{"id":24011,"date":"2023-04-29T14:13:58","date_gmt":"2023-04-29T07:13:58","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24011"},"modified":"2023-05-07T11:43:25","modified_gmt":"2023-05-07T04:43:25","slug":"tac-nhan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/29\/tac-nhan\/","title":{"rendered":"Ph\u00e2n bi\u1ec7t t\u00e1c nh\u00e2n v\u00e0 c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c trong vi\u00eam ph\u1ed5i c\u1ed9ng \u0111\u1ed3ng"},"content":{"rendered":"

Vi\u00eam ph\u1ed5i c\u1ed9ng \u0111\u1ed3ng (VPC\u0110) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn \u0111\u01b0\u1ee3c g\u00e2y ra b\u1edfi nhi\u1ec1u lo\u1ea1i vi khu\u1ea9n, virus v\u00e0 n\u1ea5m kh\u00e1c nhau. \u0110\u1ec3 ph\u00e2n bi\u1ec7t ch\u1ea9n \u0111o\u00e1n VPC\u0110, c\u00e1c b\u00e1c s\u0129 c\u0169ng c\u1ea7n ph\u1ea3i x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh. C\u00e1c x\u00e9t nghi\u1ec7m vi sinh v\u00e0 c\u00e1c k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n kh\u00e1c gi\u00fap cho b\u00e1c s\u0129 c\u00f3 th\u1ec3 ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c lo\u1ea1i vi khu\u1ea9n, virus hay n\u1ea5m g\u00e2y b\u1ec7nh v\u00e0 t\u1eeb \u0111\u00f3 ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/strong><\/p>\n

1. Ch\u1ea9n \u0111o\u00e1n t\u00e1c nh\u00e2n g\u00e2y vi\u00eam ph\u1ed5i\u00a0<\/strong><\/h1>\n

1.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh t\u00e1c nh\u00e2n g\u00e2y vi\u00eam ph\u1ed5i d\u1ef1a tr\u00ean k\u1ebft qu\u1ea3 vi sinh<\/strong><\/h3>\n

– T\u00ednh tin c\u1eady c\u1ee7a k\u1ebft qu\u1ea3 vi sinh thay \u0111\u1ed5i t\u00f9y theo b\u1ec7nh ph\u1ea9m v\u00e0 ph\u01b0\u01a1ng ph\u00e1p c\u1ea5y.<\/p>\n

– Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh t\u00e1c nh\u00e2n \u201cch\u1eafc ch\u1eafn<\/em><\/strong>\u201d khi:<\/p>\n

+ C\u1ea5y m\u00e1u d\u01b0\u01a1ng t\u00ednh;<\/p>\n

+ C\u1ea5y d\u1ecbch, m\u1ee7 c\u1ee7a ph\u1ed5i\/m\u00e0ng ph\u1ed5i, ch\u1ecdc h\u00fat xuy\u00ean th\u00e0nh ng\u1ef1c d\u01b0\u01a1ng t\u00ednh;<\/p>\n

+ Hi\u1ec7n di\u1ec7n P. jiovecci trong \u0111\u1eddm, hay d\u1ecbch r\u1eeda ph\u1ebf qu\u1ea3n ph\u1ebf nang l\u1ea5y qua n\u1ed9i soi ph\u1ebf qu\u1ea3n;<\/p>\n

+ Ph\u00e2n l\u1eadp \u0111\u01b0\u1ee3c Legionella pneumophila trong b\u1ec7nh ph\u1ea9m \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p;<\/p>\n

+ Hi\u1ec7u gi\u00e1 kh\u00e1ng th\u1ec3 kh\u00e1ng M.pneumoniae, C.pneumoniae, L.pneumophila trong m\u00e1u t\u0103ng g\u1ea5p \u2265 4 l\u1ea7n qua hai l\u1ea7n x\u00e9t nghi\u1ec7m;<\/p>\n

+ Kh\u00e1ng nguy\u00ean c\u1ee7a S.pneumoniae (n\u01b0\u1edbc ti\u1ec3u, m\u00e1u), L.pneumophila (n\u01b0\u1edbc ti\u1ec3u) d\u01b0\u01a1ng t\u00ednh.<\/p>\n

