{"id":27552,"date":"2023-04-29T19:57:43","date_gmt":"2023-04-29T12:57:43","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27552"},"modified":"2023-04-29T19:57:43","modified_gmt":"2023-04-29T12:57:43","slug":"chan-doan-va-dieu-tri-viem-mang-nao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/29\/chan-doan-va-dieu-tri-viem-mang-nao\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng n\u00e3o"},"content":{"rendered":"<p><strong>Vi\u00eam m\u00e0ng n\u00e3o l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd n\u1eb7ng n\u1ec1 trong chuy\u00ean ng\u00e0nh th\u1ea7n kinh. Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi vi\u00eam m\u00e0ng n\u00e3o g\u00f3p ph\u1ea7n l\u00e0m gi\u1ea3m nguy c\u01a1 t\u1eed vong v\u00e0 di ch\u1ee9ng cho b\u1ec7nh nh\u00e2n. Qua b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta h\u00e3y c\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Vi\u00eam m\u00e0ng n\u00e3o.<\/strong><\/p>\n<h2><span class=\"Y2IQFc\" lang=\"vi\">1.Gi\u1edbi thi\u1ec7u <\/span><\/h2>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">C\u00e1c\u00a0 tri\u1ec7u ch\u1ee9ng c\u1ee7a vi\u00eam m\u00e0ng n\u00e3o \u0111\u00e3 \u0111\u01b0\u1ee3c ghi l\u1ea1i trong v\u00f4 s\u1ed1 v\u0103n b\u1ea3n c\u1ed5 trong su\u1ed1t l\u1ecbch s\u1eed; tuy nhi\u00ean, thu\u1eadt ng\u1eef &#8216;vi\u00eam m\u00e0ng n\u00e3o&#8217; \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn sau khi b\u00e1c s\u0129 ph\u1eabu thu\u1eadt John Abercrombie \u0111\u1ecbnh ngh\u0129a n\u00f3 v\u00e0o n\u0103m 1828.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">B\u1ea5t ch\u1ea5p nh\u1eefng \u0111\u1ed9t ph\u00e1 trong ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb v\u00e0 ti\u00eam ch\u1ee7ng, n\u0103m 2015, v\u1eabn c\u00f3 8,7 tri\u1ec7u ca vi\u00eam m\u00e0ng n\u00e3o \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o tr\u00ean to\u00e0n th\u1ebf gi\u1edbi, v\u1edbi 379.000 ca t\u1eed vong sau \u0111\u00f3<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\"> Vi\u00eam m\u00e0ng n\u00e3o l\u00e0 b\u1ec7nh l\u00fd \u0111e d\u1ecda t\u00ednh m\u1ea1ng c\u00f3 th\u1ec3 do vi khu\u1ea9n ho\u1eb7c vi r\u00fat g\u00e2y ra. Tr\u01b0\u1edbc khi c\u00f3 thu\u1ed1c kh\u00e1ng sinh, t\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u00e3 g\u00e2y t\u1eed vong tr\u00ean to\u00e0n c\u1ea7u. Tuy nhi\u00ean, ngay c\u1ea3 khi c\u00f3 nh\u1eefng ti\u1ebfn b\u1ed9 y h\u1ecdc, b\u1ec7nh l\u00fd n\u00e0y v\u1eabn c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong g\u1ea7n 25%.