{"id":9985,"date":"2019-05-22T12:09:06","date_gmt":"2019-05-22T05:09:06","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=9985"},"modified":"2019-05-22T12:09:32","modified_gmt":"2019-05-22T05:09:32","slug":"cac-thuoc-dieu-tri-nhung-benh-ly-lien-quan-den-nua-phan-sau-cua-mat","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/cac-thuoc-dieu-tri-nhung-benh-ly-lien-quan-den-nua-phan-sau-cua-mat\/","title":{"rendered":"\u001dC\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb nh\u1eefng b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn n\u1eeda ph\u1ea7n sau c\u1ee7a m\u1eaft"},"content":{"rendered":"

\u0110\u00f4i ch\u00fat th\u00f4ng tin v\u1ec1 c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb nh\u1eefng b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn n\u1eeda ph\u1ea7n sau c\u1ee7a m\u1eaft.<\/h2>\n
– Trong s\u1ed1 c\u00e1c b\u1ec7nh v\u1ec1 m\u1eaft n\u00f3i chung, nh\u1eefng b\u1ec7nh thu\u1ed9c v\u1ec1 n\u1eeda ph\u1ea7n sau c\u1ee7a m\u1eaft \u0111\u1ec1u khi\u1ebfn c\u00e1c b\u00e1c s\u1ef9 nh\u00e3n khoa ph\u1ea3i \u201cng\u00e1n ng\u1ea9m\u201d v\u00e0 m\u1eb7c d\u00f9 \u0111\u00e3 t\u1ed1n r\u1ea5t nhi\u1ec1u c\u00f4ng s\u1ee9c, t\u1eadn d\u1ee5ng m\u1ecdi ph\u01b0\u01a1ng ph\u00e1p c\u1ea3 thu\u1ed1c, v\u1eadt l\u00fd l\u1eabn ph\u1eabu thu\u1eadt \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n nh\u01b0ng k\u1ebft qu\u1ea3 cu\u1ed1i c\u00f9ng l\u00e0 th\u1ecb l\u1ef1c (kh\u1ea3 n\u0103ng nh\u00ecn) c\u1ee7a b\u1ec7nh nh\u00e2n th\u01b0\u1eddng c\u1ea3i thi\u1ec7n kh\u00f4ng nhi\u1ec1u, th\u1eadm ch\u00ed m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f2n s\u1ee5t gi\u1ea3m \u0111i so v\u1edbi th\u1eddi \u0111i\u1ec3m b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. C\u00f3 r\u1ea5t nhi\u1ec1u nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn k\u1ebft c\u1ee5c n\u00e0y do v\u1eady b\u00e0i vi\u1ebft s\u1ebd ch\u1ec9 b\u00e0n lu\u1eadn m\u1ed9t ph\u1ea7n r\u1ea5t nh\u1ecf trong ch\u1ee7 \u0111\u1ec1 r\u1ed9ng l\u1edbn n\u00e0y c\u1ee7a ng\u00e0nh m\u1eaft.<\/p>\n
