1ea1i CTSN n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 “nh\u1eb9”, nh\u01b0ng \u1ea3nh h\u01b0\u1edfng l\u00ean gia \u0111\u00ecnh v\u00e0 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 n\u1eb7ng n\u1ec1.<\/p>\n

C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p \u1edf CTSN nh\u1eb9 bao g\u1ed3m:<\/p>\n

    \n
  • M\u1ec7t m\u1ecfi<\/li>\n
  • Nh\u1ee9c \u0111\u1ea7u<\/li>\n
  • C\u00e1c r\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c<\/li>\n
  • M\u1ea5t tr\u00ed nh\u1edb<\/li>\n
  • K\u00e9m ch\u00fa \u00fd\/t\u1eadp trung<\/li>\n
  • R\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7<\/li>\n
  • Ch\u00f3ng m\u1eb7t\/m\u1ea5t th\u0103ng b\u1eb1ng<\/li>\n
  • D\u1ec5 k\u00edch th\u00edch-r\u1ed1i lo\u1ea1n c\u1ea3m x\u00fac<\/li>\n
  • Tr\u1ea7m c\u1ea3m<\/li>\n
  • \u0110\u1ed9ng kinh<\/li>\n
  • Bu\u1ed3n n\u00f4n<\/li>\n
  • M\u1ea5t nh\u1eadn bi\u1ebft m\u00f9i<\/li>\n
  • Nh\u1ea1y c\u1ea3m v\u1edbi \u00e1nh s\u00e1ng v\u00e0 \u00e2m thanh<\/li>\n
  • Thay \u0111\u1ed5i t\u00e2m tr\u1ea1ng<\/li>\n
  • C\u1ea3m gi\u00e1c b\u1ecb l\u1ea1c ho\u1eb7c l\u1eabn l\u1ed9n<\/li>\n
  • Suy ngh\u0129 ch\u1eadm ch\u1ea1p<\/li>\n<\/ul>\n

    L\u01b0u \u00fd quan tr\u1ecdng:<\/p>\n

      \n
    • Kh\u00f4ng c\u00f3 ch\u1ee9ng c\u1ee9 cho th\u1ea5y c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00f4ng ph\u1ee9c t\u1ea1p c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb kh\u00e1c bi\u1ec7t \u1edf ng\u01b0\u1eddi CTSN nh\u1eb9 v\u00e0 nh\u1eefng ng\u01b0\u1eddi kh\u00e1c c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111\u00f3. T\u1ea5t c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c tr\u1ea5n an v\u1ec1 b\u1ea3n ch\u1ea5t c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y v\u00e0 khuy\u1ebfn c\u00e1o d\u1ea7n d\u1ea7n tr\u1edf l\u1ea1i c\u00e1c ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng.<\/li>\n
    • \u0110\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN nh\u1eb9 c\u00f3 nh\u1eefng tri\u1ec7u ch\u1ee9ng dai d\u1eb3ng, kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi s\u1ef1 \u0111\u1ed9ng vi\u00ean v\u00e0 an \u1ee7i c\u1ee7a ng\u01b0\u1eddi \u0111i\u1ec1u tr\u1ecb trong v\u00f2ng 3 th\u00e1ng, th\u00ec c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc \u0111\u1ec3 gi\u1edbi thi\u1ec7u h\u1ecd \u0111\u1ebfn d\u1ecbch v\u1ee5 tr\u1ecb li\u1ec7u nh\u1eadn th\u1ee9c h\u00e0nh vi. (SIGN, 2013)<\/li>\n
    • C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng c\u00e1c c\u00f4ng c\u1ee5 s\u00e0ng l\u1ecdc ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c.<\/li>\n
    • Gi\u00e1o d\u1ee5c v\u00e0 khuy\u1ebfn c\u00e1o cho ng\u01b0\u1eddi b\u1ec7nh CTSN v\u00e0 cho gia \u0111\u00ecnh\/ng\u01b0\u1eddi ch\u0103m s\u00f3c quan s\u00e1t b\u1ea5t k\u1ef3 thay \u0111\u1ed5i n\u00e0o xu\u1ea5t hi\u1ec7n \u1edf nh\u00e0 (v\u00ed d\u1ee5 nh\u01b0 c\u00e1c thay \u0111\u1ed5i v\u1ec1 h\u00e0nh vi\/ m\u1ee9c \u0111\u1ed9 t\u1ec9nh t\u00e1o).<\/li>\n
    • C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng m\u1ed9t t\u1edd th\u00f4ng tin khi xu\u1ea5t vi\u1ec7n \u0111\u1ec3 t\u00ecm ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 v\u1eady v\u00e0 nh\u1eefng vi\u1ec7c c\u1ea7n ph\u1ea3i l\u00e0m (xem Ph\u1ee5 l\u1ee5c 11 V\u00ed d\u1ee5 v\u1ec1 s\u00e1ch nh\u1ecf, t\u1edd g\u1ea5p \u0111\u01b0\u1ee3c, gi\u1ea5y xu\u1ea5t vi\u1ec7n cho ng\u01b0\u1eddi b\u1ec7nh Ch\u1ea5n th\u01b0\u01a1ng \u0110\u1ea7u Nh\u1eb9 RMH).<\/li>\n<\/ul>\n

