{"id":22839,"date":"2023-04-18T18:17:17","date_gmt":"2023-04-18T11:17:17","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22839"},"modified":"2023-04-19T11:32:21","modified_gmt":"2023-04-19T04:32:21","slug":"cap-nhap-dieu-tri-ngo-doc-botulinum","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/cap-nhap-dieu-tri-ngo-doc-botulinum\/","title":{"rendered":"C\u1eadp nh\u1eadp \u0111i\u1ec1u tr\u1ecb ng\u1ed9 \u0111\u1ed9c Botulinum"},"content":{"rendered":"

\u0110\u1ed9c t\u1ed1 botulinum<\/a> l\u00e0 m\u1ed9t lo\u1ea1i \u0111\u1ed9c t\u1ed1 do vi khu\u1ea9n Clostridium botulinum s\u1ea3n xu\u1ea5t v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y ra t\u00ecnh tr\u1ea1ng li\u1ec7t c\u01a1 v\u00e0 kh\u00f3 th\u1edf. T\u00ecnh tr\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng nh\u01b0 suy h\u00f4 h\u1ea5p, suy tim v\u00e0 t\u1eed vong. C\u1eadp nh\u1eadp \u0111i\u1ec1u tr\u1ecb ng\u1ed9 \u0111\u1ed9c Botulinum l\u00e0 r\u1ea5t quan tr\u1ecdng trong vi\u1ec7c gi\u1ea3m thi\u1ec3u c\u00e1c bi\u1ebfn ch\u1ee9ng do \u0111\u1ed9c t\u1ed1 botulinum g\u00e2y n\u00ean.<\/strong><\/p>\n

\"Ng\u1ed9
Ng\u1ed9 \u0111\u1ed9c Botulinum c\u00f3 th\u1ec3 g\u00e2y suy h\u00f4 h\u1ea5p v\u00e0 t\u1eed vong<\/figcaption><\/figure>\n

1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb ng\u1ed9 \u0111\u1ed9c Botulinum<\/span><\/b><\/h2>\n

–\u00a0C\u1ea5p c\u1ee9u v\u00e0 h\u1ed3i s\u1ee9c h\u00f4 h\u1ea5p l\u00e0 ch\u00ednh: ph\u00e1t hi\u1ec7n s\u1edbm t\u00ecnh tr\u1ea1ng li\u1ec7t c\u01a1 h\u00f4 h\u1ea5p, ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng th\u1edf, th\u1edf m\u00e1y v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 h\u1ed3i s\u1ee9c k\u00e8m theo.<\/span><\/p>\n

–\u00a0D\u00f9ng thu\u1ed1c gi\u1ea3i \u0111\u1ed9c \u0111\u1eb7c hi\u1ec7u c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t khi \u0111\u00e3 c\u00f3 ch\u1ec9 \u0111\u1ecbnh.<\/span><\/p>\n

–\u00a0B\u00e1o c\u00e1c c\u01a1 quan ch\u1ee9c n\u0103ng c\u00f9ng ph\u1ed1i h\u1ee3p gi\u1ea3i quy\u1ebft<\/span><\/p>\n

2. C\u00e1c bi\u1ec7n ph\u00e1p c\u1ee5 th\u1ec3<\/span><\/b><\/h2>\n

2.1. Ti\u1ebfp nh\u1eadn b\u1ec7nh nh\u00e2n<\/span><\/b><\/h3>\n

a)\u00a0Tri\u1ec7u ch\u1ee9ng nhi\u1ec5m \u0111\u1ed9c r\u00f5 (y\u1ebfu c\u01a1 r\u00f5, li\u1ec7t c\u01a1), b\u1ea5t k\u1ec3 ngu\u1ed3n th\u1ef1c ph\u1ea9m v\u00e0 th\u1eddi \u0111i\u1ec3m \u0103n, u\u1ed1ng:\u00a0<\/span><\/b>nh\u1eadp vi\u1ec7n<\/span><\/p>\n

b)\u00a0Ngu\u1ed3n th\u1ef1c ph\u1ea9m g\u00e2y ng\u1ed9 \u0111\u1ed9c \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh<\/span><\/b><\/p>\n

*\u00a0Sau \u0103n l\u1ea7n cu\u1ed1i c\u00f9ng qu\u00e1 8 ng\u00e0y<\/span><\/b><\/p>\n

–\u00a0B\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng: b\u1ec7nh nh\u00e2n kh\u00f4ng b\u1ecb ng\u1ed9 \u0111\u1ed9c.<\/span><\/p>\n

