{"id":20724,"date":"2023-04-15T00:31:56","date_gmt":"2023-04-14T17:31:56","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20724"},"modified":"2023-04-18T15:27:12","modified_gmt":"2023-04-18T08:27:12","slug":"lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/","title":{"rendered":"Li\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em"},"content":{"rendered":"

Vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 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. B\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0111\u00fang, \u0111i\u1ec1u tr\u1ecb \u00a0s\u1edbm v\u00e0 t\u00edch c\u1ef1c. S\u1eed d\u1ee5ng kh\u00e1ng sinh \u0111\u00f3ng vai tr\u00f2 ch\u00ednh trong \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng n\u00e3o m\u1ee7. \u01afu ti\u00ean l\u1ef1a ch\u1ecdn kh\u00e1ng sinh nh\u1ea1y c\u1ea3m v\u1edbi c\u0103n nguy\u00ean th\u01b0\u1eddng g\u1eb7p theo l\u1ee9a tu\u1ed5i trong tr\u01b0\u1eddng h\u1ee3p ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh.\u00a0<\/strong><\/p>\n

1. Nguy\u00ean t\u1eafc s\u1eed d\u1ee5ng kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7<\/h2>\n

– Kh\u1ea3 n\u0103ng th\u1ea5m t\u1ed1t v\u00e0o m\u00e0ng n\u00e3o.<\/p>\n

– C\u00f3 t\u00ednh ch\u1ea5t di\u1ec7t khu\u1ea9n trong d\u1ecbch n\u00e3o tu\u1ef7<\/p>\n

– Thu\u1ed1c ph\u1ea3i \u0111\u1ee7 li\u1ec1u v\u00e0 d\u00f9ng theo \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 ti\u00eam t\u0129nh m\u1ea1ch ngay l\u1eadp t\u1ee9c, kh\u00f4ng n\u00ean tr\u00ec ho\u00e3n vi\u1ec7c d\u00f9ng kh\u00e1ng sinh m\u00e0 n\u00ean d\u00f9ng theo \u0111\u01b0\u1eddng ti\u00eam b\u1eafp<\/p>\n

– \u01afu ti\u00ean ch\u1ecdn c\u00e1c kh\u00e1ng sinh nh\u1ea1y c\u1ea3m v\u1edbi c\u00e1c c\u0103n nguy\u00ean th\u01b0\u1eddng g\u1eb7p trong tr\u01b0\u1eddng h\u1ee3p ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh. Khi x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u0103n nguy\u00ean c\u1ea7n l\u1ef1a ch\u1ecdn kh\u00e1ng sinh theo kh\u00e1ng sinh \u0111\u1ed3.<\/p>\n

2. Li\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7<\/h2>\n

2.1. Khi ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c c\u0103n nguy\u00ean vi khu\u1ea9n:<\/h3>\n

Khi ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c c\u0103n nguy\u00ean vi khu\u1ea9n, li\u1ec7u ph\u00e1p kh\u00e1ng sinh \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh theo l\u1ee9a tu\u1ed5i b\u1ec7nh nh\u00e2n, c\u1ee5 th\u1ec3 nh\u01b0 sau:<\/p>\n

\"Li\u1ec7u
Li\u1ec7u ph\u00e1p kh\u00e1ng sinh \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em khi ch\u01b0a x\u00e1c \u0111\u1ecbnh c\u0103n nguy\u00ean<\/figcaption><\/figure>\n

2.2. Li\u1ec7u ph\u00e1p kh\u00e1ng sinh khi \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c c\u0103n nguy\u00ean g\u00e2y vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 (c\u00f3 k\u1ebft qu\u1ea3 c\u1ea5y d\u1ecbch n\u00e3o tu\u1ef7 d\u01b0\u01a1ng t\u00ednh v\u00e0 c\u00f3 kh\u00e1ng sinh \u0111\u1ed3):<\/h3>\n

