{"id":29187,"date":"2023-05-13T17:07:18","date_gmt":"2023-05-13T10:07:18","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29187"},"modified":"2023-05-13T17:07:18","modified_gmt":"2023-05-13T10:07:18","slug":"phuc-hoi-chuc-nang-benh-nhan-ctsn-hau-cap-cuu-phan-1","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/13\/phuc-hoi-chuc-nang-benh-nhan-ctsn-hau-cap-cuu-phan-1\/","title":{"rendered":"Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng b\u00ea\u0323nh nh\u00e2n CTSN h\u00e2\u0323u c\u00e2\u0301p c\u01b0\u0301u (ph\u00e2\u0300n 1)"},"content":{"rendered":"<p><strong>Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng<\/strong> cho b\u1ec7nh nh\u00e2n <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/chan-thuong-so-nao-nhan-biet-va-dieu-tri-nao\/\">ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o<\/a> \u0111\u00f2i h\u1ecfi s\u1ef1 ch\u0103m s\u00f3c v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111a ph\u01b0\u01a1ng ti\u1ec7n, bao g\u1ed3m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p v\u1eadt l\u00fd tr\u1ecb li\u1ec7u, h\u1ed7 tr\u1ee3 t\u00e2m l\u00fd, gi\u00e1o d\u1ee5c v\u00e0 h\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i. Vi\u1ec7c theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u00fap b\u1ec7nh nh\u00e2n ph\u1ee5c h\u1ed3i v\u00e0 tr\u1edf l\u1ea1i cu\u1ed9c s\u1ed1ng b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>M\u1ed9t khi ra kh\u1ecfi Khoa c\u1ea5p c\u1ee9u, c\u00e1c bi\u1ec7n ph\u00e1p sau \u0111\u00e2y c\u1ea7n \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng (PHCN) cho ng\u01b0\u1eddi b\u1ec7nh CTSN \u1ed5n \u0111\u1ecbnh n\u1ed9i khoa. Nh\u1eefng bi\u1ec7n ph\u00e1p n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i b\u1ec7nh vi\u1ec7n ho\u1eb7c t\u1ea1i c\u1ed9ng \u0111\u1ed3ng (NICE, 2014; SIGN, 2013):<\/p>\n<ol>\n<li>D\u00e1ng \u0111i, Th\u0103ng b\u1eb1ng v\u00e0 kh\u1ea3 n\u0103ng V\u1eadn \u0111\u1ed9ng di chuy\u1ec3n<\/li>\n<li>Co c\u1ee9ng v\u00e0 Tr\u01b0\u01a1ng l\u1ef1c c\u01a1<\/li>\n<li>C\u00e1c Can thi\u1ec7p \u0111i\u1ec1u tr\u1ecb V\u1eadt l\u00fd.<\/li>\n<li>C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ki\u1ec3m so\u00e1t ti\u1ec3u ti\u1ec7n<\/li>\n<li>Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng Nh\u1eadn th\u1ee9c<\/li>\n<li>PHCN c\u00e1c R\u1ed1i lo\u1ea1n H\u00e0nh vi v\u00e0 C\u1ea3m x\u00fac<\/li>\n<li>Tr\u1ea7m c\u1ea3m v\u00e0 lo l\u00e2u.<\/li>\n<li>Ch\u1ee9c n\u0103ng Th\u1ecb gi\u00e1c kh\u00f4ng<\/li>\n<li>Giao ti\u1ebfp v\u00e0 nu\u1ed1t.<\/li>\n<li>R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng T\u00ecnh d\u1ee5c.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb \u0111au.<\/li>\n<li>PHCN ngh\u1ec1 nghi\u1ec7p.<\/li>\n<\/ol>\n<p>Ba\u0300i vi\u00ea\u0301t na\u0300y se\u0303 cung c\u00e2\u0301p th\u00f4ng tin v\u00ea\u0300 ca\u0301c bi\u00ea\u0323n pha\u0301p PHCN cu\u0309a 5 mu\u0323c \u0111\u00e2\u0300u ti\u00ean trong danh sa\u0301ch tr\u00ean. 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.