{"id":4258,"date":"2017-07-21T13:00:30","date_gmt":"2017-07-21T06:00:30","guid":{"rendered":"https:\/\/yhoccongdong.org\/du-an-khac\/2017\/07\/21\/dieu-tri-hen\/"},"modified":"2024-03-17T02:46:54","modified_gmt":"2024-03-16T19:46:54","slug":"dieu-tri-hen","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/du-an-khac\/dieu-tri-hen\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb hen"},"content":{"rendered":"<p><strong><em>Bi\u00ean d\u1ecbch: DS. Tr\u1ecbnh H\u1ed3ng Nhung<\/em><\/strong><\/p>\n<p><strong><em>Hi\u1ec7u \u0111\u00ednh: TS.BS.V\u00f5 Th\u1ecb H\u00e0 &#8211; Nh\u1ecbp c\u1ea7u d\u01b0\u1ee3c l\u00e2m s\u00e0ng<\/em><\/strong><\/p>\n<h2 id=\"phuong-phap-dieu-tri-hen-suyen\">Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hen suy\u1ec5n<\/h2>\n<p><span style=\"color: #ff0000;\"><strong>CHI\u1ebeN L\u01af\u1ee2C \u0110I\u1ec0U TR\u1eca <\/strong> <\/span><\/p>\n<p>Hen suy\u1ec5n l\u00e0 m\u1ed9t b\u1ec7nh m\u00e3n t\u00ednh \u0111\u00f2i h\u1ecfi ph\u1ea3i ki\u1ec3m so\u00e1t m\u00f4i tr\u01b0\u1eddng s\u1ed1ng c\u00f9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 b\u1eb1ng thu\u1ed1c. Ki\u1ebfn th\u1ee9c v\u1ec1 d\u01b0\u1ee3c l\u00fd c\u1ee7a c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb hen suy\u1ec5n l\u00e0 kh\u00f4ng th\u1ec3 thi\u1ebfu trong vi\u1ec7c h\u1ed7 tr\u1ee3 b\u1ec7nh nh\u00e2n v\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c sai s\u00f3t v\u1ec1 tu\u00e2n th\u1ee7 trong s\u1eed d\u1ee5ng thu\u1ed1c.<\/p>\n<ul>\n<li>M\u1ee5c ti\u00eau c\u1ee7a \u0111i\u1ec1u tr\u1ecb l\u00e0 nh\u1eb1m ki\u1ec3m so\u00e1t t\u1ed1t c\u01a1n hen v\u00e0 \u0111\u1ea3m b\u1ea3o ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng t\u1ed1i \u01b0u (ph\u00f2ng ng\u1eeba c\u00e1c c\u01a1n hen nghi\u00eam tr\u1ecdng, gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng m\u00e3n t\u00ednh gi\u1eefa c\u00e1c c\u01a1n hen v\u00e0 duy tr\u00ec cu\u1ed9c s\u1ed1ng th\u01b0\u1eddng ng\u00e0y).<\/li>\n<li>Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ch\u1ee7 y\u1ebfu d\u1ef1a tr\u00ean ph\u1ed5 bi\u1ebfn ki\u1ebfn th\u1ee9c v\u1ec1 \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n, h\u1ea1n ch\u1ebf c\u00e1c y\u1ebfu t\u1ed1 th\u00fac \u0111\u1ea9y c\u01a1n hen v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c n\u1ebfu c\u01a1n hen suy\u1ec5n tr\u1edf n\u00ean nghi\u00eam tr\u1ecdng.<\/li>\n<\/ul>\n<h3>\u0110i\u1ec1u tr\u1ecb kh\u00f4ng d\u00f9ng thu\u1ed1c<\/h3>\n<p>B\u1ea5t k\u1ec3 b\u1ec7nh hen \u1edf m\u1ee9c \u0111\u1ed9 n\u00e0o, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ch\u1ee7 y\u1ebfu v\u1eabn d\u1ef1a tr\u00ean vi\u1ec7c lo\u1ea1i b\u1ecf c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y d\u1ecb \u1ee9ng (\u0111\u1ed9ng v\u1eadt, th\u1ea3m l\u00f4ng, ve, n\u1ea5m m\u1ed1c), cai nghi\u1ec7n thu\u1ed1c l\u00e1 v\u00e0 c\u00e1c thu\u1ed1c d\u1ec5 g\u00e2y ra c\u01a1n hen (thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid, t\u1ea5t c\u1ea3 c\u00e1c d\u1ea1ng thu\u1ed1c ch\u1eb9n beta, c\u00e1c d\u1eabn ch\u1ea5t c\u1ee7a prostaglandin, thu\u1ed1c tr\u1ecb ho \u2026).<\/p>\n<h3>\u0110i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c<\/h3>\n<p>Khi c\u00e1c bi\u1ec7n ph\u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 ng\u0103n ch\u1eb7n c\u00e1c c\u01a1n hen suy\u1ec5n, c\u1ea7n c\u00e2n nh\u1eafc b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c v\u00e0 vi\u1ec7c n\u00e0y ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh.<br \/>\nC\u1ea7n ph\u00e2n bi\u1ec7t hai d\u1ea1ng \u0111i\u1ec1u tr\u1ecb c\u01a1n hen, \u0111\u00f3 l\u00e0\u00a0:<\/p>\n<ul>\n<li><strong>\u0110i\u1ec1u tr\u1ecb c\u1eaft c\u01a1n: <\/strong> nh\u1eb1m gi\u1ea3m nhanh c\u00e1c tri\u1ec7u ch\u1ee9ng b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n, thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng nhanh<\/li>\n<li><strong>\u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng (\u0111i\u1ec1u tr\u1ecb n\u1ec1n l\u00e2u d\u00e0i): <\/strong> v\u1edbi m\u1ee5c ti\u00eau gi\u1ea3m t\u1ea7n su\u1ea5t v\u00e0 c\u01b0\u1eddng \u0111\u1ed9 c\u1ee7a c\u01a1n hen<\/li>\n<\/ul>\n<p>Vi\u1ec7c ch\u1ecdn l\u1ef1a ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o t\u1eebng tr\u01b0\u1eddng h\u1ee3p.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng ch\u1ec9 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p hen dai d\u1eb3ng (nhi\u1ec1u h\u01a1n 1 c\u01a1n hen m\u1ed7i tu\u1ea7n).<\/p>\n<p><strong>C\u00e1c giai \u0111o\u1ea1n hen <\/strong><\/p>\n<p><strong><em>Hen gi\u00e1n \u0111o\u1ea1n (c\u1ea5p \u0111\u1ed9 I) <\/em><\/strong><\/p>\n<p>Kh\u00f4ng c\u1ea7n thi\u1ebft ph\u1ea3i \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng trong tr\u01b0\u1eddng h\u1ee3p hen gi\u00e1n \u0111o\u1ea1n (\u00edt h\u01a1n 1 c\u01a1n hen m\u1ed7i tu\u1ea7n).<\/p>\n<p><strong><em>Hen nh\u1eb9 dai d\u1eb3ng (c\u1ea5p \u0111\u1ed9 II) <\/em><\/strong><\/p>\n<ul>\n<li>Li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng c\u1ea7n thi\u1ebft ph\u1ea3i s\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y v\u1edbi c\u00e1c thu\u1ed1c corticoid d\u1ea1ng h\u00edt, \u1edf d\u1ea1ng n\u00e0y c\u00e1c ph\u00e2n t\u1eed nh\u1ecf d\u1ec5 d\u00e0ng \u0111i v\u00e0o \u0111\u01b0\u1eddng d\u1eabn kh\u00ed do \u0111\u00f3 cho k\u1ebft qu\u1ea3 t\u1ed1t.