{"id":32844,"date":"2023-05-13T14:43:36","date_gmt":"2023-05-13T07:43:36","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32844"},"modified":"2023-05-13T14:43:36","modified_gmt":"2023-05-13T07:43:36","slug":"benh-cum-mua","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/13\/benh-cum-mua\/","title":{"rendered":"B\u1ec7nh c\u00fam m\u00f9a: Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

B\u1ec7nh c\u00fam m\u00f9a l\u00e0 m\u1ed9t b\u1ec7nh l\u00e2y nhi\u1ec5m ph\u1ed5 bi\u1ebfn do virus c\u00fam g\u00e2y ra. B\u1ec7nh th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n v\u00e0o m\u00f9a \u0111\u00f4ng v\u00e0 xu\u00e2n, v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 s\u1ed1t, \u0111au \u0111\u1ea7u, \u0111au h\u1ecdng, m\u1ec7t m\u1ecfi v\u00e0 \u0111au c\u01a1. C\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 k\u00e9o d\u00e0i t\u1eeb v\u00e0i ng\u00e0y \u0111\u1ebfn m\u1ed9t v\u00e0i tu\u1ea7n v\u00e0 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe v\u00e0 ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh<\/strong>.<\/p>\n

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

C\u00fam m\u00f9a l\u00e0 m\u1ed9t b\u1ec7nh nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh do virus c\u00fam g\u00e2y n\u00ean. B\u1ec7nh x\u1ea3y ra h\u00e0ng n\u0103m, th\u01b0\u1eddng v\u00e0o m\u00f9a \u0111\u00f4ng xu\u00e2n. B\u1ec7nh l\u00e2y nhi\u1ec5m tr\u1ef1c ti\u1ebfp t\u1eeb ng\u01b0\u1eddi b\u1ec7nh sang ng\u01b0\u1eddi l\u00e0nh th\u00f4ng qua c\u00e1c gi\u1ecdt b\u1eafn nh\u1ecf khi n\u00f3i chuy\u1ec7n, khi ho, h\u1eaft h\u01a1i. T\u1ea1i Vi\u1ec7t Nam, c\u00e1c virus g\u00e2y b\u1ec7nh c\u00fam m\u00f9a th\u01b0\u1eddng g\u1eb7p l\u00e0 c\u00fam A\/H3N2, A\/H1N1 v\u00e0 c\u00fam B.<\/p>\n

B\u1ec7nh c\u00fam m\u00f9a ti\u1ebfn tri\u1ec3n th\u01b0\u1eddng l\u00e0nh t\u00ednh, nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 bi\u1ebfn ch\u1ee9ng n\u1eb7ng v\u00e0 nguy hi\u1ec3m h\u01a1n \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 b\u1ec7nh l\u00fd m\u1ea1n t\u00ednh v\u1ec1 tim m\u1ea1ch v\u00e0 h\u00f4 h\u1ea5p, ng\u01b0\u1eddi b\u1ecb suy gi\u1ea3m mi\u1ec5n d\u1ecbch, ng\u01b0\u1eddi gi\u00e0 (> 65 tu\u1ed5i), tr\u1ebb em (< 5 tu\u1ed5i) v\u00e0 ph\u1ee5 n\u1eef c\u00f3 thai. D\u00f9 \u0111a s\u1ed1 l\u00e0nh t\u00ednh, nh\u01b0ng do s\u1ed1 ng\u01b0\u1eddi m\u1eafc nhi\u1ec1u, s\u1ed1 t\u1eed vong do c\u00fam \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 bi\u1ebfn ch\u1ee9ng cao m\u1ed9t c\u00e1ch kh\u00f4ng ng\u1edd. C\u1ea7n ph\u00e2n bi\u1ec7t c\u00fam m\u00f9a H1N1 v\u1edbi c\u00fam \u0111\u1ea1i d\u1ecbch A\/H1N1\/2009 (t\u00ean \u0111\u1ea7y \u0111\u1ee7 l\u00e0 PBA9 H1N1) l\u00e0 ch\u1ee7ng virus c\u00fam m\u1edbi lai t\u1ea1o gi\u1eefa virus c\u00fam l\u1ee3n, virus c\u00fam chim v\u00e0 virus c\u00fam ng\u01b0\u1eddi. B\u1ec7nh c\u00f3 th\u1ec3 g\u00e2y vi\u00eam ph\u1ed5i n\u1eb7ng, suy \u0111a ph\u1ee7 t\u1ea1ng d\u1eabn \u0111\u1ebfn t\u1eed vong.<\/p>\n

