{"id":22368,"date":"2023-04-21T23:20:32","date_gmt":"2023-04-21T16:20:32","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22368"},"modified":"2023-04-21T23:20:32","modified_gmt":"2023-04-21T16:20:32","slug":"viem-nao-do-virus-herpes-simplex-huong-dan-chan-doan-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/viem-nao-do-virus-herpes-simplex-huong-dan-chan-doan-dieu-tri\/","title":{"rendered":"B\u00ea\u0323nh vi\u00eam na\u0303o do virus Herpes – H\u01b0\u01a1\u0301ng d\u00e2\u0303n ch\u00e2\u0309n \u0111oa\u0301n va\u0300 \u0111i\u00ea\u0300u tri\u0323"},"content":{"rendered":"

B\u1ec7nh vi\u00eam na\u0303o do virus Herpes simplex<\/a> l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd nghi\u00eam tr\u1ecdng do virus herpes simplex t\u1ea5n c\u00f4ng h\u1ec7 th\u1ed1ng th\u1ea7n kinh trung \u01b0\u01a1ng, g\u00e2y ra vi\u00eam n\u00e3o v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan. Virus herpes simplex c\u00f3 hai lo\u1ea1i ch\u00ednh l\u00e0 HSV-1 v\u00e0 HSV-2, v\u1edbi HSV-1 th\u01b0\u1eddng g\u00e2y ra vi\u00eam n\u00e3o \u1edf tr\u1ebb em v\u00e0 ng\u01b0\u1eddi l\u1edbn tr\u1ebb, trong khi HSV-2 th\u01b0\u1eddng g\u00e2y ra vi\u00eam n\u00e3o \u1edf ng\u01b0\u1eddi l\u1edbn.<\/strong><\/p>\n

1. \u0110i\u0323nh nghi\u0303a vi\u00eam na\u0303o do virus Herpes<\/h2>\n

Vi\u00eam n\u00e3o do virus Herpes <\/em>l\u00e0 b\u1ec7nh nhi\u1ec5m tr\u00f9ng th\u1ea7n kinh c\u1ea5p t\u00ednh, xu\u1ea5t hi\u1ec7n t\u1ea3n ph\u00e1t kh\u00f4ng mang t\u00ednh ch\u1ea5t m\u00f9a. Virus Herpes <\/em>x\u00e2m nh\u1eadp v\u00e0o h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng, g\u00e2y ho\u1ea1i t\u1eed nhu m\u00f4 n\u00e3o k\u00e8m xu\u1ea5t huy\u1ebft. B\u1ec7nh th\u01b0\u1eddng kh\u1edfi ph\u00e1t c\u1ea5p t\u00ednh. Bi\u1ec3u hi\u1ec7n b\u1eb1ng s\u1ed1t, r\u1ed1i lo\u1ea1n \u00fd th\u1ee9c, di\u1ec5n bi\u1ebfn n\u1eb7ng v\u00e0 c\u00f3 nguy c\u01a1 g\u00e2y t\u1eed vong cao. Tuy nhi\u00ean, n\u1ebfu \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n s\u1edbm, \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u b\u1eb1ng Acyclovir t\u0129nh m\u1ea1ch v\u00e0 ch\u0103m s\u00f3c t\u00edch c\u1ef1c, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 ti\u00ean l\u01b0\u1ee3ng t\u1ed1t.<\/p>\n

2.\u00a0 Nguy\u00ean nh\u00e2n vi\u00eam na\u0303o do virus Herpes<\/h2>\n

C\u0103n nguy\u00ean g\u00e2y b\u1ec7nh l\u00e0 virus Herpes simplex <\/em>(HSV) typ 1 (> 95% s\u1ed1 ca b\u1ec7nh) v\u00e0 typ 2 (< 5% s\u1ed1 ca b\u1ec7nh). HSV thu\u1ed9c h\u1ecd Herpeviridae<\/em>. Vi\u00eam n\u00e3o do HSV c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n trong nhi\u1ec5m virus ti\u00ean ph\u00e1t ho\u1eb7c do virus t\u1ed3n t\u1ea1i ti\u1ec1m t\u00e0ng trong c\u01a1 th\u1ec3 t\u00e1i ho\u1ea1t v\u00e0 x\u00e2m nh\u1eadp v\u00e0o h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng g\u00e2y n\u00ean.<\/p>\n

