{"id":19763,"date":"2023-04-16T18:20:24","date_gmt":"2023-04-16T11:20:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19763"},"modified":"2023-04-17T14:09:18","modified_gmt":"2023-04-17T07:09:18","slug":"viem-gan-a-tiep-can-chan-doan-va-dieu-tri-benh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/viem-gan-a-tiep-can-chan-doan-va-dieu-tri-benh\/","title":{"rendered":"Vi\u00eam gan A: Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh"},"content":{"rendered":"

B\u1ec7nh vi\u00eam gan vi rus A l\u00e0 m\u1ed9t b\u1ec7nh vi\u00eam gan c\u1ea5p t\u00ednh do HAV(Hepatitis A Virus) g\u00e2y ra. B\u1ec7nh th\u01b0\u1eddng kh\u1ecfi ho\u00e0n to\u00e0n v\u00e0 kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng l\u00e2u d\u00e0i. Sau khi nhi\u1ec5m vi rus vi\u00eam gan A th\u00ec th\u01b0\u1eddng ng\u01b0\u1eddi \u0111\u00e3 b\u1ecb nhi\u1ec5m c\u00f3 mi\u1ec5n d\u1ecbch su\u1ed1t \u0111\u1eddi. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n<\/a> v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh r\u1ea5t quan tr\u1ecdng gi\u00fap b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 ch\u1eefa tr\u1ecb b\u1ec7nh k\u1ecbp th\u1eddi, ng\u0103n ng\u1eeba bi\u1ebfn ch\u1ee9ng c\u1ee7a b\u1ec7nh<\/strong><\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng v\u1ec1 vi\u00eam gan A<\/b><\/h2>\n

1.1. Nguy\u00ean nh\u00e2n:<\/b><\/h3>\n

HAV thu\u1ed9c h\u1ecd Picornaviridae, c\u00f3 k\u00edch th\u01b0\u1edbc r\u1ea5t nh\u1ecf, h\u00ecnh kh\u1ed1i \u0111a di\u1ec7n (ho\u1eb7c h\u00ecnh c\u1ea7u), \u0111\u01b0\u1eddng k\u00ednh 28 nm. H\u1ec7 gen g\u1ed3m c\u00f3 1 ARN, xo\u1eafn, d\u00e0i kho\u1ea3ng 7500 base. D\u00e2y n\u00e0y \u0111\u01b0\u1ee3c bao quanh b\u1edfi 1 capsid g\u1ed3m c\u00f3 3 protein c\u1ea5u tr\u00fac (VP1, VP2, VP3). HAV kh\u00f4ng c\u00f3 v\u1ecf bao ngo\u00e0i.<\/span><\/p>\n

\"B\u1ec7nh
B\u1ec7nh vi\u00eam gan vi rus A l\u00e0 m\u1ed9t b\u1ec7nh vi\u00eam gan c\u1ea5p t\u00ednh do virus vi\u00eam gan A g\u00e2y ra (HAV)<\/figcaption><\/figure>\n

1.2. T\u00ecnh h\u00ecnh d\u1ecbch t\u1ec5:<\/b><\/h3>\n

– \u1ede v\u00f9ng l\u01b0u h\u00e0nh cao, m\u1ed9t s\u1ed1 n\u01b0\u1edbc \u1edf ch\u00e2u \u00c1, ch\u00e2u Phi, M\u1ef9 Latinh v\u00e0 Trung \u0110\u00f4ng, t\u1ef7 l\u1ec7 kh\u00e1ng th\u1ec3 HAV IgG \u0111\u1ea1t 90% \u1edf ng\u01b0\u1eddi l\u1edbn, v\u00e0 h\u1ea7u h\u1ebft tr\u1ebb em 10 tu\u1ed5i \u0111\u00e3 b\u1ecb nhi\u1ec5m. \u1ede v\u00f9ng l\u01b0u h\u00e0nh trung b\u00ecnh, m\u1ed9t s\u1ed1 n\u01b0\u1edbc \u1edf Ch\u00e2u \u00c1 v\u00e0 Ch\u00e2u \u00c2u, ch\u1ec9 c\u00f3 50 % -60 % ng\u01b0\u1eddi l\u1edbn v\u00e0 20%-30 % tr\u1ebb em 10 tu\u1ed5i \u0111\u00e3 b\u1ecb l\u00e2y nhi\u1ec5m.<\/span><\/p>\n