–\u00a0C\u00f3 tri\u1ec7u ch\u1ee9ng nh\u01b0ng nh\u1eb9 (m\u1ec7t m\u1ecfi, suy nh\u01b0\u1ee3c): nh\u1eadp vi\u1ec7n n\u1ebfu tri\u1ec7u ch\u1ee9ng \u0111ang ti\u1ebfn tri\u1ec3n n\u1eb7ng d\u1ea7n, n\u1ebfu t\u00ecnh tr\u1ea1ng kh\u00f4ng thay \u0111\u1ed5i ho\u1eb7c \u0111ang c\u00f3 xu h\u01b0\u1edbng c\u1ea3i thi\u1ec7n d\u1ea7n c\u00f3 th\u1ec3 cho b\u1ec7nh nh\u00e2n v\u1ec1 \u0111i\u1ec1u tr\u1ecb v\u00e0 theo d\u00f5i t\u1ea1i y t\u1ebf c\u01a1 s\u1edf sau khi \u0111\u00e3 \u0111\u00e1nh gi\u00e1 \u0111\u1ea7y \u0111\u1ee7.<\/span><\/p>\n

*\u00a0Sau \u0103n l\u1ea7n cu\u1ed1i trong v\u00f2ng 8 ng\u00e0y:\u00a0<\/span><\/b>nh\u1eadp vi\u1ec7n \u0111\u00e1nh gi\u00e1 v\u00e0 theo d\u00f5i n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng. Cho v\u1ec1, k\u00ea \u0111\u01a1n than ho\u1ea1t v\u00e0 thu\u1ed1c nhu\u1eadn tr\u00e0ng n\u1ebfu kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, h\u01b0\u1edbng d\u1eabn theo d\u00f5i t\u1ea1i nh\u00e0 v\u00e0 kh\u00e1m t\u1ea1i c\u01a1 s\u1edf y t\u1ebf g\u1ea7n nh\u1ea5t (sau khi \u0111\u00e3 \u0111\u00e1nh gi\u00e1 \u0111\u1ea7y \u0111\u1ee7).<\/span><\/p>\n

2.2. T\u1ea9y \u0111\u1ed9c<\/span><\/b><\/h3>\n

–\u00a0G\u00e2y n\u00f4n: n\u1ebfu b\u1ec7nh nh\u00e2n m\u1edbi \u0103n ngu\u1ed3n th\u1ef1c ph\u1ea9m nghi ng\u1edd<\/span><\/p>\n

–\u00a0Than ho\u1ea1t: ph\u1ea7n l\u1edbn b\u1ec7nh nh\u00e2n \u0111\u1ebfn vi\u1ec7n mu\u1ed9n, tuy nhi\u00ean n\u00ean d\u00f9ng do c\u00e1c \u0111\u1ed9c t\u1ed1 c\u00f9ng vi khu\u1ea9n v\u1eabn t\u1ed3n t\u1ea1i trong \u0111\u01b0\u1eddng ti\u00eau h\u00f3a nhi\u1ec1u gi\u1edd t\u1edbi nhi\u1ec1u ng\u00e0y sau. Li\u1ec1u d\u00f9ng 1g\/kg, k\u1ebft h\u1ee3p\u00a0sorbitol\u00a0v\u1edbi li\u1ec1u t\u01b0\u01a1ng \u0111\u01b0\u01a1ng li\u1ec1u than ho\u1ea1t.<\/span><\/p>\n

2.3. \u0110i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng<\/span><\/b><\/h3>\n

B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i s\u00e1t, \u0111\u1eb7c bi\u1ec7t t\u00ecnh tr\u1ea1ng li\u1ec7t c\u00e1c c\u01a1 v\u00e0 t\u00ecnh tr\u1ea1ng h\u00f4 h\u1ea5p.<\/span><\/p>\n

a) Suy h\u00f4 h\u1ea5p:\u00a0<\/span><\/b>x\u1eed tr\u00ed t\u00f9y theo m\u1ee9c \u0111\u1ed9<\/span><\/p>\n

–\u00a0Li\u1ec7t h\u1ea7u h\u1ecdng, ho kh\u1ea1c k\u00e9m, \u1ee9 \u0111\u1ecdng \u0111\u1eddm r\u00e3i: h\u00fat \u0111\u1eddm r\u00e3i, n\u1eb1m nghi\u00eang, \u0111\u1eb7t \u1ed1ng th\u00f4ng d\u1ea1 d\u00e0y cho \u0103n. N\u00ean \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n s\u1edbm b\u1ea3o v\u1ec7 \u0111\u01b0\u1eddng th\u1edf.<\/span><\/p>\n

