{"id":29474,"date":"2023-04-29T18:31:21","date_gmt":"2023-04-29T11:31:21","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29474"},"modified":"2023-04-29T18:31:21","modified_gmt":"2023-04-29T11:31:21","slug":"benh-nam-phoi-huong-dan-chan-doan-cua-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/29\/benh-nam-phoi-huong-dan-chan-doan-cua-bo-y-te\/","title":{"rendered":"B\u1ec7nh n\u1ea5m ph\u1ed5i: H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n c\u1ee7a B\u1ed9 Y t\u1ebf"},"content":{"rendered":"<p><strong>B\u1ec7nh n\u1ea5m ph\u1ed5i th\u01b0\u1eddng l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a m\u1ed9t t\u00ecnh tr\u1ea1ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch: HIV, s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch nh\u01b0 h\u00f3a ch\u1ea5t \u0111i\u1ec1u tr\u1ecb ung th\u01b0, <\/strong><strong>corticoid k\u00e9o d\u00e0i, thu\u1ed1c ch\u1ed1ng th\u1ea3i gh\u00e9p, b\u1ec7nh h\u1ec7 th\u1ed1ng ho\u1eb7c n\u1ea5m ph\u00e1t tri\u1ec3n tr\u00ean n\u1ec1n c\u1ee7a m\u1ed9t t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i c\u00f3 tr\u01b0\u1edbc nh\u01b0 hang lao, gi\u00e3n ph\u1ebf qu\u1ea3n. Ng\u01b0\u1eddi ta ph\u00e2n bi\u1ec7t 2 lo\u1ea1i ch\u00ednh: nhi\u1ec5m n\u1ea5m c\u1ed5 \u0111i\u1ec3n (Crytococcus, Histoplasmoses), nhi\u1ec5m n\u1ea5m c\u01a1 h\u1ed9i (Candida, Aspergillus).\u00a0Ba lo\u1ea1i n\u1ea5m g\u00e2y b\u1ec7nh \u1edf ph\u1ed5i th\u01b0\u1eddng g\u1eb7p nh\u1ea5t: Aspergillus, Candida v\u00e0 Cryptococcus.<\/strong><\/p>\n<h2>1. B\u1ec7nh n\u1ea5m ph\u1ed5i do Aspergillus<\/h2>\n<p>N\u1ea5m Aspergillus g\u00e2y b\u1ec7nh \u1edf ph\u1ed5i c\u00f3 3 th\u1ec3: U n\u1ea5m ph\u1ed5i, n\u1ea5m ph\u1ed5i ph\u1ebfqu\u1ea3n d\u1ecb \u1ee9ng v\u00e0 n\u1ea5m ph\u1ed5i x\u00e2m nh\u1eadp.<\/p>\n<h3>1.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh u n\u1ea5m (Aspergilloma)<\/h3>\n<p><strong>D\u1ef1a v\u00e0o tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng v\u00e0 th\u1ef1c th\u1ec3:\u00a0<\/strong><br \/>\n\u2014 C\u00f3 th\u1ec3 c\u00f3 m\u1ed9t ho\u1eb7c nhi\u1ec1u d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng sau:<br \/>\n+ S\u00fat c\u00e2n, m\u1ec7t m\u1ecfi, \u0111au ng\u1ef1c, s\u1ed1t cao 39-40 \u0111\u1ed9 C.<\/p>\n<p>+ Ho ra m\u00e1u (50-80%): D\u00e2y m\u00e1u, th\u01b0\u1eddng t\u00e1i ph\u00e1t nhi\u1ec1u l\u1ea7n, \u0111\u00f4i khi ho ra m\u00e1u n\u1eb7ng.