{"id":8668,"date":"2020-10-23T16:01:50","date_gmt":"2020-10-23T09:01:50","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/cac-thay-doi-o-mong-cua-nguoi-benh-ung-thu\/"},"modified":"2020-10-23T16:01:50","modified_gmt":"2020-10-23T09:01:50","slug":"cac-thay-doi-o-mong-cua-nguoi-benh-ung-thu","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/cac-thay-doi-o-mong-cua-nguoi-benh-ung-thu\/","title":{"rendered":"C\u00e1c thay \u0111\u1ed5i \u1edf m\u00f3ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh ung th\u01b0"},"content":{"rendered":"<h2><strong>T\u1ed5ng quan chung<\/strong><\/h2>\n<p>M\u00f3ng gi\u00fap b\u1ea3o v\u1ec7 \u0111\u1ea7u ng\u00f3n tay v\u00e0 ng\u00f3n ch\u00e2n v\u00e0 gi\u00fap c\u00e1c ng\u00f3n tay th\u1ef1c hi\u1ec7n c\u00e1c \u0111\u1ed9ng t\u00e1c nh\u01b0 g\u00e3i ho\u1eb7c nh\u1eb7t m\u1ed9t v\u1eadt g\u00ec \u0111\u00f3. M\u00f3ng th\u01b0\u1eddng c\u00f3 \u1edf m\u1ed7i ng\u00f3n tay v\u00e0 ng\u00f3n ch\u00e2n. Ch\u00fang \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o v\u1edbi 2 ph\u1ea7n: \u201c\u0111\u0129a m\u00f3ng\u201d (ph\u1ea7n c\u1ee9ng nh\u1ea5t v\u00e0 l\u00e0 ph\u1ea7n c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y) v\u00e0ph\u1ea7n m\u00f4 m\u1ec1m n\u1eb1m d\u01b0\u1edbi \u201c\u0111\u0129a m\u00f3ng\u201d.<\/p>\n<p>M\u00f3ng nh\u1eadn m\u00e1u v\u00e0 ch\u1ea5t dinh d\u01b0\u1ee1ng t\u1eeb c\u01a1 th\u1ec3. Ch\u00fang \u0111\u01b0\u1ee3c g\u1eafn v\u1edbi c\u01a1 th\u1ec3 b\u1eb1ng gi\u01b0\u1eddng m\u00f3ng, ho\u1ea1t \u0111\u1ed9ng nh\u01b0 r\u1ec5 c\u00e2y v\u00e0 nh\u1eadn ch\u1ea5t dinh d\u01b0\u1ee1ng \u0111\u1ec3 gi\u00fap m\u00f3ng kh\u1ecfe m\u1ea1nh v\u00e0 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho t\u1ebf b\u00e0o m\u00f3ng m\u1edbi h\u00ecnh th\u00e0nh v\u00e0 ph\u00e1t tri\u1ec3n. Khi m\u00f3ng ph\u00e1t tri\u1ec3n, t\u1ebf b\u00e0o m\u1edbi \u0111\u1ea9y t\u1ebf b\u00e0o c\u0169 ra ngo\u00e0i. C\u00e1c t\u1ebf b\u00e0o m\u00f3ng c\u0169 \u0111\u01b0\u1ee3c \u0111\u1ea9y v\u1ec1 ph\u00eda tr\u01b0\u1edbc,tr\u1edf n\u00ean b\u1eb1ng ph\u1eb3ng v\u00e0 c\u1ee9ng h\u01a1n t\u1ea1o th\u00e0nh \u0111\u0129a m\u00f3ng. Ph\u1ea7n \u0111\u0129a m\u00f3ng kh\u00f4ng c\u00f3 t\u1ebf b\u00e0o, do v\u1eady c\u00f3 th\u1ec3 c\u1eaft m\u00f3ng m\u00e0 kh\u00f4ng \u0111au.<\/p>\n<p>Bi\u1ebfn \u0111\u1ed5i v\u1ec1 m\u00f3ng l\u00e0 do nh\u1eefng v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe kh\u00e1c nhau, c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf m\u00f3ng tay, m\u00f3ng ch\u00e2n ho\u1eb7c c\u1ea3 hai. M\u1ed9t s\u1ed1 lo\u1ea1i ung th\u01b0 v\u00e0 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y thay \u0111\u1ed5i \u1edf m\u00f3ng. Nh\u1eefng thay \u0111\u1ed5i n\u00e0y c\u00f3 th\u1ec3 x\u1ea3y \u1edf gi\u01b0\u1eddng m\u00f3ng ho\u1eb7c ch\u00ednh ph\u1ea7n \u0111\u0129a m\u00f3ng. Bi\u1ebfn \u0111\u1ed5i \u1edf m\u00f3ng c\u00f3 th\u1ec3 t\u1ea1m th\u1eddi ho\u1eb7c k\u00e9o d\u00e0i.