{"id":23478,"date":"2023-04-18T11:17:03","date_gmt":"2023-04-18T04:17:03","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=23478"},"modified":"2023-04-18T15:45:20","modified_gmt":"2023-04-18T08:45:20","slug":"tiep-can-co-giat-o-tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/tiep-can-co-giat-o-tre-em\/","title":{"rendered":"Ti\u1ebfp c\u1eadn co gi\u1eadt \u1edf tr\u1ebb em"},"content":{"rendered":"

Co gi\u1eadt \u1edf tr\u1ebb em l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng ph\u1ee9c t\u1ea1p bi\u1ec3u hi\u1ec7n m\u1ed9t s\u1ef1 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng n\u00e3o k\u1ecbch ph\u00e1t kh\u00f4ng ch\u1ee7 \u00fd g\u00e2y ra do c\u00f3 m\u1ed9t ho\u1ea1t \u0111\u1ed9ng qu\u00e1 m\u1ee9c, b\u1ea5t th\u01b0\u1eddng v\u00e0 \u0111\u1ed3ng th\u1eddi c\u1ee7a m\u1ed9t nh\u00f3m nhi\u1ec1u ho\u1eb7c \u00edt c\u00e1c neurone. L\u00e0 c\u1ea5p c\u1ee9u th\u1ea7n kinh th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb em, do nhi\u1ec1u nguy\u00ean nh\u00e2n v\u00e0 c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng, c\u00f3 th\u1ec3 g\u00e2y thi\u1ebfu oxy n\u00e3o, t\u1eed vong; th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u1edf tr\u1ebb em l\u00e0 s\u1ed1t cao co gi\u1eadt.<\/strong><\/p>\n

1. \u00a0Nguy\u00ean nh\u00e2n g\u00e2y co gi\u1eadt \u1edf tr\u1ebb em.\u00a0
\n<\/strong><\/h2>\n

1.1. Co gi\u1eadt c\u00f3 nguy\u00ean nh\u00e2n th\u00fac \u0111\u1ea9y
\n<\/strong><\/h3>\n

– C\u00f3 s\u1ed1t:
\n<\/strong>+ Nhi\u1ec5m tr\u00f9ng h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng: vi\u00eam n\u00e3o, vi\u00eam m\u00e0ng n\u00e3o, s\u1ed1t r\u00e9t th\u1ec3 n\u00e3o, \u00e1p-xe n\u00e3o.
\n+ Co gi\u1eadt trong l\u1ef5, vi\u00eam d\u1ea1 d\u00e0y ru\u1ed9t.
\n+ Kh\u00e1c: s\u1ed1t co gi\u1eadt trong c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng nh\u01b0 vi\u00eam tai gi\u1eefa, vi\u00eam ph\u1ed5i, nhi\u1ec5m tr\u00f9ng ti\u1ec3u, nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p tr\u00ean.
\n– Kh\u00f4ng s\u1ed1t:
\n<\/strong>+ Nguy\u00ean nh\u00e2n t\u1ea1i h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng:
\n\u00a7 Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o
\n\u00a7 Xu\u1ea5t huy\u1ebft n\u00e3o-m\u00e0ng n\u00e3o: thi\u1ebfu vitamin K, r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u, v\u1ee1 d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u n\u00e3o
\n\u00a7 Thi\u1ebfu oxy n\u00e3o
\n\u00a7 U n\u00e3o
\n+ Nguy\u00ean nh\u00e2n ngo\u00e0i h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng:
\n\u00a7 R\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a: t\u0103ng hay h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, thi\u1ebfu vitamin B1, B6.
\n\u00a7 R\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i: t\u0103ng hay gi\u1ea3m Na+, gi\u1ea3m Ca++, gi\u1ea3m Mg++ m\u00e1u.
\n\u00a7 Ng\u1ed9 \u0111\u1ed9c: phosphore h\u1eefa c\u01a1, thu\u1ed1c di\u1ec7t chu\u1ed9t, kh\u00e1ng histamin.
\n\u00a7 T\u0103ng huy\u1ebft \u00e1p.<\/p>\n

