{"id":3277,"date":"2025-04-23T13:29:10","date_gmt":"2025-04-23T06:29:10","guid":{"rendered":"https:\/\/hienbacsi.com\/?p=3277"},"modified":"2025-04-23T13:29:10","modified_gmt":"2025-04-23T06:29:10","slug":"cap-nhat-chan-doan-hien-dai-cua-benh-trao-nguoc-da-day-thuc-quan-gerd-lyon-consensus-2-0","status":"publish","type":"post","link":"https:\/\/hienbacsi.com\/index.php\/2025\/04\/23\/cap-nhat-chan-doan-hien-dai-cua-benh-trao-nguoc-da-day-thuc-quan-gerd-lyon-consensus-2-0\/","title":{"rendered":"C\u1eadp Nh\u1eadt Ch\u1ea9n \u0110o\u00e1n Hi\u1ec7n \u0110\u1ea1i c\u1ee7a B\u1ec7nh Tr\u00e0o Ng\u01b0\u1ee3c D\u1ea1 D\u00e0y-Th\u1ef1c Qu\u1ea3n (GERD): Lyon Consensus 2.0"},"content":{"rendered":"\n

ThS BS Tr\u1ea7n H\u1eefu Hi\u1ec1n<\/h1>\n\n\n\n

T\u1ed1t nghi\u1ec7p b\u1eb1ng DIU \u0110H Corse CH Ph\u00e1p<\/p>\n\n\n\n

Gi\u1edbi Thi\u1ec7u<\/h2>\n\n\n\n

B\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y-th\u1ef1c qu\u1ea3n (Gastroesophageal Reflux Disease – GERD) l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng ph\u1ed5 bi\u1ebfn trong y h\u1ecdc, g\u00e2y ra b\u1edfi s\u1ef1 tr\u00e0o ng\u01b0\u1ee3c c\u00e1c n\u1ed9i dung t\u1eeb d\u1ea1 d\u00e0y l\u00ean th\u1ef1c qu\u1ea3n, d\u1eabn \u0111\u1ebfn c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00f3 ch\u1ecbu v\u00e0\/ho\u1eb7c bi\u1ebfn ch\u1ee9ng. \u0110\u1ec3 c\u1ea3i thi\u1ec7n t\u00ednh \u0111\u1eb7c hi\u1ec7u trong ch\u1ea9n \u0111o\u00e1n v\u00e0 qu\u1ea3n l\u00fd GERD, Lyon Consensus 2.0 \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1eadp nh\u1eadt d\u1ef1a tr\u00ean c\u00e1c nghi\u00ean c\u1ee9u m\u1edbi nh\u1ea5t, \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 v\u00e0o ng\u00e0y 21 th\u00e1ng 9 n\u0103m 2023 tr\u00ean t\u1ea1p ch\u00ed Gut<\/em>.<\/p>\n\n\n\n

<\/figure>\n\n\n\n
\n\n\n\n

1. \u0110\u1ecbnh Ngh\u0129a C\u00e1c Thu\u1eadt Ng\u1eef M\u1edbi v\u1ec1 GERD<\/h2>\n\n\n\n

Lyon Consensus 2.0 \u0111\u00e3 gi\u1edbi thi\u1ec7u m\u1ed9t s\u1ed1 kh\u00e1i ni\u1ec7m v\u00e0 thu\u1eadt ng\u1eef m\u1edbi nh\u1eb1m n\u00e2ng cao t\u00ednh ch\u00ednh x\u00e1c trong ch\u1ea9n \u0111o\u00e1n v\u00e0 qu\u1ea3n l\u00fd GERD:<\/p>\n\n\n\n

