{"id":33490,"date":"2023-05-14T15:55:10","date_gmt":"2023-05-14T08:55:10","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=33490"},"modified":"2023-05-14T15:55:10","modified_gmt":"2023-05-14T08:55:10","slug":"hoi-chung-guillain-barre-tiep-can-chan-doan-va-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/14\/hoi-chung-guillain-barre-tiep-can-chan-doan-va-dieu-tri\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng Guillain Barr\u00e9: Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"
Guillain Barr\u00e9 l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u1ea7n kinh hi\u1ebfm g\u1eb7p nh\u01b0ng nghi\u00eam tr\u1ecdng, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng th\u1ea7n kinh v\u1eadn \u0111\u1ed9ng v\u00e0 th\u1ea7n kinh c\u1ea3m gi\u00e1c c\u1ee7a c\u01a1 th\u1ec3. B\u1ec7nh n\u00e0y th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u b\u1eb1ng tri\u1ec7u ch\u1ee9ng c\u1ee7a m\u1ed9t b\u1ec7nh nhi\u1ec5m tr\u00f9ng ho\u1eb7c vi\u00eam, sau \u0111\u00f3 d\u1ea7n d\u1ea7n \u0111\u01b0a \u0111\u1ebfn s\u1ef1 suy gi\u1ea3m ch\u1ee9c n\u0103ng c\u1ee7a c\u00e1c c\u01a1 v\u00e0 th\u1ea7n kinh. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u s\u00e2u h\u01a1n t\u1eeb c\u00e1c tri\u1ec7u ch\u1ee9ng ban \u0111\u1ea7u \u0111\u1ebfn c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7n c\u00f3, nh\u1eb1m gi\u00fap c\u00e1c b\u1ec7nh nh\u00e2n v\u00e0 c\u00e1c chuy\u00ean gia y t\u1ebf c\u00f3 th\u1ec3 hi\u1ec3u r\u00f5 h\u01a1n v\u1ec1 b\u1ec7nh l\u00fd n\u00e0y v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t cho b\u1ec7nh nh\u00e2n.<\/strong><\/div>\n
\n
\"H\u1ed9i
H\u1ed9i ch\u1ee9ng Guillain-Barr\u00e9 – Vinmec<\/figcaption><\/figure>\n<\/div>\n

1. T\u1ed5ng quan HC Guillain Barr\u00e9<\/strong><\/h2>\n
– H\u1ed9i ch\u1ee9ng Guillain-Barr\u00e9 (GBS) l\u00e0 1 c\u1ea5p c\u1ee9u th\u1ea7n kinh x\u1ea3y ra \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i.<\/div>\n
– Vi\u00eam \u0111a d\u00e2y th\u1ea7n kinh ti\u1ebfn tri\u1ec3n nhanh ch\u00f3ng v\u1edbi bi\u1ec3u hi\u1ec7n y\u1ebfu ho\u1eb7c li\u1ec7t.<\/div>\n
– GBS th\u01b0\u1eddng x\u1ea3y ra sau vi\u00eam nhi\u1ec5m \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean v\u00e0 d\u1ea1 d\u00e0y ru\u1ed9t: ph\u1ea7n l\u1edbn do Epstain Barr Virus, CMV, HBV, HIV v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 Campilobacter jejuni, ngo\u00e0i ra c\u00f2n c\u00f3 Mycoplasma.<\/div>\n
– Sau ti\u00eam vacxin, sau ph\u1eabu thu\u1eadt.<\/div>\n

2. C\u01a1 ch\u1ebf b\u1ec7nh sinh <\/strong>HC Guillain Barr\u00e9<\/strong><\/h2>\n
\u2666 GBS l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch \u0111\u1ed1i v\u1edbi t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng tr\u01b0\u1edbc \u0111\u00f3.<\/div>\n
\u2666 \u0110\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch sai l\u1ec7ch -> t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh ngo\u1ea1i bi\u00ean.<\/div>\n
\u2666 Ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch c\u00f3 th\u1ec3 h\u01b0\u1edbng t\u1edbi Myelin ho\u1eb7c s\u1ee3i tr\u1ee5c c\u1ee7a d\u00e2y th\u1ea7n kinh ngo\u1ea1i vi, d\u1eabn \u0111\u1ebfn vi\u1ec7c kh\u1eed Myelin v\u00e0 c\u00e1c d\u1ea1ng GBS theo s\u1ee3i tr\u1ee5c.<\/div>\n