<\/p>\n<h2><strong>Nh\u1eefng ki\u1ec3u thay \u0111\u1ed5i \u1edf m\u00f3ng<\/strong><\/h2>\n<p>T\u00f9y thu\u1ed9c v\u00e0o nguy\u00ean nh\u00e2n g\u00e2y n\u00ean s\u1ef1 thay \u0111\u1ed5i v\u1ec1 m\u00f3ng, c\u00f3 th\u1ec3 th\u1ea5y nh\u1eefng thay \u0111\u1ed5i v\u1ec1 h\u00ecnh th\u1ee9c, c\u1ea3m gi\u00e1c, v\u00e0 ho\u1ea1t \u0111\u1ed9ng c\u1ee7a m\u00f3ng. B\u1ea1n c\u0169ng c\u00f3 th\u1ec3 nh\u1eadn th\u1ea5y nh\u1eefng thay \u0111\u1ed5i v\u1ec1 ph\u1ea7n m\u00f4 m\u1ec1m xung quanh ho\u1eb7c ph\u00eda d\u01b0\u1edbi m\u00f3ng. Nh\u1eefng thay \u0111\u1ed5i th\u01b0\u1eddng g\u1eb7p bao g\u1ed3m:<\/p>\n<ul>\n<li>Thay \u0111\u1ed5i v\u1ec1 \u0111\u1ed9 d\u00e0y v\u00e0 ch\u1eafc kh\u1ecfe c\u1ee7a m\u00f3ng, l\u00e0m cho m\u00f3ng tr\u1edf n\u00ean y\u1ebfu h\u01a1n.<\/li>\n<li>Ph\u1ea7n gi\u01b0\u1eddng m\u00f3ng, ng\u00f3n tay &#8211; ch\u00e2n b\u1ecb \u0111au v\u00e0 d\u1ec5 t\u1ed5n th\u01b0\u01a1ng.<\/li>\n<li>V\u00f9ng da xung quanh \u0111\u01b0\u1eddng ch\u00e2n m\u00f3ng b\u1ecb kh\u00f4, n\u1ee9t.<\/li>\n<li>Thay \u0111\u1ed5i v\u1ec1 m\u00e0u s\u1eafc c\u1ee7a m\u00f3ng ho\u1eb7c gi\u01b0\u1eddng m\u00f3ng (ho\u1eb7c b\u1ecb m\u1ea5t m\u00e0u ho\u1eb7c qu\u00e1 nhi\u1ec1u s\u1eafc t\u1ed1, t\u1ed1i h\u01a1n b\u00ecnh th\u01b0\u1eddng).<\/li>\n<li>C\u00e1c v\u1ebft n\u1ee9t, v\u1ebft r\u1ed7, r\u00e3nh ho\u1eb7c ho\u1eb7c xu\u1ea5t hi\u1ec7n nh\u1eefng v\u1ebft b\u1ea5t th\u01b0\u1eddng tr\u00ean m\u00f3ng.<\/li>\n<li>Ph\u1ea7n \u0111\u0129a m\u00f3ng t\u00e1ch ra kh\u1ecfi gi\u01b0\u1eddng m\u00f3ng ho\u1eb7c b\u1ecb r\u01a1i ra.<\/li>\n<li>M\u00f3ng ph\u00e1t tri\u1ec3n ch\u1eadm h\u01a1n b\u00ecnh th\u01b0\u1eddng ho\u1eb7c thi\u1ebfu t\u0103ng tr\u01b0\u1edfng t\u1ea1m th\u1eddi.<\/li>\n<\/ul>\n<h2><strong>Thay \u0111\u1ed5i v\u1ec1 m\u00f3ng \u1edf ng\u01b0\u1eddi b\u1ec7nh ung th\u01b0<\/strong><\/h2>\n<p>M\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng ho\u1eb7c thay \u0111\u1ed5i v\u1ec1 m\u00f3ng. Thu\u1ed1c ung th\u01b0 th\u01b0\u1eddng l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra thay \u0111\u1ed5i v\u1ec1 m\u00f3ng, nh\u01b0ng x\u1ea1 tr\u1ecb c\u0169ng c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n.<\/p>\n<p>Nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c nhau c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nh\u1eefng t\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng, c\u0169ng nh\u01b0 t\u1ebf b\u00e0o m\u00f3ng b\u1eb1ng c\u00e1c c\u00e1ch kh\u00e1c nhau, v\u00e0 nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a ch\u00fang c\u0169ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng kh\u00e1c nhau \u0111\u1ebfn m\u00f3ng. M\u1ed9t, hai, m\u1ed9t v\u00e0i ho\u1eb7c t\u1ea5t c\u1ea3 m\u00f3ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng. M\u1ed9t s\u1ed1 thay \u0111\u1ed5i x\u1ea3y ra s\u1edbm sau khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, nh\u01b0ng c\u0169ng x\u1ea3y ra thay \u0111\u1ed5i sau v\u00e0i tu\u1ea7n ho\u1eb7c v\u00e0i th\u00e1ng.\u00a0 Nh\u1eefng bi\u1ebfn \u0111\u1ed5i tr\u00ean m\u00f3ng c\u00f3 th\u1ec3 l\u00e0 t\u1ea1m th\u1eddi, l\u00e2u d\u00e0i ho\u1eb7c v\u0129nh vi\u1ec5n. C\u1ea7n nh\u1edb r\u1eb1ng m\u1ed9t s\u1ed1 lo\u1ea1i ung th\u01b0 v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra nh\u1eefng thay \u0111\u1ed5i v\u1ec1 m\u00f3ng, nh\u01b0ng m\u1ed9t s\u1ed1 v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe v\u00e0 thu\u1ed1c kh\u00f4ng ph\u1ea3i ung th\u01b0 c\u0169ng c\u00f3 th\u1ec3 g\u00e2y thay \u0111\u1ed5i m\u00f3ng. V\u00ec v\u1eady c\u1ea7n n\u00f3i cho b\u00e1c s\u0129 bi\u1ebft v\u1ec1 t\u1ea5t c\u1ea3 v\u1ea5n \u0111\u1ec1 y t\u1ebf b\u1ea1n \u0111ang g\u1eb7p ph\u1ea3i, c\u00e1c thu\u1ed1c, vitamin, kho\u00e1ng ch\u1ea5t, v\u00e0 nh\u1eefng ch\u1ea5t b\u1ed5 sung b\u1ea1n \u0111ang d\u00f9ng.