{"id":35933,"date":"2023-07-01T14:19:08","date_gmt":"2023-07-01T07:19:08","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35933"},"modified":"2023-07-01T14:19:08","modified_gmt":"2023-07-01T07:19:08","slug":"viem-tieu-phe-quan-nguyen-nhan-trieu-chung-va-phuong-phap-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/07\/01\/viem-tieu-phe-quan-nguyen-nhan-trieu-chung-va-phuong-phap-dieu-tri\/","title":{"rendered":"Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n: Nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"<p><strong>Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n (VTPQ) l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam ph\u1ebf qu\u1ea3n nh\u1ecf \u0111\u01b0\u1eddng k\u00ednh &lt; 2mm th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb d\u01b0\u1edbi 2 tu\u1ed5i, \u0111\u1eb7c tr\u01b0ng b\u1edfi h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng: th\u1edf nhanh, r\u00fat l\u00f5m l\u1ed3ng ng\u1ef1c, kh\u00f2 kh\u00e8 v\u00e0 ran ph\u1ed5i x\u1ea3y ra sau nhi\u1ec5m vir\u00fat \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean. L\u00e2y truy\u1ec1n ch\u1ee7 y\u1ebfu do ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi ch\u1ea5t ti\u1ebft khi ng\u01b0\u1eddi b\u1ec7nh ho, h\u1eaft h\u01a1i ho\u1eb7c gi\u00e1n ti\u1ebfp qua ng\u01b0\u1eddi ch\u0103m s\u00f3c, nh\u00e2n vi\u00ean y t\u1ebf, \u0111\u1ed3 ch\u01a1i c\u1ee7a tr\u1ebb&#8230; Ch\u1ea9n \u0111o\u00e1n ch\u1ee7 y\u1ebfu d\u1ef1a v\u00e0o l\u00e2m s\u00e0ng.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35934 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/b28bc38f-7705-426b-acee-7c048e0cf42f-300x300.jpg\" alt=\"viem-tieu-phe-quan\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/b28bc38f-7705-426b-acee-7c048e0cf42f-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/b28bc38f-7705-426b-acee-7c048e0cf42f-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/b28bc38f-7705-426b-acee-7c048e0cf42f-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/07\/b28bc38f-7705-426b-acee-7c048e0cf42f.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2>1.\u00a0\u00a0\u00a0 Nguy\u00ean nh\u00e2n vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n<\/h2>\n<p>Th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb t\u1eeb 2-24 th\u00e1ng. \u0110a s\u1ed1 tr\u1ebb m\u1eafc b\u1ec7nh \u1edf nh\u00f3m \u2264 12 th\u00e1ng. 80% x\u1ea3y ra \u1edf tr\u1ebb \u2264 6 th\u00e1ng.<\/p>\n<p>T\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh:th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 vir\u00fat h\u1ee3p b\u00e0o h\u00f4 h\u1ea5p RSV (&gt; 50% tr\u01b0\u1eddng h\u1ee3p), k\u1ebf \u0111\u1ebfn l\u00e0 Parain\ufb02uenza virus, Adenovirus, Rhinovirus, Human metapneumovirus, Human bocavirus v\u00e0 Mycoplasma.