3. L\u00e2m s\u00e0ng c\u1ee7a <\/strong>HC Guillain Barr\u00e9<\/strong><\/h2>\n

3.1. Giai \u0111o\u1ea1n kh\u1edfi ph\u00e1t <\/strong>HC Guillain Barr\u00e9<\/strong>:<\/strong><\/h3>\n
\u2666 Th\u1eddi k\u1ef3 kh\u1edfi \u0111\u1ea7u th\u01b0\u1eddng t\u1eeb 6- 10 ng\u00e0y, c\u0169ng c\u00f3 khi tri\u1ec7u ch\u1ee9ng x\u1ea3y ra nhanh trong 24 \u2013 48h \u0111\u1ea7u<\/div>\n
<\/div>\n
\u2666 Bi\u1ec3u hi\u1ec7n v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng:<\/div>\n
\u2022 D\u1ecb c\u1ea3m.<\/div>\n
\u2022 \u0110au lan t\u1ecfa c\u00e1c c\u01a1, \u0111au l\u01b0ng.<\/div>\n
\u2022 Y\u1ebfu c\u01a1, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng.<\/div>\n

3.2. Giai \u0111o\u1ea1n to\u00e0n ph\u00e1t<\/strong><\/h3>\n
\u2666 R\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c v\u1eadn \u0111\u1ed9ng lan t\u1ecfa, \u0111\u1ed1i x\u1ee9ng 2 b\u00ean, c\u00f3 th\u1ec3 c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 li\u1ec7t c\u00e1c d\u00e2y th\u1ea7n kinh s\u1ecd n\u00e3o.<\/div>\n
<\/div>\n
\u2666 R\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng:<\/div>\n
\u2022 Li\u1ec7t to\u00e0n chi, th\u01b0\u1eddng g\u1eb7p 2 chi d\u01b0\u1edbi.<\/div>\n
\u2022 Li\u1ec7t c\u00e1c c\u01a1 th\u00e2n m\u00ecnh: ng\u1ef1c, b\u1ee5ng.<\/div>\n
\u2022 Li\u1ec7t c\u00e1c d\u00e2y th\u1ea7n kinh s\u1ecd n\u00e3o ph\u1ed5 bi\u1ebfn l\u00e0: d\u00e2y s\u1ed1 VII 2 b\u00ean.<\/div>\n
\u2022 Li\u1ec7t c\u00e1c d\u00e2y th\u1ea7n kinh s\u1ecd n\u00e3o ph\u00e1t \u00e2m v\u00e0 nu\u1ed1t th\u01b0\u1eddng k\u00edn \u0111\u00e1o<\/div>\n
<\/div>\n
\u2666 R\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c th\u01b0\u1eddng nh\u1eb9 nh\u00e0ng v\u1edbi d\u1ecb c\u1ea3m ho\u1eb7c t\u00ea g\u1ea7n ng\u1ecdn chi lan to\u00e0n th\u00e2n k\u00e8m c\u1ea3m gi\u00e1c \u0111au.<\/div>\n
\u2666 R\u1ed1i lo\u1ea1n ph\u1ea3n x\u1ea1: gi\u1ea3m ho\u1eb7c m\u1ea5t ph\u1ea3n x\u1ea1.<\/div>\n
\u2666 C\u00e1c d\u1ea5u t\u1ed5n th\u01b0\u01a1ng th\u00e1p (-)<\/div>\n
\u2666 R\u1ed1i lo\u1ea1n th\u1ef1c v\u1eadt, c\u1ea7n ch\u00fa \u00fd nh\u1ecbp tim nhanh, h\u1ea1 huy\u1ebft \u00e1p.<\/div>\n
<\/div>\n
C\u00e1c th\u1ec3 l\u00e2m s\u00e0ng:<\/strong><\/div>\n
– B\u1ec7nh \u0111a d\u00e2y th\u1ea7n kinh do vi\u00eam c\u1ea5p t\u00ednh (AIDP)<\/strong><\/div>\n
\u2022 M\u1ea5t myelin ngo\u1ea1i bi\u00ean nhi\u1ec1u \u1ed5.<\/div>\n
\u2022 T\u00e1i t\u1ea1o myelin ch\u1eadm ch\u1ea1p.<\/div>\n
