{"id":22030,"date":"2020-09-02T19:17:05","date_gmt":"2020-09-02T12:17:05","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=22030"},"modified":"2025-01-08T20:51:06","modified_gmt":"2025-01-08T13:51:06","slug":"etonogestrel-implanon-implanon-nxt","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/etonogestrel-implanon-implanon-nxt\/","title":{"rendered":"Etonogestrel &#8211; Implanon\/Implanon NXT"},"content":{"rendered":"<p><strong>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: <\/strong><\/p>\n<p><strong><em>Ho\u1ea1t ch\u1ea5t :<\/em> <\/strong><a href=\"https:\/\/pharmog.com\/wp\/etonogestrel\/\"><strong>Etonogestrel<\/strong><\/a><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u00f4\u0301c tra\u0301nh thai.<\/em><\/p>\n<p><strong><em>Nh\u00f3m<\/em><\/strong> <strong><em>ph\u00e1p l\u00fd: <\/em><\/strong><em>Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine)<\/em><\/p>\n<p><strong><em>M\u00e3 ATC<\/em><\/strong> (Anatomical Therapeutic Chemical): G03AC08.<\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c:<\/em><\/strong><\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c:<\/em><\/strong> Implanon , Implanon NXT<\/p>\n<p><strong><em>H\u00e3ng s\u1ea3n xu\u1ea5t <\/em><\/strong>: N.V. Organon<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>2. D\u1ea1ng b\u00e0o ch\u1ebf H\u00e0m l\u01b0\u1ee3ng: <\/strong><\/p>\n<p><strong><em>D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n<p>Que c\u1ea5y d\u01b0\u1edbi da: h\u1ed9p 1 que, h\u1ed9p 5 que.<\/p>\n<p>[Thanh m\u1ec1m, d\u1ebbo, m\u00e0u tr\u1eafng \u0111\u1ebfn tr\u1eafng nh\u1ea1t, d\u00e0i 4cm v\u00e0 \u0111\u01b0\u1eddng k\u00ednh 2mm, \u0111\u01b0\u1ee3c n\u1ea1p s\u1eb5n trong kim th\u00e9p kh\u00f4ng g\u1ec9 c\u1ee7a m\u1ed9t d\u1ee5ng c\u1ee5 v\u00f4 khu\u1ea9n, d\u00f9ng m\u1ed9t l\u1ea7n, s\u1eb5n s\u00e0ng \u0111\u1ec3 s\u1eed d\u1ee5ng. D\u1ee5ng c\u1ee5 c\u1ea5y ch\u1ee9a que c\u1ea5y \u0111\u01b0\u1ee3c \u0111\u00f3ng trong m\u1ed9t v\u1ec9 l\u00e0m b\u1eb1ng polyethyleneterephtalat glycol (PETG) trong su\u1ed1t \u0111\u01b0\u1ee3c d\u00e1n k\u00edn v\u1edbi m\u1ed9t c\u00e1i n\u1eafp. V\u1ec9 \u0111\u1ef1ng d\u1ee5ng c\u1ee5 c\u1ea5y n\u00e0y \u0111\u01b0\u1ee3c \u0111\u00f3ng trong h\u1ed9p carton c\u00f9ng v\u1edbi &#8221;T\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng&#8221;].<\/p>\n<p>M\u1ed7i que c\u1ea5y: Etonogestrel 68mg.<\/p>\n<p><strong><em>Thu\u1ed1c tham kh\u1ea3o:<\/em><\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\"><strong><em>IMPLANON NXT<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i que c\u1ea5y c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Etonogestrel<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>68 mg<\/td>\n<\/tr>\n<tr>\n<td>T\u00e1 d\u01b0\u1ee3c<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>v\u1eeba \u0111\u1ee7 (Xem m\u1ee5c 6.1)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"531\" height=\"399\" class=\"wp-image-22035\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/word-image-16.png\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/word-image-16.png 531w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/word-image-16-300x225.png 300w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/word-image-16-213x160.png 213w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/word-image-16-90x68.png 90w\" sizes=\"auto, (max-width: 531px) 100vw, 531px\" \/><\/p>\n<p><strong>3. Video by Pharmog:<\/strong><\/p>\n<p><strong>[VIDEO D\u01af\u1ee2C L\u00dd]<\/strong><\/p>\n<p>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;<\/p>\n<p>\u25ba K\u1ecbch B\u1ea3n: PharmogTeam<\/p>\n<p>\u25ba Youtube: https:\/\/www.youtube.com\/c\/pharmog<\/p>\n<p>\u25ba Facebook: https:\/\/www.facebook.com\/pharmog\/<\/p>\n<p>\u25ba Group : H\u1ed9i nh\u1eefng ng\u01b0\u1eddi m\u00ea d\u01b0\u1ee3c l\u00fd<\/p>\n<p>\u25ba Instagram : https:\/\/www.instagram.com\/pharmogvn\/<\/p>\n<p>\u25ba Website: pharmog.com<\/p>\n<p><strong>4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng: <\/strong><\/p>\n<p><strong>4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>Tr\u00e1nh thai.<\/p>\n<p>\u0110\u00e3 thi\u1ebft l\u1eadp t\u00ednh an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 \u1edf ph\u1ee5 n\u1eef t\u1eeb 18 \u0111\u1ebfn 40 tu\u1ed5i.<\/p>\n<p><strong>4.2. Li\u1ec1u d\u00f9ng C\u00e1ch d\u00f9ng:<\/strong><\/p>\n<p><strong><em>C\u00e1ch d\u00f9ng<\/em><\/strong> :.<\/p>\n<p>Ph\u1ea3i lo\u1ea1i tr\u1eeb kh\u1ea3 n\u0103ng c\u00f3 thai tr\u01b0\u1edbc khi c\u1ea5y Implanon NXT.<\/p>\n<p>Nh\u00e2n vi\u00ean y t\u1ebf c\u1ea7n tham gia m\u1ed9t kh\u00f3a hu\u1ea5n luy\u1ec7n v\u1ec1 c\u00e1ch s\u1eed d\u1ee5ng d\u1ee5ng c\u1ee5 c\u1ea5y Implanon NXT v\u00e0 c\u00e1c k\u1ef9 thu\u1eadt c\u1ea5y v\u00e0 r\u00fat que c\u1ea5y Implanon NXT v\u00e0 n\u1ebfu c\u1ea7n, n\u00ean y\u00eau c\u1ea7u s\u1ef1 gi\u00e1m s\u00e1t tr\u01b0\u1edbc khi c\u1ea5y ho\u1eb7c r\u00fat que c\u1ea5y.<\/p>\n<p>Tr\u01b0\u1edbc khi c\u1ea5y que c\u1ea5y, \u0111\u1ecdc k\u1ef9 v\u00e0 tu\u00e2n th\u1ee7 nh\u1eefng h\u01b0\u1edbng d\u1eabn v\u1ec1 vi\u1ec7c c\u1ea5y v\u00e0 r\u00fat que c\u1ea5y trong m\u1ee5c \u201cC\u00e1ch c\u1ea5y Implanon NXT\u201d v\u00e0 m\u1ee5c \u201cC\u00e1ch r\u00fat Implanon NXT\u201d.<\/p>\n<p>Xin vui l\u00f2ng li\u00ean h\u1ec7 nh\u00e0 cung c\u1ea5p t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng n\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 c\u00e2u h\u1ecfi n\u00e0o.<\/p>\n<p>N\u1ebfu kh\u00f4ng ch\u1eafc ch\u1eafn v\u1ec1 c\u00e1c b\u01b0\u1edbc c\u1ea7n thi\u1ebft \u0111\u1ec3 c\u1ea5y v\u00e0\/ho\u1eb7c r\u00fat Implanon NXT an to\u00e0n, kh\u00f4ng th\u1eed th\u1ee7 thu\u1eadt n\u00e0y.<\/p>\n<p><em>C\u00e1ch s\u1eed d\u1ee5ng Implanon NXT<\/em><\/p>\n<p>Implanon NXT l\u00e0 thu\u1ed1c tr\u00e1nh thai ch\u1ee9a n\u1ed9i ti\u1ebft c\u00f3 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i. M\u1ed9t que c\u1ea5y \u0111\u01b0\u1ee3c \u0111\u1eb7t d\u01b0\u1edbi da v\u00e0 c\u00f3 th\u1ec3 \u0111\u1ec3 t\u1ea1i ch\u1ed7 trong ba n\u0103m. Kh\u00f4ng r\u00fat que c\u1ea5y mu\u1ed9n h\u01a1n ba n\u0103m sau ng\u00e0y c\u1ea5y. N\u00ean th\u00f4ng b\u00e1o cho ng\u01b0\u1eddi s\u1eed d\u1ee5ng bi\u1ebft r\u1eb1ng h\u1ecd c\u00f3 th\u1ec3 y\u00eau c\u1ea7u r\u00fat que c\u1ea5y b\u1ea5t k\u1ef3 th\u1eddi gian n\u00e0o. Nh\u00e2n vi\u00ean y t\u1ebf c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc thay que c\u1ea5y m\u1edbi s\u1edbm h\u01a1n \u1edf nh\u1eefng ng\u01b0\u1eddi ph\u1ee5 n\u1eef n\u1eb7ng c\u00e2n (xem m\u1ee5c \u201cC\u1ea3nh b\u00e1o\u201d). C\u1ea5y ngay m\u1ed9t que c\u1ea5y m\u1edbi ngay sau khi r\u00fat que c\u1ea5y c\u0169 s\u1ebd \u0111\u1ea3m b\u1ea3o s\u1ef1 tr\u00e1nh thai li\u00ean t\u1ee5c. N\u1ebfu kh\u00f4ng mu\u1ed1n ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng Implanon NXT nh\u01b0ng mu\u1ed1n ti\u1ebfp t\u1ee5c tr\u00e1nh thai th\u00ec n\u00ean khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai kh\u00e1c.<\/p>\n<p>C\u01a1 s\u1edf \u0111\u1ec3 s\u1eed d\u1ee5ng hi\u1ec7u qu\u1ea3 v\u00e0 sau \u0111\u00f3 r\u00fat th\u00e0nh c\u00f4ng que c\u1ea5y Implanon NXT l\u00e0 ti\u1ebfn h\u00e0nh c\u1ea5y d\u01b0\u1edbi da ch\u00ednh x\u00e1c v\u00e0 c\u1ea9n th\u1eadn theo \u0111\u00fang h\u01b0\u1edbng d\u1eabn. N\u1ebfu que c\u1ea5y kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea5y theo \u0111\u00fang h\u01b0\u1edbng d\u1eabn (xem \u201cC\u00e1ch c\u1ea5y Implanon NXT&#8221;), v\u00e0 v\u00e0o \u0111\u00fang ng\u00e0y qui \u0111\u1ecbnh (xem \u201cKhi n\u00e0o c\u1ea5y Implanon NXT\u201d), \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 g\u00e2y c\u00f3 thai ngo\u00e0i \u00fd mu\u1ed1n. Khi que c\u1ea5y \u0111\u01b0\u1ee3c c\u1ea5y s\u00e2u v\u00e0o d\u01b0\u1edbi l\u1edbp m\u00f4 d\u01b0\u1edbi da (c\u1ea5y s\u00e2u) c\u00f3 th\u1ec3 kh\u00f4ng s\u1edd th\u1ea5y que c\u1ea5y v\u00e0 g\u00e2y kh\u00f3 kh\u0103n cho vi\u1ec7c \u0111\u1ecbnh v\u1ecb v\u00e0\/ho\u1eb7c r\u00fat que c\u1ea5y (xem c\u00e1c ph\u1ea7n \u201cC\u00e1ch r\u00fat Implanon NXT\u201d v\u00e0 \u201cC\u1ea3nh b\u00e1o\u201d)<\/p>\n<p>N\u00ean c\u1ea5y Implanon NXT d\u01b0\u1edbi da ngay d\u01b0\u1edbi l\u1edbp da \u1edf m\u1eb7t trong c\u1ee7a c\u00e1nh tay kh\u00f4ng thu\u1eadn tr\u00ean m\u1ecfm l\u1ed3i c\u1ea7u trong x\u01b0\u01a1ng c\u00e1nh tay. V\u1ecb tr\u00ed c\u1ea5y n\u00e0y n\u1eb1m tr\u00ean c\u01a1 tam \u0111\u1ea7u kho\u1ea3ng 8-10cm (3-4 inch) t\u1eeb m\u1ecfm l\u1ed3i c\u1ea7u trong x\u01b0\u01a1ng c\u00e1nh tay v\u00e0 3-5cm (1,25-2 inch) ph\u00eda sau r\u00e3nh gi\u1eefa c\u01a1 nh\u1ecb \u0111\u1ea7u v\u00e0 c\u01a1 tam \u0111\u1ea7u. V\u1ecb tr\u00ed n\u00e0y nh\u1eb1m tr\u00e1nh c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn v\u00e0 c\u00e1c d\u00e2y th\u1ea7n kinh n\u1eb1m trong v\u00e0 xung quanh r\u00e3nh n\u00e0y (xem h\u00ecnh 2a, 2b).<\/p>\n<p>Ngay sau khi c\u1ea5y ph\u1ea3i ki\u1ec3m tra s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a que c\u1ea5y b\u1eb1ng c\u00e1ch s\u1edd nh\u1eb9. Trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng s\u1edd th\u1ea5y que c\u1ea5y ho\u1eb7c nghi ng\u1edd kh\u00f4ng c\u00f3 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a que c\u1ea5y (xem m\u1ee5c \u201cC\u00e1ch c\u1ea5y Implanon NXT\u201d).<\/p>\n<p>Trong h\u1ed9p Implanon NXT c\u00f3 ch\u1ee9a m\u1ed9t &#8221;Phi\u1ebfu d\u00e0nh cho ng\u01b0\u1eddi S\u1eed D\u1ee5ng&#8221; c\u00f3 ghi s\u1ed1 l\u00f4 c\u1ee7a que c\u1ea5y \u0111\u1ec3 ph\u00e1t cho ng\u01b0\u1eddi ph\u1ee5 n\u1eef. Nh\u00e2n vi\u00ean y t\u1ebf \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u ghi ng\u00e0y c\u1ea5y, c\u00e1nh tay c\u1ea5y v\u00e0 ng\u00e0y d\u1ef1 \u0111\u1ecbnh r\u00fat que c\u1ea5y tr\u00ean &#8221;Phi\u1ebfu d\u00e0nh cho ng\u01b0\u1eddi S\u1eed D\u1ee5ng&#8221;. Trong h\u1ed9p c\u0169ng c\u00f3 ch\u1ee9a nh\u00e3n d\u00ednh ghi s\u1ed1 l\u00f4 \u0111\u1ec3 nh\u00e2n vi\u00ean y t\u1ebf l\u01b0u trong h\u1ed3 s\u01a1.<\/p>\n<p><em>Khi n\u00e0o c\u1ea5y Implanon NXT<\/em><\/p>\n<p>QUAN TR\u1eccNG: Ph\u1ea3i lo\u1ea1i tr\u1eeb kh\u1ea3 n\u0103ng c\u00f3 thai tr\u01b0\u1edbc khi \u0111\u1eb7t que c\u1ea5y.<\/p>\n<p>Th\u1eddi gian c\u1ea5y ph\u1ee5 thu\u1ed9c v\u00e0o ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai g\u1ea7n \u0111\u00e2y c\u1ee7a ng\u01b0\u1eddi ph\u1ee5 n\u1eef, nh\u01b0 sau:<\/p>\n<p>Kh\u00f4ng s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai n\u1ed9i ti\u1ebft trong th\u00e1ng tr\u01b0\u1edbc<\/p>\n<p>N\u00ean c\u1ea5y que c\u1ea5y trong kho\u1ea3ng th\u1eddi gian t\u1eeb ng\u00e0y 1 (ng\u00e0y \u0111\u1ea7u ti\u00ean th\u1ea5y kinh) \u0111\u1ebfn ng\u00e0y 5 c\u1ee7a chu k\u1ef3 kinh nguy\u1ec7t, ngay ca\u0309 khi \u00e2m \u0111\u1ea1o v\u00e2\u0303n co\u0300n cha\u0309y ma\u0301u.<\/p>\n<p>N\u00ea\u0301u c\u00e2\u0301y theo khuy\u00ea\u0301n ca\u0301o, kh\u00f4ng c\u00e2\u0300n ph\u01b0\u01a1ng pha\u0301p tra\u0301nh thai h\u00f4\u0303 tr\u01a1\u0323. Khi c\u00e2\u0301y ngoa\u0300i th\u01a1\u0300i gian khuy\u00ea\u0301n ca\u0301o, n\u00ean s\u01b0\u0309 du\u0323ng ph\u01b0\u01a1ng pha\u0301p ma\u0300ng ch\u0103\u0301n \u0111\u00ea\u0301n 7 nga\u0300y sau khi c\u00e2\u0301y. N\u00ea\u0301u \u0111a\u0303 giao h\u01a1\u0323p, pha\u0309i loa\u0323i tr\u01b0\u0300 kha\u0309 n\u0103ng mang thai.