<\/p>\n<p>\u1ede c\u00e1c n\u01b0\u1edbc \u00f4n \u0111\u1edbi, VTPQ th\u01b0\u1eddng x\u1ea3y ra v\u00e0o m\u00f9a \u0111\u00f4ng, \u0111\u1ea7u m\u00f9a xu\u00e2n; d\u1ecbch RSV x\u1ea3y ra th\u01b0\u1eddng t\u1eeb th\u00e1ng 11 \u0111\u1ebfn th\u00e1ng 4. \u1ede c\u00e1c n\u01b0\u1edbc nhi\u1ec7t \u0111\u1edbi, VTPQ do RSV xu\u1ea5t hi\u1ec7n quanh n\u0103m.<\/p>\n<h2>2.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ch\u1ea9n \u0111o\u00e1n<\/h2>\n<p><strong>2.1 Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/strong><\/p>\n<p>Ch\u1ee7 y\u1ebfu d\u1ef1a v\u00e0o l\u00e2m s\u00e0ng: b\u1ec7nh x\u1ea3y ra \u1edf tr\u1ebb d\u01b0\u1edbi 2 tu\u1ed5i, \u0111\u1eb7c tr\u01b0ng b\u1edfi bi\u1ec3u hi\u1ec7n nhi\u1ec5m vir\u00fat h\u00f4 h\u1ea5p tr\u00ean (s\u1ed1t nh\u1eb9, ho, h\u1eaft h\u01a1i,ch\u1ea3y n\u01b0\u1edbc m\u0169i) 1-3 ng\u00e0y; sau \u0111\u00f3 l\u00e0 kh\u00f2 kh\u00e8 v\u00e0 th\u1edf g\u1eafng s\u1ee9c (th\u1edf nhanh, ph\u1eadp ph\u1ed3ng c\u00e1nh m\u0169i hay r\u00fat l\u00f5m l\u1ed3ng ng\u1ef1c). Kh\u00e1m ph\u1ed5i c\u00f3 ran ng\u00e1y, ran r\u00edt v\u00e0 ran \u1ea9m nh\u1ecf h\u1ea1t lan t\u1ecfa v\u00e0o cu\u1ed1i th\u00ec h\u00edt v\u00e0o v\u00e0 \u0111\u1ea7u th\u00ec th\u1edf ra. Trong tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng, kh\u00f4ng nghe \u0111\u01b0\u1ee3c ph\u1ebf \u00e2m khi t\u1eafc ngh\u1ebdn ho\u00e0n to\u00e0n ti\u1ec3u ph\u1ebf qu\u1ea3n. \u1ede tr\u1ebb nh\u1ecf, \u0111\u1eb7c bi\u1ec7t tr\u1ebb s\u01a1 sinh thi\u1ebfu th\u00e1ng, c\u00f3 th\u1ec3 g\u1eb7p th\u1edf kh\u00f4ng \u0111\u1ec1u hay c\u01a1n ng\u01b0ng th\u1edf k\u00e9o d\u00e0i.<\/p>\n<p><strong>2.2\u00a0 Ch\u1ea9n \u0111o\u00e1n m\u1ee9c \u0111\u1ed9 n\u1eb7ng:<\/strong><\/p>\n<table width=\"918\">\n<tbody>\n<tr>\n<td width=\"252\">&nbsp;<\/td>\n<td width=\"227\"><strong>VTPQ nh\u1eb9<\/strong><\/td>\n<td width=\"227\"><strong>VTPQ trung b\u00ecnh<\/strong><\/td>\n<td width=\"213\"><strong>VTPQ n\u1eb7ng<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"252\">\u0102n\/b\u00fa<\/td>\n<td width=\"227\">B\u00ecnh th\u01b0\u1eddng<\/td>\n<td width=\"227\">K\u00e9m, c\u00f2n h\u01a1n 1\/2<\/td>\n<td width=\"213\">B\u1ecf \u0103n, b\u00fa<\/td>\n<\/tr>\n<tr>\n<td width=\"252\">T\u1ea7n s\u1ed1 th\u1edf<\/td>\n<td width=\"227\">&lt; 2 th\u00e1ng: \u2265 60\/ph\u00fat<\/p>\n<p>&gt; 2 th\u00e1ng: \u2265 50\/ph\u00fat<\/td>\n<td width=\"227\">&gt; 60\/ph\u00fat<\/td>\n<td width=\"213\">&gt; 70\/ph\u00fat<\/td>\n<\/tr>\n<tr>\n<td width=\"252\">R\u00fat l\u00f5m l\u1ed3ng ng\u1ef1c<\/td>\n<td width=\"227\">Nh\u1eb9<\/td>\n<td width=\"227\">Trung b\u00ecnh<\/td>\n<td width=\"213\">N\u1eb7ng<\/td>\n<\/tr>\n<tr>\n<td width=\"252\">Ph\u1eadp ph\u1ed3ng c\u00e1nh m\u0169i \/ th\u1edf r\u00ean<\/td>\n<td width=\"227\">Kh\u00f4ng c\u00f3<\/td>\n<td width=\"227\">Kh\u00f4ng c\u00f3<\/td>\n<td width=\"213\">C\u00f3<\/td>\n<\/tr>\n<tr>\n<td width=\"252\">SpO<sub>2<\/sub><\/td>\n<td width=\"227\">&gt; 92%<\/td>\n<td width=\"227\">88-92%<\/td>\n<td width=\"213\">&lt; 88%<\/td>\n<\/tr>\n<tr>\n<td width=\"252\">To\u00e0n tr\u1ea1ng<\/td>\n<td width=\"227\">B\u00ecnh th\u01b0\u1eddng<\/td>\n<td width=\"227\">B\u1ee9t r\u1ee9t, k\u00edch th\u00edch<\/td>\n<td width=\"213\">Li b\u00ec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>Tr\u1ebb c\u00f3 nguy c\u01a1 cao b\u1ecb VTPQ n\u1eb7ng:<\/h3>\n<ul>\n<li>Tr\u1ebb \u0111\u1ebb non hi\u1ec7n d\u01b0\u1edbi 3 th\u00e1ng tu\u1ed5i.