{"id":27991,"date":"2023-04-26T17:11:12","date_gmt":"2023-04-26T10:11:12","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27991"},"modified":"2023-04-26T17:11:12","modified_gmt":"2023-04-26T10:11:12","slug":"viem-mang-nao-do-nao-mo-cau-chan-doan-dieu-tri-va-du-phong","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/26\/viem-mang-nao-do-nao-mo-cau-chan-doan-dieu-tri-va-du-phong\/","title":{"rendered":"Vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u: ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 ph\u00f2ng"},"content":{"rendered":"

Vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng nghi\u00eam tr\u1ecdng, c\u00f3 nguy c\u01a1 \u0111\u1ec3 l\u1ea1i di ch\u1ee9ng ho\u1eb7c g\u00e2y t\u1eed vong cho b\u1ec7nh nh\u00e2n n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi. Trong b\u00e0i vi\u1ebft n\u00e0y ch\u00fang ta c\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb, d\u1ef1 ph\u00f2ng c\u1ee7a b\u1ec7nh l\u00fd n\u00e0y.<\/strong><\/p>\n

1. \u0110\u1ea0I C\u01af\u01a0NG<\/b><\/h2>\n

1.1. Kh\u00e1i ni\u1ec7m<\/b><\/p>\n

B\u1ec7nh nhi\u1ec5m n\u00e3o m\u00f4 c\u1ea7u l\u00e0 m\u1ed9t b\u1ec7nh truy\u1ec1n nhi\u1ec5m g\u00e2y d\u1ecbch, do vi khu\u1ea9n\u00a0Neisseria meningitidis\u00a0<\/i>g\u00e2y ra. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng th\u01b0\u1eddng g\u1eb7p l\u00e0 vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 v\u00e0\/ho\u1eb7c nhi\u1ec5m khu\u1ea9n huy\u1ebft, c\u00f3 th\u1ec3 g\u00e2y s\u1ed1c d\u1eabn \u0111\u1ebfn t\u1eed vong, n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi.<\/p>\n

B\u1ec7nh l\u00e2y truy\u1ec1n qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p do h\u00edt ph\u1ea3i c\u00e1c gi\u1ecdt nh\u1ecf d\u1ecbch ti\u1ebft m\u0169i h\u1ecdng b\u1ecb nhi\u1ec5m\u00a0Neisseria meningitidis,<\/i>\u00a0kh\u1ea3 n\u0103ng l\u00e2y truy\u1ec1n s\u1ebd t\u0103ng n\u1ebfu c\u00f3 \u0111\u1ed3ng nhi\u1ec5m c\u00f9ng c\u00e1c vi r\u00fat \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p.<\/p>\n

1.2. D\u1ecbch t\u1ec5 h\u1ecdc<\/b><\/p>\n

B\u1ec7nh x\u1ea3y ra r\u1ea3i r\u00e1c ho\u1eb7c th\u00e0nh d\u1ecbch \u1edf nhi\u1ec1u n\u01a1i tr\u00ean th\u1ebf gi\u1edbi, ch\u1ee7 y\u1ebfu v\u00e0o m\u00f9a \u0111\u00f4ng xu\u00e2n. B\u1ec7nh c\u00f3 th\u1ec3 g\u1eb7p \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i, th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 tr\u1ebb d\u01b0\u1edbi 5 tu\u1ed5i, thanh thi\u1ebfu ni\u00ean t\u1eeb 14 \u0111\u1ebfn 20 tu\u1ed5i, nh\u1eefng ng\u01b0\u1eddi s\u1ed1ng trong khu v\u1ef1c t\u1eadp th\u1ec3 \u0111\u00f4ng ng\u01b0\u1eddi (nh\u00e0 tr\u1ebb, tr\u01b0\u1eddng h\u1ecdc, chung c\u01b0 v.v\u2026) v\u00e0 c\u00e1c c\u01a1 \u0111\u1ecba suy gi\u1ea3m mi\u1ec5n d\u1ecbch. Ch\u00e2u Phi c\u1eadn Sahara l\u00e0 n\u01a1i c\u00f3 c\u00e1c v\u1ee5 d\u1ecbch l\u1edbn x\u1ea3y ra: v\u1ee5 d\u1ecbch 1996-1997 c\u00f3 250.00 ca m\u1eafc v\u00e0 25.000 ca t\u1eed vong, v\u1ee5 d\u1ecbch n\u0103m 2009 t\u1ea1i 14 n\u01b0\u1edbc Ch\u00e2u Phi v\u1edbi 88.199 ng\u01b0\u1eddi m\u1eafc v\u00e0 5.352 ng\u01b0\u1eddi t\u1eed vong. \u1ede Vi\u1ec7t Nam, th\u1ec9nh tho\u1ea3ng v\u1eabn c\u00f3 c\u00e1c v\u1ee5 d\u1ecbch l\u1ebb t\u1ebb \u1edf c\u00e1c \u0111\u1ecba ph\u01b0\u01a1ng, ri\u00eang n\u0103m 1977 v\u1ee5 d\u1ecbch \u1edf Th\u00e0nh ph\u1ed1 H\u1ed3 Ch\u00ed Minh c\u00f3 1015 ca m\u1eafc, do n\u00e3o m\u00f4 c\u1ea7u nh\u00f3m C g\u00e2y ra.<\/p>\n

