{"id":27982,"date":"2023-04-26T16:11:24","date_gmt":"2023-04-26T09:11:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27982"},"modified":"2023-04-26T16:11:24","modified_gmt":"2023-04-26T09:11:24","slug":"dieu-tri-va-du-phong-viem-nao-cap-do-virus-o-tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/26\/dieu-tri-va-du-phong-viem-nao-cap-do-virus-o-tre-em\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 ph\u00f2ng Vi\u00eam n\u00e3o c\u1ea5p do virus \u1edf tr\u1ebb em"},"content":{"rendered":"<p><strong>Vi\u00eam n\u00e3o c\u1ea5p do virus l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd nguy hi\u1ec3m v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng cho s\u1ee9c kh\u1ecfe c\u1ee7a tr\u1ebb em. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh vi\u00eam n\u00e3o do virus \u1edf tr\u1ebb em l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh ph\u1ee9c t\u1ea1p v\u00e0 \u0111\u00f2i h\u1ecfi s\u1ef1 chuy\u00ean m\u00f4n cao t\u1eeb c\u00e1c chuy\u00ean gia y t\u1ebf. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd c\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 ph\u00f2ng cho vi\u00eam n\u00e3o c\u1ea5p do virus \u1edf tr\u1ebb em.<\/strong><\/p>\n<h2 style=\"font-weight: 400;\"><strong>1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb vi\u00eam n\u00e3o<\/strong><\/h2>\n<p style=\"font-weight: 400;\"><em>1.1 B\u1ea3o \u0111\u1ea3m c\u00e1c ch\u1ee9c n\u0103ng s\u1ed1ng<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; B\u1ea3o \u0111\u1ea3m th\u00f4ng kh\u00ed, ch\u1ed1ng suy h\u00f4 h\u1ea5p, ch\u1ed1ng c\u00e1c r\u1ed1i lo\u1ea1n tu\u1ea7n ho\u00e0n, s\u1ed1c, tru\u1ef5 m\u1ea1ch;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ch\u1ed1ng ph\u00f9 n\u00e3o;<\/p>\n<p style=\"font-weight: 400;\"><em>1.2 \u0110i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; H\u1ea1 nhi\u1ec7t;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ch\u1ed1ng co gi\u1eadt;<\/p>\n<p style=\"font-weight: 400;\">&#8211; \u0110i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1n n\u01b0\u1edbc, \u0111i\u1ec7n gi\u1ea3i, \u0111\u01b0\u1eddng huy\u1ebft (n\u1ebfu c\u00f3).<\/p>\n<p style=\"font-weight: 400;\"><em>1.3 Ch\u0103m s\u00f3c v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; \u0110\u1ea3m b\u1ea3o ch\u0103m s\u00f3c v\u00e0 dinh d\u01b0\u1ee1ng;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng s\u1edbm;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ph\u00f2ng v\u00e0 ch\u1ed1ng b\u1ed9i nhi\u1ec5m; nhi\u1ec5m khu\u1ea9n b\u1ec7nh vi\u1ec7n.