{"id":22849,"date":"2023-04-19T13:38:07","date_gmt":"2023-04-19T06:38:07","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22849"},"modified":"2023-04-19T14:28:41","modified_gmt":"2023-04-19T07:28:41","slug":"huong-dan-chan-doan-adenovirus-theo-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/huong-dan-chan-doan-adenovirus-theo-bo-y-te\/","title":{"rendered":"H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n Adenovirus theo B\u1ed9 Y t\u1ebf"},"content":{"rendered":"

Adenovirus l\u00e0 m\u1ed9t lo\u1ea1i virus g\u00e2y b\u1ec7nh \u1edf con ng\u01b0\u1eddi, \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean to\u00e0n th\u1ebf gi\u1edbi v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u lo\u1ea1i b\u1ec7nh kh\u00e1c nhau. Ch\u1ea9n \u0111o\u00e1n adenovirus l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ch\u00ednh x\u00e1c v\u00e0 hi\u1ec7u qu\u1ea3 cho b\u1ec7nh nh\u00e2n. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y s\u1ebd cung c\u1ea5p th\u00f4ng tin v\u1ec1 h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n Adenovirus theo B\u1ed9 Y t\u1ebf.<\/strong><\/p>\n

\"Adenovirus
Adenovirus l\u00e0 m\u1ed9t lo\u1ea1i virus g\u00e2y b\u1ec7nh \u1edf con ng\u01b0\u1eddi<\/figcaption><\/figure>\n

1. Ch\u1ea9n \u0111o\u00e1n ca b\u1ec7nh<\/span><\/b><\/h2>\n

Ca b\u1ec7nh x\u00e1c \u0111\u1ecbnh:<\/span><\/b>\u00a0Ng\u01b0\u1eddi \u0111ang c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng v\u00e0 c\u00f3 k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m d\u01b0\u01a1ng t\u00ednh v\u1edbi vi r\u00fat adeno.<\/span><\/p>\n

Ca b\u1ec7nh nghi ng\u1edd:<\/span><\/b>\u00a0L\u00e0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 bi\u1ec3u hi\u1ec7n nhi\u1ec5m vi r\u00fat c\u1ea5p t\u00ednh v\u00e0 c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng \u1edf m\u1ed9t s\u1ed1 c\u01a1 quan, t\u1ed5 ch\u1ee9c th\u01b0\u1eddng g\u1eb7p nh\u01b0 h\u00f4 h\u1ea5p, m\u1eaft, h\u1ea1ch c\u1ed5, ti\u00eau h\u00f3a.<\/span><\/p>\n

Ng\u01b0\u1eddi mang vi r\u00fat adeno:<\/span><\/b> Ng\u01b0\u1eddi c\u00f3 k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m d\u01b0\u01a1ng t\u00ednh v\u1edbi vi r\u00fat adeno nh\u01b0ng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng. Vi r\u00fat Adenovirus c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i trong c\u01a1 th\u1ec3 m\u1ed9t th\u1eddi gian d\u00e0i m\u00e0 kh\u00f4ng g\u00e2y ra tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng n\u00e0o. Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y, vi r\u00fat Adenovirus v\u1eabn c\u00f3 th\u1ec3 l\u00e2y lan cho ng\u01b0\u1eddi kh\u00e1c th\u00f4ng qua ti\u1ebfp x\u00fac v\u1edbi ch\u1ea5t b\u1ea9n ho\u1eb7c gi\u1ecdt b\u1eafn t\u1eeb ng\u01b0\u1eddi mang vi r\u00fat. Do \u0111\u00f3, ng\u01b0\u1eddi mang vi r\u00fat Adenovirus m\u00e0 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u0169ng c\u00f3 th\u1ec3 l\u00e0 ng\u01b0\u1eddi g\u00e2y l\u00e2y nhi\u1ec5m cho ng\u01b0\u1eddi kh\u00e1c.<\/span><\/p>\n