Ng\u01b0\u1eddi b\u1ec7nh v\u00e0 ng\u01b0\u1eddi l\u00e0nh mang vi khu\u1ea9n l\u00e0 ngu\u1ed3n ch\u1ee9a duy nh\u1ea5t, \u01b0\u1edbc t\u00ednh c\u00f3 kho\u1ea3ng 10 \u2013 20% d\u00e2n s\u1ed1 mang vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u t\u1ea1i h\u1ea7u h\u1ecdng m\u00e0 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng (ng\u01b0\u1eddi l\u00e0nh mang tr\u00f9ng), t\u1ef7 l\u1ec7 n\u00e0y c\u00f3 th\u1ec3 t\u0103ng \u0111\u1ebfn 40-50% trong c\u00e1c v\u1ee5 d\u1ecbch.<\/p>\n

\u0110\u00e3 ph\u00e1t hi\u1ec7n 13 typ huy\u1ebft thanh, trong \u0111\u00f3 c\u00f3 c\u00e1c typ hay g\u00e2y b\u1ec7nh l\u00e0: A, B, C, X, Y, Z v\u00e0 W135<\/a><\/p>\n

2. CH\u1ea8N \u0110O\u00c1N VI\u00caM M\u00c0NG N\u00c3O DO N\u00c3O M\u00d4 C\u1ea6U<\/b><\/h2>\n

2.1. Ch\u1ea9n \u0111o\u00e1n ca b\u1ec7nh l\u00e2m s\u00e0ng:<\/b><\/p>\n

a. D\u1ef1a v\u00e0o y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5: C\u00f3 ti\u1ebfp x\u00fac v\u1edbi b\u1ec7nh nh\u00e2n ho\u1eb7c s\u1ed1ng trong t\u1eadp th\u1ec3 (nh\u00e0 tr\u1ebb, tr\u01b0\u1eddng h\u1ecdc, k\u00fd t\u00fac x\u00e1, doanh tr\u1ea1i,\u2026) c\u00f3 ng\u01b0\u1eddi \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1ecb m\u1eafc b\u1ec7nh do n\u00e3o m\u00f4 c\u1ea7u.<\/p>\n

b. D\u1ef1a v\u00e0o l\u00e2m s\u00e0ng:<\/p>\n

– Th\u1eddi k\u1ef3 \u1ee7 b\u1ec7nh trung b\u00ecnh l\u00e0 4 ng\u00e0y (2-10 ng\u00e0y).<\/p>\n

– Bi\u1ec3u hi\u1ec7n nhi\u1ec5m tr\u00f9ng r\u00f5: S\u1ed1t cao \u0111\u1ed9t ng\u1ed9t, c\u00f3 th\u1ec3 c\u00f3 r\u00e9t run, ho, \u0111au h\u1ecdng, m\u1ec7t m\u1ecfi, nh\u1ee9c \u0111\u1ea7u.<\/p>\n

