{"id":31997,"date":"2023-05-05T22:19:51","date_gmt":"2023-05-05T15:19:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31997"},"modified":"2023-05-05T22:19:51","modified_gmt":"2023-05-05T15:19:51","slug":"tiep-can-tre-bi-sot-dinh-nghia-co-che-anh-huong-va-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/05\/tiep-can-tre-bi-sot-dinh-nghia-co-che-anh-huong-va-dieu-tri\/","title":{"rendered":"Ti\u1ebfp c\u1eadn tr\u1ebb b\u1ecb s\u1ed1t: \u0110\u1ecbnh ngh\u0129a, c\u01a1 ch\u1ebf, \u1ea3nh h\u01b0\u1edfng v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

S\u1ed1t l\u00e0 tri\u1ec7u ch\u1ee9ng r\u1ea5t ph\u1ed5 bi\u1ebfn \u1edf tr\u1ebb em v\u00e0 l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a nhi\u1ec1u b\u1ec7nh l\u00fd kh\u00e1c nhau, t\u1eeb nh\u1eb9 \u0111\u1ebfn nghi\u00eam tr\u1ecdng. Vi\u1ec7c ti\u1ebfp c\u1eadn tr\u1ebb b\u1ecb s\u1ed1t \u0111\u00fang c\u00e1ch r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u v\u1ec1 Ti\u1ebfp c\u1eadn tr\u1ebb b\u1ecb s\u1ed1t, bao g\u1ed3m c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y s\u1ed1t, c\u00e1ch \u0111o v\u00e0 ki\u1ec3m tra s\u1ed1t \u1edf tr\u1ebb em, nh\u1eefng d\u1ea5u hi\u1ec7u c\u1ea7n l\u01b0u \u00fd v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb s\u1ed1t hi\u1ec7u qu\u1ea3.<\/strong><\/p>\n

\"Ch\u0103m
\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Ch\u0103m s\u00f3c tr\u1ebb b\u1ecb s\u1ed1t | Vinmec<\/strong><\/figcaption><\/figure>\n

1. \u0110\u1ecbnh ngh\u0129a s\u1ed1t<\/strong><\/h2>\n

– S\u1ed1t khi th\u00e2n nhi\u1ec7t c\u01a1 th\u1ec3 v\u01b0\u1ee3t qu\u00e1 gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng, nhi\u1ec7t \u0111\u1ed9 \u1edf n\u00e1ch \u2265 37,5\u00baC (n\u00e1ch kh\u00f4 r\u00e1o) ho\u1eb7c \u1edf h\u1eadu m\u00f4n \u2265 38oC.
\n– Ph\u00e1t hi\u1ec7n tri\u1ec7u ch\u1ee9ng s\u1ed1t b\u1eb1ng c\u00e1ch h\u1ecfi b\u00e0 m\u1eb9, s\u1edd v\u00e0o ng\u1ef1c tr\u1ebb \u1edf v\u00f9ng n\u00e1ch ho\u1eb7c \u0111o nhi\u1ec7t \u0111\u1ed9 (\u0110\u1ed9 nh\u1ea1y 84%, \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 76%).<\/p>\n

– Ph\u00e2n \u0111\u1ed9 s\u1ed1t:<\/strong>
\no Tr\u1ebb s\u01a1 sinh kh\u1ecfe m\u1ea1nh (t\u1eeb 0 \u0111\u1ebfn 28-30 ng\u00e0y tu\u1ed5i) v\u00e0 tr\u1ebb t\u1eeb 1-3 th\u00e1ng tu\u1ed5i, s\u1ed1t khi nhi\u1ec7t \u0111\u1ed9 t\u1ea1i tr\u1ef1c tr\u00e0ng \u226538.0\u00baC (100.4\u00baF).
\no Tr\u1ebb t\u1eeb 3 -36 th\u00e1ng tu\u1ed5i, s\u1ed1t th\u01b0\u1eddng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh khi nhi\u1ec7t \u0111\u1ed9 tr\u1ef1c tr\u00e0ng \u226538 39\u00baC (100102\u00baF) v\u00e0 khi nhi\u1ec7t \u0111\u1ed9 tr\u1ef1c tr\u00e0ng \u226539.0\u00baC(102.2\u00baF) n\u1ebfu kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng tr\u00ean l\u00e2m s\u00e0ng.
\no \u1ede tr\u1ebb l\u1edbn h\u01a1n v\u00e0 ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, s\u1ed1t c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh khi nhi\u1ec7t \u0111\u1ed9 t\u1ea1i mi\u1ec7ng \u226537.8 – 39.4\u00baC (100 – 103\u00baF) v\u00e0 c\u00f3 t\u00ecnh tr\u1ea1ng c\u1ea7n quan t\u00e2m khi nhi\u1ec7t \u0111\u1ed9 t\u1ea1i mi\u1ec7ng \u226539.5\u00baC.<\/p>\n