\"Vi\u00eam
Vi\u00eam na\u0303o do virus Herpes<\/figcaption><\/figure>\n

3.\u00a0 Ch\u00e2\u0309n \u0111oa\u0301n vi\u00eam na\u0303o do virus Herpes<\/h2>\n

3.1. L\u00e2m s\u00e0ng<\/strong><\/h3>\n
    \n
  • Kh\u1edfi ph\u00e1t \u0111\u1ed9t ng\u1ed9t;<\/li>\n
  • S\u1ed1t, \u0111au \u0111\u1ea7u; d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng th\u00f9y th\u00e1i d\u01b0\u01a1ng v\u00e0 th\u00f9y tr\u00e1n n\u00e3o nh\u01b0 thay \u0111\u1ed5i c\u1ea3m nh\u1eadn m\u00f9i ho\u1eb7c m\u1ea5t c\u1ea3m gi\u00e1c m\u00f9i, thay \u0111\u1ed5i t\u00ednh c\u00e1ch, m\u1ea5t tr\u00ed nh\u1edb; c\u00e1c bi\u1ec3u hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng n\u00e3o kh\u00e1c nh\u01b0: co gi\u1eadt, h\u00f4n m\u00ea, v\u2026<\/li>\n
  • Vi\u00eam n\u00e3o c\u00f3 th\u1ec3 \u0111i k\u00e8m v\u1edbi vi\u00eam m\u00e0ng n\u00e3o v\u00e0 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 c\u00e1c bi\u1ec3u hi\u1ec7n c\u1ee9ng g\u00e1y, d\u1ea5u Kernig d\u01b0\u01a1ng t\u00ednh.<\/li>\n<\/ul>\n

