{"id":29871,"date":"2023-05-04T17:23:40","date_gmt":"2023-05-04T10:23:40","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29871"},"modified":"2023-05-10T18:58:12","modified_gmt":"2023-05-10T11:58:12","slug":"ton-thuong-than-cap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/ton-thuong-than-cap\/","title":{"rendered":"T\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p: ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

T\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p trong y h\u1ecdc, \u0111\u1eb7c bi\u1ec7t th\u01b0\u1eddng x\u1ea3y ra \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang trong t\u00ecnh tr\u1ea1ng n\u1eb7ng, \u0111e d\u1ecda t\u00ednh m\u1ea1ng. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 t\u0103ng c\u01b0\u1eddng ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. Hi\u1ec7n nay, c\u00f3 nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong th\u1ef1c ti\u1ec5n l\u00e2m s\u00e0ng, bao g\u1ed3m c\u1ea3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn, gi\u1ea3m \u00e1p l\u1ef1c trong c\u00e1c m\u1ea1ch th\u1eadn, \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng v\u00e0 ki\u1ec3m so\u00e1t l\u01b0\u1ee3ng n\u01b0\u1edbc v\u00e0 c\u00e1c ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i trong c\u01a1 th\u1ec3.<\/strong><\/p>\n

1.Ch\u1ea9n \u0111o\u00e1n <\/strong><\/h1>\n

1.1. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/h3>\n

Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u01a1 b\u1ea3n c\u1ee7a t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p l\u00e0 s\u1ef1 gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng n\u01b0\u1edbc ti\u1ec3u do suy gi\u1ea3m m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn.<\/p>\n

Ngo\u00e0i ra ng\u01b0\u1eddi b\u1ec7nh c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng kh\u00e1c nhau t\u00f9y thu\u1ed9c v\u00e0o c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y suy th\u1eadn c\u1ea5p do \u0111\u00f3 \u0111\u00f2i h\u1ecfi ph\u1ea3i khai th\u00e1c ti\u1ec1n s\u1eed v\u00e0 kh\u00e1m l\u00e2m s\u00e0ng \u0111\u1ec3 c\u00f3 ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n g\u00e2y ra t\u00ecnh tr\u1ea1ng t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p. V\u00ed d\u1ee5:<\/p>\n

– Nhi\u1ec5m khu\u1ea9n huy\u1ebft: Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 \u0111\u00e3 ti\u1ebfn h\u00e0nh c\u00e1c th\u1ee7 thu\u1eadt x\u00e2m l\u1ea5n tr\u01b0\u1edbc \u0111\u00f3, c\u00f3 d\u1ea5u hi\u1ec7u c\u1ee7a c\u00e1c nhi\u1ec5m tr\u00f9ng c\u1ee5c b\u1ed9 l\u00e0 \u0111\u01b0\u1eddng v\u00e0o c\u1ee7a nhi\u1ec5m khu\u1ea9n huy\u1ebft. Bi\u1ec3u hi\u1ec7n s\u1ed1t cao r\u00e9t run\u2026<\/p>\n

– Gi\u1ea3m th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n hi\u1ec7u d\u1ee5ng: Bi\u1ec3u hi\u1ec7n b\u1ec7nh ti\u00eau h\u00f3a nh\u01b0 xu\u1ea5t huy\u1ebft, th\u1eadn, t\u1ed5n th\u01b0\u01a1ng da nh\u01b0 b\u1ecfng, sau ph\u1eabu thu\u1eadt trong th\u1eddi gian g\u1ea7n \u0111\u00e2y, nhi\u1ec5m tr\u00f9ng huy\u1ebft, sau ch\u1ea5n th\u01b0\u01a1ng\u2026<\/p>\n

– T\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ni\u1ec7u g\u00e2y \u1ee9 n\u01b0\u1edbc b\u1ec3 th\u1eadn ni\u1ec7u qu\u1ea3n: Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh ti\u1ebft ni\u1ec7u, sinh d\u1ee5c ho\u1eb7c ung th\u01b0 v\u00f9ng ch\u1eadu<\/p>\n