\u2022 Y\u1ebfu c\u01a1 \u0111\u1ed1i x\u1ee9ng ti\u1ebfn tri\u1ec3n.<\/div>\n
\u2022 Gi\u1ea3m ho\u1eb7c m\u1ea5t ph\u1ea3n x\u1ea1 g\u00e2n x\u01b0\u01a1ng.<\/div>\n
<\/div>\n
– B\u1ec7nh th\u1ea7n kinh tr\u1ee5c v\u1eadn \u0111\u1ed9ng c\u1ea5p t\u00ednh (AMAN)<\/strong><\/div>\n
\u2022 X\u1ea3y ra sau nhi\u1ec5m Campylobacter pylory.<\/div>\n
\u2022 T\u1ed5n th\u01b0\u01a1ng s\u1ee3i tr\u1ee5c neuron v\u1eadn \u0111\u1ed9ng ngo\u1ea1i bi\u00ean, kh\u00f4ng c\u00f3 m\u1ea5t myelin.<\/div>\n
\u2022 PXGX c\u00f3 th\u1ec3 kh\u00f4ng thay \u0111\u1ed5i.<\/div>\n
\u2022 D\u00e2y TKCG kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng.<\/div>\n
\u2022 X\u1ea3y ra nhanh ch\u00f3ng v\u00e0 d\u1eef d\u1ed9i.<\/div>\n
<\/div>\n
– B\u1ec7nh th\u1ea7n kinh tr\u1ee5c v\u1eadn \u0111\u1ed9ng v\u00e0 c\u1ea3m gi\u00e1c c\u1ea5p t\u00ednh (AMSAN)<\/strong><\/div>\n
\u2022 Th\u01b0\u1eddng g\u1eb7p nh\u1ea5t tr\u00ean l\u00e2m s\u00e0ng<\/div>\n
\u2022 Tri\u1ec7u ch\u1ee9ng \u01b0u th\u1ebf li\u00ean quan c\u1ea3m gi\u00e1c<\/div>\n
\u2022 Ch\u1ee7 y\u1ebfu t\u1ed5n th\u01b0\u01a1ng tr\u1ee5c c\u1ee7a c\u1ea3 s\u1ee3i TK t\u1ef1 \u0111\u1ed9ng v\u00e0 c\u1ea3m gi\u00e1c<\/div>\n
\u2022 S\u1ef1 ph\u1ee5c h\u1ed3i ch\u1eadm v\u00e0 kh\u00f4ng ho\u00e0n to\u00e0n<\/div>\n
<\/div>\n
– H\u1ed9i ch\u1ee9ng Miller Fisher (MFS)<\/strong><\/div>\n
\u2022 Li\u1ec7t v\u1eadn nh\u00e3n<\/div>\n
\u2022 Th\u1ea5t \u0111i\u1ec1u c\u1ea3m gi\u00e1c s\u00e2u<\/div>\n
\u2022 M\u1ea5t PXGX<\/div>\n
<\/div>\n
\u2666 Ti\u1ebfn tri\u1ec3n theo 3 giai \u0111o\u1ea1n:<\/strong><\/div>\n
\u2022 Li\u1ec7t nhanh trong v\u00f2ng 1-4 tu\u1ea7n \u0111\u1ea7u.<\/div>\n
\u2022 Duy tr\u00ec t\u00ecnh tr\u1ea1ng to\u00e0n ph\u00e1t kho\u1ea3ng 1-3 tu\u1ea7n.<\/div>\n
\u2022 Ph\u1ee5c h\u1ed3i d\u1ea7n trong v\u00f2ng v\u00e0i tu\u1ea7n \u0111\u1ebfn v\u00e0i th\u00e1ng.<\/div>\n
<\/div>\n
\u2666 B\u1ec7nh r\u1ea5t hi\u1ebfm khi t\u00e1i ph\u00e1t.<\/div>\n
\u2666 Bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m: li\u1ec7t c\u01a1 h\u00f4 h\u1ea5p, v\u00e0 c\u00e1c c\u01a1 h\u1ea7u h\u1ecdng..<\/div>\n

4. C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/h2>\n

4.1 D\u1ecbch n\u00e3o t\u1ee7y<\/strong><\/h3>\n
\u2022 T\u0103ng albumin ( ch\u1ee7 y\u1ebfu l\u00e0 IgG): 150mg% – 300mg%.<\/div>\n
\u2022 T\u1ebf b\u00e0o: th\u01b0\u1eddng d\u01b0\u1edbi 10\/mm3.<\/div>\n

