{"id":31025,"date":"2023-05-04T17:12:42","date_gmt":"2023-05-04T10:12:42","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31025"},"modified":"2023-05-08T12:30:23","modified_gmt":"2023-05-08T05:30:23","slug":"viem-phoi-khong","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/viem-phoi-khong\/","title":{"rendered":"Vi\u00eam ph\u1ed5i kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb: Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

Vi\u00eam ph\u1ed5i l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng \u0111\u1ebfn t\u00ednh m\u1ea1ng. Tuy nhi\u00ean, \u0111\u00f4i khi vi\u00eam ph\u1ed5i c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi \u0111\u1ec3 tr\u00e1nh c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb c\u1ee7a B\u1ed9 Y t\u1ebf 2012.<\/strong><\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/h1>\n

Vi\u00eam ph\u1ed5i kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb bao g\u1ed3m nh\u1eefng tr\u01b0\u1eddng h\u1ee3p vi\u00eam ph\u1ed5i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh nh\u01b0ng c\u00f3 \u0111\u00e1p \u1ee9ng ch\u1eadm ho\u1eb7c kh\u00f4ng c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb.<\/p>\n

Tr\u01b0\u1edbc khi kh\u1eb3ng \u0111\u1ecbnh vi\u00eam ph\u1ed5i kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb c\u1ea7n l\u01b0u \u00fd nh\u1eefng y\u1ebfu t\u1ed1 l\u00e0m vi\u00eam ph\u1ed5i ti\u1ebfn tri\u1ec3n ch\u1eadm bao g\u1ed3m:<\/p>\n

– C\u00f3 b\u1ec7nh m\u1ea1n t\u00ednh k\u00e8m theo:<\/p>\n

    \n
  • B\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh: BPTNMT, gi\u00e3n ph\u1ebf qu\u1ea3n, x\u01a1 ph\u1ed5i.<\/li>\n
  • Nghi\u1ec7n r\u01b0\u1ee3u.<\/li>\n
  • B\u1ec7nh l\u00fd th\u1ea7n kinh: t\u0103ng nguy c\u01a1 h\u00edt ph\u1ea3i, gi\u1ea3m kh\u1ea3 n\u0103ng ho, kh\u1ea1c \u0111\u1eddm.<\/li>\n
  • Suy tim sung huy\u1ebft.<\/li>\n
  • Suy th\u1eadn.<\/li>\n
  • Nhi\u1ec5m HIV, suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/li>\n
  • C\u00f3 b\u1ec7nh l\u00fd \u00e1c t\u00ednh k\u00e8m theo.<\/li>\n
  • \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/li>\n<\/ul>\n

    – Tu\u1ed5i > 50: b\u1ec7nh ti\u1ebfn tri\u1ec3n ch\u1eadm h\u01a1n.<\/p>\n

    – Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i n\u1eb7ng: c\u00f3 th\u1ec3 c\u1ea7n \u0111\u1ebfn 10 tu\u1ea7n \u0111\u1ec3 s\u1ea1ch t\u1ed5n th\u01b0\u01a1ng.<\/p>\n

    – Vi\u00eam ph\u1ed5i do c\u00e1c vi khu\u1ea9n kh\u00f4ng \u0111i\u1ec3n h\u00ecnh c\u00f3 tho\u00e1i lui b\u1ec7nh nhanh h\u01a1n.<\/p>\n

    \"\"
    \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Ngu\u1ed3n: Antibiotics Surprisingly Ineffective on Pneumonia – Healthline<\/strong><\/figcaption><\/figure>\n

    2. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h2>\n

    2.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/strong><\/h3>\n

    – Tr\u00ean l\u00e2m s\u00e0ng: kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh \u0111\u1ea7y \u0111\u1ee7 sau 10 ng\u00e0y ho\u1eb7c c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng n\u1eb7ng l\u00ean sau 5 ng\u00e0y \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh \u0111\u1ea7y \u0111\u1ee7.<\/p>\n

    – Tr\u00ean X-quang ph\u1ed5i: t\u1ed5n th\u01b0\u01a1ng tr\u00ean X-quang kh\u00f4ng thuy\u00ean gi\u1ea3m sau 1 th\u00e1ng \u0111i\u1ec1u tr\u1ecb, ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng ti\u1ebfn tri\u1ec3n n\u1eb7ng h\u01a1n sau 5 ng\u00e0y \u0111i\u1ec1u tr\u1ecb.<\/p>\n