      Ghi ch\u00fa: M\u1ed9t s\u1ed1 c\u00e1c tri\u1ec7u ch\u1ee9ng k\u1ec3 tr\u00ean c\u00f3 th\u1ec3 kh\u00f4ng xu\u1ea5t hi\u1ec7n ho\u1eb7c kh\u00f4ng \u0111\u01b0\u1ee3c ghi nh\u1eadn t\u1ea1i th\u1eddi \u0111i\u1ec3m b\u1ecb ch\u1ea5n th\u01b0\u01a1ng. Ch\u00fang c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n ch\u1eadm v\u00e0i ng\u00e0y ho\u1eb7c v\u00e0i tu\u1ea7n tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n. C\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y th\u01b0\u1eddng kh\u00f3 nh\u1eadn th\u1ea5y v\u00e0 th\u01b0\u1eddng b\u1ecb ng\u01b0\u1eddi b\u1ec7nh,\u00a0 gia \u0111\u00ecnh v\u00e0 b\u00e1c s\u0129 b\u1ecf s\u00f3t.<\/p>\n

      2. Chi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 ph\u00f2ng ng\u1eeba \u0111\u00f4\u0301i v\u01a1\u0301i CTSN V\u1eeba v\u00e0 N\u1eb7ng<\/h2>\n

      2.1. C\u00e1c R\u1ed1i lo\u1ea1n \u00dd th\u1ee9c k\u00e9o d\u00e0i (Prolonged Disorders of Consciousness, PDOC)<\/strong><\/h3>\n

      Sau ch\u1ea5n th\u01b0\u01a1ng n\u00e3o n\u1eb7ng, nhi\u1ec1u ng\u01b0\u1eddi b\u1ec7nh CTSN c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n qua c\u00e1c giai \u0111o\u1ea1n \u00fd th\u1ee9c kh\u00e1c nhau bao g\u1ed3m c\u00e1c giai \u0111o\u1ea1n h\u00f4n m\u00ea, t\u00ecnh tr\u1ea1ng th\u1ef1c v\u1eadt (Vegetative State, VS), Qu\u00ean sau Ch\u1ea5n th\u01b0\u01a1ng (PTA) cho \u0111\u1ebfn khi h\u1ecd tr\u1edf l\u1ea1i tr\u1ea1ng th\u00e1i \u00fd th\u1ee9c \u0111\u1ea7y \u0111\u1ee7. M\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh s\u1ebd v\u1eabn c\u00f2n \u1edf trong t\u00ecnh tr\u1ea1ng th\u1ef1c v\u1eadt v\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem l\u00e0 r\u1ed1i lo\u1ea1n \u00fd th\u1ee9c k\u00e9o d\u00e0i (prolonged disorders of consciousness, PDOC), ngh\u0129a l\u00e0 t\u1ed3n t\u1ea1i l\u00e2u h\u01a1n 4 tu\u1ea7n.<\/p>\n

      Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN n\u00e0y n\u00ean \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ebfn v\u00e0 x\u1eed l\u00fd b\u1edfi c\u00e1c \u0111\u01a1n v\u1ecb chuy\u00ean v\u1ec1 PDOC. Ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i \u0111\u01b0\u1ee3c th\u0103m kh\u00e1m b\u1edfi \u00edt nh\u1ea5t hai b\u00e1c s\u0129 chuy\u00ean v\u1ec1 \u0111\u00e1nh gi\u00e1 c\u00e1c r\u1ed1i lo\u1ea1n \u00fd th\u1ee9c. Nh\u1eefng b\u00e1c s\u0129 n\u00e0y c\u1ea7n tham kh\u1ea3o c\u00e1c quan \u0111i\u1ec3m c\u1ee7a nh\u00e2n vi\u00ean y t\u1ebf, c\u00e1c nh\u00e2n vi\u00ean l\u00e2m s\u00e0ng kh\u00e1c bao g\u1ed3m c\u00e1c nh\u00e0 t\u00e2m l\u00fd th\u1ea7n kinh l\u00e2m s\u00e0ng, c\u00e1c k\u1ef9 thu\u1eadt vi\u00ean ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u v\u00e0 k\u1ef9 thu\u1eadt vi\u00ean v\u1eadt l\u00fd tr\u1ecb li\u1ec7u, ng\u01b0\u1eddi ch\u0103m s\u00f3c v\u00e0 ng\u01b0\u1eddi th\u00e2n v\u1ec1 c\u00e1c ph\u1ea3n \u1ee9ng v\u00e0 \u0111\u00e1p \u1ee9ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh (Hi\u1ec7p H\u1ed9i C\u00e1c B\u00e1c s\u0129 Ho\u00e0ng Gia Anh qu\u1ed1c, 2013).<\/p>\n