Ng\u01b0\u1eddi ph\u01a1i nhi\u1ec5m v\u1edbi vi r\u00fat adeno:<\/span><\/b> N<\/span>g\u01b0\u1eddi ph\u01a1i nhi\u1ec5m v\u1edbi vi r\u00fat Adenovirus l\u00e0 nh\u1eefng ng\u01b0\u1eddi ti\u1ebfp x\u00fac g\u1ea7n v\u1edbi ng\u01b0\u1eddi b\u1ec7nh ho\u1eb7c ng\u01b0\u1eddi mang vi r\u00fat Adenovirus. Adenovirus c\u00f3 th\u1ec3 l\u00e2y lan t\u1eeb ng\u01b0\u1eddi sang ng\u01b0\u1eddi th\u00f4ng qua ti\u1ebfp x\u00fac v\u1edbi c\u00e1c ch\u1ea5t b\u1ea9n nh\u01b0 n\u01b0\u1edbc, ph\u00e2n, ho\u1eb7c ti\u1ebfp x\u00fac v\u1edbi c\u00e1c v\u1eadt d\u1ee5ng b\u1ecb nhi\u1ec5m virus. Ngo\u00e0i ra, vi r\u00fat Adenovirus c\u0169ng c\u00f3 th\u1ec3 l\u00e2y lan th\u00f4ng qua ti\u1ebfp x\u00fac v\u1edbi c\u00e1c gi\u1ecdt b\u1eafn khi ng\u01b0\u1eddi b\u1ec7nh ho ho\u1eb7c h\u1eaft h\u01a1i.<\/p>\n

C\u00e1c nh\u00f3m ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 cao ph\u01a1i nhi\u1ec5m v\u1edbi vi r\u00fat Adenovirus bao g\u1ed3m:<\/p>\n

    \n
  • Ng\u01b0\u1eddi s\u1ed1ng trong m\u00f4i tr\u01b0\u1eddng \u0111\u00f4ng ng\u01b0\u1eddi, ch\u1eb3ng h\u1ea1n nh\u01b0 trong c\u00e1c tr\u1ea1i t\u00f9 nh\u00e2n, tr\u1ea1i qu\u00e2n \u0111\u1ed9i, tr\u01b0\u1eddng h\u1ecdc, tr\u01b0\u1eddng m\u1ea7m non v\u00e0 nh\u00e0 tr\u1ebb.<\/li>\n
  • Ng\u01b0\u1eddi ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n b\u1ecb nhi\u1ec5m vi r\u00fat Adenovirus, bao g\u1ed3m c\u00e1c nh\u00e2n vi\u00ean y t\u1ebf, gia \u0111\u00ecnh v\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c.<\/li>\n
  • Ng\u01b0\u1eddi c\u00f3 h\u1ec7 mi\u1ec5n d\u1ecbch suy y\u1ebfu, bao g\u1ed3m nh\u1eefng ng\u01b0\u1eddi \u0111ang \u0111i\u1ec1u tr\u1ecb ung th\u01b0, nh\u1eefng ng\u01b0\u1eddi \u0111ang s\u1eed d\u1ee5ng corticosteroid, nh\u1eefng ng\u01b0\u1eddi \u0111ang s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch, v\u00e0 nh\u1eefng ng\u01b0\u1eddi m\u1eafc c\u00e1c b\u1ec7nh l\u00fd mi\u1ec5n d\u1ecbch kh\u00e1c.<\/li>\n<\/ul>\n

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

    2.1. Th\u1ec3 vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p c\u1ea5p<\/span><\/i><\/b><\/h3>\n

    – C\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c c\u0103n nguy\u00ean vi r\u00fat, vi khu\u1ea9n th\u00f4ng th\u01b0\u1eddng hay g\u1eb7p kh\u00e1c:<\/span><\/p>\n

