{"id":33315,"date":"2023-05-12T22:10:55","date_gmt":"2023-05-12T15:10:55","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=33315"},"modified":"2023-05-12T22:10:55","modified_gmt":"2023-05-12T15:10:55","slug":"du-khuan-huyet-cap-nhat-dinh-nghia-chan-doan-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/12\/du-khuan-huyet-cap-nhat-dinh-nghia-chan-doan-dieu-tri\/","title":{"rendered":"Du khu\u1ea9n huy\u1ebft: c\u1eadp nh\u1eadt \u0111\u1ecbnh ngh\u0129a, ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"<div><strong>Du khu\u1ea9n huy\u1ebft l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 hi\u1ec7n di\u1ec7n vi khu\u1ea9n ho\u1ea1t \u0111\u1ed9ng trong d\u00f2ng m\u00e1u. Du khu\u1ea9n huy\u1ebft c\u00f3 th\u1ec3 x\u1ea3y ra nh\u1ea5t th\u1eddi \u1edf ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh (nh\u01b0 sau khi \u0111\u00e1nh r\u0103ng) ho\u1eb7c t\u1eeb nhi\u1ec5m tr\u00f9ng khu tr\u00fa lan t\u1edbi d\u00f2ng m\u00e1u. Y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a b\u1ec7nh g\u1ed3m \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch (\u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, ung th\u01b0), c\u00f3 \u0111\u01b0\u1eddng v\u00e0o, n\u01a1i b\u00e1m d\u00ednh cho vi khu\u1ea9n (catheter, d\u1ee5ng c\u1ee5 trong c\u01a1 th\u1ec3). Ch\u1ea9n \u0111o\u00e1n d\u1ef1a v\u00e0o c\u1ea5y m\u00e1u.<\/strong><\/div>\n<div>\n<div>\n<section id=\"PaWWkP0\" class=\"container-915194668 condensed-hidden\" data-e2e-test-id=\"section-with-header\">\n<div class=\"headerContainer--rfIL2 headerContainerActive--MANNx\">\n<div class=\"container-2547724898\">\n<h2 class=\"title-2693809452\" data-e2e-test-id=\"particle-header\">1. C\u00e1c \u0111\u1ecbnh ngh\u0129a li\u00ean quan du khu\u1ea9n huy\u1ebft<\/h2>\n<\/div>\n<\/div>\n<div class=\"show--nVz6U sectionContainer--aQ_aq\" data-e2e-test-id=\"section-content-is-shown\">\n<div>\n<div class=\"content--kLKAu baseStyles-2133108132--disableImagePointerEventOnTutorial-3958995088--anchorLinkStyles-27620709\">\n<ul class=\"condensed-hidden\">\n<li>Du khu\u1ea9n huy\u1ebft: c\u00f3 hi\u1ec7n di\u1ec7n vi khu\u1ea9n trong d\u00f2ng m\u00e1u, c\u00f3 ho\u1eb7c kh\u00f4ng tri\u1ec7u ch\u1ee9ng b\u1ec7nh l\u00fd.<\/li>\n<li>Nhi\u1ec5m khu\u1ea9n d\u00f2ng m\u00e1u (BSI): vi khu\u1ea9n trong m\u00e1u ho\u1eb7c vi n\u1ea5m trong m\u00e1u, x\u00e1c \u0111\u1ecbnh b\u1eb1ng k\u1ebft qu\u1ea3 c\u1ea5y.