{"id":4176,"date":"2021-06-08T16:01:19","date_gmt":"2021-06-08T09:01:19","guid":{"rendered":"https:\/\/yhoccongdong.org\/san-phu-khoa\/viem-mang-oi\/"},"modified":"2024-04-28T23:44:59","modified_gmt":"2024-04-28T16:44:59","slug":"viem-mang-oi","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/san-phu-khoa\/viem-mang-oi\/","title":{"rendered":"Vi\u00eam m\u00e0ng \u1ed1i"},"content":{"rendered":"<p style=\"text-align: right;\"><em><strong>Bi\u00ean d\u1ecbch: Nguy\u1ec5n Ho\u00e0ng Oanh<\/strong><\/em><\/p>\n<p style=\"text-align: right;\"><em><strong>Hi\u1ec7u \u0111\u00ednh:\u00a0BS. Thi\u1ec1u \u0110\u00ecnh Ho\u00e0ng<\/strong><\/em><\/p>\n<p>Vi\u00eam m\u00e0ng \u1ed1i (Chorioamnionitis-c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 &#8220;triple I&#8221; (b\u1ed9 ba I): ph\u1ea3n \u1ee9ng vi\u00eam ho\u1eb7c nhi\u1ec5m tr\u00f9ng t\u1eed cung ho\u1eb7c c\u1ea3 hai) l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng trong thai k\u1ef3 do nhi\u1ec5m khu\u1ea9n ho\u1eb7c ph\u1ea3n \u1ee9ng vi\u00eam c\u1ee7a m\u00e0ng \u1ed1i v\u00e0 m\u00e0ng \u0111\u1ec7m.<\/p>\n<h2>C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng<\/h2>\n<p>C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng c\u1ee7a vi\u00eam m\u00e0ng \u1ed1i bao g\u1ed3m:<\/p>\n<ul>\n<li>M\u1eb9 s\u1ed1t (nhi\u1ec7t \u0111\u1ed9 khi chuy\u1ec3n d\u1ea1 &gt;38 \u0111\u1ed9 C). C\u00e1c d\u1ea5u hi\u1ec7u kh\u00e1c bao g\u1ed3m:<\/li>\n<li>Nh\u1ecbp tim thai c\u01a1 b\u1ea3n nhanh ( &gt;160 nh\u1ecbp\/ph\u00fat t\u1eeb 10 ph\u00fat tr\u1edf l\u00ean, kh\u00f4ng bao g\u1ed3m nh\u1ecbp t\u0103ng, nh\u1ecbp gi\u1ea3m v\u00e0 c\u00f3 dao \u0111\u1ed9ng n\u1ed9i t\u1ea1i)<\/li>\n<li>B\u1ea1ch c\u1ea7u m\u00e1u m\u1eb9 t\u0103ng (t\u1ed5ng s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u &gt;15.000 t\u1ebf b\u00e0o\/\u03bcL) khi kh\u00f4ng d\u00f9ng corticosteroid<\/li>\n<li>D\u1ecbch m\u1ee7 ch\u1ea3y ra t\u1eeb l\u1ed7 c\u1ed5 t\u1eed cung<\/li>\n<li>C\u00e1c d\u1ea5u hi\u1ec7u kh\u00f4ng \u0111\u1eb7c hi\u1ec7u kh\u00e1c nh\u01b0 nh\u1ecbp tim nhanh \u1edf m\u1eb9 v\u00e0 t\u1eed cung \u1ea5n \u0111au \u00edt \u0111\u01b0\u1ee3c nh\u1ea5n m\u1ea1nh h\u01a1n trong b\u00e1o c\u00e1o t\u1eeb h\u1ed9i th\u1ea3o do Vi\u1ec7n S\u1ee9c kh\u1ecfe Tr\u1ebb em v\u00e0 Ph\u00e1t tri\u1ec3n Con ng\u01b0\u1eddi c\u1ee7a Hoa K\u1ef3 (NICHD) th\u1ef1c hi\u1ec7n<\/li>\n<\/ul>\n<p>H\u1ed9i th\u1ea3o NICHD khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng thu\u1eadt ng\u1eef \u201cb\u1ed9 ba I\u201d \u0111\u1ec3 gi\u1ea3i th\u00edch t\u00ednh kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t c\u1ee7a b\u1ec7nh n\u00e0y.