{"id":27613,"date":"2023-04-24T00:08:18","date_gmt":"2023-04-23T17:08:18","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27613"},"modified":"2023-04-29T21:12:18","modified_gmt":"2023-04-29T14:12:18","slug":"ho-o-tre-em-nguyen-nhan-tiep-can-chan-doan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/ho-o-tre-em-nguyen-nhan-tiep-can-chan-doan\/","title":{"rendered":"Ho \u1edf tr\u1ebb em: nguy\u00ean nh\u00e2n, ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n"},"content":{"rendered":"

Theo nghi\u00ean c\u1ee9u c\u1ee7a WHO, ho l\u00e0 tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a c\u00e1c b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p t\u1ea1i c\u00e1c qu\u1ed1c gia \u0111ang ph\u00e1t tri\u1ec3n. Ho thu\u1ed9c v\u1ec1 c\u01a1 ch\u1ebf b\u1ea3o v\u1ec7 t\u1ef1 nhi\u00ean, l\u00e0 ph\u1ea3n x\u1ea1 nh\u1eb1m t\u1ed1ng xu\u1ea5t \u0111\u00e0m v\u00e0 v\u1eadt l\u1ea1 ra kh\u1ecfi\u00a0\u0111\u01b0\u1eddng th\u1edf. C\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c c\u00f3 th\u1ec3 k\u00e8m theo nh\u01b0 s\u1ed1t, \u0111au ng\u1ef1c, kh\u00f3 th\u1edf, n\u00f4n \u00f3i, s\u1ee5t c\u00e2n,… Tri\u1ec7u ch\u1ee9ng ho c\u00f3 th\u1ec3 l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a nhi\u1ec1u b\u1ec7nh l\u00fd kh\u00e1c nhau, t\u1eeb b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p \u0111\u01a1n gi\u1ea3n nh\u01b0 c\u1ea3m l\u1ea1nh \u0111\u1ebfn nh\u1eefng b\u1ec7nh l\u00fd nghi\u00eam tr\u1ecdng nh\u01b0 vi\u00eam ph\u1ed5i hay lao.<\/strong><\/p>\n

1. C\u01a1 ch\u1ebf sinh l\u00fd b\u1ec7nh<\/h2>\n

Ho thu\u1ed9c v\u1ec1 c\u01a1 ch\u1ebf b\u1ea3o v\u1ec7 t\u1ef1 nhi\u00ean, l\u00e0 ph\u1ea3n x\u1ea1 nh\u1eb1m t\u1ed1ng xu\u1ea5t \u0111\u00e0m v\u00e0 v\u1eadt l\u1ea1 ra kh\u1ecfi\u00a0\u0111\u01b0\u1eddng th\u1edf, l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 k\u00edch th\u00edch th\u1ee5 th\u1ec3 ho. C\u00e1c th\u1ee5 th\u1ec3 n\u00e0y n\u1eb1m trong l\u1edbp ni\u00eam\u00a0m\u1ea1c v\u00e0 l\u1edbp d\u01b0\u1edbi ni\u00eam t\u1eeb h\u1ea7u \u0111\u1ebfn c\u00e1c ti\u1ec3u ph\u1ebf qu\u1ea3n t\u1eadn. C\u00e1c th\u1ee5 th\u1ec3 nh\u1ea1y c\u1ea3m c\u01a1 h\u1ecdc th\u00ec\u00a0ph\u00e2n b\u1ed1 ch\u1ee7 y\u1ebfu \u1edf h\u1ea7u v\u00e0 kh\u00ed qu\u1ea3n, trong khi nh\u1eefng th\u1ee5 th\u1ec3 nh\u1ea1y c\u1ea3m h\u00f3a h\u1ecdc th\u00ec ph\u00e2n\u00a0b\u1ed1 ch\u1ee7 y\u1ebfu \u1edf \u0111\u01b0\u1eddng d\u1eabn kh\u00ed xa. Ch\u00fang ph\u00e1t t\u00edn hi\u1ec7u h\u01b0\u1edbng t\u00e2m qua th\u1ea7n kinh thi\u1ec7t\u00a0h\u1ea7u (IX) v\u00e0 th\u1ea7n kinh lang thang (X) \u0111\u1ebfn trung khu ho n\u1eb1m \u1edf v\u00f9ng tr\u00ean th\u00e2n n\u00e3o v\u00e0 c\u1ea7u\u00a0n\u00e3o. T\u00edn hi\u1ec7u ly t\u00e2m t\u1eeb trung khu ho qua d\u00e2y X, th\u1ea7n kinh ho\u00e0nh, th\u1ea7n kinh v\u1eadn \u0111\u1ed9ng t\u1ee7y\u00a0s\u1ed1ng \u0111\u1ebfn thanh qu\u1ea3n v\u00e0 c\u01a1 ho\u00e0nh c\u0169ng nh\u01b0 c\u01a1 th\u00e0nh ng\u1ef1c, th\u00e0nh b\u1ee5ng v\u00e0 khung ch\u1eadu. V\u1ecf n\u00e3o c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t ch\u1ee7 \u0111\u1ed9ng hay \u1ee9c ch\u1ebf ph\u1ea3n x\u1ea1 ho.<\/p>\n