\n<ul>\n<li>Nhi\u1ec5m khu\u1ea9n d\u00f2ng m\u00e1u nguy\u00ean ph\u00e1t: vi sinh v\u1eadt ph\u00e2n l\u1eadp \u0111\u01b0\u1ee3c kh\u00f4ng li\u00ean quan nhi\u1ec5m tr\u00f9ng t\u1ea1i n\u01a1i kh\u00e1c. V\u00c0\n<ul>\n<li>X\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c vi khu\u1ea9n kh\u00f4ng th\u01b0\u1eddng tr\u00fa <span class=\"nowrap\">\u2265 1 k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u<\/span><\/li>\n<li>Ho\u1eb7c t\u00e1c nh\u00e2n kh\u00f4ng th\u01b0\u1eddng tr\u00fa x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c qua k\u1ebft qu\u1ea3 vi sinh kh\u00f4ng ph\u00e2n l\u1eadp (PCR).<\/li>\n<li><span class=\"nowrap\">Ho\u1eb7c t\u00e1c nh\u00e2n th\u01b0\u1eddng tr\u00fa d\u01b0\u01a1ng t\u00ednh\u2265 2 k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u \u1edf nhi\u1ec1u th\u1eddi \u0111i\u1ec3m kh\u00e1c nhau tr\u00ean b\u1ec7nh nh\u00e2n s\u1ed1t, \u1edbn l\u1ea1nh, h\u1ea1 huy\u1ebft \u00e1p.<\/span><\/li>\n<\/ul>\n<\/li>\n<li>BSI th\u1ee9 ph\u00e1t\n<ul>\n<li>BSI th\u1ee9 ph\u00e1t do nhi\u1ec5m tr\u00f9ng t\u1ea1i v\u1ecb tr\u00ed kh\u00e1c nh\u01b0 vi\u00eam ph\u1ed5i, nhi\u1ec5m tr\u00f9ng ni\u1ec7u.<\/li>\n<li>X\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c \u0111\u1ed3ng th\u1eddi m\u1ed9t vi sinh v\u1eadt trong k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u v\u00e0 c\u1ea5y t\u1eeb ngu\u1ed3n nhi\u1ec5m tr\u00f9ng.<span id=\"E83bc2561f2837c7698611e4ae0fe8775\" class=\"api explanation\" data-type=\"bonus\" data-content=\"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\"><\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Vi\u00eam n\u1ed9i m\u1ea1ch: vi\u00eam \u0111\u1ed9ng m\u1ea1ch ho\u1eb7c t\u0129nh m\u1ea1ch, g\u00e2y ra do li\u00ean quan du khu\u1ea9n huy\u1ebft k\u00e9o d\u00e0i.<\/li>\n<li><a href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/nhiem-khuan-huyet-la-gi\/\">Nhi\u1ec5m tr\u00f9ng huy\u1ebft<\/a>: m\u1ed9t b\u1ec7nh l\u00fd \u0111e d\u1ecda t\u00ednh m\u1ea1ng do r\u1ed1i lo\u1ea1n \u0111\u00e1p \u1ee9ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u1edbi nhi\u1ec5m tr\u00f9ng, g\u00e2y t\u1ed5n th\u01b0\u01a1ng m\u00f4 v\u00e0 c\u01a1 quan, c\u00f3 th\u1ec3 d\u1eabn t\u1edbi suy t\u1ea1ng.<\/li>\n<\/ul>\n<\/div>\n<div><\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<div>\n<section id=\"4aW3kP0\" class=\"container-915194668 condensed-hidden\" data-e2e-test-id=\"section-with-header\">\n<div class=\"headerContainer--rfIL2 headerContainerActive--MANNx\">\n<div class=\"container-2547724898\">\n<h2 class=\"title-2693809452\" data-e2e-test-id=\"particle-header\"><span id=\"Zaffd591847432f751bbc97b55c2557f6\">2. B\u1ec7nh nguy\u00ean c\u1ee7a du khu\u1ea9n huy\u1ebft.