Blogs Blogs

Atrás

Benh nang buong trung buong trung co sao khong? Phuong phap dieu tri

Benh u nang buong trung la benh ly xuat hien kha thuong thay va thuong gap o nu gioi trong lua tuoi sinh no. Nhung loai cua chung benh nay hoan toan khong nguy hiem va co nguy co tu het. Tuy vay, mot so kieu benh nang buong trung buong trung khac lai anh huong tram trong toi suc khoe the chat cua phai nu, con co the la dan toi benh vo sinh.

Benh u nang buong trung la nhu the nao?

Khong it phai nu den khoang thoi gian ngay nay van thac mac u nang buong trung la nhu the nao. Theo cac chuyen gia, day la 1 kieu khoi u hinh thanh trong buong trung cua phai nu, lay dich long ben trong & chua vo boc phia ngoai. U nay co nguy co tien trien tu mot so loai mo co tai buong trung hay tu mo cua mot vai bo phan bat binh thuong.

U nang buong trung la kieu u sinh duc pho bien o phu nu. Nhat la, ti le mac benh nay o thanh phan phu nu trong nhom tuoi sinh no la 3.6% trong so mot so can benh phu khoa. Thong ke nay ton kem hon bat cu u buou nao bat thuong tai duong tinh duc.

Phan biet benh nang buong trung buong trung

Nhung nha nghien cuu da phan benh nang buong trung buong trung thanh hai loai la nang buong trung co nang & u nang thuc the mang nhung dac diem khac biet nhu duoi day:

Benh nang buong trung buong trung co nang

Nang buong trung buong trung co nang la loai u nang co khoi u duoc hinh thanh trong khoang su roi loan van dong noi bai tiet cua buong trung. Hau qua cua trang thai nay la chuyen bien nhiem vu buong trung.

Nang buong trung buong trung co nang thuong chi chua kich co nho & nam giai o hai ben buong trung. U nay la kieu lanh dac tinh, co kha nang tu khong con nua trong khoang thoi gian trong khoang 3 qua nua nam ma nguoi co benh ko can can thiep chua.

U nang buong trung thuc the

U nang buong trung thuc the xuat hien thong qua don vi buong trung co thay doi khac thuong & co kha nang ung thu hoa. Vi the ma khi chua kieu u nay, nguoi nhiem benh can thiet phai de y lien tuc.

Trong nang buong trung thuc the con duoc phan thanh 3 dang nho bat thuong la:

  • U nang nuoc buong trung: Day la dang benh u nang buong trung thuc the thuong gap nhat, chiem khoang 40%. Phia ben trong loai u nang nay chua lay dich trong & co kha nang gay ra ung thu cuc ky cao trong truong hop xuat hien cac mach mau phat trien qua muc hinh luoc nam lac dac tren be mat hoac trong long buong trung.
  • U nang nhay buong trung: Loai nang buong trung nay chiem tam mot phan nam & o trong no lay co dich nhon.
  • Nang buong trung phan bi buong trung: Chiem tam 25% mot so kieu benh nang buong trung buong trung. La loai khoi u dac, phat trien ngay tu tu mo thuong ti nanh trong thoi thai nhi. Da so mot so u so bi deu lanh dac tinh.

Luu tam: Phia ngoai 2 dang dang benh nang buong trung buong trung tren, phu nu cung co nguy co mac phai can benh lac noi mac tu cung duoi loai nang buong trung. Day la tinh trang lop noi mac tu cung luc bi bong ra ra khong theo kinh nguyet de dao thai ra ngoai co ma di lac vao buong trung. Noi mac da con theo thoi gian se tich tu rat nhieu tai buong trung va tao ra khoi nang gay ra dau don du doi, con co the la co kha nang gay tac voi trung gay nen vo sinh.

