{"id":3975,"date":"2018-08-24T23:45:25","date_gmt":"2018-08-24T16:45:25","guid":{"rendered":"https:\/\/yhoccongdong.org\/du-an-khoa-nhi\/2018\/08\/24\/loet-ap-to-aphthous-mieng\/"},"modified":"2024-03-04T13:50:30","modified_gmt":"2024-03-04T06:50:30","slug":"loet-ap-to-aphthous-mieng","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/nhi-khoa\/loet-ap-to-aphthous-mieng\/","title":{"rendered":"Lo\u00e9t \u00e1p &#8211; t\u01a1 (aphthous) mi\u1ec7ng"},"content":{"rendered":"<ul>\n<li style=\"text-align: justify\">Lo\u00e9t \u00e1p-t\u01a1 l\u00e0 nh\u1eefng v\u1ebft lo\u00e9t \u1edf mi\u1ec7ng \u0111au, khu tr\u00fa, n\u00f4ng, h\u00ecnh tr\u00f2n ho\u1eb7c oval v\u1edbi \u0111\u00e1y m\u00e0u x\u00e1m.<\/li>\n<li style=\"text-align: justify\">Lo\u00e9t \u00e1p-t\u01a1 l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t trong c\u00e1c lo\u1ea1i lo\u00e9t mi\u1ec7ng. \u00c1p-t\u01a1 t\u00e1i ph\u00e1t c\u00f3 th\u1ec3 g\u1eb7p \u1edf nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh Celiac v\u00e0 ch\u1ee9ng vi\u00eam ru\u1ed9t m\u1ea1n ho\u1eb7c ng\u01b0\u1eddi b\u1ecb suy gi\u1ea3m mi\u1ec5n d\u1ecbch (nhi\u1ec5m HIV).<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">Nguy\u00ean nh\u00e2n v\u00e0 sinh b\u1ec7nh h\u1ecdc<\/h2>\n<p style=\"text-align: justify\"><strong>Sinh b\u1ec7nh h\u1ecdc c\u1ee7a \u00e1p- t\u01a1<\/strong> c\u0169ng ch\u01b0a r\u00f5 r\u00e0ng. M\u1ed9t gi\u1ea3 thuy\u1ebft cho r\u1eb1ng \u00e1p t\u01a1 c\u00f3 th\u1ec3 l\u00e0 do r\u1ed1i lo\u1ea1n t\u1ea1i ch\u1ed7 qua trung gian mi\u1ec5n d\u1ecbch t\u1ebf b\u00e0o, c\u00f9ng s\u1ef1 gi\u1ea3i ph\u00f3ng c\u1ee7a c\u00e1c cytokine ti\u1ec1n vi\u00eam.<\/p>\n<p style=\"text-align: justify\"><strong>C\u00e1c y\u1ebfu t\u1ed1 l\u00e0m gia t\u0103ng s\u1ef1 xu\u1ea5t hi\u1ec7n \u00e1p t\u01a1 g\u1ed3m:<\/strong> y\u1ebfu t\u1ed1 gia \u0111\u00ecnh, ch\u1ea5n th\u01b0\u01a1ng, hormone, stress. S\u1ef1 thi\u1ebfu h\u1ee5t c\u1ee7a vitamin v\u00e0 ch\u1ea5t kho\u00e1ng c\u0169ng c\u00f3 li\u00ean quan t\u1edbi \u00e1p t\u01a1 t\u00e1i ph\u00e1t, \u0111\u1eb7c bi\u1ec7t l\u00e0 thi\u1ebfu h\u1ee5t vitamin B12. Tuy nhi\u00ean, 1 th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean \u1edf 120 b\u1ec7nh nh\u00e2n b\u1ecb \u00e1p t\u01a1, vi\u1ec7c cung c\u1ea5p multivitamin \u0111\u00e3 kh\u00f4ng l\u00e0m gi\u1ea3m \u0111\u01b0\u1ee3c s\u1ed1 \u0111\u1ee3t v\u00e0 th\u1eddi gian 1 \u0111\u1ee3t c\u1ee7a \u00e1p t\u01a1 trong n\u0103m.