<\/p>\n<p style=\"font-weight: 400;\"><em>1.4 \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n<\/em><\/p>\n<h2 style=\"font-weight: 400;\"><strong>2. \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3 vi\u00eam n\u00e3o<\/strong><\/h2>\n<p style=\"font-weight: 400;\"><em>2.1 B\u1ea3o \u0111\u1ea3m th\u00f4ng kh\u00ed, ch\u1ed1ng suy h\u00f4 h\u1ea5p<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; Lu\u00f4n b\u1ea3o \u0111\u1ea3m th\u00f4ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p: \u0111\u1eb7t tr\u1ebb n\u1eb1m ng\u1eeda, k\u00ea g\u1ed1i d\u01b0\u1edbi vai, \u0111\u1ea7u ng\u1eeda ra sau v\u00e0 nghi\u00eang v\u1ec1 m\u1ed9t b\u00ean, h\u00fat \u0111\u1eddm d\u00e3i khi c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng xu\u1ea5t ti\u1ebft, \u1ee9 \u0111\u1ecdng.<\/p>\n<p style=\"font-weight: 400;\">&#8211; N\u1ebfu suy h\u00f4 h\u1ea5p:<\/p>\n<p style=\"font-weight: 400;\"><em>Th\u1edf oxy:<\/em><\/p>\n<p style=\"font-weight: 400;\">+ Ch\u1ec9 \u0111\u1ecbnh: co gi\u1eadt, suy h\u00f4 h\u1ea5p, \u0111\u1ed9 b\u00e3o ho\u00e0 oxy SaO2 d\u01b0\u1edbi 90% (n\u1ebfu \u0111o \u0111\u01b0\u1ee3c)<\/p>\n<p style=\"font-weight: 400;\">+ Ph\u01b0\u01a1ng ph\u00e1p: Th\u1edf oxy qua \u1ed1ng th\u00f4ng, li\u1ec1u l\u01b0\u1ee3ng 1-3 l\u00edt\/ph\u00fat ho\u1eb7c qua m\u1eb7t n\u1ea1 v\u1edbi li\u1ec1u l\u01b0\u1ee3ng 5-6l\u00edt\/ph\u00fat tu\u1ef3 theo l\u1ee9a tu\u1ed5i v\u00e0 m\u1ee9c \u0111\u1ed9 suy h\u00f4 h\u1ea5p.<\/p>\n<p style=\"font-weight: 400;\"><em>\u0110\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n v\u00e0 th\u1edf m\u00e1y:<\/em><\/p>\n<p style=\"font-weight: 400;\">+ Ch\u1ec9 \u0111\u1ecbnh: Ng\u01b0ng th\u1edf ho\u1eb7c c\u00f3 c\u01a1n ng\u01b0ng th\u1edf, th\u1ea5t b\u1ea1i khi th\u1edf oxy, SpO2 d\u01b0\u1edbi 85% k\u00e9o d\u00e0i.<\/p>\n<p style=\"font-weight: 400;\">+ Ph\u01b0\u01a1ng ph\u00e1p:<\/p>\n<p style=\"font-weight: 400;\"><u>C\u00e1c th\u00f4ng s\u1ed1 ban \u0111\u1ea7u khi th\u1edf m\u00e1y:<\/u><\/p>\n<p style=\"font-weight: 400;\">Ch\u1ebf \u0111\u1ed9: th\u1edf ki\u1ec3m so\u00e1t th\u1ec3 t\u00edch<\/p>\n<p style=\"font-weight: 400;\">FiO2 ban \u0111\u1ea7u: 100%; th\u1ec3 t\u00edch kh\u00ed l\u01b0u th\u00f4ng (TV): 10- 15ml\/kg.<\/p>\n<p style=\"font-weight: 400;\">T\u1ea7n s\u1ed1 th\u1edf: d\u01b0\u1edbi 1 tu\u1ed5i: 25 l\u1ea7n\/ph\u00fat; t\u1eeb 1-5 tu\u1ed5i: 20 l\u1ea7n\/ph\u00fat; tr\u00ean 5 tu\u1ed5i: 15 l\u1ea7n\/ph\u00fat. T\u1ef7 l\u1ec7 h\u00edt v\u00e0o\/th\u1edf ra (I\/E): 1\/2<\/p>\n<p style=\"font-weight: 400;\">C\u00e0i \u0111\u1eb7t PEEP: ban \u0111\u1ea7u 4 cm H<sub>2<\/sub>O<\/p>\n<p style=\"font-weight: 400;\"><u>\u0110i\u1ec1u ch\u1ec9nh c\u00e1c th\u00f4ng s\u1ed1<\/u>\u00a0d\u1ef1a tr\u00ean di\u1ec5n bi\u1ebfn, \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng v\u00e0 SaO2, kh\u00ed m\u00e1u;<\/p>\n<p style=\"font-weight: 400;\"><u>Trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng \u0111\u1eb7t \u0111\u01b0\u1ee3c n\u1ed9i kh\u00ed qu\u1ea3n<\/u>\u00a0th\u00ec b\u00f3p b\u00f3ng gi\u00fap th\u1edf qua m\u1eb7t n\u1ea1. N\u1ebfu kh\u00f4ng c\u00f3 m\u00e1y th\u1edf th\u00ec b\u00f3p b\u00f3ng qua n\u1ed9i kh\u00ed qu\u1ea3n. T\u1ea7n s\u1ed1 b\u00f3p b\u00f3ng t\u1eeb 20 \u0111\u1ebfn 30 l\u1ea7n\/ph\u00fat.