{"id":11301,"date":"2024-03-28T08:34:20","date_gmt":"2024-03-28T01:34:20","guid":{"rendered":"https:\/\/benhviendaihocyhaiduong.com\/?p=11301"},"modified":"2024-04-15T22:37:41","modified_gmt":"2024-04-15T15:37:41","slug":"sieu-am-dan-hoi-mo-nhung-dieu-ban-can-biet","status":"publish","type":"post","link":"https:\/\/benhviendaihocyhaiduong.com\/?p=11301","title":{"rendered":"Si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4 – nh\u1eefng \u0111i\u1ec1u b\u1ea1n c\u1ea7n bi\u1ebft"},"content":{"rendered":"

Khoa Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh \u2013 B\u1ec7nh vi\u1ec7n Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc K\u1ef9 thu\u1eadt Y t\u1ebf H\u1ea3i D\u01b0\u01a1ng, k\u1ef9 thu\u1eadt si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean Logic -4D- P7 c\u1ee7a h\u00e3ng GE: v\u1edbi k\u1ef9 thu\u1eadt si\u00eau \u00e2m SWE \u0111\u1ea1t ti\u00eau chu\u1ea9n qu\u1ed1c t\u1ebf. To\u00e0n b\u1ed9 quy tr\u00ecnh si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i gan \u0111\u1ec1u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi \u0111\u1ed9i ng\u0169 b\u00e1c s\u1ef9 c\u00f3 kinh nghi\u1ec7m v\u00e0 \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o b\u00e0i b\u1ea3n s\u1ebd gi\u00fap ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ec7nh l\u00fd tuy\u1ebfn v\u00fa, tuy\u1ebfn gi\u00e1p, b\u1ec7nh gan m\u1ea1n t\u00ednh, \u0111\u1eb7c bi\u1ec7t l\u00e0 vi\u00eam gan virus B, C, vi\u00eam gan do r\u01b0\u1ee3u, gan nhi\u1ec5m m\u1ee1,\u2026).<\/strong><\/span><\/p>\n

\"\"<\/a><\/p>\n

K\u1ef9 thu\u1eadt si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4 \u0111\u00e3 ra \u0111\u1eddi t\u1eeb n\u0103m 1991 v\u00e0 ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n m\u1ea1nh m\u1ebd. Si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4 cho ph\u00e9p \u0111\u00e1nh gi\u00e1 \u0111\u1ed9 c\u1ee9ng c\u1ee7a m\u00f4, t\u1ea1o ra b\u01b0\u1edbc ngo\u1eb7t th\u1ee9 2 c\u1ee7a ng\u00e0nh si\u00eau \u00e2m ch\u1ea9n \u0111o\u00e1n v\u00e0 cho ph\u00e9p \u0111\u00e1nh gi\u00e1 t\u00ednh ch\u1ea5t c\u1ee7a m\u00f4 t\u1ed5n th\u01b0\u01a1ng.<\/span><\/p>\n

C\u00f3 2 lo\u1ea1i si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4:<\/strong><\/span><\/p>\n

    \n
  1. Strain Elastography: l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111o \u0111\u1ed9 \u0111\u00e0n h\u1ed3i b\u1eb1ng vi\u1ec7c s\u1eed d\u1ee5ng s\u00f3ng d\u1ecdc. \u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ecbnh t\u00ednh<\/strong> (\u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng c\u00f3 c\u1ee9ng h\u01a1n m\u00f4 xung quanh hay kh\u00f4ng), b\u00e1n \u0111\u1ecbnh l\u01b0\u1ee3ng <\/strong>(x\u00e1c \u0111\u1ecbnh c\u1ee9ng h\u01a1n m\u00f4 xung quanh bao nhi\u00eau l\u1ea7n). V\u1edbi c\u00f9ng 1 l\u1ef1c t\u00e1c d\u1ee5ng, m\u00f4 m\u1ec1m d\u1ecbch chuy\u1ec3n nhi\u1ec1u v\u00e0 m\u00f4 c\u1ee9ng d\u1ecbch chuy\u1ec3n \u00edt. M\u1ee9c \u0111\u1ed9 chuy\u1ec3n d\u1eddi \u0111\u01b0\u1ee3c hi\u1ec3n th\u1ecb tr\u00ean b\u1ea3n \u0111\u1ed3 \u0111\u00e0n h\u1ed3i (Elastogram). K\u1ef9 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean tuy\u1ebfn v\u00fa, tuy\u1ebfn gi\u00e1p, u m\u1ee1 d\u01b0\u1edbi da, h\u1ea1ch c\u1ed5…Nh\u1eefng t\u1ed5 th\u01b0\u01a1ng c\u00f3 m\u1ee9c \u0111\u1ed9 c\u1ee9ng cao th\u00ec c\u00f3 nguy c\u01a1 \u00e1c t\u00ednh cao v\u00e0 c\u1ea7n th\u1ef1c hi\u1ec7n c\u00e1c k\u1ef9 thu\u1eadt chuy\u00ean s\u00e2u kh\u00e1c ph\u1ed1i h\u1ee3p x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n.<\/span><\/li>\n
  2. Shear Wave Elastography: L\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ecbnh l\u01b0\u1ee3ng: s\u1eed d\u1ee5ng s\u00f3ng ngang. V\u1eadt c\u00e0ng c\u1ee9ng th\u00ec v\u1eadn t\u1ed1c s\u00f3ng ngang c\u00e0ng cao. \u0110\u01a1n v\u1ecb \u0111o \u0111\u1ed9 c\u1ee9ng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 kPa. C\u00f3 nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p:<\/span><\/li>\n<\/ol>\n