<\/span><\/li>\n<\/ul>\n<h2>2. <span class=\"Y2IQFc\" lang=\"vi\">C\u0103n nguy\u00ean g\u00e2y b\u1ec7nh<\/span><\/h2>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\"> Vi\u00eam m\u00e0ng n\u00e3o \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 vi\u00eam c\u1ee7a m\u00e0ng n\u00e3o. M\u00e0ng n\u00e3o c\u00f3 ba l\u1edbp (m\u00e0ng c\u1ee9ng, m\u00e0ng nh\u1ec7n v\u00e0 m\u00e0ng m\u1ec1m) l\u00f3t \u1ed1ng \u0111\u1ed1t s\u1ed1ng v\u00e0 h\u1ed9p s\u1ecd bao quanh n\u00e3o v\u00e0 t\u1ee7y s\u1ed1ng. Vi\u00eam m\u00e0ng n\u00e3o c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c g\u00e2y ra b\u1edfi c\u00e1c qu\u00e1 tr\u00ecnh nhi\u1ec5m tr\u00f9ng v\u00e0 kh\u00f4ng nhi\u1ec5m tr\u00f9ng (r\u1ed1i lo\u1ea1n t\u1ef1 mi\u1ec5n d\u1ecbch, h\u1ed9i ch\u1ee9ng ung th\u01b0\/c\u1eadn ung th\u01b0, ph\u1ea3n \u1ee9ng thu\u1ed1c).<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">C\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh truy\u1ec1n nhi\u1ec5m c\u1ee7a vi\u00eam m\u00e0ng n\u00e3o bao g\u1ed3m:<\/span><\/li>\n<\/ul>\n<p><span class=\"Y2IQFc\" lang=\"vi\">&#8211; <a href=\"https:\/\/www.vinmec.com\/vi\/vac-xin\/kien-thuc-tiem-chung\/cac-benh-viem-mang-nao-do-vi-khuan\/#:~:text=Vi%C3%AAm%20m%C3%A0ng%20n%C3%A3o%20l%C3%A0%20t%C3%ACnh,di%20ch%E1%BB%A9ng%20v%C3%A0%20t%E1%BB%AD%20vong.\">Vi khu\u1ea9n<\/a><\/span><\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">&#8211; <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/benh-viem-mang-nao-nuoc-trong\/#:~:text=Vi%C3%AAm%20m%C3%A0ng%20n%C3%A3o%20n%C6%B0%E1%BB%9Bc%20trong%20(vi%C3%AAm%20m%C3%A0ng%20n%C3%A3o%20virus)%20l%C3%A0,%C3%ADt%20d%E1%BA%ABn%20%C4%91%E1%BA%BFn%20t%E1%BB%AD%20vong.\">Vi r\u00fat<\/a><\/span><\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">&#8211; N\u1ea5m v\u00e0 k\u00fd sinh tr\u00f9ng \u00edt ph\u1ed5 bi\u1ebfn h\u01a1n. <\/span><\/p>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y vi\u00eam m\u00e0ng n\u00e3o: <\/span><\/li>\n<\/ul>\n<p>&#8211; B\u1ec7nh l\u00fd m\u00e3n t\u00ednh (suy th\u1eadn, ti\u1ec3u \u0111\u01b0\u1eddng, suy th\u01b0\u1ee3ng th\u1eadn)<\/p>\n<p>&#8211; Kh\u00f4ng ti\u00eam vaccine<\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">&#8211; T\u00ecnh tr\u1ea1ng \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch (ng\u01b0\u1eddi \u0111\u01b0\u1ee3c gh\u00e9p t\u1ea1ng, suy gi\u1ea3m mi\u1ec5n d\u1ecbch b\u1ea9m sinh, AIDS) <\/span><\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">&#8211; S\u1ed1ng trong \u0111i\u1ec1u ki\u1ec7n \u0111\u00f4ng \u0111\u00fac ti\u1ebfp x\u00fac, v\u00f9ng d\u1ecbch t\u1ec5<\/span><\/p>\n<p>&#8211; Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n<\/p>\n<p>&#8211; Ti\u00eam ch\u00edch ma t\u00fay<\/p>\n<p>&#8211; C\u1eaft l\u00e1ch.<\/p>\n<figure id=\"attachment_27620\" aria-describedby=\"caption-attachment-27620\" style=\"width: 251px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-27620\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Viem-mang-nao.jpg\" alt=\"Minh-hoa-viem-mang-nao\" width=\"251\" height=\"201\" \/><figcaption id=\"caption-attachment-27620\" class=\"wp-caption-text\">Minh h\u1ecda vi\u00eam m\u00e0ng n\u00e3o<\/figcaption><\/figure>\n<h2>3. Ch\u1ea9n \u0111o\u00e1n vi\u00eam m\u00e0ng n\u00e3o<\/h2>\n<p><strong>3.1. L\u00e2m s\u00e0ng<\/strong><\/p>\n<p>B\u1ec7nh bi\u1ec3u hi\u1ec7n 2 h\u1ed9i ch\u1ee9ng ch\u00ednh sau \u0111\u00e2y:<\/p>\n<ul>\n<li>H\u1ed9i ch\u1ee9ng nhi\u1ec5m tr\u00f9ng: BN s\u1ed1t cao c\u00f3 th\u1ec3 \u0111\u1ebfn 39-40 \u0111\u1ed9 C, c\u00f3 t\u00ecnh tr\u1ea1ng nhi\u1ec5m khu\u1ea9n nhi\u1ec5m \u0111\u1ed9c nh\u01b0 li b\u00ec, m\u1ec7t m\u1ecfi, b\u1ecf \u0103n, m\u00f4i kh\u00f4, da xanh t\u00e1i, l\u01b0\u1ee1i b\u1ea9n<\/li>\n<li>H\u1ed9i ch\u1ee9ng m\u00e0ng n\u00e3o:<\/li>\n<\/ul>\n<p>+ <em>Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng<\/em>:<\/p>\n<p>&#8211; Nh\u1ee9c \u0111\u1ea7u: \u0110au li\u00ean t\u1ee5c, c\u1ea3 2 b\u00ean, nh\u1ea5t l\u00e0 v\u00f9ng th\u00e1i d\u01b0\u01a1ng- ch\u1ea9m<\/p>\n<p>&#8211; S\u1ee3 \u00e1nh s\u00e1ng<\/p>\n<p>&#8211; N\u00f4n: N\u00f4n t\u1ef1 nhi\u00ean, n\u00f4n v\u1ecdt d\u1ec5 d\u00e0ng, nhi\u1ec1u l\u1ea7n, kh\u00f4ng li\u00ean quan \u0111\u1ebfn b\u1eefa \u0103n<\/p>\n<p>&#8211; T\u00e1o b\u00f3n: L\u00e0 bi\u1ec3u hi\u1ec7n th\u01b0\u1eddng th\u1ea5y, tuy nhi\u00ean \u1edf tr\u1ebb em \u0111\u00f4i khi g\u1eb7p \u1ec9a l\u1ecfng.<\/p>\n<p>+ <em>Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3<\/em>:<\/p>\n<p>&#8211; D\u1ea5u hi\u1ec7u g\u00e1y c\u1ee9ng<\/p>\n<p>&#8211; Kernig (+)<\/p>\n<p>&#8211; Brudzinski (+)<\/p>\n<p>&#8211; V\u1ea1ch m\u00e0ng n\u00e3o (+)<\/p>\n<p>&#8211; T\u0103ng c\u1ea3m gi\u00e1c \u0111au.<\/p>\n<p>&#8211; Giai \u0111o\u1ea1n mu\u1ed9n: C\u00f3 r\u1ed1i lo\u1ea1n tri gi\u00e1c(Li b\u00ec ho\u1eb7c v\u1eadt v\u00e3), h\u00f4n m\u00ea, li\u1ec7t khu tr\u00fa , c\u00f3 th\u1ec3 c\u00f3 co gi\u1eadt.<\/p>\n<p><strong>3.2. C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\"><span class=\"Y2IQFc\" lang=\"vi\">Vi\u00eam m\u00e0ng n\u00e3o \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n th\u00f4ng qua ph\u00e2n t\u00edch d\u1ecbch n\u00e3o t\u1ee7y, bao g\u1ed3m s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u, glucose, protein, nu\u00f4i c\u1ea5y v\u00e0 trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, ph\u1ea3n \u1ee9ng chu\u1ed7i polymerase (PCR). D\u1ecbch n\u00e3o t\u1ee7y c\u00f3 th\u1ec3 \u0111o \u0111\u01b0\u1ee3c \u00e1p l\u1ef1c.<\/span><\/span><\/li>\n<li>X\u00e9t nghi\u1ec7m b\u1ed5 sung n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ph\u00f9 h\u1ee3p v\u1edbi c\u0103n nh\u00e2n nghi ng\u1edd:<\/li>\n<\/ul>\n<p>&#8211; Virus: PCR \u0111a m\u1ed3i v\u00e0 PCR \u0111\u1eb7c hi\u1ec7u.<\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">\u00a0 \u00a0 \u00a0 \u00a0&#8211; N\u1ea5m: C\u1ea5y n\u1ea5m d\u1ecbch n\u00e3o t\u1ee7y.<\/span><\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">\u00a0 \u00a0 \u00a0 \u00a0&#8211; Nhu\u1ed9m t\u00ecm Cryptococcus Mycobacteria.