<\/span><\/h2>\n<\/div>\n<\/div>\n<div class=\"show--nVz6U sectionContainer--aQ_aq\" data-e2e-test-id=\"section-content-is-shown\">\n<div class=\"content--kLKAu baseStyles-2133108132--disableImagePointerEventOnTutorial-3958995088--anchorLinkStyles-27620709\">\n<h3 id=\"Y586847ff4bc3a9c545148023a27137b9\" class=\"condensed-hidden\">2.1. Ngu\u1ed3n nhi\u1ec5m tr\u00f9ng<\/h3>\n<ul>\n<li>Nhi\u1ec5m tr\u00f9ng d\u00f2ng m\u00e1u (BSI) tho\u00e1ng qua: g\u00e2y ra do c\u00e1c th\u1ee7 thu\u1eadt nh\u1ecf nh\u01b0 \u0111\u1eb7t catheter t\u0129nh m\u1ea1ch, \u0111i\u1ec1u tr\u1ecb nha khoa, sinh thi\u1ebft.<\/li>\n<\/ul>\n<ul class=\"condensed-hidden\">\n<li>BSI gi\u00e1n \u0111o\u1ea1n:\n<ul>\n<li>Xu\u1ea5t ph\u00e1t t\u1eeb nh\u1eefng \u1ed5 nhi\u1ec5m tr\u00f9ng gi\u1edbi h\u1ea1n (abscess trong \u1ed5 b\u1ee5ng, abscess m\u00f4 m\u1ec1m)<\/li>\n<li>Xu\u1ea5t ph\u00e1t t\u1eeb \u1ed5 nhi\u1ec5m tr\u00f9ng khu tr\u00fa (vi\u00eam ph\u1ed5i, <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/nhung-dieu-can-biet-ve-nhiem-trung-duong-tiet-nieu\/#:~:text=Nhi%E1%BB%85m%20tr%C3%B9ng%20%C4%91%C6%B0%E1%BB%9Dng%20ti%E1%BA%BFt%20ni%E1%BB%87u%20l%C3%A0%20g%C3%AC%3F,b%C3%A0ng%20quang%20v%C3%A0%20ni%E1%BB%87u%20%C4%91%E1%BA%A1o.\">nhi\u1ec5m tr\u00f9ng ti\u1ec3u<\/a>, vi\u00eam x\u01b0\u01a1ng t\u1ee7y)<\/li>\n<\/ul>\n<\/li>\n<li>BSI tr\u01b0\u1eddng di\u1ec5n: nhi\u1ec5m tr\u00f9ng n\u1ed9i m\u1ea1ch (vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c, nhi\u1ec5m tr\u00f9ng \u0111o\u1ea1n m\u1ea1ch m\u00e1u gh\u00e9p, nhi\u1ec5m tr\u00f9ng huy\u1ebft kh\u1ed1i).<\/li>\n<\/ul>\n<div class=\"condensed-hidden\">\n<div class=\"merke content-box green\">Du khu\u1ea9n huy\u1ebft tho\u00e1ng qua kh\u00f4ng c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh khi thao t\u00e1c \u1edf c\u00e1c v\u1ecb tr\u00ed h\u1eefu khu\u1ea9n (nh\u01b0 \u0111\u1ed9ng t\u00e1c \u0111\u00e1nh r\u0103ng).<\/div>\n<\/div>\n<h3 id=\"Y37317418f03e69f266e28698f72bab5b\" class=\"condensed-hidden\">2.2. Y\u1ebfu t\u1ed1 nguy c\u01a1 nhi\u1ec5m khu\u1ea9n d\u00f2ng m\u00e1u (BSI).<\/h3>\n<p>C\u00e1c y\u1ebfu t\u1ed1 l\u00e0m suy gi\u1ea3m h\u1ec7 mi\u1ec5n d\u1ecbch:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/nao-la-suy-giam-mien-dich-bam-sinh\/\">Suy gi\u1ea3m mi\u1ec5n d\u1ecbch b\u1ea9m sinh<\/a> ho\u1eb7c m\u1eafc ph\u1ea3i.<\/li>\n<li>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/li>\n<li>Suy c\u01a1 quan l\u1edbn nh\u01b0 <a href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/chan-doan-va-cac-giai-doan-cua-xo-gan\/\">x\u01a1 gan<\/a>, b\u1ec7nh th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i.