– Ch\u1ea9n \u0111o\u00e1n t\u00e1c nh\u00e2n c\u00f3 \u201ckh\u1ea3 n\u0103ng<\/em><\/strong>\u201d khi:<\/p>\n

+ Vi khu\u1ea9n ph\u00e2n l\u1eadp \u0111\u01b0\u1ee3c khi c\u1ea5y \u0111\u1eddm l\u00e0 vi khu\u1ea9n g\u00e2y b\u1ec7nh th\u01b0\u1eddng g\u1eb7p + ph\u00e1t tri\u1ec3n m\u1ea1nh + k\u1ebft qu\u1ea3 soi \u0111\u1eddm ph\u00f9 h\u1ee3p;<\/p>\n

+ Vi khu\u1ea9n ph\u00e2n l\u1eadp \u0111\u01b0\u1ee3c khi c\u1ea5y \u0111\u1eddm kh\u00f4ng ph\u1ea3i l\u00e0 lo\u1ea1i vi khu\u1ea9n g\u00e2y b\u1ec7nh th\u01b0\u1eddng g\u1eb7p + ph\u00e1t tri\u1ec3n y\u1ebfu + k\u1ebft qu\u1ea3 soi \u0111\u1eddm ph\u00f9 h\u1ee3p.<\/p>\n

*Khuy\u1ebfn c\u00e1o \u0111\u00e1nh gi\u00e1 vi sinh tr\u00ean b\u1ec7nh nh\u00e2n VPC\u0110<\/strong><\/p>\n\n\n\n\n\n\n\n\n
Vi\u00eam ph\u1ed5i \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa<\/strong><\/td>\n<\/tr>\n
–\u00a0Kh\u00f4ng c\u1ea7n x\u00e9t nghi\u1ec7m vi sinh<\/p>\n

–\u00a0Nhu\u1ed9m gram v\u00e0 c\u1ea5y \u0111\u1eddm \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao nhi\u1ec5m vi khu\u1ea9n \u0111a kh\u00e1ng ho\u1eb7c c\u00e1c t\u00e1c nh\u00e2n kh\u00f4ng th\u01b0\u1eddng g\u1eb7p<\/td>\n<\/tr>\n

Vi\u00eam ph\u1ed5i \u0111i\u1ec1u tr\u1ecb n\u1ed9i tr\u00fa<\/strong><\/td>\n<\/tr>\n
–\u00a0C\u1ea5y m\u00e1u 2 l\u1ea7n<\/p>\n

–\u00a0Nhu\u1ed9m gram v\u00e0 c\u1ea5y m\u1ed9t m\u1eabu \u0111\u1eddm \u0111\u1ea1t ti\u00eau chu\u1ea9n<\/p>\n

–\u00a0Kh\u00e1ng nguy\u00ean n\u01b0\u1edbc ti\u1ec3u ch\u1ea9n \u0111o\u00e1n\u00a0Legionella pneumonphila\u00a0<\/em>(v\u00f9ng d\u1ecbch t\u1ec5 ho\u1eb7c khi c\u00f3 d\u1ecbch)<\/p>\n

–\u00a0Nhu\u1ed9m kh\u00e1ng c\u1ed3n \u2013 acid v\u00e0 c\u1ea5y \u0111\u1eddm t\u00ecm lao n\u1ebfu l\u00e2m s\u00e0ng hay X-quang ph\u1ed5i nghi ng\u1edd lao<\/p>\n

–\u00a0Soi v\u00e0 c\u1ea5y \u0111\u1eddm t\u00ecm n\u1ea5m, huy\u1ebft thanh ch\u1ea9n \u0111o\u00e1n n\u1ea5m n\u1ebfu l\u00e2m s\u00e0ng hay X-quang ph\u1ed5i nghi ng\u1edd<\/p>\n