      2.2. Chi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 ph\u00f2ng ng\u1eeba cho h\u00f4n m\u00ea<\/h3>\n

      L\u00e0 tr\u1ea1ng th\u00e1i ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng tu\u00e2n theo m\u1ec7nh l\u1ec7nh, kh\u00f4ng n\u00f3i v\u00e0 kh\u00f4ng m\u1edf m\u1eaft \u0111\u01b0\u1ee3c (ngh\u0129a l\u00e0, GCS 8 \u0111i\u1ec3m ho\u1eb7c th\u1ea5p h\u01a1n). (NICE, 2014)<\/p>\n

      Mu\u0323c \u0111i\u0301ch \u0111i\u00ea\u0300u tri\u0323<\/p>\n

        \n
      • Gi\u1eef v\u1ec7 sinh t\u1ed1t<\/li>\n
      • \u0110\u1ea3m b\u1ea3o cung c\u1ea5p d\u1ecbch v\u00e0 dinh d\u01b0\u1ee1ng<\/li>\n
      • Thi\u1ebft l\u1eadp v\u00e0 duy tr\u00ec \u0111\u01b0\u1eddng th\u1edf th\u00f4ng tho\u00e1ng<\/li>\n
      • Ng\u0103n ng\u1eeba nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p<\/li>\n
      • \u0110\u1eb7t t\u01b0 th\u1ebf \u0111\u00fang v\u00e0 xoay tr\u1edf th\u01b0\u1eddng xuy\u00ean<\/li>\n<\/ul>\n

        2.2.1. Gi\u1eef v\u1ec7 sinh t\u1ed1t<\/h4>\n
          \n
        • \u0110\u1ec3 ph\u00f2ng ng\u1eeba nhi\u1ec5m tr\u00f9ng v\u00e0 t\u1ed5n th\u01b0\u01a1ng da (bao g\u1ed3m c\u1ea3 lo\u00e9t do t\u1ef3 \u0111\u00e8) m\u00e0 c\u00f3 th\u1ec3 l\u00e0m t\u00ecnh tr\u1ea1ng x\u1ea5u \u0111i v\u00e0 c\u1ea3n tr\u1edf s\u1ef1 h\u1ed3i ph\u1ee5c<\/li>\n
        • C\u1ea7n x\u1eed l\u00fd ti\u1ec3u ti\u1ec7n kh\u00f4ng t\u1ef1 ch\u1ee7<\/li>\n
        • Gi\u1eef cho ng\u01b0\u1eddi b\u1ec7nh CTSN s\u1ea1ch s\u1ebd<\/li>\n<\/ul>\n

          \u0110\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin, xin tham kh\u1ea3o t\u00e0i li\u1ec7u y t\u1ebf v\u00e0 \u0111i\u1ec1u d\u01b0\u1ee1ng c\u00f3 li\u00ean quan.<\/p>\n