\"\"
\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Ngu\u1ed3n: Flu (Influenza) – National Foundation Infectious disease<\/strong><\/figcaption><\/figure>\n

2. T\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh<\/strong><\/h2>\n

Virus g\u00e2y b\u1ec7nh c\u00fam l\u00e0 Myxovirus influenzae, thu\u1ed9c h\u1ecd Orthomyxoviridae, c\u00f3 ch\u1ee9a ARN, s\u1ee3i \u0111\u01a1n, xo\u1eafn \u0111\u1ed1i x\u1ee9ng, v\u1ecf ngo\u00e0i \u0111\u1ec3 l\u1ed9 ra hai kh\u00e1ng nguy\u00ean glycoprotein l\u00e0 neuraminidase (NA) v\u00e0 hemagglutinine (HA1-HA2). Kh\u00e1ng nguy\u00ean H v\u00e0 N c\u1ee7a virus c\u00fam A th\u01b0\u1eddng xuy\u00ean bi\u1ebfn \u0111\u1ed5i theo th\u1eddi gian, n\u1ebfu bi\u1ebfn \u0111\u1ed5i \u00edt g\u1ecdi l\u00e0 d\u1eddi kh\u00e1ng nguy\u00ean (draft), bi\u1ebfn \u0111\u1ed5i nhi\u1ec1u l\u00e0 chuy\u1ec3n kh\u00e1ng nguy\u00ean (shift). \u0110i\u1ec1u n\u00e0y gi\u1ea3i th\u00edch nh\u1eefng v\u1ee5 \u0111\u1ea1i d\u1ecbch, ng\u01b0\u1eddi m\u1eafc \u0111\u1ee3t tr\u01b0\u1edbc v\u1eabn c\u00f3 th\u1ec3 m\u1eafc \u0111\u1ee3t sau, v\u00e0 vaccin kh\u00f3 c\u00f3 hi\u1ec7u qu\u1ea3.<\/p>\n

Kh\u00e1ng nguy\u00ean H c\u00f3 t\u1eeb H1 \u0111\u1ebfn H15, N c\u00f3 t\u1eeb N1 \u0111\u1ebfn N9. Trong \u0111\u00f3 t\u1ed5 h\u1ee3p c\u00e1c virus c\u00fam c\u00f3 H t\u1eeb H1 \u0111\u1ebfn H3 v\u00e0 N t\u1eeb N1 \u0111\u1ebfn N3 l\u00e0 nh\u1eefng virus g\u00e2y c\u00fam cho ng\u01b0\u1eddi (H1N1, H2N1, H3N1\u2026) T\u1eeb H5 \u0111\u1ebfn H9 th\u01b0\u1eddng g\u00e2y b\u1ec7nh cho lo\u00e0i chim.<\/p>\n

C\u00f3 th\u1ec3 c\u00f3 t\u00ecnh tr\u1ea1ng lai t\u1ea1o gi\u1eefa c\u00fam ng\u01b0\u1eddi, c\u00fam chim v\u00e0 c\u00fam c\u1ee7a c\u00e1c \u0111\u1ed9ng v\u1eadt (nh\u01b0 l\u1ee3n) t\u1ea1o th\u00e0nh nh\u1eefng ch\u1ee7ng c\u00fam m\u1edbi g\u00e2y b\u1ec7nh cho ng\u01b0\u1eddi (v\u00ed d\u1ee5 c\u00fam PBA9 H1N1 x\u1ea3y ra n\u0103m 2009 \u1edf Mehico lan sang Hoa K\u1ef3.<\/p>\n

