{"id":30412,"date":"2023-05-03T15:13:13","date_gmt":"2023-05-03T08:13:13","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30412"},"modified":"2023-05-03T15:13:13","modified_gmt":"2023-05-03T08:13:13","slug":"phinh-dong-dong-mach-chu","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/phinh-dong-dong-mach-chu\/","title":{"rendered":"Ph\u00ecnh \u0111\u1ed9ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7"},"content":{"rendered":"

Ph\u00ecnh \u0111\u1ed9ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/a> \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 \u0111\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 gi\u00e3n l\u1edbn tr\u00ean 50% so v\u1edbi \u0111\u01b0\u1eddng k\u00ednh \u0111\u1ed9ng m\u1ea1ch tham chi\u1ebfu \u1edf ng\u01b0\u1eddi c\u00f9ng l\u1ee9a tu\u1ed5i. T\u1ed5n th\u01b0\u01a1ng x\u1ea3y ra \u1edf c\u1ea3 3 l\u1edbp \u00e1o c\u1ee7a th\u00e0nh \u0110M ch\u1ee7.<\/strong><\/p>\n

1. T\u1ed5ng quan<\/h2>\n

Ph\u00ecnh \u0111\u1ed9ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 \u0111\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 gi\u00e3n l\u1edbn tr\u00ean 50% so v\u1edbi \u0111\u01b0\u1eddng k\u00ednh \u0111\u1ed9ng m\u1ea1ch tham chi\u1ebfu \u1edf ng\u01b0\u1eddi c\u00f9ng l\u1ee9a tu\u1ed5i. T\u1ed5n th\u01b0\u01a1ng x\u1ea3y ra \u1edf c\u1ea3 3 l\u1edbp \u00e1o c\u1ee7a th\u00e0nh \u0110M ch\u1ee7.<\/p>\n

Ph\u00ecnh \u0110M ch\u1ee7 ng\u1ef1c \u00edt g\u1eb7p h\u01a1n nhi\u1ec1u so v\u1edbi ph\u00ecnh \u0110M ch\u1ee7 b\u1ee5ng (\u01b0\u1edbc t\u00ednh kho\u1ea3ng 6\/100.000 ng\u01b0\u1eddi\/n\u0103m). H\u1ea7u h\u1ebft ph\u00ecnh \u0110M ch\u1ee7 ng\u1ef1c kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng. Ph\u00ecnh l\u1edbn \u0110M ch\u1ee7 ng\u1ef1c c\u00f3 nguy c\u01a1 v\u1ee1 tr\u00ean 74% v\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong l\u00ean \u0111\u1ebfn 90% khi v\u1ee1 kh\u1ed1i ph\u00ecnh.<\/p>\n

2. Nguy\u00ean nh\u00e2n<\/h2>\n

\u0110a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p ph\u00ecnh \u0110M ch\u1ee7 ng\u1ef1c l\u00e0 do tho\u00e1i ho\u00e1, v\u1edbi c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh l\u00fd x\u01a1 v\u1eefa m\u1ea1ch m\u00e1u.<\/p>\n

Vi\u00eam \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 do nhi\u1ec5m khu\u1ea9n, ho\u1eb7c do b\u1ec7nh h\u1ec7 th\u1ed1ng nh\u01b0 vi\u00eam \u0111\u1ed9ng m\u1ea1ch t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3, b\u1ec7nh Takayasu, vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p…<\/p>\n

B\u1ec7nh l\u00fd m\u00f4 li\u00ean k\u1ebft nh\u01b0 h\u1ed9i ch\u1ee9ng Marfan, h\u1ed9i ch\u1ee9ng Ehlers-Danlos. T\u1ed5n th\u01b0\u01a1ng \u0110M ch\u1ee7 do ch\u1ea5n th\u01b0\u01a1ng (tai n\u1ea1n, ph\u0201u thu\u1eadt – th\u1ee7 thu\u1eadt). Van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 hai l\u00e1 van g\u00e2y ph\u00ecnh gi\u00e3n \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean.<\/p>\n

Nguy\u00ean nh\u00e2n di truy\u1ec1n: b\u1ec7nh nh\u00e2n \u0111\u1ed9t bi\u1ebfn gen TGFBR1, TGFBR2, FBN1, MYH11.<\/p>\n