<\/p>\n<p><strong>D\u1ea5u hi\u1ec7u thay \u0111\u1ed5i c\u1ee7a m\u00f3ng<\/strong><\/p>\n<ul>\n<li><strong>V\u00f9ng t\u1ed1i c\u1ea1nh \u0111\u01b0\u1eddng ch\u00e2n m\u00f3ng (t\u1ed5n th\u01b0\u01a1ng d\u01b0\u1edbi da):<\/strong> tr\u00f4ng nh\u01b0 v\u1ebft b\u1ea7m t\u00edm \u1edf d\u01b0\u1edbi m\u00f3ng, th\u01b0\u1eddng ch\u1ea1y d\u1ecdc theo m\u00e9p d\u01b0\u1edbi c\u1ee7a m\u00f3ng, g\u1ea7n l\u1edbp da xung quanh \u0111\u01b0\u1eddng ch\u00e2n m\u00f3ng. Nh\u1eefng thay \u0111\u1ed5i v\u1ec1 m\u00e0u s\u1eafc ki\u1ec3u n\u00e0y c\u00f3 th\u1ec3 th\u1ea5y trong ung th\u01b0 m\u00f3ng (\u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 u h\u1eafc t\u1ed1) v\u00e0 c\u0169ng c\u00f3 th\u1ec3 l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a m\u1ed9t s\u1ed1 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ung th\u01b0.<\/li>\n<li><strong>V\u1ebft n\u1ee9t: <\/strong>nh\u1eefng v\u1ebft n\u1ee9t nh\u1ecf, v\u1ebft c\u1eaft, ho\u1eb7c v\u1ebft r\u00e1ch \u1edf \u0111\u1ea7u ng\u00f3n, \u0111\u0129a m\u00f3ng, gi\u01b0\u1eddng m\u00f3ng, c\u00f3 th\u1ec3 r\u1ea5t \u0111au.<\/li>\n<li><strong>Xu\u1ea5t huy\u1ebft (xu\u1ea5t huy\u1ebft m\u1ea3ng):<\/strong> nh\u1eefng \u0111\u01b0\u1eddng nh\u1ecf m\u00e0u \u0111\u1ecf \u1edf m\u00f3ng l\u00e0 nh\u1eefng v\u00f9ng ch\u1ea3y m\u00e1u ph\u00eda d\u01b0\u1edbi \u0111\u0129a m\u00f3ng.<\/li>\n<li><strong>T\u0103ng s\u1eafc t\u1ed1:<\/strong> ph\u1ea7n \u0111\u0129a m\u00f3ng th\u01b0\u1eddng trong m\u1edd (s\u00e1ng). M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c ho\u1eb7c x\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng da ho\u1eb7c m\u00f3ng b\u1ecb t\u1ed1i s\u1eabm m\u00e0u. Th\u00f4ng th\u01b0\u1eddng thay \u0111\u1ed5i ki\u1ec3u n\u00e0y ch\u1ec9 l\u00e0 t\u1ea1m th\u1eddi, nh\u01b0ng c\u0169ng c\u00f3 khi l\u00e0 v\u0129nh vi\u1ec5n v\u00e0 c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u1edf m\u1ed9t ph\u1ea7n ho\u1eb7c to\u00e0n b\u1ed9 m\u00f3ng.<\/li>\n<li><strong>Vi\u00eam (vi\u00eam quanh m\u00f3ng):<\/strong> m\u00f3ng b\u1ecb \u0111\u1ecf, thi tho\u1ea3ng c\u00f3 s\u01b0ng \u1edf gi\u01b0\u1eddng m\u00f3ng v\u00e0 xung quanh \u0111\u1ea7u ng\u00f3n tay, ch\u00e2n; \u0111\u00f4i khi c\u00f3 k\u00e8m nhi\u1ec5m tr\u00f9ng do vi khu\u1ea9n ho\u1eb7c n\u1ea5m g\u00e2y c\u1ea3m gi\u00e1c r\u1ea5t \u0111au v\u00e0 h\u1ea1n ch\u1ebf ho\u1ea1t \u0111\u1ed9ng th\u01b0\u1eddng ng\u00e0y c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/li>\n<li><strong>M\u00f3ng b\u1ecb n\u00e2ng l\u00ean (bong m\u00f3ng): <\/strong>th\u01b0\u1eddng l\u00e0 t\u00ecnh tr\u1ea1ng t\u1ea1m th\u1eddi nh\u01b0ng c\u00f3 th\u1ec3 g\u00e2y kh\u00f3 ch\u1ecbu. N\u1ebfu m\u00f3ng n\u00e2ng l\u00ean xa kh\u1ecfi gi\u01b0\u1eddng m\u00f3ng, c\u00f3 th\u1ec3 b\u1ecb r\u01a1i ra v\u00e0 tr\u1edf th\u00e0nh n\u01a1i d\u1ec5 nhi\u1ec5m tr\u00f9ng.<\/li>\n<li><strong>M\u1ea5t m\u00f3ng:<\/strong> \u0111\u0129a m\u00f3ng m\u1ea5t ho\u00e0n to\u00e0n. M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c l\u00e0 nguy\u00ean nh\u00e2n \u0111\u0129a m\u00f3ng r\u01a1i h\u1eb3n ra. Tri\u1ec7u ch\u1ee9ng n\u00e0y ch\u1ec9 l\u00e0 t\u1ea1m th\u1eddi nh\u01b0ng g\u00e2y \u0111au v\u00e0 t\u0103ng nguy c\u01a1 nhi\u1ec5m tr\u00f9ng.