{"id":22885,"date":"2023-04-19T12:40:06","date_gmt":"2023-04-19T05:40:06","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22885"},"modified":"2023-04-19T14:48:06","modified_gmt":"2023-04-19T07:48:06","slug":"benh-san-la-phoi-nguyen-nhan-trieu-chung-va-chan-doan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/benh-san-la-phoi-nguyen-nhan-trieu-chung-va-chan-doan\/","title":{"rendered":"B\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i: Nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n"},"content":{"rendered":"

B\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i l\u00e0 do s\u00e1n l\u00e1 thu\u1ed9c gi\u1ed1ng\u00a0Paragonimus<\/i> k\u00fd sinh<\/a> trong ph\u1ed5i ho\u1eb7c m\u00e0ng ph\u1ed5i g\u00e2y n\u00ean. Ng\u01b0\u1eddi nhi\u1ec5m b\u1ec7nh do \u0103n ph\u1ea3i t\u00f4m, cua ch\u01b0a \u0111\u01b0\u1ee3c n\u1ea5u ch\u00edn c\u00f3 nhi\u1ec5m \u1ea5u tr\u00f9ng s\u00e1n l\u00e1 ph\u1ed5i. Vi\u1ec7c hi\u1ec3u bi\u1ebft v\u1ec1 nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i l\u00e0 r\u1ea5t quan tr\u1ecdng, gi\u00fap ph\u00e1t hi\u1ec7n v\u00e0 ch\u1eefa tr\u1ecb b\u1ec7nh k\u1ecbp th\u1eddi, t\u1eeb \u0111\u00f3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 m\u1eafc b\u1ec7nh v\u00e0 tr\u00e1nh \u0111\u01b0\u1ee3c nh\u1eefng bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng.<\/span><\/strong><\/p>\n

1. T\u00e1c nh\u00e2n c\u1ee7a\u00a0<\/span><\/b>b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i<\/strong><\/span><\/h2>\n

– Tr\u00ean th\u1ebf gi\u1edbi c\u00f3 h\u01a1n 40 lo\u00e0i s\u00e1n l\u00e1 ph\u1ed5i thu\u1ed9c gi\u1ed1ng Paragonimus \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e2y nhi\u1ec5m cho \u0111\u1ed9ng v\u1eadt v\u00e0 ng\u01b0\u1eddi. Trong s\u1ed1 h\u01a1n 10 lo\u00e0i \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e2y nhi\u1ec5m sang ng\u01b0\u1eddi, ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 P. westermani.<\/span><\/p>\n

– Hi\u1ec7n t\u1ea1i \u1edf Vi\u1ec7t Nam m\u1edbi ch\u1ec9 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c lo\u00e0i P. heterotremus g\u00e2y b\u1ec7nh tr\u00ean ng\u01b0\u1eddi.<\/span><\/p>\n

– B\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i th\u01b0\u1eddng g\u1eb7p \u1edf m\u1ed9t s\u1ed1 t\u1ec9nh nh\u01b0: Lai Ch\u00e2u, S\u01a1n La, H\u00f2a B\u00ecnh, L\u00e0o Cai, Y\u00ean B\u00e1i, H\u00e0 Giang, L\u1ea1ng S\u01a1n, Tuy\u00ean Quang, Ph\u00fa Th\u1ecd, Ngh\u1ec7 An.<\/span><\/p>\n

2. Ngu\u1ed3n b\u1ec7nh<\/span><\/b><\/h2>\n

C\u00e1c \u0111\u1ed9ng v\u1eadt hoang d\u00e3 nh\u01b0 ch\u1ed3n, c\u00e1o, c\u1ea7y, h\u1ed5, b\u00e1o…nhi\u1ec5m s\u00e1n l\u00e1 ph\u1ed5i. Cua, t\u00f4m \u1edf su\u1ed1i \u0111\u00e1 mang \u1ea5u tr\u00f9ng s\u00e1n l\u00e1 ph\u1ed5i.<\/span><\/p>\n

3. T\u00ednh c\u1ea3m nhi\u1ec5m v\u00e0 mi\u1ec5n d\u1ecbch<\/span><\/b><\/h2>\n

M\u1ecdi ng\u01b0\u1eddi \u0111\u1ec1u c\u00f3 kh\u1ea3 n\u0103ng m\u1eafc b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i. Ng\u01b0\u1eddi sau khi nhi\u1ec5m \u1ea5u tr\u00f9ng s\u00e1n l\u00e1 ph\u1ed5i 5-6 tu\u1ea7n, s\u1ebd xu\u1ea5t hi\u1ec7n kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u trong m\u00e1u.<\/span><\/p>\n