    \n
  • Actionable GERD<\/strong>: L\u00e0 t\u00ecnh tr\u1ea1ng GERD m\u00e0 c\u00e1c k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m th\u1ef1c qu\u1ea3n (nh\u01b0 n\u1ed9i soi ho\u1eb7c gi\u00e1m s\u00e1t tr\u00e0o ng\u01b0\u1ee3c) cung c\u1ea5p b\u1eb1ng ch\u1ee9ng r\u00f5 r\u00e0ng, h\u1ed7 tr\u1ee3 vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh, n\u00e2ng c\u1ea5p ho\u1eb7c c\u00e1 nh\u00e2n h\u00f3a ph\u01b0\u01a1ng ph\u00e1p qu\u1ea3n l\u00fd cho b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng. \u0110\u00e2y l\u00e0 tr\u01b0\u1eddng h\u1ee3p c\u1ea7n can thi\u1ec7p d\u00e0i h\u1ea1n b\u1eb1ng thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton (Proton Pump Inhibitor – PPI), ph\u1eabu thu\u1eadt (nh\u01b0 fundoplication n\u1ed9i soi ho\u1eb7c magnetic sphincter augmentation – MSA), ho\u1eb7c c\u00e1c li\u1ec7u ph\u00e1p n\u1ed9i soi kh\u00e1c.<\/li>\n\n\n\n
  • GERD Ch\u01b0a \u0110\u01b0\u1ee3c Ch\u1ee9ng Minh (Unproven GERD)<\/strong>: L\u00e0 t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n ch\u01b0a c\u00f3 b\u1eb1ng ch\u1ee9ng r\u00f5 r\u00e0ng v\u1ec1 GERD t\u1eeb n\u1ed9i soi ho\u1eb7c gi\u00e1m s\u00e1t tr\u00e0o ng\u01b0\u1ee3c tr\u01b0\u1edbc \u0111\u00f3. \u0110\u1ed1i v\u1edbi nh\u00f3m n\u00e0y, c\u00e1c x\u00e9t nghi\u1ec7m nh\u01b0 gi\u00e1m s\u00e1t pH k\u00e9o d\u00e0i ho\u1eb7c pH-impedance \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n khi kh\u00f4ng d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf ti\u1ebft acid \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh ho\u1eb7c lo\u1ea1i tr\u1eeb GERD.<\/li>\n\n\n\n
  • GERD \u0110\u00e3 \u0110\u01b0\u1ee3c Ch\u1ee9ng Minh (Proven GERD)<\/strong>: L\u00e0 t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n c\u00f3 b\u1eb1ng ch\u1ee9ng k\u1ebft lu\u1eadn t\u1eeb n\u1ed9i soi (nh\u01b0 vi\u00eam th\u1ef1c qu\u1ea3n \u0111\u1ed9 LA B, C, D ho\u1eb7c Barrett\u2019s esophagus) ho\u1eb7c gi\u00e1m s\u00e1t tr\u00e0o ng\u01b0\u1ee3c b\u1ea5t th\u01b0\u1eddng. V\u1edbi nh\u00f3m n\u00e0y, n\u1ebfu tri\u1ec7u ch\u1ee9ng v\u1eabn t\u1ed3n t\u1ea1i d\u00f9 \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb t\u1ed1i \u01b0u, s\u1ebd s\u1eed d\u1ee5ng gi\u00e1m s\u00e1t pH-impedance khi \u0111ang d\u00f9ng PPI \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 GERD kh\u00e1ng tr\u1ecb.<\/li>\n\n\n\n
  • Tr\u00e0o Ng\u01b0\u1ee3c Kh\u00e1ng Tr\u1ecb (Refractory GERD)<\/strong>: L\u00e0 t\u00ecnh tr\u1ea1ng GERD kh\u00f4ng c\u1ea3i thi\u1ec7n d\u00f9 \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb t\u1ed1i \u01b0u b\u1eb1ng PPI, th\u01b0\u1eddng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh qua c\u00e1c t\u1ed5n th\u01b0\u01a1ng ni\u00eam m\u1ea1c (nh\u01b0 vi\u00eam th\u1ef1c qu\u1ea3n \u0111\u1ed9 LA B tr\u1edf l\u00ean) ho\u1eb7c gi\u00e1m s\u00e1t pH-impedance b\u1ea5t th\u01b0\u1eddng khi \u0111ang d\u00f9ng thu\u1ed1c.<\/li>\n\n\n\n
  • Th\u1eddi Gian Ti\u1ebfp X\u00fac Acid (Acid Exposure Time – AET)<\/strong>: L\u00e0 t\u1ef7 l\u1ec7 ph\u1ea7n tr\u0103m th\u1eddi gian th\u1ef1c qu\u1ea3n ti\u1ebfp x\u00fac v\u1edbi acid (pH < 4) trong 24 gi\u1edd, \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng gi\u00e1m s\u00e1t pH ho\u1eb7c pH-impedance. C\u00e1c ng\u01b0\u1ee1ng AET (< 4%, 4-6%, > 6%) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e2n lo\u1ea1i GERD b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng r\u00f5 r\u00e0ng ho\u1eb7c b\u1ea5t th\u01b0\u1eddng.<\/li>\n\n\n\n
  • Tr\u1edf Ng\u1ea1i \u0110\u00eam Trung B\u00ecnh (Mean Nocturnal Baseline Impedance – MNBI)<\/strong>: L\u00e0 ch\u1ec9 s\u1ed1 \u0111o \u0111\u1ed9 c\u1ea3n tr\u1edf \u0111i\u1ec7n tr\u1edf ni\u00eam m\u1ea1c th\u1ef1c qu\u1ea3n v\u00e0o ban \u0111\u00eam, ph\u1ea3n \u00e1nh t\u1ed5n th\u01b0\u01a1ng ni\u00eam m\u1ea1c do tr\u00e0o ng\u01b0\u1ee3c, th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t ch\u1ec9 s\u1ed1 h\u1ed7 tr\u1ee3 trong gi\u00e1m s\u00e1t pH-impedance.<\/li>\n<\/ul>\n\n\n\n