<\/p>\n<p>\u2014 X\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n ti\u1ec1n s\u1eed c\u00f3: Lao ph\u1ed5i, \u0111i\u1ec1u tr\u1ecb h\u00f3a ch\u1ea5t ch\u1ed1ng ung th\u01b0, b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch d\u00e0i ng\u00e0y: corticoid, thu\u1ed1c<br \/>\nch\u1ed1ng th\u1ea3i gh\u00e9p, b\u1ec7nh nh\u00e2n HIV.<\/p>\n<p>\u2014 \u0110\u00f4i khi t\u00ecnh c\u1edd ph\u00e1t hi\u1ec7n th\u1ea5y u n\u1ea5m tr\u00ean phim X-quang ph\u1ed5i.<\/p>\n<p><strong>C\u1eadn l\u00e2m s\u00e0ng:<\/strong><\/p>\n<p>\u2014 X-quang ph\u1ed5i chu\u1ea9n: U n\u1ea5m \u0111i\u1ec3n h\u00ecnh c\u00f3 t\u1ed5n th\u01b0\u01a1ng h\u00ecnh l\u1ee5c l\u1ea1c g\u1ed3n m\u1ed9t h\u1ed1c r\u1ed7ng trong c\u00f3 ch\u1ee9a kh\u1ed1i n\u1ea5m \u0111\u1eb7c v\u00e0 m\u1ed9t li\u1ec1m kh\u00ed \u1edf ph\u00eda tr\u00ean c\u1ee7a kh\u1ed1i n\u1ea5m.<\/p>\n<p>\u2014\u00a0 Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh ng\u1ef1c: cho ph\u00e9p ph\u00e1t hi\u1ec7n r\u00f5 h\u01a1n t\u1ed5n th\u01b0\u01a1ng hang n\u1ea5m h\u00ecnh l\u1ee5c l\u1ea1c v\u1edbi li\u1ec1m h\u01a1i \u1edf ph\u00eda tr\u00ean c\u00f3 th\u1ec3 c\u00f3 k\u00e8m theo ho\u1eb7c kh\u00f4ng c\u00e1c t\u1ed5n<br \/>\nth\u01b0\u01a1ng kh\u00e1c: x\u01a1 co k\u00e9o, tho\u00e1i h\u00f3a d\u1ea1ng k\u00e9n, d\u00e0y m\u00e0ng ph\u1ed5i n\u1ebfu t\u1ed5n th\u01b0\u01a1ng s\u00e1t m\u00e0ng ph\u1ed5i, \u0111\u00f4i khi c\u00f3 h\u00ecnh \u1ea3nh calci h\u00f3a trong kh\u1ed1i n\u1ea5m.<\/p>\n<p>\u2014Vi sinh: soi tr\u1ef1c ti\u1ebfp v\u00e0\/ho\u1eb7c c\u1ea5y \u0111\u1eddm, d\u1ecbch r\u1eeda ph\u1ebf qu\u1ea3n ph\u1ebf nang t\u00ecm th\u1ea5y n\u1ea5m Aspergillus.<\/p>\n<h3>1.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t u n\u1ea5m Aspergillus<\/h3>\n<p>\u2014 \u00c1p xe ph\u1ed5i: C\u00f3 d\u1ea5u hi\u1ec7u \u1ed9c m\u1ee7, c\u00f3 h\u00ecnh \u1ea3nh m\u1ee9c n\u01b0\u1edbc h\u01a1i tr\u00ean Xquang, \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh.<\/p>\n<p>\u2014 Ung th\u01b0 ph\u1ed5i \u00e1p xe h\u00f3a: Sinh thi\u1ebft t\u1ed5n th\u01b0\u01a1ng th\u1ea5y t\u1ed5n th\u01b0\u01a1ng ung th\u01b0.<\/p>\n<h3>1.3. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh n\u1ea5m Aspergillus ph\u1ebf qu\u1ea3n ph\u1ed5i d\u1ecb \u1ee9ng (b\u1ec7nh Hinson Pepys):<\/h3>\n<p>L\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng t\u0103ng t\u00ednh nh\u1ea1y c\u1ea3m c\u1ee7a ph\u1ebf qu\u1ea3n ph\u1ed5i \u0111\u1ed1i v\u1edbi n\u1ea5m aspegillus fumigatus.