{"id":4089,"date":"2018-09-03T23:11:19","date_gmt":"2018-09-03T16:11:19","guid":{"rendered":"https:\/\/yhoccongdong.org\/du-an-khoa-nhi\/2018\/09\/03\/corticoid-trong-cac-benh-thuong-gap-o-tre\/"},"modified":"2024-03-04T13:50:44","modified_gmt":"2024-03-04T06:50:44","slug":"corticoid-trong-cac-benh-thuong-gap-o-tre","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/nhi-khoa\/corticoid-trong-cac-benh-thuong-gap-o-tre\/","title":{"rendered":"Corticoid trong c\u00e1c b\u1ec7nh th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb"},"content":{"rendered":"<p style=\"text-align: justify\">Corticoid l\u00e0 m\u1ed9t nh\u00f3m thu\u1ed1c r\u1ea5t \u2018\u2019l\u1ee3i h\u1ea1i\u201c \u2013 nhi\u1ec1u khi c\u00f3 \u00fd ngh\u0129a quy\u1ebft \u0111\u1ecbnh c\u1ee9u s\u1ed1ng b\u1ec7nh nh\u00e2n. T\u1eebng \u0111\u01b0\u1ee3c lang b\u0103m ho\u1eb7c nhi\u1ec1u ng\u01b0\u1eddi b\u00e1n thu\u1ed1c coi nh\u01b0 th\u1ea7n d\u01b0\u1ee3c c\u00f3 th\u1ec3 tr\u1ecb b\u00e1ch b\u1ec7nh. Bao g\u1ed3m c\u1ea3 \u0111i\u1ec1u tr\u1ecb bi\u1ebfng \u0103n.<\/p>\n<p style=\"text-align: justify\">Danh s\u00e1ch c\u00e1c b\u1ec7nh d\u01b0\u1edbi \u0111\u00e2y \u0111\u01b0\u1ee3c ph\u00e9p s\u1eed d\u1ee5ng corticoid trong \u0111i\u1ec1u tr\u1ecb, \u0111\u1ea7y \u0111\u1ee7 ch\u1ee9ng c\u1edb v\u00e0 \u0111\u00e3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc l\u1ee3i \u00edch v\u01b0\u1ee3t xa t\u00e1c h\u1ea1i. N\u1ebfu con b\u1ea1n m\u1eafc 1 trong nh\u1eefng ch\u1ee9ng b\u1ec7nh n\u00e0y v\u00e0 b\u00e1c s\u0129 c\u00f3 k\u00ea Corticoid th\u00ec b\u1ea1n c\u00f3 th\u1ec3 y\u00ean t\u00e2m.<\/p>\n<p style=\"text-align: justify\">T\u1ea5t nhi\u00ean ngo\u00e0i danh s\u00e1ch b\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 c\u00f2n c\u00e1c b\u1ec7nh kh\u00e1c n\u1eefa c\u00f3 ch\u1ec9 \u0111\u1ecbnh corticoid. Nh\u01b0ng \u0111\u1ec3 an to\u00e0n b\u1ea1n n\u00ean h\u1ecfi l\u1ea1i ng\u01b0\u1eddi k\u00ea \u0111\u01a1n ho\u1eb7c tham kh\u1ea3o \u00fd ki\u1ebfn chuy\u00ean gia n\u1ebfu con b\u1ea1n \u0111\u01b0\u1ee3c k\u00ea hay b\u00e1n corticoid cho nh\u1eefng b\u1ec7nh kh\u00f4ng n\u1eb1m trong danh s\u00e1ch n\u00e0y.<\/p>\n<p style=\"text-align: justify\"><strong>Ph\u1ea7n 1: Nh\u00f3m b\u1ec7nh h\u00f4 h\u1ea5p<\/strong><\/p>\n<h2 style=\"text-align: justify\">Vi\u00eam m\u0169i d\u1ecb \u1ee9ng<\/h2>\n<p style=\"text-align: justify\">Khi vi\u00eam m\u0169i d\u1ecb \u1ee9ng \u1ea3nh h\u01b0\u1edfng t\u1edbi ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng ho\u1eb7c l\u00e0m cho suy\u1ec5n tr\u1edf n\u00ean dai d\u1eb3ng kh\u00f3 ki\u1ec3m so\u00e1t. Corticoid d\u1ea1ng x\u1ecbt m\u0169i l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay. Corticoid u\u1ed1ng c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong v\u00e0i ng\u00e0y \u0111\u1ed1i v\u1edbi nh\u1eefng c\u01a1n d\u1ecb \u1ee9ng m\u0169i n\u1eb7ng trong th\u1eddi gian ch\u1edd \u0111\u1ee3i corticoid x\u1ecbt v\u00e0 anti-histamine ph\u00e1t huy t\u00e1c d\u1ee5ng.