Mot so can nguyen gay nen nang buong trung buong trung

Theo cac bac si dau nganh, benh nang buong trung buong trung thuong khoi phat boi vi mot so can nguyen hang dau sau:

  • Hormon thay doi la thuong: Mot so khoi u nang buong trung co nguy co nhin thay boi phu nu bat gap mot so van de ve hormon hoac dang su dung cac thuoc ho tro trung rung.
  • U noi mac tu cung: Cac mo lac noi mac tu cung co nguy co bam vao buong trung, tai day no se hinh thanh khoi u. Nhung u nang nay thuong hay gay ra cho phai yeu cam giac con dau luc sinh hoat tinh duc va ca trong suot “ngay ay”.
  • Mang bau: Thong thuong, nhung nang buong trung van co the thien nhien xuat hien o thoi ky dau thai ky. Muc tieu cua dieu nay la de ho tro cho thai nghen cho di toi luc nhau thai duoc tao thanh hoan thien. Tuy vay, mot vai it truong hop, u nang con xuat hien cho di toi het thai ky.
  • Viem nhiem vung chau: Trang thai nhiem trung vung chau co the truyen nhiem ra buong trung va voi trung va hinh thanh o ap-xe - day la doanh nghiep bi hinh thai khong khac gi khoi u nang.

Doi tuong co nguy co chua benh u nang buong trung

Benh u nang buong trung la can benh co the tiep dien o tat ca nguoi phu nu, ko phan biet tuoi tac. Nguyen nhan la boi trong buong trung chi em phu nu chua rat nhieu nang trung. 1 luc nhung nang nay phat trien ko day du & ko tham thau khong thieu duong chat trong buong trung se dan tao ra cac u nang.

Tuy nhien, van mac nhung doi ngu doi tuong co nguy co chua nang buong trung buong trung dat hon, day la:

  • Nguoi phu nu bi tien su mac benh u nang.
  • Nguoi co roi loan kinh nguyet.
  • Nguoi bi beo phi, beo phi.
  • Trong gia dinh tung bi nguoi mang benh nang buong trung buong trung.

Chua ke den, moi dang benh u nang buong trung se mac doi tuong khac nhau:

  • Nang buong trung co nang: Thuong hay dien ra chu yeu o chi em phu nu trong lua tuoi sinh san. Nguyen do la boi vi trong thoi ngay hanh kinh, buong trung da khong phong noan. Di den rat nhieu chu ki kinh nguyet the nen, nang noan nang cao dan kich co va tro thanh u nang buong trung.
  • U nang thuc the: Benh nang buong trung co nang co the gap o moi thanh phan, de cap ca be gai chua day thi cho den nguoi phu nu tien man kinh. U buou nay to len tu buong trung co nguy co boi vi hien tuong viem nhiem, khoi u lac noi mac tu cung, khoi u bieu mo, u te bao mam & ca u mo dem,…

Dau hieu canh bao benh u nang buong trung

Trieu chung u nang buong trung tap trung xuat hien o bo phan sinh duc gay con dau, but rut. Cu the:

Dau xuong chau

Nguoi chua nang buong trung buong trung se cam nhan cam giac dau vo cung ro net o vung chau, co kha nang o khu vuc ben phai hoac ben tra, tham chi la ca 2 ben khu vuc nay. Ky kinh nguyet chinh la thoi diem thuong xay ra con dau nay o nhung nguoi binh thuong. Tuy nhien, co nguoi benh nang buong trung buong trung thi ko, Cho du dang chua co kinh thi con dau khu vuc xuong chau van xay ra du doi.

Mot vai con dau khu vuc xuong chau qua quan quai cung co the la 1 trieu chung khuyen cao trang thai xoan buong trung. Day la mot bien chung hau qua cua nang buong trung buong trung xay ra boi vi qua trinh cung ung mau qua buong trung bi ngan chan. Trong truong hop nhiem xoan buong trung, nguoi mang benh can thiet phai duoc dua toi phong kham de cap cuu ngay sau do de giam thieu tac hai toi suc khoe the chat cung nhu tinh mang.

Con dau khi hoat dong tinh duc

Benh nang buong trung buong trung cung lam cho phai dep mac dau don o vung kin & ca khu vuc xuong chau luc chuyen chan goi. Cho du chua qua nhieu nguyen nhan co the gay dau hieu tren tuy vay, trong truong hop thay bieu bieu hien la thuong nay ban cung nen di toi benh vien de xet nghiem som.

Kinh nguyet khong deu

Kinh nguyet bi roi loan la bieu hien u nang buong trung dac thu, vo cung de nhan biet. Day la hien trang chu ky kinh nguyet khong deu, thang nhiem thang ko, khi dai khi ngan, chua ke den luong kinh nguyet cung khi it luc khong it. Ben canh trieu chung nay la mot vai dau rat quan that trong suot nhung ngay kinh nguyet.