<\/p>\n<p><strong>C\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng:<\/strong><\/p>\n<p>\u2014 Tri\u1ec7u ch\u1ee9ng c\u1ee7a hen ph\u1ebf qu\u1ea3n ti\u1ebfn tri\u1ec3n t\u1eebng \u0111\u1ee3t \u1edf b\u1ec7nh nh\u00e2n c\u00f3 t\u1ea1ng atopi (eczema, d\u1ecb \u1ee9ng th\u1ee9c \u0103n, vi\u00eam m\u0169i xoang d\u1ecb \u1ee9ng&#8230;).<\/p>\n<p>\u2014 Hen \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y th\u01b0\u1eddng n\u1eb7ng dai d\u1eb3ng v\u00e0 th\u01b0\u1eddng ph\u1ee5 thu\u1ed9c corticoid.<\/p>\n<p>\u2014 Trong c\u01a1n hen kh\u00e1m ph\u1ed5i th\u1ea5y c\u00f3 ran r\u00edt ran ng\u00e1y.<\/p>\n<p><strong>\u0110\u1eb7c \u0111i\u1ec3m c\u1eadn l\u00e2m s\u00e0ng:<\/strong><\/p>\n<p>\u2014 T\u1ed5n th\u01b0\u01a1ng th\u00e2m nhi\u1ec5m \u1edf ph\u1ed5i tr\u00ean X-quang, \u0111\u00f4i khi c\u00f3 h\u00ecnh \u1ea3nh gi\u00e3n ph\u1ebf qu\u1ea3n \u1edf nh\u1eefng ph\u1ebf qu\u1ea3n l\u1edbn.<\/p>\n<p>\u2014 T\u0103ng b\u1ea1ch c\u1ea7u \u01b0a acid trong m\u00e1u ngo\u1ea1i vi &gt; 500\/mL.<br \/>\n\u2014 IgE trong m\u00e1u t\u0103ng &gt; 2000 UI\/mL.<\/p>\n<p>\u2014 T\u00ecm th\u1ea5y n\u1ea5m Aspegillus v\u00e0 nhi\u1ec1u b\u1ea1ch c\u1ea7u \u01b0a acid trong \u0111\u1eddm.<\/p>\n<h3>1.4. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t n\u1ea5m Aspergilus ph\u1ebf qu\u1ea3n ph\u1ed5i d\u1ecb \u1ee9ng:<\/h3>\n<p>\u2014Vi\u00eam ph\u1ebf qu\u1ea3n do n\u1ea5m g\u00e2y t\u1eafc ngh\u1ebdn: Do x\u00e2m nh\u1eadp c\u1ee7a n\u1ea5m\u00a0aspergillus v\u00e0o kh\u00ed qu\u1ea3n v\u00e0 c\u00e1c ph\u1ebf qu\u1ea3n \u1edf g\u1ea7n \u1edf ng\u01b0\u1eddi kh\u00f4ng c\u00f3 c\u01a1 \u0111\u1ecba d\u1ecb \u1ee9ng.<\/p>\n<p>\u2014 U h\u1ea1t ph\u1ebf qu\u1ea3n: Ho, kh\u00f3 th\u1edf r\u00edt, \u0111au ng\u1ef1c, c\u00f3 ho m\u00e1u, s\u1ed1t, suy s\u1ee5p to\u00e0n th\u00e2n. X-quang c\u00f3 nh\u1eefng n\u1ed1t \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c nhi\u1ec1u n\u1ed1t, h\u00ecnh \u1ea3nh x\u1eb9p ph\u1ed5i, nh\u1eefng<br \/>\nkh\u1ed1i ho\u1ea1i t\u1eed \u1edf nhu m\u00f4 ph\u1ed5i.<\/p>\n<p>\u2014 Vi\u00eam ph\u1ed5i t\u0103ng b\u1ea1ch c\u1ec1u \u00e1i toan (H\u1ed9i ch\u1ee9ng Churg Strauss, b\u1ec7nh Carrington): T\u1ed5n th\u01b0\u01a1ng th\u00e2m nhi\u1ec5m \u1edf ph\u1ed5i v\u00e0 t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan trong m\u00e1u<br \/>\nngo\u1ea1i vi.