{"id":35930,"date":"2023-07-01T13:51:47","date_gmt":"2023-07-01T06:51:47","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35930"},"modified":"2023-07-01T13:51:47","modified_gmt":"2023-07-01T06:51:47","slug":"trieu-chung-sot-ret-cach-nhan-biet-va-dieu-tri-hieu-qua","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/07\/01\/trieu-chung-sot-ret-cach-nhan-biet-va-dieu-tri-hieu-qua\/","title":{"rendered":"Tri\u1ec7u ch\u1ee9ng s\u1ed1t r\u00e9t: C\u00e1ch nh\u1eadn bi\u1ebft v\u00e0 \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3"},"content":{"rendered":"<p><strong>S\u1ed1t r\u00e9t l\u00e0 m\u1ed9t b\u1ec7nh truy\u1ec1n nhi\u1ec5m l\u00e2y qua \u0111\u01b0\u1eddng m\u00e1u do k\u00fd sinh tr\u00f9ng plasmodium g\u00e2y ra. \u00a0 L\u00e0 b\u1ec7nh c\u1ee7a v\u00f9ng nhi\u1ec7t \u0111\u1edbi thu\u1eadn l\u1ee3i cho mu\u1ed7i ph\u00e1t tri\u1ec3n.Tri\u1ec7u ch\u1ee9ng b\u1ec7nh s\u1ed1t r\u00e9t th\u01b0\u1eddng l\u00e0 s\u1ed1t theo chu k\u1ef3, \u1edbn l\u1ea1nh, n\u1eb7ng h\u01a1n c\u00f3 th\u1ec3 g\u00e2y co gi\u1eadt, suy h\u00f4 h\u1ea5p, thi\u1ebfu m\u00e1u huy\u1ebft t\u00e1n l\u00e1ch to\u2026 \u0110i\u1ec1u tr\u1ecb s\u1ed1t r\u00e9t b\u1eb1ng thu\u1ed1c ch\u1ed1ng s\u1ed1t r\u00e9t, b\u1ec7nh nh\u00e2n c\u1ea7n nh\u1eadp vi\u1ec7n \u0111\u1ec3 theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb v\u00e0 ki\u1ec3m tra m\u1eadt \u0111\u1ed9 k\u00fd sinh tr\u00f9ng 12 &#8211; 24 gi\u1edd\/ l\u1ea7n.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35931 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/1926843f-11f2-4768-a7a0-736db14d1cd8-300x300.jpg\" alt=\"sot-ret\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/1926843f-11f2-4768-a7a0-736db14d1cd8-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/1926843f-11f2-4768-a7a0-736db14d1cd8-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/1926843f-11f2-4768-a7a0-736db14d1cd8-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/1926843f-11f2-4768-a7a0-736db14d1cd8.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2><strong>\u00a0 1. \u0110\u1ea1i c\u01b0\u01a1ng s\u1ed1t r\u00e9t<\/strong><\/h2>\n<p><strong>1.1 \u0110\u1ecbnh ngh\u0129a:<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">S\u1ed1t r\u00e9t l\u00e0 m\u1ed9t b\u1ec7nh truy\u1ec1n nhi\u1ec5m do k\u00fd sinh tr\u00f9ng <\/span><i><span style=\"font-weight: 400;\">Plasmodium<\/span><\/i><span style=\"font-weight: 400;\"> g\u00e2y ra, l\u00e2y lan qua trung gian c\u1ee7a mu\u1ed7i Anopheles (mu\u1ed7i \u0111\u00f2n x\u00f3c). \u0110\u00e2y l\u00e0 m\u1ed9t lo\u1ea1i b\u1ec7nh to\u00e0n th\u00e2n, c\u00f3 th\u1ec3 l\u00e0m t\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u c\u01a1 quan kh\u00e1c nhau. Ngo\u00e0i bi\u1ec3u hi\u1ec7n \u0111i\u1ec3n h\u00ecnh l\u00e0 c\u01a1n s\u1ed1t r\u00e9t, c\u00e1c b\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng n\u1eb7ng v\u00e0 g\u00e2y t\u1eed vong.