{"id":31608,"date":"2023-05-07T10:12:55","date_gmt":"2023-05-07T03:12:55","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31608"},"modified":"2023-05-07T10:12:55","modified_gmt":"2023-05-07T03:12:55","slug":"viem-gan-b-va-thai-nghen-chan-doan-va-phong-benh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/07\/viem-gan-b-va-thai-nghen-chan-doan-va-phong-benh\/","title":{"rendered":"Vi\u00eam gan B v\u00e0 thai ngh\u00e9n: Ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00f2ng b\u1ec7nh"},"content":{"rendered":"

Vi\u00eam gan<\/a> virus l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m th\u01b0\u1eddng g\u1eb7p. Tr\u01b0\u1edbc \u0111\u00e2y ph\u00e2n l\u00e0m 2 lo\u1ea1i vi\u00eam gan do virus vi\u00eam gan A v\u00e0 B. Ng\u00e0y nay \u0111\u00e3 t\u00ecm ra 5 lo\u1ea1i vi\u00eam gan l\u00e0 A, B, C, D, E. Vi\u00eam gan do virus B, C, D th\u01b0\u1eddng g\u00e2y n\u00ean vi\u00eam gan m\u1ea1n t\u00ednh v\u00e0 x\u01a1 gan.<\/strong><\/p>\n

1. Ch\u1ea9n \u0111o\u00e1n vi\u00eam gan B v\u00e0 thai ngh\u00e9n<\/h2>\n

1.1 Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh <\/strong><\/p>\n

    \n
  • \n
      \n
    • Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

      + <\/strong>Th\u1eddi k\u1ef3 \u1ee7 b\u1ec7nh:\u00a0 trung b\u00ecnh 2-4 tu\u1ea7n. Nhi\u1ec5m virus x\u1ea3y ra b\u1ea5t k\u1ef3 giai \u0111o\u1ea1n n\u00e0o c\u1ee7a thai ngh\u00e9n.Trong th\u1eddi gian \u1ee7 b\u1ec7nh th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111\u1eb7c hi\u1ec7u. N\u1ebfu c\u00f3 ch\u1ec9 l\u00e0 m\u1ec7t m\u1ecfi, ch\u00e1n \u0103n, bu\u1ed3n n\u00f4n hay n\u00f4n, d\u1ec5 nh\u1ea7m v\u1edbi tri\u1ec7u ch\u1ee9ng ngh\u00e9n.<\/p>\n

      + Th\u1eddi k\u1ef3 ph\u00e1t b\u1ec7nh: khi c\u00f3 tri\u1ec7u ch\u1ee9ng th\u00ec b\u1ec7nh \u0111\u00e3 n\u1eb7ng, d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng r\u00f5 r\u1ec7t. M\u1ec7t m\u1ecfi ch\u00e1n \u0103n, s\u1ee5t c\u00e2n, \u0111au v\u00f9ng gan, hay v\u00f9ng th\u01b0\u1ee3ng v\u1ecb, bu\u1ed3n n\u00f4n, n\u00f4n v\u00e0 s\u1ed1t.\u00a0 N\u01b0\u1edbc ti\u1ec3u \u00edt d\u1ea7n, m\u00e0u v\u00e0ng s\u1eabm, v\u00e0ng da, v\u00e0ng m\u1eaft, ng\u1ee9a to\u00e0n th\u00e2n hay g\u1eb7p (75%). Gan to, \u1ea5n \u0111au v\u00f9ng gan.<\/p>\n

        \n
      • Tri\u1ec7u ch\u1ee9ng c\u1eadn l\u00e2m s\u00e0ng:<\/li>\n<\/ul>\n

        + <\/strong>X\u00e9t nghi\u1ec7m kh\u00f4ng \u0111\u1eb7c hi\u1ec7u: men gan t\u0103ng cao, t\u0103ng globulin m\u00e1u.<\/p>\n

        + X\u00e9t nghi\u1ec7m \u0111\u1eb7c hi\u1ec7u: HBsAg, HBeAg, PCR(\u0111\u1ecbnh l\u01b0\u1ee3ng vi r\u00fat trong m\u00e1u).<\/p>\n

        1.2 Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/p>\n

          \n
        • \u1ee8 m\u1eadt do thai ngh\u00e9n hay t\u00e1i ph\u00e1t.<\/li>\n
        • Vi\u00eam gan k\u00e8m theo nhi\u1ec5m khu\u1ea9n ti\u1ebft ni\u1ec7u<\/li>\n
        • Ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng<\/li>\n<\/ul>\n

