{"id":24182,"date":"2023-04-18T19:10:31","date_gmt":"2023-04-18T12:10:31","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24182"},"modified":"2023-04-19T11:21:54","modified_gmt":"2023-04-19T04:21:54","slug":"chan-doan-lam-sang-va-phan-do-benh-tay-chan-mieng-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/chan-doan-lam-sang-va-phan-do-benh-tay-chan-mieng-bo-y-te\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng v\u00e0 ph\u00e2n \u0111\u1ed9 b\u1ec7nh tay ch\u00e2n mi\u1ec7ng – B\u1ed9 Y t\u1ebf"},"content":{"rendered":"

B\u1ec7nh tay ch\u00e2n mi\u1ec7ng l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m l\u00e2y t\u1eeb ng\u01b0\u1eddi sang ng\u01b0\u1eddi, d\u1ec5 g\u00e2y th\u00e0nh d\u1ecbch do vi r\u00fat \u0111\u01b0\u1eddng ru\u1ed9t g\u00e2y ra. Hai nh\u00f3m t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh th\u01b0\u1eddng g\u1eb7p l\u00e0 Coxsackie virus A16 v\u00e0 Enterovirus 71 (EV71). Bi\u1ec3u hi\u1ec7n ch\u00ednh l\u00e0 t\u1ed5n th\u01b0\u01a1ng da, ni\u00eam m\u1ea1c d\u01b0\u1edbi d\u1ea1ng ph\u1ecfng n\u01b0\u1edbc \u1edf c\u00e1c v\u1ecb tr\u00ed \u0111\u1eb7c bi\u1ec7t nh\u01b0 ni\u00eam m\u1ea1c mi\u1ec7ng, l\u00f2ng b\u00e0n tay, l\u00f2ng b\u00e0n ch\u00e2n, m\u00f4ng, g\u1ed1i. B\u1ec7nh c\u00f3 th\u1ec3 g\u00e2y nhi\u1ec1u bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m<\/a> nh\u01b0 vi\u00eam n\u00e3o-m\u00e0ng n\u00e3o, vi\u00eam c\u01a1 tim, ph\u00f9 ph\u1ed5i c\u1ea5p d\u1eabn \u0111\u1ebfn t\u1eed vong n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 x\u1eed tr\u00ed k\u1ecbp th\u1eddi. C\u00e1c tr\u01b0\u1eddng h\u1ee3p bi\u1ebfn ch\u1ee9ng n\u1eb7ng th\u01b0\u1eddng do EV71.<\/strong><\/p>\n

1. L\u00e2m s\u00e0ng b\u1ec7nh tay ch\u00e2n mi\u1ec7ng:<\/strong><\/h2>\n

1.1. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng:<\/h3>\n

a) Giai \u0111o\u1ea1n \u1ee7 b\u1ec7nh: 3-7 ng\u00e0y.<\/p>\n

b) Giai \u0111o\u1ea1n kh\u1edfi ph\u00e1t: T\u1eeb 1-2 ng\u00e0y v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 s\u1ed1t nh\u1eb9, m\u1ec7t m\u1ecfi, \u0111au h\u1ecdng, bi\u1ebfng \u0103n, ti\u00eau ch\u1ea3y v\u00e0i l\u1ea7n trong ng\u00e0y.<\/p>\n

c) Giai \u0111o\u1ea1n to\u00e0n ph\u00e1t: C\u00f3 th\u1ec3 k\u00e9o d\u00e0i 3-10 ng\u00e0y v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a b\u1ec7nh:<\/p>\n

– Lo\u00e9t mi\u1ec7ng: v\u1ebft lo\u00e9t \u0111\u1ecf hay ph\u1ecfng n\u01b0\u1edbc \u0111\u01b0\u1eddng k\u00ednh 2-3 mm \u1edf ni\u00eam m\u1ea1c mi\u1ec7ng, l\u1ee3i, l\u01b0\u1ee1i, g\u00e2y \u0111au mi\u1ec7ng, b\u1ecf \u0103n, b\u1ecf b\u00fa, t\u0103ng ti\u1ebft n\u01b0\u1edbc b\u1ecdt.<\/p>\n

