{"id":29708,"date":"2023-05-06T22:09:58","date_gmt":"2023-05-06T15:09:58","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29708"},"modified":"2023-05-06T22:09:58","modified_gmt":"2023-05-06T15:09:58","slug":"roi-loan-tang-dong-giam-chu-y-o-tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/roi-loan-tang-dong-giam-chu-y-o-tre-em\/","title":{"rendered":"R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd \u1edf tr\u1ebb em"},"content":{"rendered":"

R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd<\/strong> (ADHD) l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n t\u00e2m l\u00fd ph\u1ed5 bi\u1ebfn \u1edf tr\u1ebb em, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u00e1c tri\u1ec7u ch\u1ee9ng t\u0103ng \u0111\u1ed9ng, kh\u00f4ng ch\u00fa \u00fd v\u00e0 b\u1ea5t \u1ed5n c\u1ea3m x\u00fac. ADHD<\/a> c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y c\u1ee7a tr\u1ebb, g\u00e2y \u1ea3nh h\u01b0\u1edfng ti\u00eau c\u1ef1c \u0111\u1ebfn h\u1ecdc t\u1eadp, quan h\u1ec7 x\u00e3 h\u1ed9i v\u00e0 s\u1ef1 t\u1ef1 tin.\u00a0C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a ADHD bao g\u1ed3m s\u1ef1 t\u0103ng \u0111\u1ed9ng, kh\u00f4ng ch\u00fa \u00fd v\u00e0 b\u1ea5t \u1ed5n c\u1ea3m x\u00fac, bao g\u1ed3m s\u1ef1 kh\u00f3 ch\u1ecbu, d\u1ec5 b\u1ecb ph\u00e2n t\u00e2m, kh\u00f3 t\u1eadp trung, qu\u00ean, l\u01a1 \u0111\u00e3ng v\u00e0 c\u1ea3m x\u00fac b\u1ea5t \u1ed5n. ADHD th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n trong giai \u0111o\u1ea1n s\u1edbm c\u1ee7a tu\u1ed5i th\u01a1 v\u00e0 c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c \u0111\u1ebfn tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh. \u0110i\u1ec1u tr\u1ecb cho ADHD bao g\u1ed3m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c v\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c.\u00a0T\u1ed5ng th\u1ec3, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ADHD \u0111\u00f2i h\u1ecfi s\u1ef1 h\u1ee3p t\u00e1c gi\u1eefa c\u00e1c chuy\u00ean gia y t\u1ebf v\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c tr\u1ebb. M\u1ed9t \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 nh\u1eadn ra v\u00e0 gi\u1ea3i quy\u1ebft s\u1edbm c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a ADHD \u0111\u1ec3 gi\u00fap tr\u1ebb ph\u00e1t tri\u1ec3n t\u1ed1i \u0111a ti\u1ec1m n\u0103ng c\u1ee7a m\u00ecnh.<\/p>\n

\"R\u1ed1i
R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd \u1edf tr\u1ebb em<\/figcaption><\/figure>\n

Ta\u0301c gia\u0309:\u00a0L\u00ea T\u1ea5n Gi\u00e0u, Nguy\u1ec5n V\u0103n Th\u00e0nh, T\u1ea1 V\u0103n Tr\u1ea7m<\/em>
\nB\u1ec7nh vi\u1ec7n \u0110a khoa Trung t\u00e2m Ti\u1ec1n Giang<\/em><\/p>\n

Ba\u0300i vi\u00ea\u0301t tri\u0301ch ngu\u00f4\u0300n t\u01b0\u0300 H\u00f4\u0323i Th\u00e2\u0300n kinh ho\u0323c Vi\u00ea\u0323t Nam<\/em><\/p>\n