    2.2. Ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n<\/strong><\/h3>\n

    – Do t\u00ecnh tr\u1ea1ng kh\u00e1ng thu\u1ed1c c\u1ee7a c\u00e1c t\u00e1c nh\u00e2n g\u00e2y vi\u00eam ph\u1ed5i. C\u1ea7n l\u01b0u \u00fd \u0111\u1ebfn y\u1ebfu t\u1ed1 kh\u00e1ng thu\u1ed1c \u1edf c\u00e1c tr\u01b0\u1eddng h\u1ee3p:<\/p>\n

      \n
    • B\u1ec7nh nh\u00e2n c\u00f3 suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/li>\n
    • C\u00f3 b\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh k\u00e8m theo.<\/li>\n
    • C\u00f3 ti\u1ebfp x\u00fac th\u01b0\u1eddng xuy\u00ean v\u1edbi tr\u1ebb em < 5 tu\u1ed5i.<\/li>\n
    • \u0110i\u1ec1u tr\u1ecb kh\u00e1ng sinh d\u00f2ng beta -lactam trong v\u00f2ng 6 th\u00e1ng.<\/li>\n
    • C\u00f3 vi\u00eam ph\u1ed5i trong v\u00f2ng 1 n\u0103m tr\u01b0\u1edbc.<\/li>\n
    • Nh\u1eadp vi\u1ec7n trong 3 th\u00e1ng tr\u01b0\u1edbc.<\/li>\n
    • Vi\u00eam ph\u1ed5i m\u1eafc ph\u1ea3i \u1edf b\u1ec7nh vi\u1ec7n.<\/li>\n<\/ul>\n

      – Do ch\u1ea9n \u0111o\u00e1n ch\u01b0a \u0111\u00fang c\u00e1c t\u00e1c nh\u00e2n g\u00e2y vi\u00eam ph\u1ed5i:<\/p>\n

        \n
      • Vi\u00eam ph\u1ed5i m\u1ea1n t\u00ednh do\u00a0Pseudomonas pseudomalei <\/em>(tr\u1ef1c khu\u1ea9n Whitemore).<\/li>\n
      • Lao ph\u1ed5i.<\/li>\n
      • N\u1ea5m ph\u1ed5i.<\/li>\n<\/ul>\n

        – Vi\u00eam ph\u1ed5i c\u00f3 bi\u1ebfn ch\u1ee9ng: \u00e1p xe ph\u1ed5i, tr\u00e0n m\u1ee7 m\u00e0ng ph\u1ed5i.<\/p>\n

        – C\u00e1c nguy\u00ean nh\u00e2n kh\u00f4ng nhi\u1ec5m tr\u00f9ng.<\/p>\n

          \n
        • Ung th\u01b0 ph\u1ed5i: t\u1ed5n th\u01b0\u01a1ng th\u00e2m nhi\u1ec5m c\u1ee7a ung th\u01b0 ti\u1ec3u ph\u1ebf qu\u1ea3n ph\u1ebf nang, vi\u00eam ph\u1ed5i sau t\u1eafc ngh\u1ebdn.<\/li>\n
        • T\u1ed5n th\u01b0\u01a1ng ph\u1ed5i k\u1ebd trong c\u00e1c b\u1ec7nh t\u1ef1 mi\u1ec5n.<\/li>\n
        • Vi\u00eam ph\u1ed5i do thu\u1ed1c.<\/li>\n
        • Ngh\u1ebdn m\u1ea1ch ph\u1ed5i.<\/li>\n
        • Ph\u00f9 ph\u1ed5i huy\u1ebft \u0111\u1ed9ng.<\/li>\n
        • Vi\u00eam ph\u1ed5i t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan.<\/li>\n
        • Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n t\u1eafc ngh\u1ebdn vi\u00eam ph\u1ed5i t\u1ed5 ch\u1ee9c h\u00f3a (BOOP, ho\u1eb7c COP).<\/li>\n<\/ul>\n

          2.3. C\u00e1c th\u0103m d\u00f2 ch\u1ea9n \u0111o\u00e1n c\u1ea7n th\u1ef1c hi\u1ec7n trong <\/strong>vi\u00eam ph\u1ed5i kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb<\/strong><\/h3>\n