<\/span><\/p>\n<p><strong>1.2 T\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh<\/strong><\/p>\n<ul>\n<li><i><span style=\"font-weight: 400;\">Plasmodium falciparum, p. vivax <\/span><\/i><span style=\"font-weight: 400;\">chi\u1ebfm \u01b0u th\u1ebf 95%. C\u00f2n <\/span><i><span style=\"font-weight: 400;\">p. malariae<\/span><\/i><span style=\"font-weight: 400;\"> ch\u1ec9 g\u1eb7p \u1edf m\u1ed9t t\u1ef7 l\u1ec7 r\u1ea5t th\u1ea5p<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> C\u00f4n tr\u00f9ng trung gian truy\u1ec1n b\u1ec7nh<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Kho\u1ea3ng 50 lo\u1ea1i Anopheles lan truy\u1ec1n b\u1ec7nh: Anopheles minimus, Anopheles sundaicus, A. balabacensis, A. subpictus.<\/span><\/p>\n<p><strong>1.3 T\u00f3m t\u1eaft sinh b\u1ec7nh h\u1ecdc<\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">V\u1ea5n \u0111\u1ec1 t\u00ednh th\u1ea5m th\u00e0nh m\u1ea1ch:<\/span><\/li>\n<li><span style=\"font-weight: 400;\">S\u1ef1 thay \u0111\u1ed5i c\u1ee7a h\u1ed3ng c\u1ea7u:<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0<\/span><span style=\"font-weight: 400;\">Hi\u1ec7n t\u01b0\u1ee3ng t\u0103ng t\u00ednh k\u1ebft d\u00ednh v\u00e0o th\u00e0nh mao m\u1ea1ch<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Cytokine<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Thi\u1ebfu d\u01b0\u1ee1ng kh\u00ed \u1edf c\u00e1c m\u00f4: Nh\u1eefng sang th\u01b0\u01a1ng do thi\u1ebfu d\u01b0\u1ee1ng kh\u00ed c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i trong giai \u0111o\u1ea1n \u0111\u1ea7u, nh\u01b0ng s\u1ebd d\u1ea7n d\u1ea7n ti\u1ebfn \u0111\u1ebfn b\u1ea5t h\u1ed3i ph\u1ee5c n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eeda ch\u1eefa k\u1ecbp th\u1eddi.<\/span><\/li>\n<\/ul>\n<h2><strong>2. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/h2>\n<p><strong>2.1 <\/strong><span style=\"font-weight: 400;\"><strong>Th\u1eddi k\u1ef3 \u1ee7 b\u1ec7nh:<\/strong> kh\u00f4ng tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">12 ng\u00e0y (9-14) \u0111\u1ed1i v\u1edbi <\/span><i><span style=\"font-weight: 400;\">p. falciparum<\/span><\/i><\/li>\n<li><span style=\"font-weight: 400;\">14 ng\u00e0y (8-17) \u0111\u1ed1i v\u1edbi <\/span><i><span style=\"font-weight: 400;\">p. vivax<\/span><\/i><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0<\/span><span style=\"font-weight: 400;\">28 ng\u00e0y (14-40) \u0111\u1ed1i v\u1edbi <\/span><i><span