<\/p>\n<p>\u0110\u1ed5i t\u1eeb ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai sang Implanon NXT<\/p>\n<p>\u0110\u1ed5i t\u1eeb m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai n\u1ed9i ti\u1ebft d\u1ea1ng ph\u1ed1i h\u1ee3p (thu\u1ed1c tr\u00e1nh thai ph\u1ed1i h\u1ee3p d\u1ea1ng u\u1ed1ng (combined oral contraceptive-COC), v\u00f2ng \u0111\u1eb7t \u00e2m \u0111\u1ea1o ho\u1eb7c mi\u1ebfng d\u00e1n tr\u00ean da)<\/p>\n<p>T\u1ed1t nh\u1ea5t n\u00ean c\u1ea5y que c\u1ea5y v\u00e0o ng\u00e0y k\u1ebf ti\u1ebfp sau khi u\u1ed1ng vi\u00ean thu\u1ed1c tr\u00e1nh thai ch\u1ee9a ho\u1ea1t ch\u1ea5t cu\u1ed1i c\u00f9ng (vi\u00ean cu\u1ed1i c\u00f9ng ch\u1ee9a ho\u1ea1t ch\u1ea5t tr\u00e1nh thai) c\u1ee7a v\u1ec9 thu\u1ed1c tr\u00e1nh thai ph\u1ed1i h\u1ee3p, nh\u01b0ng mu\u1ed9n nh\u1ea5t v\u00e0o ng\u00e0y k\u1ebf ngay sau giai \u0111o\u1ea1n t\u1ea1m ngh\u1ec9 u\u1ed1ng thu\u1ed1c tr\u00e1nh thai ho\u1eb7c ngay sau ng\u00e0y u\u1ed1ng vi\u00ean gi\u1ea3 d\u01b0\u1ee3c cu\u1ed1i c\u00f9ng c\u1ee7a v\u1ec9 thu\u1ed1c tr\u00e1nh thai ph\u1ed1i h\u1ee3p. Trong tr\u01b0\u1eddng h\u1ee3p \u0111ang s\u1eed d\u1ee5ng v\u00f2ng \u0111\u1eb7t \u00e2m \u0111\u1ea1o ho\u1eb7c mi\u1ebfng d\u00e1n tr\u00ean da, t\u1ed1t nh\u1ea5t n\u00ean c\u1ea5y que c\u1ea5y v\u00e0o ng\u00e0y l\u1ea5y ch\u00fang ra, nh\u01b0ng kh\u00f4ng mu\u1ed9n h\u01a1n ng\u00e0y c\u1ea7n thay v\u00f2ng \u0111\u1eb7t \u00e2m \u0111\u1ea1o ho\u1eb7c mi\u1ebfng d\u00e1n k\u1ebf ti\u1ebfp. N\u00ea\u0301u c\u00e2\u0301y theo khuy\u00ea\u0301n ca\u0301o, kh\u00f4ng c\u00e2\u0300n ph\u01b0\u01a1ng pha\u0301p tra\u0301nh thai h\u00f4\u0303 tr\u01a1\u0323. Khi c\u00e2\u0301y ngoa\u0300i th\u01a1\u0300i gian khuy\u00ea\u0301n ca\u0301o, n\u00ean s\u01b0\u0309 du\u0323ng ph\u01b0\u01a1ng pha\u0301p ma\u0300ng ch\u0103\u0301n \u0111\u00ea\u0301n 7 nga\u0300y sau khi c\u00e2\u0301y. N\u00ea\u0301u \u0111a\u0303 giao h\u01a1\u0323p, pha\u0309i loa\u0323i tr\u01b0\u0300 kha\u0309 n\u0103ng mang thai.<\/p>\n<p>\u0110\u1ed5i t\u1eeb ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai ch\u1ec9 ch\u1ee9a progestagen (nh\u01b0 thu\u1ed1c vi\u00ean ch\u1ec9 ch\u1ee9a progestagen, thu\u1ed1c ti\u00eam, que c\u1ea5y, ho\u1eb7c d\u1ee5ng c\u1ee5 \u0111\u1eb7t t\u1eed cung [intrauterine system &#8211; IUS])<\/p>\n<p>C\u00f3 r\u1ea5t nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai ch\u1ec9 ch\u1ee9a progestagen, vi\u1ec7c c\u1ea5y que c\u1ea5y c\u1ea7n th\u1ef1c hi\u1ec7n nh\u01b0 sau:<\/p>\n<p>Thu\u1ed1c ti\u00eam tr\u00e1nh thai: C\u1ea5y que c\u1ea5y v\u00e0o ng\u00e0y c\u1ea7n ti\u00eam thu\u1ed1c k\u1ebf ti\u1ebfp.<\/p>\n<p>Thu\u1ed1c vi\u00ean ch\u1ec9 ch\u1ee9a progestagen: C\u00f3 th\u1ec3 \u0111\u1ed5i t\u1eeb thu\u1ed1c vi\u00ean ch\u1ec9 ch\u1ee9a progestagen sang Implanon NXT v\u00e0o b\u1ea5t k\u1ef3 ng\u00e0y n\u00e0o trong th\u00e1ng. N\u00ean c\u1ea5y que c\u1ea5y trong v\u00f2ng 24 gi\u1edd sau khi u\u1ed1ng vi\u00ean thu\u1ed1c cu\u1ed1i c\u00f9ng.<\/p>\n<p>Que c\u1ea5y\/d\u1ee5ng c\u1ee5 \u0111\u1eb7t t\u1eed cung (IUS): C\u1ea5y que c\u1ea5y v\u00e0o c\u00f9ng ng\u00e0y r\u00fat que c\u1ea5y ho\u1eb7c l\u1ea5y IUS.<\/p>\n<p>N\u00ea\u0301u c\u00e2\u0301y theo khuy\u00ea\u0301n ca\u0301o, kh\u00f4ng c\u00e2\u0300n ph\u01b0\u01a1ng pha\u0301p tra\u0301nh thai h\u00f4\u0303 tr\u01a1\u0323. Khi c\u00e2\u0301y ngoa\u0300i th\u01a1\u0300i gian khuy\u00ea\u0301n ca\u0301o, n\u00ean s\u01b0\u0309 du\u0323ng ph\u01b0\u01a1ng pha\u0301p ma\u0300ng ch\u0103\u0301n \u0111\u00ea\u0301n 7 nga\u0300y sau khi c\u00e2\u0301y. N\u00ea\u0301u \u0111a\u0303 giao h\u01a1\u0323p, pha\u0309i loa\u0323i tr\u01b0\u0300 kha\u0309 n\u0103ng mang thai.<\/p>\n<p>Sau s\u1ea9y thai ho\u1eb7c h\u01b0 thai<\/p>\n<p>Ba th\u00e1ng \u0111\u1ea7u: N\u00ean c\u1ea5y que c\u1ea5y trong v\u00f2ng 5 ng\u00e0y sau khi s\u1ea9y thai ho\u1eb7c h\u01b0 thai trong ba th\u00e1ng \u0111\u1ea7u.<\/p>\n<p>Ba th\u00e1ng gi\u1eefa: N\u00ean c\u1ea5y que c\u1ea5y v\u00e0o kho\u1ea3ng t\u1eeb ng\u00e0y 21 \u0111\u1ebfn 28 sau khi s\u1ea9y ho\u1eb7c h\u01b0 thai trong ba th\u00e1ng gi\u1eefa.<\/p>\n<p>N\u00ea\u0301u c\u00e2\u0301y theo khuy\u00ea\u0301n ca\u0301o, kh\u00f4ng c\u00e2\u0300n ph\u01b0\u01a1ng pha\u0301p tra\u0301nh thai h\u00f4\u0303 tr\u01a1\u0323. Khi c\u00e2\u0301y ngoa\u0300i th\u01a1\u0300i gian khuy\u00ea\u0301n ca\u0301o, n\u00ean s\u01b0\u0309 du\u0323ng ph\u01b0\u01a1ng pha\u0301p ma\u0300ng ch\u0103\u0301n \u0111\u00ea\u0301n 7 nga\u0300y sau khi c\u00e2\u0301y. N\u00ea\u0301u \u0111a\u0303 giao h\u01a1\u0323p, pha\u0309i loa\u0323i tr\u01b0\u0300 kha\u0309 n\u0103ng mang thai.<\/p>\n<p>Sau khi sinh<\/p>\n<p>Cho con b\u00fa: N\u00ean c\u1ea5y que c\u1ea5y sau tu\u1ea7n th\u1ee9 t\u01b0 sau khi sinh (xem m\u1ee5c \u201cS\u1eed d\u1ee5ng \u1edf ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa\u201d). N\u00ean s\u01b0\u0309 du\u0323ng ph\u01b0\u01a1ng pha\u0301p ma\u0300ng ch\u0103\u0301n \u0111\u00ea\u0301n 7 nga\u0300y sau khi c\u00e2\u0301y. N\u00ea\u0301u \u0111a\u0303 giao h\u01a1\u0323p, pha\u0309i loa\u0323i tr\u01b0\u0300 kha\u0309 n\u0103ng mang thai.<\/p>\n<p>Kh\u00f4ng cho con b\u00fa: N\u00ean c\u1ea5y que c\u1ea5y v\u00e0o kho\u1ea3ng t\u1eeb ng\u00e0y 21 \u0111\u1ebfn 28 sau khi sinh. N\u00ea\u0301u c\u00e2\u0301y theo khuy\u00ea\u0301n ca\u0301o, kh\u00f4ng c\u00e2\u0300n ph\u01b0\u01a1ng pha\u0301p tra\u0301nh thai h\u00f4\u0303 tr\u01a1\u0323. Khi \u0111\u0103\u0323t que c\u00e2\u0301y mu\u00f4\u0323n h\u01a1n 28 nga\u0300y sau khi sinh, n\u00ean s\u01b0\u0309 du\u0323ng ph\u01b0\u01a1ng pha\u0301p ma\u0300ng ch\u0103\u0301n \u0111\u00ea\u0301n 7 nga\u0300y sau khi c\u00e2\u0301y. N\u00ea\u0301u \u0111a\u0303 giao h\u01a1\u0323p, pha\u0309i loa\u0323i tr\u01b0\u0300 kha\u0309 n\u0103ng mang thai.<\/p>\n<p><em>C\u00e1ch c\u1ea5y Implanon NXT<\/em><\/p>\n<p>C\u01a1 s\u1edf \u0111\u1ec3 s\u1eed d\u1ee5ng hi\u1ec7u qu\u1ea3 v\u00e0 sau \u0111\u00f3 r\u00fat th\u00e0nh c\u00f4ng que c\u1ea5y Implanon NXT l\u00e0 ti\u1ebfn h\u00e0nh c\u1ea5y ch\u00ednh x\u00e1c v\u00e0 c\u1ea9n th\u1eadn que c\u1ea5y v\u00e0o c\u00e1nh tay kh\u00f4ng thu\u1eadn theo h\u01b0\u1edbng d\u1eabn. C\u1ea3 nh\u00e2n vi\u00ean y t\u1ebf v\u00e0 ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n c\u1ea3m nh\u1eadn que c\u1ea5y n\u1eb1m d\u01b0\u1edbi da sau khi \u0111\u1eb7t que c\u1ea5y.<\/p>\n<p>Que c\u1ea5y n\u00ean \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o ngay b\u00ean d\u01b0\u1edbi da, ngay d\u01b0\u1edbi l\u1edbp da \u1edf m\u1eb7t trong c\u1ee7a ph\u1ea7n tr\u00ean c\u00e1nh tay kh\u00f4ng thu\u1eadn.<\/p>\n<p>Khi que c\u1ea5y \u0111\u01b0\u1ee3c c\u1ea5y s\u00e2u h\u01a1n v\u00e0o l\u1edbp m\u00f4 d\u01b0\u1edbi da (c\u1ea5y s\u00e2u) c\u00f3 th\u1ec3 kh\u00f4ng s\u1edd th\u1ea5y que c\u1ea5y v\u00e0 g\u00e2y kh\u00f3 kh\u0103n trong vi\u1ec7c \u0111\u1ecbnh v\u1ecb v\u00e0\/ho\u1eb7c r\u00fat que c\u1ea5y (xem c\u00e1c ph\u1ea7n &#8220;C\u00e1ch r\u00fat Implanon NXT&#8221; v\u00e0 &#8220;C\u1ea3nh b\u00e1o&#8221;).<\/p>\n<p>N\u1ebfu que c\u1ea5y \u0111\u01b0\u1ee3c c\u1ea5y s\u00e2u c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh ho\u1eb7c m\u1ea1ch m\u00e1u. C\u1ea5y s\u00e2u ho\u1eb7c c\u1ea5y kh\u00f4ng \u0111\u00fang c\u00f3 th\u1ec3 g\u00e2y d\u1ecb c\u1ea3m (do t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh) v\u00e0 di chuy\u1ec3n que c\u1ea5y (do \u0111\u01b0a que c\u1ea5y v\u00e0o trong c\u01a1 ho\u1eb7c c\u00e2n c\u01a1), v\u00e0 trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm, c\u00f3 th\u1ec3 \u0111\u01b0a que c\u1ea5y v\u00e0o trong m\u1ea1ch m\u00e1u.<\/p>\n<p>Ph\u1ea3i c\u1ea5y Implanon NXT trong \u0111i\u1ec1u ki\u1ec7n v\u00f4 khu\u1ea9n v\u00e0 ch\u1ec9 n\u00ean th\u1ef1c hi\u1ec7n b\u1edfi nh\u00e2n vi\u00ean y t\u1ebf th\u00e0nh th\u1ea1o thao t\u00e1c. Ch\u1ec9 n\u00ean c\u1ea5y que c\u1ea5y v\u1edbi d\u1ee5ng c\u1ee5 c\u00f3 que c\u1ea5y \u0111\u01b0\u1ee3c n\u1ea1p s\u1eb5n.<\/p>\n<p><em>Th\u1ee7 thu\u1eadt c\u1ea5y<\/em><\/p>\n<p>\u0110\u1ec3 gi\u00fap \u0111\u1ea3m b\u1ea3o que c\u1ea5y \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o ngay d\u01b0\u1edbi da, chuy\u00ean gia y t\u1ebf n\u00ean \u1edf v\u1ecb tr\u00ed \u0111\u1ec3 th\u1ea5y s\u1ef1 \u0111\u01b0a ra ph\u00eda tr\u01b0\u1edbc c\u1ee7a kim b\u1eb1ng c\u00e1ch quan s\u00e1t thi\u1ebft b\u1ecb c\u1ea5y t\u1eeb ph\u00eda b\u00ean, kh\u00f4ng ph\u1ea3i t\u1eeb ph\u00eda tr\u00ean c\u00e1nh tay. Khi quan s\u00e1t t\u1eeb ph\u00eda b\u00ean, c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y r\u00f5 v\u1ecb tr\u00ed c\u1ea5y v\u00e0 s\u1ef1 di chuy\u1ec3n c\u1ee7a kim ngay d\u01b0\u1edbi da.<\/p>\n<p>Nh\u1eb1m m\u1ee5c \u0111\u00edch minh h\u1ecda, c\u00e1c h\u00ecnh m\u00f4 t\u1ea3 m\u1eb7t trong c\u00e1nh tay tr\u00e1i.<\/p>\n<p>&#8211; xem h\u00ecnh.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"1431\" height=\"2047\" class=\"wp-image-22036\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content.png\" alt=\"Image from Drug Label Content\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content.png 1431w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-210x300.png 210w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-768x1099.png 768w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-716x1024.png 716w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-419x600.png 419w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-112x160.png 112w\" sizes=\"auto, (max-width: 1431px) 100vw, 1431px\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"2186\" height=\"3119\" class=\"wp-image-22037\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-1.png\" alt=\"Image from Drug Label Content\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-1.png 2186w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-1-210x300.png 210w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-1-768x1096.png 768w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-1-718x1024.png 718w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-1-421x600.png 421w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-1-112x160.png 112w\" sizes=\"auto, (max-width: 2186px) 100vw, 2186px\" \/><\/p>\n<p>N\u1ebfu kh\u00f4ng s\u1edd th\u1ea5y que c\u1ea5y sau khi c\u1ea5y:<\/p>\n<p>N\u1ebfu kh\u00f4ng th\u1ec3 s\u1edd th\u1ea5y que c\u1ea5y ho\u1eb7c nghi ng\u1edd v\u1ec1 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a n\u00f3, que c\u1ea5y c\u00f3 th\u1ec3 \u0111\u00e3 kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea5y ho\u1eb7c c\u00f3 th\u1ec3 \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea5y s\u00e2u:<\/p>\n<p>Ki\u1ec3m tra thi\u1ebft b\u1ecb c\u1ea5y. Kim c\u1ea7n \u0111\u01b0\u1ee3c r\u00fat l\u1ea1i ho\u00e0n to\u00e0n v\u00e0 ch\u1ec9 n\u00ean nh\u00ecn th\u1ea5y \u0111\u01b0\u1ee3c \u0111\u1ea7u m\u00e0u t\u00edm c\u1ee7a thanh b\u1ecbt.