<\/li>\n<li>Tr\u1ebb b\u1ecb b\u1ec7nh tim b\u1ea9m sinh, lo\u1ea1n s\u1ea3n ph\u1ebf qu\u1ea3n-ph\u1ed5i ho\u1eb7c b\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh kh\u00e1c, b\u1ec7nh l\u00fd th\u1ea7n kinh-c\u01a1.<\/li>\n<li>Tr\u1ebb suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/li>\n<\/ul>\n<h3>2.3 Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/h3>\n<ul>\n<li>Hen ph\u1ebf qu\u1ea3n:l\u00e0 ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t quan tr\u1ecdng.Ti\u1ec1n s\u1eedgia \u0111\u00ecnh c\u00f3 hen, ch\u00e0m da, c\u01a1 \u0111\u1ecba d\u1ecb \u1ee9ng, c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n gi\u00fap ch\u1ea9n \u0111o\u00e1n hen.<\/li>\n<li>Vi\u00eam ph\u1ed5i do vi khu\u1ea9n: kh\u00f3 ph\u00e2n bi\u1ec7t vi\u00eam ph\u1ed5i do vi khu\u1ea9n v\u00e0 VTPQ \u1edf tr\u1ebb nh\u0169 nhi v\u00ec bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a c\u1ea3 hai b\u1ec7nh \u0111\u1ec1u kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. Tr\u1ebb b\u1ecb vi\u00eam ph\u1ed5i do vi khu\u1ea9n c\u00f3 th\u1ec3 c\u00f3 bi\u1ec3u hi\u1ec7n n\u1eb7ng h\u01a1n nh\u01b0 s\u1ed1t cao, nghe ph\u1ed5i c\u00f3 ran n\u1ed5.<\/li>\n<li>B\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh: c\u1ea7n nghi ng\u1edd khi tr\u1ebb c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng k\u00e9o d\u00e0i ho\u1eb7c t\u00e1i ph\u00e1t nh\u01b0 kh\u00f2 kh\u00e8, ho t\u00e1i ph\u00e1t; th\u1edf r\u00edt, ho\u1eb7c nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p t\u00e1i ph\u00e1t.<\/li>\n<li>Vi\u00eam ph\u1ed5i h\u00edt \u1edf tr\u1ebb tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n v\u00e0\/ho\u1eb7c r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng nu\u1ed1t:bi\u1ec3u hi\u1ec7n g\u1ee3i \u00fd bao g\u1ed3m ho khi \u0103n, t\u00edm khi b\u00fa, th\u1edf r\u00edt t\u00e1i ph\u00e1t ho\u1eb7c m\u1ea1n t\u00ednh.<\/li>\n<li>C\u00e1c b\u1ec7nh l\u00fd b\u1ea9m sinh: v\u00f2ng nh\u1eabn m\u1ea1ch m\u00e1u b\u1ea9m sinh, h\u1eb9p kh\u00ed qu\u1ea3n b\u1ea9m sinh.N\u1ed9i soi ph\u1ebf qu\u1ea3n, ch\u1ee5p CT-scan c\u00f3 th\u1ec3 gi\u00fap ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/li>\n<\/ul>\n<p><strong>2.4 C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n<ul>\n<li>X-quang ng\u1ef1c<\/li>\n<li>C\u00f4ng th\u1ee9c m\u00e1u<\/li>\n<li>N\u1ed3ng \u0111\u1ed9 CRP huy\u1ebft thanh trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng [2].