{"id":11086,"date":"2019-06-18T17:16:55","date_gmt":"2019-06-18T10:16:55","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=11086"},"modified":"2019-06-18T17:16:55","modified_gmt":"2019-06-18T10:16:55","slug":"viem-gan-d","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/viem-gan-d\/","title":{"rendered":"Vi\u00eam gan D"},"content":{"rendered":"

\u1ede c\u00e1c b\u00e0i tr\u01b0\u1edbc vnras.com\/drug<\/a> \u0111\u00e3 gi\u1edbi thi\u1ec7u t\u1edbi c\u00e1c b\u1ea1n hai c\u0103n b\u1ec7nh nguy hi\u1ec3m l\u00e0 Vi\u00ean gan B v\u00e0 vi\u00eam gan C<\/a>. \u1ede b\u00e0i n\u00e0y nh\u00e0 thu\u1ed1c xin gi\u1edbi thi\u1ec7u t\u1edbi c\u00e1c b\u1ea1n m\u1ed9t b\u1ec7nh vi\u00eam gan nguy hi\u1ec3m n\u1eefa v\u1edbi t\u1ec9 l\u1ec7 m\u1eafc r\u1ea5t cao c\u00f9ng v\u1edbi vi\u00eam gan B<\/a>. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 to\u00e0n b\u1ed9 nh\u1eefng g\u00ec b\u1ea1n c\u1ea7n bi\u1ebft v\u1ec1 Vi\u00eam gan D.<\/p>\n

T\u1ed5ng quan<\/h2>\n
Vi\u00eam gan si\u00eau vi D l\u00e0 b\u1ec7nh nhi\u1ec5m tr\u00f9ng gan do virus vi\u00eam gan D l\u00e0 HDV (Hepatitis D Virus) g\u00e2y ra. Ch\u00fang c\u00f3 m\u1ed9t \u0111i\u1ec3m \u0111\u1eb7c bi\u1ec7t \u0111\u00f3 l\u00e0 c\u1ea7n virus vi\u00eam gan B (HBV) \u0111\u1ec3 nh\u00e2n l\u00ean. Do \u0111\u00f3 nhi\u1ec5m HDV lu\u00f4n x\u1ea3y ra \u0111\u1ed3ng th\u1eddi v\u1edbi nhi\u1ec5m HBV.<\/p>\n
Virus l\u00e2y nhi\u1ec5m qua \u0111\u01b0\u1eddng ti\u1ebfp x\u00fac v\u1edbi m\u00e1u ho\u1eb7c v\u1edbi d\u1ecbch c\u01a1 th\u1ec3 c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh. Truy\u1ec1n t\u1eeb m\u1eb9 sang con r\u1ea5t hi\u1ebfm g\u1eb7p.<\/p>\n
$\"Con$
H\u00ecnh \u1ea3nh: Con \u0111\u01b0\u1eddng l\u00e2y truy\u1ec1n c\u1ee7a c\u00e1c lo\u1ea1i virus g\u00e2y vi\u00eam gan<\/figcaption><\/figure>\n
\u00cdt nh\u1ea5t 5% s\u1ed1 b\u1ec7nh nh\u00e2n vi\u00eam gan B (nhi\u1ec5m HBV) m\u1ea1n t\u00ednh b\u1ecb nhi\u1ec5m \u0111\u1ed3ng th\u1eddi HDV. T\u00ednh \u0111\u1ebfn ng\u00e0y 23\/07\/2018, c\u00f3 kho\u1ea3ng 15-20 tri\u1ec7u ng\u01b0\u1eddi tr\u00ean th\u1ebf gi\u1edbi nhi\u1ec5m HDV. Tuy nhi\u00ean \u0111\u00e2y l\u00e0 con s\u1ed1 kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7 v\u00ec nhi\u1ec1u qu\u1ed1c gia kh\u00f4ng c\u00f3 b\u00e1o c\u00e1o v\u1ec1 nhi\u1ec5m HDV.<\/p>\n
Tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, t\u1ed5ng s\u1ed1 l\u01b0\u1ee3ng ng\u01b0\u1eddi nhi\u1ec5m HDV \u0111\u00e3 gi\u1ea3m \u0111\u00e1ng k\u1ec3 k\u1ec3 t\u1eeb n\u0103m 1980 do ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng HBV to\u00e0n c\u1ea7u \u0111\u1ea1t \u0111\u01b0\u1ee3c nh\u1eefng th\u00e0nh c\u00f4ng.<\/p>\n