          2.2.2. \u0110\u1ea3m b\u1ea3o Cung c\u1ea5p D\u1ecbch v\u00e0 Dinh d\u01b0\u1ee1ng<\/h4>\n
            \n
          • T\u1ea5t c\u1ea3 nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd v\u1edbi t\u00ecnh tr\u1ea1ng cung c\u1ea5p d\u1ecbch v\u00e0 dinh d\u01b0\u1ee1ng. C\u1ea7n b\u1ed3i ph\u1ee5 d\u1ecbch m\u1ed9t c\u00e1ch th\u00edch h\u1ee3p \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ho\u1eb7c ph\u00f2ng ng\u1eeba m\u1ea5t n\u01b0\u1edbc.<\/li>\n
          • T\u1ea5t c\u1ea3 nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN c\u1ea7n \u0111\u01b0\u1ee3c s\u00e0ng l\u1ecdc v\u1ec1 suy dinh d\u01b0\u1ee1ng<\/li>\n
          • C\u00e1c ng\u01b0\u1eddi b\u1ec7nh, nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 suy dinh d\u01b0\u1ee1ng, k\u1ec3 c\u1ea3 nh\u1eefng ng\u01b0\u1eddi b\u1ecb kh\u00f3 nu\u1ed1t, n\u00ean \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u \u0111\u1ebfn m\u1ed9t chuy\u00ean gia dinh d\u01b0\u1ee1ng \u0111\u1ec3 \u0111\u01b0\u1ee3c l\u01b0\u1ee3ng gi\u00e1 v\u00e0 x\u1eed l\u00fd li\u00ean t\u1ee5c.<\/li>\n
          • Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN \u1edf trong t\u00ecnh tr\u1ea1ng h\u00f4n m\u00ea c\u1ea7n \u0111\u01b0\u1ee3c:\n
              \n
            • Cho \u0103n qua \u1ed1ng th\u00f4ng (m\u0169i – d\u1ea1 d\u00e0y) trong v\u00f2ng 24 gi\u1edd sau khi nh\u1eadp vi\u1ec7n<\/li>\n
            • C\u00e2n nh\u1eafc s\u1eed d\u1ee5ng \u1ed1ng th\u00f4ng m\u0169i c\u00f3 m\u00f3c (bridle) ho\u1eb7c ph\u1eabu thu\u1eadt m\u1edf th\u00f4ng d\u1ea1 d\u00e0y n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng th\u1ec3 ch\u1ecbu \u0111\u1ef1ng \u0111\u01b0\u1ee3c \u1ed1ng th\u00f4ng m\u0169i – d\u1ea1 d\u00e0y<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

              \u0110\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin, xin tham kh\u1ea3o t\u00e0i li\u1ec7u v\u1ec1 \u0111i\u1ec1u d\u01b0\u1ee1ng c\u00f3 li\u00ean quan.<\/p>\n

              2.2.3. Ph\u00f2ng ng\u1eeba nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p:<\/h4>\n
                \n
              • Nh\u1eb1m ph\u00f2ng ng\u1eeba t\u00ecnh tr\u1ea1ng suy gi\u1ea3m s\u1ee9c kho\u1ebb v\u00e0 t\u1eed<\/li>\n
              • \u0110\u1eb7t t\u01b0 th\u1ebf tr\u1ecb li\u1ec7u v\u00e0 thay \u0111\u1ed5i t\u01b0 th\u1ebf m\u1ed7i 2 gi\u1edd \u0111\u1ec3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho kh\u00f4ng kh\u00ed v\u00e0o t\u1ea5t c\u1ea3 c\u00e1c v\u00f9ng c\u1ee7a ph\u1ed5i.<\/li>\n
              • (N\u1ebfu c\u1ea7n) c\u00f3 th\u1ec3 h\u00fat \u0111\u1eddm gi\u1ea3i \u0111\u1ec3 l\u00e0m s\u1ea1ch v\u00e0 th\u00f4ng \u0111\u01b0\u1eddng th\u1edf.<\/li>\n<\/ul>\n

                2.2.4. \u0110\u1eb7t t\u01b0 th\u1ebf tr\u1ecb li\u1ec7u ph\u00f9 h\u1ee3p v\u00e0 xoay tr\u1edf th\u01b0\u1eddng xuy\u00ean<\/h4>\n
                  \n
                • Nh\u1eb1m th\u00fac \u0111\u1ea9y v\u00e0 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n ph\u1ee5c h\u1ed3i t\u1ed1i \u01b0u v\u1edbi CTSN th\u00f4ng qua:\n
                    \n
                  • Gi\u00fap b\u00ecnh th\u01b0\u1eddng ho\u00e1 tr\u01b0\u01a1ng l\u1ef1c c\u01a1.<\/li>\n
                  • Cung c\u1ea5p th\u00f4ng tin c\u1ea3m gi\u00e1c th\u00edch h\u1ee3p.<\/li>\n
                  • Ph\u00f2ng ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 lo\u00e9t do t\u1ef3 \u0111\u00e8, co r\u00fat, \u0111au v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 h\u00f4 h\u1ea5p<\/li>\n<\/ul>\n<\/li>\n
                  • N\u00ean thay \u0111\u1ed5i t\u01b0 th\u1ebf n\u1eb1m m\u1ed7i 2 gi\u1edd.<\/li>\n
                  • C\u00f3 th\u1ec3 c\u1ea7n c\u00e1c trang b\u1ecb \u0111\u1eb7c bi\u1ec7t nh\u01b0:\n
                      \n
                    • N\u1ec7m c\u1ee9ng (n\u1ec7m m\u1ec1m g\u00e2y kh\u00f3 kh\u0103n cho t\u1ea1o thu\u1eadn v\u1eadn \u0111\u1ed9ng ch\u1ee7 \u0111\u1ed9ng)<\/li>\n
                    • G\u1ed1i ch\u00eam v\u00e0 cu\u1ed9n x\u1ed1p\/v\u1ea3i \u0111\u1ec3 gi\u00fap duy tr\u00ec c\u00e1c t\u01b0 th\u1ebf tr\u1ecb li\u1ec7u c\u1ea7n thi\u1ebft<\/li>\n<\/ul>\n<\/li>\n
                    • C\u1ea9n th\u1eadn khi thao t\u00e1c v\u1edbi ng\u01b0\u1eddi b\u1ec7nh<\/li>\n
                    • \u0110\u1ed1i x\u1eed nh\u01b0 th\u1ec3 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c m\u1ecdi cu\u1ed9c tr\u00f2 chuy\u1ec7n<\/li>\n<\/ul>\n