<\/p>\n<p>S\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a que c\u1ea5y. Do b\u1ea3n ch\u1ea5t ch\u1eafn b\u1ee9c x\u1ea1 c\u1ee7a que c\u1ea5y, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p th\u00edch h\u1ee3p \u0111\u1ec3 \u0111\u1ecbnh v\u1ecb que c\u1ea5y l\u00e0 ch\u1ee5p X-quang hai chi\u1ec1u v\u00e0 ch\u1ee5p X-quang c\u1eaft l\u1edbp \u0111i\u1ec7n to\u00e1n (ch\u1ee5p CT). Si\u00eau \u00e2m qu\u00e9t (USS) v\u1edbi \u0111\u1ea7u d\u00f2 cao t\u1ea7n tuy\u1ebfn t\u00ednh (10 MHz ho\u1eb7c cao h\u01a1n) ho\u1eb7c ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. Trong tr\u01b0\u1eddng h\u1ee3p c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ee5p h\u00ecnh \u1ea3nh n\u00e0y th\u1ea5t b\u1ea1i, n\u00ean x\u00e1c \u0111\u1ecbnh s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a que c\u1ea5y b\u1eb1ng c\u00e1ch \u0111o n\u1ed3ng \u0111\u1ed9 etonogestrel trong m\u1eabu m\u00e1u c\u1ee7a ng\u01b0\u1eddi ph\u1ee5 n\u1eef. Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y, nh\u00e0 cung c\u1ea5p s\u1ebd cung c\u1ea5p h\u01b0\u1edbng d\u1eabn th\u00edch h\u1ee3p. Cho \u0111\u1ebfn khi \u0111\u00e3 x\u00e1c \u0111\u1ecbnh s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a que c\u1ea5y, ng\u01b0\u1eddi ph\u1ee5 n\u1eef ph\u1ea3i s\u1eed d\u1ee5ng m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai kh\u00f4ng ch\u1ee9a hormone.<\/p>\n<p>C\u1ea7n \u0111\u1ecbnh v\u1ecb que c\u1ea5y \u0111\u01b0\u1ee3c \u0111\u1eb7t s\u00e2u v\u00e0 r\u00fat c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t \u0111\u1ec3 tr\u00e1nh nguy c\u01a1 di chuy\u1ec3n xa (xem ph\u1ea7n C\u1ea3nh b\u00e1o).<\/p>\n<p><em>C\u00e1ch r\u00fat que c\u1ea5y Implanon NXT<\/em><\/p>\n<p>Vi\u1ec7c r\u00fat que c\u1ea5y ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh trong \u0111i\u1ec1u ki\u1ec7n v\u00f4 khu\u1ea9n b\u1edfi chuy\u00ean gia y t\u1ebf quen thu\u1ed9c v\u1edbi k\u1ef9 thu\u1eadt r\u00fat que c\u1ea5y. N\u1ebfu kh\u00f4ng quen thu\u1ed9c v\u1edbi k\u1ef9 thu\u1eadt r\u00fat que c\u1ea5y, li\u00ean h\u1ec7 v\u1edbi nh\u00e0 cung c\u1ea5p \u0111\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin.<\/p>\n<p>Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u quy tr\u00ecnh r\u00fat que c\u1ea5y, chuy\u00ean gia y t\u1ebf c\u1ea7n \u0111\u00e1nh gi\u00e1 v\u1ecb tr\u00ed c\u1ee7a que c\u1ea5y. X\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed ch\u00ednh x\u00e1c c\u1ee7a que c\u1ea5y \u1edf c\u00e1nh tay b\u1eb1ng c\u00e1ch s\u1edd n\u1eafn.<\/p>\n<p>N\u1ebfu kh\u00f4ng s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c que c\u1ea5y, tham kh\u1ea3o &#8221;Phi\u00ea\u0301u da\u0300nh cho ng\u01b0\u01a1\u0300i s\u01b0\u0309 du\u0323ng&#8221; ho\u1eb7c h\u1ed3 s\u01a1 y t\u1ebf \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh c\u00e1nh tay c\u00f3 ch\u1ee9a que c\u1ea5y. N\u1ebfu kh\u00f4ng s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c que c\u1ea5y, n\u00f3 c\u00f3 th\u1ec3 n\u1eb1m s\u00e2u ho\u1eb7c \u0111\u00e3 di chuy\u1ec3n. Xem x\u00e9t r\u1eb1ng que c\u1ea5y c\u00f3 th\u1ec3 n\u1eb1m g\u1ea7n c\u00e1c m\u1ea1ch m\u00e1u v\u00e0 d\u00e2y th\u1ea7n kinh. Vi\u1ec7c r\u00fat que c\u1ea5y kh\u00f4ng th\u1ec3 s\u1edd th\u1ea5y ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi chuy\u00ean gia y t\u1ebf c\u00f3 kinh nghi\u1ec7m trong vi\u1ec7c r\u00fat que c\u1ea5y \u0111\u1eb7t s\u00e2u v\u00e0 quen thu\u1ed9c v\u1edbi vi\u1ec7c \u0111\u1ecbnh v\u1ecb que c\u1ea5y v\u00e0 gi\u1ea3i ph\u1eabu c\u1ee7a c\u00e1nh tay. Li\u00ean h\u1ec7 v\u1edbi nh\u00e0 cung c\u1ea5p t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng \u0111\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin.<\/p>\n<p>Xem ph\u1ea7n d\u01b0\u1edbi \u0111\u00e2y v\u1ec1 \u201c\u0110\u1ecbnh v\u1ecb v\u00e0 r\u00fat que c\u1ea5y kh\u00f4ng s\u1edd th\u1ea5y\u201d n\u1ebfu kh\u00f4ng th\u1ec3 s\u1edd th\u1ea5y que c\u1ea5y.<\/p>\n<p>Th\u1ee7 thu\u1eadt r\u00fat m\u1ed9t que c\u1ea5y s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c<\/p>\n<p>Nh\u1eb1m m\u1ee5c \u0111\u00edch minh h\u1ecda, c\u00e1c h\u00ecnh m\u00f4 t\u1ea3 m\u1eb7t trong c\u00e1nh tay tr\u00e1i.<\/p>\n<p>&#8211; xem h\u00ecnh.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"2186\" height=\"3109\" class=\"wp-image-22038\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-2.png\" alt=\"Image from Drug Label Content\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-2.png 2186w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-2-211x300.png 211w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-2-768x1092.png 768w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-2-720x1024.png 720w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-2-422x600.png 422w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-2-112x160.png 112w\" sizes=\"auto, (max-width: 2186px) 100vw, 2186px\" \/><\/p>\n<p>\u0110\u1ecbnh v\u1ecb v\u00e0 r\u00fat m\u1ed9t que c\u1ea5y kh\u00f4ng s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c<\/p>\n<p>\u0110\u00f4i khi c\u00f3 c\u00e1c b\u00e1o c\u00e1o v\u1ec1 vi\u1ec7c di chuy\u1ec3n que c\u1ea5y; th\u00f4ng th\u01b0\u1eddng \u0111i\u1ec1u n\u00e0y li\u00ean quan \u0111\u1ebfn s\u1ef1 di chuy\u1ec3n nh\u1eb9 so v\u1edbi v\u1ecb tr\u00ed ban \u0111\u1ea7u (xem ph\u1ea7n \u201cC\u1ea3nh b\u00e1o\u201d), nh\u01b0ng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn kh\u00f4ng s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c que c\u1ea5y \u1edf v\u1ecb tr\u00ed c\u1ea5y. C\u00f3 th\u1ec3 kh\u00f4ng s\u1edd th\u1ea5y que c\u1ea5y khi que c\u1ea5y \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea5y s\u00e2u ho\u1eb7c b\u1ecb di l\u1ec7ch v\u00e0 do \u0111\u00f3 c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i c\u00f3 c\u00e1c th\u1ee7 thu\u1eadt ch\u1ee5p h\u00ecnh \u1ea3nh, nh\u01b0 \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 d\u01b0\u1edbi \u0111\u00e2y \u0111\u1ec3 \u0111\u1ecbnh v\u1ecb que c\u1ea5y.<\/p>\n<p>C\u1ea7n ph\u1ea3i lu\u00f4n lu\u00f4n \u0111\u1ecbnh v\u1ecb m\u1ed9t que c\u1ea5y kh\u00f4ng s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c tr\u01b0\u1edbc khi c\u1ed1 g\u1eafng r\u00fat ra. Do b\u1ea3n ch\u1ea5t c\u1ea3n quang c\u1ee7a que c\u1ea5y, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p th\u00edch h\u1ee3p \u0111\u1ec3 \u0111\u1ecbnh v\u1ecb que c\u1ea5y bao g\u1ed3m ch\u1ee5p X-quang hai chi\u1ec1u v\u00e0 ch\u1ee5p X-quang c\u1eaft l\u1edbp \u0111i\u1ec7n to\u00e1n (ch\u1ee5p CT). Si\u00eau \u00e2m qu\u00e9t (USS) v\u01a1\u0301i \u0111\u1ea7u d\u00f2 cao t\u1ea7n tuy\u1ebfn t\u00ednh (10 MHz ho\u0103\u0323c cao h\u01a1n) ho\u0103\u0323c chu\u0323p c\u00f4\u0323ng h\u01b0\u01a1\u0309ng t\u01b0\u0300 (MRI) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. M\u1ed9t khi \u0111\u00e3 \u0111\u1ecbnh v\u1ecb que c\u1ea5y \u1edf c\u00e1nh tay, vi\u1ec7c r\u00fat que c\u1ea5y ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi chuy\u00ean gia y t\u1ebf c\u00f3 kinh nghi\u1ec7m trong vi\u1ec7c r\u00fat que c\u1ea5y \u0111\u1eb7t s\u00e2u v\u00e0 quen thu\u1ed9c v\u1edbi gi\u1ea3i ph\u1eabu c\u1ee7a c\u00e1nh tay. N\u00ean xem x\u00e9t s\u1eed d\u1ee5ng h\u01b0\u1edbng d\u1eabn b\u1eb1ng si\u00eau \u00e2m trong khi r\u00fat.<\/p>\n<p>N\u1ebfu kh\u00f4ng th\u1ec3 t\u00ecm th\u1ea5y que c\u1ea5y trong c\u00e1nh tay sau nh\u1eefng n\u1ed7 l\u1ef1c \u0111\u1ecbnh v\u1ecb to\u00e0n di\u1ec7n, h\u00e3y xem x\u00e9t \u00e1p d\u1ee5ng k\u1ef9 thu\u1eadt ch\u1ee5p h\u00ecnh \u1ea3nh ng\u1ef1c v\u00ec c\u00e1c bi\u1ebfn c\u1ed1 hi\u1ebfm g\u1eb7p c\u1ee7a s\u1ef1 di chuy\u1ec3n \u0111\u1ebfn m\u1ea1ch m\u00e1u ph\u1ed5i \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. N\u1ebfu que c\u1ea5y n\u1eb1m \u1edf ng\u1ef1c, c\u00f3 th\u1ec3 c\u1ea7n \u0111\u1ebfn ph\u1eabu thu\u1eadt ho\u1eb7c th\u1ee7 thu\u1eadt n\u1ed9i m\u1ea1ch \u0111\u1ec3 r\u00fat que c\u1ea5y ra; n\u00ean tham v\u1ea5n c\u00e1c chuy\u00ean gia y t\u1ebf th\u00e0nh th\u1ea1o v\u1ec1 gi\u1ea3i ph\u1eabu c\u1ee7a ng\u1ef1c.<\/p>\n<p>Trong tr\u01b0\u1eddng h\u1ee3p c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh \u0111\u1ecbnh v\u1ecb que c\u1ea5y th\u1ea5t b\u1ea1i, vi\u1ec7c x\u00e1c \u0111\u1ecbnh n\u1ed3ng \u0111\u1ed9 etonogestrel trong m\u00e1u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a que c\u1ea5y. Xin li\u00ean h\u1ec7 nh\u00e0 cung c\u1ea5p t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng \u0111\u1ec3 \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn th\u00eam.<\/p>\n<p>N\u1ebfu que c\u1ea5y di chuy\u1ec3n b\u00ean trong c\u00e1nh tay, vi\u1ec7c r\u00fat ra c\u00f3 th\u1ec3 \u0111\u00f2i h\u1ecfi ti\u1ec3u ph\u1eabu v\u1edbi m\u1ed9t \u0111\u01b0\u1eddng r\u1ea1ch l\u1edbn h\u01a1n ho\u1eb7c ph\u1eabu thu\u1eadt trong ph\u00f2ng m\u1ed5. R\u00fat c\u00e1c que c\u1ea5y \u0111\u01b0\u1ee3c c\u1ea5y s\u00e2u c\u1ea7n \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh th\u1eadn tr\u1ecdng \u0111\u1ec3 gi\u00fap ng\u0103n ng\u1eeba t\u1ed5n th\u01b0\u01a1ng c\u00e1c c\u1ea5u tr\u00fac th\u1ea7n kinh ho\u1eb7c m\u1ea1ch m\u00e1u s\u00e2u h\u01a1n \u1edf c\u00e1nh tay. Que c\u1ea5y kh\u00f4ng s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c v\u00e0 \u0111\u01b0\u1ee3c c\u1ea5y s\u00e2u c\u1ea7n \u0111\u01b0\u1ee3c r\u00fat b\u1edfi c\u00e1c chuy\u00ean gia y t\u1ebf th\u00e0nh th\u1ea1o gi\u1ea3i ph\u1eabu c\u1ee7a c\u00e1nh tay v\u00e0 r\u00fat c\u00e1c que c\u1ea5y \u0111\u01b0\u1ee3c c\u1ea5y s\u00e2u.<\/p>\n<p>Khuy\u1ebfn c\u00e1o kh\u00f4ng n\u00ean ph\u1eabu thu\u1eadt th\u0103m d\u00f2 khi ch\u01b0a bi\u1ebft v\u1ecb tr\u00ed ch\u00ednh x\u00e1c c\u1ee7a que c\u1ea5y.<\/p>\n<p>Xin li\u00ean h\u1ec7 nh\u00e0 cung c\u1ea5p t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng \u0111\u1ec3 \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn th\u00eam.<\/p>\n<p><em>C\u00e1ch thay Implanon NXT<\/em><\/p>\n<p>C\u00f3 th\u1ec3 thay ngay que c\u1ea5y m\u1edbi sau khi r\u00fat que c\u1ea5y c\u0169 v\u00e0 c\u0169ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 th\u1ee7 thu\u1eadt c\u1ea5y \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 trong ph\u1ea7n \u201cC\u00e1ch c\u1ea5y Implanon NXT\u201d.<\/p>\n<p>Que c\u1ea5y m\u1edbi c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u1ea5y v\u00e0o trong c\u00f9ng m\u1ed9t c\u00e1nh tay v\u00e0 qua c\u00f9ng m\u1ed9t \u0111\u01b0\u1eddng r\u1ea1ch d\u00f9ng \u0111\u1ec3 r\u00fat que c\u1ea5y c\u0169 (xem ph\u1ea7n &#8221;C\u00e1ch c\u1ea5y Implanon NXT&#8221;. N\u1ebfu \u0111ang s\u1eed d\u1ee5ng c\u00f9ng m\u1ed9t \u0111\u01b0\u1eddng r\u1ea1ch \u0111\u1ec3 c\u1ea5y m\u1ed9t que c\u1ea5y m\u1edbi, g\u00e2y t\u00ea v\u1ecb tr\u00ed c\u1ea5y [v\u00ed d\u1ee5 2 mL lidocaine (1%)] ngay d\u01b0\u1edbi da t\u1ea1i \u0111\u01b0\u1eddng r\u1ea1ch \u0111\u1ec3 r\u00fat que c\u1ea5y d\u1ecdc theo chi\u1ec1u d\u00e0i \u201cr\u00e3nh c\u1ea5y\u201d v\u00e0 tu\u00e2n theo c\u00e1c b\u01b0\u1edbc ti\u1ebfp theo nh\u01b0 m\u00f4 t\u1ea3 trong ph\u1ea7n h\u01b0\u1edbng d\u1eabn v\u1ec1 c\u1ea5y.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p>D\u00f9ng m\u1ed9t que c\u1ea5y trong th\u1eddi gian 3 n\u0103m.