4. Chu k\u1ef3 c\u1ee7a\u00a0s\u00e1n l\u00e1 ph\u1ed5i<\/strong><\/span><\/b><\/h2>\n

<\/span><\/p>\n

H\u00ecnh 1: Chu k\u1ef3 ph\u00e1t tri\u1ec3n c\u1ee7a s\u00e1n l\u00e1 ph\u1ed5i (Ngu\u1ed3n CDC, 2013)<\/span><\/p>\n

    \n
  • 1. S\u00e1n l\u00e1 ph\u1ed5i \u0111\u1ebb tr\u1ee9ng, tr\u1ee9ng theo \u0111\u1eddm qua h\u1ecdng ra ngo\u00e0i ho\u1eb7c theo ph\u00e2n khi nu\u1ed1t \u0111\u1eddm, tr\u1ee9ng r\u01a1i xu\u1ed1ng n\u01b0\u1edbc.<\/span><\/li>\n
  • 2. \u1ede m\u00f4i tr\u01b0\u1eddng n\u01b0\u1edbc tr\u1ee9ng ph\u00e1t tri\u1ec3n v\u00e0 n\u1edf ra \u1ea5u tr\u00f9ng l\u00f4ng.<\/span><\/li>\n
  • 3. \u1ea4u tr\u00f9ng l\u00f4ng chui v\u00e0o \u1ed1c \u0111\u1ec3 ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng \u0111u\u00f4i.<\/span><\/li>\n
  • 4. \u1ea4u tr\u00f9ng \u0111u\u00f4i r\u1eddi \u1ed1c b\u01a1i t\u1ef1 do trong n\u01b0\u1edbc, x\u00e2m nh\u1eadp v\u00e0o t\u00f4m cua n\u01b0\u1edbc ng\u1ecdt, r\u1ee5ng \u0111u\u00f4i ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng nang \u1edf trong th\u1ecbt v\u00e0 ph\u1ee7 t\u1ea1ng c\u1ee7a t\u00f4m, cua.<\/span><\/li>\n
  • 5. Ng\u01b0\u1eddi (ho\u1eb7c \u0111\u1ed9ng v\u1eadt) \u0103n ph\u1ea3i t\u00f4m, cua c\u00f3 \u1ea5u tr\u00f9ng nang ch\u01b0a \u0111\u01b0\u1ee3c n\u1ea5u ch\u00edn nh\u01b0: cua n\u01b0\u1edbng, m\u1eafm cua, u\u1ed1ng n\u01b0\u1edbc cua s\u1ed1ng th\u00ec sau khi \u0103n: \u1ea5u tr\u00f9ng s\u00e1n v\u00e0o d\u1ea1 d\u00e0y v\u00e0 ru\u1ed9t, xuy\u00ean qua th\u00e0nh \u1ed1ng ti\u00eau h\u00f3a v\u00e0o \u1ed5 b\u1ee5ng r\u1ed3i xuy\u00ean qua c\u01a1 ho\u00e0nh v\u00e0 m\u00e0ng ph\u1ed5i v\u00e0o ph\u1ebf qu\u1ea3n \u0111\u1ec3 l\u00e0m t\u1ed5 \u1edf \u0111\u00f3.<\/span><\/li>\n
  • 6. Th\u1eddi gian t\u1eeb khi \u0103n ph\u1ea3i \u1ea5u tr\u00f9ng \u0111\u1ebfn khi c\u00f3 s\u00e1n tr\u01b0\u1edfng th\u00e0nh kho\u1ea3ng 5-6 tu\u1ea7n.<\/span><\/span><\/li>\n<\/ul>\n

    5. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i<\/span><\/strong><\/h2>\n

    – C\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i ph\u1ee5 thu\u1ed9c v\u00e0o v\u1ecb tr\u00ed k\u00fd sinh c\u1ee7a s\u00e1n v\u00e0 m\u1ee9c \u0111\u1ed9 bi\u1ec3u hi\u1ec7n c\u1ee7a b\u1ec7nh ph\u1ee5 thu\u1ed9c v\u00e0o s\u1ee9c kh\u1ecfe ng\u01b0\u1eddi b\u1ec7nh.<\/span><\/p>\n

    – C\u00e1c tri\u1ec7u ch\u1ee9ng ch\u00ednh c\u1ee7a b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i:<\/span><\/p>\n

    + Ho k\u00e9o d\u00e0i nhi\u1ec1u th\u00e1ng, nhi\u1ec1u n\u0103m; ti\u1ebfn tri\u1ec3n t\u1eebng \u0111\u1ee3t c\u1ea5p t\u00ednh. Ho v\u00e0 kh\u1ea1c \u0111\u1eddm l\u1eabn m\u00e1u (th\u01b0\u1eddng ra \u00edt m\u1ed9t l\u1eabn v\u1edbi \u0111\u1eddm, m\u00e0u \u0111\u1ecf t\u01b0\u01a1i, ho\u1eb7c \u0111\u1ecf th\u1eabm, ho\u1eb7c m\u00e0u r\u1ec9 s\u1eaft, c\u0169ng c\u00f3 khi ho ra nhi\u1ec1u m\u00e1u t\u01b0\u01a1i m\u1ed9t l\u00fac t\u00f9y thu\u1ed9c v\u00e0o t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u n\u01a1i k\u00fd sinh trong ph\u1ebf qu\u1ea3n.<\/span><\/p>\n