4.2 \u0110i\u1ec7n c\u01a1<\/strong><\/h3>\n
\u2022 Ph\u00e2n lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng Myelin hay s\u1ee3i tr\u1ee5c: gi\u1ea3m t\u1ed1c \u0111\u1ed9 d\u1eabn truy\u1ec1n th\u1ea7n kinh, k\u00e9o d\u00e0i th\u1eddi gian ti\u1ec1m s\u00f3ng F v\u00e0 ph\u1ea3n x\u1ea1 H, h\u00ecnh \u1ea3nh ph\u00e2n t\u00e1n \u0111i\u1ec7n th\u1ebf.<\/div>\n
\u2022 C\u00f3 th\u1ec3 b\u00ecnh th\u01b0\u1eddng trong giai \u0111o\u1ea1n s\u1edbm v\u00e0 th\u01b0\u1eddng r\u00f5 r\u1ec7t nh\u1ea5t kho\u1ea3ng 2 tu\u1ea7n sau khi b\u1eaft \u0111\u1ea7u tri\u1ec7u ch\u1ee9ng.<\/div>\n

4.3 MRI<\/strong><\/h3>\n

4.4 Kh\u00e1ng th\u1ec3:<\/strong><\/h3>\n

C\u00e1c kh\u00e1ng th\u1ec3 Glycolipid nh\u01b0: GQ1b, GM1, GD1a …<\/p>\n

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

5.1 Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/strong><\/h3>\n
Theo Ashburry v\u00e0 Comblath 1990:<\/strong><\/div>\n
– Ti\u00eau chu\u1ea9n b\u1eaft bu\u1ed9c<\/strong><\/div>\n
\u2022 Y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n d\u1ea7n c\u1ea3 tay v\u00e0 ch\u00e2n<\/div>\n
\u2022 Gi\u1ea3m ho\u1eb7c m\u1ea5t ph\u1ea3n x\u1ea1 g\u00e2n x\u01b0\u01a1ng<\/div>\n
<\/div>\n
– Ti\u00eau chu\u1ea9n h\u1ed5 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n<\/strong><\/div>\n
\u2022 Ti\u1ebfn tri\u1ec3n d\u01b0\u1edbi 4 tu\u1ea7n<\/div>\n
\u2022 T\u1ed5n th\u01b0\u01a1ng \u0111\u1ed1i x\u1ee9ng<\/div>\n
\u2022 Li\u1ec7t d\u00e2y VII 2 b\u00ean<\/div>\n
\u2022 R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u1ef1 \u0111\u1ed9ng<\/div>\n
\u2022 Kh\u00f4ng s\u1ed1t l\u00fac kh\u1edfi b\u1ec7nh<\/div>\n
\u2022 B\u1eaft \u0111\u1ea7u h\u1ed3i ph\u1ee5c 2-4 tu\u1ea7n sau khi ti\u1ebfn tri\u1ec3n.<\/div>\n
<\/div>\n
C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/div>\n
\u2022 DNT:<\/strong> protein t\u0103ng, t\u1ebf b\u00e0o < 10 \/mm3<\/div>\n
\u2022 \u0110i\u1ec7n c\u01a1 \u0111\u1ed3:<\/strong> d\u1eabn truy\u1ec1n th\u1ea7n kinh b\u1ecb ch\u1eadm ho\u1eb7c ngh\u1ebdn.<\/div>\n