1. Li\u0323ch s\u01b0\u0309<\/h2>\n

R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb em. 2500 n\u0103m tr\u01b0\u1edbc, Hypocrate \u0111\u00e3 m\u00f4 t\u1ea3 nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y l\u00e0 \u201cnh\u1eefng \u0111\u00e1p \u1ee9ng t\u0103ng nhanh cho nh\u1eefng tr\u1ea3i nghi\u1ec7m c\u1ea3m gi\u00e1c nh\u01b0ng c\u0169ng \u00edt b\u1ec1n b\u1ec9 v\u00e0 t\u00e2m tr\u00ed chuy\u1ec3n nhanh ch\u00f3ng sang \u1ea5n t\u01b0\u1ee3ng ti\u1ebfp theo\u201d. T\u0103ng \u0111\u1ed9ng l\u00e0 tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u1eb7t t\u00ean cho r\u1ed1i lo\u1ea1n n\u00e0y khi l\u1ea7n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o B\u1ea3ng ph\u00e2n lo\u1ea1i b\u1ec7nh qu\u1ed1c t\u1ebf l\u1ea7n th\u1ee9 9 c\u1ee7a T\u1ed5 ch\u1ee9c Y t\u1ebf th\u1ebf gi\u1edbi (ICD-9), \u201ch\u1ed9i ch\u1ee9ng t\u0103ng \u0111\u1ed9ng c\u1ee7a th\u1eddi th\u01a1 \u1ea5u\u201d, sau \u0111\u00f3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u201cr\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng\u201d trong B\u1ea3ng ph\u00e2n lo\u1ea1i b\u1ec7nh qu\u1ed1c t\u1ebf l\u1ea7n th\u1ee9 10 (ICD-10).
\nTrong H\u01b0\u1edbng d\u1eabn Ch\u1ea9n \u0111o\u00e1n v\u00e0 Th\u1ed1ng k\u00ea b\u1ec7nh t\u00e2m th\u1ea7n, phi\u00ean b\u1ea3n th\u1ee9 hai (DSM-2) g\u1ecdi l\u00e0 \u201cph\u1ea3n \u1ee9ng t\u0103ng \u0111\u1ed9ng th\u1eddi th\u01a1 \u1ea5u\u201d. N\u0103m 1980, vai tr\u00f2 gi\u1ea3m ch\u00fa \u00fd m\u1edbi \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn v\u00e0 r\u1ed1i lo\u1ea1n \u0111\u1ed5i t\u00ean th\u00e0nh \u201cr\u1ed1i lo\u1ea1n gi\u1ea3m ch\u00fa \u00fd c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 t\u0103ng \u0111\u1ed9ng\u201d (DSM-3). N\u0103m 1994, H\u01b0\u1edbng d\u1eabn Ch\u1ea9n \u0111o\u00e1n v\u00e0 Th\u1ed1ng k\u00ea b\u1ec7nh t\u00e2m th\u1ea7n, phi\u00ean b\u1ea3n th\u1ee9 t\u01b0 (DSM-4) g\u1ecdi l\u00e0 \u201cr\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd\u201d. N\u0103m 2013, phi\u00ean b\u1ea3n l\u1ea7n th\u1ee9 n\u0103m c\u1ee7a DSM (DSM-5), c\u00f3 thay \u0111\u1ed5i m\u1ed9t s\u1ed1 ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n.<\/p>\n

2. Kha\u0301i ni\u00ea\u0323m<\/h2>\n

R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd (Attention Deficit Hyperactivity Disorder, vi\u1ebft t\u1eaft l\u00e0 ADHD) l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n bi\u1ec3u hi\u1ec7n \u1edf th\u1eddi th\u01a1 \u1ea5u v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng t\u0103ng \u0111\u1ed9ng, thi\u1ebfu ki\u1ec1m ch\u1ebf v\u00e0 ho\u1eb7c kh\u00f4ng ch\u00fa \u00fd. C\u00e1c tri\u1ec7u ch\u1ee9ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c, h\u1ecdc t\u1eadp, h\u00e0nh vi, c\u1ea3m x\u00fac v\u00e0 x\u00e3 h\u1ed9i.<\/p>\n

3. Di\u0323ch t\u00ea\u0303 ho\u0323c<\/h2>\n

T\u1ef7 l\u1ec7 ADHD \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf tr\u1ebb em thay \u0111\u1ed5i t\u1eeb 2 \u0111\u1ebfn 18 ph\u1ea7n tr\u0103m t\u00f9y thu\u1ed9c v\u00e0o ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n v\u00e0 d\u00e2n s\u1ed1 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. T\u1ef7 l\u1ec7 hi\u1ec7n m\u1eafc \u1edf tr\u1ebb em trong \u0111\u1ed9 tu\u1ed5i \u0111i h\u1ecdc \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh l\u00e0 t\u1eeb 9 \u0111\u1ebfn 15 ph\u1ea7n tr\u0103m, l\u00e0m cho n\u00f3 tr\u1edf th\u00e0nh m\u1ed9t trong nh\u1eefng r\u1ed1i lo\u1ea1n ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf th\u1eddi th\u01a1 \u1ea5u. ADHD ph\u1ed5 bi\u1ebfn \u1edf nam h\u01a1n n\u1eef (t\u1ef7 l\u1ec7 nam\/n\u1eef l\u00e0 4:1 \u0111\u1ed1i v\u1edbi lo\u1ea1i t\u0103ng \u0111\u1ed9ng ch\u1ee7 y\u1ebfu v\u00e0 2:1 \u0111\u1ed1i v\u1edbi lo\u1ea1i kh\u00f4ng ch\u00fa \u00fd ch\u1ee7 y\u1ebfu). \u1ede Hoa K\u1ef3, b\u00e1o c\u00e1o c\u1ee7a Vi\u1ec7n s\u1ee9c kh\u1ecfe qu\u1ed1c gia Hoa K\u1ef3 (NHIS) t\u1eeb n\u0103m 2015 \u0111\u1ebfn 2016, t\u1ef7 l\u1ec7 hi\u1ec7n m\u1eafc ADHD l\u00e0 14% \u1edf nam v\u00e0 6% \u1edf n\u1eef. T\u1ea1i Vi\u1ec7t Nam, theo Ho\u00e0ng C\u1ea9m T\u00fa, Vi\u1ec7n Nhi Trung \u01b0\u01a1ng n\u0103m 1999, t\u1ef7 l\u1ec7 t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd l\u00e0 2,68%. N\u0103m 2013, \u0110\u1eb7ng Ho\u00e0ng Minh v\u00e0 c\u1ed9ng s\u1ef1 v\u1edbi \u0111\u1ec1 t\u00e0i nghi\u00ean c\u1ee9u \u201cS\u1ee9c kh\u1ecfe t\u00e2m th\u1ea7n c\u1ee7a tr\u1ebb em Vi\u1ec7t Nam-Th\u1ef1c tr\u1ea1ng v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1\u201d, \u0111\u00e3 \u0111\u01b0a ra t\u1ef7 l\u1ec7 4% tr\u1ebb em Vi\u1ec7t Nam c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 ch\u00fa \u00fd.<\/p>\n