<\/p>\n<p><strong>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>Thu\u1ed1c tr\u00e1nh thai ch\u1ec9 ch\u1ee9a progestagen kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng khi c\u00f3 b\u1ea5t k\u1ef3 t\u00ecnh tr\u1ea1ng n\u00e0o d\u01b0\u1edbi \u0111\u00e2y:<\/p>\n<p>\u0110\u00e3 bi\u1ebft ho\u1eb7c nghi ng\u1edd c\u00f3 thai<\/p>\n<p>\u0110ang b\u1ecb r\u1ed1i lo\u1ea1n huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch<\/p>\n<p>\u0110\u00e3 x\u00e1c \u0111\u1ecbnh ho\u1eb7c nghi ng\u1edd b\u1ecb c\u00e1c b\u1ec7nh \u00e1c t\u00ednh m\u1eabn c\u1ea3m v\u1edbi steroid sinh d\u1ee5c<\/p>\n<p>\u0110ang co\u0301 ho\u0103\u0323c ti\u00ea\u0300n s\u01b0\u0309 co\u0301 kh\u00f4\u0301i u gan (la\u0300nh ti\u0301nh ho\u0103\u0323c a\u0301c ti\u0301nh)<\/p>\n<p>Hi\u1ec7n t\u1ea1i ho\u1eb7c ti\u1ec1n s\u1eed b\u1ec7nh gan n\u1eb7ng v\u1edbi c\u00e1c th\u00f4ng s\u1ed1 ch\u1ee9c n\u0103ng gan ch\u01b0a tr\u1edf l\u1ea1i b\u00ecnh th\u01b0\u1eddng<\/p>\n<p>Xu\u1ea5t huy\u1ebft \u00e2m \u0111\u1ea1o kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n.<\/p>\n<p>Qu\u00e1 m\u1eabn v\u1edbi ho\u1ea1t ch\u1ea5t ho\u1eb7c b\u1ea5t k\u1ef3 t\u00e1 d\u01b0\u1ee3c n\u00e0o c\u1ee7a Implanon NXT.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>4.4 Th\u1eadn tr\u1ecdng:<\/strong><\/p>\n<p><em>C\u1ea3nh b\u00e1o<\/em><\/p>\n<p>B\u1ea5t k\u1ef3 d\u1ea5u hi\u1ec7u n\u00e0o d\u01b0\u1edbi \u0111\u00e2y xu\u1ea5t hi\u1ec7n l\u1ea7n \u0111\u1ea7u trong th\u1eddi gian d\u00f9ng Implanon NXT, n\u00ean d\u1eebng thu\u1ed1c ngay l\u1eadp t\u1ee9c.<\/p>\n<p>\u0110\u00e3 bi\u1ebft ho\u1eb7c nghi ng\u1edd c\u00f3 thai<\/p>\n<p>\u0110ang b\u1ecb r\u1ed1i lo\u1ea1n huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch<\/p>\n<p>\u0110\u00e3 x\u00e1c \u0111\u1ecbnh ho\u1eb7c nghi ng\u1edd b\u1ecb c\u00e1c b\u1ec7nh \u00e1c t\u00ednh m\u1eabn c\u1ea3m v\u1edbi steroid sinh d\u1ee5c<\/p>\n<p>\u0110ang co\u0301 ho\u0103\u0323c ti\u00ea\u0300n s\u01b0\u0309 co\u0301 kh\u00f4\u0301i u gan (la\u0300nh ti\u0301nh ho\u0103\u0323c a\u0301c ti\u0301nh)<\/p>\n<p>Hi\u1ec7n t\u1ea1i ho\u1eb7c ti\u1ec1n s\u1eed b\u1ec7nh gan n\u1eb7ng v\u1edbi c\u00e1c th\u00f4ng s\u1ed1 ch\u1ee9c n\u0103ng gan ch\u01b0a tr\u1edf l\u1ea1i b\u00ecnh th\u01b0\u1eddng<\/p>\n<p>Xu\u1ea5t huy\u1ebft \u00e2m \u0111\u1ea1o kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n<\/p>\n<p>Qu\u00e1 m\u1eabn v\u1edbi ho\u1ea1t ch\u1ea5t ho\u1eb7c b\u1ea5t k\u1ef3 t\u00e1 d\u01b0\u1ee3c n\u00e0o c\u1ee7a Implanon NXT.<\/p>\n<p>N\u00ea\u0301u co\u0301 b\u00e2\u0301t ky\u0300 t\u00ecnh tr\u1ea1ng\/y\u00ea\u0301u t\u00f4\u0301 nguy c\u01a1 n\u00e0o \u0111\u01b0\u01a1\u0323c \u0111\u00ea\u0300 c\u00e2\u0323p d\u01b0\u01a1\u0301i \u0111\u00e2y, n\u00ean c\u00e2n nh\u0103\u0301c l\u01a1\u0323i i\u0301ch cu\u0309a vi\u00ea\u0323c s\u01b0\u0309 du\u0323ng progestagen v\u01a1\u0301i nguy c\u01a1 co\u0301 th\u00ea\u0309 xa\u0309y ra \u0111\u00f4\u0301i v\u01a1\u0301i t\u01b0\u0300ng phu\u0323 n\u01b0\u0303 va\u0300 tha\u0309o lu\u00e2\u0323n v\u01a1\u0301i ho\u0323 tr\u01b0\u01a1\u0301c khi ho\u0323 quy\u00ea\u0301t \u0111i\u0323nh s\u1eed d\u1ee5ng Implanon NXT. N\u1ebfu b\u1ea5t k\u1ef3 t\u00ecnh tr\u1ea1ng n\u00e0o d\u01b0\u1edbi \u0111\u00e2y tr\u1edf n\u00ean tr\u1ea7m tr\u1ecdng h\u01a1n, k\u1ecbch ph\u00e1t ho\u1eb7c xu\u1ea5t hi\u1ec7n l\u1ea7n \u0111\u1ea7u ti\u00ean, n\u00ean tham kh\u1ea3o \u00fd ki\u1ebfn b\u00e1c s\u1ef9. B\u00e1c s\u1ef9 s\u1ebd quy\u1ebft \u0111\u1ecbnh c\u00f3 n\u00ean ng\u1eebng bi\u1ec7n ph\u00e1p hay kh\u00f4ng.<\/p>\n<p><em>Ung th\u01b0 v\u00fa<\/em><\/p>\n<p>No\u0301i chung nguy c\u01a1 ung th\u01b0 vu\u0301 t\u0103ng theo tu\u00f4\u0309i. Nguy c\u01a1 ung th\u01b0 v\u00fa h\u01a1i t\u0103ng trong th\u1eddi gian d\u00f9ng thu\u1ed1c tr\u00e1nh thai (ph\u1ed1i h\u1ee3p) d\u1ea1ng u\u1ed1ng. S\u1ef1 t\u0103ng nguy c\u01a1 n\u00e0y m\u1ea5t d\u1ea7n trong v\u00f2ng 10 n\u0103m sau khi ng\u1eebng d\u00f9ng thu\u1ed1c tr\u00e1nh thai u\u1ed1ng v\u00e0 kh\u00f4ng li\u00ean quan \u0111\u1ebfn th\u1eddi gian d\u00f9ng thu\u1ed1c m\u00e0 li\u00ean quan \u0111\u1ebfn tu\u1ed5i c\u1ee7a ng\u01b0\u1eddi ph\u1ee5 n\u1eef khi u\u1ed1ng thu\u1ed1c tr\u00e1nh thai. S\u00f4\u0301 tr\u01b0\u01a1\u0300ng h\u01a1\u0323p ung th\u01b0 vu\u0301 d\u1ef1 ki\u1ebfn tr\u00ean m\u1ed7i 10.000 phu\u0323 n\u01b0\u0303 du\u0300ng thu\u00f4\u0301c tra\u0301nh thai ph\u00f4\u0301i h\u01a1\u0323p d\u1ea1ng u\u1ed1ng (t\u00ednh \u0111\u00ea\u0301n 10 n\u0103m sau khi ng\u1eebng thu\u00f4\u0301c) so v\u01a1\u0301i ng\u01b0\u01a1\u0300i ch\u01b0a bao gi\u01a1\u0300 s\u01b0\u0309 du\u0323ng ca\u0301c thu\u00f4\u0301c na\u0300y trong cu\u0300ng th\u1eddi gian \u0111\u00f3 \u0111\u01b0\u1ee3c t\u00ednh theo c\u00e1c nh\u00f3m tu\u1ed5i t\u01b0\u01a1ng \u1ee9ng l\u00e0: 4,5\/4 (16-19 tu\u00f4\u0309i), 17,5\/16 (20-24 tu\u00f4\u0309i), 48,7\/44 (25-29 tu\u00f4\u0309i), 110\/100 (30-34 tu\u00f4\u0309i), 180\/160 (35-39 tu\u00f4\u0309i) va\u0300 260\/230 (40-44 tu\u00f4\u0309i). Nguy c\u01a1 \u01a1\u0309 nh\u01b0\u0303ng ph\u1ee5 n\u1eef du\u0300ng ca\u0301c ph\u01b0\u01a1ng pha\u0301p tra\u0301nh thai chi\u0309 ch\u01b0\u0301a progestagen co\u0301 th\u00ea\u0309 co\u0301 bi\u00ean \u0111\u00f4\u0323 t\u01b0\u01a1ng t\u01b0\u0323 nh\u01b0 khi u\u1ed1ng vi\u00ean thu\u00f4\u0301c tra\u0301nh thai ph\u00f4\u0301i h\u01a1\u0323p. Tuy nhi\u00ean, \u0111\u00f4\u0301i v\u01a1\u0301i ca\u0301c bi\u00ea\u0323n pha\u0301p na\u0300y, ch\u01b0a \u0111\u1ee7 b\u0103\u0300ng ch\u01b0\u0301ng \u0111\u1ec3 k\u1ebft lu\u1eadn. So v\u1edbi nguy c\u01a1 b\u1ecb ung th\u01b0 v\u00fa trong \u0111\u1eddi, s\u1ef1 gia t\u0103ng nguy c\u01a1 ung th\u01b0 v\u00fa li\u00ean quan \u0111\u1ebfn thu\u1ed1c tr\u00e1nh thai d\u1ea1ng u\u1ed1ng l\u00e0 th\u1ea5p. Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 v\u00fa tr\u00ean ph\u1ee5 n\u1eef d\u00f9ng thu\u1ed1c tr\u00e1nh thai d\u1ea1ng u\u1ed1ng c\u00f3 xu h\u01b0\u1edbng \u00edt ti\u1ebfn tri\u1ec3n h\u01a1n so v\u1edbi nh\u1eefng ng\u01b0\u1eddi ch\u01b0a t\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c tr\u00e1nh thai u\u1ed1ng. T\u0103ng nguy c\u01a1 tr\u00ean ph\u1ee5 n\u1eef u\u1ed1ng thu\u1ed1c tr\u00e1nh thai c\u00f3 th\u1ec3 do ch\u1ea9n \u0111o\u00e1n s\u1edbm h\u01a1n, do t\u00e1c d\u1ee5ng sinh h\u1ecdc c\u1ee7a thu\u1ed1c tr\u00e1nh thai d\u1ea1ng u\u1ed1ng ho\u1eb7c do k\u1ebft h\u1ee3p c\u1ea3 hai.<\/p>\n<p><em>B\u1ec7nh gan<\/em><\/p>\n<p>Khi xu\u1ea5t hi\u1ec7n r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng gan c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh t\u1ed1t nh\u1ea5t n\u00ean \u0111i ki\u1ec3m tra v\u00e0 kh\u00e1m chuy\u00ean khoa.<\/p>\n<p><em>Huy\u1ebft kh\u1ed1i v\u00e0 c\u00e1c bi\u1ebfn c\u1ed1 m\u1ea1ch m\u00e1u kh\u00e1c<\/em><\/p>\n<p>Nh\u01b0\u0303ng nghi\u00ean c\u01b0\u0301u di\u0323ch t\u00ea\u0303 ho\u0323c \u0111a\u0303 li\u00ean k\u00ea\u0301t vi\u00ea\u0323c s\u01b0\u0309 du\u0323ng thu\u00f4\u0301c tra\u0301nh thai ph\u1ed1i h\u1ee3p d\u1ea1ng u\u1ed1ng v\u01a1\u0301i s\u01b0\u0323 gia t\u0103ng ty\u0309 l\u00ea\u0323 t\u0103\u0301c ti\u0303nh ma\u0323ch do huy\u00ea\u0301t kh\u00f4\u0301i (venous thromboembolism &#8211; VTE, huy\u00ea\u0301t kh\u00f4\u0301i ti\u0303nh ma\u0323ch s\u00e2u va\u0300 nghe\u0303n ma\u0323ch ph\u00f4\u0309i). M\u0103\u0323c du\u0300 ch\u01b0a bi\u1ebft c\u00f3 s\u01b0\u0323 li\u00ean quan l\u00e2m sa\u0300ng cu\u0309a pha\u0301t hi\u00ea\u0323n na\u0300y \u0111\u00f4\u0301i v\u01a1\u0301i etonogestrel (ch\u00e2\u0301t chuy\u00ea\u0309n ho\u0301a co\u0301 hoa\u0323t ti\u0301nh sinh ho\u0323c cu\u0309a desogestrel) \u0111\u01b0\u01a1\u0323c du\u0300ng trong vi\u00ean tra\u0301nh thai kh\u00f4ng ch\u01b0\u0301a tha\u0300nh ph\u00e2\u0300n estrogen hay kh\u00f4ng, nh\u01b0ng n\u00ean ru\u0301t que c\u1ea5y trong tr\u01b0\u01a1\u0300ng h\u01a1\u0323p \u0111\u00e3 x\u00e1c \u0111\u1ecbnh c\u00f3 huy\u00ea\u0301t kh\u00f4\u0301i. Cu\u0303ng n\u00ean xem xe\u0301t ru\u0301t que c\u1ea5y trong tr\u01b0\u01a1\u0300ng h\u01a1\u0323p b\u00e2\u0301t \u0111\u00f4\u0323ng l\u00e2u ng\u00e0y do ph\u00e2\u0303u thu\u00e2\u0323t ho\u0103\u0323c do b\u00ea\u0323nh ly\u0301. M\u1eb7c d\u00f9 Implanon NXT l\u00e0 thu\u1ed1c tr\u00e1nh thai ch\u1ec9 ch\u1ee9a progestagen, khuy\u1ebfn c\u00e1o \u0111\u00e1nh gi\u00e1 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u00e3 bi\u1ebft l\u00e0m t\u0103ng nguy c\u01a1 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch v\u00e0 \u0111\u1ed9ng m\u1ea1ch. N\u00ean th\u00f4ng ba\u0301o cho ng\u01b0\u1eddi phu\u0323 n\u01b0\u0303 c\u00f3 ti\u1ec1n s\u1eed bi\u0323 r\u1ed1i lo\u1ea1n huy\u00ea\u0301t kh\u00f4\u0301i t\u0103\u0301c ma\u0323ch tr\u01b0\u01a1\u0301c \u0111\u00e2y bi\u00ea\u0301t v\u00ea\u0300 kha\u0309 n\u0103ng ta\u0301i pha\u0301t b\u1ec7nh.<\/p>\n<p>\u0110a\u0303 co\u0301 ca\u0301c ba\u0301o ca\u0301o h\u00e2\u0323u ma\u0303i v\u00ea\u0300 ca\u0301c bi\u00ea\u0301n c\u00f4\u0301 thuy\u00ean t\u0103\u0301c huy\u00ea\u0301t kh\u00f4\u0301i \u0111\u00f4\u0323ng ma\u0323ch va\u0300 ti\u0303nh ma\u0323ch nghi\u00eam tro\u0323ng, bao g\u00f4\u0300m ca\u0309 tr\u01b0\u01a1\u0300ng h\u01a1\u0323p nghe\u0303n ma\u0323ch ph\u00f4\u0309i (m\u00f4\u0323t s\u00f4\u0301 tr\u01b0\u01a1\u0300ng h\u01a1\u0323p t\u01b0\u0309 vong), huy\u00ea\u0301t kh\u00f4\u0301i ti\u0303nh ma\u0323ch s\u00e2u, nh\u00f4\u0300i ma\u0301u c\u01a1 tim va\u0300 \u0111\u00f4\u0323t quy\u0323 \u01a1\u0309 phu\u0323 n\u01b0\u0303 s\u01b0\u0309 du\u0323ng que c\u00e2\u0301y ch\u1ee9a etonogestrel. Pha\u0309i ru\u0301t que c\u00e2\u0301y Implanon NXT trong tr\u01b0\u01a1\u0300ng h\u01a1\u0323p bi\u0323 huy\u00ea\u0301t kh\u00f4\u0301i.<\/p>\n<p><em>Cao huy\u1ebft \u00e1p<\/em><\/p>\n<p>N\u00ean ng\u1eebng s\u1eed d\u1ee5ng Implanon NXT n\u1ebfu b\u1ecb cao huy\u1ebft \u00e1p k\u00e9o d\u00e0i trong su\u1ed1t th\u1eddi gian d\u00f9ng Implanon NXT, ho\u1eb7c n\u1ebfu b\u1ecb cao huy\u1ebft \u00e1p \u0111\u00e1ng k\u1ec3 m\u00e0 kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb h\u1ea1 huy\u1ebft \u00e1p.<\/p>\n<p><em>C\u00e1c \u1ea3nh h\u01b0\u1edfng l\u00ean s\u1ef1 chuy\u1ec3n h\u00f3a carbonhydrate v\u00e0 lipid<\/em><\/p>\n<p>M\u1eb7c d\u00f9 progestagen c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 \u0111\u1ec1 kh\u00e1ng insulin ngo\u1ea1i bi\u00ean v\u00e0 s\u1ef1 dung n\u1ea1p glucose, kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 s\u1ef1 c\u1ea7n thi\u1ebft thay \u0111\u1ed5i ch\u1ebf \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb \u1edf b\u1ec7nh nh\u00e2n ti\u1ec3u \u0111\u01b0\u1eddng s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai ch\u1ec9 ch\u1ee9a progestagen. Tuy nhi\u00ean, ph\u1ee5 n\u1eef b\u1ecb b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i th\u1eadn tr\u1ecdng trong khi s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai ch\u1ec9 ch\u1ee9a progestagen.<\/p>\n<p>V\u1edbi ph\u1ee5 n\u1eef \u0111ang \u0111i\u1ec1u tr\u1ecb t\u0103ng lipid m\u00e1u, n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd n\u1ebfu quy\u1ebft \u0111\u1ecbnh d\u00f9ng Implanon NXT. M\u1ed9t v\u00e0i progestagen c\u00f3 th\u1ec3 l\u00e0m t\u0103ng m\u1ee9c LDL v\u00e0 c\u00f3 th\u1ec3 l\u00e0m cho vi\u1ec7c ki\u1ec3m so\u00e1t lipid m\u00e1u tr\u1edf n\u00ean kh\u00f3 kh\u0103n h\u01a1n.<\/p>\n<p><em>N\u00e1m da<\/em><\/p>\n<p>\u0110\u00f4i khi xu\u1ea5t hi\u1ec7n n\u00e1m da, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng ph\u1ee5 n\u1eef c\u00f3 ti\u1ec1n s\u1eed n\u00e1m da l\u00fac mang thai. Ph\u1ee5 n\u1eef c\u00f3 xu h\u01b0\u1edbng n\u00e1m da n\u00ean tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi \u00e1nh n\u1eafng m\u1eb7t tr\u1eddi ho\u1eb7c tia t\u1eed ngo\u1ea1i trong th\u1eddi gian d\u00f9ng Implanon NXT.