          \u0110\u00e1nh gi\u00e1 l\u1ea1i c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng: khai th\u00e1c k\u1ef9 l\u1ea1i ti\u1ec1n s\u1eed, c\u00e1c y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5, b\u1ec7nh s\u1eed, kh\u00e1m l\u00e2m s\u00e0ng chi ti\u1ebft, trong \u0111\u00f3 l\u01b0u \u00fd c\u00e1c y\u1ebfu t\u1ed1 l\u00e0m gia t\u0103ng t\u00ednh kh\u00e1ng thu\u1ed1c, c\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn v\u1eadt ch\u1ee7 nh\u01b0 suy gi\u1ea3m mi\u1ec5n d\u1ecbch, b\u1ec7nh m\u1ea1n t\u00ednh k\u00e8m theo.<\/p>\n

          \u2666 X\u00e9t nghi\u1ec7m vi sinh:<\/strong><\/p>\n

          – C\u1ea5y m\u00e1u: 2 l\u1ea7n li\u00ean ti\u1ebfp.<\/p>\n

          – N\u01b0\u1edbc ti\u1ec3u: t\u00ecm kh\u00e1ng nguy\u00ean\u00a0Legionella pneumophila<\/em>.<\/p>\n

          – \u0110\u1eddm, d\u1ecbch ph\u1ebf qu\u1ea3n, d\u1ecbch m\u00e0ng ph\u1ed5i (t\u00f9y theo t\u1eebng b\u1ec7nh nh\u00e2n):<\/p>\n

            \n
          • Nhu\u1ed9m gram, Giemsa, mi\u1ec5n d\u1ecbch hu\u1ef3nh quang \u0111\u1ec3 ph\u00e1t hi\u1ec7n\u00a0Legionella<\/em>; nhu\u1ed9m Ziehl-Neelsen ph\u00e1t hi\u1ec7n c\u00e1c ch\u1ee7ng\u00a0Mycobacterium<\/strong>spp. v\u00e0\u00a0Nocardia<\/em>spp.<\/li>\n
          • C\u1ea5y ph\u00e1t hi\u1ec7n c\u00e1c vi khu\u1ea9n th\u00f4ng th\u01b0\u1eddng,\u00a0Legionella, mycobacteria<\/em>, v\u00e0 n\u1ea5m.<\/li>\n<\/ul>\n

            \u2666 N\u1ed9i soi ph\u1ebf qu\u1ea3n:<\/strong><\/p>\n

            – Ph\u00e1t hi\u1ec7n c\u00e1c b\u1ea5t th\u01b0\u1eddng trong l\u00f2ng ph\u1ebf qu\u1ea3n, qua \u0111\u00f3 ti\u1ebfn h\u00e0nh sinh thi\u1ebft, ch\u1ea3i c\u00e1c t\u1ed5n th\u01b0\u01a1ng, r\u1eeda ph\u1ebf qu\u1ea3n v\u00f9ng ph\u1ed5i t\u1ed5n th\u01b0\u01a1ng.<\/p>\n

            – L\u1ea5y d\u1ecbch ph\u1ebf qu\u1ea3n l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m nh\u01b0: t\u1ebf b\u00e0o, PCR-MTB, c\u1ea5y MGIT t\u00ecm tr\u1ef1c khu\u1ea9n lao, nhu\u1ed9m soi, c\u1ea5y t\u00ecm vi khu\u1ea9n.<\/p>\n

            – \u0110\u1ecbnh h\u01b0\u1edbng nguy\u00ean nh\u00e2n d\u1ef1a theo t\u1ebf b\u00e0o d\u1ecbch r\u1eeda ph\u1ebf qu\u1ea3n:<\/p>\n

              \n
            • Ch\u1ee7 y\u1ebfu b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n trung t\u00ednh: vi\u00eam ph\u1ed5i do vi khu\u1ea9n ho\u1eb7c BOOP.<\/li>\n
            • Ch\u1ee7 y\u1ebfu b\u1ea1ch c\u1ea7u lympho: lao ph\u1ed5i, vi\u00eam ph\u1ed5i t\u0103ng c\u1ea3m, b\u1ec7nh sacoit, x\u01a1 ph\u1ed5i.<\/li>\n
            • Ch\u1ee7 y\u1ebfu b\u1ea1ch c\u1ea7u \u00e1i toan: vi\u00eam ph\u1ed5i t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan, n\u1ea5m ph\u1ed5i,\u00a0Pneumocystis jirovecii<\/em>, b\u1ec7nh h\u1ec7 th\u1ed1ng, vi\u00eam ph\u1ed5i do thu\u1ed1c.<\/li>\n
            • \u0110\u1ea1i th\u1ef1c b\u00e0o c\u00f3 m\u1ea3nh v\u00f9i Hemosiderin: xu\u1ea5t huy\u1ebft ph\u1ebf nang.<\/li>\n<\/ul>\n