<\/p>\n<figure id=\"attachment_29208\" aria-describedby=\"caption-attachment-29208\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-29208 size-large\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/NGUYEN-VAN-HUNG-T12-2020-1-1024x683.jpeg\" alt=\"Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng cho b\u00ea\u0323nh nh\u00e2n CTSN giai \u0111oa\u0323n h\u00e2\u0323u c\u00e2\u0301p c\u01b0\u0301u \" width=\"1024\" height=\"683\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/NGUYEN-VAN-HUNG-T12-2020-1-1024x683.jpeg 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/NGUYEN-VAN-HUNG-T12-2020-1-300x200.jpeg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/NGUYEN-VAN-HUNG-T12-2020-1-768x512.jpeg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/NGUYEN-VAN-HUNG-T12-2020-1-1536x1024.jpeg 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/NGUYEN-VAN-HUNG-T12-2020-1-2048x1365.jpeg 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption id=\"caption-attachment-29208\" class=\"wp-caption-text\">Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng cho b\u00ea\u0323nh nh\u00e2n CTSN giai \u0111oa\u0323n h\u00e2\u0323u c\u00e2\u0301p c\u01b0\u0301u<\/figcaption><\/figure>\n<h2>1. Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng \u01a1\u0309 d\u00e1ng \u0111i, Th\u0103ng b\u1eb1ng v\u00e0 V\u1eadn \u0111\u1ed9ng di chuy\u1ec3n<\/h2>\n<p><em>\u0110\u00e1nh gi\u00e1: Thang \u0111i\u1ec3m Th\u0103ng b\u1eb1ng Berg, Thang \u0111i\u1ec3m Tinetti<\/em><\/p>\n<h3>1.1. Ng\u1ed3i v\u00e0 Th\u0103ng b\u1eb1ng ng\u1ed3i<\/h3>\n<ul>\n<li>Ng\u01b0\u1eddi b\u1ec7nh b\u1ecb ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o kh\u00f4ng th\u1ec3 gi\u1eef th\u0103ng b\u1eb1ng ng\u1ed3i c\u1ea7n \u0111\u01b0\u1ee3c c\u1ea5p m\u1ed9t chi\u1ebfc xe l\u0103n ph\u00f9 h\u1ee3p v\u00e0 c\u00e1c bi\u1ec7n ph\u00e1p n\u00e2ng \u0111\u1ee1 ng\u1ed3i ph\u00f9 h\u1ee3p, v\u00e0 th\u01b0\u1eddng xuy\u00ean xem x\u00e9t l\u1ea1i h\u1ec7 th\u1ed1ng ng\u1ed3i khi nhu c\u1ea7u c\u1ee7a h\u1ecd thay \u0111\u1ed5i.<\/li>\n<li>Tr\u1ebb em v\u00e0 thanh thi\u1ebfu ni\u00ean c\u1ea7n \u0111\u01b0\u1ee3c cung c\u1ea5p xe l\u0103n v\u00e0 bi\u1ec7n ph\u00e1p n\u00e2ng \u0111\u1ee1 ng\u1ed3i ph\u00f9 h\u1ee3p v\u1edbi l\u1ee9a tu\u1ed5i.<\/li>\n<li>Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nhu c\u1ea7u t\u01b0 th\u1ebf ph\u1ee9c t\u1ea1p c\u1ea7n \u0111\u01b0\u1ee3c gi\u1edbi thi\u1ec7u \u0111\u1ebfn m\u1ed9t nh\u00f3m chuy\u00ean gia li\u00ean ng\u00e0nh, bao g\u1ed3m chuy\u00ean gia c\u00f3 chuy\u00ean m\u00f4n v\u1ec1 t\u01b0 th\u1ebf ng\u1ed3i.<\/li>\n<\/ul>\n<h3>1.2. \u0110i l\u1ea1i (D\u00e1ng \u0111i)<\/h3>\n<ul>\n<li>Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 kh\u1ea3 n\u0103ng v\u1eadn \u0111\u1ed9ng di chuy\u1ec3n c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t s\u1eed d\u1ee5ng c\u00e1c d\u1ee5ng c\u1ee5 tr\u1ee3 gi\u00fap \u0111\u1ee9ng ho\u1eb7c \u0111i ph\u00f9 h\u1ee3p.<\/li>\n<li>C\u00f3 th\u1ec3 h\u01b0\u1edbng d\u1eabn l\u1ea1i d\u00e1ng \u0111i b\u1eb1ng s\u1eed d\u1ee5ng m\u00e1y t\u1eadp \u0111i c\u00f3 n\u00e2ng \u0111\u1ee1 m\u1ed9t ph\u1ea7n tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3, t\u1eadp \u1edf thanh song song.<\/li>\n<li>T\u1eadp m\u1ea1nh c\u01a1 c\u00f3 th\u1ec3 gi\u00fap ki\u1ec3m so\u00e1t v\u1eadn \u0111\u1ed9ng v\u00e0 do \u0111\u00f3 tr\u1ee3 gi\u00fap cho d\u00e1ng \u0111i v\u00e0 ch\u1ee9c n\u0103ng.<\/li>\n<li>T\u1eadp \u0111i l\u1ea1i v\u00e0 v\u1eadn \u0111\u1ed9ng gi\u00fap c\u1ea3i thi\u1ec7n s\u1ee9c b\u1ec1n tim ph\u1ed5i (Nh\u00f3m C\u00e1c H\u01b0\u1edbng d\u1eabn New Zealand, 2006)<\/li>\n<li>C\u00e1c d\u1ee5ng c\u1ee5 tr\u1ee3 gi\u00fap v\u00e0 d\u1ee5ng c\u1ee5 ch\u1ec9nh h\u00ecnh: c\u00e1c d\u1ee5ng c\u1ee5 ch\u1ec9nh h\u00ecnh nh\u01b0 d\u1ee5ng c\u1ee5 ch\u1ec9nh h\u00ecnh c\u1ed5 b\u00e0n ch\u00e2n ho\u1eb7c n\u1eb9p b\u00e0n tay c\u00f3 th\u1ec3 gi\u00fap m\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh duy tr\u00ec t\u01b0 th\u1ebf b\u00ecnh th\u01b0\u1eddng ho\u1eb7c l\u00e0m v\u1eefng trong c\u00e1c v\u1eadn \u0111\u1ed9ng ch\u1ee9c n\u0103ng. Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 v\u1eadn \u0111\u1ed9ng di chuy\u1ec3n c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t s\u1eed d\u1ee5ng c\u00e1c d\u1ee5ng c\u1ee5 tr\u1ee3 gi\u00fap \u0111\u1ee9ng v\u00e0 \u0111i ph\u00f9 h\u1ee3p \u0111\u1ec3 c\u1ea3i thi\u1ec7n \u0111\u1ed9 v\u1eefng, c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c d\u1ee5ng c\u1ee5 ch\u1ec9nh h\u00ecnh c\u1ed5 b\u00e0n ch\u00e2n.<\/li>\n<li>C\u1ea7n ph\u1ea3i ch\u00fa \u00fd khi l\u1eafp d\u1ee5ng c\u1ee5 ch\u1ec9nh h\u00ecnh nh\u1eb1m tr\u00e1nh c\u00e1c v\u00f9ng \u0111\u00e8 \u00e9p, \u0111\u1eb7c bi\u1ec7t khi c\u00f3 bi\u1ebfn d\u1ea1ng ho\u1eb7c gi\u1ea3m c\u1ea3m gi\u00e1c.<\/li>\n<li>N\u1ebfu cung c\u1ea5p d\u1ee5ng c\u1ee5 ch\u1ec9nh h\u00ecnh th\u00ec n\u00f3 c\u1ea7n ph\u1ea3i v\u1eeba v\u00e0 h\u1ee3p v\u1edbi ng\u01b0\u1eddi b\u1ec7nh<\/li>\n<li>C\u00f4ng ngh\u1ec7 robot c\u00f3 th\u1ec3 s\u1ebd c\u00f3 s\u1eb5n tr\u00ean quy m\u00f4 r\u1ed9ng h\u01a1n.<\/li>\n<\/ul>\n<h2>2. Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng co c\u1ee9ng v\u00e0 tr\u01b0\u01a1ng l\u1ef1c c\u01a1<\/h2>\n<p><em>\u0110\u00e1nh gi\u00e1: Thang \u0111i\u1ec3m Ashworth c\u00f3 ch\u1ec9nh s\u1eeda (MAS)\u00a0<\/em><\/p>\n<p>Trong CTSN co c\u1ee9ng c\u00f3 b\u1ec7nh sinh t\u01b0\u01a1ng t\u1ef1 nh\u01b0 trong nh\u1eefng b\u1ec7nh g\u00e2y h\u1ed9i ch\u1ee9ng neurone v\u1eadn \u0111\u1ed9ng tr\u00ean (ngh\u0129a l\u00e0 li\u1ec7t trung \u01b0\u01a1ng), nh\u01b0 l\u00e0 CTSN.<\/p>\n<ul>\n<li>Co c\u1ee9ng c\u00f3 th\u1ec3 t\u0103ng l\u00ean b\u1edfi nhi\u1ec1u lo\u1ea1i k\u00edch th\u00edch (nh\u01b0 b\u00e0ng quang c\u0103ng, lo\u00e9t do t\u1ef3 \u0111\u00e8) v\u00e0 do \u0111\u00f3 c\u00e1c v\u1ea5n \u0111\u1ec1 n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c x\u1eed l\u00fd th\u00edch h\u1ee3p.<\/li>\n<li>Ki\u1ec3m so\u00e1t \u0111au v\u00e0 \u0111\u00e1nh gi\u00e1 t\u01b0 th\u1ebf n\u1eb1m, ng\u1ed3i l\u00e0 nh\u1eefng c\u00e2n nh\u1eafc \u0111\u1ea7u ti\u00ean quan tr\u1ecdng trong x\u1eed l\u00fd co c\u1ee9ng.<\/li>\n<li>C\u00f3 th\u1ec3 xem x\u00e9t s\u1eed d\u1ee5ng n\u1eb9p, b\u00f3 b\u1ed9t, k\u00e9o d\u00e3n th\u1ee5 \u0111\u1ed9ng trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p co r\u00fat v\u00e0 bi\u1ebfn d\u1ea1ng t\u0103ng ti\u1ebfn.<\/li>\n<li>N\u00ean s\u1eed d\u1ee5ng \u0111\u1ed9c t\u1ed1 Botulinum ph\u1ed1i h\u1ee3p v\u1edbi nh\u1eefng t\u00e1c \u0111\u1ed9ng t\u1eeb k\u1ef9 thu\u1eadt vi\u00ean VLTL\/H\u0110TL\/chuy\u00ean vi\u00ean ch\u1ec9nh h\u00ecnh khi th\u00edch h\u1ee3p<\/li>\n<li>Ti\u00eam phong b\u1ebf th\u1ea7n kinh<\/li>\n<li>Thu\u1ed1c u\u1ed1ng.<\/li>\n<li>Ph\u00f2ng ng\u1eeba co c\u1ee9ng l\u00e0 \u0111i\u1ec1u quan tr\u1ecdng. C\u00f3 th\u1ec3 ph\u00f2ng ng\u1eeba b\u1eb1ng khuy\u1ebfn kh\u00edch c\u00e1c m\u1eabu v\u1eadn \u0111\u1ed9ng v\u00e0 ch\u1ee9c n\u0103ng b\u00ecnh th\u01b0\u1eddng, gi\u1ea3m \u0111au v\u00e0 kh\u00f3 ch\u1ecbu, gi\u1ea3m s\u1ee3 h\u00e3i v\u00e0 c\u1ea9n th\u1eadn khi thao t\u00e1c v\u1edbi ng\u01b0\u1eddi b\u1ec7nh CTSN.<\/li>\n<\/ul>\n<h3>2.1. X\u1eed l\u00fd Co r\u00fat<\/h3>\n<ul>\n<li>Co r\u00fat l\u00e0 r\u00fat ng\u1eafn c\u00e1c m\u00f4 m\u1ec1m d\u1eabn \u0111\u1ebfn gi\u1ea3m t\u1ea7m v\u1eadn \u0111\u1ed9ng kh\u1edbp (ROM) do c\u00e1c khi\u1ebfm khuy\u1ebft (v\u00ed d\u1ee5 nh\u01b0 y\u1ebfu ho\u1eb7c co c\u1ee9ng) v\u00e0 \u0111\u1eb7t t\u01b0 th\u1ebf x\u1ea5u k\u00e9o d\u00e0i. \u0110\u1eb7c bi\u1ec7t ph\u1ed5 bi\u1ebfn l\u00e0 m\u1ea5t v\u1eadn \u0111\u1ed9ng xoay ngo\u00e0i vai, du\u1ed7i khu\u1ef7u, quay ng\u1eeda c\u1eb3ng tay, du\u1ed7i c\u1ed5 tay v\u00e0 ng\u00f3n tay v\u00e0 d\u1ea1ng ng\u00f3n c\u00e1i, g\u1eadp mu c\u1ed5 ch\u00e2n v\u00e0 xoay trong kh\u1edbp h\u00e1ng.