{"id":27454,"date":"2023-04-23T15:30:03","date_gmt":"2023-04-23T08:30:03","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27454"},"modified":"2023-04-24T15:15:18","modified_gmt":"2023-04-24T08:15:18","slug":"viem-phoi-nang-do-vi-rut-cum-a-huong-dan-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/viem-phoi-nang-do-vi-rut-cum-a-huong-dan-dieu-tri\/","title":{"rendered":"Vi\u00eam ph\u1ed5i n\u1eb7ng do vi r\u00fat c\u00fam A: h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"<p><strong>Vi\u00eam ph\u1ed5i n\u1eb7ng l\u00e0 t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i g\u00e2y suy h\u00f4 h\u1ea5p ti\u1ebfn tri\u1ec3n nhanh c\u0103n nguy\u00ean do c\u00e1c virut c\u00fam A g\u00e2y ra. Vi r\u00fat c\u00fam A thu\u1ed9c h\u1ecd<\/strong> <strong>virus Influenza g\u00e2y b\u1ec7nh nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n th\u00e0nh d\u1ecbch do kh\u1ea3 n\u0103ng l\u00e2y truy\u1ec1n d\u1ec5 d\u00e0ng qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p.\u00a0Th\u00f4ng th\u01b0\u1eddng b\u1ec7nh di\u1ec5n bi\u1ebfn nh\u1eb9 v\u00e0 h\u1ed3i ph\u1ee5c trong v\u00f2ng 2-7 ng\u00e0y, nh\u01b0ng \u0111\u1ed1i v\u1edbi tr\u1ebb em, ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, ng\u01b0\u1eddi c\u00f3 b\u1ec7nh m\u00e3n t\u00ednh&#8230; b\u1ec7nh c\u00f3 th\u1ec3 di\u1ec5n bi\u1ebfn n\u1eb7ng h\u01a1n, d\u1ec5 b\u1ecb bi\u1ebfn ch\u1ee9ng v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1eed vong. Ph\u1ea7n l\u1edbn ng\u01b0\u1eddi b\u1ec7nh t\u1eed vong v\u00ec suy h\u00f4 h\u1ea5p do c\u00f3 t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i n\u1eb7ng ho\u1eb7c do suy \u0111a ph\u1ee7 t\u1ea1ng, nhi\u1ec5m khu\u1ea9n b\u1ec7nh vi\u1ec7n ph\u1ed1i h\u1ee3p.\u00a0<\/strong><\/p>\n<h2>\u00a01. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i n\u1eb7ng do vi r\u00fat c\u00fam A.<\/h2>\n<ul>\n<li>C\u1ea7n ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi (d\u00f9ng thu\u1ed1c di\u1ec7t virut s\u1edbm) c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam ph\u1ed5i do c\u00fam \u0111\u1eb7c bi\u1ec7t do c\u00fam A(H<sub>5<\/sub>N<sub>1<\/sub>).<\/li>\n<li>C\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u1ea1i c\u00e1c \u0111\u01a1n v\u1ecb h\u1ed3i s\u1ee9c.<\/li>\n<li>Th\u1ef1c hi\u1ec7n bi\u1ec7n ph\u00e1p c\u00e1ch ly \u0111\u1ec3 tr\u00e1nh l\u00e2y nhi\u1ec5m.<\/li>\n<\/ul>\n<h2>2. \u0110i\u1ec1u tr\u1ecb ban \u0111\u1ea7u ng\u01b0\u1eddi b\u1ec7nh vi\u00eam ph\u1ed5i n\u1eb7ng do vi r\u00fat c\u00fam A.<\/h2>\n<h3><strong>2.1. X\u1eed tr\u00ed ban \u0111\u1ea7u v\u00e0 v\u1eadn chuy\u1ec3n c\u1ea5p c\u1ee9u <\/strong><\/h3>\n<ul>\n<li>Cho ng\u01b0\u1eddi b\u1ec7nh v\u00e0o khu v\u1ef1c c\u00e1ch ly t\u1ea1m th\u1eddi.<\/li>\n<li>D\u00f9ng ngay thu\u1ed1c di\u1ec7t vi r\u00fat Oseltamivir li\u1ec1u 300mg\/ng\u00e0y u\u1ed1ng chia 2 l\u1ea7n n\u1ebfu nghi ng\u1edd do c\u00fam A (H<sub>5<\/sub>N<sub>1<\/sub>), li\u1ec1u 150mg\/ng\u00e0y chia 2 l\u1ea7n cho c\u00e1c c\u00fam A kh\u00e1c.