<\/p>\n<p>\u2014 B\u1ec7nh ph\u1ed5i do k\u00fd sinh tr\u00f9ng: C\u00f3 t\u1ed5n th\u01b0\u01a1ng th\u00e2m nhi\u1ec5m mau bay \u1edf ph\u1ed5i (h\u1ed9i ch\u1ee9ng Loeffler).<\/p>\n<p>&nbsp;<\/p>\n<h3>1.5. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh n\u1ea5m Aspergillus th\u1ec3 x\u00e2m nh\u1eadp<\/h3>\n<p><strong>D\u1ef1a v\u00e0o tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng:<\/strong><\/p>\n<p>\u2014 \u1ede b\u1ec7nh nh\u00e2n c\u00f3 gi\u1ea3m b\u1ea1ch c\u1ea7u ho\u1eb7c suy gi\u1ea3m mi\u1ec5n d\u1ecbch: c\u00f3 th\u1ec3 c\u00f3 m\u1ed9t ho\u1eb7c nhi\u1ec1u d\u1ea5u hi\u1ec7u: s\u1ed1t k\u00e9o d\u00e0i d\u00f9ng kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng kh\u00f4ng \u0111\u1ee1, ho khan<br \/>\ndai d\u1eb3ng, gi\u1ea3m khi d\u00f9ng corticoid, c\u00f3 th\u1ec3 ho ra m\u00e1u m\u1ee9c \u0111\u1ed9 nh\u1eb9 t\u1edbi n\u1eb7ng. \u0110au ng\u1ef1c ki\u1ec3u \u0111au m\u00e0ng ph\u1ed5i, m\u1ec7t m\u1ecfi, ch\u00e1n \u0103n, g\u1ea7y s\u00fat c\u00e2n&#8230;<\/p>\n<p>\u2014 Kh\u00e1m ph\u1ed5i: th\u01b0\u1eddng ngh\u00e8o n\u00e0n, \u0111\u00f4i khi c\u00f3 ran n\u1ed5 khu tr\u00fa ho\u1eb7c ch\u1ec9 c\u00f3 h\u1ed9i ch\u1ee9ng 3 gi\u1ea3m.<\/p>\n<p><strong>\u0110\u1eb7c \u0111i\u1ec3m c\u1eadn l\u00e2m s\u00e0ng:<\/strong><\/p>\n<p>\u2014 Xquang ph\u1ed5i, ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh: t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng \u0111\u00e1m m\u1edd ho\u1eb7c n\u1ed1t m\u1edd m\u00e0 c\u00f3 b\u00f3ng xung quanh n\u1ed1t m\u1edd do ch\u1ea3y m\u00e1u v\u00e0 c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng<br \/>\nki\u1ec3u vi\u00eam ph\u1ed5i ho\u1ea1i t\u1eed ho\u1eb7c nhi\u1ec1u \u1ed5 \u00e1p xe nh\u1ecf. \u0110\u00f4i khi c\u00f3 tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i, tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i.<\/p>\n<p>\u2014 N\u1ed9i soi ph\u1ebf qu\u1ea3n: \u0111\u00f4i khi c\u00f3 t\u1ed5n th\u01b0\u01a1ng vi\u00eam lo\u00e9t k\u00e8m gi\u1ea3 m\u1ea1c tr\u1eafng trong l\u00f2ng kh\u00ed ph\u1ebf qu\u1ea3n. Soi tr\u1ef1c ti\u1ebfp th\u1ea5y s\u1ee3i n\u1ea5m v\u00e0 c\u1ea5y \u0111\u01b0\u1ee3c n\u1ea5m<br \/>\nAspergillus t\u1eeb d\u1ecbch r\u1eeda ph\u1ebf qu\u1ea3n ph\u1ebf nang.