{"id":24667,"date":"2023-04-19T13:53:39","date_gmt":"2023-04-19T06:53:39","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24667"},"modified":"2023-04-19T14:26:05","modified_gmt":"2023-04-19T07:26:05","slug":"dieu-tri-va-theo-doi-tre-so-sinh-mac-covid-19-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/dieu-tri-va-theo-doi-tre-so-sinh-mac-covid-19-bo-y-te\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb v\u00e0 theo d\u00f5i tr\u1ebb s\u01a1 sinh m\u1eafc Covid-19 \u2013 B\u1ed9 Y t\u1ebf"},"content":{"rendered":"<p><strong>Tr\u1ebb s\u01a1 sinh c\u00f3 th\u1ec3 nhi\u1ec5m Covid-19 theo 3 c\u00e1ch: l\u00e2y qua \u0111\u01b0\u1eddng m\u00e1u ho\u1eb7c n\u01b0\u1edbc \u1ed1i t\u1eeb m\u1eb9 nhi\u1ec5m SARS-CoV-2; l\u00e2y trong khi \u0111\u1ebb (ti\u1ebfp x\u00fac d\u1ecbch ti\u1ebft m\u1eb9 nh\u01b0 m\u00e1u, d\u1ecbch \u1ed1i v\u00e0 l\u00e2y sau \u0111\u1ebb (qua ti\u1ebfp x\u00fac v\u1edbi m\u1eb9 hay ng\u01b0\u1eddi ch\u0103m s\u00f3c sau sinh); c\u00e1c d\u1eef li\u1ec7u khoa h\u1ecdc \u0111\u1ebfn nay ch\u01b0a k\u1ebft lu\u1eadn \u0111\u01b0\u1eddng l\u00e2y qua s\u1eefa m\u1eb9. Trong \u0111\u00f3 l\u00e2y nhi\u1ec5m tr\u01b0\u1edbc v\u00e0 trong sinh \u00edt khi x\u1ea3y ra, <\/strong><strong>COVID-19 \u1edf tr\u1ebb s\u01a1 sinh <\/strong><strong>ch\u1ee7 y\u1ebfu l\u00e2y nhi\u1ec5m trong qu\u00e1 tr\u00ecnh ch\u0103m s\u00f3c sau sinh.\u00a0<\/strong><\/p>\n<h2>1. \u0110\u1eb7c \u0111i\u1ec3m<\/h2>\n<ul>\n<li>Kho\u1ea3ng t\u1eeb 1,6 &#8211; 2% tr\u1ebb s\u01a1 sinh d\u01b0\u01a1ng t\u00ednh v\u1edbi SARS-CoV-2 (th\u1eddi \u0111i\u1ec3m XN \u2264 3 ng\u00e0y sau \u0111\u1ebb) t\u1eeb b\u00e0 m\u1eb9 nhi\u1ec5m SARS-CoV-2 h\u1ea7u h\u1ebft tr\u1ebb kh\u00f4ng tri\u1ec7u ch\u1ee9ng ho\u1eb7c tri\u1ec7u ch\u1ee9ng nh\u1eb9; tuy nhi\u00ean tr\u1ebb c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n n\u1eb7ng v\u1edbi nhi\u1ec5m tr\u00f9ng huy\u1ebft, vi\u00eam ph\u1ed5i hay t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan (h\u1ed9i ch\u1ee9ng vi\u00eam \u0111a h\u1ec7 th\u1ed1ng, MIS-N) nh\u01b0 tr\u1ebb em. Tr\u1ebb s\u01a1 sinh nhi\u1ec5m SARS-CoV-2 ti\u00ean l\u01b0\u1ee3ng t\u1ed1t, t\u1eed vong r\u1ea5t th\u1ea5p.<\/li>\n<\/ul>\n<ul>\n<li><strong>C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 n\u1eb7ng<\/strong>\n<ul>\n<li>Tr\u1ebb \u0111\u1ebb non, nh\u1eb9 c\u00e2n.<\/li>\n<li>M\u1eb9 m\u1eafc COVID-19 n\u1eb7ng.<\/li>\n<\/ul>\n<\/li>\n<li><strong>\u0110\u1eb7c \u0111i\u1ec3m m\u1eafc COVID-19 \u1edf tr\u1ebb s\u01a1 sinh<\/strong>\n<ul>\n<li>Nhi\u1ec5m SARS-CoV-2 trong b\u00e0o thai x\u00e9t nghi\u1ec7m Real-time RT-PCR SARS-CoV-2 d\u01b0\u01a1ng t\u00ednh t\u1ea1i th\u1eddi \u0111i\u1ec3m &lt; 24 gi\u1edd tu\u1ed5i.<\/li>\n<li>Nhi\u1ec5m SARS-CoV-2 trong l\u00fac sinh x\u00e9t nghi\u1ec7m Real-time RT-PCR d\u01b0\u01a1ng t\u00ednh t\u1ea1i th\u1eddi \u0111i\u1ec3m 24-48 gi\u1edd sau<\/li>\n<li>Nhi\u1ec5m SARS-CoV-2 sau sinh x\u00e9t nghi\u1ec7m Real-time RT-PCR d\u01b0\u01a1ng t\u00ednh t\u1ea1i th\u1eddi \u0111i\u1ec3m &gt; 48 gi\u1edd tu\u1ed5i.