{"id":33121,"date":"2022-06-30T16:44:32","date_gmt":"2022-06-30T09:44:32","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=33121"},"modified":"2022-06-30T16:44:32","modified_gmt":"2022-06-30T09:44:32","slug":"di-dang-duong-tho-bam-sinh-cpam","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/di-dang-duong-tho-bam-sinh-cpam\/","title":{"rendered":"D\u1ecb d\u1ea1ng \u0111\u01b0\u1eddng th\u1edf b\u1ea9m sinh &#8211; CPAM"},"content":{"rendered":"<p style=\"text-align: right;\">T\u1ea3i file PDF b\u00e0i vi\u1ebft <strong>D\u1ecb d\u1ea1ng \u0111\u01b0\u1eddng th\u1edf b\u1ea9m sinh &#8211; CPAM<\/strong><b>\u00a0<\/b><a href=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM.pptx.pdf\">t\u1ea1i \u0111\u00e2y<\/a><\/p>\n<p style=\"text-align: right;\">B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c d\u1ecbch b\u1edfi Tr\u1ea7n Th\u1ecb Thu, Dr. L\u00ea V\u0169 Duy<\/p>\n<h2>\u0110\u1ea1i c\u01b0\u01a1ng<\/h2>\n<p>D\u1ecb d\u1ea1ng \u0111\u01b0\u1eddng th\u1edf b\u1ea9m sinh &#8211; Congenital pulmonary airway malformations (CPAM) l\u00e0 m\u1ed9t kh\u1ed1i nhi\u1ec1u nang c\u1ee7a nhu m\u00f4 ph\u1ed5i, v\u1edbi b\u1ea5t th\u01b0\u1eddng c\u1ee7a s\u1ef1 h\u00ecnh th\u00e0nh ph\u1ebf qu\u1ea3n. \u0110\u00e2y \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a d\u1ecb d\u1ea1ng ph\u1ed5i ph\u1ebf qu\u1ea3n li\u00ean quan \u0111\u1ebfn ru\u1ed9t tr\u01b0\u1edbc.<\/p>\n<h2>Thu\u1eadt ng\u1eef<\/h2>\n<p>Tr\u01b0\u1edbc \u0111\u00e2y b\u1ec7nh \u0111\u01b0\u1ee3c g\u1ecdi v\u1edbi t\u00ean d\u1ecb d\u1ea1ng nang tuy\u1ebfn ph\u1ed5i b\u1ea9m sinh &#8211; congenital cystic adenomatoid malformations (CCAM).<\/p>\n<h2>D\u1ecbch t\u1ec5<\/h2>\n<p>Chi\u1ebfm kho\u1ea3ng 25% c\u00e1c b\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh c\u1ee7a ph\u1ed5i.<\/p>\n<p>T\u1ef7 l\u1ec7 m\u1eafc ~ 1: 1500-4000 tr\u1ebb sinh ra s\u1ed1ng v\u00e0 ch\u1ee7 y\u1ebfu \u1edf tr\u1ebb nam.<\/p>\n<h2>Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng<\/h2>\n<p>Th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1eb1ng si\u00eau \u00e2m tr\u01b0\u1edbc sinh ho\u1eb7c trong th\u1eddi k\u1ef3 s\u01a1 sinh khi c\u00f3 t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p. T\u1ed5n th\u01b0\u01a1ng l\u1edbn c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn gi\u1ea3m s\u1ea3n ph\u1ed5i, c\u00f3 ti\u00ean l\u01b0\u1ee3ng x\u1ea5u.<\/p>\n<p>T\u1ed5n th\u01b0\u01a1ng nh\u1ecf c\u00f3 th\u1ec3 kh\u00f4ng ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c cho \u0111\u1ebfn tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh v\u00e0 th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n nhi\u1ec5m tr\u00f9ng t\u00e1i di\u1ec5n.<\/p>\n<h2>B\u1ec7nh l\u00fd h\u1ecdc<\/h2>\n<p>L\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a s\u1ef1 ph\u00e1t tri\u1ec3n b\u1ea5t th\u01b0\u1eddng ph\u1ebf qu\u1ea3n ph\u1ebf nang v\u1edbi s\u1ef1 t\u0103ng sinh m\u00f4 th\u1eeba \u1edf \u0111\u01a1n v\u1ecb h\u00f4 h\u1ea5p d\u1ea1ng nang tuy\u1ebfn m\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 h\u00ecnh th\u00e0nh ph\u1ebf nang ph\u00f9 h\u1ee3p.<\/p>\n<p>Tr\u00ean m\u00f4 h\u1ecdc \u0111\u1eb7c tr\u01b0ng l\u00e0 s\u1ef1 h\u00ecnh th\u00e0nh m\u00f4 tuy\u1ebfn c\u1ee7a ti\u1ec3u ph\u1ebf qu\u1ea3n d\u1ea1ng nang l\u1edbn ho\u1eb7c nang nh\u1ecf \u0111\u01b0\u1ee3c l\u00f3t b\u1edfi t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 tr\u1ee5 ho\u1eb7c l\u1eadp ph\u01b0\u01a1ng, kh\u00f4ng c\u00f3 s\u1ee5n v\u00e0 c\u00e1c tuy\u1ebfn ph\u1ebf qu\u1ea3n.