<\/p>\n<p style=\"text-align: justify\">M\u1eb7c d\u1ea7u c\u00f3 1 v\u00e0i nghi\u00ean c\u1ee9u quan s\u00e1t b\u00e1o c\u00e1o c\u00f3 s\u1ef1 gia t\u0103ng ph\u00e1t tri\u1ec3n \u00e1p t\u01a1 t\u1ea1m th\u1eddi sau khi ng\u01b0ng h\u00fat thu\u1ed1c l\u00e1, nh\u01b0ng c\u00e1c nghi\u00ean c\u1ee9u kh\u00e1c l\u1ea1i kh\u00f4ng ph\u00e1t hi\u1ec7n ra m\u1ed1i li\u00ean quan n\u00e0y.<\/p>\n<p style=\"text-align: justify\"><strong>C\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c g\u00e2y \u00e1p t\u01a1 bao g\u1ed3m<\/strong> <strong>vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c nh\u01b0:<\/strong>\u00a0MTX, v\u00e0 t\u00ecnh tr\u1ea1ng gi\u1ea3m b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n do m\u1ecdi nguy\u00ean nh\u00e2n.<\/p>\n<h2 style=\"text-align: justify\">\u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng c\u1ee7a \u00e1p t\u01a1<\/h2>\n<p style=\"text-align: justify\">Bi\u1ec3u hi\u1ec7n ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a \u00e1p t\u01a1 \u0111\u00f3 l\u00e0 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a c\u00e1c v\u1ebft lo\u00e9t h\u00ecnh tr\u00f2n ho\u1eb7c oval, ranh gi\u1edbi r\u00f5 r\u00e0ng, nh\u1ecf, v\u00e0 \u0111au, \u0111\u00e1y x\u00e1m m\u00e0u th\u01b0\u1eddng t\u1ef1 l\u00e0nh sau 10- 14 ng\u00e0y m\u00e0 kh\u00f4ng \u0111\u1ec3 l\u1ea1i s\u1eb9o.<\/p>\n<p style=\"text-align: justify\">Trong t\u00ecnh hu\u1ed1ng n\u1eb7ng h\u01a1n, v\u1ebft lo\u00e9t c\u00f3 th\u1ec3 r\u1ed9ng (&gt; 5 mm) v\u00e0 c\u00f3 th\u1ec3 k\u00e9o d\u00e0i t\u1edbi 6 tu\u1ea7n l\u1ec5, tuy nhi\u00ean t\u00ecnh tr\u1ea1ng n\u00e0y th\u00ec \u00edt g\u1eb7p. \u0110\u00f4i khi nhi\u1ec1u v\u1ebft lo\u00e9t v\u00e0 nh\u00fa nh\u1ecf c\u00f3 th\u1ec3 t\u1eadp trung l\u1ea1i th\u00e0nh t\u1eebng c\u1ee5m g\u1ecdi l\u00e0 Herpetiform(h\u00ecnh) v\u00e0 c\u00f3 th\u1ec3 k\u00e9o d\u00e0i 7- 10 ng\u00e0y. Sodium lauryl sulfate (\u0111\u1ed3ng ph\u00e2n natri lauryl sulfat, l\u00e0 m\u1ed9t h\u1ee3p ch\u1ea5t h\u1eefu c\u01a1 t\u1ed5ng h\u1ee3p v\u1edbi c\u00f4ng th\u1ee9c CH3 11SO4Na. N\u00f3 l\u00e0 m\u1ed9t ch\u1ea5t ho\u1ea1t \u0111\u1ed9ng b\u1ec1 m\u1eb7t anion \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong nhi\u1ec1u s\u1ea3n ph\u1ea9m l\u00e0m s\u1ea1ch v\u00e0 v\u1ec7 sinh. Mu\u1ed1i natri l\u00e0 m\u1ed9t ch\u1ea5t h\u1eefu c\u01a1 sulfat) ch\u1ea5t t\u1ea9y trong kem \u0111\u00e1nh r\u0103ng c\u00f3 th\u1ec3 k\u00e9o d\u00e0i th\u1eddi gian l\u00e0m l\u00e0nh v\u1ebft lo\u00e9t.