–\u00a0Suy h\u00f4 h\u1ea5p: \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n, th\u1edf m\u00e1y.<\/span><\/p>\n

–\u00a0H\u1ed3i s\u1ee9c, th\u1edf m\u00e1y nh\u01b0 v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p do b\u1ec7nh l\u00fd th\u1ea7n kinh c\u01a1.<\/span><\/p>\n

–\u00a0Chu\u1ea9n b\u1ecb s\u1eb5n c\u00e1c bi\u1ec7n ph\u00e1p s\u1ebd \u00e1p d\u1ee5ng v\u1edbi th\u1edf m\u00e1y d\u00e0i ng\u00e0y.<\/span><\/p>\n

b)\u00a0Ti\u00eau h\u00f3a<\/span><\/b><\/p>\n

–\u00a0B\u1ec7nh nh\u00e2n th\u01b0\u1eddng c\u00f3 gi\u1ea3m nhu \u0111\u1ed9ng ru\u1ed9t, li\u1ec7t ru\u1ed9t c\u01a1 n\u0103ng trong khi trong \u0111\u01b0\u1eddng ti\u00eau h\u00f3a c\u00f3 th\u1ec3 c\u00f2n b\u00e0o t\u1eed vi khu\u1ea9n g\u00e2y b\u1ec7nh.<\/span><\/p>\n

–\u00a0Theo d\u00f5i s\u00e1t nhu \u0111\u1ed9ng ru\u1ed9t, t\u00ecnh tr\u1ea1ng ti\u00eau h\u00f3a th\u1ee9c \u0103n, \u0111\u1ea1i ti\u1ec7n,\u00a0kali\u00a0m\u00e1u.<\/span><\/p>\n

–\u00a0B\u00f9\u00a0kali\u00a0m\u00e1u n\u1ebfu h\u1ea1\u00a0kali.<\/span><\/p>\n

– Metoclopramide:<\/span><\/p>\n

+ Ng\u01b0\u1eddi l\u1edbn 10mg\/l\u1ea7n, 3 l\u1ea7n\/ng\u00e0y, ti\u00eam t\u0129nh m\u1ea1ch.<\/span><\/p>\n

+ Tr\u1ebb em: 0,1mg\/kg\/l\u1ea7n, 3 l\u1ea7n\/ng\u00e0y, ti\u00eam t\u0129nh m\u1ea1ch.<\/span><\/p>\n

–\u00a0\u0110i\u1ec1u tr\u1ecb t\u00e1o b\u00f3n: c\u00f3 th\u1ec3 d\u00f9ng\u00a0sorbitol:\u00a01g\/kg, u\u1ed1ng, t\u1ea1m ng\u1eebng n\u1ebfu \u1ec9a ch\u1ea3y.<\/span><\/p>\n

–\u00a0B\u1ec7nh nh\u00e2n tr\u1ebb nh\u1ecf, ng\u01b0\u1eddi cao tu\u1ed5i, \u0103n u\u1ed1ng ph\u1ea3i th\u1ef1c ph\u1ea9m c\u00f3 \u0111\u1ed9c t\u1ed1 trong khi \u0111ang d\u00f9ng kh\u00e1ng sinh (nguy c\u01a1 b\u00e0o t\u1eed vi khu\u1ea9n ph\u00e1t tri\u1ec3n trong \u0111\u01b0\u1eddng ti\u00eau h\u00f3a): n\u00ean u\u1ed1ng men ti\u00eau h\u00f3a.<\/span><\/p>\n

–\u00a0Ch\u1ebf \u0111\u1ed9 \u0103n: t\u0103ng c\u01b0\u1eddng ch\u1ea5t x\u01a1.<\/span><\/p>\n

–\u00a0C\u00e1c bi\u1ec7n ph\u00e1p k\u00edch th\u00edch, t\u0103ng nhu \u0111\u1ed9ng ru\u1ed9t: t\u0103ng v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng, l\u00fd li\u1ec7u ph\u00e1p, xoa b\u1ee5ng.<\/span><\/p>\n

c)\u00a0Ph\u00f2ng, \u0111i\u1ec1u tr\u1ecb c\u00e1c bi\u1ebfn ch\u1ee9ng<\/span><\/b><\/p>\n