<\/li>\n<li>Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh b\u1ecb y\u1ebfu li\u1ec7t c\u01a1 n\u1eb7ng \u0111\u1eb7c bi\u1ec7t c\u00f3 nguy c\u01a1 h\u00ecnh th\u00e0nh co r\u00fat b\u1edfi v\u00ec b\u1ea5t k\u1ef3 kh\u1edbp ho\u1eb7c c\u01a1 n\u00e0o kh\u00f4ng \u0111\u01b0\u1ee3c th\u01b0\u1eddng xuy\u00ean di chuy\u1ec3n ho\u1eb7c k\u00e9o d\u00e0i \u0111\u1ec1u c\u00f3 nguy c\u01a1 b\u1ecb c\u00e1c bi\u1ebfn ch\u1ee9ng m\u00f4 m\u1ec1m, cu\u1ed1i c\u00f9ng s\u1ebd l\u00e0m h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng v\u00e0 c\u00f3 th\u1ec3 g\u00e2y \u0111au.<\/li>\n<li>M\u1eb7c d\u00f9 m\u00f4 m\u1ec1m \u0111\u01b0\u1ee3c cho l\u00e0 c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c k\u00e9o d\u00e0i \u0111\u1ec3 ph\u00f2ng ng\u1eeba co r\u00fat, nh\u01b0ng can thi\u1ec7p ph\u00f9 h\u1ee3p nh\u1ea5t \u0111\u1ec3 ph\u00f2ng ng\u1eeba ho\u1eb7c x\u1eed l\u00fd co r\u00fat hi\u1ec7n v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c r\u00f5 v\u00e0 c\u00e1c chuy\u00ean gia c\u00f3 \u00fd ki\u1ebfn tr\u00e1i chi\u1ec1u<\/li>\n<li>\u0110\u1ec3 \u0111\u1ea3m b\u1ea3o duy tr\u00ec t\u1ea7m v\u1eadn \u0111\u1ed9ng, c\u1ea7n ph\u1ea3i theo d\u00f5i c\u00e1c c\u01a1 c\u00f3 nguy c\u01a1 b\u1ecb r\u00fat ng\u1eafn.<\/li>\n<li>C\u1ea7n \u00e1p d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb th\u00f4ng th\u01b0\u1eddng (nh\u01b0 k\u00e9o d\u00e3n, khuy\u1ebfn kh\u00edch v\u1eadn \u0111\u1ed9ng di chuy\u1ec3n, l\u00e0m m\u1ea1nh c\u01a1) cho nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN c\u00f3 nguy c\u01a1 ho\u1eb7c \u0111\u00e3 h\u00ecnh th\u00e0nh co r\u00fat.<\/li>\n<\/ul>\n<p>C\u00e1c k\u1ef9 thu\u1eadt vi\u00ean v\u1eadt l\u00fd tr\u1ecb li\u1ec7u \u0111\u00f3ng m\u1ed9t vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c ph\u00f2ng ng\u1eeba v\u00e0 x\u1eed l\u00fd c\u00e1c tr\u01b0\u1eddng h\u1ee3p co r\u00fat.<\/p>\n<h3>2.2. Vi\u00eam c\u01a1 c\u1ed1t ho\u00e1\/C\u1ed1t h\u00f3a l\u1ea1c ch\u1ed7<\/h3>\n<ul>\n<li>Ph\u00f2ng ng\u1eeba bi\u1ebfn ch\u1ee9ng n\u00e0y l\u00e0 quan tr\u1ecdng nh\u1ea5t, ch\u1eb3ng h\u1ea1n nh\u01b0 c\u1ea9n th\u1eadn kh\u00f4ng k\u00e9o d\u00e3n qu\u00e1 m\u1ee9c c\u00e1c kh\u1edbp, \u0111\u1eb7c bi\u1ec7t n\u1ebfu th\u1ef1c hi\u1ec7n c\u00e1c v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng.<\/li>\n<li>N\u1ebfu bi\u1ebfn ch\u1ee9ng n\u00e0y xu\u1ea5t hi\u1ec7n th\u00ec c\u1ea7n ph\u1ea3i ngh\u1ec9 ng\u01a1i v\u00e0 c\u1ea9n th\u1eadn khi thao t\u00e1c v\u1edbi kh\u1edbp b\u1ecb \u1ea3nh h\u01b0\u1edfng.<\/li>\n<\/ul>\n<h2>3. Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng b\u0103\u0300ng ca\u0301c ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u<\/h2>\n<ul>\n<li>Sinh ho\u1ea1t h\u00e0ng ng\u00e0y (ADL)<\/li>\n<li>Ch\u1ee9c n\u0103ng chi tr\u00ean<\/li>\n<\/ul>\n<h3>3.1. Sinh ho\u1ea1t h\u00e0ng ng\u00e0y (ADL)<\/h3>\n<p><em>\u0110\u00e1nh gi\u00e1: Ch\u1ec9 s\u1ed1 Barthel v\u00e0 \u0110o l\u01b0\u1eddng \u0110\u1ed9c l\u1eadp Ch\u1ee9c n\u0103ng (FIM)\u00a0<\/em><em>\u00a0<\/em><\/p>\n<ul>\n<li>T\u1ea5t c\u1ea3 c\u00e1c nhi\u1ec7m v\u1ee5 sinh ho\u1ea1t h\u00e0ng ng\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c t\u1eadp luy\u1ec7n trong m\u00f4i tr\u01b0\u1eddng th\u1ef1c t\u1ebf v\u00e0 th\u00edch h\u1ee3p nh\u1ea5t, v\u1edbi c\u01a1 h\u1ed9i th\u1ef1c h\u00e0nh k\u1ef9 n\u0103ng ngo\u00e0i c\u00e1c bu\u1ed5i tr\u1ecb li\u1ec7u.