{"id":3336,"date":"2023-04-13T19:58:04","date_gmt":"2023-04-13T12:58:04","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=3336"},"modified":"2023-04-14T15:20:21","modified_gmt":"2023-04-14T08:20:21","slug":"viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/","title":{"rendered":"Vi\u00eam gan B m\u1ea1n &#8211; Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo B\u1ed9 Y t\u1ebf 2019"},"content":{"rendered":"<p><strong>Vi\u00eam gan B m\u1ea1n l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m quan tr\u1ecdng, ph\u1ed5 bi\u1ebfn to\u00e0n c\u1ea7u, do virus vi\u00eam gan B (HBV) g\u00e2y ra. HBV l\u00e2y nhi\u1ec5m qua \u0111\u01b0\u1eddng m\u00e1u, quan h\u1ec7 t\u00ecnh d\u1ee5c v\u00e0 t\u1eeb m\u1eb9 sang con. Vi\u1ec7t Nam n\u1eb1m trong v\u00f9ng d\u1ecbch t\u1ec5 l\u01b0u h\u00e0nh cao c\u1ee7a nhi\u1ec5m HBV (t\u1ec9 l\u1ec7 nhi\u1ec5m HBV &gt;8%) v\u1edbi \u0111\u01b0\u1eddng l\u00e2y ch\u1ee7 y\u1ebfu l\u00e0 t\u1eeb m\u1eb9 truy\u1ec1n sang con. <\/strong><\/p>\n<p><strong>HBV c\u00f3 th\u1ec3 g\u00e2y vi\u00eam gan t\u1ed1i c\u1ea5p, vi\u00eam gan c\u1ea5p v\u00e0 vi\u00eam gan m\u1ea1n, ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan, HCC. H\u01a1n 95% ng\u01b0\u1eddi l\u1edbn b\u1ecb vi\u00eam gan B c\u1ea5p s\u1ebd h\u1ed3i ph\u1ee5c m\u1ed9t c\u00e1ch t\u1ef1 nhi\u00ean m\u00e0 kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00e1ng virus. \u0110i\u1ec1u tr\u1ecb vi\u00eam gan B c\u1ea5p ch\u1ee7 y\u1ebfu l\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3. <\/strong><\/p>\n<h2><strong>1. Ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m virus vi\u00eam gan B m\u1ea1n.<\/strong><\/h2>\n<ul>\n<li>HBsAg v\u00e0\/ho\u1eb7c HBV DNA d\u01b0\u01a1ng t\u00ednh \u2265 6 th\u00e1ng, ho\u1eb7c<\/li>\n<li>HbsAg d\u01b0\u01a1ng t\u00ednh v\u00e0 anti-HBc IgM \u00e2m t\u00ednh.<\/li>\n<\/ul>\n<h2><strong>2. \u0110i\u1ec1u tr\u1ecb vi\u00eam gan B m\u1ea1n.<\/strong><\/h2>\n<h3><strong>2.1 M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb. <\/strong><\/h3>\n<ul>\n<li>\u1ee8c ch\u1ebf l\u00e2u d\u00e0i s\u1ef1 sao ch\u00e9p c\u1ee7a HBV.<\/li>\n<li>C\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng, ng\u0103n ng\u1eeba di\u1ec5n ti\u1ebfn x\u01a1 gan, HCC.<\/li>\n<li>D\u1ef1 ph\u00f2ng l\u00e2u truy\u1ec1n HBV cho c\u1ed9ng \u0111\u1ed3ng bao g\u1ed3m d\u1ef1 ph\u00f2ng l\u00e2y truy\u1ec1n m\u1eb9 con.<\/li>\n<li>D\u1ef1 ph\u00f2ng \u0111\u1ee3t b\u00f9ng ph\u00e1t vi\u00eam gan B.<\/li>\n<\/ul>\n<h3><strong>2.2 Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb. <\/strong><\/h3>\n<ul>\n<li>L\u1ef1a ch\u1ecdn ban \u0111\u1ea7u l\u00e0 c\u00e1c thu\u1ed1c u\u1ed1ng nucleotide analogues (NA). Ch\u1ec9 n\u00ean d\u00f9ng ph\u00e1c \u0111\u1ed3 c\u00f3 Peg-IFN \u0111\u1ed1i v\u1edbi m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1eb7c bi\u1ec7t.