{"id":6693,"date":"2018-09-03T23:12:44","date_gmt":"2018-09-03T16:12:44","guid":{"rendered":"https:\/\/yhoccongdong.org\/nhi-khoa\/viem-tieu-phe-quan-cap-o-tre\/"},"modified":"2024-03-04T13:50:44","modified_gmt":"2024-03-04T06:50:44","slug":"viem-tieu-phe-quan-cap-o-tre","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/nhi-khoa\/viem-tieu-phe-quan-cap-o-tre\/","title":{"rendered":"Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n c\u1ea5p \u1edf tr\u1ebb"},"content":{"rendered":"<div class=\"_1pfm\">\n<div id=\"u_0_3u\" class=\"_3d9q\">\n<div class=\"_4-u2 _hoc clearfix _4-u8\">\n<div class=\"clearfix\">\n<div id=\"u_0_3v\" class=\"lfloat _ohe\">\n<h2><span style=\"text-align: justify\">Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n c\u1ea5p l\u00e0 g\u00ec?<\/span><\/h2>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"content_container\">\n<div class=\"clearfix\">\n<div id=\"js_12\" class=\"_2pie _14i5 _1qkq _1qkx\" role=\"main\">\n<div id=\"pagelet_timeline_main_column\">\n<div id=\"u_0_40\">\n<div class=\"_1xnd\">\n<div class=\"_4-u2 _4-u8\">\n<div class=\"permalinkPost\">\n<div class=\"_5pcb\">\n<div role=\"feed\">\n<div id=\"u_0_j\" class=\"_4-u2 mbm _4mrt _5jmm _5pat _5v3q _4-u8\" role=\"article\">\n<div id=\"u_0_x\" class=\"_3ccb\">\n<div class=\"_5pcr userContentWrapper\">\n<div class=\"_1dwg _1w_m _q7o\">\n<div id=\"js_1q\" class=\"_5pbx userContent _3576\">\n<p style=\"text-align: justify\">L\u00e0 1 b\u1ec7nh vi\u00eam c\u1ea5p t\u00ednh c\u00e1c ph\u1ebf qu\u1ea3n c\u1ee1 nh\u1ecf v\u00e0 trung b\u00ecnh x\u1ea3y ra \u1edf tr\u1ebb t\u1eeb 1 th\u00e1ng \u0111\u1ebfn 2 tu\u1ed5i do si\u00eau vi g\u00e2y ra, kh\u1edfi ph\u00e1t sau vi\u00eam h\u00f4 h\u1ea5p tr\u00ean v\u1edbi \u0111\u1eb7c tr\u01b0ng l\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng: ho, kh\u00f2 kh\u00e8, th\u1edf nhanh, r\u00fat l\u00f5m l\u1ed3ng ng\u1ef1c.<\/p>\n<h2 style=\"text-align: justify\">Nguy\u00ean nh\u00e2n g\u00e2y vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n c\u1ea5p l\u00e0 g\u00ec?<\/h2>\n<p style=\"text-align: justify\">Do si\u00eau vi \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p g\u00e2y ra.<\/p>\n<ul>\n<li style=\"text-align: justify\">Virus h\u1ee3p b\u00e0o h\u00f4 h\u1ea5p (RSV) l\u00e0 t\u00e1c nh\u00e2n h\u00e0ng \u0111\u1ea7u: chi\u1ebfm 50-70% c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n c\u1ea5p.<\/li>\n<li style=\"text-align: justify\">Human metapneumovirus<\/li>\n<li style=\"text-align: justify\">Adenovirus: l\u00e0 lo\u1ea1i c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y bi\u1ebfn ch\u1ee9ng n\u1eb7ng.