{"id":3430,"date":"2023-04-10T18:54:44","date_gmt":"2023-04-10T11:54:44","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=3430"},"modified":"2023-04-19T15:02:02","modified_gmt":"2023-04-19T08:02:02","slug":"cai-dat-thong-so-may-tho-tren-benh-nhan-hoi-suc-phau-thuat-tim","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/cai-dat-thong-so-may-tho-tren-benh-nhan-hoi-suc-phau-thuat-tim\/","title":{"rendered":"C\u00e0i \u0111\u1eb7t th\u00f4ng s\u1ed1 m\u00e1y th\u1edf tr\u00ean b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim"},"content":{"rendered":"<p><strong>C\u00e0i \u0111\u1eb7t th\u00f4ng s\u1ed1 m\u00e1y th\u1edf \u0111\u00fang c\u00e1ch l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng trong vi\u1ec7c qu\u1ea3n l\u00fd b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim.\u00a0 Theo American Society of Anesthesiologists v\u00e0 Society of Critical Care Medicine, vi\u1ec7c thi\u1ebft l\u1eadp m\u1ee9c \u0111\u1ed9 PEEP, t\u1ea7n s\u1ed1 th\u1edf v\u00e0 th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng \u00a0ph\u00f9 h\u1ee3p c\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng h\u1ed3i ph\u1ee5c ph\u1ed5i v\u00e0 gi\u1ea3m nguy c\u01a1 vi\u00eam ph\u1ed5i.\u00a0<\/strong><\/p>\n<h2><strong>1.Thi\u1ebft l\u1eadp ban \u0111\u1ea7u c\u1ee7a m\u00e1y th\u1edf nh\u01b0 sau:<\/strong><\/h2>\n<ul>\n<li>Th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng (VT): 6-8 mL\/kg.\u0110\u00e2y l\u00e0 th\u1ec3 t\u00edch kh\u00ed \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o trong m\u1ed7i chu k\u1ef3 th\u1edf.Ch\u1ec9 \u0111\u1ecbnh VT tu\u1ef3 theo t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd c\u1ee7a b\u1ec7nh nh\u00e2n<\/li>\n<li>T\u1ea7n s\u1ed1 th\u1edf(TS): 10-12 l\u1ea7n\/ph\u00fat<\/li>\n<li>N\u1ed3ng \u0111\u1ed9 oxy trong kh\u00ed h\u00edt v\u00e0o (FiO2): 1,0<\/li>\n<li>\u00c1p l\u1ef1c d\u01b0\u01a1ng cu\u1ed1i th\u00ec th\u1edf ra (Positive end-expiratory pressure &#8211; PEEP): 5 cm H2O<\/li>\n<li>T\u1ef7 l\u1ec7 th\u1edf h\u00edt v\u00e0o : th\u1edf th\u1edf ra (Inspiratory:Expiratory ratio &#8211; I:E) t\u1eeb 1:2 \u0111\u1ebfn 1:3.<\/li>\n<\/ul>\n<p>Th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng \u00a0v\u00e0 t\u1ea7n s\u1ed1 th\u1edf \u0111\u01b0\u1ee3c ch\u1ecdn \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c th\u00f4ng kh\u00ed trung b\u00ecnh kho\u1ea3ng 100 mL\/kg\/ph\u00fat. Th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng th\u1ea5p c\u00f3 th\u1ec3 t\u1ed1t h\u01a1n so v\u1edbi th\u1ec3 t\u00edch cao\u00a0 c\u1ee7a h\u1ed9i ch\u1ee9ng suy h\u00f4 h\u1ea5p c\u1ea5p ng\u01b0\u1eddi l\u1edbn (adult respiratory distress syndrome &#8211; ARDS) sau ph\u1eabu thu\u1eadt. Ng\u01b0\u1ee3c l\u1ea1i, b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) th\u01b0\u1eddng c\u00f3 l\u1ee3i t\u1eeb t\u1ea7n s\u1ed1 th\u1edf th\u1ea5p v\u00e0 th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng cao v\u1edbi t\u1ed1c \u0111\u1ed9 d\u00f2ng kh\u00ed h\u00edt v\u00e0o t\u0103ng l\u00ean. \u0110i\u1ec1u n\u00e0y cho ph\u00e9p th\u1eddi gian th\u1edf ra nhi\u1ec1u h\u01a1n.