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb vi\u00eam gan B m\u1ea1n v\u1edbi NA l\u00e0 \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i, c\u00f3 th\u1ec3 k\u00e9o d\u00e0i su\u1ed1t \u0111\u1eddi.<\/li>\n<li>Tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<h3><strong>2.3 Chu\u1ea9n b\u1ecb \u0111i\u1ec1u tr\u1ecb. <\/strong><\/h3>\n<ul>\n<li><strong>T\u01b0 v\u1ea5n cho ng\u01b0\u1eddi b\u1ec7nh v\u1ec1 c\u00e1c v\u1ea5n \u0111\u1ec1 sau: <\/strong><\/li>\n<\/ul>\n<p>+ S\u1ef1 c\u1ea7n thi\u1ebft, m\u1ee5c ti\u00eau v\u00e0 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u1edbi thu\u1ed1c kh\u00e1ng virus.<\/p>\n<p>+ T\u1ea7m quan tr\u1ecdng c\u1ee7a tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb (c\u00e1ch u\u1ed1ng thu\u1ed1c, u\u1ed1ng thu\u1ed1c \u0111\u00fang gi\u1edd, t\u00e1i kh\u00e1m \u0111\u00fang h\u1eb9n).<\/p>\n<p>+ C\u00e1c x\u00e9t nghi\u1ec7m c\u1ea7n thi\u1ebft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n, theo d\u00f5i v\u00e0 \u0111\u00e1nh gi\u00e1 \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>+ Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i, c\u00f3 th\u1ec3 su\u1ed1t \u0111\u1eddi (v\u1edbi NA).<\/p>\n<p>+ T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a thu\u1ed1c.<\/p>\n<p>+ Bi\u1ebfn ch\u1ee9ng HCC c\u00f3 th\u1ec3 x\u1ea3y ra, k\u1ec3 c\u1ea3 trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00e1ng virus, \u0111\u1eb7c bi\u1ec7t c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 x\u01a1 h\u00f3a gan F \u22653.<\/p>\n<ul>\n<li><strong><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/y-nghia-cac-xet-nghiem-chan-doan-benh-viem-gan-b\/\">C\u00e1c x\u00e9t nghi\u1ec7m c\u1ea7n l\u00e0m tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb<\/a>: <\/strong><\/li>\n<\/ul>\n<p>+ T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u.<\/p>\n<p>+ AST, ALT, creatinine huy\u1ebft thanh.<\/p>\n<p>+ C\u00e1c x\u00e9t nghi\u1ec7m \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan khi c\u1ea7n thi\u1ebft nh\u01b0 bilirubin, albumin, t\u1ec9 l\u1ec7 prothrombin, INR.<\/p>\n<p>+ Si\u00eau \u00e2m b\u1ee5ng, AFP.<\/p>\n<p>+ HBeAg, t\u1ea3i l\u01b0\u1ee3ng HBV DNA.<\/p>\n<p>+ Anti-HCV.<\/p>\n<p>+ <a href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/danh-gia-xo-hoa-gan-fibrosis-bang-ky-thuat-sieu-am-dan-hoi-mo-gan-hien-dai\/\">\u0110\u00e1nh gi\u00e1 giai \u0111o\u1ea1n x\u01a1 h\u00f3a gan<\/a> b\u1eb1ng ch\u1ec9 s\u1ed1 APRI ho\u1eb7c m\u1ed9t trong c\u00e1c k\u0129 thu\u1eadt: Fibroscan, sinh thi\u1ebft gan.<\/p>\n<p>+ N\u1ebfu ng\u01b0\u1eddi b\u1ec7nh \u0111i\u1ec1u tr\u1ecb Peg-IFN c\u1ea7n l\u00e0m th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p (TSH, FT3, FT4), \u0111i\u1ec7n t\u00e2m \u0111\u1ed3.<\/p>\n<p>+ C\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c theo ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng.<\/p>\n<h2><strong>3. C\u00e1c ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb vi\u00eam gan B m\u1ea1n.<\/strong><\/h2>\n<h3><strong>3.1. \u0110\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p x\u01a1 gan c\u00f2n b\u00f9 ho\u1eb7c m\u1ea5t b\u00f9.<\/strong><\/h3>\n<p>Ch\u1ea9n \u0111o\u00e1n d\u1ef1a v\u00e0o tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u00e0\/ho\u1eb7c k\u1ebft qu\u1ea3 \u0111\u00e1nh gi\u00e1 x\u01a1 h\u00f3a gan l\u00e0 F4 b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00f4ng x\u00e2m l\u1ea5n ho\u1eb7c sinh thi\u1ebft.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb khi t\u1ea3i l\u01b0\u1ee3ng HBV DNA tr\u00ean ng\u01b0\u1ee1ng b\u1ea5t k\u1ec3 n\u1ed3ng \u0111\u1ed9 ALT v\u00e0 t\u00ecnh tr\u1ea1ng HBeAg.<\/p>\n<h3><strong>3.2. \u0110\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng x\u01a1 gan.<\/strong><\/h3>\n<p>\u0110i\u1ec1u tr\u1ecb vi\u00eam gan B m\u1ea1n cho ng\u01b0\u1eddi b\u1ec7nh khi \u0111\u00e1p \u1ee9ng c\u1ea3 2 ti\u00eau chu\u1ea9n.<\/p>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng t\u1ebf b\u00e0o gan.<\/li>\n<li>AST, ALT &gt;2 l\u1ea7n gi\u1edbi h\u1ea1n tr\u00ean v\u00e0\/ho\u1eb7c<\/li>\n<li>X\u01a1 h\u00f3a gan F \u2265 2<\/li>\n<li>Virus \u0111ang t\u0103ng sinh:<\/li>\n<li>HBV DNA \u2265 20,000 IU\/mL (\u226510exp5 copies\/mL) n\u1ebfu HBeAg d\u01b0\u01a1ng t\u00ednh.<\/li>\n<li>HBV DNA \u22652,000 IU\/mL (\u226510exp4 copies\/mL) n\u1ebfu HBeAg \u00e2m t\u00ednh.<\/li>\n<\/ul>\n<p>\u0110\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p ch\u01b0a \u0111\u00e1p \u1ee9ng \u0111\u1ee7 2 ti\u00eau chu\u1ea9n tr\u00ean, ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb khi c\u00f3 m\u1ed9t trong c\u00e1c ti\u00eau chu\u1ea9n sau:<\/p>\n<p>+ Tr\u00ean 30 tu\u1ed5i v\u1edbi m\u1ee9c ALT cao h\u01a1n gi\u1edbi h\u1ea1n tr\u00ean k\u00e9o d\u00e0i (ghi nh\u1eadn \u00edt nh\u1ea5t 3 l\u1ea7n trong kho\u1ea3ng 24 \u2013 48 tu\u1ea7n) v\u00e0 HBV DNA &gt;20,000 IU\/mL, b\u1ea5t k\u1ec3 t\u00ecnh tr\u1ea1ng HBeAg.<\/p>\n<p>+ C\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 HCC ho\u1eb7c x\u01a1 gan.<\/p>\n<p>+ C\u00f3 c\u00e1c bi\u1ec3u hi\u1ec7n ngo\u00e0i gan nh\u01b0 vi\u00eam c\u1ea7u th\u1eadn, vi\u00eam \u0111a kh\u1edbp, cryoglobulin m\u00e1u, vi\u00eam \u0111a n\u00fat \u0111\u1ed9ng m\u1ea1ch.<\/p>\n<p>+ T\u00e1i ph\u00e1t sau ng\u01b0ng \u0111i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00e1ng virus HBV.<\/p>\n<h3><strong>3.3. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb.<\/strong><\/h3>\n<ul>\n<li>Tenofovir disoproxil fumarate (TDF): li\u1ec1u 300mg\/ng\u00e0y, ch\u1ec9nh li\u1ec1u theo m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn. Tr\u1ebb em \u226512 tu\u1ed5i v\u00e0 \u226535kg d\u00f9ng li\u1ec1u nh\u01b0 ng\u01b0\u1eddi l\u1edbn. T\u00e1c d\u1ee5ng ph\u1ee5: B\u1ec7nh th\u1eadn, h\u1ed9i ch\u1ee9ng Fanconi, h\u1ed9i ch\u1ee9ng lo\u00e3ng x\u01b0\u01a1ng, nhi\u1ec5m toan lactic.