style=\"font-weight: 400;\">p. malariae<\/span><\/i><\/li>\n<li><span style=\"font-weight: 400;\">17 ng\u00e0y (16-18) \u0111\u1ed1i v\u1edbi <\/span><i><span style=\"font-weight: 400;\">p. ovale<\/span><\/i><\/li>\n<\/ul>\n<p><strong><i>2.2 S\u1ed1t r\u00e9t c\u01a1n<\/i><\/strong><\/p>\n<p><i><span style=\"font-weight: 400;\">\u00a0<\/span><\/i><span style=\"font-weight: 400;\">C\u01a1n s\u1ed1t r\u00e9t \u0111i\u1ec3n h\u00ecnh \u0111\u01b0\u1ee3c chia l\u00e0m ba th\u1eddi k\u1ef3:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Th\u1eddi k\u1ef3 1:\u00a0 Giai \u0111o\u1ea1n l\u1ea1nh<\/span><\/p>\n<ul>\n<li><i><span style=\"font-weight: 400;\">Th\u1eddi k\u1ef3 2.<\/span><\/i><span style=\"font-weight: 400;\"> Giai \u0111o\u1ea1n n\u00f3ng<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Th\u1eddi k\u1ef3 3.Giai \u0111o\u1ea1n \u0111\u1ed5 m\u1ed3 h\u00f4i<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Kh\u00e1m th\u1ef1c th\u1ec3 trong c\u01a1n s\u1ed1t r\u00e9t:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">T\u1ec9nh, ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c nh\u01b0ng r\u1ea5t \u0111\u1edd \u0111\u1eabn, gan v\u00e0 l\u00e1ch l\u1edbn qu\u00e1 b\u1edd s\u01b0\u1eddn v\u00e0 \u0111au khi s\u1edd \u0111\u1ebfn.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Sau nhi\u1ec1u c\u01a1n b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 xanh xao, thi\u1ebfu m\u00e1u.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a c\u01a1n s\u1ed1t r\u00e9t:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">C\u01a1n lu\u00f4n lu\u00f4n di\u1ec5n ti\u1ebfn theo ba giai \u0111o\u1ea1n nh\u01b0 tr\u00ean.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">C\u01a1n x\u1ea3y ra \u1edf gi\u1edd gi\u1ea5c t\u01b0\u01a1ng \u0111\u1ed1i nh\u1ea5t \u0111\u1ecbnh.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">C\u01a1n x\u1ea3y ra \u0111\u00fang chu k\u1ef3 t\u00f9y theo lo\u1ea1i <\/span><i><span style=\"font-weight: 400;\">Plasmodium<\/span><\/i><span style=\"font-weight: 400;\"> m\u1eafc ph\u1ea3i,24 gi\u1edd \u0111\u1ed1i v\u1edbi <\/span><i><span style=\"font-weight: 400;\">p. falciparum\\<\/span><\/i><span style=\"font-weight: 400;\"> 48 gi\u1edd \u0111\u1ed1i v\u1edbi <\/span><i><span style=\"font-weight: 400;\">p. vivax.<\/span><\/i><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">Gi\u1eefa c\u00e1c c\u01a1n, b\u1ec7nh nh\u00e2n v\u1eabn c\u1ea3m th\u1ea5y d\u1ec5 ch\u1ecbu, b\u00ecnh th\u01b0\u1eddng.<\/span><\/li>\n<\/ul>\n<p><strong>2.3 S\u1ed1t r\u00e9t n\u1eb7ng, c\u00f3 bi\u1ebfn ch\u1ee9ng<\/strong><\/p>\n<p><strong>\u0110i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Ng\u01b0\u1eddi m\u1edbi v\u00e0o v\u00f9ng s\u1ed1t r\u00e9t l\u01b0u h\u00e0nh (kh\u00f4ng c\u00f3 mi\u1ec5n d\u1ecbch).