1.2. Co gi\u1eadt kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n th\u00fac \u0111\u1ea9y<\/h3>\n

C\u01a1n co gi\u1eadt t\u00e1i ph\u00e1t v\u00e0 kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n th\u00fac \u0111\u1ea9y th\u00ec c\u00f3 th\u1ec3 h\u01b0\u1edbng \u0111\u1ebfn nguy\u00ean nh\u00e2n co gi\u1eadt l\u00e0 do \u0111\u1ed9ng kinh.<\/p>\n

\"minh-hoa-co-giat-o-tre-em\"<\/p>\n

2. L\u00e2m s\u00e0ng co gi\u1eadt \u1edf tr\u1ebb em.<\/h2>\n

2.1. B\u1ec7nh s\u1eed<\/h3>\n

– H\u1ecfi v\u1ec1 c\u01a1n co gi\u1eadt:
\n+ C\u01a1n gi\u1eadt l\u1ea7n \u0111\u1ea7u ti\u00ean hay \u0111\u00e3 nhi\u1ec1u l\u1ea7n
\n+ Ki\u1ec3u gi\u1eadt: c\u01a1n co c\u1ee9ng-co gi\u1eadt, c\u01a1n co c\u1ee9ng, c\u01a1n gi\u1eadt c\u01a1
\n+ C\u00f3 m\u1ea5t \u00fd th\u1ee9c kh\u00f4ng: c\u00f3 nh\u1eadn bi\u1ebft xung quanh v\u00e0 l\u00e0m theo y\u00eau c\u1ea7u trong c\u01a1n kh\u00f4ng, sau c\u01a1n c\u00f3 nh\u1edb \u0111\u01b0\u1ee3c s\u1ef1 ki\u1ec7n trong c\u01a1n kh\u00f4ng.
\n+ C\u00f3 r\u1ed1i lo\u1ea1n tri gi\u00e1c sau c\u01a1n gi\u1eadt kh\u00f4ng
\n+ V\u1ecb tr\u00ed: c\u1ee5c b\u1ed9, m\u1ed9t b\u00ean, hai b\u00ean hay to\u00e0n th\u1ec3
\n+ Th\u1eddi gian: k\u00e9o d\u00e0i bao l\u00e2u
\n+ S\u1ed1 l\u1ea7n co gi\u1eadt trong \u0111\u1ee3t b\u1ec7nh n\u00e0y
\n– N\u1ebfu nghi ng\u1edd \u0111\u1ed9ng kinh khai th\u00e1c th\u00eam v\u1ec1 c\u01a1n co gi\u1eadt nh\u01b0 sau:
\n+ H\u1ecfi v\u1ec1 d\u1ea5u hi\u1ec7u ti\u1ec1n tri\u1ec7u: kh\u00f3 ch\u1ecbu v\u00f9ng th\u01b0\u1ee3ng v\u1ecb, c\u1ea3m gi\u00e1c lo s\u1ee3, \u0111au.
\n+ C\u01a1n x\u1ea3y ra khi n\u00e0o: \u0111ang th\u1ee9c hay \u0111ang ng\u1ee7, th\u1eddi gian trong ng\u00e0y.
\n+ C\u00f3 r\u1ed1i lo\u1ea1n h\u1ec7 t\u1ef1 ch\u1ee7: ch\u1ea3y n\u01b0\u1edbc b\u1ecdt, v\u00e3 m\u1ed3 h\u00f4i, ti\u00eau ti\u1ec3u trong c\u01a1n,\u2026