    + S\u1ed1t: h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 s\u1ed1t, kh\u00f4ng c\u00f3 t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng v\u00e0 \u00edt suy s\u1ee5p.<\/span><\/p>\n

    + C\u00f3 th\u1ec3 c\u00f3 t\u1ee9c ng\u1ef1c, kh\u00f3 th\u1edf.<\/span><\/p>\n

    + Nghe ph\u1ed5i c\u00f3 ran ng\u00e1y, ran r\u00edt.<\/span><\/p>\n

    + C\u00f3 h\u1ed9i ch\u1ee9ng 3 gi\u1ea3m \u1edf \u0111\u00e1y ph\u1ed5i khi c\u00f3 tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i (n\u1ebfu s\u00e1n \u1edf trong m\u00e0ng ph\u1ed5i ch\u00fang g\u00e2y tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i).<\/span><\/p>\n

    – \u0110\u1ed1i v\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p s\u00e1n khu tr\u00fa \u1edf ph\u1ee7 t\u1ea1ng kh\u00e1c, tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng di\u1ec5n bi\u1ebfn ph\u1ee9c t\u1ea1p, t\u00f9y theo ph\u1ee7 t\u1ea1ng k\u00fd sinh. N\u1ebfu s\u00e1n \u1edf n\u00e3o, th\u01b0\u1eddng c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111\u1ed9ng kinh, s\u00e1n \u1edf gan g\u00e2y \u00e1p xe gan…<\/span><\/p>\n

    6. C\u1eadn l\u00e2m s\u00e0ng<\/h2>\n

    6.1. X\u00e9t nghi\u1ec7m<\/span><\/b><\/h3>\n

    + Soi t\u01b0\u01a1i: \u0111\u1eddm, ph\u00e2n, d\u1ecbch m\u00e0ng ph\u1ed5i t\u00ecm tr\u1ee9ng s\u00e1n l\u00e1 ph\u1ed5i.<\/span><\/p>\n

    + C\u00f4ng th\u1ee9c m\u00e1u c\u00f3 th\u1ec3 c\u00f3 t\u0103ng B\u1ea1ch c\u1ea7u \u00e1i toan.<\/span><\/p>\n

    + \u0110\u1ecbnh l\u01b0\u1ee3ng IgE c\u00f3 th\u1ec3 t\u0103ng.<\/span><\/p>\n

    + X\u00e9t nghi\u1ec7m mi\u1ec5n d\u1ecbch: ELISA s\u00e1n l\u00e1 ph\u1ed5i (+)<\/span><\/p>\n

    6.2. Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh<\/span><\/b><\/h3>\n

    + Xquang ng\u1ef1c: c\u00f3 n\u1ed1t m\u1edd, \u0111\u00e1m m\u1edd, c\u00f3 h\u00ecnh hang nh\u1ecf v\u00e0 ch\u1ee7 y\u1ebfu \u1edf v\u00f9ng th\u1ea5p (n\u1ebfu s\u00e1n \u1edf trong ph\u1ed5i) ho\u1eb7c h\u00ecnh \u1ea3nh tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i (n\u1ebfu s\u00e1n \u1edf trong m\u00e0ng ph\u1ed5i).<\/span><\/p>\n

    + Ch\u1ee5p CT\/ MRI ng\u1ef1c: d\u00f9ng trong ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p ho ra m\u00e1u kh\u00e1c nh\u01b0 ung th\u01b0 ph\u1ed5i, gi\u00e3n ph\u1ebf qu\u1ea3n, lao ph\u1ed5i…<\/span><\/p>\n

    + Si\u00eau \u00e2m \u1ed5 b\u1ee5ng: t\u00ecm t\u1ed5n th\u01b0\u01a1ng s\u00e1n l\u00e1 ph\u1ed5i l\u1ea1c ch\u1ed7.<\/span><\/p>\n

    7. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i<\/span><\/strong><\/h2>\n

    7.1. Ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nghi ng\u1edd<\/span><\/b><\/h3>\n

    – \u0110\u00e3 t\u1eebng \u0103n cua \u0111\u00e1, t\u00f4m su\u1ed1i ch\u01b0a n\u1ea5u ch\u00edn ho\u1eb7c<\/span><\/p>\n

    – S\u1ed1ng \u1edf trong v\u00f9ng d\u1ecbch t\u1ec5.<\/span><\/p>\n

    – C\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng n\u00eau \u1edf tr\u00ean.<\/span><\/p>\n

