{"id":29674,"date":"2023-05-02T16:04:19","date_gmt":"2023-05-02T09:04:19","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29674"},"modified":"2023-05-02T16:04:19","modified_gmt":"2023-05-02T09:04:19","slug":"cap-nhap-ky-thuat-cat-loc-nhu-mo-gan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/02\/cap-nhap-ky-thuat-cat-loc-nhu-mo-gan\/","title":{"rendered":"C\u1eadp nh\u1eadp k\u1ef9 thu\u1eadt c\u1eaft l\u1ecdc nhu m\u00f4 gan"},"content":{"rendered":"

C\u1eaft l\u1ecdc nhu m\u00f4 gan \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 ch\u1ec9 vi\u1ec7c c\u1eaft b\u1ecf t\u1ed5 ch\u1ee9c gan t\u1ed5n th\u01b0\u01a1ng do ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c \u00e1p xe ho\u1ea1i t\u1eed t\u1ed5 ch\u1ee9c gan. Vi\u1ec7c c\u1eaft l\u1ecdc nhu m\u00f4 c\u1ea7n theo nguy\u00ean t\u1eafc ti\u1ebft ki\u1ec7m t\u1ed1i \u0111a t\u1ed5 ch\u1ee9c gan l\u00e0nh b\u1ecb c\u1eaft b\u1ecf nh\u01b0ng c\u0169ng ph\u1ea3i \u0111\u1ea3m b\u1ea3o l\u1ea5y h\u1ebft t\u1ed5 ch\u1ee9c b\u1ec7nh l\u00fd kh\u00f4ng c\u00f2n kh\u1ea3 n\u0103ng ph\u1ee5c h\u1ed3i.<\/strong><\/p>\n

\"\"<\/p>\n

1. Ch\u1ec9 \u0111\u1ecbnh<\/b><\/h2>\n

– Ch\u1ea5n th\u01b0\u01a1ng gan<\/a>: nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng gan ph\u1ea3i m\u1ed5 c\u1ea5p c\u1ee9u kh\u00f4ng \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n \u0111\u01b0\u1ee3c. Trong qu\u00e1 tr\u00ecnh x\u1eed tr\u00ed nhu m\u00f4 gan v\u1ee1 c\u1ea7n c\u1eaft l\u1ecdc t\u1ed5 ch\u1ee9c gan v\u1ee1 kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng ph\u1ee5c h\u1ed3i (m\u1ea5t cu\u1ed1ng m\u1ea1ch) ho\u1eb7c \u0111\u00f4i khi vi\u1ec7c c\u1eaft l\u1ecdc nh\u1eb1m b\u1ed9c l\u1ed9 r\u00f5 t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch (t\u0129nh m\u1ea1ch gan, \u0110M gan\u2026) \u0111ang ch\u1ea3y m\u00e1u gi\u00fap vi\u1ec7c x\u1eed l\u00fd c\u1ea7m m\u00e1u \u0111\u01b0\u1ee3c t\u1ed1t.<\/p>\n

– \u00c1p xe gan<\/a>: Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u00e1p xe gan \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n (n\u1ed9i khoa v\u00e0 ch\u1ecdc h\u00fat \u00e1p xe) th\u1ea5t b\u1ea1i c\u1ea7n \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt th\u00e1o m\u1ee7 v\u00e0 c\u1eaft l\u1ecdc t\u1ed5 ch\u1ee9c gan ho\u1ea1i t\u1eed v\u00e0 m\u1edf r\u1ed9ng \u1ed5 \u00e1p xe gi\u00fap vi\u1ec7c d\u1eabn l\u01b0u sau m\u1ed5 hi\u1ec7u qu\u1ea3.<\/p>\n

2. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/b><\/h2>\n

Kh\u00f4ng ch\u1ec9 \u0111\u1ecbnh c\u1eaft l\u1ecdc nhu m\u00f4 gan \u0111\u1ed1i v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u00e1c t\u00ednh<\/p>\n

3. Chu\u1ea9n b\u1ecb<\/b><\/h2>\n

3.1. Ng\u01b0\u1eddi th\u1ef1c hi\u1ec7n:<\/b><\/h3>\n

– L\u00e0 ph\u1eabu thu\u1eadt vi\u00ean chuy\u00ean khoa ti\u00eau ho\u00e1, gan m\u1eadt.<\/p>\n

– C\u00f3 kinh nghi\u1ec7m ph\u1eabu thu\u1eadt gan m\u1eadt > 5 n\u0103m.<\/p>\n