                      Ghi ch\u00fa: Theo d\u00f5i th\u01b0\u1eddng xuy\u00ean c\u00e1c d\u1ea5u hi\u1ec7u sinh t\u1ed3n (\u0111\u1eb7c bi\u1ec7t l\u00e0 huy\u1ebft \u00e1p, nh\u1ecbp tim, nh\u1ecbp th\u1edf) v\u00e0 \u0111\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng dung n\u1ea1p v\u1edbi t\u1eebng t\u01b0 th\u1ebf<\/p>\n

                      \u0110\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin, xin tham kh\u1ea3o t\u00e0i li\u1ec7u v\u1ec1 y h\u1ecdc v\u00e0 \u0111i\u1ec1u d\u01b0\u1ee1ng li\u00ean quan.<\/p>\n

                      2.3.\u00a0 T\u00ecnh tr\u1ea1ng th\u1ef1c v\u1eadt k\u00e9o d\u00e0i (PVS)<\/h3>\n

                      \u0110\u00e2y l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n v\u1ec1 \u00fd th\u1ee9c, trong \u0111\u00f3 c\u00e1c ng\u01b0\u1eddi b\u1ec7nh b\u1ecb t\u1ed5n th\u01b0\u01a1ng n\u00e3o n\u1eb7ng n\u1ec1 \u1edf trong m\u1ed9t tr\u1ea1ng th\u00e1i th\u1ee9c t\u1ec9nh m\u1ed9t ph\u1ea7n ch\u1ee9 kh\u00f4ng t\u1ec9nh h\u1eb3n. Sau b\u1ed1n tu\u1ea7n \u1edf t\u00ecnh tr\u1ea1ng th\u1ef1c v\u1eadt (VS), ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u00e0 \u1edf t\u00ecnh tr\u1ea1ng th\u1ef1c v\u1eadt k\u00e9o d\u00e0i (PVS). Sau m\u1ed9t n\u0103m t\u1eeb khi ch\u1ea5n th\u01b0\u01a1ng, ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c x\u1ebfp l\u00e0 t\u00ecnh tr\u1ea1ng th\u1ef1c v\u1eadt v\u0129nh vi\u1ec5n (Permanent Vegetative State).<\/p>\n

                      Ch\u1ea9n \u0111o\u00e1n t\u00ecnh tr\u1ea1ng th\u1ef1c v\u1eadt ch\u1ec9 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ed1i thi\u1ec3u l\u00e0 1 th\u00e1ng sau khi ch\u1ea5n th\u01b0\u01a1ng v\u00e0 c\u1ea7n h\u1ed9i \u0111\u1ee7 t\u1ea5t c\u1ea3 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m sau \u0111\u00e2y (SIGN, 2013):<\/p>\n