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Ph\u1ee5 n\u1eef c\u00f3 thai.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Tr\u1ebb em trong l\u1ee9a tu\u1ed5i t\u1eeb s\u00e1u \u0111\u1ebfn ch\u00edn th\u00e1ng tu\u1ed5i.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Nh\u1eefng ng\u01b0\u1eddi lao \u0111\u1ed9ng n\u1eb7ng.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Nh\u1eefng ng\u01b0\u1eddi nghi\u1ec7n ma t\u00fay, x\u00ec ke.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Nh\u1eefng ng\u01b0\u1eddi \u0111i\u1ec1u tr\u1ecb kh\u00f4ng \u0111\u1ee7 li\u1ec1u l\u01b0\u1ee3ng<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><strong>S\u1ed1t r\u00e9t th\u1ec3 n\u00e3o<\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">S\u1ed1t li\u00ean t\u1ee5c kh\u00f4ng d\u1ee9t c\u01a1n, nh\u1ee9c \u0111\u1ea7u nhi\u1ec1u,<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">Li b\u00ec, k\u00e9m ti\u1ebfp x\u00fac ho\u1eb7c g\u1eaft g\u1ecfng, lo s\u1ee3, h\u00e0nh vi b\u1ea5t th\u01b0\u1eddng ho\u1eb7c b\u1ee9t r\u1ee9t, v\u1eadt v\u00e3, n\u00f3i s\u1ea3ng, l\u01a1 m\u01a1, co gi\u1eadt, r\u1ed3i \u0111i v\u00e0o h\u00f4n m\u00ea n\u1eb7ng d\u1ea7n.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">G\u1ed3ng ng\u01b0\u1eddi ki\u1ec3u c\u1eaft n\u00e3o hay v\u1ecf n\u00e3o, ph\u1ea3n x\u1ea1 g\u00e2n x\u01b0\u01a1ng t\u0103ng ho\u1eb7c m\u1ea5t, \u0111\u00f4i khi c\u00f3 d\u1ea7u th\u1ea7n kinh khu tr\u00fa, d\u1ea5u t\u1ed5n th\u01b0\u01a1ng ti\u1ec3u n\u00e3o. c\u00f3 d\u1ea5u c\u1ed5 c\u1ee9ng, Kernig, Brudzinski.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">Thi\u1ec3u ni\u1ec7u hay v\u00f4 ni\u1ec7u (n\u01b0\u1edbc ti\u1ec3u &lt;400ml\/24 gi\u1edd ng\u01b0\u1eddi l\u1edbn, &lt;12 ml\/kg\/24 gi\u1edd tr\u1ebb em).<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Ur\u00ea huy\u1ebft v\u00e0 creatinin m\u00e1u t\u0103ng: tr\u00ean 13 mg\/dl).<\/span><\/li>\n<\/ul>\n<p><strong>V\u00e0ng da v\u00e0 thay \u0111\u1ed5i ch\u1ee9c n\u0103ng gan<\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">V\u00e0ng da v\u00e0 gan l\u1edbn, c\u00f3 th\u1ec3 k\u00e8m theo suy th\u1eadn.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 <\/span><span style=\"font-weight: 400;\">X\u00e9t nghi\u1ec7m bilirubin gi\u00e1n ti\u1ebfp, tr\u1ef1c ti\u1ebfp gia t\u0103ng, transaminase t\u0103ng nh\u1eb9 th\u1eddi gian prothrombine h\u01a1i k\u00e9o d\u00e0i\u2026<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><strong>Thi\u1ebfu m\u00e1u:<\/strong> Hay g\u1eb7p \u1edf tr\u1ebb em v\u00e0 