{"id":21859,"date":"2023-04-16T14:07:40","date_gmt":"2023-04-16T07:07:40","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21859"},"modified":"2023-04-17T12:48:01","modified_gmt":"2023-04-17T05:48:01","slug":"chan-doan-va-dieu-tri-nhiem-trung-tieu-tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/chan-doan-va-dieu-tri-nhiem-trung-tieu-tre-em\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng ti\u1ec3u tr\u1ebb em"},"content":{"rendered":"

Nhi\u1ec5m tr\u00f9ng ti\u1ec3u\u00a0 l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u00e2m s\u00e0ng th\u01b0\u1eddng g\u1eb7p v\u00e0 quan tr\u1ecdng \u1edf tr\u1ebb em<\/a>. Nhi\u1ec5m tr\u00f9ng ti\u1ec3u tr\u00ean ( vi\u00eam \u0111\u00e0i b\u1ec3 th\u1eadn c\u1ea5p ) c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng th\u1eadn, suy th\u1eadn v\u00e0 b\u1ec7nh th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i. M\u1eb7c d\u00f9 tr\u1ebb vi\u00eam \u0111\u00e0i b\u1ec3 th\u1eadn c\u00f3 khuynh h\u01b0\u1edbng bi\u1ec3u hi\u1ec7n s\u1ed1t, ph\u00e2n bi\u1ec7t gi\u1eefa vi\u00eam \u0111\u00e0i b\u1ec3 th\u1eadn c\u1ea5p v\u00e0 vi\u00eam b\u00e0ng quang tr\u00ean l\u00e2m s\u00e0ng th\u01b0\u1eddng kh\u00f3, \u0111\u1eb7c bi\u1ec7t \u1edf tr\u1ebb < 2 tu\u1ed5i.<\/strong><\/p>\n

\"minh-hoa-nhiem-trung-tieu\"<\/p>\n

1. Ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng ti\u1ec3u: <\/strong><\/h2>\n

Nhi\u1ec5m tr\u00f9ng ti\u1ec3u \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh t\u1ed1t nh\u1ea5t khi c\u00f3 vi khu\u1ea9n ni\u1ec7u \u0111\u00e1ng k\u1ec3 \u1edf m\u1ed9t b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec3u b\u1ea1ch c\u1ea7u (b\u1eb1ng ch\u1ee9ng c\u1ee7a \u0111\u00e1p \u1ee9ng vi\u00eam). N\u1ebfu c\u1ea5y n\u01b0\u1edbc ti\u1ec3u m\u1ecdc c\u00f3 \u00fd ngh\u0129a Entrerococcus, Klebsiella ho\u1eb7c P.aeruginosa \u1edf m\u1ed9t tr\u1ebb c\u00f3 tri\u1ec7u ch\u1ee9ng c\u1ee7a nhi\u1ec5m tr\u00f9ng ti\u1ec3u, nhi\u1ec5m tr\u00f9ng ti\u1ec3u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n trong s\u1ef1 v\u1eafng m\u1eb7t c\u1ee7a ti\u1ec3u<\/p>\n

Vi khu\u1ea9n ni\u1ec7u c\u00f3 \u00fd ngh\u0129a:<\/em><\/p>\n

+ \u2265 100.000 CFU\/ml n\u01b0\u1edbc ti\u1ec3u m\u1ed9t lo\u1ea1i vi khu\u1ea9n g\u00e2y b\u1ec7nh \u0111\u01b0\u1eddng ni\u1ec7u: n\u01b0\u1edbc ti\u1ec3u gi\u1eeda d\u00f2ng<\/p>\n

+ \u2265 50.000 CFU\/ml n\u01b0\u1edbc ti\u1ec3u m\u1ed9t lo\u1ea1i vi khu\u1ea9n g\u00e2y b\u1ec7nh \u0111\u01b0\u1eddng ni\u1ec7u: n\u01b0\u1edbc ti\u1ec3u qua th\u00f4ng ti\u1ec3u<\/p>\n

+ B\u1ea5t k\u1ef3 vi khu\u1ea9n g\u00e2y b\u1ec7nh \u0111\u01b0\u1eddng ti\u1ec3u: ch\u1ecdc h\u00fat b\u00e0ng quang<\/p>\n