          2. H\u1eadu qu\u1ea3 v\u00e0 ti\u00ean l\u01b0\u1ee3ng <\/strong>vi\u00eam gan B v\u00e0 thai ngh\u00e9n<\/h2>\n

          Nguy hi\u1ec3m cho c\u1ea3 m\u1eb9 v\u00e0 thai.<\/p>\n

            \n
          • Bi\u1ebfn ch\u1ee9ng<\/li>\n<\/ul>\n

            + Vi\u00eam gan c\u1ea5p, ho\u1ea1i t\u1eed t\u1ebf b\u00e0o gan g\u00e2y teo gan v\u00e0ng c\u1ea5p, h\u00f4n m\u00ea gan, t\u1eed vong 80%.<\/p>\n

            + Suy ch\u1ee9c n\u0103ng gan, gi\u1ea3m y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u g\u00e2y ch\u1ea3y m\u00e1u khi \u0111\u1ebb, s\u1ea9y thai.<\/p>\n

            +\u00a0 X\u01a1 gan, ung th\u01b0 gan.<\/p>\n

            + M\u1eb9 mang kh\u00e1ng nguy\u00ean HBsAg c\u00f3 th\u1ec3 l\u00e2y truy\u1ec1n cho con. N\u1ebfu b\u1ecb nhi\u1ec5m trong 10 tu\u1ea7n \u0111\u1ea7u thai ngh\u00e9n th\u01b0\u1eddng\u00a0 g\u00e2y d\u1ecb d\u1ea1ng thai, s\u1ea9y thai. N\u1ebfu b\u1ecb nhi\u1ec5m t\u1eeb sau tu\u1ea7n th\u1ee9 12, tr\u1ebb c\u00f3 th\u1ec3 b\u1ecb vi\u00eam gan c\u1ea5p, b\u1ec7nh hay x\u1ea3y ra th\u00e1ng th\u1ee9 3 sau \u0111\u1ebb, kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng, \u0111\u00f4i khi ch\u1ec9 c\u00f3 d\u1ea5u hi\u1ec7u gan to.<\/p>\n

              \n
            • Ti\u00ean l\u01b0\u1ee3ng \u00a0<\/strong><\/li>\n<\/ul>\n

              + Cho m\u1eb9: ch\u1ea3y m\u00e1u khi s\u1ea9y thai hay \u0111\u1ebb, g\u00e2y r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u v\u00e0 t\u1eed vong. N\u1ebfu vi\u00eam gan t\u1ed1i c\u1ea5p s\u1ebd b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng gan d\u1eabn \u0111\u1ebfn h\u00f4n m\u00ea gan, l\u00e2u d\u00e0i c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn x\u01a1 gan, ung th\u01b0 gan<\/p>\n

              + Cho thai: <\/strong>ti\u00ean l\u01b0\u1ee3ng d\u00e8 d\u1eb7t, s\u1ea9y thai, \u0111\u1ebb non, thai ch\u1ebft l\u01b0u, vi\u00eam gan<\/p>\n

              3. \u0110i\u1ec1u tr\u1ecb<\/h2>\n
                \n
              • Cho \u0111\u1ebfn nay ch\u01b0a c\u00f3 \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u, ch\u1ec9 c\u00f3 \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ef1 ph\u00f2ng, thai ph\u1ee5 ngh\u1ec9 ng\u01a1i ho\u00e0n to\u00e0n, dinh d\u01b0\u1ee1ng t\u1ed1t \u0111\u1ec1 ph\u00f2ng thi\u1ebfu m\u00e1u, suy dinh d\u01b0\u1ee1ng<\/li>\n<\/ul>\n
                  \n
                • Trong th\u1eddi gian mang thai kh\u00e1m chuy\u00ean khoa x\u00e9t nghi\u1ec7m PCR t\u1ea3i l\u01b0\u1ee3ng vi r\u00fat trong m\u00e1u , \u0111i\u1ec1u tr\u1ecb thu\u1ed1c di\u1ec7t virus.<\/li>\n
                • \u0110i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u n\u1ebfu c\u00f3<\/li>\n
                • Tr\u00e1nh ch\u1ea5n th\u01b0\u01a1ng v\u00f9ng gan<\/li>\n
                • Tr\u00e1nh ph\u1eabu thu\u1eadt, th\u1ee7 thu\u1eadt n\u1ebfu kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh c\u1ea5p c\u1ee9u. Trong v\u00e0 sau \u0111\u1ebb \u0111i\u1ec1u tr\u1ecb ch\u1ea3y m\u00e1u, chu\u1ea9n b\u1ecb h\u1ed3i s\u1ee9c v\u00e0 truy\u1ec1n m\u00e1u.<\/li>\n<\/ul>\n