<\/p>\n<p>\u2014 T\u00ecm th\u1ea5y s\u1ee3i n\u1ea5m v\u00e0 x\u00e2m nh\u1eadp c\u1ee7a n\u1ea5m tr\u00ean m\u1ea3nh sinh thi\u1ebft qua n\u1ed9i soi ph\u1ebf qu\u1ea3n ho\u1eb7c tr\u00ean b\u1ec7nh ph\u1ea9m sinh thi\u1ebft xuy\u00ean th\u00e0nh ng\u1ef1c d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn<br \/>\nc\u1ee7a ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh.<\/p>\n<h2>2. B\u1ec7nh n\u1ea5m ph\u1ed5i do Candida.<\/h2>\n<h3>2.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1ec7nh n\u1ea5m ph\u1ed5i Candida<\/h3>\n<p><strong>D\u1ef1a v\u00e0o tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng:<\/strong><\/p>\n<p>\u2014Tr\u00ean b\u1ec7nh nh\u00e2n c\u00f3 gi\u1ea3m b\u1ea1ch c\u1ea7u k\u00e9o d\u00e0i, suy gi\u1ea3m mi\u1ec5n d\u1ecbch c\u00f3 \u0111\u1eb7t \u1ed1ng th\u00f4ng t\u0129nh m\u1ea1ch, \u1ed1ng d\u00e2n l\u01b0u c\u00e1c khoang \u0111\u1ec3 l\u00e2u xu\u1ea5t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u:<\/p>\n<ul>\n<li>S\u1ed1t th\u1ea5t th\u01b0\u1eddng k\u00e9o d\u00e0i m\u1ee9c \u0111\u1ed9 trung b\u00ecnh t\u1edbi n\u1eb7ng.<\/li>\n<li>Ho khan ho\u1eb7c c\u00f3 \u0111\u1eddm.<\/li>\n<li>C\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n kh\u00e0n ti\u1ebfng.<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng \u1edf mi\u1ec7ng, h\u1ecdng: m\u1ed9t l\u1edbp m\u00e0u tr\u1eafng ph\u1ee7 to\u00e0n b\u1ed9 m\u1eb7t l\u01b0\u1ee1i kh\u00f3 nu\u1ed1t c\u00f3 th\u1ec3 c\u00f3 c\u00e1c \u1ed5 lo\u00e9t k\u00e8m gi\u1ea3 m\u1ea1c tr\u1eafng tr\u00ean ni\u00eam m\u1ea1c mi\u1ec7ng.<\/li>\n<li>\u0110au sau x\u01b0\u01a1ng \u1ee9c, th\u1edf r\u00edt ho\u1eb7c c\u00f3 c\u01a1n kh\u00f3 th\u1edf nh\u01b0 hen ph\u1ebf qu\u1ea3n, \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n, \u0111\u00e1p \u1ee9ng v\u1edbi kh\u00e1ng sinh.<\/li>\n<\/ul>\n<p><strong>\u0110\u1eb7c \u0111i\u1ec3m c\u1eadn l\u00e2m s\u00e0ng:<\/strong><\/p>\n<p>\u2014 X-quang ph\u1ed5i: t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng \u0111\u00e1m m\u1edd, n\u1ed1t m\u1edd tr\u00f2n \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c r\u1ea3i th\u00e0nh \u0111\u00e1m.<\/p>\n<p>\u2014 N\u1ed9i soi ph\u1ebf qu\u1ea3n: c\u00f3 th\u1ec3 c\u00f3 t\u1ed5n th\u01b0\u01a1ng b\u1ec1 m\u1eb7t ph\u1ebf qu\u1ea3n \u0111\u01b0\u1ee3c l\u00f3t b\u1edfi m\u1ed9t l\u1edbp m\u00e0u ghi kh\u00f4ng d\u00ednh, tr\u1ea3i d\u00e0i su\u1ed1t d\u1ecdc l\u00f2ng ph\u1ebf qu\u1ea3n, c\u00f3 khi ho\u1ea1i t\u1eed bao ph\u1ee7 l\u00ean tr\u00ean b\u1ec1 m\u1eb7t ni\u00eam m\u1ea1c.