{"id":20302,"date":"2023-04-15T00:28:19","date_gmt":"2023-04-14T17:28:19","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20302"},"modified":"2023-04-19T12:11:19","modified_gmt":"2023-04-19T05:11:19","slug":"co-che-benh-sinh-va-giai-phau-benh-viem-mang-nao-mu-o-tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/co-che-benh-sinh-va-giai-phau-benh-viem-mang-nao-mu-o-tre-em\/","title":{"rendered":"C\u01a1 ch\u1ebf b\u1ec7nh sinh v\u00e0 gi\u1ea3i ph\u1eabu b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em"},"content":{"rendered":"

Vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 l\u00e0 t\u00ecnh tr\u1ea1ng nhi\u1ec5m khu\u1ea9n m\u00e0ng n\u00e3o do c\u00e1c <\/strong>t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh c\u00f3 kh\u1ea3 n\u0103ng sinh m\u1ee7 (ch\u1ee7 y\u1ebfu l\u00e0 m\u1ed9t s\u1ed1 lo\u1ea1i vi khu\u1ea9n) x\u00e2m <\/strong>nh\u1eadp v\u00e0o m\u00e0ng n\u00e3o g\u00e2y n\u00ean. L\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh c\u1ea5p c\u1ee9u nguy hi\u1ec3m, <\/strong>th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb em, nhi\u1ec1u nh\u1ea5t l\u00e0 \u1edf l\u1ee9a tu\u1ed5i d\u01b0\u1edbi 3 tu\u1ed5i, t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 di <\/strong>ch\u1ee9ng kh\u00e1 cao.<\/strong><\/p>\n

1. Nguy\u00ean nh\u00e2n v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 vi\u00eam m\u00e0ng n\u00e3o m\u1ee7<\/h2>\n

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

C\u00f3 r\u1ea5t nhi\u1ec1u lo\u1ea1i vi khu\u1ea9n c\u00f3 th\u1ec3 g\u00e2y vi\u00eam m\u00e0ng n\u00e3o. T\u1ea7n su\u1ea5t m\u1eafc t\u1eebng lo\u1ea1i vi khu\u1ea9n t\u00f9y thu\u1ed9c v\u00e0o l\u1ee9a tu\u1ed5i b\u1ec7nh nh\u00e2n v\u00e0 m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 li\u00ean quan t\u1edbi s\u1ee9c \u0111\u1ec1 kh\u00e1ng c\u1ee7a c\u01a1 th\u1ec3. Ba lo\u1ea1i vi khu\u1ea9n g\u00e2y b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 hay g\u1eb7p nh\u1ea5t l\u00e0:<\/p>\n

    \n
  • Ph\u1ebf c\u1ea7u (Streptococcus pneumoniae)<\/li>\n
  • H. Influenzae (Haemophilus influenzae)<\/li>\n
  • N\u00e3o m\u00f4 c\u1ea7u (Neisseria meningitidis)<\/li>\n<\/ul>\n

    Ri\u00eang \u1edf giai \u0111o\u1ea1n s\u01a1 sinh v\u00e0 tr\u1ebb nh\u1ecf d\u01b0\u1edbi 3 th\u00e1ng tu\u1ed5i, c\u0103n nguy\u00ean g\u00e2y b\u1ec7nh th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 c\u00e1c lo\u1ea1i vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t (nh\u01b0 E. Coli…), Klebsiella, Listeria, li\u00ean c\u1ea7u nh\u00f3m B.
    \nNgo\u00e0i ra nhi\u1ec1u lo\u1ea1i vi khu\u1ea9n v\u00e0 n\u1ea5m kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 l\u00e0 c\u0103n nguy\u00ean g\u00e2y VMNM nh\u01b0ng \u00edt g\u1eb7p h\u01a1n v\u00e0 th\u01b0\u1eddng x\u1ea3y ra tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 t\u00ecnh tr\u1ea1ng\u00a0suy gi\u1ea3m mi\u1ec5n d\u1ecbch, nhi\u1ec5m khu\u1ea9n huy\u1ebft…<\/p>\n

    1.2 C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1<\/h3>\n

    1.2.1. M\u00f4i tr\u01b0\u1eddng s\u1ed1ng:<\/p>\n

    Tr\u1ebb em \u1edf m\u00f4i tr\u01b0\u1eddng t\u1eadp th\u1ec3 ( nh\u00e0 tr\u1ebb, m\u1eabu gi\u00e1o…) d\u1ec5 c\u00f3 nguy c\u01a1 m\u1eafc h\u01a1n c\u00e1c tr\u1ebb \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c t\u1ea1i nh\u00e0. Th\u01b0\u1eddng ghi nh\u1eadn l\u00e0 c\u00e1c vi khu\u1ea9n Heamophillus influenza tyb B v\u00e0 Neisseria meningitidis.<\/p>\n