– B\u1ea1n c\u00f3 th\u1ec3 t\u01b0\u1edfng t\u01b0\u1ee3ng n\u1eeda ph\u1ea7n sau c\u1ee7a m\u1eaft gi\u1ed1ng nh\u01b0 ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a qu\u1ea3 d\u1eeba sau khi ch\u1eb7t m\u1edf n\u1eafp \u0111\u1ec3 u\u1ed1ng l\u1ea5y n\u01b0\u1edbc. Ph\u1ea7n n\u01b0\u1edbc b\u00ean trong c\u00f3 th\u1ec3 hi\u1ec3u \u0111\u01a1n gi\u1ea3n l\u00e0 m\u00f4i tr\u01b0\u1eddng d\u1ecbch k\u00ednh c\u1ee7a m\u1eaft v\u00e0 ph\u1ea7n c\u00f9i d\u1eeba b\u00e1m \u1edf vi\u1ec1n l\u00e0 khu v\u1ef1c d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c v\u00e0 m\u1ea1ch m\u00e1u v\u00f5ng m\u1ea1c. Vi\u1ebft nh\u01b0 v\u1eady cho d\u1ec5 hi\u1ec3u nh\u01b0ng th\u1ef1c t\u1ebf gi\u1ea3i ph\u1eabu sinh l\u00fd m\u1eaft \u1edf khu v\u1ef1c n\u00e0y r\u1ea5t ph\u1ee9c t\u1ea1p v\u00e0 c\u00e1c b\u1ec7nh l\u00fd th\u01b0\u1eddng ph\u00e1t sinh \u1edf c\u1ea5p \u0111\u1ed9 t\u1ebf b\u00e0o. M\u00e0 \u0111\u00e3 \u1edf c\u1ea5p \u0111\u1ed9 nh\u1ecf nh\u01b0 v\u1eady th\u00ec n\u1ebfu \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c, thu\u1ed1c \u0111\u00f3 ph\u1ea3i \u0111\u01b0\u1ee3c b\u00e0o ch\u1ebf \u0111\u1eb7c bi\u1ec7t \u0111\u1ec3 c\u00f3 \u00e1i l\u1ef1c cao nh\u1ea5t v\u00e0 ch\u1ecdn l\u1ecdc t\u00e1c d\u1ee5ng tr\u00ean t\u1ebf b\u00e0o \u0111\u00edch, c\u00f2n \u0111\u1ebfn giai \u0111o\u1ea1n c\u1ea7n ph\u1ea3i \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ph\u1eabu thu\u1eadt th\u00ec m\u1eb7c d\u00f9 \u0111\u1ebfn nay \u0111\u00e3 c\u00f3 nhi\u1ec1u thi\u1ebft b\u1ecb h\u1ed7 tr\u1ee3 nh\u00ecn v\u00e0o b\u00ean trong m\u1eaft c\u0169ng nh\u01b0 c\u00e1c d\u1ee5ng c\u1ee5 ph\u1eabu thu\u1eadt tinh x\u1ea3o, c\u00e1c thao t\u00e1c v\u1eabn ph\u1ea3i th\u1ef1c hi\u1ec7n b\u1eb1ng tay ng\u01b0\u1eddi b\u00e1c s\u1ef9. \u0110i\u1ec1u \u0111\u00f3 \u0111\u1ed3ng ngh\u0129a v\u1edbi vi\u1ec7c nguy c\u01a1 th\u1ea5t b\u1ea1i trong ph\u1eabu thu\u1eadt r\u1ea5t cao \u0111\u1ed1i v\u1edbi nh\u00f3m b\u1ec7nh l\u00fd n\u00e0y, ch\u00ednh v\u00ec th\u1ebf nhi\u1ec1u b\u1ec7nh nh\u00e2n cho r\u1eb1ng m\u1ed5 xong th\u00ec th\u1ea5y m\u1eaft c\u00f2n k\u00e9m h\u01a1n, t\u1eeb \u201cl\u1ee3n l\u00e0nh th\u00e0nh l\u1ee3n qu\u00e8\u201d.<\/p>\n