5.2 Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/h3>\n
C\u00e1c b\u1ec7nh y\u1ebfu c\u01a1 c\u1ea5p t\u00ednh t\u01b0\u01a1ng t\u1ef1 nh\u01b0: nh\u01b0\u1ee3c c\u01a1, nhi\u1ec5m \u0111\u1ed9c do Clostridium botulinum, b\u1ea1i li\u1ec7t (ch\u1ee7 y\u1ebfu ngo\u00e0i Hoa K\u00ec), li\u1ec7t do b\u1ecd ve c\u1eafn, nhi\u1ec5m virus West Nile, b\u1ec7nh th\u1ea7n kinh do chuy\u1ec3n h\u00f3a v\u00e0 vi\u00eam t\u1ee7y c\u1eaft ngang, tuy nhi\u00ean nh\u1eefng b\u1ec7nh l\u00fd n\u00e0y c\u00f3 th\u1ec3 ph\u00e2n bi\u1ec7t nh\u01b0 sau:<\/div>\n
\u2022 Nh\u01b0\u1ee3c c\u01a1 th\u01b0\u1eddng kh\u00f4ng li\u00ean t\u1ee5c, n\u1eb7ng h\u01a1n khi ho\u1ea1t \u0111\u1ed9ng l\u00e2u.<\/div>\n
\u2022 Nhi\u1ec5m \u0111\u1ed9c do \u0111\u1ed9c t\u1ed1 botulinum c\u00f3 th\u1ec3 g\u00e2y gi\u00e3n \u0111\u1ed3ng t\u1eed (50%) v\u00e0 b\u1ec7nh l\u00fd th\u1ea7n kinh s\u1ecd \u01b0u th\u1ebf kh\u00f4ng c\u00f3 r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c.<\/div>\n
\u2022 B\u1ea1i li\u1ec7t th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n th\u00e0nh c\u00e1c d\u1ecbch b\u1ec7nh.<\/div>\n
\u2022 Li\u1ec7t do b\u1ecd ve c\u1eafn g\u00e2y li\u1ec7t t\u0103ng d\u1ea7n nh\u01b0ng kh\u00f4ng r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c.<\/div>\n
\u2022 Vi-r\u00fat West Nile g\u00e2y ra \u0111au \u0111\u1ea7u, s\u1ed1t, v\u00e0 li\u1ec7t kh\u00f4ng \u0111\u1ed1i x\u1ee9ng nh\u01b0ng kh\u00f4ng r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c.<\/div>\n
\u2022 B\u1ec7nh th\u1ea7n kinh chuy\u1ec3n h\u00f3a x\u1ea3y ra tr\u00ean n\u1ec1n b\u1ec7nh r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a m\u1ea1n t\u00ednh.<\/div>\n
\u2022 Vi\u00eam t\u1ee7y c\u1eaft ngang g\u00e2y \u0111au, y\u1ebfu, c\u1ea3m gi\u00e1c b\u1ea5t th\u01b0\u1eddng v\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng ti\u1ebft ni\u1ec7u.<\/div>\n

6. \u0110i\u1ec1u tr\u1ecb <\/strong>HC Guillain Barr\u00e9<\/strong><\/h2>\n

6.1 M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb <\/strong>HC Guillain Barr\u00e9<\/strong>:<\/strong><\/h3>\n
\u2022 R\u00fat ng\u1eafn giai \u0111o\u1ea1n vi\u00eam<\/div>\n
\u2022 Gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong \u1edf th\u1ec3 n\u1eb7ng<\/div>\n
\u2022 C\u1ea3i thi\u1ec7n ti\u00ean l\u01b0\u1ee3ng<\/div>\n

6.2 \u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u <\/strong>HC Guillain Barr\u00e9<\/strong>:<\/strong><\/h3>\n
\u2022 L\u1ecdc huy\u1ebft t\u01b0\u01a1ng<\/div>\n
\u2022 Globulin t\u0129nh m\u1ea1ch (IVIG)<\/div>\n

6.2.1 L\u1ecdc huy\u1ebft t\u01b0\u01a1ng<\/strong><\/h3>\n
\u2022 L\u1ea7n l\u1ecdc: 2 l\u1ea7n cho th\u1ec3 nh\u1eb9, tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng t\u0103ng g\u1ea5p \u0111\u00f4i.<\/div>\n
\u2022 Th\u1eddi gian l\u1ecdc: 10-14 ng\u00e0y.<\/div>\n
\u2022 Th\u1ec3 t\u00edch l\u1ecdc t\u1ed5ng c\u1ed9ng l\u00e0 200 \u2013 250 ml\/kg<\/div>\n

6.2.2 IVIG<\/strong><\/h3>\n
\u2022 Li\u1ec1u: 400mg\/kg\/ng\u00e0y trong 5 ng\u00e0y.<\/div>\n
\u2022 L\u1ecdc huy\u1ebft t\u01b0\u01a1ng<\/a> v\u00e0 IVIG c\u00f3 hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng \u2192 khuy\u1ebfn c\u00e1o l\u1ef1a ch\u1ecdn IVIG<\/div>\n
* C\u00e1c thu\u1ed1c Corticoid kh\u00f4ng cho th\u1ea5y hi\u1ec7u qu\u1ea3.<\/div>\n