–\u00a0Nhi\u1ec5m khu\u1ea9n b\u1ec7nh vi\u1ec7n<\/span><\/p>\n

–\u00a0Ch\u1ed1ng lo\u00e9t, v\u1ec7 sinh c\u01a1 th\u1ec3 b\u1ec7nh nh\u00e2n<\/span><\/p>\n

2.4. Thu\u1ed1c gi\u1ea3i \u0111\u1ed9c<\/span><\/b><\/h3>\n

–\u00a0Gi\u1ea3i \u0111\u1ed9c t\u1ed1\u00a0botulinum\u00a0l\u00e0 c\u00e1c m\u1ea3nh kh\u00e1ng th\u1ec3\/kh\u00e1ng th\u1ec3 trung h\u00f2a \u0111\u1eb7c hi\u1ec7u \u0111\u1ed9c t\u1ed1\u00a0botulinum.\u00a0Thu\u1ed1c c\u1ea7n c\u00f3 \u0111\u1ee7 c\u00e1c th\u00e0nh ph\u1ea7n kh\u00e1ng th\u1ec3\/m\u1ea3nh kh\u00e1ng th\u1ec3 trung h\u00f2a c\u00e1c th\u00e0nh ph\u1ea7n \u0111\u1ed9c t\u1ed1 t\u01b0\u01a1ng \u1ee9ng c\u00f3 th\u1ec3 g\u00e2y ng\u1ed9 \u0111\u1ed9c tr\u00ean ng\u01b0\u1eddi. V\u1ec1 l\u00fd thuy\u1ebft thu\u1ed1c ch\u1ec9 c\u00f3 t\u00e1c d\u1ee5ng v\u1edbi c\u00e1c \u0111\u1ed9c t\u1ed1 c\u00f2n t\u1ef1 do, kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng v\u1edbi c\u00e1c \u0111\u1ed9c t\u1ed1 \u0111\u00e3 g\u1eafn t\u1ea1i th\u1ea7n kinh, do \u0111\u00f3 kh\u00f4ng th\u1ec3 ngay l\u1eadp t\u1ee9c \u0111\u1ea3o ng\u01b0\u1ee3c l\u1ea1i c\u00e1c tri\u1ec7u ch\u1ee9ng li\u1ec7t \u0111\u00e3 x\u1ea3y ra. Tuy nhi\u00ean, thu\u1ed1c c\u00f3 th\u1ec3 ng\u0103n ng\u1ed9 \u0111\u1ed9c ti\u1ebfn tri\u1ec3n n\u1eb7ng l\u00ean v\u00e0 r\u00fat ng\u1eafn \u0111\u00e1ng k\u1ec3 th\u1eddi gian ng\u1ed9 \u0111\u1ed9c, gi\u1ea3m th\u1eddi gian th\u1edf m\u00e1y, h\u1ed3i s\u1ee9c v\u00e0 th\u1eddi gian n\u1eb1m vi\u1ec7n.<\/span><\/p>\n

–\u00a0Thu\u1ed1c \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o lo\u1ea1i thu\u1ed1c hi\u1ebfm, thu\u1ed1c m\u1ed3 c\u00f4i, s\u1ed1 l\u01b0\u1ee3ng ch\u1ebf ph\u1ea9m thu\u1ed1c gi\u1ea3i \u0111\u1ed9c t\u1ed1\u00a0botulinum\u00a0\u0111\u01b0\u1ee3c l\u01b0u h\u00e0nh m\u1ee9c \u0111\u1ed9 h\u1ea1n ch\u1ebf trong ch\u01b0\u01a1ng tr\u00ecnh d\u1ef1 tr\u1eef thu\u1ed1c hi\u1ebfm c\u1ee7a c\u00e1c qu\u1ed1c gia. Ch\u1ebf ph\u1ea9m \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp nhi\u1ec1u trong c\u00e1c t\u00e0i li\u1ec7u h\u01b0\u1edbng d\u1eabn g\u1ea7n \u0111\u00e2y v\u00e0 \u01b0u ti\u00ean s\u1eed d\u1ee5ng hi\u1ec7n nay l\u00e0\u00a0Botulism Antitoxin\u00a0Heptavalent (s\u1ea3n xu\u1ea5t t\u1eeb ng\u1ef1a, l\u00e0 c\u00e1c m\u1ea3nh kh\u00e1ng th\u1ec3 F(ab’)2<\/sub>\u00a0trung h\u00f2a c\u00e1c \u0111\u1ed9c t\u1ed1\u00a0botulinum type A,\u00a0B, C, D, E, F, v\u00e0 G).<\/span><\/p>\n