<\/li>\n<li>C\u1ea7n x\u00e2y d\u1ef1ng v\u00e0 th\u1ef1c hi\u1ec7n m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh \u0111i\u1ec1u tr\u1ecb ri\u00eang theo c\u00e1 nh\u00e2n nh\u1eb1m gia t\u0103ng t\u1ed1i \u0111a s\u1ef1 \u0111\u1ed9c l\u1eadp trong c\u00e1c l\u0129nh v\u1ef1c t\u1ef1 ch\u0103m s\u00f3c, lao \u0111\u1ed9ng v\u00e0 gi\u1ea3i tr\u00ed.<\/li>\n<li>Gia \u0111\u00ecnh v\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c c\u1ea7n tham gia thi\u1ebft l\u1eadp c\u00e1c th\u00f3i quen th\u00edch h\u1ee3p nh\u1ea5t cho c\u00e1c sinh ho\u1ea1t h\u00e0ng ng\u00e0y cho ng\u01b0\u1eddi b\u1ec7nh CTSN, c\u00f3 t\u00ednh \u0111\u1ebfn l\u1ed1i s\u1ed1ng v\u00e0 nh\u1eefng l\u1ef1a ch\u1ecdn c\u1ee7a h\u1ecd.<\/li>\n<li>T\u1ea5t c\u1ea3 nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN g\u1eb7p kh\u00f3 kh\u0103n trong c\u00e1c sinh ho\u1ea1t h\u00e0ng ng\u00e0y c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c l\u01b0\u1ee3ng gi\u00e1 b\u1edfi c\u00e1c k\u1ef9 thu\u1eadt vi\u00ean H\u0110TL, \u0111i\u1ec1u d\u01b0\u1ee1ng ho\u1eb7c c\u00e1n b\u1ed9 y t\u1ebf kh\u00e1c c\u00f3 chuy\u00ean m\u00f4n v\u00e0 kinh nghi\u1ec7m v\u1ec1 ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o.<\/li>\n<li>C\u00e1c d\u1ecbch v\u1ee5 ch\u0103m s\u00f3c y t\u1ebf c\u1ea7n nh\u1eadn th\u1ee9c r\u1eb1ng ch\u0103m s\u00f3c cho ng\u01b0\u1eddi b\u1ecb ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o c\u00f3 th\u1ec3 c\u00f3 ngh\u0129a l\u00e0 gi\u00e1m s\u00e1t v\u00e0 th\u1ef1c h\u00e0nh c\u00e1c k\u1ef9 n\u0103ng s\u1ed1ng \u1edf c\u1ed9ng \u0111\u1ed3ng ch\u1ee9 kh\u00f4ng ph\u1ea3i l\u00e0 ch\u0103m s\u00f3c th\u1ec3 ch\u1ea5t tr\u1ef1c ti\u1ebfp.<\/li>\n<li>C\u1ea7n cung c\u1ea5p c\u00e1c ch\u01b0\u01a1ng tr\u00ecnh t\u1eadp luy\u1ec7n \u0111\u1ec3 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng. C\u00e1c b\u00e0i t\u1eadp l\u00e0 nh\u1eb1m m\u1ee5c \u0111\u00edch s\u1eed d\u1ee5ng ch\u1ee9c n\u0103ng.<\/li>\n<\/ul>\n<h3>3.2. T\u1ea1o thu\u1eadn Ch\u1ee9c n\u0103ng Chi tr\u00ean<\/h3>\n<ul>\n<li>Th\u00f4ng th\u01b0\u1eddng s\u1ef1 h\u1ed3i ph\u1ee5c ho\u1ea1t \u0111\u1ed9ng c\u1ee7a chi tr\u00ean x\u1ea3y ra nhanh nh\u1ea5t trong 6 th\u00e1ng \u0111\u1ea7u sau ch\u1ea5n th\u01b0\u01a1ng.<\/li>\n<li>C\u1ea7n khuy\u1ebfn kh\u00edch th\u1ef1c h\u00e0nh c\u00e1c ho\u1ea1t \u0111\u1ed9ng c\u1ee7a chi tr\u00ean \u0111\u1eb7c bi\u1ec7t ch\u00fa tr\u1ecdng \u0111\u1ebfn c\u00e1c ho\u1ea1t \u0111\u1ed9ng t\u1eadp theo t\u00e1c v\u1ee5 c\u1ee5 th\u1ec3 v\u00e0 ch\u1ee9c n\u0103ng<\/li>\n<li>C\u00e1c lo\u1ea1i can thi\u1ec7p kh\u00e1c c\u00f3 th\u1ec3 l\u00e0:\n<ul>\n<li>T\u1eadp theo t\u00e1c v\u1ee5 l\u1eb7p l\u1ea1i nh\u01b0 v\u01b0\u01a1n t\u1edbi, n\u1eafm b\u1eaft, ch\u1ec9, di chuy\u1ec3n v\u00e0 \u0111i\u1ec1u khi\u1ec3n c\u00e1c \u0111\u1ed3 v\u1eadt trong c\u00e1c nhi\u1ec7m v\u1ee5 ch\u1ee9c n\u0103ng<\/li>\n<li>Th\u1ef1c h\u00e0nh qua t\u01b0\u1edfng t\u01b0\u1ee3ng (mental pratice) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem nh\u01b0 l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt h\u1ed7 tr\u1ee3 cho t\u1eadp luy\u1ec7n th\u00f4ng th\u01b0\u1eddng \u0111\u1ec3 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng c\u1ee7a chi tr\u00ean<\/li>\n<li>Nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh g\u1eb7p kh\u00f3 kh\u0103n khi s\u1eed d\u1ee5ng