<\/li>\n<li>Thu\u1ed1c \u1ee9c ch\u1ebf leukotrien (nh\u01b0 <strong> <em> montelukast <\/em> <\/strong> (bi\u1ec7t d\u01b0\u1ee3c Singulair)) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng c\u00f9ng v\u1edbi corticoid d\u1ea1ng h\u00edt n\u1ebfu \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng ch\u01b0a \u0111\u00e1p \u1ee9ng \u0111\u1ee7 ho\u1eb7c c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng thay th\u1ebf cho corticoide d\u1ea1ng h\u00edt \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb v\u1edbi thu\u1ed1c n\u00e0y, c\u00e1c b\u1ec7nh nh\u00e2n ch\u1ec9 b\u1ecb hen suy\u1ec5n nh\u1eb9 v\u00e0 ch\u01b0a b\u1ecb c\u01a1n hen suy\u1ec5n n\u1eb7ng tr\u01b0\u1edbc \u0111\u00f3.<\/li>\n<li><strong><em>Natri cromoglycate <\/em> <\/strong> (bi\u1ec7t d\u01b0\u1ee3c Lomudal) c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng tuy nhi\u00ean d\u1ea1ng kh\u00ed n\u00e9n aerosol l\u00e0m h\u1ea1n ch\u1ebf vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c n\u00e0y.<\/li>\n<\/ul>\n<p><strong><em>Hen trung b\u00ecnh dai d\u1eb3ng (c\u1ea5p \u0111\u1ed9 III) <\/em><\/strong><\/p>\n<p>Tr\u01b0\u1eddng h\u1ee3p n\u00e0y \u0111\u00f2i h\u1ecfi \u0111i\u1ec1u tr\u1ecb n\u1ec1n k\u1ebft h\u1ee3p hai thu\u1ed1c trong \u0111\u00f3 v\u1eabn gi\u1eef m\u1ed9t thu\u1ed1c corticoid d\u1ea1ng h\u00edt li\u1ec1u cao c\u00f9ng m\u1ed9t thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n. Thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i ho\u1eb7c theophylin (hi\u1ebfm).<\/p>\n<p><strong><em>Hen n\u1eb7ng dai d\u1eb3ng (c\u1ea5p \u0111\u1ed9 IV) <\/em><\/strong><\/p>\n<p>\u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng \u0111\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p n\u00e0y \u0111\u00f2i h\u1ecfi k\u1ebft h\u1ee3p nhi\u1ec1u thu\u1ed1c. \u1ede h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p, b\u1ec7nh nh\u00e2n d\u00f9ng k\u1ebft h\u1ee3p m\u1ed9t thu\u1ed1c corticoid d\u1ea1ng h\u00edt v\u00e0 m\u1ed9t thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i. Ngo\u00e0i ra, c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p th\u00eam m\u1ed9t thu\u1ed1c corticoid \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c theophylline (hi\u1ebfm).<\/p>\n<p><img decoding=\"async\" style=\"width: 620px; height: 425px;\" src=\"\/\/yhoccongdong.org\/Documents\/2853_dieu-tri-hen-theo-muc-do-nghiem-trong-cua-benh.jpg\" alt=\"\u0110i\u1ec1u tr\u1ecb hen theo m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh\" \/><\/p>\n<h2>Ki\u1ec3m so\u00e1t \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng<\/h2>\n<ul>\n<li>Th\u00f4ng th\u01b0\u1eddng, trong tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng cho ph\u00e9p ki\u1ec3m so\u00e1t b\u1ec7nh trong nhi\u1ec1u th\u00e1ng, khuy\u1ebfn c\u00e1o gi\u1ea3m d\u1ea7n li\u1ec1u l\u01b0\u1ee3ng ho\u1eb7c s\u1ed1 l\u01b0\u1ee3ng thu\u1ed1c s\u1eed d\u1ee5ng.<\/li>\n<li>Ng\u01b0\u1ee3c l\u1ea1i, n\u1ebfu c\u01a1n hen kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t, khuy\u1ebfn c\u00e1o t\u0103ng li\u1ec1u thu\u1ed1c corticoid d\u1ea1ng h\u00edt ho\u1eb7c th\u00eam 1 thu\u1ed1c v\u00e0o li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<h3>Tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3<\/h3>\n<p><em>C\u1eaft c\u01a1n hen <\/em><\/p>\n<ul>\n<li>\u0110\u1ec3 c\u1eaft c\u01a1n hen, c\u00e1c thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng ng\u1eafn l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay, ti\u1ebfp \u0111\u1ebfn c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c kh\u00e1ng cholinergic d\u1ea1ng h\u00edt. N\u1ebfu v\u1eabn kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c c\u01a1n hen, c\u1ea7n d\u00f9ng l\u1eb7p l\u1ea1i thu\u1ed1c ch\u1ee7 v\u1eadn beta 2. N\u1ebfu v\u1eabn th\u1ea5t b\u1ea1i th\u00ec c\u1ea7n hi\u1ec3u \u0111\u00e2y c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t c\u01a1n hen c\u1ea5p t\u00ednh nghi\u00eam tr\u1ecdng.<\/li>\n<li>Trong tr\u01b0\u1eddng h\u1ee3p c\u01a1n hen n\u1eb7ng c\u1ea5p t\u00ednh (kh\u00f3 n\u00f3i, ho, v\u00e3 m\u1ed3 h\u00f4i, th\u1edf nhanh, nh\u1ecbp tim nhanh, l\u01b0u l\u01b0\u1ee3ng th\u1edf ra \u0111\u1ec9nh PEF &lt; 30% so v\u1edbi PEF ti\u00ean l\u01b0\u1ee3ng, thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng ng\u1eafn kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3) c\u1ea7n \u0111\u01b0a b\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n kh\u1ea9n c\u1ea5p k\u00e8m theo th\u1edf oxy cao d\u00f2ng (6-8l\/ph\u00fat), s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng ng\u1eafn d\u1ea1ng phun kh\u00ed dung ho\u1eb7c ti\u00eam d\u01b0\u1edbi da v\u00e0 corticoid ti\u00eam \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch.<\/li>\n<\/ul>\n<p><strong><em>\u0110i\u1ec1u tr\u1ecb b\u1ec7nh hen suy\u1ec5n d\u1ecb \u1ee9ng nghi\u00eam tr\u1ecdng <\/em><\/strong><\/p>\n<p>\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n hen suy\u1ec5n d\u1ecb \u1ee9ng dai d\u1eb3ng nghi\u00eam tr\u1ecdng, c\u1ea7n \u00e1p d\u1ee5ng c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb s\u1eed d\u1ee5ng cho hen c\u1ea5p \u0111\u1ed9 III v\u00e0 IV. N\u1ebfu kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3, c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng omalizumab (kh\u00e1ng th\u1ec3 anti-IgE) \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n.<\/p>\n<p><strong><em>\u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng c\u01a1n hen do g\u1eafng s\u1ee9c <\/em><\/strong><\/p>\n<ul>\n<li>\u0110\u1ec3 d\u1ef1 ph\u00f2ng c\u01a1n hen do g\u1eafng s\u1ee9c, \u0111\u1ea7u ti\u00ean c\u1ea7n ph\u1ed5 bi\u1ebfn ki\u1ebfn th\u1ee9c cho b\u1ec7nh nh\u00e2n\u00a0l\u00e0m sao kh\u1edfi \u0111\u1ed9ng \u0111\u00fang c\u00e1ch v\u00e0 t\u1eadp luy\u1ec7n v\u1eeba ph\u1ea3i.