<\/li>\n<li>\u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3<\/li>\n<li>T\u00ecm kh\u00e1ng nguy\u00ean RSV trong d\u1ecbch r\u1eeda m\u0169i b\u1eb1ng c\u00e1c k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n nhanh nh\u01b0 mi\u1ec5n d\u1ecbch hu\u1ef3nh quang (immunofluorescent), mi\u1ec5n d\u1ecbch enzyme (enzyme immunoassay).<\/li>\n<li>Kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch<\/li>\n<\/ul>\n<h2>3.\u00a0 \u0110i\u1ec1u tr\u1ecb vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n<\/h2>\n<p><strong>3.1 Ch\u1ec9 \u0111\u1ecbnh nh\u1eadp vi\u1ec7n:<\/strong><\/p>\n<ul>\n<li>Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n trung b\u00ecnh ho\u1eb7c n\u1eb7ng.<\/li>\n<li>Bi\u1ec3u hi\u1ec7n m\u1ea5t n\u01b0\u1edbc ho\u1eb7c b\u00fa k\u00e9m.<\/li>\n<li>T\u00edm ho\u1eb7c b\u1ec7nh s\u1eed c\u00f3 ng\u01b0ng th\u1edf.<\/li>\n<li>Tr\u1ebb c\u00f3 nguy c\u01a1 cao.<\/li>\n<\/ul>\n<p><strong>3.2 Ti\u00eau chu\u1ea9n ra vi\u1ec7n:<\/strong><\/p>\n<ul>\n<li>VTPQ m\u1ee9c \u0111\u1ed9 nh\u1eb9-trung b\u00ecnh.<\/li>\n<li>SpO<sub>2<\/sub> \u2265 92% khi th\u1edf kh\u00ed tr\u1eddi (n\u1ebfu \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1edf oxy th\u00ec ph\u1ea3i ng\u01b0ng oxy \u00edt nh\u1ea5t 4 gi\u1edd tr\u01b0\u1edbc \u0111\u00f3).<\/li>\n<li>B\u00fa \u0111\u01b0\u1ee3c (\u00edt nh\u1ea5t 2\/3 l\u01b0\u1ee3ng b\u00fa b\u00ecnh th\u01b0\u1eddng).<\/li>\n<li>B\u1ed1 m\u1eb9 c\u00f3 th\u1ec3 \u0111\u01b0a tr\u1ebb t\u00e1i kh\u00e1m n\u1ebfu t\u00ecnh tr\u1ea1ng b\u1ec7nh c\u1ee7a ch\u00e1u n\u1eb7ng h\u01a1n.<\/li>\n<\/ul>\n<p><strong>3.3 X\u1eed tr\u00ed vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n c\u1ea5p:<\/strong><\/p>\n<ul>\n<li>Th\u1edf oxy:<\/li>\n<li>Cho tr\u1ebb th\u1edf oxy khi c\u1ea7n \u0111\u1ec3 duy tr\u00ec SpO<sub>2<\/sub> &gt; 92%, th\u01b0\u1eddng cho th\u1edf oxy qua canuyn m\u0169i. \u0110\u1ed1i v\u1edbi tr\u1ebb nh\u0169 nhi n\u00ean cho th\u1edf oxy t\u1ed1i \u0111a 2 l\u00edt\/ph\u00fat.<\/li>\n<li>Cai oxy: c\u1ea7n \u0111\u00e1nh gi\u00e1 c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng \u0111\u1ec3 cai oxy:\n<ul>\n<li>Bi\u1ec3u hi\u1ec7n l\u00e2m l\u00e0ng \u1ed5n \u0111\u1ecbnh v\u00e0 c\u1ea3i thi\u1ec7n.<\/li>\n<li>SpO<sub>2<\/sub> \u1ed5n \u0111\u1ecbnh tr\u00ean 95%.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>C\u00e1ch cai oxy: gi\u1ea3m d\u1ea7n l\u01b0u l\u01b0\u1ee3ng oxy m\u1ed7i 4 gi\u1edd: 2 l\u00edt\/ph\u00fat -&gt; 1,5 l\u00edt\/ph\u00fat -&gt;\u00a0 1 l\u00edt\/ph\u00fat &#8211; &gt; 0,5 l\u00edt\/ph\u00fat -&gt; 0,25 l\u00edt\/ph\u00fat sau \u0111\u00f3 ng\u01b0ng oxy, th\u1edf kh\u00ed tr\u1eddi. 30 ph\u00fat sau m\u1ed7i l\u1ea7n gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng oxy, c\u1ea7n \u0111\u00e1nh gi\u00e1 SpO<sub>2<\/sub>, m\u1ea1ch, t\u1ea7n s\u1ed1 th\u1edf, d\u1ea5u g\u1eafng s\u1ee9c. N\u1ebfu SpO<sub>2<\/sub> kh\u00f4ng \u1ed5n \u0111\u1ecbnh tr\u00ean 95% th\u00ec kh\u00f4ng gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng oxy th\u00eam n\u1eefa.