    Nh\u1eefng \u0111\u1ecbnh ngh\u0129a n\u00e0y gi\u00fap ph\u00e2n bi\u1ec7t r\u00f5 r\u00e0ng c\u00e1c giai \u0111o\u1ea1n v\u00e0 m\u1ee9c \u0111\u1ed9 GERD, t\u1eeb \u0111\u00f3 \u0111\u1ecbnh h\u01b0\u1edbng chi\u1ebfn l\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n\n\n\n

    <\/figure>\n\n\n\n
    \n\n\n\n

    2. Tri\u1ec7u Ch\u1ee9ng c\u1ee7a GERD<\/h2>\n\n\n\n

    Tri\u1ec7u ch\u1ee9ng c\u1ee7a GERD \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i d\u1ef1a tr\u00ean m\u1ee9c \u0111\u1ed9 li\u00ean quan \u0111\u1ebfn c\u00e1c \u0111\u1ee3t tr\u00e0o ng\u01b0\u1ee3c, bao g\u1ed3m:<\/p>\n\n\n\n

      \n
    • Tri\u1ec7u Ch\u1ee9ng Th\u01b0\u1eddng G\u1eb7p (Typical Symptoms)<\/strong>:\n
        \n
      • \u0110au Th\u1ef1c Qu\u1ea3n (Heartburn)<\/strong>: C\u1ea3m gi\u00e1c n\u00f3ng r\u00e1t sau x\u01b0\u01a1ng \u1ee9c, th\u01b0\u1eddng sau khi \u0103n.<\/li>\n\n\n\n
      • Tr\u00e0o Ng\u01b0\u1ee3c (Regurgitation)<\/strong>: S\u1ef1 tr\u00e0o ng\u01b0\u1ee3c th\u1ee9c \u0103n ho\u1eb7c d\u1ecbch d\u1ea1 d\u00e0y l\u00ean h\u1ecdng ho\u1eb7c mi\u1ec7ng.<\/li>\n\n\n\n
      • \u0110au Ng\u1ef1c Th\u1ef1c Qu\u1ea3n (Esophageal Chest Pain)<\/strong>: \u0110au ng\u1ef1c li\u00ean quan \u0111\u1ebfn th\u1ef1c qu\u1ea3n, c\u00f3 th\u1ec3 nh\u1ea7m v\u1edbi \u0111au tim.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
      • Tri\u1ec7u Ch\u1ee9ng \u00cdt Li\u00ean Quan (Atypical Symptoms)<\/strong>:\n
          \n
        • Ho m\u00e3n t\u00ednh, kh\u00e0n gi\u1ecdng, ho\u1eb7c hen suy\u1ec5n c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn tr\u00e0o ng\u01b0\u1ee3c, nh\u01b0ng t\u1ef7 l\u1ec7 x\u00e1c nh\u1eadn th\u1ea5p.<\/li>\n\n\n\n
        • \u1ee2 h\u01a1i (Supragastric Belching)<\/strong>: Hi\u1ec7n t\u01b0\u1ee3ng nu\u1ed1t kh\u00f4ng kh\u00ed qu\u00e1 m\u1ee9c, \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh qua pH-impedance v\u1edbi s\u1ef1 t\u0103ng nhanh \u0111i\u1ec7n tr\u1edf trong th\u1ef1c qu\u1ea3n.<\/li>\n\n\n\n
        • Ruminaton<\/strong>: H\u00e0nh vi t\u00e1i nhai th\u1ee9c \u0103n, th\u01b0\u1eddng x\u1ea3y ra sau b\u1eefa \u0103n v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c ph\u00e2n bi\u1ec7t v\u1edbi tr\u00e0o ng\u01b0\u1ee3c.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
        • Tri\u1ec7u Ch\u1ee9ng Kh\u00f4ng Li\u00ean Quan (Unrelated Symptoms)<\/strong>:\n
            \n
          • \u0110au b\u1ee5ng, bu\u1ed3n n\u00f4n, ho\u1eb7c kh\u00f3 nu\u1ed1t kh\u00f4ng do tr\u00e0o ng\u01b0\u1ee3c (tr\u1eeb khi nh\u1ea7m l\u1eabn v\u1edbi \u0111au th\u01b0\u1ee3ng v\u1ecb).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n