2. C\u01a1 ch\u1ebf g\u00e2y s\u1ed1t<\/strong><\/h2>\n

a.Trung t\u00e2m \u0111i\u1ec1u h\u00f2a th\u00e2n nhi\u1ec7t:<\/strong>
\n– Trung t\u00e2m \u0111i\u1ec1u h\u00f2a th\u00e2n nhi\u1ec7t \u1edf v\u00f9ng tr\u01b0\u1edbc th\u1ecb c\u1ee7a v\u00f9ng d\u01b0\u1edbi \u0111\u1ed3i (hypothalamus), \u1edf v\u00f9ng n\u00e0y c\u00f3 nh\u1eefng neuron c\u00f3 ho\u1ea1t \u0111\u1ed9ng thay \u0111\u1ed5i li\u00ean t\u1ee5c \u0111\u1ed1i v\u1edbi s\u1ef1 thay \u0111\u1ed5i nhi\u1ec7t \u0111\u1ed9 (\u0111o b\u1eb1ng \u0111i\u1ec7n th\u1ebf ho\u1ea1t \u0111\u1ed9ng), \u0111\u00f3 l\u00e0 c\u00e1c t\u1ebf b\u00e0o kh\u1edfi ph\u00e1t c\u01a1 ch\u1ebf \u0111i\u1ec1u nhi\u1ec7t.
\n– \u0110i\u1ec3m nhi\u1ec7t (set point) l\u00e0 nhi\u1ec7t \u0111\u1ed9 m\u00e0 TT\u0110HTN ph\u1ea3i \u0111i\u1ec1u h\u00f2a gi\u1eefa hai qu\u00e1 tr\u00ecnh s\u1ea3n nhi\u1ec7t v\u00e0 th\u1ea3i nhi\u1ec7t, \u0111\u1ec3 th\u00e2n nhi\u1ec7t \u0111\u01b0\u1ee3c gi\u1eef \u1ed5n \u0111\u1ecbnh \u1edf nhi\u1ec7t \u0111\u1ed9 \u0111\u00f3.
\n– Khi m\u00e0 s\u1ea3n nhi\u1ec7t t\u0103ng, hay gi\u1ea3m th\u1ea3i nhi\u1ec7t ho\u1eb7c c\u1ea3 hai th\u00ec s\u1ebd g\u00e2y t\u0103ng th\u00e2n nhi\u1ec7t, bi\u1ec3u hi\u1ec7n l\u00e0 s\u1ed1t.<\/p>\n