<\/li>\n<li>D\u00f9ng methyprednisolone 1-2 mg\/kg\/ng\u00e0y chia 2 l\u1ea7n ti\u00eam t\u0129nh m\u1ea1ch.<\/li>\n<li>Sau \u0111\u00f3 nhanh ch\u00f3ng chuy\u1ec3n ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ebfn c\u00e1c \u0111\u01a1n v\u1ecb h\u1ed3i s\u1ee9c.<\/li>\n<\/ul>\n<h3><strong>2.2. X\u1eed tr\u00ed t\u1ea1i b\u1ec7nh vi\u1ec7n.<\/strong><\/h3>\n<p><strong>C\u00e1c bi\u1ec7n ph\u00e1p c\u00e1ch li:<\/strong><\/p>\n<ul>\n<li>Th\u1ef1c hi\u1ec7n quy tr\u00ecnh c\u00e1ch li ng\u01b0\u1eddi b\u1ec7nh v\u00e0 c\u00e1c quy tr\u00ecnh v\u1ec1 x\u1eed l\u00ed ch\u1ea5t th\u1ea3i.<\/li>\n<li>Th\u1ef1c hi\u1ec7n quy tr\u00ecnh kh\u1eed khu\u1ea9n c\u00e1c d\u1ee5ng c\u1ee5, trang thi\u1ebft b\u1ecb y t\u1ebf ph\u1ee5c v\u1ee5 ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb v\u00e0 ch\u0103m s\u00f3c ng\u01b0\u1eddi b\u1ec7nh tr\u00e1nh l\u00e2y nhi\u1ec5m.<\/li>\n<\/ul>\n<p><strong>\u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u:<\/strong><\/p>\n<ul>\n<li>Thu\u1ed1c kh\u00e1ng vir\u00fat: d\u00f9ng s\u1edbm ngay khi c\u00f3 ch\u1ea9n \u0111o\u00e1n ho\u1eb7c nghi ng\u1edd nhi\u1ec5m c\u00fam. T\u1ed1t nh\u1ea5t trong v ng 48-72 gi\u1edd t\u1eeb khi ph\u00e1t b\u1ec7nh.<\/li>\n<\/ul>\n<p>+ C\u00fam A (H<sub>5<\/sub>N<sub>1<\/sub>): oseltamivir 300mg\/ng\u00e0y chia 2 l\u1ea7n, d\u00f9ng \u0111\u1ebfn khi x\u00e9t nghi\u1ec7m d\u1ecbch ph\u1ebf qu\u1ea3n \u00e2m t\u00ednh.<\/p>\n<p>+ C\u00fam c\u00fam A (H<sub>1<\/sub>N<sub>1<\/sub>):\u00a0 oseltamivir 150mg\/ng\u00e0y, d\u00f9ng trong 7 ng\u00e0y.<\/p>\n<ul>\n<li>Methylprednisolon 1-2mg\/kg\/ng\u00e0y ti\u00eam t\u0129nh m\u1ea1ch chia 02 l\u1ea7n trong 03 \u2013 05 ng\u00e0y.<\/li>\n<\/ul>\n<p><strong>C\u00e1c bi\u1ec7n ph\u00e1p h\u1ed7 tr\u1ee3<\/strong><\/p>\n<ul>\n<li>H\u00f4 h\u1ea5p<\/li>\n<\/ul>\n<p>+ N\u1eb1m \u0111\u1ea7u cao 30<sup>0<\/sup>, tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh c\u00f3 s\u1ed1c cho ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m \u0111\u1ea7u th\u1eb3ng.<\/p>\n<p>+ Li\u1ec7u ph\u00e1p oxy: m\u1ee5c ti\u00eau duy tr\u00ec SpO<sub>2<\/sub>&gt; 92% v\u00e0 PaO<sub>2<\/sub>&gt; 60 mmHg.<\/p>\n<p>+ Th\u1edf m\u00e1y kh\u00f4ng x\u00e2m nh\u1eadp: n\u1ebfu \u00f4 xy li\u1ec7u ph\u00e1p kh\u00f4ng k\u1ebft qu\u1ea3.<\/p>\n<p>+ Th\u1edf m\u00e1y x\u00e2m nh\u1eadp qua \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n: (xem qui tr\u00ecnh th\u1edf m\u00e1y cho b\u1ec7nh nh\u00e2n ARDS).<\/p>\n<p>+ N\u1ebfu th\u1ea5t b\u1ea1i (PaO<sub>2<\/sub>\/FiO<sub>2<\/sub>&lt; 100) v\u1edbi c\u00e1c ph\u01b0\u01a1ng th\u1ee9c th\u1edf m\u00e1y th\u00f4ng th\u01b0\u1eddng, c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p kh\u00e1c nh\u01b0; th\u1edf m\u00e1y t\u1ea7n s\u1ed1 cao (HFO) ho\u1eb7c trao \u0111\u1ed5i oxy ngo\u00e0i c\u01a1 th\u1ec3 (ECMO) n\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n.