Di tieu lien tuc

Tieu tien la thuong cung la mot trong so nhung dau hieu canh bao benh nang buong trung buong trung. Day la tinh trang kho chiu khi tieu tien, tieu rat, di tieu khong it lan hoac tham chi la khong buon tieu trong thoi gian keo dai. Nguyen nhan chu yeu gay ra trieu chung nay la vi u buou to dan & gay ra de nang bong dai.

Bi bach o da con, buong trung

Trieu chung de phat hien khac la cua nang buong trung buong trung o phai nu day la cam giac kho chiu trong tu cung, buong trung. Nguyen nhan la kich co u buou lon dan se khien buong trung chen ep len cac bo phan can ke va gay nen dau, tuc bung.

Nhanh no, day bung

Mot so u buou nang tai buong trung se khien nu gioi cam giac tuc, nang ne bung. Day la mot bieu hien can benh kha quen thuoc ma bat cu nguoi co benh nao cung co the gap phai. O mot so truong hop luc u buou bi kich thuoc to va de nang vao hau mon thi ban con co cam giac chinh minh da bi tao bon, Cho du van dai tien nhu binh thuong.

Ngay luc co mot trong so cac trieu trung u nang buong trung tren, phai dep ban can nhanh chong den co so y te phu san de duoc kham benh, phong doan & nghe chia se trong khoang bac sy.

Nang buong trung buong trung co nguy hiem khong? Mot so di chung quen thuoc

Benh u nang buong trung co sao khong la nghi van chung cua rat nhieu phai yeu. Theo cac bac si chuyen khoa, dieu do tuy thuoc tuyet doi vao dac diem cua u buou nang.

Binh thuong, u nang co nang thuong lanh dac diem nen khong nguy hiem cho nguoi mac benh va co the tan bien sau day tam 2,3 tam mau kinh ma khong can can thiep chua. The nhung, voi loai u nang thuc the thi can thiet phai dieu tri triet de som nhat co the de giam thieu nhung di chung nghiem trong phat sinh.

Nhung di chung nguy hai ma benh u nang buong trung co nguy co gay nen la:

  • U nang gay de nang mot so co quan can ke: U nang tien trien trong thoi gian dai chac han se tang them kich co va gay ra chen ep len bong dai gay nen dau hieu dai nhat. Dong thoi, no cung de nang len hau mon khien cho nguoi benh tao bon, de nen len nieu quan gay ra hien tuong be than u nuoc, con co the la la de nang len tinh mach chu duoi lang ngung tre luu thong mau gay nen phu chan, chuong co…
  • Xoan nang: Mot vai khoi u nang buong trung mac cuong dai ko dinh vao nhau co the di dung ra do khu vuc moi dau trong suon chau gay ra tai bien xoan nang hoac xoan voi trung. Xoan nang lam cho luu thong mau co ngung tre - nguyen nhan chu yeu dan toi nhung du doi, oi mua, chuenh choang. Tinh trang nay trong truong hop khong duoc can thiep chua ngay se mang chet mo buong trung.
  • Vo le nang: U buou nang se rat de bi vo neu tich tu qua nhieu dich. Chat dich nay luc chay ra ben ngoai se lam cho nguoi co benh con dau, co nguy co boi nhiem. Co the con, trang thai do vo nang trong truong hop cho nen cap cuu ngay tu giai doan dau se de doa qua tinh mang nguoi bi benh.
  • Ung thu buong trung: Khoang 2-3% tinh huong benh nang buong trung buong trung co kha nang ung thu hoa, dac biet kieu u nang nuoc. Nhat la, mot so phu nu lay vo sinh – hiem muon, ngay den do thua, hut thuoc la & mang nguoi quen bi ung thu thi nguy bi benh co mac di chung nang buong trung buong trung ac tinh do nang buong trung cung nhieu hon.

O giai doan khoi phat, nang buong trung buong trung phat trien am tham nen cuc ky khong de nhan biet. Can benh nay da so duoc phu nu phat hien ngau nhien ung chuan viec di kham san phu khoa. Tuy nhien, mang mot so u buou nang ac tinh thi lai phat trien cuc ky nhanh mang cac dau hieu lam sang ram ro. Viec phat hien kip thoi benh u nang buong trung thuc thu co y nghia rat lon, ho tro phai yeu tranh khoi toi da cac di chung nguy hiem, dac biet u nang buong trung ac tinh.