    3.2.\u00a0\u00a0 C\u1eadn l\u00e2m s\u00e0ng<\/h3>\n
      \n
    • C\u00f4ng th\u1ee9c m\u00e1u: kh\u00f4ng c\u00f3 bi\u1ebfn \u0111\u1ed5i \u0111\u1eb7c hi\u1ec7u.<\/li>\n
    • D\u1ecbch n\u00e3o t\u1ee7y: protein th\u01b0\u1eddng t\u0103ng nh\u1eb9 < 1 g\/l; b\u1ea1ch c\u1ea7u t\u0103ng (10-200 t\u1ebf b\u00e0o\/mm3<\/sup>, hi\u1ebfm khi > 500\/mm3<\/sup>), \u0111a s\u1ed1 l\u00e0 Trong giai \u0111o\u1ea1n s\u1edbm, b\u1ea1ch c\u1ea7u trung t\u00ednh c\u00f3 th\u1ec3 chi\u1ebfm \u01b0u th\u1ebf. C\u00f3 th\u1ec3 g\u1eb7p h\u1ed3ng c\u1ea7u trong DNT do t\u00ecnh tr\u1ea1ng xu\u1ea5t huy\u1ebft ho\u1ea1i t\u1eed nhu m\u00f4 n\u00e3o. DNT c\u00f3 th\u1ec3 b\u00ecnh th\u01b0\u1eddng trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p.<\/li>\n
    • Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh: t\u1ed5n th\u01b0\u01a1ng n\u00e3o c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n sau kh\u1edfi ph\u00e1t tri\u1ec7u ch\u1ee9ng 2-4 ng\u00e0y; ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI) c\u00f3 \u0111\u1ed9 nh\u1ea1y cao h\u01a1n ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh trong vi\u1ec7c ph\u00e1t hi\u1ec7n s\u1edbm nh\u1eefng t\u1ed5n th\u01b0\u01a1ng tr\u00ean n\u00e3o do HSV v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong giai \u0111o\u1ea1n \u0111\u1ea7u c\u1ee7a b\u1ec7nh. T\u1ed5n th\u01b0\u01a1ng g\u1ee3i \u00fd vi\u00eam n\u00e3o do HSV bao g\u1ed3m gi\u1ea3m t\u00edn hi\u1ec7u th\u00ec T1 v\u00e0 t\u0103ng t\u00edn hi\u1ec7u th\u00ec T2 \u1edf ch\u1ea5t x\u00e1m th\u00f9y th\u00e1i d\u01b0\u01a1ng trong v\u00e0 th\u00f9y tr\u00e1n, c\u00f3 th\u1ec3 c\u00f3 xu\u1ea5t huy\u1ebft k\u00e8m theo; t\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng kh\u00f4ng \u0111\u1ed1i x\u1ee9ng, c\u00f3 th\u1ec3 lan \u0111\u1ebfn th\u00f9y \u0111\u1ea3o v\u00e0 g\u00f3c h\u1ed3i h\u1ea3i m\u00e3. MRI b\u00ecnh th\u01b0\u1eddng trong kho\u1ea3ng 10% s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 HSV-PCR (+).<\/li>\n
    • \u0110i\u1ec7n n\u00e3o \u0111\u1ed3 (EEG): c\u00f3 ho\u1ea1t \u0111\u1ed9ng s\u00f3ng ch\u1eadm kh\u00f4ng \u0111\u1eb7c hi\u1ec7u trong 5-7 ng\u00e0y \u0111\u1ea7u c\u1ee7a b\u1ec7nh, ti\u1ebfp theo l\u00e0 s\u00f3ng nh\u1ecdn k\u1ecbch ph\u00e1t ho\u1eb7c ph\u1ee9c h\u1ee3p pha \u01b0u th\u1ebf \u1edf v\u00f9ng th\u00e1i d\u01b0\u01a1ng; c\u00f3 th\u1ec3 g\u1eb7p bi\u1ec3u hi\u1ec7n ph\u00f3ng \u0111i\u1ec7n d\u1ea1ng \u0111\u1ed9ng kinh b\u00ean t\u1eebng \u0111\u1ee3t \u1edf th\u00f9y th\u00e1i d\u01b0\u01a1ng, th\u01b0\u1eddng \u1edf ng\u00e0y th\u1ee9 2-14 c\u1ee7a b\u1ec7nh.<\/li>\n<\/ul>\n

      3.3.\u00a0\u00a0 Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/h3>\n

      C\u1ea7n ngh\u0129 t\u1edbi vi\u00eam n\u00e3o do HSV \u1edf b\u1ea5t c\u1ee9 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 bi\u1ec3u hi\u1ec7n vi\u00eam n\u00e3o c\u1ea5p t\u00ednh n\u00e0o, nh\u1ea5t l\u00e0 trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh l\u1ebb t\u1ebb kh\u00f4ng mang t\u00ednh ch\u1ea5t m\u00f9a c\u00f3 c\u00e1c bi\u1ec3u hi\u1ec7n g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng th\u00f9y th\u00e1i d\u01b0\u01a1ng ho\u1eb7c th\u00f9y tr\u00e1n n\u00e3o \u1edf m\u1ed9t b\u00ean.<\/p>\n

      Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh vi\u00eam n\u00e3o do HSV: x\u00e9t nghi\u1ec7m PCR ADN HSV d\u1ecbch n\u00e3o t\u1ee7y. X\u00e9t nghi\u1ec7m c\u00f3 \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u cao. PCR HSV c\u00f3 th\u1ec3 \u00e2m t\u00ednh gi\u1ea3 khi x\u00e9t nghi\u1ec7m trong v\u00f2ng 1-3 ng\u00e0y sau kh\u1edfi b\u1ec7nh.<\/p>\n