<\/p>\n<ul>\n<li>C\u00e1c bi\u1ec7n ph\u00e1p h\u1ed7 tr\u1ee3 suy \u0111a t\u1ea1ng<\/li>\n<\/ul>\n<p>+ Tu\u1ea7n ho\u00e0n: \u0111\u1eb7t catheter t\u0129nh m\u1ea1ch trung t\u00e2m, b\u00f9 d\u1ecbch duy tr\u00ec \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch trung t\u00e2m 7-10 cmH<sub>2<\/sub>O (cao h\u01a1n \u1edf ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1edf m\u00e1y), s\u1eed d\u1ee5ng thu\u1ed1c v\u1eadn m\u1ea1ch n\u1ebfu c\u00f3 huy\u1ebft \u00e1p t\u1ee5t khi \u0111\u00e3 duy tr\u00ec \u0111\u1ee7 d\u1ecbch.<\/p>\n<p>+ H\u1ed7 tr\u1ee3 suy \u0111a t\u1ea1ng:<\/p>\n<p>L\u1ecdc m\u00e1u v\u1edbi qu\u1ea3 l\u1ecdc c\u00f3 kh\u1ea3 n\u0103ng h\u1ea5p ph\u1ee5 cytokine (nh\u01b0 qu\u1ea3 l\u1ecdc PMX c\u00f3 ch\u1ea5t li\u1ec7u l\u00e0 polymycine B, ho\u1eb7c c\u00e1c lo\u1ea1i kh\u00e1c) cho \u0111\u1ebfn khi ch\u1ee9c n\u0103ng trao \u0111\u1ed5i kh\u00ed c\u1ee7a ph\u1ed5i \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n (P\/F \u2265 300) th\u00ec ng\u1eebng.<\/p>\n<p>L\u1ecdc m\u00e1u li\u00ean t\u1ee5c t\u0129nh m\u1ea1ch-t\u0129nh m\u1ea1ch (CVVH) v\u1edbi th\u1ec3 t\u00edch d\u1ecbch thay th\u1ebf l\u1edbn (\u226545 ml\/kg\/gi\u1edd). Ti\u00eau chu\u1ea9n ng\u1eebng l\u1ecdc m\u00e1u khi ti\u1ebfn h\u00e0nh cai th\u1edf m\u00e1y ho\u1eb7c ch\u1ec9 s\u1ed1 oxy h\u00f3a m\u00e1u \u2265 300, chuy\u1ec3n l\u1ecdc m\u00e1u ng\u1eaft qu\u00e3ng n\u1ebfu c\u00f3 ch\u1ec9 \u0111\u1ecbnh cho suy th\u1eadn c\u1ea5p.<\/p>\n<p>+ Duy tr\u00ec hemoglobin 90 -100g\/L b\u1eb1ng truy\u1ec1n kh\u1ed1i h\u1ed3ng c\u1ea7u.<\/p>\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u (DIC) n\u1ebfu c\u00f3: truy\u1ec1n cryo, kh\u1ed1i ti\u1ec3u c\u1ea7u, thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng &#8230; n\u1ebfu c\u00f3 ch\u1ec9 \u0111\u1ecbnh.<\/li>\n<\/ul>\n<p>+ \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 suy gan n\u1ebfu c\u00f3: truy\u1ec1n huy\u1ebft t\u01b0\u01a1ng t\u01b0\u01a1i, gan nh\u00e2n t\u1ea1o (MARS) ho\u1eb7c thay huy\u1ebft t\u01b0\u01a1ng (PEX) n\u1ebfu c\u00f3 ch\u1ec9 \u0111\u1ecbnh.<\/p>\n<p><strong>C\u00e1c \u0111i\u1ec1u tr\u1ecb kh\u00e1c<\/strong><\/p>\n<p>+ Kh\u00e1ng sinh n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nhi\u1ec5m khu\u1ea9n, ch\u00fa \u00fd s\u1eed d\u1ee5ng c\u00e1c kh\u00e1ng sinh cho nhi\u1ec5m khu\u1ea9n b\u1ec7nh vi\u1ec7n n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nhi\u1ec5m khu\u1ea9n b\u1ec7nh vi\u1ec7n (xem b\u00e0i vi\u00eam ph\u1ed5i b\u1ec7nh vi\u1ec7n).<\/p>\n<p>+ \u0110i\u1ec1u tr\u1ecb c\u00e1c bi\u1ebfn ch\u1ee9ng: n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh c\u00f3 tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i c\u1ea7n d\u1eabn l\u01b0u kh\u00ed v\u00e0 d\u1ecbch m\u00e0ng ph\u1ed5i n\u1ebfu c\u00f3 tr\u00e0n kh\u00ed, d\u1ecbch m\u00e0ng ph\u1ed5i, c\u1ea7n ch\u00fa \u00fd \u1edf ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1edf m\u00e1y x\u00e2m nh\u1eadp v\u1edbi PEEP cao.<\/p>\n<p>+ Corticoid: d\u00f9ng hydrocortisone 200 mg\/ng\u00e0y chia 4 l\u1ea7n ti\u00eam t\u0129nh m\u1ea1ch.