                  4. Ph\u00f2ng b\u1ec7nh<\/h2>\n
                    \n
                  • S\u1eed d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p t\u00ecnh d\u1ee5c an to\u00e0n \u0111\u1ec3 ng\u0103n ch\u1eb7n c\u00e1c b\u1ec7nh l\u00e2y truy\u1ec1n qua \u0111\u01b0\u1eddng t\u00ecnh d\u1ee5c<\/li>\n
                  • Ph\u00e1t hi\u1ec7n s\u1edbm thai ph\u1ee5 c\u00f3 vi\u00eam gan \u0111\u1ec3 qu\u1ea3n l\u00fd v\u00e0 t\u01b0 v\u1ea5n khi c\u00f3 thai, trong khi \u0111\u1ebb, v\u00e0 sau \u0111\u1ebb. Khuy\u00ean kh\u00e1m l\u1ea1i chuy\u00ean khoa gan m\u1eadt sau \u0111\u1ebb 3 th\u00e1ng.<\/li>\n
                  • Ti\u00eam globulin mi\u1ec5n d\u1ecbch vi\u00eam gan B v\u00e0 vaccine cho tr\u1ebb s\u01a1 sinh, cho nh\u1eefng ng\u01b0\u1eddi ch\u0103m s\u00f3c.<\/li>\n<\/ul>\n

                    \"Vi\u00eam<\/p>\n

                    Vaccin vi\u00eam gan B: c\u00f3 2 lo\u1ea1i<\/p>\n

                    + Vaccin th\u1ebf h\u1ec7 1: s\u1ea3n xu\u1ea5t t\u1eeb kh\u00e1ng nguy\u00ean HbsAg c\u1ee7a virus trong huy\u1ebft thanh ng\u01b0\u1eddi b\u1ec7nh, m\u1ee9c \u0111\u1ed9 an to\u00e0n kh\u00f4ng cao, hi\u1ec7n nay \u00edt \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng.<\/p>\n

                    + Vaccin th\u1ebf h\u1ec7 2: l\u1ea5y gene t\u1eeb virus c\u1ea5y v\u00e0o n\u1ea5m men bia s\u1ebd cho m\u1ed9t s\u1ea3n ph\u1ea9m m\u1edbi gi\u1ed1ng virus (t\u00e1i t\u1ed5 h\u1ee3p ADN), \u0111\u1ed9 an to\u00e0n cao v\u00e0 hi\u1ec7u qu\u1ea3 t\u1ea1o mi\u1ec5n d\u1ecbch t\u1ed1t, \u0111ang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i<\/p>\n

                    + \u1ede nh\u1eefng n\u01a1i c\u00f3 d\u1ecbch t\u1ec5 h\u1ecdc vi\u00eam gan B cao, ng\u01b0\u1eddi nhi\u1ec5m virus vi\u00eam gan B cao th\u00ec khuy\u1ebfn kh\u00edch ti\u00eam vaccin vi\u00eam gan B cho t\u1ea5t c\u1ea3 c\u00e1c em b\u00e9 m\u00e0 m\u1eb9 kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n s\u00e0ng l\u1ecdc<\/p>\n

                    + Vaccin ph\u1ed1i h\u1ee3p v\u1edbi HBIg \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho t\u1ea5t c\u1ea3 con c\u1ee7a b\u00e0 m\u1eb9 mang virus vi\u00eam gan B<\/p>\n

                    Nhi\u1ec5m HBV c\u1ea5p t\u00ednh trong thai k\u1ef3 th\u01b0\u1eddng kh\u00f4ng nghi\u00eam tr\u1ecdng v\u00e0 kh\u00f4ng li\u00ean quan \u0111\u1ebfn t\u0103ng t\u1ef7 l\u1ec7 t\u1eed vong ho\u1eb7c qu\u00e1i thai.\u00a0\u0110i\u1ec1u tr\u1ecb ch\u1ee7 y\u1ebfu l\u00e0 h\u1ed7 tr\u1ee3.\u00a0Tuy nhi\u00ean, HBV c\u1ea5p t\u00ednh c\u00f3 li\u00ean quan \u0111\u1ebfn s\u1ef1 l\u00e2y truy\u1ec1n t\u1eeb m\u1eb9 sang con.\u00a0N\u1ebfu ng\u01b0\u1eddi m\u1eb9 v\u1eabn d\u01b0\u01a1ng t\u00ednh v\u1edbi kh\u00e1ng nguy\u00ean b\u1ec1 m\u1eb7t vi\u00eam gan B (HBsAg) ho\u1eb7c c\u00f3 DNA HBV c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c, tr\u1ebb s\u01a1 sinh n\u00ean \u0111\u01b0\u1ee3c ti\u00eam\u00a0globulin mi\u1ec5n d\u1ecbch vi\u00eam gan B\u00a0(HBIG) ngo\u00e0i vi\u1ec7c ti\u00eam ph\u00f2ng vi\u00eam gan B th\u00f4ng th\u01b0\u1eddng.\u00a0Li\u1ec7u ph\u00e1p kh\u00e1ng vi-r\u00fat cho ng\u01b0\u1eddi m\u1eb9 c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 l\u00e2y truy\u1ec1n.<\/p>\n