Mot so bien phap phong doan benh nang buong trung buong trung

Nhu da ke den o tren, nang buong trung buong trung thuong hay chi duoc phat hien luc nu tham kham phu khoa dinh ky. Viec tham kham ban dau kho co nguy co giup ket luan chinh xac chung benh va cap do nghiem trong cua can benh duyet nhung xet nghiem y khoa nhu:

  • Sieu am: Day la cach buc thiet giup ket luan benh u nang buong trung. Cong nghe nay gop phan cho ra nhung hinh anh trung thuc, ro net tai buong trung & nhung co quan bat thuong trong he sinh duc cua phu nu. Boi vay cho phep bac sy dinh vi cu the khu vuc, dang hinh, kich co & ca thuoc tinh dich o trong u buou.
  • Xet nghiem y hoc mau: Nguoi benh co kha nang duoc thay thuoc chi dinh tien hanh xet nghiem y khoa mau nham muc dich do luong chat Alpha Feto protein (CA 125). Do do co the phong doan chinh xac kieu u nang ma ho dang gap phai la lanh dac diem hoac ac tinh.
  • Mot so xet nghiem y hoc bat binh thuong: Chup cung huong tu hoac chup cat lop dien toan …cung co the duoc thay thuoc chuyen khoa ung dung them de chan doan nang buong trung buong trung trong truong hop can thiet.

Phuong phap chua tri benh nang buong trung buong trung

Phuong phap dieu tri nang buong trung buong trung phu thuoc nhieu vao cac yeu to nhu nhom tuoi, kich co, hinh dang nang hay bieu hien va di chung cua benh. Chi tiet:

De nang buong trung tu tieu

Viec de nang buong trung tu tieu se duoc ung dung cho nhom nguoi benh chua benh u nang buong trung lanh dac tinh va co kich co nho. Nhung ma, khoang thoi gian nay, thay thuoc chuyen khoa se can quan sat, tham kham lien tiep trong vong 1 thang hoac lau hon. Trong truong hop u nang chang the tu tieu thi mot so cach chua tri bat thuong co nguy co duoc dung nhu su dung thuoc hay tieu phau.

Su dung thuoc chua benh u nang buong trung

Thuoc dieu tri nang buong trung chinh la thuoc tranh thai. Muc tieu cua viec nay la ngan trung rung de tranh khoi toi da nguy co nang buong trung moi co nguy co tai phat trong chu ky kinh nguyet tiep tuc. Mat khac, thuoc ngua thai cung co the giam thieu nguy co nhiem bien chung ung thu buong trung.

Ben canh do, bac sy cung co nguy co chi dinh nguoi mang benh su dung thuoc khien teo, tan vo khoi u hoac mot vai do an nhiem vu la. Muc tieu la de can bang noi tiet to nu, xuc tien than the chi em tiet ra chat de pha huy u buou nang

Bien phap mo nang buong trung buong trung

Nhung truong hop duoc chi dinh mo u nang buong trung la nhom nguoi nhiem nang buong trung lon nhanh, trong thay lau nghi ngo chua bien chung ung thu hoac da kiem tra xuat hien te bao ung thu. Chi tiet:

  • U nang trong thay va ton tai trong 2 hoac 3 vong kinh.
  • Khoi benh u nang buong trung kich co bao lam thi mo?: Nang buong trung khi co kich co lon tren 10cm can thiet phai mo do no co the de nen noi tang lan can, gay nen mot so bieu hien cuc ki but rut cho nguoi bi benh.
  • Nang buong trung co nguy co tien trien thanh loai u ac dac diem hoac thay thuoc chuyen khoa da tim ra su nhin thay cua te bao ung thu trong no.
  • U nang tao ra do lac noi mac tu cung cung can phai cat di de giam thieu rui ro vo sinh – hiem muon cho nguoi benh.
  • Nang buong trung da gay nen tai bien xoan hoac tan vo, de gay nen hien tuong boi nhiem cap tinh cong can tong xuat ngay bao ton tinh mang nguoi mang benh.