<\/p>\n<p style=\"text-align: justify\">M\u1ed9t v\u00e0i ng\u01b0\u1eddi c\u00f3 th\u1ec3 b\u1ecb t\u1eeb 2-4 \u0111\u1ee3t trong 1 n\u0103m trong khi 1 s\u1ed1 ng\u01b0\u1eddi kh\u00e1c c\u00f3 th\u1ec3 b\u1ecb li\u00ean t\u1ee5c. \u00e1p t\u01a1 g\u1eb7p \u1edf tr\u1ebb em v\u00e0 thi\u1ebfu ni\u00ean nhi\u1ec1u h\u01a1n l\u00e0 ng\u01b0\u1eddi l\u1edbn.<\/p>\n<h2 style=\"text-align: justify\">\u0110i\u1ec1u tr\u1ecb \u00e1p t\u01a1 nh\u01b0 th\u1ebf n\u00e0o?<\/h2>\n<p style=\"text-align: justify\">H\u1ea7u h\u1ebft \u0111i\u1ec1u tr\u1ecb \u00e1p t\u01a1 l\u00e0 nh\u1eb1m l\u00e0m gi\u1ea3m tri\u1ec7u ch\u1ee9ng, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng <strong>Triamcinolon<\/strong> thoa v\u1ebft lo\u00e9t, <strong>gel fluocinonide<\/strong> v\u00e0 c\u00e1c thu\u1ed1c gi\u1ea3m \u0111au t\u1ea1i ch\u1ed7 kh\u00e1c. C\u00f3 th\u1ec3 d\u00f9ng 2-4 l\u1ea7n\/ ng\u00e0y cho \u0111\u1ebfn khi v\u1ebft lo\u00e9t l\u00e0nh. N\u1ebfu thoa s\u1edbm th\u00ec v\u1ebft lo\u00e9t l\u00e0nh nhanh h\u01a1n.<\/p>\n<p style=\"text-align: justify\">Ch\u1ea5m dung d\u1ecbch h\u00f3a ch\u1ea5t ch\u1eb3ng h\u1ea1n nh\u01b0 b\u1ea1c nitrate hay Debacterol c\u0169ng c\u00f3 \u00edch, n\u00f3 c\u00f3 th\u1ec3 gi\u1ea3i quy\u1ebft t\u00ecnh tr\u1ea1ng \u0111au nhanh h\u01a1n m\u1eb7c d\u00f9 n\u00f3 kh\u00f4ng gi\u00fap l\u00e0m l\u00e0nh v\u1ebft lo\u00e9t nhanh h\u01a1n. N\u00ean g\u00e2y t\u00ea t\u1ea1i ch\u1ed7 b\u1eb1ng lidocain tr\u01b0\u1edbc khi b\u00f4i h\u00f3a ch\u1ea5t v\u00e0 b\u1ec7nh nh\u00e2n n\u00ean s\u00fac mi\u1ec7ng v\u00e0i ph\u00fat sau khi l\u00e0m xong.<\/p>\n<p style=\"text-align: justify\">Ch\u00edch Glucocorticoid v\u00e0o v\u1ebft lo\u00e9t ho\u1eb7c u\u1ed1ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c t\u1ed5n th\u01b0\u01a1ng t\u00e1i ph\u00e1t ho\u1eb7c b\u1ec7nh n\u1eb7ng. Colchicine, dapsone, pentoxifylline, interferon alfa, v\u00e0 levamisole c\u0169ng c\u00f3 th\u1ec3 c\u00f3 gi\u00e1 tr\u1ecb \u0111i\u1ec1u tr\u1ecb trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng.<\/p>\n<p style=\"text-align: justify\">Thalidomide \u0111\u00e3 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u \u1edf b\u1ec7nh nh\u00e2n b\u1ecb \u00e1p t\u01a1 n\u1eb7ng. Trong 1 th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n HIV b\u1ecb \u00e1p t\u01a1, \u0111i\u1ec1u tr\u1ecb v\u1edbi thalidomide 200 mg\/ ng\u00e0y trong 4 tu\u00e0n. k\u1ebft qu\u1ea3 cho th\u1ea5y l\u00e0nh v\u1ebft lo\u00e9t \u1edf 16\/29 b\u1ec7nh nh\u00e2n (55%) trong nh\u00f3m c\u00f3 d\u00f9ng thu\u1ed1c. trong khi \u1edf nh\u00f3m d\u00f9ng gi\u1ea3 d\u01b0\u1ee3c ch\u1ec9 c\u00f3 2\/28 b\u1ec7nh nh\u00e2n l\u00e0 l\u00e0nh chi\u1ebfm 7%. M\u1ed9t nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u \u1edf 92 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 HIV b\u1ecb \u00e1p t\u01a1 (trong \u0111\u00f3 c\u00f3 16 b\u1ec7nh nh\u00e2n b\u1ec7nh nh\u00e2n b\u1ecb h\u1ed9i ch\u1ee9ng behcet\u2019s) c\u0169ng b\u00e1o c\u00e1o l\u00e0 thu\u1ed1c n\u00e0y c\u00f3 hi\u1ec7u qu\u1ea3 \u1edf li\u1ec1u th\u1ea5p, v\u1edbi li\u1ec1u kh\u1edfi \u0111\u1ea7u l\u00e0 50 m \/ ng\u00e0y thalidomide l\u00e0m gi\u1ea3m ho\u00e0n to\u00e0n \u1edf 85 % b\u1ec7nh nh\u00e2n trong v\u00f2ng 14 ng\u00e0y. T\u00e1i ph\u00e1t l\u00e0 t\u00ecnh tr\u1ea1ng th\u01b0\u1eddng g\u1eb7p c\u1ee7a li\u1ec7u ph\u00e1p n\u00e0y, duy tr\u00ec li\u1ec1u th\u1ea5p l\u00e0m gi\u1ea3m \u0111\u01b0\u1ee3c t\u00e1i ph\u00e1t. Thalidomide c\u00f3 th\u1ec3 g\u00e2y ra qu\u00e1i thai n\u00ean kh\u00f4ng d\u00f9ng \u0111\u01b0\u1ee3c cho ph\u1ee5 n\u1eef c\u00f3 thai.<\/p>\n<h2 style=\"text-align: justify\">T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p style=\"text-align: justify\"><a href=\"https:\/\/www.facebook.com\/diendannhikhoa\/posts\/754620311402158\" target=\"_blank\" rel=\"noopener\">https:\/\/www.facebook.com\/diendannhikhoa\/posts\/754620311402158<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bi\u1ec3u hi\u1ec7n c\u1ee7a \u00e1p t\u01a1 \u0111\u00f3 l\u00e0 c\u00e1c v\u1ebft lo\u00e9t h\u00ecnh tr\u00f2n ho\u1eb7c oval, ranh gi\u1edbi r\u00f5, nh\u1ecf, v\u00e0 \u0111au, \u0111\u00e1y x\u00e1m m\u00e0u th\u01b0\u1eddng t\u1ef1 l\u00e0nh sau 10- 14 ng\u00e0y<\/p>\n","protected":false},"author":14,"featured_media":3976,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[6104],"tags":[5619,5620],"series":[3454],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - 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