K\u1ebft qu\u1ea3 \u00e2m t\u00ednh gi\u1ea3: kh\u00e1ng sinh ki\u1ec1m khu\u1ea9n trong n\u01b0\u1edbc ti\u1ec3u, t\u1ed1c \u0111\u1ed9 l\u01b0u l\u01b0\u1ee3ng n\u01b0\u1edbc ti\u1ec3u nhanh, t\u1eaft ngh\u1ebdn ni\u1ec7u qu\u1ea3n l\u00e0m gi\u1ea3m b\u00e0i ti\u1ebft vi khu\u1ea9n v\u00e0o b\u00e0ng quang.<\/p>\n

Ti\u1ec3u b\u1ea1ch c\u1ea7u: <\/em>s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a B\u1ea1ch c\u1ea7u trong n\u01b0\u1edbc ti\u1ec3u l\u00e0 kh\u00f4ng \u0111\u1eb7c hi\u1ec7u cho nhi\u1ec5m tr\u00f9ng ti\u1ec3u. Tuy nhi\u00ean, nhi\u1ec5m tr\u00f9ng ti\u1ec3u th\u1eadt s\u1ef1 nh\u01b0ng kh\u00f4ng c\u00f3 ti\u1ec3u b\u1ea1ch c\u1ea7u \u00edt g\u1eb7p, chi\u1ebfm t\u1ef7 l\u1ec7 10%.<\/p>\n

C\u00e1c tr\u1ebb nghi ng\u1edd c\u00f3 nhi\u1ec5m tr\u00f9ng ti\u1ec3u d\u1ef1a tr\u00ean k\u1ebft qu\u1ea3 c\u1ea5y d\u01b0\u01a1ng t\u00ednh m\u1ed9t t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh kh\u00f4ng ph\u1ea3i Entrerococcus, Klebsiella ho\u1eb7c P.aeruginosa m\u00e0 kh\u00f4ng c\u00f3 B\u1ea1ch c\u1ea7u ni\u1ec7u, l\u1eadp l\u1ea1i t\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u v\u00e0 c\u1ea5y n\u01b0\u1edbc ti\u1ec3u c\u00f3 th\u1ec3 gi\u00fap ph\u00e2n bi\u1ec7t gi\u1eeda nhi\u1ec5m tr\u00f9ng s\u1edbm v\u00e0 vi khu\u1ea9n x\u00e2m nh\u1eadp:<\/p>\n

– B\u1ea1ch c\u1ea7u ni\u1ec7u v\u00e0 vi khu\u1ea9n ni\u1ec7u trong m\u1eabu l\u1ea7n hai g\u1ee3i \u00fd nhi\u1ec5m tr\u00f9ng ti\u1ec3u<\/p>\n

– Kh\u00f4ng c\u00f3 B\u1ea1ch c\u1ea7u ni\u1ec7u v\u00e0 vi khu\u1ea9n ni\u1ec7u trong m\u1eabu l\u1ea7n hai g\u1ee3i \u00fd ngo\u1ea1i nhi\u1ec5m m\u1eabu n\u01b0\u1edbc ti\u1ec3u l\u1ea7n \u0111\u1ea7u<\/p>\n

    \n
  • Vi khu\u1ea9n ni\u1ec7u m\u00e0 kh\u00f4ng c\u00f3 B\u1ea1ch c\u1ea7u trong m\u1eabu n\u01b0\u1edbc ti\u1ec3u l\u1ea7n hai g\u1ee3i \u00fd vi khu\u1ea9n ni\u1ec7u kh\u00f4ng tri\u1ec7u ch\u1ee9ng.<\/li>\n<\/ul>\n

    2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/h2>\n

    Vi khu\u1ea9n ni\u1ec7u kh\u00f4ng tri\u1ec7u ch\u1ee9ng: c\u00f3 s\u01b0 hi\u1ec7n di\u1ec7n c\u1ee7a vi khu\u1ea9n trong \u0111\u01b0\u1eddng ti\u1ec3u nh\u01b0ng kh\u00f4ng g\u00e2y ph\u1ea3n \u1ee9ng vi\u00eam. Vi khu\u1ea9n th\u01b0\u1eddng c\u00f3 \u0111\u1ed9c l\u1ef1c th\u1ea5p v\u00e0 t\u1ef1 gi\u1ea3i quy\u1ebft m\u00e0 kh\u00f4ng g\u00e2y s\u1eb9o th\u1eadn, gi\u1ea3m \u0111\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn. \u0110i\u1ec1u tr\u1ecb kh\u00e1ng sinh kh\u00f4ng c\u00f3 l\u1ee3i cho tr\u1ebb v\u1ec1 l\u00e2u d\u00e0i.<\/p>\n