\u0110\u1ed3ng nhi\u1ec5m HBV-HDV \u0111\u01b0\u1ee3c coi l\u00e0 d\u1ea1ng vi\u00eam gan si\u00eau vi m\u1ea1n t\u00ednh nghi\u00eam tr\u1ecdng nh\u1ea5t do c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng li\u00ean quan \u0111\u1ebfn gan nh\u01b0 x\u01a1 gan v\u00e0 ung th\u01b0 gan ti\u1ebfn tri\u1ec3n r\u1ea5t nhanh.<\/p>\n
T\u1ec9 l\u1ec7 \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng n\u00f3i chung l\u00e0 th\u1ea5p. Vi\u00eam gan D c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00f2ng ng\u1eeba b\u1eb1ng ti\u00eam vaccin ph\u00f2ng ng\u1eeba vi\u00eam gan B.<\/p>\n
D\u1ecbch t\u1ec5<\/h2>\n
C\u00e1c khu v\u1ef1c c\u00f3 t\u1ec9 l\u1ec7 nhi\u1ec5m cao bao g\u1ed3m ch\u00e2u Phi (Trung v\u00e0 T\u00e2y Phi), ch\u00e2u \u00c1 (Trung v\u00e0 B\u1eafc \u00c1, Vi\u1ec7t Nam, M\u00f4ng C\u1ed5, Pakistan, Nh\u1eadt B\u1ea3n, \u0110\u00e0i B\u1eafc Trung Qu\u1ed1c), c\u00e1c qu\u1ed1c \u0111\u1ea3o Th\u00e1i B\u00ecnh D\u01b0\u01a1ng (Kiribati, Nauru), \u0110\u00f4ng \u00c2u (\u0110\u00f4ng \u0110\u1ecba Trung H\u1ea3i, Th\u1ed5 Nh\u0129 K\u00ec), Nam M\u1ef9 (l\u01b0u v\u1ef1c s\u00f4ng Amazon) v\u00e0 Greenland. Tuy nhi\u00ean th\u00f4ng tin tr\u00ean l\u00e0 th\u1ed1ng k\u00ea kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7 v\u00ec c\u00f3 nhi\u1ec1u qu\u1ed1c gia kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u b\u00e1o c\u00e1o v\u1ec1 m\u1ee9c \u0111\u1ed9 ph\u1ed5 bi\u1ebfn c\u1ee7a HDV.<\/p>\n
Nguy\u00ean nh\u00e2n<\/h2>\n
Nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh l\u00e0 virus HDV, thu\u1ed9c chi Deltavirus<\/em>, c\u00f3 l\u00f5i axit nucleic l\u00e0 ARN chu\u1ed7i \u0111\u01a1n v\u1edbi 1679 nucleotide. Tr\u00ecnh t\u1ef1 nucleotide c\u1ee7a n\u00f3 t\u1ef1 b\u1ed5 sung \u0111\u1ebfn 70%, d\u1eabn \u0111\u1ebfn ARN c\u00f3 d\u1ea1ng s\u1ee3i \u0111\u00f4i, gi\u1ed1ng h\u00ecnh que. V\u1ecf capsid g\u1ed3m kho\u1ea3ng 200 ph\u00e2n t\u1eed kh\u00e1ng nguy\u00ean vi\u00eam gan D (HDAg, g\u1ed3m hai lo\u1ea1i l\u00e0 L-HDAg v\u00e0 S-HDAg). V\u1ecf envelope l\u00e0 c\u00e1c kh\u00e1ng nguy\u00ean b\u1ec1 m\u1eb7t c\u1ee7a vi\u00eam gan B HBsAg.<\/p>\n
$\"C\u1ea5u$
\u1ea2nh: C\u1ea5u tr\u00fac virus HDV.<\/figcaption><\/figure>\n
C\u00e1c con \u0111\u01b0\u1eddng l\u00e2y truy\u1ec1n vi\u00eam gan D t\u01b0\u01a1ng t\u1ef1 nh\u01b0 l\u00e2y truy\u1ec1n vi\u00eam gan B: qua \u0111\u01b0\u1eddng m\u00e1u v\u00e0 truy\u1ec1n c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb m\u00e1u, \u0111\u1eb7c bi\u1ec7t c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng ti\u00eam ch\u00edch ma t\u00fay d\u1ec5 b\u1ecb nhi\u1ec5m b\u1ec7nh, ti\u1ebfp x\u00fac v\u1edbi d\u1ecbch c\u01a1 th\u1ec3 c\u1ee7a ng\u01b0\u1eddi nhi\u1ec5m b\u1ec7nh.<\/p>\n