–\u00a0Soi \u0111\u1eddm t\u00ecm\u00a0P. jijovecii\u00a0<\/em>n\u1ebfu l\u00e2m s\u00e0ng hay X-quang ph\u1ed5i nghi ng\u1edd<\/p>\n

–\u00a0Huy\u1ebft thanh ch\u1ea9n \u0111o\u00e1n\u00a0M.pneumoniae, C.pneumoniae, Legionella. Spp<\/em>, virus h\u00f4 h\u1ea5p (v\u00f9ng d\u1ecbch t\u1ec5 ho\u1eb7c khi c\u00f3 d\u1ecbch)<\/p>\n

–\u00a0C\u1ea5y d\u1ecbch m\u00e0ng ph\u1ed5i n\u1ebfu c\u00f3 tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i<\/td>\n<\/tr>\n

Vi\u00eam ph\u1ed5i \u0111i\u1ec1u tr\u1ecb t\u1ea1i khoa \u0110i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c<\/strong><\/td>\n<\/tr>\n
–\u00a0Nhu\u1ed9m gram v\u00e0 c\u1ea5y m\u1ed9t m\u1eabu \u0111\u1eddm \u0111\u1ea1t ti\u00eau chu\u1ea9n, d\u1ecbch ph\u1ebf qu\u1ea3n, ho\u1eb7c b\u1ec7nh ph\u1ea9m l\u1ea5y qua ch\u1ea3i ph\u1ebf qu\u1ea3n qua n\u1ed9i soi ph\u1ebf qu\u1ea3n c\u00f3 b\u1ea3o v\u1ec7 ho\u1eb7c r\u1eeda ph\u1ebf qu\u1ea3n \u2013 ph\u1ebf nang.<\/p>\n

–\u00a0C\u00e1c k\u1ef9 thu\u1eadt kh\u00e1c nh\u01b0 vi\u00eam ph\u1ed5i \u0111i\u1ec1u tr\u1ecb n\u1ed9i tr\u00fa<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\"\"
Ngu\u1ed3n<\/strong>: Klebsiella pneumoniae- Lab Diagnosis, Treatment, Prevention<\/em><\/figcaption><\/figure>\n

1.2. Ch\u1ea9n \u0111o\u00e1n t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh d\u1ef1a tr\u00ean kinh nghi\u1ec7m<\/strong><\/h3>\n

Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n c\u0103n nguy\u00ean c\u00f3 \u00fd ngh\u0129a quan tr\u1ecdng trong vi\u1ec7c l\u1ef1a ch\u1ecdn ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n. Tuy nhi\u00ean, khi x\u00e9t nghi\u1ec7m vi sinh kh\u00f4ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u00ec kh\u00f4ng c\u1ea7n thi\u1ebft\/kh\u00f4ng kh\u1ea3 thi ho\u1eb7c \u0111\u00e3 khi x\u00e9t nghi\u1ec7m vi sinh \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n nh\u01b0ng k\u1ebft qu\u1ea3 ch\u01b0a c\u00f3 ho\u1eb7c \u00e2m t\u00ednh v\u00ec ch\u1ea9n \u0111o\u00e1n t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh ph\u1ea3i d\u1ef1a v\u00e0o kinh nghi\u1ec7m c\u1ee7a b\u00e1c s\u0129 l\u00e2m s\u00e0ng.<\/p>\n

2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c v\u00e0 c\u00e1c t\u00e1c nh\u00e2n kh\u00e1c<\/strong><\/h2>\n

2.1. Lao ph\u1ed5i do t\u00e1c nh\u00e2n Mycobacterium tuberculosis<\/strong><\/h3>\n

– Ti\u1ec1n s\u1eed ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi m\u1eafc lao.<\/p>\n

– Ho kh\u1ea1c \u0111\u1eddm k\u00e9o d\u00e0i, c\u00f3 th\u1ec3 ho m\u00e1u, s\u1ed1t nh\u1eb9 v\u1ec1 chi\u1ec1u, g\u1ea7y s\u00fat c\u00e2n.<\/p>\n

