{"id":31665,"date":"2023-05-04T14:41:20","date_gmt":"2023-05-04T07:41:20","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31665"},"modified":"2023-05-04T16:32:19","modified_gmt":"2023-05-04T09:32:19","slug":"boc-tach-dong-mach-chu-dai-cuong-va-cac-he-thong-phan-loai","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/boc-tach-dong-mach-chu-dai-cuong-va-cac-he-thong-phan-loai\/","title":{"rendered":"B\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7: \u0111\u1ea1i c\u01b0\u01a1ng v\u00e0 c\u00e1c h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i"},"content":{"rendered":"

B\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd c\u1ea5p c\u1ee9u c\u00f3 \u0111\u1eb7c tr\u01b0ng l\u00e0 t\u00ecnh tr\u00e0ng r\u00e1ch l\u1edbp \u00e1o trong c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 d\u1eabn \u0111\u1ebfn h\u00ecnh th\u00e0nh n\u00ean m\u1ed9t l\u00f2ng m\u1ea1ch gi\u1ea3 – false channel. D\u01b0\u1edbi \u00e1p l\u1ef1c, m\u00e1u lu\u1ed3n v\u00e0o v\u1ebft r\u00e1ch v\u00e0 s\u1ebd b\u00f3c c\u00e1c l\u1edbp c\u1ee7a m\u1ea1ch m\u00e1u ra, t\u1ea1o n\u00ean c\u01a1n \u0111au d\u1eef d\u1ed9i, \u0111c b\u1ec7nh nh\u00e2n m\u00f4 t\u1ea3 l\u00e0 c\u01a1n \u0111au theo ki\u1ec3u x\u00e9 r\u00e1ch \u2013 tearing pain.<\/strong><\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng<\/h2>\n

\u0110\u00e2y l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u trong y khoa r\u1ea5t nghi\u00eam tr\u1ecdng, b\u1edfi v\u00ec n\u00f3 c\u00f3 th\u1ec3 l\u00e0m t\u1eafc m\u1ed9t ph\u1ea7n c\u00e1c nh\u00e1nh c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u c\u1ea5p cho c\u01a1 th\u1ec3, d\u1eabn \u0111\u1ebfn kh\u00f4ng cung c\u1ea5p \u0111\u1ee7 m\u00e1u theo nhu c\u1ea7u c\u01a1 th\u1ec3 v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c t\u1ea1ng quan tr\u1ecdng. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nghi\u00eam tr\u1ecdng, \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u00f3 th\u1ec3 v\u1ee1 v\u00e0 nhanh ch\u00f3ng g\u00e2y t\u1eed vong.<\/p>\n

1.1 D\u1ecbch t\u1ec3 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/h3>\n

B\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd hi\u1ebfm g\u1eb7p, v\u1edbi t\u1ef7 l\u1ec7 kho\u1ea3ng 2-3.5\/100000 m\u1ed7i n\u0103m. Th\u01b0\u1eddng g\u1eb7p \u1edf nam gi\u1edbi h\u01a1n so v\u1edbi n\u1eef gi\u1edbi, v\u1edbi t\u1ef7 l\u1ec7 nam gi\u1edbi trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 65%, 50% tr\u01b0\u1eddng h\u1ee3p b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf n\u1eef l\u00e0 ph\u1ee5 n\u1eef mang thai d\u01b0\u1edbi 40 tu\u1ed5i.
\nB\u1ec7nh nh\u00e2n t\u1eeb 40-70 tu\u1ed5i th\u01b0\u1eddng d\u1ec5 m\u1eafc b\u1ec7nh l\u00fd n\u00e0y, chi\u1ebfm kho\u1ea3ng 75% tr\u01b0\u1eddng h\u1ee3p b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. T\u1ef7 l\u1ec7 m\u1eafc cao nh\u1ea5t l\u00e0 \u1edf \u0111\u1ed9 tu\u1ed5i t\u1eeb 50-65. B\u00f3c t\u00e1ch x\u1ea3y ra \u1edf \u0111\u1ed9 tu\u1ed5i 30-40 th\u01b0\u1eddng c\u00f3 li\u00ean quan \u0111\u1ebfn c\u00e1c y\u1ebfu t\u1ed1 di truy\u1ec1n v\u00e0\/ho\u1eb7c c\u00e1c b\u1ec7nh l\u00fd m\u00f4 li\u00ean k\u1ebft nh\u01b0 h\u1ed9i ch\u1ee9ng Marfan, 90% tr\u01b0\u1eddng h\u1ee3p x\u1ea3y ra \u1edf nam gi\u1edbi m\u1eafc t\u0103ng huy\u1ebft \u00e1p \u1edf \u0111\u1ed9 tu\u1ed5i t\u1eeb 40-60. Th\u01b0\u1eddng g\u1eb7p h\u01a1n \u1edf ng\u01b0\u1eddi Caribe g\u1ed1c Phi h\u01a1n l\u00e0 ng\u01b0\u1eddi da tr\u1eafng, c\u00f3 l\u1ebd l\u00e0 do t\u1ef7 l\u1ec7 m\u1eafc huy\u1ebft \u00e1p. Ng\u01b0\u1eddi ch\u00e2u \u00c1 c\u00f3 t\u1ef7 l\u1ec7 m\u1eafc th\u1ea5p nh\u1ea5t.<\/p>\n