            Lyon Consensus 2.0 khuy\u1ebfn ngh\u1ecb th\u1eed nghi\u1ec7m thu\u1ed1c \u1ee9c ch\u1ebf acid (PPI) cho c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh m\u00e0 kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u b\u00e1o \u0111\u1ed9ng (alarm symptoms), trong khi c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00f4ng \u0111i\u1ec3n h\u00ecnh c\u1ea7n x\u00e9t nghi\u1ec7m tr\u01b0\u1edbc khi can thi\u1ec7p d\u00e0i h\u1ea1n.<\/p>\n\n\n\n

            C\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a GERD<\/figcaption><\/figure>\n\n\n\n
            \n\n\n\n

            3. Ch\u1ea9n \u0110o\u00e1n GERD v\u00e0 Ph\u01b0\u01a1ng Ph\u00e1p Theo D\u00f5i v\u1edbi Ti\u00eau Chu\u1ea9n M\u1edbi<\/h2>\n\n\n\n

            3.1. Ph\u01b0\u01a1ng Ph\u00e1p Ch\u1ea9n \u0110o\u00e1n<\/h3>\n\n\n\n

            Ch\u1ea9n \u0111o\u00e1n GERD d\u1ef1a tr\u00ean n\u1ed9i soi v\u00e0 gi\u00e1m s\u00e1t tr\u00e0o ng\u01b0\u1ee3c, v\u1edbi c\u00e1c ti\u00eau chu\u1ea9n m\u1edbi nh\u01b0 sau:<\/p>\n\n\n\n