a) Ch\u1ec9 \u0111\u1ecbnh<\/span><\/b><\/p>\n

–\u00a0Ng\u1ed9 \u0111\u1ed9c th\u1ef1c ph\u1ea9m do \u0111\u1ed9c t\u1ed1\u00a0botulinum\u00a0khi c\u00f3 tri\u1ec7u ch\u1ee9ng r\u00f5, c\u00e0ng s\u1edbm c\u00e0ng hi\u1ec7u qu\u1ea3, t\u1ed1t nh\u1ea5t l\u00e0 tr\u01b0\u1edbc khi c\u00e1c tri\u1ec7u ch\u1ee9ng chuy\u1ec3n sang n\u1eb7ng, tuy nhi\u00ean thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ea5t k\u1ef3 giai \u0111o\u1ea1n n\u00e0o c\u1ee7a ng\u1ed9 \u0111\u1ed9c khi t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n c\u00f2n n\u1eb7ng.<\/span><\/p>\n

–\u00a0Kh\u00f4ng ch\u1edd \u0111\u1ee3i k\u1ebft qu\u1ea3 c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ed9c t\u1ed1 ho\u1eb7c nu\u00f4i c\u1ea5y vi khu\u1ea9n m\u1edbi ch\u1ec9 \u0111\u1ecbnh d\u00f9ng cho b\u1ec7nh nh\u00e2n.<\/span><\/p>\n

b)\u00a0Th\u1eadn tr\u1ecdng:\u00a0<\/span><\/b>\u0111\u1eb7c bi\u1ec7t v\u1edbi ng\u01b0\u1eddi d\u1ecb \u1ee9ng v\u1edbi c\u00e1c ch\u1ebf ph\u1ea9m sinh h\u1ecdc t\u1eeb ng\u1ef1a (c\u1ea7n h\u1ecfi ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng). Ng\u01b0\u1eddi c\u00f3 c\u01a1 \u0111\u1ecba d\u1ecb \u1ee9ng (hen, ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng, m\u00e0y \u0111ay, s\u1ea9n ng\u1ee9a, ch\u00e0m, vi\u00eam m\u0169i d\u1ecb \u1ee9ng).<\/span><\/p>\n

c)\u00a0Li\u1ec1u v\u00e0 c\u00e1ch d\u00f9ng<\/span><\/b><\/p>\n

–\u00a0C\u00f3 th\u1ec3 d\u00f9ng\u00a0corticoid\u00a0tr\u01b0\u1edbc \u0111\u1ec3 d\u1ef1 ph\u00f2ng ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng.<\/span><\/p>\n

–\u00a0Ng\u01b0\u1eddi 17 tu\u1ed5i tr\u1edf l\u00ean:\u00a0li\u1ec1u\u00a01 l\u1ecd, b\u1ea5t k\u1ec3 c\u00e2n n\u1eb7ng c\u1ee7a b\u1ec7nh nh\u00e2n, pha v\u1edbi dung d\u1ecbch natri clorua 0,9%, t\u1ef7 l\u1ec7 1:10, truy\u1ec1n t\u0129nh m\u1ea1ch: t\u1ed1c \u0111\u1ed9 ban \u0111\u1ea7u 0,5ml\/ph\u00fat, theo d\u00f5i n\u1ebfu kh\u00f4ng c\u00f3 b\u1ea5t th\u01b0\u1eddng, t\u0103ng t\u1ed1c \u0111\u1ed9 g\u1ea5p \u0111\u00f4i sau m\u1ed7i 30 ph\u00fat, \u0111\u1ea3m b\u1ea3o t\u1ed1c \u0111\u1ed9 kh\u00f4ng qu\u00e1 2ml\/ph\u00fat.<\/span><\/p>\n