<\/li>\n<li style=\"text-align: justify\">C\u00e1c si\u00eau vi kh\u00e1c: Rhinovirus, parainfluenza&#8230;..<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">B\u1ec7nh l\u00e2y truy\u1ec1n nh\u01b0 th\u1ebf n\u00e0o?<\/h2>\n<p style=\"text-align: justify\">B\u1ec7nh truy\u1ec1n qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p t\u1eeb tr\u1ebb n\u00e0y sang tr\u1ebb kh\u00e1c qua c\u00e1c gi\u1ecdt ch\u1ea5t ti\u1ebft \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p. RSV c\u00f3 th\u1ec3 s\u1ed1ng tr\u00ean da 30 ph\u00fat, 6-7 ti\u1ebfng tr\u00ean qu\u1ea7n \u00e1o, v\u1eadt d\u1ee5ng. v\u00e0i ng\u00e0y trong c\u00e1c gi\u1ecdt ti\u1ebft h\u00f4 h\u1ea5p.<\/p>\n<h2 style=\"text-align: justify\">Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh nh\u01b0 th\u1ebf n\u00e0o?<\/h2>\n<p style=\"text-align: justify\">Kh\u1edfi \u0111\u1ea7u tr\u1ebb b\u1ecb vi\u00eam long h\u00f4 h\u1ea5p tr\u00ean v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng: s\u1ed1t nh\u1eb9 ho\u1eb7c v\u1eeba, ho, s\u1ed5 m\u0169i, h\u1eaft h\u01a1i&#8230;. Sau 1-3 ng\u00e0y xu\u1ea5t hi\u1ec7n kh\u00f2 kh\u00e8, th\u1edf nhanh, co l\u00f5m l\u1ed3ng ng\u1ef1c, h\u00f5m \u1ee9c, kho\u1ea3ng gian s\u01b0\u1eddn.<\/p>\n<h2 style=\"text-align: justify\">C\u00f3 c\u1ea7n l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m hay xquang ng\u1ef1c hay kh\u00f4ng?<\/h2>\n<p style=\"text-align: justify\">\u0110a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u1ea7n \u0111\u1ebfn c\u00e1c x\u00e9t nghi\u1ec7m hay xquang ng\u1ef1c.<\/p>\n<p style=\"text-align: justify\">Ch\u1ee5p Xquang ng\u1ef1c v\u00e0 x\u00e9t nghi\u1ec7m m\u00e1u khi c\u1ea7n: x\u00e1c \u0111\u1ecbnh bi\u1ebfn ch\u1ee9ng c\u1ee7a VTPQ c\u1ea5p, ph\u00e2n bi\u1ec7t v\u1edbi m\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n kh\u00e1c g\u00e2y kh\u00f2 kh\u00e8 nh\u01b0 vi\u00eam ph\u1ed5i, d\u1ecb v\u1eadt \u0111\u01b0\u1eddng th\u1edf, \u0111\u00e1nh gi\u00e1 c\u00e1c nhi\u1ec5m tr\u00f9ng \u0111i k\u00e8m.<\/p>\n<p style=\"text-align: justify\"><strong>C\u00f4ng th\u1ee9c m\u00e1u:<\/strong> c\u00f4ng th\u1ee9c m\u00e1u kh\u00f4ng c\u00f3 bi\u1ebfn \u0111\u1ed5i, khi c\u00f3 b\u1ed9i nhi\u1ec5m ho\u1eb7c nhi\u1ec5m tr\u00f9ng \u0111i k\u00e8m th\u00ec b\u1ea1ch c\u1ea7u s\u1ebd t\u0103ng, v\u1edbi d\u00f2ng \u0111a nh\u00e2n trung t\u00ednh \u01b0u th\u1ebf.<\/p>\n<p style=\"text-align: justify\"><strong>CRP<\/strong>: n\u1ebfu c\u00f3 b\u1ed9i nhi\u1ec5m CRP &gt; 20.