{"id":27974,"date":"2023-04-26T17:17:36","date_gmt":"2023-04-26T10:17:36","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27974"},"modified":"2023-04-26T17:17:36","modified_gmt":"2023-04-26T10:17:36","slug":"viem-nao-cap-tre-em-chan-doan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/26\/viem-nao-cap-tre-em-chan-doan\/","title":{"rendered":"Vi\u00eam n\u00e3o c\u1ea5p do virus \u1edf tr\u1ebb em: \u0110\u1ecbnh ngh\u0129a, d\u1ecbch t\u1ec5 h\u1ecdc, ch\u1ea9n \u0111o\u00e1n"},"content":{"rendered":"

Vi\u00eam n\u00e3o c\u1ea5p l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd nguy hi\u1ec3m \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe con ng\u01b0\u1eddi. Tuy nhi\u00ean, trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n vi\u00eam n\u00e3o c\u1ea5p do virus \u1edf tr\u1ebb em \u0111ang g\u1eb7p nhi\u1ec1u kh\u00f3 kh\u0103n. V\u1edbi nh\u1eefng tri\u1ec7u ch\u1ee9ng kh\u00e1c nhau, vi\u1ec7c x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh v\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p l\u00e0 \u0111i\u1ec1u c\u1ea7n thi\u1ebft \u0111\u1ec3 gi\u00fap tr\u1ebb kh\u1ecfi b\u1ec7nh m\u1ed9t c\u00e1ch nhanh ch\u00f3ng v\u00e0 an to\u00e0n. Trong b\u00e0i vi\u1ebft n\u00e0y ch\u00fang ta c\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 \u0111\u1ecbnh ngh\u0129a, d\u1ecbch t\u1ec5 h\u1ecdc v\u00e0 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh l\u00fd nguy hi\u1ec3m n\u00e0y \u1edf tr\u1ebb em.<\/strong><\/p>\n

1. \u0110\u1ecbnh ngh\u0129a<\/strong><\/h2>\n

Vi\u00eam n\u00e3o c\u1ea5p l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam nhi\u1ec5m c\u1ea5p t\u00ednh \u1edf m\u00f4 n\u00e3o – c\u00f3 th\u1ec3 lan to\u1ea3 hay khu tr\u00fa, do nhi\u1ec1u nguy\u00ean nh\u00e2n g\u00e2y n\u00ean nh\u01b0ng ph\u1ea7n l\u1edbn l\u00e0 do m\u1ed9t s\u1ed1 lo\u1ea1i virus.<\/p>\n

B\u1ec7nh vi\u00eam n\u00e3o c\u1ea5p do virus c\u00f3 th\u1ec3 l\u00e2y truy\u1ec1n qua mu\u1ed7i \u0111\u1ed1t (\u0111\u1ed1i v\u1edbi c\u00e1c lo\u1ea1i\u00a0arbovirus<\/em>\u00a0nh\u01b0 vi\u00eam n\u00e3o Nh\u1eadt B\u1ea3n); qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p (nh\u01b0\u00a0virus Herpes Simplex-HSP<\/em>) ho\u1eb7c qua \u0111\u01b0\u1eddng ti\u00eau ho\u00e1 (nh\u01b0 c\u00e1c lo\u1ea1i virus \u0111\u01b0\u1eddng ru\u1ed9t). B\u1ec7nh th\u01b0\u1eddng kh\u1edfi ph\u00e1t c\u1ea5p t\u00ednh di\u1ec5n bi\u1ebfn n\u1eb7ng, t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 di ch\u1ee9ng kh\u00e1 cao; hay g\u1eb7p \u1edf tr\u1ebb em v\u1edbi c\u00e1c \u0111\u1ed9 tu\u1ed5i kh\u00e1c nhau.<\/p>\n

2. D\u1ecbch t\u1ec5 h\u1ecdc<\/strong><\/h2>\n

B\u1ec7nh vi\u00eam n\u00e3o c\u1ea5p g\u1eb7p r\u1ea3i r\u00e1c quanh n\u0103m \u1edf h\u1ea7u h\u1ebft c\u00e1c \u0111\u1ecba ph\u01b0\u01a1ng. Tuy nhi\u00ean, t\u1ef7 l\u1ec7 m\u1eafc c\u00f3 xu h\u01b0\u1edbng t\u0103ng v\u00e0o m\u00f9a n\u00f3ng (t\u1eeb th\u00e1ng 3 \u0111\u1ebfn th\u00e1ng 8 h\u00e0ng n\u0103m).<\/p>\n