ph\u1ee5 n\u1eef c\u00f3 thai, Hb m\u00e1u gi\u1ea3m d\u01b0\u1edbi 5g\/dl ho\u1eb7c dung t\u00edch h\u1ed3ng c\u1ea7u d\u01b0\u1edbi 15%<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><strong>Bi\u1ec3u hi\u1ec7n \u0111\u01b0\u1eddng ti\u00eau h\u00f3a:<\/strong> N\u00f4n \u00f3i, \u0111au b\u1ee5ng, ti\u00eau ch\u1ea3y, c\u00f3 th\u1ec3 g\u1eb7p ti\u00eau ch\u1ea3y \u1ed3 \u1ea1t, ph\u00e2n l\u1ecfng gi\u1ed1ng d\u1ecbch t\u1ea3 ho\u1eb7c ti\u00eau ch\u1ea3y v\u1edbi h\u1ed9i ch\u1ee9ng l\u1ef5, ph\u00e2n c\u00f3 \u0111\u00e0m nh\u1edbt.<\/span><\/p>\n<p><strong>Bi\u1ec3u hi\u1ec7n xu\u1ea5t huy\u1ebft: <\/strong><span style=\"font-weight: 400;\">Xu\u1ea5t huy\u1ebft da v\u1edbi nh\u1eefng \u0111\u1ed1m tr\u00f2n, b\u1edd \u0111\u1ec1u, n\u1ed5i g\u1ed3, ng\u1ea3 m\u00e0u t\u00edm xanh, k\u00edch th\u01b0\u1edbc 1 mm-1 cm ho\u1eb7c xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a (\u00f3i m\u00e1u, ti\u00eau ph\u00e2n \u0111en. ..).<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><strong>Ph\u00f9 ph\u1ed5i:<\/strong> <\/span><span style=\"font-weight: 400;\">T\u0103ng nh\u1ecbp th\u1edf, b\u1ec7nh nh\u00e2n kh\u00f3 th\u1edf t\u0103ng d\u1ea7n, ph\u1ed5i \u0111\u1ea7y rale.. B\u1ec7nh c\u1ea3nh kh\u00f3 \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u00f3 th\u1ec3 t\u1eed vong.<\/span><\/p>\n<p><strong>S\u1ed1c<\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> \u00a0 <\/span><span style=\"font-weight: 400;\">\u201cS\u1ed1t r\u00e9t th\u1ec3 gi\u00e1 l\u1ea1nh\u201d<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 <\/span><span style=\"font-weight: 400;\">Suy tu\u1ea7n ho\u00e0n v\u1edbi \u00e1p huy\u1ebft th\u1ea5p, m\u1ea1ch nhanh, y\u1ebfu, da l\u1ea1nh, \u0111\u1ea7u chi t\u00edm<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 <\/span><span style=\"font-weight: 400;\">K\u00e8m ph\u00f9 ph\u1ed5i, toan bi\u1ebfn d\u01b0\u1ee1ng<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 <\/span><span style=\"font-weight: 400;\">B\u1ec7nh c\u1ea3nh nhi\u1ec5m tr\u00f9ng huy\u1ebft gram \u00e2m ph\u1ed1i h\u1ee3p xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a \u1ed3 \u1ea1t..<\/span><\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<p><span style=\"font-weight: 400;\"><strong>Ti\u1ec3u huy\u1ebft s\u1eafc t\u1ed1<\/strong>: S\u1ed1t, l\u1ea1nh run, v\u00e0ng da, ti\u1ec3u huy\u1ebft s\u1eafc t\u1ed1, n\u01b0\u1edbc ti\u1ec3u s\u1eadm \u0111en, do t\u00e1n huy\u1ebft \u1ed3 \u1ea1t v\u00e0 nhanh ch\u00f3ng, d\u1eabn \u0111\u1ebfn thi\u1ebfu m\u00e1u c\u1ea5p, c\u00f3 bi\u1ebfn ch\u1ee9ng suy th\u1eadn, tr\u1ee5y tim m\u1ea1ch<\/span><\/p>\n<p><strong>H\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft: <\/strong><span style=\"font-weight: 400;\">B\u1ed3n ch\u1ed3n, lo s\u1ee3, kh\u00f3 th\u1edf, c\u1ea3m gi\u00e1c l\u1ea1nh, v\u00e3 m\u1ed3 h\u00f4i, tim \u0111\u1eadp nhanh, nh\u1ee9c \u0111\u1ea7u. l\u01a1 m\u01a1, h\u00f4n m\u00ea, t\u01b0 th\u1ebf co c\u1ee9ng \u01b0\u1ee1n ng\u01b0\u1eddi, co gi\u1eadt to\u00e0n th\u00e2n v\u00e0 s\u1ed1c.