– May m\u1eafn l\u00e0, m\u1ed9t s\u1ed1 b\u1ec7nh trong nh\u00f3m n\u00e0y c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 b\u1eb1ng thu\u1ed1c ti\u00eam n\u1ed9i nh\u00e3n (ti\u00eam v\u00e0o trong m\u1eaft) v\u00e0 duy tr\u00ec c\u1ea3i thi\u1ec7n th\u1ecb l\u1ef1c k\u00e9o d\u00e0i tr\u01b0\u1edbc khi ph\u1ea3i \u0111\u1ebfn giai \u0111o\u1ea1n can thi\u1ec7p b\u1eb1ng ph\u1eabu thu\u1eadt. Danh s\u00e1ch c\u00e1c b\u1ec7nh \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t ch\u1ec9 \u0111\u1ecbnh t\u1ea1i Vi\u1ec7t Nam c\u1ee7a nh\u00f3m thu\u1ed1c n\u00e0y \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea t\u1ed5ng h\u1ee3p nh\u01b0 sau (m\u1ed7i thu\u1ed1c s\u1ebd c\u00f3 ch\u1ec9 \u0111\u1ecbnh \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t kh\u00e1c nhau n\u00ean m\u1ecdi ng\u01b0\u1eddi c\u1ea7n ch\u00fa \u00fd \u0111\u1ecdc k\u1ef9 ch\u1ec9 \u0111\u1ecbnh tr\u00ean t\u1edd r\u01a1i s\u1ea3n ph\u1ea9m):<\/p>\n
1. Tho\u00e1i h\u00f3a ho\u00e0ng \u0111i\u1ec3m li\u00ean quan \u0111\u1ebfn tu\u1ed5i gi\u00e0 c\u00f3 t\u00e2n m\u1ea1ch (th\u1ec3 \u01b0\u1edbt) (Wet age-related macular degeneration – wAMD) (Lucentis\u00ae c\u1ee7a Novartis, Eylea\u00ae c\u1ee7a Bayer)<\/p>\n
$\"lucentis\"$ $\"Eylea\"$ <\/p>\n
2. Suy gi\u1ea3m th\u1ecb l\u1ef1c do b\u1ec7nh l\u00fd v\u00f5ng m\u1ea1c \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 ph\u00f9 ho\u00e0ng \u0111i\u1ec3m do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. (Diabetic retinopathy and diabetic macular edema \u2013 DR & DME) (Lucentis\u00ae c\u1ee7a Novartis, Eylea\u00ae c\u1ee7a Bayer, Ozurdex\u00ae c\u1ee7a Allergan)<\/p>\n
$\"Ozurdex\"$ <\/p>\n
3. Suy gi\u1ea3m th\u1ecb l\u1ef1c do ph\u00f9 ho\u00e0ng \u0111i\u1ec3m th\u1ee9 ph\u00e1t do t\u1eafc t\u0129nh m\u1ea1ch v\u00f5ng m\u1ea1c (t\u0129nh m\u1ea1ch v\u00f5ng m\u1ea1c nh\u00e1nh ho\u1eb7c t\u0129nh m\u1ea1c v\u00f5ng m\u1ea1c trung t\u00e2m) (Branch or Central macular edema following retinal vein occlusion \u2013 RVO) (Lucentis\u00ae c\u1ee7a Novartis, Eylea\u00ae c\u1ee7a Bayer, Ozurdex\u00ae c\u1ee7a Allergan)<\/p>\n
4. T\u00e2n m\u1ea1ch h\u1eafc m\u1ea1c do c\u1eadn th\u1ecb b\u1ec7nh l\u00fd (Myopic choroidal neovascularization \u2013 mCNV) (Lucentis\u00ae c\u1ee7a Novartis, Eylea\u00ae c\u1ee7a Bayer)<\/p>\n
5. Vi\u00eam m\u00e0ng b\u1ed3 \u0111\u00e0o sau (Posterior Uveitis) (Ozurdex\u00ae c\u1ee7a Allergan, Humira\u00ae c\u1ee7a Abbvie \u2013 thu\u1ed1c n\u00e0y ph\u1ea3i \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p v\u1edbi corticoid)<\/p>\n