\n+ Bi\u1ec3u hi\u1ec7n sau c\u01a1n: r\u1ed1i lo\u1ea1n tri gi\u00e1c, ng\u1ee7 l\u1ecbm, t\u1ec9nh t\u00e1o gi\u1eefa c\u00e1c c\u01a1n, nh\u1ee9c \u0111\u1ea7u, y\u1ebfu li\u1ec7t, m\u1ea5t ng\u00f4n ng\u1eef
\n+ C\u00f3 b\u1ecb ch\u1ea5n th\u01b0\u01a1ng do c\u01a1n co gi\u1eadt g\u00e2y ra kh\u00f4ng
\n+ C\u00f3 y\u1ebfu t\u1ed1 k\u00edch th\u00edch hay th\u00fac \u0111\u1ea9y kh\u00f4ng
\n+ C\u00f3 th\u1ec3 nh\u1edd cha m\u1eb9 b\u00e9 m\u00f4 t\u1ea3 l\u1ea1i c\u01a1n co gi\u1eadt
\n– T\u00ecm hi\u1ec3u v\u1ec1 c\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn nguy\u00ean nh\u00e2n th\u00fac \u0111\u1ea9y:
\n+ S\u1ed1t, \u00f3i m\u1eeda, nh\u1ee9c \u0111\u1ea7u
\n+ Ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u
\n+ Ti\u00eau ch\u1ea3y, ti\u00eau \u0111\u00e0m m\u00e1u
\n+ D\u1ea5u y\u1ebfu li\u1ec7t
\n+ N\u1ebfu \u0111ang \u0111i\u1ec1u tr\u1ecb \u0111\u1ed9ng kinh th\u00ec h\u1ecfi tr\u1ebb c\u00f3 b\u1ecf thu\u1ed1c kh\u00f4ng, c\u00f3 d\u00f9ng thu\u1ed1c g\u00ec k\u00e8m kh\u00f4ng,\u2026
\n+ Kh\u1ea3 n\u0103ng b\u1ecb ng\u1ed9 \u0111\u1ed9c: thu\u1ed1c, h\u00f3a ch\u1ea5t, ph\u00e2n b\u00f3n, thu\u1ed1c di\u1ec7t chu\u1ed9t,\u2026
\n– Ti\u1ec1n s\u1eed:
\n+ C\u01a1n gi\u1eadt \u0111\u1ea7u ti\u00ean hay \u0111\u00e3 nhi\u1ec1u l\u1ea7n
\n+ Ti\u1ec1n c\u0103n s\u1ea3n khoa. Ti\u1ec1n c\u0103n co gi\u1eadt do s\u1ed1t. Ti\u1ec1n c\u0103n ch\u1ea5n th\u01b0\u01a1ng.
\n+ B\u1ec7nh l\u00fd th\u1ea7n kinh tr\u01b0\u1edbc: b\u1ea1i n\u00e3o, ch\u1eadm ph\u00e1t tri\u1ec3n t\u00e2m th\u1ea7n v\u1eadn \u0111\u1ed9ng, b\u1ec7nh chuy\u1ec3n h\u00f3a.
\n+ Thu\u1ed1c d\u00f9ng tr\u01b0\u1edbc \u0111\u00e2y: c\u00f3 \u0111ang d\u00f9ng thu\u1ed1c \u0111\u1ed9ng kinh kh\u00f4ng v\u00e0 \u0111\u00e1p \u1ee9ng c\u1ee7a tr\u1ebb v\u1edbi thu\u1ed1c.
\n+ Ti\u1ec1n c\u0103n gia \u0111\u00ecnh c\u00f3 li\u00ean quan \u0111\u1ebfn co gi\u1eadt hay b\u1ec7nh l\u00fd kh\u00e1c.<\/p>\n