                    Ph\u1ee5 n\u1eef mang thai th\u01b0\u1eddng dung n\u1ea1p t\u1ed1t v\u1edbi HBV m\u00e3n t\u00ednh kh\u00f4ng m\u1eafc b\u1ec7nh gan ti\u1ebfn tri\u1ec3n. Tuy nhi\u00ean, nh\u1eefng b\u00e0 m\u1eb9 c\u00f3 HBsAg d\u01b0\u01a1ng t\u00ednh n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd trong th\u1eddi k\u1ef3 mang thai v\u00e0 sau khi sinh, v\u00ec nh\u1eefng ph\u1ee5 n\u1eef n\u00e0y c\u00f3 nguy c\u01a1 b\u00f9ng ph\u00e1t vi\u00eam gan. \u0110\u1ed1i v\u1edbi nh\u1eefng b\u00e0 m\u1eb9 b\u1ecb nhi\u1ec5m HBV m\u1ea1n t\u00ednh, t\u00e1c \u0111\u1ed9ng c\u1ee7a vi\u1ec7c nhi\u1ec5m HBV \u0111\u1ed1i v\u1edbi tr\u1ebb s\u01a1 sinh ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh r\u00f5 r\u00e0ng. \u00a0Tuy nhi\u00ean, ph\u1ee5 n\u1eef b\u1ecb x\u01a1 gan c\u00f3 nguy c\u01a1 cao b\u1ecb bi\u1ebfn ch\u1ee9ng chu sinh v\u00e0 k\u1ebft qu\u1ea3 x\u1ea5u cho m\u1eb9 v\u00e0 thai nhi, bao g\u1ed3m h\u1ea1n ch\u1ebf t\u0103ng tr\u01b0\u1edfng trong t\u1eed cung, nhi\u1ec5m tr\u00f9ng trong t\u1eed cung, sinh non v\u00e0 thai ch\u1ebft trong t\u1eed cung.<\/p>\n

                    Ng\u0103n ng\u1eeba l\u00e2y truy\u1ec1n t\u1eeb m\u1eb9 sang con: Tuy nhi\u00ean, ti\u00eam HBIG v\u00e0 v\u1eafc-xin vi\u00eam gan B cho tr\u1ebb s\u01a1 sinh khi sinh c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u s\u1ef1 l\u00e2y truy\u1ec1n \u00edt nh\u1ea5t 95 ph\u1ea7n tr\u0103m.<\/p>\n

                    Ngo\u00e0i vi\u1ec7c ch\u1ee7ng ng\u1eeba ch\u1ee7 \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng cho tr\u1ebb s\u01a1 sinh, li\u1ec7u ph\u00e1p kh\u00e1ng vi-r\u00fat cho ng\u01b0\u1eddi m\u1eb9 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 l\u00e2y truy\u1ec1n t\u1eeb m\u1eb9 sang con<\/p>\n","protected":false},"excerpt":{"rendered":"

                    Vi\u00eam gan virus l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m th\u01b0\u1eddng g\u1eb7p. Tr\u01b0\u1edbc \u0111\u00e2y ph\u00e2n l\u00e0m 2 lo\u1ea1i vi\u00eam gan do virus vi\u00eam gan A v\u00e0 B. Ng\u00e0y nay \u0111\u00e3 t\u00ecm ra 5 lo\u1ea1i vi\u00eam gan l\u00e0 A, B, C, D, E. Vi\u00eam gan do virus B, C, D th\u01b0\u1eddng g\u00e2y n\u00ean vi\u00eam gan m\u1ea1n t\u00ednh v\u00e0 x\u01a1 […]<\/p>\n","protected":false},"author":49,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[13,33],"tags":[],"yoast_head":"\nVi\u00eam gan B v\u00e0 thai ngh\u00e9n: Ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00f2ng b\u1ec7nh - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam gan virus l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m th\u01b0\u1eddng g\u1eb7p. Tr\u01b0\u1edbc \u0111\u00e2y ph\u00e2n l\u00e0m 2 lo\u1ea1i vi\u00eam gan do virus vi\u00eam gan A v\u00e0 B.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vi\u00eam gan B v\u00e0 thai ngh\u00e9n: Ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00f2ng b\u1ec7nh - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Vi\u00eam gan virus l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m th\u01b0\u1eddng g\u1eb7p. 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