– X-quang ph\u1ed5i c\u00f3 t\u1ed5n th\u01b0\u01a1ng nghi lao (n\u1ed1t, th\u00e2m nhi\u1ec5m, hang x\u01a1). C\u00f3 khi kh\u00f4ng \u0111i\u1ec3n h\u00ecnh nh\u1ea5t l\u00e0 \u1edf ng\u01b0\u1eddi suy gi\u1ea3m mi\u1ec5n d\u1ecbch (HIV\/AIDS, d\u00f9ng corticoid k\u00e9o d\u00e0i. ).<\/p>\n

– Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh: T\u00ecm th\u1ea5y tr\u1ef1c khu\u1ea9n kh\u00e1ng c\u1ed3n, kh\u00e1ng toan (AFB) trong \u0111\u1eddm ho\u1eb7c d\u1ecbch ph\u1ebf qu\u1ea3n qua soi tr\u1ef1c ti\u1ebfp, nu\u00f4i c\u1ea5y MGIT d\u01b0\u01a1ng t\u00ednh.<\/p>\n

2.2. T\u1eafc \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i<\/strong><\/h3>\n

– C\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1: b\u1ec7nh nh\u00e2n sau \u0111\u1ebb, sau ph\u1eabu thu\u1eadt \u1edf v\u00f9ng ti\u1ec3u khung, sau ch\u1ea5n th\u01b0\u01a1ng, g\u00e3y x\u01b0\u01a1ng, b\u1ea5t \u0111\u1ed9ng l\u00e2u ng\u00e0y, vi\u00eam t\u1eafc t\u0129nh m\u1ea1ch chi d\u01b0\u1edbi, d\u00f9ng thu\u1ed1c tr\u00e1nh thai.<\/p>\n

– \u0110au ng\u1ef1c d\u1eef d\u1ed9i, ho ra m\u00e1u, kh\u00f3 th\u1edf, c\u00f3 th\u1ec3 c\u00f3 d\u1ea5u hi\u1ec7u s\u1ed1c.<\/p>\n

– \u0110i\u1ec7n t\u00e2m \u0111\u1ed3 c\u00f3 th\u1ec3 th\u1ea5y d\u1ea5u hi\u1ec7u t\u00e2m ph\u1ebf c\u1ea5p: S s\u00e2u \u1edf D1, Q s\u00e2u \u1edf D3, tr\u1ee5c ph\u1ea3i, block nh\u00e1nh ph\u1ea3i.<\/p>\n

– Kh\u00ed m\u00e1u c\u00f3 th\u1ec3 th\u1ea5y t\u0103ng th\u00f4ng kh\u00ed: PaO2 gi\u1ea3m v\u00e0 PaCO2 gi\u1ea3m.<\/p>\n

– D-dimer m\u00e1u t\u0103ng cao.<\/p>\n

– Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh c\u00f3 ti\u00eam thu\u1ed1c c\u1ea3n quang t\u0129nh m\u1ea1ch c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n v\u1ecb tr\u00ed \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i b\u1ecb t\u1eafc.<\/p>\n

2.3. <\/strong>U<\/strong>ng th\u01b0 ph\u1ed5i<\/strong><\/h3>\n

– Th\u01b0\u1eddng g\u1eb7p \u1edf ng\u01b0\u1eddi > 50 tu\u1ed5i, c\u00f3 ti\u1ec1n s\u1eed nghi\u1ec7n thu\u1ed1c l\u00e1.<\/p>\n

– Ho kh\u1ea1c \u0111\u1eddm l\u1eabn m\u00e1u, g\u1ea7y s\u00fat c\u00e2n.<\/p>\n

– X-quang ph\u1ed5i c\u00f3 \u0111\u00e1m m\u1edd.<\/p>\n

– Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh ng\u1ef1c, soi ph\u1ebf qu\u1ea3n v\u00e0 sinh thi\u1ebft gi\u00fap ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh.<\/p>\n