<\/li>\n<li>N\u1ebfu d\u1ef1 ph\u00f2ng kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3, c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc k\u1ebft h\u1ee3p \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c. Theo \u0111\u00f3, thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng ng\u1eafn ho\u1eb7c k\u00e9o d\u00e0i \u0111\u01b0\u1ee3c d\u00f9ng tr\u01b0\u1edbc khi t\u1eadp luy\u1ec7n t\u1eeb 15 \u0111\u1ebfn 30 ph\u00fat (v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao tr\u00ean 60 ph\u00fat m\u1ed7i ng\u00e0y).<\/li>\n<li>Ch\u1ebf ph\u1ea9m k\u1ebft h\u1ee3p m\u1ed9t thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 v\u00e0 m\u1ed9t thu\u1ed1c kh\u00e1ng cholinergic \u0111\u01b0\u1ee3c l\u01b0u h\u00e0nh tr\u00ean th\u1ecb tr\u01b0\u1eddng d\u01b0\u1edbi t\u00ean bi\u1ec7t d\u01b0\u1ee3c Bronchodual c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng c\u01a1n hen do g\u1eafng s\u1ee9c.<\/li>\n<li><strong><em>Montelukast\u00a0v\u00e0\u00a0natri cromoglicate <\/em> <\/strong> c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 d\u1ef1 ph\u00f2ng trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y.<\/li>\n<\/ul>\n<h2><span style=\"color: #ff0000;\"><strong>TH\u00d4NG TIN C\u1eacP NH\u1eacT <\/strong> <\/span><\/h2>\n<h3>C\u00e1c thu\u1ed1c r\u00fat kh\u1ecfi th\u1ecb tr\u01b0\u1eddng Ph\u00e1p<\/h3>\n<p>C\u00e1c thu\u1ed1c Beclone ( <strong> <em> beclometason <\/em> <\/strong> ), Buventol h\u00edt <em> <strong> (salbutamol <\/strong> <\/em> ), Maxair t\u1ef1 \u0111\u1ed9ng <em> ( <strong> pirbuterol) <\/strong> <\/em> , Ventodisk <strong> <em> (salbutamol) <\/em> <\/strong> kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c l\u01b0u h\u00e0nh tr\u00ean th\u1ecb tr\u01b0\u1eddng.<br \/>\nRi\u00eang v\u1edbi Pulmicort <strong> <em> (budesonid) <\/em> <\/strong> ch\u1ec9 d\u1ea1ng h\u1ed7n d\u1ecbch (100 v\u00e0 200 \u03bcg) b\u1ecb r\u00fat kh\u1ecfi th\u1ecb tr\u01b0\u1eddng. T\u1ea5t c\u1ea3 c\u00e1c d\u1ea1ng ch\u1ebf ph\u1ea9m b\u1ed9t (Turbuhaler 100, 200, 400 \u03bcg) v\u1eabn ti\u1ebfp t\u1ee5c \u0111\u01b0\u1ee3c l\u01b0u h\u00e0nh.<\/p>\n<h3>C\u00e1c thu\u1ed1c m\u1edbi l\u01b0u h\u00e0nh<\/h3>\n<ul>\n<li>T\u1eeb ng\u00e0y 22\/03\/2011, Xolair (omalizumab) \u0111\u01b0\u1ee3c chi tr\u1ea3 b\u1edfi b\u1ea3o hi\u1ec3m cho t\u1ea5t c\u1ea3 c\u00e1c ch\u1ec9 \u0111\u1ecbnh \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p v\u1edbi b\u1ea5t k\u00ec n\u1ed3ng \u0111\u1ed9 Ig E n\u00e0o c\u1ee7a b\u1ec7nh nh\u00e2n \u0111o \u0111\u01b0\u1ee3c.<\/li>\n<li>Ngo\u00e0i ra, li\u1ec1u t\u1ed1i \u0111a theo khuy\u1ebfn c\u00e1o \u0111\u00e3 \u0111\u01b0\u1ee3c xem x\u00e9t l\u1ea1i v\u00e0 n\u00e2ng t\u1eeb 375mg l\u00ean 600mg m\u1ed7i 2 tu\u1ea7n.<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong>C\u00c1C THU\u1ed0C S\u1eec D\u1ee4NG TRONG \u0110I\u1ec0U TR\u1eca <\/strong> <\/span><\/p>\n<p><strong>C\u1eaft c\u01a1n hen <\/strong><\/p>\n<p><strong>C\u00e1c thu\u1ed1c ch\u1ee7 v\u1eadn beta th\u1eddi gian t\u00e1c d\u1ee5ng ng\u1eafn <\/strong><\/p>\n<ul>\n<li>\u0110\u00e2y l\u00e0 li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u tay nh\u1eb1m c\u1eaft c\u01a1n hen. C\u00e1c thu\u1ed1c n\u00e0y l\u00e0m gi\u00e3n ph\u1ebf qu\u1ea3n sau v\u00e0i ph\u00fat v\u00e0 t\u00e1c d\u1ee5ng c\u00f3 th\u1ec3 k\u00e9o d\u00e0i \u0111\u1ebfn 4 gi\u1edd.<\/li>\n<li>C\u00e1c thu\u1ed1c ch\u1ee7 v\u1eadn beta t\u00e1c d\u1ee5ng ng\u1eafn l\u00e0 nh\u1eefng ho\u1ea1t ch\u1ea5t \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t, c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p l\u00e0 t\u0103ng nh\u1ecbp tim, \u0111\u1eb7c bi\u1ec7t n\u1ebfu d\u00f9ng l\u1eb7p l\u1ea1i nhi\u1ec1u l\u1ea7n ho\u1eb7c run chi.<\/li>\n<\/ul>\n<p>C\u00e1c thu\u1ed1c kh\u00e1ng cholinergic d\u1ea1ng h\u00edt<\/p>\n<ul>\n<li><em><strong>Ipratropium <\/strong> <\/em> d\u1ea1ng h\u00edt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng c\u1ee7a c\u00e1c c\u01a1n hen tr\u1ea7m tr\u1ecdng ho\u1eb7c h\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng nhanh d\u1ea1ng h\u00edt. Trong \u0111\u1ee3t k\u1ecbch ph\u00e1t nghi\u00eam tr\u1ecdng ho\u1eb7c c\u01a1n hen c\u1ea5p t\u00ednh n\u1eb7ng, <strong> <em> ipratropium <\/em> <\/strong> c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng qua m\u00e1y kh\u00ed dung \u0111\u1ec3 h\u1ea1n ch\u1ebf c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 h\u00f4 h\u1ea5p, \u0111\u1eb7c bi\u1ec7t l\u00e0 v\u1edbi b\u1ec7nh nhi.<\/li>\n<li><em><strong>Ipratropium <\/strong> <\/em> l\u00e0 m\u1ed9t ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 cholinergic t\u00e1c d\u1ee5ng \u1edf kh\u00ed qu\u1ea3n, t\u00e1c d\u1ee5ng l\u00e0m gi\u00e3n kh\u00ed qu\u1ea3n k\u00e9m h\u01a1n so v\u1edbi thu\u1ed1c ch\u1ee7 v\u1eadn beta 2. T\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c n\u00e0y kh\u00e1 nhanh v\u00e0 c\u00f3 th\u1ec3 k\u00e9o d\u00e0i t\u1eeb 4 \u0111\u1ebfn 6 gi\u1edd \u0111\u1ed3ng h\u1ed3.<\/li>\n<li>C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 g\u1eb7p l\u00e0 c\u00e1c t\u00e1c d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 atropin (b\u00ed ti\u1ec3u, t\u00e1o b\u00f3n, c\u00e1c r\u1ed1i lo\u1ea1n v\u1ec1 m\u1eaft). Tuy nhi\u00ean, t\u00e1c d\u1ee5ng t\u1ea1i ch\u1ed7 m\u1edbi l\u00e0 ph\u1ed5 bi\u1ebfn nh\u1ea5t v\u00e0 th\u01b0\u1eddng l\u00e0 kh\u00f4 mi\u1ec7ng h\u1ecdng. M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p b\u1ecb co th\u1eaft ph\u1ebf qu\u1ea3n \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. Trong tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec3 thu\u1ed1c d\u00ednh v\u00e0o m\u1eaft, c\u00f3 th\u1ec3 x\u1ea3y ra ph\u1ea3n \u1ee9ng gi\u00e3n \u0111\u1ed3ng t\u1eed v\u00e0 glaucoma g\u00f3c \u0111\u00f3ng.