      3.4.\u00a0\u00a0 Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h3>\n

      Vi\u00eam n\u00e3o do HSV c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi vi\u00eam m\u00e0ng n\u00e3o m\u1ee7, vi\u00eam n\u00e3o – m\u00e0ng n\u00e3o do c\u00e1c c\u0103n nguy\u00ean virus kh\u00e1c.<\/p>\n

        \n
      • Vi\u00eam m\u00e0ng n\u00e3o m\u1ee7: vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 c\u0169ng di\u1ec5n bi\u1ebfn c\u1ea5p t\u00ednh, c\u00f3 s\u1ed1t, v\u00e0 c\u00f3 th\u1ec3 \u0111i k\u00e8m v\u1edbi r\u1ed1i lo\u1ea1n \u00fd th\u1ee9c, t\u01b0\u01a1ng t\u1ef1 nh\u01b0 vi\u00eam n\u00e3o do HSV. DNT trong VMN m\u1ee7 c\u00f3 t\u0103ng protein (th\u01b0\u1eddng > 1 g\/L), \u0111\u01b0\u1eddng gi\u1ea3m, t\u1ebf b\u00e0o t\u0103ng cao (v\u00e0i tr\u0103m \u0111\u1ebfn h\u00e0ng ch\u1ee5c ngh\u00ecn t\u1ebf b\u00e0o\/mm3<\/sup>), ch\u1ee7 y\u1ebfu l\u00e0 b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n trung t\u00ednh. Soi v\u00e0 c\u1ea5y DNT cho ph\u00e9p x\u00e1c \u0111\u1ecbnh vi khu\u1ea9n g\u00e2y b\u1ec7nh.<\/li>\n
      • Vi\u00eam n\u00e3o do c\u00e1c virus kh\u00e1c (vi\u00eam n\u00e3o Nh\u1eadt B\u1ea3n, c\u00e1c lo\u1ea1i Enterovirus, v.v…) c\u00f3 th\u1ec3 c\u00f3 di\u1ec5n bi\u1ebfn t\u01b0\u01a1ng t\u1ef1 nh\u01b0 vi\u00eam n\u00e3o do HSV; bi\u1ebfn lo\u1ea1n DNT kh\u00f4ng kh\u00e1c bi\u1ec7t so v\u1edbi vi\u00eam n\u00e3o do HSV. T\u1ed5n th\u01b0\u01a1ng n\u00e3o lan t\u1ecfa tr\u00ean phim c\u1ed9ng h\u01b0\u1edfng t\u1eeb th\u01b0\u1eddng g\u1eb7p trong c\u00e1c vi\u00eam n\u00e3o do c\u00e1c virus kh\u00e1c, trong khi t\u1ed5n th\u01b0\u01a1ng trong vi\u00eam n\u00e3o do HSV c\u00f3 \u01b0u th\u1ebf \u1edf th\u00f9y tr\u00e1n v\u00e0 th\u00f9y th\u00e1i d\u01b0\u01a1ng. X\u00e9t nghi\u1ec7m PCR \u0111\u1eb7c hi\u1ec7u cho c\u00e1c virus vi\u00eam n\u00e3o Nh\u1eadt B\u1ea3n, Enterovirus c\u00f3 gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n c\u00e1c c\u0103n nguy\u00ean n\u00e0y.<\/li>\n<\/ul>\n

        4.\u00a0 \u0110i\u00ea\u0300u tri\u0323 vi\u00eam na\u0303o do virus Herpes<\/h2>\n

        4.1. M\u1ee5c ti\u00eau v\u00e0 nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/strong><\/h3>\n

        \u0110i\u1ec1u tr\u1ecb vi\u00eam n\u00e3o do HSV bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u b\u1eb1ng thu\u1ed1c kh\u00e1ng virus acyclovir t\u0129nh m\u1ea1ch v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3. C\u1ea7n ch\u1ec9 \u0111\u1ecbnh s\u1edbm acyclovir ngay khi nghi ng\u1edd vi\u00eam n\u00e3o do HSV \u0111\u1ed3ng th\u1eddi v\u1edbi vi\u1ec7c ti\u1ebfn h\u00e0nh c\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n (MRI s\u1ecd n\u00e3o v\u00e0 PCR Herpes <\/em>d\u1ecbch n\u00e3o t\u1ee7y). \u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u mu\u1ed9n \u0111i k\u00e8m v\u1edbi nguy c\u01a1 t\u1eed vong cao v\u00e0 di ch\u1ee9ng th\u1ea7n kinh n\u1eb7ng n\u1ec1 trong tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh s\u1ed1ng s\u00f3t.<\/p>\n