– D\u1ea5u hi\u1ec7u m\u00e0ng n\u00e3o – n\u00e3o:<\/p>\n

+ \u0110au \u0111\u1ea7u d\u1eef d\u1ed9i, bu\u1ed3n n\u00f4n, n\u00f4n, t\u00e1o b\u00f3n, g\u00e1y c\u1ee9ng, (tr\u1ebb nh\u1ecf c\u00f3 th\u1ec3 c\u00f3 ti\u00eau ch\u1ea3y, th\u00f3p ph\u1ed3ng v\u00e0 g\u00e1y m\u1ec1m).<\/p>\n

+ R\u1ed1i lo\u1ea1n \u00fd th\u1ee9c, li b\u00ec, k\u00edch th\u00edch v\u1eadt v\u00e3, c\u00f3 th\u1ec3 c\u00f3 co gi\u1eadt, h\u00f4n m\u00ea.<\/p>\n

– Ban xu\u1ea5t huy\u1ebft ho\u1ea1i t\u1eed h\u00ecnh sao, xu\u1ea5t hi\u1ec7n s\u1edbm v\u00e0 lan nhanh, th\u01b0\u1eddng g\u1eb7p \u1edf hai chi d\u01b0\u1edbi.<\/p>\n

– T\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng nhi\u1ec5m \u0111\u1ed9c n\u1eb7ng, nhanh ch\u00f3ng v\u00e0o t\u00ecnh tr\u1ea1ng s\u1ed1c: M\u1ea1ch nhanh, HA h\u1ea1 ho\u1eb7c HA k\u1eb9t (hi\u1ec7u s\u1ed1 huy\u1ebft \u00e1p t\u00e2m thu \u2013 t\u00e2m tr\u01b0\u1eddng < 20 mmHg), thi\u1ec3u ni\u1ec7u, v\u00f4 ni\u1ec7u, \u0111\u00f4ng m\u00e1u n\u1ed9i m\u1ea1ch r\u1ea3i r\u00e1c, suy th\u01b0\u1ee3ng th\u1eadn, suy \u0111a t\u1ea1ng v\u00e0 c\u00f3 th\u1ec3 t\u1eed vong nhanh trong v\u00f2ng 24h.<\/p>\n

2.2. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ca b\u1ec7nh:<\/b><\/p>\n

– L\u00e0 ca b\u1ec7nh l\u00e2m s\u00e0ng, c\u00f3 k\u00e8m theo x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh b\u1eb1ng m\u1ed9t trong c\u00e1c x\u00e9t nghi\u1ec7m sau:<\/p>\n

+ Soi th\u1ea5y song c\u1ea7u gram (-), c\u1ea5y ph\u00e2n l\u1eadp \u0111\u01b0\u1ee3c\u00a0N.meningitidis\u00a0<\/i>trong d\u1ecbch n\u00e3o t\u1ee7y<\/p>\n

+ C\u1ea5y m\u00e1u ph\u00e2n l\u1eadp \u0111\u01b0\u1ee3c\u00a0N.meningitidis<\/i><\/p>\n

+ Soi v\u00e0 c\u1ea5y ph\u00e2n l\u1eadp \u0111\u01b0\u1ee3c\u00a0N.meningitidis\u00a0<\/i>trong t\u1eed ban<\/p>\n

+ PCR (+) v\u1edbi\u00a0N.meningitidis trong d\u1ecbch n\u00e3o t\u1ee7y, m\u00e1u, t\u1eed ban (n\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n l\u00e0m x\u00e9t nghi\u1ec7m)<\/i><\/p>\n

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

– B\u1ec7nh do li\u00ean c\u1ea7u l\u1ee3n (Streptococcus suis)<\/i>:<\/p>\n

+ Y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5 ti\u1ebfp x\u00fac v\u1edbi l\u1ee3n \u1ed1m, ch\u1ebft, gi\u1ebft m\u1ed5 ho\u1eb7c \u0103n th\u1ecbt l\u1ee3n n\u1ea5u ch\u01b0a ch\u00edn k\u1ef9.<\/p>\n

+ C\u00f3 tri\u1ec7u ch\u1ee9ng c\u1ee7a nhi\u1ec5m khu\u1ea9n huy\u1ebft ho\u1eb7c vi\u00eam m\u00e0ng n\u00e3o<\/p>\n