<\/p>\n<p>\u2014 T\u00ecm th\u1ea5y n\u1ea5m Candida trong d\u1ecbch r\u1eeda ph\u1ebf qu\u1ea3n ph\u1ebf nang v\u00e0 tr\u00ean m\u1ea3nh sinh thi\u1ebft qua n\u1ed9i soi ph\u1ebf qu\u1ea3n ho\u1eb7c sinh thi\u1ebft xuy\u00ean th\u00e0nh ng\u1ef1c.<\/p>\n<p>\u2014 C\u1ea5y m\u00e1u c\u00f3 n\u1ea5m Candida.<\/p>\n<p>\u2014 N\u1ed9i soi th\u1ef1c qu\u1ea3n, d\u1ea1 d\u00e0y c\u00f3 t\u1ed5n th\u01b0\u01a1ng do n\u1ea5m Candida.<\/p>\n<h2>3. B\u1ec7nh n\u1ea5m ph\u1ed5i do Cryptococcus<\/h2>\n<h3>3.1. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh n\u1ea5m ph\u1ed5i do Cryptococcus<\/h3>\n<p><strong>D\u1ef1a v\u00e0o tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng:<\/strong><br \/>\n\u2014 S\u1ed1t, \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t.<\/p>\n<p>\u2014 Kich th\u00edch, r\u1ed1i lo\u1ea1n \u00fd th\u1ee9c, c\u00f3 nh\u1eefng c\u01a1n co gi\u1eadt, h\u00f4n m\u00ea, li\u1ec7t th\u1ea7n kinh s\u1ecd, v\u1eadn \u0111\u1ed9ng.<\/p>\n<p>\u2014 T\u0103ng \u00e1p l\u1ef1c s\u1ecd l\u00e0 y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng x\u1ea5u, d\u1ec5 t\u1eed vong.<br \/>\n\u2014 Tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p: ho dai d\u1eb3ng, kh\u00f3 th\u1edf, \u0111au ng\u1ef1c kh\u00f4ng x\u00e1c \u0111\u1ecbnh.<br \/>\n\u2014 Tr\u00ean da: c\u00f3 c\u00e1c n\u1ed1t ph\u1ecfng, lo\u00e9t.<\/p>\n<p><strong>\u0110\u1eb7c \u0111i\u1ec3m c\u1eadn l\u00e2m s\u00e0ng<\/strong><br \/>\n<em>X-quang:<\/em><\/p>\n<p>\u2014 Th\u00e2m nhi\u1ec5m ph\u1ed5i \u0111\u1ed3ng nh\u1ea5t, h\u00ecnh \u1ea3nh h\u1ea1ch to \u1edf r\u1ed1n ph\u1ed5i. X\u1eb9p ph\u1ed5i<br \/>\nth\u00f9y ho\u1eb7c ph\u00e2n th\u00f9y. C\u00f3 th\u1ec3 c\u00f3 h\u00ecnh \u1ea3nh gi\u00e3n ph\u1ebf qu\u1ea3n.<\/p>\n<p>\u2014 T\u1ed5n th\u01b0\u01a1ng nhu m\u00f4 ph\u1ed5i d\u1ea1ng l\u01b0\u1edbi n\u1ed1t, \u00e1p xe ho\u1eb7c vi\u00eam m\u00e0ng ph\u1ed5i.<\/p>\n<ul>\n<li>C\u00e1c t\u1ed5n th\u01b0\u01a1ng bh\u00e1c: T\u1ed5n th\u01b0\u01a1ng \u1edf m\u1eaft, xoang, t\u1ee7y s\u1ed1ng, h\u1ea1ch, l\u00e1ch, c\u01a1 quan ti\u00eau h\u00f3a, ti\u1ebft ni\u1ec7u.<\/li>\n<\/ul>\n<p><em>X\u00e9t nghi\u1ec7m mi\u1ec5n d\u1ecbch h\u1ecdc.