<\/p>\n<p>Kh\u00f4ng gi\u1ed1ng nang ph\u1ebf qu\u1ea3n, c\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u00e0y th\u00f4ng th\u01b0\u01a1ng gi\u1eefa c\u00e1c nang v\u00e0 c\u00f3 th\u1ec3 th\u00f4ng v\u1edbi c\u00e2y kh\u00ed ph\u1ebf qu\u1ea3n.<\/p>\n<h2>Ph\u00e2n lo\u1ea1i<\/h2>\n<p>\u0110\u01b0\u1ee3c chia th\u00e0nh 5 nh\u00f3m, ch\u1ee7 y\u1ebfu d\u1ef1a v\u00e0o k\u00edch th\u01b0\u1edbc nang.<\/p>\n<h3>Type I<\/h3>\n<ul>\n<li>Ph\u1ed5 bi\u1ebfn nh\u1ea5t: 70% tr\u01b0\u1eddng h\u1ee3p<\/li>\n<li>Nhi\u1ec1u nang l\u1edbn<\/li>\n<li>M\u1ed9t ho\u1eb7c nhi\u1ec1u nang tr\u1ed9i: 2-10cm<\/li>\n<li>C\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c bao quanh b\u1edfi nhi\u1ec1u nang nh\u1ecf.<\/li>\n<\/ul>\n<h3>Type II<\/h3>\n<ul>\n<li>15-20%<\/li>\n<li>C\u00e1c nang c\u00f3 \u0111\u01b0\u1eddng k\u00ednh &lt; 2cm<\/li>\n<li>Li\u00ean quan v\u1edbi c\u00e1c b\u1ea5t th\u01b0\u1eddng kh\u00e1c:\n<ul>\n<li>Lo\u1ea1n s\u1ea3n ho\u1eb7c b\u1ea5t s\u1ea3n th\u1eadn<\/li>\n<li>Ph\u1ed5i bi\u1ec7t l\u1eadp<\/li>\n<li>C\u00e1c b\u1ea5t th\u01b0\u1eddng tim b\u1ea9m sinh.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>Type III<\/h3>\n<ul>\n<li>10%<\/li>\n<li>Nang nh\u1ecf: \u0111\u01b0\u1eddng k\u00ednh &lt; 5mm<\/li>\n<li>\u0110i\u1ec3n h\u00ecnh l\u00e0 t\u1ed5n th\u01b0\u01a1ng to\u00e0n b\u1ed9 th\u00f9y<\/li>\n<li>Ti\u00ean l\u01b0\u1ee3ng x\u1ea5u h\u01a1n.<\/li>\n<\/ul>\n<h3>Type IV<\/h3>\n<ul>\n<li>C\u00e1c nang kh\u00f4ng c\u00f3 t\u1ebf b\u00e0o l\u00f3t (nang l\u1edbn th\u00e0nh m\u1ecfng c\u00f3 m\u1ee9c d\u1ecbch-d\u1ecbch ho\u1eb7c d\u1ecbch kh\u00ed)<\/li>\n<li>\u0110i\u1ec3n h\u00ecnh ch\u1ec9 t\u1ed5n th\u01b0\u01a1ng 1 th\u00f9y<\/li>\n<li>C\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi type I tr\u00ean h\u00ecnh \u1ea3nh.<\/li>\n<\/ul>\n<h3>Type 0<\/h3>\n<ul>\n<li>R\u1ea5t hi\u1ebfm, th\u01b0\u1eddng t\u1eed vong sau sinh<\/li>\n<li>Lo\u1ea1n s\u1ea3n ho\u1eb7c b\u1ea5t s\u1ea3n c\u00e1c t\u00fai ph\u1ebf nang<\/li>\n<li>L\u00e0 s\u1ef1 ng\u1eebng ph\u00e1t tri\u1ec3n c\u1ee7a ph\u1ed5i.<\/li>\n<li>Th\u01b0\u1eddng \u1edf m\u1ed9t ph\u1ed5i v\u00e0 t\u1ed5n th\u01b0\u01a1ng \u1edf 1 th\u00f9y ph\u1ed5i.<\/li>\n<li>\u00cdt g\u1eb7p \u1edf th\u00f9y gi\u1eefa.<\/li>\n<\/ul>\n<h2>Li\u00ean quan<\/h2>\n<ul>\n<li>T\u1ed5n th\u01b0\u01a1ng hybrid: CPAM ph\u1ed1i h\u1ee3p v\u1edbi ph\u1ed5i bi\u1ec7t l\u1eadp.<\/li>\n<li>B\u1ea5t s\u1ea3n th\u1eadn<\/li>\n<li>\u0110a \u1ed1i<\/li>\n<li>Ph\u00f9 thai<\/li>\n<li>B\u1ec7nh l\u00fd \u00e1c t\u00ednh \u1edf ph\u1ed5i:\n<ul>\n<li>~10% tr\u1ebb em ung th\u01b0 ph\u1ed5i c\u00f3 ti\u1ec1n s\u1eed CPAM<\/li>\n<li>Ung th\u01b0 bi\u1ec3u m\u00f4 ph\u1ebf qu\u1ea3n ph\u1ebf nang li\u00ean quan v\u1edbi CPAM type I<\/li>\n<li>U nguy\u00ean b\u00e0o ph\u1ed5i c\u00f3 li\u00ean quan v\u1edbi CPAM type 4.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>\u0110\u1eb7c \u0111i\u1ec3m h\u00ecnh \u1ea3nh<\/h2>\n<h3>Si\u00eau \u00e2m tr\u01b0\u1edbc sinh<\/h3>\n<ul>\n<li>CPAM th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng t\u1ed5n th\u01b0\u01a1ng 1 kh\u1ed1i d\u1ea1ng nang ho\u1eb7c \u0111\u1eb7c.<\/li>\n<li>Kh\u1ed1i \u0111\u1eb7c th\u01b0\u1eddng li\u00ean quan v\u1edbi CPAM type III v\u00e0 \u0111i\u1ec3n h\u00ecnh l\u00e0 t\u0103ng \u00e2m.