<\/p>\n<p style=\"font-weight: 400;\"><u>D\u1eebng th\u1edf m\u00e1y v\u00e0 r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n<\/u>\u00a0khi b\u1ec7nh nh\u00e2n t\u1ef1 th\u1edf, h\u1ebft co gi\u1eadt, huy\u1ebft \u0111\u1ed9ng h\u1ecdc \u1ed5n \u0111\u1ecbnh, tri gi\u00e1c c\u1ea3i thi\u1ec7n, kh\u00ed m\u00e1u b\u00ecnh th\u01b0\u1eddng v\u1edbi FiO2 d\u01b0\u1edbi 40% v\u00e0 PEEP 4 cm H<sub>2<\/sub>O.<\/p>\n<p style=\"font-weight: 400;\"><em>2.2 Ch\u1ed1ng ph\u00f9 n\u00e3o<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; Ch\u1ec9 \u0111\u1ecbnh: khi c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a ph\u00f9 n\u00e3o nh\u01b0 nh\u1ee9c \u0111\u1ea7u k\u00e8m theo d\u1ea5u hi\u1ec7u k\u00edch th\u00edch, v\u1eadt v\u00e3 ho\u1eb7c li b\u00ec, h\u00f4n m\u00ea (c\u00f3 th\u1ec3 k\u00e8m theo ph\u00f9 gai th\u1ecb, \u0111\u1ed3ng t\u1eed kh\u00f4ng \u0111\u1ec1u; li\u1ec7t khu tr\u00fa; co c\u1ee9ng; nh\u1ecbp th\u1edf kh\u00f4ng \u0111\u1ec1u; m\u1ea1ch ch\u1eadm k\u00e8m theo huy\u1ebft \u00e1p t\u0103ng&#8230;)<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ph\u01b0\u01a1ng ph\u00e1p:<\/p>\n<p style=\"font-weight: 400;\">+ T\u01b0 th\u1ebf n\u1eb1m: \u0111\u1ea7u cao 15 &#8211; 30 \u0111\u1ed9;<\/p>\n<p style=\"font-weight: 400;\">+ Th\u1edf oxy: Khi th\u1edf m\u00e1y c\u1ea7n t\u0103ng th\u00f4ng kh\u00ed v\u00e0 gi\u1eef PaO2 t\u1eeb 90 \u0111\u1ebfn 100mmHg v\u00e0 PaCO2 t\u1eeb 30 \u0111\u1ebfn 35 mmHg;<\/p>\n<p style=\"font-weight: 400;\">+ Dung d\u1ecbch Manitol 20%: Li\u1ec1u 0,5 g\/kg (2,5 ml\/kg) truy\u1ec1n t\u0129nh m\u1ea1ch 15-30 ph\u00fat. C\u00f3 th\u1ec3 truy\u1ec1n nh\u1eafc l\u1ea1i sau 8 gi\u1edd n\u1ebfu c\u00f3 d\u1ea5u hi\u1ec7u ph\u00f9 n\u00e3o nh\u01b0ng kh\u00f4ng qu\u00e1 ba l\u1ea7n trong 24 gi\u1edd v\u00e0 kh\u00f4ng qu\u00e1 ba ng\u00e0y. Kh\u00f4ng d\u00f9ng Manitol trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 s\u1ed1c, ph\u00f9 ph\u1ed5i;<\/p>\n<p style=\"font-weight: 400;\">+ Khi truy\u1ec1n c\u1ea7n theo d\u00f5i l\u00e2m s\u00e0ng v\u00e0 di\u1ec7n gi\u1ea3i \u0111\u1ed3 (n\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n) \u0111\u1ec3 ph\u00e1t hi\u1ec7n d\u1ea5u hi\u1ec7u qu\u00e1 t\u1ea3i v\u00e0 r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i. \u0110\u1ed1i v\u1edbi tr\u1ebb nh\u1ecf d\u01b0\u1edbi 3 th\u00e1ng sau truy\u1ec1n Manitol c\u00f3 th\u1ec3 cho truy\u1ec1n ch\u1eadm dung d\u1ecbch Ringer lactat v\u1edbi li\u1ec1u 20-30ml\/kg;<\/p>\n<p style=\"font-weight: 400;\">+ C\u00f3 th\u1ec3 d\u00f9ng Dexamethason li\u1ec1u 0,15 &#8211; 0,20 mg\/kg ti\u00eam t\u0129nh m\u1ea1ch ch\u1eadm cho m\u1ed7i 6 gi\u1edd trong m\u1ed9t v\u00e0i ng\u00e0y \u0111\u1ea7u.