<\/li>\n<li><strong>Xu\u1ea5t hi\u1ec7n c\u00e1c g\u1edd v\u00e0 r\u00e3nh tr\u00ean \u0111\u0129a m\u00f3ng:<\/strong> M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c l\u00e0 nguy\u00ean nh\u00e2n t\u1ea1o n\u00ean c\u00e1c g\u1edd ho\u1eb7c r\u00e3nh c\u00f3 m\u00e0u s\u1eafc h\u00ecnh d\u1ea1ng kh\u00e1c nhau tr\u00ean \u0111\u0129a m\u00f3ng. D\u1ea5u hi\u1ec7u n\u00e0y c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n v\u00e0 t\u1ed3n t\u1ea1i trong su\u1ed1t qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb v\u00e0 s\u1ebd bi\u1ebfn m\u1ea5t khi m\u00f3ng m\u1ecdc ho\u00e0n thi\u1ec7n. Nh\u1eefng thay \u0111\u1ed5i n\u00e0y th\u01b0\u1eddng kh\u00f4ng \u0111au.<\/li>\n<\/ul>\n<h2><strong>Nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 g\u00e2y bi\u1ebfn \u0111\u1ed5i m\u00f3ng<\/strong><\/h2>\n<p>M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u00f3 th\u1ec3 l\u00e0m m\u00f3ng ng\u1eebng ph\u00e1t tri\u1ec3n khi b\u1ea1n \u0111ang s\u1eed d\u1ee5ng ch\u00fang. N\u1ebfu b\u1ea1n \u0111ang trong c\u00e1c chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb, m\u00f3ng c\u1ee7a b\u1ea1n c\u00f3 th\u1ec3 m\u1ecdc m\u1ed9t ch\u00fat \u1edf gi\u1eefa c\u00e1c chu k\u1ef3, nh\u01b0ng c\u00f3 th\u1ec3 t\u1ea1o n\u00ean \u0111\u01b0\u1eddng ngang m\u00e0u tr\u1eafng tr\u00ean \u0111\u0129a m\u00f3ng, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u0111\u01b0\u1eddng Beau. Ch\u00fang th\u01b0\u1eddng v\u00f4 h\u1ea1i v\u00e0 s\u1ebd bi\u1ebfn m\u1ea5t khi \u0111i\u1ec1u tr\u1ecb k\u1ebft th\u00fac.<\/p>\n<p><em><strong>D\u01b0\u1edbi \u0111\u00e2y l\u00e0 m\u1ed9t s\u1ed1 thay \u0111\u1ed5i v\u1ec1 m\u00f3ng, v\u00e0 m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n.<\/strong> <\/em>S\u1eed d\u1ee5ng nhi\u1ec1u h\u01a1n m\u1ed9t lo\u1ea1i thu\u1ed1c g\u00e2y bi\u1ebfn \u0111\u1ed5i m\u00f3ng c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5.<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"524\"><strong>C\u00e1c lo\u1ea1i thay \u0111\u1ed5i tr\u00ean m\u00f3ng<\/strong><\/td>\n<td width=\"724\"><strong>Nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c thay \u0111\u1ed5i n\u00e0y<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"524\">T\u1ed1i v\u00f9ng da xung quanh \u0111\u01b0\u1eddng ch\u00e2n m\u00f3ng<\/td>\n<td width=\"724\"><strong>\u0110i\u1ec1u tr\u1ecb \u0111\u00edch<\/strong> (sorafenib, sunitinib)<\/td>\n<\/tr>\n<tr>\n<td width=\"524\">T\u0103ng s\u1eafc t\u1ed1 m\u00f3ng<\/td>\n<td width=\"724\"><strong>\u0110i\u1ec1u tr\u1ecb c\u00e1c h\u00f3a ch\u1ea5t nh\u01b0:<\/strong> Bleomycin, capecitabine, cyclophosphamide, dacarbazine, danorubicin, doxorubicin, idarubicin, melphalan, methotrexate<\/p>\n<p><strong>\u0110i\u1ec1u tr\u1ecb \u0111\u00edch \u1ee9c ch\u1ebf EGFR<\/strong> (erlotinib, gefitinib) <strong>v\u00e0 kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng<\/strong> (cetuximab, panitumumab)<\/td>\n<\/tr>\n<tr>\n<td width=\"524\">V\u1ebft n\u1ee9t (r\u00e3nh s\u00e2u)<\/td>\n<td width=\"724\"><strong>\u0110i\u1ec1u tr\u1ecb \u0111\u00edch