<\/p>\n<h2 style=\"text-align: justify\">Vi\u00eam s\u01b0ng h\u1ecdng<\/h2>\n<p style=\"text-align: justify\">M\u1ed9t meta-analysis cho th\u1ea5y 1 \u0111\u01a1n li\u1ec1u dexamethasone c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111au trong ch\u1ee9ng vi\u00eam s\u01b0ng h\u1ecdng \u1edf tr\u1ebb tr\u00ean 5 tu\u1ed5i \u2013 m\u1eb7c d\u00f9 b\u1eb1ng ch\u1ee9ng l\u00e0 c\u00f3 nh\u01b0ng ch\u01b0a \u0111\u01b0a v\u00e0o khuy\u1ebfn c\u00e1o. c\u00e1i n\u00e0y c\u1ea7n ch\u1edd th\u00eam tr\u01b0\u1edbc khi \u00e1p d\u1ee5ng th\u1ef1c ti\u1ec5n.<\/p>\n<h2 style=\"text-align: justify\">Tr\u01b0\u1edbc khi r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n<\/h2>\n<p style=\"text-align: justify\">T\u1ea1i c\u00e1c b\u1ec7nh vi\u1ec7n tr\u01b0\u1edbc r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n cho b\u1ec7nh nh\u00e2n \u0111ang th\u1edf m\u00e1y, dexamethasone c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u1eb1m ch\u1ed1ng vi\u00eam v\u00e0 ch\u1ed1ng ph\u00f9 n\u1ec1 v\u00f9ng thanh- kh\u00ed qu\u1ea3n b\u1ecb t\u1ed5n th\u01b0\u01a1ng do \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n.<\/p>\n<h2 style=\"text-align: justify\">Hen ph\u1ebf qu\u1ea3n (suy\u1ec5n)<\/h2>\n<p style=\"text-align: justify\"><strong>D\u1ef1 ph\u00f2ng suy\u1ec5n<\/strong>: Trong tr\u01b0\u1eddng h\u1ee3p con b\u1ea1n b\u1ecb suy\u1ec5n dai d\u1eb3ng ho\u1eb7c c\u00f3 nh\u1eefng c\u01a1n suy\u1ec5n n\u1eb7ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh ph\u00f2ng ng\u1eeba, corticoid d\u1ea1ng x\u1ecbt s\u1ebd \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh (FLIXOTIDE, SERETIDE, PULMICORT\u2026) corticoid \u0111\u01b0\u1eddng to\u00e0n th\u00e2n (u\u1ed1ng) \u0111\u00f4i khi \u0111\u01b0\u1ee3c d\u00f9ng v\u1edbi m\u1ee5c \u0111\u00edch d\u1ef1 ph\u00f2ng nh\u01b0ng hi\u1ebfm.<\/p>\n<p style=\"text-align: justify\"><strong>C\u1eaft c\u01a1n suy\u1ec5n:<\/strong> Khi con b\u1ea1n v\u00e0o m\u1ed9t c\u01a1n suy\u1ec5n t\u1eeb m\u1ee9c \u0111\u1ed9 trung b\u00ecnh tr\u1edf l\u00ean (c\u01a1n suy\u1ec5n trung b\u00ecnh \u0111\u01b0\u1ee3c nh\u1eadn d\u1ea1ng l\u00e0 c\u01a1n suy\u1ec5n c\u00f3 r\u00fat l\u00f5m ng\u1ef1c v\u00e0 tr\u1ebb v\u1eabn t\u1ec9nh t\u00e1o, kh\u00f4ng t\u00edm) ho\u1eb7c c\u01a1n suy\u1ec5n nh\u1eb9 nh\u01b0ng \u0111\u00e1p \u1ee9ng k\u00e9m v\u1edbi thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n (salbutamol) (Phun v\u00e0i l\u1ea7n m\u00e0 kh\u00f4ng ra c\u01a1n).<\/p>\n<h2 style=\"text-align: justify\">Croup (vi\u00eam thanh kh\u00ed ph\u1ebf qu\u1ea3n c\u1ea5p)<\/h2>\n<p style=\"text-align: justify\">Hi\u1ec7n t\u01b0\u1ee3ng vi\u00eam ph\u00f9 n\u1ec1 thanh kh\u00ed ph\u1ebf qu\u1ea3n \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u00ecnh tr\u1ea1ng khan ti\u1ebfng (hoarsen), th\u1edf r\u00edt(stridor) hay kh\u00f2 kh\u00e8 (wheezing).