    1.2.2. C\u00e1c y\u1ebfu t\u1ed1 ch\u1ee7 th\u1ec3<\/p>\n

    – C\u01a1 \u0111\u1ecba:<\/p>\n

      \n
    • Nam m\u1eafc nhi\u1ec1u h\u01a1n n\u1eef<\/li>\n
    • Tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb nh\u1ecf, nh\u1ea5t l\u00e0 tr\u1ebb \u0111\u1ebb non, suy dinh d\u01b0\u1ee1ng…<\/li>\n
    • Ng\u01b0\u1eddi b\u1ecb c\u1eaft l\u00e1ch d\u1ec5 b\u1ecb vi\u00eam m\u00e0ng n\u00e3o do ph\u1ebf c\u1ea7u, H.influenza tyb B v\u00e0 tr\u1ef1c khu\u1ea9n Gram \u00e2m.<\/li>\n<\/ul>\n

      –\u00a0 Tr\u1ebb hay b\u1ecb m\u1eafc c\u00e1c b\u1ec7nh: nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean, vi\u00eam tai gi\u1eefa , vi\u00eam tai x\u01b0\u01a1ng ch\u0169m, vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c …; c\u00e1c \u1ed5 nhi\u1ec5m tr\u00f9ng c\u1ea1nh m\u00e0ng n\u00e3o (vi\u00eam xoang s\u00e0ng, xoang b\u01b0\u1edbm, xoang tr\u00e1n…).<\/p>\n

      – C\u00e1c b\u1ec7nh l\u00fd to\u00e0n th\u00e2n: \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, suy gi\u1ea3m mi\u1ec5n d\u1ecbch, lao, \u0111i\u1ec1u tr\u1ecb corticoid…<\/p>\n

      – C\u00e1c b\u1ea5t th\u01b0\u1eddng h\u1ec7 th\u1ea7n kinh g\u00e2y r\u00f2 th\u00f4ng d\u1ecbch n\u00e3o t\u1ee7y: c\u00e1c d\u1ecb t\u1eadt b\u1ea9m sinh, tho\u00e1t v\u1ecb m\u00e0ng n\u00e3o t\u1ee7y…<\/p>\n

      – Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o, c\u00e1c ph\u1eabu thu\u1eadt th\u1ea7n kinh, d\u1eabn l\u01b0u n\u00e3o th\u1ea5t.<\/p>\n

      2. C\u01a1 ch\u1ebf b\u1ec7nh sinh vi\u00eam m\u00e0ng n\u00e3o m\u1ee7<\/h2>\n

      Vi khu\u1ea9n x\u00e2m nh\u1eadp v\u00e0o m\u00e0ng n\u00e3o theo ba con \u0111\u01b0\u1eddng: m\u00e1u, b\u1ea1ch huy\u1ebft v\u00e0 \u0111\u01b0\u1eddng k\u1ebf c\u1eadn.<\/p>\n

      \u1ede tr\u1ebb em, kh\u1edfi \u0111\u1ea7u vi khu\u1ea9n x\u00e2m nh\u1eadp qua ni\u00eam m\u1ea1c m\u0169i, h\u1ecdng, thanh qu\u1ea3n v\u00e0 ph\u1ebf qu\u1ea3n, t\u00f9y theo ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3, vi khu\u1ea9n c\u00f3 th\u1ec3 ch\u1ec9 khu tr\u00fa v\u00e0 g\u00e2y b\u1ec7nh t\u1ea1i ch\u1ed7 ho\u1eb7c v\u00e0o h\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u hay b\u1ea1ch huy\u1ebft. Qua \u0111\u01b0\u1eddng m\u00e1u, do ch\u1ee9c n\u0103ng b\u1ea3o v\u1ec7 c\u1ee7a h\u00e0ng r\u00e0o m\u00e1u n\u00e3o \u1edf tr\u1ebb nh\u1ecf ch\u01b0a ho\u00e0n ch\u1ec9nh, vi khu\u1ea9n c\u0169ng c\u00f3 th\u1ec3 x\u00e2m nh\u1eadp v\u00e0o m\u00e0ng n\u00e3o v\u00e0 g\u00e2y vi\u00eam m\u00e0ng n\u00e3o nhi\u1ec5m khu\u1ea9n ti\u00ean ph\u00e1t.<\/p>\n