        4.2. \u0110i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00e1ng virus acyclovir<\/h3>\n
          \n
        • Li\u1ec1u d\u00f9ng: Acyclovir 10 mg\/kg truy\u1ec1n t\u0129nh m\u1ea1ch 8 gi\u1edd m\u1ed9t l\u1ea7n. Acyclovir ph\u1ea3i \u0111\u01b0\u1ee3c pha t\u1edbi n\u1ed3ng \u0111\u1ed9 \u2264 7 mg\/ml (t\u1ed1i thi\u1ec3u 50 ml dung m\u00f4i cho 250 mg thu\u1ed1c ho\u1eb7c 100 ml cho 500 mg) v\u00e0 truy\u1ec1n trong th\u1eddi gian tr\u00ean 1 gi\u1edd \u0111\u1ec3 h\u1ea1n ch\u1ebf \u1ea3nh h\u01b0\u1edfng l\u00ean ch\u1ee9c n\u0103ng th\u1eadn. B\u00f9 \u0111\u1ee7 n\u01b0\u1edbc tr\u01b0\u1edbc v\u00e0 sau khi truy\u1ec1n acyclovir (d\u1ecbch v\u00e0o 2-3 l\u00edt\/ng\u00e0y), thay \u0111\u1ed5i v\u1ecb tr\u00ed truy\u1ec1n \u0111\u1ec3 tr\u00e1nh vi\u00eam m\u1ea1ch; th\u1eadn tr\u1ecdng khi d\u00f9ng ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c g\u00e2y \u0111\u1ed9c cho th\u1eadn v\u00e0 gi\u1ea3m li\u1ec1u khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 suy th\u1eadn.<\/li>\n
        • Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb: \u0111i\u1ec1u tr\u1ecb acyclovir t\u0129nh m\u1ea1ch trong 10-14 ng\u00e0y \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh vi\u00eam n\u00e3o do HSV kh\u00f4ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p vi\u00eam n\u00e3o do HSV n\u1eb7ng ho\u1eb7c ng\u01b0\u1eddi b\u1ec7nh suy gi\u1ea3m mi\u1ec5n d\u1ecbch, th\u1eddi gian \u0111i\u1ec1u tr\u1ecb acyclovir c\u00f3 th\u1ec3 k\u00e9o d\u00e0i \u0111\u1ebfn 21 ng\u00e0y. X\u00e9t nghi\u1ec7m l\u1ea1i PCR Herpes <\/em>DNT sau th\u1eddi \u0111i\u1ec3m n\u00e0y v\u00e0 d\u1eebng acyclovir khi kh\u00f4ng c\u00f2n ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c ADN c\u1ee7a virus trong d\u1ecbch n\u00e3o t\u1ee7y. Trong tr\u01b0\u1eddng h\u1ee3p PCR c\u00f2n d\u01b0\u01a1ng t\u00ednh, ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb acyclovir v\u00e0 x\u00e9t nghi\u1ec7m l\u1ea1i PCR sau 1 tu\u1ea7n; d\u1eebng \u0111i\u1ec1u tr\u1ecb khi x\u00e9t nghi\u1ec7m \u00e2m t\u00ednh.<\/li>\n<\/ul>\n