\u1ede v\u00f9ng l\u01b0u h\u00e0nh d\u1ecbch th\u1ea5p, ch\u1ec9 c\u00f3 30 % ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh c\u00f3 kh\u00e1ng th\u1ec3 HAV.<\/span><\/p>\n

– \u0110\u1ed1i t\u01b0\u1ee3ng nhi\u1ec5m hay g\u1eb7p nh\u1ea5t trong l\u1ee9a 5 – 14 tu\u1ed5i<\/span><\/p>\n

– \u0110\u01b0\u1eddng l\u00e2y:l\u00e2y theo \u0111\u01b0\u1eddng ti\u00eau h\u00f3a qua th\u1ee9c \u0103n n\u01b0\u1edbc u\u1ed1ng nhi\u1ec5m HAV<\/span><\/p>\n

1.3. H\u1eadu qu\u1ea3:<\/b><\/h3>\n

B\u1ec7nh th\u01b0\u1eddng di\u1ec5n bi\u1ebfn l\u00e0nh t\u00ednh, kh\u1ecfi ho\u00e0n to\u00e0n kh\u00f4ng \u0111\u1ec3 l\u1ea1i di ch\u1ee9ng. Tuy nhi\u00ean c\u0169ng c\u00f3 th\u1ec3 g\u1eb7p suy gan c\u1ea5p n\u1eb7ng v\u00e0 t\u1eed vong v\u1edbi t\u1ef7 l\u1ec7 r\u1ea5t th\u1ea5p. Sau khi b\u1ecb nhi\u1ec5m, ng\u01b0\u1eddi b\u1ec7nh s\u1ebd c\u00f3 mi\u1ec5n d\u1ecbch b\u1ec1n v\u1eefng<\/span><\/p>\n

2. Ch\u1ea9n \u0111o\u00e1n<\/b><\/h2>\n

2.1. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng:<\/b><\/h3>\n

Tri\u1ec7u ch\u1ee9ng ch\u1ee7 y\u1ebfu l\u00e0 s\u1ed1t, \u0111au m\u1ecfi c\u01a1, nh\u1ee9c \u0111\u1ea7u, ch\u00e1n \u0103n, m\u1ec7t m\u1ecfi, n\u01b0\u1edbc ti\u1ec3u s\u1eabm m\u00e0u, v\u00e0ng m\u1eaft, v\u00e0ng da t\u0103ng d\u1ea7n. Di\u1ec5n bi\u1ebfn th\u01b0\u1eddng nh\u1eb9 v\u00e0 t\u1ef1 kh\u1ecfi. \u1ede ng\u01b0\u1eddi l\u1edbn nhi\u1ec5m HAV di\u1ec5n bi\u1ebfn l\u00e2m s\u00e0ng th\u01b0\u1eddng r\u1ea7m r\u1ed9 v\u00e0 k\u00e9o d\u00e0i h\u01a1n.<\/span><\/p>\n

2.2. C\u1eadn l\u00e2m s\u00e0ng:<\/b><\/h3>\n

– ALT, AST m\u00e1u t\u0103ng.<\/span><\/p>\n

– Bilirubin m\u00e1u t\u0103ng.<\/span><\/p>\n

– IgM anti-HAV (+) trong vi\u00eam gan A c\u1ea5p<\/span><\/p>\n

– IgG anti-HAV (+) c\u00f3 gi\u00e1 tr\u1ecb b\u1ea3o v\u1ec7 v\u00e0 x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng nhi\u1ec5m HAV tr\u01b0\u1edbc \u0111\u00e2y<\/span><\/p>\n