    – Si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i tho\u00e1ng qua (Transient Elastography) b\u1eb1ng m\u00e1y Fibroscan: l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ra \u0111\u1eddi \u0111\u1ea7u ti\u00ean c\u1ee7a si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i \u0111\u1ecbnh l\u01b0\u1ee3ng, ngay sau \u0111\u00f3 n\u00f3 r\u1ea5t th\u1ecbnh h\u00e0nh l\u00e0m ng\u01b0\u1eddi ta khi n\u00f3i v\u1ec1 si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4 gan \u0111\u1ecbnh l\u01b0\u1ee3ng l\u00e0 nh\u1eafc \u0111\u1ebfn Fibroscan. H\u1ea1n ch\u1ebf c\u1ee7a k\u1ef9 thu\u1eadt n\u00e0y l\u00e0 kh\u00f4ng nh\u00ecn th\u1ea5y h\u00ecnh \u1ea3nh B-mode khi th\u1ef1c hi\u1ec7n k\u1ef9 thu\u1eadt v\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec, c\u1ed5 ch\u01b0\u1edbng, vi\u00eam gan ho\u1ea1t \u0111\u1ed9ng, khoang li\u00ean s\u01b0\u1eddn h\u1eb9p ho\u1eb7c c\u00f3 t\u1ed5n th\u01b0\u01a1ng khu tr\u00fa \u1edf gan ph\u1ea3i s\u1ebd cho k\u1ebft qu\u1ea3 kh\u00f4ng ch\u00ednh x\u00e1c.<\/span><\/p>\n

    – K\u1ef9 thu\u1eadt \u0111o v\u1eadn t\u1ed1c s\u00f3ng bi\u1ebfn d\u1ea1ng b\u1eb1ng k\u1ef9 thu\u1eadt ARFI (Acoustic Radiation Force Impulse imaging). K\u1ef9 thu\u1eadt n\u00e0y ho\u1ea1t \u0111\u1ed9ng theo nguy\u00ean l\u00fd ghi h\u00ecnh b\u1eb1ng xung l\u1ef1c x\u1ea1 \u00e2m, c\u00f3 th\u1ec3 kh\u1ea3o s\u00e1t c\u00e1c m\u00f4 \u1edf s\u00e2u m\u00e0 kh\u00f4ng ph\u1ea3i \u1ea5n \u0111\u1ea7u d\u00f2. K\u1ef9 thu\u1eadt ARFI k\u00edch th\u00edch c\u01a1 h\u1ecdc m\u00f4 b\u1eb1ng c\u00e1ch d\u00f9ng xung \u0111\u1ea9y th\u1eddi gian ng\u1eafn trong v\u00f9ng \u0111\u01b0\u1ee3c ch\u1ecdn, t\u1ea1o n\u00ean s\u00f3ng bi\u1ebfn d\u1ea1ng th\u1eb3ng g\u00f3c v\u1edbi xung \u0111\u1ea9y, sau \u0111\u00f3 \u0111o v\u1eadn t\u1ed1c s\u00f3ng bi\u1ebfn d\u1ea1ng.<\/span><\/p>\n