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><strong>2. Ch\u1ea9n \u0111o\u00e1n COVID-19 \u1edf tr\u1ebb s\u01a1 sinh<\/strong><\/h2>\n<ul>\n<li>\n<ul>\n<li><strong>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/li>\n<\/ul>\n<p>Th\u01b0\u1eddng kh\u00f4ng tri\u1ec7u ch\u1ee9ng ho\u1eb7c tri\u1ec7u ch\u1ee9ng nh\u1eb9 v\u00e0 kh\u00f4ng \u0111\u1eb7c hi\u1ec7u nh\u01b0: s\u1ed1t, ho, b\u00fa k\u00e9m, n\u00f4n, ti\u00eau ch\u1ea3y, tr\u1ebb li b\u00ec, kh\u00f3c y\u1ebfu, th\u1edf nhanh, c\u00f3 c\u01a1n ng\u1eebng th\u1edf, t\u00edm t\u00e1i khi n\u1eb7ng.<\/p>\n<ul>\n<li>X\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m SARS-CoV-2 s\u1edbm \u1edf tr\u1ebb s\u01a1 sinh \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong v\u00f2ng 24 gi\u1edd sau sinh v\u00e0 sau khi \u0111\u01b0\u1ee3c k\u1ec1 da \u00edt nh\u1ea5t 90 ph\u00fat v\u00e0 ho\u00e0n th\u00e0nh c\u1eef b\u00fa \u0111\u1ea7u ti\u00ean tr\u00ean ng\u1ef1c m\u1eb9. N\u1ebfu k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m \u00e2m t\u00ednh th\u1ef1c hi\u1ec7n l\u1ea1i x\u00e9t nghi\u1ec7m sau 48-72 gi\u1edd.<\/li>\n<li>X\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m SARS-CoV-2 mu\u1ed9n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n nh\u01b0 x\u00e9t nghi\u1ec7m d\u00e0nh cho tr\u1ebb<\/li>\n<li>B\u1ec7nh ph\u1ea9m x\u00e9t nghi\u1ec7m: d\u1ecbch t\u1ef5 h\u1ea7u, d\u1ecbch n\u1ed9i kh\u00ed qu\u1ea3n (n\u1ebfu tr\u1ebb \u0111\u01b0\u1ee3c \u0111\u1eb7t NKQ).<\/li>\n<li>C\u1ea7n lo\u1ea1i tr\u1eeb kh\u1ea3 n\u0103ng nhi\u1ec5m khu\u1ea9n do vi tr\u00f9ng, vi r\u00fat kh\u00e1c.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-24684 size-medium aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/pexels-photo-12116876-300x200.jpeg\" alt=\"minh-hoa-covid-19-o-tre-so-sinh\" width=\"300\" height=\"200\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/pexels-photo-12116876-300x200.jpeg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/pexels-photo-12116876-1024x684.jpeg 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/pexels-photo-12116876-768x513.jpeg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/pexels-photo-12116876-1536x1026.jpeg 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/pexels-photo-12116876.jpeg 1880w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2><strong>3. \u0110i\u1ec1u tr\u1ecb COVID-19 \u1edf tr\u1ebb s\u01a1 sinh<\/strong><\/h2>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><strong>Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/strong>\n<ul>\n<li>Kh\u00f4ng c\u00f3 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u.<\/li>\n<li>Ch\u1ee7 y\u1ebfu \u0111i\u1ec1u tr\u1ecb n\u00e2ng \u0111\u1ee1, \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>\u0110i\u1ec1u tri bi\u1ebfn ch\u1ee9ng n\u1ebfu c\u00f3<\/li>\n<li>Tr\u1ebb n\u00ean \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c b\u1edfi m\u1eb9 ho\u1eb7c ng\u01b0\u1eddi th\u00e2n trong gia \u0111\u00ecnh, ti\u1ebfp t\u1ee5c b\u00fa m\u1eb9 v\u00e0 \u0111\u1ea3m b\u1ea3o ph\u00f2ng ng\u1eeba chu\u1ea9n. Ch\u1ec9 \u0111\u01b0a tr\u1ebb v\u00e0o \u0111\u01a1n v\u1ecb h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c khi c\u00f3 tri\u1ec7u ch\u1ee9ng n\u1eb7ng c\u1ea7n can thi\u1ec7p v\u00e0 ti\u1ebfp t\u1ee5c cho \u0103n s\u1eefa m\u1eb9 n\u1ebfu kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0103n \u0111\u01b0\u1eddng ru\u1ed9t.