<\/p>\n<p style=\"font-weight: 400;\"><em>2.3 Ch\u1ed1ng s\u1ed1c<\/em><\/p>\n<p style=\"font-weight: 400;\">N\u1ebfu c\u00f3 t\u00ecnh tr\u1ea1ng s\u1ed1c, c\u1ea7n truy\u1ec1n d\u1ecbch theo ph\u00e1c \u0111\u1ed3 ch\u1ed1ng s\u1ed1c- c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng Dopamin truy\u1ec1n t\u0129nh m\u1ea1ch, li\u1ec1u b\u1eaft \u0111\u1ea7u t\u1eeb 5\u00a0mg\/kg\/ph\u00fat v\u00e0 t\u0103ng d\u1ea7n, t\u1ed1i \u0111a kh\u00f4ng qu\u00e1 15\u00a0m\u00e0g\/kg\/ph\u00fat, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng Dobutamin n\u1ebfu c\u00f3 vi\u00eam c\u01a1 tim.<\/p>\n<p style=\"font-weight: 400;\"><em>* H\u1ea1 nhi\u1ec7t<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; Cho tr\u1ebb u\u1ed1ng \u0111\u1ee7 n\u01b0\u1edbc, n\u1edbi r\u1ed9ng qu\u1ea7n \u00e1o, t\u00e3 l\u00f3t v\u00e0 ch\u01b0\u1eddm m\u00e1t;<\/p>\n<p style=\"font-weight: 400;\">&#8211; N\u1ebfu s\u1ed1t tr\u00ean 38<sup>0<\/sup>C h\u1ea1 nhi\u1ec7t b\u1eb1ng paracetamol 10-15mg\/kg\/l\u1ea7n, u\u1ed1ng ho\u1eb7c \u0111\u1eb7t h\u1eadu m\u00f4n ( c\u00f3 th\u1ec3 nh\u1eafc l\u1ea1i sau 6 gi\u1edd, ng\u00e0y 4 l\u1ea7n n\u1ebfu c\u00f2n s\u1ed1t); tr\u01b0\u1eddng h\u1ee3p s\u1ed1t tr\u00ean 40<sup>0<\/sup>C ho\u1eb7c u\u1ed1ng kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3 c\u00f3 th\u1ec3 ti\u00eam propacetamol (Prodafagan) 20 &#8211; 30mg\/kg\/l\u1ea7n ti\u00eam t\u0129nh m\u1ea1ch;<\/p>\n<p style=\"font-weight: 400;\"><em>2.4 Ch\u1ed1ng co gi\u1eadt<\/em><\/p>\n<p style=\"font-weight: 400;\">Diazepam: s\u1eed d\u1ee5ng theo m\u1ed9t trong c\u00e1c c\u00e1ch d\u01b0\u1edbi \u0111\u00e2y:<\/p>\n<p style=\"font-weight: 400;\">&#8211; \u0110\u01b0\u1eddng t\u0129nh m\u1ea1ch: li\u1ec1u 0,2 &#8211; 0,3mg\/kg, ti\u00eam t\u0129nh m\u1ea1ch ch\u1eadm (ch\u1ec9 th\u1ef1c hi\u1ec7n \u1edf c\u01a1 s\u1edf c\u00f3 \u0111i\u1ec1u ki\u1ec7n h\u1ed3i s\u1ee9c v\u00ec c\u00f3 th\u1ec3 g\u00e2y ng\u1eebng th\u1edf);<\/p>\n<p style=\"font-weight: 400;\">&#8211; \u0110\u01b0\u1eddng ti\u00eam b\u1eafp: li\u1ec1u 0,2 &#8211; 0,3mg\/kg;<\/p>\n<p style=\"font-weight: 400;\">&#8211; \u0110\u01b0\u1eddng tr\u1ef1c tr\u00e0ng: li\u1ec1u 0,5mg\/kg;<\/p>\n<p style=\"font-weight: 400;\"><em>C\u00e1ch th\u1ee9c<\/em><\/p>\n<p style=\"font-weight: 400;\">L\u1ea5y l\u01b0\u1ee3ng thu\u1ed1c \u0111\u00e3 t\u00ednh (theo c\u00e2n n\u1eb7ng) t\u1eeb \u1ed1ng Diazepam d\u1ea1ng ti\u00eam v\u00e0o b\u01a1m ti\u00eam 1ml. Sau \u0111\u00f3 r\u00fat b\u1ecf kim, \u0111\u01b0a b\u01a1m ti\u00eam v\u00e0o tr\u1ef1c tr\u00e0ng 4-5cm v\u00e0 b\u01a1m thu\u1ed1c. K\u1eb9p gi\u1eef m\u00f4ng tr\u1ebb trong v\u00e0i ph\u00fat.