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><strong>2.4 S\u1ed1t r\u00e9t \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">Nh\u1eefng ph\u1ee5 n\u1eef c\u00f3 thai l\u1ea7n \u0111\u1ea7u, c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng n\u1eb7ng, m\u1eadt \u0111\u1ed9 k\u00fd sinh tr\u00f9ng trong b\u00e1nh nhau cao, v\u00e0 c\u00f3 nhi\u1ec1u bi\u1ebfn ch\u1ee9ng h\u01a1n: H\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, suy thai, thi\u1ebfu m\u00e1u, ph\u00f9 ph\u1ed5i, suy tim, nhi\u1ec5m tr\u00f9ng Nh\u1eefng tai bi\u1ebfn c\u1ee7a thai k\u1ef3 nh\u01b0: s\u1ea9y thai, thai ch\u1ebft l\u01b0u, sinh non ho\u1eb7c\u00a0 c\u00e2n n\u1eb7ng l\u00fac sinh th\u1ea5p.<\/span><\/p>\n<p><strong>2.5 S\u1ed1t r\u00e9t \u1edf tr\u1ebb em<\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">\u0110a s\u1ed1 c\u00e1c em s\u1ed1t kh\u00e1 cao, 40 \u0111\u1ed9 C, m\u1eb7t \u0111\u1ecf, th\u1edf nhanh. \u0110\u00f4i khi nhi\u1ec7t \u0111\u1ed9 kh\u00f4ng qu\u00e1 cao nh\u01b0ng c\u0169ng c\u00f3 bi\u1ec3u hi\u1ec7n co gi\u1eadt. C\u01a1n co gi\u1eadt ch\u1ec9 k\u00e9o d\u00e0i v\u00e0i ph\u00fat nh\u01b0ng ph\u1ea3n \u00e1nh m\u1ed9t s\u1ef1 k\u00edch th\u00edch c\u1ee7a n\u00e3o. Tr\u1ebb kh\u00f4ng v\u00e0o m\u00ea s\u00e2u sau c\u01a1n gi\u1eadt v\u00e0 t\u1ec9nh l\u1ea1i nhanh ch\u00f3ng.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Tr\u1ebb ph\u00f9, s\u1ee5t c\u00e2n, suy dinh d\u01b0\u1ee1ng, d\u1ec5 b\u1ecb nhi\u1ec5m tr\u00f9ng ph\u1ed5i hay ti\u00eau ch\u1ea3y, tr\u1ebb d\u1ec5 r\u01a1i v\u00e0o t\u00ecnh tr\u1ea1ng n\u1eb7ng: th\u1ec3 n\u00e3o, thi\u1ebfu m\u00e1u v\u00e0 c\u00f3 th\u1ec3 t\u1eed vong.<\/span><\/li>\n<\/ul>\n<h2><strong>3. \u0110i\u1ec1u tr\u1ecb s\u1ed1t r\u00e9t<\/strong><\/h2>\n<p><strong>3.1 Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; C\u1eaft s\u1ed1t.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Di\u1ec7t nhanh k\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t, tr\u00e1nh t\u00e1i ph\u00e1t v\u00e0 l\u00e2y lan.