    7.2. Ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh x\u00e1c \u0111\u1ecbnh<\/span><\/b><\/h3>\n

    L\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd k\u00e8m theo c\u00e1c x\u00e9t nghi\u1ec7m sau:<\/span><\/p>\n

    – X\u00e9t nghi\u1ec7m<\/span><\/p>\n

    + T\u00ecm th\u1ea5y tr\u1ee9ng s\u00e1n l\u00e1 ph\u1ed5i trong \u0111\u1eddm, ph\u00e2n, d\u1ecbch m\u00e0ng ph\u1ed5i.<\/span><\/p>\n

    + ELISA s\u00e1n l\u00e1 ph\u1ed5i (+)<\/span><\/p>\n

    + C\u00f3 th\u1ec3 c\u00f3 t\u0103ng B\u1ea1ch c\u1ea7u \u00e1i toan<\/span><\/p>\n

    + \u0110\u1ecbnh l\u01b0\u1ee3ng IgE c\u00f3 th\u1ec3 t\u0103ng<\/span><\/p>\n

    – Xquang ng\u1ef1c: c\u00f3 n\u1ed1t m\u1edd, m\u1ea3ng m\u1edd, c\u00f3 h\u00ecnh hang nh\u1ecf v\u00e0 ch\u1ee7 y\u1ebfu \u1edf v\u00f9ng th\u1ea5p (n\u1ebfu s\u00e1n \u1edf trong ph\u1ed5i) ho\u1eb7c h\u00ecnh \u1ea3nh tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i (n\u1ebfu s\u00e1n \u1edf trong m\u00e0ng ph\u1ed5i).<\/span><\/p>\n

    7.3. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/span><\/b><\/h3>\n

    – B\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi b\u1ec7nh lao ph\u1ed5i.<\/span><\/p>\n

    – Ngo\u00e0i ra c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c t\u00ecnh tr\u1ea1ng g\u00e2y ho ra m\u00e1u kh\u00e1c nh\u01b0 gi\u00e3n ph\u1ebf qu\u1ea3n, ung th\u01b0 ph\u1ed5i…<\/span><\/p>\n

    – Ph\u00e2n bi\u1ec7t c\u00e1c b\u1ec7nh k\u00fd sinh tr\u00f9ng g\u00e2y t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i do nguy\u00ean nh\u00e2n kh\u00e1c nh\u01b0 toxocara, s\u00e1n l\u00e1 gan l\u1edbn, giun l\u01b0\u01a1n, giun m\u00f3c…<\/span><\/p>\n

    T\u00f3m l\u1ea1i, hi\u1ec3u bi\u1ebft v\u1ec1 nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ed1i v\u1edbi c\u1ea3 ng\u01b0\u1eddi d\u00e2n v\u00e0 c\u00e1c chuy\u00ean gia y t\u1ebf, gi\u00fap ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh hi\u1ec7u qu\u1ea3 h\u01a1n. Ngo\u00e0i ra, hi\u1ec3u bi\u1ebft v\u1ec1 b\u1ec7nh c\u00f2n c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 ki\u1ec3m so\u00e1t c\u00e1c d\u1ecbch b\u1ec7nh truy\u1ec1n nhi\u1ec5m li\u00ean quan \u0111\u1ebfn \u0111\u1ed9ng v\u1eadt, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong vi\u1ec7c s\u1ea3n xu\u1ea5t v\u00e0 ti\u00eau th\u1ee5 th\u1ef1c ph\u1ea9m.Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

    B\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i l\u00e0 do s\u00e1n l\u00e1 thu\u1ed9c gi\u1ed1ng\u00a0Paragonimus k\u00fd sinh trong ph\u1ed5i ho\u1eb7c m\u00e0ng ph\u1ed5i g\u00e2y n\u00ean. Ng\u01b0\u1eddi nhi\u1ec5m b\u1ec7nh do \u0103n ph\u1ea3i t\u00f4m, cua ch\u01b0a \u0111\u01b0\u1ee3c n\u1ea5u ch\u00edn c\u00f3 nhi\u1ec5m \u1ea5u tr\u00f9ng s\u00e1n l\u00e1 ph\u1ed5i. Vi\u1ec7c hi\u1ec3u bi\u1ebft v\u1ec1 nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i l\u00e0 r\u1ea5t […]<\/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":"\nB\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i: Nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n<\/title>\n<meta name=\"description\" content=\"Vi\u1ec7c hi\u1ec3u bi\u1ebft v\u1ec1 nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i l\u00e0 r\u1ea5t quan tr\u1ecdng, gi\u00fap ph\u00e1t hi\u1ec7n v\u00e0 ch\u1eefa tr\u1ecb b\u1ec7nh k\u1ecbp th\u1eddi, ...\" \/>\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\" 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