              \n
            • N\u1ed9i Soi (Endoscopy)<\/strong>:\n
                \n
              • B\u1eb1ng Ch\u1ee9ng K\u1ebft Lu\u1eadn (Conclusive Evidence)<\/strong>: Vi\u00eam th\u1ef1c qu\u1ea3n \u0111\u1ed9 LA B, C, D, Barrett\u2019s esophagus (x\u00e1c nh\u1eadn qua sinh thi\u1ebft), ho\u1eb7c h\u1eb9p th\u1ef1c qu\u1ea3n do lo\u00e9t (peptic stricture) \u0111\u01b0\u1ee3c coi l\u00e0 b\u1eb1ng ch\u1ee9ng ch\u1eafc ch\u1eafn c\u1ee7a GERD.<\/li>\n\n\n\n
              • Y\u00eau C\u1ea7u<\/strong>: N\u1ed9i soi n\u00ean th\u1ef1c hi\u1ec7n sau \u00edt nh\u1ea5t 2-4 tu\u1ea7n ng\u1eebng PPI \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c, \u0111\u1eb7c bi\u1ec7t v\u1edbi GERD ch\u01b0a ch\u1ee9ng minh.<\/li>\n\n\n\n
              • H\u1ed7 Tr\u1ee3 (Supportive Evidence)<\/strong>: Tho\u00e1t v\u1ecb ho\u00e0nh (hiatal hernia) l\u00e0 d\u1ea5u hi\u1ec7u h\u1ed7 tr\u1ee3, nh\u01b0ng sinh thi\u1ebft th\u00f4ng th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
              • Gi\u00e1m S\u00e1t Tr\u00e0o Ng\u01b0\u1ee3c (Ambulatory Reflux Monitoring)<\/strong>:\n
                  \n
                • \u0110\u1ed1i v\u1edbi GERD Ch\u01b0a Ch\u1ee9ng Minh<\/strong>:\n
                    \n
                  • Gi\u00e1m S\u00e1t pH Kh\u00f4ng D\u00e2y K\u00e9o D\u00e0i (Prolonged Wireless pH Monitoring)<\/strong>: L\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u01b0u ti\u00ean, k\u00e9o d\u00e0i 96 gi\u1edd, v\u1edbi ng\u01b0\u1ee1ng AET < 4% lo\u1ea1i tr\u1eeb GERD, AET > 6% tr\u00ean \u2265 2 ng\u00e0y x\u00e1c nh\u1eadn GERD, v\u00e0 AET < 4% v\u1edbi m\u1ed1i li\u00ean h\u1ec7 tri\u1ec7u ch\u1ee9ng-tr\u00e0o ng\u01b0\u1ee3c d\u01b0\u01a1ng t\u00ednh (> 95% Symptom Association Probability – SAP ho\u1eb7c > 50% Symptom Index – SI) ch\u1ea9n \u0111o\u00e1n nh\u1ea1y c\u1ea3m tr\u00e0o ng\u01b0\u1ee3c (reflux hypersensitivity).<\/li>\n\n\n\n
                  • Gi\u00e1m S\u00e1t pH-impedance<\/strong>: H\u1eefu \u00edch khi nghi ng\u1edd \u1ee3 kh\u00ed d\u1ea1 d\u00e0y, ruminaton, ho\u1eb7c tri\u1ec7u ch\u1ee9ng ph\u1ed5i, nh\u1edd kh\u1ea3 n\u0103ng ph\u00e1t hi\u1ec7n tr\u00e0o ng\u01b0\u1ee3c kh\u00f4ng acid v\u00e0 t\u00ednh to\u00e1n MNBI.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
                  • \u0110\u1ed1i v\u1edbi GERD \u0110\u00e3 Ch\u1ee9ng Minh v\u1edbi Tri\u1ec7u Ch\u1ee9ng K\u00e9o D\u00e0i<\/strong>:\n
                      \n
                    • Gi\u00e1m S\u00e1t pH-impedance khi D\u00f9ng PPI<\/strong>: \u0110\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 GERD kh\u00e1ng tr\u1ecb, v\u1edbi ng\u01b0\u1ee1ng AET > 4% ho\u1eb7c > 80 \u0111\u1ee3t tr\u00e0o ng\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p n\u00e2ng cao (nh\u01b0 ph\u1eabu thu\u1eadt).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n

                      3.2. Ti\u00eau Chu\u1ea9n M\u1edbi Theo Lyon Consensus 2.0<\/h3>\n\n\n\n
                        \n
                      • Ng\u01b0\u1ee1ng AET (Acid Exposure Time)<\/strong>:\n
                          \n
                        • < 4%: B\u00ecnh th\u01b0\u1eddng, lo\u1ea1i tr\u1eeb GERD.<\/li>\n\n\n\n
                        • 4-6%: Kh\u00f4ng r\u00f5 r\u00e0ng, c\u1ea7n th\u00eam b\u1eb1ng ch\u1ee9ng h\u1ed7 tr\u1ee3.<\/li>\n\n\n\n
                        • 6% tr\u00ean \u2265 2 ng\u00e0y: X\u00e1c nh\u1eadn GERD, c\u1ea7n \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
                        • MNBI (Mean Nocturnal Baseline Impedance)<\/strong>:\n
                            \n
                          • Gi\u00e1 tr\u1ecb th\u1ea5p (< 1500-2000 \u03a9) h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n t\u1ed5n th\u01b0\u01a1ng ni\u00eam m\u1ea1c do tr\u00e0o ng\u01b0\u1ee3c, nh\u01b0ng ch\u1ec9 mang t\u00ednh b\u1ed5 tr\u1ee3.<\/li>\n<\/ul>\n<\/li>\n\n\n\n
                          • C\u00e1c Ch\u1ec9 S\u1ed1 \u0110\u00e3 Lo\u1ea1i B\u1ecf<\/strong>: Ch\u1ec9 s\u1ed1 s\u00f3ng peristaltic sau tr\u00e0o ng\u01b0\u1ee3c (Postreflux Swallow-Induced Peristaltic Wave – PSPW) kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng do t\u00ednh ph\u1ee9c t\u1ea1p v\u00e0 thi\u1ebfu t\u00ednh chu\u1ea9n h\u00f3a.<\/li>\n\n\n\n
                          • C\u00e1 Nh\u00e2n H\u00f3a Ch\u1ea9n \u0110o\u00e1n<\/strong>: T\u00f9y thu\u1ed9c v\u00e0o tri\u1ec7u ch\u1ee9ng v\u00e0 ngu\u1ed3n l\u1ef1c, b\u00e1c s\u0129 c\u00f3 th\u1ec3 ch\u1ecdn gi\u1eefa gi\u00e1m s\u00e1t pH kh\u00f4ng d\u00e2y ho\u1eb7c pH-impedance, \u0111\u1ea3m b\u1ea3o t\u1ed1i \u01b0u h\u00f3a hi\u1ec7u qu\u1ea3 v\u00e0 chi ph\u00ed.<\/li>\n<\/ul>\n\n\n\n
                            \n\n\n\n

