{"id":15659,"date":"2026-07-14T14:47:28","date_gmt":"2026-07-14T07:47:28","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=15659"},"modified":"2026-07-14T15:51:54","modified_gmt":"2026-07-14T08:51:54","slug":"bai-1-gioi-thieu-don-vi-quan-ly-hen-copd","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=15659","title":{"rendered":"B\u00c0I 1: GI\u1edaI THI\u1ec6U \u0110\u01a0N V\u1eca QU\u1ea2N L\u00dd HEN-COPD"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>\u0110\u1ed3ng h\u00e0nh c\u00f9ng ng\u01b0\u1eddi b\u1ec7nh trong h\u00e0nh tr\u00ecnh ki\u1ec3m so\u00e1t b\u1ec7nh h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hen ph\u1ebf qu\u1ea3n v\u00e0 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) l\u00e0 hai b\u1ec7nh h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh th\u01b0\u1eddng g\u1eb7p. Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 ho k\u00e9o d\u00e0i, kh\u00f2 kh\u00e8, n\u1eb7ng ng\u1ef1c, kh\u00f3 th\u1edf khi g\u1eafng s\u1ee9c, th\u1ee9c gi\u1ea5c v\u1ec1 \u0111\u00eam ho\u1eb7c c\u00f3 nh\u1eefng \u0111\u1ee3t b\u1ec7nh n\u1eb7ng l\u00ean ph\u1ea3i \u0111i c\u1ea5p c\u1ee9u, nh\u1eadp vi\u1ec7n. \u0110i\u1ec1u \u0111\u00e1ng m\u1eebng l\u00e0 n\u1ebfu \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0111\u00fang, \u0111i\u1ec1u tr\u1ecb \u0111\u00fang v\u00e0 theo d\u00f5i \u0111\u1ec1u \u0111\u1eb7n, ph\u1ea7n l\u1edbn ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng t\u1ed1t h\u01a1n, gi\u1ea3m \u0111\u1ee3t c\u1ea5p v\u00e0 duy tr\u00ec ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ea1i B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh, ho\u1ea1t \u0111\u1ed9ng kh\u00e1m, \u0111i\u1ec1u tr\u1ecb v\u00e0 qu\u1ea3n l\u00fd ng\u01b0\u1eddi b\u1ec7nh hen-COPD \u0111\u00e3 \u0111\u01b0\u1ee3c Khoa N\u1ed9i H\u00f4 h\u1ea5p tri\u1ec3n khai trong nhi\u1ec1u n\u0103m. Tr\u00ean n\u1ec1n t\u1ea3ng \u0111\u00f3, \u0110\u01a1n v\u1ecb Qu\u1ea3n l\u00fd Hen-COPD \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng nh\u1eb1m chu\u1ea9n h\u00f3a h\u01a1n n\u1eefa m\u1ed9t chu\u1ed7i ch\u0103m s\u00f3c li\u00ean t\u1ee5c: kh\u00e1m ngo\u1ea1i tr\u00fa; \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p khi ph\u00f9 h\u1ee3p; h\u01b0\u1edbng d\u1eabn v\u00e0 ki\u1ec3m tra k\u1ef9 thu\u1eadt thu\u1ed1c h\u00edt; theo d\u00f5i ki\u1ec3m so\u00e1t b\u1ec7nh v\u00e0 nguy c\u01a1 \u0111\u1ee3t c\u1ea5p; ph\u1ed1i h\u1ee3p ch\u0103m s\u00f3c n\u1ed9i tr\u00fa, sau xu\u1ea5t vi\u1ec7n v\u00e0 h\u1ed9i ch\u1ea9n khi b\u1ec7nh ph\u1ee9c t\u1ea1p ho\u1eb7c n\u1eb7ng.