+ Ban xu\u1ea5t huy\u1ebft d\u01b0\u1edbi d\u1ea1ng n\u1ed1t, \u0111\u00e1m m\u1ea3ng ho\u1eb7c lan r\u1ed9ng to\u00e0n th\u00e2n.<\/p>\n

+ C\u00f3 th\u1ec3 c\u00f3 suy tu\u1ea7n ho\u00e0n, h\u00f4 h\u1ea5p ho\u1eb7c suy \u0111a t\u1ea1ng.<\/p>\n

+ Ch\u1ea9n \u0111o\u00e1n b\u1eb1ng nu\u00f4i c\u1ea5y ph\u00e2n l\u1eadp vi khu\u1ea9n\u00a0S. suis\u00a0<\/i>ho\u1eb7c PCR (+) v\u1edbi li\u00ean c\u1ea7u l\u1ee3n trong m\u00e1u ho\u1eb7c d\u1ecbch n\u00e3o t\u1ee7y.<\/p>\n

– Nhi\u1ec5m khu\u1ea9n huy\u1ebft do c\u00e1c vi khu\u1ea9n kh\u00e1c<\/p>\n

– Vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 do c\u00e1c c\u0103n nguy\u00ean kh\u00e1c<\/p>\n

– S\u1ed1t xu\u1ea5t huy\u1ebft dengue:<\/p>\n

+ S\u1ed1t cao \u0111\u1ed9t ng\u1ed9t.<\/p>\n

+ \u0110au \u0111\u1ea7u, \u0111au m\u1ecfi to\u00e0n th\u00e2n, \u0111au nh\u1ee9c nhi\u1ec1u hai h\u1ed1c m\u1eaft.<\/p>\n

+ Da xung huy\u1ebft, \u00edt khi c\u00f3 ph\u00e1t ban.<\/p>\n

+ D\u1ea5u hi\u1ec7u xu\u1ea5t huy\u1ebft \u1edf d\u01b0\u1edbi da, ni\u00eam m\u1ea1c ho\u1eb7c n\u1ed9i t\u1ea1ng.<\/p>\n

+ X\u00e9t nghi\u1ec7m m\u00e1u: B\u1ea1ch c\u1ea7u gi\u1ea3m, Ti\u1ec3u c\u1ea7u gi\u1ea3m, Hct b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng.<\/p>\n

+ X\u00e9t nghi\u1ec7m huy\u1ebft thanh: NS1 ho\u1eb7c kh\u00e1ng th\u1ec3 kh\u00e1ng dengue IgM (+)<\/p>\n

– Ban xu\u1ea5t huy\u1ebft do Sch\u00f6nlein-Henoch:<\/p>\n

+ Th\u01b0\u1eddng s\u1ed1t nh\u1eb9 ho\u1eb7c kh\u00f4ng s\u1ed1t<\/p>\n

+ Ban xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da \u0111\u1ed1i x\u1ee9ng \u1edf 2 ch\u00e2n (d\u1ea1ng b\u1ed1t), 2 tay (d\u1ea1ng g\u0103ng).<\/p>\n

+ C\u00f3 th\u1ec3: \u0111au kh\u1edbp, \u0111au b\u1ee5ng, xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a, vi\u00eam tinh ho\u00e0n, vi\u00eam th\u1eadn<\/a><\/p>\n

\"Minh-hoa-viem-mang-nao\"
Minh h\u1ecda Vi\u00eam m\u00e0ng n\u00e3o<\/figcaption><\/figure>\n

3. \u0110I\u1ec0U TR\u1eca VI\u00caM M\u00c0NG N\u00c3O DO N\u00c3O M\u00d4 C\u1ea6U<\/b><\/h2>\n