<\/p>\n<p style=\"text-align: justify\"><strong>Xquang ph\u1ed5i:<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify\">D\u00e0y th\u00e0nh ph\u1ebf qu\u1ea3n\/ vi\u00eam ph\u1ed5i k\u1ebd: 50-80%<\/li>\n<li style=\"text-align: justify\">\u1ee8 kh\u00ed ph\u1ebf nang: 50%, ch\u1ec9 c\u00f3 \u1ee9 kh\u00ed \u0111\u01a1n thu\u1ea7n: 2%.<\/li>\n<li style=\"text-align: justify\">Th\u00e2m nhi\u1ec5m ph\u1ed5i: 30%<\/li>\n<li style=\"text-align: justify\">X\u1eb9p ph\u1ed5i: x\u1eb9p th\u00f9y tr\u00ean ph\u1ed5i ph\u1ea3i th\u01b0\u1eddng g\u1eb7p nh\u1ea5t, x\u1eb9p th\u00f9y gi\u1eefa 22%, th\u00f9y l\u01b0\u1ee1i 16%. X\u1eb9p th\u00f9y d\u01b0\u1edbi: 5%.<\/li>\n<li style=\"text-align: justify\">B\u00ecnh th\u01b0\u1eddng: 10%.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">Khi n\u00e0o c\u1ea7n cho tr\u1ebb nh\u1eadp vi\u1ec7n?<\/h2>\n<p style=\"text-align: justify\"><strong>Tr\u1ebb d\u01b0\u1edbi 3 th\u00e1ng<\/strong> tu\u1ed5i c\u00f3 1 trong 2 bi\u1ec3u hi\u1ec7n sau:<\/p>\n<p style=\"text-align: justify\">Nh\u1ecbp th\u1edf nhanh theo tu\u1ed5i: t\u1eeb 60 ln\u00e2 tr\u1edf l\u00ean v\u1edbi tr\u1ebb d\u01b0\u1edbi 60 ng\u00e0y, t\u1eeb 50 l\u1ea7n tr\u1edf l\u00ean v\u1edbi tr\u1ebb t\u1eeb 60 &#8211; 90 ng\u00e0y tu\u1ed5i.<\/p>\n<p style=\"text-align: justify\">M\u1ea1ch tr\u00ean 140 l\u1ea7n\/ p<\/p>\n<p style=\"text-align: justify\"><strong>Tr\u1ebb t\u1eeb 3 th\u00e1ng tr\u1edf l\u00ean<\/strong>: cho nh\u1eadp vi\u1ec7n khi c\u00f3 1 trong c\u00e1c d\u1ea5u hi\u1ec7u:<\/p>\n<ul>\n<li style=\"text-align: justify\">Nh\u1ecbp th\u1edf \u2265 70 l\u00e2n\/ p<\/li>\n<li style=\"text-align: justify\">M\u1ea1ch \u2265 150 l\/ p<\/li>\n<li style=\"text-align: justify\">T\u00edm t\u00e1i<\/li>\n<li style=\"text-align: justify\">Thay \u0111\u1ed5i tri gi\u00e1c.<\/li>\n<li style=\"text-align: justify\">X\u1eb9p ph\u1ed5i tr\u00ean Xquang.<\/li>\n<li style=\"text-align: justify\">C\u00f3 c\u01a1n ng\u01b0ng th\u1edf.<\/li>\n<\/ul>\n<h2>\u0110i\u1ec1u tr\u1ecb t\u1ea1i nh\u00e0 cho nh\u1eefng tr\u01b0\u1eddng h\u1ee3p VTPQ kh\u00f4ng n\u1eb7ng<\/h2>\n<ul>\n<li style=\"text-align: justify\">B\u00f9 \u0111\u1ee7 n\u01b0\u1edbc<\/li>\n<li style=\"text-align: justify\">Th\u00f4ng tho\u00e1ng m\u0169i b\u1eb1ng n\u01b0\u1edbc mu\u1ed1i sinh l\u00fd.<\/li>\n<li style=\"text-align: justify\">Theo d\u00f5i ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh.<\/li>\n<li style=\"text-align: justify\">Kh\u00f4ng d\u00f9ng c\u00e1c thu\u1ed1c: d\u00e3n ph\u1ebf qu\u1ea3n, corticoid, n\u01b0\u1edbc mu\u1ed1i \u01b0u tr\u01b0\u01a1ng.