    Vi\u00eam \u00e2m h\u1ed9 \u00e2m \u0111\u1ea1o kh\u00f4ng \u0111\u1eb7c hi\u1ec7u, vi\u00eam ni\u1ec7u \u0111\u1ea1o k\u00edch \u1ee9ng, s\u1ecfi ni\u1ec7u, vi\u00eam ni\u1ec7u \u0111\u1ea1o th\u1ee9 ph\u00e1t do b\u1ec7nh l\u00e2y truy\u1ec1n qua t\u00ecnh d\u1ee5c c\u00f3 th\u1ec3 g\u00e2y c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a \u0111\u01b0\u1eddng ti\u1ec3u (ti\u1ec3u g\u1ea5p, ti\u1ec3u l\u1eaft nh\u1eaft, ti\u1ec3u \u0111au) v\u00e0 c\u00f3 vi khu\u1ea9n ni\u1ec7u.<\/p>\n

    R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng ru\u1ed9t b\u00e0ng quang v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a \u0111\u01b0\u1eddng ti\u1ec3u v\u00e0 c\u1ea5y n\u01b0\u1edbc ti\u1ec3u \u00e2m t\u00ednh.<\/p>\n

    3.\u00a0 \u0110i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng ti\u1ec3u:<\/h2>\n
      \n
    • M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb: lo\u1ea1i tr\u1eeb nhi\u1ec5m tr\u00f9ng v\u00e0 ph\u00f2ng nhi\u1ec5m tr\u00f9ng huy\u1ebft, l\u00e0m gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ea5p (s\u1ed1t, ti\u1ec3u \u0111au, ti\u1ec3u l\u1eaft nh\u1eaft), ph\u00f2ng ng\u1eeba t\u00e1i ph\u00e1t v\u00e0 bi\u1ebfn ch\u1ee9ng l\u00e2u d\u00e0i nh\u01b0 cao huy\u1ebft \u00e1p, s\u1eb9o th\u1eadn, suy ch\u1ee9c n\u0103ng th\u1eadn.<\/li>\n<\/ul>\n

      \u0110i\u1ec1u tr\u1ecb kh\u00e1ng sinh: <\/em><\/strong>\u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh theo kinh nghi\u1ec7m n\u00ean b\u1eaft \u0111\u1ea7u ngay sau khi \u0111\u00e3 thu th\u1eadp n\u01b0\u1edbc ti\u1ec3u \u1edf tr\u1ebb nghi ng\u1edd nhi\u1ec5m tr\u00f9ng ti\u1ec3u v\u00e0 c\u00f3 T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u d\u01b0\u01a1ng t\u00ednh, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng tr\u1ebb c\u00f3 nguy c\u01a1 cao s\u1eb9o th\u1eadn n\u1ebfu nhi\u1ec5m tr\u00f9ng ti\u1ec3u kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb s\u1edbm: s\u1ed1t > 390<\/sup>C, v\u1ebb b\u1ec7nh n\u1eb7ng, nh\u1ea1y \u0111au g\u00f3c s\u01b0\u1eddn c\u1ed9t s\u1ed1ng, suy gi\u1ea3m mi\u1ec5n d\u1ecbch ho\u1eb7c d\u1ecb d\u1ea1ng ti\u1ebft ni\u1ec7u \u0111\u00e3 bi\u1ebft.<\/p>\n

      Ch\u1ecdn l\u1ef1a kh\u00e1ng sinh n\u00ean t\u00f9y v\u00e0o t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh th\u01b0\u1eddng g\u1eb7p v\u00e0 s\u1ef1 nh\u1ea1y c\u1ea3m c\u1ee7a vi tr\u00f9ng. C\u00e1c cephalosporine th\u1ebf h\u1ec7 3 (cefixime, cefpodoxime, cefdinir, ceftibuten, cefotaxime, ceftriaxone) v\u00e0 aminoglycoside l\u00e0 c\u00e1c thu\u1ed1c ban \u0111\u1ea7u ph\u00f9 h\u1ee3p. C\u00e1c thu\u1ed1c n\u00e0y kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb Enterococcus v\u00e0 kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng \u0111\u01a1n \u0111\u1ed9c cho c\u00e1c b\u1ec7nh nh\u00e2n nghi ng\u1edd nhi\u1ec5m tr\u00f9ng ti\u1ec3u do Enterococcus (\u0111\u1eb7t th\u00f4ng ti\u1ec3u, d\u1ee5ng c\u1ee5 trong \u0111\u01b0\u1eddng ti\u1ec3u, b\u1ea5t th\u01b0\u1eddng gi\u1ea3i ph\u1eabu). C\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y n\u00ean k\u1ebft h\u1ee3p th\u00eam amoxicillin ho\u1eb7c ampicillin.<\/p>\n