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110i\u1ec3m kh\u00e1c bi\u1ec7t c\u1ee7a \u0110\u01a1n v\u1ecb l\u00e0 ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng ch\u1ec9 \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n thu\u1ed1c cho m\u1ed9t l\u1ea7n kh\u00e1m, m\u00e0 \u0111\u01b0\u1ee3c nh\u00ecn nh\u1eadn trong m\u1ed9t k\u1ebf ho\u1ea1ch qu\u1ea3n l\u00fd b\u1ec7nh m\u1ea1n t\u00ednh. B\u00e1c s\u0129 s\u1ebd \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 ki\u1ec3m so\u00e1t b\u1ec7nh, nguy c\u01a1 \u0111\u1ee3t c\u1ea5p, k\u1ef9 thu\u1eadt s\u1eed d\u1ee5ng thu\u1ed1c h\u00edt, ti\u1ec1n s\u1eed c\u1ea5p c\u1ee9u\/nh\u1eadp vi\u1ec7n, thu\u1ed1c \u0111ang d\u00f9ng, c\u00e1c b\u1ec7nh \u0111i k\u00e8m v\u00e0 nhu c\u1ea7u cai thu\u1ed1c l\u00e1, v\u1eadn \u0111\u1ed9ng\/ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p ho\u1eb7c ti\u00eam ch\u1ee7ng khi ph\u00f9 h\u1ee3p. T\u00f9y t\u1eebng tr\u01b0\u1eddng h\u1ee3p, c\u00e1c c\u00f4ng c\u1ee5 chu\u1ea9n h\u00f3a c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, nh\u01b0 ACT (Asthma Control Test &#8211; B\u1ea3ng ki\u1ec3m so\u00e1t hen) \u1edf ng\u01b0\u1eddi b\u1ec7nh hen; CAAT\/CAT (Chronic Airways Assessment Test\/COPD Assessment Test &#8211; b\u1ea3ng \u0111\u00e1nh gi\u00e1 t\u00e1c \u0111\u1ed9ng c\u1ee7a b\u1ec7nh \u0111\u01b0\u1eddng th\u1edf m\u1ea1n) v\u00e0 mMRC (modified Medical Research Council dyspnea scale &#8211; thang kh\u00f3 th\u1edf c\u1ea3i bi\u00ean) \u1edf ng\u01b0\u1eddi b\u1ec7nh COPD.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh hen kh\u00f3 ki\u1ec3m so\u00e1t, nghi hen n\u1eb7ng, COPD nhi\u1ec1u \u0111\u1ee3t c\u1ea5p ho\u1eb7c t\u1eebng ph\u1ea3i nh\u1eadp vi\u1ec7n, \u0110\u01a1n v\u1ecb h\u01b0\u1edbng t\u1edbi nh\u1eadn di\u1ec7n s\u1edbm v\u00e0 h\u1ed9i ch\u1ea9n chuy\u00ean m\u00f4n khi c\u1ea7n. M\u1ee5c ti\u00eau l\u00e0 t\u00ecm nh\u1eefng y\u1ebfu t\u1ed1 c\u00f3 th\u1ec3 s\u1eeda \u0111\u01b0\u1ee3c tr\u01b0\u1edbc khi k\u1ebft lu\u1eadn b\u1ec7nh \u201cqu\u00e1 n\u1eb7ng\u201d, ch\u1eb3ng h\u1ea1n d\u00f9ng thu\u1ed1c h\u00edt ch\u01b0a \u0111\u00fang, tu\u00e2n th\u1ee7 ch\u01b0a \u0111\u1ea7y \u0111\u1ee7, l\u1ea1m d\u1ee5ng thu\u1ed1c gi\u1ea3m tri\u1ec7u ch\u1ee9ng, h\u00fat thu\u1ed1c l\u00e1, vi\u00eam m\u0169i xoang, tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y-th\u1ef1c qu\u1ea3n, b\u00e9o ph\u00ec, ng\u01b0ng th\u1edf khi ng\u1ee7, b\u1ec7nh tim m\u1ea1ch ho\u1eb7c ch\u1ea9n \u0111o\u00e1n kh\u00e1c g\u00e2y tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng t\u1ef1.