4. R\u00f4\u0301i loa\u0323n \u0111i ke\u0300m<\/h2>\n

\u2022 R\u1ed1i lo\u1ea1n th\u00e1ch th\u1ee9c ch\u1ed1ng \u0111\u1ed1i t\u1ed3n t\u1ea1i v\u1edbi ADHD trong kho\u1ea3ng 50 \u0111\u1ebfn 80 ph\u1ea7n tr\u0103m c\u00e1c tr\u01b0\u1eddng h\u1ee3p.
\n\u2022 R\u1ed1i lo\u1ea1n c\u01b0 x\u1eed: c\u00f9ng t\u1ed3n t\u1ea1i v\u1edbi ADHD \u1edf 1\/3 s\u1ed1 tr\u01b0\u1eddng h\u1ee3p.
\n\u2022 R\u1ed1i lo\u1ea1n lo \u00e2u: c\u00f9ng t\u1ed3n t\u1ea1i v\u1edbi ADHD trong kho\u1ea3ng 20 \u0111\u1ebfn 40 ph\u1ea7n tr\u0103m c\u00e1c tr\u01b0\u1eddng h\u1ee3p.
\n\u2022 Tr\u1ea7m c\u1ea3m: c\u00f9ng t\u1ed3n t\u1ea1i v\u1edbi ADHD \u1edf 1\/3 s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. Tr\u1ebb em b\u1ecb ADHD v\u00e0 r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m \u0111i k\u00e8m c\u00f3 th\u1ec3 c\u00f3 ng\u01b0\u1eddi trong gia \u0111\u00ecnh c\u00f3 ti\u1ec1n s\u1eed m\u1eafc r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m nghi\u00eam tr\u1ecdng. Thanh thi\u1ebfu ni\u00ean b\u1ecb ADHD v\u00e0 r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m c\u00f3 nhi\u1ec1u nguy c\u01a1 c\u00f3 \u00fd \u0111\u1ecbnh t\u1ef1 t\u1eed h\u01a1n.
\n\u2022 R\u1ed1i lo\u1ea1n h\u1ecdc t\u1eadp: 20 \u0111\u1ebfn 60 ph\u1ea7n tr\u0103m.
\n\u2022 R\u1ed1i lo\u1ea1n ph\u1ed1i h\u1ee3p ph\u00e1t tri\u1ec3n: Kho\u1ea3ng m\u1ed9t n\u1eeda s\u1ed1 tr\u1ebb ADHD \u0111\u00e1p \u1ee9ng c\u00e1c ti\u00eau ch\u00ed v\u1ec1 r\u1ed1i lo\u1ea1n ph\u1ed1i h\u1ee3p ph\u00e1t tri\u1ec3n (DCD).
\n\u2022 R\u1ed1i lo\u1ea1n ph\u1ed5 t\u1ef1 k\u1ef7 th\u01b0\u1eddng c\u00f9ng t\u1ed3n t\u1ea1i v\u1edbi ADHD. Tr\u1ebb ADHD v\u00e0 r\u1ed1i lo\u1ea1n ph\u1ed5 t\u1ef1 k\u1ef7 k\u00e8m theo th\u01b0\u1eddng b\u1ecb suy gi\u1ea3m nh\u1eadn th\u1ee9c, c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 h\u00e0nh vi v\u00e0 t\u00e2m th\u1ea7n nghi\u00eam tr\u1ecdng h\u01a1n so v\u1edbi tr\u1ebb ADHD ho\u1eb7c r\u1ed1i lo\u1ea1n ph\u1ed5 t\u1ef1 k\u1ef7 ri\u00eang bi\u1ec7t.
\n\u2022 R\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7.<\/p>\n