      T\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh c\u00f3 th\u1ec3 t\u1eeb c\u00e1c \u1ed5 nhi\u1ec5m khu\u1ea9n trong c\u01a1 th\u1ec3, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c v\u1ecb tr\u00ed c\u1eadn k\u1ec1 m\u00e0ng n\u00e3o ( tai gi\u1eefa, x\u01b0\u01a1ng ch\u0169m, c\u00e1c xoang, h\u1ed1c m\u1eaft…) ho\u1eb7c t\u1eeb m\u1ed9t \u1edf vi\u00eam \u1edf xa (vi\u00eam ph\u1ed5i, vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c, nhi\u1ec5m khu\u1ea9n ti\u1ebft ni\u1ec7u, nhi\u1ec5m khu\u1ea9n ti\u00eau h\u00f3a…); do ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c v\u1ebft th\u01b0\u01a1ng v\u00f9ng s\u1ecd n\u00e3o, c\u1ed9t s\u1ed1ng… x\u00e2m nh\u1eadp v\u00e0o m\u00e0ng n\u00e3o g\u00e2y vi\u00eam m\u00e0ng n\u00e3o nhi\u1ec5m khu\u1ea9n th\u1ee9 ph\u00e1t.<\/p>\n

      Vi\u00eam m\u00e0ng n\u00e3o nhi\u1ec5m khu\u1ea9n x\u1ea3y ra khi c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh sinh v\u01b0\u1ee3t qua c\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng c\u1ee7a c\u01a1 th\u1ec3 ng\u01b0\u1eddi b\u1ec7nh. C\u01a1 ch\u1ebf n\u00e0y bao g\u1ed3m:<\/p>\n

        \n
      • T\u00e1c nh\u00e2n g\u00e2y vi\u00eam m\u00e0ng n\u00e3o k\u1ebft d\u00ednh \u0111\u01b0\u1ee3c v\u00e0 \u0111\u1ecbnh khu tr\u00ean b\u1ec1 m\u1eb7t bi\u1ec3u m\u00f4 ni\u00eam m\u1ea1c ng\u01b0\u1eddi b\u1ec7nh<\/li>\n
      • X\u00e2m nh\u1eadp v\u00e0 s\u1ed1ng s\u00f3t trong l\u00f2ng m\u1ea1ch m\u00e1u<\/li>\n
      • V\u01b0\u1ee3t qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o<\/li>\n
      • S\u1ed1ng \u0111\u01b0\u1ee3c trong d\u1ecbch n\u00e3o t\u1ee7y<\/li>\n<\/ul>\n