\u00a0Thu\u1eadt ng\u1eef &#8220;b\u1ed9 ba I&#8221; d\u00f9ng \u0111\u1ec3 ch\u1ec9 s\u1ef1 nhi\u1ec5m tr\u00f9ng ho\u1eb7c vi\u00eam t\u1eed cung ho\u1eb7c c\u1ea3 hai, v\u00e0 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1eb1ng nh\u1eefng ti\u00eau chu\u1ea9n nghi\u00eam ng\u1eb7t;\u00a0tuy nhi\u00ean, thu\u1eadt ng\u1eef n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn r\u1ed9ng r\u00e3i.\u00a0Vi\u1ec7c ph\u00e2n bi\u1ec7t gi\u1eefa vi\u00eam m\u00e0ng \u1ed1i th\u1ec3 l\u00e2m s\u00e0ng v\u00e0 m\u00f4 h\u1ecdc l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft;\u00a0th\u1ec3 vi\u00eam m\u00e0ng \u1ed1i m\u00f4 h\u1ecdc th\u01b0\u1eddng c\u00f3 xu h\u01b0\u1edbng \u201cim l\u1eb7ng\u201d v\u00e0 ch\u1ec9 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n khi g\u00e2y ra h\u1eadu qu\u1ea3 l\u00e0 chuy\u1ec3n d\u1ea1 sinh non ho\u1eb7c \u1ed1i v\u1ee1 non (PPROM).\u00a0Nguy c\u01a1 nhi\u1ec5m tr\u00f9ng s\u01a1 sinh t\u0103ng l\u00ean khi m\u1eb9 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n vi\u00eam m\u00e0ng \u1ed1i trong chuy\u1ec3n d\u1ea1;\u00a0tuy nhi\u00ean, nguy c\u01a1 n\u00e0y gi\u1ea3m \u0111\u00e1ng k\u1ec3 so v\u1edbi v\u1edbi th\u1eddi k\u1ef3 tr\u01b0\u1edbc \u0111\u00e2y khi vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng sinh trong chuy\u1ec3n d\u1ea1 ch\u01b0a ph\u1ed5 bi\u1ebfn.<\/p>\n<h2>Ch\u1ea9n \u0111o\u00e1n<\/h2>\n<p>Ch\u1ea9n \u0111o\u00e1n vi\u00eam m\u00e0ng \u1ed1i th\u01b0\u1eddng d\u1ef1a tr\u00ean th\u0103m kh\u00e1m l\u00e2m s\u00e0ng v\u1edbi nh\u1eefng d\u1ea5u hi\u1ec7u nh\u01b0 s\u1ed1t, tim thai nhanh, b\u1ea1ch c\u1ea7u m\u00e1u m\u1eb9 t\u0103ng hay d\u1ecbch m\u1ee7 t\u1eeb l\u1ed7 c\u1ed5 t\u1eed cung.\u00a0Ngo\u00e0i ra, thai ph\u1ee5 b\u1ecb vi\u00eam m\u00e0ng \u1ed1i c\u00f3 th\u1ec3 c\u00f3 bi\u1ec3u hi\u1ec7n m\u1ec7t m\u1ecfi, nhi\u1ec5m tr\u00f9ng nhi\u1ec5m \u0111\u1ed9c, t\u1ee5t huy\u1ebft \u00e1p, v\u00e3 m\u1ed3 h\u00f4i v\u00e0\/ho\u1eb7c da l\u1ea1nh, \u1ea9m.\u00a0Tuy nhi\u00ean, \u0111\u1ed1i v\u1edbi vi\u00eam m\u00e0ng \u1ed1i th\u1ec3 m\u00f4 h\u1ecdc, c\u00f3 th\u1ec3 kh\u00f4ng c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng nhi\u1ec5m tr\u00f9ng (hay c\u00f2n g\u1ecdi l\u00e0 vi\u00eam m\u00e0ng \u1ed1i im l\u1eb7ng).