– Vi\u00eam n\u00e3o Nh\u1eadt B\u1ea3n: L\u01b0u h\u00e0nh \u1edf h\u1ea7u h\u1ebft c\u00e1c \u0111\u1ecba ph\u01b0\u01a1ng n\u01b0\u1edbc ta, th\u01b0\u1eddng g\u00e2y d\u1ecbch v\u00e0o c\u00e1c th\u00e1ng 5,6,7; g\u1eb7p nhi\u1ec1u nh\u1ea5t \u1edf l\u1ee9a tu\u1ed5i t\u1eeb 2 \u0111\u1ebfn 8; l\u00e2y truy\u1ec1n qua trung gian mu\u1ed7i \u0111\u1ed1t.<\/p>\n

– Vi\u00eam n\u00e3o c\u1ea5p do c\u00e1c virus \u0111\u01b0\u1eddng ru\u1ed9t: b\u1ec7nh x\u1ea9y ra quanh n\u0103m nh\u01b0ng nhi\u1ec1u h\u01a1n \u1edf c\u00e1c th\u00e1ng t\u1eeb 3 \u0111\u1ebfn 6; th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb nh\u1ecf v\u00e0 l\u00e2y truy\u1ec1n qua \u0111\u01b0\u1eddng ti\u00eau ho\u00e1.<\/p>\n

– Vi\u00eam n\u00e3o c\u1ea5p do\u00a0virus Herpes Simplex<\/em>: b\u1ec7nh x\u1ea9y ra quanh n\u0103m, th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb tr\u00ean 2 tu\u1ed5i (HSP typ 1). Tr\u1ebb s\u01a1 sinh c\u00f3 th\u1ec3 m\u1eafc b\u1ec7nh vi\u00eam n\u00e3o c\u1ea5p do HSP typ 2.<\/p>\n

– C\u00e1c lo\u1ea1i virus kh\u00e1c \u00edt g\u1eb7p h\u01a1n c\u00f3 th\u1ec3 x\u1ea9y ra r\u1ea3i r\u00e1c quanh n\u0103m v\u1edbi c\u00e1c b\u1ec7nh c\u1ea3nh ri\u00eang; c\u00e1c virus c\u00fam, s\u1edfi, quai b\u1ecb,\u00a0Rubella, Adenovirus, Epstein-Barr, HIV, Cytomegalovirus…<\/em><\/p>\n

\"Minh-hoa-viem-nao-cap\"
Minh h\u1ecda vi\u00eam n\u00e3o c\u1ea5p<\/figcaption><\/figure>\n

3. Ch\u1ea9n \u0111o\u00e1n Vi\u00eam n\u00e3o c\u1ea5p \u1edf tr\u1ebb em<\/strong><\/h2>\n

Ch\u1ea9n \u0111o\u00e1n d\u1ef1a v\u00e0o c\u00e1c y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5 h\u1ecdc, c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng; lo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh c\u00f3 bi\u1ec3u hi\u1ec7n th\u1ea7n kinh nh\u01b0ng kh\u00f4ng ph\u1ea3i vi\u00eam n\u00e3o (xem ph\u1ea7n ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t).<\/p>\n

3.1. Y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5<\/strong><\/p>\n

C\u0103n c\u1ee9 v\u00e0o tu\u1ed5i, m\u00f9a, n\u01a1i c\u01b0 tr\u00fa, s\u1ed1 ng\u01b0\u1eddi m\u1eafc trong c\u00f9ng m\u1ed9t th\u1eddi gian.<\/p>\n

3.2. L\u00e2m s\u00e0ng<\/strong><\/p>\n

3.2.1. Giai \u0111o\u1ea1n kh\u1edfi ph\u00e1t<\/em><\/p>\n

– S\u1ed1t: s\u1ed1t l\u00e0 tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn, x\u1ea9y ra \u0111\u1ed9t ng\u1ed9t, s\u1ed1t li\u00ean t\u1ee5c 39-400\u00a0<\/sup>C nh\u01b0ng c\u0169ng c\u00f3 khi s\u1ed1t kh\u00f4ng cao;<\/p>\n

– Nh\u1ee9c \u0111\u1ea7u, qu\u1ea5y kh\u00f3c, k\u00edch th\u00edch, k\u00e9m linh ho\u1ea1t;<\/p>\n

– Bu\u1ed3n n\u00f4n, n\u00f4n.<\/p>\n

C\u00f3 th\u1ec3 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c tu\u1ef3 theo lo\u1ea1i virus nh\u01b0:<\/p>\n

+ Ho, ch\u1ea3y n\u01b0\u1edbc m\u0169i;<\/p>\n

+ Ti\u00eau ch\u1ea3y, ph\u00e2n kh\u00f4ng c\u00f3 nh\u00e0y, m\u00e1u;<\/p>\n

+ Ph\u00e1t ban: m\u1ea9n \u0111\u1ecf, b\u1ecdng n\u01b0\u1edbc ho\u1eb7c ban \u1edf l\u00f2ng b\u00e0n tay, b\u00e0n ch\u00e2n k\u00e8m lo\u00e9t mi\u1ec7ng (b\u1ec7nh tay – ch\u00e2n – mi\u1ec7ng g\u1eb7p \u1edf vi\u00eam n\u00e3o do\u00a0Enterovirus 71<\/em>).<\/p>\n