<\/li>\n<\/ul>\n<ul>\n<li><strong>Thu\u1ed1c s\u1eed d\u1ee5ng<\/strong>\n<ul>\n<li>Corticoid cho tr\u1ebb s\u01a1 sinh: c\u1ea7n c\u00e2n nh\u1eafc c\u1ea9n th\u1eadn, ch\u1ec9 \u0111\u1ecbnh khi t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i v\u00e0 ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i h\u1ed7 tr\u1ee3 th\u1edf m\u00e1y, \u0111\u1ed3ng th\u1eddi ph\u1ea3i lo\u1ea1i tr\u1eeb t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng n\u1eb7ng. Li\u1ec1u dexamethason 0,15 mg\/kg\/ng\u00e0y ti\u00eam t\u0129nh m\u1ea1ch 1 l\u1ea7n x 5-14 ng\u00e0y.<\/li>\n<li>Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng d\u1ef1 ph\u00f2ng: c\u1ea7n c\u00e2n nh\u1eafc c\u1ea9n th\u1eadn v\u00ec nguy c\u01a1 g\u00e2y xu\u1ea5t huy\u1ebft n\u00e3o. Ch\u1ec9 s\u1eed d\u1ee5ng khi tr\u1ebb c\u00f3 d\u1ea5u hi\u1ec7u c\u1ee7a huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch: heparin chu\u1ea9n ho\u1eb7c heparin tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p. Li\u1ec1u heparin tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p 1 mg\/kg\/l\u1ea7n x 2 l\u1ea7n\/ng\u00e0y c\u00e1ch m\u1ed7i 12 gi\u1edd (ti\u00eam d\u01b0\u1edbi da). Ng\u1eebng khi c\u00f3 bi\u1ec3u hi\u1ec7n xu\u1ea5t huy\u1ebft ho\u1eb7c r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u n\u1eb7ng \u0111e do\u1ea1 xu\u1ea5t huy\u1ebft.<\/li>\n<li>H\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p: n\u1ebfu tr\u1ebb suy h\u00f4 h\u1ea5p do vi\u00eam ph\u1ed5i, \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p v\u1edbi \u00f4 xy qua g\u1ecdng m\u0169i; khi tr\u1ebb kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u00f4 xy g\u1ecdng m\u0169i 2 l\u00edt\/p chuy\u1ec3n th\u1edf NCPAP; n\u1ebfu kh\u00f4ng \u0111\u00e1p \u1ee9ng chuy\u1ec3n \u0111\u1eb7t NKQ th\u1edf m\u00e1y<\/li>\n<li>H\u1ed9i ch\u1ee9ng MIS-N: \u0111\u1ea3m b\u00e0o nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb chung, d\u00f9ng IVIG 01 g\/kg\/ng\u00e0y x 2 ng\u00e0y, truy\u1ec1n t\u0129nh m\u1ea1ch trong 12-18 gi\u1edd v\u00e0 methylprednison 01 mg\/kg\/m\u1ed7i 12 gi\u1edd.<\/li>\n<\/ul>\n<\/li>\n<li><strong><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/dich-2019-ncov\/thong-tin-suc-khoe\/huong-dan-cham-soc-tre-em-nhiem-virus-corona\/\">Th\u1ef1c h\u00e0nh ch\u0103m s\u00f3c<\/a> v\u00e0 tr\u00e1nh l\u00e2y ch\u00e9o<\/strong>\n<ul>\n<li>Khi tr\u1ebb s\u01a1 sinh nhi\u1ec5m SARS-CoV-2 hay nghi nhi\u1ec5m, tr\u1ebb c\u1ea7n ch\u0103m s\u00f3c c\u00e1ch ly v\u1edbi c\u00e1c tr\u1ebb kh\u00e1c \u0111\u1ec3 ph\u00f2ng ng\u1eeba l\u00e2y nhi\u1ec5m.