<\/p>\n<p>H\u01a1n n\u1eefa, tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng c\u1ee7a vi\u00eam m\u00e0ng \u1ed1i kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng c\u00f3 li\u00ean quan \u0111\u1ebfn b\u1eb1ng ch\u1ee9ng c\u00f3 vi\u00eam nhau thai \u0111i k\u00e8m.\u00a0\u0110i\u1ec1u n\u00e0y \u0111\u1eb7c bi\u1ec7t \u0111\u00fang n\u1ebfu ch\u1ec9 d\u00f9ng d\u1ea5u hi\u1ec7u m\u1eb9 s\u1ed1t \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n.<\/p>\n<p>C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng khi th\u0103m kh\u00e1m tr\u1ebb s\u01a1 sinh nghi ng\u1edd nhi\u1ec5m tr\u00f9ng huy\u1ebft \u0111\u01b0\u1ee3c sinh ra t\u1eeb m\u1eb9 b\u1ecb vi\u00eam m\u00e0ng \u1ed1i th\u01b0\u1eddng m\u01a1 h\u1ed3 v\u00e0 kh\u00f4ng \u0111\u1eb7c hi\u1ec7u, c\u00f3 th\u1ec3 bao g\u1ed3m:<\/p>\n<ul>\n<li>B\u1ea5t th\u01b0\u1eddng v\u1eadn \u0111\u1ed9ng (v\u00ed d\u1ee5: h\u00f4n m\u00ea, gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c c\u01a1, kh\u00f3c y\u1ebfu, b\u00fa k\u00e9m)<\/li>\n<li>H\u00f4 h\u1ea5p: Kh\u00f3 th\u1edf, suy h\u00f4 h\u1ea5p, t\u00edm t\u00e1i, xu\u1ea5t huy\u1ebft ph\u1ed5i v\u00e0\/ho\u1eb7c ng\u01b0ng th\u1edf<\/li>\n<li>Tim m\u1ea1ch: Nh\u1ecbp tim nhanh, h\u1ea1 huy\u1ebft \u00e1p, th\u1eddi gian \u0111\u1ed5 \u0111\u1ea7y mao m\u1ea1ch k\u00e9o d\u00e0i, da l\u1ea1nh, \u1ea9m, t\u00edm t\u00e1i ho\u1eb7c da l\u1ed1m \u0111\u1ed1m, v\u00e0\/ho\u1eb7c thi\u1ec3u ni\u1ec7u<\/li>\n<li>Ti\u00eau h\u00f3a: Ch\u01b0\u1edbng b\u1ee5ng, n\u00f4n m\u1eeda, ti\u00eau ch\u1ea3y v\u00e0\/ho\u1eb7c ph\u00e2n c\u00f3 m\u00e1u<\/li>\n<li>H\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng: R\u1ed1i lo \u0111i\u1ec1u h\u00f2a th\u00e2n nhi\u1ec7t, b\u1ea5t th\u01b0\u1eddng v\u1eadn \u0111\u1ed9ng, ng\u01b0ng th\u1edf v\u00e0\/ho\u1eb7c co gi\u1eadt<\/li>\n<li>Huy\u1ebft h\u1ecdc v\u00e0\/ho\u1eb7c gan: Xanh xao, ch\u1ea5m xu\u1ea5t huy\u1ebft ho\u1eb7c ban xu\u1ea5t huy\u1ebft, ch\u1ea3y m\u00e1u l\u01b0\u1ee3ng nhi\u1ec1u<\/li>\n<\/ul>\n<h3>C\u1eadn l\u00e2m s\u00e0ng<\/h3>\n<p>Trong chuy\u1ec3n d\u1ea1, ch\u1ea9n \u0111o\u00e1n vi\u00eam m\u00e0ng \u1ed1i th\u01b0\u1eddng d\u1ef1a tr\u00ean l\u00e2m s\u00e0ng, \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi thai \u0111\u1ee7 th\u00e1ng.