\u0110\u1eb7c t\u00ednh kh\u00e1ng nguy\u00ean cho ph\u00e9p ph\u00e2n virus c\u00fam th\u00e0nh 3 lo\u1ea1i ch\u00ednh: A, B, C, kh\u00e1c nhau ho\u00e0n to\u00e0n v\u1ec1 t\u00ednh kh\u00e1ng nguy\u00ean (kh\u00f4ng c\u00f3 mi\u1ec5n d\u1ecbch ch\u00e9o). D\u1ecbch g\u00e2y ra b\u1edfi virus c\u00fam A, c\u00f3 chu k\u1ef3 kho\u1ea3ng 2-3 n\u0103m, t\u1ea1o ra c\u00e1c v\u1ee5 d\u1ecbch lan r\u1ed9ng, \u0111\u1eb7c tr\u01b0ng b\u1eb1ng t\u1ef7 l\u1ec7 t\u1eed vong cao, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf ng\u01b0\u1eddi gi\u00e0. D\u1ecbch g\u00e2y ra do virus c\u00fam B c\u00f3 chu k\u1ef3 d\u00e0i h\u01a1n 5-6 n\u0103m, d\u1ecbch th\u01b0\u1eddng khu tr\u00fa h\u01a1n, \u00edt nghi\u00eam tr\u1ecdng h\u01a1n nh\u01b0ng \u0111\u00f4i khi c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi d\u1ecbch do c\u00fam A g\u00e2y ra. Virus c\u00fam C c\u00f3 th\u1ec3 g\u00e2y d\u1ecbch m\u1ed9t m\u00ecnh ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi d\u1ecbch c\u00fam A ho\u1eb7c l\u00e0 m\u1ed9t s\u1ed1 ca b\u1ec7nh l\u1ebb t\u1ebb. C\u00e1c ch\u1ee7ng \u0111\u01b0\u1ee3c \u0111\u1eb7t t\u00ean d\u1ef1a theo: typ kh\u00e1ng nguy\u00ean, ngu\u1ed3n g\u1ed1c v\u1eadt ch\u1ee7 n\u1ebfu kh\u00f4ng ph\u1ea3i l\u00e0 ng\u01b0\u1eddi, ngu\u1ed3n g\u1ed1c \u0111\u1ecba l\u00fd, m\u00e3 s\u1ed1 ch\u1ee7ng, n\u0103m ph\u00e2n l\u1eadp virus.<\/p>\n

3. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh c\u00fam m\u00f9a<\/strong><\/h2>\n

3.1. L\u00e2m s\u00e0ng<\/strong><\/h3>\n

S\u1ed1t (th\u01b0\u1eddng tr\u00ean 38 \u0111\u1ed9 C), \u0111au nh\u1ee9c c\u01a1 to\u00e0n th\u00e2n v\u00e0 c\u00f3 m\u1ed9t trong s\u1ed1 c\u00e1c bi\u1ec3u hi\u1ec7n v\u1ec1 h\u00f4 h\u1ea5p nh\u01b0 \u0111au h\u1ecdng, h\u1eaft h\u01a1i, ng\u1ea1t m\u0169i, ch\u1ea3y n\u01b0\u1edbc m\u0169i, ho, kh\u00f3 th\u1edf.<\/p>\n

H\u00ecnh \u1ea3nh ch\u1ee5p XQ ph\u1ed5i b\u00ecnh th\u01b0\u1eddng ho\u1eb7c c\u00f3 t\u1ed5n th\u01b0\u01a1ng th\u00e2m nhi\u1ec5m lan t\u1ecfa \u1edf ph\u1ed5i.<\/p>\n

\"\"
\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Ngu\u1ed3n: Influenza – BMJ 2016<\/strong><\/figcaption><\/figure>\n

3.2. X\u00e9t nghi\u1ec7m <\/strong><\/h3>\n

C\u00f4ng th\u1ee9c m\u00e1u b\u1ea1ch c\u1ea7u b\u00ecnh th\u01b0\u1eddng ho\u1eb7c gi\u1ea3m.<\/p>\n

3.3. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh <\/strong>b\u1ec7nh c\u00fam m\u00f9a<\/strong><\/h3>\n

C\u00f3 y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5: s\u1ed1ng ho\u1eb7c \u0111\u1ebfn t\u1eeb khu v\u1ef1c c\u00f3 b\u1ec7nh c\u00fam l\u01b0u h\u00e0nh ho\u1eb7c c\u00f3 ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi ng\u01b0\u1eddi b\u1ec7nh c\u00fam.<\/p>\n

L\u00e2m s\u00e0ng: c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 n\u00eau tr\u00ean.<\/p>\n

X\u00e9t nghi\u1ec7m d\u01b0\u01a1ng t\u00ednh v\u1edbi virus c\u00fam b\u1eb1ng k\u1ef9 thu\u1eadt RT-PCR ho\u1eb7c real time<\/p>\n

RT-PCR ho\u1eb7c nu\u00f4i c\u1ea5y virus \u0111\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh ph\u1ea9m l\u00e0 d\u1ecbch ngo\u00e1y h\u1ecdng, d\u1ecbch t\u1ef5 h\u1ea7u, d\u1ecbch ph\u1ebf qu\u1ea3n.<\/p>\n

3.4. Ch\u1ea9n \u0111o\u00e1n m\u1ee9c \u0111\u1ed9 b\u1ec7nh <\/strong>c\u00fam m\u00f9a<\/strong><\/h3>\n

3.4.1. C\u00fam ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng (c\u00fam nh\u1eb9)<\/strong><\/p>\n

L\u00e2m s\u00e0ng c\u00f3 bi\u1ec3u hi\u1ec7n h\u1ed9i ch\u1ee9ng c\u00fam \u0111\u01a1n thu\u1ea7n.<\/p>\n