<\/p>\n<ul>\n<li>V\u1eadt l\u00fd tr\u1ecb li\u1ec7u h\u00f4 h\u1ea5p: kh\u00f4ng n\u00ean ti\u1ebfn h\u00e0nh v\u1eadt l\u00fd tr\u1ecb li\u1ec7u h\u00f4 h\u1ea5p cho tr\u1ebb b\u1ecb VTPQ \u0111\u1ec3 tr\u00e1nh g\u00e2y stress cho tr\u1ebb v\u00e0 \u0111\u1ec3 gi\u1ea3m chi ph\u00ed \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li>Cung c\u1ea5p d\u1ecbch v\u00e0 dinh d\u01b0\u1ee1ng:<\/li>\n<li>Cho \u0103n\/b\u00fa t\u1eebng b\u1eefa nh\u1ecf.<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh nu\u00f4i \u0103n qua \u1ed1ng th\u00f4ng m\u0169i-d\u1ea1 d\u00e0y khi tr\u1ebb th\u1edf nhanh &gt; 70 l\u1ea7n\/ph\u00fat, n\u00f4n li\u00ean t\u1ee5c khi \u0103n\/b\u00fa, khi SpO<sub>2<\/sub> &lt; 90% d\u00f9 \u0111ang th\u1edf oxy, th\u1edf g\u1eafng s\u1ee9c r\u00f5 khi \u0103n u\u1ed1ng ho\u1eb7c b\u00fa.<\/li>\n<li>Tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng, c\u1ea7n truy\u1ec1n d\u1ecbch v\u00e0 nu\u00f4i d\u01b0\u1ee1ng b\u1eb1ng \u0111\u01b0\u1eddng TM v\u00e0 l\u01b0\u1ee3ng d\u1ecbch cung c\u1ea5p cho tr\u1ebb ch\u1ec9 b\u1eb1ng 75% nhu c\u1ea7u h\u1eb1ng ng\u00e0y.<\/li>\n<li>N\u1ebfu tr\u1ebb c\u00f3 bi\u1ec3u hi\u1ec7n s\u1ed1c, c\u00e2n nh\u1eafc truy\u1ec1n nhanh dung d\u1ecbch Natri Clorua 0,9%, sau \u0111\u00f3 b\u00f9 d\u1ecbch thi\u1ebfu h\u1ee5t trong 24 gi\u1edd. N\u1ebfu tr\u1ebb b\u1ecb suy h\u00f4 h\u1ea5p n\u1eb7ng nh\u01b0ng kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n m\u1ea5t n\u01b0\u1edbc, ch\u1ec9 truy\u1ec1n d\u1ecbch TM v\u1edbi l\u01b0\u1ee3ng b\u1eb1ng 75% nhu c\u1ea7u c\u0103n b\u1ea3n \u0111\u1ec3 tr\u00e1nh h\u1ed9i ch\u1ee9ng t\u0103ng ti\u1ebft ADH b\u1ea5t th\u01b0\u1eddng.<\/li>\n<\/ul>\n<p><strong>Thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n:<\/strong><\/p>\n<ul>\n<li>Salbutamol: c\u00e2n nh\u1eafc \u0111i\u1ec1u tr\u1ecb th\u1eed salbutamol phun kh\u00ed dung ho\u1eb7c b\u00ecnh h\u00edt \u0111\u1ecbnh li\u1ec1u qua bu\u1ed3ng \u0111\u1ec7m, nh\u1ea5t l\u00e0 \u0111\u1ed1i v\u1edbi tr\u1ebb &gt; 6 th\u00e1ng tu\u1ed5i, c\u00f3 c\u01a1 \u0111\u1ecba d\u1ecb \u1ee9ng v\u00e0 ti\u1ec1n s\u1eed kh\u00f2 kh\u00e8. Li\u1ec1u l\u01b0\u1ee3ng: 2,5 mg phun kh\u00ed dung ho\u1eb7c 6 x\u1ecbt (lo\u1ea1i 100 mcg\/x\u1ecbt) 1 l\u1ea7n, \u0111\u00e1nh gi\u00e1 20 ph\u00fat sau khi d\u00f9ng; ch\u1ec9 l\u1eadp l\u1ea1i khi l\u00e2m s\u00e0ng c\u1ea3i thi\u1ec7n.<\/li>\n<li>Adrenaline phun kh\u00ed dung: c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng khi c\u1ea7n v\u1edbi li\u1ec1u: Adrenalin 1 mg\/ml: 1-2 ml pha trong 2-5 ml n\u01b0\u1edbc mu\u1ed1i sinh l\u00fd; c\u00f3 th\u1ec3 l\u1eadp l\u1ea1i 1-2 gi\u1edd.<\/li>\n<li>Corticosteroid \u0111\u01b0\u1eddng to\u00e0n th\u00e2n v\u00e0 phun kh\u00ed dung: kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng \u1edf b\u1ec7nh nhi VTPQC.<\/li>\n<li>Kh\u00ed dung n\u01b0\u1edbc mu\u1ed1i \u01b0u tr\u01b0\u01a1ng (3%): ch\u1ec9 n\u00ean s\u1eed d\u1ee5ng \u1edf tr\u1ebb VTPQ nh\u1eadp vi\u1ec7n, kh\u00f4ng d\u00f9ng \u1edf khoa kh\u00e1m b\u1ec7nh.