– Ph\u00e1t ban d\u1ea1ng ph\u1ecfng n\u01b0\u1edbc: \u1ede l\u00f2ng b\u00e0n tay, l\u00f2ng b\u00e0n ch\u00e2n, g\u1ed1i, m\u00f4ng; t\u1ed3n t\u1ea1i trong th\u1eddi gian ng\u1eafn (d\u01b0\u1edbi 7 ng\u00e0y) sau \u0111\u00f3 c\u00f3 th\u1ec3 \u0111\u1ec3 l\u1ea1i v\u1ebft th\u00e2m, r\u1ea5t hi\u1ebfm khi lo\u00e9t hay b\u1ed9i nhi\u1ec5m.<\/p>\n

– S\u1ed1t nh\u1eb9.<\/p>\n

– N\u00f4n.<\/p>\n

– N\u1ebfu tr\u1ebb s\u1ed1t cao v\u00e0 n\u00f4n nhi\u1ec1u d\u1ec5 c\u00f3 nguy c\u01a1 bi\u1ebfn ch\u1ee9ng.<\/p>\n

– Bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh, tim m\u1ea1ch, h\u00f4 h\u1ea5p th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n s\u1edbm t\u1eeb ng\u00e0y 2 \u0111\u1ebfn ng\u00e0y 5 c\u1ee7a b\u1ec7nh.<\/p>\n

d) Giai \u0111o\u1ea1n lui b\u1ec7nh: Th\u01b0\u1eddng t\u1eeb 3-5 ng\u00e0y sau, tr\u1ebb h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n n\u1ebfu kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng.<\/p>\n

1.2. C\u00e1c th\u1ec3 l\u00e2m s\u00e0ng b\u1ec7nh tay ch\u00e2n mi\u1ec7ng:<\/h3>\n

– Th\u1ec3 t\u1ed1i c\u1ea5p: B\u1ec7nh di\u1ec5n ti\u1ebfn r\u1ea5t nhanh c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng n\u1eb7ng nh\u01b0 suy tu\u1ea7n ho\u00e0n, suy h\u00f4 h\u1ea5p, h\u00f4n m\u00ea d\u1eabn \u0111\u1ebfn t\u1eed vong trong v\u00f2ng 24-48 gi\u1edd.<\/p>\n

– Th\u1ec3 c\u1ea5p t\u00ednh v\u1edbi b\u1ed1n giai \u0111o\u1ea1n \u0111i\u1ec3n h\u00ecnh nh\u01b0 tr\u00ean.<\/p>\n

– Th\u1ec3 kh\u00f4ng \u0111i\u1ec3n h\u00ecnh: D\u1ea5u hi\u1ec7u ph\u00e1t ban kh\u00f4ng r\u00f5 r\u00e0ng ho\u1eb7c ch\u1ec9 c\u00f3 lo\u00e9t mi\u1ec7ng ho\u1eb7c ch\u1ec9 c\u00f3 tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh, tim m\u1ea1ch, h\u00f4 h\u1ea5p m\u00e0 kh\u00f4ng ph\u00e1t ban v\u00e0 lo\u00e9t mi\u1ec7ng.<\/p>\n

2. <\/strong>C\u1eadn l\u00e2m s\u00e0ng :<\/strong><\/h2>\n

2.1. C\u00e1c x\u00e9t nghi\u1ec7m c\u01a1 b\u1ea3n:<\/h3>\n

– C\u00f4ng th\u1ee9c m\u00e1u: B\u1ea1ch c\u1ea7u th\u01b0\u1eddng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng. B\u1ea1ch c\u1ea7u t\u0103ng tr\u00ean 16.000\/mm3 hay \u0111\u01b0\u1eddng huy\u1ebft t\u0103ng > 160 mg% (8,9 mmol\/L) th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn bi\u1ebfn ch\u1ee9ng<\/p>\n

– Protein C ph\u1ea3n \u1ee9ng (CRP) (n\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n) trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng (< 10 mg\/L).<\/p>\n