          Kh\u00f4ng khuy\u1ebfn c\u00e1o acyclovir u\u1ed1ng do kh\u1ea3 n\u0103ng h\u1ea5p thu qua ni\u00eam m\u1ea1c ru\u1ed9t th\u1ea5p v\u00e0 n\u1ed3ng \u0111\u1ed9 trong m\u00e1u\/d\u1ecbch n\u00e3o t\u1ee7y kh\u00f4ng b\u1ea3o \u0111\u1ea3m.<\/em><\/p>\n

          Trong tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb acyclovir t\u0129nh m\u1ea1ch do nghi ng\u1edd vi\u00eam n\u00e3o do HSV nh\u01b0ng sau \u0111\u00f3 ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb (x\u00e1c \u0111\u1ecbnh m\u1ed9t b\u1ec7nh l\u00fd kh\u00e1c, ho\u1eb7c kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u0111\u1eb7c tr\u01b0ng tr\u00ean phim MRI s\u1ecd n\u00e3o v\u00e0 PCR Herpes d\u1ecbch n\u00e3o t\u1ee7y \u00e2m t\u00ednh), ng\u1eebng \u0111i\u1ec1u tr\u1ecb acyclovir.<\/em><\/p>\n

          4.3.\u00a0\u00a0 \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3<\/h3>\n

          Ng\u01b0\u1eddi b\u1ec7nh vi\u00eam n\u00e3o do HSV trong giai \u0111o\u1ea1n \u0111\u1ea7u c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u00e0 ch\u0103m s\u00f3c t\u1ea1i khoa \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c; c\u00e1c ch\u1ee9c n\u0103ng s\u1ed1ng nh\u01b0 h\u00f4 h\u1ea5p, tu\u1ea7n ho\u00e0n c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd v\u00e0 can thi\u1ec7p khi c\u1ea7n thi\u1ebft. C\u00e1c \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 bao g\u1ed3m:<\/p>\n

            \n
          • H\u1ea1 nhi\u1ec7t b\u1eb1ng paracetamol u\u1ed1ng ho\u1eb7c truy\u1ec1n t\u0129nh m\u1ea1ch.<\/li>\n
          • \u0110i\u1ec1u tr\u1ecb t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.<\/li>\n
          • \u0110i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1n n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i.<\/li>\n
          • \u0110i\u1ec1u tr\u1ecb ch\u1ed1ng co gi\u1eadt n\u1ebfu x\u1ea3y<\/li>\n
          • \u0110i\u1ec1u tr\u1ecb corticoid \u0111\u1ed3ng th\u1eddi v\u1edbi acyclovir \u0111\u01b0\u1ee3c th\u1ea5y l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 trong vi\u00eam n\u00e3o do HSV do c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m ph\u00f9 n\u00e3o v\u00e0 gi\u1ea3m ph\u1ea3n \u1ee9ng vi\u00eam trong nhu m\u00f4 n\u00e3o.<\/li>\n
          • Kh\u00e1ng sinh ch\u1ed1ng b\u1ed9i nhi\u1ec5m n\u1ebfu c\u00f3 ch\u1ec9 \u0111\u1ecbnh.<\/li>\n<\/ul>\n

            5.\u00a0 Ti\u00ea\u0301n tri\u00ea\u0309n va\u0300 bi\u00ea\u0301n ch\u01b0\u0301ng vi\u00eam na\u0303o do virus Herpes<\/h2>\n

            Ng\u01b0\u1eddi b\u1ec7nh vi\u00eam n\u00e3o do HSV \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb s\u1edbm acyclovir t\u0129nh m\u1ea1ch th\u01b0\u1eddng ti\u1ebfn tri\u1ec3n t\u1ed1t d\u1ea7n, s\u1ed1t gi\u1ea3m d\u1ea7n v\u00e0 nhi\u1ec7t \u0111\u1ed9 tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng trong 3-5 ng\u00e0y,\u00a0 \u00fd th\u1ee9c c\u1ea3i thi\u1ec7n d\u1ea7n. C\u00e1c y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng t\u1ed1t bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u acyclovir s\u1edbm, ng\u01b0\u1eddi\u00a0 b\u1ec7nh tr\u1ebb tu\u1ed5i, t\u00ecnh tr\u1ea1ng tinh th\u1ea7n theo thang \u0111i\u1ec3m Glasgow l\u00fac b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb kh\u00f4ng qu\u00e1 th\u1ea5p. M\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh v\u1eabn c\u00f3 di ch\u1ee9ng v\u1ec1 th\u1ea7n kinh sau \u0111i\u1ec1u tr\u1ecb, nh\u1ea5t l\u00e0 ng\u01b0\u1eddi<\/p>\n