<\/li>\n<li>B\u1ec7nh \u00e1c t\u00ednh (nh\u01b0 ung th\u01b0 huy\u1ebft h\u1ecdc)<\/li>\n<li>Thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch ho\u1eb7c thu\u1ed1c g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o<\/li>\n<li>Gi\u1ea3m b\u1ea1ch c\u1ea7u<\/li>\n<\/ul>\n<p>Y\u1ebfu t\u1ed1 nguy c\u01a1 th\u00fac \u0111\u1ea9y vi khu\u1ea9n x\u00e2m nh\u1eadp.<\/p>\n<ul>\n<li>C\u00f3 \u0111\u01b0\u1eddng v\u00e0o t\u0129nh m\u1ea1ch v\u00e0\/ho\u1eb7c d\u1ee5ng c\u1ee5 c\u1ea5y gh\u00e9p.<\/li>\n<li>B\u1ec7nh m\u1ea1ch m\u00e1u ngo\u1ea1i bi\u00ean k\u00e8m lo\u00e9t da.<\/li>\n<li>S\u1eed d\u1ee5ng thu\u1ed1c t\u0129nh m\u1ea1ch<\/li>\n<\/ul>\n<h3 id=\"Y2ca568c1394ba66d23fe09c1da842300\" class=\"condensed-hidden\">2.3. C\u00e1c nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p v\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1.<\/h3>\n<div class=\"condensed-hidden paragraph\"><span class=\"scientific-name\"><span class=\"leitwort\">Staphylococcus\u00a0<\/span><span class=\"leitwort\">aureus:\u00a0<\/span><\/span><\/div>\n<ul>\n<li>Nhi\u1ec5m tr\u00f9ng da v\u00e0 m\u00f4 m\u1ec1m<\/li>\n<li>D\u1ee5ng c\u1ee5 c\u1ea5y gh\u00e9p<\/li>\n<li>Catheter t\u0129nh m\u1ea1ch trung t\u00e2m<\/li>\n<li>Vi\u00eam x\u01b0\u01a1ng \u0111\u1ed1t s\u1ed1ng<\/li>\n<\/ul>\n<p>Staphylococci Coagulase \u00e2m t\u00ednh:<\/p>\n<ul>\n<li>D\u1ee5ng c\u1ee5 c\u1ea5y gh\u00e9p<\/li>\n<li>Catheter t\u0129nh m\u1ea1ch trung t\u00e2m<\/li>\n<\/ul>\n<p>Enterobacteriaceae (most commonly E. coli):<\/p>\n<ul>\n<li>Nhi\u1ec5m tr\u00f9ng ni\u1ec7u.<\/li>\n<li>B\u1ec7nh l\u00fd trong \u1ed5 b\u1ee5ng.<\/li>\n<\/ul>\n<p>Pseudomonas aeruginosa:<\/p>\n<ul>\n<li>B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh.<\/li>\n<li>N\u1eb1m l\u00e2u<\/li>\n<li>Th\u1eddi gian n\u1eb1m vi\u1ec7n k\u00e9o d\u00e0i<\/li>\n<\/ul>\n<p>Enterococci:<\/p>\n<ul>\n<li>B\u1ec7nh ru\u1ed9t vi\u00eam<\/li>\n<li>Ung th\u01b0 \u0111\u1ea1i tr\u1ef1c tr\u00e0ng<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng ni\u1ec7u<\/li>\n<\/ul>\n<p>Vi khu\u1ea9n gram \u00e2m nh\u01b0 Enterobacteriaceae g\u00e2y g\u1ea7n m\u1ed9t n\u1eeda tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n d\u00f2ng m\u00e1u t\u1eeb c\u1ed9ng \u0111\u1ed3ng v\u00e0 1\/3 tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n li\u00ean quan ch\u0103m s\u00f3c y t\u1ebf.