– Ng\u1ed9 \u0111\u1ed9c thu\u1ed1c ho\u1eb7c c\u00e1c ch\u1ea5t kh\u00e1c:<\/p>\n

– Suy tim, suy gan, ung th\u01b0, b\u1ec7nh m\u1ea1ch m\u00e1u\u2026<\/p>\n

1.2. Tri\u1ec7u ch\u1ee9ng c\u1eadn l\u00e2m s\u00e0ng<\/strong><\/h3>\n

– X\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u: n\u00ean \u0111\u01b0\u1ee3c l\u00e0m th\u01b0\u1eddng qui \u1edf t\u1ea5t c\u1ea3 c\u00e1c ng\u01b0\u1eddi b\u1ec7nh t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p.<\/p>\n

– X\u00e9t nghi\u1ec7m huy\u1ebft h\u1ecdc nh\u01b0 c\u00f4ng th\u1ee9c m\u00e1u, t\u1ef7 l\u1ec7 Prothrombin, IRN\u2026 r\u1ea5t c\u1ea7n thi\u1ebft trong t\u00ecnh tr\u1ea1ng \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p c\u00f3 li\u00ean quan \u0111\u1ebfn thi\u1ebfu m\u00e1u do xu\u1ea5t huy\u1ebft hay tan huy\u1ebft, c\u00e1c tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft do gi\u1ea3m ti\u1ec3u c\u1ea7u, huy\u1ebft kh\u1ed1i, vi\u00eam t\u1eafc m\u1ea1ch\u2026<\/p>\n

– X\u00e9t nghi\u1ec7m \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3 trong \u0111\u00f3 \u0111\u1eb7c bi\u1ec7t ch\u00fa \u00fd t\u00ecnh tr\u1ea1ng t\u0103ng Kali m\u00e1u \u0111\u1ec3 c\u00f3 ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi. – X\u00e9t nghi\u1ec7m c\u00e1c ch\u1ec9 s\u1ed1 amylase, b2-microglobulin\u2026 l\u00e0 nh\u1eefng ch\u1ec9 s\u1ed1 theo d\u00f5i cho s\u1ef1 b\u00e0i ti\u1ebft n\u01b0\u1edbc ti\u1ec3u c\u1ee7a protein tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed nh\u1ecf m\u00e0 c\u00f3 th\u1ec3 d\u1ec5 d\u00e0ng l\u1ecdc b\u1edfi c\u1ea7u th\u1eadn v\u00e0 t\u00e1i h\u1ea5p thu c\u1ee7a \u1ed1ng b\u00ecnh th\u01b0\u1eddng. T\u0103ng b\u00e0i ti\u1ebft n\u01b0\u1edbc ti\u1ec3u c\u1ee7a c\u00e1c protein n\u00e0y c\u00f3 th\u1ec3 ph\u1ea3n \u00e1nh t\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng \u1ed1ng th\u1eadn v\u00e0 c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u c\u1ee7a t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p.<\/p>\n

-X\u00e9t nghi\u1ec7m h\u1ed7 tr\u1ee3 ti\u1ebfp theo cho ch\u1ea9n \u0111o\u00e1n t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i l\u00e0 \u0111o n\u1ed3ng \u0111\u1ed9 natri ho\u1eb7c s\u1ef1 b\u00e0i ti\u1ebft c\u1ee7a natri trong n\u01b0\u1edbc ti\u1ec3u.<\/p>\n

-X\u00e9t nghi\u1ec7m ure, creatinin\u2026 c\u00f3 bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn t\u00f9y theo giai \u0111o\u1ea1n b\u1ec7nh.<\/p>\n

1.3. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p<\/strong><\/h3>\n

Ch\u1ea9n \u0111o\u00e1n theo m\u1ee9c \u0111\u1ed9 t\u0103ng n\u1eb7ng: nguy c\u01a1, t\u1ed5n th\u01b0\u01a1ng v\u00e0 suy ch\u1ee9c n\u0103ng d\u1eabn \u0111\u1ebfn hai h\u1eadu qu\u1ea3 l\u00e0 m\u1ea5t ch\u1ee9c n\u0103ng th\u1eadn v\u00e0 b\u1ec7nh th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i; ti\u00eau chu\u1ea9n RIFLE (the increasing severity classes Risk, Injury, and Failure, and the two outcome classes Loss and End Stage Kidney Disease-RIFLE).<\/p>\n