3.4.2. C\u00fam c\u00f3 bi\u1ebfn ch\u1ee9ng (c\u00fam n\u1eb7ng)<\/strong><\/p>\n

L\u00e0 ca b\u1ec7nh c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng nh\u01b0 tr\u00ean ho\u1eb7c ca b\u1ec7nh \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh k\u00e8m theo m\u1ed9t trong c\u00e1c bi\u1ec3u hi\u1ec7n sau:<\/p>\n

C\u00f3 t\u1ed5n th\u01b0\u01a1ng \u1edf ph\u1ed5i v\u1edbi bi\u1ec3u hi\u1ec7n suy h\u00f4 h\u1ea5p tr\u00ean l\u00e2m s\u00e0ng (th\u1edf nhanh, kh\u00f3 th\u1edf, SpO2 gi\u1ea3m, PaO2 gi\u1ea3m) v\u00e0\/ho\u1eb7c:<\/p>\n

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  • C\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng th\u1ee9 ph\u00e1t nh\u01b0 vi\u00eam xoang, vi\u00eam ph\u1ed5i do b\u1ed9i nhi\u1ec5m vi khu\u1ea9n, s\u1ed1c nhi\u1ec5m khu\u1ea9n, suy \u0111a ph\u1ee7 t\u1ea1ng.<\/li>\n
  • C\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u n\u1eb7ng l\u00ean c\u1ee7a c\u00e1c b\u1ec7nh l\u00fd m\u1ea1n t\u00ednh k\u00e8m theo (b\u1ec7nh ph\u1ed5i, b\u1ec7nh gan, suy th\u1eadn, ti\u1ec3u \u0111\u01b0\u1eddng, b\u1ec7nh tim m\u1ea1ch, b\u1ec7nh v\u1ec1 m\u00e1u).<\/li>\n<\/ul>\n

    C\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng nguy c\u01a1 d\u1ec5 m\u1eafc c\u00fam bi\u1ebfn ch\u1ee9ng bao g\u1ed3m:<\/p>\n

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    • Tr\u1ebb em: d\u01b0\u1edbi 5 tu\u1ed5i, suy dinh d\u01b0\u1ee1ng, b\u00e9o ph\u00ec, hen ph\u1ebf qu\u1ea3n ho\u1eb7c b\u1ecb suy gi\u1ea3m mi\u1ec5n d\u1ecbch b\u1ea9m sinh hay m\u1eafc ph\u1ea3i.<\/li>\n
    • Ng\u01b0\u1eddi gi\u00e0 tr\u00ean 65 tu\u1ed5i.<\/li>\n
    • Ph\u1ee5 n\u1eef c\u00f3 thai.<\/li>\n
    • Ng\u01b0\u1eddi l\u1edbn m\u1eafc c\u00e1c b\u1ec7nh m\u1ea1n t\u00ednh.<\/li>\n
    • Suy gi\u1ea3m mi\u1ec5n d\u1ecbch (ng\u01b0\u1eddi b\u1ec7nh \u0111ang \u0111i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng ung th\u01b0, HIV\/AIDS).<\/li>\n<\/ul>\n

      3.5. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/h3>\n

      Nhi\u1ec5m c\u00e1c lo\u1ea1i virus kh\u00e1c (nh\u01b0 Parainfluenza, Adenovirus, virus h\u1ee3p b\u00e0o h\u00f4 h\u1ea5p, Coronavirus, Enterovirus).<\/p>\n

      Nhi\u1ec5m c\u00e1c vi khu\u1ea9n n\u1ed9i b\u00e0o (nh\u01b0 Mycoplasma, Chlamydiae, Coxiella).<\/p>\n

      B\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng \u0111\u1ec1u gi\u1ed1ng nh\u01b0 c\u00fam (h\u1ed9i ch\u1ee9ng c\u00fam). Ch\u1ec9 c\u00f3 x\u00e9t nghi\u1ec7m sinh h\u1ecdc m\u1edbi c\u00f3 gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh.<\/p>\n