<\/p>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<div>\n<section id=\"kaWmkP0\" class=\"container-915194668 condensed-hidden\" data-e2e-test-id=\"section-with-header\">\n<div class=\"headerContainer--rfIL2 headerContainerActive--MANNx\">\n<div class=\"container-2547724898\">\n<h2 class=\"title-2693809452\" data-e2e-test-id=\"particle-header\">3. \u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng c\u1ee7a du khu\u1ea9n huy\u1ebft.<\/h2>\n<\/div>\n<\/div>\n<div class=\"show--nVz6U sectionContainer--aQ_aq\" data-e2e-test-id=\"section-content-is-shown\">\n<div>\n<div class=\"content--kLKAu baseStyles-2133108132--disableImagePointerEventOnTutorial-3958995088--anchorLinkStyles-27620709\">\n<div class=\"condensed-hidden paragraph\">\u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng ph\u1ee5 thu\u1ed9c v\u00e0o ngu\u1ed3n nhi\u1ec5m khu\u1ea9n, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 kh\u00f4ng tri\u1ec7u ch\u1ee9ng ho\u1eb7c t\u1ef1 kh\u1ecfi.<\/div>\n<ul class=\"condensed-hidden\">\n<li>Tri\u1ec7u ch\u1ee9ng to\u00e0n th\u00e2n\n<ul>\n<li>S\u1ed1t<\/li>\n<li>\u1edan l\u1ea1nh v\u00e0 r\u00e9t run<\/li>\n<li>D\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u\n<ul>\n<li><span id=\"Lb0b0ac82cf76eea9e326d8063be70dee\" class=\"api dictionary\" data-phrasegroup-id=\"FCXgFZ0\" data-type=\"bonus\" data-content=\"PHA+QSBnZW5lcmFsIGZlZWxpbmcgb2YgZGlzY29tZm9ydCwgaWxsbmVzcywgb3IgdW5lYXNpbmVzcy48L3A+\" data-source=\"Lb0b0ac82cf76eea9e326d8063be70dee\">M\u1ec7t m\u1ecfi<\/span><\/li>\n<li>\u0102n u\u1ed1ng k\u00e9m<\/li>\n<li>L\u00fa l\u1eabn<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>D\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng t\u1ea1i v\u1ecb tr\u00ed nhi\u1ec5m tr\u00f9ng:\n<ul>\n<li>C\u00f3 c\u00e1c d\u1ee5ng c\u1ee5 b\u00ean trong c\u01a1 th\u1ec3 nh\u01b0 catheter t\u0129nh m\u1ea1ch trung t\u00e2m, m\u00e1y tr\u1ee3 tim\n<ul>\n<li>C\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n ph\u00f9, s\u01b0ng, ch\u1ea3y m\u1ee7.<\/li>\n<\/ul>\n<\/li>\n<li>H\u00f4 h\u1ea5p: ho, kh\u00f3 th\u1edf<\/li>\n<li>Tim: \u00e2m th\u1ed5i m\u1edbi xu\u1ea5t hi\u1ec7n<\/li>\n<li>Ni\u1ec7u: ti\u1ec3u kh\u00f3, \u0111au h\u00f4ng l\u01b0ng<\/li>\n<li>Da v\u00e0 m\u00f4 m\u1ec1m: \u0111\u1ecf da, d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng v\u1ebft th\u01b0\u01a1ng<\/li>\n<li>C\u01a1 x\u01b0\u01a1ng: \u0111au.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<div>\n<section id=\"OaWIkP0\" class=\"container-915194668 condensed-hidden\" data-e2e-test-id=\"section-with-header\">\n<div class=\"headerContainer--rfIL2 headerContainerActive--MANNx\">\n<div class=\"container-2547724898\">\n<h2 class=\"title-2693809452\" data-e2e-test-id=\"particle-header\">4. Ch\u1ea9n \u0111o\u00e1n du khu\u1ea9n huy\u1ebft.