        M\u1ed9t khi vi khu\u1ea9n \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e2m nh\u1eadp v\u00e0o trong khoang m\u00e0ng nh\u1ec7n, c\u01a1 th\u1ec3 kh\u00f4ng c\u00f2n \u0111\u1ee7 kh\u1ea3 n\u0103ng \u0111\u1ec3 \u1ee9c ch\u1ebf s\u1ef1 nhi\u1ec5m khu\u1ea9n. Ng\u01b0\u1eddi ta \u0111\u00e3 ch\u1ee9ng minh \u0111\u01b0\u1ee3c r\u1eb1ng trong d\u1ecbch n\u00e3o t\u1ee7y, l\u01b0\u1ee3ng b\u1ed5 th\u1ec3 b\u1ecb gi\u1ea3m do b\u1ecb ph\u00e2n ho\u1ea1i b\u1edfi c\u00e1c protease b\u1ea1ch c\u1ea7u. \u0110i\u1ec1u n\u00e0y l\u00e0m cho ho\u1ea1t t\u00ednh opsonic b\u1ecb gi\u1ea3m \u0111i t\u1ea1i n\u01a1i nhi\u1ec5m khu\u1ea9n. N\u1ed3ng \u0111\u1ed9 Imunoglobulin (IgG) trong d\u1ecbch n\u00e3o t\u1ee7y c\u0169ng gi\u1ea3m nhi\u1ec1u so v\u1edbi n\u1ed3ng \u0111\u1ed9 trong m\u00e1u. Ngo\u00e0i ra, d\u00f9 c\u00f3 s\u1ef1 gia t\u0103ng b\u1ea1ch c\u1ea7u trong d\u1ecbch n\u00e3o t\u1ee7y, nh\u01b0ng c\u00e1c b\u1ea1ch c\u1ea7u n\u00e0y m\u1ea5t kh\u1ea3 n\u0103ng opsonic\u00a0v\u00e0 di\u1ec7t khu\u1ea9n, \u0111\u01b0a \u0111\u1ebfn s\u1ef1 gia t\u0103ng s\u1ed1 l\u01b0\u1ee3ng l\u1edbn vi khu\u1ea9n trong d\u1ecbch n\u00e3o t\u1ee7y. Do vi khu\u1ea9n s\u1eed d\u1ee5ng glucose qua chuy\u1ec3n h\u00f3a k\u1ef5 kh\u00ed s\u1ebd g\u00e2y ti\u00eau th\u1ee5 glucose r\u1ea5t m\u1ea1nh (l\u00e0m glucose d\u1ecbch n\u00e3o t\u1ee7y gi\u1ea3m th\u1ea5p) \u0111\u1ed3ng th\u1eddi vi khu\u1ea9n ti\u1ebft ch\u1ea5t lipopolysaccharid k\u00edch th\u00edch c\u00e1c ch\u1ea5t trung gian h\u00f3a h\u1ecdc g\u00e2y vi\u00eam nh\u01b0 prostaglandin, interleukin-1, TNF alpha g\u00e2y ra ph\u1ea3n \u1ee9ng vi\u00eam d\u1ecb \u1ee9ng (k\u00e9o theo b\u1ea1ch c\u1ea7u, b\u1ed5 th\u1ec3, kh\u00e1ng th\u1ec3… v\u00e0o d\u1ecbch n\u00e3o t\u1ee7y). T\u00ecnh tr\u1ea1ng nhi\u1ec5m \u0111\u1ed9c l\u00e0m thay \u0111\u1ed5i t\u00ednh th\u1ea5m th\u00e0nh m\u1ea1ch g\u00e2y ph\u00f9 n\u00e3o, t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd v\u00e0 gi\u1ea3m h\u1ea5p thu d\u1ecbch n\u00e3o t\u1ee7y. M\u1ed9t s\u1ed1 vi khu\u1ea9n c\u00f2n c\u00f3 th\u1ec3 x\u00e2m nh\u1eadp v\u00e0o t\u1ed5 ch\u1ee9c n\u00e3o g\u00e2y vi\u00eam nh\u1ec5m, ph\u00f9 n\u1ec1 n\u00e3o k\u00e9o theo c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng n\u1eb7ng n\u1ec1.<\/p>\n

        3. Gi\u1ea3i ph\u1eabu b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o m\u1ee7<\/h2>\n

        Ph\u1ea3n \u1ee9ng vi\u00eam m\u00e0ng n\u00e3o l\u00e0m cho m\u00e0ng n\u00e3o d\u00e0y l\u00ean nhi\u1ec1u nh\u1ea5t l\u00e0 \u1edf xung quanh c\u00e1c t\u0129nh m\u1ea1ch, d\u1ecdc theo chi\u1ec1u cong c\u1ee7a n\u00e3o b\u1ed9, theo c\u00e1c khuy\u1ebft s\u00e2u c\u1ee7a r\u00e3nh, quanh ti\u1ec3u n\u00e3o. L\u01b0u l\u01b0\u1ee3ng tu\u1ea7n ho\u00e0n n\u00e3o b\u1ecb r\u1ed1i lo\u1ea1n: vi\u00eam t\u1eafc t\u0129nh m\u1ea1ch v\u1ecf n\u00e3o g\u00e2y hi\u1ec7n t\u01b0\u1ee3ng h\u1eb9p l\u00f2ng m\u1ea1ch ho\u1eb7c huy\u1ebft t\u1eafc, \u0111\u01b0a \u0111\u1ebfn t\u00ecnh tr\u1ea1ng nh\u1ed3i m\u00e1u hay thi\u1ebfu m\u00e1u v\u00f9ng v\u1ecf n\u00e3o ho\u1eb7c d\u01b0\u1edbi v\u1ecf n\u00e3o. Vi khu\u1ea9n v\u00e0 hi\u1ec7n t\u01b0\u1ee3ng vi\u00eam kh\u00f4ng x\u00e2m nh\u1eadp tr\u1ef1c ti\u1ebfp v\u00e0o m\u00f4 n\u00e3o nh\u01b0ng ph\u1ea7n n\u00e3o k\u1ebf c\u1eadn hay b\u1ecb sung huy\u1ebft v\u00e0 ph\u00f9 n\u1ec1, t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd c\u00f3 th\u1ec3 g\u00e2y tr\u1edf ng\u1ea1i cho tu\u1ea7n ho\u00e0n n\u00e3o. Ph\u00f9 n\u00e3o \u0111\u00f4i khi x\u1ea3y ra kh\u00e1 tr\u1ea7m tr\u1ecdng m\u1eb7c d\u00f9 t\u1ebf b\u00e0o \u1edf d\u1ecbch n\u00e3o t\u1ee7y kh\u00f4ng cao l\u1eafm. \u1ede m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y g\u00e2y t\u1ee5t n\u00e3o \u1edf th\u00f9y th\u00e1i d\u01b0\u01a1ng hay ti\u1ec3u n\u00e3o, ch\u00e8n \u00e9p trung n\u00e3o v\u00e0 h\u00e0nh t\u1ee7y.<\/p>\n