              \u2666 Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh:<\/strong><\/p>\n

              – Ch\u1ee5p X-quang ph\u1ed5i nh\u1eb1m t\u00ecm nh\u1eefng t\u1ed5n th\u01b0\u01a1ng nh\u01b0: tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i, h\u00ecnh hang, ho\u1eb7c nh\u1eefng t\u1ed5n th\u01b0\u01a1ng m\u1edbi xu\u1ea5t hi\u1ec7n.<\/p>\n

              – Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh ng\u1ef1c: \u0111\u00e1nh gi\u00e1 chi ti\u1ebft h\u01a1n v\u1ec1 nh\u1eefng t\u1ed5n th\u01b0\u01a1ng nhu m\u00f4 ph\u1ed5i, m\u00e0ng ph\u1ed5i, kho\u1ea3ng k\u1ebd, trung th\u1ea5t.<\/p>\n

              \u2666 Sinh thi\u1ebft ph\u1ed5i v\u00f9ng t\u1ed5n th\u01b0\u01a1ng v\u1edbi c\u00e1c bi\u1ec7n ph\u00e1p\u00a0<\/strong><\/p>\n

              – Sinh thi\u1ebft ph\u1ed5i xuy\u00ean th\u00e0nh ph\u1ebf qu\u1ea3n qua n\u1ed9i soi ph\u1ebf qu\u1ea3n (ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong tr\u01b0\u1eddng h\u1ee3p vi\u00eam m\u1ee7 ph\u1ebf qu\u1ea3n).<\/p>\n

              – Sinh thi\u1ebft ph\u1ed5i xuy\u00ean th\u00e0nh ng\u1ef1c d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn c\u1ee7a ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh, ho\u1eb7c si\u00eau \u00e2m (khi t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i l\u1edbn, \u00e1p s\u00e1t th\u00e0nh ng\u1ef1c).<\/p>\n

              – N\u1ed9i soi l\u1ed3ng ng\u1ef1c ho\u1eb7c sinh thi\u1ebft ph\u1ed5i m\u1edf: cho ph\u00e9p l\u1ea5y m\u1ea3nh sinh thi\u1ebft l\u1edbn, \u0111\u1eb7c bi\u1ec7t h\u1eefu \u00edch trong ch\u1ea9n \u0111o\u00e1n c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam ph\u1ed5i k\u1ebd.<\/p>\n

              3. \u0110\u1ecbnh h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb<\/strong><\/h2>\n

              3.1. Theo nguy\u00ean nh\u00e2n g\u00e2y vi\u00eam ph\u1ed5i kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb<\/strong><\/h3>\n

              – Tr\u00e0n m\u1ee7 m\u00e0ng ph\u1ed5i: m\u1edf m\u00e0ng ph\u1ed5i d\u1eabn l\u01b0u, d\u00f9ng k\u1ebft h\u1ee3p 2-3 kh\u00e1ng sinh.<\/p>\n

              – \u00c1p xe ph\u1ed5i: d\u1eabn l\u01b0u m\u1ee7 \u1ed5 \u00e1p xe, d\u00f9ng k\u1ebft h\u1ee3p 2-3 kh\u00e1ng sinh, th\u1eddi gian \u0111i\u1ec1u tr\u1ecb 4-6 tu\u1ea7n<\/p>\n

              – Lao ph\u1ed5i: d\u00f9ng thu\u1ed1c ch\u1ed1ng lao.<\/p>\n

              – N\u1ea5m ph\u1ed5i: d\u00f9ng thu\u1ed1c ch\u1ed1ng n\u1ea5m.<\/p>\n

              – Ung th\u01b0 ph\u1ed5i: ph\u1eabu thu\u1eadt, h\u00f3a tr\u1ecb li\u1ec7u, x\u1ea1 tr\u1ecb ho\u1eb7c k\u1ebft h\u1ee3p nhi\u1ec1u bi\u1ec7n ph\u00e1p t\u00f9y theo giai \u0111o\u1ea1n b\u1ec7nh.<\/p>\n

              3.2. \u0110i\u1ec1u ch\u1ec9nh c\u00e1c b\u1ea5t th\u01b0\u1eddng c\u1ee7a b\u1ec7nh nh\u00e2n<\/strong><\/h3>\n