– \u0110\u01b0\u1eddng huy\u1ebft, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3, X quang ph\u1ed5i \u0111\u1ed1i v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 bi\u1ebfn ch\u1ee9ng t\u1eeb \u0111\u1ed9 2b.<\/p>\n

2.2. C\u00e1c x\u00e9t nghi\u1ec7m theo d\u00f5i ph\u00e1t hi\u1ec7n bi\u1ebfn ch\u1ee9ng:<\/h3>\n

– Kh\u00ed m\u00e1u khi c\u00f3 suy h\u00f4 h\u1ea5p<\/p>\n

– Troponin I, si\u00eau \u00e2m tim khi nh\u1ecbp tim nhanh \u2265 150 l\u1ea7n\/ph\u00fat, nghi ng\u1edd vi\u00eam c\u01a1 tim ho\u1eb7c s\u1ed1c.<\/p>\n

– D\u1ecbch n\u00e3o t\u1ee7y:<\/p>\n

+ Ch\u1ec9 \u0111\u1ecbnh ch\u1ecdc d\u00f2 t\u1ee7y s\u1ed1ng khi c\u00f3 bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh ho\u1eb7c kh\u00f4ng lo\u1ea1i tr\u1eeb vi\u00eam m\u00e0ng n\u00e3o m\u1ee7.<\/p>\n

+ X\u00e9t nghi\u1ec7m protein b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng, s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng, c\u00f3 th\u1ec3 l\u00e0 b\u1ea1ch c\u1ea7u \u0111\u01a1n nh\u00e2n hay b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n \u01b0u th\u1ebf.<\/p>\n

2.3. X\u00e9t nghi\u1ec7m ph\u00e1t hi\u1ec7n vi r\u00fat<\/strong> (n\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n) t\u1eeb \u0111\u1ed9 2b tr\u1edf l\u00ean ho\u1eb7c c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t: L\u1ea5y b\u1ec7nh ph\u1ea9m h\u1ea7u h\u1ecdng, ph\u1ecfng n\u01b0\u1edbc, tr\u1ef1c tr\u00e0ng, d\u1ecbch n\u00e3o tu\u1ef7 \u0111\u1ec3 th\u1ef1c hi\u1ec7n x\u00e9t nghi\u1ec7m RT-PCR ho\u1eb7c ph\u00e2n l\u1eadp vi r\u00fat ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n.<\/p>\n

2.4. Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb n\u00e3o:<\/strong> Ch\u1ec9 th\u1ef1c hi\u1ec7n khi c\u00f3 \u0111i\u1ec1u ki\u1ec7n v\u00e0 khi c\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c b\u1ec7nh l\u00fd ngo\u1ea1i th\u1ea7n kinh.<\/p>\n

3. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh tay ch\u00e2n mi\u1ec7ng:<\/strong><\/h2>\n

3.1. Ch\u1ea9n \u0111o\u00e1n ca l\u00e2m s\u00e0ng:<\/h3>\n

D\u1ef1a v\u00e0o tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u00e0 d\u1ecbch t\u1ec5 h\u1ecdc.<\/p>\n

– Y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5: C\u0103n c\u1ee9 v\u00e0o tu\u1ed5i, m\u00f9a, v\u00f9ng l\u01b0u h\u00e0nh b\u1ec7nh, s\u1ed1 tr\u1ebb m\u1eafc b\u1ec7nh trong c\u00f9ng m\u1ed9t th\u1eddi gian.<\/p>\n

– L\u00e2m s\u00e0ng: Ph\u1ecfng n\u01b0\u1edbc \u0111i\u1ec3n h\u00ecnh \u1edf mi\u1ec7ng, l\u00f2ng b\u00e0n tay, l\u00f2ng b\u00e0n ch\u00e2n, g\u1ed1i, m\u00f4ng, k\u00e8m s\u1ed1t ho\u1eb7c kh\u00f4ng.<\/p>\n

\"minh-hoa-tay-chan-mieng\"
Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng b\u1ec7nh tay ch\u00e2n mi\u1ec7ng<\/figcaption><\/figure>\n

3.2. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1ec7nh tay ch\u00e2n mi\u1ec7ng:<\/h3>\n