        \"Gi\u1ea3i
        Gi\u1ea3i ph\u1eabu b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 (l\u1ea5y h\u00ecnh ko b\u1ecb c\u1eaft ch\u1eef e nhe)<\/figcaption><\/figure>\n

        M\u1ee7 m\u00e0ng n\u00e3o th\u01b0\u1eddng hi\u1ec7n di\u1ec7n trong khoang d\u01b0\u1edbi nh\u1ec7n, nhi\u1ec1u nh\u1ea5t l\u00e0 ph\u1ea7n \u0111\u00e1y v\u00e0 khoang g\u1ea7n ti\u1ec3u n\u00e3o, sau \u0111\u00f3 lan ra hai r\u00e3nh l\u1edbn tr\u00ean n\u00e3o. Th\u00e0nh n\u00e3o th\u1ea5t c\u0169ng c\u00f3 th\u1ec3 c\u00f3 m\u1ee7, m\u1ea5t l\u1edbp t\u1ebf b\u00e0o ph\u1ee7 m\u1eb7t trong n\u00e3o th\u1ea5t. Tr\u1ea7n m\u1ee7 m\u00e0ng c\u1ee9ng hi\u1ebfm x\u1ea3y ra h\u01a1n.<\/p>\n

        T\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh s\u1ecd x\u1ea3y ra n\u01a1i t\u00edch t\u1ee5 nhi\u1ec1u d\u1ecbch vi\u00eam. Th\u1ea7n kinh III v\u00e0 IV c\u00f3 th\u1ec3 t\u1ed5n th\u01b0\u01a1ng n\u1eb7ng do t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd. N\u00e3o \u00fang th\u1ee7y c\u00f3 th\u1ec3 x\u1ea3y ra do ngh\u1ebdn s\u1ef1 l\u01b0u th\u00f4ng c\u1ee7a d\u1ecbch n\u00e3o t\u1ee7y trong n\u00e3o th\u1ea5t hay ngo\u00e0i n\u00e3o.<\/p>\n

        T\u00f3m l\u1ea1i, c\u00f3 nhi\u1ec1u c\u0103n nguy\u00ean vi khu\u1ea9n g\u00e2y b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o m\u1ee7. Vi khu\u1ea9n c\u00f3 th\u1ec3 x\u00e2m nh\u1eadp v\u00e0o m\u00e0ng n\u00e3o qua nhi\u1ec1u con \u0111\u01b0\u1eddng: m\u00e1u, b\u1ea1ch huy\u1ebft v\u00e0 con \u0111\u01b0\u1eddng k\u1ebf c\u1eadn. Vi\u00eam m\u00e0ng n\u00e3o c\u00f3 th\u1ec3 g\u00e2y ph\u00f9 n\u00e3o, gi\u00e3n n\u00e3o th\u1ea5t v\u00e0 t\u1ee5 m\u1ee7 khoang d\u01b0\u1edbi nh\u1ec7n. V\u00ec v\u00e2y, c\u1ea7n ph\u00e1t hi\u1ec7n v\u00e0 ch\u1ea9n \u0111o\u00e1n s\u1edbm b\u1ec7nh \u0111\u1ec3 tr\u00e1nh c\u00e1c bi\u1ebfn ch\u1ee9ng n\u1eb7ng.<\/p>\n

        T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/p>\n

          \n
        1. Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y H\u00e0 N\u1ed9i (2020). B\u00e0i gi\u1ea3ng nhi khoa<\/li>\n
        2. Catherine L.Tacon and Oliver Flower (2012). Diagnosis and management of bacterial meningitis in the paediatric population: a review<\/li>\n<\/ol>\n

           <\/p>\n

           <\/p>\n

          <\/h2>\n","protected":false},"excerpt":{"rendered":"

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