3. Ti\u1ebfn tri\u1ec3n t\u1ef1 nhi\u00ean<\/h2>\n

Ph\u00ecnh \u0110M ch\u1ee7 l\u00ean do tho\u00e1i ho\u00e1 th\u01b0\u1eddng ti\u1ebfn tri\u1ec3n v\u1edbi t\u1ed1c \u0111\u1ed9 0,1 cm\/n\u0103m. Ph\u00ecnh \u0110M ch\u1ee7 xu\u1ed1ng ti\u1ebfn tri\u1ec3n v\u1edbi t\u1ed1c \u0111\u1ed9 0,3 cm\/n\u0103m.<\/p>\n

Nguy c\u01a1 v\u1ee1 ph\u00ecnh t\u0103ng l\u00ean theo \u0111\u01b0\u1eddng k\u00ednh kh\u1ed1i ph\u00ecnh. Ph\u00ecnh \u0110M ch\u1ee7 ng\u1ef1c > 60 mm c\u00f3 nguy c\u01a1 v\u1ee1 7 %\/n\u0103m.<\/p>\n

4. L\u00e2m s\u00e0ng<\/h2>\n

\u0110a s\u1ed1 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng. Khi k\u00edch th\u01b0\u1edbc kh\u1ed1i ph\u00ecnh ti\u1ebfn tri\u1ec3n nhanh, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111au ng\u1ef1c, \u0111au l\u01b0ng t\u01b0\u01a1ng t\u1ef1 t\u00e1ch th\u00e0nh \u0110M ch\u1ee7.<\/p>\n

Ph\u00ecnh \u0110M ch\u1ee7 l\u00ean th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng nhi\u1ec1u h\u01a1n ph\u00ecnh \u0110M ch\u1ee7 xu\u1ed1ng nh\u01b0: Ho, kh\u00f3 th\u1edf, ho m\u00e1u n\u1ebfu kh\u1ed1i ph\u00ecnh ch\u00e8n \u00e9p v\u00e0o kh\u00ed ph\u1ebf qu\u1ea3n.<\/p>\n

H\u1ed9i ch\u1ee9ng t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean n\u1ebfu kh\u1ed1i ph\u00ecnh ch\u00e8n \u00e9p v\u00e0o t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean.<\/p>\n

V\u1ee1 ph\u00ecnh \u0110M ch\u1ee7: \u0110au ng\u1ef1c, t\u1ee5t \u00e1p, s\u1ed1c m\u1ea5t m\u00e1u, n\u00f4n m\u00e1u n\u1ebfu c\u00f3 r\u00f2 \u0110M ch\u1ee7 – th\u1ef1c qu\u1ea3n.<\/p>\n

5. Th\u0103m d\u00f2 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh<\/h2>\n

Ch\u1ec9 \u0111\u1ecbnh ch\u1ee5p CT, MRI \u0111\u1ed9ng m\u1ea1ch ch\u1ee7:<\/p>\n

    \n
  • Ph\u00ecnh \u0110M ch\u1ee7 c\u00f3 tri\u1ec7u ch\u1ee9ng.<\/li>\n
  • B\u1ec7nh nh\u00e2n kh\u00f4ng tri\u1ec7u ch\u1ee9ng nh\u01b0ng c\u00f3 nguy c\u01a1 cao: ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 ng\u01b0\u1eddi ph\u00ecnh,t\u00e1ch th\u00e0nh \u0110M ch\u1ee7 do r\u1ed1i lo\u1ea1n gen di truy\u1ec1n.<\/li>\n<\/ul>\n

    \"Ph\u00ecnh<\/p>\n

    B\u1ec7nh nh\u00e2n ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ng\u1ef1c \u0111o\u1ea1n xu\u1ed1ng<\/strong><\/p>\n