ho\u1eb7c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng<\/strong> (cetuximab, panitumumab)<\/td>\n<\/tr>\n<tr>\n<td width=\"524\">Xu\u1ea5t huy\u1ebft (xu\u1ea5t huy\u1ebft m\u1ea3nh)<\/td>\n<td width=\"724\"><strong>H\u00f3a ch\u1ea5t<\/strong> (doxorubicin, docetaxel, paclitaxel, nab-paclitaxel)<\/td>\n<\/tr>\n<tr>\n<td width=\"524\">Vi\u00eam (vi\u00eam quanh m\u00f3ng)<\/td>\n<td width=\"724\"><strong>H\u00f3a ch\u1ea5t<\/strong> (doxorubicin, docetaxel, paclitaxel, nab-paclitaxel)<\/p>\n<p><strong>\u0110i\u1ec1u tr\u1ecb \u0111\u00edch \u1ee9c ch\u1ebf EGFR<\/strong> (erlotinib, gefitinib, dacomitinib), <strong>kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng<\/strong> (cetuximab, necitumumab, panitumumab), <strong>v\u00e0 \u1ee9c ch\u1ebf mTOR<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"524\">M\u00f3ng b\u1ecb n\u00e2ng l\u00ean (bong m\u00f3ng)<\/td>\n<td width=\"724\"><strong>H\u00f3a ch\u1ea5t<\/strong> dacarbazine, daunorubicin, and mitoxantrone (everolimus, temsirolimus)<\/p>\n<p><strong>\u0110i\u1ec1u tr\u1ecb \u0111\u00edch nh\u01b0 \u1ee9c ch\u1ebf mTOR<\/strong> (everolimus, temsirolimus)<\/td>\n<\/tr>\n<tr>\n<td width=\"524\">M\u1ea5t m\u00f3ng<\/td>\n<td width=\"724\"><strong>\u0110i\u1ec1u tr\u1ecb h\u00f3a ch\u1ea5t <\/strong>bleomycin and 5-fluorouracil (5-FU)<\/td>\n<\/tr>\n<tr>\n<td width=\"524\">C\u00e1c g\u1edd, r\u00e3nh ho\u1eb7c m\u1ea5t m\u00e0u m\u00f3ng<\/td>\n<td width=\"724\"><strong>H\u00f3a ch\u1ea5t<\/strong> cyclophosphamide, doxorubicin, docetaxel, hydroxyurea, idarubicin, ifosfamide, and 5-fluorouracil (5-FU)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2><strong>Qu\u1ea3n l\u00fd nh\u1eefng thay \u0111\u1ed5i v\u1ec1 m\u00f3ng<\/strong><\/h2>\n<p>R\u1ea5t nhi\u1ec1u thay \u0111\u1ed5i tr\u00ean m\u00f3ng x\u1ea3y ra trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00ecnh th\u1ee9c c\u1ee7a m\u00f3ng.<\/p>\n<p>V\u00ed d\u1ee5, c\u00e1c n\u1ebfp g\u1ea5p, \u0111\u01b0\u1eddng k\u1ebb tr\u00ean m\u00f3ng th\u01b0\u1eddng kh\u00f4ng \u0111au, nh\u01b0ng l\u00e0m cho m\u00f3ng nh\u00ecn kh\u00f4ng \u0111\u1eb9p m\u1eaft th\u1eadm ch\u00ed kh\u00f3 ch\u1ecbu. N\u1ebfu thay \u0111\u1ed5i tr\u00ean m\u00f3ng l\u00e0 do ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 th\u00ec khi d\u1eebng \u0111i\u1ec1u tr\u1ecb v\u00e0 m\u00f3ng m\u1ecdc l\u1ea1i c\u00e1c thay \u0111\u1ed5i n\u00e0y s\u1ebd bi\u1ebfn m\u1ea5t.<\/p>\n<p><strong><em>Nh\u1eefng thay \u0111\u1ed5i t\u1ea1m th\u1eddi tr\u00ean m\u00f3ng bao g\u1ed3m<\/em><\/strong><\/p>\n<ul>\n<li>Thay \u0111\u1ed5i v\u1ec1 m\u00e0u s\u1eafc (v\u00f9ng da t\u1ed1i, t\u0103ng s\u1eafc t\u1ed1 m\u00f4)<\/li>\n<li>Xu\u1ea5t huy\u1ebft m\u1ea3nh<\/li>\n<li>C\u00e1c n\u1ebfp g\u1ea5p, \u0111\u01b0\u1eddng k\u1ebb, n\u1ebfp nh\u0103n tr\u00ean m\u00f3ng<\/li>\n<\/ul>\n<p><strong><em>\u0110\u1ed1i v\u1edbi nh\u1eefng thay \u0111\u1ed5i nh\u1ecf, kh\u00f4ng \u0111au, c\u00f3 th\u1ec3 x\u1eed tr\u00ed nh\u01b0 sau\u00a0 \u00a0<\/em><\/strong><\/p>\n<ul>\n<li>B\u1ea3o v\u1ec7 m\u00f3ng b\u1ecb ch\u1ebb, n\u1ebfp g\u1ea5p, m\u1ecfng manh b\u1eb1ng s\u01a1n m\u00f3ng tay h\u00f2a tan trong n\u01b0\u1edbc, ho\u1eb7c l\u00e0 thu\u1ed1c d\u01b0\u1ee1ng b\u00f3ng m\u00f3ng do b\u00e1c s\u1ef9 k\u00ea \u0111\u01a1n.