– X\u00e9t nghi\u1ec7m RT-PCR ho\u1eb7c ph\u00e2n l\u1eadp c\u00f3 vi r\u00fat g\u00e2y b\u1ec7nh.<\/p>\n

4. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/strong><\/h2>\n

4.1. C\u00e1c b\u1ec7nh c\u00f3 bi\u1ec3u hi\u1ec7n lo\u00e9t mi\u1ec7ng:<\/h3>\n

Vi\u00eam lo\u00e9t mi\u1ec7ng (\u00e1p-t\u01a1): V\u1ebft lo\u00e9t s\u00e2u, c\u00f3 d\u1ecbch ti\u1ebft, hay t\u00e1i ph\u00e1t.<\/p>\n

4.2. C\u00e1c b\u1ec7nh c\u00f3 ph\u00e1t ban da:<\/h3>\n

– S\u1ed1t ph\u00e1t ban: h\u1ed3ng ban xen k\u1ebd \u00edt d\u1ea1ng s\u1ea9n, th\u01b0\u1eddng c\u00f3 h\u1ea1ch sau tai.<\/p>\n

– D\u1ecb \u1ee9ng: h\u1ed3ng ban \u0111a d\u1ea1ng, kh\u00f4ng c\u00f3 ph\u1ecfng n\u01b0\u1edbc.<\/p>\n

– Vi\u00eam da m\u1ee7: \u0110\u1ecf, \u0111au, c\u00f3 m\u1ee7.<\/p>\n

– Thu\u1ef7 \u0111\u1eadu: Ph\u1ecfng n\u01b0\u1edbc nhi\u1ec1u l\u1ee9a tu\u1ed5i, r\u1ea3i r\u00e1c to\u00e0n th\u00e2n.<\/p>\n

– Nhi\u1ec5m khu\u1ea9n huy\u1ebft do n\u00e3o m\u00f4 c\u1ea7u: m\u1ea3ng xu\u1ea5t huy\u1ebft ho\u1ea1i t\u1eed trung t\u00e2m.<\/p>\n

– S\u1ed1t xu\u1ea5t huy\u1ebft Dengue: Ch\u1ea5m xu\u1ea5t huy\u1ebft, b\u1ea7m m\u00e1u, xu\u1ea5t huy\u1ebft ni\u00eam m\u1ea1c.<\/p>\n

4.3. Vi\u00eam n\u00e3o-m\u00e0ng n\u00e3o:<\/h3>\n

– Vi\u00eam m\u00e0ng n\u00e3o do vi khu\u1ea9n.<\/p>\n

– Vi\u00eam n\u00e3o-m\u00e0ng n\u00e3o do vi r\u00fat kh\u00e1c.<\/p>\n

4.4. Nhi\u1ec5m khu\u1ea9n huy\u1ebft, s\u1ed1c nhi\u1ec5m khu\u1ea9n, vi\u00eam ph\u1ed5i.<\/h3>\n

5. Bi\u1ebfn ch\u1ee9ng b\u1ec7nh tay ch\u00e2n mi\u1ec7ng:<\/strong><\/h2>\n

5.1. Bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh:<\/h3>\n

Vi\u00eam n\u00e3o, vi\u00eam th\u00e2n n\u00e3o, vi\u00eam n\u00e3o t\u1ee7y, vi\u00eam m\u00e0ng n\u00e3o.<\/p>\n

– Rung gi\u1eadt c\u01a1 (myoclonic jerk, gi\u1eadt m\u00ecnh ch\u1edbi v\u1edbi): T\u1eebng c\u01a1n ng\u1eafn 1-2 gi\u00e2y, ch\u1ee7 y\u1ebfu \u1edf tay v\u00e0 ch\u00e2n, d\u1ec5 xu\u1ea5t hi\u1ec7n khi b\u1eaft \u0111\u1ea7u gi\u1ea5c ng\u1ee7 hay khi cho tr\u1ebb n\u1eb1m ng\u1eeda.<\/p>\n