<\/p>\n<p><em>Th\u1ec3 tr\u1ecdng<\/em><\/p>\n<p>Hi\u1ec7u qu\u1ea3 tr\u00e1nh thai c\u1ee7a Implanon NXT li\u00ean quan \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 etonogestrel trong huy\u1ebft t\u01b0\u01a1ng m\u00e0 n\u1ed3ng \u0111\u1ed9 n\u00e0y v\u1ed1n t\u1ef7 l\u1ec7 ngh\u1ecbch v\u1edbi th\u1ec3 tr\u1ecdng, v\u00e0 gi\u1ea3m d\u1ea7n theo th\u1eddi gian \u0111\u1eb7t que c\u1ea5y. Kinh nghi\u1ec7m l\u00e2m s\u00e0ng trong n\u0103m s\u1eed d\u1ee5ng th\u1ee9 ba \u1edf nh\u1eefng ph\u1ee5 n\u1eef n\u1eb7ng c\u00e2n c\u00f2n h\u1ea1n ch\u1ebf. Do \u0111\u00f3 kh\u00f4ng th\u1ec3 lo\u1ea1i tr\u1eeb hi\u1ec7u qu\u1ea3 tr\u00e1nh thai \u1edf ph\u1ee5 n\u1eef n\u1eb7ng c\u00e2n trong n\u0103m th\u1ee9 ba l\u00e0 th\u1ea5p h\u01a1n so v\u1edbi ph\u1ee5 n\u1eef c\u00e2n n\u1eb7ng b\u00ecnh th\u01b0\u1eddng. C\u00e1c nh\u00e2n vi\u00ean y t\u1ebf c\u00f3 th\u1ec3 c\u1ea7n xem x\u00e9t \u0111\u1ec3 thay que c\u1ea5y s\u1edbm h\u01a1n cho nh\u1eefng ph\u1ee5 n\u1eef n\u1eb7ng c\u00e2n.<\/p>\n<p><em>C\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ea5y que<\/em><\/p>\n<p>C\u00f3 th\u1ec3 tu\u1ed9t que c\u1ea5y \u0111\u1eb7c bi\u1ec7t l\u00e0 khi que kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea5y \u0111\u00fang nh\u01b0 h\u01b0\u1edbng d\u1eabn n\u00eau trong m\u1ee5c \u201cC\u00e1ch c\u1ea5y Implanon NXT\u201d, ho\u1eb7c l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a ph\u1ea3n \u1ee9ng vi\u00eam t\u1ea1i ch\u1ed7.<\/p>\n<p>\u0110\u00e3 c\u00f3 c\u00e1c b\u00e1o c\u00e1o v\u1ec1 s\u1ef1 di chuy\u1ec3n que c\u1ea5y kh\u1ecfi v\u1ecb tr\u00ed c\u1ea5y trong c\u00e1nh tay, c\u00f3 th\u1ec3 do c\u1ea5y s\u00e2u (xem m\u1ee5c \u201cC\u00e1ch c\u1ea5y Implanon NXT\u201d) ho\u1eb7c do ngo\u1ea1i l\u1ef1c (nh\u01b0 n\u1eafn b\u00f3p que c\u1ea5y ho\u1eb7c va ch\u1ea1m trong th\u1ec3 thao). C\u0169ng c\u00f3 nh\u1eefng b\u00e1o c\u00e1o sau l\u01b0u h\u00e0nh tuy hi\u1ebfm v\u1ec1 que c\u1ea5y n\u1eb1m b\u00ean trong c\u00e1c m\u1ea1ch m\u00e1u \u1edf c\u00e1nh tay v\u00e0 \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, c\u00f3 th\u1ec3 do c\u1ea5y s\u00e2u ho\u1eb7c c\u1ea5y v\u00e0o trong m\u1ea1ch. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p que c\u1ea5y di chuy\u1ec3n kh\u1ecfi v\u1ecb tr\u00ed c\u1ea5y vi\u1ec7c \u0111\u1ecbnh v\u1ecb c\u00f3 th\u1ec3 kh\u00f3 kh\u0103n h\u01a1n v\u00e0 khi r\u00fat que c\u1ea5y c\u1ea7n \u0111\u1ebfn th\u1ee7 thu\u1eadt ph\u1eabu thu\u1eadt nh\u1ecf b\u1eb1ng c\u00e1ch r\u1ea1ch r\u1ed9ng h\u01a1n ho\u1eb7c th\u1ee7 thu\u1eadt ph\u1eabu thu\u1eadt trong ph\u00f2ng ph\u1eabu thu\u1eadt. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p m\u00e0 que c\u1ea5y di chuy\u1ec3n v\u00e0o \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, c\u00f3 th\u1ec3 c\u1ea7n ph\u1eabu thu\u1eadt ho\u1eb7c th\u1ee7 thu\u1eadt n\u1ed9i m\u1ea1ch \u0111\u1ec3 r\u00fat que c\u1ea5y (xem m\u1ee5c \u201cC\u00e1ch r\u00fat Implanon NXT\u201d). B\u1ea5t c\u1ee9 khi n\u00e0o kh\u00f4ng s\u1edd th\u1ea5y que c\u1ea5y, c\u1ea7n \u0111\u1ecbnh v\u1ecb v\u00e0 r\u00fat que c\u1ea5y. N\u1ebfu kh\u00f4ng th\u1ec3 r\u00fat que c\u1ea5y, t\u00e1c d\u1ee5ng tr\u00e1nh thai v\u00e0 nguy c\u01a1 t\u00e1c d\u1ee5ng ngo\u1ea1i \u00fd li\u00ean quan \u0111\u1ebfn progestagen c\u00f3 th\u1ec3 ti\u1ebfp di\u1ec5n qu\u00e1 th\u1eddi gian mong \u0111\u1ee3i.<\/p>\n<p><em>U nang bu\u1ed3ng tr\u1ee9ng<\/em><\/p>\n<p>C\u0169ng nh\u01b0 c\u00e1c thu\u1ed1c tr\u00e1nh thai ch\u1ee9a n\u1ed9i ti\u1ebft li\u1ec1u th\u1ea5p, nang no\u00e3n c\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n v\u00e0 \u0111\u00f4i khi ti\u1ebfp t\u1ee5c ph\u00e1t tri\u1ec3n v\u01b0\u1ee3t k\u00edch th\u01b0\u1edbc b\u00ecnh th\u01b0\u1eddng. Th\u01b0\u1eddng th\u00ec nh\u1eefng nang no\u00e3n ngo\u1ea1i c\u1ee1 n\u00e0y t\u1ef1 bi\u1ebfn m\u1ea5t. Th\u00f4ng th\u01b0\u1eddng, ch\u00fang kh\u00f4ng g\u00e2y tri\u1ec7u ch\u1ee9ng; m\u1ed9t v\u00e0i tr\u01b0\u1eddng h\u1ee3p g\u00e2y \u0111au b\u1ee5ng nh\u1eb9. Hi\u1ebfm khi c\u1ea7n can thi\u1ec7p ph\u1eabu thu\u1eadt.<\/p>\n<p><em>Mang thai ngo\u00e0i t\u1eed cung<\/em><\/p>\n<p>T\u00e1c d\u1ee5ng tr\u00e1nh thai ngo\u00e0i t\u1eed cung c\u1ee7a c\u00e1c thu\u1ed1c tr\u00e1nh thai c\u1ed5 \u0111i\u1ec3n ch\u1ec9 ch\u1ee9a progestagen kh\u00f4ng t\u1ed1t nh\u01b0 thu\u1ed1c ph\u1ed1i h\u1ee3p d\u1ea1ng u\u1ed1ng v\u00ec s\u1ef1 r\u1ee5ng tr\u1ee9ng th\u01b0\u1eddng x\u1ea3y ra trong khi d\u00f9ng ph\u01b0\u01a1ng ph\u00e1p n\u00e0y. Cho d\u00f9 th\u1ef1c t\u1ebf Implanon NXT c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf s\u1ef1 r\u1ee5ng tr\u1ee9ng nh\u01b0ng c\u0169ng c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t c\u00f3 thai ngo\u00e0i t\u1eed cung n\u1ebfu ng\u01b0\u1eddi ph\u1ee5 n\u1eef m\u1ea5t kinh ho\u1eb7c \u0111au b\u1ee5ng.<\/p>\n<p><em>C\u00e1c t\u00ecnh tr\u1ea1ng kh\u00e1c<\/em><\/p>\n<p>Nh\u1eefng t\u00ecnh tr\u1ea1ng sau \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o khi mang thai ho\u1eb7c s\u1eed d\u1ee5ng steroid sinh d\u1ee5c nh\u01b0ng ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c m\u1ed1i li\u00ean quan v\u1edbi progestagen: v\u00e0ng da v\u00e0\/ho\u1eb7c ng\u1ee9a do \u1ee9 m\u1eadt; h\u00ecnh th\u00e0nh s\u1ecfi m\u1eadt; r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a porphyrin; Lupus ban \u0111\u1ecf to\u00e0n th\u00e2n; h\u1ed9i ch\u1ee9ng t\u0103ng ur\u00ea m\u00e1u do t\u00e1n huy\u1ebft; m\u00faa v\u1eddn Sydenham; Herpes trong th\u1eddi gian mang thai; m\u1ea5t th\u00ednh l\u1ef1c do x\u01a1 c\u1ee9ng tai v\u00e0 ph\u00f9 m\u1ea1ch (di truy\u1ec1n).<\/p>\n<p><em>Th\u0103m kh\u00e1m l\u00e2m s\u00e0ng\/h\u1ed9i ch\u1ea9n<\/em><\/p>\n<p>Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng ho\u1eb7c d\u00f9ng l\u1ea1i Implanon NXT n\u00ean h\u1ecfi \u0111\u1ea7y \u0111\u1ee7 b\u1ec7nh s\u1eed (bao g\u1ed3m ti\u1ec1n s\u1eed gia \u0111\u00ecnh) v\u00e0 lo\u1ea1i tr\u1eeb c\u00f3 thai. N\u00ean \u0111o huy\u1ebft \u00e1p v\u00e0 kh\u00e1m th\u1ef1c th\u1ec3 theo th\u00f4ng tin h\u01b0\u1edbng d\u1eabn trong Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 C\u1ea3nh b\u00e1o. N\u00ean khuy\u00ean ng\u01b0\u1eddi ph\u1ee5 n\u1eef t\u00e1i kh\u00e1m sau ba th\u00e1ng c\u1ea5y Implanon NXT. Trong khi t\u00e1i kh\u00e1m n\u00ean \u0111o huy\u1ebft \u00e1p, gi\u1ea3i \u0111\u00e1p c\u00e1c c\u00e2u h\u1ecfi, th\u1eafc m\u1eafc ho\u1eb7c than phi\u1ec1n v\u1ec1 t\u00e1c d\u1ee5ng ngo\u1ea1i \u00fd. T\u1ea7n su\u1ea5t v\u00e0 t\u00ednh ch\u1ea5t c\u1ee7a nh\u1eefng l\u1ea7n kh\u00e1m \u0111\u1ecbnh k\u1ef3 sau \u0111\u00f3 n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh ph\u00f9 h\u1ee3p v\u1edbi t\u1eebng ph\u1ee5 n\u1eef, t\u00f9y theo \u0111\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng.<\/p>\n<p>N\u00ean gi\u1ea3i th\u00edch cho ng\u01b0\u1eddi ph\u1ee5 n\u1eef bi\u1ebft Implanon NXT kh\u00f4ng b\u1ea3o v\u1ec7 h\u1ecd kh\u1ecfi l\u00e2y nhi\u1ec5m HIV (AIDS) v\u00e0 c\u00e1c b\u1ec7nh l\u00e2y truy\u1ec1n qua \u0111\u01b0\u1eddng sinh d\u1ee5c kh\u00e1c.<\/p>\n<p><em>Gi\u1ea3m hi\u1ec7u qu\u1ea3 do thu\u1ed1c d\u00f9ng \u0111\u1ed3ng th\u1eddi<\/em><\/p>\n<p>Hi\u1ec7u qu\u1ea3 c\u1ee7a Implanon NXT c\u00f3 th\u1ec3 suy gi\u1ea3m khi d\u00f9ng c\u00f9ng v\u1edbi c\u00e1c thu\u1ed1c l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 etonogestrel trong huy\u1ebft t\u01b0\u01a1ng (xem m\u1ee5c \u201cT\u01b0\u01a1ng t\u00e1c\u201d).<\/p>\n<p><em>Thay \u0111\u1ed5i ki\u1ec3u xu\u1ea5t huy\u1ebft \u00e2m \u0111\u1ea1o<\/em><\/p>\n<p>Trong qu\u00e1 tr\u00ecnh s\u1eed d\u1ee5ng Implanon NXT, ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u00f3 th\u1ec3 thay \u0111\u1ed5i ki\u1ec3u ra m\u00e1u kinh v\u00e0 th\u01b0\u1eddng kh\u00f4ng d\u1ef1 \u0111o\u00e1n tr\u01b0\u1edbc. C\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n ki\u1ec3u ra m\u00e1u kinh b\u1ea5t th\u01b0\u1eddng (m\u1ea5t kinh, th\u01b0a h\u01a1n, th\u01b0\u1eddng xuy\u00ean h\u01a1n ho\u1eb7c ra m\u00e1u li\u00ean t\u1ee5c), v\u00e0 thay \u0111\u1ed5i l\u01b0\u1ee3ng m\u00e1u kinh (gi\u1ea3m ho\u1eb7c t\u0103ng) ho\u1eb7c th\u1eddi gian ra m\u00e1u kinh. M\u1ea5t kinh \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf 1 trong s\u1ed1 5 ph\u1ee5 n\u1eef trong khi 1 trong s\u1ed1 5 ph\u1ee5 n\u1eef kh\u00e1c c\u00f3 b\u00e1o c\u00e1o v\u1ec1 thay \u0111\u1ed5i t\u1ea7n su\u1ea5t v\u00e0\/ho\u1eb7c ra m\u00e1u k\u00e9o d\u00e0i. \u1ede nhi\u1ec1u ph\u1ee5 n\u1eef, ki\u1ec3u ra m\u00e1u kinh trong ba th\u00e1ng \u0111\u1ea7u ti\u00ean c\u00f3 th\u1ec3 d\u1ef1 \u0111o\u00e1n \u0111\u01b0\u1ee3c ki\u1ec3u ra m\u00e1u kinh trong t\u01b0\u01a1ng lai. Cung c\u1ea5p th\u00f4ng tin, t\u01b0 v\u1ea5n v\u00e0 s\u1eed d\u1ee5ng nh\u1eadt k\u00fd kinh nguy\u1ec7t c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n s\u1ef1 ch\u1ea5p nh\u1eadn ki\u1ec3u ra m\u00e1u kinh c\u1ee7a ng\u01b0\u1eddi ph\u1ee5 n\u1eef. N\u00ean \u0111\u00e1nh gi\u00e1 ra m\u00e1u \u00e2m \u0111\u1ea1o khi c\u1ea7n thi\u1ebft v\u00e0 c\u00f3 th\u1ec3 bao g\u1ed3m kh\u00e1m l\u00e2m s\u00e0ng \u0111\u1ec3 lo\u1ea1i tr\u1eeb b\u1ec7nh l\u00fd ph\u1ee5 khoa ho\u1eb7c c\u00f3 thai.<\/p>\n<p><em>Que c\u1ea5y b\u1ecb g\u00e3y ho\u1eb7c b\u1ecb u\u1ed1n cong \u1edf v\u1ecb tr\u00ed trong c\u00e1nh tay<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o que c\u1ea5y b\u1ecb g\u00e3y ho\u1eb7c b\u1ecb u\u1ed1n cong khi c\u00f2n n\u1eb1m trong c\u00e1nh tay c\u1ee7a b\u1ec7nh nh\u00e2n. D\u1ef1a tr\u00ean c\u00e1c s\u1ed1 li\u1ec7u in vitro, khi que c\u1ea5y b\u1ecb g\u00e3y hay b\u1ecb u\u1ed1n cong, s\u1ef1 ph\u00f3ng th\u00edch etonogestrel c\u00f3 th\u1ec3 t\u0103ng nh\u1eb9. S\u1ef1 thay \u0111\u1ed5i n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 t\u00e1c d\u1ee5ng c\u00f3 \u00fd ngh\u0129a v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng.<\/p>\n<p>\u0110i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i l\u1ea5y h\u1ebft to\u00e0n b\u1ed9 que c\u1ea5y khi th\u1ef1c hi\u1ec7n l\u1ea5y que c\u1ea5y ra (xem \u201cC\u00e1ch r\u00fat que c\u1ea5y&#8221;).<\/p>\n<p><strong>T\u00e1c \u0111\u1ed9ng c\u1ee7a thu\u1ed1c tr\u00ean ng\u01b0\u1eddi l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/strong><\/p>\n<p>Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb ch\u00f3ng m\u1eb7t, nh\u1ee9c \u0111\u1ea7u, ho\u1eb7c bu\u1ed3n ng\u1ee7 trong khi d\u00f9ng Implanon NXT n\u00ean h\u1ea1n ch\u1ebf l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/p>\n<p><strong>4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<\/strong><\/p>\n<p><em>X\u1ebfp h\u1ea1ng c\u1ea3nh b\u00e1o<\/em><\/p>\n<p>AU TGA pregnancy category: B3<\/p>\n<p>US FDA pregnancy category: NA<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>Kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng Implanon NXT trong th\u1eddi gian mang thai. N\u00ean r\u00fat que c\u1ea5y n\u1ebfu c\u00f3 thai trong th\u1eddi gian d\u00f9ng Implanon NXT. Nh\u1eefng nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt cho th\u1ea5y li\u1ec1u r\u1ea5t cao progestagen c\u00f3 th\u1ec3 g\u00e2y t\u00ecnh tr\u1ea1ng nam h\u00f3a nh\u1eefng b\u00e0o thai gi\u1ed1ng c\u00e1i. Nh\u1eefng nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 s\u00e2u r\u1ed9ng kh\u00f4ng th\u1ea5y t\u0103ng nguy c\u01a1 d\u1ecb t\u1eadt b\u1ea9m sinh \u1edf tr\u1ebb sinh ra t\u1eeb nh\u1eefng ng\u01b0\u1eddi m\u1eb9 s\u1eed d\u1ee5ng thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft ph\u1ed1i h\u1ee3p tr\u01b0\u1edbc khi mang thai, c\u0169ng kh\u00f4ng g\u00e2y qu\u00e1i thai khi v\u00f4 t\u00ecnh u\u1ed1ng thu\u1ed1c tr\u00e1nh thai ph\u1ed1i h\u1ee3p trong th\u1eddi k\u1ef3 mang thai. M\u1eb7c d\u00f9 \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng cho t\u1ea5t c\u1ea3 thu\u1ed1c tr\u00e1nh thai \u0111\u01b0\u1eddng u\u1ed1ng, nh\u01b0ng ch\u01b0a r\u00f5 c\u00f3 ph\u00f9 h\u1ee3p v\u1edbi Implanon NXT hay kh\u00f4ng.