Ch\u1ea9n \u0111o\u00e1n<\/h2>\n
Kh\u00f4ng th\u1ec3 ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t vi\u00eam gan D (\u0111i k\u00e8m vi\u00eam gan B) v\u1edbi c\u00e1c vi\u00eam gan si\u00eau vi kh\u00e1c tr\u00ean l\u00e2m s\u00e0ng ch\u1ec9 d\u1ef1a v\u00e0o tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng.<\/p>\n
Ch\u1ea9n \u0111o\u00e1n vi\u00eam gan D th\u01b0\u1eddng d\u1ef1a v\u00e0o hi\u1ec7u gi\u00e1 kh\u00e1ng th\u1ec3 ch\u1ed1ng HDV (Anti-HDV) typ IgM v\u00e0 IgG. Kh\u00e1ng th\u1ec3 typ IgM th\u01b0\u1eddng d\u01b0\u01a1ng t\u00ednh \u1edf giai \u0111o\u1ea1n c\u1ea5p t\u00ednh v\u00e0 typ IgG th\u01b0\u1eddng d\u01b0\u01a1ng t\u00ednh \u1edf giai \u0111o\u1ea1n m\u1ea1n t\u00ednh. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh th\u01b0\u1eddng d\u1ef1a v\u00e0o s\u1ef1 xu\u1ea5t hi\u1ec7n ARN HDV trong huy\u1ebft thanh.<\/p>\n
Tuy nhi\u00ean ch\u1ea9n \u0111o\u00e1n HDV c\u00f3 s\u1eb5n kh\u00f4ng \u0111\u01b0\u1ee3c ph\u1ed5 bi\u1ebfn r\u1ed9ng r\u00e3i v\u00e0 kh\u00f4ng c\u00f3 ti\u00eau chu\u1ea9n n\u00e0o cho \u0111\u1ecbnh l\u01b0\u1ee3ng ARN HDV trong huy\u1ebft thanh. Theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng HBsAg r\u1ea5t h\u1eefu \u00edch n\u1ebfu kh\u00f4ng c\u00f3 s\u1eb5n \u0111\u1ecbnh l\u01b0\u1ee3ng ARN HDV.<\/p>\n
Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/h2>\n
$\"Tri\u1ec7u$
H\u00ecnh \u1ea3nh: Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh vi\u00eam gan D<\/figcaption><\/figure>\n
90% b\u1ec7nh nh\u00e2n vi\u00eam gan \u0111\u1ed3ng nhi\u1ec5m HBV-HDV kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng.<\/p>\n
Vi\u00eam gan D (k\u00e8m vi\u00eam gan B) c\u1ea5p t\u00ednh:<\/em><\/p>\n
C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a vi\u00eam gan D (k\u00e8m vi\u00eam gan B) c\u1ea5p t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a vi\u00eam gan B c\u1ea5p. Tuy nhi\u00ean c\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 tr\u1ea7m tr\u1ecdng h\u01a1n v\u00e0 k\u00e9o d\u00e0i h\u01a1n.<\/p>\n
\n
Th\u1eddi k\u00ec \u1ee7 b\u1ec7nh:<\/em><\/li>\n<\/ul>\n
Th\u01b0\u1eddng kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n tr\u00ean l\u00e2m s\u00e0ng. Th\u1eddi gian c\u00f3 th\u1ec3 ng\u1eafn h\u01a1n trong tr\u01b0\u1eddng h\u1ee3p b\u1ed9i nhi\u1ec5m t\u1eeb vi\u00eam gan B.<\/p>\n
\n
Th\u1eddi k\u00ec kh\u1edfi ph\u00e1t:<\/em><\/li>\n<\/ul>\n
S\u1ed1t nh\u1eb9 ho\u1eb7c kh\u00f4ng.<\/p>\n
\u0110au t\u1ee9c v\u00f9ng b\u1ee5ng b\u00ean ph\u1ea3i, ngay d\u01b0\u1edbi x\u01b0\u01a1ng s\u01b0\u1eddn (c\u00f2n g\u1ecdi h\u1ea1 s\u01b0\u1eddn ph\u1ea3i, v\u1ecb tr\u00ed th\u00f4ng th\u01b0\u1eddng c\u1ee7a gan, tr\u1eeb m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ea3o ng\u01b0\u1ee3c ph\u1ee7 t\u1ea1ng th\u00ec gan \u1edf h\u1ea1 s\u01b0\u1eddn tr\u00e1i).<\/p>\n