<\/span><\/p>\n<p>&#8211; \u0110i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng<\/p>\n<p><strong>3.2 \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3<\/strong><\/p>\n<p><b>V\u1edbi <\/b><b><i>p. vivax, ovale v\u00e0 malariae<\/i><\/b><\/p>\n<p><b>Chloroquine <\/b><span style=\"font-weight: 400;\">25mg\/kg chia trong 3 ng\u00e0y<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">Ng\u00e0y 1: Chloroquine 600mg c\u01a1 b\u1ea3n v\u00e0 6-8 gi\u1edd sau 300mg c\u01a1 b\u1ea3n<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">Ng\u00e0y 2 v\u00e0 3: Chloroquine 300mg c\u01a1 b\u1ea3n.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 \u00a0 \u00a0 <\/span><b>Primaquine: <\/b><span style=\"font-weight: 400;\">15mg \/ ng\u00e0y X 14 ng\u00e0y.<\/span><\/li>\n<\/ul>\n<p><b>\u00a0Tr\u1ebb em, <\/b><span style=\"font-weight: 400;\">li\u1ec1u Chloroquine \u0111\u01b0\u1ee3c t\u00ednh nh\u01b0 sau:<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> Ng\u00e0y 1: 10mg\/kg, 6-8 gi\u1edd sau 5mg\/kg;<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Ng\u00e0y 2: 5mg\/kg.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Ng\u00e0y 3: 5mg\/kg.<\/span><\/li>\n<li><b>Primaquine: <\/b><span style=\"font-weight: 400;\">0, 3mg\/kg\/ng\u00e0y trong 14 ng\u00e0y (tr\u1ebb tr\u00ean 5 tu\u1ed5i).<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Kh\u00f4ng d\u00f9ng Primaquin \u1edf ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 tr\u1ebb em d\u01b0\u1edbi 5 tu\u1ed5i<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">V\u1edbi <\/span><b>\u00a0<\/b><b><i>p. falciparum<\/i><\/b><\/p>\n<p><b>&#8211; Artesunate <\/b><span style=\"font-weight: 400;\">(vi\u00ean 50mg): Nl: 4 vi\u00ean, N2-3: m\u1ed7i ng\u00e0y 2v sau \u0111\u00f3 ph\u1ed1i h\u1ee3p <\/span><b>Mefloquin <\/b><span style=\"font-weight: 400;\">(vi\u00ean 250mg): 3 vi\u00ean u\u1ed1ng m\u1ed9t l\u1ea7n duy nh\u1ea5t.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Ho\u1eb7c: <\/span><b>Artemisinin <\/b><span style=\"font-weight: 400;\">(vi\u00ean 250mg): Nl: 4 vi\u00ean, N2-3: m\u1ed7i ng\u00e0y 2v, sau \u0111\u00f3 ph\u1ed1i h\u1ee3p <\/span><b>Mefloquin <\/b><span style=\"font-weight: 400;\">(vi\u00ean 250mg): 3 vi\u00ean u\u1ed1ng m\u1ed9t l\u1ea7n duy nh\u1ea5t.<\/span><\/p>\n<p><strong>3.3 \u0110i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng<\/strong><\/p>\n<p><b>&#8211; Ch\u1ed1ng s\u1ed1t cao:<\/b><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">H\u1ea1 nhi\u1ec7t v\u1eadt l\u00fd<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u00a0 \u00a0 \u00a0 \u00a0 <\/span><span style=\"font-weight: 400;\">Paracetamol, li\u1ec1u 10mg\/kg\/li\u1ec1u.