{"id":30280,"date":"2023-05-01T22:06:11","date_gmt":"2023-05-01T15:06:11","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30280"},"modified":"2023-05-02T07:44:11","modified_gmt":"2023-05-02T00:44:11","slug":"dieu-tri-benh-dong-mach-canh-do-xo-vua","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/dieu-tri-benh-dong-mach-canh-do-xo-vua\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh do x\u01a1 v\u1eefa"},"content":{"rendered":"

Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh<\/a> do x\u01a1 v\u1eefa c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p nh\u01b0 thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng, s\u1eed d\u1ee5ng thu\u1ed1c, ph\u1eabu thu\u1eadt<\/strong><\/p>\n

\"B\u1ec7nh
B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh do x\u01a1 v\u0169a<\/figcaption><\/figure>\n

1. N\u1ed9i khoa<\/h2>\n

\u0110i\u1ec1u ch\u1ec9nh c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a b\u1ec7nh l\u00fd x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch v\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u:
\n– B\u1ecf h\u00fat thu\u1ed1c l\u00e1, thu\u1ed1c l\u00e0o.
\n– Ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p, duy tr\u00ec huy\u1ebft \u00e1p nh\u1ecf h\u01a1n 140\/90 mmHg.
\n– Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u ch\u1eb7t ch\u1ebd n\u1ebfu b\u1ec7nh nh\u00e2n b\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.
\n– Ki\u1ec3m so\u00e1t lipid m\u00e1u: H\u01b0\u1edbng d\u1eabn d\u00f9ng statin \u0111\u1ec3 ki\u1ec3u so\u00e1t lipid m\u00e1u t\u00edch c\u1ef1c \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed nh\u1ed3i m\u00e1u n\u00e3o do x\u01a1 v\u1eefa ho\u1eb7c c\u01a1n thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 tho\u00e1ng qua \u0111\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 v\u00e0 bi\u1ebfn c\u1ed1 tim m\u1ea1ch. M\u1ee5c ti\u00eau gi\u1ea3m
\nLDL-C \u2265 50% so v\u1edbi m\u1ee9c n\u1ec1n (khi b\u1ec7nh nh\u00e2n ch\u01b0a \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng b\u1ea5t k\u00ec thu\u1ed1c h\u1ea1 lipid m\u00e1u n\u00e0o) v\u00e0 \u0111\u00edch LDL-C < 1,4 mmol\/L (< 55 mg\/dL).
\n– Thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u :
\n+ Aspirin 75 – 100 mg\/24h, ho\u1eb7c
\n+ Clopidogrel 75 mg\/24h (n\u1ebfu kh\u00f4ng dung n\u1ea1p aspirin).<\/p>\n

2. \u0110i\u1ec1u tr\u1ecb t\u00e1i th\u00f4ng m\u1ea1ch \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh<\/h2>\n

Quy\u1ebft \u0111\u1ecbnh t\u00e1i th\u00f4ng m\u1ea1ch \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh d\u1ef1a tr\u00ean ti\u1ec1n s\u1eed \u0111\u1ed9t qu\u1ef5\/c\u01a1n thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 tho\u00e1ng qua trong v\u00f2ng 6 th\u00e1ng, tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng, m\u1ee9c \u0111\u1ed9 h\u1eb9p, tu\u1ed5i, gi\u1edbi, b\u1ec7nh l\u00fd ph\u1ed1i h\u1ee3p v\u00e0 k\u1ef3 v\u1ecdng s\u1ed1ng. C\u00f3 2 ph\u01b0\u01a1ng ph\u00e1p t\u00e1i th\u00f4ng m\u1ea1ch \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh: Ph\u1eabu thu\u1eadt b\u00f3c t\u00e1ch n\u1ed9i m\u1ea1c \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh \u2013 m\u1ea3ng x\u01a1 v\u1eefa (CEA) ho\u1eb7c can thi\u1ec7p \u0111\u1eb7t stent \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh
\n(CAS).<\/p>\n