<\/li>\n<li>C\u00f3 th\u1ec3 c\u00f3 hi\u1ec7u \u1ee9ng kh\u1ed1i g\u00e2y \u0111\u1ea9y l\u1ec7ch tim sang b\u00ean \u0111\u1ed1i di\u1ec7n.<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 \u1ed5n \u0111\u1ecbnh v\u1ec1 k\u00edch th\u01b0\u1edbc ho\u1eb7c th\u1eadm ch\u00ed c\u00f3 th\u1ec3 tho\u00e1i tri\u1ec3n.<\/li>\n<li>C\u00f3 th\u1ec3 th\u1ea5y ph\u00f9 thai v\u00e0 \u0111a \u1ed1i.<\/li>\n<\/ul>\n<h3>X \u2013 quang<\/h3>\n<ul>\n<li>Type I v\u00e0 II c\u00f3 th\u1ec3 th\u1ea5y tr\u00ean x-quang ng\u1ef1c l\u00e0 t\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u nang (ch\u1ee9a \u0111\u1ea7y kh\u00ed).<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng l\u1edbn c\u00f3 th\u1ec3 g\u00e2y hi\u1ec7u \u1ee9ng kh\u1ed1i: \u0111\u1ea9y l\u1ec7ch trung th\u1ea5t, \u1ea5n l\u00f5m ho\u1eb7c \u0111\u1ea3o ng\u01b0\u1ee3c c\u01a1 ho\u00e0nh.<\/li>\n<li>Trong th\u1eddi k\u1ef3 s\u01a1 sinh, c\u00e1c nang c\u00f3 th\u1ec3 ch\u1ee9a \u0111\u1ea7y ho\u00e0n to\u00e0n ho\u1eb7c m\u1ed9t ph\u1ea7n m\u1ee9c d\u1ecbch-d\u1ecbch. C\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 thay \u0111\u1ed5i k\u00edch th\u01b0\u1edbc (do c\u00f3 s\u1ef1 th\u00f4ng th\u01b0\u01a1ng qua l\u1ed7 Kohn).<\/li>\n<li>Type III t\u1ed5n th\u01b0\u01a1ng c\u00f3 d\u1ea1ng \u0111\u1eb7c.<\/li>\n<\/ul>\n<h3>CT<\/h3>\n<ul>\n<li>C\u00f3 vai tr\u00f2 trong quan tr\u1ecdng trong x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed v\u00e0 m\u1ee9c \u0111\u1ed9 c\u1ee7a t\u1ed5n th\u01b0\u01a1ng. CTA gi\u00fap x\u00e1c \u0111\u1ecbnh ngu\u1ed3n m\u1ea1ch nu\u00f4i c\u1ee7a t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<li>CT cho h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng c\u1ee7a c\u00e1c type. Type III c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng t\u1ed5n th\u01b0\u01a1ng \u0111\u00f4ng \u0111\u1eb7c.<\/li>\n<\/ul>\n<h2>\u0110i\u1ec1u tr\u1ecb v\u00e0 ti\u00ean l\u01b0\u1ee3ng<\/h2>\n<p>Ph\u1eabu thu\u1eadt (c\u1eaft th\u00f9y ph\u1ed5i) \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng, c\u1ea3 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p s\u1edbm v\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nhi\u1ec5m tr\u00f9ng t\u00e1i ph\u00e1t mu\u1ed9n.<\/p>\n<p>Type I c\u00f3 ti\u00ean l\u01b0\u1ee3ng t\u1ed1t nh\u1ea5t.<\/p>\n<h3>C\u00e1c bi\u1ebfn ch\u1ee9ng<\/h3>\n<ul>\n<li>Tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i t\u00e1i ph\u00e1t<\/li>\n<li>Tr\u00e0n m\u00e1u m\u00e0ng ph\u1ed5i<\/li>\n<li>Tr\u00e0n m\u1ee7 m\u00e0ng ph\u1ed5i<\/li>\n<li>T\u0103ng nguy c\u01a1 m\u1eafc c\u00e1c kh\u1ed1i u \u00e1c t\u00ednh: BAC, ung th\u01b0 ph\u1ebf qu\u1ea3n, u nguy\u00ean b\u00e0o ph\u1ed5i, sarcoma c\u01a1 v\u00e2n.<\/li>\n<li>Ph\u00f9 thai g\u00e2y ra:\n<ul>\n<li>Ch\u00e8n \u00e9p tim thai v\u00e0 c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn<\/li>\n<li>Ch\u00e8n \u00e9p ph\u1ea7n ph\u1ed5i b\u00ecnh th\u01b0\u1eddng g\u00e2y ra gi\u1ea3m s\u1ea3n ph\u1ed5i.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h2>\n<ul>\n<li>Nang ph\u1ebf qu\u1ea3n:\n<ul>\n<li>Th\u01b0\u1eddng m\u1ed9t nang<\/li>\n<li>Th\u01b0\u1eddng kh\u00f4ng th\u00f4ng v\u1edbi c\u00e2y ph\u1ebf qu\u1ea3n n\u00ean kh\u00f4ng ch\u1ee9a \u0111\u1ea7y kh\u00ed.<\/li>\n<\/ul>\n<\/li>\n<li>Ph\u1ed5i bi\u1ec7t l\u1eadp:\n<ul>\n<li>\u0110\u01b0\u1ee3c c\u1ea5p m\u00e1u b\u1edfi \u0111\u1ed9ng m\u1ea1ch h\u1ec7 th\u1ed1ng<\/li>\n<li>C\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi CPAM.