– N\u00ean ch\u00fa \u00fd nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd ho\u1eb7c sau khi \u0111i\u1ec1u tr\u1ecb h\u1ebft nhi\u1ec5m khu\u1ea9n m\u00e0 t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i kh\u00f4ng c\u1ea3i thi\u1ec7n sau 1 th\u00e1ng ho\u1eb7c vi\u00eam ph\u1ed5i t\u00e1i ph\u00e1t \u1edf c\u00f9ng m\u1ed9t v\u1ecb tr\u00ed.<\/p>\n

2.4. <\/strong>G<\/strong>i\u00e3n ph\u1ebf qu\u1ea3n b\u1ed9i nhi\u1ec5m<\/strong><\/h3>\n

– B\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed ho kh\u1ea1c \u0111\u1eddm m\u1ee7 k\u00e9o d\u00e0i, c\u00f3 s\u1ed1t.<\/p>\n

– Kh\u00e1m ph\u1ed5i: C\u00f3 ran \u1ea9m, ran n\u1ed5 c\u1ed1 \u0111\u1ecbnh.<\/p>\n

– C\u1ea7n ch\u1ee5p phim c\u1eaft l\u1edbp vi t\u00ednh l\u1ed3ng ng\u1ef1c l\u1edbp m\u1ecfng 1 mm \u0111\u1ed9 ph\u00e2n gi\u1ea3i cao \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n.<\/p>\n

2.5. <\/strong>V<\/strong>i\u00eam ph\u1ed5i do t\u1ef1 mi\u1ec5n v\u00ec d\u00f9ng thu\u1ed1c<\/strong><\/h3>\n

– H\u1ecfi k\u1ef9 ti\u1ec1n s\u1eed d\u00f9ng thu\u1ed1c, \u0111\u1eb7c bi\u1ec7t ch\u00fa \u00fd t\u1edbi c\u00e1c thu\u1ed1c hay g\u00e2y vi\u00eam ph\u1ed5i nh\u01b0 cordarone…<\/p>\n

– C\u00e1c tri\u1ec7u ch\u1ee9ng s\u1ebd gi\u1ea3m ho\u1eb7c m\u1ea5t \u0111i khi ng\u1eebng thu\u1ed1c s\u1edbm.<\/p>\n

2.6. P<\/strong>h\u00f9 ph\u1ed5i b\u00e1n c\u1ea5p kh\u00f4ng \u0111i\u1ec3n h\u00ecnh<\/strong><\/h3>\n

– \u0110i\u1ec1u tr\u1ecb thu\u1ed1c l\u1ee3i ti\u1ec3u<\/p>\n

– Ch\u1ee5p l\u1ea1i phim X quang ph\u1ed5i \u0111\u00e1nh gi\u00e1 t\u1ed5n th\u01b0\u01a1ng.<\/p>\n

2.7. <\/strong>\u00a0V<\/strong>i\u00eam ph\u1ed5i do h\u00edt<\/strong><\/h3>\n

Hay g\u1eb7p: vi\u00eam ph\u1ed5i do s\u1eb7c d\u1ea7u<\/p>\n

– G\u1eb7p \u1edf nh\u1eefng ng\u01b0\u1eddi d\u00f9ng thu\u1ed1c nh\u1ecf m\u0169i c\u00f3 tinh d\u1ea7u, gi\u1ecdt d\u1ea7u l\u1ecdt v\u00e0o ph\u1ed5i. Ng\u01b0\u1eddi h\u00edt ph\u1ea3i x\u0103ng, d\u1ea7u h\u1ecfa, d\u1ea7u maz\u00fat.<\/p>\n

– Sau khi b\u1ecb s\u1eb7c, b\u1ec7nh nh\u00e2n s\u1ed1t r\u1ea5t cao 39 \u2013 40\u2070 C k\u00e9o d\u00e0i 1 \u2013 2 tu\u1ea7n l\u1ec5, \u0111au ng\u1ef1c d\u1eef d\u1ed9i, ho s\u1eb7c s\u1ee5a. Sau v\u00e0i ng\u00e0y ho kh\u1ea1c \u0111\u1eddm c\u00f3 m\u00e1u v\u00e0 m\u1ee7.<\/p>\n

