{"id":3213,"date":"2023-01-03T09:43:55","date_gmt":"2023-01-03T02:43:55","guid":{"rendered":"https:\/\/benhvienthaihoa.vn\/?p=3213"},"modified":"2025-06-22T23:26:30","modified_gmt":"2025-06-22T16:26:30","slug":"bai-4-lam-dung-thuoc-uc-che-bom-proton-trong-cac-benh-ly-da-day-ta-trang","status":"publish","type":"post","link":"https:\/\/benhvienthaihoa.vn\/en\/bai-4-lam-dung-thuoc-uc-che-bom-proton-trong-cac-benh-ly-da-day-ta-trang\/","title":{"rendered":"B\u00e0i 4: L\u1ea1m d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton trong c\u00e1c b\u1ec7nh l\u00fd d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng"},"content":{"rendered":"<p>Guideline \u0111i\u1ec1u tr\u1ecb gerd<\/p>\n<p><a href=\"http:\/\/magazine.canhgiacduoc.org.vn\" target=\"_blank\" rel=\"noopener\">http:\/\/magazine.canhgiacduoc.org.vn<\/a><\/p>\n<p>N. Barnes. Overuse of Proton Pump Inhibitors in the Hospitalized Patient. US Pharm. 2015;40(12):HS22-HS25<\/p>\n<p>Thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton (PPI) gi\u1ea3m n\u1ed3ng \u0111\u1ed9 acid d\u1ea1 d\u00e0y b\u1eb1ng c\u00e1ch li\u00ean k\u1ebft v\u00e0 \u1ee9c ch\u1ebf kh\u00f4ng thu\u1eadn ngh\u1ecbch b\u01a1m H+ K+ ATPase. PPI \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p:<\/p>\n<ul>\n<li>Lo\u00e9t d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng<\/li>\n<li>Tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y \u2013 th\u1ef1c qu\u1ea3n<\/li>\n<li>H\u1ed9i ch\u1ee9ng Zollinger \u2013 Ellison<\/li>\n<li>Lo\u00e9t do NSAIDs<\/li>\n<li>Helicobacter pylori<\/li>\n<\/ul>\n<p>C\u00e1c ch\u1ec9 \u0111\u1ecbnh tr\u00ean s\u1eed d\u1ee5ng thu\u1ed1c PPI l\u00e0 ph\u00f9 h\u1ee3p v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c b\u00e1c s\u0129 l\u00e2m s\u00e0ng th\u1ef1c hi\u1ec7n k\u00ea \u0111\u01a1n \u0111\u1ec3 tr\u00e1nh t\u00ecnh tr\u1ea1ng kh\u00f4ng tu\u00e2n th\u1ee7 s\u1eed d\u1ee5ng thu\u1ed1c (t\u1ef1 \u00fd t\u0103ng li\u1ec1u, gi\u1ea3m li\u1ec1u, s\u1eed d\u1ee5ng k\u00e9o d\u00e0i, ng\u1eebng s\u1eed d\u1ee5ng \u0111\u1ed9t ng\u1ed9t)<\/p>\n<p>Hi\u1ec7n t\u1ea1i, nh\u00f3m thu\u1ed1c PPI \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn trong l\u00e2m s\u00e0ng. C\u00e1c tr\u01b0\u1eddng h\u1ee3p l\u1ea1m d\u1ee5ng thu\u1ed1c c\u0169ng xu\u1ea5t hi\u1ec7n. Vi\u1ec7c k\u00ea \u0111\u01a1n PPI kh\u00f4ng ph\u00f9 h\u1ee3p, v\u1eeba l\u00e0m t\u0103ng chi ph\u00ed \u0111i\u1ec1u tr\u1ecb, v\u1eeba c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00f4ng mong mu\u1ed1n cho b\u1ec7nh nh\u00e2n.<\/p>\n<p>C\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u00f3 th\u1ec3 k\u1ec3 \u0111\u1ebfn:<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3210 size-full\" src=\"https:\/\/benhvienthaihoa.vn\/wp-content\/uploads\/2023\/01\/z4008994548023_cd2064cd2f1b9c8e75ebc874d57059cb.jpg\" alt=\"\" width=\"624\" height=\"244\" srcset=\"https:\/\/benhvienthaihoa.vn\/wp-content\/uploads\/2023\/01\/z4008994548023_cd2064cd2f1b9c8e75ebc874d57059cb.jpg 624w, https:\/\/benhvienthaihoa.vn\/wp-content\/uploads\/2023\/01\/z4008994548023_cd2064cd2f1b9c8e75ebc874d57059cb-320x125.jpg 320w, https:\/\/benhvienthaihoa.vn\/wp-content\/uploads\/2023\/01\/z4008994548023_cd2064cd2f1b9c8e75ebc874d57059cb-540x211.jpg 540w\" sizes=\"auto, (max-width: 624px) 100vw, 624px\" \/><\/p>\n<p>M\u1ed9t s\u1ed1 bi\u1ebfn c\u1ed1 b\u1ea5t l\u1ee3i kh\u00e1c c\u00f3 th\u1ec3 li\u00ean quan tuy nhi\u00ean c\u01a1 ch\u1ebf kh\u00f4ng r\u00f5 r\u00e0ng:<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3208 size-full\" src=\"https:\/\/benhvienthaihoa.vn\/wp-content\/uploads\/2023\/01\/z4008994838018_03aed47ac97da3a4cca31f447e9c186d.jpg\" alt=\"\" width=\"624\" height=\"352\" srcset=\"https:\/\/benhvienthaihoa.vn\/wp-content\/uploads\/2023\/01\/z4008994838018_03aed47ac97da3a4cca31f447e9c186d.jpg 624w, https:\/\/benhvienthaihoa.vn\/wp-content\/uploads\/2023\/01\/z4008994838018_03aed47ac97da3a4cca31f447e9c186d-320x181.jpg 320w, https:\/\/benhvienthaihoa.vn\/wp-content\/uploads\/2023\/01\/z4008994838018_03aed47ac97da3a4cca31f447e9c186d-540x305.jpg 540w\" sizes=\"auto, (max-width: 624px) 100vw, 624px\" \/><\/p>\n<p>C\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng h\u1ee3p l\u00fd PPI:<\/p>\n<ul>\n<li>K\u00ea \u0111\u01a1n PPI qu\u00e1 m\u1ee9c trong \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng lo\u00e9t do stress tr\u00ean b\u1ec7nh nh\u00e2n kh\u00f4ng n\u1eb7ng \u0111ang \u0111i\u1ec1u tr\u1ecb n\u1ed9i tr\u00fa.