$\"Humira\"$ <\/p>\n[Trong nh\u00f3m n\u00e0y c\u00f2n c\u00f3 ho\u1ea1t ch\u1ea5t bevacizumab trong bi\u1ec7t d\u01b0\u1ee3c Avastine\u00ae c\u1ee7a Roche nh\u01b0ng kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t ch\u00ednh th\u1ee9c cho \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd \u0111\u00e1y m\u1eaft]\n
– Ni\u1ec1m vui \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 b\u00e1c s\u1ef9 l\u00e0 c\u00f3 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 nh\u01b0ng n\u1ed7i bu\u1ed3n c\u0169ng b\u1eaft \u0111\u1ea7u khi nh\u00ecn l\u00ean b\u1ea3ng chi ph\u00ed \u0111i\u1ec1u tr\u1ecb t\u1ed5ng th\u1ec3 theo t\u1eebng m\u1eb7t b\u1ec7nh. Thu\u1ed1c n\u00e0o c\u0169ng \u0111\u1eaft ti\u1ec1n do ho\u1eb7c l\u00e0 c\u00f3 b\u1ea3n ch\u1ea5t sinh h\u1ecdc ho\u1eb7c l\u00e0 do b\u00e0o ch\u1ebf \u1edf d\u1ea1ng gi\u1ea3i ph\u00f3ng k\u00e9o d\u00e0i (d\u1ea1ng implant c\u1ee7a Ozurdex\u00ae). V\u00ed d\u1ee5 nh\u01b0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n b\u1ecb tho\u00e1i h\u00f3a ho\u00e0ng \u0111i\u1ec3m li\u00ean quan \u0111\u1ebfn tu\u1ed5i gi\u00e0 th\u1ec3 t\u00e2n m\u1ea1ch (wAMD) c\u1ea7n ph\u1ea3i ti\u00eam duy tr\u00ec h\u00e0ng th\u00e1ng \u0111\u1ec3 c\u1ea3i thi\u1ec7n th\u1ecb l\u1ef1c \u0111\u1ebfn m\u1ee9c t\u1ed1i \u0111a sau \u0111\u00f3 m\u1edbi chuy\u1ec3n sang ph\u00e1c \u0111\u1ed3 \u201c\u0111i\u1ec1u tr\u1ecb v\u00e0 m\u1edf r\u1ed9ng\u201d (hi\u1ec3u n\u00f4m na l\u00e0 theo d\u00f5i \u0111\u00e1p \u1ee9ng c\u1ee7a b\u1ec7nh nh\u00e2n r\u1ed3i n\u1ebfu th\u1ecb l\u1ef1c v\u1eabn duy tr\u00ec t\u1ed1t th\u00ec gi\u00e3n d\u1ea7n kho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c l\u1ea7n ti\u00eam theo tu\u1ea7n). V\u00e0 n\u1ebfu b\u00e1c s\u1ef9 ch\u1ecdn bi\u1ec7t d\u01b0\u1ee3c Eylea\u00ae th\u00ec c\u0103n c\u1ee9 v\u00e0o nghi\u00ean c\u1ee9u RIVAL m\u1edbi \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 \u0111\u1ea7u n\u0103m 2019 (https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30676617<\/a> ), s\u1ed1 ti\u1ec1n b\u1ec7nh nh\u00e2n Vi\u1ec7t Nam ph\u1ea3i b\u1ecf ra kho\u1ea3ng 291 tri\u1ec7u trong n\u0103m \u0111\u1ea7u ti\u00ean (t\u01b0\u01a1ng \u1ee9ng v\u1edbi s\u1ed1 m\u0169i trung b\u00ecnh l\u00e0 9.7 m\u0169i x 30 tri\u1ec7u\/(m\u0169i + ph\u00ed kh\u00e1m) trong v\u00f2ng 12 th\u00e1ng \u0111\u1ea7u), nh\u01b0ng n\u1ebfu b\u00e1c