{"id":27637,"date":"2023-04-23T22:54:11","date_gmt":"2023-04-23T15:54:11","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27637"},"modified":"2023-04-23T22:54:11","modified_gmt":"2023-04-23T15:54:11","slug":"viem-gan-virus-e-chan-doan-va-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/viem-gan-virus-e-chan-doan-va-dieu-tri\/","title":{"rendered":"Vi\u00eam gan virus E: Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

Vi\u00eam gan virus E (HEV)<\/a> l\u00e0 m\u1ed9t b\u1ec7nh l\u00e2y qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, do virus vi\u00eam gan virus E g\u00e2y ra. B\u1ec7nh c\u00f3 th\u1ec3 g\u00e2y th\u00e0nh d\u1ecbch do nhi\u1ec5m b\u1ea9n ngu\u1ed3n n\u01b0\u1edbc. Vi\u00eam gan virus E l\u00e0 m\u1ed9t b\u1ec7nh vi\u00eam gan c\u1ea5p t\u00ednh do virus E g\u00e2y ra. Virus E \u0111\u01b0\u1ee3c truy\u1ec1n t\u1eeb ng\u01b0\u1eddi n\u00e0y sang ng\u01b0\u1eddi kh\u00e1c qua \u0111\u01b0\u1eddng ti\u00eau ho\u00e1, th\u00f4ng qua n\u01b0\u1edbc u\u1ed1ng ho\u1eb7c th\u1ef1c ph\u1ea9m b\u1ecb nhi\u1ec5m virus. Vi\u00eam gan virus E l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u1edbn v\u1ec1 s\u1ee9c kh\u1ecfe \u1edf c\u00e1c khu v\u1ef1c \u0111ang ph\u00e1t tri\u1ec3n, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf c\u00e1c n\u01b0\u1edbc c\u00f3 \u0111i\u1ec1u ki\u1ec7n v\u1ec7 sinh k\u00e9m.<\/strong><\/p>\n

\"\"
\u00a0Virus vi\u00eam gan virus E c\u00f3 th\u1ec3 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng gan<\/span><\/figcaption><\/figure>\n

1. Nguy\u00ean nh\u00e2n:<\/b><\/h2>\n

HEV l\u00e0 m\u1ed9t virus h\u01b0\u1edbng gan, h\u1ecd Hepeviridae, l\u00e0 m\u1ed9t v\u00f2ng nh\u1ecf RNA \u0111\u01b0\u1eddng k\u00ednh kho\u1ea3ng 34 nanomet, d\u00e0i kho\u1ea3ng 7,5 kilobases. HEV c\u00f3 5 genotype (t\u1eeb 1 \u0111\u1ebfn 5).<\/span><\/p>\n

2. T\u00ecnh h\u00ecnh d\u1ecbch t\u1ec5:<\/b><\/h2>\n

HEV hay g\u1eb7p \u1edf c\u00e1c n\u01b0\u1edbc \u0111ang ph\u00e1t tri\u1ec3n v\u1edbi t\u1ef7 l\u1ec7 t\u1eeb 0.2 \u0111\u1ebfn 4%, nh\u01b0 \u1edf ch\u00e2u \u00c1, Trung \u0110\u00f4ng v\u00e0 ch\u00e2u Phi, hi\u1ebfm g\u1eb7p \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n, tuy nhi\u00ean HEV IgG c\u00f3 th\u1ec3 g\u1eb7p \u1edf tr\u00ean to\u00e0n th\u1ebf gi\u1edbi.<\/span><\/p>\n

3. H\u1eadu qu\u1ea3:<\/b><\/h2>\n

\u0110\u00e2y th\u01b0\u1eddng l\u00e0 m\u1ed9t lo\u1ea1i b\u1ec7nh t\u1ef1 kh\u1ecfi v\u00e0 h\u1ea7u h\u1ebft ng\u01b0\u1eddi nhi\u1ec5m b\u1ec7nh t\u1ef1 h\u1ed3i ph\u1ee5c m\u00e0 kh\u00f4ng \u0111\u1ec3 l\u1ea1i bi\u1ebfn ch\u1ee9ng v\u1ec1 l\u00e2u d\u00e0i. Tuy nhi\u00ean b\u1ec7nh c\u00f3 th\u1ec3 tr\u1edf n\u00ean \u00e1c t\u00ednh v\u00e0 nguy hi\u1ec3m, nh\u1ea5t l\u00e0 khi b\u1ec7nh nh\u00e2n \u0111ang mang thai \u1edf 3 th\u00e1ng cu\u1ed1i thai k\u1ef3, t\u1ef7 l\u1ec7 t\u1eed vong c\u00f3 th\u1ec3 l\u00ean \u0111\u1ebfn 1- 20%. B\u1ec7nh c\u00f3 th\u1ec3 di\u1ec5n bi\u1ebfn m\u1ea1n t\u00ednh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n gh\u00e9p t\u1ea1ng, nhi\u1ec5m HIV, d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch.<\/span><\/p>\n