    Si\u00eau \u00e2m tim: <\/strong>\u0110\u00e1nh gi\u00e1 \u0111\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 l\u00ean, t\u00ecnh tr\u1ea1ng h\u1edf van \u0110M ch\u1ee7 k\u00e8m theo. Khi nghi ng\u1edd c\u00f3 ph\u00ecnh \u0110M ch\u1ee7 tr\u00ean si\u00eau \u00e2m ho\u1eb7c X-quang ng\u1ef1c th\u1eb3ng th\u00ec c\u1ea7n ph\u1ea3i ch\u1ee5p CLVT ho\u1eb7c CHT (c\u00f3 ho\u1eb7c kh\u00f4ng ti\u00eam thu\u1ed1c c\u1ea3n quang\/\u0111\u1ed1i quang t\u1eeb) \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 to\u00e0n b\u1ed9 \u0110M ch\u1ee7 v\u00e0 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed v\u00e0 m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng. Y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh \u0111\u1ebfn chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u1ee7a ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ng\u1ef1c l\u00e0 ph\u1ee5 thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc kh\u1ed1i ph\u00ecnh. Do \u0111\u00f3 c\u1ea7n ph\u1ea3i \u0111o \u0111\u1ea1c v\u00e0 \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1eddng k\u00ednh l\u1edbn nh\u1ea5t vu\u00f4ng g\u00f3c v\u1edbi tr\u1ee5c d\u1ecdc c\u1ee7a \u0110M ch\u1ee7. T\u00ecm ki\u1ebfm c\u00e1c t\u1ed5n th\u01b0\u01a1ng k\u00e8m theo nh\u01b0 t\u1ee5 m\u00e1u trong th\u00e0nh, lo\u00e9t xuy\u00ean th\u00e0nh \u0110M ch\u1ee7 v\u00e0 \u0111\u00e1nh gi\u00e1 c\u00e1c m\u1ea1ch m\u00e1u li\u00ean quan v\u1edbi v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng.<\/p>\n

    Si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c, CLVT v\u00e0 CHT c\u1ea7n \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh v\u00e0 c\u00f3 th\u1ec3 l\u1eb7p l\u1ea1i nh\u1eb1m \u0111\u00e1nh gi\u00e1 s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a t\u1ed5n th\u01b0\u01a1ng. \u0110i\u1ec1u n\u00e0y \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng \u0111\u1ed1i v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng \u1edf m\u1ee9c ranh gi\u1edbi \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh l\u1ef1a ch\u1ecdn c\u00e1c ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb\/can thi\u1ec7p v\u00e0 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n trong th\u1eddi gian theo d\u00f5i.<\/p>\n

    6. \u0110i\u1ec1u tr\u1ecb<\/h2>\n

    Theo khuy\u1ebfn c\u00e1o v\u1ec1 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0110M ch\u1ee7 c\u1ee7a H\u1ed9i Tim m\u1ea1ch Ch\u00e2u \u00c2u (ESC) n\u0103m 2014.<\/p>\n

    6.1 \u0110\u1ed1i v\u1edbi ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean<\/h3>\n
      \n
    • Ph\u0201u thu\u1eadt n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 h\u1ed9i ch\u1ee9ng Marfan v\u00e0 \u0111\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 l\u00ean > 50 mm.<\/li>\n<\/ul>\n

      C\u00e2n nh\u1eafc ph\u0201u thu\u1eadt n\u1ebfu:<\/p>\n

        \n
      • \u0110\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 l\u00ean > 45 mm \u1edf b\u1ec7nh nh\u00e2n c\u00f3 h\u1ed9i ch\u1ee9ng Marfan v\u00e0 c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 (ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 t\u00e1ch th\u00e0nh \u0110M ch\u1ee7 v\u00e0\/ho\u1eb7c k\u00edch th\u01b0\u1edbc \u0110M ch\u1ee7 t\u0103ng tr\u00ean 3mm\/n\u0103m; h\u1edf van \u0110M ch\u1ee7\/van hai l\u00e1 m\u1ee9c \u0111\u1ed9 nhi\u1ec1u, ph\u1ee5 n\u1eef c\u00f3 mong mu\u1ed1n c\u00f3 thai).<\/li>\n
      • \u0110\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 l\u00ean > 50 mm \u1edf b\u1ec7nh nh\u00e2n van \u0110M ch\u1ee7 hai l\u00e1 van v\u00e0 nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 ((ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 t\u00e1ch th\u00e0nh \u0110M ch\u1ee7 v\u00e0\/ho\u1eb7c k\u00edch th\u01b0\u1edbc \u0110M ch\u1ee7 t\u0103ng tr\u00ean 3 mm\/n\u0103m; h\u1eb9p eo \u0110M ch\u1ee7; t\u0103ng huy\u1ebft \u00e1p).<\/li>\n
      • \u0110\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 l\u00ean > 55 mm.<\/li>\n<\/ul>\n