<\/p>\n<ul style=\"text-align: justify\">\n<li><strong>Croup nh\u1eb9<\/strong> (Westley score)\u2264 2 \u0111i\u1ec3m: u\u1ed1ng dexamethasone (0.15 to 0.6 mg\/kg, maximum dose 10 mg)- li\u1ec1u duy nh\u1ea5t<\/li>\n<li><strong>Croup trung b\u00ecnh<\/strong> (Westley Score) 3- 7 \u0111i\u1ec3m: DEXAMETHASONE 0.6 mg\/ kg -1 li\u1ec1u (c\u00f3 th\u1ec3 u\u1ed1ng, ti\u00eam) ho\u1eb7c kh\u00ed dung pulmicort c\u0169ng l\u00e0 1 l\u1ef1a ch\u1ecdn thay th\u1ebf ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c<\/li>\n<li><strong>Croup n\u1eb7ng<\/strong> (westlay score 8- 11 \u0111i\u1ec3m) \u0111e d\u1ecda t\u00ednh m\u1ea1ng (\u2265 12 \u0111i\u1ec3m) ngo\u00e0i corticoid ph\u1ea3i h\u1ed7 tr\u1ee3 th\u00eam nhi\u1ec1u bi\u1ec7n ph\u00e1p kh\u00e1c)<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">Lo\u1ea1n s\u1ea3n ph\u1ebf qu\u1ea3n ph\u1ed5i (dysplasia bronchopulmonary)<\/h2>\n<p style=\"text-align: justify\">Th\u01b0\u1eddng g\u1eb7p \u1edf c\u00e1c b\u00e9 s\u01a1 sinh v\u00ec l\u00ed do n\u00e0o \u0111\u00f3 ph\u1ea3i \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 th\u1edf oxy trong th\u1eddi gian d\u00e0i. corticoid c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u01b0\u1ee3c m\u1ee9c \u0111\u1ed9 vi\u00eam v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng ph\u1ed5i.<\/p>\n<h2 style=\"text-align: justify\">C\u00e1c b\u1ec7nh l\u00fd kh\u00e1c<\/h2>\n<p style=\"text-align: justify\">Vi\u00eam m\u0169i h\u1ecdng, vi\u00eam amidan, vi\u00eam V.A, vi\u00eam tai gi\u1eefa, vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n, vi\u00eam ph\u1ed5i kh\u00f4ng bi\u1ebfn ch\u1ee9ng\u2026 kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh corticoid<\/p>\n<h2 style=\"text-align: justify\">T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p style=\"text-align: justify\"><a href=\"https:\/\/www.facebook.com\/diendannhikhoa\/posts\/705257529671770?__tn__=K-R\" target=\"_blank\" rel=\"noopener\">https:\/\/www.facebook.com\/diendannhikhoa\/posts\/705257529671770?__tn__=K-R<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Danh s\u00e1ch c\u00e1c b\u1ec7nh d\u01b0\u1edbi \u0111\u00e2y \u0111\u01b0\u1ee3c ph\u00e9p s\u1eed d\u1ee5ng corticoid trong \u0111i\u1ec1u tr\u1ecb, \u0111\u1ea7y \u0111\u1ee7 ch\u1ee9ng c\u1edb v\u00e0 \u0111\u00e3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc l\u1ee3i \u00edch v\u01b0\u1ee3t xa t\u00e1c h\u1ea1<\/p>\n","protected":false},"author":14,"featured_media":4091,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[6104],"tags":[5675,5676,5677],"series":[3454],"coauthors":[2652],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Corticoid trong c\u00e1c b\u1ec7nh th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb - D\u1ef1 \u00e1n Nhi 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