Ho g\u1ed3m ba pha: (1) h\u00edt s\u00e2u; (2) \u0111\u00f3ng n\u1eafp thanh m\u00f4n, d\u00e3n c\u01a1 ho\u00e0nh, co c\u01a1 th\u1edf ra v\u00e0\u00a0(3) m\u1edf \u0111\u1ed9t ng\u1ed9t n\u1eafp thanh m\u00f4n. Trong pha 2, \u00e1p l\u1ef1c trong l\u1ed3ng ng\u1ef1c c\u00f3 th\u1ec3 l\u00ean t\u1edbi\u00a0300 mmHg v\u00e0 c\u00f3 th\u1ec3 truy\u1ec1n t\u1edbi m\u1ea1ch m\u00e1u v\u00e0 khoang n\u00e3o t\u1ee7y. V\u1eadn t\u1ed1c lu\u1ed3ng kh\u00ed trong\u00a0pha 3 cao nh\u1ea5t \u1edf \u0111\u01b0\u1eddng d\u1eabn kh\u00ed trung t\u00e2m v\u00e0 c\u00f3 th\u1ec3 \u0111\u1ea1t 3\/4 t\u1ed1c \u0111\u1ed9 \u00e2m thanh. V\u1eadn t\u1ed1c n\u00e0y\u00a0ph\u1ee5 thu\u1ed9c v\u00e0o s\u1ef1 m\u1edf \u0111\u1ed9t ng\u1ed9t c\u1ee7a n\u1eafp thanh m\u00f4n v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 t\u1ed1ng xu\u1ea5t\u00a0\u0111\u00e0m. V\u00ec v\u1eady, b\u1ec7nh nh\u00e2n c\u00f3 b\u1ea5t th\u01b0\u1eddng ch\u1ee9c n\u0103ng n\u1eafp thanh m\u00f4n hay m\u1edf kh\u00ed qu\u1ea3n c\u00f3\u00a0ph\u1ea3n x\u1ea1 ho k\u00e9m hi\u1ec7u qu\u1ea3.<\/p>\n

K\u00edch th\u00edch ho c\u00f3 th\u1ec3 t\u1eeb trung \u01b0\u01a1ng, nh\u01b0 t\u00e2m l\u00fd, hay t\u1eeb ph\u1ed5i, t\u1eeb \u0111\u01b0\u1eddng th\u1edf l\u1edbn \u0111\u1ebfn\u00a0nhu m\u00f4 ph\u1ed5i. Ho c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra b\u1edfi nguy\u00ean nh\u00e2n ngo\u00e0i ph\u1ed5i, nh\u01b0 m\u00e0ng ph\u1ed5i, c\u01a1\u00a0ho\u00e0nh, m\u00e0ng ngo\u00e0i tim, hay k\u00edch th\u00edch th\u1ea7n kinh Arnold (nh\u00e1nh th\u1ea7n kinh X) do c\u00f3 r\u00e1y\u00a0tai hay d\u1ecb v\u1eadt \u1edf tai ngo\u00e0i.<\/p>\n