s\u1ef9 ch\u1ecdn bi\u1ec7t d\u01b0\u1ee3c Lucentis\u00ae th\u00ec s\u1ed1 ti\u1ec1n ph\u1ea3i b\u1ecf ra ch\u1ec9 b\u1eb1ng m\u1ed9t n\u1eeda v\u00ec c\u00f9ng s\u1ed1 m\u0169i ti\u00eam. Trong nghi\u00ean c\u1ee9u RIVAL n\u00e0y, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 k\u1ebft lu\u1eadn kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a v\u1ec1 s\u1ef1 c\u1ea3i thi\u1ec7n th\u1ecb l\u1ef1c gi\u1eefa 2 ho\u1ea1t ch\u1ea5t \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng sau 52 tu\u1ea7n (Aflibercept trong bi\u1ec7t d\u01b0\u1ee3c Eylea\u00ae v\u00e0 Ranibizumab trong bi\u1ec7t d\u01b0\u1ee3c Lucentis\u00ae).<\/p>\n
– N\u1ebfu ch\u00fang ta ch\u1ec9 d\u1eebng \u1edf nghi\u00ean c\u1ee9u n\u00e0y th\u00ec ch\u1eafc h\u1eb3n b\u1ec7nh nh\u00e2n hay b\u00e1c s\u1ef9 s\u1ebd b\u1edbt \u0111au \u0111\u1ea7u c\u00e2n nh\u1eafc l\u1ef1a ch\u1ecdn l\u00e0m g\u00ec c\u1ea3. V\u1ea5n \u0111\u1ec1 n\u1eb1m \u1edf nghi\u00ean c\u1ee9u Protocol T n\u0103m 2016 (https:\/\/www.reviewofophthalmology.com\/article\/a-closer-look-at-drcrnet-protocol-t<\/a>) cho k\u1ebft qu\u1ea3 r\u1ea5t tr\u00e1i ng\u01b0\u1ee3c. \u1ede nh\u00f3m b\u1ec7nh nh\u00e2n b\u1ecb wAMD c\u00f3 th\u1ecb l\u1ef1c ban \u0111\u1ea7u th\u1ea5p (<20\/50 theo b\u1ea3ng th\u1ecb l\u1ef1c Snellen) th\u00ec s\u1ed1 ch\u1eef EDTRS (ki\u1ec3m tra th\u1ecb l\u1ef1c b\u1eb1ng c\u00e1ch \u0111\u1ebfm s\u1ed1 l\u01b0\u1ee3ng ch\u1eef thay v\u00ec \u0111\u1ecdc theo h\u00e0ng tr\u00ean b\u1ea3ng th\u1ecb l\u1ef1c Snellen) \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n \u1edf nh\u00f3m ti\u00eam n\u1ed9i nh\u00e3n Eylea\u00ae l\u00e0 18.9 (h\u01a1n 3 h\u00e0ng th\u1ecb l\u1ef1c) l\u1edbn h\u01a1n c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea so v\u1edbi 14.2 ch\u1eef \u1edf nh\u00f3m ti\u00eam Lucentis\u00ae li\u1ec1u 0.3mg (\u1edf M\u1ef9 ch\u1ec9 ph\u00ea duy\u1ec7t li\u1ec1u 0.3mg, thay v\u00ec li\u1ec1u 0.5mg nh\u01b0 tr\u00ean to\u00e0n th\u1ebf gi\u1edbi). Nhi\u1ec1u chuy\u00ean gia cho r\u1eb1ng vi\u1ec7c m\u1ee9c li\u1ec1u c\u1ee7a bi\u1ec7t d\u01b0\u1ee3c Lucentis\u00ae \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong nghi\u00ean c\u1ee9u th\u1ea5p h\u01a1n so v\u1edbi li\u1ec1u chu\u1ea9n c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u. Tr\u00ean \u0111\u00e2y ch\u1ec9 l\u00e0 m\u1ed9t v\u00ed d\u1ee5 trong s\u1ed1 r\u1ea5t nhi\u1ec1u ch\u1ec9 \u0111\u1ecbnh c\u1ee7a nh\u00f3m thu\u1ed1c n\u00e0y.<\/p>\n