<\/p>\n<p>D\u1eef li\u1ec7u d\u01b0\u1ee3c c\u1ea3nh gi\u00e1c v\u1edbi nhi\u1ec1u thu\u1ed1c tr\u00e1nh thai ch\u1ee9a etonogestrel v\u00e0 desogestrel (etonogestrel l\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a c\u1ee7a desogestrel) kh\u00f4ng cho th\u1ea5y t\u0103ng nguy c\u01a1.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>D\u1eef li\u1ec7u l\u00e2m s\u00e0ng cho th\u1ea5y Implanon NXT kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 ti\u1ebft s\u1eefa ho\u1eb7c ch\u1ea5t l\u01b0\u1ee3ng s\u1eefa m\u1eb9 (n\u1ed3ng \u0111\u1ed9 protein, lactose ho\u1eb7c ch\u1ea5t b\u00e9o). Tuy nhi\u00ean ch\u1ec9 m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf etonogestrel \u0111\u01b0\u1ee3c ti\u1ebft v\u00e0o s\u1eefa m\u1eb9. D\u1ef1a tr\u00ean l\u01b0\u1ee3ng s\u1eefa b\u00fa trung b\u00ecnh m\u1ed7i ng\u00e0y l\u00e0 150 mL\/kg, li\u1ec1u etonogestrel trung b\u00ecnh h\u00e0ng ng\u00e0y \u1edf tr\u1ebb b\u00fa m\u1eb9 t\u00ednh sau m\u1ed9t th\u00e1ng l\u00e0 kho\u1ea3ng 27 ng\/kg\/ng\u00e0y. Li\u1ec1u n\u00e0y t\u01b0\u01a1ng \u1ee9ng kho\u1ea3ng 2,2% li\u1ec1u h\u00e0ng ng\u00e0y \u0111i\u1ec1u ch\u1ec9nh theo th\u1ec3 tr\u1ecdng c\u1ee7a ng\u01b0\u1eddi m\u1eb9 v\u00e0 kho\u1ea3ng 0,2% li\u1ec1u tuy\u1ec7t \u0111\u1ed1i h\u00e0ng ng\u00e0y c\u1ee7a ng\u01b0\u1eddi m\u1eb9. Sau \u0111\u00f3 n\u1ed3ng \u0111\u1ed9 etonogestrel gi\u1ea3m d\u1ea7n theo th\u1eddi gian b\u00fa m\u1eb9.<\/p>\n<p>D\u1eef li\u1ec7u theo d\u00f5i k\u00e9o d\u00e0i \u1edf 38 tr\u1ebb em c\u00f3 m\u1eb9 c\u1ea5y que c\u1ea5y trong th\u1eddi gian t\u1eeb tu\u1ea7n 4 \u0111\u1ebfn tu\u1ea7n 8 sau khi sinh. Nh\u1eefng \u0111\u1ee9a tr\u1ebb n\u00e0y \u0111\u01b0\u1ee3c b\u00fa m\u1eb9 \u0111\u1ebfn 14 th\u00e1ng v\u00e0 \u0111\u01b0\u1ee3c theo d\u00f5i \u0111\u1ebfn 36 th\u00e1ng tu\u1ed5i. \u0110\u00e1nh gi\u00e1 s\u1ef1 t\u0103ng tr\u01b0\u1edfng, ph\u00e1t tri\u1ec3n th\u1ec3 ch\u1ea5t v\u00e0 t\u00e2m th\u1ea7n v\u1eadn \u0111\u1ed9ng kh\u00f4ng cho th\u1ea5y s\u1ef1 kh\u00e1c bi\u1ec7t so v\u1edbi nh\u1eefng \u0111\u1ee9a tr\u1ebb \u0111\u01b0\u1ee3c b\u00fa m\u1eb9 m\u00e0 ng\u01b0\u1eddi m\u1eb9 s\u1eed d\u1ee5ng v\u00f2ng tr\u00e1nh thai (IUD) (n=33). Tuy nhi\u00ean, c\u1ea7n theo d\u00f5i th\u1eadn tr\u1ecdng s\u1ef1 t\u0103ng tr\u01b0\u1edfng v\u00e0 ph\u00e1t tri\u1ec3n c\u1ee7a tr\u1ebb. D\u1ef1a tr\u00ean d\u1eef li\u1ec7u thu \u0111\u01b0\u1ee3c, Implanon NXT c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong th\u1eddi k\u1ef3 cho con b\u00fa v\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u1ea5y sau khi sinh 4 tu\u1ea7n.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/strong><\/p>\n<p>T\u00e1c d\u1ee5ng ngo\u1ea1i \u00fd nghi\u00eam tr\u1ecdng<\/p>\n<p>Xem ph\u1ea7n &#8220;C\u1ea3nh b\u00e1o&#8221;.<\/p>\n<p>C\u00e1c t\u00e1c d\u1ee5ng ngo\u1ea1i \u00fd kh\u00e1c<\/p>\n<p>Trong th\u1eddi gian d\u00f9ng Implanon NXT, ng\u01b0\u1eddi ph\u1ee5 n\u1eef th\u01b0\u1eddng c\u00f3 nh\u1eefng thay \u0111\u1ed5i ki\u1ec3u ra m\u00e1u kinh, c\u00f3 th\u1ec3 l\u00e0 thay \u0111\u1ed5i t\u1ea7n su\u1ea5t ra m\u00e1u kinh (kh\u00f4ng c\u00f3, th\u01b0a h\u01a1n, th\u01b0\u1eddng xuy\u00ean h\u01a1n ho\u1eb7c li\u00ean t\u1ee5c), l\u01b0\u1ee3ng m\u00e1u kinh (gi\u1ea3m ho\u1eb7c t\u0103ng) ho\u1eb7c th\u1eddi gian ra m\u00e1u kinh. V\u00f4 kinh \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf kho\u1ea3ng 1 tr\u00ean 5 ng\u01b0\u1eddi ph\u1ee5 n\u1eef trong khi 1 tr\u00ean 5 ng\u01b0\u1eddi ph\u1ee5 n\u1eef kh\u00e1c \u0111\u00e3 b\u00e1o c\u00e1o ra m\u00e1u kinh th\u01b0\u1eddng xuy\u00ean v\u00e0\/ho\u1eb7c k\u00e9o d\u00e0i h\u01a1n. \u0110\u00f4i khi c\u00f3 b\u00e1o c\u00e1o ch\u1ea3y m\u00e1u n\u1eb7ng. Trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng, thay \u0111\u1ed5i ki\u1ec3u ra m\u00e1u kinh l\u00e0 l\u00fd do ph\u1ed5 bi\u1ebfn nh\u1ea5t g\u00e2y ng\u1eebng s\u1eed d\u1ee5ng (kho\u1ea3ng 11%). Ch\u1ee9ng \u0111au b\u1ee5ng kinh c\u00f3 xu h\u01b0\u1edbng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n khi d\u00f9ng Implanon NXT. Nh\u1eefng thay \u0111\u1ed5i v\u1ec1 ki\u1ec3u ra m\u00e1u kinh trong ba th\u00e1ng s\u1eed d\u1ee5ng \u0111\u1ea7u ti\u00ean th\u01b0\u1eddng l\u00e0 c\u01a1 s\u1edf \u0111\u1ec3 d\u1ef1 \u0111o\u00e1n ki\u1ec3u ra m\u00e1u kinh trong t\u01b0\u01a1ng lai \u1edf nhi\u1ec1u ph\u1ee5 n\u1eef.<\/p>\n<p>Nh\u1eefng t\u00e1c d\u1ee5ng ngo\u1ea1i \u00fd li\u00ean quan \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea trong b\u1ea3ng.<\/p>\n<p>&#8211; xem b\u1ea3ng.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"1442\" height=\"1613\" class=\"wp-image-22039\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-3.png\" alt=\"Image from Drug Label Content\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-3.png 1442w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-3-268x300.png 268w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-3-768x859.png 768w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-3-915x1024.png 915w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-3-536x600.png 536w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/09\/image-from-drug-label-content-3-143x160.png 143w\" sizes=\"auto, (max-width: 1442px) 100vw, 1442px\" \/><\/p>\n<p>Trong m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng v\u1ec1 Implanon NXT, trong \u0111\u00f3 c\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u \u0111\u00e3 y\u00eau c\u1ea7u ki\u1ec3m tra v\u1ecb tr\u00ed que c\u1ea5y sau khi \u0111\u1eb7t v\u00e0o, ph\u1ea3n \u1ee9ng t\u1ea1i ch\u1ed7 c\u1ea5y \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf 8,6% ph\u1ee5 n\u1eef. Ban \u0111\u1ecf l\u00e0 bi\u1ebfn ch\u1ee9ng t\u1ea1i ch\u1ed7 c\u1ea5y th\u01b0\u1eddng g\u1eb7p nh\u1ea5t, \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o trong v\u00e0\/ho\u1eb7c ngay sau khi \u0111\u1eb7t que c\u1ea5y, x\u1ea3y ra \u1edf 3,3% \u0111\u1ed1i t\u01b0\u1ee3ng. Ngo\u00e0i ra, kh\u1ed1i t\u1ee5 m\u00e1u (3%), b\u1ea7m t\u00edm (2%), \u0111au (1%) v\u00e0 s\u01b0ng (0,7%) \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o.<\/p>\n<p>Trong \u0111i\u1ec1u tra sau khi l\u01b0u h\u00e0nh s\u1ea3n ph\u1ea9m, \u0111\u00e3 g\u1eb7p t\u0103ng huy\u1ebft \u00e1p li\u00ean quan \u0111\u1ebfn l\u00e2m s\u00e0ng nh\u01b0ng hi\u1ebfm. T\u0103ng ti\u1ebft b\u00e3 nh\u1eddn c\u0169ng \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. Pha\u0309n \u01b0\u0301ng pha\u0309n v\u00ea\u0323, n\u00f4\u0309i m\u00ea\u0300 \u0111ay, phu\u0300 ma\u0323ch, phu\u0300 ma\u0323ch tr\u00e2\u0300m tro\u0323ng h\u01a1n va\u0300\/ho\u0103\u0323c phu\u0300 ma\u0323ch di truy\u00ea\u0300n tr\u00e2\u0300m tro\u0323ng h\u01a1n co\u0301 th\u00ea\u0309 xa\u0309y ra. C\u1ea5y ho\u1eb7c r\u00fat que c\u1ea5y c\u00f3 th\u1ec3 g\u00e2y b\u1ea7m t\u00edm, k\u00edch \u1ee9ng nh\u1eb9 t\u1ea1i ch\u1ed7, \u0111au ho\u1eb7c ng\u1ee9a. C\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n x\u01a1 h\u00f3a t\u1ea1i ch\u1ed7 c\u1ea5y, c\u00f3 th\u1ec3 h\u00ecnh th\u00e0nh s\u1eb9o ho\u1eb7c ph\u00e1t tri\u1ec3n \u1ed5 \u00e1p-xe. C\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n d\u1ecb c\u1ea3m ho\u1eb7c gi\u1ed1ng d\u1ecb c\u1ea3m. \u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 vi\u1ec7c tu\u1ed9t ho\u1eb7c di chuy\u1ec3n que c\u1ea5y, bao g\u1ed3m di chuy\u1ec3n t\u1edbi l\u1ed3ng ng\u1ef1c tuy hi\u1ebfm. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm n\u00e0y, c\u00e1c que c\u1ea5y \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong m\u1ea1ch bao g\u1ed3m c\u1ea3 \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i. V\u00e0i tr\u01b0\u1eddng h\u1ee3p que c\u1ea5y \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i c\u00f3 b\u00e1o c\u00e1o v\u1ec1 vi\u1ec7c \u0111au ng\u1ef1c v\u00e0\/ho\u1eb7c kh\u00f3 th\u1edf; c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00e1c b\u00e1o c\u00e1o kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng (xem m\u1ee5c \u201cC\u1ea3nh b\u00e1o\u201d). C\u00f3 th\u1ec3 c\u1ea7n can thi\u1ec7p ph\u1eabu thu\u1eadt khi r\u00fat que c\u1ea5y.<\/p>\n<p>Trong tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm \u0111\u00e3 c\u00f3 b\u00e1o c\u00e1o mang thai ngo\u00e0i t\u1eed cung (xem m\u1ee5c \u201cC\u1ea3nh b\u00e1o\u201d).<\/p>\n<p>\u1ede nh\u1eefng ng\u01b0\u1eddi ph\u1ee5 n\u1eef d\u00f9ng thu\u1ed1c tr\u00e1nh thai (ph\u1ed1i h\u1ee3p d\u1ea1ng u\u1ed1ng) m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ngo\u1ea1i \u00fd (nghi\u00eam tr\u1ecdng) \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. C\u00e1c t\u00e1c d\u1ee5ng n\u00e0y bao g\u1ed3m b\u1ec7nh l\u00fd huy\u1ebft kh\u1ed1i ngh\u1ebdn t\u0129nh m\u1ea1ch, huy\u1ebft kh\u1ed1i ngh\u1ebdn \u0111\u1ed9ng m\u1ea1ch, kh\u1ed1i u ph\u1ee5 thu\u1ed9c n\u1ed9i ti\u1ebft (nh\u01b0 u gan, ung th\u01b0 v\u00fa) v\u00e0 n\u00e1m da, m\u1ed9t s\u1ed1 \u0111\u00e3 \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y chi ti\u1ebft trong m\u1ee5c \u201cC\u1ea3nh b\u00e1o\u201d.<\/p>\n<p><em>Th\u00f4ng b\u00e1o cho B\u00e1c s\u0129 nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n g\u1eb7p ph\u1ea3i khi s\u1eed d\u1ee5ng thu\u1ed1c.<\/em><\/p>\n<p><strong>4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<\/strong><\/p>\n<p>Ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c. V\u1edbi c\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i nh\u1eb9, th\u01b0\u1eddng ch\u1ec9 c\u1ea7n ng\u1eebng thu\u1ed1c. Tr\u01b0\u1eddng h\u1ee3p m\u1eabn c\u1ea3m n\u1eb7ng ho\u1eb7c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, c\u1ea7n ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 (gi\u1eef tho\u00e1ng kh\u00ed v\u00e0 d\u00f9ng epinephrin, th\u1edf oxygen, d\u00f9ng kh\u00e1ng histamin, corticoid&#8230;).<\/p>\n<p><strong>4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/strong><\/p>\n<p><em>T\u01b0\u01a1ng t\u00e1c thu\u1ed1c<\/em><\/p>\n<p>L\u01b0u \u00fd: c\u1ea7n tham kh\u1ea3o th\u00f4ng tin k\u00ea toa c\u1ee7a c\u00e1c thu\u1ed1c d\u00f9ng \u0111\u1ed3ng th\u1eddi \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh c\u00e1c t\u01b0\u01a1ng t\u00e1c c\u00f3 th\u1ec3 x\u1ea3y ra.<\/p>\n<p><em>\u1ea2nh h\u01b0\u1edfng c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1c \u0111\u1ebfn Implanon NXT<\/em><\/p>\n<p>T\u01b0\u01a1ng t\u00e1c gi\u1eefa c\u00e1c thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft v\u00e0 c\u00e1c thu\u1ed1c kh\u00e1c c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ra m\u00e1u kinh v\u00e0\/ho\u1eb7c gi\u1ea3m t\u00e1c d\u1ee5ng tr\u00e1nh thai.