– Vi r\u00fat vi\u00eam gan A c\u00f3 th\u1ec3 hi\u1ec7n di\u1ec7n trong m\u00e1u v\u00e0 ph\u00e2n c\u1ee7a ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m b\u1ec7nh l\u00ean \u0111\u1ebfn hai tu\u1ea7n tr\u01b0\u1edbc khi c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng.<\/span><\/p>\n

2.3. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/b><\/h3>\n

– D\u1ecbch t\u1ec5: <\/i><\/b>ti\u1ec1n s\u1eed ti\u1ebfp x\u00fac v\u1edbi th\u1ef1c ph\u1ea9m ho\u1eb7c ngu\u1ed3n n\u01b0\u1edbc b\u1ecb \u00f4 nhi\u1ec5m hay tr\u1ef1c ti\u1ebfp qua quan h\u1ec7 t\u00ecnh d\u1ee5c mi\u1ec7ng – h\u1eadu m\u00f4n, ho\u1eb7c ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam gan virus A<\/span><\/p>\n

– L\u00e2m s\u00e0ng: <\/i><\/b>ch\u00e1n \u0103n, m\u1ec7t m\u1ecfi, v\u00e0ng m\u1eaft-v\u00e0ng da<\/span><\/p>\n

– C\u1eadn l\u00e2m s\u00e0ng: <\/i><\/b>anti HAV IgM (+)<\/span><\/p>\n

2.4. Ch\u1ea9n \u0111o\u00e1n th\u1ec3 l\u00e2m s\u00e0ng:<\/b><\/h3>\n

2.4.1. Vi\u00eam gan virus A c\u1ea5p t\u00ednh:<\/span><\/h4>\n

Tri\u1ec7u ch\u1ee9ng ch\u1ee7 y\u1ebfu l\u00e0 s\u1ed1t, \u0111au m\u1ecfi c\u01a1, nh\u1ee9c \u0111\u1ea7u, ch\u00e1n \u0103n, m\u1ec7t m\u1ecfi, n\u01b0\u1edbc ti\u1ec3u s\u1eabm m\u00e0u, v\u00e0ng m\u1eaft, v\u00e0ng da t\u0103ng d\u1ea7n. Di\u1ec5n bi\u1ebfn th\u01b0\u1eddng t\u1ef1 kh\u1ecfi.<\/span><\/p>\n

2.4.2. Vi\u00eam gan vi r\u00fat A t\u1ed1i c\u1ea5p (2%): <\/span><\/p>\n

S\u1ed1t cao, v\u00e0ng m\u1eaft, m\u1ec7t l\u1ea3, gan teo nh\u1ecf, h\u00f4n m\u00ea gan d\u1eabn \u0111\u1ebfn t\u1eed vong<\/span><\/p>\n

2.4.3. Vi\u00eam gan vi r\u00fat A k\u00e9o d\u00e0i: <\/span><\/h4>\n

\u00cdt g\u1eb7p. \u1ee8 m\u1eadt k\u00e9o d\u00e0i \u0111\u00f4i khi c\u00f3 th\u1ec3 x\u1ea3y ra t\u1eeb 2-3 th\u00e1ng, \u00edt \u0111\u1ec3 l\u1ea1i h\u1eadu qu\u1ea3 n\u1eb7ng n\u1ec1.<\/span><\/p>\n

3. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t b\u1ec7nh <\/b>vi\u00eam gan A<\/b><\/h2>\n

– C\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y vi\u00eam gan kh\u00e1c nh\u01b0: vi\u00eam gan nhi\u1ec5m \u0111\u1ed9c, vi\u00eam gan do virus kh\u00e1c, vi\u00eam gan t\u1ef1 mi\u1ec5n\u2026<\/span><\/p>\n