        6.2 \u0110\u1ed1i v\u1edbi ph\u00ecnh quai \u0110M ch\u1ee7<\/h3>\n

        Ch\u1ec9 \u0111\u1ecbnh ph\u0201u thu\u1eadt cho ph\u00ecnh quai \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 c\u00f2n g\u00e2y tranh c\u00e3i do nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng n\u00e3o trong l\u00fac ph\u0201u thu\u1eadt. Cho \u0111\u1ebfn hi\u1ec7n t\u1ea1i c\u00f3 r\u1ea5t \u00edt c\u00e1c d\u1eef li\u1ec7u v\u1ec1 s\u1ef1 ti\u1ebfn tri\u1ec3n t\u1ef1 nhi\u00ean c\u1ee7a ph\u00ecnh \u0111\u01a1n thu\u1ea7n ph\u1ea7n quai \u0110M ch\u1ee7 do ph\u00ecnh quai \u0110M ch\u1ee7 th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi ph\u00ecnh \u0110M ch\u1ee7 ph\u1ea7n l\u00ean ho\u1eb7c xu\u1ed1ng.<\/p>\n

        Ph\u1eabu thu\u1eadt n\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n ph\u00ecnh quai \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u00f3 \u0111\u01b0\u1eddng k\u00ednh l\u1edbn nh\u1ea5t > 55 mm ho\u1eb7c c\u00f3 tri\u1ec7u ch\u1ee9ng\/d\u1ea5u hi\u1ec7u ch\u00e8n \u00e9p c\u00e1c c\u01a1 quan l\u00e2n c\u1eadn. C\u1ea7n c\u00e2n nh\u1eafc l\u1ee3i \u00edch v\u00e0 nguy c\u01a1 r\u1ee7i ro tr\u01b0\u1edbc khi ch\u1ec9 \u0111\u1ecbnh ph\u0201u thu\u1eadt v\u00ec ph\u0201u thu\u1eadt thay quai \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 \u0111\u1ed9t qu\u1ef5 n\u00e3o cao h\u01a1n so v\u1edbi ph\u0201u thu\u1eadt \u1edf ph\u1ea7n l\u00ean ho\u1eb7c xu\u1ed1ng \u0110M ch\u1ee7 ng\u1ef1c. Ch\u1ec9 \u0111\u1ecbnh thay quai \u0110M ch\u1ee7 b\u00e1n ph\u1ea7n ho\u1eb7c to\u00e0n b\u1ed9 th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf b\u1ec7nh nh\u00e2n c\u00f3 k\u00e8m theo ph\u00ecnh \u0110M ch\u1ee7 ph\u1ea7n l\u00ean ho\u1eb7c xu\u1ed1ng.<\/p>\n

