{"id":11580,"date":"2024-09-01T08:56:00","date_gmt":"2024-09-01T01:26:00","guid":{"rendered":"https:\/\/abtvn.com\/?p=11580"},"modified":"2025-08-06T12:07:13","modified_gmt":"2025-08-06T04:37:13","slug":"benh-sot-ret-va-sot-xuat-huyet","status":"publish","type":"post","link":"https:\/\/abtvn.com\/en\/benh-sot-ret-va-sot-xuat-huyet\/","title":{"rendered":"B\u1ec7nh s\u1ed1t r\u00e9t v\u00e0 s\u1ed1t xu\u1ea5t huy\u1ebft: Tri\u1ec7u ch\u1ee9ng, nguy\u00ean nh\u00e2n v\u00e0 c\u00e1ch ph\u00f2ng ng\u1eeba<\/strong>"},"content":{"rendered":"

S\u1ed1t r\u00e9t<\/strong> and s\u1ed1t xu\u1ea5t huy\u1ebft<\/strong> l\u00e0 hai c\u0103n b\u1ec7nh truy\u1ec1n nhi\u1ec5m nguy hi\u1ec3m, \u0111\u1eb7c bi\u1ec7t ph\u1ed5 bi\u1ebfn \u1edf c\u00e1c v\u00f9ng nhi\u1ec7t \u0111\u1edbi. N\u0103m 2021, Vi\u1ec7t Nam ghi nh\u1eadn kho\u1ea3ng 120.000 ca m\u1eafc s\u1ed1t xu\u1ea5t huy\u1ebft, trong \u0111\u00f3 c\u00f3 h\u01a1n 30.000 ca n\u1eb7ng. \u0110\u1ed3ng th\u1eddi, c\u1ea3 n\u01b0\u1edbc c\u0169ng b\u00e1o c\u00e1o t\u1eeb 3.500 \u0111\u1ebfn 4.000 ca m\u1eafc s\u1ed1t r\u00e9t trong c\u00f9ng n\u0103m.<\/p>\n\n\n\n

Ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c b\u1ec7nh l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t trong vi\u1ec7c t\u1ed1i \u01b0u h\u00f3a ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p, nh\u1ea5t l\u00e0 khi t\u00ecnh tr\u1ea1ng kh\u00e1ng thu\u1ed1c \u0111ang gia t\u0103ng.<\/p>\n\n\n\n

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1. B\u1ec7nh h\u1ecdc v\u1ec1 s\u1ed1t r\u00e9t v\u00e0 s\u1ed1t xu\u1ea5t huy\u1ebft<\/strong><\/h2>\n\n\n\n

1.1. \u0110\u1ecbnh ngh\u0129a<\/strong><\/h3>\n\n\n\n

B\u1ec7nh s\u1ed1t r\u00e9t<\/strong> (Malaria) l\u00e0 m\u1ed9t b\u1ec7nh truy\u1ec1n nhi\u1ec5m do k\u00fd sinh tr\u00f9ng Plasmodium<\/em><\/strong><\/a> g\u00e2y ra \u1edf ng\u01b0\u1eddi, ch\u1ee7 y\u1ebfu l\u00e2y lan qua \u0111\u01b0\u1eddng m\u00e1u v\u1edbi lo\u00e0i mu\u1ed7i Anopheles l\u00e0 trung gian truy\u1ec1n b\u1ec7nh. C\u00f3 5 lo\u1ea1i k\u00fd sinh tr\u00f9ng Plasmodium<\/em><\/strong> g\u00e2y b\u1ec7nh s\u1ed1t r\u00e9t cho con ng\u01b0\u1eddi: Plasmodium falciparum<\/em>, Plasmodium vivax<\/em>, Plasmodium malariae<\/em>, Plasmodium ovale<\/em>, v\u00e0 Plasmodium knowlesi<\/em>.<\/a><\/strong> B\u1ec7nh th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n qua c\u00e1c c\u01a1n s\u1ed1t r\u00e9t \u0111i\u1ec3n h\u00ecnh v\u1edbi ba tri\u1ec7u ch\u1ee9ng ch\u00ednh: r\u00e9t run, s\u1ed1t, v\u00e0 \u0111\u1ed5 m\u1ed3 h\u00f4i. B\u1ec7nh c\u00f3 chu k\u1ef3 ph\u00e1t tri\u1ec3n nh\u1ea5t \u0111\u1ecbnh v\u00e0 s\u1ebd k\u1ebft th\u00fac n\u1ebfu kh\u00f4ng c\u00f3 t\u00e1i nhi\u1ec5m. K\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t t\u1ea1o ra mi\u1ec5n d\u1ecbch \u0111\u1eb7c hi\u1ec7u nh\u01b0ng kh\u00f4ng l\u00e2u d\u00e0i.<\/p>\n\n\n\n