<\/p>\n<p>M\u1ed9t m\u1ee9c \u00e1p l\u1ef1c d\u01b0\u01a1ng cu\u1ed1i th\u00ec th\u1edf ra (5 cm H2O) th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u00eam v\u00e0o \u0111\u1ec3 ng\u0103n x\u1eb9p ph\u1ed5i. M\u1ee9c \u0111\u1ed9 PEEP t\u1eeb 10 cm H2O tr\u1edf l\u00ean th\u01b0\u1eddng c\u1ea7n thi\u1ebft \u0111\u1ec3 c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng h\u1ed3i ph\u1ee5c ph\u1ed5i, nh\u01b0ng n\u00f3 ph\u1ea3i \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng c\u1ea9n th\u1eadn v\u00ec n\u00f3 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u t\u0129nh m\u1ea1ch v\u00e0 l\u00e0m t\u1ed5n th\u01b0\u01a1ng ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i v\u00e0 th\u1ea5t ph\u1ea3i. C\u1ea7n c\u1ea9n tr\u1ecdng khi b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ee9c n\u0103ng th\u1ea5t ph\u1ea3i b\u1ecb t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<h2>2. C\u00e1c Mode th\u1edf \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng:<\/h2>\n<h3><strong>2.1.Ch<\/strong><strong>\u1ebf<\/strong> <strong>\u0111<\/strong><strong>\u1ed9 h\u1ed7 tr\u1ee3\/ki\u1ec3m so\u00e1t (A\/C):<\/strong><\/h3>\n<p>Cung c\u1ea5p m\u1ed9t th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng \u0111\u01b0\u1ee3c \u0111\u1eb7t tr\u01b0\u1edbc khi \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi l\u1ef1c h\u00edt c\u1ee7a b\u1ec7nh nh\u00e2n ho\u1eb7c t\u1ea1i c\u00e1c kho\u1ea3ng th\u1eddi gian \u0111\u01b0\u1ee3c \u0111\u1eb7t tr\u01b0\u1edbc n\u1ebfu kh\u00f4ng c\u00f3 th\u1edf. T\u1ea7n s\u1ed1 h\u00f4 h\u1ea5p n\u00ean \u0111\u01b0\u1ee3c \u0111\u1eb7t \u1edf m\u1ee9c 10-12 l\u1ea7n\/ph\u00fat tr\u01b0\u1edbc khi b\u1ec7nh nh\u00e2n b\u1eaft \u0111\u1ea7u th\u1edf t\u1ef1 ph\u00e1t. N\u1ebfu b\u1ec7nh nh\u00e2n\u00a0 th\u1edf kh\u00f4ng \u0111\u1ed3ng b\u1ed9 v\u1edbi m\u00e1y th\u1edf ho\u1eb7c th\u1edf qu\u00e1 nhanh, s\u1ebd c\u00f3 nguy c\u01a1 g\u00e2y ra t\u0103ng ki\u1ec1m h\u00f4 h\u1ea5p ho\u1eb7c toan h\u00f4 h\u1ea5p \u0111\u00e1ng k\u1ec3. Ch\u1ebf \u0111\u1ed9 th\u00f4ng kh\u00ed n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng t\u1ed1t nh\u1ea5t ch\u1ec9 khi b\u1ec7nh nh\u00e2n c\u1ea7n h\u1ed7 tr\u1ee3 th\u00f4ng kh\u00ed \u0111\u00e1ng k\u1ec3 v\u00e0 kh\u00f4ng n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m d\u1ea7n.