chi tr\u00ean c\u1ea7n c\u00f3 c\u01a1 h\u1ed9i th\u1ef1c h\u00e0nh c\u00e0ng nhi\u1ec1u c\u00e0ng t\u1ed1t c\u00e1c ho\u1ea1t \u0111\u1ed9ng c\u1ee7a chi tr\u00ean, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c nhi\u1ec7m v\u1ee5 ch\u1ee9c n\u0103ng v\u00e0 c\u00f3 m\u1ee5c \u0111\u00edch<\/li>\n<li>\u0110eo n\u1eb9p\n<ul>\n<li>\u0110\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh CTSN (c\u0169ng gi\u1ed1ng nh\u01b0 nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh sau \u0111\u1ed9t qu\u1ef5) c\u00f3 nguy c\u01a1 ho\u1eb7c \u0111\u00e3 h\u00ecnh th\u00e0nh co c\u1ee9ng v\u00e0 \u0111ang \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c PHCN to\u00e0n di\u1ec7n, vi\u1ec7c \u0111eo n\u1eb9p ho\u1eb7c \u0111\u1eb7t c\u00e1c c\u01a1 \u1edf t\u01b0 th\u1ebf k\u00e9o d\u00e3n trong m\u1ed9t th\u1eddi gian d\u00e0i m\u1ed9t c\u00e1ch th\u01b0\u1eddng quy kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o. Nh\u01b0ng n\u00ean c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng n\u1eb9p c\u1ed5 b\u00e0n tay \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nguy c\u01a1, v\u00ed d\u1ee5 nh\u01b0 nh\u1eefng ng\u01b0\u1eddi c\u00f3 b\u00e0n tay b\u1ea5t \u0111\u1ed9ng do y\u1ebfu, t\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1.<\/li>\n<li>N\u1ebfu s\u1eed d\u1ee5ng n\u1eb9p c\u1ed5 b\u00e0n tay, ch\u00fang c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c c\u00e1c nh\u00e2n vi\u00ean y t\u1ebf c\u00f3 tr\u00ecnh \u0111\u1ed9 l\u01b0\u1ee3ng gi\u00e1 v\u00e0 l\u1eafp \u0111\u1eb7t v\u00e0 ph\u1ea3i l\u1eadp k\u1ebf ho\u1ea1ch \u0111\u00e1nh gi\u00e1 l\u1ea1i.<\/li>\n<li>Khi ch\u1ec9 \u0111\u1ecbnh n\u1eb9p, \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i h\u01b0\u1edbng d\u1eabn cho ng\u01b0\u1eddi b\u1ec7nh CTSN v\u00e0 gia \u0111\u00ecnh\/ng\u01b0\u1eddi ch\u0103m s\u00f3c c\u00e1ch mang\/th\u00e1o v\u00e0 c\u00e1ch ch\u0103m s\u00f3c n\u1eb9p. C\u0169ng c\u1ea7n h\u01b0\u1edbng d\u1eabn vi\u1ec7c theo d\u00f5i ch\u1eb7t ch\u1ebd c\u00e1c d\u1ea5u hi\u1ec7u \u0111\u1ecf da v\u00e0 t\u1ed5n th\u01b0\u01a1ng<\/li>\n<\/ul>\n<\/li>\n<li>Tr\u1ecb li\u1ec7u v\u1edbi Robot, th\u1ef1c t\u1ebf \u1ea3o, k\u00edch th\u00edch \u0111i\u1ec7n, \u0111eo \u0111ai&#8230;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>4. Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng ki\u1ec3m so\u00e1t \u0111\u1ea1i ti\u1ec3u ti\u1ec7n<\/h2>\n<p>C\u1ea7n ph\u1ea3i ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1 \u0111\u1ea7y \u0111\u1ee7 ch\u1ee9c n\u0103ng b\u00e0ng quang v\u00e0 \u0111\u01b0\u1eddng ru\u1ed9t trong th\u1eddi gian nhi\u1ec1u ng\u00e0y sau khi nh\u1eadp vi\u1ec7n. C\u1ea7n xem x\u00e9t \u0111\u1ebfn ch\u1ee9c n\u0103ng th\u1ec3 ch\u1ea5t, nh\u1eadn th\u1ee9c v\u00e0 c\u1ea3m x\u00fac c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u00e0 nh\u00f3m \u0111a chuy\u00ean ng\u00e0nh n\u00ean ph\u1ed1i h\u1ee3p \u0111\u1ec3 l\u1eadp k\u1ebf ho\u1ea1ch can thi\u1ec7p cho t\u1eebng c\u00e1 nh\u00e2n.<\/p>\n<p>M\u1ed9t k\u1ebf ho\u1ea1ch ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng cho ti\u1ec3u kh\u00f4ng t\u1ef1 ch\u1ee7 c\u1ea7n bao g\u1ed3m:<\/p>\n<ul>\n<li>M\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh theo d\u00f5i \u0111\u1ec1u \u0111\u1eb7n.<\/li>\n<li>C\u00e1c bi\u1ec7n ph\u00e1p \u0111\u1ec3 th\u00f4ng b\u00e1o cho ng\u01b0\u1eddi ch\u0103m s\u00f3c bi\u1ebft ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nhu c\u1ea7u \u0111i ti\u1ec3u khi c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 giao ti\u1ebfp.