5. C\u01a1 ch\u00ea\u0301 b\u00ea\u0323nh sinh<\/h2>\n

C\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a ADHD \u0111\u1ebfn nay v\u1eabn ch\u01b0a bi\u1ebft r\u00f5. Vi\u1ec7c m\u1ea5t c\u00e2n b\u1eb1ng c\u00f3 t\u00ednh di truy\u1ec1n trong chuy\u1ec3n h\u00f3a catecholamine t\u1ea1i v\u1ecf n\u00e3o c\u00f3 th\u1ec3 \u0111\u00f3ng vai tr\u00f2 nguy\u00ean ph\u00e1t, t\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ec9 ra qua h\u00ecnh \u1ea3nh h\u1ecdc kh\u1ea3o s\u00e1t ch\u1ee9c n\u0103ng v\u00e0 c\u1ea5u tr\u00fac n\u00e3o, qua c\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt v\u00e0 qua \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c c\u00f3 ho\u1ea1t t\u00ednh noradrenergic.
\nY\u1ebfu t\u1ed1 di truy\u1ec1n \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng t\u1ecf c\u00f3 \u1ea3nh h\u01b0\u1edfng trong b\u1ec7nh sinh ADHD v\u00e0 \u0111\u01b0\u1ee3c cho l\u00e0 y\u1ebfu t\u1ed1 c\u00f3 \u00fd ngh\u0129a nh\u1ea5t trong s\u1ef1 h\u00ecnh th\u00e0nh ADHD. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u tr\u00ean c\u00e1c tr\u1ebb sinh \u0111\u00f4i \u0111\u00e3 cho th\u1ea5y s\u1ef1 t\u01b0\u01a1ng h\u1ee3p l\u00ean \u0111\u1ebfn 92% \u1edf tr\u1ebb song sinh \u0111\u1ed3ng h\u1ee3p t\u1eed v\u00e0 33% \u1edf tr\u1ebb song sinh d\u1ecb h\u1ee3p t\u1eed. N\u1ebfu m\u1eb9 b\u1ecb ADHD, t\u1ef7 l\u1ec7 con b\u1ecb ADHD s\u1ebd \u0111\u1ea1t 15-20%; n\u1ebfu b\u1ed1 b\u1ecb ADHD, t\u1ef7 l\u1ec7 m\u1eafc \u1edf con l\u00e0 25-30%; c\u1ea3 b\u1ed1 v\u00e0 m\u1eb9 c\u00f9ng b\u1ecb ADHD, tr\u1ebb sinh ra c\u00f3 55-92% kh\u1ea3 n\u0103ng b\u1ecb ADHD.
\nC\u00e1c y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng kh\u00e1c nhau c\u00f3 th\u1ec3 \u0111\u00f3ng vai tr\u00f2 th\u1ee9 y\u1ebfu trong c\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a ADHD, t\u1ea7m quan tr\u1ecdng c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng c\u00f2n \u0111ang tranh c\u00e3i.
\nC\u00e1c y\u1ebfu t\u1ed1 ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng (ph\u1ee5 gia th\u1ef1c ph\u1ea9m, \u0111\u01b0\u1eddng, nh\u1ea1y c\u1ea3m v\u1edbi th\u1ef1c ph\u1ea9m, thi\u1ebfu axit b\u00e9o thi\u1ebft y\u1ebfu, thi\u1ebfu kho\u00e1ng ch\u1ea5t) kh\u00f4ng t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn h\u00e0nh vi c\u1ee7a tr\u1ebb \u1edf m\u1ee9c \u0111\u1ed9 r\u00f5 tr\u00ean l\u00e2m s\u00e0ng c\u0169ng nh\u01b0 kh\u00f4ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m ch\u00ednh trong ph\u1ea7n l\u1edbn c\u00e1c ca ADHD. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 \u00edt tr\u1ebb c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng nh\u1eb9 tr\u00ean h\u00e0nh vi khi s\u1eed d\u1ee5ng c\u00e1c th\u1ef1c ph\u1ea9m c\u00f3 ch\u1ee9a ph\u1ee5 gia, m\u00e0u nh\u00e2n t\u1ea1o, ho\u1eb7c qu\u00e1 nhi\u1ec1u \u0111\u01b0\u1eddng, ho\u1eb7c d\u00f9ng kh\u00f4ng \u0111\u1ee7 c\u00e1c acid b\u00e9o c\u1ea7n thi\u1ebft v\u00e0 mu\u1ed1i kho\u00e1ng. Ngo\u00e0i ra, nh\u1ea1y c\u1ea3m v\u1edbi th\u1ef1c ph\u1ea9m c\u0169ng c\u00f3 th\u1ec3 li\u00ean quan v\u1edbi c\u00e1c b\u1ea5t th\u01b0\u1eddng h\u00e0nh vi, d\u00f9 r\u1ea5t hi\u1ebfm g\u1eb7p \u1edf tr\u1ebb ADHD.
\nTi\u1ebfp x\u00fac v\u1edbi thu\u1ed1c l\u00e1 tr\u01b0\u1edbc khi sinh v\u00e0 sinh non\/nh\u1eb9 c\u00e2n c\u00f3 li\u00ean quan \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ADHD.<\/p>\n