1.2 Nguy\u00ean nh\u00e2n c\u1ee7a b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/h3>\n


\n<\/strong>C\u00e1c nguy\u00ean nh\u00e2n m\u1eafc ph\u1ea3i
\n<\/strong>\u2022 T\u0103ng huy\u1ebft \u00e1p
\n\u2022 X\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch
\n\u2022 Ch\u1ea5n th\u01b0\u01a1ng ng\u1ef1c k\u00edn<\/a> (tai n\u1ea1n xe h\u01a1i, m\u1eb7c d\u00f9 nh\u1eefng ch\u1ea5n th\u01b0\u01a1ng do c\u01a1 ch\u1ebf gi\u1ea3m t\u1ed1c \u0111\u1ed9t ng\u1ed9t \u2013 deceleration injuries th\u01b0\u1eddng g\u00e2y v\u1ee1 \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 h\u01a1n, g\u00e2y r\u00e1ch c\u1ea3 3 l\u1edbp c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7) ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng do \u0111i\u1ec1u tr\u1ecb g\u00e2y ra (trong khi ti\u1ebfn h\u00e0nh th\u1ee7 thu\u1eadt \u0111\u1eb7t catheter ho\u1eb7c khi b\u01a1m b\u00f3ng \u0111\u1ed1i xung \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 – intra aortic balloon pump counterpulsation)
\n\u2022 Ph\u1ee5 n\u1eef mang thai, \u0111\u1eb7c bi\u1ec7t l\u00e0 qu\u00fd ba v\u00e0 sau khi sinh
\n\u2022 Giang mai (giai \u0111o\u1ea1n ba \u2013 tertiary stage) do g\u00e2y vi\u00eam m\u1ea1ch \u1ea3nh h\u01b0\u1edfng l\u00ean \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.
\n\u2022 S\u1eed d\u1ee5ng cocaine v\u00e0 amphetamine
\n\u2022 Ph\u1eabu thu\u1eadt tim – \u0111\u1eb7c bi\u1ec7t l\u00e0 thay van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, b\u1edfi v\u00ec t\u00ecnh tr\u1ea1ng h\u1edf ch\u1ee7 c\u00f3 th\u1ec3 g\u00e2y d\u00e3n v\u00e0 y\u1ebfu th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/p>\n

C\u00e1c nguy\u00ean nh\u00e2n b\u1ea9m sinh
\n<\/strong>\u2022 C\u00e1c b\u1ec7nh l\u00fd di truy\u1ec1n\/b\u1ea5t th\u01b0\u1eddng v\u1ec1 m\u00f4 li\u00ean k\u1ebft \u1ea3nh h\u01b0\u1edfng l\u00ean \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, \u1ea3nh h\u01b0\u1edfng l\u00ean c\u1ea5u tr\u00fac v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a m\u00f4 li\u00ean k\u1ebft\/protein (v\u00ed d\u1ee5 nh\u01b0 collagen v\u00e0 elastin) t\u1ea1i th\u00e0nh c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 – h\u1ed9i ch\u1ee9ng Marfan (th\u01b0\u1eddng g\u00e2y b\u00f3c t\u00e1ch \u0111o\u1ea1n g\u1ea7n), h\u1ed9i ch\u1ee9ng Ehler-Danlos.
\n\u2022 H\u1ed9i ch\u1ee9ng Turner (g\u00e2y d\u00e3n g\u1ed1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7)
\n\u2022 Van ch\u1ee7 hai l\u00e1 gia t\u0103ng nguy c\u01a1 b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean.
\n\u2022 H\u1eb9p eo \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 – coarctation of the aorta.<\/p>\n