<\/li>\n<\/ul>\n<\/li>\n<li>Tho\u00e1t v\u1ecb ho\u00e0nh b\u1ea9m sinh: c\u00e1c quai ru\u1ed9t n\u1eb1m trong l\u1ed3ng ng\u1ef1c.<\/li>\n<li>Kh\u00ed ph\u1ebf th\u0169ng th\u00f9y ph\u1ed5i b\u1ea9m sinh: t\u0103ng s\u00e1ng c\u1ee7a m\u1ed9t th\u00f9y ph\u1ed5i, kh\u00f4ng c\u00f3 th\u00e0nh ph\u1ea7n nang ho\u1eb7c \u0111\u1eb7c.<\/li>\n<li>Gi\u00e3n ph\u1ebf qu\u1ea3n d\u1ea1ng nang khu tr\u00fa.<\/li>\n<li>V\u1edbi type I tr\u00ean CT c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi gi\u00e3n ph\u1ebf qu\u1ea3n ho\u1eb7c x\u1eb9p ph\u1ed5i do x\u01a1 co k\u00e9o.<\/li>\n<\/ul>\n<h2>C\u00e1c v\u00ed d\u1ee5<\/h2>\n<h3>Case 1: CPAM type I<\/h3>\n<p>Tr\u1ebb n\u1eef, 1,5 tu\u1ed5i. Vi\u00eam ph\u1ed5i t\u00e1i di\u1ec5n, kh\u00f3 th\u1edf. Phim x-quang ng\u1ef1c tr\u01b0\u1edbc \u0111\u00f3 cho th\u1ea5y c\u00f3 th\u1ec3 c\u00f3 tho\u00e1t v\u1ecb ho\u00e0nh.<\/p>\n<p>M\u1ed9t v\u00f9ng t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng nang l\u1edbn \u1edf b\u00ean ng\u1ef1c ph\u1ea3i, m\u1ed9t s\u1ed1 c\u00f3 m\u1ee9c d\u1ecbch kh\u00ed, \u0111\u00e8 \u0111\u1ea9y trung th\u1ea5t. C\u01a1 ho\u00e0nh ph\u1ea3i kh\u00f4ng quan s\u00e1t r\u00f5.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33122\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-1.jpg.png\" alt=\"\" width=\"950\" height=\"1273\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-1.jpg.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-1.jpg-299x400.png 299w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-1.jpg-597x800.png 597w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-1.jpg-768x1029.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-1.jpg-350x469.png 350w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<p>Tr\u00ean CT: nhi\u1ec1u nang v\u1edbi k\u00edch th\u01b0\u1edbc kh\u00e1c nhau, l\u1edbn nh\u1ea5t 8 cm, chi\u1ebfm h\u1ea7u h\u1ebft nhu m\u00f4 ph\u1ed5i, x\u1eb9p ph\u1ea7n nhu m\u00f4 ph\u1ed5i c\u00f2n l\u1ea1i. Kh\u00ed qu\u1ea3n, trung th\u1ea5t b\u1ecb \u0111\u1ea9y l\u1ec7ch. C\u01a1 ho\u00e0nh c\u00f2n li\u00ean t\u1ee5c.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33123\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-2.jpg.png\" alt=\"\" width=\"950\" height=\"620\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-2.jpg.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-2.jpg-613x400.png 613w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-2.jpg-768x501.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-2.jpg-350x228.png 350w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33124\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-3.png\" alt=\"\" width=\"950\" height=\"670\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-3.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-3-567x400.png 567w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-3-768x542.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-3-350x247.png 350w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<p>Phim ch\u1ee5p sau u\u1ed1ng c\u1ea3n quang c\u0169ng cho th\u1ea5y c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m tr\u00ean.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33125\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-4.png\" alt=\"\" width=\"950\" height=\"1476\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-4.