{"id":31605,"date":"2023-05-04T18:39:42","date_gmt":"2023-05-04T11:39:42","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31605"},"modified":"2023-05-04T18:39:42","modified_gmt":"2023-05-04T11:39:42","slug":"di-tat-tim-bam-sinh-va-kham-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/di-tat-tim-bam-sinh-va-kham-lam-sang\/","title":{"rendered":"Ti\u1ebfp c\u1eadn b\u1ec7nh nh\u00e2n b\u1ecb d\u1ecb t\u1eadt tim b\u1ea9m sinh"},"content":{"rendered":"

D\u1ecb t\u1eadt tim b\u1ea9m sinh<\/a> (TBS) n\u1eb1m trong nh\u00f3m nh\u1eefng d\u1ecb t\u1eadt b\u1ea9m sinh ph\u1ed5 bi\u1ebfn nh\u1ea5t, \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 g\u1eb7p kho\u1ea3ng 0,6 – 0,8% tr\u1ebb s\u01a1 sinh. T\u1ea1i Vi\u1ec7t Nam, c\u00f3 kho\u1ea3ng 10.000 tr\u1ebb s\u01a1 sinh m\u1eafc tim b\u1ea9m sinh m\u1ed7i n\u0103m.V\u1edbi nh\u1eefng ti\u1ebfn b\u1ed9 trong \u0111i\u1ec1u tr\u1ecb, hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh tim b\u1ea9m sinh \u0111\u00e3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3, h\u01a1n 85% tr\u1ebb c\u00f3 b\u1ec7nh tim b\u1ea9m sinh c\u00f3 th\u1ec3 s\u1ed1ng \u0111\u1ebfn tu\u1ed5i v\u1ecb th\u00e0nh ni\u00ean v\u00e0 tr\u01b0\u1edfng th\u00e0nh, trong s\u1ed1 \u0111\u00f3 c\u00f3 c\u1ea3 nh\u1eefng b\u1ec7nh tim b\u1ea9m sinh t\u1ed5n th\u01b0\u01a1ng ph\u1ee9c t\u1ea1p.<\/strong><\/p>\n

\"D\u1ecb<\/p>\n

T\u1ee9 ch\u1ee9ng Fallot l\u00e0 1 trong nh\u1eefng d\u1ecb t\u1eadt tim b\u1ea9m sinh.<\/strong><\/p>\n

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

V\u1edbi nh\u1eefng ti\u1ebfn b\u1ed9 trong \u0111i\u1ec1u tr\u1ecb, hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh tim b\u1ea9m sinh \u0111\u00e3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3, h\u01a1n 85% tr\u1ebb c\u00f3 b\u1ec7nh tim b\u1ea9m sinh c\u00f3 th\u1ec3 s\u1ed1ng \u0111\u1ebfn tu\u1ed5i v\u1ecb th\u00e0nh ni\u00ean v\u00e0 tr\u01b0\u1edfng th\u00e0nh, trong s\u1ed1 \u0111\u00f3 c\u00f3 c\u1ea3 nh\u1eefng d\u1ecb t\u1eadt tim b\u1ea9m sinh t\u1ed5n th\u01b0\u01a1ng ph\u1ee9c t\u1ea1p. Nh\u1edd s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ph\u1eabu thu\u1eadt, can thi\u1ec7p v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa tim m\u1ea1ch nhi, s\u1ed1 l\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n tim b\u1ea9m sinh \u0111\u1ea1t \u0111\u1ebfn tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh ng\u00e0y c\u00e0ng t\u0103ng l\u00ean. Ngo\u00e0i ra, nhi\u1ec1u b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh tim c\u1ea5u tr\u00fac ho\u1eb7c b\u1ec7nh van tim b\u1ea9m sinh ti\u1ebfn tri\u1ec3n t\u1eeb t\u1eeb, ch\u1ec9 bi\u1ec3u hi\u1ec7n mu\u1ed9n \u1edf tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh.<\/p>\n