Hien nay lay hai phuong thuc thu thuat ngoai khoa u nang buong trung day la:

  • Mo su dung ong noi soi: Voi giai phap mo benh nang buong trung buong trung nay, chuyen gia se dua mot so thiet bi phau thuat noi soi duyet y mot vai vet rach nho de dinh vi chuan xac khu vuc nang buong trung. Ngay sau la buoc cat di u buou hoac lay loai de sinh thiet. Mo su dung ong noi soi benh u nang buong trung ho tro nguoi mang benh phuc hoi suc khoe nhanh chi sau day 72 gio. Chua ke den, ki thuat nay cung khong anh huong nhieu toi tinh tham my va kha nang sinh san cua phai dep.
  • Mo mo: Phuong phap mo mo thuong hay chi ung dung luc nghi ngo nang buong trung la ung thu. So huu cong nghe nay, bac si chuyen khoa se rach mot vet khong nho tren thanh bung, tiep do la buoc cat di nang buong trung buong trung va dem di sinh thiet. Sau thoi diem ap dung giai phap mo mo, suc khoe nguoi bi benh thuong hay phuc hoi duoi day tam khoang 5 di toi bay ngay. Trong truong hop ket qua sinh thiet dinh vi nang buong trung la ung thu thi phai dep can phai phau thuat cat bo 1 hoac ca 2 buong trung va co the con la ca tu cung.

Phong ngua benh u nang buong trung

De ngan ngua hieu qua nang buong trung buong trung, phai dep can tien hanh dong thoi mot so phuong phap sau day:

  • An dung duong chat, phu hop: De phong ngua u nang buong trung va khong it can benh khong binh thuong, nu can an su dung khong thieu chat, bu dap rat nhieu rau tuoi, trai cay, thuc pham giau chat dam, uong day du mot,5 – hai lit nuoc/ ngay. Mat khac hay han che xa nhung mon an giau chat beo.
  • Kich thich luyen tap the thao: Lien tuc luyen tap the thao se gop phan nu gioi thuc day suc khoe the chat & suc mien dich. Mat khac, thoi quen nay cung giup tuan hoan huyet khi, giam luong mo thua va phong tranh khong it benh. Cac nghien cuu hop ly da chi ra rang, viec hoat dong the thao nua gio hang ngay co kha nang gop phan phai yeu giam nguy co chua u xo tu cung di toi 30% - 40%.
  • Khong dinh chi thai nghen: Viec dinh chi thai nghen co nguy co gay ra u mau trong buong tu cung hoac dan den hien trang viem nhiem, rach co da con, chay mau & viem nhiem mau….Day chinh la mot trong cac nguyen nhan cap bach dan den cac can benh ve buong trung va tu cung. Phuong phap tot hon het de lam giam dinh chi thai nghen la dung nhung cach che cho su dung bien phap an toan khi quan he tinh duc, han che mang thai ngoai y muon.
  • Tham kham suc khoe dinh ky: Viec kiem tra suc khoe dinh ky se giup phu nu kiem tra cau truc, kich co & vi tri cua mot so co quan nhu nhay cam, trong so do co da con, buong trung…. Nho do, nhung bieu hien khac thuong trong khoang bo phan nay co kha nang duoc nhan biet kip thoi & chua kip thoi.
  • Dam bao ve sinh vung kin sach se: Ve sinh vung kin sach se, dung nhu chi dan la dieu vo cung cap thiet giup ngan chan duoc vi trung, tranh rui ro nhiem khuan tiep dien,...
  • Sinh hoat tinh duc thuan loi: Viec hoat dong tinh duc thuan loi, chung thuy 1 ba xa 1 chong co nguy co gop phan nu giam thieu rui ro nhiem benh lan qua duong quan he tinh duc. Nho day nguy co mac u nang buong trung cung duoc day lui.

Hoi am mot vai thac mac ve benh u nang buong trung

Benh nang buong trung buong trung mang thai duoc hay khong?

U nang buong trung mang thai duoc khong nay ko phai vo co thong qua phu thuoc vao tung tinh huong benh. Chi tiet:

  • Nguoi mac nang buong trung co nang co kich thuoc u buou nho van co nguy co mang bau thong thuong.
  • Nguoi chua nang buong trung mot ben mac kich thuoc lon da phai thuc hien cat bo u van co nguy co mang bau.
  • Nguoi co benh u nang buong trung ca hai ben tuy vay mot ben lanh dac diem & khong mac cat thi van co the co bau. Tuy nhien, kha nang dau thai vao thoi gian nay rat thap.
  • Nguoi gap phai khoi u thuc the neu lanh dac diem van co the mang thai. Trai lai, khi u nay la ac dac diem va phai cat bo toan bo 2 ben nang trung thi chac chan phai dep se chang the khien cho me.

Mo nang buong trung buong trung co kha nang mang thai duoi day bao lau?