– Ng\u1ee7 g\u00e0, b\u1ee9t r\u1ee9t, ch\u1edbi v\u1edbi, \u0111i lo\u1ea1ng cho\u1ea1ng, run chi, m\u1eaft nh\u00ecn ng\u01b0\u1ee3c.<\/p>\n

– Rung gi\u1eadt nh\u00e3n c\u1ea7u.<\/p>\n

– Y\u1ebfu, li\u1ec7t chi (li\u1ec7t m\u1ec1m c\u1ea5p).<\/p>\n

– Li\u1ec7t d\u00e2y th\u1ea7n kinh s\u1ecd n\u00e3o.<\/p>\n

– Co gi\u1eadt, h\u00f4n m\u00ea l\u00e0 d\u1ea5u hi\u1ec7u n\u1eb7ng, th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi suy h\u00f4 h\u1ea5p, tu\u1ea7n ho\u00e0n.<\/p>\n

– T\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 (bi\u1ec3u hi\u1ec7n du\u1ed7i c\u1ee9ng m\u1ea5t n\u00e3o, g\u1ed3ng c\u1ee9ng m\u1ea5t v\u1ecf)<\/p>\n

5.2. Bi\u1ebfn ch\u1ee9ng tim m\u1ea1ch, h\u00f4 h\u1ea5p:<\/h3>\n

Vi\u00eam c\u01a1 tim, ph\u00f9 ph\u1ed5i c\u1ea5p, t\u0103ng huy\u1ebft \u00e1p, suy tim, tr\u1ee5y m\u1ea1ch.<\/p>\n

– M\u1ea1ch nhanh > 150 l\u1ea7n\/ph\u00fat.<\/p>\n

– Th\u1eddi gian \u0111\u1ed5 \u0111\u1ea7y mao m\u1ea1ch ch\u1eadm tr\u00ean 2 gi\u00e2y.<\/p>\n

– Da n\u1ed5i v\u00e2n t\u00edm, v\u00e3 m\u1ed3 h\u00f4i, chi l\u1ea1nh. C\u00e1c bi\u1ec3u hi\u1ec7n r\u1ed1i lo\u1ea1n v\u1eadn m\u1ea1ch c\u00f3 th\u1ec3 ch\u1ec9 khu tr\u00fa \u1edf 1 v\u00f9ng c\u01a1 th\u1ec3 (1 tay, 1 ch\u00e2n,…)<\/p>\n

– Giai \u0111o\u1ea1n \u0111\u1ea7u c\u00f3 huy\u1ebft \u00e1p t\u0103ng (HA t\u00e2m thu: tr\u1ebb d\u01b0\u1edbi 1 tu\u1ed5i 100 mmHg, tr\u1ebb t\u1eeb 1-2 tu\u1ed5i \u2265 110 mmHg, tr\u1ebb tr\u00ean 2 tu\u1ed5i \u2265 115 mmHg), giai \u0111o\u1ea1n sau m\u1ea1ch, huy\u1ebft \u00e1p kh\u00f4ng \u0111o \u0111\u01b0\u1ee3c.<\/p>\n

– Kh\u00f3 th\u1edf: Th\u1edf nhanh, r\u00fat l\u00f5m ng\u1ef1c, kh\u00f2 kh\u00e8, th\u1edf r\u00edt th\u00ec h\u00edt v\u00e0o, th\u1edf n\u00f4ng, th\u1edf b\u1ee5ng, th\u1edf kh\u00f4ng \u0111\u1ec1u.<\/p>\n

– Ph\u00f9 ph\u1ed5i c\u1ea5p: S\u00f9i b\u1ecdt h\u1ed3ng, kh\u00f3 th\u1edf, t\u00edm t\u00e1i, ph\u1ed5i nhi\u1ec1u ran \u1ea9m, n\u1ed9i kh\u00ed qu\u1ea3n c\u00f3 m\u00e1u hay b\u1ecdt h\u1ed3ng.<\/p>\n

6. Ph\u00e2n \u0111\u1ed9 l\u00e2m s\u00e0ng b\u1ec7nh tay ch\u00e2n mi\u1ec7ng:<\/strong><\/h3>\n
    \n
  • \u0110\u1ed9 1:<\/strong> Ch\u1ec9 lo\u00e9t mi\u1ec7ng v\u00e0\/ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng da.<\/li>\n
  • \u0110\u1ed9 2:<\/strong><\/li>\n<\/ul>\n