<\/li>\n<\/ul>\n<p><strong>\u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng <\/strong><\/p>\n<p><strong>C\u00e1c thu\u1ed1c corticoid d\u1ea1ng h\u00edt <\/strong><\/p>\n<ul>\n<li>T\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c thu\u1ed1c corticoide d\u1ea1ng h\u00edt \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh qua nhi\u1ec1u th\u1eed nghi\u1ec7m c\u00f3 m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng cao. Thu\u1ed1c n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng \u1edf c\u00e1c b\u1ec7nh nh\u00e2n hen dai d\u1eb3ng.<\/li>\n<li>C\u00e1c thu\u1ed1c corticoid d\u1ea1ng h\u00edt \u0111\u00f2i h\u1ecfi s\u1eed d\u1ee5ng h\u00e0ng ng\u00e0y. Thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng, kh\u1ea3 n\u0103ng h\u00f4 h\u1ea5p v\u00e0 t\u1ea7n su\u1ea5t c\u01a1n hen \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang \u0111\u01b0\u1ee3c ch\u1eefa tr\u1ecb b\u1eb1ng m\u1ed9t thu\u1ed1c ch\u1ed1ng vi\u00eam \u1edf ph\u1ebf qu\u1ea3n. Th\u1eddi gian k\u00e9o d\u00e0i t\u00e1c d\u1ee5ng c\u00f3 th\u1ec3 k\u00e9o d\u00e0i t\u1eeb m\u1ed9t v\u00e0i ng\u00e0y \u0111\u1ebfn v\u00e0i tu\u1ea7n.<\/li>\n<\/ul>\n<p>V\u1ec1 c\u01a1 b\u1ea3n, c\u00e1c thu\u1ed1c corticoid d\u1ea1ng h\u00edt \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t, t\u00e1c d\u1ee5ng ph\u1ee5 ch\u1ee7 y\u1ebfu th\u01b0\u1eddng g\u1eb7p t\u1ea1i ch\u1ed7 (n\u1ea5m candida h\u1ecdng, kh\u00e0n gi\u1ecdng, \u0111au h\u1ecdng) v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng n\u00e0y s\u1ebd \u0111\u01b0\u1ee3c ng\u0103n ch\u1eb7n b\u1eb1ng c\u00e1ch s\u00fac mi\u1ec7ng sau khi s\u1eed d\u1ee5ng thu\u1ed1c.<\/p>\n<p><strong>C\u00e1c thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i <\/strong><\/p>\n<ul>\n<li>C\u00e1c thu\u1ed1c n\u00e0y c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m gi\u00e3n ph\u1ebf qu\u1ea3n k\u00e9o d\u00e0i trong 12h.<\/li>\n<li>\u0110\u01b0\u1ee3c d\u00f9ng h\u00e0ng ng\u00e0y d\u01b0\u1edbi d\u1ea1ng h\u00edt ho\u1eb7c u\u1ed1ng (Bricanyl LP, Oxeol). Tuy nhi\u00ean, d\u1ea1ng vi\u00ean n\u00e9n u\u1ed1ng c\u00f3 t\u1ef7 l\u1ec7 l\u1ee3i \u00edch\/nguy c\u01a1 th\u1ea5p h\u01a1n d\u1ea1ng h\u00edt do \u0111\u00f3 \u00edt \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n. Tuy nhi\u00ean, c\u00e1c thu\u1ed1c d\u1ea1ng n\u00e0y l\u1ea1i c\u00f3 l\u1ee3i th\u1ebf nh\u1ea5t \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n cao tu\u1ed5i c\u00f3 nh\u1eefng v\u1ea5n \u0111\u1ec1 v\u1ec1 ph\u1ed1i h\u1ee3p tay v\u00e0 mi\u1ec7ng.<\/li>\n<li>C\u00e1c ho\u1ea1t ch\u1ea5t n\u00e0y <strong> kh\u00f4ng bao gi\u1edd \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u01a1n \u0111\u1ed9c <\/strong> \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng b\u1ec7nh hen v\u00ec c\u00e1c thu\u1ed1c n\u00e0y n\u1ebfu d\u00f9ng \u0111\u01a1n \u0111\u1ed9c l\u00e0m t\u0103ng nguy c\u01a1 nh\u1eadp vi\u1ec7n v\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong so v\u1edbi d\u00f9ng gi\u1ea3 d\u01b0\u1ee3c. Khi \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p v\u1edbi m\u1ed9t thu\u1ed1c corticoid d\u1ea1ng h\u00edt, c\u00e1c thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 t\u0103ng ch\u1ee9c n\u0103ng ph\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 gi\u1ea3m s\u1ed1 l\u1ea7n x\u1ea3y ra c\u00e1c c\u01a1n k\u1ecbch ph\u00e1t c\u1ee7a b\u1ec7nh. D\u1ea1ng k\u1ebft h\u1ee3p n\u00e0y c\u0169ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o khi corticoid d\u1ea1ng h\u00edt kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 \u0111\u00e1p \u1ee9ng. C\u00e1c ch\u1ebf ph\u1ea9m k\u1ebft h\u1ee3p m\u1ed9t corticoid v\u00e0 m\u1ed9t thu\u1ed1c ch\u1ee7 v\u1eadn beta 2 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i do \u0111\u00f3 c\u0169ng \u0111\u01b0\u1ee3c l\u01b0u h\u00e0nh tr\u00ean th\u1ecb tr\u01b0\u1eddng. C\u00e1c thu\u1ed1c n\u00e0y c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 s\u1ef1 tu\u00e2n th\u1ee7 c\u1ee7a b\u1ec7nh nh\u00e2n do gi\u1ea3m s\u1ed1 l\u1ea7n s\u1eed d\u1ee5ng trong ng\u00e0y.<\/li>\n<li>C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 t\u0103ng nh\u1ecbp tim, run r\u1ea9y chi, chu\u1ed9t r\u00fat, h\u1ea1 kali m\u00e1u v\u00e0\/ho\u1eb7c r\u1ed1i lo\u1ea1n \u0111\u01b0\u1eddng huy\u1ebft n\u1ebfu s\u1eed d\u1ee5ng li\u1ec1u cao.<\/li>\n<\/ul>\n<p><strong>C\u00e1c montelukast <\/strong><\/p>\n<ul>\n<li><em><strong>Montelukast <\/strong> <\/em> (bi\u1ec7t d\u01b0\u1ee3c Singulair) l\u00e0 h\u1ee3p ch\u1ea5t \u1ee9c ch\u1ebf leukotrien d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng l\u00e0m gi\u1ea3m vi\u00eam ph\u1ebf qu\u1ea3n. Hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c n\u00e0y th\u1ea5p h\u01a1n corticoide d\u1ea1ng h\u00edt v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t \u0111\u01a1n tr\u1ecb li\u1ec7u \u1edf b\u1ec7nh nh\u00e2n hen dai d\u1eb3ng m\u1ee9c \u0111\u1ed9 trung b\u00ecnh.<\/li>\n<li>T\u00e1c d\u1ee5ng ph\u1ee5 r\u1ea5t hi\u1ebfm g\u1eb7p th\u01b0\u1eddng l\u00e0 \u0111au \u0111\u1ea7u ho\u1eb7c r\u1ed1i lo\u1ea1n ti\u00eau ho\u00e1 nh\u1eb9. Tuy nhi\u00ean, v\u00e0o th\u00e1ng 6\/2011, m\u1ed9t trung t\u00e2m c\u1ea3nh gi\u00e1c d\u01b0\u1ee3c \u1edf T\u00e2y Ban Nha \u0111\u00e3 c\u1ea3nh b\u00e1o c\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m l\u00fd ti\u1ec1m t\u00e0ng m\u00e0 <strong> <em> montelukast <\/em> <\/strong> c\u00f3 th\u1ec3 g\u00e2y ra (b\u1ed3n ch\u1ed3n, m\u1ea5t ng\u1ee7, th\u01b0\u1eddng xuy\u00ean g\u1eb7p \u00e1c m\u1ed9ng, \u1ea3o gi\u00e1c v\u00e0 th\u00edch g\u00e2y h\u1ea5n).