<\/p>\n<p>C\u00e1c t\u01b0\u01a1ng t\u00e1c sau \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn trong y v\u0103n (ch\u1ee7 y\u1ebfu v\u1edbi thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft ph\u1ed1i h\u1ee3p nh\u01b0ng \u0111\u00f4i khi c\u0169ng x\u1ea3y ra v\u1edbi thu\u1ed1c tr\u00e1nh thai ch\u1ec9 ch\u1ee9a progestagen).<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a t\u1ea1i gan<\/em><\/p>\n<p>C\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c ho\u1eb7c c\u00e1c s\u1ea3n ph\u1ea9m th\u1ea3o d\u01b0\u1ee3c g\u00e2y c\u1ea3m \u1ee9ng men gan, nh\u1ea5t l\u00e0 c\u00e1c men cytochrome P450 (CYP), c\u00f3 th\u1ec3 g\u00e2y t\u0103ng thanh th\u1ea3i, gi\u1ea3m n\u1ed3ng \u0111\u1ed9 huy\u1ebft t\u01b0\u01a1ng c\u1ee7a n\u1ed9i ti\u1ebft t\u1ed1 sinh d\u1ee5c v\u00e0 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m hi\u1ec7u qu\u1ea3 c\u1ee7a Implanon NXT. Nh\u1eefng ch\u1ebf ph\u1ea9m n\u00e0y bao g\u1ed3m phenytoin, phenobarbital, primidon, bosentan, carbamazepin, rifampicin, v\u00e0 c\u0169ng c\u00f3 th\u1ec3 oxcarbazepin, topiramat, felbamat, griseofulvin, m\u1ed9t s\u1ed1 ch\u1ea5t \u1ee9c ch\u1ebf protease HIV (nh\u01b0 ritonavir) v\u00e0 c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf men sao ch\u00e9p ng\u01b0\u1ee3c non-nucleoside (nh\u01b0 efavirenz) v\u00e0 s\u1ea3n ph\u1ea9m ch\u1ee9a ph\u01b0\u01a1ng thu\u1ed1c th\u1ea3o d\u01b0\u1ee3c c\u1ee7a th\u00e1nh Johns.<\/p>\n<p>C\u1ea3m \u1ee9ng enzyme c\u00f3 th\u1ec3 x\u1ea3y ra sau v\u00e0i ng\u00e0y \u0111i\u1ec1u tr\u1ecb. C\u1ea3m \u1ee9ng enzyme t\u1ed1i \u0111a th\u01b0\u1eddng \u0111\u01b0\u1ee3c quan s\u00e1t th\u1ea5y trong v\u00f2ng v\u00e0i tu\u1ea7n. Sau khi ng\u1eebng \u0111i\u1ec1u tr\u1ecb, c\u1ea3m \u1ee9ng enzyme c\u00f3 th\u1ec3 k\u00e9o d\u00e0i kho\u1ea3ng 28 ng\u00e0y.<\/p>\n<p>Khi d\u00f9ng c\u00f9ng v\u1edbi thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft t\u1ed1, c\u00e1c k\u1ebft h\u1ee3p c\u1ee7a ch\u1ea5t \u1ee9c ch\u1ebf protease HIV (v\u00ed d\u1ee5: nelfinavir) v\u00e0 c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf men sao ch\u00e9p ng\u01b0\u1ee3c non-nucleoside (nh\u01b0 nevirapine), v\u00e0\/ho\u1eb7c c\u00e1c s\u1ef1 k\u1ebft h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb virus vi\u00eam gan C (HCV) (v\u00ed d\u1ee5 boceprevir, telaprevir), c\u00f3 th\u1ec3 l\u00e0m t\u0103ng ho\u1eb7c gi\u1ea3m n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a c\u00e1c progestin, bao g\u1ed3m etonogestrel. T\u00e1c \u0111\u1ed9ng th\u1ef1c s\u1ef1 c\u1ee7a nh\u1eefng thay \u0111\u1ed5i n\u00e0y c\u00f3 th\u1ec3 th\u1ec3 hi\u1ec7n qua l\u00e2m s\u00e0ng trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p.<\/p>\n<p>N\u00ean l\u01b0u \u00fd vi\u1ec7c Implanon NXT c\u00f3 th\u1ec3 b\u1ecb gi\u1ea3m hi\u1ec7u qu\u1ea3 \u1edf nh\u1eefng ph\u1ee5 n\u1eef \u0111ang d\u00f9ng b\u1ea5t k\u1ef3 thu\u1ed1c ho\u1eb7c s\u1ea3n ph\u1ea9m th\u1ea3o d\u01b0\u1ee3c g\u00e2y c\u1ea3m \u1ee9ng men gan n\u00eau tr\u00ean. N\u1ebfu ng\u01b0\u1eddi ph\u1ee5 n\u1eef quy\u1ebft \u0111\u1ecbnh ti\u1ebfp t\u1ee5c d\u00f9ng Implanon NXT, n\u00ean l\u01b0u \u00fd h\u1ecd d\u00f9ng m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai kh\u00f4ng n\u1ed9i ti\u1ebft trong su\u1ed1t th\u1eddi gian d\u00f9ng thu\u1ed1c \u0111\u1ed3ng th\u1eddi v\u00e0 \u0111\u1ebfn 28 ng\u00e0y sau khi ng\u1eebng thu\u1ed1c.<\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf CYP3A4 m\u1ea1nh (v\u00ed d\u1ee5 ketoconazole, itraconazole, clarithromycin) ho\u1eb7c trung b\u00ecnh (v\u00ed d\u1ee5 fluconazole, diltiazem, erythromycin) c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 c\u00e1c progestin trong huy\u1ebft thanh, k\u1ec3 c\u1ea3 etonogestrel.<\/p>\n<p><em>\u1ea2nh h\u01b0\u1edfng c\u1ee7a Implanon NXT \u0111\u1ebfn c\u00e1c thu\u1ed1c kh\u00e1c<\/em><\/p>\n<p>Thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn chuy\u1ec3n h\u00f3a c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1c. Theo \u0111\u00f3, n\u1ed3ng \u0111\u1ed9 c\u00e1c thu\u1ed1c n\u00e0y trong huy\u1ebft t\u01b0\u01a1ng v\u00e0 trong m\u00f4 c\u00f3 th\u1ec3 t\u0103ng l\u00ean (nh\u01b0 ciclosporin) ho\u1eb7c gi\u1ea3m \u0111i (nh\u01b0 lamotrigin).<\/p>\n<p><em>C\u00e1c th\u00f4ng s\u1ed1 x\u00e9t nghi\u1ec7m<\/em><\/p>\n<p>D\u1eef li\u1ec7u thu \u0111\u01b0\u1ee3c v\u1edbi thu\u1ed1c tr\u00e1nh thai ph\u1ed1i h\u1ee3p d\u1ea1ng u\u1ed1ng cho th\u1ea5y c\u00e1c steroid c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 c\u1ee7a m\u1ed9t s\u1ed1 x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng, bao g\u1ed3m c\u00e1c th\u00f4ng s\u1ed1 sinh h\u00f3a c\u1ee7a ch\u1ee9c n\u0103ng gan, tuy\u1ebfn gi\u00e1p, th\u1eadn v\u00e0 tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn, n\u1ed3ng \u0111\u1ed9 c\u00e1c protein (ch\u1ea5t mang) trong huy\u1ebft thanh, nh\u01b0 globulin g\u1eafn k\u1ebft corticosteroid, c\u00e1c th\u00e0nh ph\u1ea7n lipid\/lipoprotein, c\u00e1c th\u00f4ng s\u1ed1 chuy\u1ec3n h\u00f3a carbohydrat v\u00e0 c\u00e1c th\u00f4ng s\u1ed1 v\u1ec1 \u0111\u00f4ng m\u00e1u v\u00e0 ti\u00eau s\u1ee3i huy\u1ebft. Nh\u1eefng thay \u0111\u1ed5i n\u00e0y th\u01b0\u1eddng n\u1eb1m trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng. Ch\u01b0a bi\u1ebft r\u00f5 m\u1ee9c \u0111\u1ed9 li\u00ean quan nh\u1eefng thay \u0111\u1ed5i n\u00e0y khi d\u00f9ng thu\u1ed1c tr\u00e1nh thai ch\u1ec9 ch\u1ee9a progestagen.<\/p>\n<p><strong>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/strong><\/p>\n<p>Ph\u1ea3i r\u00fat que c\u1ea5y c\u0169 ra tr\u01b0\u1edbc khi c\u1ea5y que c\u1ea5y m\u1edbi. Ch\u01b0a c\u00f3 d\u1eef li\u1ec7u v\u1ec1 qu\u00e1 li\u1ec1u etonogestrel. Nh\u00ecn chung kh\u00f4ng c\u00f3 b\u00e1o c\u00e1o t\u00e1c d\u1ee5ng c\u00f3 h\u1ea1i nghi\u00eam tr\u1ecdng khi d\u00f9ng qu\u00e1 li\u1ec1u thu\u1ed1c tr\u00e1nh thai.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/strong><\/p>\n<p><strong>5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<\/strong><\/p>\n<p>Nh\u00f3m d\u01b0\u1ee3c tr\u1ecb li\u1ec7u: Progestagens<\/p>\n<p>Ph\u00e2n lo\u1ea1i ATC: G03AC08<\/p>\n<p>Implanon NXT l\u00e0 que c\u1ea5y kh\u00f4ng b\u1ecb ph\u00e2n h\u1ee7y sinh h\u1ecdc, c\u1ea3n quang v\u00e0 ch\u1ee9a etonogestrel \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 c\u1ea5y d\u01b0\u1edbi da, \u0111\u01b0\u1ee3c n\u1ea1p s\u1eb5n trong d\u1ee5ng c\u1ee5 v\u00f4 khu\u1ea9n, d\u00f9ng m\u1ed9t l\u1ea7n. Etonogestrel l\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a sinh h\u1ecdc c\u00f3 ho\u1ea1t t\u00ednh c\u1ee7a desogestrel, m\u1ed9t progestagen \u0111\u01b0\u1ee3c d\u00f9ng r\u00f4\u0323ng ra\u0303i trong thu\u00f4\u0301c tra\u0301nh thai d\u1ea1ng u\u1ed1ng. V\u1ec1 c\u00e2\u0301u tru\u0301c, thu\u1ed1c co\u0301 ngu\u00f4\u0300n g\u00f4\u0301c t\u01b0\u0300 19-nortestosteron va\u0300 co\u0301 a\u0301i l\u01b0\u0323c g\u0103\u0301n k\u00ea\u0301t ma\u0323nh v\u01a1\u0301i nh\u01b0\u0303ng thu\u0323 th\u00ea\u0309 progesteron ta\u0323i ca\u0301c c\u01a1 quan \u0111i\u0301ch. Hi\u00ea\u0323u qua\u0309 tra\u0301nh thai c\u1ee7a etonogestrel chu\u0309 y\u00ea\u0301u qua ta\u0301c du\u0323ng \u01b0\u0301c ch\u00ea\u0301 r\u1ee5ng tr\u1ee9ng. Kh\u00f4ng th\u1ea5y r\u1ee5ng tr\u1ee9ng trong hai n\u0103m \u0111\u1ea7u s\u1eed d\u1ee5ng que c\u1ea5y v\u00e0 r\u1ea5t hi\u1ebfm x\u1ea3y ra trong n\u0103m th\u01b0\u0301 ba. Ngoa\u0300i ta\u0301c du\u0323ng \u01b0\u0301c ch\u00ea\u0301 r\u1ee5ng tr\u1ee9ng, etonogestrel cu\u0303ng la\u0300m thay \u0111\u00f4\u0309i ch\u1ea5t nh\u1ea7y c\u00f4\u0309 t\u01b0\u0309 cung g\u00e2y ca\u0309n tr\u01a1\u0309 s\u1ef1 di chuy\u00ea\u0309n c\u1ee7a tinh tru\u0300ng. Ca\u0301c th\u01b0\u0309 nghi\u00ea\u0323m l\u00e2m sa\u0300ng \u0111a\u0303 \u0111\u01b0\u01a1\u0323c ti\u00ea\u0301n ha\u0300nh \u01a1\u0309 phu\u0323 n\u01b0\u0303 t\u1eeb 18 \u0111\u1ebfn 40 tu\u00f4\u0309i. M\u0103\u0323c du\u0300 kh\u00f4ng ti\u00ea\u0301n ha\u0300nh so sa\u0301nh tr\u01b0\u0323c ti\u00ea\u0301p nh\u01b0ng \u00edt nh\u1ea5t hi\u00ea\u0323u qua\u0309 tra\u0301nh thai cu\u0303ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ca\u0301c thu\u00f4\u0301c tra\u0301nh thai ph\u1ed1i h\u01a1\u0323p \u0111\u01b0\u1eddng u\u1ed1ng. Trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng kh\u00f4ng ghi nh\u1eadn c\u00f3 thai trong 35.057 chu k\u1ef3 c\u1ea5y thu\u1ed1c; ch\u1ec9 s\u1ed1 Pearl quan s\u00e1t th\u1ea5y l\u00e0 0,00 (gi\u1edbi h\u1ea1n tin c\u1eady 95%: 0,00-0,14). Tuy nhi\u00ean c\u1ea7n bi\u1ebft r\u1eb1ng tr\u00ean th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng kh\u00f4ng ph\u01b0\u01a1ng ph\u00e1p n\u00e0o \u0111\u01b0\u1ee3c cho l\u00e0 hi\u1ec7u qu\u1ea3 100%. Hi\u1ec7u qu\u1ea3 tr\u00e1nh thai cao c\u00f2n do l\u00fd do kh\u00e1c b\u1edfi v\u00ec t\u00e1c d\u1ee5ng tr\u00e1nh thai c\u1ee7a Implanon NXT kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o vi\u1ec7c tu\u00e2n th\u1ee7 d\u00f9ng thu\u1ed1c c\u1ee7a ng\u01b0\u1eddi ph\u1ee5 n\u1eef. T\u00e1c d\u1ee5ng tr\u00e1nh thai c\u1ee7a etonogestrel c\u00f3 th\u1ec3 m\u1ea5t \u0111i nhanh ch\u00f3ng sau khi r\u00fat que c\u1ea5y, th\u1ec3 hi\u1ec7n qua vi\u1ec7c kinh nguy\u1ec7t tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng. M\u0103\u0323c du\u0300 etonogestrel \u01b0\u0301c ch\u00ea\u0301 s\u01b0\u0323 ru\u0323ng tr\u01b0\u0301ng, hoa\u0323t \u0111\u00f4\u0323ng cu\u0309a bu\u00f4\u0300ng tr\u1ee9ng kh\u00f4ng bi\u0323 \u01b0\u0301c ch\u00ea\u0301 hoa\u0300n toa\u0300n. N\u00f4\u0300ng \u0111\u00f4\u0323 trung bi\u0300nh cu\u0309a estradiol v\u00e2\u0303n cao h\u01a1n n\u1ed3ng \u0111\u1ed9 estradiol \u1edf giai \u0111o\u1ea1n nang no\u00e3n s\u1edbm. Trong m\u1ed9t nghi\u00ean c\u01b0\u0301u hai n\u0103m so sa\u0301nh m\u1eadt \u0111\u1ed9 ch\u1ea5t kho\u00e1ng trong x\u01b0\u01a1ng \u01a1\u0309 44 ng\u01b0\u01a1\u0300i s\u1eed d\u1ee5ng v\u01a1\u0301i nho\u0301m ch\u01b0\u0301ng g\u00f4\u0300m 29 ng\u01b0\u01a1\u0300i s\u1eed d\u1ee5ng v\u00f2ng tr\u00e1nh thai (IUD), kh\u00f4ng th\u1ea5y t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i tr\u00ean kh\u1ed1i x\u01b0\u01a1ng. Kh\u00f4ng th\u1ea5y \u1ea3nh h\u01b0\u1edfng c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng tr\u00ean chuy\u1ec3n h\u00f3a lipid. S\u1eed d\u1ee5ng thu\u1ed1c tr\u00e1nh thai ch\u1ee9a progestagen co\u0301 th\u00ea\u0309 a\u0309nh h\u01b0\u01a1\u0309ng \u0111\u00ea\u0301n s\u1ef1 \u0111\u00ea\u0300 kha\u0301ng insulin va\u0300 dung na\u0323p glucose. C\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng c\u00f2n cho th\u1ea5y nh\u1eefng ng\u01b0\u1eddi d\u00f9ng Implanon NXT \u00edt b\u1ecb \u0111au b\u1ee5ng kinh h\u01a1n.