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

      4.1. Nguy\u00ean t\u1eafc chung<\/strong><\/h3>\n

      Ng\u01b0\u1eddi b\u1ec7nh nghi ng\u1edd nhi\u1ec5m c\u00fam ho\u1eb7c \u0111\u00e3 x\u00e1c \u0111\u1ecbnh nhi\u1ec5m c\u00fam ph\u1ea3i \u0111\u01b0\u1ee3c c\u00e1ch ly y t\u1ebf v\u00e0 th\u00f4ng b\u00e1o k\u1ecbp th\u1eddi cho c\u01a1 quan y t\u1ebf d\u1ef1 ph\u00f2ng.<\/p>\n

      Nhanh ch\u00f3ng \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh v\u00e0 ph\u00e2n lo\u1ea1i m\u1ee9c \u0111\u1ed9 b\u1ec7nh. C\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh n\u1eb7ng ho\u1eb7c c\u00f3 bi\u1ebfn ch\u1ee9ng n\u1eb7ng c\u1ea7n k\u1ebft h\u1ee3p c\u00e1c bi\u1ec7n ph\u00e1p h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u0103n nguy\u00ean.<\/p>\n

      Thu\u1ed1c kh\u00e1ng virus \u0111\u01b0\u1ee3c d\u00f9ng c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh.<\/p>\n

      \u01afu ti\u00ean \u0111i\u1ec1u tr\u1ecb t\u1ea1i ch\u1ed7, n\u1ebfu \u0111i\u1ec1u ki\u1ec7n c\u01a1 s\u1edf \u0111i\u1ec1u tr\u1ecb cho ph\u00e9p n\u00ean h\u1ea1n ch\u1ebf chuy\u1ec3n tuy\u1ebfn.<\/p>\n

      4.2. X\u1eed tr\u00ed theo m\u1ee9c \u0111\u1ed9 b\u1ec7nh<\/strong><\/h3>\n
        \n
      • C\u00fam c\u00f3 bi\u1ebfn ch\u1ee9ng<\/strong>: c\u1ea7n \u0111\u01b0\u1ee3c nh\u1eadp vi\u1ec7n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb v\u00e0 d\u00f9ng thu\u1ed1c kh\u00e1ng virus c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t.<\/li>\n
      • C\u00fam c\u00f3 k\u00e8m theo c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1<\/strong>: n\u00ean \u0111\u01b0\u1ee3c nh\u1eadp vi\u1ec7n \u0111\u1ec3 theo d\u00f5i v\u00e0 xem x\u00e9t \u0111i\u1ec1u tr\u1ecb s\u1edbm thu\u1ed1c kh\u00e1ng virus.<\/li>\n
      • C\u00fam ch\u01b0a bi\u1ebfn ch\u1ee9ng<\/strong>: c\u00f3 th\u1ec3 kh\u00f4ng c\u1ea7n x\u00e9t nghi\u1ec7m ho\u1eb7c \u0111i\u1ec1u tr\u1ecb c\u00fam t\u1ea1i c\u01a1 s\u1edf y t\u1ebf n\u1ebfu bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng nh\u1eb9. N\u1ebfu tri\u1ec7u ch\u1ee9ng n\u1eb7ng l\u00ean ho\u1eb7c ng\u01b0\u1eddi b\u1ec7nh lo l\u1eafng v\u1ec1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe n\u00ean \u0111\u1ebfn c\u01a1 s\u1edf y t\u1ebf \u0111\u1ec3 \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u00e0 ch\u0103m s\u00f3c.<\/li>\n<\/ul>\n

        4.3. \u0110i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00e1ng virus<\/strong><\/h3>\n

        Ch\u1ec9 \u0111\u1ecbnh<\/strong>: c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m c\u00fam A ho\u1eb7c B (nghi ng\u1edd ho\u1eb7c x\u00e1c \u0111\u1ecbnh) c\u00f3 bi\u1ebfn ch\u1ee9ng ho\u1eb7c c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1.<\/p>\n

        Thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng hi\u1ec7n nay l\u00e0 oseltamivir ho\u1eb7c\/v\u00e0 zanamivir.<\/p>\n

        Li\u1ec1u l\u01b0\u1ee3ng oseltamivir \u0111\u01b0\u1ee3c t\u00ednh theo l\u1ee9a tu\u1ed5i v\u00e0 c\u00e2n n\u1eb7ng. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb l\u00e0 5 ng\u00e0y.<\/p>\n

        Ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em > 13 tu\u1ed5i<\/strong>: 75 mg x 2 l\u1ea7n\/ng\u00e0y.<\/p>\n

        Tr\u1ebb em \u2265 12 th\u00e1ng \u0111\u1ebfn \u2264 13 tu\u1ed5i<\/strong>:<\/p>\n