    – Ghi h\u00ecnh s\u00f3ng bi\u1ebfn d\u1ea1ng si\u00eau thanh (Supersonic Shear wave Imaging: SSI)<\/span><\/p>\n

    – Point SWE: si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i \u0111\u1ecbnh l\u01b0\u1ee3ng \u0111i\u1ec3m. K\u1ef9 thu\u1eadt n\u00e0y k\u1ebft h\u1ee3p gi\u1eefa si\u00eau \u00e2m B-mode, Doppler v\u00e0 Elastography. M\u1ed7i l\u1ea7n th\u1ef1c hi\u1ec7n 1 thao t\u00e1c \u0111o \u0111\u01b0\u1ee3c 1 con s\u1ed1 \u0111\u1ea1i di\u1ec7n cho 1 \u0111i\u1ec3m, v\u00e0 khi \u0111\u00f3 ta c\u1ea7n th\u1ef1c hi\u1ec7n 10 l\u1ea7n \u0111o \u0111\u1ec3 l\u1ea5y tr\u1ecb s\u1ed1 trung b\u00ecnh.<\/span><\/p>\n

    – 2D-SWE: si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i \u0111\u1ecbnh l\u01b0\u1ee3ng \u0111a \u0111i\u1ec3m. K\u1ef9 thu\u1eadt n\u00e0y c\u00f3 b\u1ea3n \u0111\u1ed3 \u0111\u00e0n h\u1ed3i \u0111\u1ecbnh l\u01b0\u1ee3ng \u0111\u1ed9 c\u1ee9ng t\u1ea1i m\u1ed9t v\u00f9ng, ROI l\u1edbn v\u00e0 c\u00f3 h\u00ecnh \u1ea3nh B-mode h\u01b0\u1edbng d\u1eabn. V\u00ec v\u1eady \u0111\u00e2y l\u00e0 k\u1ef9 thu\u1eadt c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c cao nh\u1ea5t trong c\u00e1c ph\u01b0\u01a1ng ph\u00e1p. C\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n v\u1edbi b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec, c\u1ed5 ch\u01b0\u1edbng… H\u00ecnh \u0111\u00e0n h\u1ed3i \u0111\u01b0\u1ee3c t\u1ea1o trong 1 b\u1ea3n \u0111\u00e0n h\u1ed3i \u0111\u1ecbnh l\u01b0\u1ee3ng, v\u00e0 ta thu \u0111\u01b0\u1ee3c \u0111\u1ed9 c\u1ee9ng trung b\u00ecnh c\u1ee7a c\u00e1c \u0111i\u1ec3m \u1ea3nh. K\u1ef9 thu\u1eadt n\u00e0y ch\u1ec9 c\u1ea7n \u0111o 5 l\u1ea7n l\u00e0 \u0111\u1ee7.<\/span><\/p>\n