H\u1ea7u h\u1ebft nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt gi\u1ea3m nh\u1eb9 ho\u1eb7c ph\u0201u thu\u1eadt s\u1eeda ch\u1eefa. Nh\u01b0 v\u1eady, m\u1ed9t v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng quan t\u00e2m trong nh\u00f3m b\u1ec7nh tim b\u1ea9m sinh b\u00ean c\u1ea1nh vi\u1ec7c ho\u00e0n thi\u1ec7n ph\u1eabu thu\u1eadt, can thi\u1ec7p v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa tim m\u1ea1ch nhi ch\u00ednh l\u00e0 theo d\u00f5i chuy\u00ean khoa v\u00e0 qu\u1ea3n l\u00fd nh\u00f3m b\u1ec7nh nh\u00e2n tim b\u1ea9m sinh ng\u01b0\u1eddi l\u1edbn sau khi \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt gi\u1ea3m nh\u1eb9\/s\u1eeda ch\u1eefa.<\/p>\n

D\u1ecb t\u1eadt tim b\u1ea9m sinh ng\u01b0\u1eddi l\u1edbn<\/strong><\/p>\n\n\n\n\n\n\n\n
\u00a0<\/strong><\/p>\n

B\u1ec7nh TBS kh\u00f4ng t\u00edm<\/strong><\/td>\n

\u00a0<\/strong><\/p>\n

B\u1ec7nh TBS c\u00f3 t\u00edm<\/strong><\/td>\n<\/tr>\n

\u00a0<\/strong><\/p>\n

Th\u00f4ng li\u00ean nh\u0129<\/td>\n

\u00a0<\/strong><\/p>\n

\u0110\u1ea3o g\u1ed1c \u0111\u1ed9ng m\u1ea1ch<\/td>\n<\/tr>\n

\u00a0<\/strong><\/p>\n

Th\u00f4ng li\u00ean th\u1ea5t<\/td>\n

\u00a0<\/strong><\/p>\n

T\u1ee9 ch\u1ee9ng Fallot<\/td>\n<\/tr>\n

\u00a0<\/strong><\/p>\n

Th\u00f4ng s\u00e0n nh\u0129 th\u1ea5t<\/td>\n

\u00a0<\/strong><\/p>\n

B\u1ec7nh nh\u00e2n sau ph\u0201u thu\u1eadt Fontan<\/td>\n<\/tr>\n

\u00a0<\/strong><\/p>\n

H\u1eb9p ph\u1ed5i<\/td>\n

\u00a0<\/strong><\/p>\n

\u0110\u1ea3o g\u1ed1c \u0111\u1ed9ng m\u1ea1ch t\u1ef1 s\u1eeda ch\u1eefa<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n
\u00a0<\/strong><\/p>\n

H\u1eb9p \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i<\/td>\n

\u00a0<\/strong><\/p>\n

B\u1ec7nh Ebstein n\u1eb7ng<\/td>\n<\/tr>\n

\u00a0<\/strong><\/p>\n

H\u1eb9p eo \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/td>\n

<\/td>\n<\/tr>\n
\u00a0<\/strong><\/p>\n

T\u0129nh m\u1ea1ch ph\u1ed5i \u0111\u1ed5 v\u1ec1 b\u1ea5t th\u01b0\u1eddng<\/td>\n

<\/td>\n<\/tr>\n
\u00a0<\/strong><\/p>\n

B\u1ec7nh Ebstein<\/td>\n

<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Ch\u00fa th\u00edch: TBS: Tim b\u1ea9m sinh<\/em><\/p>\n

2. Kh\u00e1m l\u00e2m s\u00e0ng<\/h2>\n

2.1 Nh\u00ecn<\/h3>\n

T\u00edm, ng\u00f3n tay d\u00f9i tr\u1ed1ng<\/strong><\/p>\n

\u0110o \u0111\u1ed9 b\u00e3 o h\u00f2a oxy trong m\u00e1u b\u1eb1ng m\u00e1y \u0111o SpO2. T\u00edm trung t\u00e2m l\u00e0 t\u00ecnh tr\u1ea1ng gi\u1ea3m \u0111\u1ed9 b\u00e3o ho\u00e0 oxy m\u00e1u \u0111\u1ed9ng m\u1ea1ch; kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n t\u00ecnh tr\u1ea1ng t\u00edm \u1edf da v\u00e0 ni\u00eam m\u1ea1c khi n\u1ed3ng \u0111\u1ed9 hemoglobin kh\u1eed trong m\u00e1u h\u1ec7 tu\u1ea7n ho\u00e0n l\u1edbn h\u01a1n 5 g\/dL <\/em>.<\/p>\n