<\/p>\n<p style=\"font-weight: 400;\">&#8211; N\u1ebfu sau 10 ph\u00fat v\u1eabn c\u00f2n co gi\u1eadt th\u00ec cho li\u1ec1u Diazepam l\u1ea7n th\u1ee9hai.<\/p>\n<p style=\"font-weight: 400;\">&#8211; N\u1ebfu v\u1eabn ti\u1ebfp t\u1ee5c co gi\u1eadt th\u00ec cho li\u1ec1u Diazepam l\u1ea7n th\u1ee9 ba, ho\u1eb7c phenobarbital (gacdenal) 10-15 mg\/kg pha lo\u00e3ng v\u1edbi dung d\u1ecbch dextrose 5% truy\u1ec1n t\u0129nh m\u1ea1ch trong 30 ph\u00fat. Sau \u0111\u00f3 d\u00f9ng li\u1ec1u duy tr\u00ec 5-8mg\/kg\/24 gi\u1edd chia ba l\u1ea7n, ti\u00eam b\u1eafp ho\u1eb7c chuy\u1ec3n t\u1edbi khoa \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c.<\/p>\n<p style=\"font-weight: 400;\"><em>* \u0110i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i, \u0111\u01b0\u1eddng huy\u1ebft (n\u1ebfu c\u00f3)<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; B\u1ed3i ph\u1ee5 \u0111\u1ee7 n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i. C\u1ea7n th\u1eadn tr\u1ecdng khi c\u00f3 d\u1ea5u hi\u1ec7u ph\u00f9 ph\u1ed5i;<\/p>\n<p style=\"font-weight: 400;\">&#8211; S\u1eed d\u1ee5ng dung d\u1ecbch Natri Clorua v\u00e0 Glucoza \u0111\u1eb3ng tr\u01b0\u01a1ng. L\u01b0\u1ee3ng d\u1ecbch truy\u1ec1n t\u00ednh theo tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3;<\/p>\n<p style=\"font-weight: 400;\">&#8211; \u0110i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i v\u00e0 th\u0103ng b\u1eb1ng ki\u1ec1m &#8211; toan d\u1ef1a v\u00e0o \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3 v\u00e0 kh\u00ed m\u00e1u.<\/p>\n<p style=\"font-weight: 400;\"><em>2.5 \u0110\u1ea3m b\u1ea3o dinh d\u01b0\u1ee1ng v\u00e0 ch\u0103m s\u00f3c, ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng<\/em><\/p>\n<p style=\"font-weight: 400;\">+ Dinh d\u01b0\u1ee1ng:<\/p>\n<p style=\"font-weight: 400;\">&#8211; Cung c\u1ea5p th\u1ee9c \u0103n d\u1ec5 ti\u00eau, n\u0103ng l\u01b0\u1ee3ng cao, \u0111\u1ee7 mu\u1ed1i kho\u00e1ng v\u00e0 vitamin. N\u0103ng l\u01b0\u1ee3ng \u0111\u1ea3m b\u1ea3o cung c\u1ea5p 50 &#8211; 60 kcal\/kg\/ng\u00e0y.