– Khi hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 chi ph\u00ed b\u1ecf ra \u0111\u01b0\u1ee3c x\u00e9t \u0111\u1ebfn, v\u00e0 \u1edf \u0111\u00e2y l\u00e0 chi ph\u00ed r\u1ea5t cao th\u00ec m\u1ed9t l\u1ea7n n\u1eefa b\u1ec7nh nh\u00e2n v\u00e0 b\u00e1c s\u1ef9 n\u00ean c\u00f9ng th\u1ea3o lu\u1eadn ph\u01b0\u01a1ng \u00e1n l\u1ef1a ch\u1ecdn v\u1edbi ho\u00e0n c\u1ea3nh c\u1ee7a b\u1ec7nh nh\u00e2n. M\u1ed7i m\u1eb7t b\u1ec7nh \u0111\u1ec1u c\u00f3 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb kh\u00e1c nhau t\u01b0\u01a1ng \u1ee9ng v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c nhau nh\u01b0ng khi \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh li\u00ean quan \u0111\u1ebfn n\u1eeda ph\u1ea7n sau n\u00e0y, chi ph\u00ed t\u1ed5ng th\u1ec3 c\u1ea7n \u0111\u01b0\u1ee3c th\u00f4ng b\u00e1o cho b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. Khi x\u00e1c \u0111\u1ecbnh c\u00f3 kh\u1ea3 n\u0103ng chi tr\u1ea3 chi ph\u00ed \u0111\u00f3, ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n tu\u00e2n th\u1ee7 th\u1eddi gian th\u0103m kh\u00e1m v\u00e0 \u0111\u1ecbnh k\u1ef3 ti\u00eam \u0111\u1ec3 duy tr\u00ec th\u1ecb l\u1ef1c t\u1ed1t nh\u1ea5t. \u1ede vi\u1ec7n ad \u0111\u00e3 ch\u1ee9ng ki\u1ebfn nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n th\u1ea5y th\u1ecb l\u1ef1c c\u1ea3i thi\u1ec7n t\u1ed1t sau khi ti\u00eam n\u00ean t\u01b0\u1edfng \u0111\u00e3 kh\u1ecfi v\u00e0 \u201cqu\u00ean\u201d b\u00e1c s\u1ef9 lu\u00f4n khi ch\u01b0a ti\u00eam \u0111\u1ee7 li\u1ec1u, cho \u0111\u1ebfn khi th\u1ecb l\u1ef1c s\u1ee5t gi\u1ea3m th\u00ec m\u1edbi b\u1eaft \u0111\u1ea7u t\u00ecm \u0111\u1ebfn vi\u1ec7n \u0111\u1ec3 ti\u00eam l\u1ea1i. Vi\u1ec7c n\u00e0y s\u1ebd khi\u1ebfn chi ph\u00ed \u0111i\u1ec1u tr\u1ecb t\u0103ng th\u00eam do nhi\u1ec1u m\u1eb7t b\u1ec7nh c\u1ea7n ph\u1ea3i c\u00f3 pha \u201cn\u1ea1p\u201d (b\u1eaft bu\u1ed9c ph\u1ea3i ti\u00eam \u0111\u1ee7 s\u1ed1 m\u0169i gi\u1ed1ng nh\u01b0 d\u1ea1ng ph\u00e1c \u0111\u1ed3 li\u1ec1u \u201ct\u1ea5n c\u00f4ng\u201d c\u1ee7a corticoid) th\u00ec k\u1ebft qu\u1ea3 th\u1ecb l\u1ef1c m\u1edbi duy tr\u00ec t\u1ed1t.<\/p>\n