    + Vi r\u00fat c\u00fam m\u00f9a, vi r\u00fat \u00e1 c\u00fam, vi r\u00fat h<\/span>\u1ee3p b\u00e0o h\u00f4 h\u1ea5p (RSV), Rhino virus, Myxovirus v\u00e0 c\u00e1c ch\u1ee7ng Coronavirus th\u00f4ng th\u01b0\u1eddng. C\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c c\u00f3 th\u1ec3 g\u00e2y vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh n\u1eb7ng nh\u01b0 c\u00fam gia c\u1ea7m A\/H5N1, A\/H7N9, A\/H5N6, SARS-CoV-2.<\/span><\/p>\n

    + Mycoplasma pneumonia v\u00e0 c\u00e1c vi khu\u1ea9n kh\u00e1c nh\u01b0 ph\u1ebf c\u1ea7u, t\u1ee5 c\u1ea7u v\u00e0ng.<\/span><\/p>\n

    – C\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t t\u00ecnh tr\u1ea1ng n\u1eb7ng c\u1ee7a b\u1ec7nh do HAdV (suy h\u00f4 h\u1ea5p, suy ch\u1ee9c n\u0103ng c\u00e1c c\u01a1 quan…) v\u1edbi nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh kh\u00e1c ho\u1eb7c do t\u00ecnh tr\u1ea1ng n\u1eb7ng c\u1ee7a b\u1ec7nh l\u00fd m\u1ea1n t\u00ednh k\u00e8m theo.<\/span><\/p>\n

    – Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi t\u00ecnh tr\u1ea1ng \u0111\u1ed3ng nhi\u1ec5m v\u1edbi vi khu\u1ea9n ho\u1eb7c vi r\u00fat kh\u00e1c.<\/span><\/p>\n

    2.2. Th\u1ec3 vi\u00eam d\u1ea1 d\u00e0y – ru\u1ed9t c\u1ea5p<\/span><\/i><\/b><\/h3>\n

    Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi vi\u00eam d\u1ea1 d\u00e0y ru\u1ed9t c\u1ea5p do nguy\u00ean nh\u00e2n kh\u00e1c, vi\u00eam ru\u1ed9t th\u1eeba, l\u1ed3ng ru\u1ed9t.<\/span><\/p>\n

    2.3. Th\u1ec3 vi\u00eam k\u1ebft m\u1ea1c<\/span><\/i><\/b><\/h3>\n

    – Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t vi\u00eam k\u1ebft m\u1ea1c c\u1ea5p do nguy\u00ean nh\u00e2n kh\u00e1c.<\/span><\/p>\n

    – Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi b\u1ec7nh Kawasaki, H\u1ed9i ch\u1ee9ng vi\u00eam \u0111a h\u1ec7 th\u1ed1ng.<\/span><\/p>\n

    3. Ch\u1ea9n \u0111o\u00e1n m\u1ee9c \u0111\u1ed9 l\u00e2m s\u00e0ng<\/span><\/b><\/h2>\n

    3.1. M\u1ee9c \u0111\u1ed9 nh\u1eb9<\/span><\/i><\/b><\/h3>\n

    – Tri\u1ec7u ch\u1ee9ng kh\u00f4ng \u0111i\u1ec3n h\u00ecnh: s\u1ed1t, \u0111au h\u1ecdng, ho, ch\u1ea3y m\u0169i, ng\u1ea1t m\u0169i, \u0111au m\u1eaft \u0111\u1ecf, ti\u00eau ch\u1ea3y, n\u00f4n, kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng c\u1ee7a vi\u00eam ph\u1ed5i.<\/span><\/p>\n

    – Nh\u1ecbp th\u1edf b\u00ecnh th\u01b0\u1eddng theo tu\u1ed5i.<\/span><\/p>\n

    – Kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n c\u1ee7a thi\u1ebfu \u00f4 xy, Sp<\/span>O2<\/span><\/sub>\u00a0\u2265 96% khi th\u1edf kh\u00ed tr\u1eddi.<\/span><\/p>\n