<\/li>\n<li>Entecavir (ETV): li\u1ec1u 0.5mg\/ng\u00e0y (1mg\/ng\u00e0y n\u1ebfu t\u1eebng s\u1eed d\u1ee5ng lamivudine ho\u1eb7c c\u00f3 x\u01a1 gan m\u1ea5t b\u00f9), ch\u1ec9nh li\u1ec1u theo m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn. T\u00e1c d\u1ee5ng ph\u1ee5: nhi\u1ec5m toan lactic.<\/li>\n<li>Tenofovir alafenamide: li\u1ec1u 25mg\/ng\u00e0y, kh\u00f4ng c\u1ea7n gi\u1ea3m li\u1ec1u trong suy th\u1eadn. Tr\u1ebb \u226512 tu\u1ed5i d\u00f9ng li\u1ec1u ng\u01b0\u1eddi l\u1edbn. T\u00e1c d\u1ee5ng ph\u1ee5: nhi\u1ec5m toan lactic, kh\u00f4ng ch\u1ec9 \u0111\u1ecbnh cho x\u01a1 gan m\u1ea5t b\u00f9.<\/li>\n<li>Peg-IFN-\u03b1-2a ng\u01b0\u1eddi l\u1edbn v\u00e0 IFN-\u03b1-2b cho tr\u1ebb em: 180\u00b5g\/tu\u1ea7n. Tr\u1ebb \u22651 tu\u1ed5i: 6 tri\u1ec7u \u0111\u01a1n v\u1ecb\/m2 x3 l\u1ea7n\/tu\u1ea7n. T\u00e1c d\u1ee5ng ph\u1ee5: gi\u1ea3 c\u00fam, m\u1ec7t m\u1ecfi, r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n, gi\u1ea3m b\u1ea1ch c\u1ea7u, r\u1ed1i lo\u1ea1n mi\u1ec5n d\u1ecbch \u1edf ng\u01b0\u1eddi l\u1edbn, ch\u00e1n \u0103n v\u00e0 s\u1ee5t c\u00e2n.<\/li>\n<\/ul>\n<h3><strong>3.4. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb.<\/strong><\/h3>\n<ul>\n<li>V\u1edbi thu\u1ed1c NA, \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i, c\u00f3 th\u1ec3 su\u1ed1t \u0111\u1eddi. Ng\u01b0\u1eddi x\u01a1 gan ph\u1ea3i \u0111i\u1ec1u tr\u1ecb su\u1ed1t \u0111\u1eddi. Ng\u01b0\u1eddi ch\u01b0a x\u01a1 gan: \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i, c\u00f3 th\u1ec3 xem x\u00e9t ng\u01b0ng \u0111i\u1ec1u tr\u1ecb trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau \u0111\u00e2y.<\/li>\n<\/ul>\n<p>+ Vi\u00eam gan B m\u1ea1n c\u00f3 HBeAg d\u01b0\u01a1ng: ng\u01b0ng sau khi \u0111i\u1ec1u tr\u1ecb th\u00eam 12 th\u00e1ng k\u1ec3 t\u1eeb khi chuy\u1ec3n huy\u1ebft thanh HBeAg ho\u1eb7c m\u1ea5t HBsAg.<\/p>\n<p>+ Vi\u00eam gan B m\u1ea1n c\u00f3 HBeAg \u00e2m t\u00ednh: ng\u01b0ng \u0111i\u1ec1u tr\u1ecb khi t\u1ea3i l\u01b0\u1ee3ng HBV DNA d\u01b0\u1edbi ng\u01b0\u1ee1ng v\u00e0 m\u1ea5t HBsAg.<\/p>\n<p>+ N\u1ebfu kh\u00f4ng th\u1ec3 \u0111o t\u1ea3i l\u01b0\u1ee3ng HBV DNA th\u00ec ng\u01b0ng thu\u1ed1c khi m\u1ea5t HBsAg \u00edt nh\u1ea5t 12 th\u00e1ng.<\/p>\n<p>+ HBcrAg \u00e2m t\u00ednh.<\/p>\n<ul>\n<li>Ch\u1ec9 ng\u01b0ng khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 \u0111i\u1ec1u ki\u1ec7n theo d\u00f5i \u0111\u1ecbnh k\u1ef3 trong th\u1eddi gian d\u00e0i \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng t\u00e1i ho\u1ea1t HBV sau khi ng\u01b0ng thu\u1ed1c.<\/li>\n<\/ul>\n<p>Ngu\u1ed3n: H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam gan vi r\u00fat B. B\u1ed9 Y t\u1ebf 2019.