    \u0110\u1ed9 2a:<\/strong> c\u00f3 m\u1ed9t trong c\u00e1c d\u1ea5u hi\u1ec7u sau:<\/p>\n

    + B\u1ec7nh s\u1eed c\u00f3 gi\u1eadt m\u00ecnh d\u01b0\u1edbi 2 l\u1ea7n\/30 ph\u00fat v\u00e0 kh\u00f4ng ghi nh\u1eadn l\u00fac kh\u00e1m<\/p>\n

    + S\u1ed1t tr\u00ean 2 ng\u00e0y, hay s\u1ed1t tr\u00ean 390C, n\u00f4n, l\u1eeb \u0111\u1eeb, kh\u00f3 ng\u1ee7, qu\u1ea5y kh\u00f3c v\u00f4 c\u1edb.<\/p>\n

    \u0110\u1ed9 2b:<\/strong> c\u00f3 d\u1ea5u hi\u1ec7u thu\u1ed9c nh\u00f3m 1 ho\u1eb7c nh\u00f3m 2 :<\/p>\n

    * Nh\u00f3m 1: C\u00f3 m\u1ed9t trong c\u00e1c bi\u1ec3u hi\u1ec7n sau:<\/em><\/strong><\/p>\n

    – Gi\u1eadt m\u00ecnh ghi nh\u1eadn l\u00fac kh\u00e1m.<\/p>\n

    – B\u1ec7nh s\u1eed c\u00f3 gi\u1eadt m\u00ecnh \u2265 2 l\u1ea7n \/30 ph\u00fat.<\/p>\n

    – B\u1ec7nh s\u1eed c\u00f3 gi\u1eadt m\u00ecnh k\u00e8m theo m\u1ed9t d\u1ea5u hi\u1ec7u sau:<\/p>\n

    + Ng\u1ee7 g\u00e0.<\/p>\n

    + M\u1ea1ch nhanh > 130 l\u1ea7n \/ph\u00fat (khi tr\u1ebb n\u1eb1m y\u00ean, kh\u00f4ng s\u1ed1t).<\/p>\n

    * Nh\u00f3m 2: C\u00f3 m\u1ed9t trong c\u00e1c bi\u1ec3u hi\u1ec7n sau:<\/em><\/strong><\/p>\n

    – S\u1ed1t cao \u2265 39,5oC (\u0111o nhi\u1ec7t \u0111\u1ed9 h\u1eadu m\u00f4n) kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c h\u1ea1 s\u1ed1t.<\/p>\n

    – M\u1ea1ch nhanh > 150 l\u1ea7n \/ph\u00fat (khi tr\u1ebb n\u1eb1m y\u00ean, kh\u00f4ng s\u1ed1t).<\/p>\n

    – Th\u1ea5t \u0111i\u1ec1u: run chi, run ng\u01b0\u1eddi, ng\u1ed3i kh\u00f4ng v\u1eefng, \u0111i lo\u1ea1ng cho\u1ea1ng.<\/p>\n

    – Rung gi\u1eadt nh\u00e3n c\u1ea7u, l\u00e1c m\u1eaft.<\/p>\n

    – Y\u1ebfu chi ho\u1eb7c li\u1ec7t chi.<\/p>\n

    – Li\u1ec7t th\u1ea7n kinh s\u1ecd: nu\u1ed1t s\u1eb7c, thay \u0111\u1ed5i gi\u1ecdng n\u00f3i\u2026<\/p>\n

    \u0110\u1ed9 3: c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u sau:<\/strong><\/p>\n

    – M\u1ea1ch nhanh > 170 l\u1ea7n\/ph\u00fat (khi tr\u1ebb n\u1eb1m y\u00ean, kh\u00f4ng s\u1ed1t).<\/p>\n

    – M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 m\u1ea1ch ch\u1eadm (d\u1ea5u hi\u1ec7u r\u1ea5t n\u1eb7ng).<\/p>\n