– C\u00f3 kinh nghi\u1ec7m c\u1eaft gan<\/p>\n

3.2. Ng\u01b0\u1eddi b\u1ec7nh:<\/b><\/h3>\n

– Ng\u00e0y tr\u01b0\u1edbc m\u1ed5 ph\u1ea3i \u0111\u01b0\u1ee3c v\u1ec7 sinh th\u00e2n th\u1ec3, c\u1ea1o l\u00f4ng b\u1ed9 ph\u1eadn sinh d\u1ee5c, th\u1ee5t th\u00e1o s\u1ea1ch, trong tr\u01b0\u1eddng h\u1ee3p c\u1eaft gan l\u1edbn ph\u1ea3i \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb \u0111\u1ea1i tr\u00e0ng. \u0110\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng gan ph\u1ea3i m\u1ed5 c\u1ea5p c\u1ee9u th\u00ec t\u1ed1i thi\u1ec3u ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u1eb7t m\u1ed9t vein truy\u1ec1n t\u0129nh m\u1ea1ch \u0111\u1ee7 l\u1edbn \u0111\u1ec3 b\u00f9 d\u1ecbch v\u00e0 m\u00e1u, t\u1ed1t nh\u1ea5t l\u00e0 c\u00f3 \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch trung \u01b0\u01a1ng.<\/p>\n

– Ng\u01b0\u1eddi b\u1ec7nh v\u00e0 ng\u01b0\u1eddi nh\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 b\u1ec7nh l\u00fd, v\u1ec1 quy tr\u00ecnh ph\u1eabu thu\u1eadt, c\u00e1c tai bi\u1ebfn r\u1ee7i ro c\u00f3 th\u1ec3 x\u1ea3y ra trong v\u00e0 sau ph\u1eabu thu\u1eadt.<\/p>\n

3.3. Ph\u01b0\u01a1ng ti\u1ec7n:<\/b><\/h3>\n

– Khung van x\u00edch k\u00e9o th\u00e0nh b\u1ee5ng.<\/p>\n

– B\u1ed9 ph\u1eabu thu\u1eadt ti\u00eau ho\u00e1 th\u00f4ng th\u01b0\u1eddng<\/p>\n

– Ch\u1ec9 ph\u1eabu thu\u1eadt 2.0 tr\u1edf l\u00ean \u0111\u1ec3 kh\u00e2u c\u1ea7m m\u00e1u nhu m\u00f4\u2026<\/p>\n

4. C\u00e1c b\u01b0\u1edbc ti\u1ebfn h\u00e0nh<\/b><\/h2>\n

4.1. T\u01b0 th\u1ebf:<\/b><\/h3>\n

– Ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m ng\u1eeda, 2 tay d\u1ea1ng vu\u00f4ng g\u00f3c v\u1edbi ng\u01b0\u1eddi.<\/p>\n

– Ph\u1eabu thu\u1eadt vi\u00ean \u0111\u1ee9ng b\u00ean ph\u1ea3i ng\u01b0\u1eddi b\u1ec7nh, ng\u01b0\u1eddi ph\u1ee5 1 v\u00e0 2 \u0111\u1ee9ng b\u00ean tr\u00e1i, d\u1ee5ng c\u1ee5 vi\u00ean \u0111\u1ee9ng c\u00f9ng b\u00ean ph\u1eabu thu\u1eadt vi\u00ean.<\/p>\n

4.2. V\u00f4 c\u1ea3m:<\/b><\/h3>\n

– G\u00e2y m\u00ea n\u1ed9i kh\u00ed qu\u1ea3n, \u0111\u1eb7t sonde d\u1ea1 d\u00e0y, \u0111\u1eb7t sonde ti\u1ec3u, vein ngo\u1ea1i vi v\u00e0 trung \u01b0\u01a1ng. Th\u01b0\u1eddng k\u00ea m\u1ed9t g\u1ed1i nh\u1ecf \u1edf m\u0169i \u1ee9c \u0111\u1ec3 b\u1ed9c l\u1ed9 r\u00f5 \u0111\u01b0\u1eddng m\u1ed5, s\u00e1t tr\u00f9ng to\u00e0n b\u1ed9 \u1ed5 b\u1ee5ng t\u1eeb d\u01b0\u1edbi n\u00fam v\u00fa \u0111\u1ebfn x\u01b0\u01a1ng mu.<\/p>\n