2.2. Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3<\/h3>\n

– \u0110\u00e1nh gi\u00e1 tri gi\u00e1c: t\u1ec9nh t\u00e1o hay l\u1eeb \u0111\u1eeb, li b\u00ec, l\u01a1 m\u01a1, h\u1ed1t ho\u1ea3ng, n\u00f3i s\u1ea3ng, h\u00f4n m\u00ea.
\n– \u0110\u00e1nh gi\u00e1 sinh hi\u1ec7u: th\u00e2n nhi\u1ec7t, m\u1ea1ch, huy\u1ebft \u00e1p, nh\u1ecbp th\u1edf
\n– T\u00ecm c\u00e1c d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd nguy\u00ean nh\u00e2n:
\n+ D\u1ea5u m\u00e0ng n\u00e3o: c\u1ed5 g\u01b0\u1ee3ng, d\u1ea5u Brudzinski, th\u00f3p ph\u1ed3ng
\n+ D\u1ea5u g\u1ee3i \u00fd xu\u1ea5t huy\u1ebft: thi\u1ebfu m\u00e1u \u1edf tr\u1ebb s\u01a1 sinh v\u00e0 nh\u0169 nhi
\n+ D\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb: li\u1ec7t th\u1ea7n kinh n\u1ed9i s\u1ecd, y\u1ebfu li\u1ec7t chi
\n+ D\u1ea5u ch\u1ea5n th\u01b0\u01a1ng: b\u1ea7m m\u00e1u, r\u00e1ch da \u0111\u1ea7u
\n+ Kh\u00e1m da: m\u1ea3ng c\u00e0 ph\u00ea s\u1eefa, b\u01b0\u1edbu m\u00e1u, m\u1ea3ng da \u0111\u1ecf t\u00edm tr\u00ean m\u1eb7t,\u2026
\n+ Kh\u00e1m \u0111\u00e1y m\u1eaft: d\u1ea5u ph\u00f9 gai, xu\u1ea5t huy\u1ebft, vi\u00eam m\u00e0ng m\u1ea1ch v\u00f5ng m\u1ea1c
\n+ \u0110\u1ec3 \u00fd m\u00f9i h\u00f4i to\u00e1t ra t\u1eeb ng\u01b0\u1eddi ho\u1eb7c h\u01a1i th\u1edf c\u1ee7a b\u1ec7nh nhi
\n– Kh\u00e1m t\u1ed5ng qu\u00e1t v\u00e0 kh\u00e1m th\u1ea7n kinh.<\/p>\n

2.3. C\u1eadn l\u00e2m s\u00e0ng<\/h3>\n

– <\/strong>\u0110\u01b0\u1eddng huy\u1ebft, ch\u1ee9c n\u0103ng th\u1eadn, gan
\n– <\/strong>Ion \u0111\u1ed3: t\u0103ng hay gi\u1ea3m Na+ m\u00e1u, gi\u1ea3m Ca++ hay Mg++ m\u00e1u
\n– <\/strong>C\u00f4ng th\u1ee9c m\u00e1u, CRP khi nghi ng\u1edd nhi\u1ec5m tr\u00f9ng
\n– <\/strong>C\u1ea5y m\u00e1u, c\u1ea5y ph\u00e2n, c\u1ea5y n\u01b0\u1edbc ti\u1ec3u
\n– <\/strong>K\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t. Huy\u1ebft thanh ch\u1ea9n \u0111o\u00e1n t\u00e1c nh\u00e2n khi nghi ng\u1edd vi\u00eam n\u00e3o.
\n– <\/strong>Test nhanh ch\u1ea9n \u0111o\u00e1n s\u1ed1t xu\u1ea5t huy\u1ebft
\n– <\/strong>L\u1ea5y m\u1eabu d\u1ecbch d\u1ea1 d\u00e0y, m\u00e1u khi nghi ng\u1edd ng\u1ed9 \u0111\u1ed9c
\n– <\/strong>Ch\u1ecdc d\u00f2 d\u1ecbch n\u00e3o t\u1ee7y: khi nghi ng\u1edd nhi\u1ec5m tr\u00f9ng h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng.
\n– <\/strong>Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh: si\u00eau \u00e2m n\u00e3o xuy\u00ean th\u00f3p \u1edf tr\u1ebb nh\u1ecf, CT scan c\u00f3 c\u1ea3n quang.
\n– <\/strong>MRI khi nghi ng\u1edd \u0111\u1ed9ng kinh tri\u1ec7u ch\u1ee9ng, b\u1ec7nh l\u00fd ch\u1ea5t tr\u1eafng, vi\u00eam m\u1ea1ch m\u00e1u n\u00e3o, d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u n\u00e3o, nh\u1ed3i m\u00e1u n\u00e3o nh\u1ecf v\u00e0 s\u00e2u.
\n<\/strong>– \u0110i\u1ec7n n\u00e3o \u0111\u1ed3: khi nghi ng\u1edd \u0111\u1ed9ng kinh.<\/p>\n


\n<\/strong>3. \u0110i\u1ec1u tr\u1ecb co gi\u1eadt \u1edf tr\u1ebb em.<\/h2>\n

3.1. Nguy\u00ean t\u1eafc<\/h3>\n

– H\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p: th\u00f4ng \u0111\u01b0\u1eddng th\u1edf v\u00e0 cung c\u1ea5p oxy
\n– C\u1eaft c\u01a1n co gi\u1eadt
\n– \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n<\/p>\n