–\u00a0Ng\u01b0\u1eddi t\u1eeb 1-16 tu\u1ed5i: d\u00f9ng li\u1ec1u theo c\u00e2n n\u1eb7ng, theo t\u1ef7 l\u1ec7 ph\u1ea7n tr\u0103m so v\u1edbi li\u1ec1u c\u1ee7a ng\u01b0\u1eddi l\u1edbn (li\u1ec1u ng\u01b0\u1eddi l\u1edbn l\u00e0 1 l\u1ecd). C\u00e1ch pha l\u1ea5y to\u00e0n b\u1ed9 l\u1ecd thu\u1ed1c v\u00e0 pha nh\u01b0 tr\u00ean, sau \u0111\u00f3 l\u1ea5y ra l\u01b0\u1ee3ng thu\u1ed1c \u0111\u00fang b\u1eb1ng li\u1ec1u \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00ednh theo c\u00e2n n\u1eb7ng c\u1ee7a b\u1ec7nh nh\u00e2n. Li\u1ec1u d\u00f9ng c\u1ee5 th\u1ec3 nh\u01b0 sau:<\/span><\/p>\n

B\u1ea3ng Li\u1ec1u thu\u1ed1c gi\u1ea3i \u0111\u1ed9c Botulism Antitoxin Heptavalent d\u00e0nh cho tr\u1ebb em<\/span><\/b><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

C\u00e2n n\u1eb7ng b\u1ec7nh nh\u00e2n (kg)<\/p>\n<\/td>\n

\n

T\u1ef7 l\u1ec7 ph\u1ea7n tr\u0103m so v\u1edbi li\u1ec1u ng\u01b0\u1eddi l\u1edbn (%)<\/p>\n<\/td>\n<\/tr>\n

\n

10- 14<\/p>\n<\/td>\n

\n

20<\/p>\n<\/td>\n<\/tr>\n

\n

15 – 19<\/p>\n<\/td>\n

\n

30<\/p>\n<\/td>\n<\/tr>\n

\n

20 – 24<\/p>\n<\/td>\n

\n

40<\/p>\n<\/td>\n<\/tr>\n

\n

25 – 29<\/p>\n<\/td>\n

\n

50<\/p>\n<\/td>\n<\/tr>\n

\n

30 – 34<\/p>\n<\/td>\n

\n

60<\/p>\n<\/td>\n<\/tr>\n

\n

35 – 39<\/p>\n<\/td>\n

\n

65<\/p>\n<\/td>\n<\/tr>\n

\n

40 – 44<\/p>\n<\/td>\n

\n

70<\/p>\n<\/td>\n<\/tr>\n

\n

45 – 49<\/p>\n<\/td>\n

\n

75<\/p>\n<\/td>\n<\/tr>\n

\n

50 – 54<\/p>\n<\/td>\n

\n

80<\/p>\n<\/td>\n<\/tr>\n

\n

\u226555<\/p>\n<\/td>\n

\n

100<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

– Tr\u1ebb < 1 tu\u1ed5i: d\u00f9ng li\u1ec1u b\u1eb1ng 10% li\u1ec1u c\u1ee7a ng\u01b0\u1eddi l\u1edbn, t\u01b0\u01a1ng \u0111\u01b0\u01a1ng 10% c\u1ee7a 1 l\u1ecd thu\u1ed1c gi\u1ea3i \u0111\u1ed9c. C\u00e1ch pha nh\u01b0 tr\u00ean, t\u1ed1c \u0111\u1ed9 truy\u1ec1n 0,01ml\/kg\/ph\u00fat, sau \u0111\u00f3 theo d\u00f5i s\u00e1t n\u1ebfu kh\u00f4ng c\u00f3 b\u1ea5t th\u01b0\u1eddng, c\u1ee9 m\u1ed7i 30 ph\u00fat t\u0103ng li\u1ec1u th\u00eam 0,01ml\/kg\/ph\u00fat \u0111\u1ea3m b\u1ea3o t\u1ed1c \u0111\u1ed9 t\u1ed1i \u0111a kh\u00f4ng qu\u00e1 0,03ml\/kg\/ph\u00fat.<\/span><\/p>\n

2.5. Ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c c\u01a1 quan ch\u1ee9c n\u0103ng<\/span><\/b><\/h3>\n

Th\u00f4ng b\u00e1o ngay cho c\u00e1c c\u01a1 quan ch\u1ee9c n\u0103ng (c\u01a1 quan y t\u1ebf d\u1ef1 ph\u00f2ng, an to\u00e0n th\u1ef1c ph\u1ea9m, c\u01a1 s\u1edf y t\u1ebf qu\u1ea3n l\u00fd c\u1ee7a khu v\u1ef1c,…) khi c\u00f3 b\u1ec7nh nh\u00e2n nghi ng\u1edd b\u1ecb ng\u1ed9 \u0111\u1ed9c th\u1ef1c ph\u1ea9m do \u0111\u1ed9c t\u1ed1\u00a0botulinum.<\/span><\/p>\n