C\u00e1c x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh t\u00f9y theo nguy\u00ean nh\u00e2n g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p v\u00e0 giai \u0111o\u1ea1n b\u1ec7nh.<\/p>\n

\"\"
\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Bi\u1ec3u \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n theo ti\u00eau chu\u1ea9n RIFLE. Ngu\u1ed3n<\/strong>: B\u1ed9 Y t\u1ebf 2015<\/em><\/figcaption><\/figure>\n

2. \u0110i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p<\/strong><\/h2>\n

2.1. \u0110\u1ea3m b\u1ea3o th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n <\/strong><\/h3>\n

\u0110\u1eb7t catheter t\u0129nh m\u1ea1ch trung t\u00e2m \u0111\u1ec3 theo d\u00f5i vi\u1ec7c \u0111\u1ea3m b\u1ea3o \u0111\u1ee7 th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n. S\u1ef1 thi\u1ebfu ho\u1eb7c th\u1eeba th\u1ec3 t\u00edch \u0111\u1ec1u kh\u00f4ng c\u00f3 l\u1ee3i cho th\u1eadn. X\u00e1c \u0111\u1ecbnh l\u01b0\u1ee3ng c\u1ee5 th\u1ec3 s\u1ed1 l\u01b0\u1ee3ng d\u1ecbch c\u1ea7n b\u00f9 v\u00e0 theo nguy\u00ean t\u1eafc b\u00f9 nh\u1eefng l\u01b0\u1ee3ng d\u1ecbch nh\u1ecf c\u1ee7a nhi\u1ec1u lo\u1ea1i d\u1ecbch kh\u00e1c nhau, kh\u00f4ng d\u00f9ng duy nh\u1ea5t m\u1ed9t lo\u1ea1i d\u1ecbch. S\u1eed d\u1ee5ng l\u1ee3i ti\u1ec3u ch\u1ec9 n\u00ean b\u1eaft \u0111\u1ea7u khi \u0111\u00e3 b\u00f9 \u0111\u1ee7 th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n.<\/p>\n

2.2. \u0110i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i <\/strong><\/h3>\n

R\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i r\u1ea5t th\u01b0\u1eddng xuy\u00ean g\u1eb7p v\u00e0 quan tr\u1ecdng nh\u1ea5t c\u1ee7a s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng bao g\u1ed3m r\u1ed1i lo\u1ea1n natri, kali, canxi v\u00e0 ph\u1ed1t pho.<\/p>\n

H\u1ea1 natri m\u00e1u v\u00e0 t\u0103ng kali m\u00e1u l\u00e0 ph\u1ed5 bi\u1ebfn nh\u1ea5t v\u00e0 nh\u1eefng r\u1ed1i lo\u1ea1n n\u00e0y lu\u00f4n c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n nhanh ch\u00f3ng v\u00e0 \u0111i\u1ec1u ch\u1ec9nh v\u1ec1 m\u1ee9c an to\u00e0n cho ng\u01b0\u1eddi b\u1ec7nh tr\u01b0\u1edbc khi ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u00e1c b\u1ec7nh c\u01a1 b\u1ea3n. S\u1ef1 nh\u1ea5n m\u1ea1nh v\u1ec1 \u0111i\u1ec1u ch\u1ec9nh \u0111i\u1ec7n gi\u1ea3i l\u00e0 do nh\u1eefng r\u1ed1i lo\u1ea1n \u1edf ng\u01b0\u1eddi b\u1ec7nh v\u1edbi h\u1ea1 natri m\u00e1u c\u00f3 nguy c\u01a1 cao g\u00e2y ph\u00f9 n\u00e3o, v\u00e0 t\u0103ng kali m\u00e1u c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn \u0111e d\u1ecda t\u00ednh m\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh do \u1ea3nh h\u01b0\u1edfng c\u1ee7a r\u1ed1i lo\u1ea1n nh\u1ecbp tim. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n nhanh ch\u00f3ng v\u00e0 x\u1eed tr\u00ed hi\u1ec7u qu\u1ea3 nh\u1eefng r\u1ed1i lo\u1ea1n n\u00e0y s\u1ebd h\u1ea1n ch\u1ebf nguy c\u01a1 \u0111e d\u1ecda t\u00ednh m\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