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-4-257x400.png 257w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-4-515x800.png 515w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-4-768x1193.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-4-350x544.png 350w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<h3>Case 2: CPAM type I.<\/h3>\n<p>Tr\u1ebb s\u01a1 sinh, suy h\u00f4 h\u1ea5p.<\/p>\n<p>Phim x-quang cho th\u1ea5y nhi\u1ec1u t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng nang \u1edf b\u00ean ng\u1ef1c ph\u1ea3i, \u0111\u00e8 \u0111\u1ea9y trung th\u1ea5t sang tr\u00e1i.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33126\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-5.png\" alt=\"\" width=\"950\" height=\"950\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-5.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-5-400x400.png 400w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-5-800x800.png 800w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-5-280x280.png 280w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-5-768x768.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-5-350x350.png 350w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-5-100x100.png 100w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<p>Tr\u00ean CT: t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng nhi\u1ec1u nang l\u1edbn \u1edf trung t\u00e2m c\u1ee7a th\u00f9y d\u01b0\u1edbi ph\u1ed5i ph\u1ea3i, xung quanh d\u00e0y th\u00e0nh v\u00e0 th\u00e2m nhi\u1ec5m kh\u00f4ng r\u00f5 r\u00e0ng, c\u00f3 th\u1ec3 do vi\u00eam. Ph\u00e2n th\u00f9y \u0111\u00e1y gi\u1eefa v\u00e0 \u0111\u00e1y b\u00ean t\u0103ng th\u1ec3 t\u00edch do th\u1edf b\u00f9, ph\u00e2n th\u00f9y \u0111\u00e1y tr\u01b0\u1edbc b\u00ecnh th\u01b0\u1eddng. T\u1ed5n th\u01b0\u01a1ng g\u00e2y hi\u1ec7u \u1ee9ng kh\u1ed1i \u0111\u1ea9y r\u1ed1n ph\u1ed5i v\u00e0 th\u00f9y gi\u1eefa ra ph\u00eda tr\u01b0\u1edbc. Ph\u1ed5i tr\u00e1i b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33127\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-6.png\" alt=\"\" width=\"950\" height=\"950\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-6.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-6-400x400.png 400w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-6-800x800.png 800w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-6-280x280.png 280w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-6-768x768.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-6-350x350.png 350w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-6-100x100.png 100w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/> <img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33128\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-7.png\" alt=\"\" width=\"950\" height=\"950\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-7.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-7-400x400.png 400w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-7-800x800.png 800w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-7-280x280.png 280w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-7-768x768.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-7-350x350.png 350w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-7-100x100.png 100w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/> <img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33129\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-8.png\" alt=\"\" width=\"950\" height=\"950\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-8.