                        \n
                      • Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 nh\u1eadn bi\u1ebft b\u1ea3n th\u00e2n ho\u1eb7c m\u00f4i tr\u01b0\u1eddng v\u00e0 kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c v\u1edbi ng\u01b0\u1eddi kh\u00e1c.<\/li>\n
                      • Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 c\u00e1c ph\u1ea3n \u1ee9ng h\u00e0nh vi ch\u1ee7 \u00fd, ho\u1eb7c c\u00f3 m\u1ee5c \u0111\u00edch c\u00f3 kh\u1ea3 n\u0103ng l\u1eb7p l\u1ea1i, b\u1ec1n v\u1eefng, \u0111\u1ed1i v\u1edbi c\u00e1c k\u00edch th\u00edch th\u1ecb gi\u00e1c, th\u00ednh gi\u00e1c, x\u00fac gi\u00e1c ho\u1eb7c \u0111au.<\/li>\n
                      • Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 hi\u1ec3u ho\u1eb7c di\u1ec5n \u0111\u1ea1t ng\u00f4n ng\u1eef.<\/li>\n
                      • S\u1ef1 t\u1ec9nh t\u00e1o kh\u00f4ng th\u01b0\u1eddng xuy\u00ean bi\u1ec3u hi\u1ec7n b\u1eb1ng s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a chu k\u1ef3 th\u1ee9c – ng\u1ee7.<\/li>\n
                      • C\u00e1c ch\u1ee9c n\u0103ng t\u1ef1 \u0111\u1ed9ng c\u1ee7a th\u00e2n n\u00e3o v\u00e0 v\u00f9ng d\u01b0\u1edbi \u0111\u1ed3i \u0111\u01b0\u1ee3c b\u1ea3o t\u1ed3n \u0111\u1ea7y \u0111\u1ee7 \u0111\u1ea3m b\u1ea3o s\u1ef1 s\u1ed1ng (t\u1ed3n t\u1ea1i) v\u1edbi ch\u0103m s\u00f3c y t\u1ebf v\u00e0 \u0111i\u1ec1u d\u01b0\u1ee1ng.<\/li>\n
                      • M\u1ea5t ki\u1ec3m so\u00e1t \u0111\u1ea1i v\u00e0 ti\u1ec3u ti\u1ec7n.<\/li>\n
                      • C\u00e1c ph\u1ea3n x\u1ea1 d\u00e2y th\u1ea7n kinh s\u1ecd n\u00e3o v\u00e0 ph\u1ea3n x\u1ea1 d\u00e2y th\u1ea7n kinh gai s\u1ed1ng \u0111\u01b0\u1ee3c b\u1ea3o t\u1ed3n m\u1ed9t ph\u1ea7n.<\/li>\n<\/ul>\n

                        \u00dd ki\u1ebfn c\u00e1c chuy\u00ean gia cho r\u1eb1ng v\u1ea5n \u0111\u1ec1 v\u0129nh vi\u1ec5n c\u1ee7a t\u00ecnh tr\u1ea1ng th\u1ef1c v\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra khi m\u1ed9t ng\u01b0\u1eddi b\u1ec7nh v\u1eabn duy tr\u00ec trong m\u1ed9t t\u00ecnh tr\u1ea1ng >12 th\u00e1ng sau t\u1ed5n th\u01b0\u01a1ng n\u00e3o do ch\u1ea5n th\u01b0\u01a1ng v\u00e0 >3 th\u00e1ng sau m\u1ed9t t\u1ed5n th\u01b0\u01a1ng n\u00e3o kh\u00f4ng do nguy\u00ean nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng (nh\u01b0 thi\u1ebfu oxy n\u00e3o).<\/p>\n

                        Sau th\u1eddi \u0111i\u1ec3m n\u00e0y, s\u1ef1 h\u1ed3i ph\u1ee5c \u00fd th\u1ee9c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem nh\u01b0 kh\u00f3 c\u00f3 th\u1ec3 x\u1ea3y ra nh\u01b0ng kh\u00f4ng ph\u1ea3i l\u00e0 kh\u00f4ng th\u1ec3 x\u1ea3y ra.<\/p>\n

                        \u0110i\u1ec1u tr\u1ecb<\/h3>\n

                        Ng\u01b0\u1eddi b\u1ec7nh \u1edf trong \u201ct\u00ecnh tr\u1ea1ng th\u1ef1c v\u1eadt\u201d c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i trong m\u1ed9t kho\u1ea3ng th\u1eddi gian k\u00e9o d\u00e0i, do \u0111\u00f3 \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 kh\u00f4ng \u0111\u1ec3 c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng x\u1ea3y ra. Do \u0111\u00f3 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb l\u00e0 nh\u1eb1m m\u1ee5c \u0111\u00edch duy tr\u00ec (xem H\u00f4n m\u00ea – \u1edf tr\u00ean).<\/p>\n