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u1ede ng\u01b0\u1eddi b\u1ec7nh hen kh\u00f3 ki\u1ec3m so\u00e1t ho\u1eb7c nghi hen n\u1eb7ng, b\u00ean c\u1ea1nh h\u00f4 h\u1ea5p k\u00fd v\u00e0 \u0111\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng, \u0110\u01a1n v\u1ecb c\u00f3 th\u1ec3 tri\u1ec3n khai c\u00e1c \u0111\u00e1nh gi\u00e1 chuy\u00ean s\u00e2u theo ch\u1ec9 \u0111\u1ecbnh nh\u01b0 \u0111o ph\u00e2n su\u1ea5t nitric oxide trong kh\u00ed th\u1edf ra (FeNO), \u0111\u1ecbnh l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u \u00e1i toan trong m\u00e1u, IgE to\u00e0n ph\u1ea7n v\u00e0\/ho\u1eb7c IgE \u0111\u1eb7c hi\u1ec7u. Nh\u1eefng th\u00f4ng tin n\u00e0y gi\u00fap b\u00e1c s\u0129 hi\u1ec3u th\u00eam v\u1ec1 ki\u1ec3u vi\u00eam, m\u1ee9c \u0111\u1ed9 d\u1ecb \u1ee9ng v\u00e0 l\u1ef1a ch\u1ecdn h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb c\u00e1 th\u1ec3 h\u00f3a khi ph\u00f9 h\u1ee3p. Tuy nhi\u00ean, kh\u00f4ng c\u00f3 m\u1ed9t x\u00e9t nghi\u1ec7m \u0111\u01a1n l\u1ebb n\u00e0o t\u1ef1 quy\u1ebft \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n ho\u1eb7c ph\u00e1c \u0111\u1ed3; k\u1ebft qu\u1ea3 lu\u00f4n c\u1ea7n \u0111\u01b0\u1ee3c di\u1ec5n gi\u1ea3i c\u00f9ng tri\u1ec7u ch\u1ee9ng, ti\u1ec1n s\u1eed \u0111\u1ee3t c\u1ea5p, thu\u1ed1c \u0111ang d\u00f9ng, k\u1ef9 thu\u1eadt thu\u1ed1c h\u00edt v\u00e0 ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110\u01a1n v\u1ecb t\u0103ng c\u01b0\u1eddng c\u00e1c ho\u1ea1t \u0111\u1ed9ng gi\u00e1o d\u1ee5c ng\u01b0\u1eddi b\u1ec7nh th\u00f4ng qua c\u00e2u l\u1ea1c b\u1ed9 ng\u01b0\u1eddi b\u1ec7nh, t\u00e0i li\u1ec7u h\u01b0\u1edbng d\u1eabn, truy\u1ec1n th\u00f4ng tr\u1ef1c tuy\u1ebfn v\u00e0 c\u00e1c bu\u1ed5i t\u01b0 v\u1ea5n nh\u00f3m. Ng\u01b0\u1eddi b\u1ec7nh s\u1ebd \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn c\u00e1ch nh\u1eadn bi\u1ebft d\u1ea5u hi\u1ec7u b\u1ec7nh n\u1eb7ng l\u00ean, c\u00e1ch d\u00f9ng thu\u1ed1c h\u00edt \u0111\u00fang, c\u00e1ch ph\u00f2ng ng\u1eeba \u0111\u1ee3t c\u1ea5p, vai tr\u00f2 c\u1ee7a ti\u00eam ch\u1ee7ng, v\u1eadn \u0111\u1ed9ng, ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p v\u00e0 th\u1eddi \u0111i\u1ec3m c\u1ea7n \u0111i kh\u00e1m s\u1edbm.