<\/li>\n<li>Khi m\u1eb9 nhi\u1ec5m SARS-CoV-2, tr\u1ebb sinh ra c\u1ea7n \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c v\u00e0 ph\u00f2ng ng\u1eeba l\u00e2y nhi\u1ec5m theo H\u01b0\u1edbng d\u1eabn t\u1ea1m th\u1eddi d\u1ef1 ph\u00f2ng v\u00e0 x\u1eed tr\u00ed COVID-19 do ch\u1ee7ng vi r\u00fat SARS-CoV-2 \u1edf ph\u1ee5 n\u1eef mang thai v\u00e0 tr\u1ebb s\u01a1 sinh c\u1ee7a B\u1ed9 Y t\u1ebf ban h\u00e0nh theo Quy\u1ebft \u0111\u1ecbnh s\u1ed1 3982\/Q\u0110-BYT ng\u00e0y 18\/08\/2021. \u0110\u1eb7c bi\u1ec7t c\u1ea7n cho tr\u1ebb \u0111\u01b0\u1ee3c da k\u1ec1 da ngay sau sinh v\u1edbi m\u1eb9, k\u00e9o d\u00e0i \u0111\u1ebfn sau 90 ph\u00fat v\u00e0 ho\u00e0n t\u1ea5t c\u1eef b\u00fa m\u1eb9 \u0111\u1ea7u ti\u00ean. N\u1ebfu m\u1eb9 kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng th\u1ec3 n\u1eb7ng, t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho m\u1eb9 v\u00e0 tr\u1ebb chung ph\u00f2ng v\u00e0 duy tr\u00ec nu\u00f4i con b\u1eb1ng s\u1eefa m\u1eb9 \u0111\u1ed3ng th\u1eddi \u00e1p d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba l\u00e2y nhi\u1ec5m qua<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><strong>4. Ti\u00eam ch\u1ee7ng vaccin<\/strong><\/h2>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Hi\u1ec7n ch\u1ec9 c\u00f3 v\u1eafc xin c\u1ee7a Pfizer\/BioNTech ch\u1ee9ng minh \u0111\u01b0\u1ee3c an to\u00e0n v\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 t\u1ea1o ra ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch m\u1ea1nh m\u1ebd v\u1edbi \u0111\u1ed1i t\u01b0\u1ee3ng l\u00e0 tr\u1ebb em t\u1eeb 5 \u0111\u1ebfn 11 tu\u1ed5i, v\u00ec v\u1eady m\u1ed9t s\u1ed1 n\u01b0\u1edbc \u0111\u00e3 \u00e1p d\u1ee5ng ti\u00eam ch\u1ee7ng cho tr\u1ebb \u2265 5 tu\u1ed5i. C\u00e1c v\u1eafc xin kh\u00e1c \u0111\u1ed1i v\u1edbi l\u1ee9a tu\u1ed5i &lt; 5 tu\u1ed5i v\u1eabn \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. Quy\u1ebft \u0111\u1ecbnh tri\u1ec3n khai ti\u00eam ch\u1ee7ng ph\u1ee5 thu\u1ed9c v\u00e0o \u0111i\u1ec1u ki\u1ec7n c\u1ee5 th\u1ec3 c\u1ee7a Vi\u1ec7t Nam, B\u1ed9 Y t\u1ebf s\u1ebd c\u00f3 h\u01b0\u1edbng d\u1eabn c\u1ee5 th\u1ec3.<\/li>\n<li>C\u1ea7n \u01b0u ti\u00ean cho tr\u1ebb thu\u1ed9c \u0111\u1ed1i t\u01b0\u1ee3ng nguy c\u01a1 n\u1eb7ng: tr\u1ebb b\u00e9o ph\u00ec, c\u00f3 b\u1ec7nh n\u1ec1n v\u00e0 kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Ngu\u1ed3n: <em>Quy\u00ea\u0301t \u0111i\u0323nh s\u00f4\u0301 405\/Q\u0110-BYT nga\u0300y 22 tha\u0301ng 02 n\u0103m 2022<\/em><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tr\u1ebb s\u01a1 sinh c\u00f3 th\u1ec3 nhi\u1ec5m Covid-19 theo 3 c\u00e1ch: l\u00e2y qua \u0111\u01b0\u1eddng m\u00e1u ho\u1eb7c n\u01b0\u1edbc \u1ed1i t\u1eeb m\u1eb9 nhi\u1ec5m SARS-CoV-2; l\u00e2y trong khi \u0111\u1ebb (ti\u1ebfp x\u00fac d\u1ecbch ti\u1ebft m\u1eb9 nh\u01b0 m\u00e1u, d\u1ecbch \u1ed1i v\u00e0 l\u00e2y sau \u0111\u1ebb (qua ti\u1ebfp x\u00fac v\u1edbi m\u1eb9 hay ng\u01b0\u1eddi ch\u0103m s\u00f3c sau sinh); c\u00e1c d\u1eef li\u1ec7u khoa h\u1ecdc \u0111\u1ebfn [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - 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