<\/li>\n<li>Biotin (m\u1ed9t lo\u1ea1i th\u1ef1c ph\u1ea9m ch\u1ee9c n\u0103ng) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u00ea \u0111\u1ec3 m\u00f3ng c\u1ee7a b\u1ea1n kh\u1ecfe h\u01a1n. H\u1ecfi b\u00e1c s\u0129 tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng \u0111\u1ec3 bi\u1ebft d\u00f9ng biotin c\u00f3 an to\u00e0n cho b\u1ea1n kh\u00f4ng.<\/li>\n<\/ul>\n<p>Tuy nhi\u00ean, m\u1ed9t s\u1ed1 thay \u0111\u1ed5i tr\u00ean m\u00f3ng g\u00e2y \u0111au, ho\u1eb7c li\u00ean quan \u0111\u1ebfn nhi\u1ec5m tr\u00f9ng, v\u00e0 c\u1ea7n \u0111i\u1ec1u tr\u1ecb. H\u1ecfi \u00fd ki\u1ebfn b\u00e1c s\u0129 c\u1ee7a b\u1ea1n c\u00e1ch x\u1eed tr\u00ed n\u00e0o l\u00e0 t\u1ed1t nh\u1ea5t cho t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ea1n tr\u01b0\u1edbc khi c\u1ed1 g\u1eafng l\u00e0m b\u1ea5t c\u1ee9 \u0111i\u1ec1u g\u00ec t\u1ea1i nh\u00e0.<\/p>\n<ul>\n<li><strong>Vi\u00eam m\u00f3ng (vi\u00eam quanh m\u00f3ng):<\/strong> \u0110i\u1ec1u tr\u1ecb theo khuy\u1ebfn c\u00e1o c\u1ee7a b\u00e1c s\u0129; c\u00f3 th\u1ec3 bao g\u1ed3m s\u1eed d\u1ee5ng thu\u1ed1c m\u1ee1 steroid v\u00e0 ng\u00e2m b\u1eb1ng h\u1ed7n h\u1ee3p gi\u1ea5m tr\u1eafng v\u1edbi n\u01b0\u1edbc (m\u1ed9t ph\u1ea7n n\u01b0\u1edbc m\u1ed9t ph\u1ea7n gi\u1ea5m), ng\u00e2m n\u01b0\u1edbc kh\u1eed tr\u00f9ng, u\u1ed1ng thu\u1ed1c ch\u1ed1ng vi\u00eam ho\u1eb7c kh\u00e1ng sinh.<\/li>\n<li><strong>M\u00f3ng b\u1ecb n\u00e2ng l\u00ean (bong m\u00f3ng): <\/strong>Ph\u1eabu thu\u1eadt l\u1ea5y b\u1ecf m\u1ed9t ph\u1ea7n \u0111\u0129a m\u00f3ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 l\u00e0m gi\u1ea3m \u0111au.<\/li>\n<li><strong>Vi\u00eam m\u00f3ng (do vi khu\u1ea9n ho\u1eb7c n\u1ea5m):<\/strong> thu\u1ed1c m\u1ee1 kh\u00e1ng khu\u1ea9n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u00e1c s\u0129 khuy\u00ean d\u00f9ng v\u00e0 c\u1ea7n b\u00f4i th\u01b0\u1eddng xuy\u00ean l\u00ean m\u00f3ng ho\u1eb7c gi\u01b0\u1eddng m\u00f3ng.<\/li>\n<li><strong>C\u00e1c v\u1ebft n\u1ee9t (r\u00e3nh s\u00e2u c\u00f3 th\u1ec3 m\u1edf ho\u1eb7c g\u00e2y t\u00e1ch m\u00f3ng):<\/strong> Ph\u1eabu thu\u1eadt l\u1ea5y b\u1ecf m\u1ed9t ph\u1ea7n \u0111\u0129a m\u00f3ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 l\u00e0m gi\u1ea3m \u0111au<\/li>\n<\/ul>\n<h2><strong>Ng\u01b0\u1eddi b\u1ec7nh n\u00ean l\u00e0m g\u00ec?<\/strong><\/h2>\n<p>C\u00f3 th\u1ec3 ch\u00fang ta kh\u00f4ng th\u1ec3 ng\u0103n ng\u1eeba \u0111\u01b0\u1ee3c nh\u1eefng bi\u1ebfn \u0111\u1ed5i tr\u00ean m\u00f3ng nh\u01b0ng v\u1eabn c\u00f3 th\u1ec3 x\u1eed tr\u00ed nh\u1eefng thay \u0111\u1ed5i nh\u1ecf, v\u00e0 ng\u0103n nh\u1eefng thay \u0111\u1ed5i ti\u1ebfn tri\u1ec3n n\u1eb7ng h\u01a1n.<\/p>\n<p><strong><em>Nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p x\u1eed tr\u00ed c\u00f3 th\u1ec3 bao g\u1ed3m:<\/em><\/strong><\/p>\n<ul>\n<li>Ki\u1ec3m tra ng\u00f3n tay ch\u00e2n h\u00e0ng ng\u00e0y \u0111\u1ec3 ph\u00e1t hi\u1ec7n ngay nh\u1eefng thay \u0111\u1ed5i tr\u00ean m\u00f3ng.<\/li>\n<li>S\u1eed d\u1ee5ng s\u01a1n m\u00f3ng lo\u1ea1i tan trong n\u01b0\u1edbc \u0111\u1ec3 c\u1ee7ng c\u1ed1 v\u00e0 b\u1ea3o v\u1ec7 nh\u1eefng m\u00f3ng c\u00f3 n\u1ebfp g\u1ea5p, m\u1ecfng manh, ho\u1eb7c b\u1ecb ch\u1ebb.