<\/li>\n<\/ul>\n<p><strong>C\u00e1c cromone <\/strong><\/p>\n<p><em><strong>Natri cromoglycate <\/strong> <\/em> (bi\u1ec7t d\u01b0\u1ee3c Lomudal) c\u00f3 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng hen kh\u00e1 t\u1ed1t. Thu\u1ed1c n\u00e0y \u1ee9c ch\u1ebf gi\u1ea3i ph\u00f3ng c\u1ee7a t\u1ebf b\u00e0o mast v\u00e0 c\u00e1c ch\u1ea5t trung gian g\u00e2y vi\u00eam \u2013 k\u1ebft qu\u1ea3 thu \u0111\u01b0\u1ee3c t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1c thu\u1ed1c corticosteroid d\u1ea1ng h\u00edt. Natri cromolyn \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i b\u1ec7nh hen dai d\u1eb3ng d\u1ea1ng nh\u1eb9. Tuy nhi\u00ean, thu\u1ed1c n\u00e0y \u00edt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u00ec \u0111\u01b0\u1ee3c l\u01b0u h\u00e0nh tr\u00ean th\u1ecb tr\u01b0\u1eddng d\u01b0\u1edbi h\u00ecnh th\u1ee9c thu\u1ed1c x\u1ecbt kh\u00ed n\u00e9n.<\/p>\n<p>C\u00e1c ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i hi\u1ebfm g\u1eb7p \u1edf m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p l\u00e0 b\u00ed ti\u1ec3u ho\u1eb7c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng tr\u00ean da \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o.<\/p>\n<p><strong>Theophylline <\/strong><\/p>\n<p><span style=\"line-height: 1.6em;\">\u0110\u00e2y l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn b\u1ed5 sung trong \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng b\u1eb1ng corticoid. Theophylline (Dilatrane, Theostat\u2026) l\u00e0 m\u1ed9t thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n d\u1ea1ng u\u1ed1ng cho ph\u00e9p c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng c\u1ee7a ph\u1ed5i v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng. <\/span><\/p>\n<p>Tuy nhi\u00ean, do kho\u1ea3ng \u0111i\u1ec1u tr\u1ecb h\u1eb9p n\u00ean vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c n\u00e0y b\u1ecb h\u1ea1n ch\u1ebf v\u00ec c\u00e1c t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i v\u00e0 c\u00e1c t\u01b0\u01a1ng t\u00e1c thu\u1ed1c c\u00f3 th\u1ec3 x\u1ea3y ra. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a thu\u1ed1c l\u00e0 r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7, ch\u00e1n \u0103n, h\u01b0ng ph\u1ea5n, t\u0103ng nh\u1ecbp tim, n\u1ebfu d\u00f9ng qu\u00e1 li\u1ec1u c\u00f3 th\u1ec3 g\u00e2y ra co gi\u1eadt.<\/p>\n<p><strong>Omalizumab <\/strong><\/p>\n<ul>\n<li><strong><em>Omalizumab <\/em> <\/strong> l\u00e0 m\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng g\u1eafn v\u1edbi IgE trong huy\u1ebft thanh, y\u1ebfu t\u1ed1 quan tr\u1ecdng c\u1ee7a m\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng d\u1ecb \u1ee9ng th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n<\/li>\n<li><em><strong>Omalizumab <\/strong> <\/em> \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb hen suy\u1ec5n d\u1ecb \u1ee9ng nghi\u00eam tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n t\u1eeb 6 tu\u1ed5i tr\u1edf l\u00ean b\u1eb1ng \u0111\u01b0\u1eddng ti\u00eam d\u01b0\u1edbi da. Li\u1ec1u l\u01b0\u1ee3ng v\u00e0 t\u1ea7n su\u1ea5t ti\u00eam (m\u1ed7i 2-4 tu\u1ea7n) \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh d\u1ef1a tr\u00ean c\u00e2n n\u1eb7ng c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 n\u1ed3ng \u0111\u1ed9 IgE.<\/li>\n<li>C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 x\u1ea3y ra bao g\u1ed3m: s\u1ed1t, ph\u1ea3n \u1ee9ng t\u1ea1i ch\u1ed7 ti\u00eam, ph\u00e1t ban. M\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 hi\u1ebfm g\u1eb7p nh\u01b0ng nghi\u00eam tr\u1ecdng kh\u00e1c c\u0169ng \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o, \u0111\u00f3 l\u00e0: gi\u1ea3m ti\u1ec3u c\u1ea7u n\u1eb7ng, s\u1ed1c ph\u1ea3n v\u1ec7 ho\u1eb7c thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u01a1 tim.<\/li>\n<\/ul>\n<p><strong>Tri\u1ec3n v\u1ecdng m\u1edbi trong \u0111i\u1ec1u tr\u1ecb <\/strong><\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 \u0111i\u1ec1u tr\u1ecb hen suy\u1ec5n r\u1ea5t \u0111\u01b0\u1ee3c quan t\u00e2m.<\/p>\n<ul>\n<li>R\u1ea5t nhi\u1ec1u kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng kh\u00e1ng trung gian g\u00e2y vi\u00eam hi\u1ec7n \u0111ang \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng b\u1ec7nh hen n\u1eb7ng, v\u00ed d\u1ee5\u00a0: <strong> MEDI-527 <\/strong> (kh\u00e1ng interleukin-9) v\u00e0 <em> <strong> mepolizumab <\/strong> <\/em> (kh\u00e1ng interleukin-5).<\/li>\n<li>Nh\u1eefng ch\u1ea5t kh\u00e1ng TNF-alpha (nh\u01b0 <em> <strong> infliximab <\/strong> <\/em> ho\u1eb7c <strong> <em> etanercept <\/em> <\/strong> ) c\u0169ng \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u trong ch\u1ec9 \u0111\u1ecbnh n\u00e0y c\u0169ng nh\u01b0 c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf phosphodiesterase type 4. C\u00e1c ho\u1ea1t ch\u1ea5t n\u00e0y cho ph\u00e9p h\u1ea1n ch\u1ebf t\u00ecnh tr\u1ea1ng vi\u00eam trong t\u1ebf b\u00e0o b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf c\u00e1c enzym tham gia v\u00e0o qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a c\u1ee7a AMP v\u00e0 GMP.