2.1. Ph\u1eabu thu\u1eadt<\/h3>\n

Ph\u1eabu thu\u1eadt l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kinh \u0111i\u1ec3n
\n– Ph\u01b0\u01a1ng ph\u00e1p: B\u00f3c n\u1ed9i m\u1ea1c \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh – m\u1ea3ng x\u01a1 v\u1eefa \u0111\u01a1n thu\u1ea7n ho\u1eb7c l\u1ea5y n\u1ed9i m\u1ea1c \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh – m\u1ea3ng x\u01a1 v\u1eefa k\u00e8m theo \u0111\u1eb7t mi\u1ebfng v\u00e1 (patch).
\n– Bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn ph\u1eabu thu\u1eadt:
\n+ T\u0103ng huy\u1ebft \u00e1p (20%)
\n+ H\u1ea1 huy\u1ebft \u00e1p (5%)
\n+ Ch\u1ea3y m\u00e1u n\u00e3o (< 1%)
\n+ T\u1eafc \u0111\u1ed9ng m\u1ea1ch c\u1ea5p, \u0111\u1ed9t qu\u1ef5, nh\u1ed3i m\u00e1u c\u01a1 tim (1%)
\n+ Thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch
\n+ Li\u1ec7t th\u1ea7n kinh s\u1ecd
\n+ Nhi\u1ec5m tr\u00f9ng
\n+ T\u00e1i h\u1eb9p
\n+ T\u1eed vong
\n– Nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao khi ph\u1eabu thu\u1eadt:
\n+ Tu\u1ed5i > 80
\n+ Suy tim NYHA III-IV, EF \u2264 30 %
\n+ \u0110au th\u1eaft ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh
\n+ T\u1ed5n th\u01b0\u01a1ng th\u00e2n chung ho\u1eb7c nhi\u1ec1u nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh
\n+ Ph\u1eabu thu\u1eadt tim c\u1ea5p trong v\u00f2ng 30 ng\u00e0y
\n+ Nh\u1ed3i m\u00e1u c\u01a1 tim trong v\u00f2ng 30 ng\u00e0y
\n+ B\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh n\u1eb7ng v\u00e0 suy th\u1eadn n\u1eb7ng<\/p>\n

2.2. Can thi\u1ec7p \u0111\u1eb7t stent \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh<\/h3>\n

– L\u00e0 bi\u1ec7n ph\u00e1p c\u00f3 th\u1ec3 l\u1ef1a ch\u1ecdn thay th\u1ebf cho ph\u1eabu thu\u1eadt.
\n– Qua \u0111\u01b0\u1eddng \u1ed1ng th\u00f4ng (t\u1eeb \u0111\u00f9i), \u0111\u1eb7t stent \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh t\u1ea1i ch\u1ed7 h\u1eb9p c\u00f3 th\u1ec3 k\u00e8m theo s\u1eed d\u1ee5ng b\u00f3ng nong ho\u1eb7c kh\u00f4ng. Th\u01b0\u1eddng c\u1ea7n m\u1ed9t l\u01b0\u1edbi l\u1ecdc \u0111o\u1ea1n xa ng\u0103n huy\u1ebft kh\u1ed1i b\u1eafn l\u00ean n\u00e3o.
\n– Nh\u1eefng th\u1eed nghi\u1ec7m g\u1ea7n \u0111\u00e2y cho th\u1ea5y \u0111\u1eb7t stent \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh cho k\u1ebft qu\u1ea3 kh\u00f4ng k\u00e9m h\u01a1n so v\u1edbi ph\u1eabu thu\u1eadt khi theo d\u00f5i l\u00e2u d\u00e0i v\u00e0 tr\u00e1nh \u0111\u01b0\u1ee3c nh\u1eefng nguy c\u01a1 ti\u1ec1m \u1ea9n li\u00ean quan \u0111\u1ebfn ph\u1eabu thu\u1eadt nh\u1ea5t l\u00e0 \u1edf b\u1ec7nh nh\u00e2n nguy c\u01a1 ph\u1eabu thu\u1eadt cao do
\nc\u00e1c b\u1ec7nh l\u00fd \u0111i k\u00e8m.
\n– Bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn can thi\u1ec7p:
\n+ Bi\u1ebfn ch\u1ee9ng ch\u00ednh l\u00e0 \u0111\u1ed9t qu\u1ef5.
\n+ Tai bi\u1ebfn m\u1ea1ch n\u00e3o tho\u00e1ng qua.
\n+ Nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p, t\u1eed vong.
\n+ T\u1ee5t huy\u1ebft \u00e1p v\u00e0 nh\u1ecbp ch\u1eadm \u00edt g\u1eb7p, th\u01b0\u1eddng tho\u00e1ng qua v\u00e0 nh\u1eb9.
\n+ C\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00e1c li\u00ean quan \u0111\u1ebfn th\u1ee7 thu\u1eadt nh\u01b0: T\u1ee5 m\u00e1u t\u1ea1i v\u1ecb tr\u00ed ch\u1ecdc m\u1ea1ch, d\u1ecb \u1ee9ng v\u1edbi thu\u1ed1c c\u1ea3n quang, suy th\u1eadn do thu\u1ed1c c\u1ea3n quang…<\/p>\n

2.3. \u0110i\u1ec1u tr\u1ecb ch\u1ed1ng huy\u1ebft kh\u1ed1i li\u00ean quan \u0111\u1ebfn can thi\u1ec7p, ph\u1eabu thu\u1eadt<\/h3>\n