<\/p>\n<p><em>C\u00e1c \u0111\u1eb7c \u0111i\u1ec3m v\u1ec1 \u0111\u1eb7t que c\u1ea5y v\u00e0 r\u00fat que c\u1ea5y<\/em><\/p>\n<p>Trong m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng, que c\u1ea5y Implanon NXT \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1eb7t \u1edf 301 ph\u1ee5 n\u1eef. Th\u1eddi gian c\u1ea5y trung b\u00ecnh (t\u1eeb l\u00fac th\u00e1o n\u1eafp b\u1ea3o v\u1ec7 c\u1ee7a d\u1ee5ng c\u1ee5 c\u1ea5y cho \u0111\u1ebfn khi r\u00fat kim ra kh\u1ecfi c\u00e1nh tay) l\u00e0 27,9 gi\u00e2y (\u0111\u1ed9 l\u1ec7ch chu\u1ea9n (SD) = 29,3, n=291). Sau khi c\u1ea5y, c\u00f3 th\u1ec3 s\u1edd th\u1ea5y 300 trong s\u1ed1 301 que c\u1ea5y Implanon NXT (99,7%). M\u1ed9t que c\u1ea5y duy nh\u1ea5t kh\u00f4ng s\u1edd th\u1ea5y \u0111\u00e3 kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o theo \u0111\u00fang h\u01b0\u1edbng d\u1eabn. \u0110\u1ed1i v\u1edbi 293 trong s\u1ed1 301 \u0111\u1ed1i t\u01b0\u1ee3ng, c\u00e1c d\u1eef li\u1ec7u v\u1ec1 kh\u1ea3 n\u0103ng s\u1edd th\u1ea5y \u0111\u00e3 \u0111\u01b0\u1ee3c thu th\u1eadp tr\u01b0\u1edbc khi r\u00fat que c\u1ea5y. Que c\u1ea5y c\u00f3 th\u1ec3 s\u1edd th\u1ea5y \u0111\u01b0\u1ee3c \u0111\u1ed1i v\u1edbi t\u1ea5t c\u1ea3 293 \u0111\u1ed1i t\u01b0\u1ee3ng v\u1edbi d\u1eef li\u1ec7u v\u1ec1 kh\u1ea3 n\u0103ng s\u1edd th\u1ea5y. \u0110\u1ed1i v\u1edbi 4 \u0111\u1ed1i t\u01b0\u1ee3ng, kh\u1ea3 n\u0103ng s\u1edd th\u1ea5y kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 v\u00e0 4 \u0111\u1ed1i t\u01b0\u1ee3ng kh\u00e1c \u0111\u00e3 b\u1ecb m\u1ea5t theo d\u00f5i tr\u01b0\u1edbc khi r\u00fat que c\u1ea5y.<\/p>\n<p>Trong hai th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng v\u1edbi que c\u1ea5y Implanon NXT, t\u1ed5ng c\u1ed9ng c\u00f3 116 \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng X-quang 2 chi\u1ec1u v\u00e0o l\u00fac (sau khi) \u0111\u1eb7t v\u00e0\/ho\u1eb7c (tr\u01b0\u1edbc khi) r\u00fat que c\u1ea5y. \u0110\u1ed1i v\u1edbi 101 trong s\u1ed1 103 \u0111\u1ed1i t\u01b0\u1ee3ng (98,1%) \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u00e1nh gi\u00e1 v\u1ec1 X-quang v\u00e0o l\u00fac \u0111\u1eb7t v\u00e0 tr\u01b0\u1edbc khi r\u00fat ra, que c\u1ea5y Implanon NXT \u0111\u00e3 \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y r\u00f5 r\u00e0ng; \u0111\u1ed1i v\u1edbi 2 \u0111\u1ed1i t\u01b0\u1ee3ng, que c\u1ea5y kh\u00f4ng th\u1ec3 nh\u00ecn th\u1ea5y r\u00f5 sau khi \u0111\u1eb7t nh\u01b0ng c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y r\u00f5 tr\u01b0\u1edbc khi r\u00fat. T\u1ea5t c\u1ea3 c\u00e1c que c\u1ea5y c\u1ee7a 13 \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng X-quang ch\u1ec9 v\u00e0o l\u00fac \u0111\u1eb7t (n=12) ho\u1eb7c ch\u1ec9 tr\u01b0\u1edbc khi r\u00fat (n=1) \u0111\u1ec1u c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y r\u00f5 r\u00e0ng.<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>V\u1ec1 c\u1ea5u tr\u00fac, thu\u1ed1c c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb 19-nortestosterone v\u00e0 c\u00f3 \u00e1i l\u1ef1c g\u1eafn k\u1ebft m\u1ea1nh v\u1edbi nh\u1eefng th\u1ee5 th\u1ec3 progesterone t\u1ea1i c\u00e1c c\u01a1 quan \u0111\u00edch. Que c\u1ea5y Etonogestrel c\u00f3 hi\u1ec7u qu\u1ea3 tr\u00e1nh thai ch\u1ee7 y\u1ebfu qua t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf r\u1ee5ng tr\u1ee9ng.<\/p>\n<p>S\u1ef1 r\u1ee5ng tr\u1ee9ng kh\u00f4ng x\u1ea3y ra trong 2 n\u0103m \u0111\u1ea7u d\u00f9ng thu\u1ed1c, v\u00e0 hi\u1ebfm x\u1ea3y ra trong n\u0103m th\u1ee9 3. Ngo\u00e0i t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf r\u1ee5ng tr\u1ee9ng, Que c\u1ea5y Etonogestrel c\u0169ng l\u00e0m thay \u0111\u1ed5i ch\u1ea5t nh\u1ea7y c\u1ed5 t\u1eed cung g\u00e2y c\u1ea3n tr\u1edf s\u1ef1 di chuy\u1ec3n c\u1ee7a tinh tr\u00f9ng.<\/p>\n<p><strong>[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/p>\n<p><strong>5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<\/strong><\/p>\n<p><em>H\u1ea5p thu<\/em><\/p>\n<p>Sau khi c\u1ea5y, etonogestrel nhanh ch\u00f3ng \u0111\u01b0\u1ee3c h\u1ea5p thu v\u00e0o h\u1ec7 tu\u1ea7n ho\u00e0n. N\u1ed3ng \u0111\u1ed9 \u1ee9c ch\u1ebf s\u1ef1 r\u1ee5ng tr\u1ee9ng \u0111\u1ea1t \u0111\u01b0\u1ee3c trong v\u00f2ng 1 ng\u00e0y. N\u1ed3ng \u0111\u1ed9 t\u1ed1i \u0111a trong huy\u1ebft thanh (t\u1eeb 472 \u0111\u1ebfn 1270 pg\/mL) \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u1eeb 1 \u0111\u1ebfn 13 ng\u00e0y. T\u1ed1c \u0111\u1ed9 ph\u00f3ng th\u00edch thu\u1ed1c c\u1ee7a que c\u1ea5y gi\u1ea3m theo th\u1eddi gian. K\u1ebft qu\u1ea3 l\u00e0 n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft thanh gi\u1ea3m nhanh trong v\u00e0i th\u00e1ng \u0111\u1ea7u. \u0110\u1ebfn cu\u1ed1i n\u0103m \u0111\u1ea7u s\u1eed d\u1ee5ng, n\u1ed3ng \u0111\u1ed9 trung b\u00ecnh \u0111o \u0111\u01b0\u1ee3c kho\u1ea3ng 200 pg\/mL (thay \u0111\u1ed5i t\u1eeb 150-261 pg\/mL), r\u1ed3i gi\u1ea3m ch\u1eadm c\u00f2n 156 pg\/mL (t\u1eeb 111-202 pg\/mL) v\u00e0o cu\u1ed1i n\u0103m th\u1ee9 ba. S\u1ef1 thay \u0111\u1ed5i n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft thanh c\u00f3 th\u1ec3 m\u1ed9t ph\u1ea7n do s\u1ef1 kh\u00e1c nhau v\u1ec1 th\u1ec3 tr\u1ecdng.<\/p>\n<p><em>Ph\u00e2n ph\u1ed1i<\/em><\/p>\n<p>Kho\u1ea3ng 95,5-99% etonogestrel g\u1eafn v\u1edbi protein trong huy\u1ebft thanh, ch\u1ee7 y\u1ebfu l\u00e0 albumin v\u00e0 m\u1ed9t ph\u1ea7n \u00edt h\u01a1n l\u00e0 globulin g\u1eafn k\u1ebft v\u1edbi n\u1ed9i ti\u1ebft sinh d\u1ee5c. Th\u1ec3 t\u00edch ph\u00e2n ph\u1ed1i trung \u01b0\u01a1ng v\u00e0 to\u00e0n b\u1ed9 theo th\u1ee9 t\u1ef1 l\u00e0 27 L v\u00e0 220 L, v\u00e0 h\u1ea7u nh\u01b0 kh\u00f4ng thay \u0111\u1ed5i trong th\u1eddi gian d\u00f9ng Implanon NXT.<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a<\/em><\/p>\n<p>Etonogestrel b\u1ecb hydroxyl h\u00f3a v\u00e0 b\u1ecb kh\u1eed. C\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a \u0111\u01b0\u1ee3c li\u00ean h\u1ee3p th\u00e0nh d\u1ea1ng sulfat v\u00e0 glucuronid. Nh\u1eefng nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt cho th\u1ea5y tu\u1ea7n ho\u00e0n gan-ru\u1ed9t c\u00f3 l\u1ebd kh\u00f4ng g\u00f3p ph\u1ea7n v\u00e0o ho\u1ea1t t\u00ednh progestagen c\u1ee7a etonogestrel.<\/p>\n<p><em>Th\u1ea3i tr\u1eeb<\/em><\/p>\n<p>Sau khi ti\u00eam t\u0129nh m\u1ea1ch etonogestrel, th\u1eddi gian b\u00e1n th\u1ea3i trung b\u00ecnh kho\u1ea3ng 25 gi\u1edd v\u00e0 \u0111\u1ed9 thanh th\u1ea3i huy\u1ebft thanh kho\u1ea3ng 7,5 L\/gi\u1edd. C\u1ea3 \u0111\u1ed9 thanh th\u1ea3i v\u00e0 th\u1eddi gian b\u00e1n th\u1ea3i lu\u00f4n h\u1eb1ng \u0111\u1ecbnh trong th\u1eddi gian d\u00f9ng thu\u1ed1c. Etonogestrel v\u00e0 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a c\u1ee7a n\u00f3, \u1edf d\u1ea1ng c\u00e1c steroid t\u1ef1 do ho\u1eb7c d\u1ea1ng li\u00ean h\u1ee3p, \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft qua n\u01b0\u1edbc ti\u1ec3u v\u00e0 ph\u00e2n (t\u1ef7 l\u1ec7 1,5:1). \u1ede ph\u1ee5 n\u1eef \u0111ang cho con b\u00fa, sau khi c\u1ea5y que thu\u1ed1c, etonogestrel \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft trong s\u1eefa m\u1eb9 v\u1edbi t\u1ef7 l\u1ec7 s\u1eefa\/huy\u1ebft thanh l\u00e0 0,44-0,50 trong 4 th\u00e1ng \u0111\u1ea7u ti\u00ean. \u1ede ph\u1ee5 n\u1eef \u0111ang cho con b\u00fa, li\u1ec1u etonogestrel trung b\u00ecnh truy\u1ec1n qua tr\u1ebb nh\u1ecf kho\u1ea3ng 0,2% c\u1ee7a li\u1ec1u etonogestrel tuy\u1ec7t \u0111\u1ed1i h\u00e0ng ng\u00e0y \u1edf ng\u01b0\u1eddi m\u1eb9 (2,2% khi c\u00e1c gi\u00e1 tr\u1ecb \u0111\u01b0\u1ee3c ti\u00eau chu\u1ea9n h\u00f3a theo kg th\u1ec3 tr\u1ecdng). N\u1ed3ng \u0111\u1ed9 ho\u1ea1t ch\u1ea5t gi\u1ea3m d\u1ea7n v\u00e0 gi\u1ea3m c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea theo th\u1eddi gian.<\/p>\n<p><strong>5.3 Gi\u1ea3i th\u00edch: <\/strong><\/p>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong>5.4 Thay th\u1ebf thu\u1ed1c : <\/strong><\/p>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong><em>*L\u01b0u \u00fd:<\/em><\/strong><\/p>\n<p><strong><em>C\u00e1c th\u00f4ng tin v\u1ec1 thu\u1ed1c tr\u00ean Pharmog.com ch\u1ec9 mang t\u00ednh ch\u1ea5t tham kh\u1ea3o Khi d\u00f9ng thu\u1ed1c c\u1ea7n tuy\u1ec7t \u0111\u1ed1i tu\u00e2n theo theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u00e1c s\u0129 <\/em><\/strong><\/p>\n<p><strong><em>Ch\u00fang t\u00f4i kh\u00f4ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m v\u1ec1 b\u1ea5t c\u1ee9 h\u1eadu qu\u1ea3 n\u00e0o x\u1ea3y ra do t\u1ef1 \u00fd d\u00f9ng thu\u1ed1c d\u1ef1a theo c\u00e1c th\u00f4ng tin tr\u00ean Pharmog.com<\/em><\/strong><\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/strong><\/p>\n<p><strong>6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<\/strong><\/p>\n<p>&#8230;<\/p>\n<p><strong>6.2. T\u01b0\u01a1ng k\u1ef5 :<\/strong><\/p>\n<p>Kh\u00f4ng \u00e1p d\u1ee5ng.<\/p>\n<p><strong>6.3. B\u1ea3o qu\u1ea3n: <\/strong><\/p>\n<p>B\u1ea3o qu\u1ea3n trong bao b\u00ec g\u1ed1c d\u01b0\u1edbi 30oC.<\/p>\n<p>D\u1ee5ng c\u1ee5 ch\u1ec9 \u0111\u01b0\u1ee3c d\u00f9ng m\u1ed9t l\u1ea7n.<\/p>\n<p><strong>6.4. Th\u00f4ng tin kh\u00e1c :<\/strong><\/p>\n<p>M\u00f4 t\u1ea3<\/p>\n<p>Implanon NXT l\u00e0 m\u1ed9t que c\u1ea5y ch\u1ec9 ch\u1ee9a progestagen, kh\u00f4ng b\u1ecb ph\u00e2n h\u1ee7y sinh h\u1ecdc, c\u1ea3n quang, v\u00e0 \u0111\u01b0\u1ee3c \u0111\u1eb7t trong m\u1ed9t d\u1ee5ng c\u1ee5 v\u00f4 khu\u1ea9n, d\u00f9ng m\u1ed9t l\u1ea7n.<\/p>\n<p>M\u1ed7i que c\u1ea5y c\u00f3 t\u00ednh c\u1ea3n quang ch\u1ee9a 68 mg etonogestrel; t\u1ed1c \u0111\u1ed9 ph\u00f3ng th\u00edch kho\u1ea3ng 60-70 mcg\/ng\u00e0y trong 5-6 tu\u1ea7n v\u00e0 gi\u1ea3m c\u00f2n 35-45 mcg\/ng\u00e0y v\u00e0o cu\u1ed1i n\u0103m \u0111\u1ea7u ti\u00ean, v\u00e0 sau \u0111\u00f3 kho\u1ea3ng 30-40 mcg\/ng\u00e0y v\u00e0o cu\u1ed1i n\u0103m th\u1ee9 hai v\u00e0 kho\u1ea3ng 25-30 mcg\/ng\u00e0y v\u00e0o cu\u1ed1i n\u0103m th\u1ee9 ba. D\u1ee5ng c\u1ee5 \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 c\u1ea5y b\u1eb1ng m\u1ed9t tay v\u00e0 gi\u00fap t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i cho vi\u1ec7c c\u1ea5y que c\u1ea5y d\u01b0\u1edbi da m\u1ed9t c\u00e1ch ch\u00ednh x\u00e1c.<\/p>\n<p><strong>6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/p>\n<p>D\u01b0\u1ee3c Th\u01b0 Qu\u1ed1c Gia Vi\u1ec7t Nam<\/p>\n<p>Ho\u1eb7c HDSD Thu\u1ed1c.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: Ho\u1ea1t ch\u1ea5t : Etonogestrel Ph\u00e2n lo\u1ea1i: Thu\u00f4\u0301c tra\u0301nh thai. Nh\u00f3m ph\u00e1p l\u00fd: Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine) M\u00e3 ATC (Anatomical Therapeutic Chemical): G03AC08. Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c: Bi\u1ec7t d\u01b0\u1ee3c: Implanon , Implanon NXT H\u00e3ng s\u1ea3n xu\u1ea5t : N.V. Organon 2. D\u1ea1ng b\u00e0o [&hellip;]<\/p>\n","protected":false},"author":8612,"featured_media":22035,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[419],"tags":[746],"class_list":["post-22030","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biet-duoc","tag-etonogestrel"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/22030","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/users\/8612"}],"replies":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/comments?post=22030"}],"version-history":[{"count":2,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/22030\/revisions"}],"predecessor-version":[{"id":48760,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/22030\/revisions\/48760"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/22035"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=22030"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=22030"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=22030"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}