<\/p>\n<p style=\"font-weight: 400;\">&#8211; \u0110\u1ea3m b\u1ea3o cho tr\u1ebb b\u00fa m\u1eb9. Tr\u1ebb kh\u00f4ng b\u00fa \u0111\u01b0\u1ee3c ph\u1ea3i ch\u00fa \u00fd v\u1eaft s\u1eefa m\u1eb9 v\u00e0 \u0111\u1ed5 t\u1eebng th\u00eca nh\u1ecf ho\u1eb7c \u0103n b\u1eb1ng \u1ed1ng th\u00f4ng m\u0169i- d\u1ea1 d\u00e0y (chia l\u00e0m nhi\u1ec1u b\u1eefa ho\u1eb7c nh\u1ecf gi\u1ecdt li\u00ean t\u1ee5c). C\u1ea7n th\u1eadn tr\u1ecdng v\u00ec d\u1ec5 s\u1eb7c v\u00e0 g\u00e2y h\u1ed9i ch\u1ee9ng tr\u00e0o ng\u01b0\u1ee3c;<\/p>\n<p style=\"font-weight: 400;\">&#8211; N\u1ebfu tr\u1ebb kh\u00f4ng t\u1ef1 \u0103n \u0111\u01b0\u1ee3c th\u00ec ph\u1ea3i cho \u0103n qua \u1ed1ng th\u00f4ng m\u0169i &#8211; d\u1ea1 d\u00e0y hay dinh d\u01b0\u1ee1ng qua truy\u1ec1n t\u0129nh m\u1ea1ch. N\u00ean b\u1ed5 sung vitamin C, vitamin nh\u00f3m B.<\/p>\n<p style=\"font-weight: 400;\">+ Ch\u0103m s\u00f3c v\u00e0 theo d\u00f5i:<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ch\u00fa \u00fd ch\u0103m s\u00f3c da, mi\u1ec7ng, th\u01b0\u1eddng xuy\u00ean thay \u0111\u1ed5i t\u01b0 th\u1ebf \u0111\u1ec3 tr\u00e1nh t\u1ed5n th\u01b0\u01a1ng do \u0111\u00e8 \u00e9p g\u00e2y lo\u00e9t v\u00e0 v\u1ed7 rung \u0111\u1ec3 tr\u00e1nh x\u1eb9p ph\u1ed5i v\u00e0 vi\u00eam ph\u1ed5i do \u1ee9 \u0111\u1ecdng \u0111\u1eddm d\u00e3i.<\/p>\n<p style=\"font-weight: 400;\">&#8211; H\u00fat \u0111\u1eddm d\u00e3i th\u01b0\u1eddng xuy\u00ean;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ch\u1ed1ng t\u00e1o b\u00f3n;<\/p>\n<p style=\"font-weight: 400;\">&#8211; B\u00ed ti\u1ec3u ti\u1ec7n, c\u0103ng b\u00e0ng quang: g\u00f5 c\u1ea7u b\u00e0ng quang. H\u1ea1n ch\u1ebf th\u00f4ng ti\u1ec3u v\u00ec c\u00f3 nguy c\u01a1 g\u00e2y b\u1ed9i nhi\u1ec5m;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Th\u01b0\u1eddng xuy\u00ean theo d\u00f5i c\u00e1c d\u1ea5u hi\u1ec7u sinh t\u1ed3n, m\u1ee9c \u0111\u1ed9 tri gi\u00e1c; c\u00e1c d\u1ea5u hi\u1ec7u ph\u00f9 n\u00e3o; SaO2, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3 v\u00e0 \u0111\u01b0\u1eddng huy\u1ebft.<\/p>\n<p style=\"font-weight: 400;\">+ Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng: ti\u1ebfn h\u00e0nh s\u1edbm khi tr\u1ebb \u1ed5n \u0111\u1ecbnh l\u00e2m s\u00e0ng ho\u1eb7c khi c\u00f3 di ch\u1ee9ng.<\/p>\n<p style=\"font-weight: 400;\"><em>2.6 Thu\u1ed1c kh\u00e1ng virus<\/em><\/p>\n<p style=\"font-weight: 400;\">Khi nghi ng\u1edd vi\u00eam n\u00e3o do\u00a0<em>Virus Herpes Simplex<\/em>\u00a0th\u00ec c\u00f3 th\u1ec3 d\u00f9ng Acyclovir, li\u1ec1u 10mg\/kg\/ m\u1ed7i 8 gi\u1edd, truy\u1ec1n t\u0129nh m\u1ea1ch trong 1 gi\u1edd. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb: \u00edt nh\u1ea5t 14 ng\u00e0y.<\/p>\n<p style=\"font-weight: 400;\"><em>2.7 Thu\u1ed1c kh\u00e1ng sinh<\/em><\/p>\n<p style=\"font-weight: 400;\">\u0110\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p sau:<\/p>\n<p style=\"font-weight: 400;\">&#8211; Tr\u01b0\u1eddng h\u1ee3p ch\u01b0a lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c vi\u00eam m\u00e0ng n\u00e3o m\u1ee7;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Khi b\u1ed9i nhi\u1ec5m.