{"id":5972,"date":"2019-04-02T15:29:46","date_gmt":"2019-04-02T08:29:46","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=5972"},"modified":"2019-04-02T15:33:02","modified_gmt":"2019-04-02T08:33:02","slug":"chi-phi-hieu-qua-cua-lieu-phap-corticosteroids-truoc-sinh-o-nhung-phu-nu-co-nguy-co-sinh-non-muon","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/chi-phi-hieu-qua-cua-lieu-phap-corticosteroids-truoc-sinh-o-nhung-phu-nu-co-nguy-co-sinh-non-muon\/","title":{"rendered":"Chi ph\u00ed &#8211; Hi\u1ec7u qu\u1ea3 c\u1ee7a li\u1ec7u ph\u00e1p Corticosteroids tr\u01b0\u1edbc sinh \u1edf nh\u1eefng ph\u1ee5 n\u1eef c\u00f3 nguy c\u01a1 sinh non mu\u1ed9n"},"content":{"rendered":"<p>B\u00e1c s\u0129 V\u0169 Nh\u1eadt Khang \u2013 Nh\u00f3m sinh non BV M\u1ef9 \u0110\u1ee9c<\/p>\n<p><strong>Li\u1ec7u ph\u00e1p corticosteroids<\/strong> tr\u01b0\u1edbc sinh l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb chu\u1ea9n cho c\u00e1c thai ph\u1ee5 c\u00f3 nguy c\u01a1 cao chuy\u1ec3n d\u1ea1 sinh non tr\u01b0\u1edbc 34 tu\u1ea7n. C\u00e1c thu\u1ed1c Corticosteroids s\u1ebd c\u1ea3i thi\u1ec7n t\u1ef7 l\u1ec7 s\u1ed1ng tr\u1ebb s\u01a1 sinh b\u1eb1ng c\u00e1ch gi\u00fap ph\u1ed5i c\u1ee7a tr\u1ebb tr\u01b0\u1edfng th\u00e0nh. Tr\u01b0\u1edbc \u0111\u00e2y, nhi\u1ec1u nghi\u00ean c\u1ee9u cho r\u1eb1ng steroids kh\u00f4ng th\u1eadt s\u1ef1 c\u00f3 \u00edch hay c\u1ea7n thi\u1ebft cho c\u00e1c tr\u1ebb s\u01a1 sinh sinh non mu\u1ed9n, tuy nhi\u00ean m\u1ed9t nghi\u00ean c\u1ee9u ng\u1eabu nhi\u00ean l\u00e2m s\u00e0ng c\u00f3 \u0111\u1ed1i ch\u1ee9ng th\u1ef1c hi\u1ec7n v\u00e0o n\u0103m 2016 b\u1edfi \u0110\u01a1n v\u1ecb S\u1ea3n Nhi (MUFU: Maternal-Fetal Medicine Units) c\u1ee7a t\u1ed5 ch\u1ee9c Eunice Kennedy Shriver thu\u1ed9c Vi\u1ec7n S\u1ee9c kh\u1ecfe tr\u1ebb em &amp; Ph\u00e1t tri\u1ec3n con ng\u01b0\u1eddi (NICHD: NIH&#8217;s Eunice Kennedy Shriver National Institute of Child Health and Human Development), cho th\u1ea5y n\u1ebfu ch\u1ec9 \u0111\u1ecbnh corticosteroids \u1edf nh\u00f3m thai ph\u1ee5 c\u00f3 th\u1ec3 c\u00f3 m\u1ed9t s\u1ed1 l\u1ee3i \u00edch. Nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ec9 ra c\u00e1c tr\u1ebb s\u01a1 sinh c\u00f3 m\u1eb9 \u0111\u01b0\u1ee3c nh\u1eadn betamethasone th\u00ec c\u00f3 \u00edt bi\u1ebfn ch\u1ee9ng v\u1ec1 ph\u1ed5i v\u00e0 c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb h\u00f4 h\u1ea5p c\u1ea7n thi\u1ebft kh\u00e1c c\u0169ng \u00edt h\u01a1n so v\u1edbi tr\u1ebb sinh ra t\u1eeb b\u00e0 m\u1eb9 kh\u00f4ng s\u1eed d\u1ee5ng corticosteroids. C\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a steroids bao g\u1ed3m nhi\u1ec5m tr\u00f9ng (nhi\u1ec5m tr\u00f9ng huy\u1ebft), t\u1ea1o c\u1ee5c m\u00e1u \u0111\u00f4ng v\u00e0 lo\u00e3ng x\u01b0\u01a1ng.<\/p>\n<p>Trong nghi\u00ean c\u1ee9u n\u00e0y, MFMU \u0111\u00e1nh gi\u00e1 chi ph\u00ed \u0111i\u1ec1u tr\u1ecb c\u1ee7a 1.426 thai ph\u1ee5 v\u00e0 tr\u1ebb s\u01a1 sinh g\u1ed3m chi ph\u00ed cho thu\u1ed1c betamethasone s\u1eed d\u1ee5ng, chi ph\u00ed y t\u1ebf cho b\u00e0 m\u1eb9 v\u00e0 chi ph\u00ed cho vi\u1ec7c ch\u0103m s\u00f3c t\u00edch c\u1ef1c cho tr\u1ebb s\u01a1 sinh, th\u1eddi gian n\u1eb1m vi\u1ec7n v\u00e0 s\u1ed1 l\u1ea7n t\u00e1i kh\u00e1m sau \u0111\u00f3. Hi\u1ec7u qu\u1ea3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng t\u1ef7 l\u1ec7 tr\u1ebb s\u01a1 