– Ph\u1ea1m vi c\u1ee7a ch\u1ee7 \u0111\u1ec1 n\u00e0y qu\u00e1 r\u1ed9ng l\u1edbn n\u00ean ad xin k\u1ebft th\u00fac b\u00e0i b\u1eb1ng th\u00f4ng tin v\u1ec1 thu\u1ed1c n\u00e0o \u0111\u01b0\u1ee3c b\u1ea3o hi\u1ec3m y t\u1ebf Vi\u1ec7t Nam chi tr\u1ea3.<\/p>\n
+ Theo th\u00f4ng t\u01b0 30\/2018\/ TT-BYT, t\u00ednh \u0111\u1ebfn th\u1eddi \u0111i\u1ec3m hi\u1ec7n t\u1ea1i, ch\u1ec9 duy nh\u1ea5t c\u00f3 ho\u1ea1t ch\u1ea5t Ranibizumab (Lucentis\u00ae c\u1ee7a Novartis) c\u00f3 trong danh m\u1ee5c \u0111\u01b0\u1ee3c b\u1ea3o hi\u1ec3m chi tr\u1ea3 c\u00f3 \u0111i\u1ec1u ki\u1ec7n (t\u1ea1i khoa m\u1eaft b\u1ec7nh vi\u1ec7n d\u1ea1ng \u0111\u1eb7c bi\u1ec7t (trung \u01b0\u01a1ng) ho\u1eb7c b\u1ec7nh vi\u1ec7n chuy\u00ean khoa m\u1eaft h\u1ea1ng I v\u00e0 II).<\/p>\n
+ Ho\u1ea1t ch\u1ea5t Aflibercept (Eylea\u00ae c\u1ee7a Bayer) ch\u01b0a xin \u0111\u01b0\u1ee3c v\u00e0o danh m\u1ee5c n\u00e0y do m\u1edbi v\u00e0o th\u1ecb tr\u01b0\u1eddng Vi\u1ec7t Nam.<\/p>\n
+ Ho\u1ea1t ch\u1ea5t Dexamethason d\u1ea1ng implant gi\u1ea3i ph\u00f3ng k\u00e9o d\u00e0i (Ozurdex\u00ae c\u1ee7a Allergan) m\u1edbi b\u1ecb g\u1ea1t kh\u1ecfi danh m\u1ee5c \u0111\u01b0\u1ee3c chi tr\u1ea3. (H\u01a1i bu\u1ed3n \u0111\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam m\u00e0ng b\u1ed3 \u0111\u00e0o sau v\u00ec bi\u1ec7t d\u01b0\u1ee3c n\u00e0y \u0111\u01b0\u1ee3c coi l\u00e0 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 t\u1ed1i \u01b0u nh\u1ea5t \u0111\u1ed1i v\u1edbi b\u1ec7nh n\u00e0y)<\/p>\n
+ Ho\u1ea1t ch\u1ea5t Bevacizumab (Avastine\u00ae c\u1ee7a Roche) kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh ch\u00ednh th\u1ee9c cho ti\u00eam n\u1ed9i nh\u00e3n n\u00ean \u0111\u01b0\u01a1ng nhi\u00ean l\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c chi tr\u1ea3. Tuy nhi\u00ean \u0111\u00e2y v\u1eabn l\u00e0 top 1 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nhi\u1ec1u nh\u1ea5t t\u00ednh theo s\u1ed1 m\u0169i ti\u00eam c\u1ea3 \u1edf Vi\u1ec7t Nam v\u00e0 nhi\u1ec1u n\u01b0\u1edbc tr\u00ean th\u1ebf gi\u1edbi \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd \u0111\u00e1y m\u1eaft do chi ph\u00ed r\u1ebb, m\u1ed9t l\u1ecd 100mg\/4ml c\u00f3 th\u1ec3 chia t\u1edbi 10-20 li\u1ec1u ti\u00eam 1.25mg.<\/p>\n