    SI\u00caU \u00c2M \u0110\u00c0N H\u1ed2I M\u00d4 GAN<\/strong><\/span><\/p>\n

    H\u1ea7u h\u1ebft b\u1ec7nh gan m\u1ea1n do b\u1ea5t c\u1ee9 nguy\u00ean nh\u00e2n g\u00ec n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u1ec1u c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn x\u01a1 h\u00f3a gan, cu\u1ed1i c\u00f9ng ti\u1ebfn tri\u1ec3n \u0111\u1ebfn x\u01a1 gan v\u00e0 ung th\u01b0 gan. X\u01a1 h\u00f3a gan l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a t\u1ed5n th\u01b0\u01a1ng m\u1ea1n t\u00ednh \u1edf gan, bi\u1ec3u hi\u1ec7n b\u1edfi s\u1ef1 t\u00edch t\u1ee5 c\u01a1 ch\u1ea5t gian b\u00e0o do s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng gi\u1eefa s\u1ea3n xu\u1ea5t, l\u1eafng \u0111\u1ecdng v\u00e0 ph\u00e1 h\u1ee7y. X\u01a1 h\u00f3a gan s\u1ebd di\u1ec5n ti\u1ebfn t\u1eeb t\u1eeb \u0111\u1ebfn x\u01a1 gan. M\u1ee9c \u0111\u1ed9 x\u01a1 h\u00f3a gan l\u00e0 y\u1ebfu t\u1ed1 d\u1ef1 \u0111o\u00e1n bi\u1ebfn ch\u1ee9ng v\u00e0 t\u1eed vong li\u00ean quan \u0111\u1ebfn b\u1ec7nh gan r\u1ea5t quan tr\u1ecdng v\u00e0 c\u00f3 \u00fd ngh\u0129a. \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 x\u01a1 h\u00f3a gan r\u1ea5t c\u1ea7n thi\u1ebft trong ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb, theo d\u00f5i v\u00e0 ti\u00ean l\u01b0\u1ee3ng vi\u00eam gan m\u1ea1n, g\u00f3p ph\u1ea7n quan tr\u1ecdng nh\u1eb1m gi\u1ea3m t\u1ef7 l\u1ec7 ti\u1ebfn tri\u1ec3n \u0111\u1ebfn x\u01a1 gan v\u00e0 ung th\u01b0 gan. Cho \u0111\u1ebfn nay, sinh thi\u1ebft gan v\u1eabn \u0111\u01b0\u1ee3c xem l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 x\u01a1 h\u00f3a gan v\u00e0 ph\u00e2n lo\u1ea1i x\u01a1 ho\u00e1 gan theo Metavir \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn nh\u1ea5t. Tuy nhi\u00ean, sinh thi\u1ebft gan l\u00e0 ph\u01b0\u01a1ng ph\u00e1p x\u00e2m nh\u1eadp, c\u00f3 th\u1ec3 c\u00f3 bi\u1ebfn ch\u1ee9ng v\u00e0 m\u1ed9t s\u1ed1 h\u1ea1n ch\u1ebf. Do \u0111\u00f3, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p\u00a0 \u0111\u00e1nh gi\u00e1 x\u01a1 h\u00f3a gan kh\u00f4ng x\u00e2m nh\u1eadp tr\u00ean th\u1ebf gi\u1edbi ng\u00e0y c\u00e0ng ph\u00e1t tri\u1ec3n, \u0111\u00e3 v\u00e0 \u0111ang \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1eb1m h\u1ea1n ch\u1ebf nhu c\u1ea7u sinh thi\u1ebft gan.<\/span><\/p>\n

    Trong \u0111\u00f3 si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4 gan, c\u00f3 th\u1ec3 \u0111\u1ecbnh l\u01b0\u1ee3ng, \u0111\u1ed9 ch\u00ednh x\u00e1c cao, \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n nhanh ch\u00f3ng , l\u00e0m \u0111\u01b0\u1ee3c nhi\u1ec1u l\u1ea7n. kh\u00f4ng g\u00e2y \u0111au \u0111\u1edbn hay b\u1ea5t k\u1ef3 s\u1ef1 kh\u00f3 ch\u1ecbu n\u00e0o cho ng\u01b0\u1eddi b\u1ec7nh, b\u00ean c\u1ea1nh \u0111\u00f3 k\u1ef9 thu\u1eadt n\u00e0y c\u00f3 gi\u00e1 th\u00e0nh r\u1ebb. S\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa \u0111\u1ecbnh l\u01b0\u1ee3ng \u0111\u1ed9 c\u1ee9ng gan v\u1edbi si\u00eau \u00e2m th\u01b0\u1eddng quy (B-Mode v\u00e0 Doppler) trong c\u00f9ng m\u1ed9t l\u1ea7n kh\u00e1m, \u0111em l\u1ea1i hi\u1ec7u qu\u1ea3 cao, ch\u00ednh x\u00e1c, gi\u00fap cho b\u1ec7nh nh\u00e2n c\u00f3 c\u01a1 h\u1ed9i t\u1ea7m so\u00e1t x\u01a1 h\u00f3a gan s\u1edbm h\u01a1n. Vi\u1ec7c x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 x\u01a1 h\u00f3a gan nh\u1eb1m m\u1ee5c \u0111\u00edch:<\/span><\/p>\n

    +. \u0110\u00e1nh gi\u00e1 \u0111\u1ed9 x\u01a1 h\u00f3a gan tr\u00ean c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 cao d\u1eabn \u0111\u1ebfn x\u01a1 gan hay ung th\u01b0 gan nh\u01b0: Vi\u00eam gan B, C, x\u01a1 gan r\u01b0\u1ee3u, gan nhi\u1ec5m m\u1ee1, m\u1ed9t s\u1ed1 b\u1ec7nh chuy\u1ec3n h\u00f3a \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn gan nh\u1eb1m \u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n, theo d\u00f5i \u0111i\u1ec1u tr\u1ecb v\u00e0 ti\u00ean l\u01b0\u1ee3ng x\u01a1 h\u00f3a gan \u0111\u1ec3 tr\u00e1nh ti\u1ebfn tri\u1ec3n \u0111\u1ebfn x\u01a1 gan<\/span><\/p>\n