– V\u1edbi Ph\u1ebf c\u1ea7u (S. Pneumoniae):<\/p>\n

+ N\u1ebfu vi khu\u1ea9n c\u00f2n nh\u1ea1y c\u1ea3m v\u1edbi Penicilin: D\u00f9ng Benzyl Penicilin li\u1ec1u 60mg\/kg ti\u00eam TM ch\u1eadm cho m\u1ed7i 6 gi\u1edd (250.000UI \/kg\/24h).<\/p>\n

+ N\u1ebfu kh\u00f4ng l\u00e0m \u0111\u01b0\u1ee3c hay kh\u00f4ng c\u00f3 kh\u00e1ng sinh \u0111\u1ed3 v\u00e0 MIC n\u1ed3ng \u0111\u1ed9 \u1ee9c ch\u1ebf t\u1ed1i thi\u1ec3u (MIC) >0,125mg\/l c\u1ea7n d\u00f9ng Cefotaxime ho\u1eb7c Ceftriaxone theo c\u00e1ch d\u00f9ng t\u1ea1i b\u1ea3ng tr\u00ean, ph\u1ed1i h\u1ee3p v\u1edbi Vancomycine 60mg\/kg\/24h chia 4 l\u1ea7n truy\u1ec1n t\u0129nh m\u1ea1ch , ph\u1ed1i h\u1ee3p Rifampicin 20mg\/kg chia 2 l\u1ea7n u\u1ed1ng . Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng ph\u1ea3i k\u00e9o d\u00e0i t\u1eeb 10-14 ng\u00e0y.<\/p>\n

– V\u1edbi H. Influenzae: D\u00f9ng Cefotaxime ho\u1eb7c Ceftriaxone theo c\u00e1ch d\u00f9ng t\u1ea1i b\u1ea3ng tr\u00ean.<\/strong> Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng t\u1eeb 7-10 ng\u00e0y. N\u1ebfu kh\u00f4ng \u0111\u00e1p \u1ee9ng ph\u1ed1i h\u1ee3p pefloxacine 10 \u2013 15 mg\/kg\/ng\u00e0y chia 2 -3 l\u1ea7n truy\u1ec1n t\u0129nh m\u1ea1ch trong ng\u00e0y hay Meropenem 120mg\/kg\/ng\u00e0y chia 3-4 l\u1ea7n ti\u00eam m\u1ea1ch hay truy\u1ec1n t\u0129nh m\u1ea1ch.<\/p>\n

– V\u1edbi N\u00e3o m\u00f4 c\u1ea7u (N. Meningitidis): Penicillin G 250000UI\/kg\/24h; ho\u1eb7c Ampicillin 200mg\/kg\/24h IV chia 4 l\u1ea7n. C\u0169ng c\u00f3 th\u1ec3 d\u00f9ng Cefotaxime ho\u1eb7c Ceftriaxone theo c\u00e1ch d\u00f9ng v\u00e0 li\u1ec1u l\u01b0\u1ee3ng \u0111\u00e3 n\u00eau trong b\u1ea3ng tr\u00ean. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng t\u1eeb 5 – 7 ng\u00e0y.<\/p>\n

– V\u1edbi c\u00e1c lo\u1ea1i tr\u1ef1c khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t Gr (-): D\u00f9ng Cefotaxime ho\u1eb7c Ceftriaxone ph\u1ed1i h\u1ee3p v\u1edbi Gentamycin nh\u01b0 \u0111\u00e3 n\u00eau trong b\u1ea3ng tr\u00ean. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng k\u00e9o d\u00e0i h\u01a1n t\u1edbi 3 tu\u1ea7n.<\/p>\n

– Ri\u00eang v\u1edbi Listeria c\u1ea7n d\u00f9ng Benzyl Penicilin (li\u1ec1u 250.000UI \/ Kg \/ 24h chia 4 l\u1ea7n) ho\u1eb7c Ampicillin (li\u1ec1u 300 mg \/ Kg \/ 24h chia 4 – 6 l\u1ea7n). (k\u1ebft h\u1ee3p Trimethoprim + sulfamethoxazole li\u1ec1u \u201c5 + 25\u201d mg\/Kg cho m\u1ed7i 6 gi\u1edd (\u201c20+100\u201d\/Kg\/24h), ho\u1eb7c k\u1ebft h\u1ee3p Gentamicin theo li\u1ec1u 5mg\/Kg\/24h cho nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng). Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng t\u1eeb 2-3 tu\u1ea7n.<\/p>\n