          \n
        • C\u00e2n n\u1eb7ng \u2264 15 kg: 30 mg x 2 l\u1ea7n\/ng\u00e0y.<\/li>\n
        • C\u00e2n n\u1eb7ng > 15 kg \u0111\u1ebfn 23 kg: 45 mg x 2 l\u1ea7n\/ng\u00e0y.<\/li>\n
        • C\u00e2n n\u1eb7ng > 23 kg \u0111\u1ebfn 40 kg 60 mg x 2 l\u1ea7n\/ng\u00e0y.<\/li>\n
        • C\u00e2n n\u1eb7ng > 40 kg 75 mg x 2 l\u1ea7n\/ng\u00e0y.<\/li>\n<\/ul>\n

          Tr\u1ebb < 12 th\u00e1ng tu\u1ed5i: <\/strong><\/p>\n

            \n
          • th\u00e1ng 2 mg\/kg x 2 l\u1ea7n\/ng\u00e0y.<\/li>\n
          • 1-3 th\u00e1ng 2,5 mg\/kg x 2 l\u1ea7n\/ng\u00e0y.<\/li>\n
          • 3-12 th\u00e1ng 3 mg\/kg x 2 l\u1ea7n\/ng\u00e0y.<\/li>\n<\/ul>\n

            Zanamivir<\/strong>: d\u1ea1ng h\u00edt \u0111\u1ecbnh li\u1ec1u, s\u1eed d\u1ee5ng trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 oseltamivir, ch\u1eadm \u0111\u00e1p \u1ee9ng ho\u1eb7c kh\u00e1ng v\u1edbi oseltamivir. Li\u1ec1u l\u01b0\u1ee3ng zanamivir \u0111\u01b0\u1ee3c t\u00ednh nh\u01b0 sau:<\/p>\n

              \n
            • Ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em > 7 tu\u1ed5i<\/strong>: 10 mg (2 l\u1ea7n h\u00edt 5-mg) x 2 l\u1ea7n\/ng\u00e0y.<\/li>\n
            • Tr\u1ebb em t\u1eeb 5 – 7 tu\u1ed5i<\/strong>: 10 mg (2 l\u1ea7n h\u00edt 5-mg) x 1 l\u1ea7n\/ng\u00e0y.<\/li>\n<\/ul>\n

              4.4. \u0110i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng <\/strong>b\u1ec7nh c\u00fam m\u00f9a<\/strong><\/h3>\n

              H\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p khi c\u00f3 suy h\u00f4 h\u1ea5p: th\u1edf oxy, th\u1edf CPAP ho\u1eb7c th\u00f4ng kh\u00ed nh\u00e2n t\u1ea1o t\u00f9y t\u1eebng tr\u01b0\u1eddng h\u1ee3p.<\/p>\n

              Ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1edbm c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ed9i nhi\u1ec5m vi khu\u1ea9n v\u1edbi kh\u00e1ng sinh th\u00edch h\u1ee3p.<\/p>\n

              Ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb suy \u0111a ph\u1ee7 t\u1ea1ng.<\/p>\n

              4.5. \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3<\/strong><\/h3>\n

              H\u1ea1 s\u1ed1t: ch\u1ec9 d\u00f9ng paracetamol khi s\u1ed1t tr\u00ean 38.5 \u0111\u1ed9 C, kh\u00f4ng d\u00f9ng thu\u1ed1c nh\u00f3m salicylate nh\u01b0 aspirin \u0111\u1ec3 h\u1ea1 s\u1ed1t.<\/p>\n

              \u0110\u1ea3m b\u1ea3o c\u00e2n b\u1eb1ng n\u01b0\u1edbc \u0111i\u1ec7n gi\u1ea3i.<\/p>\n

              \u0110\u1ea3m b\u1ea3o ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng h\u1ee3p l\u00fd.<\/p>\n

              4.6. Ti\u00eau chu\u1ea9n ra vi\u1ec7n<\/strong><\/h3>\n

              H\u1ebft s\u1ed1t v\u00e0 h\u1ebft c\u00e1c tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p tr\u00ean 48 gi\u1edd (tr\u1eeb ho).<\/p>\n

              T\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng \u1ed5n \u0111\u1ecbnh.<\/p>\n

              Sau khi ra vi\u1ec7n ph\u1ea3i c\u00e1ch ly y t\u1ebf t\u1ea1i nh\u00e0 cho \u0111\u1ebfn h\u1ebft 7 ng\u00e0y t\u00ednh t\u1eeb khi kh\u1edfi ph\u00e1t tri\u1ec7u ch\u1ee9ng.<\/p>\n