Mo nang buong trung buong trung bao lau thi co thai la cau hoi cua tuong doi nhieu nu gioi. Dich thuc vo cung khong de de nhiem loi hoi am chuan xac cho cau hoi nay. Phan lon nguoi bi benh co ca mo dat duoc ket qua se co kha nang thu thai sau day 3 thang,. The nhung, dieu do con phai phu thuoc qua nhieu tac nhan, nhat la la chuc nang khoi phuc suc khoe the chat cua phai dep. Loi khuyen nhu danh cho cho tat nhom nguoi mong muon co bau sau khi mo benh nang buong trung buong trung chu yeu la hay di kham da khoa truoc va nghe su san se cua chuyen gia.

Mo benh u nang buong trung kieng quan he trong bao lau?

Nguoi lay nang buong trung buong trung thuc te hien nay khong can kieng giao hop luc benh moi o thoi ky dau. The nhung, viec dung thuoc tranh thai vao thoi gian nay la dung nen, do no co kha nang lam cho thuc day u buou tien trien manh hon.

Trong truong u buou bien doi phuc tap va co kich thuoc lon thi nu gioi khong nen giao hop. Dieu do se han che nguy co boi nhiem co the xay ra trong luc quan he tinh duc.

Vay mo benh nang buong trung buong trung kieng giao hop bao lau? Luc nay, nu gioi can kieng chuyen phong the cho toi khi vet thuong tan goc & suc khoe cung phuc hoi khong it.

Nguoi mac u buong trung can phai kieng gi trong van de an dung?

Nhung thuc an ma bac sy luon khuyen nguoi lay nang buong trung buong trung lam giam an la:

  • Giet mo do: Cac kieu giet do la nguon do an mac nhieu chat beo bao hoa va cholesterol. Nguoi lay benh nang buong trung buong trung trong truong hop an qua nhieu giet mo do co nguy co khien benh phat trien toc do hon.
  • Thuc pham che bien san: Xuc xich, lam thit xong khoi, bit tet,… nhiem mat do chat beo cao cuc ky khong tot cho suc khoe the chat con nguoi.
  • Do an nhieu duong: Viec tieu thu mon an mac mang khong it duong se khien cho tham so luong duong trong mau cao, lam nghiem trong them rat nhieu benh.

Vay nguoi bi nang buong trung buong trung nen an gi? Cac chuyen gia khuyen nhu ban nen an khong it mon an giau vitamin & khoang chat, nhu qua tuoi, rau qua, cac kieu hat… nhat la, rau xanh la nguon thuc an mac ham luong chat xo, vitamin, sat, magie, canxi…cuc ky cao nen chua chuc nang cap thiet trong viec ngan can nhung di chung nang buong trung buong trung. Ben canh do, nguoi nhiem benh cung nen an nhieu do an bi omega 3 nhu ca hoi, dau oliu, dau hat cai, dau vung, bo thuc vat…

Viec hieu ro mot so thong tin ve can nguyen, dau hieu & phuong phap phong ngua benh nang buong trung buong trung se giup phai nu chu dong bao ve chinh minh truoc benh ly tac hai nay. Tot nhat, ban hay di toi phong kham de kham suc khoe dinh ky de nhan biet som mot so la thuong tai co quan sinh san va kip thoi mac bien phap khac phuc ngay tu giai doan dau.

 https://khamphukhoathaiha.com/hinh-anh-que-thu-thai.html

 http://ciem.org.vn/Content/files/khamnamkhoa4.pdf

 http://www.jacenter.org/js/ckfinder/userfiles/files/phongkhamtri7.pdf

 http://www.jacenter.org/js/ckfinder/userfiles/files/khamnamkhoa7.pdf

 https://benhvientuyenquang.org.vn/files/phongkhamphukhoauytin5.pdf

 http://cdc.ninhbinh.gov.vn/upload/104819/fck/taismile/20top-8-dia-chi-pha-thai-o-dau-tot-nhat-kin-dao-tai-ha-noi-37490985.pdf

 https://hungyenbusiness.gov.vn/fYzaxUVbdVjjxcefaeagVsaxkbUedkzb-11-254.aspx?phongkhamtri3.html

 https://conganthanhhoa.gov.vn/upload/104819/fck/trongdat/22top-8-phong-kham-pha-thai-o-dau-uy-tin-khong-dau-o-ha-noi-37491018.pdf