Ch\u00fa \u00fd:
\nTr\u00ean nh\u1eefng tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 c\u00f3 bi\u1ec3u hi\u1ec7n suy gan, suy th\u1eadn li\u1ec1u kh\u00e1ng sinh s\u1eed d\u1ee5ng c\u1ea7n \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc, t\u00ednh to\u00e1n c\u1ee5 th\u1ec3 tu\u1ef3 theo m\u1ee9c \u0111\u1ed9 suy gan, th\u1eadn v\u00e0 t\u00ecnh tr\u1ea1ng b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o m\u1ee7<\/p>\n

3.\u0110i\u1ec1u tr\u1ecb ph\u1ed1i h\u1ee3p<\/h2>\n

– N\u1ebfu b\u1ec7nh nh\u00e2n h\u00f4n m\u00ea ho\u1eb7c c\u00f3 d\u1ea5u hi\u1ec7u nhi\u1ec5m khu\u1ea9n n\u1eb7ng, \u0111e do\u1ea1 shock nhi\u1ec5m khu\u1ea9n c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, ch\u0103m s\u00f3c t\u1ea1i ph\u00f2ng c\u1ea5p c\u1ee9u ho\u1eb7c \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c.<\/p>\n

– Ch\u1ed1ng ph\u00f9 n\u00e3o n\u1ebfu c\u00f3 bi\u1ec3u hi\u1ec7n t\u0103ng \u00e1p l\u1ef1c s\u1ecd b\u1eb1ng manitol 20%<\/p>\n

– N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 co gi\u1eadt: C\u1eaft c\u01a1n gi\u1eadt b\u1eb1ng Seduxen, li\u1ec1u 0,1- 0,2mg \/kg\/l\u1ea7n pha trong dung d\u1ecbch NaCl 0,9% ti\u00eam t\u0129nh m\u1ea1ch ch\u1eadm cho t\u1edbi khi ng\u1eebng gi\u1eadt. N\u1ebfu v\u1eabn c\u00f2n gi\u1eadt c\u00f3 th\u1ec3 ti\u00eam l\u1ea1i c\u1ee9 sau m\u1ed7i 10 ph\u00fat nh\u01b0ng kh\u00f4ng qu\u00e1 3 l\u1ea7n. Ph\u00f2ng co gi\u1eadt b\u1eb1ng Barbituric (Gardenal) u\u1ed1ng li\u1ec1u 5 – 20mg\/kg\/ng\u00e0y, k\u1ebft h\u1ee3p v\u1edbi vi\u1ec7c d\u00f9ng thu\u1ed1c h\u1ea1 nhi\u1ec7t, ch\u1ed1ng ph\u00f9 n\u00e3o, c\u00e2n b\u1eb1ng n\u01b0\u1edbc, \u0111i\u1ec7n gi\u1ea3i v\u00e0 th\u0103ng b\u1eb1ng toan ki\u1ec1m khi c\u1ea7n thi\u1ebft.<\/p>\n

– N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 suy h\u00f4 h\u1ea5p c\u1ea7n \u0111\u01b0\u1ee3c cho th\u1edf oxy ho\u1eb7c h\u00f4 h\u1ea5p h\u1ed7 tr\u1ee3, k\u1ec3 c\u1ea3 cho th\u1edf m\u00e1y khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh.<\/p>\n

– Ch\u1ed1ng vi\u00eam b\u1eb1ng Dexamethason li\u1ec1u 0,2-0,4 mg\/kg\/ng\u00e0y chia 2 l\u1ea7n ti\u00eam t\u0129nh m\u1ea1ch ch\u1eadm trong 3 ng\u00e0y \u0111\u1ea7u cho nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng.<\/p>\n