<\/p>\n<p>C\u00e1c x\u00e9t nghi\u1ec7m c\u1ea7n l\u00e0m \u0111\u1ed1i v\u1edbi thai ph\u1ee5 kh\u00f4ng tri\u1ec7u ch\u1ee9ng nh\u01b0ng c\u00f3 bi\u1ec3u hi\u1ec7n chuy\u1ec3n d\u1ea1 sinh non ho\u1eb7c \u1ed1i v\u1ee1 non g\u1ed3m:<\/p>\n<ul>\n<li>Ki\u1ec3m tra n\u01b0\u1edbc \u1ed1i<\/li>\n<li>X\u00e9t nghi\u1ec7m m\u00e1u m\u1eb9<\/li>\n<li>X\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u m\u1eb9<\/li>\n<li>X\u00e9t nghi\u1ec7m s\u00e0ng l\u1ecdc li\u00ean c\u1ea7u khu\u1ea9n nh\u00f3m B (GBS) \u1edf m\u1eb9<\/li>\n<\/ul>\n<p>X\u00e9t nghi\u1ec7m \u1edf thai ph\u1ee5 s\u1ed1t, nghi ng\u1edd c\u00f3 vi\u00eam m\u00e0ng \u1ed1i:<\/p>\n<ul>\n<li>T\u1ed5ng s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u (WBC)<\/li>\n<li>N\u1ed3ng \u0111\u1ed9 protein ph\u1ea3n \u1ee9ng C (CRP)<\/li>\n<li>\u0110\u1ecbnh l\u01b0\u1ee3ng ph\u1ee9c h\u1ee3p ch\u1ea5t \u1ee9c ch\u1ebf enzyme alpha1-proteinase (A1PI)<\/li>\n<li>N\u1ed3ng \u0111\u1ed9 interleukin-6 (IL-6) ho\u1eb7c ferritin huy\u1ebft thanh<\/li>\n<\/ul>\n<p>C\u00e1c c\u1eadn l\u00e2m s\u00e0ng d\u00f9ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 n\u01b0\u1edbc \u1ed1i v\u00e0 d\u1ecbch ti\u1ebft ni\u1ec7u sinh d\u1ee5c, g\u1ed3m:<\/p>\n<ul>\n<li>C\u1ea5y vi khu\u1ea9n<\/li>\n<li>S\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u<\/li>\n<li>Nhu\u1ed9m Gram<\/li>\n<li>pH<\/li>\n<li>N\u1ed3ng \u0111\u1ed9 glucose<\/li>\n<li>Ho\u1ea1t \u0111\u1ed9ng esterase c\u1ee7a b\u1ea1ch c\u1ea7u<\/li>\n<li>N\u1ed3ng \u0111\u1ed9 n\u1ed9i \u0111\u1ed9c t\u1ed1, lactoferrin v\u00e0 \/ ho\u1eb7c cytokine (\u0111\u1eb7c bi\u1ec7t l\u00e0 IL-6)<\/li>\n<li>Ph\u1ea3n \u1ee9ng chu\u1ed7i polymerase (PCR) \u0111\u1ed1i v\u1edbi c\u00e1c vi sinh v\u1eadt x\u00e1c \u0111\u1ecbnh<\/li>\n<li>Fibronectin c\u1ee7a b\u00e0o thai, y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng gi\u1ed1ng insulin g\u1eafn v\u1edbi protein-1 (IGFBP-1) v\u00e0 n\u1ed3ng \u0111\u1ed9 sialidase<\/li>\n<li>C\u1ea5u h\u00ecnh proteomic<\/li>\n<\/ul>\n<p>Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m khu\u1ea9n huy\u1ebft kh\u1edfi ph\u00e1t s\u1edbm, vi\u00eam ph\u1ed5i, ho\u1eb7c vi\u00eam m\u00e0ng n\u00e3o \u1edf tr\u1ebb s\u01a1 sinh l\u00e0 khi c\u1ea5y b\u1ec7nh ph\u1ea9m th\u00edch h\u1ee3p (nh\u01b0 m\u00e1u, d\u1ecbch ti\u1ebft kh\u00ed qu\u1ea3n, d\u1ecbch n\u00e3o t\u1ee7y) v\u00e0 c\u00f3 vi khu\u1ea9n m\u1ecdc. C\u00e1c x\u00e9t nghi\u1ec7m s\u00e0ng l\u1ecdc nhi\u1ec5m tr\u00f9ng s\u01a1 sinh bao g\u1ed3m WBC v\u00e0 CRP.