2. Ph\u00e2n lo\u1ea1i<\/h2>\n

– Theo th\u1eddi gian: c\u1ea5p t\u00ednh (< 2 tu\u1ea7n), b\u00e1n c\u1ea5p (2-4 tu\u1ea7n), m\u1ea1n t\u00ednh (> 4 tu\u1ea7n)<\/p>\n

– T\u00ednh ch\u1ea5t: ho \u0111\u00e0m, ho khan<\/p>\n

3. Nguy\u00ean nh\u00e2n<\/h2>\n

3.1. Ho c\u1ea5p t\u00ednh<\/h3>\n

– Nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p c\u1ea5p
\n– H\u00edt s\u1eb7c\/d\u1ecb v\u1eadt \u0111\u01b0\u1eddng th\u1edf
\n– Hen
\n– H\u00edt kh\u00ed \u0111\u1ed9c: kh\u00f3i thu\u1ed1c, CO,\u2026<\/p>\n

3.2. Ho b\u00e1n c\u1ea5p<\/h3>\n

– H\u1eadu nhi\u1ec5m si\u00eau vi, Mycoplasma
\n– Vi\u00eam ph\u1ebf qu\u1ea3n c\u1ea5p.<\/p>\n

3.3. Ho m\u1ea1n t\u00ednh<\/h3>\n

– H\u1eadu nhi\u1ec5m si\u00eau vi, Mycoplasma, ho g\u00e0
\n– Nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p k\u00e9o d\u00e0i ho\u1eb7c t\u00e1i \u0111i t\u00e1i l\u1ea1i
\n– Nhi\u1ec5m lao
\n– H\u1ed9i ch\u1ee9ng ch\u1ea3y m\u0169i sau
\n– H\u1ed9i ch\u1ee9ng h\u00edt
\n– Tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y \u2013 th\u1ef1c qu\u1ea3n, r\u00f2 kh\u00ed qu\u1ea3n \u2013 th\u1ef1c qu\u1ea3n
\n– Hen
\n– Gi\u00e3n ph\u1ebf qu\u1ea3n, x\u01a1 nang, r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng l\u00f4ng chuy\u1ec3n, b\u1ec7nh ph\u1ed5i m\u00f4 k\u1ebd
\n– B\u1ec7nh l\u00fd tim m\u1ea1ch
\n– B\u1ec7nh l\u00fd \u00e1c t\u00ednh v\u00f9ng trung th\u1ea5t
\n– D\u1ecb t\u1eadt b\u1ea9m sinh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p<\/p>\n

4. Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n<\/h2>\n

4.1. B\u1ec7nh s\u1eed<\/h3>\n

– Th\u1eddi gian: c\u1ea5p t\u00ednh\/b\u00e1n c\u1ea5p\/m\u1ea1n t\u00ednh. N\u1ebfu ho m\u1ea1n t\u00ednh, l\u01b0u \u00fd tu\u1ed5i b\u1eaft \u0111\u1ea7u ho\u00a0(g\u1ee3i \u00fd nguy\u00ean nh\u00e2n b\u1ea9m sinh) ho\u1eb7c ti\u1ebfn tri\u1ec3n n\u1eb7ng d\u1ea7n (g\u1ee3i \u00fd nhi\u1ec5m lao ho\u1eb7c b\u1ec7nh\u00a0l\u00fd \u00e1c t\u00ednh ch\u00e8n \u0111\u01b0\u1eddng th\u1edf).<\/p>\n

– Ho\u00e0n c\u1ea3nh kh\u1edfi ph\u00e1t: \u0111\u1ed9t ng\u1ed9t (d\u1ecb v\u1eadt, s\u1eb7c), sau g\u1eafng s\u1ee9c\/ti\u1ebfp x\u00fac d\u1ecb nguy\u00ean\/thay\u00a0\u0111\u1ed5i th\u1eddi ti\u1ebft (hen), trong l\u00fac \u0111ang \u0103n\/b\u00fa (li\u00ean quan h\u00edt s\u1eb7c, r\u00f2 kh\u00ed qu\u1ea3n \u2013 th\u1ef1c qu\u1ea3n), sau\u00a0\u0103n ch\u1ea5t r\u1eafn (vi\u00eam th\u1ef1c qu\u1ea3n t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan),\u2026<\/p>\n