                        2.4. Ch\u1ee9ng Qu\u00ean Sau Ch\u1ea5n th\u01b0\u01a1ng (PTA)<\/h3>\n
                          \n
                        • L\u00e0 m\u1ed9t tr\u1ea1ng th\u00e1i l\u1eabn l\u1ed9n x\u1ea3y ra ngay sau t\u1ed5n th\u01b0\u01a1ng n\u00e3o do ch\u1ea5n th\u01b0\u01a1ng, trong \u0111\u00f3 ng\u01b0\u1eddi b\u1ecb ch\u1ea5n th\u01b0\u01a1ng b\u1ecb m\u1ea5t \u0111\u1ecbnh h\u01b0\u1edbng v\u00e0 kh\u00f4ng th\u1ec3 nh\u1edb nh\u1eefng s\u1ef1 ki\u1ec7n x\u1ea3y ra sau ch\u1ea5n th\u01b0\u01a1ng.<\/li>\n
                        • Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 kh\u00f4ng th\u1ec3 n\u00f3i \u0111\u01b0\u1ee3c t\u00ean c\u1ee7a m\u00ecnh, n\u01a1i ch\u1ed1n, v\u00e0 th\u1eddi gian hi\u1ec7n t\u1ea1i.<\/li>\n
                        • Trong khi PTA ti\u1ebfp di\u1ec5n, c\u00e1c s\u1ef1 ki\u1ec7n m\u1edbi kh\u00f4ng th\u1ec3 \u0111\u01b0\u1ee3c l\u01b0u tr\u1eef trong b\u1ed9 nh\u1edb.<\/li>\n
                        • Nh\u1eadn th\u1ee9c v\u1ec1 m\u00f4i tr\u01b0\u1eddng c\u1ee7a h\u1ecd c\u00f3 th\u1ec3 b\u1ecb b\u00f3p m\u00e9o v\u00e0 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 kh\u00f4ng nh\u1eadn th\u1ee9c \u0111\u01b0\u1ee3c t\u00ecnh tr\u1ea1ng c\u1ee7a h\u1ecd v\u00e0 c\u1ea7n ph\u1ea3i nh\u1eadp vi\u1ec7n. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 l\u00e0m n\u1eb7ng th\u00eam s\u1ef1 l\u1eabn l\u1ed9n ho\u1eb7c s\u1ee3 h\u00e3i c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh . S\u1ef1 l\u1eabn l\u1ed9n v\u00e0 m\u1ea5t \u0111\u1ecbnh h\u01b0\u1edbng nh\u01b0 v\u1eady c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng b\u1ed3n ch\u1ed3n, k\u00edch \u0111\u1ed9ng, g\u00e2y h\u1ea5n b\u1eb1ng l\u1eddi n\u00f3i v\u00e0 h\u00e0nh \u0111\u1ed9ng v\u00e0 ng\u01b0\u1eddi b\u1ec7nh th\u01b0\u1eddng \u0111i lang thang (Snow and Ponsford, 2013)<\/li>\n
                        • Khi tr\u00ed nh\u1edb li\u00ean t\u1ee5c tr\u1edf l\u1ea1i, PTA \u0111\u01b0\u1ee3c xem l\u00e0 \u0111\u00e3 k\u1ebft th\u00fac.<\/li>\n
                        • C\u00e1c nghi\u00ean c\u1ee9u ch\u1ee9ng t\u1ecf r\u1eb1ng th\u1eddi gian PTA c\u00e0ng d\u00e0i th\u00ec khi\u1ebfm khuy\u1ebft v\u1ec1 tr\u00ed tu\u1ec7 c\u00e0ng n\u1eb7ng v\u00e0 c\u00e0ng \u00edt c\u00f3 kh\u1ea3 n\u0103ng tr\u1edf l\u1ea1i l\u00e0m vi\u1ec7c (SIGN, 2013; Nh\u00f3m c\u00e1c H\u01b0\u1edbng d\u1eabn New Zealand, 2006; NICE, 2014)<\/li>\n<\/ul>\n

                          S\u00e0ng l\u1ecdc PTA\u00a0<\/strong><\/p>\n

                            \n
                          • Thang \u0111i\u1ec3m Qu\u00ean Sau Ch\u1ea5n th\u01b0\u01a1ng Westmead<\/li>\n
                          • S\u00e0ng l\u1ecdc n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi c\u00e1c k\u1ef9 thu\u1eadt vi\u00ean H\u0110TL<\/li>\n<\/ul>\n