<\/p>\n<h3><strong>2.2.Th\u1edf th\u00f4ng kh\u00ed b\u1eaft bu\u1ed9c <\/strong><strong>ng\u1eaft qu\u00e3ng<\/strong> <strong>\u0111<\/strong><strong>\u1ed3ng b\u1ed9 (SIMV): <\/strong><\/h3>\n<p>Trong ch\u1ebf \u0111\u1ed9 SIMV, b\u1ec7nh nh\u00e2n th\u1edf t\u1ef1 ph\u00e1t v\u00e0 t\u1ea1i c\u00e1c kho\u1ea3ng th\u1eddi gian \u0111\u01b0\u1ee3c \u0111\u1eb7t tr\u01b0\u1edbc, th\u1edf t\u1ef1 ph\u00e1t ti\u1ebfp theo \u0111\u01b0\u1ee3c b\u1ed5 sung th\u00eam m\u1ed9t th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng \u0111\u1ea7y \u0111\u1ee7 t\u1eeb m\u00e1y th\u1edf. V\u00ec th\u1edf c\u1ee7a m\u00e1y \u0111\u01b0\u1ee3c \u0111\u1ed3ng b\u1ed9 v\u1edbi n\u1ed7 l\u1ef1c c\u1ee7a b\u1ec7nh nh\u00e2n, \u00e1p su\u1ea5t \u0111\u1ec9nh cao \u0111\u01b0\u1ee3c tr\u00e1nh v\u00e0 th\u1edf tr\u1edf n\u00ean d\u1ec5 ch\u1ecbu h\u01a1n. V\u00ec nhi\u1ec1u n\u1ed7 l\u1ef1c c\u1ee7a b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c b\u1ed5 sung, SIMV kh\u00f4ng n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong giai \u0111o\u1ea1n \u0111\u1ea7u c\u1ee7a h\u1ed7 tr\u1ee3 th\u00f4ng kh\u00ed v\u00ec n\u00f3 t\u0103ng c\u00f4ng h\u00f4 h\u1ea5p h\u01a1n so v\u1edbi ch\u1ebf \u0111\u1ed9 A\/C. Tuy nhi\u00ean, \u0111\u00e2y l\u00e0 m\u1ed9t ch\u1ebf \u0111\u1ed9 tuy\u1ec7t v\u1eddi cho vi\u1ec7c gi\u1ea3m d\u1ea7n th\u00f4ng kh\u00ed v\u00ec n\u00f3 t\u1ea1o ra s\u1ef1 \u0111\u1ed3ng b\u1ed9 t\u1ed1t gi\u1eefa b\u1ec7nh nh\u00e2n v\u00e0 m\u00e1y th\u1edf, b\u1ea3o t\u1ed3n ch\u1ee9c n\u0103ng c\u01a1 h\u00f4 h\u1ea5p v\u00e0 t\u1ea1o ra \u00e1p l\u1ef1c \u0111\u01b0\u1eddng th\u1edf th\u1ea5p.<\/p>\n<h3><strong>2.3.Th\u1edf h\u1ed7 tr\u1ee3 \u00e1p l\u1ef1c(PSV):<\/strong><\/h3>\n<p>L\u00e0 m\u1ed9t h\u1ec7 th\u1ed1ng gi\u1edbi h\u1ea1n \u00e1p l\u1ef1c \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi b\u1ec7nh nh\u00e2n, ch\u1ec9 cung c\u1ea5p th\u00f4ng kh\u00ed khi \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi vi\u1ec7c h\u00edt c\u1ee7a b\u1ec7nh nh\u00e2n. Sau \u0111\u00f3, h\u1ec7 th\u1ed1ng s\u1ebd cung c\u1ea5p \u00e1p l\u1ef1c h\u00edt v\u00e0 d\u00f2ng kh\u00ed v\u00e0o \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p cho \u0111\u1ebfn khi d\u00f2ng th\u1edf h\u00edt gi\u1ea3m xu\u1ed1ng kho\u1ea3ng 25% so v\u1edbi gi\u00e1 tr\u1ecb \u0111\u1ec9nh c\u1ee7a n\u00f3 v\u00e0 th\u1edf ra s\u1ebd di\u1ec5n ra m\u1ed9t c\u00e1ch t\u1ef1 nhi\u00ean. N\u1ed7 l\u1ef1c c\u1ee7a b\u1ec7nh nh\u00e2n quy\u1ebft \u0111\u1ecbnh t\u1ea7n s\u1ed1 h\u00f4 h\u1ea5p, th\u1eddi gian h\u00edt v\u00e0 t\u1ed1c \u0111\u1ed9 d\u00f2ng kh\u00ed v\u00e0 th\u1eddi gian th\u1edf ra. Th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng \u0111\u01b0\u1ee3c cung c\u1ea5p ph\u1ee5 thu\u1ed9c v\u00e0o vi\u1ec7c h\u00edt c\u1ee7a b\u1ec7nh nh\u00e2n, m\u1ee9c \u0111\u1ed9 h\u1ed7 tr\u1ee3 \u00e1p l\u1ef1c \u0111\u01b0\u1ee3c ch\u1ecdn.