7. Ti\u00ean l\u01b0\u1ee3ng v\u00e0 bi\u1ebfn ch\u1ee9ng:<\/strong><\/h2>\n

7.1. Ti\u00ean l\u01b0\u1ee3ng:<\/strong><\/h3>\n
– Kho\u1ea3ng 70% h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n, k\u1ec3 c\u1ea3 li\u1ec7t c\u01a1 h\u00f4 h\u1ea5p c\u1ea7n ph\u1ea3i th\u1edf m\u00e1y h\u1ed7 tr\u1ee3.<\/div>\n
– T\u1ef7 l\u1ec7 h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n t\u1eeb 48 – 90% trong n\u0103m \u0111\u00e2\u0300u, 60 – 88% trong n\u0103m th\u01b0\u0301 hai.<\/div>\n
– H\u00f4\u0300i phu\u0323c ke\u0301m n\u1ebfu > 60 tu\u00f4\u0309i, ti\u00ea\u0301n tri\u00ea\u0309n nhanh, \u0111i\u1ec7n c\u01a1 t\u00f4\u0309n th\u01b0\u01a1ng s\u01a1\u0323i tru\u0323c, th\u1edf m\u00e1y h\u1ed7 tr\u1ee3 d\u00e0i nga\u0300y.<\/div>\n

7.2. Bi\u1ebfn ch\u1ee9ng:<\/strong><\/h3>\n
– Quan tro\u0323ng nh\u00e2\u0301t la\u0300 suy h\u00f4 h\u00e2\u0301p c\u00e2\u0301p do li\u00ea\u0323t c\u01a1 h\u00f4 h\u00e2\u0301p, vi\u00eam ph\u00f4\u0309i do hi\u0301t pha\u0309i, x\u1eb9p ph\u1ed5i, thuy\u00ean t\u0103\u0301c ma\u0323ch ph\u00f4\u0309i.<\/div>\n
– C\u00e1c r\u1ed1i l\u1ecdan th\u1ea7n kinh t\u1ef1 \u0111\u1ed9ng: r\u1ed1i loa\u0323n nhi\u0323p tim, t\u0103ng ti\u00ea\u0301t di\u0323ch ph\u00ea\u0301 qua\u0309n ph\u00f4\u0309i, li\u00ea\u0323t ru\u00f4\u0323t c\u01a1 n\u0103ng, b\u00ed ti\u1ec3u ti\u1ec7n, vi\u00eam \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, lo\u00e9t t\u1ef3 \u0111\u00e8\u2026<\/div>\n
– Di ch\u1ee9ng li\u1ec7t kh\u00f4ng h\u1ed3i ph\u1ee5c.<\/div>\n
<\/div>\n
Ngu\u1ed3n tham kh\u1ea3o:<\/strong><\/div>\n
    \n
  • B\u00e0i gi\u1ea3ng N\u1ed9i khoa \u0110H Y Hu\u1ebf 2018<\/li>\n
  • Thay huy\u1ebft t\u01b0\u01a1ng trong \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng Guillain Barre – Vinmec.com<\/li>\n<\/ul>\n
    <\/div>\n
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    Guillain Barr\u00e9 l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u1ea7n kinh hi\u1ebfm g\u1eb7p nh\u01b0ng nghi\u00eam tr\u1ecdng, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng th\u1ea7n kinh v\u1eadn \u0111\u1ed9ng v\u00e0 th\u1ea7n kinh c\u1ea3m gi\u00e1c c\u1ee7a c\u01a1 th\u1ec3. B\u1ec7nh n\u00e0y th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u b\u1eb1ng tri\u1ec7u ch\u1ee9ng c\u1ee7a m\u1ed9t b\u1ec7nh nhi\u1ec5m tr\u00f9ng ho\u1eb7c vi\u00eam, sau \u0111\u00f3 d\u1ea7n d\u1ea7n \u0111\u01b0a \u0111\u1ebfn s\u1ef1 suy gi\u1ea3m ch\u1ee9c […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nH\u1ed9i ch\u1ee9ng Guillain Barr\u00e9: Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"Guillain Barr\u00e9 l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u1ea7n kinh hi\u1ebfm g\u1eb7p nh\u01b0ng nghi\u00eam tr\u1ecdng, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng th\u1ea7n kinh v\u1eadn \u0111\u1ed9ng v\u00e0 th\u1ea7n kinh c\u1ea3m gi\u00e1c\" \/>\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=\"H\u1ed9i ch\u1ee9ng Guillain Barr\u00e9: Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - 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