3.1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/b><\/p>\n

– Ch\u1ea9n \u0111o\u00e1n s\u1edbm ca b\u1ec7nh<\/p>\n

– S\u1eed d\u1ee5ng kh\u00e1ng sinh s\u1edbm<\/p>\n

– H\u1ed3i s\u1ee9c t\u00edch c\u1ef1c<\/p>\n

– C\u00e1ch ly b\u1ec7nh nh\u00e2n<\/p>\n

3.2. \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3<\/b><\/p>\n

2.1. Kh\u00e1ng sinh: Ch\u1ecdn m\u1ed9t trong c\u00e1c kh\u00e1ng sinh sau + Penicillin G: 20 \u2013 30 tri\u1ec7u UI (\u0111\u01a1n v\u1ecb qu\u1ed1c t\u1ebf)\/ng\u00e0y, truy\u1ec1n t\u0129nh m\u1ea1ch li\u00ean t\u1ee5c ho\u1eb7c ti\u00eam t\u0129nh m\u1ea1ch 2 – 4gi\u1edd\/l\u1ea7n. Tr\u1ebb em 200.000-300.000UI\/kg\/ng\u00e0y.<\/p>\n

+ Ampicillin: 2g\/l\u1ea7n, ti\u00eam t\u0129nh m\u1ea1ch 6h\/l\u1ea7n. Tr\u1ebb em 200-250 mg\/kg\/ng\u00e0y.<\/p>\n

+ Cefotaxim: 2g\/l\u1ea7n, ti\u00eam t\u0129nh m\u1ea1ch 6gi\u1edd\/l\u1ea7n. Tr\u1ebb em 200-300mg\/kg\/ng\u00e0y.<\/p>\n

+ Ceftriaxon: 2g\/l\u1ea7n, ti\u00eam t\u0129nh m\u1ea1ch12h\/l\u1ea7n. Tr\u1ebb em 100mg\/kg\/ng\u00e0y.<\/p>\n

– N\u1ebfu d\u1ecb \u1ee9ng v\u1edbi c\u00e1c kh\u00e1ng sinh nh\u00f3m Betalactamin:<\/p>\n

+ Chloramphenicol 1g, d\u00f9ng 2-3g\/ng\u00e0y, tr\u1ebb em t\u1eeb 50-100mg\/kg\/ng\u00e0y (n\u1ebfu c\u00f2n t\u00e1c d\u1ee5ng).<\/p>\n

+ Ciprofloxacin 400 mg\/l\u1ea7n, truy\u1ec1n t\u0129nh m\u1ea1ch 2 l\u1ea7n\/ng\u00e0y. Tr\u1ebb em 15 mg\/kg\/l\u1ea7n truy\u1ec1n t\u0129nh m\u1ea1ch x 2 l\u1ea7n \/ng\u00e0y.<\/p>\n

Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh t\u1ed1i thi\u1ec3u t\u1eeb 7 \u2013 14 ng\u00e0y ho\u1eb7c 4 \u2013 5 ng\u00e0y sau khi b\u1ec7nh nh\u00e2n h\u1ebft s\u1ed1t, t\u00ecnh tr\u1ea1ng huy\u1ebft\u00a0 \u0111\u1ed9ng \u1ed5n\u00a0 \u0111\u1ecbnh, x\u00e9t nghi\u1ec7m d\u1ecbch n\u00e3o tu\u1ef7 b\u00ecnh th\u01b0\u1eddng (\u0111\u1ed1i v\u1edbi vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 do N\u00e3o m\u00f4 c\u1ea7u).<\/p>\n

– \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 v\u00e0 tri\u1ec7u ch\u1ee9ng:<\/p>\n

+ H\u1ea1 s\u1ed1t<\/p>\n

+ An th\u1ea7n<\/p>\n

+ Ch\u1ed1ng ph\u00f9 n\u00e3o<\/p>\n

+ \u0110i\u1ec1u tr\u1ecb suy tu\u1ea7n ho\u00e0n, s\u1ed1c: b\u00f9 d\u1ecbch, thu\u1ed1c v\u1eadn m\u1ea1ch.<\/p>\n

+ H\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p<\/p>\n

+ L\u1ecdc m\u00e1u li\u00ean t\u1ee5c<\/p>\n

+ \u0110i\u1ec1u ch\u1ec9nh n\u01b0\u1edbc, \u0111i\u1ec7n gi\u1ea3i v\u00e0 th\u0103ng b\u1eb1ng ki\u1ec1m toan<\/p>\n

+ V\u1ec7 sinh th\u00e2n th\u1ec3 v\u00e0 dinh d\u01b0\u1ee1ng \u0111\u1ea7y \u0111\u1ee7<\/p>\n