3.2.2. Giai \u0111o\u1ea1n to\u00e0n ph\u00e1t<\/em><\/p>\n

Sau giai \u0111o\u1ea1n kh\u1edfi ph\u00e1t, c\u00e1c bi\u1ec3u hi\u1ec7n th\u1ea7n kinh s\u1ebd nhanh ch\u00f3ng xu\u1ea5t hi\u1ec7n:<\/p>\n

– R\u1ed1i lo\u1ea1n tri gi\u00e1c t\u1eeb nh\u1eb9 \u0111\u1ebfn n\u1eb7ng nh\u01b0: ng\u1ee7 g\u00e0, li b\u00ec, l\u01a1 m\u01a1 \u0111\u1ebfn h\u00f4n m\u00ea;<\/p>\n

– Th\u01b0\u1eddng c\u00f3 co gi\u1eadt;<\/p>\n

– C\u00f3 th\u1ec3 c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh kh\u00e1c: d\u1ea5u hi\u1ec7u m\u00e0ng n\u00e3o, c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa (li\u1ec7t n\u1eeda ng\u01b0\u1eddi ho\u1eb7c t\u1ee9 chi), t\u0103ng ho\u1eb7c gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c c\u01a1…<\/p>\n

– C\u00f3 th\u1ec3 c\u00f3 suy h\u00f4 h\u1ea5p, ph\u00f9 ph\u1ed5i c\u1ea5p, suy tim ho\u1eb7c s\u1ed1c.<\/p>\n

3.2.3. C\u00e1c th\u1ec3 l\u00e2m s\u00e0ng<\/em><\/p>\n

– Th\u1ec3 t\u1ed1i c\u1ea5p: S\u1ed1t cao li\u00ean t\u1ee5c, co gi\u1eadt, h\u00f4n m\u00ea s\u00e2u, suy h\u00f4 h\u1ea5p, tru\u1ef5 m\u1ea1ch v\u00e0 d\u1eabn \u0111\u1ebfn t\u1eed vong nhanh;<\/p>\n

– Th\u1ec3 c\u1ea5p t\u00ednh: di\u1ec5n bi\u1ebfn c\u1ea5p v\u1edbi c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng n\u1eb7ng, \u0111i\u1ec3n h\u00ecnh;<\/p>\n

– Th\u1ec3 nh\u1eb9: r\u1ed1i lo\u1ea1n tri gi\u00e1c m\u1ee9c \u0111\u1ed9 nh\u1eb9 v\u00e0 ph\u1ee5c h\u1ed3i nhanh ch\u00f3ng.<\/p>\n

3.3. C\u1eadn l\u00e2m s\u00e0ng<\/em><\/p>\n

D\u1ecbch n\u00e3o – tu\u1ef7:\u00a0<\/em>C\u00f3 \u00fd ngh\u0129a quan tr\u1ecdng trong ch\u1ea9n \u0111o\u00e1n, c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh x\u00e9t nghi\u1ec7m d\u1ecbch n\u00e3o- tu\u1ef7 s\u1edbm khi nghi ng\u1edd vi\u00eam n\u00e3o.<\/p>\n

– D\u1ecbch trong, \u00e1p l\u1ef1c b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng;<\/p>\n

– T\u1ebf b\u00e0o b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng t\u1eeb v\u00e0i ch\u1ee5c \u0111\u1ebfn v\u00e0i tr\u0103m\/mm3<\/sup>, ch\u1ee7 y\u1ebfu l\u00e0 b\u1ea1ch c\u1ea7u \u0111\u01a1n nh\u00e2n;<\/p>\n

– Protein b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng (th\u01b0\u1eddng t\u0103ng nh\u1eb9 trong vi\u00eam n\u00e3o Nh\u1eadt B\u1ea3n), glucose v\u00e0 mu\u1ed1i b\u00ecnh th\u01b0\u1eddng.<\/p>\n

Ch\u00fa \u00fd:<\/em><\/p>\n

– N\u00ean g\u1eedi d\u1ecbch n\u00e3o- tu\u1ef7 \u0111\u1ec3 l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1eb7c hi\u1ec7u ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh c\u0103n nguy\u00ean virus (nh\u01b0 PCR, ELISA, ph\u00e2n l\u1eadp virus…);<\/em><\/p>\n

– Kh\u00f4ng n\u00ean ch\u1ecdc d\u00f2 d\u1ecbch n\u00e3o- tu\u1ef7 trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 d\u1ea5u hi\u1ec7u t\u0103ng \u00e1p l\u1ef1c trong s\u1ecd c\u00f3 nguy c\u01a1 g\u00e2y t\u1ee5t (l\u1ecdt) n\u00e3o, \u0111ang s\u1ed1c, suy h\u00f4 h\u1ea5p n\u1eb7ng.<\/em><\/p>\n