sinh kh\u00f4ng c\u00f3 c\u00e1c k\u1ebft c\u1ee5c ch\u00ednh c\u1ee7a nghi\u00ean c\u1ee9u: h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p trong v\u00f2ng 72h \u0111\u1ea7u sau sinh b\u1eb1ng CPAP ho\u1eb7c th\u1edf oxy l\u01b0u l\u01b0\u1ee3ng cao qua canula trong v\u00f2ng \u2265 2h, ho\u1eb7c cung c\u1ea5p Oxy th\u00f4ng qua FiO2 30% ho\u1eb7c nhi\u1ec1u h\u01a1n trong v\u00f2ng \u2265 4h v\u00e0 s\u1eed d\u1ee5ng EMCO (oxy h\u00f3a b\u1eb1ng m\u00e0ng ngo\u00e0i c\u01a1 th\u1ec3) ho\u1eb7c th\u00f4ng kh\u00ed nh\u00e2n t\u1ea1o (th\u1edf m\u00e1y).<\/p>\n<p>V\u1edbi nh\u00e1nh betamethasone, t\u1ed5ng chi ph\u00ed trung b\u00ecnh cho m\u1eb9 v\u00e0 b\u00e9 l\u00e0 4.681 \u0111\u00f4 la v\u00e0 gi\u1ea3m c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea so v\u1edbi chi ph\u00ed c\u1ee7a nh\u00f3m kh\u00f4ng \u0111i\u1ec1u tr\u1ecb bethamethasone l\u00e0 5.379 \u0111\u00f4 la. V\u1edbi t\u1ef7 l\u1ec7 sinh non mu\u1ed9n t\u1ea1i M\u1ef9 l\u00e0 6,9% v\u00e0 chi ph\u00ed s\u1ebd gi\u1ea3m h\u01a1n 700 \u0111\u00f4 la\/ m\u1ed9t tr\u01b0\u1eddng h\u1ee3p n\u1ebfu \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng corticosteroids.<\/p>\n<p>B\u00e0 Cynthia Gymfi-Bannerman v\u00e0 c\u1ed9ng s\u1ef1 th\u00f4ng qua nghi\u00ean c\u1ee9u r\u00fat ra k\u1ebft lu\u1eadn, vi\u1ec7c ch\u1ec9 \u0111\u1ecbnh bethamethasone cho nh\u00f3m thai ph\u1ee5 c\u00f3 nguy c\u01a1 cao sinh non mu\u1ed9n s\u1ebd l\u00e0m gi\u1ea3m chi ph\u00ed \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u1ea3i thi\u1ec7n c\u00e1c k\u1ebft c\u1ee5c ng\u1eafn h\u1ea1n tr\u00ean tr\u1ebb s\u01a1 sinh, do \u0111\u00f3 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb n\u00e0y c\u00f3 th\u1ec3 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb chi\u1ebfn l\u01b0\u1ee3c mang t\u00ednh kinh t\u1ebf cao.<\/p>\n<p>Ngu\u1ed3n: Cost &#8211; effectiveness of Antenatal Corticosteroid Therapy vs No Therapy in Women at Risk of Late Preterm Delivery. JAMA Pediatrics, 2019;<br \/>\nDOI: 10.1001\/jamapediatrics.2019.0032 Link\u00a0<a href=\"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/article-abstract\/2726998\" rel=\"noopener\">https:\/\/jamanetwork.com\/journals\/jamapediatrics\/article-abstract\/2726998<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u00e1c s\u0129 V\u0169 Nh\u1eadt Khang \u2013 Nh\u00f3m sinh non BV M\u1ef9 \u0110\u1ee9c Li\u1ec7u ph\u00e1p corticosteroids tr\u01b0\u1edbc sinh l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb chu\u1ea9n cho c\u00e1c thai ph\u1ee5 c\u00f3 nguy c\u01a1 cao chuy\u1ec3n d\u1ea1 sinh non tr\u01b0\u1edbc 34 tu\u1ea7n. C\u00e1c thu\u1ed1c Corticosteroids s\u1ebd c\u1ea3i thi\u1ec7n t\u1ef7 l\u1ec7 s\u1ed1ng tr\u1ebb s\u01a1 sinh b\u1eb1ng c\u00e1ch gi\u00fap ph\u1ed5i c\u1ee7a [&#8230;]\n","protected":false},"author":1,"featured_media":5981,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5972","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\/5972","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=5972"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5972\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/5981"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5972"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5972"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5972"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}