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-8-400x400.png 400w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-8-800x800.png 800w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-8-280x280.png 280w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-8-768x768.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-8-350x350.png 350w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-8-100x100.png 100w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<h3>Case 3:<\/h3>\n<p>Tr\u1ebb n\u1eef, 2 ng\u00e0y tu\u1ed5i, suy h\u00f4 h\u1ea5p.<\/p>\n<p>Phim ch\u1ee5p cho th\u1ea5y th\u00f9y tr\u00ean ph\u1ed5i tr\u00e1i c\u00f3 nhi\u1ec1u t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng nang l\u1edbn, g\u00e2y x\u1eb9p th\u00f9y d\u01b0\u1edbi v\u00e0 \u0111\u1ea9y trung th\u1ea5t sang ph\u1ea3i.<\/p>\n<p>Ch\u1ea9n \u0111o\u00e1n: CPAM type I.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33130\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-9.png\" alt=\"\" width=\"950\" height=\"475\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-9.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-9-800x400.png 800w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-9-768x384.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-9-350x175.png 350w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<h3>Case 4:<\/h3>\n<p>Tr\u00ean si\u00eau \u00e2m tr\u01b0\u1edbc sinh.<\/p>\n<p>Ph\u1ed5i ph\u1ea3i t\u0103ng \u00e2m h\u01a1n ph\u1ed5i tr\u00e1i v\u1edbi c\u00e1c nang nh\u1ecf. Hi\u1ec7u \u1ee9ng kh\u1ed1i g\u00e2y \u0111\u1ea9y l\u1ec7ch t\u00e2m nh\u0129 tr\u00e1i.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33131\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-10.png\" alt=\"\" width=\"950\" height=\"813\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-10.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-10-467x400.png 467w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-10-935x800.png 935w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-10-768x657.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-10-350x300.png 350w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33132\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-11.png\" alt=\"\" width=\"950\" height=\"725\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-11.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-11-524x400.png 524w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-11-768x586.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-11-350x267.png 350w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/> <img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33133\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-12.png\" alt=\"\" width=\"950\" height=\"685\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-12.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-12-555x400.png 555w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-12-768x554.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-12-350x252.png 350w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<h3>Case 5:<\/h3>\n<p>Ph\u00e2n bi\u1ec7t v\u1edbi tho\u00e1t v\u1ecb ho\u00e0nh b\u1ea9m sinh.<\/p>\n<p>Tr\u1ebb s\u01a1 sinh, suy h\u00f4 h\u1ea5p.