M\u00e1u<\/em><\/p>\n

– C\u00f4ng th\u1ee9c m\u00e1u: s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u t\u0103ng nh\u1eb9 ho\u1eb7c b\u00ecnh th\u01b0\u1eddng;<\/p>\n

– \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3 v\u00e0 \u0111\u01b0\u1eddng huy\u1ebft th\u01b0\u1eddng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng.<\/p>\n

C\u00e1c x\u00e9t nghi\u1ec7m x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n<\/em>(\u00e1p d\u1ee5ng t\u1ea1i c\u01a1 s\u1edf c\u00f3 \u0111i\u1ec1u ki\u1ec7n)<\/p>\n

– T\u00ecm kh\u00e1ng th\u1ec3 IgM \u0111\u1eb7c hi\u1ec7u cho t\u1eebng lo\u1ea1i c\u0103n nguy\u00ean b\u1eb1ng k\u1ef9 thu\u1eadt th\u1eed nghi\u1ec7m mi\u1ec5n d\u1ecbch g\u1eafn enzym (ELISA);<\/p>\n

– T\u00ecm kh\u00e1ng nguy\u00ean \u0111\u1eb7c hi\u1ec7u cho t\u1eebng lo\u1ea1i c\u0103n nguy\u00ean b\u1eb1ng k\u1ef9 thu\u1eadt ph\u1ea3n \u1ee9ng khuy\u1ebfch \u0111\u1ea1i chu\u1ed7i polymeza (PCR),<\/p>\n

– Ph\u00e2n l\u1eadp virus t\u1eeb d\u1ecbch n\u00e3o-tu\u1ef7, m\u00e1u, b\u1ecdng n\u01b0\u1edbc \u1edf da, d\u1ecbch m\u0169i h\u1ecdng, ph\u00e2n.<\/p>\n

C\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c:<\/em>ch\u1ec9 \u0111\u1ecbnh khi c\u1ea7n thi\u1ebft<\/p>\n

– \u0110i\u1ec7n n\u00e3o \u0111\u1ed3;<\/p>\n

– Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh (CT scan) n\u00e3o;<\/p>\n

– Ch\u1ee5p tim ph\u1ed5i.<\/p>\n

3.4. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/em><\/p>\n

C\u1ea7n lo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh th\u1ea7n kinh sau \u0111\u00e2y:<\/p>\n

– Co gi\u1eadt do s\u1ed1t cao;<\/p>\n

– Vi\u00eam m\u00e0ng n\u00e3o m\u1ee7;<\/p>\n

– Vi\u00eam m\u00e0ng n\u00e3o do lao;<\/p>\n

– Ng\u1ed9 \u0111\u1ed9c c\u1ea5p;<\/p>\n

– S\u1ed1t r\u00e9t th\u1ec3 n\u00e3o;<\/p>\n

– Ch\u1ea3y m\u00e1u n\u00e3o – m\u00e0ng n\u00e3o;<\/p>\n

– \u0110\u1ed9ng kinh.<\/p>\n

Ngu\u1ed3n t\u00e0i li\u1ec7u: B\u1ed9 Y t\u1ebf<\/strong><\/p>\n

Xem th\u00eam: Vi\u00eam n\u00e3o \u1edf tr\u1ebb: D\u1ea5u hi\u1ec7u, c\u00e1ch x\u1eed l\u00fd v\u00e0 h\u01b0\u1edbng d\u1eabn ch\u0103m s\u00f3c<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Vi\u00eam n\u00e3o c\u1ea5p l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd nguy hi\u1ec3m \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe con ng\u01b0\u1eddi. Tuy nhi\u00ean, trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n vi\u00eam n\u00e3o c\u1ea5p do virus \u1edf tr\u1ebb em \u0111ang g\u1eb7p nhi\u1ec1u kh\u00f3 kh\u0103n. V\u1edbi nh\u1eefng tri\u1ec7u ch\u1ee9ng kh\u00e1c nhau, vi\u1ec7c x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh v\u00e0 ph\u01b0\u01a1ng […]<\/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":"\nVi\u00eam n\u00e3o c\u1ea5p do virus \u1edf tr\u1ebb em: \u0110\u1ecbnh ngh\u0129a, d\u1ecbch t\u1ec5 h\u1ecdc, ch\u1ea9n \u0111o\u00e1n<\/title>\n<meta name=\"description\" content=\"Vi\u00eam n\u00e3o c\u1ea5p l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd nguy hi\u1ec3m \u0111\u1ed1i v\u1edbi s\u1ee9c kh\u1ecfe con ng\u01b0\u1eddi. 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