<\/li>\n<li>M\u1ed9t ch\u1ebf \u0111\u1ed9 \u0111i v\u1ec7 sinh d\u1ef1a tr\u00ean k\u1ef9 thu\u1eadt c\u1ee7ng c\u1ed1 trong tr\u01b0\u1eddng h\u1ee3p suy gi\u1ea3m nh\u1eadn th\u1ee9c.<\/li>\n<\/ul>\n<p>Sau khi b\u1ecb CTSN, t\u00e1o b\u00f3n l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p do b\u1ea5t \u0111\u1ed9ng, s\u1eed d\u1ee5ng thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1ng cholinergic, x\u1ea5u h\u1ed5 v\u00ec thi\u1ebfu s\u1ef1 ri\u00eang t\u01b0, \u0103n u\u1ed1ng k\u00e9m. T\u00e1o b\u00f3n c\u00f3 th\u1ec3 tr\u1ea7m tr\u1ecdng th\u00eam do c\u00e1c v\u1ea5n \u0111\u1ec1 th\u1ea7n kinh kh\u00e1c k\u00e8m theo nh\u01b0 t\u1ed5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng. T\u00e1o b\u00f3n c\u00f3 th\u1ec3 g\u00e2y kh\u00f3 ch\u1ecbu v\u00e0 l\u00e0m co c\u1ee9ng tr\u1ea7m tr\u1ecdng th\u00eam.<\/p>\n<p>C\u1ea7n ph\u1ea3i b\u1eaft \u0111\u1ea7u m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh x\u1eed l\u00fd \u0111\u01b0\u1eddng ru\u1ed9t t\u00edch c\u1ef1c \u0111\u1ec3 thi\u1ebft l\u1eadp m\u1eabu b\u00ecnh th\u01b0\u1eddng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t, v\u1edbi s\u1ef1 h\u1ed7 tr\u1ee3 v\u00e0 gi\u00fap \u0111\u1ee1 c\u1ee7a ng\u01b0\u1eddi ch\u0103m s\u00f3c ch\u00ednh khi th\u00edch h\u1ee3p. \u0110i\u1ec1u n\u00e0y bao g\u1ed3m (Nh\u00f3m C\u00e1c H\u01b0\u1edbng d\u1eabn c\u1ee7a NewZeland, 2006):<\/p>\n<ul>\n<li>\u0110\u1ea3m b\u1ea3o \u0111\u1ee7 l\u01b0\u1ee3ng n\u01b0\u1edbc \u0111\u01b0a v\u00e0o.<\/li>\n<li>S\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t nhu\u1eadn tr\u00e0ng t\u1ef1 nhi\u00ean nh\u01b0 m\u1eadn, qu\u1ea3 Kiwi ho\u1eb7c thu\u1ed1c nhu\u1eadn tr\u00e0ng t\u1ea1o kh\u1ed1i \u0111\u01a1n gi\u1ea3n (n\u1ebfu u\u1ed1ng \u0111\u1ee7 n\u01b0\u1edbc).<\/li>\n<li>Khuy\u1ebfn kh\u00edch t\u1eadp v\u1eadn \u0111\u1ed9ng v\u00e0 \u0111\u1ee9ng, n\u1ebfu \u0111\u01b0\u1ee3c.<\/li>\n<li>Tr\u00e1nh d\u00f9ng c\u00e1c thu\u1ed1c l\u00e0m gi\u1ea3m nhu \u0111\u1ed9ng ru\u1ed9t, nh\u01b0 codeine v\u00e0 thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m ba v\u00f2ng.<\/li>\n<li>Ch\u00fa \u00fd \u0111\u1ea3m b\u1ea3o s\u1ef1 ri\u00eang t\u01b0 v\u00e0 tho\u1ea3i m\u00e1i t\u1ed1i \u0111a khi \u0111i v\u1ec7<\/li>\n<li>N\u00e2ng \u0111\u1ee1 ng\u01b0\u1eddi b\u1ec7nh ng\u1ed3i \u0111\u1ec3 \u0111\u1ea1i ti\u1ec7n l\u00ean m\u1ed9t b\u1ec7 x\u00ed ho\u1eb7c b\u00f4 v\u1ec7 sinh s\u1edbm nh\u1ea5t n\u1ebfu an to\u00e0n, v\u00e0 v\u00e0o m\u1ed9t th\u1eddi gian \u0111\u1ec1u \u0111\u1eb7n m\u1ed7i ng\u00e0y.<\/li>\n<\/ul>\n<h2>5. Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c<\/h2>\n<p><em>\u0110\u00e1nh gi\u00e1: Thang \u0111i\u1ec3m Rancho Los Amigos Scale (RLAS)\u00a0<\/em><em>\u00a0<\/em><\/p>\n<p>B\u1ea3n ch\u1ea5t c\u1ee7a c\u00e1c khi\u1ebfm khuy\u1ebft nh\u1eadn th\u1ee9c do CTSN ph\u1ea7n n\u00e0o ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng v\u00e0 v\u1ecb tr\u00ed c\u1ee7a t\u1ed5n th\u01b0\u01a1ng. C\u00e1c khi\u1ebfm khuy\u1ebft nh\u1eadn th\u1ee9c c\u00f3 th\u1ec3 bao g\u1ed3m: c\u00e1c kh\u00f3 kh\u0103n trong vi\u1ec7c hi\u1ec3u v\u00e0\/ho\u1eb7c t\u1ea1o l\u1eddi n\u00f3i; c\u00e1c kh\u00f3 kh\u0103n v\u1edbi ch\u00fa \u00fd, tr\u00ed nh\u1edb v\u00e0 kh\u1ea3 n\u0103ng t\u1eadp trung; c\u00e1c kh\u00f3 kh\u0103n v\u1edbi vi\u1ec7c b\u1eaft \u0111\u1ea7u v\u00e0 l\u1eadp k\u1ebf ho\u1ea1ch ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y; v\u00e0 c\u00e1c khi\u1ebfm khuy\u1ebft trong c\u00e1c