T\u00edm v\u00e0 ng\u00f3n tay d\u00f9i tr\u1ed1ng g\u1ee3i \u00fd b\u1ec7nh nh\u00e2n tim b\u1ea9m sinh c\u00f3 lu\u1ed3ng shunt ph\u1ea3i – tr\u00e1i ho\u1eb7c shunt tr\u00e1i – ph\u1ea3i giai \u0111o\u1ea1n mu\u1ed9n b\u1ecb \u0111\u1ea3o chi\u1ec1u.<\/p>\n

Do ph\u1ee5 thu\u1ed9c n\u1ed3ng \u0111\u1ed9 hemoglobin, d\u1ea5u hi\u1ec7u t\u00edm c\u00f3 th\u1ec3 gi\u1ea3m \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb thi\u1ebfu m\u00e1u.<\/p>\n

S\u1eb9o m\u1ed5 c\u0169<\/strong><\/p>\n

H\u1ecfi ti\u1ec1n s\u1eed ph\u1eabu thu\u1eadt tim.<\/p>\n

Quan s\u00e1t l\u1ed3ng ng\u1ef1c \u0111\u00e1nh gi\u00e1 s\u1eb9o m\u1ed5.<\/p>\n

Quan s\u00e1t v\u1ecb tr\u00ed m\u1ecfm tim: T hay \u0111\u1ed5i, sang ph\u1ea3i…<\/p>\n

\u0110\u00e1nh gi\u00e1 c\u00e1c y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng \u0111i k\u00e8m: V \u1eb9o c\u1ed9t s\u1ed1ng , r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p li\u00ean quan \u0111\u1ebfn ph\u0201u thu\u1eadt l\u1ed3ng ng\u1ef1c tr\u01b0\u1edbc \u0111\u00f3.. .<\/p>\n

T\u0129nh m\u1ea1ch c\u1ea3nh<\/strong><\/p>\n

Cho bi\u1ebft th\u00f4ng tin v\u1ec1 r\u1ed1i lo\u1ea1n nh\u1ecbp tim, d\u1ea1ng s\u00f3ng v\u00e0 \u00e1p l\u1ef1c.<\/p>\n

T\u0103ng \u00e1p l\u1ef1c \u0111\u1ed5 \u0111\u1ea7y nh\u0129 ph\u1ea3i d\u0201n \u0111\u1ebfn s\u00f3ng a l\u1edbn, g\u1eb7p trong h\u1eb9p van \u0111\u1ed9ng ph\u1ed5i n\u1eb7ng \u0111\u01a1n thu\u1ea7n ho\u1eb7c thi\u1ec3u s\u1ea3n van ba l\u00e1 , suy th\u1ea5t ph\u1ea3i ho\u1eb7c c\u00e1c nguy\u00ean nh\u00e2n c\u1ea3n tr\u1edf \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i.<\/p>\n

T\u0129nh m\u1ea1ch c\u1ea3nh n\u1ed5i t\u1eebng l\u00fac trong tr\u01b0\u1eddng h\u1ee3p block nh\u0129 – th\u1ea5t: N h\u0129 co trong khi van ba l\u00e1 \u0111\u00f3ng.<\/p>\n

S\u00f3ng v l\u1edbn l\u00e0 \u0111\u1eb7c tr\u01b0ng c\u1ee7a h\u1edf van ba l\u00e1.<\/p>\n

2.2 S\u1edd, b\u1eaft m\u1ea1ch<\/h3>\n

Kh\u00e1m t\u1ea5t c\u1ea3 c\u00e1c m\u1ea1ch m\u00e1u. H\u1eb9p eo \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1eb1ng kh\u00e1m l\u00e2m s\u00e0ng: \u0110 \u1ed9ng m\u1ea1ch \u0111\u00f9i hai b\u00ean b\u1eaft y\u1ebfu, \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh v\u00e0 \u0111\u1ed9ng m\u1ea1ch quay tr\u00ean ch\u1ed7 h\u1eb9p n\u1ea3y m\u1ea1nh.<\/p>\n