<\/p>\n<p>C\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng s\u01a1 sinh kh\u1edfi ph\u00e1t s\u1edbm bao g\u1ed3m:<\/p>\n<ul>\n<li>IL-6 huy\u1ebft thanh ho\u1eb7c n\u1ed3ng \u0111\u1ed9 c\u00e1c cytokine kh\u00e1c<\/li>\n<li>N\u1ed3ng \u0111\u1ed9 procalcitonin<\/li>\n<li>\u0110\u1ecbnh l\u01b0\u1ee3ng amyloid A trong huy\u1ebft thanh<\/li>\n<\/ul>\n<h3>H\u00ecnh \u1ea3nh h\u1ecdc<\/h3>\n<p>Khi thai ch\u01b0a th\u1ea5y \u0111\u01b0\u1ee3c tr\u00ean si\u00eau \u00e2m, si\u00eau \u00e2m qua ng\u00e3 \u00e2m \u0111\u1ea1o c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nh\u1eefng ph\u1ee5 n\u1eef c\u00f3 k\u00eanh c\u1ed5 t\u1eed cung ng\u1eafn.\u00a0K\u00eanh c\u1ed5 t\u1eed cung ng\u1eafn l\u00e0m t\u0103ng nguy c\u01a1 sinh non.<\/p>\n<p>Si\u00eau \u00e2m b\u1ee5ng c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng kh\u1ecfe m\u1ea1nh c\u1ee7a thai nhi, c\u0169ng nh\u01b0 ph\u00e2n t\u00edch tr\u1eafc \u0111\u1ed3 sinh v\u1eadt l\u00fd (BPP).<\/p>\n<h3>Th\u1ee7 thu\u1eadt<\/h3>\n<p>C\u00e1c th\u1ee7 thu\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 khi nghi ng\u1edd vi\u00eam m\u00e0ng \u1ed1i ho\u1eb7c nhi\u1ec5m tr\u00f9ng huy\u1ebft kh\u1edfi ph\u00e1t s\u1edbm \u1edf tr\u1ebb s\u01a1 sinh (EOS):<\/p>\n<ul>\n<li>Ch\u1ecdc h\u00fat b\u1eb1ng kim d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn c\u1ee7a si\u00eau \u00e2m v\u00e0 ph\u00e2n t\u00edch n\u01b0\u1edbc \u1ed1i: c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n vi\u00eam m\u00e0ng \u1ed1i c\u1ea5p t\u00ednh<\/li>\n<li>Ph\u00e2n t\u00edch \u0111\u1ea1i th\u1ec3\/vi th\u1ec3 c\u1ee7a nhau thai, m\u00e0ng thai, d\u00e2y r\u1ed1n<\/li>\n<li>T\u1ed5ng s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o m\u00e1u (CBC) v\u00e0 c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc c\u1ee7a ph\u1ea3n \u1ee9ng vi\u00eam, c\u1ea5y m\u00e1u v\u00e0 ch\u1ee5p X quang ph\u1ed5i<\/li>\n<li>C\u00f2n nhi\u1ec1u tranh c\u00e3i: Ch\u1ecdc d\u00f2 t\u1ee7y s\u1ed1ng tr\u1ebb s\u01a1 sinh<\/li>\n<\/ul>\n<h3>\u0110i\u1ec1u tr\u1ecb<\/h3>\n<p>\u0110i\u1ec1u tr\u1ecb cho b\u00e0 m\u1eb9 v\u00e0\/ho\u1eb7c tr\u1ebb s\u01a1 sinh b\u1ecb vi\u00eam m\u00e0ng \u1ed1i bao g\u1ed3m kh\u1edfi ph\u00e1t chuy\u1ec3n d\u1ea1 s\u1edbm, ch\u0103m s\u00f3c h\u1ed7 tr\u1ee3 v\u00e0 s\u1eed d\u1ee5ng kh\u00e1ng sinh.