– \u1ede c\u00e1c b\u00e0i sau, ad s\u1ebd \u0111i s\u00e2u h\u01a1n v\u00e0o t\u1eebng ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 m\u1ecdi ng\u01b0\u1eddi c\u00f9ng c\u00e2n nh\u1eafc xem lo\u1ea1i thu\u1ed1c n\u00e0o l\u00e0 h\u1ee3p l\u00fd \u0111\u1ed1i v\u1edbi ch\u1ec9 \u0111\u1ecbnh \u0111\u00f3.<\/p>\n
Nh\u00e0 thu\u1ed1c Chuy\u00ean Khoa M\u1eaft HD H\u00e0 N\u1ed9i kh\u00f4ng b\u00e1n c\u00e1c thu\u1ed1c n\u00e0y m\u00e0 ch\u1ec9 c\u00f3 b\u00ean vi\u1ec7n c\u1ee7a ad cung c\u1ea5p d\u1ecbch v\u1ee5 ti\u00eam n\u1ed9i nh\u00e3n bao g\u1ed3m thu\u1ed1c v\u00e0 s\u1ed1 l\u1ea7n th\u0103m kh\u00e1m sau \u0111\u00f3:<\/p>\n
+ D\u1ecbch v\u1ee5 ti\u00eam Avastine\u00ae li\u1ec1u 1.25mg: 2.200.000\u0111\/ l\u1ea7n. Gi\u00e1 nh\u1eadp thu\u1ed1c (gi\u00e1 tr\u00fang th\u1ea7u to\u00e0n qu\u1ed1c theo ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ung th\u01b0): 8.285.865\/ l\u1ecd 4ml ch\u1ee9a 100mg Bevacizumab c\u1ee7a h\u00e3ng Roche, s\u1ea3n xu\u1ea5t t\u1ea1i \u0110\u1ee9c.<\/p>\n
+ D\u1ecbch v\u1ee5 ti\u00eam Lucentis\u00ae li\u1ec1u 0.5mg: 14.500.000\u0111\/ l\u1ea7n. Gi\u00e1 nh\u1eadp thu\u1ed1c (gi\u00e1 tr\u00fang th\u1ea7u to\u00e0n qu\u1ed1c): 13.125.022\u0111\/ \u1ed1ng 0.165ml ch\u1ee9a 1.65mg Ranibizumab c\u1ee7a h\u00e3ng Novartis, s\u1ea3n xu\u1ea5t t\u1ea1i Th\u1ee5y S\u1ef9.<\/p>\n
+ D\u1ecbch v\u1ee5 ti\u00eam Eylea\u00ae li\u1ec1u 2mg: 30.000.000\u0111\/ l\u1ea7n. Gi\u00e1 k\u00ea khai v\u1edbi C\u1ee5c qu\u1ea3n l\u00fd D\u01b0\u1ee3c: 27.562.500\u0111\/ \u1ed1ng 0.278ml ch\u1ee9a 11.12mg Aflibercept c\u1ee7a h\u00e3ng Bayer, s\u1ea3n xu\u1ea5t t\u1ea1i M\u1ef9.<\/p>\n
+ D\u1ecbch v\u1ee5 ti\u00eam Ozurdex\u00ae li\u1ec1u 0.7mg: 30.000.000\u0111\/l\u1ea7n. Gi\u00e1 k\u00ea khai v\u1edbi C\u1ee5c qu\u1ea3n l\u00fd D\u01b0\u1ee3c: 25.365.000\u0111\/ \u1ed1ng ch\u1ee9a 0.7mg Dexamethason d\u1ea1ng implant gi\u1ea3i ph\u00f3ng ch\u1eadm c\u1ee7a h\u00e3ng Allergan, s\u1ea3n xu\u1ea5t t\u1ea1i Ireland.<\/p>\n
Xin c\u1ea3m \u01a1n qu\u00fd kh\u00e1ch \u0111\u00e3 \u0111\u1ecdc b\u00e0i v\u00e0 mong nh\u1eadn \u0111\u01b0\u1ee3c nhi\u1ec1u s\u1ef1 chia s\u1ebb t\u1eeb m\u1ecdi ng\u01b0\u1eddi.
\nTh\u1ea1c s\u0129 D\u01b0\u1ee3c s\u0129 Tr\u1ea7n H\u1ea3i \u0110\u00f4ng<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
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