<\/span><\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">\u00a0 \u00a0 \u00a0 \u00a0&#8211; Soi t\u01b0\u01a1i v\u00e0 nu\u00f4i c\u1ea5y d\u1ecbch n\u00e3o t\u1ee7y.<\/span><\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">\u00a0 \u00a0 \u00a0 \u00a0&#8211; B\u1ec7nh Lyme: T\u00ecm kh\u00e1ng th\u1ec3 burgdorferi trong d\u1ecbch n\u00e3o t\u1ee7y.<\/span><\/p>\n<ul>\n<li id=\"tw-target-text\" class=\"tw-data-text tw-text-large tw-ta\" dir=\"ltr\" data-placeholder=\"B\u1ea3n d\u1ecbch\"><span class=\"Y2IQFc\" lang=\"vi\">L\u00fd t\u01b0\u1edfng nh\u1ea5t l\u00e0 n\u00ean l\u1ea5y m\u1eabu d\u1ecbch n\u00e3o tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh. Tuy nhi\u00ean, khi ch\u1ea9n \u0111o\u00e1n vi\u00eam m\u00e0ng n\u00e3o do vi khu\u1ea9n c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t k\u1ef9 l\u01b0\u1ee1ng v\u00e0 \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh n\u1eb7ng, n\u00ean b\u1eaft \u0111\u1ea7u d\u00f9ng kh\u00e1ng sinh tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n ch\u1ecdc d\u1ecbch n\u00e3o t\u1ee7y.<\/span><\/li>\n<li dir=\"ltr\" data-placeholder=\"B\u1ea3n d\u1ecbch\">C\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a ch\u1ecdc d\u1ecbch n\u00e3o t\u1ee7y:<\/li>\n<\/ul>\n<p>&#8211; T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd: N\u1ebfu c\u00f3 nghi ng\u1edd t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd c\u1ea7n tr\u00e1nh ch\u1ecdc d\u1ecbch n\u00e3o t\u1ee7y v\u00ec c\u00f3 th\u1ec3 g\u00e2y tho\u00e1t v\u1ecb n\u00e3o g\u00e2y t\u1eed vong. C\u1ea7n d\u1ef1a v\u00e0o tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u00e0 phim c\u1eaft l\u1edbp vi t\u00ednh s\u1ecd n\u00e3o \u0111\u1ec3 \u0111\u00e1nh gi\u00e1.<\/p>\n<p>&#8211; Nhi\u1ec5m khu\u1ea9n da ho\u1eb7c m\u00f4 m\u1ec1m v\u00f9ng ch\u1ecdc kim l\u1ea5y d\u1ecbch n\u00e3o t\u1ee7y.<\/p>\n<p>&#8211; Nguy c\u01a1 ch\u1ea3y m\u00e1u: B\u1ec7nh l\u00fd c\u1ee7a m\u00e1u d\u1ec5 g\u00e2y ch\u1ea3y m\u00e1u, BN \u0111ang d\u00f9ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng.<\/p>\n<p>&#8211; T\u00ecnh tr\u1ea1ng b\u1ec7nh n\u1eb7ng ho\u1eb7c \u0111\u00e3 c\u00f3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh qua ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh, c\u1ed9ng h\u01b0\u1edfng t\u1eeb ,&#8230; nh\u01b0 u n\u00e3o, xu\u1ea5t huy\u1ebft n\u00e3o,&#8230;<\/p>\n<p><strong>3.3. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/p>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">\u0110\u1ed9t qu\u1ef5.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">M\u00e1u t\u1ee5 d\u01b0\u1edbi m\u00e0ng c\u1ee9ng.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Xu\u1ea5t huy\u1ebft d\u01b0\u1edbi nh\u1ec7n.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">U n\u00e3o di c\u0103n.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">\u00c1p xe n\u00e3o (c\u00f3 th\u1ec3 c\u00f9ng t\u1ed3n t\u1ea1i v\u1edbi vi\u00eam m\u00e0ng n\u00e3o).