<\/p>\n<p>Phim x-quang cho th\u1ea5y nhi\u1ec1u t\u1ed5n th\u01b0\u01a1ng trong l\u00f2ng s\u00e1ng n\u1eb1m \u1edf l\u1ed3ng ng\u1ef1c tr\u00e1i, g\u00e2y d\u1ecbch chuy\u1ec3n b\u00f3ng tim. \u1ed0ng sonde d\u1ea1 d\u00e0y \u0111i v\u1ec1 ph\u00eda b\u00ean tr\u00e1i. Kh\u00f4ng th\u1ea5y c\u00e1c c\u1ea5u tr\u00fac c\u1ee7a \u1ed1ng ti\u00eau h\u00f3a trong \u1ed5 b\u1ee5ng.<\/p>\n<h3><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33134\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-13.png\" alt=\"\" width=\"950\" height=\"950\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-13.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-13-400x400.png 400w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-13-800x800.png 800w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-13-280x280.png 280w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-13-768x768.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-13-350x350.png 350w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-13-100x100.png 100w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/h3>\n<h3>Case 6:<\/h3>\n<p>Ph\u00e2n bi\u1ec7t v\u1edbi k\u00e9n kh\u00ed. Tr\u1ebb nam, 2 th\u00e1ng tu\u1ed5i, sau \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i. Phim ch\u1ee5p cho th\u1ea5y nhi\u1ec1u k\u00e9n kh\u00ed th\u00e0nh m\u1ecfng n\u1eb1m \u1edf \u0111\u00e1y ph\u1ed5i hai b\u00ean.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-33135\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-14.png\" alt=\"\" width=\"950\" height=\"862\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-14.png 950w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-14-441x400.png 441w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-14-882x800.png 882w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-14-768x697.png 768w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2022\/06\/CPAM-14-350x318.png 350w\" sizes=\"auto, (max-width: 950px) 100vw, 950px\" \/><\/p>\n<h3>Ngu\u1ed3n tham kh\u1ea3o<\/h3>\n<p>Dr Mohamed Saber, <a href=\"https:\/\/radiopaedia.org\/articles\/congenital-pulmonary-airway-malformation\" rel=\"noopener\">Congenital pulmonary airway malformation<\/a>, Radiopaedia. Truy c\u1eadp ng\u00e0y 30\/06\/2022<\/p>\n","protected":false},"excerpt":{"rendered":"<p>T\u1ea3i file PDF b\u00e0i vi\u1ebft D\u1ecb d\u1ea1ng \u0111\u01b0\u1eddng th\u1edf b\u1ea9m sinh &#8211; CPAM\u00a0t\u1ea1i \u0111\u00e2y B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c d\u1ecbch b\u1edfi Tr\u1ea7n Th\u1ecb Thu, Dr. L\u00ea V\u0169 Duy \u0110\u1ea1i c\u01b0\u01a1ng D\u1ecb d\u1ea1ng \u0111\u01b0\u1eddng th\u1edf b\u1ea9m sinh &#8211; Congenital pulmonary airway malformations (CPAM) l\u00e0 m\u1ed9t kh\u1ed1i nhi\u1ec1u nang c\u1ee7a nhu m\u00f4 ph\u1ed5i, v\u1edbi b\u1ea5t th\u01b0\u1eddng c\u1ee7a s\u1ef1 h\u00ecnh [&#8230;]\n","protected":false},"author":1,"featured_media":33136,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-33121","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\/33121","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=33121"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/33121\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/33136"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=33121"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=33121"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=33121"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}