<\/h2>\n<\/div>\n<\/div>\n<div class=\"show--nVz6U sectionContainer--aQ_aq\" data-e2e-test-id=\"section-content-is-shown\">\n<div>\n<div class=\"content--kLKAu baseStyles-2133108132--disableImagePointerEventOnTutorial-3958995088--anchorLinkStyles-27620709\">\n<div class=\"condensed-hidden paragraph\">Ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng d\u00f2ng m\u00e1u c\u1ea7n c\u1ea5y m\u00e1u.<\/div>\n<ul class=\"condensed-hidden\">\n<li>Ch\u1ec9 \u0111\u1ecbnh <a href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/cay-mau-trong-chan-doan-nhiem-khuan-huyet\/\">c\u1ea5y m\u00e1u<\/a>: c\u1ea7n ch\u1ecdn l\u1ecdc\n<ul class=\"additional\">\n<li>C\u1ea7n t\u00ednh to\u00e1n x\u00e1c su\u1ea5t l\u00e2m s\u00e0ng: du khu\u1ea9n huy\u1ebft nguy c\u01a1 cao x\u1ea3y ra n\u1ebfu c\u00f3:\n<ul>\n<li>Ti\u00eau chu\u1ea9n<a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/hoi-chung-dap-ung-viem-toan-sirs-la-gi\/#:~:text=1.,b%E1%BA%A3o%20v%E1%BB%87%20c%E1%BB%A7a%20c%C6%A1%20th%E1%BB%83.\"> h\u1ed9i ch\u1ee9ng \u0111\u00e1p \u1ee9ng vi\u00eam to\u00e0n th\u00e2n<\/a> (SIRS) th\u1ecfa m\u00e3n<\/li>\n<li>S\u1ed1t + \u1edbn l\u1ea1nh\/r\u00e9t run<\/li>\n<\/ul>\n<\/li>\n<li>C\u00e2n nh\u1eafc s\u1eed d\u1ee5ng c\u00e1c thang \u0111i\u1ec3m d\u1ef1 \u0111o\u00e1n (kh\u00f4ng d\u00f9ng r\u1ed9ng r\u00e3i).<\/li>\n<li>Quy\u1ebft \u0111\u1ecbnh t\u1eebng tr\u01b0\u1eddng h\u1ee3p cho b\u1ec7nh nh\u00e2n suy gi\u1ea3m mi\u1ec5n d\u1ecbch, ti\u1ec1n s\u1eed nhi\u1ec5m khu\u1ea9n \u0111a kh\u00e1ng.<\/li>\n<\/ul>\n<\/li>\n<li>\u0110\u1ecdc k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u:\n<ul>\n<li>Li\u00ean h\u1ec7 k\u1ebft qu\u1ea3 d\u01b0\u01a1ng t\u00ednh v\u1edbi l\u00e2m s\u00e0ng \u0111\u1ec3 xem x\u00e9t t\u00ednh h\u1ee3p l\u00fd.<\/li>\n<li>C\u00f3 th\u1ec3 d\u01b0\u01a1ng t\u00ednh gi\u1ea3.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<div>\n<section id=\"laWvkP0\" class=\"container-915194668 condensed-hidden\" data-e2e-test-id=\"section-with-header\">\n<div class=\"headerContainer--rfIL2 headerContainerActive--MANNx\">\n<div class=\"container-2547724898\">\n<h2 class=\"title-2693809452\" data-e2e-test-id=\"particle-header\"><span id=\"Z22c888fc89d8b6908dddf457be50a407\">5. X\u1eed tr\u00ed du khu\u1ea9n huy\u1ebft<\/span><\/h2>\n<\/div>\n<\/div>\n<div class=\"show--nVz6U sectionContainer--aQ_aq\" data-e2e-test-id=\"section-content-is-shown\">\n<div class=\"content--kLKAu baseStyles-2133108132--disableImagePointerEventOnTutorial-3958995088--anchorLinkStyles-27620709\">\n<h4 class=\"condensed-hidden\">5.1. X\u1eed