\u0110o huy\u1ebft \u00e1p chi tr\u00ean v\u00e0 chi d\u01b0\u1edbi . Kh\u00f4ng \u0111o huy\u1ebft \u00e1p \u1edf b\u00ean tay c\u00f9ng b\u00ean s\u1eb9o m\u1ed5 ng\u1ef1c (trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u0201u thu\u1eadt l\u00e0m c\u1ea7u n\u1ed1i Blalock- Taussig b\u1eb1ng \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n, huy\u1ebft \u00e1p \u0111o \u0111\u01b0\u1ee3c b\u00ean tay c\u00f9ng b\u00ean s\u1eb9o m\u1ed5 kh\u00f4ng ph\u1ea3n \u00e1nh huy\u1ebft \u00e1p th\u1ef1c t\u1ebf).<\/p>\n

M\u1ea1ch n\u1ea3y m\u1ea1nh, ch\u00ecm s\u00e2u : H \u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 n\u1eb7ng, c\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch, ho\u1eb7c sau ph\u0201u thu\u1eadt l\u00e0m shunt ch\u1ee7 – ph\u1ed5i ( V\u00ed d\u1ee5 : C \u1ea7u n\u1ed1i Blalock – Taussig).<\/p>\n

M\u1ea1ch n\u1ea3y m\u1ea1nh \u1edf chi tr\u00ean b\u00ean ph\u1ea3i : H \u1eb9p tr\u00ean van \u0110M ch\u1ee7 \u1edf b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng Williams, do hi\u1ec7u \u1ee9ng Coanda l\u00e0m d\u00f2ng m\u00e1u ch\u1ea3y xu\u00f4i theo h\u01b0\u1edbng b\u1ec1 m\u1eb7t cong.<\/p>\n

Rung miu t\u1ea1i v\u1ecb tr\u00ed \u0111\u1ed9ng m\u1ea1ch \u0111\u00f9i c\u00f3 th\u1ec3 do bi\u1ebfn ch\u1ee9ng th\u00f4ng \u0111\u1ed9ng t\u0129nh – m\u1ea1ch sau ch\u1ecdc m\u1ea1ch \u0111\u00f9i.<\/p>\n

Kh\u00e1m v\u1ecb tr\u00ed m\u1ecfm tim, ki\u1ec3m tra v\u1ecb tr\u00ed gan v\u00e0 d\u1ea1 d\u00e0y.<\/p>\n

    \n
  • Situs inversus<\/strong> v\u1edbi m\u1ecfm tim b\u00ean ph\u1ea3i – h\u00ecnh \u1ea3nh soi g\u01b0\u01a1ng c\u1ee7a b\u00ecnh th\u01b0\u1eddng , v\u1edbi 95% b\u1ec7nh nh\u00e2n kh\u00f4ng k\u00e8m theo d\u1ecb t\u1eadt TBS.<\/li>\n<\/ul>\n
      \n
    • Situs solitus<\/strong> v\u1edbi m\u1ecfm tim quay ph\u1ea3i th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi d\u1ecb t\u1eadt TBS (th\u01b0\u1eddng l\u00e0 TBS ph\u1ee9c t\u1ea1p).<\/li>\n<\/ul>\n

      Di\u1ec7n tim \u0111\u1eadp d\u01b0\u1edbi m\u0169i \u1ee9c: Q u\u00e1 t\u1ea3i th\u1ea5t ph\u1ea3i (qu\u00e1 t\u1ea3i th\u1ec3 t\u00edch v\u00e0\/ho \u1eb7c \u00e1p l\u1ef1c th\u1ea5t ph\u1ea3i) th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n sau ph\u0201u thu\u1eadt s\u1eeda ch\u1eefa Fallot IV.<\/p>\n

      Ti\u1ebfng tim T2 m\u1ea1nh c\u1ea1nh \u1ee9c tr\u00e1i: T\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/p>\n