    – V\u00e3 m\u1ed3 h\u00f4i, l\u1ea1nh to\u00e0n th\u00e2n ho\u1eb7c khu tr\u00fa.<\/p>\n

    – HA t\u00e2m thu t\u0103ng:<\/p>\n

    + Tr\u1ebb d\u01b0\u1edbi 12 th\u00e1ng HA > 100 mmHg.<\/p>\n

    + Tr\u1ebb t\u1eeb 12 th\u00e1ng \u0111\u1ebfn d\u01b0\u1edbi 24 th\u00e1ng HA > 110 mmHg.<\/p>\n

    + Tr\u1ebb t\u1eeb tr\u00ean 24 th\u00e1ng HA > 115 mmHg.<\/p>\n

    – Th\u1edf nhanh, th\u1edf b\u1ea5t th\u01b0\u1eddng: C\u01a1n ng\u01b0ng th\u1edf, th\u1edf b\u1ee5ng, th\u1edf n\u00f4ng, r\u00fat l\u00f5m ng\u1ef1c, kh\u00f2 kh\u00e8, th\u1edf r\u00edt th\u00ec h\u00edt v\u00e0o.<\/p>\n

    – R\u1ed1i lo\u1ea1n tri gi\u00e1c (Glasgow < 10 \u0111i\u1ec3m).<\/p>\n

    – T\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1.<\/p>\n

    \u0110\u1ed9 4:<\/strong> c\u00f3 m\u1ed9t trong c\u00e1c d\u1ea5u hi\u1ec7u sau:<\/p>\n

    – S\u1ed1c.<\/p>\n

    – Ph\u00f9 ph\u1ed5i c\u1ea5p.<\/p>\n

    – T\u00edm t\u00e1i, SpO2 < 92%.<\/p>\n

    – Ng\u01b0ng th\u1edf, th\u1edf n\u1ea5c.<\/p>\n

    T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/p>\n

    Ngu\u1ed3n: H<\/strong>\u01b0\u1edbng d\u1eabn<\/strong> ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tay – ch\u00e2n – mi\u1ec7ng (Ban h\u00e0nh k\u00e8m theo Quy\u1ebft \u0111\u1ecbnh s\u1ed1 1003\/Q\u0110-BYT ng\u00e0y 30 th\u00e1ng 3 n\u0103m 2012 c\u1ee7a B\u1ed9 tr\u01b0\u1edfng B\u1ed9 Y t\u1ebf)<\/em><\/p>\n

     <\/p>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    B\u1ec7nh tay ch\u00e2n mi\u1ec7ng l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m l\u00e2y t\u1eeb ng\u01b0\u1eddi sang ng\u01b0\u1eddi, d\u1ec5 g\u00e2y th\u00e0nh d\u1ecbch do vi r\u00fat \u0111\u01b0\u1eddng ru\u1ed9t g\u00e2y ra. Hai nh\u00f3m t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh th\u01b0\u1eddng g\u1eb7p l\u00e0 Coxsackie virus A16 v\u00e0 Enterovirus 71 (EV71). Bi\u1ec3u hi\u1ec7n ch\u00ednh l\u00e0 t\u1ed5n th\u01b0\u01a1ng da, ni\u00eam m\u1ea1c d\u01b0\u1edbi d\u1ea1ng ph\u1ecfng n\u01b0\u1edbc \u1edf c\u00e1c […]<\/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":"\nCh\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng v\u00e0 ph\u00e2n \u0111\u1ed9 b\u1ec7nh tay ch\u00e2n mi\u1ec7ng - B\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh tay-ch\u00e2n-mi\u1ec7ng l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m l\u00e2y t\u1eeb ng\u01b0\u1eddi sang ng\u01b0\u1eddi, d\u1ec5 g\u00e2y th\u00e0nh d\u1ecbch do vi r\u00fat \u0111\u01b0\u1eddng ru\u1ed9t g\u00e2y ra.\" \/>\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=\"Ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng v\u00e0 ph\u00e2n \u0111\u1ed9 b\u1ec7nh tay ch\u00e2n mi\u1ec7ng - 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