6. L\u00e2m sa\u0300ng<\/h2>\n

ADHD l\u00e0 m\u1ed9t h\u1ed9i ch\u1ee9ng bao g\u1ed3m 3 nh\u00f3m tri\u1ec7u ch\u1ee9ng: t\u0103ng \u0111\u1ed9ng, thi\u1ebfu k\u1ec1m ch\u1ebf, v\u00e0 gi\u1ea3m ch\u00fa \u00fd.
\n* Gi\u1ea3m ch\u00fa \u00fd:
\n\u2013 Th\u01b0\u1eddng kh\u00f4ng th\u1ec3 ch\u00fa \u00fd k\u1ef9 l\u01b0\u1ee1ng v\u00e0o c\u00e1c chi ti\u1ebft, ho\u1eb7c ph\u1ea1m nh\u1eefng l\u1ed7i do c\u1ea9u th\u1ea3 trong h\u1ecdc t\u1eadp, trong c\u00f4ng vi\u1ec7c ho\u1eb7c trong c\u00e1c ho\u1ea1t \u0111\u1ed9ng kh\u00e1c.
\n\u2013 Th\u01b0\u1eddng kh\u00f3 kh\u0103n duy tr\u00ec s\u1ef1 ch\u00fa \u00fd trong nhi\u1ec7m v\u1ee5 ho\u1eb7c trong c\u00e1c ho\u1ea1t \u0111\u1ed9ng ch\u01a1i.
\n\u2013 Th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n d\u01b0\u1eddng nh\u01b0 kh\u00f4ng l\u1eafng nghe nh\u1eefng g\u00ec ng\u01b0\u1eddi kh\u00e1c n\u00f3i tr\u1ef1c ti\u1ebfp v\u1edbi tr\u1ebb.
\n\u2013 Th\u01b0\u1eddng kh\u00f4ng th\u1ec3 l\u00e0m theo to\u00e0n b\u1ed9 nh\u1eefng ch\u1ec9 d\u1eabn ho\u1eb7c kh\u00f4ng ho\u00e0n th\u00e0nh b\u00e0i t\u1eadp, c\u00f4ng vi\u1ec7c trong gia \u0111\u00ecnh (kh\u00f4ng ph\u1ea3i h\u00e0nh vi ch\u1ed1ng \u0111\u1ed1i ho\u1eb7c kh\u00f4ng hi\u1ec3u \u0111\u01b0\u1ee3c c\u00e1c ch\u1ec9 d\u1eabn).
\n\u2013 Th\u01b0\u1eddng kh\u00f3 kh\u0103n trong c\u00e1ch t\u1ed5 ch\u1ee9c c\u00f4ng vi\u1ec7c v\u00e0 c\u00e1c ho\u1ea1t \u0111\u1ed9ng.
\n\u2013 Th\u01b0\u1eddng tr\u00e1nh n\u00e9, kh\u00f4ng th\u00edch ho\u1eb7c mi\u1ec5n c\u01b0\u1ee1ng th\u1ef1c hi\u1ec7n c\u00e1c nhi\u1ec7m v\u1ee5 \u0111\u00f2i h\u1ecfi ph\u1ea3i duy tr\u00ec nh\u1eefng n\u1ed7 l\u1ef1c tinh th\u1ea7n.
\n\u2013 Th\u01b0\u1eddng \u0111\u00e1nh m\u1ea5t nh\u1eefng v\u1eadt d\u1ee5ng c\u1ea7n thi\u1ebft.
\n\u2013 Th\u01b0\u1eddng d\u1ec5 b\u1ecb sao nh\u00e3ng b\u1edfi nh\u1eefng k\u00edch th\u00edch b\u00ean ngo\u00e0i.
\n\u2013 Th\u01b0\u1eddng qu\u00ean c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y.
\n* T\u0103ng ho\u1ea1t \u0111\u1ed9ng
\n\u2013 C\u1eed \u0111\u1ed9ng ch\u00e2n tay li\u00ean t\u1ee5c ho\u1eb7c ng\u1ed3i kh\u00f4ng y\u00ean.
\n\u2013 R\u1eddi kh\u1ecfi ch\u1ed7 trong l\u1edbp ho\u1eb7c trong c\u00e1c t\u00ecnh hu\u1ed1ng kh\u00e1c m\u00e0 c\u1ea7n ph\u1ea3i ng\u1ed3i y\u00ean m\u1ed9t ch\u1ed7.
\n\u2013 Th\u01b0\u1eddng ch\u1ea1y quanh ho\u1eb7c leo tr\u00e8o qu\u00e1 m\u1ee9c trong c\u00e1c t\u00ecnh hu\u1ed1ng m\u00e0 \u0111i\u1ec1u \u0111\u00f3 l\u00e0 kh\u00f4ng th\u00edch h\u1ee3p.
\n\u2013 Th\u01b0\u1eddng kh\u00f3 kh\u0103n trong khi ch\u01a1i ho\u1eb7c trong c\u00e1c ho\u1ea1t \u0111\u1ed9ng y\u00eau c\u1ea7u gi\u1eef y\u00ean l\u1eb7ng.
\n\u2013 Th\u01b0\u1eddng ho\u1ea1t \u0111\u1ed9ng li\u00ean t\u1ee5c.
\n* S\u1ef1 xung \u0111\u1ed9ng
\n\u2013 Th\u01b0\u1eddng n\u00f3i qu\u00e1 m\u1ee9c.
\n\u2013 Th\u01b0\u1eddng bu\u1ed9t mi\u1ec7ng n\u00f3i c\u00e2u tr\u1ea3 l\u1eddi tr\u01b0\u1edbc khi c\u00e1c c\u00e2u h\u1ecfi \u0111\u01b0\u1ee3c \u0111\u1eb7t ra ho\u00e0n ch\u1ec9nh.
\n\u2013 Th\u01b0\u1eddng kh\u00f3 kh\u0103n ch\u1edd \u0111\u1ee3i theo h\u00e0ng ho\u1eb7c ch\u1edd \u0111\u1ebfn l\u01b0\u1ee3t.
\n\u2013 Th\u01b0\u1eddng ng\u1eaft l\u1eddi ho\u1eb7c x\u00e2m ph\u1ea1m v\u00e0o v\u1ea5n \u0111\u1ec1 c\u1ee7a ng\u01b0\u1eddi kh\u00e1c.<\/p>\n