nhi\u1ec7m v\u1ee5 nh\u1eadn th\u1ee9c kh\u00e1c nh\u01b0 suy lu\u1eadn, ph\u00e1n \u0111o\u00e1n, b\u1eaft \u0111\u1ea7u, l\u1eadp k\u1ebf ho\u1ea1ch, gi\u1ea3i quy\u1ebft v\u1ea5n \u0111\u1ec1 v\u00e0 ra quy\u1ebft \u0111\u1ecbnh. C\u00e1c khi\u1ebfm khuy\u1ebft t\u01b0\u01a1ng \u0111\u1ed1i nh\u1eb9 h\u01a1n trong c\u00e1c l\u0129nh v\u1ef1c nh\u01b0 \u01b0u ti\u00ean v\u00e0 ra quy\u1ebft \u0111\u1ecbnh c\u00f3 th\u1ec3 c\u00f3 \u1ea3nh h\u01b0\u1edfng s\u00e2u s\u1eafc \u0111\u1ebfn ho\u1ea1t \u0111\u1ed9ng ch\u1ee9c n\u0103ng.<\/p>\n<p>PHCN nh\u1eadn th\u1ee9c c\u1ea7n bao g\u1ed3m:<\/p>\n<ul>\n<li>Trong giai \u0111o\u1ea1n c\u1ea5p t\u00ednh, x\u1eed l\u00fd trong m\u1ed9t m\u00f4i tr\u01b0\u1eddng c\u00f3 c\u1ea5u tr\u00fac v\u00e0 kh\u00f4ng g\u00e2y ph\u00e2n t\u00e2m, c\u00e1c ch\u01b0\u01a1ng tr\u00ecnh h\u01b0\u1edbng m\u1ee5c ti\u00eau cho nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 kh\u00f3 kh\u0103n v\u1ec1 ch\u1ee9c n\u0103ng \u0111i\u1ec1u h\u00e0nh<\/li>\n<li>C\u1ed1 g\u1eafng t\u0103ng c\u01b0\u1eddng s\u1ef1 ch\u00fa \u00fd v\u00e0 c\u00e1c k\u1ef9 n\u0103ng x\u1eed l\u00fd th\u00f4ng tin (ch\u1ee9c n\u0103ng \u0111i\u1ec1u h\u00e0nh)<\/li>\n<li>H\u01b0\u1edbng d\u1eabn c\u00e1c k\u1ef9 thu\u1eadt b\u00f9 tr\u1eeb v\u00ed d\u1ee5 nh\u01b0 l\u00e0 c\u00e1c chi\u1ebfn l\u01b0\u1ee3c b\u00f9 tr\u1eeb tr\u00ed nh\u1edb ch\u00fa tr\u1ecdng v\u00e0o vi\u1ec7c c\u1ea3i thi\u1ec7n ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y thay v\u00ec khi\u1ebfm khuy\u1ebft tr\u00ed nh\u1edb<\/li>\n<li>S\u1eed d\u1ee5ng c\u00e1c tr\u1ee3 gi\u00fap tr\u00ed nh\u1edb b\u00ean ngo\u00e0i<\/li>\n<\/ul>\n<p>C\u1ea7n cung c\u1ea5p th\u00f4ng tin v\u00e0 h\u1ed7 tr\u1ee3 li\u00ean t\u1ee5c cho gia \u0111\u00ecnh v\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c n\u1ebfu c\u1ea7n thi\u1ebft \u0111\u1ec3 gi\u00fap h\u1ecd hi\u1ec3u c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 nh\u1eadn th\u1ee9c v\u00e0 h\u00e0nh vi, h\u01b0\u1edbng d\u1eabn c\u00e1ch t\u01b0\u01a1ng t\u00e1c ph\u00f9 h\u1ee3p v\u1edbi ng\u01b0\u1eddi b\u1ecb CTSN v\u00e0 c\u00e1ch ti\u1ebfp c\u1eadn c\u00e1c d\u1ecbch v\u1ee5 ch\u0103m s\u00f3c.<\/p>\n<p>\u0110\u1ec3 \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn th\u00eam v\u1ec1 Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c, xin tham kh\u1ea3o: C\u00e1c H\u01b0\u1edbng d\u1eabn Ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u cho CTSN.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng cho b\u1ec7nh nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o \u0111\u00f2i h\u1ecfi s\u1ef1 ch\u0103m s\u00f3c v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111a ph\u01b0\u01a1ng ti\u1ec7n, bao g\u1ed3m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p v\u1eadt l\u00fd tr\u1ecb li\u1ec7u, h\u1ed7 tr\u1ee3 t\u00e2m l\u00fd, gi\u00e1o d\u1ee5c v\u00e0 h\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i. Vi\u1ec7c theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng b\u00ea\u0323nh nh\u00e2n CTSN h\u00e2\u0323u c\u00e2\u0301p c\u01b0\u0301u (ph\u00e2\u0300n 1)<\/title>\n<meta name=\"description\" content=\"Phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng \u01a1\u0309 b\u1ec7nh nh\u00e2n CTSN g\u1ed3m ca\u0301c ph\u01b0\u01a1ng pha\u0301p v\u1eadt l\u00fd tr\u1ecb li\u1ec7u, h\u1ed7 tr\u1ee3 t\u00e2m l\u00fd, gi\u00e1o d\u1ee5c v\u00e0 h\u1ed7 tr\u1ee3 x\u00e3 h\u1ed9i.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, 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