b. \u0110i\u1ec1u h\u00f2a th\u00e2n nhi\u1ec7t:<\/strong><\/p>\n

C\u00e1c y\u1ebfu t\u1ed1 g\u00e2y s\u1ed1t c\u00f2n g\u1ecdi l\u00e0 ch\u1ea5t g\u00e2y s\u1ed1t ngo\u1ea1i sinh (exogenous pyrogen\/EP). Ng\u00e0y nay ng\u01b0\u1eddi ta bi\u1ebft r\u00f5 r\u1eb1ng c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y s\u1ed1t t\u00e1c \u0111\u1ed9ng l\u00ean t\u1ebf b\u00e0o th\u1ef1c b\u00e0o c\u00f3 ngu\u1ed3n g\u1ed1c t\u1ee7y x\u01b0\u01a1ng l\u00e0m s\u1ea3n xu\u1ea5t ra ch\u1ea5t g\u00e2y s\u1ed1t n\u1ed9i sinh (th\u01b0\u1eddng l\u00e0 IL1 V\u00e0 IL6). Ch\u1ea5t g\u00e2y s\u1ed1t n\u1ed9i sinh t\u00e1c \u0111\u1ed9ng l\u00ean trung t\u00e2m \u0111i\u1ec1u nhi\u1ec7t b\u1eb1ng c\u00e1ch g\u1eafn l\u00ean neuron c\u1ea3m nh\u1eadn nhi\u1ec7t \u0111\u1ed9 \u1edf v\u00f9ng tr\u01b0\u1edbc th\u1ecb \u1edf v\u00f9ng d\u01b0\u1edbi \u0111\u1ed3i l\u00e0m cho c\u00e1c t\u1ebf b\u00e0o n\u1ed9i m\u1ea1c c\u1ee7a m\u1ea1ch m\u00e1u t\u1ed5ng h\u1ee3p ra c\u00e1c s\u1ea3n ph\u1ea9m t\u1eeb Arachidonic acid l\u00e0 PGE2, g\u00e2y s\u1ef1 thay \u0111\u1ed5i h\u1ec7 th\u1ed1ng t\u00edn hi\u1ec7u th\u1ee9 hai l\u00e0 AMP v\u00f2ng (cAMP) l\u00e0m thay \u0111\u1ed5i \u0111i\u1ec3m \u0111i\u1ec1u nhi\u1ec7t g\u00e2y ra s\u1ed1t.
\n– Do ch\u1ee7ng ng\u1eeba
\n– Do c\u1ea3m n\u1eafng hay c\u00e1c ch\u1ee9ng c\u1ea3m th\u00f4ng th\u01b0\u1eddng.
\n– Do m\u1eb7c qu\u00e1 nhi\u1ec1u qu\u1ea7n \u00e1o
\n– B\u1ec7nh ung th\u01b0, huy\u1ebft thanh, b\u1ec7nh r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a.
\n– Do thu\u1ed1c: kh\u00e1ng sinh, adrenalin, cafein\u2026<\/p>\n

3. \u1ea2nh h\u01b0\u1edfng c\u1ee7a s\u1ed1t:<\/strong><\/h3>\n

a. C\u00f3 l\u1ee3i:<\/strong><\/p>\n

– T\u0103ng kh\u1ea3 n\u0103ng \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch: t\u0103ng sinh b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n trung t\u00ednh, t\u0103ng kh\u1ea3 n\u0103ng s\u1ea3n xu\u1ea5t kh\u00e1ng th\u1ec3, b\u1ed5 th\u1ec3.
\n– \u1ee8c ch\u1ebf sinh tr\u01b0\u1edfng c\u1ee7a vi khu\u1ea9n nh\u1edd t\u0103ng nhi\u1ec7t \u0111\u1ed9, gi\u1ea3m l\u01b0\u1ee3ng s\u0103t trong huy\u1ebft thanh.
\n– T\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho virus ti\u00eau h\u1ee7y lysosome g\u00e2y ch\u1ebft t\u1ebf b\u00e0o k\u00e9o theo s\u1ef1 ch\u1ebft c\u1ee7a virus \u0111\u1ed3ng th\u1eddi \u1ee9c ch\u1ebf kh\u00f4ng \u0111\u1eb7c hi\u1ec7u \u0111\u1ebfn s\u1ef1 t\u1ed5ng h\u1ee3p c\u1ee7a nhi\u1ec1u ch\u1ea5t v\u00e0 s\u1ef1 sinh tr\u01b0\u1edfng c\u1ee7a virut qua trung gian interferon
\n– T\u0103ng chuy\u1ec3n h\u00f3a t\u1ea1i gan: t\u0103ng chuy\u1ec3n h\u00f3a n\u0103ng l\u01b0\u1ee3ng, t\u0103ng kh\u1ea3 n\u0103ng ch\u1ed1ng \u0111\u1ed9c, kh\u1eed \u0111\u1ed9c\u2026
\n– Thay \u0111\u1ed5i n\u1ed9i ti\u1ebft: t\u0103ng thyroxin, adrenalin, noradrenain, cortisol\u2026<\/p>\n