– C\u00f3 th\u1ec3 xem x\u00e9t s\u1eed d\u1ee5ng corticoids trong tr\u01b0\u1eddng h\u1ee3p s\u1ed1c kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c v\u1eadn m\u1ea1ch. Th\u01b0\u1eddng d\u00f9ng Methylprednisone li\u1ec1u 1-2 mg\/kg\/ng\u00e0y, ho\u1eb7c Hydrocortisone 4mg\/kg\/ng\u00e0y, trong th\u1eddi gian 2 ng\u00e0y.<\/a><\/p>\n

4. PH\u00d2NG B\u1ec6NH<\/b><\/h2>\n

4.1. Ph\u00f2ng b\u1ec7nh chung:<\/b><\/p>\n

– Th\u1ef1c hi\u1ec7n t\u1ed1t v\u1ec7 sinh c\u00e1 nh\u00e2n: r\u1eeda tay th\u01b0\u1eddng xuy\u00ean b\u1eb1ng x\u00e0 ph\u00f2ng, s\u00fac mi\u1ec7ng h\u1ecdng b\u1eb1ng c\u00e1c dung d\u1ecbch s\u00e1t khu\u1ea9n m\u0169i h\u1ecdng th\u00f4ng th\u01b0\u1eddng.<\/p>\n

– Th\u1ef1c hi\u1ec7n t\u1ed1t v\u1ec7 sinh n\u01a1i \u1edf, th\u00f4ng tho\u00e1ng n\u01a1i \u1edf, n\u01a1i l\u00e0m vi\u1ec7c.<\/p>\n

– C\u00f3 th\u1ec3 ti\u00eam v\u1eafc xin ph\u00f2ng b\u1ec7nh.<\/p>\n

– Khi ph\u00e1t hi\u1ec7n c\u00f3 d\u1ea5u hi\u1ec7u nghi ng\u1edd m\u1eafc b\u1ec7nh c\u1ea7n \u0111i kh\u00e1m t\u1ea1i c\u00e1c c\u01a1 s\u1edf kh\u00e1m ch\u1eefa b\u1ec7nh c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t.<\/p>\n

4.2. Ph\u00f2ng b\u1ec7nh trong b\u1ec7nh vi\u1ec7n:<\/b><\/p>\n

– C\u00e1ch ly b\u1ec7nh nh\u00e2n<\/p>\n

– \u0110eo kh\u1ea9u trang khi ti\u1ebfp x\u00fac ho\u1eb7c ch\u0103m s\u00f3c ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

– Qu\u1ea3n l\u00fd v\u00e0 kh\u1eed khu\u1ea9n \u0111\u1ed3 d\u00f9ng v\u00e0 ch\u1ea5t th\u1ea3i c\u1ee7a b\u1ec7nh nh\u00e2n, d\u1ecbch ti\u1ebft m\u0169i h\u1ecdng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

– C\u00f3 th\u1ec3 s\u1eed d\u1ee5ng thu\u1ed1c d\u1ef1 ph\u00f2ng cho nh\u00e2n vi\u00ean y t\u1ebf v\u00e0 ng\u01b0\u1eddi ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi b\u1ec7nh nh\u00e2n.<\/p>\n

4.3. Ph\u00f2ng b\u1ec7nh \u0111\u1eb7c hi\u1ec7u:<\/b><\/p>\n

4.1. Ti\u00eam ph\u00f2ng v\u1eafc xin:<\/p>\n

– Hi\u1ec7n nay \u0111\u00e3 c\u00f3 v\u1eafc xin ph\u00f2ng b\u1ec7nh n\u00e3o m\u00f4 c\u1ea7u nh\u00f3m A, B v\u00e0 C<\/p>\n

– C\u00f3 th\u1ec3 ti\u00eam cho tr\u1ebb t\u1eeb 2 tu\u1ed5i tr\u1edf l\u00ean, ti\u00eam 1 li\u1ec1u duy nh\u1ea5t, nh\u1eafc l\u1ea1i m\u1ed7i 3 n\u0103m\/l\u1ea7n.<\/p>\n