B\u1ec7nh nh\u00e2n ch\u00e1n \u0103n, bu\u1ed3n n\u00f4n, m\u1ec7t m\u1ecfi nhi\u1ec1u, kh\u00f4ng mu\u1ed1n l\u00e0m g\u00ec. N\u01b0\u1edbc ti\u1ec3u \u00edt v\u00e0 s\u1eabm…<\/p>\n
\n
Th\u1eddi k\u00ec to\u00e0n ph\u00e1t:<\/em><\/li>\n<\/ul>\n
C\u00e1c tri\u1ec7u ch\u1ee9ng ph\u00e1t tri\u1ec3n v\u00e0 n\u1eb7ng l\u00ean:<\/p>\n
\n
Gan to v\u00e0 \u0111au, l\u00e1ch c\u00f3 th\u1ec3 to.<\/li>\n
Ch\u00e1n \u0103n, m\u1ec7t m\u1ecfi, r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a…<\/li>\n
V\u00e0ng da (do t\u0103ng bilirubin to\u00e0n ph\u1ea7n, m\u00e0 ch\u1ee7 y\u1ebfu l\u00e0 bilirubin tr\u1ef1c ti\u1ebfp), v\u00e0ng m\u1eaft ph\u00e1t tri\u1ec3n nhanh.<\/li>\n
Ph\u00e2n b\u1ea1c m\u00e0u (c\u00f3 th\u1ec3 tr\u1eafng nh\u01b0 ph\u00e2n c\u00f2).<\/li>\n
N\u01b0\u1edbc ti\u1ec3u \u00edt v\u00e0 s\u1eabm m\u00e0u (gi\u1ed1ng m\u00e0u n\u01b0\u1edbc v\u1ed1i).<\/li>\n
R\u1ea5t ng\u1ee9a (do t\u00edch t\u1ee5 bilirubin d\u01b0\u1edbi da k\u00edch th\u00edch c\u00e1c th\u1ee5 c\u1ea3m th\u1ec3 g\u00e2y ng\u1ee9a, ng\u1ee9a trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng histamin H1).<\/li>\n
Th\u1eddi k\u00ec h\u1ed3i ph\u1ee5c:<\/em><\/li>\n<\/ul>\n
Th\u01b0\u1eddng c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng \u0111a ni\u1ec7u.<\/p>\n
C\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng gi\u1ea3m d\u1ea7n r\u1ed3i m\u1ea5t.<\/p>\n
B\u1ec7nh nh\u00e2n c\u1ea3m th\u1ea5y kh\u1ecfe l\u00ean, d\u1ec5 ch\u1ecbu d\u1ea7n, \u0103n ng\u1ee7 t\u1ed1t.<\/p>\n
N\u01b0\u1edbc ti\u1ec3u trong tr\u1edf l\u1ea1i, ph\u00e2n c\u0169ng tr\u1edf v\u1ec1 m\u00e0u nh\u01b0 c\u0169.<\/p>\n
Gan d\u1ea7n tr\u1edf v\u1ec1 k\u00edch th\u01b0\u1edbc b\u00ecnh th\u01b0\u1eddng.<\/p>\n
S\u1ef1 m\u1ec7t m\u1ecfi v\u00e0 \u0111au t\u1ee9c h\u1ea1 s\u01b0\u1eddn ph\u1ea3i c\u00f3 th\u1ec3 c\u00f2n k\u00e9o d\u00e0i nhi\u1ec1u th\u00e1ng sau \u0111\u00f3.<\/p>\n
Vi\u00eam gan D (k\u00e8m vi\u00eam gan B) m\u1ea1n t\u00ednh:<\/em><\/p>\n
D\u01b0\u1edbi 5% b\u1ec7nh nh\u00e2n vi\u00eam gan c\u1ea5p chuy\u1ec3n sang m\u1ea1n t\u00ednh.<\/p>\n
B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 ho\u00e0n to\u00e0n b\u00ecnh th\u01b0\u1eddng.<\/p>\n
C\u00f3 th\u1ec3 c\u00f3 m\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng nh\u01b0 vi\u00eam gan c\u1ea5p: m\u1ec7t m\u1ecfi, ch\u00e1n \u0103n, \u0111au b\u1ee5ng…<\/p>\n