b. C\u00f3 h\u1ea1i:<\/strong> X\u1ea3y ra khi s\u1ed1t cao k\u00e9o d\u00e0i, s\u1ed1t \u1edf nh\u1eefng c\u01a1 th\u1ec3 suy y\u1ebfu, suy dinh d\u01b0\u1ee1ng nh\u01b0:
\n– T\u0103ng ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn, shock
\n– M\u1ea5t n\u01b0\u1edbc, r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i qua m\u1ed3 h\u00f4i v\u00e0 t\u0103ng nh\u1ecbp th\u1edf
\n– C\u00f3 th\u1ec3 g\u00e2y co gi\u1eadt do s\u1ed1t
\n– \u0110\u1eafng mi\u1ec7ng, ch\u00e1n \u0103n, kh\u00f4 ni\u00eam m\u1ea1c, gi\u1ea3m ti\u1ebft d\u1ecbch v\u00e0 nhu \u0111\u1ed9ng \u1ed1ng ti\u00eau h\u00f3a
\n– Suy tim, ki\u1ec1m h\u00f4 h\u1ea5p
\n– S\u1ed1t cao g\u00e2y v\u1ee1 h\u1ed3ng c\u1ea7u g\u00e2y thi\u1ebfu m\u00e1u, t\u0103ng chuy\u1ec3n h\u00f3a g\u00e2y suy ki\u1ec7t<\/p>\n

4. \u0110i\u1ec1u tr\u1ecb<\/strong><\/h2>\n

4.1 Lau m\u00e1t:<\/strong><\/h3>\n

– C\u1edfi b\u1edbt qu\u1ea7n \u00e1o, cho tr\u1ebb m\u1eb7c \u0111\u1ed3 m\u1ecfng v\u00e0 r\u1ed9ng \u0111\u1ec3 d\u1ec5 tho\u00e1t nhi\u1ec7t.
\n– Cho tr\u1ebb n\u1eb1m \u1edf n\u01a1i tho\u00e1ng m\u00e1t, gi\u1ea3m nhi\u1ec7t trong ph\u00f2ng.
\n– Cho tr\u1ebb u\u1ed1ng nhi\u1ec1u n\u01b0\u1edbc.
\n– Cho tr\u1ebb d\u00f9ng thu\u1ed1c h\u1ea1 s\u1ed1t.
\n– Lau m\u00e1t cho tr\u1ebb b\u1eb1ng n\u01b0\u1edbc \u1ea5m.<\/p>\n

S\u1eed d\u1ee5ng 5 kh\u0103n \u01b0\u1edbt nh\u1ecf: 4 kh\u0103n \u0111\u1eb7t \u1edf hai b\u00ean n\u00e1ch v\u00e0 hai b\u00ean b\u1eb9n, 1 kh\u0103n d\u00f9ng \u0111\u1ec3 lau kh\u1eafp ng\u01b0\u1eddi. Thay m\u1ed7i 2-3 ph\u00fat. Ng\u01b0ng lau khi nhi\u1ec7t \u0111\u1ed9 b\u00e9 xu\u1ed1ng d\u01b0\u1edbi 38,50C ho\u1eb7c sau khi \u0111\u00e3 lau 30 ph\u00fat.<\/p>\n

Lau kh\u00f4 v\u00e0 cho b\u00e9 m\u1eb7c l\u1ea1i \u0111\u1ed3 m\u1ecfng. C\u00f3 th\u1ec3 t\u1eafm cho b\u00e9 b\u1eb1ng n\u01b0\u1edbc \u1ea5m. N\u00ean d\u00f9ng n\u01b0\u1edbc \u1ea5m c\u00f3 nhi\u1ec7t \u0111\u1ed9 th\u1ea5p <\/a>h\u01a1n 20 \u0111\u1ed9 C so v\u1edbi th\u00e2n nhi\u1ec7t tr\u1ebb.
\nKhi lau m\u00e1t l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb s\u1ed1t, \u0111\u1ec1 ngh\u1ecb lau m\u00e1t v\u1edbi \u0111\u1ed9 \u1ea5m th\u00edch h\u1ee3p. Lau m\u00e1t c\u00f3 hi\u1ec7u qu\u1ea3 h\u01a1n ng\u00e2m b\u1edfi v\u00ec bay h\u01a1i \u1edf da l\u00e0m t\u0103ng th\u00eam m\u1ea5t nhi\u1ec7t.<\/p>\n