– V\u1edbi b\u1ec7nh nh\u00e2n can thi\u1ec7p \u0111\u1eb7t stent:
\n+ Kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u k\u00e9p li\u1ec1u n\u1ea1p tr\u01b0\u1edbc th\u1ee7 thu\u1eadt: Aspirin 300 mg v\u00e0 clopidogrel 300 mg.
\n+ Kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u k\u00e9p li\u1ec1u duy tr\u00ec sau \u0111\u1eb7t stent 1 th\u00e1ng: Aspirin 75 – 100 mg\/24h v\u00e0 clopidogrel 75 mg\/24h.
\n+ Sau \u0111\u00f3 d\u00f9ng kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u \u0111\u01a1n l\u00e2u d\u00e0i: Aspirin 75 – 100 mg\/24h ho\u1eb7c clopidogrel 75 mg\/24h. Tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng (kh\u00e1ng vitamin K ho\u1eb7c DOACs) v\u00ec l\u00fd do kh\u00e1c th\u00ec ch\u1ec9 c\u1ea7n s\u1eed d\u1ee5ng
\nthu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u01a1n \u0111\u1ed9c.
\n+ Kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf glycoprotein IIb\/IIIa th\u01b0\u1eddng quy.
\n+ Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng: Kh\u00f4ng c\u1ea7n d\u00f9ng ch\u1ed1ng \u0111\u00f4ng sau th\u1ee7 thu\u1eadt.
\n– V\u1edbi b\u1ec7nh nh\u00e2n ph\u1eabu thu\u1eadt: ch\u1ec9 c\u1ea7n dung kh\u00e1ng ti\u1ec3u c\u1ea7u \u0111\u01a1n l\u00e2u d\u00e0i sau m\u1ed5 (ho\u1eb7c aspirin ho\u1eb7c clopidogrel)<\/p>\n


\n<\/strong>2.4. \u0110\u00e1nh gi\u00e1 nguy c\u01a1 \u1edf b\u1ec7nh nh\u00e2n h\u1eb9p \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh<\/h3>\n

Nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m sau d\u1ef1 \u0111o\u00e1n nguy c\u01a1 cao \u1edf b\u1ec7nh nh\u00e2n h\u1eb9p \u0111\u1ed9ng m\u1ea1ch:
\n– L\u00e2m s\u00e0ng: B\u1ec7nh nh\u00e2n \u0111\u00e3 b\u1ecb \u0111\u1ed9t qu\u1ef5 ho\u1eb7c c\u01a1n thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 tho\u00e1ng qua \u0111\u1ed1i b\u00ean.
\n– H\u00ecnh \u1ea3nh h\u1ecdc: Nh\u1ed3i m\u00e1u n\u00e3o kh\u00f4ng tri\u1ec7u ch\u1ee9ng, \u1edf c\u00f9ng b\u00ean.
\n– Si\u00eau \u00e2m: H\u1eb9p ti\u1ebfn tri\u1ec3n (> 20%), t\u1eafc m\u1ea1ch t\u1ef1 ph\u00e1t tr\u00ean si\u00eau \u00e2m xuy\u00ean s\u1ecd (t\u00edn hi\u1ec7u t\u0103ng t\u1ef7 tr\u1ecdng tho\u00e1ng qua – HITS), d\u1ef1 tr\u1eef m\u1ea1ch m\u00e1u n\u00e3o gi\u1ea3m, m\u1ea3ng x\u01a1 v\u1eefa l\u1edbn (> 40 mm2), m\u1ea3ng x\u01a1 v\u1eefa r\u1ed7ng \u00e2m (Echolucent), c\u00f3 v\u00f9ng gi\u1ea3m \u00e2m g\u1ea7n n\u1ed9i m\u1ea1c.
\n– C\u1ed9ng h\u01b0\u1edfng t\u1eeb m\u1ea1ch m\u00e1u: Ch\u1ea3y m\u00e1u trong m\u1ea3ng x\u01a1 v\u1eefa, l\u00f5i gi\u00e0u lipid ho\u1ea1i t\u1eed.<\/p>\n

2.5. Ch\u1ec9 \u0111\u1ecbnh t\u00e1i th\u00f4ng m\u1ea1ch cho b\u1ec7nh nh\u00e2n h\u1eb9p \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh kh\u00f4ng tri\u1ec7u ch\u1ee9ng<\/h3>\n