– Th\u1eddi \u0111i\u1ec3m ho n\u1eb7ng h\u01a1n trong ng\u00e0y: v\u1ec1 \u0111\u00eam g\u1ea7n s\u00e1ng (hen), sau khi n\u1eb1m (h\u1ed9i ch\u1ee9ng ch\u1ea3y m\u0169i sau, tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y \u2013 th\u1ef1c qu\u1ea3n, suy tim sung huy\u1ebft,\u2026), ho \u0111\u00e0m nhi\u1ec1u v\u00e0o\u00a0bu\u1ed5i s\u00e1ng (gi\u00e3n ph\u1ebf qu\u1ea3n, x\u01a1 nang, r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng l\u00f4ng chuy\u1ec3n).<\/p>\n

– Y\u1ebfu t\u1ed1 gi\u1ea3m ho: thay \u0111\u1ed5i t\u01b0 th\u1ebf, thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n,\u2026<\/p>\n

– Ho khan hay \u0111\u00e0m (l\u01b0\u1ee3ng \u0111\u00e0m, m\u00e0u s\u1eafc \u0111\u00e0m). L\u01b0u \u00fd, m\u00e0u v\u00e0ng xanh c\u1ee7a \u0111\u00e0m\u00a0l\u00e0 do b\u1ea1ch c\u1ea7u ch\u1ebft v\u00e0 ph\u00f3ng th\u00edch men myeloperoxidase. T\u00ednh ch\u1ea5t n\u00e0y ch\u1ec9 n\u00f3i l\u00ean \u0111\u00e0m\u00a0b\u1ecb \u1ee9 \u0111\u1ecdng l\u1ea1i ch\u1ee9 kh\u00f4ng n\u00f3i l\u00ean s\u1ef1 nhi\u1ec5m tr\u00f9ng.<\/p>\n

– \u00c2m s\u1eafc ho: \u00f4ng \u1ed5ng nh\u01b0 ch\u00f3 s\u1ee7a \u201cbarking cough\u201d (vi\u00eam thanh kh\u00ed qu\u1ea3n), ng\u1eaft qu\u00e3ng \u201cstaccato cough\u201d (nhi\u1ec5m si\u00eau vi h\u00f4 h\u1ea5p ho\u1eb7c nhi\u1ec5m vi khu\u1ea9n kh\u00f4ng \u0111i\u1ec3n h\u00ecnh), k\u1ecbch ph\u00e1t t\u1eebng c\u01a1n d\u00e0i \u0111\u1ecf m\u1eb7t \u201cwhooping cough\u201d (ho g\u00e0),\u2026<\/p>\n

– Tri\u1ec7u ch\u1ee9ng k\u00e8m theo: h\u00edt s\u1eb7c, s\u1ed1t, kh\u00f3 th\u1edf, \u0111au ng\u1ef1c, n\u00f4n \u00f3i, \u00f3i m\u00e1u, s\u1ee5t c\u00e2n,\u2026<\/p>\n

– Ti\u1ec1n s\u1eed s\u1ea3n khoa v\u00e0 s\u01a1 sinh<\/p>\n

– Ti\u1ec1n c\u0103n gia \u0111\u00ecnh: b\u1ec7nh l\u00fd d\u1ecb \u1ee9ng, lao, hen,\u2026<\/p>\n

– M\u00f4i tr\u01b0\u1eddng s\u1ed1ng: \u1ea9m m\u1ed1c, kh\u00f3i b\u1ee5i, kh\u00f3i thu\u1ed1c l\u00e1, th\u00fa nu\u00f4i, c\u00e2y tr\u1ed3ng,\u2026<\/p>\n

4.2. Kh\u00e1m l\u00e2m s\u00e0ng<\/h3>\n

– \u0110\u00e1nh gi\u00e1 d\u1ea5u hi\u1ec7u c\u1ea7n c\u1ea5p c\u1ee9u<\/p>\n

– L\u1ea5y sinh hi\u1ec7u, SpO2, ch\u1ec9 s\u1ed1 dinh d\u01b0\u1ee1ng<\/p>\n

– \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 g\u1eafng s\u1ee9c h\u00f4 h\u1ea5p<\/p>\n