M\u1eb7c d\u00f9 lau v\u1edbi n\u01b0\u1edbc l\u1ea1nh gi\u00fap gi\u1ea3m nhi\u1ec7t \u0111\u1ed9 c\u00f3 th\u1ec3 nhanh h\u01a1n, nh\u01b0ng \u0111\u1ed3ng th\u1eddi c\u0169ng g\u1eady kh\u00f3 ch\u1ecbu h\u01a1n.
\nR\u01b0\u1ee3u kh\u00f4ng n\u00ean \u0111\u01b0\u1ee3c d\u00f9ng v\u00ec khi n\u00f3 b\u1ed1c l\u00ean c\u00f3 th\u1ec3 h\u1ea5p thu qua m\u00e0ng ph\u1ebf nang ho\u1eb7c c\u00f3 th\u1ec3 xuy\u00ean qua da, g\u00e2y \u0111\u1ed9c h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng<\/p>\n

4.2 Paracetamol (Acetaminophen)<\/strong><\/h3>\n

Li\u1ec1u c\u1ee7a Acetaminophen l\u00e0 10-15 mg\/kg (max 800 mg-1 g) theo \u0111\u01b0\u1eddng u\u1ed1ng m\u1ed7i 4-6h (kh\u00f4ng qu\u00e1 5 li\u1ec1u\/24h) v\u1edbi li\u1ec1u t\u1ed1i \u0111a m\u1ed7i ng\u00e0y l\u00e0 75 mg\/kg m\u1ed7i ng\u00e0y cho t\u1edbi 4 g\/ng\u00e0y (v\u00e0i c\u00f4ng th\u1ee9c \u0111\u1ec1 ngh\u1ecb v\u1edbi li\u1ec1u t\u1ed1i \u0111a tr\u00ean ng\u00e0y th\u1ea5p h\u01a1n).
\nX\u1ea5p x\u1ec9 80% tr\u1ebb s\u1ed1t \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi Acetaminophen gi\u1ea3m kho\u1ea3n 1-2\u00b0C (1.8 to 3.6\u00b0F). Acetaminophen b\u1eaft \u0111\u1ea7u hi\u1ec7u qu\u1ea3 sau 30-60 ph\u00fat v\u00e0 \u0111\u1eb7t \u0111\u1ec9nh sau 3-4h. Th\u1eddi gian t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i 4-6h<\/p>\n

4.3 Ibupropen<\/strong><\/h3>\n
    \n
  • Ibuprofen \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb nh\u01b0 l\u00e0 thu\u1ed1c h\u1ea1 s\u1ed1t ban \u0111\u1ea7u khi c\u1ea7n ch\u1ec9 \u0111\u1ecbnh gi\u1ea3m vi\u00eam v\u00e0 h\u1ea1 s\u1ed1t (vd tr\u1ebb b\u1ecb vi\u00eam kh\u1edbp thi\u1ebfu ni\u00ean). Li\u1ec1u c\u1ee7a Ibuprofen l\u00e0 10 mg\/kg (max li\u1ec1u 600 mg) theo \u0111\u01b0\u1eddng mi\u1ec7ng m\u1ed7i 6h v\u1edbi li\u1ec1u t\u1ed1i \u0111a m\u1ed7i ng\u00e0y l\u00e0 40 mg\/kg cho t\u01a1i 2,4 g\/ng\u00e0y.<\/li>\n
  • Ibuprofen b\u1eaft \u0111\u1ea7u hi\u1ec7u qu\u1ea3 trong <60 ph\u00fat v\u00e0 \u0111\u1ea1t \u0111\u1ec9nh (gi\u1ea3m nhi\u1ec7t \u0111\u1ed9 t\u1eeb 1-2\u00b0C [1.8 to 3.6\u00b0F]) trong kho\u1ea3n 3-4h. Th\u1eddi gian t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i 6-8h.<\/li>\n
  • Ibuprofen th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh v\u1edbi tr\u1ebb <6 th\u00e1ng. V\u1edbi tr\u1ebb gi\u1edbi h\u1ea1n ch\u1ee9c n\u0103ng th\u1eadn tr\u00ean tr\u1ebb nh\u0169 nhi v\u00e0 tr\u1ebb nh\u1ecf v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m t\u0103ng nguy c\u01a1 ng\u1ed9 \u0111\u1ed9c th\u1eadn. T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a Ibuprofen c\u00f3 th\u1ec3 bao g\u1ed3m vi\u00eam d\u1ea1 d\u00e0y v\u00e0 xu\u1ea5t huy\u1ebft d\u1ea1 d\u00e0y.<\/li>\n<\/ul>\n