              5. D\u1ef1 ph\u00f2ng <\/strong>b\u1ec7nh c\u00fam m\u00f9a<\/strong><\/h2>\n

              5.1. C\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng b\u1ec7nh <\/strong>c\u00fam m\u00f9a<\/strong><\/h3>\n
                \n
              • Ph\u1ea3i \u0111eo kh\u1ea9u trang khi ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi b\u1ec7nh nghi nhi\u1ec5m c\u00fam.<\/li>\n
              • T\u0103ng c\u01b0\u1eddng r\u1eeda tay.<\/li>\n
              • V\u1ec7 sinh h\u00f4 h\u1ea5p khi ho kh\u1ea1c.<\/li>\n
              • Tr\u00e1nh t\u1eadp trung \u0111\u00f4ng ng\u01b0\u1eddi khi c\u00f3 d\u1ecbch x\u1ea3y ra.<\/li>\n<\/ul>\n

                5.2. Ph\u00f2ng l\u00e2y nhi\u1ec5m t\u1eeb ng\u01b0\u1eddi b\u1ec7nh<\/strong><\/h3>\n
                  \n
                • C\u00e1ch ly ng\u01b0\u1eddi b\u1ec7nh \u1edf bu\u1ed3ng ri\u00eang.<\/li>\n
                • Ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i \u0111eo kh\u1ea9u trang trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb.<\/li>\n
                • Th\u01b0\u1eddng xuy\u00ean l\u00e0m s\u1ea1ch v\u00e0 kh\u1eed khu\u1ea9n bu\u1ed3ng b\u1ec7nh v\u00e0 qu\u1ea7n \u00e1o, d\u1ee5ng c\u1ee5 c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/li>\n<\/ul>\n

                  5.3. Ph\u00f2ng cho nh\u00e2n vi\u00ean y t\u1ebf<\/strong><\/h3>\n

                  R\u1eeda tay th\u01b0\u1eddng quy tr\u01b0\u1edbc v\u00e0 sau khi th\u0103m kh\u00e1m ng\u01b0\u1eddi b\u1ec7nh b\u1eb1ng x\u00e0 ph\u00f2ng ho\u1eb7c dung d\u1ecbch s\u00e1t khu\u1ea9n nhanh.<\/p>\n

                  Ph\u01b0\u01a1ng ti\u1ec7n ph\u00f2ng h\u1ed9 g\u1ed3m kh\u1ea9u trang, g\u0103ng tay, m\u0169, bao gi\u1ea7y ho\u1eb7c \u1ee7ng, m\u1eb7t n\u1ea1 che m\u1eb7t… ph\u1ea3i lu\u00f4n c\u00f3 s\u1eb5n \u1edf khu v\u1ef1c c\u00e1ch ly, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u00fang c\u00e1ch v\u00e0 khi c\u1ea7n thi\u1ebft.<\/p>\n

                  Sau khi d\u00f9ng \u0111\u01b0\u1ee3c x\u1eed l\u00fd theo quy \u0111\u1ecbnh c\u1ee7a B\u1ed9 Y t\u1ebf.<\/p>\n

                  Gi\u00e1m s\u00e1t: l\u1eadp danh s\u00e1ch nh\u00e2n vi\u00ean y t\u1ebf tr\u1ef1c ti\u1ebfp ch\u0103m s\u00f3c, \u0111i\u1ec1u tr\u1ecb cho ng\u01b0\u1eddi b\u1ec7nh, nh\u00e2n vi\u00ean l\u00e0m vi\u1ec7c t\u1ea1i khoa c\u00f3 ng\u01b0\u1eddi b\u1ec7nh v\u00e0 nh\u00e2n vi\u00ean ph\u00f2ng x\u00e9t nghi\u1ec7m x\u1eed l\u00fd b\u1ec7nh ph\u1ea9m. Nh\u1eefng nh\u00e2n vi\u00ean n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i th\u00e2n nhi\u1ec7t v\u00e0 c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng h\u00e0ng ng\u00e0y.<\/p>\n

                  Nh\u00e2n vi\u00ean mang thai, m\u1eafc b\u1ec7nh tim ph\u1ed5i m\u1ea1n t\u00ednh n\u00ean tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n