Ph\u1eabu thu\u1eadt b\u00f3c t\u00e1ch n\u1ed9i m\u1ea1c n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 ph\u1eabu thu\u1eadt m\u1ee9c \u0111\u1ed9 trung b\u00ecnh, c\u00f3 h\u1eb9p 60-99% v\u00e0 kh\u00f4ng tri\u1ec7u ch\u1ee9ng, n\u1ebfu c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng v\u00e0\/ho\u1eb7c tr\u00ean h\u00ecnh \u1ea3nh m\u00e0 c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn t\u0103ng nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 c\u00f9ng b\u00ean x\u1ea3y ra mu\u1ed9n, v\u1edbi \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 \u0111\u1ed9t qu\u1ef5\/t\u1eed vong quanh ph\u1eabu thu\u1eadt < 3% v\u00e0 k\u00ec v\u1ecdng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n tr\u00ean 5 n\u0103m.
\nCan thi\u1ec7p n\u1ed9i m\u1ea1ch c\u00f3 th\u1ec3 l\u00e0 bi\u1ec7n ph\u00e1p l\u1ef1a ch\u1ecdn \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 ph\u1eabu thu\u1eadt cao, c\u00f3 h\u1eb9p 60-99% v\u00e0 kh\u00f4ng tri\u1ec7u ch\u1ee9ng, n\u1ebfu c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng v\u00e0\/ho\u1eb7c tr\u00ean h\u00ecnh \u1ea3nh m\u00e0 c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn t\u0103ng nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 c\u00f9ng b\u00ean x\u1ea3y ra mu\u1ed9n, \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 \u0111\u1ed9t qu\u1ef5\/t\u1eed vong quanh th\u1ee7 thu\u1eadt < 3% v\u00e0 k\u00ec v\u1ecdng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n tr\u00ean 5 n\u0103m.<\/p>\n

2.6. Ch\u1ec9 \u0111\u1ecbnh t\u00e1i th\u00f4ng m\u1ea1ch cho b\u1ec7nh nh\u00e2n h\u1eb9p \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh c\u00f3 tri\u1ec7u ch\u1ee9ng<\/h3>\n

– Ph\u1eabu thu\u00e2t b\u00f3c t\u00e1ch n\u1ed9i m\u1ea1c \u2013 x\u01a1 v\u1eefa \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng v\u1edbi h\u1eb9p 70 – 99% \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh, t\u1ef7 l\u1ec7 \u0111\u1ed9t qu\u1ef5 \/ t\u1eed vong chu ph\u1eabu \u01b0\u1edbc \u0111o\u00e1n l\u00e0 < 6%. Ph\u1eabu thu\u1eadt n\u00e0y c\u0169ng n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t \u1edf b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng v\u1edbi h\u1eb9p\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a050 \u2013 69% \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh, t\u1ef7 l\u1ec7 \u0111\u1ed9t qu\u1ef5 \/ t\u1eed vong chu ph\u1eabu \u01b0\u1edbc \u0111o\u00e1n l\u00e0 < 6%.
\n– Khi t\u00e1i th\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n nguy c\u01a1 ph\u1eabu thu\u1eadt trung b\u00ecnh m\u1eafc b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh c\u00f3 tri\u1ec7u ch\u1ee9ng, can thi\u1ec7p n\u1ed9i m\u1ea1ch c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem x\u00e9t thay th\u1ebf cho ph\u1eabu thu\u1eadt, t\u1ef7 l\u1ec7 \u0111\u1ed9t qu\u1ef5 \/ t\u1eed vong quanh th\u1ee7 thu\u1eadt \u01b0\u1edbc \u0111o\u00e1n l\u00e0 <6%.
\n– Bi\u1ec7n ph\u00e1p t\u00e1i th\u00f4ng \u1edf b\u1ec7nh nh\u00e2n h\u1eb9p m\u1ea1ch c\u1ea3nh 50 \u2013 99% c\u00f3 tri\u1ec7u ch\u1ee9ng c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t, t\u1ed1t nh\u1ea5t l\u00e0 trong v\u00f2ng 14 ng\u00e0y k\u1ec3 t\u1eeb khi c\u00f3 tri\u1ec7u ch\u1ee9ng kh\u1edfi ph\u00e1t.
\n– KH\u00d4NG ch\u1ec9 \u0111\u1ecbnh t\u00e1i th\u00f4ng \u1edf b\u1ec7nh nh\u00e2n b\u1ecb h\u1eb9p \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh <50%<\/p>\n","protected":false},"excerpt":{"rendered":"

Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh do x\u01a1 v\u1eefa c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p nh\u01b0 thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng, s\u1eed d\u1ee5ng thu\u1ed1c, ph\u1eabu thu\u1eadt 1. N\u1ed9i khoa \u0110i\u1ec1u ch\u1ec9nh c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a b\u1ec7nh l\u00fd x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch v\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u: – B\u1ecf […]<\/p>\n","protected":false},"author":25,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\n\u0110i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh do x\u01a1 v\u1eefa - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh do x\u01a1 v\u1eefa c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p nh\u01b0 thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng, s\u1eed d\u1ee5ng thu\u1ed1c, ph\u1eabu thu\u1eadt.\" \/>\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=\"\u0110i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh do x\u01a1 v\u1eefa - 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