    Note: kh\u00f4ng \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p hay xen k\u1ebd gi\u1eefa acetaminophen v\u00e0 ibuprofen \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb s\u1ed1t tr\u00ean tr\u1ebb. M\u1eb7c d\u00f9 ph\u1ed3i h\u1ee3p ho\u1eb7c xen k\u1ebd 2 lo\u1ea1i thu\u1ed1c c\u00f3 th\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng h\u01a1n so v\u1edbi s\u1eed d\u1ee5ng \u0111\u01a1n \u0111\u1ed9c trong vi\u1ec7c gi\u1ea3m s\u1ed1t nh\u01b0ng ch\u01b0a r\u00f5 r\u00e0ng r\u1eb1ng \u0111\u00e2y l\u00e0 gi\u1ea3m l\u00e2m s\u00e0ng. B\u00ean c\u1ea1nh c\u00f3 \u00edt th\u00f4ng tin v\u1ec1 \u1ea3nh h\u01b0\u1edfng g\u00e2y kh\u00f3 ch\u1ecbu cho tr\u1ebb ho\u1eb7c \u0111\u1ed9 an to\u00e0n c\u1ee7a s\u1eed d\u1ee5ng ph\u1ed1i h\u1ee3p ho\u1eb7c xen k\u1ebd trong \u0111i\u1ec1u tr\u1ecb h\u1ea1 s\u1ed1t v\u00e0 theo l\u00fd thuy\u1ebft c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan ho\u1eb7c th\u1eadn.<\/p>\n

    4.4 Nh\u1eadp vi\u1ec7n khi:<\/strong><\/h3>\n

    – Tr\u1ebb < 2 th\u00e1ng tu\u1ed5i, c\u00f3 nhi\u1ec7t \u0111\u1ed9 \u2265 380C b\u1ea5t k\u1ec3 c\u00f3 tri\u1ec7u ch\u1ee9ng g\u00ec kh\u00e1c hay kh\u00f4ng
    \n– Tr\u1ebb \u2265 2 th\u00e1ng: khi c\u00f3 d\u1ea5u hi\u1ec7u sau: kh\u00f4ng th\u1ec3 u\u1ed1ng \u0111\u01b0\u1ee3c ho\u1eb7c b\u1ecf b\u00fa, n\u00f4n \u00f3i t\u1ea5t c\u1ea3 m\u1ecdi th\u1ee9, co gi\u1eadt, li b\u00ec kh\u00f3 \u0111\u00e1nh th\u1ee9c, c\u1ed5 g\u01b0\u1ee3ng, th\u00f3p ph\u1ed3ng, s\u1ed1c, d\u1ea5u hi\u1ec7u xu\u1ea5t huy\u1ebft da ni\u00eam m\u1ea1c<\/p>\n

    Ngu\u1ed3n tham kh\u1ea3o<\/strong><\/p>\n

      \n
    • Gi\u00e1o tr\u00ecnh \u0111\u1ea1i h\u1ecdc nhi khoa \u2013 \u0110\u1ea1i h\u1ecdc y d\u01b0\u1ee3c Hu\u1ebf t\u1eadp 1,2.<\/li>\n
    • Gi\u00e1o tr\u00ecnh \u0111\u1ea1i h\u1ecdc nhi khoa \u2013 \u0110\u1ea1i h\u1ecdc y d\u01b0\u1ee3c TP HCM t\u1eadp 1,2.<\/li>\n
    • Fever without a source in children 3 to 36 months of age – Coburn H Allen, MD.<\/li>\n
    • Fever in Children: Pearls and Pitfalls – Egidio Barbi, Pierluigi Marzuillo, Elena Neri, Samuele Naviglio, and Baruch S. Krauss, Sari A. Acra, Academic Editor .<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

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