            50 tu\u1ed5i. C\u00e1c di ch\u1ee9ng c\u00f3 th\u1ec3 g\u1eb7p bao g\u1ed3m \u0111\u1ed9ng kinh, sa s\u00fat tr\u00ed tu\u1ec7, gi\u1ea3m tr\u00ed nh\u1edb, v.v… ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c l\u00e0m \u0111i\u1ec7n n\u00e3o \u0111\u1ed3 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111\u1ed9ng kinh, \u0111i\u1ec1u tr\u1ecb ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng n\u1ebfu c\u00f3 ch\u1ec9 \u0111\u1ecbnh.<\/p>\n

            6.\u00a0 Pho\u0300ng b\u00ea\u0323nh vi\u00eam na\u0303o do virus Herpes<\/h2>\n

            Hi\u1ec7n ch\u01b0a c\u00f3 bi\u1ec7n ph\u00e1p c\u00f3 hi\u1ec7u qu\u1ea3 \u0111\u1ec3 d\u1ef1 ph\u00f2ng vi\u00eam n\u00e3o do HSV.<\/p>\n

            T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/h3>\n
              \n
            1. Aksamit A.J. Herpes simplex encephalitis in adult and older children<\/em>. Current treatment options in neurology (2005) Vol 5, March; pp 53-57.<\/li>\n
            2. Corey L. Herpes simplex viruses. <\/em>Harrison\u2019s principles of internal medicine 16th edition, 2004; pp 1070-1074.<\/li>\n
            3. Solomon ,\u00a0 Michael\u00a0\u00a0 B.D.,\u00a0\u00a0 Smith\u00a0\u00a0 P.E.,\u00a0\u00a0 Sanderson\u00a0\u00a0 F.,\u00a0\u00a0 Davies\u00a0\u00a0 N.W.S.,\u00a0 Hart I.J., et al. Management of suspected viral encephalitis in adults. Association of British Neurologists and British Infection Association National Guidelines. Journal of Infection (2012) 64, 347e373.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

              B\u1ec7nh vi\u00eam na\u0303o do virus Herpes simplex l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd nghi\u00eam tr\u1ecdng do virus herpes simplex t\u1ea5n c\u00f4ng h\u1ec7 th\u1ed1ng th\u1ea7n kinh trung \u01b0\u01a1ng, g\u00e2y ra vi\u00eam n\u00e3o v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan. Virus herpes simplex c\u00f3 hai lo\u1ea1i ch\u00ednh l\u00e0 HSV-1 v\u00e0 HSV-2, v\u1edbi HSV-1 th\u01b0\u1eddng g\u00e2y ra vi\u00eam n\u00e3o \u1edf tr\u1ebb […]<\/p>\n","protected":false},"author":42,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nB\u00ea\u0323nh vi\u00eam na\u0303o do virus Herpes - H\u01b0\u01a1\u0301ng d\u00e2\u0303n ch\u00e2\u0309n \u0111oa\u0301n va\u0300 \u0111i\u00ea\u0300u tri\u0323<\/title>\n<meta name=\"description\" content=\"B\u00ea\u0323nh vi\u00eam n\u00e3o do virus Herpes simplex t\u1ea5n c\u00f4ng h\u1ec7 th\u1ed1ng th\u1ea7n kinh trung \u01b0\u01a1ng, g\u00e2y ra vi\u00eam n\u00e3o v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan.\" \/>\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=\"B\u00ea\u0323nh vi\u00eam na\u0303o do virus Herpes - 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