<\/em><\/p>\n<p>\u2014 IgE to\u00e0n b\u1ed9 t\u0103ng &gt; 1000 ng\/ml (b\u00ecnh th\u01b0\u1eddng 420 UI\/ml), c\u00f3 th\u1ec3 gi\u1ea3m \u0111i sau khi \u0111i\u1ec1u tr\u1ecb corticoid.<\/p>\n<p>-\u2014 \u0110\u1ecbnh l\u01b0\u1ee3ng precipitin trong m\u00e1u l\u00e0 x\u00e9t nghi\u1ec7m kh\u00e1 \u0111\u1eb7c hi\u1ec7u.<\/p>\n<p><em>X\u00e9t nghi\u1ec7m t\u00ecm n\u1ea5m.<\/em><br \/>\n\u2014 Khi nhu\u1ed9m b\u1ec7nh ph\u1ea9m v\u1edbi m\u1ef1c T\u00e0u th\u1ea5y r\u00f5 s\u1ee3i n\u1ea5m.<\/p>\n<p>\u2014 Nu\u00f4i c\u1ea5y trong m\u00f4i tr\u01b0\u1eddng Sabouraud: d\u1ecbch n\u00e3o t\u1ee7y, d\u1ecbch r\u1eeda ph\u1ebf qu\u1ea3n ph\u1ebf nang, m\u1ea3nh sinh thi\u1ebft ph\u1ebf qu\u1ea3n ho\u1eb7c ph\u1ed1i, c\u1ea5y m\u00e1u c\u00f3 n\u1ea5m.<\/p>\n<p><em>X\u00e9t nghi\u1ec7m t\u00ecm kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u:<\/em><\/p>\n<p>K\u1ef9 thu\u1eadt ELISA: khi l\u01b0\u1ee3ng IgE ho\u1eb7c IgG g\u1ea5p 2 l\u1ea7n trong huy\u1ebft thanh c\u1ee7a b\u1ec7nh nh\u00e2n b\u1ecb hen.<\/p>\n<p>&nbsp;<\/p>\n<p>Ngu\u1ed3n: B\u1ed9 Y t\u1ebf 2012, H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ea5m ph\u1ed5i.<\/p>\n<p><a href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/chan-doan-va-dieu-tri-nam-phoi\/\">Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ea5m ph\u1ed5i<\/a><\/p>\n<div class=\"share\"><\/div>\n","protected":false},"excerpt":{"rendered":"<p>B\u1ec7nh n\u1ea5m ph\u1ed5i th\u01b0\u1eddng l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a m\u1ed9t t\u00ecnh tr\u1ea1ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch: HIV, s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch nh\u01b0 h\u00f3a ch\u1ea5t \u0111i\u1ec1u tr\u1ecb ung th\u01b0, corticoid k\u00e9o d\u00e0i, thu\u1ed1c ch\u1ed1ng th\u1ea3i gh\u00e9p, b\u1ec7nh h\u1ec7 th\u1ed1ng ho\u1eb7c n\u1ea5m ph\u00e1t tri\u1ec3n tr\u00ean n\u1ec1n c\u1ee7a m\u1ed9t t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i c\u00f3 tr\u01b0\u1edbc nh\u01b0 [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>B\u1ec7nh n\u1ea5m ph\u1ed5i: H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n c\u1ee7a B\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh n\u1ea5m ph\u1ed5i x\u1ea3y ra tr\u00ean c\u01a1 \u0111\u1ecba suy gi\u1ea3m mi\u1ec5n d\u1ecbch, g\u1ed3m n\u1ea5m c\u1ed5 \u0111i\u1ec3n v\u00e0 n\u1ea5m c\u01a1 h\u1ed9i. 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