<\/p>\n<figure id=\"attachment_27976\" aria-describedby=\"caption-attachment-27976\" style=\"width: 265px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-27976\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Viem-nao-265x300.jpg\" alt=\"Minh-hoa-viem-nao-cap\" width=\"265\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Viem-nao-265x300.jpg 265w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Viem-nao.jpg 356w\" sizes=\"(max-width: 265px) 100vw, 265px\" \/><figcaption id=\"caption-attachment-27976\" class=\"wp-caption-text\">Minh h\u1ecda vi\u00eam n\u00e3o c\u1ea5p<\/figcaption><\/figure>\n<h2><strong>3. Ph\u00e2n tuy\u1ebfn \u0111i\u1ec1u tr\u1ecb<\/strong><\/h2>\n<p style=\"font-weight: 400;\"><em>3.1. Tuy\u1ebfn x\u00e3:<\/em>\u00a0Ph\u00e1t hi\u1ec7n c\u00e1c tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd, x\u1eed tr\u00ed c\u1ea5p c\u1ee9u ban \u0111\u1ea7u, h\u1ea1 nhi\u1ec7t, ch\u1ed1ng co gi\u1eadt (n\u1ebfu c\u00f3) v\u00e0 chuy\u1ec3n l\u00ean tuy\u1ebfn tr\u00ean.<\/p>\n<p style=\"font-weight: 400;\"><em>3.2. Tuy\u1ebfn huy\u1ec7n<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; Ch\u1ea9n \u0111o\u00e1n v\u00e0 x\u1eed tr\u00ed th\u1ec3 nh\u1eb9;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Chuy\u1ec3n l\u00ean tuy\u1ebfn tr\u00ean c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng ho\u1eb7c ti\u00ean l\u01b0\u1ee3ng n\u1eb7ng v\u00e0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 \u0111i\u1ec1u ki\u1ec7n ch\u1ecdc d\u00f2 d\u1ecbch n\u00e3o &#8211; tu\u1ef7.<\/p>\n<p style=\"font-weight: 400;\"><em>3.3. Tuy\u1ebfn t\u1ec9nh<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; Ti\u1ebfp nh\u1eadn kh\u00e1m v\u00e0 \u0111i\u1ec1u tr\u1ecb cho t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam n\u00e3o c\u1ea5p;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ch\u1ec9 chuy\u1ec3n l\u00ean tuy\u1ebfn tr\u00ean khi b\u1ec7nh nh\u00e2n n\u1eb7ng, v\u01b0\u1ee3t qu\u00e1 kh\u1ea3 n\u0103ng v\u1ec1 chuy\u00ean m\u00f4n trong ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p style=\"font-weight: 400;\"><em>3.4. Tuy\u1ebfn Trung \u01b0\u01a1ng<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; Ti\u1ebfp nh\u1eadn kh\u00e1m v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam n\u00e3o c\u1ea5p v\u00e0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p do tuy\u1ebfn d\u01b0\u1edbi chuy\u1ec3n l\u00ean;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ch\u1ec9 \u0111\u1ea1o v\u00e0 h\u1ed7 tr\u1ee3 tuy\u1ebfn d\u01b0\u1edbi trong ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ti\u1ebfn h\u00e0nh c\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n.