<\/p>\n<p>+ D\u1ef1 ph\u00f2ng huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u b\u1eb1ng c\u00e1c bi\u1ec7n ph\u00e1p c\u01a1 h\u1ecdc ho\u1eb7c s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng heparin tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p v\u1edbi li\u1ec1u d\u1ef1 ph\u00f2ng.<\/p>\n<p>+ D\u1ef1 ph\u00f2ng lo\u00e9t ti\u00eau h\u00f3a do stress: s\u1eed d\u1ee5ng thu\u1ed1c b\u1ecdc ni\u00eam m\u1ea1c nh\u01b0 sucrafate\u00a01g x 2 l\u1ea7n l\u00fac \u0111\u00f3i, ho\u1eb7c c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton nh\u01b0 omeprazol, pantoprozol &#8230;<\/p>\n<p>+ Ch\u0103m s\u00f3c, nu\u00f4i d\u01b0\u1ee1ng, ch\u1ed1ng lo\u00e9t v\u00e0 ph\u00f2ng nhi\u1ec5m khu\u1ea9n b\u1ec7nh vi\u1ec7n.<\/p>\n<p>+ Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng m\u00e1u n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh c\u00f3 t\u0103ng \u0111\u01b0\u1eddng m\u00e1u.<\/p>\n<p>+ Ki\u1ec3m so\u00e1t c\u00e2n b\u1eb1ng n\u01b0\u1edbc, \u0111i\u1ec7n gi\u1ea3i, th\u0103ng b\u1eb1ng ki\u1ec1m toan.<\/p>\n<h2>3. T\u1ec9 l\u1ec7 t\u1eed vong v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a vi\u00eam ph\u1ed5i n\u1eb7ng.<\/h2>\n<ul>\n<li>T\u1ec9 l\u1ec7 t\u1eed vong kho\u1ea3ng 50% \u1edf c\u00e1c tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i n\u1eb7ngv\u00e0 \u0111i\u1ec1u tr\u1ecb mu\u1ed9n.<\/li>\n<li>B\u1ec7nh di\u1ec5n bi\u1ebfn n\u1eb7ng \u1edf c\u00e1c ng\u01b0\u1eddi b\u1ec7nh c\u00f3 c\u01a1 \u0111\u1ecba suy gi\u1ea3m mi\u1ec5n d\u1ecbch nh\u01b0 mang thai, d\u00f9ng c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch.<\/li>\n<\/ul>\n<h2>4. C\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng b\u1ec7nh c\u00fam.<\/h2>\n<ul>\n<li>Kh\u00f4ng ti\u1ebfp x\u00fac v\u1edbi gia c\u1ea7m s\u1ed1ng khi c\u00f3 d\u1ecbch.<\/li>\n<li>Khi c\u00f3 bi\u1ec3u hi\u1ec7n gia c\u1ea7m \u1ed1m ch\u1ebft ph\u1ea3i b\u00e1o c\u01a1 quan ch\u1ee9c n\u0103ng x\u1eed l\u00ed.<\/li>\n<li>Khi c\u00f3 bi\u1ec3u hi\u1ec7n nhi\u1ec5m c\u00fam ph\u1ea3i \u0111\u1ebfn kh\u00e1m t\u1ea1i c\u00e1c c\u01a1 s\u1edf y t\u1ebf ngay.<\/li>\n<\/ul>\n<p>Do c\u00fam di\u1ec5n bi\u1ebfn l\u00e0nh t\u00ednh n\u00ean \u0111a ph\u1ea7n b\u1ec7nh nh\u00e2n c\u00fam ch\u1ec9 c\u1ea7n \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng, c\u01a1 th\u1ec3 s\u1ebd t\u1ef1 lo\u1ea1i tr\u1eeb virus trong v\u00f2ng 5-7 ng\u00e0y, c\u00e1c kh\u00e1ng sinh th\u01b0\u1eddng d\u00f9ng kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng di\u1ec7t virus.<\/p>\n<ul>\n<li>Hi\u1ec7n nay c\u00f3 nhi\u1ec1u lo\u1ea1i thu\u1ed1c c\u00fam m\u1edbi \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u v\u00e0 ph\u00e1t tri\u1ec3n, trong \u0111\u00f3 Tamiflu (Oseltamivir) hi\u1ec7n \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng t\u1ea1i Vi\u1ec7t Nam c\u00f3 hi\u1ec7u qu\u1ea3 kh\u00e1 t\u1ed1t n\u1ebfu \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong v\u00f2ng 48 gi\u1edd \u0111\u1ea7u c\u1ee7a b\u1ec7nh.