    – Th\u1ea7n kinh: tr\u1ebb t\u1ec9nh, sinh ho\u1ea1t b\u00ecnh th\u01b0\u1eddng.<\/span><\/p>\n

    – Tr\u1ebb b\u00fa m\u1eb9\/\u0103n\/u\u1ed1ng b\u00ecnh th\u01b0\u1eddng.<\/span><\/p>\n

    – Xquang ph\u1ed5i b\u00ecnh th\u01b0\u1eddng.<\/span><\/p>\n

    3.2. M\u1ee9c \u0111\u1ed9 trung b\u00ecnh<\/span><\/i><\/b><\/h3>\n

    – C\u00f3 tri\u1ec7u ch\u1ee9ng vi\u00eam ph\u1ed5i nh\u01b0ng kh\u00f4ng c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a vi\u00eam ph\u1ed5i n\u1eb7ng v\u00e0 nguy k\u1ecbch:<\/span><\/p>\n

    + Th\u1edf nhanh: < 2 th\u00e1ng \u2265 60 l\u1ea7n\/ph\u00fat; 2-11 th\u00e1ng \u2265 50 l\u1ea7n\/ph\u00fat; 1-5 tu\u1ed5i \u2265 40 l\u1ea7n\/ph\u00fat.<\/span><\/p>\n

    + Sp<\/span>O2<\/span><\/sub>: 94 – 95% khi th\u1edf kh\u00ed tr\u1eddi.<\/span><\/p>\n

    + Th\u1ea7n kinh: t\u1ec9nh, m\u1ec7t, \u0103n\/b\u00fa\/u\u1ed1ng \u00edt h\u01a1n.<\/span><\/p>\n

    + Xquang ph\u1ed5i c\u00f3 t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng vi\u00eam ph\u1ebf qu\u1ea3n ph\u1ed5i ho\u1eb7c m\u1edd khu tr\u00fa ch\u1ec9 m\u1ed9t th\u00f9y ph<\/span>\u1ed5i, kh\u00f4ng c\u00f3 tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i.<\/span><\/p>\n

    3.3. M\u1ee9c \u0111\u1ed9 n\u1eb7ng<\/span><\/i><\/b><\/h3>\n

    C\u00f3 m\u1ed9t trong c\u00e1c d\u1ea5u hi\u1ec7u sau<\/span><\/p>\n

    – Tr\u1ebb c\u00f3 tri\u1ec7u ch\u1ee9ng vi\u00eam ph\u1ed5i n\u1eb7ng, ch\u01b0a c\u00f3 d\u1ea5u hi\u1ec7u nguy hi\u1ec3m \u0111e d\u1ecda t\u00ednh m\u1ea1ng:<\/span><\/p>\n

    + Th\u1edf nhanh theo tu\u1ed5i k\u00e8m \u2265 1 d\u1ea5u hi\u1ec7u co r\u00fat l\u1ed3ng ng\u1ef1c ho\u1eb7c th\u1edf r\u00ean (tr\u1ebb < 2 th\u00e1ng), ph\u1eadp ph\u1ed3ng c\u00e1nh m\u0169i;<\/span><\/p>\n

    + Th\u1ea7n kinh: tr\u1ebb kh\u00f3 ch\u1ecbu, qu\u1ea5y kh\u00f3c;<\/span><\/p>\n

    + Tr\u1ebb b\u00fa\/\u0103n k\u00e9m, u\u1ed1ng kh\u00f3.<\/span><\/p>\n

    – Sp<\/span>O2<\/span><\/sub>: 90 – < 94% khi th\u1edf kh\u00ed tr\u1eddi.<\/span><\/p>\n

    – Xquang ph\u1ed5i c\u00f3 t\u1ed5n th\u01b0\u01a1ng t\u1eeb hai th\u00f9y ph\u1ed5i tr\u1edf l\u00ean ho\u1eb7c c\u00f3 tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i.<\/span><\/p>\n