<\/li>\n<\/ul>\n<p><img decoding=\"async\" style=\"width: 620px; height: 310px;\" src=\"\/\/yhoccongdong.org\/Documents\/2854_cac-thuoc-chong-chi-dinh-ket-hop-voi-theophyline.jpg\" alt=\"C\u00e1c thu\u1ed1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh k\u1ebft h\u1ee3p v\u1edbi theophyline\" \/><\/p>\n<p><strong>* Bu\u1ed3ng h\u00edt: thi\u1ebft b\u1ecb trung gian gi\u1eefa b\u00ecnh x\u1ecbt thu\u1ed1c v\u00e0 mi\u1ec7ng. <\/strong><\/p>\n<h2 id=\"\"><img decoding=\"async\" style=\"width: 300px; height: 170px;\" src=\"\/\/yhoccongdong.org\/Documents\/2855_buong-hit.jpg\" alt=\"Bu\u1ed3ng h\u00edt\" \/><\/p>\n<p>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb hen suy\u1ec5n<\/h2>\n<p><strong>Corticosteroid <\/strong><\/p>\n<p>C\u00e1c ch\u1ea5t n\u00e0y x\u00e2m nh\u1eadp v\u00e0o c\u00e1c t\u1ebf b\u00e0o ph\u1ebf qu\u1ea3n v\u00e0 k\u00edch ho\u1ea1t th\u1ee5 th\u1ec3 c\u1ee7a glucocorticoid v\u00e0 \u1ee9c ch\u1ebf s\u1ef1 t\u1ed5ng h\u1ee3p c\u1ee7a c\u00e1c ph\u00e2n t\u1eed g\u00e2y vi\u00eam (interleukin, TNF-alpha, cytokine, leukotrienes &#8230;). Do \u0111\u00f3, corticosteroid c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p.<\/p>\n<p><strong>Omalizumab <\/strong><\/p>\n<p>Thu\u1ed1c li\u00ean k\u1ebft v\u1edbi IgE, do \u0111\u00f3 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 IgE t\u1ef1 do v\u1ed1n c\u00f3 th\u1ec3 k\u00edch ho\u1ea1t m\u1ed9t ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng.<\/p>\n<p><strong>C\u00e1c cromone <\/strong><\/p>\n<p>C\u00e1c ch\u1ea5t n\u00e0y \u1ee9c ch\u1ebf s\u1ef1 gi\u1ea3i ph\u00f3ng c\u1ee7a t\u1ebf b\u00e0o mast v\u00e0 c\u00e1c ch\u1ea5t trung gian g\u00e2y vi\u00eam. Do \u0111\u00f3 c\u00e1c ch\u1ea5t n\u00e0y c\u00f3 t\u00e1c d\u1ee5ng kh\u00e1ng vi\u00eam.<\/p>\n<p><strong>Montelukast <\/strong><\/p>\n<p>\u0110\u00e2y l\u00e0 m\u1ed9t ch\u1ea5t \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 leukotrien nang-LT1.\u00a0Montelukast\u00a0c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf co th\u1eaft ph\u1ebf qu\u1ea3n, vi\u00eam ph\u1ebf qu\u1ea3n v\u00e0 t\u0103ng ti\u1ebft d\u1ecbch g\u00e2y ra b\u1edfi leukotrien.<\/p>\n<p><strong>C\u00e1c ch\u1ea5t ch\u1ee7 v\u1eadn beta 2 <\/strong><\/p>\n<p>\u0110\u00e2y l\u00e0 c\u00e1c ch\u1ea5t ch\u1ee7 v\u1eadn tr\u1ef1c ti\u1ebfp v\u00e0 ch\u1ecdn l\u1ecdc c\u00e1c th\u1ee5 th\u1ec3 \u03b2 adrenergic ph\u1ebf qu\u1ea3n. K\u00edch th\u00edch c\u00e1c th\u1ee5 th\u1ec3 trong chu tr\u00ecnh t\u1ed5ng h\u1ee3p AMP v\u00f2ng v\u00e0 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 n\u1ed9i b\u00e0o c\u1ee7a canxi do \u0111\u00f3 g\u00e2y gi\u00e3n c\u01a1 tr\u01a1n ph\u1ebf qu\u1ea3n v\u00e0 gi\u00e3n ph\u1ebf qu\u1ea3n.<\/p>\n<p><strong>Theophylline <\/strong><\/p>\n<p>L\u00e0m gi\u00e3n c\u01a1 tr\u01a1n ph\u1ebf qu\u1ea3n do \u0111\u00f3 l\u00e0m gi\u00e3n ph\u1ebf qu\u1ea3n.<\/p>\n<p><strong>Thu\u1ed1c kh\u00e1ng cholinergic <\/strong><\/p>\n<p>C\u00e1c thu\u1ed1c n\u00e0y ch\u1eb7n th\u1ee5 th\u1ec3 cholinergic tr\u00ean c\u01a1 tr\u01a1n ph\u1ebf qu\u1ea3n do \u0111\u00f3 c\u00f3 t\u00e1c d\u1ee5ng gi\u00e3n ph\u1ebf qu\u1ea3n<\/p>\n<p><span style=\"color: #ff0000;\"><strong>GI\u00c1M S\u00c1T <\/strong> <\/span><\/p>\n<p>M\u1ed9t v\u00e0i ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh li\u00ean quan \u0111\u1ebfn thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n d\u1ea1ng u\u1ed1ng \u0111\u00e3 \u0111\u01b0\u1ee3c bi\u1ebft, \u0111\u00f3 l\u00e0\u00a0:<\/p>\n<ul>\n<li>Theophylin\u00a0: tr\u1ebb d\u01b0\u1edbi 30 th\u00e1ng<\/li>\n<li>Bambuterol\u00a0d\u1ea1ng u\u1ed1ng\u00a0: tr\u1ebb d\u01b0\u1edbi 15 tu\u1ed5i, ph\u1ee5 n\u1eef c\u00f3 thai, cho con b\u00fa<\/li>\n<li>Terbutaline\u00a0d\u1ea1ng u\u1ed1ng\u00a0: tr\u1ebb d\u01b0\u1edbi 5 tu\u1ed5i<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong>H\u1ed6 TR\u1ee2 B\u1ec6NH NH\u00c2N <\/strong> <\/span><\/p>\n<p><strong>C\u00f4 C. l\u00e0 m\u1eb9 c\u1ee7a T. (nam, 16 tu\u1ed5i) b\u1ecb b\u1ec7nh hen suy\u1ec5n <\/strong><\/p>\n<p>\u00ab\u00a0Con t\u00f4i b\u1eaft \u0111\u1ea7u b\u1ecb vi\u00eam ph\u1ebf qu\u1ea3n v\u00e0 sau \u0111\u00f3 l\u00e0 hen suy\u1ec5n. V\u00e0o n\u0103m 8 tu\u1ed5i, ch\u00e1u \u0111\u00e3 b\u1ecb l\u00ean c\u01a1n hen do d\u1ecb \u1ee9ng ph\u1ea5n hoa. C\u00e1c c\u01a1n hen th\u01b0\u1eddng x\u1ea3y ra v\u00e0o ban \u0111\u00eam n\u00ean t\u00f4i r\u1ea5t lo l\u1eafng.\u00a0\u00a0Ch\u00e1u th\u01b0\u1eddng c\u1ea3m th\u1ea5y kh\u00f3 th\u1edf v\u00e0 c\u1ea3m gi\u00e1c nh\u01b0 l\u1eeda \u0111\u1ed1t trong ph\u1ed5i. Khi c\u01a1n hen x\u1ea3y ra, Ventolin ho\u00e0n to\u00e0n kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng. T\u00f4i \u0111\u00e3 ph\u1ea3i \u0111\u01b0a T. \u0111i c\u1ea5p c\u1ee9u v\u00e0 ch\u00e1u ph\u1ea3i n\u1eb1m vi\u1ec7n 5 ng\u00e0y. T\u00f4i th\u1ef1c s\u1ef1 c\u1ea3m th\u1ea5y s\u1ee3 v\u00ec t\u00ecnh tr\u1ea1ng c\u1ee7a ch\u00e1u kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n nhanh ch\u00f3ng. T\u00f4i lu\u00f4n theo d\u00f5i c\u1ea3nh b\u00e1o v\u1ec1 c\u00e1c \u0111\u1ee3t ph\u1ea5n hoa \u0111\u1ec3 ph\u00f2ng ng\u1eeba vi\u1ec7c l\u00ean c\u01a1n hen c\u1ee7a ch\u00e1u. \u0110\u1ebfn nay, con t\u00f4i ch\u1ec9 ph\u1ea3i \u0111i\u1ec1u tr\u1ecb trong th\u1eddi gian c\u00f3 ti\u1ebfp x\u00fac v\u1edbi ph\u1ea5n hoa. Ch\u00e1u c\u0169ng c\u00f3 th\u1ec3 b\u1ecb l\u00ean c\u01a1n hen khi qu\u00e1 g\u1eafng s\u1ee9c nh\u01b0ng ch\u00e1u bi\u1ebft \u0111i\u1ec1u n\u00e0y\u00a0\u00bb<\/p>\n<p><strong>B\u1ec7nh hen suy\u1ec5n d\u01b0\u1edbi g\u00f3c \u0111\u1ed9 c\u1ee7a b\u1ec7nh nh\u00e2n <\/strong><\/p>\n<p><em>T\u00e1c \u0111\u1ed9ng v\u1ec1 th\u1ec3 ch\u1ea5t <\/em><\/p>\n<p>B\u1ec7nh hen kh\u00f3 ki\u1ec3m so\u00e1t c\u00f3 th\u1ec3 l\u00e0m h\u1ea1n ch\u1ebf c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 l\u1ef1c do \u0111\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng.<\/p>\n<p><em>T\u00e1c \u0111\u1ed9ng v\u1ec1 t\u00e2m l\u00fd <\/em><\/p>\n<p>B\u1ec7nh hen n\u1eb7ng c\u00f3 th\u1ec3 g\u00e2y lo l\u1eafng cho b\u1ec7nh\u00a0\u00a0nh\u00e2n v\u00e0 ng\u01b0\u1eddi th\u00e2n. C\u00e1c b\u1ec7nh nh\u00e2n th\u01b0\u1eddng ph\u1ea3i h\u1ea1n ch\u1ebf \u0111i du l\u1ecbch do s\u1ee3 l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam b\u1ec7nh hen suy\u1ec5n c\u1ee7a h\u1ecd.<\/p>\n<p><em>T\u00e1c \u0111\u1ed9ng v\u1ec1 m\u1eb7t x\u00e3 h\u1ed9i <\/em><\/p>\n<p>B\u1ec7nh hen c\u00f3 th\u1ec3 khi\u1ebfn b\u1ec7nh nh\u00e2n ph\u1ea3i s\u1eed d\u1ee5ng th\u01b0\u1eddng xuy\u00ean thu\u1ed1c v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 khi c\u01a1n hen x\u1ea3y ra. \u0110i\u1ec1u n\u00e0y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00ecnh \u1ea3nh c\u1ee7a h\u1ecd v\u1edbi ng\u01b0\u1eddi kh\u00e1c. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng c\u00f3 xu h\u01b0\u1edbng t\u1ef1 ngh\u1ec9 vi\u1ec7c. B\u1ec7nh hen kh\u00f3 ki\u1ec3m so\u00e1t c\u00f3 th\u1ec3 l\u00e0 l\u00fd do c\u1ee7a vi\u1ec7c ngh\u1ec9 h\u1ecdc v\u00e0 ngh\u1ec9 vi\u1ec7c c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n<p><strong>T\u01b0 v\u1ea5n cho b\u1ec7nh nh\u00e2n <\/strong><\/p>\n<p><em>V\u1ec1 b\u1ec7nh hen <\/em><\/p>\n<ul>\n<li>\u0110\u1ec3 ki\u1ec3m so\u00e1t t\u1ed1t b\u1ec7nh hen, b\u1ec7nh nh\u00e2n c\u1ea7n ph\u1ea3i bi\u1ebft v\u00e0 hi\u1ec3u c\u00e1c m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb do b\u00e1c s\u0129 \u0111\u1ec1 ra v\u00e0 c\u00f3 th\u1ec3 nh\u1eadn bi\u1ebft khi c\u00e1c d\u1ea5u hi\u1ec7u x\u1ea5u \u0111i (t\u0103ng t\u1ea7n s\u1ed1 xu\u1ea5t hi\u1ec7n c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng v\u1ec1 \u0111\u00eam, ph\u1ea3i t\u0103ng li\u1ec1u thu\u1ed1c ch\u1ee7 v\u1eadn beta t\u00e1c d\u1ee5ng nhanh, c\u00f3 d\u00e2u hi\u1ec7u kh\u00f2 kh\u00e8 \u2026)<\/li>\n<li>M\u1ed9t c\u01a1n hen c\u1ea7n ph\u1ea3i d\u00f9ng qu\u00e1 6 nh\u00e1t x\u1ecbt thu\u1ed1c ch\u1ee7 v\u1eadn beta t\u00e1c d\u1ee5ng nhanh c\u00f3 th\u1ec3 l\u00e0 c\u01a1n hen c\u1ea5p nghi\u00eam tr\u1ecdng c\u1ea7n ph\u1ea3i \u0111\u01b0a \u0111i c\u1ea5p c\u1ee9u.<\/li>\n<li>\u0110\u1ec1 ngh\u1ecb b\u1ec7nh nh\u00e2n mua m\u00e1y \u0111o c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u0111\u1ec3 t\u1ef1 ki\u1ec3m tra th\u01b0\u1eddng xuy\u00ean ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p ho\u1eb7c trong giai \u0111o\u1ea1n c\u1ea5p c\u1ee7a b\u1ec7nh (nh\u01b0 m\u00e1y \u0111o l\u01b0u l\u01b0\u1ee3ng th\u1edf ra \u0111\u1ec9nh) .<\/li>\n<li>Th\u00f4ng b\u00e1o cho b\u1ed1 m\u1eb9 c\u1ee7a tr\u1ebb c\u00f3 th\u1ec3 th\u00f4ng b\u00e1o v\u1edbi tr\u01b0\u1eddng h\u1ecdc v\u1ec1 t\u00ecnh tr\u1ea1ng c\u1ee7a tr\u1ebb \u0111\u1ec3 c\u00f3 ch\u1ebf \u0111\u1ed9 sinh ho\u1ea1t t\u1ea1i tr\u01b0\u1eddng ph\u00f9 h\u1ee3p cho tr\u1ebb b\u1ecb hen.<\/li>\n<\/ul>\n<p><em>V\u1ec1 \u0111i\u1ec1u tr\u1ecb <\/em><\/p>\n<ul>\n<li>Gi\u1ea3i th\u00edch cho b\u1ec7nh nh\u00e2n s\u1ef1 kh\u00e1c bi\u1ec7t gi\u1eefa vi\u1ec7c \u0111i\u1ec1u tr\u1ecb c\u1eaft c\u01a1n v\u00e0 \u0111i\u1ec1u tr\u1ecb\u00a0\u00a0d\u1ef1 ph\u00f2ng.<\/li>\n<li>Gi\u1ea3i th\u00edch r\u1eb1ng b\u1ec7nh hen kh\u00f4ng th\u1ec3 ch\u1eefa kh\u1ecfi nh\u01b0ng \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m t\u1ea7n su\u1ea5t x\u1ea3y ra c\u01a1n hen v\u00e0 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh.<\/li>\n<li>Nh\u1ea5n m\u1ea1nh t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c tu\u00e2n th\u1ee7 trong s\u1eed d\u1ee5ng thu\u1ed1c (kh\u00f4ng gi\u00e1n \u0111o\u1ea1n) v\u00e0 vi\u1ec7c theo d\u00f5i th\u01b0\u1eddng xuy\u00ean.<\/li>\n<li>Ki\u1ec3m tra hi\u1ec7u qu\u1ea3 c\u1ee7a \u0111i\u1ec1u tr\u1ecb sau m\u1ed9t v\u00e0i tu\u1ea7n.<\/li>\n<li>Tr\u1ea5n \u00e1n b\u1ec7nh nh\u00e2n v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a corticoide d\u1ea1ng h\u00edt, t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n r\u1ea5t hi\u1ebfm g\u1eb7p do ch\u1ec9 m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf thu\u1ed1c \u0111i v\u00e0o v\u00f2ng tu\u1ea7n ho\u00e0n m\u00e1u. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 ch\u1ee7 y\u1ebfu c\u1ee7a thu\u1ed1c n\u00e0y th\u01b0\u1eddng \u1edf t\u1ea1i ch\u1ed7 (nhi\u1ec5m n\u1ea5m candida h\u1ea7u h\u1ecdng, kh\u00f3 n\u00f3i, ho) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ng\u0103n ng\u1eeba b\u1eb1ng c\u00e1ch s\u00fac mi\u1ec7ng ho\u1eb7c \u0111\u00e1nh r\u0103ng sau khi d\u00f9ng thu\u1ed1c.<\/li>\n<li>H\u01b0\u1edbng d\u1eabn b\u1ec7nh nh\u00e2n c\u00e1ch s\u1eed d\u1ee5ng \u0111\u00fang c\u00e1c thi\u1ebft b\u1ecb h\u00f4 h\u1ea5p. Y\u00eau c\u1ea7u b\u1ec7nh nh\u00e2n l\u00e0m th\u1ef1c t\u1ebf \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh c\u00e1c l\u1ed7i c\u00f3 th\u1ec3 x\u1ea3y ra v\u00e0 gi\u1ea3i th\u00edch m\u1ed9t l\u1ea7n n\u1eefa v\u00e0o l\u1ea7n sau \u0111\u00f3. C\u00f3 th\u1ec3 y\u00eau c\u1ea7u c\u00e1c c\u00f4ng ty d\u01b0\u1ee3c ph\u1ea9m cung c\u1ea5p c\u00e1c m\u1eabu s\u1ea3n ph\u1ea9m gi\u1ea3 \u0111\u1ec3 th\u1ef1c h\u00e0nh. S\u1eed d\u1ee5ng ph\u00f2ng h\u00edt \u0111\u1ec3 h\u1ea1n ch\u1ebf s\u1ef1 ti\u1ebfp x\u00fac c\u1ee7a tay v\u00e0 mi\u1ec7ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf tr\u1ebb d\u01b0\u1edbi 6 tu\u1ed5i v\u00e0 \u1edf ng\u01b0\u1eddi gi\u00e0. Vi\u1ec7c n\u00e0y c\u1ea3i thi\u1ec7n hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c v\u00e0 gi\u1ea3m nguy c\u01a1 l\u1eafng \u0111\u1ecdng t\u1ebf b\u00e0o n\u1ea5m trong h\u1ecdng. Th\u00e1o r\u1eddi c\u00e1c b\u1ed9 ph\u1eadn v\u00e0 r\u1eeda s\u1ea1ch b\u1eb1ng n\u01b0\u1edbc v\u00e0 dung d\u1ecbch t\u1ea9y r\u1eeda h\u00e0ng tu\u1ea7n. R\u1eeda th\u1eadt s\u1ea1ch v\u00e0 \u0111\u1ec3 kh\u00f4 \u0111\u1ec3 h\u1ea1n ch\u1ebf t\u00edch \u0111i\u1ec7n. Khi c\u00e1c van kh\u00f4ng c\u00f2n ho\u1ea1t \u0111\u1ed9ng t\u1ed1t ho\u1eb7c b\u1ecb c\u1ee9ng l\u1ea1i, c\u1ea7n thi\u1ebft ph\u1ea3i thay th\u1ec3 bu\u1ed3ng h\u00edt.