<\/li>\n<li>B\u00e1o cho b\u00e1c s\u1ef9 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 bi\u1ebft ngay khi th\u1ea5y nh\u1eefng thay \u0111\u1ed5i tr\u00ean m\u00f3ng.<\/li>\n<li>Lu\u00f4n c\u1eaft ng\u1eafn m\u00f3ng. M\u00f3ng ng\u1eafn s\u1ebd \u00edt khi b\u1ecb g\u00e3y ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng h\u01a1n.<\/li>\n<li>Gi\u1eef m\u00f3ng lu\u00f4n s\u1ea1ch s\u1ebd \u0111\u1ec3 tr\u00e1nh nguy c\u01a1 nhi\u1ec5m tr\u00f9ng.<\/li>\n<li>B\u1ea3o v\u1ec7 b\u00e0n tay khi ph\u1ea3i ng\u00e2m tay trong n\u01b0\u1edbc (nh\u01b0 khi r\u1eeda b\u00e1t), khi l\u00e0m v\u01b0\u1eddn, lau d\u1ecdn. Mang g\u0103ng tay lao \u0111\u1ed9ng khi l\u00e0m nh\u1eefng c\u00f4ng vi\u1ec7c n\u00e0y \u0111\u1ec3 b\u1ea3o v\u1ec7 m\u00f3ng.<\/li>\n<li>Kh\u00f4ng \u0111i l\u00e0m m\u00f3ng \u1edf ti\u1ec7m m\u00f3ng khi \u0111ang \u0111i\u1ec1u tr\u1ecb ung th\u01b0.<\/li>\n<li>\u0110i gi\u00e0y r\u1ed9ng.<\/li>\n<li>Tr\u00e1nh t\u1ea1o \u00e1p l\u1ef1c l\u00ean gi\u01b0\u1eddng m\u00f3ng (c\u1ea3 ng\u00f3n tay v\u00e0 ch\u00e2n).<\/li>\n<li>N\u1ebfu \u0111ang s\u1eed d\u1ee5ng nh\u00f3m thu\u1ed1c Taxane (\u0111\u1eb7c bi\u1ec7t l\u00e0 Docetaxel), c\u00f3 th\u1ec3 ch\u01b0\u1eddm l\u1ea1nh m\u00f3ng c\u1ee7a b\u1ea1n tr\u01b0\u1edbc truy\u1ec1n thu\u1ed1c 15 ph\u00fat, trong khi truy\u1ec1n, v\u00e0 sau khi truy\u1ec1n 15 ph\u00fat \u0111\u1ec3 gi\u00fap ng\u0103n ng\u1eeba m\u00f3ng b\u1ecb bong.<\/li>\n<\/ul>\n<p>N\u00f3i cho b\u00e1c s\u1ef9 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 bi\u1ebft ngay khi b\u1ea1n nh\u1eadn th\u1ea5y b\u1ea5t k\u1ef3 thay \u0111\u1ed5i n\u00e0o tr\u00ean m\u00f3ng, \u0111i\u1ec1u n\u00e0y r\u1ea5t quan tr\u1ecdng. Ph\u00f2ng ng\u1eeba v\u00e0 tr\u00e1nh th\u01b0\u01a1ng t\u00edch \u1edf m\u00f3ng l\u00e0 m\u1ed9t ph\u1ea7n r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1eef cho m\u00f3ng kh\u1ecfe m\u1ea1nh. N\u1ebfu b\u1ea1n d\u00f9ng thu\u1ed1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nh\u1eefng thay \u0111\u1ed5i v\u1ec1 m\u00f3ng, c\u1ea7n n\u00f3i cho b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 bi\u1ebft thu\u1ed1c t\u00e1c d\u1ee5ng v\u1edbi b\u1ea1n \u1edf m\u1ee9c \u0111\u1ed9 n\u00e0o v\u00e0 b\u00e1o cho b\u00e1c s\u1ef9 n\u1ebfu c\u00f3 nh\u1eefng v\u1ea5n \u0111\u1ec1 kh\u00e1c v\u1ec1 m\u00f3ng xu\u1ea5t hi\u1ec7n.<\/p>\n<h2><strong>C\u00e1c c\u00e2u h\u1ecfi v\u1ec1 thay \u0111\u1ed5i \u1edf m\u00f3ng<\/strong><\/h2>\n<p>N\u1ebfu b\u1ea1n lo l\u1eafng ho\u1eb7c c\u00f3 nguy c\u01a1 c\u00f3 nh\u1eefng thay \u0111\u1ed5i \u1edf m\u00f3ng, c\u00f3 th\u1ec3 h\u1ecfi b\u00e1c s\u1ef9 \u0111i\u1ec1u tr\u1ecb nh\u1eefng c\u00e2u h\u1ecfi sau:<\/p>\n<ul>\n<li>T\u00f4i c\u00f3 n\u00ean s\u01a1n m\u00f3ng b\u1eb1ng lo\u1ea1i s\u01a1n b\u1ea3o v\u1ec7 m\u00f3ng kh\u00f4ng? N\u1ebfu kh\u00f4ng n\u00ean th\u00ec l\u00fd do t\u1ea1i sao?<\/li>\n<li>T\u00f4i c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c ch\u0103m s\u00f3c, l\u00e0m \u0111\u1eb9p m\u00f3ng theo ch\u1ebf \u0111\u1ed9 nh\u01b0 tr\u01b0\u1edbc \u0111\u00e2y v\u1eabn th\u01b0\u1eddng l\u00e0m kh\u00f4ng? H\u00e3y gi\u1ea3i th\u00edch r\u00f5 n\u1ebfu b\u1ea1n \u0111ang \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c m\u00f3ng theo ch\u1ebf \u0111\u1ed9 \u0111\u1eb7c bi\u1ec7t t\u1ea1i salon chuy\u00ean nghi\u1ec7p, v\u00ed d\u1ee5 d\u00f9ng m\u00f3ng acrylic ho\u1eb7c gel ho\u1eb7c l\u00e0m b\u00f3ng m\u00f3ng.