    3.4. M\u1ee9c \u0111\u1ed9 nguy k\u1ecbch<\/span><\/i><\/b><\/h3>\n

    – C\u00f3 m\u1ed9t trong c\u00e1c d\u1ea5u hi\u1ec7u sau<\/span><\/p>\n

    – Suy h\u00f4 h\u1ea5p n\u1eb7ng Sp<\/span>O2<\/span><\/sub> < 90% khi th\u1edf kh\u00ed tr\u1eddi, c\u1ea7n \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n th\u00f4ng kh\u00ed x\u00e2m nh\u1eadp.<\/span><\/p>\n

    – D\u1ea5u hi\u1ec7u nguy hi\u1ec3m \u0111e d\u1ecda t\u00ednh m\u1ea1ng:<\/span><\/p>\n

    + T\u00edm trung t\u00e2m;<\/span><\/p>\n

    + Th\u1edf b\u1ea5t th\u01b0\u1eddng, r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1edf;<\/span><\/p>\n

    + Th\u1ea7n kinh: \u00fd th\u1ee9c gi\u1ea3m kh\u00f3 \u0111\u00e1nh th\u1ee9c ho\u1eb7c h\u00f4n m\u00ea;<\/span><\/p>\n

    + Tr\u1ebb b\u1ecf b\u00fa\/\u0103n ho\u1eb7c kh\u00f4ng u\u1ed1ng \u0111\u01b0\u1ee3c;<\/span><\/p>\n

    – H\u1ed9i ch\u1ee9ng suy h\u00f4 h\u1ea5p c\u1ea5p ti\u1ebfn tri\u1ec3n (ARDS).<\/span><\/p>\n

    – Huy\u1ebft \u00e1p t\u1ee5t, s\u1ed1c, s\u1ed1c nhi\u1ec5m tr\u00f9ng, lactat m\u00e1u > 2 mmol\/L.<\/span><\/p>\n

    – Suy \u0111a t\u1ea1ng.<\/span><\/p>\n

    – C\u01a1n b\u00e3o cytokin<\/span><\/p>\n

    T\u00f3m l\u1ea1i, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n b\u1ec7nh do adenovirus c\u00f3 th\u1ec3 kh\u00f3 kh\u0103n v\u00ec c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1 t\u01b0\u01a1ng \u0111\u1ed3ng v\u1edbi c\u00e1c b\u1ec7nh kh\u00e1c. V\u00ec v\u1eady, vi\u1ec7c x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c c\u1ea7n s\u1ef1 h\u1ed7 tr\u1ee3 t\u1eeb c\u00e1c x\u00e9t nghi\u1ec7m v\u00e0 \u0111\u00e1nh gi\u00e1 c\u1ee7a b\u00e1c s\u0129. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh do adenovirus th\u01b0\u1eddng l\u00e0 h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p v\u00e0 ti\u00eau h\u00f3a c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

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

    Adenovirus l\u00e0 m\u1ed9t lo\u1ea1i virus g\u00e2y b\u1ec7nh \u1edf con ng\u01b0\u1eddi, \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean to\u00e0n th\u1ebf gi\u1edbi v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u lo\u1ea1i b\u1ec7nh kh\u00e1c nhau. Ch\u1ea9n \u0111o\u00e1n adenovirus l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 \u0111\u01b0a ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ch\u00ednh x\u00e1c v\u00e0 hi\u1ec7u qu\u1ea3 cho b\u1ec7nh nh\u00e2n. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y s\u1ebd cung […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[3],"yoast_head":"\nH\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n Adenovirus theo B\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"Adenovirus l\u00e0 m\u1ed9t lo\u1ea1i virus g\u00e2y b\u1ec7nh \u1edf con ng\u01b0\u1eddi, \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean to\u00e0n th\u1ebf gi\u1edbi v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u lo\u1ea1i b\u1ec7nh kh\u00e1c nhau. 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