      3. K\u1ebft lu\u1eadn<\/h2>\n

      B\u1ec7nh tim b\u1ea9m sinh l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh tim ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf tr\u1ebb em, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kho\u1ea3ng m\u1ed9t tr\u1ebb em trong m\u1ed7i 100 tr\u1ebb \u0111\u01b0\u1ee3c sinh ra. Tuy nhi\u00ean, v\u1edbi ti\u1ebfn b\u1ed9 trong y h\u1ecdc v\u00e0 ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe, t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t c\u1ee7a nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh tim b\u1ea9m sinh \u0111\u00e3 t\u0103ng l\u00ean \u0111\u00e1ng k\u1ec3 trong nh\u1eefng n\u0103m qua.<\/p>\n

      Ti\u1ebfp c\u1eadn b\u1ec7nh tim b\u1ea9m sinh bao g\u1ed3m\u00a0 ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng, c\u1eadn l\u00e2m s\u00e0ng, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1eeb \u0111\u01a1n gi\u1ea3n \u0111\u1ebfn ph\u1ee9c t\u1ea1p, t\u00f9y thu\u1ed9c v\u00e0o t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n. Trong tr\u01b0\u1eddng h\u1ee3p nh\u1eb9, c\u00e1c bi\u1ec7n ph\u00e1p ch\u1eefa tr\u1ecb kh\u00f4ng \u0111\u00f2i h\u1ecfi ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng, bao g\u1ed3m thu\u1ed1c \u0111\u1ec3 gi\u1ea3m ti\u1ec1n t\u1ea3i, h\u1eadu t\u1ea3i ho\u1eb7c c\u00e1c thu\u1ed1c kh\u00e1c \u0111\u1ec3 h\u1ed7 tr\u1ee3 tim ho\u1ea1t \u0111\u1ed9ng t\u1ed1t h\u01a1n. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p nghi\u00eam tr\u1ecdng h\u01a1n, ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 c\u1ea7n thi\u1ebft \u0111\u1ec3 s\u1eeda ch\u1eefa b\u1ea5t k\u1ef3 s\u1ef1 b\u1ea5t th\u01b0\u1eddng n\u00e0o trong c\u1ea5u tr\u00fac tim.<\/p>\n","protected":false},"excerpt":{"rendered":"

      D\u1ecb t\u1eadt tim b\u1ea9m sinh (TBS) n\u1eb1m trong nh\u00f3m nh\u1eefng d\u1ecb t\u1eadt b\u1ea9m sinh ph\u1ed5 bi\u1ebfn nh\u1ea5t, \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 g\u1eb7p kho\u1ea3ng 0,6 – 0,8% tr\u1ebb s\u01a1 sinh. T\u1ea1i Vi\u1ec7t Nam, c\u00f3 kho\u1ea3ng 10.000 tr\u1ebb s\u01a1 sinh m\u1eafc tim b\u1ea9m sinh m\u1ed7i n\u0103m.V\u1edbi nh\u1eefng ti\u1ebfn b\u1ed9 trong \u0111i\u1ec1u tr\u1ecb, hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u00e1c […]<\/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":"\nD\u1ecb t\u1eadt tim b\u1ea9m sinh v\u00e0 kh\u00e1m l\u00e2m s\u00e0ng<\/title>\n<meta name=\"description\" content=\"D\u1ecb t\u1eadt tim b\u1ea9m sinh \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 g\u1eb7p kho\u1ea3ng 0,6 - 0,8% tr\u1ebb s\u01a1 sinh. T\u1ea1i Vi\u1ec7t Nam, c\u00f3 kho\u1ea3ng 10.000 tr\u1ebb s\u01a1 sinh m\u1eafc tim b\u1ea9m sinh m\u1ed7i n\u0103m.\" \/>\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=\"D\u1ecb t\u1eadt tim b\u1ea9m sinh v\u00e0 kh\u00e1m l\u00e2m s\u00e0ng\" \/>\n<meta property=\"og:description\" content=\"D\u1ecb t\u1eadt tim b\u1ea9m sinh \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 g\u1eb7p kho\u1ea3ng 0,6 - 0,8% tr\u1ebb s\u01a1 sinh. 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