4.3. K\u1ef9 thu\u1eadt:<\/b><\/h3>\n

– B\u01b0\u1edbc 1: m\u1edf b\u1ee5ng: t\u00f9y theo k\u00edch th\u01b0\u1edbc th\u01b0\u01a1ng t\u1ed5n m\u00e0 c\u00f3 th\u1ec3 l\u1ef1a ch\u1ecdn c\u00e1c \u0111\u01b0\u1eddng m\u1ed5 nh\u01b0: \u0110\u01b0\u1eddng tr\u1eafng gi\u1eefa tr\u00ean d\u01b0\u1edbi r\u1ed1n, \u0111\u01b0\u1eddng d\u01b0\u1edbi s\u01b0\u1eddn m\u1edf r\u1ed9ng l\u00ean m\u0169i \u1ee9c (\u0111\u01b0\u1eddng Mercedes) ho\u1eb7c \u0111\u01b0\u1eddng ch\u1eef d\u01b0\u1edbi s\u01b0\u1eddn b\u00ean ph\u1ea3i.<\/p>\n

– B\u01b0\u1edbc 2: \u0110\u00e1nh gi\u00e1 th\u01b0\u01a1ng t\u1ed5n \u0111\u1ea1i th\u1ec3 to\u00e0n b\u1ed9 gan v\u00e0 ph\u1ea7n gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng. Ch\u00e8n g\u1ea1c t\u1ea1m th\u1eddi \u0111\u1ed1i v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u0111ang ch\u1ea3y m\u00e1u. Th\u0103m kh\u00e1m, \u0111\u00e1nh gi\u00e1 c\u00e1c b\u1ed9 ph\u1eadn kh\u00e1c nh\u01b0: d\u1ea1 d\u00e0y, ru\u1ed9t non, \u0111\u1ea1i tr\u00e0ng, l\u00e1ch\u2026<\/p>\n

– B\u01b0\u1edbc 3: Gi\u1ea3i ph\u00f3ng gan: Tu\u1ef3 t\u1ed5n th\u01b0\u01a1ng m\u00e0 ti\u1ebfn h\u00e0nh gi\u1ea3i ph\u00f3ng gan b\u00ean n\u00e0o ho\u1eb7c \u0111\u00f4i khi ph\u1ea3i gi\u1ea3i ph\u00f3ng c\u1ea3 2 b\u00ean gan b\u1eb1ng vi\u1ec7c c\u1eaft d\u00e2y ch\u1eb1ng tr\u00f2n, d\u00e2y ch\u1eb1ng li\u1ec1m, d\u00e2y ch\u1eb1ng tam gi\u00e1c.<\/p>\n

– B\u01b0\u1edbc 4: Ki\u1ec3m so\u00e1t cu\u1ed1ng gan c\u00f3 th\u1ec3 lu\u1ed3n d\u00e2y ki\u1ec3m so\u00e1t to\u00e0n b\u1ed9 cu\u1ed1ng gan tr\u01b0\u1edbc khi ti\u1ebfn h\u00e0nh c\u1eaft l\u1ecdc nhu m\u00f4 gan. C\u00f3 th\u1ec3 ki\u1ec3m so\u00e1t to\u00e0n b\u1ed9 cu\u1ed1ng ho\u1eb7c ch\u1ecdn l\u1ecdc n\u1eeda cu\u1ed1ng gan.<\/p>\n

– B\u01b0\u1edbc 5: C\u1eaft l\u1ecdc nhu m\u00f4 gan<\/p>\n

+ Nh\u1eadn \u0111\u1ecbnh ranh gi\u1edbi v\u00f9ng nhu m\u00f4 gan ho\u1ea1i t\u1eed ho\u1eb7c kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng h\u1ed3i ph\u1ee5c v\u1edbi nhu m\u00f4 gan l\u00e0nh. Vi\u1ec7c c\u1eaft l\u1ecdc kh\u00f4ng theo gi\u1ea3i ph\u1eabu m\u00e0 theo th\u01b0\u01a1ng t\u1ed5n nh\u01b0ng c\u1ea7n \u0111\u1ea3m b\u1ea3o ph\u1ea7n nhu gan \u0111\u1ec3 l\u1ea1i \u0111\u01b0\u1ee3c nu\u00f4i d\u01b0\u1ee1ng v\u00e0 d\u1eabn l\u01b0u m\u00e1u t\u0129nh m\u1ea1ch t\u1ed1t.<\/p>\n