7. Ti\u00eau chu\u00e2\u0309n ch\u00e2\u0309n \u0111oa\u0301n theo DSM-5<\/h2>\n

Ti\u00eau chu\u1ea9n th\u1ed1ng nh\u1ea5t trong ch\u1ea9n \u0111o\u00e1n ADHD \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1edfi Hi\u1ec7p h\u1ed9i T\u00e2m th\u1ea7n Hoa K\u1ef3 v\u00e0 c\u00f4ng b\u1ed1 trong S\u1ed5 tay Ch\u1ea9n \u0111o\u00e1n v\u00e0 Th\u1ed1ng k\u00ea c\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n V (DSM-5). Nguy\u00ean t\u1eafc ch\u1ea9n \u0111o\u00e1n:
\n\u2013 C\u00e1c tri\u1ec7u ch\u1ee9ng ph\u1ea3i hi\u1ec7n di\u1ec7n \u1edf h\u01a1n m\u1ed9t m\u00f4i tr\u01b0\u1eddng s\u1ed1ng (VD, \u1edf tr\u01b0\u1eddng v\u00e0 \u1edf nh\u00e0).
\n\u2013 C\u00e1c tri\u1ec7u ch\u1ee9ng ph\u1ea3i t\u1ed3n t\u1ea1i \u00edt nh\u1ea5t 6 th\u00e1ng.
\n\u2013 C\u00e1c tri\u1ec7u ch\u1ee9ng ph\u1ea3i hi\u1ec7n di\u1ec7n tr\u01b0\u1edbc 12 tu\u1ed5i.
\n\u2013 C\u00e1c tri\u1ec7u ch\u1ee9ng ph\u1ea3i g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ee9c n\u0103ng h\u1ecdc t\u1eadp, x\u00e3 h\u1ed9i, ho\u1eb7c c\u00e1c ho\u1ea1t \u0111\u1ed9ng ngh\u1ec1 nghi\u1ec7p.
\n\u2013 C\u00e1c tri\u1ec7u ch\u1ee9ng ph\u1ea3i qu\u00e1 m\u1ee9c so v\u1edbi \u0111\u1ed9 ph\u00e1t tri\u1ec3n c\u1ee7a tr\u1ebb.
\n\u2013 C\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n kh\u00e1c c\u00f3 th\u1ec3 g\u00e2y tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng t\u1ef1 ph\u1ea3i \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb.
\nT\u00f9y theo c\u00e1c tri\u1ec7u ch\u1ee9ng n\u1ed5i b\u1eadt, ADHD \u0111\u01b0\u1ee3c ph\u00e2n th\u00e0nh ba nh\u00f3m nh\u1ecf: nh\u00f3m gi\u1ea3m ch\u00fa \u00fd, nh\u00f3m t\u0103ng \u0111\u1ed9ng \u2013 xung \u0111\u1ed9ng v\u00e0 nh\u00f3m ph\u1ed1i h\u1ee3p
\n\u2013 Nh\u00f3m gi\u1ea3m ch\u00fa \u00fd: c\u00f3 \u00edt nh\u1ea5t 6 tri\u1ec7u ch\u1ee9ng gi\u1ea3m ch\u00fa \u00fd v\u00e0 \u00edt h\u01a1n 6 tri\u1ec7u ch\u1ee9ng t\u0103ng \u0111\u1ed9ng, xung \u0111\u1ed9ng.
\n\u2013 Nh\u00f3m t\u0103ng \u0111\u1ed9ng \u2013 xung \u0111\u1ed9ng: c\u00f3 \u00edt nh\u1ea5t 6 tri\u1ec7u ch\u1ee9ng t\u0103ng \u0111\u1ed9ng \u2013 xung \u0111\u1ed9ng v\u00e0 \u00edt h\u01a1n 6 tri\u1ec7u ch\u1ee9ng m\u1ea5t ch\u00fa \u00fd.
\n\u2013 Nh\u00f3m ph\u1ed1i h\u1ee3p: c\u00f3 \u00edt nh\u1ea5t 6 tri\u1ec7u ch\u1ee9ng t\u0103ng \u0111\u1ed9ng \u2013 xung \u0111\u1ed9ng v\u00e0 \u00edt nh\u1ea5t 6 tri\u1ec7u ch\u1ee9ng m\u1ea5t ch\u00fa \u00fd.<\/p>\n

8. Ch\u00e2\u0309n \u0111oa\u0301n ph\u00e2n bi\u00ea\u0323t<\/h2>\n

\u2013 Hi\u1ebfu \u0111\u1ed9ng tr\u1ebb d\u01b0\u1edbi 3 tu\u1ed5i.
\n\u2013 R\u1ed1i lo\u1ea1n h\u00e0nh vi \u1ee9ng x\u1eed kh\u00e1c, r\u1ed1i lo\u1ea1n ch\u1ed1ng \u0111\u1ed1i nguy\u00ean ph\u00e1t.
\n\u2013 R\u1ed1i lo\u1ea1n c\u1ea3m x\u00fac l\u01b0\u1ee1ng c\u1ef1c kh\u1edfi ph\u00e1t s\u1edbm.
\n\u2013 R\u1ed1i lo\u1ea1n ph\u00e1t tri\u1ec3n lan t\u1ecfa (t\u1ef1 k\u1ef7).
\n\u2013 Lo\u1ea1n th\u1ea7n tr\u1ebb em (t\u00e2m th\u1ea7n ph\u00e2n li\u1ec7t).
\n\u2013 R\u1ed1i lo\u1ea1n lo \u00e2u.
\n\u2013 R\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m.<\/p>\n