      Kh\u00e1ng sinh u\u1ed1ng: <\/em>Ph\u1ea7n l\u1edbn c\u00e1c tr\u1ebb > 2 th\u00e1ng kh\u00f4ng n\u00f4n \u00f3i v\u00e0 kh\u00f4ng c\u00f3 b\u1ea5t th\u01b0\u1eddng ni\u1ec7u sinh d\u1ee5c c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh u\u1ed1ng (cephalosporine th\u1ebf h\u1ec7 3). Amoxicillin, amoxicillin-clavulanic, cephalosporine th\u1ebf h\u1ec7 1, bactrim n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng v\u00ec t\u1ef7 l\u1ec7 \u0111\u1ec1 kh\u00e1ng ng\u00e0y c\u00e0ng t\u0103ng. Fluroquinolone r\u1ea5t c\u00f3 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb E.coli, t\u1ef7 l\u1ec7 kh\u00e1ng thu\u1ed1c \u1edf tr\u1ebb em l\u00e0 hi\u1ebfm. Cirofloxacine kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng nh\u01b0 thu\u1ed1c ban \u0111\u1ea7u \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng ti\u1ec3u m\u00e0 ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng ti\u1ec3u do Pseudomonas aeruginosa ho\u1eb7c do c\u00e1c vi khu\u1ea9n gram \u00e2m \u0111a kh\u00e1ng kh\u00e1c.<\/p>\n

      Kh\u00e1ng sinh t\u1ec9nh m\u1ea1ch: <\/em>cho c\u00e1c b\u1ec7nh nhi < 2 th\u00e1ng, nhi\u1ec5m tr\u00f9ng huy\u1ebft tr\u00ean l\u00e2m s\u00e0ng (nhi\u1ec5m \u0111\u1ed9c, h\u1ea1 huy\u1ebft \u00e1p, ph\u1ee5c h\u1ed3i mao m\u1ea1ch k\u00e9m), suy gi\u1ea3m mi\u1ec5n d\u1ecbch, \u00f3i v\u00e0 kh\u00f4ng th\u1ec3 u\u1ed1ng thu\u1ed1c, th\u1ea5t b\u1ea1i \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh u\u1ed1ng, tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang ni\u1ec7u qu\u1ea3n III-V. Kh\u00e1ng sinh t\u0129nh m\u1ea1ch ban \u0111\u1ea7u th\u00edch h\u1ee3p : Ampicill + Gentamycine, gentamycine \u0111\u01a1n \u0111\u1ed9c, cephalosporine th\u1ebf h\u1ec7 3 ho\u1eb7c 4. N\u1ebfu nghi ng\u1edd nhi\u1ec5m tr\u00f9ng ti\u1ec3u do Enterococcus, n\u00ean k\u1ebft h\u1ee3p th\u00eam Ampicillin. \u0110i\u1ec1u tr\u1ecb ti\u1ebfp theo t\u00f9y thu\u1ed9c v\u00e0o \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng v\u00e0 s\u1ef1 nh\u1ea1y c\u1ea3m c\u1ee7a vi tr\u00f9ng tr\u00ean kh\u00e1ng sinh \u0111\u1ed3. \u0110\u00e1p \u1ee9ng l\u00e2m s\u00e0ng (h\u1ebft s\u1ed1t) th\u01b0\u1eddng trong 24 \u2013 48 gi\u1edd. N\u1ebfu t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng x\u1ea5u h\u01a1n ho\u1eb7c kh\u00f4ng c\u1ea3i thi\u1ec7n trong 48 gi\u1edd, thay \u0111\u1ed5i kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng v\u00e0 th\u00eam kh\u00e1ng sinh \u0111i\u1ec1u tr\u1ecb Enterococcus n\u1ebfu ch\u01b0a c\u00f3 k\u1ebft qu\u1ea3 vi sinh. C\u1ea7n SA b\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a apxe th\u1eadn, t\u1eafc ngh\u1ebdn ho\u1eb7c c\u00e1c b\u1ea5t th\u01b0\u1eddng gi\u1ea3i ph\u1eabu c\u00f3 th\u1ec3 can thi\u1ec7p ph\u1eabu thu\u1eadt.<\/p>\n

      Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb: <\/em>3 \u2013 5 ng\u00e0y cho tr\u1ebb nhi\u1ec5m tr\u00f9ng ti\u1ec3u d\u01b0\u1edbi v\u00e0 mi\u1ec5n d\u1ecbch \u0111\u1ea7y \u0111\u1ee7. \u00cdt nh\u1ea5t 10 ng\u00e0y cho tr\u1ebb nhi\u1ec5m tr\u00f9ng ti\u1ec3u c\u00f3 s\u1ed1t, c\u00f3 th\u1ec3 chuy\u1ec3n t\u1eeb kh\u00e1ng sinh ch\u00edch qua u\u1ed1ng khi tr\u1ebb h\u1ebft s\u1ed1t 24 gi\u1edd v\u00e0 c\u00f3 th\u1ec3 u\u1ed1ng \u0111\u01b0\u1ee3c.<\/p>\n

      4. Qu\u1ea3n l\u00fd l\u00e2u d\u00e0i v\u00e0 ph\u00f2ng ng\u1eeba nhi\u1ec5m tr\u00f9ng ti\u1ec3u t\u00e1i ph\u00e1t:<\/h2>\n

      Gi\u00e1o d\u1ee5c gia \u0111\u00ecnh c\u00e1c tr\u1ebb nh\u1ecf b\u1ecb nhi\u1ec5m tr\u00f9ng ti\u1ec3u v\u1ec1 nguy c\u01a1\u00a0t\u00e1i ph\u00e1t v\u00e0 nhanh ch\u00f3ng t\u00ecm s\u1ef1 tr\u1ee3 gi\u00fap y t\u1ebf khi tr\u1ebb c\u00f3 s\u1ed1t v\u00e0 \/ ho\u1eb7c c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1eddng ti\u1ec3u.<\/p>\n

      C\u1ea5y n\u01b0\u1edbc ti\u1ec3u t\u1ea7m so\u00e1t th\u01b0\u1eddng quy \u1edf c\u00e1c tr\u1ebb kh\u00f4ng tri\u1ec7u ch\u1ee9ng sau nhi\u1ec5m tr\u00f9ng ti\u1ec3u l\u1ea7n \u0111\u1ea7u l\u00e0 kh\u00f4ng c\u1ea7n thi\u1ebft.<\/p>\n

      \u0110i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n b\u00e0ng quang ru\u1ed9t: \u0111i ti\u1ec3u \u0111\u1ecbnh gi\u1edd ( m\u1ed7i 2 \u2013 3 gi\u1edd ), \u0111i ti\u1ec3u 2 l\u1ea7n, thu\u1ed1c nhu\u1eadn tr\u01b0\u1eddng, c\u00e1c b\u00e0i t\u1eadp c\u01a1 s\u00e0n ch\u1eadu\u2026<\/p>\n

      D\u1ef1 ph\u00f2ng kh\u00e1ng sinh cho nhi\u1ec5m tr\u00f9ng ti\u1ec3u:<\/p>\n

      Ch\u1ec9 \u0111\u1ecbnh:<\/p>\n

        \n
      • Tr\u1ebb < 3 tu\u1ed5i c\u00f3 tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang ni\u1ec7u qu\u1ea3n c\u00f3 d\u00e3n ( \u0111\u1ed9 III \u2013 V), d\u1ef1 ph\u00f2ng t\u1edbi 3 tu\u1ed5i ho\u1eb7c \u00edt nh\u1ea5t 2 n\u0103m sau 1 \u0111\u1ee3t nhi\u1ec5m tr\u00f9ng ti\u1ec3u c\u00f3 s\u1ed1t<\/li>\n
      • Tr\u1ebb \u2265 3 tu\u1ed5i v\u1edbi tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang ni\u1ec7u qu\u1ea3n c\u00f3 d\u00e3n ( \u0111\u1ed9 III \u2013 V) v\u00e0 nhi\u1ec5m tr\u00f9ng ti\u1ec3u c\u00f3 s\u1ed1t, d\u1ef1 ph\u00f2ng t\u1edbi 2 n\u0103m sau 1 \u0111\u1ee3t nhi\u1ec5m tr\u00f9ng ti\u1ec3u c\u00f3 s\u1ed1t.<\/li>\n<\/ul>\n