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam gan B m\u1ea1n l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m quan tr\u1ecdng, ph\u1ed5 bi\u1ebfn to\u00e0n c\u1ea7u, do virus vi\u00eam gan B (HBV) g\u00e2y ra. HBV l\u00e2y nhi\u1ec5m qua \u0111\u01b0\u1eddng m\u00e1u, quan h\u1ec7 t\u00ecnh d\u1ee5c v\u00e0 t\u1eeb m\u1eb9 sang con. Vi\u1ec7t Nam n\u1eb1m trong v\u00f9ng d\u1ecbch t\u1ec5 l\u01b0u h\u00e0nh cao c\u1ee7a nhi\u1ec5m HBV (t\u1ec9 l\u1ec7 nhi\u1ec5m HBV &gt;8%) [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Vi\u00eam gan B m\u1ea1n - Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo B\u1ed9 Y t\u1ebf 2019 - Vinmec<\/title>\n<meta name=\"description\" content=\"HBV c\u00f3 th\u1ec3 g\u00e2y vi\u00eam gan t\u1ed1i c\u1ea5p, vi\u00eam gan c\u1ea5p v\u00e0 vi\u00eam gan m\u1ea1n, ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan, HCC. H\u01a1n 95% ng\u01b0\u1eddi l\u1edbn b\u1ecb vi\u00eam gan B c\u1ea5p s\u1ebd h\u1ed3i ph\u1ee5c.\" \/>\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=\"Vi\u00eam gan B m\u1ea1n - Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo B\u1ed9 Y t\u1ebf 2019 - Vinmec\" \/>\n<meta property=\"og:description\" content=\"HBV c\u00f3 th\u1ec3 g\u00e2y vi\u00eam gan t\u1ed1i c\u1ea5p, vi\u00eam gan c\u1ea5p v\u00e0 vi\u00eam gan m\u1ea1n, ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan, HCC. H\u01a1n 95% ng\u01b0\u1eddi l\u1edbn b\u1ecb vi\u00eam gan B c\u1ea5p s\u1ebd h\u1ed3i ph\u1ee5c.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-13T12:58:04+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-14T08:20:21+00:00\" \/>\n<meta name=\"author\" content=\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/\",\"url\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/\",\"name\":\"Vi\u00eam gan B m\u1ea1n - Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo B\u1ed9 Y t\u1ebf 2019 - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-13T12:58:04+00:00\",\"dateModified\":\"2023-04-14T08:20:21+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e\"},\"description\":\"HBV c\u00f3 th\u1ec3 g\u00e2y vi\u00eam gan t\u1ed1i c\u1ea5p, vi\u00eam gan c\u1ea5p v\u00e0 vi\u00eam gan m\u1ea1n, ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan, HCC. H\u01a1n 95% ng\u01b0\u1eddi l\u1edbn b\u1ecb vi\u00eam gan B c\u1ea5p s\u1ebd h\u1ed3i ph\u1ee5c.\",\"breadcrumb\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Vi\u00eam gan B m\u1ea1n &#8211; Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo B\u1ed9 Y t\u1ebf 2019\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e\",\"name\":\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g\",\"caption\":\"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/meogods1234gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Vi\u00eam gan B m\u1ea1n - Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo B\u1ed9 Y t\u1ebf 2019 - Vinmec","description":"HBV c\u00f3 th\u1ec3 g\u00e2y vi\u00eam gan t\u1ed1i c\u1ea5p, vi\u00eam gan c\u1ea5p v\u00e0 vi\u00eam gan m\u1ea1n, ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan, HCC. H\u01a1n 95% ng\u01b0\u1eddi l\u1edbn b\u1ecb vi\u00eam gan B c\u1ea5p s\u1ebd h\u1ed3i ph\u1ee5c.