– Kh\u00e1m: h\u1ed9i ch\u1ee9ng \u0111\u00f4ng \u0111\u1eb7c ph\u1ed5i.<\/p>\n

– X-quang ph\u1ed5i: c\u00f3 h\u00ecnh m\u1edd \u0111\u1ec1u thu\u1ef3 d\u01b0\u1edbi ho\u1eb7c m\u1ed9t b\u00ean ph\u1ed5i, c\u00f3 khi c\u1ea3 hai b\u00ean.<\/p>\n

2.8. <\/strong>\u00a0H<\/strong>\u1ed9i ch\u1ee9ng Loeffler<\/strong><\/h3>\n

– L\u00e0 nhi\u1ec5m ph\u1ed5i mau bay.<\/p>\n

– C\u00f3 h\u1ed9i ch\u1ee9ng \u0111\u00f4ng \u0111\u1eb7c, c\u00f3 t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan trong m\u00e1u v\u00e0 trong \u0111\u1eddm.<\/p>\n

– Nguy\u00ean nh\u00e2n: do giun \u0111\u0169a trong chu k\u1ef3 ph\u00e1t tri\u1ec3n \u0111i qua ph\u1ed5i g\u00e2y vi\u00eam ph\u1ed5i.<\/p>\n

– Nghe ph\u1ed5i: c\u00f3 th\u1ec3 th\u1ea5y ti\u1ebfng c\u1ecd m\u00e0ng ph\u1ed5i.<\/p>\n

– Xquang ph\u1ed5i: c\u00f3 nhi\u1ec1u d\u1ea3i m\u1edd \u0111a d\u1ea1ng v\u00e0 bi\u1ebfn m\u1ea5t sau m\u1ed9t tu\u1ea7n l\u1ec5.<\/p>\n

– Khi suy gi\u1ea3m mi\u1ec5n d\u1ecbch qua trung gian t\u1ebf b\u00e0o m\u00e0 s\u1ed1 l\u01b0\u1ee3ng CD4 < 200\/mL hay b\u1ecb vi\u00eam ph\u1ed5i do\u00a0P.jijovecii<\/em>.<\/p>\n

– Ng\u01b0\u1eddi nhi\u1ec5m HIV hay b\u1ecb vi\u00eam ph\u1ed5i do\u00a0P.jijovecii<\/em>, do\u00a0S.pneumoniae\u00a0<\/em>v\u00e0\u00a0H.influenza<\/em>.<\/p>\n

Ngu\u1ed3n:<\/strong> H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i m\u1eafc ph\u1ea3i c\u1ed9ng \u0111\u1ed3ng \u1edf ng\u01b0\u1eddi l\u1edbn c\u1ee7a B\u1ed9 Y t\u1ebf 2020.<\/p>\n","protected":false},"excerpt":{"rendered":"

Vi\u00eam ph\u1ed5i c\u1ed9ng \u0111\u1ed3ng (VPC\u0110) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn \u0111\u01b0\u1ee3c g\u00e2y ra b\u1edfi nhi\u1ec1u lo\u1ea1i vi khu\u1ea9n, virus v\u00e0 n\u1ea5m kh\u00e1c nhau. \u0110\u1ec3 ph\u00e2n bi\u1ec7t ch\u1ea9n \u0111o\u00e1n VPC\u0110, c\u00e1c b\u00e1c s\u0129 c\u0169ng c\u1ea7n ph\u1ea3i x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh. C\u00e1c x\u00e9t nghi\u1ec7m vi sinh v\u00e0 c\u00e1c k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n kh\u00e1c […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[],"yoast_head":"\nPh\u00e2n bi\u1ec7t t\u00e1c nh\u00e2n v\u00e0 c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c trong vi\u00eam ph\u1ed5i c\u1ed9ng \u0111\u1ed3ng<\/title>\n<meta name=\"description\" content=\"C\u00e1c x\u00e9t nghi\u1ec7m vi sinh v\u00e0 c\u00e1c k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n kh\u00e1c gi\u00fap cho b\u00e1c s\u0129 c\u00f3 th\u1ec3 ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c c\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh\" \/>\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 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