<\/p>\n<h2><strong>3.Theo d\u00f5i c\u00e1c v\u1ea5n \u0111\u1ec1 kh\u00e1c khi \u0111ang th\u1edf m\u00e1y:<\/strong><\/h2>\n<ul>\n<li>SpO2 li\u00ean tu\u0323c \u0111\u01b0\u01a1\u0323c s\u01b0\u0309 du\u0323ng \u0111\u1ec3 theo d\u00f5i trong su\u00f4\u0301t th\u01a1\u0309 ma\u0301y v\u01a1\u0301i hi\u00ea\u0309n thi\u0323 n\u00f4\u0300ng \u0111\u00f4\u0323 oxy trong ma\u0301u \u0111\u00f4\u0323ng ma\u0323ch (SpO2) tr\u00ean mornitor b\u00ean gi\u01b0\u01a1\u0300ng. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 ch\u00fa \u00fd \u0111\u1ebfn s\u1ef1 thay \u0111\u1ed5i \u0111\u1ed9t ng\u1ed9t trong oxy h\u00f3a v\u00e0 s\u1ebd kh\u00f4ng c\u1ea7n ph\u1ea3i l\u1ea5y kh\u00ed m\u00e1u \u0111\u1ed9ng t\u1ea7n su\u1ea5t th\u01b0\u1eddng xuy\u00ean \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n \u1ed5n \u0111\u1ecbnh. N\u1ebfu SaO2 &lt;95%, n\u00ean \u0111\u1eb7t c\u00e2u h\u1ecfi v\u1ec1 s\u1ef1 quan t\u00e2m.<\/li>\n<li>M\u1ed9t Film X-quang ng\u1ef1c n\u00ean \u0111\u01b0\u1ee3c ki\u1ec3m tra sau khi \u0111\u1ebfn ICU. V\u1ecb tr\u00ed c\u1ee7a \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n ho\u1eb7c b\u1ea5t k\u1ef3 \u0111\u01b0\u1eddng trung t\u00e2m n\u00e0o n\u00ean \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh \u0111\u00e3 \u0111\u00fang v\u1ecb tr\u00ed kh\u00f4ng. C\u00e1c v\u1ea5n \u0111\u1ec1 n\u00ean \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 v\u1ec1 s\u1ef1 m\u1edf r\u1ed9ng \/ x\u1eb9p ph\u1ed5i, kh\u00ed ph\u1ebf th\u1ee7ng , tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i , ph\u00f9 ph\u1ed5i ho\u1eb7c th\u00e2m nhi\u1ec5m. Ch\u00fa \u00fd \u0111\u1ebfn \u0111\u1ed9 r\u1ed9ng c\u1ee7a trung th\u1ea5t ch\u1ee7 y\u1ebfu \u0111\u1ec3 so s\u00e1nh sau n\u00e0y trong tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft sau ph\u1eabu thu\u1eadt.<\/li>\n<li>M\u1ed9t kh\u00ed m\u00e1u t\u1ea1i gi\u01b0\u1eddng \u0111\u1ea7u ti\u00ean n\u00ean \u0111\u01b0\u1ee3c ki\u1ec3m tra kho\u1ea3ng 15-20 ph\u00fat sau khi \u0111\u1ebfn ICU. FiO2 \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp ban \u0111\u1ea7u l\u00e0 100% l\u00e0m ranh gi\u1edbi an to\u00e0n cho \u0111\u1ebfn khi n\u1ed3ng \u0111\u1ed9 oxy trong m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1. Sau \u0111\u00f3, n\u00f3 n\u00ean \u0111\u01b0\u1ee3c gi\u1ea3m xu\u1ed1ng 40%, th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng v\u00e0 t\u1ea7n s\u1ed1 th\u1edf \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh \u0111\u1ec3 duy tr\u00ec ABGs trong kho\u1ea3ng b\u00ecnh th\u01b0\u1eddng. Ph\u1ea3i d\u1ef1 \u0111o\u00e1n r\u1eb1ng PCO2 s\u1ebd t\u0103ng khi b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c l\u00e0m \u1ea5m. Nhu c\u1ea7u chuy\u1ec3n h\u00f3a v\u00e0 s\u1ea3n xu\u1ea5t CO2 gi\u1ea3m 10% cho m\u1ed7i \u0111\u1ed9 th\u1ea5p h\u01a1n 37 \u00b0 C . ABGs ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c bao g\u1ed3m:PaO2&gt; 80 mmHg (SaO2&gt; 95%);PCO2 32-48 mmg; pH 7,32-7,48<\/li>\n<\/ul>\n<h2><strong>4.K\u1ebft lu\u1eadn v\u1ec1 c\u00e0i \u0111\u1eb7t c\u00e1c th\u00f4ng s\u1ed1<\/strong><\/h2>\n<p>T\u1ed5ng h\u1ee3p c\u00e1c nghi\u00ean c\u1ee9u v\u00e0 h\u01b0\u1edbng d\u1eabn t\u1eeb c\u00e1c ngu\u1ed3n uy t\u00edn, c\u00e0i \u0111\u1eb7t th\u00f4ng s\u1ed1 m\u00e1y th\u1edf ph\u00f9 h\u1ee3p l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng trong vi\u1ec7c qu\u1ea3n l\u00fd b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim. C\u00e1c \u0111i\u1ec1u ki\u1ec7n \u0111\u1eb7c bi\u1ec7t c\u1ee7a m\u1ed7i b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t \u0111\u1ec3 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh c\u00e0i \u0111\u1eb7t th\u00f4ng s\u1ed1 m\u00e1y th\u1edf ph\u00f9 h\u1ee3p nh\u1ea5t.<\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/\"><strong>B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c t\u1ebf Vinmec<\/strong><\/a> \u0111\u00e3 \u0111\u01b0a h\u1ec7 th\u1ed1ng m\u00e1y m\u00f3c, thi\u1ebft b\u1ecb hi\u1ec7n \u0111\u1ea1i \u0111\u1ea1t chu\u1ea9n v\u00e0o c\u00f4ng t\u00e1c th\u0103m kh\u00e1m, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 c\u00e1c b\u1ec7nh l\u00fd v\u1ec1 h\u1ed3i s\u1ee9c c\u1ea5p c\u1ee9u.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>C\u00e0i \u0111\u1eb7t th\u00f4ng s\u1ed1 m\u00e1y th\u1edf \u0111\u00fang c\u00e1ch l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quan tr\u1ecdng trong vi\u1ec7c qu\u1ea3n l\u00fd b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim.\u00a0 Theo American Society of Anesthesiologists v\u00e0 Society of Critical Care Medicine, vi\u1ec7c thi\u1ebft l\u1eadp m\u1ee9c \u0111\u1ed9 PEEP, t\u1ea7n s\u1ed1 th\u1edf v\u00e0 th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng \u00a0ph\u00f9 h\u1ee3p c\u00f3 th\u1ec3 [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":20121,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>C\u00e0i \u0111\u1eb7t th\u00f4ng s\u1ed1 m\u00e1y th\u1edf tr\u00ean b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim<\/title>\n<meta name=\"description\" content=\"C\u00e0i \u0111\u1eb7t th\u00f4ng s\u1ed1 m\u00e1y th\u1edf tr\u00ean b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim l\u00e0 v\u1ea5n \u0111\u1ec1 c\u1ea7n \u0111\u01b0\u1ee3c quan t\u00e2m. 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