– C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y v\u00e0ng da kh\u00e1c: lepspirosis, s\u1ed1t r\u00e9t,\u2026m\u1ed9t s\u1ed1 c\u0103n nguy\u00ean nh\u01b0 t\u1eafc m\u1eadt c\u01a1 gi\u1edbi nh\u01b0 u \u0111\u1ea7u t\u1ee5y, u \u0111\u01b0\u1eddng m\u1eadt, s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt\u2026<\/span><\/p>\n

4. \u0110i\u1ec1u tr\u1ecb <\/b>vi\u00eam gan A<\/b><\/h2>\n

4.1. \u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u: <\/b><\/h3>\n

Vi\u00eam gan vi r\u00fat A kh\u00f4ng c\u00f3 \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u.<\/span><\/p>\n

4.2. \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3:<\/b><\/h3>\n

4.2.1. Ch\u1ebf \u0111\u1ed9 ch\u0103m s\u00f3c:<\/span><\/h4>\n

– Ngh\u1ec9 ng\u01a1i ho\u1ea1t \u0111\u1ed9ng nh\u1eb9 nh\u00e0ng.<\/span><\/p>\n

– \u0102n gi\u00e0u \u0111\u1ea1m, vitamin, gi\u1ea3m m\u1ee1 \u0111\u1ed9ng v\u1eadt. T\u0103ng c\u01b0\u1eddng hoa qu\u1ea3 t\u01b0\u01a1i.<\/span><\/p>\n

– Kh\u00f4ng r\u01b0\u1ee3u, bia v\u00e0 h\u1ea1n ch\u1ebf s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c, h\u00f3a ch\u1ea5t g\u00e2y \u0111\u1ed9c cho gan.<\/span><\/p>\n

4.2.2. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb:<\/span><\/h4>\n

– Thu\u1ed1c b\u1ea3o v\u1ec7 m\u00e0ng t\u1ebf b\u00e0o gan: nh\u01b0 nh\u00f3m BDD (Biphenyl Dimethyl Dicarboxylate).<\/span><\/p>\n

– Thu\u1ed1c t\u0103ng c\u01b0\u1eddng chuy\u1ec3n h\u00f3a: chuy\u1ec3n amoniac \u0111\u1ed9c h\u1ea1i th\u00e0nh ure nh\u01b0 nh\u00f3m L-Ornithin L-Aspartat, Lactulose.<\/span><\/p>\n

– Thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng kh\u1eed c\u00e1c g\u1ed1c t\u1ef1 do b\u1ea3o v\u1ec7 t\u1ebf b\u00e0o kh\u1ecfi c\u00e1c ch\u1ea5t oxy h\u00f3a c\u00f3 h\u1ea1i: Glutathione.<\/span><\/p>\n

– T\u0103ng c\u01b0\u1eddng c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u: Vitamin K, Plasma t\u01b0\u01a1i\u2026<\/span><\/p>\n

– Thu\u1ed1c l\u1ee3i m\u1eadt, s\u1eed d\u1ee5ng khi c\u00f3 v\u00e0ng m\u1eaft v\u00e0ng da: chophytol, sorbitol\u2026<\/span><\/p>\n

– Thu\u1ed1c l\u1ee3i ti\u1ec3u, s\u1eed d\u1ee5ng khi b\u1ec7nh nh\u00e2n ti\u1ec3u \u00edt, b\u1eaft \u0111\u1ea7u v\u1edbi nh\u00f3m kh\u00e1ng Aldosteron, c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u kh\u00e1c.<\/span><\/p>\n

5. Ph\u00f2ng b\u1ec7nh <\/b>vi\u00eam gan A<\/b><\/h2>\n

5.1. Ti\u00eam ph\u00f2ng vaccine<\/b>:<\/span><\/h3>\n

– T\u1ea5t c\u1ea3 tr\u1ebb em l\u1edbn h\u01a1n m\u1ed9t tu\u1ed5i.<\/span><\/p>\n