4.2. D\u1ef1 ph\u00f2ng b\u1eb1ng thu\u1ed1c:<\/p>\n

– Ch\u1ec9 \u0111\u1ecbnh d\u1ef1 ph\u00f2ng b\u1eb1ng thu\u1ed1c: Nh\u1eefng ng\u01b0\u1eddi ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ch\u1eafc ch\u1eafn nhi\u1ec5m n\u00e3o m\u00f4 c\u1ea7u, bao g\u1ed3m c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau:<\/p>\n

+ Nh\u1eefng ng\u01b0\u1eddi s\u1ed1ng c\u00f9ng nh\u00e0 v\u00e0 sinh ho\u1ea1t c\u00f9ng v\u1edbi b\u1ec7nh nh\u00e2n (s\u1ed1ng trong c\u00f9ng m\u1ed9t nh\u00e0, c\u00f9ng khu nh\u00e0 tr\u1ecd, c\u00f9ng ph\u00f2ng l\u00e0m vi\u1ec7c\u2026) trong v\u00f2ng 7 ng\u00e0y tr\u01b0\u1edbc khi b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng.<\/p>\n

+ Nh\u1eefng ng\u01b0\u1eddi ti\u1ebfp x\u00fac v\u1edbi b\u1ec7nh nh\u00e2n trong th\u1eddi gian ng\u1eafn (c\u00f3 nguy c\u01a1 b\u1ecb nhi\u1ec5m b\u1ec7nh qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p nh\u01b0: n\u00f3i chuy\u1ec7n v\u1edbi b\u1ec7nh nh\u00e2n, ti\u1ebfp x\u00fac v\u1edbi d\u1ecbch ti\u1ebft \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p c\u1ee7a b\u1ec7nh nh\u00e2n\u2026)<\/p>\n

– Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng: C\u00e1c thu\u1ed1c c\u00f3 th\u1ec3 d\u1ef1 ph\u00f2ng nhi\u1ec5m n\u00e3o m\u00f4 c\u1ea7u bao g\u1ed3m Rifampicin, Ciprofloxacin, Azithromycin.<\/p>\n

+\u00a0Ciprofloxacin:\u00a0<\/b>D\u00f9ng li\u1ec1u \u0111\u01a1n duy nh\u1ea5t 500 mg cho ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em tr\u00ean 12 tu\u1ed5i.<\/p>\n

+\u00a0Rifampicin:\u00a0<\/b>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau: \u0111ang c\u00f3 bi\u1ec3u hi\u1ec7n v\u00e0ng da, c\u00f3 ti\u1ec1n s\u1eed t\u0103ng nh\u1ea1y c\u1ea3m v\u1edbi Rifampicin.<\/p>\n

D\u00f9ng trong 2 ng\u00e0y:<\/p>\n

. Ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em tr\u00ean 12 tu\u1ed5i: 600mg, 2 l\u1ea7n\/ng\u00e0y<\/p>\n

. Tr\u1ebb em t\u1eeb 1-12 tu\u1ed5i: 10mg\/kg,2 l\u1ea7n\/ng\u00e0y<\/p>\n

. Tr\u1ebb d\u01b0\u1edbi 12 th\u00e1ng: 5mg\/kg, 2 l\u1ea7n\/ng\u00e0y<\/p>\n

+ C\u00f3 th\u1ec3 d\u00f9ng\u00a0Azithromycin:\u00a0<\/b>li\u1ec1u duy nh\u1ea5t 500 mg cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 \u0111ang cho con b\u00fa, tr\u1ebb em 10mg\/kg.<\/p>\n

– Th\u1eddi gian d\u00f9ng: N\u00ean d\u00f9ng c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t, t\u1ed1t nh\u1ea5t l\u00e0 trong v\u00f2ng 24h sau khi c\u00f3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ca b\u1ec7nh.<\/p>\n

Ngu\u1ed3n: B\u1ed9 Y t\u1ebf<\/p>\n

Xem th\u00eam: 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","protected":false},"excerpt":{"rendered":"

Vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd nhi\u1ec5m tr\u00f9ng nghi\u00eam tr\u1ecdng, c\u00f3 nguy c\u01a1 \u0111\u1ec3 l\u1ea1i di ch\u1ee9ng ho\u1eb7c g\u00e2y t\u1eed vong cho b\u1ec7nh nh\u00e2n n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi. 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