<\/span><\/li>\n<\/ul>\n<p><b>&#8211; Ch\u1ed1ng co gi\u1eadt:<\/b><span style=\"font-weight: 400;\"> Diazepam ti\u00eam m\u1ea1ch (ng\u01b0\u1eddi l\u1edbn 10mg, tr\u1ebb em 0,2mg\/kg)<\/span><\/p>\n<p><b>&#8211; H\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft:<\/b><span style=\"font-weight: 400;\"> Truy\u1ec1n c\u00e1c glucose \u01b0u tr\u01b0\u01a1ng 30%, 40% hay 50% (\u1edf tr\u1ebb em t\u00ednh theo li\u1ec1u 0, 5g\/kg\/li\u1ec1u) sau \u0111\u00f3 duy tr\u00ec v\u1edbi glucose 5% hay 10%<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><strong>&#8211;\u00a0 Ch\u1ed1ng suy th\u1eadn: S<\/strong>\u1eed d\u1ee5ng l\u1ee3i ti\u1ec3u v\u1edbi li\u1ec1u t\u0103ng d\u1ea7n 40 mg r\u1ed3i 160 mg, 500 mg m\u1ed7i hai gi\u1edd n\u1ebfu kh\u00f4ng \u0111\u00e1p \u1ee9ng. c\u00f3 th\u1ec3 d\u00f9ng Dopamin (2, 5-5 mcg\/kg\/ph\u00fat)<\/span><\/p>\n<p><b>\u00a0&#8211; Ph\u00f9 ph\u1ed5i c\u1ea5p: <\/b><span style=\"font-weight: 400;\">n\u1eb1m \u0111\u1ea7u cao, h\u1ea1n ch\u1ebf l\u01b0\u1ee3ng n\u01b0\u1edbc v\u00e0o, gi\u1eef sao cho \u00e1p su\u1ea5t t\u0129nh m\u1ea1ch trung \u01b0\u01a1ng \u1edf m\u1ee9c 0-5 cm H2O, cho b\u1ec7nh nh\u00e2n th\u1edf oxy, h\u00fat \u0111\u00e0m nh\u1edbt, d\u00f9ng l\u1ee3i ti\u1ec3u m\u1ea1nh, garrot 3 chi hay n\u1eb7ng h\u01a1n n\u1eefa, tho\u00e1t b\u1edbt m\u00e1u.<\/span><\/p>\n<p><b>-S\u1ed1c: <\/b><span style=\"font-weight: 400;\">lo\u1ea1i tr\u1eeb nguy\u00ean nh\u00e2n s\u1ed1c do thi\u1ebfu n\u01b0\u1edbc (b\u00f9 d\u1ecbch \u0111\u1ea7y \u0111\u1ee7), thi\u1ebfu m\u00e1u (b\u00f9 m\u00e1u) hay s\u1ed1c do nhi\u1ec5m tr\u00f9ng gram \u00e2m (c\u1ea5y m\u00e1u v\u00e0 kh\u00e1ng sinh th\u00edch h\u1ee3p).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u0110\u1eb7t catheter CVP duy tr\u00ec 5-7 cm H2O theo d\u00f5i l\u01b0\u1ee3ng d\u1ecbch b\u00f9: dung d\u1ecbch tinh th\u1ec3 hay dung d\u1ecbch keo (huy\u1ebft t\u01b0\u01a1ng, huy\u1ebft t\u01b0\u01a1ng kh\u00f4, haemacel, dextran). Ngo\u00e0i ra, c\u00f2n c\u00f3 th\u1ec3 d\u00f9ng Dopamine.\u00a0<\/span><\/p>\n<p>Xem th\u00eam: <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/sot-co-giat-o-tre-nho-va-nhung-luu-y-bo-me-can-biet-de-xu-tri-kip-thoi\/\">S\u1ed1t co gi\u1eadt<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>S\u1ed1t r\u00e9t l\u00e0 m\u1ed9t b\u1ec7nh truy\u1ec1n nhi\u1ec5m l\u00e2y qua \u0111\u01b0\u1eddng m\u00e1u do k\u00fd sinh tr\u00f9ng plasmodium g\u00e2y ra. \u00a0 L\u00e0 b\u1ec7nh c\u1ee7a v\u00f9ng nhi\u1ec7t \u0111\u1edbi thu\u1eadn l\u1ee3i cho mu\u1ed7i ph\u00e1t tri\u1ec3n.Tri\u1ec7u ch\u1ee9ng b\u1ec7nh s\u1ed1t r\u00e9t th\u01b0\u1eddng l\u00e0 s\u1ed1t theo chu k\u1ef3, \u1edbn l\u1ea1nh, n\u1eb7ng h\u01a1n c\u00f3 th\u1ec3 g\u00e2y co gi\u1eadt, suy h\u00f4 h\u1ea5p, thi\u1ebfu m\u00e1u [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[22,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - 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