3.2. \u0110i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng<\/h3>\n

– H\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p
\n+ Th\u00f4ng tho\u00e1ng \u0111\u01b0\u1eddng th\u1edf: \u0111\u1eb7t n\u1eb1m nghi\u00eang, \u0111\u1ea7u ng\u1eeda, h\u00fat \u0111\u00e0m nh\u1edbt t\u00edch c\u1ef1c.<\/strong>
\n+ Th\u1edf oxy \u0111\u1ec3 \u0111\u1ea1t SaO2 92-96%.
\n+ \u0110\u1eb7t NKQ gi\u00fap th\u1edf n\u1ebfu th\u1ea5t b\u1ea1i v\u1edbi oxy hay c\u00f3 c\u01a1n ng\u01b0ng th\u1edf.
\n– C\u1eaft c\u01a1n co gi\u1eadt
\n+ <\/strong>B\u01b0\u1edbc 1:
\n<\/strong>\u00a7 N\u1ebfu ch\u01b0a c\u00f3 \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch:
\n\u2022 B\u01a1m h\u1eadu m\u00f4n Diazepam 0,5mg\/kg, t\u1ed1i \u0111a 5 mg v\u1edbi tr\u1ebb < 5tu\u1ed5i, 10 mg v\u1edbi tr\u1ebb> 5tu\u1ed5i.
\n\u00a7 N\u1ebfu c\u00f3 \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch d\u00f9ng:
\n\u2022 Diazepam 0,2-0,3mg\/kg\/li\u1ec1u pha lo\u00e3ng TMC, t\u1ed1i \u0111a 10mg
\n\u2022 Midazolam 0,1- 0,2mg\/kg\/l\u1ea7n TMC
\nTr\u1ebb s\u01a1 sinh: \u01b0u ti\u00ean ch\u1ecdn Phenobarbital: 15-20 mg\/kg truy\u1ec1n t\u0129nh m\u1ea1ch ch\u1eadm trong 30 ph\u00fat, n\u1ebfu sau 30 ph\u00fat v\u1eabn c\u00f2n co gi\u1eadt c\u00f3 th\u1ec3 l\u1eb7p l\u1ea1i li\u1ec1u th\u1ee9 hai 10 mg\/kg.<\/p>\n