        Ph\u0201u thu\u1eadt chuy\u1ec3n v\u1ecb (debranching) v\u00e0 TEVAR c\u00f3 th\u1ec3 coi l\u00e0 m\u1ed9t gi\u1ea3i ph\u00e1p thay th\u1ebf cho ph\u0201u thu\u1eadt thay quai \u0110M ch\u1ee7 th\u00f4ng th\u01b0\u1eddng trong m\u1ed9t s\u1ed1 t\u00ecnh hu\u1ed1ng, \u0111\u1eb7c bi\u1ec7t \u1edf b\u1ec7nh nh\u00e2n h\u1ea1 th\u00e2n nhi\u1ec7t sau c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n th\u00e0nh c\u00f4ng. Tuy nhi\u00ean, sau ph\u0201u thu\u1eadt chuy\u1ec3n v\u1ecb to\u00e0n b\u1ed9 c\u00e1c nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch nu\u00f4i n\u00e3o nh\u01b0 th\u00e2n c\u00e1nh tay \u0111\u1ea7u, \u0110M c\u1ea3nh chung tr\u00e1i, \u0110M d\u01b0\u1edbi \u0111\u00f2n tr\u00e1i, c\u0169ng nh\u01b0 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n t\u00e1ch th\u00e0nh \u0110M ch\u1ee7 type B c\u1ea5p t\u00ednh, nguy c\u01a1 l\u00f3c t\u00e1ch ng\u01b0\u1ee3c tr\u1edf th\u00e0nh type A li\u00ean quan \u0111\u1ebfn th\u1ee7 thu\u1eadt t\u0103ng l\u00ean v\u00e0 do \u0111\u00f3 c\u1ea7n c\u00e2n nh\u1eafc gi\u1eefa l\u1ee3i \u00edch v\u00e0 nguy c\u01a1 so v\u1edbi ph\u0201u thu\u1eadt thay quai \u0110M ch\u1ee7 th\u00f4ng th\u01b0\u1eddng \u0111\u1ec3 l\u1ef1a ch\u1ecdn t\u00f9y tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3.<\/p>\n

        6.2 Ph\u00ecnh \u0110M ch\u1ee7 xu\u1ed1ng<\/h3>\n
          \n
        • \u0110\u1eb7t stent-Graft \u0110M ch\u1ee7 ng\u1ef1c \u0111\u01b0\u1ee3c \u01b0u ti\u00ean h\u01a1n ph\u0201u thu\u1eadt n\u1ebfu gi\u1ea3i ph\u0201u t\u1ed5n th\u01b0\u01a1ng ph\u00f9 h\u1ee3p, ngo\u1ea1i tr\u1eeb tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n b\u1ecb h\u1ed9i ch\u1ee9ng Marfan ho\u1eb7c c\u00e1c b\u1ec7nh m\u00f4 li\u00ean k\u1ebft .<\/li>\n
        • \u0110\u1eb7t stent-Graft \u0110M ch\u1ee7 n\u1ebfu \u0111\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 xu\u1ed1ng > 55 mm (b\u1ec7nh nh\u00e2n Ch\u00e2u \u00c1 th\u1ec3 tr\u1ea1ng nh\u1ecf h\u01a1n n\u00ean c\u00f3 th\u1ec3 ch\u1ec9 \u0111\u1ecbnh khi \u0111\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 xu\u1ed1ng > 50 mm).<\/li>\n
        • N\u1ebfu gi\u1ea3i ph\u0201u kh\u00f4ng th\u00edch h\u1ee3p v\u1edbi stent-Graft, c\u00e2n nh\u1eafc th\u1ef1c hi\u1ec7n ph\u0201u thu\u1eadt n\u1ebfu \u0111\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 xu\u1ed1ng > 60 mm.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

          Ph\u00ecnh \u0111\u1ed9ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 \u0111\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 gi\u00e3n l\u1edbn tr\u00ean 50% so v\u1edbi \u0111\u01b0\u1eddng k\u00ednh \u0111\u1ed9ng m\u1ea1ch tham chi\u1ebfu \u1edf ng\u01b0\u1eddi c\u00f9ng l\u1ee9a tu\u1ed5i. T\u1ed5n th\u01b0\u01a1ng x\u1ea3y ra \u1edf c\u1ea3 3 l\u1edbp \u00e1o c\u1ee7a th\u00e0nh \u0110M ch\u1ee7. 1. T\u1ed5ng quan Ph\u00ecnh \u0111\u1ed9ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nPh\u00ecnh \u0111\u1ed9ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 - Vinmec<\/title>\n<meta name=\"description\" content=\"Ph\u00ecnh \u0111\u1ed9ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 \u0111\u01b0\u1eddng k\u00ednh \u0110M ch\u1ee7 gi\u00e3n l\u1edbn tr\u00ean 50% so v\u1edbi \u0111\u01b0\u1eddng k\u00ednh \u0111\u1ed9ng m\u1ea1ch tham chi\u1ebfu \u1edf ng\u01b0\u1eddi c\u00f9ng l\u1ee9a tu\u1ed5i.\" \/>\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=\"Ph\u00ecnh \u0111\u1ed9ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 - 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