– Ch\u1ebf \u0111\u1ed9 ch\u0103m s\u00f3c v\u00e0 nu\u00f4i d\u01b0\u1ee1ng: B\u1ea3o \u0111\u1ea3m th\u00f4ng kh\u00ed, ch\u1ed1ng \u1ee9 \u0111\u1ecdng \u0111\u1eddm r\u00e3i (h\u00fat \u0111\u1eddm r\u00e3i, v\u1ed7 rung, \u0111\u1eb7t t\u01b0 th\u1ebf n\u1eb1m ngi\u00eang, \u0111\u1ea7u th\u1ea5p…). N\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng \u0103n \u0111\u01b0\u1ee3c c\u1ea7n cho \u0103n qua sonde v\u00e0 nu\u00f4i d\u01b0\u1ee1ng h\u1ed7 tr\u1ee3 b\u1eb1ng \u0111\u01b0\u1eddng t\u0129nh<\/p>\n

4. Theo d\u00f5i ti\u1ebfn tri\u1ec3n v\u00e0 bi\u1ebfn ch\u1ee9ng<\/h2>\n

C\u1ea7n kh\u00e1m x\u00e9t v\u00e0 theo d\u00f5i b\u1ec7nh nh\u00e2n vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 h\u00e0ng ng\u00e0y ho\u1eb7c h\u00e0ng gi\u1edd tu\u1ef3 theo t\u00ecnh tr\u1ea1ng b\u1ec7nh n\u1eb7ng, nh\u1eb9 v\u1ec1 c\u00e1c ch\u1ee9c n\u0103ng s\u1ed1ng (h\u00f4 h\u1ea5p, tu\u1ea7n ho\u00e0n…), t\u00ecnh tr\u1ea1ng tri gi\u00e1c, h\u1ed9i ch\u1ee9ng m\u00e0ng n\u00e3o, t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng…
\nTi\u1ebfn h\u00e0nh c\u00e1c x\u00e9t nghi\u1ec7m c\u1ea7n thi\u1ebft (\u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3, \u0111\u01b0\u1eddng m\u00e1u, kh\u00ed m\u00e1u…) cho nh\u1eefng b\u1ec7nh nh\u00e2n n\u1eb7ng \u0111\u1ec3 gi\u00fap cho \u0111i\u1ec1u tr\u1ecb. Ri\u00eang ch\u1ecdc d\u00f2 d\u1ecbch n\u00e3o tu\u1ef7 th\u01b0\u1eddng ti\u1ebfn h\u00e0nh 3 l\u1ea7n: L\u00fac v\u00e0o vi\u1ec7n (\u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh), sau \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh t\u1eeb 1-3 ng\u00e0y (\u0111\u1ec3 \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 c\u1ee7a li\u1ec7u ph\u00e1p kh\u00e1ng sinh v\u00e0 c\u00e2n nh\u1eafc vi\u1ec7c thay \u0111\u1ed5i kh\u00e1ng sinh khi c\u1ea7n thi\u1ebft) v\u00e0 tr\u01b0\u1edbc khi ra vi\u1ec7n (\u0111\u1ec3 b\u1ea3o \u0111\u1ea3m kh\u1ecfi b\u1ec7nh).<\/p>\n

Ti\u00eau chu\u1ea9n kh\u1ecfi b\u1ec7nh ho\u00e0n to\u00e0n: H\u1ebft s\u1ed1t, l\u00e2m s\u00e0ng ho\u00e0n to\u00e0n b\u00ecnh th\u01b0\u1eddng \u00edt nh\u1ea5t 3 ng\u00e0y; d\u1ecbch n\u00e3o tu\u1ef7 tr\u1edf v\u1ec1 ng\u01b0\u1ee1ng b\u00ecnh th\u01b0\u1eddng.<\/p>\n

M\u1ed9t s\u1ed1 bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 g\u1eb7p:<\/p>\n