              – Suy gi\u1ea3m mi\u1ec5n d\u1ecbch do d\u00f9ng h\u00f3a ch\u1ea5t ho\u1eb7c corticoid: t\u1ea1m d\u1eebng c\u00e1c thu\u1ed1c g\u00e2y suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/p>\n

              – Gi\u1ea3m b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n trung t\u00ednh (< 500\/\u00a0mL): d\u00f9ng thu\u1ed1c k\u00edch th\u00edch d\u00f2ng b\u1ea1ch c\u1ea7u h\u1ea1t ho\u1eb7c k\u00edch th\u00edch b\u1ea1ch c\u1ea7u h\u1ea1t – \u0111\u1ea1i th\u1ef1c b\u00e0o.<\/p>\n

              3.3. Thay \u0111\u1ed5i kh\u00e1ng sinh<\/strong><\/h3>\n

              – Ch\u1ec9 n\u00ean thay \u0111\u1ed5i kh\u00e1ng sinh sau 72 gi\u1edd \u0111i\u1ec1u tr\u1ecb, ngo\u1ea1i tr\u1eeb nh\u1eefng tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n n\u1eb7ng, t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh, ti\u1ebfn tri\u1ec3n tr\u00ean X-quang ph\u1ed5i nhanh.<\/p>\n

              – N\u00ean l\u1ef1a ch\u1ecdn kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng, c\u00f3 t\u00e1c d\u1ee5ng v\u1edbi c\u00e1c ch\u1ee7ng kh\u00e1ng thu\u1ed1c c\u1ee7a\u00a0S. pneumonia, P. aeruginosa, S. aureus<\/em>, v\u00e0 c\u00e1c vi khu\u1ea9n y\u1ebfm kh\u00ed. Khi ch\u1ecdn kh\u00e1ng sinh c\u1ea7n quan t\u00e2m c\u00e1c y\u1ebfu t\u1ed1:<\/p>\n

                \n
              • K\u1ebft qu\u1ea3 ch\u1ea9n \u0111o\u00e1n vi sinh tr\u01b0\u1edbc \u0111\u00f3 c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n
              • M\u00f4 h\u00ecnh vi khu\u1ea9n v\u00e0 t\u00ecnh h\u00ecnh kh\u00e1ng thu\u1ed1c \u1edf \u0111\u1ecba ph\u01b0\u01a1ng.<\/li>\n
              • \u1ede nh\u1eefng v\u00f9ng c\u00f3 MRSA: ch\u1ecdn kh\u00e1ng sinh theo kh\u00e1ng sinh \u0111\u1ed3, c\u00e1c kh\u00e1ng sinh th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ecdn bao g\u1ed3m: vancomycin, k\u1ebft h\u1ee3p th\u00eam linezolid ho\u1eb7c clindamycin.<\/li>\n
              • Vi\u00eam ph\u1ed5i m\u1eafc ph\u1ea3i \u1edf b\u1ec7nh vi\u1ec7n kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb: k\u1ebft h\u1ee3p 3 kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng c\u00f3 t\u00e1c d\u1ee5ng v\u1edbi c\u00e1c vi khu\u1ea9n:\u00a0P. aeruginosa<\/em>, MRSA, Acinetobacter Spp<\/span><\/i>, vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t.<\/li>\n
              • Vi\u00eam ph\u1ed5i m\u1ea1n t\u00ednh do\u00a0Pseudomonas pseudomallei<\/span><\/i><\/em>(tr\u1ef1c khu\u1ea9n Whitmore): d\u00f9ng kh\u00e1ng sinh k\u00e9o d\u00e0i 6 th\u00e1ng.<\/li>\n<\/ul>\n

                Ngu\u1ed3n tham kh\u1ea3o<\/strong>: H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh h\u00f4 h\u1ea5p c\u1ee7a B\u1ed9 Y t\u1ebf 2012<\/p>\n","protected":false},"excerpt":{"rendered":"

                Vi\u00eam ph\u1ed5i l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng \u0111\u1ebfn t\u00ednh m\u1ea1ng. Tuy nhi\u00ean, \u0111\u00f4i khi vi\u00eam ph\u1ed5i c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi \u0111\u1ec3 tr\u00e1nh c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng. D\u01b0\u1edbi \u0111\u00e2y […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[],"yoast_head":"\nVi\u00eam ph\u1ed5i kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb: Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb<\/title>\n<meta name=\"description\" content=\"Vi\u00eam ph\u1ed5i l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng \u0111\u1ebfn t\u00ednh m\u1ea1ng. 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