    +. Thi\u1ebft l\u1eadp ch\u1ebf \u0111\u1ed9 theo d\u00f5i \u0111\u1eb7c bi\u1ec7t, x\u00e1c \u0111\u1ecbnh th\u1eddi gian t\u1ed1i \u01b0u \u0111\u1ec3 b\u1eaft \u0111\u1ea7u t\u1ea7m so\u00e1t\u00a0 bi\u1ebfn ch\u1ee9ng (ung th\u01b0 t\u1ebf b\u00e0o gan, d\u00e3n t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n\u2026) \u0111\u1ed1i v\u1edbi x\u01a1 h\u00f3a n\u1eb7ng.<\/span><\/p>\n

    +. Theo d\u00f5i \u0111i\u1ec1u tr\u1ecb: \u0111\u00e1nh gi\u00e1 ti\u1ebfn tri\u1ec3n hay tho\u00e1i tri\u1ec3n x\u01a1 h\u00f3a gan.<\/span><\/p>\n

    +. Gi\u1ea3m c\u00e1c tr\u01b0\u1eddng h\u1ee3p ph\u1ea3i sinh thi\u1ebft:\u00a0B\u00ecnh th\u01b0\u1eddng ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n sinh thi\u1ebft m\u00f4 gan \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 x\u01a1 h\u00f3a gan. V\u00ec \u0111\u00e2y l\u00e0 k\u1ef9 thu\u1eadt x\u00e2m l\u1ea5n n\u00ean c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m, \u0111\u1eb7c bi\u1ec7t v\u1edbi nh\u1eefng ng\u01b0\u1eddi c\u00f3 b\u1ec7nh l\u00fd gan n\u1eb7ng ho\u1eb7c b\u1ec7nh l\u00fd n\u1ec1n kh\u00f4ng cho ph\u00e9p can thi\u1ec7p. Nh\u1edd c\u00f3 si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4 m\u00e0 gi\u00fap b\u00e1c s\u0129 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c t\u1edbi 90% so v\u1edbi sinh thi\u1ebft l\u00e0m gi\u1ea3i ph\u1eabu b\u1ec7nh. T\u1eeb \u0111\u00f3 gi\u1ea3m thi\u1ec3u t\u1ed1i \u0111a c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u1ea7n ph\u1ea3i l\u00e0m sinh thi\u1ebft gan.<\/span><\/p>\n

    +. Ngo\u00e0i ra si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4 gan \u0111\u1ecbnh l\u01b0\u1ee3ng c\u00f2n gi\u00fap \u0111\u00e1nh gi\u00e1 c\u00e1c t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng kh\u1ed1i:\u00a0T\u1eeb si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i gan x\u00e1c \u0111\u1ecbnh \u0111\u1ed9 c\u1ee9ng c\u1ee7a m\u00f4. Th\u00f4ng qua quy \u0111\u1ed5i \u0111\u1ec3 \u0111\u00e1nh gi\u00e1, quy v\u1ec1 4 m\u1ee9c \u0111\u1ed9 n\u1ebfu score 4 l\u00e0 u \u00e1c t\u00ednh, score 2,3 nghi ng\u1edd, x\u00e9t th\u00eam c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c, score 1 l\u00e0 t\u1ed5n th\u01b0\u01a1ng l\u00e0nh t\u00ednh.\u00a0\u00a0<\/span><\/p>\n

    \"\"<\/a><\/p>\n

    Ba\u0301c si\u0303 th\u01b0\u0323c hi\u00ea\u0323n si\u00eau \u00e2m ta\u0323i b\u00ea\u0323nh vi\u00ea\u0323n Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc KTYT H\u1ea3i D\u01b0\u01a1ng<\/em><\/span><\/p>\n

    K\u1ef9 thu\u1eadt si\u00eau \u00e2m \u0111\u00e0n h\u1ed3i m\u00f4 gan SWE:<\/strong><\/span><\/p>\n