    \n
  • Tr\u00e0n d\u1ecbch d\u01b0\u1edbi m\u00e0ng c\u1ee9ng, \u1ed5 abces n\u1ed9i s\u1ecd: Th\u01b0\u1eddng b\u1ec7nh nh\u00e2n c\u00f3 t\u00ecnh tr\u1ea1ng t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd, c\u00e1c d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng v\u1eabn dai d\u1eb3ng, d\u1ecbch n\u00e3o tu\u1ef7 v\u1eabn bi\u1ebfn \u0111\u1ed5i.<\/li>\n
  • \u1ee8 d\u1ecbch n\u00e3o th\u1ea5t : g\u1eb7p ch\u1ee7 y\u1ebfu \u1edf tr\u1ebb nh\u1ecf. C\u00e1c d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng v\u00e0 d\u1ecbch n\u00e3o tu\u1ef7 c\u1ea3i thi\u1ec7n nh\u01b0ng c\u00f3 d\u1ea5u hi\u1ec7u t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd, gi\u00e3n \u0111\u01b0\u1eddng kh\u1edbp, th\u00f3p c\u0103ng…C\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u1ea7n x\u00e1c \u0111\u1ecbnh b\u1eb1ng ch\u1ee5p CT scan s\u1ecd n\u00e3o (v\u1edbi tr\u1ebb nh\u1ecf c\u00f3 th\u1ec3 si\u00eau \u00e2m qua th\u00f3p) v\u00e0 c\u00e2n nh\u1eafc kh\u1ea3 n\u0103ng ph\u1ed1i h\u1ee3p \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i khoa.<\/li>\n
  • C\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00e1c c\u00f3 th\u1ec3 g\u1eb7p l\u00e0 b\u1ea1i n\u00e3o, \u0111\u1ed9ng kinh, \u0111i\u1ebfc hay gi\u1ea3m th\u00ednh l\u1ef1c v.v…<\/li>\n<\/ul>\n

    C\u1ea7n ch\u00fa \u00fd l\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng th\u01b0\u1eddng x\u1ea3y ra \u1edf tr\u1ebb nh\u1ecf, ch\u1ea9n \u0111o\u00e1n mu\u1ed9n, \u0111i\u1ec1u tr\u1ecb kh\u00f4ng \u0111\u00fang.<\/p>\n

    Ngu\u1ed3n tham kh\u1ea3o:<\/p>\n

      \n
    1. B\u1ed9 Y T\u1ebf<\/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","protected":false},"excerpt":{"rendered":"

      Vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh c\u1ea5p c\u1ee9u nguy hi\u1ec3m, 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 ch\u1ee9ng kh\u00e1 cao. B\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0111\u00fang, \u0111i\u1ec1u tr\u1ecb \u00a0s\u1edbm v\u00e0 t\u00edch c\u1ef1c. S\u1eed d\u1ee5ng kh\u00e1ng sinh \u0111\u00f3ng vai tr\u00f2 […]<\/p>\n","protected":false},"author":39,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[15,33],"tags":[3],"yoast_head":"\nLi\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em - Vinmec<\/title>\n<meta name=\"description\" content=\"\u01afu ti\u00ean l\u1ef1a ch\u1ecdn kh\u00e1ng sinh nh\u1ea1y c\u1ea3m v\u1edbi c\u0103n nguy\u00ean th\u01b0\u1eddng g\u1eb7p theo l\u1ee9a tu\u1ed5i trong tr\u01b0\u1eddng h\u1ee3p ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Li\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em - Vinmec\" \/>\n<meta property=\"og:description\" content=\"\u01afu ti\u00ean l\u1ef1a ch\u1ecdn kh\u00e1ng sinh nh\u1ea1y c\u1ea3m v\u1edbi c\u0103n nguy\u00ean th\u01b0\u1eddng g\u1eb7p theo l\u1ee9a tu\u1ed5i trong tr\u01b0\u1eddng h\u1ee3p ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-14T17:31:56+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-18T08:27:12+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6499F3A6-511E-4BBB-88EC-574C431948BE.jpeg\" \/>\n<meta name=\"author\" content=\"Tra Hoang Thi\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Tra Hoang Thi\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/\",\"name\":\"Li\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em - Vinmec\",\"isPartOf\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-14T17:31:56+00:00\",\"dateModified\":\"2023-04-18T08:27:12+00:00\",\"author\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/839ce96e9202c472dad79292a547f41b\"},\"description\":\"\u01afu ti\u00ean l\u1ef1a ch\u1ecdn kh\u00e1ng sinh nh\u1ea1y c\u1ea3m v\u1edbi c\u0103n nguy\u00ean th\u01b0\u1eddng g\u1eb7p theo l\u1ee9a tu\u1ed5i trong tr\u01b0\u1eddng h\u1ee3p ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Li\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"https:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/839ce96e9202c472dad79292a547f41b\",\"name\":\"Tra Hoang Thi\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/0.gravatar.com\/avatar\/f302681be22f41ba406c316b86d858c4?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/0.gravatar.com\/avatar\/f302681be22f41ba406c316b86d858c4?s=96&d=mm&r=g\",\"caption\":\"Tra Hoang Thi\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/chuotchu2001gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Li\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em - Vinmec","description":"\u01afu ti\u00ean l\u1ef1a ch\u1ecdn kh\u00e1ng sinh nh\u1ea1y c\u1ea3m v\u1edbi c\u0103n nguy\u00ean th\u01b0\u1eddng g\u1eb7p theo l\u1ee9a tu\u1ed5i trong tr\u01b0\u1eddng h\u1ee3p ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Li\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em - Vinmec","og_description":"\u01afu ti\u00ean l\u1ef1a ch\u1ecdn kh\u00e1ng sinh nh\u1ea1y c\u1ea3m v\u1edbi c\u0103n nguy\u00ean th\u01b0\u1eddng g\u1eb7p theo l\u1ee9a tu\u1ed5i trong tr\u01b0\u1eddng h\u1ee3p ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/","og_site_name":"Vinmec","article_published_time":"2023-04-14T17:31:56+00:00","article_modified_time":"2023-04-18T08:27:12+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/6499F3A6-511E-4BBB-88EC-574C431948BE.jpeg"}],"author":"Tra Hoang Thi","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Tra Hoang Thi","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/","name":"Li\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em - Vinmec","isPartOf":{"@id":"https:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-14T17:31:56+00:00","dateModified":"2023-04-18T08:27:12+00:00","author":{"@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/839ce96e9202c472dad79292a547f41b"},"description":"\u01afu ti\u00ean l\u1ef1a ch\u1ecdn kh\u00e1ng sinh nh\u1ea1y c\u1ea3m v\u1edbi c\u0103n nguy\u00ean th\u01b0\u1eddng g\u1eb7p theo l\u1ee9a tu\u1ed5i trong tr\u01b0\u1eddng h\u1ee3p ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/lieu-phap-khang-sinh-trong-viem-mang-nao-mu-o-tre-em\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Li\u1ec7u ph\u00e1p kh\u00e1ng sinh trong vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 \u1edf tr\u1ebb em"}]},{"@type":"WebSite","@id":"https:\/\/noithathoaphat.in\/ctv\/#website","url":"https:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/839ce96e9202c472dad79292a547f41b","name":"Tra Hoang Thi","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/0.gravatar.com\/avatar\/f302681be22f41ba406c316b86d858c4?s=96&d=mm&r=g","contentUrl":"http:\/\/0.gravatar.com\/avatar\/f302681be22f41ba406c316b86d858c4?s=96&d=mm&r=g","caption":"Tra Hoang Thi"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/chuotchu2001gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/20724"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/39"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=20724"}],"version-history":[{"count":14,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/20724\/revisions"}],"predecessor-version":[{"id":23551,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/20724\/revisions\/23551"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=20724"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=20724"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=20724"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}