<\/li>\n<\/ul>\n<p><strong>Kh\u00e1ng sinh<\/strong>: ch\u1ec9 cho khi c\u00f3 b\u1eb1ng ch\u1ee9ng ho\u1eb7c nghi ng\u1edd b\u1ed9i nhi\u1ec5m vi tr\u00f9ng. L\u1ef1a ch\u1ecdn kh\u00e1ng sinh ban \u0111\u1ea7u nh\u01b0 vi\u00eam ph\u1ed5i do vi tr\u00f9ng.<\/p>\n<ul>\n<li>Thu\u1ed1c kh\u00e1ng vir\u00fat Ribavirin: kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng th\u01b0\u1eddng qui trong \u0111i\u1ec1u tr\u1ecb VTPQ, ch\u1ec9 c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng \u1edf b\u1ec7nh nhi VTPQ n\u1eb7ng c\u00f3 suy gi\u1ea3m mi\u1ec5n d\u1ecbch. Thu\u1ed1c \u0111\u01b0\u1ee3c d\u00f9ng d\u01b0\u1edbi d\u1ea1ng phun kh\u00ed dung li\u00ean t\u1ee5c 12-18 gi\u1edd m\u1ed7i ng\u00e0y trong 3-7 ng\u00e0y v\u1edbi m\u00e1y phun kh\u00ed dung h\u1ea1t nh\u1ecf qua hood ho\u1eb7c l\u1ec1u.<\/li>\n<\/ul>\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n<ol>\n<li>Gi\u00e1o tr\u00ecnh Nhi khoa (2020), Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y- d\u01b0\u1ee3c TPHCM.<\/li>\n<li>Coates BM et al (2015), &#8220;Wheezing, Bronchiolitis and Bronchitis&#8221;, <em>Nelson textbook of Pediatrics, <\/em>20<sup>th<\/sup> edition, W B Saunder company, Philadelphia, pp. 2044-2049.<\/li>\n<li>Piedra PA, Stark AR (2017), <em>Bronchiolitis in infants and children: Clinical features and diagnosis<\/em>, Available at: <em>http:\/\/www.uptodate.com<\/em><\/li>\n<\/ol>\n<p>Xem th\u00eam: <a href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/hen-phe-quan-o-tre-em\/\">Hen ph\u1ebf qu\u1ea3n tr\u1ebb em<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n (VTPQ) l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam ph\u1ebf qu\u1ea3n nh\u1ecf \u0111\u01b0\u1eddng k\u00ednh &lt; 2mm th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb d\u01b0\u1edbi 2 tu\u1ed5i, \u0111\u1eb7c tr\u01b0ng b\u1edfi h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng: th\u1edf nhanh, r\u00fat l\u00f5m l\u1ed3ng ng\u1ef1c, kh\u00f2 kh\u00e8 v\u00e0 ran ph\u1ed5i x\u1ea3y ra sau nhi\u1ec5m vir\u00fat \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean. L\u00e2y truy\u1ec1n ch\u1ee7 y\u1ebfu do [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,15,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n: Nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam ph\u1ebf qu\u1ea3n nh\u1ecf \u0111\u01b0\u1eddng k\u00ednh &lt; 2mm th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb d\u01b0\u1edbi 2 tu\u1ed5i, \u0111\u1eb7c tr\u01b0ng b\u1edfi h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng th\u1edf nhanh..\" \/>\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=\"Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n: Nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n l\u00e0 t\u00ecnh tr\u1ea1ng vi\u00eam ph\u1ebf qu\u1ea3n nh\u1ecf \u0111\u01b0\u1eddng k\u00ednh &lt; 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