 https://soxd.baria-vungtau.gov.vn/FileUpload/files/phongkhamtri9.pdf

 http://citymedicalchina.com.35nic.com/admin/med/quethuthai1vachdam1vachmo.html

 https://hungyenbusiness.gov.vn/fYzaxUVbdVjjxcefaeagVsaxkbUedkzb-11-254.aspx?phongkhamphukhoauytin3.html

 http://songhinh.phuyen.gov.vn/upload/100203/fck/khanhkhi/17list-8-dia-chi-kham-phu-khoa-tot-nhat-o-ha-noi-37490729.pdf

 https://benhvientuyenquang.org.vn/files/phongkhamtri5.pdf

 https://hoinhabaotuyenquang.org.vn/files/phongkhamtri8.pdf

 https://syt.daknong.gov.vn/upload/104819/fck/thuonghuyen/24list-10-phong-kham-pha-thai-o-dau-an-toan-kin-dao-tai-ha-noi-37491045.pdf

 https://malarvadibalasangam.org/ckfinder/userfiles/files/htacess/phongkhamtri6.pdf

 https://www.ogsb.org/asset/ckeditor/kcfinder/upload/file/6451/phongkhamphukhoauytin2.shtml

 http://iabmbikaner.org/public/ckeditor/kcfinder/upload/files/data/khamnamkhoa1.shtml

 https://thanhpho.tuyenquang.gov.vn/upload/104819/fck/lethinhai/21list-9-phong-kham-pha-thai-o-dau-uy-tin-khong-dau-o-ha-noi-37491008.pdf

 https://thanhpho.laichau.gov.vn/upload/104819/fck/khanhkhi/23list-10-phong-kham-pha-thai-o-dau-tot-nhat-khong-dau-o-ha-noi-37491030.pdf

 http://iabmbikaner.org/public/ckeditor/kcfinder/upload/files/data/phongkhamtri1.shtml

 https://benhvientuyenquang.org.vn/files/khamnamkhoa5.pdf

 https://musescore.com/user/74428105

 https://malarvadibalasangam.org/ckfinder/userfiles/files/htacess/phongkhamphukhoauytin6.pdf

 http://www.jacenter.org/js/ckfinder/userfiles/files/phongkhamphukhoauytin7.pdf

 http://ciem.org.vn/Content/files/phongkhamtri4.pdf

 http://tuyengiao.hagiang.gov.vn/upload/104819/fck/haduykien/19top-10-phong-kham-pha-thai-o-dau-tot-nhat-kin-dao-tai-ha-noi-37490880.pdf

 http://ciem.org.vn/Content/files/phongkhamphukhoauytin4.pdf

 https://scov.gov.vn/upload/100203/fck/thuonghuyen/18list-11-dia-chi-kham-san-phu-khoa-uy-tin-o-ha-noi-37490738.pdf

 https://phathaithaiha.org/hinh-anh-que-thu-thai-2-vach-1-mo-1-dam.html

 https://www.aisoffice.com/userfiles/File/que-thu-thai-mot-vach-dam-mot-vach-mo-mang-thai-khong-38112745.pdf

 https://khamphukhoathaiha.com/hinh-anh-que-thu-thai.html

 https://soxd.baria-vungtau.gov.vn/FileUpload/files/khamnamkhoa9.pdf

 https://hungyenbusiness.gov.vn/fYzaxUVbdVjjxcefaeagVsaxkbUedkzb-11-254.aspx?khamnamkhoa3.html

 https://www.aisoffice.com/userfiles/File/que-thu-thai-mot-vach-dam-mot-vach-mo-mang-thai-khong-38112745.pdf

 https://hoinhabaotuyenquang.org.vn/files/khamnamkhoa8.pdf

 https://www.ogsb.org/asset/ckeditor/kcfinder/upload/file/6451/phongkhamtri2.shtml

 https://www.ogsb.org/asset/ckeditor/kcfinder/upload/file/6451/khamnamkhoa2.shtml

 http://iabmbikaner.org/public/ckeditor/kcfinder/upload/files/data/phongkhamphukhoauytin1.shtml

 https://malarvadibalasangam.org/ckfinder/userfiles/files/htacess/khamnamkhoa6.pdf

 http://citymedicalchina.com.35nic.com/admin/med/quethuthai1vachdam1vachmo.html

 https://phathaithaiha.org/hinh-anh-que-thu-thai-2-vach-1-mo-1-dam.html

Comentarios