+ C\u1eaft nhu m\u00f4 gan b\u1eb1ng pincer, b\u1eb1ng dao si\u00eau \u00e2m. Trong qu\u00e1 tr\u00ecnh c\u1eaft nhu m\u00f4 gan c\u00f3 th\u1ec3 c\u1eb7p cu\u1ed1ng gan to\u00e0n b\u1ed9, th\u1eddi gian c\u1eb7p m\u1ed7i l\u1ea7n kh\u00f4ng qu\u00e1 15\u2019, gi\u1eefa c\u00e1c l\u1ea7n c\u1eb7p ngh\u1ec9 5\u2019 ho\u1eb7c kh\u00f4ng (b\u1ea3n th\u00e2n cu\u1ed1ng tr\u00e1i \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1eb7p ch\u1ecdn l\u1ecdc). Ph\u1eabu t\u00edch v\u00e0 bu\u1ed9c to\u00e0n b\u1ed9 c\u00e1c nh\u00e1nh m\u1ea1ch \u1edf di\u1ec7n c\u1eaft gan c\u00f3 th\u1ec3 d\u00f9ng dao l\u01b0\u1ee1ng c\u1ef1c, clip m\u1ea1ch m\u00e1u ho\u1eb7c dao si\u00eau \u00e2m \u0111\u1ec3 c\u1ea7m m\u00e1u c\u00e1c nh\u00e1nh nh\u1ecf.<\/p>\n

+ Ki\u1ec3m tra c\u1ea7m m\u00e1u di\u1ec7n c\u1eaft gan: sau khi c\u1eaft gan xong c\u1ea7n ki\u1ec3m tra c\u1ea9n th\u1eadn v\u00e0 kh\u00e2u c\u1ea7m m\u00e1u c\u00e1c m\u0169i ch\u1eef X, U nh\u1eefng \u0111i\u1ec3m ch\u1ea3y m\u00e1u, ho\u1eb7c \u0111\u1ed1t \u0111i\u1ec7n dao l\u01b0\u1ee1ng c\u1ef1c. Tr\u01b0\u1eddng h\u1ee3p r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u, kh\u00f4ng c\u1ea7m \u0111\u01b0\u1ee3c m\u00e1u ph\u1ea3i ch\u00e8n g\u1ea1c \u1edf di\u1ec7n c\u1eaft gan ho\u1eb7c kh\u00e2u \u00e9p to\u00e0n b\u1ed9 di\u1ec7n c\u1eaft gan.<\/p>\n

+ C\u00f3 th\u1ec3 ph\u1ea3i d\u1eabn l\u01b0u \u0111\u01b0\u1eddng m\u1eadt ho\u1eb7c m\u1edf \u0111\u01b0\u1eddng m\u1eadt l\u1ea5y s\u1ecfi \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh \u00e1p xe gan \u0111\u01b0\u1eddng m\u1eadt.<\/p>\n

– B\u01b0\u1edbc 6: \u0110\u1eb7t d\u1eabn l\u01b0u t\u1ea1i di\u1ec7n c\u1eaft, \u1ed5 \u00e1p xe v\u00e0 \u0111\u00f3ng b\u1ee5ng theo l\u1edbp gi\u1ea3i ph\u1eabu.<\/p>\n

5. Theo d\u00f5i v\u00e0 x\u1eed tr\u00ed tai bi\u1ebfn<\/b><\/h2>\n

5.1. Theo d\u00f5i:<\/b><\/h3>\n

Khi ng\u01b0\u1eddi b\u1ec7nh r\u00fat \u0111\u01b0\u1ee3c \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n th\u00ec \u0111\u01b0\u1ee3c chuy\u1ec3n v\u1ec1 b\u1ec7nh ph\u00f2ng, th\u1edf Oxy trong v\u00f2ng 48 – 72h sau m\u1ed5, nu\u00f4i d\u01b0\u1ee1ng b\u1eb1ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch ho\u00e0n to\u00e0n cho \u0111\u1ebfn khi ng\u01b0\u1eddi b\u1ec7nh trung ti\u1ec7n, c\u00e1c x\u00e9t nghi\u1ec7m sinh h\u00f3a m\u00e1u, \u0111\u00f4ng m\u00e1u, c\u00f4ng th\u1ee9c m\u00e1u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u00e0o ng\u00e0y 1, 3, 5, 7 sau m\u1ed5.<\/p>\n