                            4. K\u1ebft Lu\u1eadn<\/h2>\n\n\n\n

                            Lyon Consensus 2.0 cung c\u1ea5p m\u1ed9t khung ch\u1ea9n \u0111o\u00e1n hi\u1ec7n \u0111\u1ea1i cho GERD, v\u1edbi c\u00e1c ti\u00eau chu\u1ea9n r\u00f5 r\u00e0ng nh\u01b0 vi\u00eam th\u1ef1c qu\u1ea3n \u0111\u1ed9 LA B tr\u1edf l\u00ean l\u00e0 b\u1eb1ng ch\u1ee9ng k\u1ebft lu\u1eadn, s\u1eed d\u1ee5ng gi\u00e1m s\u00e1t pH k\u00e9o d\u00e0i 96 gi\u1edd, v\u00e0 \u0111\u00e1nh gi\u00e1 GERD kh\u00e1ng tr\u1ecb b\u1eb1ng pH-impedance khi d\u00f9ng PPI. Vi\u1ec7c c\u00e1 nh\u00e2n h\u00f3a chi\u1ebfn l\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean tri\u1ec7u ch\u1ee9ng v\u00e0 b\u1eb1ng ch\u1ee9ng x\u00e9t nghi\u1ec7m s\u1ebd gi\u00fap t\u1ed1i \u01b0u h\u00f3a qu\u1ea3n l\u00fd GERD, \u0111\u1ed3ng th\u1eddi lo\u1ea1i b\u1ecf c\u00e1c ti\u00eau ch\u00ed kh\u00f4ng hi\u1ec7u qu\u1ea3. Nh\u1eefng c\u1eadp nh\u1eadt n\u00e0y kh\u00f4ng ch\u1ec9 n\u00e2ng cao t\u00ednh \u0111\u1eb7c hi\u1ec7u m\u00e0 c\u00f2n h\u1ed7 tr\u1ee3 ph\u00e2n bi\u1ec7t GERD v\u1edbi c\u00e1c r\u1ed1i lo\u1ea1n kh\u00e1c nh\u01b0 r\u1ed1i lo\u1ea1n t\u01b0\u01a1ng t\u00e1c ru\u1ed9t-n\u00e3o (Disorders of Gut-Brain Interaction – DGBI), h\u01b0\u1edbng t\u1edbi c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng cho b\u1ec7nh nh\u00e2n.<\/p>\n\n\n\n

                            \n\n\n\n

                            T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong>:
                            Gyawali CP, et al. Gut<\/em> 2024;73:361-371. doi:10.1136\/gutjnl-2023-330616.<\/p>\n\n\n\n

                            <\/p>\n","protected":false},"excerpt":{"rendered":"

                            ThS BS Tr\u1ea7n H\u1eefu Hi\u1ec1n T\u1ed1t nghi\u1ec7p b\u1eb1ng DIU \u0110H Corse CH Ph\u00e1p Gi\u1edbi Thi\u1ec7u B\u1ec7nh tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y-th\u1ef1c qu\u1ea3n (Gastroesophageal Reflux Disease – GERD) l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng…<\/p>\n","protected":false},"author":1,"featured_media":3274,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[131],"tags":[67,110,100],"jetpack_featured_media_url":"https:\/\/hienbacsi.com\/wp-content\/uploads\/2025\/04\/img_8022-1.jpg","_links":{"self":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3277"}],"collection":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/comments?post=3277"}],"version-history":[{"count":1,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3277\/revisions"}],"predecessor-version":[{"id":3278,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/posts\/3277\/revisions\/3278"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/media\/3274"}],"wp:attachment":[{"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/media?parent=3277"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/categories?post=3277"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hienbacsi.com\/index.php\/wp-json\/wp\/v2\/tags?post=3277"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}