2. Sinh b\u1ec7nh h\u1ecdc<\/h2>\n

Khi x\u1ea3y ra t\u00ecnh tr\u1ea1ng b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, m\u00e1u lu\u1ed3n v\u00e0o gi\u1eefa l\u1edbp \u00e1o trong v\u00e0 \u00e1o gi\u1eefa c\u1ee7a m\u1ea1ch m\u00e1u. D\u01b0\u1edbi \u00e1p l\u1ef1c l\u1edbn, c\u00e1c l\u1edbp \u00e1o c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ecb l\u00f3c ra, th\u00f4ng th\u01b0\u1eddng th\u00ec l\u00f3c \u1edf v\u1ecb tr\u00ed 2\/3 trong v\u00e0 1\/3 ngo\u00e0i. B\u00f3c t\u00e1ch c\u00f3 th\u1ec3 k\u00e9o d\u00e0i m\u1ed9t \u0111o\u1ea1n g\u1ea7n v\u00e0\/ho\u1eb7c c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t \u0111o\u1ea1n d\u00e0i. Bi\u1ec3u hi\u1ec7n n\u00e0y s\u1ebd cho th\u1ea5y m\u1ed1i li\u00ean k\u1ebft gi\u1eefa l\u1edbp \u00e1o gi\u1eefa v\u00e0 l\u1edbp \u00e1o trong c\u1ee7a l\u00f2ng m\u1ea1ch gi\u1ea3.
\nH\u1ea7u h\u1ebft b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u00f3 ngu\u1ed3n g\u1ed1c t\u1ea1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean, th\u01b0\u1eddng trong v\u00f2ng 10cm k\u1ec3 t\u1eeb v\u00f9ng van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. Nh\u1eefng v\u1ebft r\u00e1ch th\u01b0\u1eddng d\u00e0i 1-5cm v\u00e0 lan theo c\u1ea3 chi\u1ec1u ngang v\u00e0 ch\u00e9o.
\n\u2022 Antegrade dissection \u2013 b\u00f3c t\u00e1ch theo d\u00f2ng ch\u1ea3y c\u1ee7a m\u00e1u: b\u00f3c t\u00e1ch theo h\u01b0\u1edbng \u0111\u1ebfn ch\u1ed7 chia \u0111\u00f4i c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1eadu v\u00e0 \u0111\u00f4i khi d\u1ecdc xu\u1ed1ng t\u1eadn ch\u1ed7 chia \u0111\u00f4i c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1eadu chung v\u00e0 \u0111\u1ed9ng m\u1ea1c \u0111\u00f9i.
\n\u2022 Retrograde dissection \u2013 b\u00f3c t\u00e1ch theo ng\u01b0\u1ee3c d\u00f2ng ch\u1ea3y c\u1ee7a m\u00e1u: b\u00f3c t\u00e1ch theo h\u01b0\u1edbng \u0111\u1ebfn g\u1ed1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 tim.
\n\u0110\u00f4i khi, b\u00f3c t\u00e1ch c\u00f3 th\u1ec3 gi\u1eefa l\u1edbp \u00e1o trong v\u00e0 \u00e1o gi\u1eefa, v\u00e0 g\u00e2y ra v\u1ee1 l\u1edbp \u00e1o ngo\u00e0i. K\u1ebft qu\u1ea3 \u0111\u00f3 l\u00e0 d\u1eabn \u0111\u1ebfn xu\u1ea5t huy\u1ebft n\u1ed9i, ho\u1eb7c ch\u00e8n \u00e9p tim d\u00f9 cho b\u00f3c t\u00e1ch kh\u00f4ng g\u00e2y ra v\u1ee1 m\u1ea1ch nh\u01b0ng t\u1ea1i l\u00f3c lan v\u00e0o m\u00e0ng ngo\u00e0i tim d\u1eabn \u0111\u1ebfn xu\u1ea5t huy\u1ebft m\u00e0ng ngo\u00e0i tim. C\u1ea3 hai t\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u1ec1u mang t\u00ednh \u0111e d\u1ecda \u0111\u1ebfn t\u00ednh m\u1ea1ng v\u00e0 c\u00f3 th\u1ec3 nhanh ch\u00f3ng d\u1eabn \u0111\u1ebfn t\u1eed vong.