tr\u00ed ban \u0111\u1ea7u v\u1edbi ng\u01b0\u1eddi b\u1ec7nh nghi BSI<\/h4>\n<\/div>\n<ul class=\"condensed-hidden\">\n<li>Thu th\u1eadp 2 &#8211; 4 m\u1eabu m\u00e1u \u0111\u1ec3 c\u1ea5y x\u00e1c \u0111\u1ecbnh BSI (ti\u00eau chu\u1ea9n v\u00e0ng)<\/li>\n<li>B\u1ec7nh nh\u00e2n huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh v\u00e0 c\u00f3 nguy c\u01a1 di\u1ec5n ti\u1ebfn n\u1eb7ng. B\u1eaft \u0111\u1ea7u chi\u1ebfn l\u01b0\u1ee3c x\u1eed tr\u00ed nhi\u1ec5m tr\u00f9ng huy\u1ebft.\n<ul class=\"additional\">\n<li>\u0110\u00e1nh gi\u00e1 ng\u01b0\u1eddi b\u1ec7nh theo c\u00e1ch ti\u1ebfp c\u1eadn ABCDE v\u00e0 h\u1ed3i s\u1ee9c.<\/li>\n<li>Kh\u1edfi \u0111\u1ea7u kh\u00e1ng sinh kinh nghi\u1ec7m theo t\u00e1c nh\u00e2n nghi ng\u1edd v\u00e0 b\u1ec7nh n\u1ec1n.<\/li>\n<\/ul>\n<\/li>\n<li>\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n \u1ed5n \u0111\u1ecbnh: quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb theo t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3.<\/li>\n<\/ul>\n<div class=\"content--kLKAu baseStyles-2133108132--disableImagePointerEventOnTutorial-3958995088--anchorLinkStyles-27620709\">\n<div class=\"condensed-hidden\">\n<div class=\"merke content-box green\">Khi c\u00f3 th\u1ec3, l\u1ea5y \u00edt nh\u1ea5t 2 m\u1eabu m\u00e1u \u0111\u1ec3 c\u1ea5y tr\u01b0\u1edbc khi d\u00f9ng kh\u00e1ng sinh.<\/div>\n<\/div>\n<h4 class=\"condensed-hidden\">5.2. C\u00e1c x\u1eed tr\u00ed ti\u1ebfp theo<\/h4>\n<ul class=\"condensed-hidden\">\n<li>L\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ngu\u1ed3n nhi\u1ec5m tr\u00f9ng (nh\u01b0 si\u00eau \u00e2m tim ch\u1ea9n \u0111o\u00e1n vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n).<\/li>\n<li>B\u1eaft \u0111\u1ea7u ki\u1ec3m so\u00e1t ngu\u1ed3n nhi\u1ec5m tr\u00f9ng (6 &#8211; 12h sau ch\u1ea9n \u0111o\u00e1n).<\/li>\n<li>Khi \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n\n<ul>\n<li>Xu\u1ed1ng thang kh\u00e1ng sinh theo t\u00e1c nh\u00e2n.<\/li>\n<li>L\u00e0m th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m t\u1ea7m so\u00e1t kh\u00e1c ho\u1eb7c \u0111i\u1ec1u tr\u1ecb d\u00e0i ng\u00e0y.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3 id=\"Yf2d8bc4f994387a3d9571aee1a06e493\" class=\"condensed-hidden\">5.3. \u0110i\u1ec1u tr\u1ecb theo m\u1ed9t s\u1ed1 t\u00e1c nh\u00e2n th\u01b0\u1eddng g\u1eb7p<\/h3>\n<div class=\"condensed-hidden paragraph\">\u0110\u1ed1i v\u1edbi S.aureus nh\u1ea1y c\u1ea3m methicillin: D\u00f9ng ph\u00e1c \u0111\u1ed3 kh\u00e1ng sinh:<\/div>\n<ul>\n<li>C\u00e1c penicillin di\u1ec7t t\u1ee5 c\u1ea7u nh\u01b0 nafcillin, oxacillin (TM 1g m\u1ed7i 4h).