9. \u0110i\u00ea\u0300u tri\u0323<\/h2>\n

M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb
\n\u2013 C\u1ea3i thi\u1ec7n quan h\u1ec7 v\u1edbi b\u1ed1 m\u1eb9, th\u1ea7y c\u00f4, anh ch\u1ecb em, ho\u1eb7c b\u1ea1n h\u1ecdc.
\n\u2013 C\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng h\u1ecdc t\u1eadp.
\n\u2013 C\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng tu\u00e2n th\u1ee7 c\u00e1c quy \u0111\u1ecbnh, n\u1ed9i quy.
\n\u0110i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c
\n\u2013 Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ADHD.
\n\u2013 Tr\u1ebb \u2265 6 tu\u1ed5i.
\n\u2013 Cha m\u1eb9 tr\u1ebb ch\u1ea5p nh\u1eadn vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c.
\n\u2013 Tr\u01b0\u1eddng n\u01a1i tr\u1ebb h\u1ecdc s\u1ebd h\u1ed7 tr\u1ee3 theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb.
\n\u2013 Kh\u00f4ng ti\u1ec1n c\u0103n nh\u1ea1y c\u1ea3m v\u1edbi thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ecdn.
\n\u2013 Tr\u1ebb c\u00f3 nh\u1ecbp tim v\u00e0 huy\u1ebft \u00e1p b\u00ecnh th\u01b0\u1eddng.
\n\u2013 Kh\u00f4ng ti\u1ec1n c\u0103n co gi\u1eadt.
\n\u2013 Kh\u00f4ng b\u1ecb h\u1ed9i ch\u1ee9ng Tourett.
\n\u2013 Kh\u00f4ng b\u1ecb r\u1ed1i lo\u1ea1n ph\u00e1t tri\u1ec3n lan t\u1ecfa.
\n\u2013 Kh\u00f4ng c\u00f3 ng\u01b0\u1eddi nghi\u1ec7n ng\u1eadp t\u1ea1i nh\u00e0.
\nNh\u00f3m thu\u1ed1c k\u00edch th\u1ea7n (Methylphenidate, Dextroamphetamine): l\u00e0 l\u1ef1a ch\u1ecdn h\u00e0ng \u0111\u1ea7u.
\nLi\u1ec1u l\u01b0\u1ee3ng: Methylphenidate 18-72 mg\/ng\u00e0y, t\u00f9y l\u1ee9a tu\u1ed5i.
\nAtomoxetine: kh\u00f4ng thu\u1ed9c nh\u00f3m thu\u1ed1c k\u00edch th\u1ea7n nh\u01b0ng c\u0169ng l\u00e0 l\u1ef1a ch\u1ecdn h\u00e0ng \u0111\u1ea7u trong \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n gi\u1ea3m ch\u00fa \u00fd \u2013 t\u0103ng \u0111\u1ed9ng, thu\u1ed1c c\u00f3 c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng l\u00e0 \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu ch\u1ea5t norepinephrin. Thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho tr\u1ebb tr\u00ean 6 tu\u1ed5i.
\nThu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m: l\u00e0 l\u1ef1a ch\u1ecdn th\u1ee9 2 trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p kh\u00e1ng v\u1edbi c\u00e1c thu\u1ed1c tr\u00ean v\u00e0 k\u00e8m theo r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m, lo \u00e2u.
\nClonidin: \u0110\u1ed3ng v\u1eadn \u03b1 adrenergic l\u00e0 l\u1ef1a ch\u1ecdn th\u1ee9 3, c\u00e1c tr\u01b0\u1eddng h\u1ee3p k\u00e8m r\u1ed1i lo\u1ea1n Tic, h\u1ed9i ch\u1ee9ng Gille de la Tourette v\u00e0 c\u00f3 nh\u1eefng h\u00e0nh vi g\u00e2y h\u1ea5n. Li\u1ec1u trung b\u00ecnh 0,1 \u0111\u1ebfn 0,25mg\/ng\u00e0y.
\nCan thi\u1ec7p t\u00e2m l\u00fd h\u00e0nh vi: duy tr\u00ec th\u1eddi kh\u00f3a bi\u1ec3u, s\u1eed d\u1ee5ng \u0111\u1ed3ng h\u1ed3, b\u00e1o gi\u1edd, t\u1ea1o m\u1ee5c ti\u00eau nh\u1ecf, gi\u1eef cho tr\u1ebb lu\u00f4n b\u1eadn r\u1ed9n, th\u01b0\u1edfng khi c\u00f3 h\u00e0nh vi t\u00edch c\u1ef1c, khuy\u1ebfn kh\u00edch t\u0103ng c\u01b0\u1eddng ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t, gi\u00fap tr\u1ebb c\u00f3 gi\u1ea5c ng\u1ee7 t\u1ed1t, d\u1ea1y tr\u1ebb c\u00e1ch l\u00e0m b\u1ea1n, k\u1ef7 lu\u1eadt nh\u1eb9 nh\u00e0ng.
\nCan thi\u1ec7p gi\u00e1o d\u1ee5c: b\u00e0i t\u1eadp vi\u1ebft l\u00ean b\u1ea3ng, ng\u1eafn g\u1ecdn r\u00f5 r\u00e0ng, v\u1ecb tr\u00ed ng\u1ed3i g\u1ea7n th\u1ea7y c\u00f4 gi\u00e1o, cho tr\u1ebb th\u00eam th\u1eddi gian \u0111\u1ec3 ho\u00e0n t\u1ea5t b\u00e0i t\u1eadp, l\u1edbp h\u1ecdc gi\u1ea3m \u00e1nh s\u00e1ng v\u00e0 ti\u1ebfng \u1ed3n.
\n\u0110i\u1ec1u tr\u1ecb ph\u1ed1i h\u1ee3p: ADHD k\u00e9m \u0111\u00e1p \u1ee9ng thu\u1ed1c \u0111\u01a1n l\u1ebb, c\u00f3 r\u1ed1i lo\u1ea1n \u0111i k\u00e8m.<\/p>\n