\nKhi m\u00e1u tr\u00e0n v\u00e0o l\u1edbp \u00e1o trong m\u00e0 b\u00f3c l\u1edbp \u00e1o trong v\u00e0 l\u1edbp \u00e1o gi\u1eefa, s\u1ebd t\u1ea1o ra l\u00f2ng m\u1ea1ch gi\u1ea3. \u1ede gi\u1eefa l\u00f2ng m\u1ea1ch th\u1eadt v\u00e0 l\u00f2ng m\u1ea1ch n\u00e0y l\u00e0 hai l\u1edbp c\u1ee7a l\u1edbp \u00e1o trong \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 m\u1ea3ng n\u1ed9i m\u1ea1c b\u1ecb b\u00f3c t\u00e1ch \u2013 intimal flap. L\u00f2ng m\u1ea1ch gi\u1ea3 n\u00e0y c\u00f3 th\u1ec3 l\u00e0m t\u1eafc l\u00f2ng m\u1ea1ch th\u1eadt.
\nC\u00f3 c\u00e1c lo\u1ea1i b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 kh\u00e1c nhau. 65% c\u00f3 ngu\u1ed3n g\u1ed1c \u1edf \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean, 10% \u1edf cung \u0111\u1ed9ng m\u1ea1ch, v\u00e0 20% t\u1ea1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 xu\u1ed1ng \u1edf \u0111o\u1ea1n ng\u1ef1c (xa so v\u1edbi d\u00e2y ch\u1eb1ng \u0111\u1ed9ng m\u1ea1ch).
\nNguy\u00ean nh\u00e2n g\u00e2y r\u00e1ch l\u1edbp n\u1ed9i m\u1ea1ch l\u00e0 kh\u00f4ng x\u00e1c \u0111\u1ecbnh r\u00f5. C\u00f3 th\u1ec3 x\u1ea3y ra do k\u1ebft qu\u1ea3 c\u1ee7a t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u n\u1ed9i m\u1ea1c h\u00ecnh th\u00e0nh t\u1eeb gia t\u0103ng \u00e1p l\u1ef1c do t\u0103ng huy\u1ebft \u00e1p, ho\u1eb7c do c\u00e1c b\u1ec7nh l\u00fd m\u00f4 li\u00ean k\u1ebft di truy\u1ec1n, nh\u01b0 h\u1ed9i ch\u1ee9ng Marfan. Trong h\u1ed9i ch\u1ee9ng Marfan, collagen v\u00e0 elastin trong l\u1edbp n\u1ed9i m\u1ea1c b\u1ecb tho\u00e1i h\u00f3a, m\u1ea5t c\u1ea5u tr\u00fac v\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng s\u1ebd d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng ho\u1ea1i t\u1eed \u00e1o trong d\u1ea1ng nang \u2013 cystic medial necrosis.
\nTrong kho\u1ea3ng 10% tr\u01b0\u1eddng h\u1ee3p, kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a r\u00e1ch n\u1ed9i m\u1ea1c. Khi \u0111\u00f3 b\u00f3c t\u00e1ch c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c g\u00e2y ra do ch\u1ea3y m\u00e1u t\u1ea1i l\u1edbp trong c\u1ee7a m\u1ea1ch m\u00e1u d\u1eabn \u0111\u1ebfn b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 th\u1ee9 ph\u00e1t \u2013 secondary aortic dissection.<\/p>\n