        Nhi\u1ec5m tr\u00f9ng ti\u1ec3u t\u00e1i ph\u00e1t, d\u1ef1 ph\u00f2ng \u00edt nh\u1ea5t 6 th\u00e1ng kh\u00f4ng c\u00f3 nhi\u1ec5m tr\u00f9ng ti\u1ec3u. Kh\u00e1ng sinh d\u1ef1 ph\u00f2ng: thu\u1ed1c \u0111\u01b0\u1ee3c u\u1ed1ng 1 l\u1ea7n v\u00e0o t\u1ed1i, tr\u01b0\u1edbc ng\u1ee7<\/p>\n

        Cotrimoxazole 2mg\/kg (trimethoprime), kh\u00f4ng s\u1eed d\u1ee5ng khi thi\u1ebfu men G6PD<\/p>\n

        Nitrofurantoin 1- 2 mg\/kg, kh\u00f4ng s\u1eed d\u1ee5ng khi thi\u1ebfu men G6PD v\u00e0 tr\u00e1nh \u1edf tr\u1ebb < 3 th\u00e1ng.<\/p>\n

        5.\u00a0\u00a0\u00a0 Ti\u00ean l\u01b0\u1ee3ng:<\/h2>\n

        Ph\u1ea7n l\u1edbn tr\u1ebb nhi\u1ec5m tr\u00f9ng ti\u1ec3u kh\u00f4ng c\u00f3 c\u00e1c di ch\u1ee9ng l\u00e2u d\u00e0i:<\/p>\n

        + 1 nghi\u00ean c\u1ee9u 111 tr\u1ebb n\u1eef c\u00f3 nguy c\u01a1 cao, theo d\u00f5i 6 \u2013 32 n\u0103m sau \u0111\u1ee3t nhi\u1ec5m tr\u00f9ng ti\u1ec3u l\u1ea7n \u0111\u1ea7u, ch\u1ec9 6% c\u00f3 gi\u1ea3m \u0111\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn v\u00e0 kh\u00f4ng c\u00f3 b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i.<\/p>\n

        + 1 nghi\u00ean c\u1ee9u 226 tr\u1ebb nhi\u1ec5m tr\u00f9ng ti\u1ec3u theo d\u00f5i t\u1eeb 1 \u2013 41 n\u0103m, 2 c\u00f3 b\u1ec7nh th\u1eadn m\u1ea1n \u0111\u01b0\u1ee3c cho l\u00e0 do nhi\u1ec5m tr\u00f9ng ti\u1ec3u.<\/p>\n","protected":false},"excerpt":{"rendered":"

        Nhi\u1ec5m tr\u00f9ng ti\u1ec3u\u00a0 l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u00e2m s\u00e0ng th\u01b0\u1eddng g\u1eb7p v\u00e0 quan tr\u1ecdng \u1edf tr\u1ebb em. Nhi\u1ec5m tr\u00f9ng ti\u1ec3u tr\u00ean ( vi\u00eam \u0111\u00e0i b\u1ec3 th\u1eadn c\u1ea5p ) c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng th\u1eadn, suy th\u1eadn v\u00e0 b\u1ec7nh th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i. M\u1eb7c d\u00f9 tr\u1ebb vi\u00eam \u0111\u00e0i b\u1ec3 th\u1eadn c\u00f3 khuynh h\u01b0\u1edbng bi\u1ec3u hi\u1ec7n […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[15,33],"tags":[3],"yoast_head":"\nCh\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng ti\u1ec3u tr\u1ebb em - Vinmec<\/title>\n<meta name=\"description\" content=\"Nhi\u1ec5m tr\u00f9ng ti\u1ec3u (NTT) l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u00e2m s\u00e0ng th\u01b0\u1eddng g\u1eb7p v\u00e0 quan tr\u1ecdng \u1edf tr\u1ebb em. 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