4. Ch\u1ea9n \u0111o\u00e1n<\/b><\/h2>\n

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

Th\u00f4ng th\u01b0\u1eddng tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh vi\u00eam gan virus E ch\u1ec9 r\u1ea5t nh\u1eb9 v\u00e0 nh\u1ea5t th\u1eddi, k\u00e9o d\u00e0i t\u1eeb v\u00e0i ng\u00e0y \u0111\u1ebfn v\u00e0i tu\u1ea7n l\u1ec5. Tri\u1ec7u ch\u1ee9ng ch\u1ee7 y\u1ebfu l\u00e0 s\u1ed1t, \u0111au m\u1ecfi c\u01a1, nh\u1ee9c \u0111\u1ea7u, ch\u00e1n \u0103n, m\u1ec7t m\u1ecfi, n\u01b0\u1edbc ti\u1ec3u s\u1eabm m\u00e0u, v\u00e0ng m\u1eaft, v\u00e0ng da t\u0103ng d\u1ea7n. \u1ede nh\u1eefng v\u00f9ng c\u00f3 d\u1ecbch t\u1ec5 l\u01b0u h\u00e0nh di\u1ec5n bi\u1ebfn l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 g\u1eb7p nh\u1eefng th\u1ec3 n\u1eb7ng v\u1edbi nh\u1eefng bi\u1ec3u hi\u1ec7n c\u1ee7a suy gan c\u1ea5p v\u00e0 c\u00f3 th\u1ec3 t\u1eed vong.<\/span><\/p>\n

4.2. C\u1eadn l\u00e2m s\u00e0ng:<\/b><\/h3>\n

– ALT, AST m\u00e1u t\u0103ng.<\/span><\/p>\n

– Bilirubin m\u00e1u t\u0103ng.<\/span><\/p>\n

– IgM anti-HEV (+) ngay khi c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 c\u00f3 th\u1ec3 k\u00e9o d\u00e0i \u0111\u1ebfn 6 th\u00e1ng.<\/span><\/p>\n

– IgG anti-HEV (+) sau 10-12 ng\u00e0y khi c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh v\u00e0 k\u00e9o d\u00e0i nhi\u1ec1u n\u0103m.<\/span><\/p>\n

– virus vi\u00eam gan E c\u00f3 th\u1ec3 hi\u1ec7n di\u1ec7n trong ph\u00e2n c\u1ee7a ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m b\u1ec7nh l\u00ean \u0111\u1ebfn hai th\u00e1ng sau khi c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng.<\/span><\/p>\n

5. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/b><\/h2>\n

– D\u1ecbch t\u1ec5: ti\u1ec1n s\u1eed ti\u1ebfp x\u00fac v\u1edbi th\u1ef1c ph\u1ea9m ho\u1eb7c ngu\u1ed3n n\u01b0\u1edbc b\u1ecb \u00f4 nhi\u1ec5m hay tr\u1ef1c ti\u1ebfp qua quan h\u1ec7 t\u00ecnh d\u1ee5c mi\u1ec7ng \u2013h\u1eadu m\u00f4n, ho\u1eb7c ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam gan virus E.<\/span><\/p>\n

– L\u00e2m s\u00e0ng: ch\u00e1n \u0103n, m\u1ec7t m\u1ecfi, v\u00e0ng m\u1eaft, v\u00e0ng da.<\/span><\/p>\n

– C\u1eadn l\u00e2m s\u00e0ng: anti HEV IgM (+).<\/span><\/p>\n

6. Ch\u1ea9n \u0111o\u00e1n th\u1ec3 l\u00e2m s\u00e0ng:<\/b><\/h2>\n

6.1. Vi\u00eam gan c\u1ea5p t\u00ednh:<\/strong><\/h3>\n

Tri\u1ec7u ch\u1ee9ng ch\u1ee7 y\u1ebfu l\u00e0 s\u1ed1t, \u0111au m\u1ecfi c\u01a1, nh\u1ee9c \u0111\u1ea7u, ch\u00e1n \u0103n, m\u1ec7t m\u1ecfi, n\u01b0\u1edbc ti\u1ec3u s\u1eabm m\u00e0u, v\u00e0ng m\u1eaft, v\u00e0ng da t\u0103ng d\u1ea7n. Di\u1ec5n bi\u1ebfn th\u01b0\u1eddng t\u1ef1 kh\u1ecfi.<\/span><\/p>\n

6.2. Vi\u00eam gan t\u1ed1i c\u1ea5p: <\/strong><\/h3>\n

S\u1ed1t cao, v\u00e0ng m\u1eaft, m\u1ec7t l\u1ea3, gan teo nh\u1ecf, h\u00f4n m\u00ea gan d\u1eabn \u0111\u1ebfn t\u1eed vong.<\/span><\/p>\n