                            \u0110i\u1ec1u tr\u1ecb<\/h3>\n
                              \n
                            • Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN khi b\u1ecb PTA \u00edt \u0111\u01b0\u1ee3c tr\u1ecb li\u1ec7u trong th\u1eddi gian PTA \u0111\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 b\u1ecb k\u00edch \u0111\u1ed9ng nh\u01b0ng c\u00f3 l\u00fd do cho th\u1ea5y tr\u1ecb li\u1ec7u v\u00e0o th\u1eddi \u0111i\u1ec3m n\u00e0y th\u1ef1c s\u1ef1 c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u00e0 gi\u00fap gi\u1ea3m th\u1eddi gian n\u1eb1m vi\u1ec7n (ISCRR, 2017).<\/li>\n
                            • \u0110i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 gi\u00fap cho ng\u01b0\u1eddi b\u1ec7nh CTSN v\u1eadn \u0111\u1ed9ng v\u00e0 an to\u00e0n.<\/li>\n
                            • Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb PTA t\u1ed1t nh\u1ea5t l\u00e0 tu\u00e2n th\u1ee7 c\u00e1c nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb h\u00e0nh vi trong \u0111\u00f3 \u0111\u1ed9i ng\u0169 nh\u00e2n vi\u00ean y t\u1ebf t\u1ea1o m\u1ed9t m\u00f4i tr\u01b0\u1eddng gi\u1ea3m thi\u1ec3u s\u1ef1 k\u00edch \u0111\u1ed9ng. C\u00e1c m\u00f4i tr\u01b0\u1eddng \u1ed3n \u00e0o v\u00e0 k\u00edch th\u00edch qu\u00e1 m\u1ee9c c\u00f3 xu h\u01b0\u1edbng l\u00e0m cho ng\u01b0\u1eddi b\u1ec7nh \u0111ang b\u1ecb PTA k\u00edch \u0111\u1ed9ng do \u0111\u00f3 t\u1ea1o ra m\u00f4i tr\u01b0\u1eddng y\u00ean t\u0129nh, an to\u00e0n v\u00e0 an ninh l\u00e0 \u0111i\u1ec1u r\u1ea5t quan tr\u1ecdng. Ng\u01b0\u1eddi b\u1ec7nh n\u00ean \u1edf ph\u00f2ng ri\u00eang v\u00e0 d\u00e0nh nhi\u1ec1u th\u1eddi gian \u1edf \u0111\u00f3 \u0111\u1ec3 l\u00e0m quen v\u1edbi m\u00f4i tr\u01b0\u1eddng c\u1ee7a h\u1ecd. Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN trong tr\u1ea1ng th\u00e1i n\u00e0y m\u00e0 c\u00f3 th\u1ec3 \u0111i \u0111\u01b0\u1ee3c n\u00ean \u0111\u01b0\u1ee3c ph\u00e9p \u0111i d\u1ea1o v\u1edbi s\u1ef1 gi\u00e1m s\u00e1t. C\u00f3 \u0111\u1ed9i ng\u0169 nh\u00e2n vi\u00ean c\u1ed1 \u0111\u1ecbnh, c\u00e1c b\u1ee9c \u1ea3nh gia \u0111\u00ecnh v\u00e0 b\u1ea3ng ch\u1ec9 \u0111\u01b0\u1eddng c\u0169ng l\u00e0m cho ng\u01b0\u1eddi b\u1ec7nh quen v\u1edbi m\u00f4i tr\u01b0\u1eddng c\u1ee7a h\u1ecd.<\/li>\n<\/ul>\n
                                \n
                              • C\u1ea7n h\u1ea1n ch\u1ebf s\u1ed1 ng\u01b0\u1eddi th\u0103m vi\u1ebfng v\u00e0 khuy\u1ebfn c\u00e1o h\u1ecd ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi b\u1ec7nh CTSN trong kho\u1ea3ng th\u1eddi gian ng\u1eafn.<\/li>\n
                              • Ng\u01b0\u1eddi b\u1ec7nh \u0111ang b\u1ecb PTA th\u01b0\u1eddng m\u1ec7t m\u1ecfi v\u00e0 c\u1ea7n ng\u1ee7 nhi\u1ec1u h\u01a1n, v\u00e0 c\u1ea7n khuy\u1ebfn kh\u00edch \u0111i\u1ec1u n\u00e0y<\/li>\n
                              • C\u1ea7n tr\u1ea5n an gia \u0111\u00ecnh\/ ng\u01b0\u1eddi ch\u0103m s\u00f3c v\u00e0 c\u00f3 th\u1ec3 cung c\u1ea5p c\u00e1c th\u00f4ng tin t\u00e0i li\u1ec7u cho gia \u0111\u00ecnh\/ng\u01b0\u1eddi ch\u0103m s\u00f3c t\u1ea1i th\u1eddi \u0111i\u1ec3m n\u00e0y.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

                                Chi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 ph\u00f2ng ng\u1eeba ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o (CTSN) l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u c\u00e1c r\u1ee7i ro v\u00e0 h\u1ea1n ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o – m\u1ed9t v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u00e2\u0301n \u0111\u00ea\u0300 v\u1ec1 ch\u1ee9c n\u0103ng v\u00e0 s\u1ee9c kh\u1ecfe. […]<\/p>\n","protected":false},"author":42,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nChi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 ph\u00f2ng ng\u1eeba CTSN nhe\u0323, v\u01b0\u0300a va\u0300 n\u0103\u0323ng - Vinmec<\/title>\n<meta name=\"description\" content=\"Chi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 ph\u00f2ng ng\u1eeba \u0111o\u0301ng vai tro\u0300 quan tro\u0323ng trong vi\u00ea\u0323c gi\u1ea3m thi\u1ec3u c\u00e1c r\u1ee7i ro v\u00e0 h\u1ea1n ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o.\" \/>\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=\"Chi\u1ebfn l\u01b0\u1ee3c x\u1eed l\u00fd v\u00e0 ph\u00f2ng ng\u1eeba CTSN nhe\u0323, v\u01b0\u0300a va\u0300 n\u0103\u0323ng - 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