<\/li>\n<li>Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u1ee7a t\u00f4i c\u00f3 th\u1ec3 g\u00e2y thay \u0111\u1ed5i v\u1ec1 m\u00f3ng hay kh\u00f4ng? Nh\u1eefng thay \u0111\u1ed5i n\u00e0o c\u00f3 th\u1ec3 x\u1ea3y ra.<\/li>\n<li>Nh\u1eefng thay \u0111\u1ed5i \u0111\u00f3 x\u1ea3y ra khi n\u00e0o v\u00e0 khi n\u00e0o s\u1ebd k\u1ebft th\u00fac?<\/li>\n<li>T\u00f4i c\u00f3 th\u1ec3 l\u00e0m g\u00ec \u0111\u1ec3 tr\u00e1nh \u0111\u01b0\u1ee3c nh\u1eefng thay \u0111\u1ed5i n\u00e0y kh\u00f4ng?<\/li>\n<li>N\u1ebfu t\u00f4i nh\u1eadn th\u1ea5y c\u00f3 thay \u0111\u1ed5i tr\u00ean m\u00f3ng, t\u00f4i n\u00ean l\u00e0m g\u00ec?<\/li>\n<li>N\u1ebfu t\u00f4i c\u00f3 nh\u1eefng thay \u0111\u1ed5i tr\u00ean m\u00f3ng, nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0o t\u00f4i c\u1ea7n tr\u00e1nh s\u1eed d\u1ee5ng?<\/li>\n<li>Nh\u1eefng thay \u0111\u1ed5i v\u1ec1 m\u00f3ng c\u00f3 l\u00e0m ch\u1eadm, t\u1ea1m d\u1eebng ho\u1eb7c ng\u01b0ng vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u1ee7a t\u00f4i kh\u00f4ng? N\u1ebfu c\u00f3, t\u00f4i c\u00f2n c\u00f3 nh\u1eefng l\u1ef1a ch\u1ecdn n\u00e0o?<\/li>\n<\/ul>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p><a href=\"https:\/\/www.cancer.org\/treatment\/treatments-and-side-effects\/physical-side-effects\/nail-changes.html\" target=\"_blank\" rel=\"noopener\">Treatments and side effects: Nail changes<\/a>. American Cancer Society www.cancer.org<\/p>\n","protected":false},"excerpt":{"rendered":"<p>M\u00f3ng gi\u00fap b\u1ea3o v\u1ec7 \u0111\u1ea7u ng\u00f3n tay v\u00e0 ng\u00f3n ch\u00e2n v\u00e0 gi\u00fap c\u00e1c ng\u00f3n tay th\u1ef1c hi\u1ec7n c\u00e1c \u0111\u1ed9ng t\u00e1c. M\u1ed9t s\u1ed1 lo\u1ea1i ung th\u01b0 v\u00e0 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n c\u1ee7a s\u1ef1 thay \u0111\u1ed5i v\u1ec1 m\u00f3ng.<\/p>\n","protected":false},"author":529,"featured_media":8669,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[2663,3352,2476,3310],"series":[1420],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>C\u00e1c thay \u0111\u1ed5i \u1edf m\u00f3ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh ung th\u01b0 - D\u1ef1 \u00e1n Ung Th\u01b0<\/title>\n<meta name=\"description\" content=\"M\u00f3ng gi\u00fap b\u1ea3o v\u1ec7 \u0111\u1ea7u ng\u00f3n tay v\u00e0 ng\u00f3n ch\u00e2n v\u00e0 gi\u00fap c\u00e1c ng\u00f3n tay th\u1ef1c hi\u1ec7n c\u00e1c \u0111\u1ed9ng t\u00e1c. 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M\u1ed9t s\u1ed1 lo\u1ea1i ung th\u01b0 v\u00e0 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n c\u1ee7a s\u1ef1 thay \u0111\u1ed5i v\u1ec1 m\u00f3ng.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/yhoccongdong.com\/ung-thu\/cac-thay-doi-o-mong-cua-nguoi-benh-ung-thu\/","og_locale":"vi_VN","og_type":"article","og_title":"C\u00e1c thay \u0111\u1ed5i \u1edf m\u00f3ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh ung th\u01b0 - D\u1ef1 \u00e1n Ung Th\u01b0","og_description":"M\u00f3ng gi\u00fap b\u1ea3o v\u1ec7 \u0111\u1ea7u ng\u00f3n tay v\u00e0 ng\u00f3n ch\u00e2n v\u00e0 gi\u00fap c\u00e1c ng\u00f3n tay th\u1ef1c hi\u1ec7n c\u00e1c \u0111\u1ed9ng t\u00e1c. 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