+ B\u01b0\u1edbc 2: sau 5-10 ph\u00fat c\u00f2n c\u01a1n, l\u1eb7p l\u1ea1i li\u1ec1u tr\u00ean l\u1ea7n th\u1ee9 2
\n+ B\u01b0\u1edbc 3: c\u01a1n co gi\u1eadt c\u00f2n ti\u1ebfp t\u1ee5c ho\u1eb7c t\u00e1i ph\u00e1t:
\n\u00a7 Fosphenytoin 20mg\/kg, t\u1ed1i \u0111a 1.000mg pha trong NS hay G5% TTM trong 30 ph\u00fat
\n\u00a7 Phenytoin 20 mg\/kg, t\u1ed1i \u0111a 1.000mg pha trong NS TTM trong 30 ph\u00fat
\n\u00a7 Phenobarbital 20mg\/kg, t\u1ed1i \u0111a 700mg TTM trong 30 ph\u00fat.
\nL\u01b0u \u00fd:
\n– Thu\u1ed1c ch\u1ed1ng co gi\u1eadt c\u00f3 th\u1ec3 g\u00e2y ng\u01b0ng th\u1edf d\u00f9 ti\u00eam m\u1ea1ch hay b\u01a1m h\u1eadu m\u00f4n, v\u00ec
\nth\u1ebf lu\u00f4n chu\u1ea9n b\u1ecb b\u00f3ng mask gi\u00fap th\u1edf, nh\u1ea5t l\u00e0 khi ti\u00eam m\u1ea1ch nhanh.
\n– Nguy c\u01a1 ng\u01b0ng th\u1edf s\u1ebd gia t\u0103ng khi ph\u1ed1i h\u1ee3p Diazepam v\u00e0 Phenobarbital.
\n+ B\u01b0\u1edbc 4: sau 5 ph\u00fat c\u00f2n c\u01a1n
\n<\/strong>\u00a7 L\u1eb7p l\u1ea1i li\u1ec1u phenobarbital (n\u1ebfu \u0111\u00e3 s\u1eed d\u1ee5ng phenytoin)
\n\u00a7 L\u1eb7p l\u1ea1i li\u1ec1u phenytoin (n\u1ebfu \u0111\u00e3 s\u1eed d\u1ee5ng phenobarbital) (GPP)
\n+ B\u01b0\u1edbc 5: sau 10 ph\u00fat c\u00f2n c\u01a1n
\n<\/strong>\u00a7 Midazolam: bolus 0,15 mg\/kg\/l\u1ea7n, c\u00f3 th\u1ec3 l\u1eadp l\u1ea1i li\u1ec1u th\u1ee9 3.
\n\u00a7 Duy tr\u00ec 0,1 mg\/kg\/gi\u1edd, c\u00f3 th\u1ec3 t\u0103ng d\u1ea7n 0,1mg\/kg\/gi\u1edd m\u1ed7i 5 ph\u00fat \u0111\u1ec3 c\u00f3 \u0111\u00e1p \u1ee9ng (t\u1ed1i \u0111a 2mg\/kg\/gi\u1edd).
\n\u00a7 M\u1eddi b\u00e1c s\u0129 G\u00e2y M\u00ea H\u1ed3i S\u1ee9c h\u1ed7 tr\u1ee3 n\u1ebfu ch\u01b0a c\u1eaft c\u01a1n gi\u1eadt sau 3 li\u1ec1u thu\u1ed1c ch\u1ed1ng co gi\u1eadt<\/p>\n

3.3. \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n<\/h3>\n

– Co gi\u1eadt do s\u1ed1t: paracetamol 15-20 mg\/kg\/li\u1ec1u nh\u00e9t h\u1eadu m\u00f4n.
\n– H\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft: tr\u1ebb l\u1edbn: dextrose 30% 2 ml\/kg ti\u00eam m\u1ea1ch. Tr\u1ebb s\u01a1 sinh: dextrose 10% 2 ml\/kg ti\u00eam m\u1ea1ch. Sau \u0111\u00f3, duy tr\u00ec b\u1eb1ng dextrose 10% truy\u1ec1n t\u0129nh m\u1ea1ch 3-5ml\/kg\/gi\u1edd.
\n– H\u1ea1 natri m\u00e1u: Natrichlorua 3% 6-10ml\/kg truy\u1ec1n t\u0129nh m\u1ea1ch trong 1 gi\u1edd.
\n– T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd (n\u1ebfu c\u00f3)
\n– Nguy\u00ean nh\u00e2n ngo\u1ea1i khoa nh\u01b0 ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u, xu\u1ea5t huy\u1ebft, u n\u00e3o: h\u1ed9i ch\u1ea9n ngo\u1ea1i th\u1ea7n kinh.
\n– \u0110\u1ed9ng kinh: d\u00f9ng thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh.<\/p>\n

4. Ch\u0103m s\u00f3c – theo d\u00f5i<\/h2>\n

– L\u00e2m s\u00e0ng: tri gi\u00e1c, m\u1ea1ch, huy\u1ebft \u00e1p, nh\u1ecbp th\u1edf, nhi\u1ec7t \u0111\u1ed9, SaO2, d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb, d\u1ea5u hi\u1ec7u t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.
\n– C\u1eadn l\u00e2m s\u00e0ng: \u0111\u01b0\u1eddng huy\u1ebft, ion \u0111\u1ed3, kh\u00ed m\u00e1u, d\u1ecbch n\u00e3o t\u1ee7y, \u0111i\u1ec7n n\u00e3o,\u2026
\n– T\u00ecm v\u00e0 \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n.<\/p>\n