<\/p>\n<h3>Li\u1ec7u ph\u00e1p d\u00f9ng thu\u1ed1c<\/h3>\n<p>Thu\u1ed1c kh\u00e1ng sinh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng \u1ed1i bao g\u1ed3m:<\/p>\n<ul>\n<li>Ampicillin v\u00e0 gentamicin<\/li>\n<li>Clindamycin ho\u1eb7c metronidazole khi nghi ng\u1edd vi\u00eam n\u1ed9i m\u1ea1c t\u1eed cung (sau khi sinh)<\/li>\n<li>Vancomycin cho b\u1ec7nh nh\u00e2n d\u1ecb \u1ee9ng v\u1edbi penicillin<\/li>\n<li>L\u1ef1a ch\u1ecdn thay th\u1ebf: \u0110\u01a1n tr\u1ecb li\u1ec7u v\u1edbi ampicillin-sulbactam, ticarcillin-clavulanate, cefoxitin, cefotetan ho\u1eb7c piperacillin-tazobactam<\/li>\n<li>Penicillin G: \u0110\u01b0\u1ee3c d\u00f9ng ri\u00eang \u0111\u1ec3 d\u1ef1 ph\u00f2ng nhi\u1ec5m GBS sau sinh;\u00a0n\u1ebfu nghi ng\u1edd nhi\u1ec5m tr\u00f9ng \u1ed1i, d\u00f9ng kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng.<\/li>\n<\/ul>\n<h3>Li\u1ec7u ph\u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c<\/h3>\n<p>Ch\u0103m s\u00f3c h\u1ed7 tr\u1ee3 tr\u1ebb s\u01a1 sinh b\u1ecb nhi\u1ec5m tr\u00f9ng c\u00f3 th\u1ec3 bao g\u1ed3m:<\/p>\n<ul>\n<li>Gi\u1eef \u1ea5m, theo d\u00f5i c\u00e1c d\u1ea5u hi\u1ec7u sinh t\u1ed3n<\/li>\n<li>Chu\u1ea9n b\u1ecb s\u1eb5n s\u00e0ng \u0111\u1ec3 h\u1ed3i s\u1ee9c to\u00e0n di\u1ec7n cho tr\u1ebb, bao g\u1ed3m \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n, cung c\u1ea5p th\u00f4ng kh\u00ed \u00e1p l\u1ef1c d\u01b0\u01a1ng<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb gi\u1ea3m th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n, s\u1ed1c, nhi\u1ec5m toan h\u00f4 h\u1ea5p v\u00e0\/ho\u1eb7c toan chuy\u1ec3n h\u00f3a<\/li>\n<li>Li\u1ec7u ph\u00e1p Surfactant thay th\u1ebf<\/li>\n<li>C\u00e2n b\u1eb1ng chuy\u1ec3n h\u00f3a glucose<\/li>\n<li>\u0110\u00e1nh gi\u00e1 v\u00e0 \u0111i\u1ec1u tr\u1ecb gi\u1ea3m ti\u1ec3u c\u1ea7u v\u00e0 r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u n\u1ebfu c\u00f3<\/li>\n<\/ul>\n<h3>L\u1ef1a ch\u1ecdn ph\u1eabu thu\u1eadt<\/h3>\n<p>C\u00f3 th\u1ec3 ch\u1ec9 \u0111\u1ecbnh m\u1ed5 l\u1ea5y thai \u0111\u1ec3 \u0111\u1ea9y nhanh qu\u00e1 tr\u00ecnh sinh.<\/p>\n<p>M\u1eb7c d\u00f9 tr\u1ebb s\u01a1 sinh b\u1ecb nhi\u1ec5m tr\u00f9ng kh\u1edfi ph\u00e1t s\u1edbm th\u01b0\u1eddng kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p ph\u1eabu thu\u1eadt, ngo\u00e0i tr\u1eeb c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau \u0111\u00e2y:<\/p>\n<ul>\n<li>\u00c1p xe ngo\u00e0i m\u00e0ng c\u1ee9ng ho\u1eb7c \u00e1p xe n\u00e3o<\/li>\n<li>\u00c1p xe d\u01b0\u1edbi da<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng khu tr\u00fa \u1edf khoang m\u00e0ng ph\u1ed5i<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng \u1ed5 b\u1ee5ng (\u0111\u1eb7c bi\u1ec7t n\u1ebfu