<\/li>\n<li>S\u1eed d\u1ee5ng k\u00e9o d\u00e0i PPI trong d\u1ef1 ph\u00f2ng v\u00e0 \u0111i\u1ec1u tr\u1ecb lo\u00e9t do NSAIDs.<\/li>\n<li>S\u1eed d\u1ee5ng PPI k\u00e9o d\u00e0i trong \u1ee3 n\u00f3ng, \u1ee3 chua, c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00f3 ch\u1ecbu \u1edf d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng ch\u01b0a r\u00f5 nguy\u00ean nh\u00e2n.<\/li>\n<\/ul>\n<p>Khi n\u00e0o n\u00ean c\u00e2n nh\u1eafc ng\u1eebng s\u1eed d\u1ee5ng PPI?<\/p>\n<p>Vi\u1ec7c c\u00e2n nh\u1eafc ti\u1ebfp t\u1ee5c ho\u1eb7c ng\u1eebng s\u1eed d\u1ee5ng PPI n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb. B\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c quy\u1ec1n t\u1ef1 \u00fd ng\u1eebng thu\u1ed1c ho\u1eb7c t\u0103ng th\u1eddi gian \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 tr\u00e1nh c\u00e1c h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng.<\/p>\n<p>Nhi\u1ec1u b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh th\u1ef1c qu\u1ea3n Barret, vi\u1ec7c s\u1eed d\u1ee5ng PPI k\u00e9o d\u00e0i l\u00e0 c\u1ea7n thi\u1ebft v\u00e0 kh\u00f4ng ph\u00f9 h\u1ee3p n\u1ebfu ng\u1eebng thu\u1ed1c. Tuy nhi\u00ean, c\u1ea7n \u0111\u00e1nh gi\u00e1 li\u1ec1u d\u00f9ng v\u00e0 s\u1ef1 c\u1ea7n thi\u1ebft ph\u1ea3i ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb trong t\u1ea5t c\u1ea3 c\u00e1c l\u1ea7n t\u00e1i kh\u00e1m. Ch\u01b0a c\u00f3 b\u1eb1ng ch\u1ee9ng r\u00f5 r\u00e0ng v\u1ec1 ch\u1ebf \u0111\u1ed9 t\u1ed1t nh\u1ea5t \u0111\u1ec3 gi\u1ea3m li\u1ec1u PPI, nh\u01b0ng nh\u00ecn chung, c\u1ea7n c\u00e2n nh\u1eafc gi\u1ea3m li\u1ec1u t\u1eeb t\u1eeb khi \u0111\u00e3 ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c c\u00e1c tri\u1ec7u ch\u1ee9ng. V\u00ed d\u1ee5, m\u1ed9t b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n Omeprazol 20mg d\u00f9ng m\u1ed7i ng\u00e0y trong 4-6 tu\u1ea7n \u0111\u1ec3 ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng c\u1ee7a GERD. B\u1ec7nh nh\u00e2n c\u00f3 \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb t\u1ed1t v\u00e0 tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n. Sau \u0111\u00f3, gi\u1ea3m li\u1ec1u xu\u1ed1ng c\u00f2n 10mg, d\u00f9ng h\u00e0ng ng\u00e0y trong 2 tu\u1ea7n r\u1ed3i ng\u1eebng thu\u1ed1c. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n omeprazol 20mg khi c\u1ea7n n\u1ebfu c\u00e1c tri\u1ec7u ch\u1ee9ng t\u00e1i ph\u00e1t.<\/p>","protected":false},"excerpt":{"rendered":"<p>Guideline \u0111i\u1ec1u tr\u1ecb gerd http:\/\/magazine.canhgiacduoc.org.vn N. Barnes. Overuse of Proton Pump Inhibitors in the Hospitalized Patient. US Pharm. 2015;40(12):HS22-HS25 Thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton (PPI) gi\u1ea3m n\u1ed3ng \u0111\u1ed9 acid d\u1ea1 d\u00e0y b\u1eb1ng c\u00e1ch li\u00ean k\u1ebft v\u00e0 \u1ee9c ch\u1ebf kh\u00f4ng thu\u1eadn ngh\u1ecbch b\u01a1m H+ K+ ATPase. PPI \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p: Lo\u00e9t d\u1ea1Leer M\u00e1s<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[57],"tags":[],"class_list":["post-3213","post","type-post","status-publish","format-standard","hentry","category-bai-viet-y-khoa"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/posts\/3213","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/comments?post=3213"}],"version-history":[{"count":5,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/posts\/3213\/revisions"}],"predecessor-version":[{"id":3547,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/posts\/3213\/revisions\/3547"}],"wp:attachment":[{"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/media?parent=3213"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/categories?post=3213"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/tags?post=3213"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}