<\/li>\n<li>Vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c d\u1ea1ng x\u00f4ng c\u00f3 th\u1ec3 c\u00f3 \u00edch \u1edf c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n ph\u1ee5 thu\u1ed9c (tr\u1ebb s\u01a1 sinh hay ng\u01b0\u1eddi gi\u00e0) ho\u1eb7c \u1edf b\u1ec7nh nh\u00e2n hen n\u1eb7ng, do \u0111\u00f3 c\u1ea7n gi\u1ea3i th\u00edch c\u00e1ch s\u1eed d\u1ee5ng cho ng\u01b0\u1eddi tr\u1ef1c ti\u1ebfp ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n<p><em>Ph\u00f2ng tr\u00e1nh c\u01a1n hen <\/em><\/p>\n<ul>\n<li>Khuy\u1ebfn c\u00e1o b\u1ec7nh nh\u00e2n lu\u00f4n mang theo c\u00e1c thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n t\u00e1c d\u1ee5ng nhanh theo m\u00ecnh<\/li>\n<li>Khuy\u00ean b\u00ean nh\u00e2n n\u00ean tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi kh\u00f3i thu\u1ed1c l\u00e1 v\u00e0 n\u1ebfu h\u1ecd \u0111ang h\u00fat thu\u1ed1c th\u00ec c\u1ea7n cai thu\u1ed1c.<\/li>\n<li>Th\u1ef1c hi\u1ec7n c\u00e1c bi\u1ec7n ph\u00e1p x\u1eed l\u00fd m\u00f4i tr\u01b0\u1eddng\u00a0s\u1ed1ng: gi\u1eef cho nhi\u1ec7t \u0111\u1ed9 ph\u00f2ng t\u1eeb 18-20 \u00b0 C, kh\u00f4 r\u00e1o, l\u00e0m s\u1ea1ch ch\u0103n m\u00e0n, th\u1ea3m. S\u1eed d\u1ee5ng b\u1ed9 l\u1ecdc kh\u00f4ng kh\u00ed \u0111\u1ec3 duy tr\u00ec \u0111\u1ed9 \u1ea9m, tr\u00e1nh s\u1eed d\u1ee5ng th\u1ea3m ho\u1eb7c \u0111\u1ed3 \u0111\u1ea1c l\u00e0m t\u1eeb l\u00f4ng v\u0169.<\/li>\n<li>Khi th\u1eddi ti\u1ebft l\u1ea1nh, tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi ph\u1ea5n hoa, che m\u0169i v\u00e0 mi\u1ec7ng b\u1eb1ng kh\u0103n khi \u1edf ngo\u00e0i tr\u1eddi<\/li>\n<li>H\u1ea1n ch\u1ebf s\u1eed d\u1ee5ng c\u00e1c s\u1ea3n ph\u1ea9m d\u1ea1ng x\u1ecbt (b\u00ecnh x\u1ecbt kh\u1eed b\u1ee5i, kh\u1eed m\u00f9i, b\u00ecnh x\u1ecbt t\u1ea9y r\u1eeda) v\u00ec c\u00f3 th\u1ec3 th\u00fac \u0111\u1ea9y co th\u1eaft ph\u1ebf qu\u1ea3n.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh c\u00f3 th\u1ec3 l\u00e0m n\u1eb7ng th\u00eam b\u1ec7nh hen suy\u1ec5n (tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n, vi\u00eam m\u0169i d\u1ecb \u1ee9ng).<\/li>\n<li>Nh\u1ea5n m\u1ea1nh t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c ph\u00f2ng ng\u1eeba virus c\u00fam v\u00e0 ph\u1ebf c\u1ea7u khu\u1ea9n \u1edf ng\u01b0\u1eddi l\u1edbn.<\/li>\n<li>Thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroide ho\u1eb7c aspirin c\u00f3 th\u1ec3 k\u00edch ho\u1ea1t c\u01a1n hen.<\/li>\n<\/ul>\n<p><em>C\u00e2u h\u1ecfi c\u1ee7a b\u1ec7nh nh\u00e2n\u00a0: Con trai t\u00f4i b\u1ecb hen th\u00ec ch\u00e1u c\u00f3 th\u1ec3 ho\u1ea1t \u0111\u1ed9ng th\u1ec3 thao kh\u00f4ng\u00a0? <\/em><\/p>\n<p>C\u00f3, \u0111\u1ec3 ki\u1ebfm so\u00e1t b\u1ec7nh hen, c\u1eadu \u1ea5y c\u00f3 th\u1ec3 t\u1eadp luy\u1ec7n m\u1ed9t s\u1ed1 m\u00f4n th\u1ec3 thao \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o, k\u1ec3 c\u1ea3 b\u01a1i. M\u00f4n l\u1eb7n v\u1edbi b\u00ecnh d\u01b0\u1ee1ng kh\u00ed b\u1ecb c\u1ea5m tuy\u1ec7t \u0111\u1ed1i c\u00f2n m\u00f4n c\u01b0\u1ee1i ng\u1ef1a kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o (do c\u00f3 nguy c\u01a1 ti\u1ebfp x\u00fac v\u1edbi c\u00e1c ch\u1ea5t g\u00e2y d\u1ecb \u1ee9ng).<\/p>\n<p><em>C\u00e2u h\u1ecfi c\u1ee7a b\u1ec7nh nh\u00e2n\u00a0: khi mang thai, c\u00f3 th\u1ec3 d\u1eebng vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh hen hay kh\u00f4ng\u00a0? <\/em><\/p>\n<p>T\u1ea5t nhi\u00ean l\u00e0 kh\u00f4ng, vi\u1ec7c d\u1eebng \u0111i\u1ec1u tr\u1ecb kh\u00f4ng nh\u1eefng khi\u1ebfn ng\u01b0\u1eddi m\u1eb9 c\u00f3 nguy c\u01a1 g\u1eb7p ph\u1ea3i c\u01a1n hen n\u1eb7ng m\u00e0 thai nhi c\u0169ng b\u1ecb \u1ea3nh h\u01b0\u1edfng (nguy c\u01a1 ti\u1ec1n s\u1ea3n gi\u1eadt, sinh non, ch\u1eadm ph\u00e1t tri\u1ec3n). M\u1ed9t s\u1ed1 li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u1ec1n (theophylline, kh\u00e1ng leukotrien v\u00e0 corticoide d\u1ea1ng h\u00edt) c\u00f3 th\u1ec3 ph\u1ea3i \u0111\u00e1nh gi\u00e1 l\u1ea1i l\u1ee3i \u00edch\/nguy c\u01a1 trong thai k\u00ec nh\u01b0ng vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ee7 v\u1eadn beta t\u00e1c d\u1ee5ng ng\u1eafn v\u00e0 nhanh kh\u00f4ng h\u1ec1 g\u00e2y h\u1ea1i.<\/p>\n<h2><span style=\"font-size: 18px;\">T\u00e0i li\u1ec7u tham kh\u1ea3o <\/span><\/h2>\n<p>1. Le moniteur des pharmacies. Cahier 2 du 2928 du 7 avril 2012<\/p>\n<p>2. <a href=\"http:\/\/nhipcauduoclamsang.blogspot.com\/2015\/04\/ieu-tri-hen-1.html\" target=\"_blank\" rel=\"noopener noreferrer\"> http:\/\/nhipcauduoclamsang.blogspot.com\/2015\/04\/ieu-tri-hen-1.html <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Hen suy\u1ec5n l\u00e0 m\u1ed9t b\u1ec7nh m\u00e3n t\u00ednh \u0111\u00f2i h\u1ecfi ph\u1ea3i ki\u1ec3m so\u00e1t m\u00f4i tr\u01b0\u1eddng s\u1ed1ng c\u00f9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 b\u1eb1ng thu\u1ed1c.<\/p>\n","protected":false},"author":339,"featured_media":4259,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5146,9993,5172],"tags":[3292,3476],"series":[1054],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u0110i\u1ec1u tr\u1ecb hen - D\u1ef1 \u00e1n kh\u00e1c<\/title>\n<meta name=\"description\" content=\"\u0110i\u1ec1u tr\u1ecb hen - 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