c\u00f3 th\u1ee7ng ru\u1ed9t)<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng x\u01b0\u01a1ng ho\u1eb7c kh\u1edbp<\/li>\n<\/ul>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p><a href=\"https:\/\/emedicine.medscape.com\/article\/973237-overview\" target=\"_blank\" rel=\"noopener\">emedicine.medscape.com\/overview<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vi\u00eam m\u00e0ng \u1ed1i l\u00e0 ph\u1ea3n \u1ee9ng vi\u00eam ho\u1eb7c nhi\u1ec5m tr\u00f9ng t\u1eed cung ho\u1eb7c c\u1ea3 hai. \u0110\u00e2y l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng trong thai k\u1ef3 do nhi\u1ec5m khu\u1ea9n ho\u1eb7c ph\u1ea3n \u1ee9ng vi\u00eam c\u1ee7a m\u00e0ng \u1ed1i v\u00e0 m\u00e0ng \u0111\u1ec7m. C\u00f9ng t\u00ecm hi\u1ec3u c\u00e1c tri\u1ec7u ch\u1ee9ng, chu\u1ea9n \u0111o\u00e1n v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb vi\u00eam m\u00e0ng \u1ed1i trong b\u00e0i vi\u1ebft n\u00e0y.<\/p>\n","protected":false},"author":371,"featured_media":4177,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5427],"tags":[4911],"series":[1611],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Vi\u00eam m\u00e0ng \u1ed1i - D\u1ef1 \u00e1n S\u1ea3n Ph\u1ee5 Khoa<\/title>\n<meta name=\"description\" content=\"Vi\u00eam m\u00e0ng \u1ed1i - D\u1ef1 \u00e1n S\u1ea3n Ph\u1ee5 Khoa\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/yhoccongdong.com\/san-phu-khoa\/viem-mang-oi\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vi\u00eam m\u00e0ng \u1ed1i - D\u1ef1 \u00e1n S\u1ea3n Ph\u1ee5 Khoa\" \/>\n<meta property=\"og:description\" content=\"Vi\u00eam m\u00e0ng \u1ed1i - D\u1ef1 \u00e1n S\u1ea3n Ph\u1ee5 Khoa\" \/>\n<meta property=\"og:url\" content=\"https:\/\/yhoccongdong.com\/san-phu-khoa\/viem-mang-oi\/\" \/>\n<meta property=\"og:site_name\" content=\"D\u1ef1 \u00e1n S\u1ea3n Ph\u1ee5 Khoa\" \/>\n<meta property=\"article:author\" content=\"https:\/\/www.facebook.com\/Thieuhoangydh\" \/>\n<meta property=\"article:published_time\" content=\"2021-06-08T09:01:19+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-04-28T16:44:59+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/yhoccongdong.com\/san-phu-khoa\/wp-content\/uploads\/sites\/4\/2021\/06\/viem-mang-oi.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"660\" \/>\n\t<meta property=\"og:image:height\" content=\"330\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"BS. 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