– Nh\u1eefng ng\u01b0\u1eddi c\u00f3 kh\u1ea3 n\u0103ng b\u1ecb ti\u1ebfp x\u00fac v\u1edbi HAV trong c\u00f4ng vi\u1ec7c.<\/span><\/p>\n

– Nh\u1eefng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng c\u00f3 quan h\u1ec7 t\u00ecnh d\u1ee5c \u0111\u1ed3ng gi\u1edbi.<\/span><\/p>\n

* Nh\u1eefng ng\u01b0\u1eddi c\u00f3 kh\u1ea3 n\u0103ng tr\u1edf th\u00e0nh b\u1ec7nh n\u1eb7ng n\u1ebfu h\u1ecd b\u1ecb nhi\u1ec5m HAV.<\/span><\/p>\n

(nh\u1eefng ng\u01b0\u1eddi c\u00f3 h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch b\u1ecb suy y\u1ebfu ho\u1eb7c b\u1ec7nh gan m\u00e3n t\u00ednh).<\/span><\/p>\n

5.2. Ph\u00f2ng b\u1ec7nh kh\u00f4ng \u0111\u1eb7c hi\u1ec7u:<\/b><\/h3>\n

– V\u1edbi ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m b\u1ec7nh: b\u1ec7nh nh\u00e2n n\u00ean r\u1eeda tay k\u1ef9 tr\u01b0\u1edbc, sau khi \u0103n v\u00e0 ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi kh\u00e1c.<\/span><\/p>\n

– V\u1edbi c\u1ed9ng \u0111\u1ed3ng: c\u00f3 th\u1ec3 gi\u1ea3m c\u01a1 h\u1ed9i b\u1ecb nhi\u1ec5m b\u1eb1ng c\u00e1c c\u00e1ch sau:<\/span><\/p>\n

+ R\u1eeda tay v\u1edbi x\u00e0 ph\u00f2ng tr\u01b0\u1edbc khi \u0103n.<\/span><\/p>\n

+ Kh\u00f4ng n\u00ean \u0103n h\u1ea3i s\u1ea3n s\u1ed1ng ho\u1eb7c n\u1ea5u ch\u01b0a ch\u00edn t\u1eeb c\u00e1c khu v\u1ef1c s\u00f4ng bi\u1ec3n b\u1ecb \u00f4 nhi\u1ec5m\u2026<\/span><\/p>\n

Vi\u00eam gan A l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd gan c\u1ea5p t\u00ednh. N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi c\u00f3 th\u1ec3 d\u1eabn t\u1edbi nh\u1eefng v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng nh\u01b0 x\u01a1 gan v\u00e0 ung th\u01b0 gan.<\/span><\/p>\n

\u00a0https:\/\/youtu.be\/chqZtI9tJSQ<\/span><\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/span><\/p>\n

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

B\u1ec7nh vi\u00eam gan vi rus A l\u00e0 m\u1ed9t b\u1ec7nh vi\u00eam gan c\u1ea5p t\u00ednh do HAV(Hepatitis A Virus) g\u00e2y ra. B\u1ec7nh th\u01b0\u1eddng kh\u1ecfi ho\u00e0n to\u00e0n v\u00e0 kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng l\u00e2u d\u00e0i. Sau khi nhi\u1ec5m vi rus vi\u00eam gan A th\u00ec th\u01b0\u1eddng ng\u01b0\u1eddi \u0111\u00e3 b\u1ecb nhi\u1ec5m c\u00f3 mi\u1ec5n d\u1ecbch su\u1ed1t \u0111\u1eddi. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"\nVi\u00eam gan A: Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh vi\u00eam gan A l\u00e0 m\u1ed9t b\u1ec7nh vi\u00eam gan c\u1ea5p t\u00ednh do HAV g\u00e2y ra. 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