Khi b\u1ecb bi\u1ebfn ch\u1ee9ng x\u01a1 gan, ung th\u01b0 gan b\u1ec7nh nh\u00e2n s\u1ebd c\u00f3 th\u00eam nh\u1eefng tri\u1ec7u ch\u1ee9ng c\u1ee7a c\u00e1c b\u1ec7nh l\u00fd n\u00e0y. \u0110\u1ed3ng nhi\u1ec5m HBV-HDV l\u00e0m ti\u1ebfn tri\u1ec3n x\u01a1 gan s\u1edbm h\u01a1n g\u1ea7n 1 th\u1eadp k\u1ec9 so v\u1edbi \u0111\u01a1n nhi\u1ec5m HBV, d\u00f9 cho HDV ng\u0103n c\u1ea3n kh\u1ea3 n\u0103ng nh\u00e2n l\u00ean c\u1ee7a HBV. C\u01a1 ch\u1ebf b\u1ec7nh sinh v\u1eabn ch\u01b0a th\u1eadt s\u1ef1 r\u00f5 r\u00e0ng.<\/p>\n
C\u1eadn l\u00e2m s\u00e0ng<\/h2>\n
$\"X\u00e9t$
H\u00ecnh \u1ea3nh minh h\u1ecda: X\u00e9t nghi\u1ec7m m\u00e1u t\u00ecm kh\u00e1ng th\u1ec3 kh\u00e1ng virus HDV<\/figcaption><\/figure>\n
C\u1eadn l\u00e2m s\u00e0ng c\u00f3 nh\u1eefng \u0111i\u1ec3m t\u01b0\u01a1ng t\u1ef1 nh\u01b0 vi\u00eam gan B \u0111\u01a1n thu\u1ea7n.<\/p>\n
Vi\u00eam gan D (k\u00e8m vi\u00eam gan B) c\u1ea5p t\u00ednh:<\/em><\/p>\n
Th\u1eddi k\u00ec kh\u1edfi ph\u00e1t:<\/em><\/p>\n
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Kh\u00e1m th\u1ef1c th\u1ec3: gan to (h\u1ea7u nh\u01b0 m\u1ecdi tr\u01b0\u1eddng h\u1ee3p).<\/li>\n
N\u01b0\u1edbc ti\u1ec3u s\u1eabm (\u0111a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p).<\/li>\n
Urobilinogen ni\u1ec7u (+).<\/li>\n<\/ul>\n
Th\u1eddi k\u00ec to\u00e0n ph\u00e1t:<\/em><\/p>\n
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ALT, AST c\u00f3 th\u1ec3 t\u0103ng tr\u00ean 5 l\u1ea7n, \u0111\u1eb7c bi\u1ec7t l\u00e0 ALT.<\/li>\n
Bilirubin to\u00e0n ph\u1ea7n t\u0103ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 bilirubin tr\u1ef1c ti\u1ebfp.<\/li>\n
Phosphatase ki\u1ec1m t\u0103ng trong tr\u01b0\u1eddng h\u1ee3p t\u1eafc m\u1eadt.<\/li>\n
Urobilinogen ni\u1ec7u (-).<\/li>\n<\/ul>\n
Th\u1eddi k\u00ec h\u1ed3i ph\u1ee5c:<\/em><\/p>\n
\n
C\u00e1c ch\u1ec9 s\u1ed1 bilirubin to\u00e0n ph\u1ea7n, transaminase m\u00e1u, c\u00e1c ch\u1ec9 s\u1ed1 sinh h\u00f3a kh\u00e1c d\u1ea7n tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng.<\/li>\n
Vi\u00eam gan D (k\u00e8m vi\u00eam gan B) m\u1ea1n t\u00ednh:<\/em><\/li>\n
HBsAg (+) \u00edt nh\u1ea5t 6 th\u00e1ng.<\/li>\n
ADN HBV huy\u1ebft thanh \u2265 10^{5<\/sup> b\u1ea3n sao\/mL.<\/li>\n}
ARN HDV (+).<\/li>\n
Kh\u00e1ng nguy\u00ean HDAg (+) ho\u1eb7c (-).<\/li>\n
AST\/ALT t\u0103ng t\u1eebng \u0111\u1ee3t hay k\u00e9o d\u00e0i.<\/li>\n
Sinh thi\u1ebft gan: h\u00ecnh \u1ea3nh vi\u00eam gan B m\u1ea1n t\u00ednh.<\/li>\n<\/ul>\n
\u0110i\u1ec1u tr\u1ecb<\/h2>\n
Vi\u00eam gan c\u1ea5p<\/em><\/h3>\n
Kh\u00f4ng c\u00f3 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u, ch\u1ee7 y\u1ebfu l\u00e0 l\u00e0 h\u1ed7 tr\u1ee3 v\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng.<\/p>\n
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Ngh\u1ec9 ng\u01a1i ho\u00e0n to\u00e0n t\u1ea1i gi\u01b0\u1eddng trong giai \u0111o\u1ea1n ti\u1ebfn tri\u1ec3n.<\/li>\n