– Kh\u00e1m h\u00f4 h\u1ea5p, tim m\u1ea1ch<\/p>\n

– Kh\u00e1m c\u00e1c c\u01a1 quan kh\u00e1c: tai m\u0169i h\u1ecdng, ch\u00e0m da, \u0111\u1ea7u chi d\u00f9i tr\u1ed1ng, ph\u00f9,\u2026<\/p>\n

4.3. Ch\u1ec9 \u0111\u1ecbnh c\u1eadn l\u00e2m s\u00e0ng (n\u1ebfu c\u1ea7n)<\/h3>\n

– C\u00f4ng th\u1ee9c m\u00e1u: lympho t\u0103ng cao (g\u1ee3i \u00fd ho g\u00e0)<\/p>\n

– X-quang ph\u1ed5i<\/p>\n

– Ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p (ch\u1ea9n \u0111o\u00e1n hen)<\/p>\n

– N\u1ed9i soi m\u0169i h\u1ecdng (t\u00ecm polyp m\u0169i, b\u1ea5t th\u01b0\u1eddng v\u00f9ng thanh qu\u1ea3n), n\u1ed9i soi \u0111\u01b0\u1eddng th\u1edf (nghi d\u1ecb v\u1eadt \u0111\u01b0\u1eddng th\u1edf)<\/p>\n

– CT scan ng\u1ef1c (nghi b\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh \u0111\u01b0\u1eddng th\u1edf)<\/p>\n

– Si\u00eau \u00e2m b\u1ee5ng (nghi tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y \u2013 th\u1ef1c qu\u1ea3n)<\/p>\n

– IDR (nghi lao)<\/p>\n

– Test l\u1ea9y da (ch\u1ea9n \u0111o\u00e1n c\u01a1 \u0111\u1ecba d\u1ecb \u1ee9ng).<\/p>\n

\"Ti\u1ebfp
Ti\u1ebfp c\u1eadn ho m\u1ea1n t\u00ednh<\/figcaption><\/figure>\n
\"Ti\u1ebfp
Ti\u1ebfp c\u1eadn ho c\u1ea5p t\u00ednh<\/figcaption><\/figure>\n

Ngu\u1ed3n: B\u00e0i gi\u1ea3ng nhi khoa \u0111\u1ea1i h\u1ecdc Y d\u01b0\u1ee3c th\u00e0nh ph\u1ed1 H\u1ed3 Ch\u00ed Minh<\/p>\n","protected":false},"excerpt":{"rendered":"

Theo nghi\u00ean c\u1ee9u c\u1ee7a WHO, ho l\u00e0 tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a c\u00e1c b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p t\u1ea1i c\u00e1c qu\u1ed1c gia \u0111ang ph\u00e1t tri\u1ec3n. Ho thu\u1ed9c v\u1ec1 c\u01a1 ch\u1ebf b\u1ea3o v\u1ec7 t\u1ef1 nhi\u00ean, l\u00e0 ph\u1ea3n x\u1ea1 nh\u1eb1m t\u1ed1ng xu\u1ea5t \u0111\u00e0m v\u00e0 v\u1eadt l\u1ea1 ra kh\u1ecfi\u00a0\u0111\u01b0\u1eddng th\u1edf. C\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c c\u00f3 th\u1ec3 k\u00e8m […]<\/p>\n","protected":false},"author":39,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1,15,33],"tags":[],"yoast_head":"\nHo \u1edf tr\u1ebb em: nguy\u00ean nh\u00e2n, ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n - Vinmec<\/title>\n<meta name=\"description\" content=\"Ho thu\u1ed9c v\u1ec1 c\u01a1 ch\u1ebf b\u1ea3o v\u1ec7 t\u1ef1 nhi\u00ean, l\u00e0 ph\u1ea3n x\u1ea1 nh\u1eb1m t\u1ed1ng xu\u1ea5t \u0111\u00e0m v\u00e0 v\u1eadt l\u1ea1 ra kh\u1ecfi \u0111\u01b0\u1eddng th\u1edf, l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 k\u00edch th\u00edch th\u1ee5 th\u1ec3 ho\" \/>\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=\"Ho \u1edf tr\u1ebb em: nguy\u00ean nh\u00e2n, ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n - 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