5.2. Bi\u1ebfn ch\u1ee9ng v\u00e0 x\u1eed l\u00fd:\u00a0<\/b><\/h3>\n

C\u00e1c bi\u1ebfn ch\u1ee9ng sau m\u1ed5 g\u1ed3m c\u00e1c bi\u1ebfn ch\u1ee9ng sau:<\/p>\n

– Suy gan sau m\u1ed5: theo ti\u00eau chu\u1ea9n Belghiti 2005 \u201c50-50\u201d: bilirubin>50\u00b5mo\/l; t\u1ef7 l\u1ec7 prothrombin< 50% v\u00e0o ng\u00e0y th\u1ee9 5 sau m\u1ed5. \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa: ch\u1ed1ng nhi\u1ec5m tr\u00f9ng, \u0111\u1ea3m b\u1ea3o ch\u1ee9c n\u0103ng th\u1eadn, b\u1ed3i ph\u1ee5 Albumin, thu\u1ed1c h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng gan, thu\u1ed1c l\u1ee3i m\u1eadt. Tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 k\u1ebft qu\u1ea3 ph\u1ea3i ti\u1ebfn h\u00e0nh l\u1ecdc huy\u1ebft t\u01b0\u01a1ng.<\/p>\n

– Ch\u1ea3y m\u00e1u trong \u1ed5 b\u1ee5ng: ch\u1ea3y m\u00e1u qua d\u1eabn l\u01b0u, hematocrite gi\u1ea3m, m\u1ea1ch nhanh v\u00e0 huy\u1ebft \u00e1p gi\u1ea3m ph\u1ea3i truy\u1ec1n m\u00e1u v\u00e0 can thi\u1ec7p m\u1ed5 l\u1ea1i c\u1ea7m m\u00e1u.<\/p>\n

– R\u00f2 m\u1eadt: khi d\u1ecbch m\u1eadt qua d\u1eabn l\u01b0u > 50ml\/ng\u00e0y trong 3 ng\u00e0y. Theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa, gi\u1eef l\u1ea1i d\u1eabn l\u01b0u \u1ed5 b\u1ee5ng th\u1eddi gian d\u00e0i v\u00e0 lu\u00f4n m\u1edf d\u1eabn l\u01b0u m\u1eadt \u0111\u1ec3 gi\u1ea3m \u00e1p \u0111\u01b0\u1eddng m\u1eadt.<\/p>\n

– Tr\u00e0n d\u1ecbch \u1ed5 b\u1ee5ng: > 500ml\/ng\u00e0y trong > 3 ng\u00e0y. \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa b\u1eb1ng b\u00f9 Albumin, thu\u1ed1c l\u1ee3i ti\u1ec3u\u2026<\/p>\n

– Bi\u1ebfn ch\u1ee9ng kh\u00e1c: nhi\u1ec5m tr\u00f9ng v\u1ebft m\u1ed5, vi\u00eam ph\u1ed5i, nhi\u1ec5m khu\u1ea9n ti\u1ebft ni\u1ec7u…\u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa v\u1edbi thu\u1ed1c kh\u00e1ng sinh.<\/p>\n

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

C\u1eaft l\u1ecdc nhu m\u00f4 gan \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 ch\u1ec9 vi\u1ec7c c\u1eaft b\u1ecf t\u1ed5 ch\u1ee9c gan t\u1ed5n th\u01b0\u01a1ng do ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c \u00e1p xe ho\u1ea1i t\u1eed t\u1ed5 ch\u1ee9c gan. Vi\u1ec7c c\u1eaft l\u1ecdc nhu m\u00f4 c\u1ea7n theo nguy\u00ean t\u1eafc ti\u1ebft ki\u1ec7m t\u1ed1i \u0111a t\u1ed5 ch\u1ee9c gan l\u00e0nh b\u1ecb c\u1eaft b\u1ecf nh\u01b0ng c\u0169ng ph\u1ea3i \u0111\u1ea3m b\u1ea3o l\u1ea5y h\u1ebft […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[],"yoast_head":"\nC\u1eadp nh\u1eadp k\u1ef9 thu\u1eadt c\u1eaft l\u1ecdc nhu m\u00f4 gan - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u1eaft l\u1ecdc nhu m\u00f4 gan \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 ch\u1ec9 vi\u1ec7c c\u1eaft b\u1ecf t\u1ed5 ch\u1ee9c gan t\u1ed5n th\u01b0\u01a1ng do ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c \u00e1p xe ho\u1ea1i t\u1eed t\u1ed5 ch\u1ee9c gan. 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