2.3. S\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u <\/strong><\/h3>\n

Thu\u1ed1c l\u1ee3i ti\u1ec3u ch\u1ec9 n\u00ean b\u1eaft \u0111\u1ea7u khi \u0111\u00e3 b\u00f9 \u0111\u1ee7 th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n. T\u1ed5ng quan ph\u00e2n t\u00edch g\u1ed9p s\u00e1u nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng furosemide \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p v\u1edbi li\u1ec1u l\u01b0\u1ee3ng kh\u00e1c nhau t\u1eeb 600-3400mg\/ng\u00e0y kh\u00f4ng gi\u1ea3m \u0111\u00e1ng k\u1ec3 l\u00e0 v\u1ec1 t\u1eed vong trong b\u1ec7nh vi\u1ec7n. Nghi\u00ean c\u1ee9u nghi\u00ean c\u1ee9u \u0111\u01a1n l\u1edbn nh\u1ea5t v\u1ec1 s\u1eed d\u1ee5ng furosemide trong \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi Cantarovich v\u00e0 c\u1ed9ng s\u1ef1, ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh l\u1ecdc m\u00e1u \u0111\u01b0\u1ee3c d\u00f9ng ng\u1eabu nhi\u00ean m\u1ed9t trong 2 ph\u00e1c \u0111\u1ed3 s\u1eed d\u1ee5ng furosemide (25 mg\/kg\/ng\u00e0y ti\u00eam t\u0129nh m\u1ea1ch ho\u1eb7c 35 mg\/kg\/ng\u00e0y \u0111\u01b0\u1eddng u\u1ed1ng) ho\u1eb7c gi\u1ea3 d\u01b0\u1ee3c. M\u1eb7c d\u00f9 th\u1eddi gian \u0111\u1ec3 \u0111\u1ea1t 2 l\u00edt\/ng\u00e0y c\u1ee7a l\u1ee3i ti\u1ec3u furosemide ng\u1eafn h\u01a1n (5,7 ng\u00e0y) so v\u1edbi gi\u1ea3 d\u01b0\u1ee3c (7,8 ng\u00e0y) v\u1edbi p= 0,004. Tuy nhi\u00ean kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t cho th\u1ea5y furosemide c\u00f3 th\u1ec3 gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong \u1edf ng\u01b0\u1eddi b\u1ec7nh t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p.<\/p>\n

2.4. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh ch\u00ednh g\u00e2y t\u00ecnh tr\u1ea1ng t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p <\/strong><\/h3>\n

2.5. Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb thay th\u1ebf th\u1eadn <\/strong><\/h3>\n

Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb thay th\u1ebf khi trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i n\u1eb7ng, toan h\u00f3a v\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn n\u1eb7ng. N\u00ean s\u1eed d\u1ee5ng m\u00e0ng l\u1ecdc sinh h\u1ecdc t\u01b0\u01a1ng th\u00edch cho l\u1ecdc m\u00e1u li\u00ean t\u1ee5c ho\u1eb7c ng\u1eaft qu\u00e3ng (Intermittent hemodialysis-IHD v\u00e0 Continuous renal replacement therapy-CRRT).<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o<\/strong>: H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh v\u1ec1 th\u1eadn \u2013 ti\u1ebft ni\u1ec7u c\u1ee7a B\u1ed9 Y t\u1ebf 2015<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 t\u0103ng c\u01b0\u1eddng […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[29,33],"tags":[],"yoast_head":"\nT\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p: ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb<\/title>\n<meta name=\"description\" content=\"T\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p trong y h\u1ecdc, \u0111\u1eb7c bi\u1ec7t th\u01b0\u1eddng x\u1ea3y ra \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang trong t\u00ecnh tr\u1ea1ng n\u1eb7ng, \u0111e d\u1ecda t\u00ednh\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, 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