3. Ti\u00ean l\u01b0\u1ee3ng v\u00e0 bi\u1ebfn ch\u1ee9ng<\/span><\/b><\/h2>\n

a) Ti\u00ean l\u01b0\u1ee3ng<\/span><\/b><\/p>\n

Ng\u1ed9 \u0111\u1ed9c th\u1ef1c ph\u1ea9m do \u0111\u1ed9c t\u1ed1\u00a0botulinum\u00a0l\u00e0 ng\u1ed9 \u0111\u1ed9c n\u1eb7ng, t\u1ef7 l\u1ec7 t\u1eed vong cao, th\u1eddi gian li\u1ec7t k\u00e9o d\u00e0i. Th\u1eddi gian th\u1edf m\u00e1y c\u1ea7n trung b\u00ecnh kho\u1ea3ng 2 th\u00e1ng sau \u0111\u00f3 m\u1edbi c\u00f3 th\u1ec3 cai th\u1edf m\u00e1y, tuy nhi\u00ean b\u1ec7nh nh\u00e2n c\u1ea7n nhi\u1ec1u th\u00e1ng \u0111\u1ec3 h\u1ed3i ph\u1ee5c.<\/span><\/p>\n

b)\u00a0Bi\u1ebfn ch\u1ee9ng:\u00a0<\/span><\/b>c\u00e1c bi\u1ebfn ch\u1ee9ng ch\u00ednh<\/span><\/p>\n

–\u00a0Nhi\u1ec5m tr\u00f9ng b\u1ec7nh vi\u1ec7n, \u0111\u1eb7c bi\u1ec7t vi\u00eam ph\u1ed5i v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a th\u1edf m\u00e1y.<\/span><\/p>\n

–\u00a0C\u00e1c bi\u1ebfn ch\u1ee9ng do b\u1ea5t \u0111\u1ed9ng, n\u1eb1m k\u00e9o d\u00e0i, lo\u00e9t<\/span><\/p>\n

–\u00a0Li\u1ec7t ru\u1ed9t, t\u00e1o b\u00f3n, tr\u00e0o ng\u01b0\u1ee3c, s\u1eb7c ph\u1ed5i.<\/span><\/p>\n

4. Ph\u00f2ng b\u1ec7nh<\/h2>\n

–\u00a0V\u1edbi c\u00e1c c\u01a1 quan ch\u1ee9c n\u0103ng: t\u0103ng c\u01b0\u1eddng c\u00f4ng t\u00e1c ki\u1ec3m so\u00e1t v\u1ec7 sinh an to\u00e0n th\u1ef1c ph\u1ea9m.<\/span><\/p>\n

– V\u1edbi ng\u01b0\u1eddi d\u00e2n:<\/span><\/p>\n

+ Ch\u1ecdn c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 ngu\u1ed3n g\u1ed1c xu\u1ea5t x\u1ee9 r\u00f5 r\u00e0ng, c\u00f3 ti\u00eau chu\u1ea9n ch\u1ea5t l\u01b0\u1ee3ng v\u00e0 an to\u00e0n \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn.<\/span><\/p>\n

+ Th\u1eadn tr\u1ecdng v\u1edbi c\u00e1c th\u1ef1c ph\u1ea9m \u0111\u00f3ng k\u00edn nh\u01b0 tr\u00ean nh\u01b0ng c\u00f3 m\u00f9i ho\u1eb7c m\u00e0u s\u1eafc thay \u0111\u1ed5i, ho\u1eb7c c\u00f3 v\u1ecb thay \u0111\u1ed5i kh\u00e1c th\u01b0\u1eddng (v\u00ed d\u1ee5 s\u1eefa chua nh\u01b0ng kh\u00f4ng c\u00f2n v\u1ecb chua b\u00ecnh th\u01b0\u1eddng).<\/span><\/p>\n

+ Kh\u00f4ng n\u00ean t\u1ef1 \u0111\u00f3ng g\u00f3i k\u00edn c\u00e1c th\u1ef1c ph\u1ea9m v\u00e0 \u0111\u1ec3 k\u00e9o d\u00e0i trong \u0111i\u1ec1u ki\u1ec7n kh\u00f4ng ph\u1ea3i \u0111\u00f4ng \u0111\u00e1 (ch\u1ec9 c\u00f3 nhi\u1ec7t \u0111\u1ed9 \u0111\u00f4ng \u0111\u00e1 m\u1edbi l\u00e0m vi khu\u1ea9n ng\u1eebng ph\u00e1t tri\u1ec3n v\u00e0 kh\u00f4ng sinh \u0111\u1ed9c t\u1ed1).<\/span><\/p>\n