<\/p>\n<h2><strong>4. Ph\u00f2ng b\u1ec7nh<\/strong><\/h2>\n<p style=\"font-weight: 400;\"><em>4.1. V\u1ec7 sinh ph\u00f2ng b\u1ec7nh<\/em><\/p>\n<p style=\"font-weight: 400;\">&#8211; V\u1ec7 sinh c\u00e1 nh\u00e2n, n\u1eb1m m\u00e0n ch\u1ed1ng mu\u1ed7i \u0111\u1ed1t;<\/p>\n<p style=\"font-weight: 400;\">&#8211; V\u1ec7 sinh \u0103n u\u1ed1ng \u0111\u1ec3 tr\u00e1nh l\u00e2y nhi\u1ec5m m\u1ea7m b\u1ec7nh qua \u0111\u01b0\u1eddng ti\u00eau ho\u00e1;<\/p>\n<p style=\"font-weight: 400;\">&#8211; V\u1ec7 sinh ngo\u1ea1i c\u1ea3nh, kh\u00f4ng nu\u00f4i gia s\u00fac g\u1ea7n nh\u00e0, g\u1ea7n khu d\u00e2n c\u01b0;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Di\u1ec7t c\u00f4n tr\u00f9ng, ti\u1ebft t\u00fac trung gian truy\u1ec1n b\u1ec7nh, di\u1ec7t b\u1ecd g\u1eady, di\u1ec7t mu\u1ed7i.<\/p>\n<p style=\"font-weight: 400;\"><em>4.2. Ti\u00eam ch\u1ee7ng<\/em><\/p>\n<p style=\"font-weight: 400;\">4.2.1. Ti\u00eam ph\u00f2ng vi\u00eam n\u00e3o Nh\u1eadt B\u1ea3n;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Ti\u00eam d\u01b0\u1edbi da;<\/p>\n<p style=\"font-weight: 400;\">&#8211; Li\u1ec1u l\u01b0\u1ee3ng: 0,5ml cho tr\u1ebb d\u01b0\u1edbi 5 tu\u1ed5i; 1ml cho tr\u1ebb tr\u00ean 5 tu\u1ed5i;<\/p>\n<p style=\"font-weight: 400;\"><em>M\u0169i 1: b\u1eaft \u0111\u1ea7u ti\u00eam<\/em><\/p>\n<p style=\"font-weight: 400;\"><em>M\u0169i 2: 7 ng\u00e0y sau m\u0169i 1<\/em><\/p>\n<p style=\"font-weight: 400;\"><em>M\u0169i 3: 1 n\u0103m sau m\u0169i 2<\/em><\/p>\n<p style=\"font-weight: 400;\"><em>Ti\u00eam nh\u1eafc l\u1ea1i sau 3-4 n\u0103m<\/em><\/p>\n<p style=\"font-weight: 400;\">4.2.2. Ti\u00eam ch\u1ee7ng v\u1eafc xin b\u1ea1i li\u1ec7t, s\u1edfi, quai b\u1ecb, thu\u1ef7 \u0111\u1eadu theo l\u1ecbch ti\u00eam ch\u1ee7ng.<\/p>\n<p>Xem th\u00eam: <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/phan-biet-viem-nao-va-viem-mang-nao-o-tre\/\">Ph\u00e2n bi\u1ec7t vi\u00eam n\u00e3o v\u00e0 vi\u00eam m\u00e0ng n\u00e3o \u1edf tr\u1ebb\u00a0<\/a><\/p>\n<p>Ngu\u1ed3n t\u00e0i li\u1ec7u: B\u1ed9 Y t\u1ebf<\/p>\n<p style=\"font-weight: 400;\">\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam n\u00e3o c\u1ea5p do virus l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd nguy hi\u1ec3m v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng cho s\u1ee9c kh\u1ecfe c\u1ee7a tr\u1ebb em. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh vi\u00eam n\u00e3o do virus \u1edf tr\u1ebb em l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh ph\u1ee9c t\u1ea1p v\u00e0 \u0111\u00f2i h\u1ecfi s\u1ef1 chuy\u00ean m\u00f4n cao t\u1eeb c\u00e1c chuy\u00ean gia y [&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 - 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