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0110\u1ec3 bu\u1ed5i kh\u00e1m c\u00f3 nhi\u1ec1u gi\u00e1 tr\u1ecb h\u01a1n, ng\u01b0\u1eddi b\u1ec7nh n\u00ean mang theo t\u1ea5t c\u1ea3 b\u00ecnh h\u00edt \u0111ang d\u00f9ng, toa thu\u1ed1c g\u1ea7n nh\u1ea5t, gi\u1ea5y ra vi\u1ec7n n\u1ebfu v\u1eeba nh\u1eadp vi\u1ec7n, th\u00f4ng tin nh\u1eefng l\u1ea7n c\u1ea5p c\u1ee9u\/\u0111\u1ee3t c\u1ea5p v\u00e0 danh s\u00e1ch c\u00e1c m\u0169i ti\u00eam \u0111\u00e3 bi\u1ebft. Nh\u1eefng d\u1eef li\u1ec7u t\u01b0\u1edfng nh\u01b0 nh\u1ecf n\u00e0y gi\u00fap b\u00e1c s\u0129 nh\u00ecn \u0111\u01b0\u1ee3c \u201cto\u00e0n c\u1ea3nh\u201d v\u00e0 x\u00e2y d\u1ef1ng k\u1ebf ho\u1ea1ch s\u00e1t v\u1edbi th\u1ef1c t\u1ebf h\u01a1n.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Th\u00f4ng \u0111i\u1ec7p c\u1ee7a \u0110\u01a1n v\u1ecb Qu\u1ea3n l\u00fd Hen-COPD r\u1ea5t r\u00f5 r\u00e0ng: b\u1ec7nh h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh c\u1ea7n \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd l\u00e2u d\u00e0i, li\u00ean t\u1ee5c v\u00e0 c\u00e1 th\u1ec3 h\u00f3a. Ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng \u0111\u01a1n \u0111\u1ed9c trong h\u00e0nh tr\u00ecnh n\u00e0y. \u0110\u1ed9i ng\u0169 Khoa N\u1ed9i H\u00f4 h\u1ea5p s\u1ebd \u0111\u1ed3ng h\u00e0nh \u0111\u1ec3 gi\u00fap ng\u01b0\u1eddi b\u1ec7nh ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng t\u1ed1t h\u01a1n, gi\u1ea3m nguy c\u01a1 nh\u1eadp vi\u1ec7n v\u00e0 s\u1ed1ng ch\u1ee7 \u0111\u1ed9ng h\u01a1n v\u1edbi b\u1ec7nh.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Tuy\u00ean b\u1ed1 mi\u1ec5n tr\u1eeb tr\u00e1ch nhi\u1ec7m: B\u00e0i vi\u1ebft nh\u1eb1m m\u1ee5c \u0111\u00edch gi\u00e1o d\u1ee5c s\u1ee9c kh\u1ecfe c\u1ed9ng \u0111\u1ed3ng, kh\u00f4ng thay th\u1ebf vi\u1ec7c th\u0103m kh\u00e1m, ch\u1ea9n \u0111o\u00e1n ho\u1eb7c ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb c\u00e1 th\u1ec3. Ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng t\u1ef1 \u00fd b\u1eaft \u0111\u1ea7u, ng\u01b0ng ho\u1eb7c thay \u0111\u1ed5i thu\u1ed1c d\u1ef1a ri\u00eang tr\u00ean n\u1ed9i dung b\u00e0i vi\u1ebft; h\u00e3y trao \u0111\u1ed5i v\u1edbi b\u00e1c s\u0129 ho\u1eb7c nh\u00e2n vi\u00ean y t\u1ebf ph\u1ee5 tr\u00e1ch.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u0110\u1ed3ng h\u00e0nh c\u00f9ng ng\u01b0\u1eddi b\u1ec7nh trong h\u00e0nh tr\u00ecnh ki\u1ec3m so\u00e1t b\u1ec7nh h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh Hen ph\u1ebf qu\u1ea3n v\u00e0 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) l\u00e0 hai b\u1ec7nh h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh th\u01b0\u1eddng g\u1eb7p. Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 ho k\u00e9o d\u00e0i, kh\u00f2 kh\u00e8, n\u1eb7ng ng\u1ef1c, kh\u00f3 th\u1edf khi g\u1eafng s\u1ee9c, th\u1ee9c gi\u1ea5c v\u1ec1 \u0111\u00eam 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