+ \u01afu ti\u00ean \u0103n c\u00e1c th\u1ef1c ph\u1ea9m m\u1edbi ch\u1ebf bi\u1ebfn, m\u1edbi n\u1ea5u ch\u00edn. L\u01b0u \u00fd n\u1ea5u ch\u00edn s\u1ebd ph\u00e1 h\u1ee7y \u0111\u1ed9c t\u1ed1\u00a0botulinum\u00a0(n\u1ebfu kh\u00f4ng may c\u00f3 trong th\u1ef1c ph\u1ea9m).<\/span><\/p>\n

+ V\u1edbi c\u00e1c th\u1ef1c ph\u1ea9m l\u00ean men, \u0111\u00f3ng g\u00f3i ho\u1eb7c che \u0111\u1eady k\u00edn theo c\u00e1ch truy\u1ec1n th\u1ed1ng (nh\u01b0 d\u01b0a mu\u1ed1i, m\u0103ng, c\u00e0 mu\u1ed1i,…): b\u1ea1n c\u1ea7n \u0111\u1ea3m b\u1ea3o ph\u1ea3i chua, m\u1eb7n.\u00a0<\/span>Khi th\u1ef1c ph\u1ea9m h\u1ebft chua th\u00ec kh\u00f4ng n\u00ean \u0103n.<\/p>\n

Vi\u1ec7c c\u1eadp nh\u1eadp c\u00e1c th\u00f4ng tin m\u1edbi nh\u1ea5t v\u1ec1 \u0111i\u1ec1u tr\u1ecb ng\u1ed9 \u0111\u1ed9c botulinum l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o cho c\u00e1c b\u00e1c s\u0129 v\u00e0 nh\u00e2n vi\u00ean y t\u1ebf c\u00f3 \u0111\u1ea7y \u0111\u1ee7 ki\u1ebfn th\u1ee9c v\u00e0 k\u1ef9 n\u0103ng nh\u1eb1m c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng. Ngo\u00e0i ra, c\u1eadp nh\u1eadp \u0111i\u1ec1u tr\u1ecb c\u0169ng gi\u00fap cho c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 ng\u1ed9 \u0111\u1ed9c botulinum \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u00fang c\u00e1ch v\u00e0 nhanh ch\u00f3ng ph\u1ee5c h\u1ed3i s\u1ee9c kh\u1ecfe.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

\u0110\u1ed9c t\u1ed1 botulinum l\u00e0 m\u1ed9t lo\u1ea1i \u0111\u1ed9c t\u1ed1 do vi khu\u1ea9n Clostridium botulinum s\u1ea3n xu\u1ea5t v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y ra t\u00ecnh tr\u1ea1ng li\u1ec7t c\u01a1 v\u00e0 kh\u00f3 th\u1edf. T\u00ecnh tr\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng nh\u01b0 suy h\u00f4 h\u1ea5p, suy tim v\u00e0 t\u1eed vong. C\u1eadp nh\u1eadp \u0111i\u1ec1u tr\u1ecb ng\u1ed9 \u0111\u1ed9c […]<\/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":"\nC\u1eadp nh\u1eadp \u0111i\u1ec1u tr\u1ecb ng\u1ed9 \u0111\u1ed9c Botulinum - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110\u1ed9c t\u1ed1 botulinum l\u00e0 m\u1ed9t lo\u1ea1i \u0111\u1ed9c t\u1ed1 do vi khu\u1ea9n Clostridium botulinum s\u1ea3n xu\u1ea5t. Ng\u1ed9 \u0111\u1ed9c Botulinum c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y ra t\u00ecnh tr\u1ea1ng li\u1ec7t c\u01a1 ...\" \/>\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=\"C\u1eadp nh\u1eadp \u0111i\u1ec1u tr\u1ecb ng\u1ed9 \u0111\u1ed9c Botulinum - Vinmec\" \/>\n<meta property=\"og:description\" content=\"\u0110\u1ed9c t\u1ed1 botulinum l\u00e0 m\u1ed9t lo\u1ea1i \u0111\u1ed9c t\u1ed1 do vi khu\u1ea9n Clostridium botulinum s\u1ea3n xu\u1ea5t. 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