<\/li>\n<li>Ho\u1eb7c cefazolin (1 &#8211; 1.5g TM m\u1ed7i 6h).<\/li>\n<li>Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb 2 &#8211; 6 tu\u1ea7n.<\/li>\n<li>Theo d\u00f5i: c\u1ea5y m\u00e1u, \u0111i\u1ec3n h\u00ecnh ch\u1ec9 \u0111\u1ecbnh sau 48h.<\/li>\n<\/ul>\n<p>\u0110\u1ed1i v\u1edbi S.aureus kh\u00e1ng methicillin:<\/p>\n<ul>\n<li>D\u00f9ng Vancomycin 15\u201320 mg\/kg TM m\u1ed7i <span class=\"nowrap\">8\u201312 h. Ho\u1eb7c daptomycin.<\/span><\/li>\n<li>Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb: <span class=\"nowrap\">\u2265 2 tu\u1ea7n n\u1ebfu kh\u00f4ng bi\u1ebfn ch\u1ee9ng. 4 &#8211; 6 tu\u1ea7n n\u1ebfu c\u00f3 bi\u1ebfn ch\u1ee9ng.<\/span><\/li>\n<li>Theo d\u00f5i: th\u1ef1c hi\u1ec7n 2 &#8211; 4 ng\u00e0y sau c\u1ea5y m\u00e1u l\u1ea7n \u0111\u1ea7u v\u00e0 l\u1eb7p l\u1ea1i cho t\u1edbi khi h\u1ebft vi khu\u1ea9n trong m\u00e1u.<\/li>\n<\/ul>\n<p>Streptococci spp: D\u00f9ng penicillin G n\u1ebfu l\u00e0 ch\u1ee7ng c\u00f2n nh\u1ea1y c\u1ea3m. D\u00f9ng vancomycin ho\u1eb7c ceftriaxone n\u1ebfu kh\u00e1ng penicillin.<\/p>\n<p>Enterobacteriaceae: V\u1edbi ch\u1ee7ng sinh ESBL d\u00f9ng meropenem\/imipenem-cilastatin\/ertapenem.<\/p>\n<p><strong>\u00a0T\u00e0i li\u1ec7u tham kh\u1ea3o:\u00a0<\/strong><\/p>\n<p>Bacteremia, Amboss.<\/p>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Du khu\u1ea9n huy\u1ebft l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 hi\u1ec7n di\u1ec7n vi khu\u1ea9n ho\u1ea1t \u0111\u1ed9ng trong d\u00f2ng m\u00e1u. Du khu\u1ea9n huy\u1ebft c\u00f3 th\u1ec3 x\u1ea3y ra nh\u1ea5t th\u1eddi \u1edf ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh (nh\u01b0 sau khi \u0111\u00e1nh r\u0103ng) ho\u1eb7c t\u1eeb nhi\u1ec5m tr\u00f9ng khu tr\u00fa lan t\u1edbi d\u00f2ng m\u00e1u. Y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[23,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Du khu\u1ea9n huy\u1ebft: c\u1eadp nh\u1eadt \u0111\u1ecbnh ngh\u0129a, ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"Du khu\u1ea9n huy\u1ebft x\u1ea3y ra khi vi sinh v\u1eadt x\u00e2m nh\u1eadp v\u00e0o m\u00e1u ch\u01b0a g\u00e2y bi\u1ebfn ch\u1ee9ng, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ebf c\u00f3 tri\u1ec7u ch\u1ee9ng to\u00e0n th\u00e2n v\u00e0 c\u1ee7a \u1ed5 nhi\u1ec5m tr\u00f9ng.\" \/>\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=\"Du khu\u1ea9n huy\u1ebft: c\u1eadp nh\u1eadt \u0111\u1ecbnh ngh\u0129a, ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb - 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