6.3. Vi\u00eam gan m\u1ea1n t\u00ednh: <\/strong><\/h3>\n

\u00cdt g\u1eb7p. Ch\u1ee7 y\u1ebfu g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n suy gi\u1ea3m mi\u1ec5n d\u1ecbch nh\u01b0 gh\u00e9p t\u1ea1ng, HIV, \u0111i\u1ec1u tr\u1ecb thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch.<\/span><\/p>\n

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

– C\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y vi\u00eam gan kh\u00e1c nh\u01b0: vi\u00eam gan nhi\u1ec5m \u0111\u1ed9c, vi\u00eam gan do virus kh\u00e1c, vi\u00eam gan t\u1ef1 mi\u1ec5n\u2026<\/span><\/p>\n

– C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y v\u00e0ng da kh\u00e1c: leptospirosis, s\u1ed1t r\u00e9t,\u2026m\u1ed9t s\u1ed1 c\u0103n nguy\u00ean t\u1eafc m\u1eadt c\u01a1 gi\u1edbi nh\u01b0 u \u0111\u1ea7u t\u1ee5y, u \u0111\u01b0\u1eddng m\u1eadt, s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt\u2026<\/span><\/p>\n

8. \u0110i\u1ec1u tr\u1ecb<\/b><\/h2>\n

\u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u:<\/b> Vi\u00eam gan virus E kh\u00f4ng c\u00f3 \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u<\/span><\/p>\n

\u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3:<\/b><\/p>\n

8.1. Ch\u1ebf \u0111\u1ed9 ch\u0103m s\u00f3c:<\/strong><\/h3>\n

– Ngh\u1ec9 ng\u01a1i ho\u1ea1t \u0111\u1ed9ng nh\u1eb9 nh\u00e0ng.<\/span><\/p>\n

– \u0102n gi\u00e0u \u0111\u1ea1m, vitamin, gi\u1ea3m m\u1ee1 \u0111\u1ed9ng v\u1eadt. T\u0103ng c\u01b0\u1eddng hoa qu\u1ea3 t\u01b0\u01a1i.<\/span><\/p>\n

– Kh\u00f4ng r\u01b0\u1ee3u, bia v\u00e0 h\u1ea1n ch\u1ebf s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c, h\u00f3a ch\u1ea5t g\u00e2y \u0111\u1ed9c cho gan.<\/span><\/p>\n

8.2. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb:<\/strong><\/h3>\n

– Thu\u1ed1c b\u1ea3o v\u1ec7 m\u00e0ng t\u1ebf b\u00e0o gan: nh\u01b0 nh\u00f3m BDD (Biphenyl Dimethyl Dicarboxylate).<\/span><\/p>\n

– Thu\u1ed1c t\u0103ng c\u01b0\u1eddng chuy\u1ec3n h\u00f3a: chuy\u1ec3n amoniac \u0111\u1ed9c h\u1ea1i th\u00e0nh ure nh\u01b0 nh\u00f3m L-Ornithin L-Aspartat, Lactulose.<\/span><\/p>\n

– Thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng kh\u1eed c\u00e1c g\u1ed1c t\u1ef1 do b\u1ea3o v\u1ec7 t\u1ebf b\u00e0o kh\u1ecfi c\u00e1c ch\u1ea5t oxy h\u00f3a c\u00f3 h\u1ea1i: Glutathione.<\/span><\/p>\n

– T\u0103ng c\u01b0\u1eddng c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u: Vitamin K, Plasma t\u01b0\u01a1i\u2026<\/span><\/p>\n

– Thu\u1ed1c l\u1ee3i m\u1eadt, s\u1eed d\u1ee5ng khi c\u00f3 v\u00e0ng m\u1eaft v\u00e0ng da: chophytol, sorbitol\u2026<\/span><\/p>\n

– Thu\u1ed1c l\u1ee3i ti\u1ec3u, s\u1eed d\u1ee5ng khi b\u1ec7nh nh\u00e2n ti\u1ec3u \u00edt, b\u1eaft \u0111\u1ea7u v\u1edbi nh\u00f3m kh\u00e1ng Aldosteron, c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c l\u1ee3i ti\u1ec3u kh\u00e1c.<\/span><\/p>\n

9. Ph\u00f2ng b\u1ec7nh<\/b><\/h2>\n

Vi\u00eam gan virus E c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ng\u0103n ng\u1eeba b\u1eb1ng c\u00e1ch ti\u00eam ph\u00f2ng, v\u1ec7 sinh c\u00e1 nh\u00e2n t\u1ed1t v\u00e0 v\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng.<\/span><\/p>\n