\u0102n u\u1ed1ng \u0111\u1ea3m b\u1ea3o cung c\u1ea5p \u0111\u1ee7 c\u00e1c ch\u1ea5t dinh d\u01b0\u1ee1ng, \u0103n th\u1ecbt n\u1ea1c, rau xanh, hoa qu\u1ea3 t\u01b0\u01a1i, ki\u00eang m\u1ee1 \u0111\u1ed9ng v\u1eadt…<\/li>\n
Ki\u00eang r\u01b0\u1ee3u bia v\u00e0 c\u00e1c \u0111\u1ed3 u\u1ed1ng c\u00f3 c\u1ed3n kh\u00e1c.<\/li>\n
C\u00f3 th\u1ec3 xem x\u00e9t nu\u00f4i d\u01b0\u1ee1ng b\u1eb1ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch.<\/li>\n
C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c b\u1ea3o v\u1ec7 t\u1ebf b\u00e0o gan n\u1ebfu c\u1ea7n: Fortec<\/em>, Nissel<\/em>, Grocel<\/em>… hay c\u00e1c thu\u1ed1c c\u00f3 ngu\u1ed3n g\u1ed1c d\u01b0\u1ee3c li\u1ec7u nh\u01b0 ch\u00f3 \u0111\u1ebb r\u0103ng c\u01b0a…<\/li>\n<\/ul>\n
Vi\u00eam gan t\u1ed1i c\u1ea5p: \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c.<\/p>\n
Vi\u00eam gan m\u1ea1n<\/em><\/h3>\n
Kh\u00f4ng c\u00f3 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u.<\/p>\n
Cho \u0111\u1ebfn nay, thu\u1ed1c duy nh\u1ea5t \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn cho \u0111i\u1ec1u tr\u1ecb vi\u00eam gan D (c\u1ea5p v\u00e0 m\u1ea1n t\u00ednh) l\u00e0 Pegylated Interferon-\u03b1. T\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c kh\u00e1ng virus \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho vi\u00eam gan B khi d\u00f9ng cho b\u1ec7nh nh\u00e2n c\u00f3 vi\u00eam gan D k\u00e8m vi\u00eam gan B ph\u1ea3i h\u1ebft s\u1ee9c c\u00e2n nh\u1eafc gi\u1eefa l\u1ee3i \u00edch v\u00e0 nguy c\u01a1.<\/p>\n
C\u00f3 th\u1ec3 c\u00e2n nh\u1eafc gh\u00e9p gan cho vi\u00eam gan t\u1ed1i c\u1ea5p ho\u1eb7c b\u1ec7nh gan m\u1ea1n t\u00ednh giai \u0111o\u1ea1n cu\u1ed1i.<\/p>\n
D\u1ef1 ph\u00f2ng<\/h2>\n
$\"V\u1eafc$
H\u00ecnh \u1ea3nh: V\u1eafc xin \u0111i\u1ec1u tr\u1ecb vi\u00eam gan D<\/figcaption><\/figure>\n
\u0110\u1ec3 ph\u00f2ng vi\u00eam gan D (k\u00e8m vi\u00eam gan B) ta s\u1eed d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p t\u01b0\u01a1ng t\u1ef1 ph\u00f2ng vi\u00eam gan B.<\/p>\n
Ph\u00f2ng b\u1ec7nh ch\u1ee7 \u0111\u1ed9ng<\/em><\/p>\n
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Ti\u00eam vaccin vi\u00eam gan B cho t\u1ea5t c\u1ea3 tr\u1ebb trong 24 gi\u1edd sau sinh, c\u00e1c m\u0169i ti\u1ebfp theo l\u00fac 2,3,4 th\u00e1ng tu\u1ed5i theo ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng m\u1edf r\u1ed9ng.<\/li>\n
Ti\u00eam vaccin cho nh\u1eefng ng\u01b0\u1eddi ch\u01b0a nhi\u1ec5m HBV (x\u00e9t nghi\u1ec7m HBsAg v\u00e0 anti-HBs tr\u01b0\u1edbc ti\u00eam ph\u00f2ng).<\/li>\n
Ti\u00eam vaccin cho nh\u00e2n vi\u00ean y t\u1ebf.<\/li>\n<\/ul>\n