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">\u0110i\u1ec1u tr\u1ecb t\u1ea1i b\u1ec7nh vi\u1ec7n cho tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng ho\u1eb7c d\u01b0\u1edbi 3 th\u00e1ng:<\/h2>\n<ul>\n<li style=\"text-align: justify\">\u0110\u1ea7u cao 30 \u0111\u1ed9.<\/li>\n<li style=\"text-align: justify\">Th\u00f4ng tho\u00e1ng m\u0169i b\u1eb1ng n\u01b0\u1edbc mu\u1ed1i sinh l\u00fd<\/li>\n<li style=\"text-align: justify\">\u0110\u1ea3m b\u1ea3o oxy: oxy \u1ea9mqua cannula \u0111\u1ec3 duy tr\u00ec SpO2 94- 96%, NCPAP, chuy\u1ec3n ICU th\u1edf m\u00e1y khi<\/li>\n<li style=\"text-align: justify\">PaO2 &lt; 70 mmHg v\u00e0 PaCO2 &gt; 55 mmHg.<\/li>\n<li style=\"text-align: justify\">\u0110\u1ea3m b\u1ea3o n\u01b0\u1edbc v\u00e0 dinh d\u01b0\u1ee1ng: dinh d\u01b0\u1ee1ng \u0111\u01b0\u1eddng mi\u1ec7ng, sonde d\u1ea1 d\u00e0y, truy\u1ec1n t\u0129nh m\u1ea1ch.<\/li>\n<\/ul>\n<p style=\"text-align: justify\">L\u01b0u \u00fd: c\u00f3 th\u1ec3 kh\u00ed dung thu\u1ed1c salbutamol \/ andrealin 3 l\u1ea7n cho nh\u1eefng tr\u01b0\u1eddng h\u1ee3p vi\u00eam TPQ n\u1eb7ng (ph\u1eadp ph\u1ed3ng c\u00e1nh m\u0169i,co l\u00f5m ng\u1ef1c, th\u1edf r\u00ean, th\u1edf tr\u00ean 70 l\/ p, t\u00edm t\u00e1i. \u0110\u00e1nh gi\u00e1 tr\u01b0\u1edbc kh\u00ed dung v\u00e0 sau kh\u00ed dung 1 gi\u1edd, n\u1ebfu \u0111\u00e1p \u1ee9ng, duy tr\u00ec m\u1ed7i 4-6 gi\u1edd, ng\u01b0ng khi c\u1ea3i thi\u1ec7n.<\/p>\n<h2 style=\"text-align: justify\">Khi n\u00e0o c\u1ea7n d\u00f9ng kh\u00e1ng sinh?<\/h2>\n<p style=\"text-align: justify\">Khi c\u00f3 d\u1ea5u hi\u1ec7u b\u1ed9i nhi\u1ec5m ho\u1eb7c \u0111\u1ed3ng nhi\u1ec5m vi khu\u1ea9n:<\/p>\n<ul>\n<li style=\"text-align: justify\">S\u1ed1t cao \u0111\u1ed9t ng\u1ed9t ho\u1eb7c k\u00e9o d\u00e0i.<\/li>\n<li style=\"text-align: justify\">Vi\u00eam tai gi\u1eefa c\u1ea5p ch\u1ea3y m\u1ee7.<\/li>\n<li style=\"text-align: justify\">Di\u1ec5n bi\u1ebfn l\u00e2m s\u00e0ng x\u1ea5u nhanh.<\/li>\n<li style=\"text-align: justify\">CTM: B\u1ea1ch c\u1ea7u t\u0103ng, \u0111a nh\u00e2n \u01b0u th\u1ebf.<\/li>\n<li style=\"text-align: justify\">CRP &gt;20 mg\/l<\/li>\n<li style=\"text-align: justify\">Xquang ph\u1ed5i: th\u00e2m nhi\u1ec5m ti\u1ebfn tri\u1ec3n.<\/li>\n<li style=\"text-align: justify\">c\u1ea5y b\u1ec7nh ph\u1ea9m (+).<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">B\u1ec7nh c\u00f3 th\u1ec3 c\u00f3 bi\u1ebfn ch\u1ee9ng g\u00ec?<\/h2>\n<ul>\n<li style=\"text-align: justify\">M\u1ea5t n\u01b0\u1edbc.