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Vi\u00eam gan B m\u1ea1n - Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo B\u1ed9 Y t\u1ebf 2019 - Vinmec","og_description":"HBV c\u00f3 th\u1ec3 g\u00e2y vi\u00eam gan t\u1ed1i c\u1ea5p, vi\u00eam gan c\u1ea5p v\u00e0 vi\u00eam gan m\u1ea1n, ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan, HCC. H\u01a1n 95% ng\u01b0\u1eddi l\u1edbn b\u1ecb vi\u00eam gan B c\u1ea5p s\u1ebd h\u1ed3i ph\u1ee5c.","og_url":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/","og_site_name":"Vinmec","article_published_time":"2023-04-13T12:58:04+00:00","article_modified_time":"2023-04-14T08:20:21+00:00","author":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n","Est. reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/","url":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/","name":"Vi\u00eam gan B m\u1ea1n - Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo B\u1ed9 Y t\u1ebf 2019 - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-13T12:58:04+00:00","dateModified":"2023-04-14T08:20:21+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e"},"description":"HBV c\u00f3 th\u1ec3 g\u00e2y vi\u00eam gan t\u1ed1i c\u1ea5p, vi\u00eam gan c\u1ea5p v\u00e0 vi\u00eam gan m\u1ea1n, ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan, HCC. H\u01a1n 95% ng\u01b0\u1eddi l\u1edbn b\u1ecb vi\u00eam gan B c\u1ea5p s\u1ebd h\u1ed3i ph\u1ee5c.","breadcrumb":{"@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/viem-gan-b-man-chi-dinh-dieu-tri-theo-bo-y-te-2019\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Vi\u00eam gan B m\u1ea1n &#8211; Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo B\u1ed9 Y t\u1ebf 2019"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b812b6273d037966dff4008e0eed896e","name":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g","contentUrl":"http:\/\/1.gravatar.com\/avatar\/d8b9ad8e288884ecf4bc8ee441f3596b?s=96&d=mm&r=g","caption":"Nguy\u1ec5n Ch\u00ed Nguy\u1ec7n"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/meogods1234gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/3336"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/69"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=3336"}],"version-history":[{"count":7,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/3336\/revisions"}],"predecessor-version":[{"id":20704,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/3336\/revisions\/20704"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=3336"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=3336"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=3336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}