<\/span><\/li>\n<\/ul>\n<p><strong><span class=\"Y2IQFc\" lang=\"vi\">3.4. \u0110i\u1ec1u tr\u1ecb <\/span><\/strong><\/p>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Thu\u1ed1c kh\u00e1ng sinh v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 l\u00e0 r\u1ea5t quan tr\u1ecdng trong m\u1ecdi tr\u01b0\u1eddng h\u1ee3p vi\u00eam m\u00e0ng n\u00e3o do vi khu\u1ea9n.<\/span><\/li>\n<li>Th\u00f4ng tho\u00e1ng \u0111\u01b0\u1eddng th\u1edf, duy tr\u00ec oxy, cung c\u1ea5p \u0111\u1ee7 d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch \u0111\u1ed3ng th\u1eddi ki\u1ec3m so\u00e1t c\u01a1n s\u1ed1t l\u00e0 nh\u1eefng ph\u1ea7n quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o.<\/li>\n<\/ul>\n<p><em>3.4.1. \u0110i\u1ec1u tr\u1ecb kh\u00e1ng sinh<\/em><\/p>\n<ul>\n<li>Kh\u1edfi \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh theo kinh nghi\u1ec7m, c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb theo kh\u00e1ng sinh \u0111\u1ed3 n\u1ebfu kh\u00f4ng \u0111\u00e1p \u1ee9ng:<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb kh\u00e1ng sinh theo kinh nghi\u1ec7m:<\/li>\n<\/ul>\n<p>&#8211; V\u1edbi tr\u1ebb s\u01a1 sinh &#8211; d\u01b0\u1edbi 1 th\u00e1ng tu\u1ed5i<\/p>\n<p>+ Amipicillin truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0<\/p>\n<p>+ Cefotaxime truy\u1ec1n t\u0129nh m\u1ea1ch ho\u1eb7c Gentamicin truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0<\/p>\n<p>+ Acyclorvir truy\u1ec1n t\u0129nh m\u1ea1ch.<\/p>\n<p>&#8211; Tr\u1ebb tr\u00ean 1 th\u00e1ng tu\u1ed5i<\/p>\n<p>+ Ampicillin truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0<\/p>\n<p>+ Ceftriaxone truy\u1ec1n t\u0129nh m\u1ea1ch.<\/p>\n<p>&#8211; Ng\u01b0\u1eddi l\u1edbn<\/p>\n<p>+ Ceftriaxone truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0<\/p>\n<p>+ Vancomycin truy\u1ec1n t\u0129nh m\u1ea1ch.<\/p>\n<p>&#8211; Ng\u01b0\u1eddi l\u1edbn tr\u00ean 50 tu\u1ed5i v\u00e0 ng\u01b0\u1eddi suy gi\u1ea3m mi\u1ec5n d\u1ecbch<\/p>\n<p>+ Ceftriaxone truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0<\/p>\n<p>+ Vancomycin truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0<\/p>\n<p>+ Ampicillin truy\u1ec1n t\u0129nh m\u1ea1ch.<\/p>\n<ul>\n<li>V\u1edbi vi\u00eam m\u00e0ng n\u00e3o do n\u1ea5m:<\/li>\n<\/ul>\n<p>+ Amphotericin B truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0<\/p>\n<p>+ Flucytosine \u0111\u01b0\u1eddng u\u1ed1ng.<\/p>\n<p><em>3.4.2 Li\u1ec7u ph\u00e1p Steroid<\/em><\/p>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">Kh\u00f4ng c\u00f3 \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng \u0111\u1ec3 h\u1ed7 tr\u1ee3 vi\u1ec7c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i steroid trong vi\u00eam m\u00e0ng n\u00e3o do vi khu\u1ea9n. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u b\u00e1o c\u00e1o gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n vi\u00eam m\u00e0ng n\u00e3o do Streptococcus pneumoniae, nh\u01b0ng kh\u00f4ng gi\u1ea3m \u1edf b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do Haemophilus influenzae ho\u1eb7c Neisseria meningitidis.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\"> \u1ede tr\u1ebb em, steroid c\u00f3 li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng suy gi\u1ea3m th\u00ednh l\u1ef1c nghi\u00eam tr\u1ecdng ch\u1ec9 trong tr\u01b0\u1eddng h\u1ee3p vi\u00eam m\u00e0ng n\u00e3o do Haemophilus influenzae.<\/span><\/li>\n<\/ul>\n<p><em>3.4.3. Ki\u1ec3m so\u00e1t t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd<\/em><\/p>\n<p><span class=\"Y2IQFc\" lang=\"vi\">N\u1ebfu b\u1ec7nh nh\u00e2n xu\u1ea5t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng c\u1ee7a t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd (thay \u0111\u1ed5i tri gi\u00e1c, gi\u00e3n \u0111\u1ed3ng t\u1eed, ph\u00f9 gai th\u1ecb, nh\u1ecbp tim ch\u1eadm), c\u00e1c bi\u1ec7n ph\u00e1p can thi\u1ec7p \u0111\u1ec3 duy tr\u00ec t\u01b0\u1edbi m\u00e1u n\u00e3o bao g\u1ed3m: <\/span><\/p>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">N\u00e2ng \u0111\u1ea7u gi\u01b0\u1eddng l\u00ean 30 \u0111\u1ed9.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">T\u0103ng th\u00f4ng kh\u00ed nh\u1eb9 \u1edf b\u1ec7nh nh\u00e2n \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n.<\/span><\/li>\n<li><span class=\"Y2IQFc\" lang=\"vi\">S\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u th\u1ea9m th\u1ea5u nh\u01b0 mannitol 20%.<\/span><\/li>\n<\/ul>\n<p>Xem th\u00eam: <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/viem-mang-nao-o-nguoi-lon-nguyen-nhan-trieu-chung-va-cach-dieu-tri\/\">Vi\u00eam m\u00e0ng n\u00e3o \u1edf ng\u01b0\u1eddi l\u1edbn: Nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb.<\/a><\/p>\n<p>Ngu\u1ed3n t\u00e0i li\u1ec7u: PubMed: <span class=\"title\">Meningitis<\/span><\/p>\n<p>Gi\u00e1o tr\u00ecnh Truy\u1ec1n Nhi\u1ec5m &#8211; \u0110\u1ea1i h\u1ecdc Y H\u00e0 N\u1ed9i 2020<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam m\u00e0ng n\u00e3o l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd n\u1eb7ng n\u1ec1 trong chuy\u00ean ng\u00e0nh th\u1ea7n kinh. Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi vi\u00eam m\u00e0ng n\u00e3o g\u00f3p ph\u1ea7n l\u00e0m gi\u1ea3m nguy c\u01a1 t\u1eed vong v\u00e0 di ch\u1ee9ng cho b\u1ec7nh nh\u00e2n. Qua b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta h\u00e3y c\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u [&hellip;]<\/p>\n","protected":false},"author":26,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng n\u00e3o - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam m\u00e0ng n\u00e3o l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd n\u1eb7ng n\u1ec1. 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