5. H\u01b0\u1edbngd\u1eabn ng\u01b0\u1eddi nh\u00e0 khi tr\u1ebb co gi\u1eadt<\/h2>\n

– \u0110\u1eb7t tr\u1ebb n\u1eb1m n\u01a1i r\u1ed9ng r\u00e3i, an to\u00e0n, n\u1eb1m \u0111\u1ea7u b\u1eb1ng h\u01a1i nghi\u00eang m\u1ed9t b\u00ean, tr\u00e1nh xa nh\u1eefng v\u1eadt s\u1eafc nh\u1ecdn, n\u1edbi l\u1ecfng qu\u1ea7n \u00e1o.
\n– K\u00eau th\u00eam ng\u01b0\u1eddi gi\u00fap \u0111\u1ee1. \u0110\u01b0a tr\u1ebb \u0111\u1ebfn trung t\u00e2m y t\u1ebf g\u1ea7n nh\u1ea5t khi tr\u1ebb b\u1ecb ch\u1ea5n th\u01b0\u01a1ng, co gi\u1eadt tr\u00ean 10 ph\u00fat, c\u00e1c c\u01a1n co gi\u1eadt t\u00e1i ph\u00e1t nhanh.
\n– Ghi nh\u1eadn \u0111\u1eb7c \u0111i\u1ec3m c\u01a1n gi\u1eadt: th\u1eddi gian, ki\u1ec3u c\u00f3 gi\u1eadt, t\u00ecnh tr\u1ea1ng th\u1ee9c t\u1ec9nh, ti\u00eau ti\u1ec3u trong c\u01a1n, tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u00e9 sau c\u01a1n,..<\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n

    \n
  1. Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb – BV Nhi \u0110\u1ed3ng 1<\/li>\n
  2. B\u00e0i gi\u1ea3ng Nhi Khoa \u2013 B\u1ed9 m\u00f4n Nhi \u2013 \u0110HYD TPHCM<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Co gi\u1eadt \u1edf tr\u1ebb em l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng ph\u1ee9c t\u1ea1p bi\u1ec3u hi\u1ec7n m\u1ed9t s\u1ef1 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng n\u00e3o k\u1ecbch ph\u00e1t kh\u00f4ng ch\u1ee7 \u00fd g\u00e2y ra do c\u00f3 m\u1ed9t ho\u1ea1t \u0111\u1ed9ng qu\u00e1 m\u1ee9c, b\u1ea5t th\u01b0\u1eddng v\u00e0 \u0111\u1ed3ng th\u1eddi c\u1ee7a m\u1ed9t nh\u00f3m nhi\u1ec1u ho\u1eb7c \u00edt c\u00e1c neurone. L\u00e0 c\u1ea5p c\u1ee9u th\u1ea7n kinh th\u01b0\u1eddng g\u1eb7p \u1edf […]<\/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":"\nTi\u1ebfp c\u1eadn co gi\u1eadt \u1edf tr\u1ebb em - Vinmec<\/title>\n<meta name=\"description\" content=\"Co gi\u1eadt \u1edf tr\u1ebb em l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng ph\u1ee9c t\u1ea1p bi\u1ec3u hi\u1ec7n m\u1ed9t s\u1ef1 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng n\u00e3o k\u1ecbch ph\u00e1t kh\u00f4ng ch\u1ee7 \u00fd c\u1ee7a c\u00e1c neurone.\" \/>\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=\"Ti\u1ebfp c\u1eadn co gi\u1eadt \u1edf tr\u1ebb em - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Co gi\u1eadt \u1edf tr\u1ebb em l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng ph\u1ee9c t\u1ea1p bi\u1ec3u hi\u1ec7n m\u1ed9t s\u1ef1 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng n\u00e3o k\u1ecbch ph\u00e1t kh\u00f4ng ch\u1ee7 \u00fd c\u1ee7a c\u00e1c neurone.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/tiep-can-co-giat-o-tre-em\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-18T04:17:03+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-18T08:45:20+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/20200202_062138_971193_tre-co-giat.max-1800x1800-1-300x180.jpg\" \/>\n<meta name=\"author\" content=\"Dai Tran Van\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dai Tran Van\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/tiep-can-co-giat-o-tre-em\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/tiep-can-co-giat-o-tre-em\/\",\"name\":\"Ti\u1ebfp c\u1eadn co gi\u1eadt \u1edf tr\u1ebb em - 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