<\/li>\n<li style=\"text-align: justify\">Ng\u01b0ng th\u1edf: 5%<\/li>\n<li style=\"text-align: justify\">Suy h\u00f4 h\u1ea5p: 14%<\/li>\n<li style=\"text-align: justify\">B\u1ed9i nhi\u1ec5m vi khu\u1ea9n: 1.2%<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">Di\u1ec5n bi\u1ebfn thu\u1eadn l\u1ee3i nh\u01b0 th\u1ebf n\u00e0o<\/h2>\n<p style=\"text-align: justify\">Th\u01b0\u1eddng th\u00ec kh\u00f2 kh\u00e8 k\u00e9o d\u00e0i kho\u1ea3ng 7 ng\u00e0y, ho n\u1eb7ng c\u00f3 th\u1ec3 k\u00e9o d\u00e0i &gt;= 14 ng\u00e0y.<\/p>\n<p style=\"text-align: justify\">Tr\u1ebb n\u00e0o l\u00e0 \u0111\u1ed1i t\u01b0\u1ee3ng nguy c\u01a1 cao?<\/p>\n<ul>\n<li style=\"text-align: justify\">Sinh non &lt; 37 tu\u1ea7n, tu\u1ed5i &lt; 12 tu\u1ea7n.<\/li>\n<li style=\"text-align: justify\">Tim b\u1ea9m sinh.<\/li>\n<li style=\"text-align: justify\">D\u1ecb t\u1eadt b\u1ea9m sinh \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p.<\/li>\n<li style=\"text-align: justify\">Lo\u1ea1n s\u1ea3n ph\u1ebf qu\u1ea3n ph\u1ed5i.<\/li>\n<li style=\"text-align: justify\">B\u1ec7nh l\u00fd th\u1ea7n kinh c\u01a1.<\/li>\n<li style=\"text-align: justify\">Suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">L\u00e0m sao \u0111\u1ec3 ph\u00f2ng b\u1ec7nh cho tr\u1ebb?<\/h2>\n<ul>\n<li style=\"text-align: justify\">Gi\u1eef v\u1ec7 sinh b\u00e0n tay<\/li>\n<li style=\"text-align: justify\">Tr\u00e1nh kh\u00f3i thu\u1ed1c l\u00e1.<\/li>\n<li style=\"text-align: justify\">Tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m khu\u1ea9n h\u00f4 h\u1ea5p c\u1ea5p<\/li>\n<li style=\"text-align: justify\">Ch\u1ee7ng ng\u1eeba c\u00fam h\u00e0ng n\u0103m.<\/li>\n<li style=\"text-align: justify\">C\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng nguy c\u01a1 cao: palivizumab: 15 mg\/kg\/th\u00e1ng ti\u00eam b\u1eafp. M\u1ed7i th\u00e1ng 1 l\u1ea7n li\u00ean t\u1ee5c trong 5 th\u00e1ng m\u00f9a b\u1ec7nh.<\/li>\n<\/ul>\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\/438137399717119\" target=\"_blank\" rel=\"noopener\">https:\/\/www.facebook.com\/diendannhikhoa\/posts\/438137399717119<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam ti\u1ec3u ph\u1ebf qu\u1ea3n c\u1ea5p l\u00e0 vi\u00eam c\u1ea5p t\u00ednh c\u00e1c ph\u1ebf qu\u1ea3n c\u1ee1 nh\u1ecf v\u00e0 trung b\u00ecnh x\u1ea3y ra \u1edf tr\u1ebb t\u1eeb 1 th\u00e1ng \u0111\u1ebfn 2 tu\u1ed5i do si\u00eau vi g\u00e2y ra.<\/p>\n","protected":false},"author":14,"featured_media":4095,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[6104],"tags":[5976,4380,5667],"series":[3454],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - 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