<\/li>\n<li>\u0110\u1ec3 ph\u00f2ng tr\u00e1nh b\u1ec7nh c\u00fam, c\u1ea7n th\u1ef1c h\u00e0nh t\u1ed1t vi\u1ec7c v\u1ec7 sinh tay, tr\u00e1nh nhi\u1ec5m l\u1ea1nh v\u00e0 d\u00f9ng c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba th\u00f4ng th\u01b0\u1eddng nh\u01b0 s\u1eed d\u1ee5ng kh\u1ea9u trang khi ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi b\u1ec7nh c\u00fam. B\u00ean c\u1ea1nh vi\u1ec7c d\u1ef1 ph\u00f2ng b\u1ec7nh th\u1ee5 \u0111\u1ed9ng, c\u00f3 th\u1ec3 d\u1ef1 ph\u00f2ng ch\u1ee7 \u0111\u1ed9ng b\u1eb1ng c\u00e1ch ti\u00eam v\u1eafc xin ph\u00f2ng ng\u1eeba c\u00fam, n\u00ean ti\u00eam h\u00e0ng n\u0103m \u0111\u1ec3 duy tr\u00ec mi\u1ec5n d\u1ecbch.<\/li>\n<li>Ti\u00eam v\u1eafc-xin l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ec7n ph\u00e1p hi\u1ec7u qu\u1ea3 gi\u00fap ph\u00f2ng ng\u1eeba b\u1ec7nh c\u00fam \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i. V\u1eafc-xin c\u00fam s\u1ebd b\u1ea3o v\u1ec7 ng\u01b0\u1eddi \u0111\u01b0\u1ee3c ti\u00eam kh\u1ecfi ba ho\u1eb7c b\u1ed1n lo\u1ea1i vi-r\u00fat c\u00fam ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u01b0u h\u00e0nh trong m\u00f9a c\u00fam n\u0103m \u0111\u00f3.<\/li>\n<\/ul>\n<p>Ngu\u1ed3n: B\u1ed9 Y t\u1ebf 2015, H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 x\u1eed tr\u00ed h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c.<\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/vac-xin\/kien-thuc-tiem-chung\/nhung-dieu-can-biet-ve-benh-cum\/\">Nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft v\u1ec1 b\u1ec7nh c\u00fam<\/a><\/p>\n<div class=\"share\"><\/div>\n<ul>\n<li style=\"list-style-type: none;\"><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam ph\u1ed5i n\u1eb7ng l\u00e0 t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i g\u00e2y suy h\u00f4 h\u1ea5p ti\u1ebfn tri\u1ec3n nhanh c\u0103n nguy\u00ean do c\u00e1c virut c\u00fam A g\u00e2y ra. Vi r\u00fat c\u00fam A thu\u1ed9c h\u1ecd virus Influenza g\u00e2y b\u1ec7nh nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p. B\u1ec7nh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n th\u00e0nh d\u1ecbch do kh\u1ea3 n\u0103ng l\u00e2y truy\u1ec1n d\u1ec5 d\u00e0ng qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p.\u00a0Th\u00f4ng [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,23,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Vi\u00eam ph\u1ed5i n\u1eb7ng do vi r\u00fat c\u00fam A: h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i n\u1eb7ng do vi r\u00fat c\u00fam A g\u1ed3m \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u (kh\u00e1ng virus, corticoid), h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p, tu\u1ea7n ho\u00e0n, \u0111i\u1ec1u tr\u1ecb suy c\u01a1 quan.\" \/>\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=\"Vi\u00eam ph\u1ed5i n\u1eb7ng do vi r\u00fat c\u00fam A: h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb - 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