                  5.4. Ti\u00eam ph\u00f2ng vaccin c\u00fam<\/strong><\/h3>\n
                    \n
                  • N\u00ean ti\u00eam ph\u00f2ng vaccin c\u00fam h\u00e0ng n\u0103m.<\/li>\n
                  • C\u00e1c nh\u00f3m c\u00f3 nguy c\u01a1 l\u00e2y nhi\u1ec5m c\u00fam n\u00ean \u0111\u01b0\u1ee3c ti\u00eam ph\u00f2ng c\u00fam l\u00e0:<\/li>\n
                  • Nh\u00e2n vi\u00ean y t\u1ebf;<\/li>\n
                  • Tr\u1ebb t\u1eeb 6 th\u00e1ng \u0111\u1ebfn 8 tu\u1ed5i;<\/li>\n
                  • Ng\u01b0\u1eddi c\u00f3 b\u1ec7nh m\u1ea1n t\u00ednh (b\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh, b\u1ec7nh tim b\u1ea9m sinh, suy tim, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, suy gi\u1ea3m mi\u1ec5n d\u1ecbch\u2026).<\/li>\n
                  • Ng\u01b0\u1eddi tr\u00ean 65 tu\u1ed5i.<\/li>\n<\/ul>\n

                    5.5. D\u1ef1 ph\u00f2ng b\u1eb1ng thu\u1ed1c<\/strong><\/h3>\n

                    C\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng b\u1eb1ng thu\u1ed1c kh\u00e1ng virus oseltamivir (Tamiflu) cho nh\u1eefng ng\u01b0\u1eddi thu\u1ed9c nh\u00f3m nguy c\u01a1 cao m\u1eafc c\u00fam bi\u1ebfn ch\u1ee9ng c\u00f3 ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh c\u00fam.<\/p>\n

                    Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng l\u00e0 10 ng\u00e0y.<\/p>\n

                    Li\u1ec1u l\u01b0\u1ee3ng nh\u01b0 sau:<\/p>\n

                    Ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em > 13 tu\u1ed5i<\/strong>: 75 mg x 1 l\u1ea7n\/ng\u00e0y.<\/p>\n

                    Tr\u1ebb em \u2265 12 th\u00e1ng \u0111\u1ebfn \u2264 13 tu\u1ed5i<\/strong>:<\/p>\n

                      \n
                    • C\u00e2n n\u1eb7ng \u2264 15 kg: 30 mg x 1 l\u1ea7n\/ng\u00e0y.<\/li>\n
                    • C\u00e2n n\u1eb7ng > 15 kg \u0111\u1ebfn 23 kg: 45 mg x 1 l\u1ea7n\/ng\u00e0y.<\/li>\n
                    • C\u00e2n n\u1eb7ng > 23 kg \u0111\u1ebfn 40 kg 60 mg x 1 l\u1ea7n\/ng\u00e0y.<\/li>\n
                    • C\u00e2n n\u1eb7ng > 40 kg 75 mg x 1 l\u1ea7n\/ng\u00e0y.<\/li>\n<\/ul>\n

                      Tr\u1ebb em < 12 th\u00e1ng<\/strong><\/p>\n

                        \n
                      • < 3 th\u00e1ng Kh\u00f4ng khuy\u1ebfn c\u00e1o tr\u1eeb tr\u01b0\u1eddng h\u1ee3p \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc k\u1ef9.<\/li>\n
                      • 3-5 th\u00e1ng 20 mg x 1 l\u1ea7n\/ng\u00e0y.<\/li>\n
                      • 6-11 th\u00e1ng 25 mg x 1 l\u1ea7n\/ng\u00e0y.<\/li>\n<\/ul>\n

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

                          \n
                        • H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh truy\u1ec1n nhi\u1ec5m c\u1ee7a B\u1ed9 Y t\u1ebf 2015.<\/li>\n<\/ul>\n
                          usechatgpt init success<\/div>\n","protected":false},"excerpt":{"rendered":"

                          B\u1ec7nh c\u00fam m\u00f9a l\u00e0 m\u1ed9t b\u1ec7nh l\u00e2y nhi\u1ec5m ph\u1ed5 bi\u1ebfn do virus c\u00fam g\u00e2y ra. B\u1ec7nh th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n v\u00e0o m\u00f9a \u0111\u00f4ng v\u00e0 xu\u00e2n, v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 s\u1ed1t, \u0111au \u0111\u1ea7u, \u0111au h\u1ecdng, m\u1ec7t m\u1ecfi v\u00e0 \u0111au c\u01a1. C\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 k\u00e9o d\u00e0i t\u1eeb v\u00e0i ng\u00e0y \u0111\u1ebfn […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[22,33],"tags":[],"yoast_head":"\nB\u1ec7nh c\u00fam m\u00f9a: Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh c\u00fam m\u00f9a l\u00e0 m\u1ed9t b\u1ec7nh l\u00e2y nhi\u1ec5m ph\u1ed5 bi\u1ebfn do virus c\u00fam g\u00e2y ra. 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