2. Ph\u00e2n lo\u1ea1i c\u1ee7a b\u00f3c t\u00e1ch \u0111\u1ed9ng mach ch\u1ee7<\/h2>\n

C\u00f3 nhi\u1ec1u h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i \u0111\u1ed1i v\u1edbi b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, d\u1ef1a tr\u00ean gi\u1ea3i ph\u1eabu ho\u1eb7c th\u1eddi gian kh\u1edfi ph\u00e1t c\u00e1c tri\u1ec7u ch\u1ee9ng.<\/p>\n

2.1 Ph\u00e2n lo\u1ea1i theo Stanford<\/h3>\n

H\u1ec7 th\u1ed1ng Stanford th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u1ea5t<\/p>\n\n\n\n\n\n
Type A 70\u201375 % <\/strong><\/td>\nType B 25\u201330 %<\/strong><\/td>\n<\/tr>\n
\u2022 \u0110\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean \u00b1 cung \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, c\u00f3 th\u1ec3 l\u00e0 \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi.
\n\u2022 C\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng l\u00ean van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/td>\n		\u2022 Li\u00ean quan \u0111\u1ebfn \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 xu\u1ed1ng \u1edf ph\u00eda ngo\u00e0i \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n tr\u00e1i (type B – \u0111\u1ed9ng
\nm\u1ea1ch ch\u1ee7 l\u00ean kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng)<\/td>\n<\/tr>\n
\u2022 C\u1ea7n \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt<\/td>\n\u2022 \u0110i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n b\u1eb1ng theo d\u00f5i huy\u1ebft \u00e1p v\u00e0 ki\u1ec3m so\u00e1t t\u1ea7n s\u1ed1 tim.
\n\u2022 Ph\u1eabu thu\u1eadt ch\u1ec9 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 bi\u1ebfn ch\u1ee9ng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

2.2 H\u1ec7 th\u1ed1ng DeBarkey<\/h3>\n

Ng\u01b0\u1ee3c v\u1edbi h\u1ec7 th\u1ed1ng Stanford, h\u1ec7 th\u1ed1ng DeBarkey d\u1ef1a tr\u00ean gi\u1ea3i ph\u1eabu:<\/p>\n\n\n\n\n
Type 1: 60 %<\/td>\nType 2: 30\u201335 %<\/td>\nType 3: 10\u201315 %<\/td>\n<\/tr>\n
Ngu\u1ed3n g\u1ed1c t\u1ea1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi, hi\u1ebfm khi l\u00f3c l\u00ean tr\u00ean v\u00e0 th\u01b0\u1eddng l\u00e0 l\u00f3c d\u00e0i xu\u1ed1ng ph\u00eda d\u01b0\u1edbi. B\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i c\u00f3 t\u0103ng huy\u1ebft \u00e1p v\u00e0 x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch.<\/td>\nNgu\u1ed3n g\u1ed1c t\u1ea1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean v\u00e0 khu tr\u00fa t\u1ea1i v\u00f9ng n\u00e0y<\/td>\nNgu\u1ed3n g\u1ed1c t\u1ea1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u00a0l\u00ean, lan \u0111\u1ebfn cung \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 th\u01b0\u1eddng xa h\u01a1n. H\u1ea7u h\u1ebft t\u1eed vong v\u00e0 th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n <65 tu\u1ed5i<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\"boc-tach-dong-mach-chu\"
H\u1ec7 th\u1ed1ng DeBarkey<\/figcaption><\/figure>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong> B\u1ec7nh H\u1ecdc Tim M\u1ea1ch Lecturio<\/p>\n","protected":false},"excerpt":{"rendered":"

B\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd c\u1ea5p c\u1ee9u c\u00f3 \u0111\u1eb7c tr\u01b0ng l\u00e0 t\u00ecnh tr\u00e0ng r\u00e1ch l\u1edbp \u00e1o trong c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 d\u1eabn \u0111\u1ebfn h\u00ecnh th\u00e0nh n\u00ean m\u1ed9t l\u00f2ng m\u1ea1ch gi\u1ea3 – false channel. D\u01b0\u1edbi \u00e1p l\u1ef1c, m\u00e1u lu\u1ed3n v\u00e0o v\u1ebft r\u00e1ch v\u00e0 s\u1ebd b\u00f3c c\u00e1c l\u1edbp c\u1ee7a m\u1ea1ch m\u00e1u ra, […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nB\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7: \u0111\u1ea1i c\u01b0\u01a1ng v\u00e0 c\u00e1c h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd c\u1ea5p c\u1ee9u c\u00f3 \u0111\u1eb7c tr\u01b0ng l\u00e0 t\u00ecnh tr\u00e0ng r\u00e1ch l\u1edbp \u00e1o trong c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.\" \/>\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=\"B\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7: \u0111\u1ea1i c\u01b0\u01a1ng v\u00e0 c\u00e1c h\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i - 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