Ti\u00eam ph\u00f2ng vaccine:<\/b><\/p>\n

Nh\u1eefng ng\u01b0\u1eddi c\u00f3 kh\u1ea3 n\u0103ng tr\u1edf th\u00e0nh m\u1ea1n t\u00ednh n\u1ebfu h\u1ecd b\u1ecb nhi\u1ec5m HEV (nh\u1eefng ng\u01b0\u1eddi c\u00f3 h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch b\u1ecb suy y\u1ebfu ho\u1eb7c b\u1ec7nh gan m\u00e3n t\u00ednh). Li\u1ec7u tr\u00ecnh ti\u00eam vaccine g\u1ed3m 3 m\u0169i \u0111\u01b0\u1ee3c ti\u00eam v\u00e0o th\u00e1ng 0, 1 v\u00e0 th\u00e1ng th\u1ee9 6.<\/span><\/p>\n

Ph\u00f2ng b\u1ec7nh kh\u00f4ng \u0111\u1eb7c hi\u1ec7u<\/b><\/p>\n

– V\u1edbi ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m vi\u00eam gan virus E: b\u1ec7nh nh\u00e2n n\u00ean r\u1eeda tay k\u1ef9 tr\u01b0\u1edbc, sau khi \u0103n v\u00e0 ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi kh\u00e1c.<\/span><\/p>\n

– V\u1edbi c\u1ed9ng \u0111\u1ed3ng c\u00f3 th\u1ec3 gi\u1ea3m c\u01a1 h\u1ed9i b\u1ecb nhi\u1ec5m b\u1eb1ng c\u00e1c c\u00e1ch sau:<\/span><\/p>\n

+ R\u1eeda tay v\u1edbi x\u00e0 ph\u00f2ng tr\u01b0\u1edbc khi \u0103n.<\/span><\/p>\n

+ Kh\u00f4ng n\u00ean \u0103n h\u1ea3i s\u1ea3n s\u1ed1ng ho\u1eb7c n\u1ea5u ch\u01b0a ch\u00edn t\u1eeb c\u00e1c khu v\u1ef1c s\u00f4ng bi\u1ec3n b\u1ecb \u00f4 nhi\u1ec5m \u2026<\/span><\/p>\n

T\u00f3m l\u1ea1i,vi\u00eam gan virus E l\u00e0 m\u1ed9t b\u1ec7nh vi\u00eam gan c\u1ea5p t\u00ednh do virus E g\u00e2y ra, truy\u1ec1n t\u1eeb ng\u01b0\u1eddi n\u00e0y sang ng\u01b0\u1eddi kh\u00e1c qua \u0111\u01b0\u1eddng ti\u00eau ho\u00e1. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n vi\u00eam gan virus E d\u1ef1a tr\u00ean c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh v\u00e0 k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m m\u00e1u \u0111\u1ec3 ph\u00e1t hi\u1ec7n kh\u00e1ng th\u1ec3 ch\u1ed1ng virus E. Hi\u1ec7n t\u1ea1i, kh\u00f4ng c\u00f3 thu\u1ed1c \u0111\u1eb7c tr\u1ecb cho vi\u00eam gan virus E v\u00e0 \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng l\u00e0 h\u1ed7 tr\u1ee3 \u0111\u1ec3 gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 gi\u1eef cho c\u01a1 th\u1ec3 \u0111\u1ea7y \u0111\u1ee7 dinh d\u01b0\u1ee1ng. \u0110\u1ec3 ph\u00f2ng ng\u1eeba vi\u00eam gan virus E, ng\u01b0\u1eddi ta khuy\u1ebfn c\u00e1o n\u00ean u\u1ed1ng n\u01b0\u1edbc s\u00f4i ho\u1eb7c n\u01b0\u1edbc \u0111\u00e3 qua x\u1eed l\u00fd \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o v\u1ec7 sinh an to\u00e0n th\u1ef1c ph\u1ea9m.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

Vi\u00eam gan virus E (HEV) l\u00e0 m\u1ed9t b\u1ec7nh l\u00e2y qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, do virus vi\u00eam gan virus E g\u00e2y ra. B\u1ec7nh c\u00f3 th\u1ec3 g\u00e2y th\u00e0nh d\u1ecbch do nhi\u1ec5m b\u1ea9n ngu\u1ed3n n\u01b0\u1edbc. Vi\u00eam gan virus E l\u00e0 m\u1ed9t b\u1ec7nh vi\u00eam gan c\u1ea5p t\u00ednh do virus E g\u00e2y ra. Virus E \u0111\u01b0\u1ee3c truy\u1ec1n t\u1eeb ng\u01b0\u1eddi n\u00e0y […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[],"yoast_head":"\nVi\u00eam gan virus E: Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam gan virus E (HEV) l\u00e0 m\u1ed9t b\u1ec7nh l\u00e2y qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, do virus vi\u00eam gan virus E g\u00e2y ra. 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