10. Ti\u00ean l\u01b0\u01a1\u0323ng<\/h2>\n

Kho\u1ea3ng 40 \u0111\u1ebfn 70% tr\u1ebb m\u1eafc r\u1ed1i lo\u1ea1n n\u00e0y t\u1ed3n t\u1ea1i \u1edf tu\u1ed5i v\u1ecb th\u00e0nh ni\u00ean, n\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng thuy\u00ean gi\u1ea3m th\u00ec th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u t\u1eeb 12 cho \u0111\u1ebfn 20 tu\u1ed5i. Ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh r\u1ed1i lo\u1ea1n n\u00e0y v\u1eabn t\u1ed3n t\u1ea1i kho\u1ea3ng 50%. Th\u01b0\u1eddng c\u00e1c r\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng c\u00f3 xu h\u01b0\u1edbng gi\u1ea3m theo tu\u1ed5i nh\u01b0ng c\u00e1c r\u1ed1i lo\u1ea1n gi\u1ea3m ch\u00fa \u00fd c\u1ea3i thi\u1ec7n \u00edt h\u01a1n. Nh\u1eefng ng\u01b0\u1eddi m\u1eafc r\u1ed1i lo\u1ea1n n\u00e0y c\u00f3 nguy c\u01a1 nhi\u1ec1u h\u01a1n c\u00f3 r\u1ed1i lo\u1ea1n nh\u00e2n c\u00e1ch ch\u1ed1ng \u0111\u1ed1i x\u00e3 h\u1ed9i, s\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t g\u00e2y nghi\u1ec7n, tr\u1ea7m c\u1ea3m, lo \u00e2u v.v\u2026<\/p>\n

T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/strong><\/h2>\n

1. B\u1ed9 Y t\u1ebf (2020). R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd.
\n2. \u0110\u1eb7ng Ho\u00e0ng Minh (2013), S\u1ee9c kh\u1ecfe T\u00e2m th\u1ea7n tr\u1ebb em Vi\u1ec7t Nam \u2013 th\u1ef1c tr\u1ea1ng v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1. \u0110\u1ea1i h\u1ecdc Gi\u00e1o d\u1ee5c \u2013 \u0110\u1ea1i h\u1ecdc Qu\u1ed1c gia H\u00e0 N\u1ed9i.
\n3. L\u00e3 Th\u1ecb B\u01b0\u1edfi (2016). R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd. S\u00e1ch gi\u00e1o khoa Nhi khoa. Nh\u00e0 xu\u1ea5t b\u1ea3n Y h\u1ecdc, trang 1912-1918.
\n4. American Psychiatric Association. Attention-deficit\/hyperactivity disorder. In: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, American Psychiatric Association, Washington, DC 2022. p.68.
\n5. De Freitas de Sousa A, Coimbra I M, Castanho J M, Polanczyk GV, Rohde LA. Attention deficit hyperactivity disorder. In Rey JM & Martin A (eds), JM Rey\u2019s IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions 2020.
\n6. Kevin RK et al. Attention deficit hyperactivity disorder in children and adolescents: Epidemiology and pathogenesis. UpToDate 64.0.
\n7. Kevin RK et al. Attention deficit hyperactivity disorder in children and adolescents: Clinical features and diagnosis. UpToDate 64.0.
\n8. Kevin RK et al. Attention deficit hyperactivity disorder in children and adolescents: Overview of treatment and prognosis. UpToDate 64.0.<\/p>\n","protected":false},"excerpt":{"rendered":"

R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd (ADHD) l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n t\u00e2m l\u00fd ph\u1ed5 bi\u1ebfn \u1edf tr\u1ebb em, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u00e1c tri\u1ec7u ch\u1ee9ng t\u0103ng \u0111\u1ed9ng, kh\u00f4ng ch\u00fa \u00fd v\u00e0 b\u1ea5t \u1ed5n c\u1ea3m x\u00fac. ADHD c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y c\u1ee7a tr\u1ebb, g\u00e2y \u1ea3nh h\u01b0\u1edfng ti\u00eau c\u1ef1c \u0111\u1ebfn […]<\/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":"\nR\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd \u1edf tr\u1ebb em - Vinmec<\/title>\n<meta name=\"description\" content=\"R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n t\u00e2m l\u00fd ph\u1ed5 bi\u1ebfn \u1edf tr\u1ebb em \u0111\u1eb7c tr\u01b0ng b\u1edfi tri\u1ec7u ch\u1ee9ng t\u0103ng \u0111\u1ed9ng, kh\u00f4ng ch\u00fa \u00fd v\u00e0 b\u1ea5t \u1ed5n c\u1ea3m x\u00fac.\" \/>\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=\"R\u1ed1i lo\u1ea1n t\u0103ng \u0111\u1ed9ng gi\u1ea3m ch\u00fa \u00fd \u1edf tr\u1ebb em - 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