Ph\u00f2ng b\u1ec7nh l\u00e2y t\u1eeb m\u1eb9 sang con<\/em><\/p>\n
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M\u1eb9 mang thai c\u00f3 HBsAg (+): Ti\u00eam vaccin vi\u00eam gan B cho tr\u1ebb ngay sau sinh theo ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng m\u1edf r\u1ed9ng v\u00e0 ti\u00eam kh\u00e1ng th\u1ec3 kh\u00e1ng HBV cho tr\u1ebb (ti\u00eam c\u00f9ng th\u1eddi \u0111i\u1ec3m nh\u01b0ng \u1edf hai v\u1ecb tr\u00ed kh\u00e1c nhau). C\u00e1c m\u0169i ti\u00eam ti\u1ebfp theo nh\u01b0 ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng m\u1edf r\u1ed9ng b\u00ecnh th\u01b0\u1eddng.<\/li>\n
M\u1eb9 mang thai c\u00f3 ADN HBV \u2265 10^{6 <\/sup>b\u1ea3n sao\/mL (200,000 IU\/mL): D\u00f9ng 3TC ho\u1eb7c TDF 3 th\u00e1ng cu\u1ed1i thai k\u00ec. X\u00e9t nghi\u1ec7m l\u1ea1i ADN HBV 3 th\u00e1ng sau sinh \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh c\u00f3 ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb hay kh\u00f4ng. C\u1ea7n theo d\u00f5i b\u1ec7nh nh\u00e2n ch\u1eb7t ch\u1ebd.<\/li>\n<\/ul>\nPh\u00f2ng b\u1ec7nh kh\u00f4ng \u0111\u1eb7c hi\u1ec7u<\/em><\/p>\n
\nM\u00e1u hi\u1ebfn c\u1ea7n \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7n s\u00e0ng l\u1ecdc HBV.<\/li>\n
Kh\u00f4ng ti\u00eam ch\u00edch ma t\u00fay, s\u1eed d\u1ee5ng chung c\u00e1c b\u01a1m kim ti\u00eam…<\/li>\n
Quan h\u1ec7 t\u00ecnh d\u1ee5c l\u00e0nh m\u1ea1nh, an to\u00e0n.<\/li>\n
Tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi m\u00e1u v\u00e0 d\u1ecbch c\u01a1 th\u1ec3 c\u1ee7a b\u1ec7nh nh\u00e2n nhi\u1ec5m HBV.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"\u1ede c\u00e1c b\u00e0i tr\u01b0\u1edbc vnras.com\/drug \u0111\u00e3 gi\u1edbi thi\u1ec7u t\u1edbi c\u00e1c b\u1ea1n hai c\u0103n b\u1ec7nh nguy hi\u1ec3m l\u00e0 Vi\u00ean gan B v\u00e0 vi\u00eam gan C. \u1ede b\u00e0i n\u00e0y nh\u00e0 thu\u1ed1c xin gi\u1edbi thi\u1ec7u t\u1edbi c\u00e1c b\u1ea1n m\u1ed9t b\u1ec7nh vi\u00eam gan nguy hi\u1ec3m n\u1eefa v\u1edbi t\u1ec9 l\u1ec7 m\u1eafc r\u1ea5t cao c\u00f9ng v\u1edbi vi\u00eam gan B. D\u01b0\u1edbi \u0111\u00e2y […]\n","protected":false},"author":1,"featured_media":11101,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-11086","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/11086","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=11086"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/11086\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/11101"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=11086"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=11086"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=11086"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}}