\"H\u00ecnh.
Figure 1.<\/a><\/strong> B\u1ec7nh s\u1ed1t r\u00e9t v\u00e0 s\u1ed1t xu\u1ea5t huy\u1ebft: Tri\u1ec7u ch\u1ee9ng, nguy\u00ean nh\u00e2n v\u00e0 c\u00e1ch ph\u00f2ng ng\u1eeba<\/em><\/figcaption><\/figure>\n\n\n\n

B\u1ec7nh l\u01b0u h\u00e0nh \u0111\u1ecba ph\u01b0\u01a1ng v\u00e0 c\u00f3 th\u1ec3 b\u00f9ng ph\u00e1t th\u00e0nh d\u1ecbch khi g\u1eb7p \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i. Hi\u1ec7n nay, v\u1eabn ch\u01b0a c\u00f3 vaccine ph\u00f2ng b\u1ec7nh nh\u01b0ng \u0111\u00e3 c\u00f3 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u v\u00e0 c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng. \u1ede Vi\u1ec7t Nam, b\u1ec7nh s\u1ed1t r\u00e9t th\u01b0\u1eddng l\u01b0u h\u00e0nh t\u1ea1i c\u00e1c v\u00f9ng r\u1eebng, \u0111\u1ed3i n\u00fai, ven bi\u1ec3n n\u01b0\u1edbc l\u1ee3 v\u00e0 xu\u1ea5t hi\u1ec7n quanh n\u0103m, \u0111\u1eb7c bi\u1ec7t l\u00e0 v\u00e0o m\u00f9a m\u01b0a. C\u00e1c tr\u01b0\u1eddng h\u1ee3p m\u1eafc b\u1ec7nh s\u1ed1t r\u00e9t \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh khi c\u00f3 k\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t trong m\u00e1u, \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n qua x\u00e9t nghi\u1ec7m lam m\u00e1u nhu\u1ed9m Giemsa, x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n nhanh t\u00ecm kh\u00e1ng nguy\u00ean ho\u1eb7c b\u1eb1ng k\u1ef9 thu\u1eadt sinh h\u1ecdc ph\u00e2n t\u1eed.<\/p>\n\n\n\n

Virus Dengue<\/strong> l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y ra b\u1ec7nh s\u1ed1t xu\u1ea5t huy\u1ebft<\/strong>. C\u00f3 b\u1ed1n ch\u1ee7ng virus Dengue \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 DENV-1, DENV-2, DENV-3 v\u00e0 DENV-4. M\u1ed9t ng\u01b0\u1eddi c\u00f3 th\u1ec3 b\u1ecb nhi\u1ec5m virus nhi\u1ec1u l\u1ea7n do c\u00e1c ch\u1ee7ng virus kh\u00e1c nhau, v\u00e0 l\u1ea7n nhi\u1ec5m sau c\u00f3 th\u1ec3 nghi\u00eam tr\u1ecdng h\u01a1n l\u1ea7n tr\u01b0\u1edbc. Virus Dengue l\u00e2y lan qua v\u1ebft c\u1eafn c\u1ee7a mu\u1ed7i c\u00e1i thu\u1ed9c chi Aedes<\/em>, th\u01b0\u1eddng ho\u1ea1t \u0111\u1ed9ng m\u1ea1nh v\u00e0o ban ng\u00e0y, \u0111\u1eb7c bi\u1ec7t l\u00e0 v\u00e0o bu\u1ed5i s\u00e1ng s\u1edbm v\u00e0 chi\u1ec1u t\u1ed1i.<\/p>\n\n\n\n

<\/div>\n\n\n\n

1.2. M\u1ed1i t\u01b0\u01a1ng quan gi\u1eefa b\u1ec7nh s\u1ed1t r\u00e9t v\u00e0 s\u1ed1t xu\u1ea5t huy\u1ebft<\/strong><\/h3>\n\n\n\n

S\u1ed1t r\u00e9t v\u00e0 s\u1ed1t xu\u1ea5t huy\u1ebft, m\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u \u0111i\u1ec3m kh\u00e1c bi\u1ec7t v\u1ec1 m\u1eb7t sinh h\u1ecdc v\u00e0 l\u00e2m s\u00e0ng, nh\u01b0ng c\u00f3 m\u1ed1i li\u00ean quan ch\u1eb7t ch\u1ebd v\u1ec1 m\u1eb7t d\u1ecbch t\u1ec5 h\u1ecdc v\u00e0 y t\u1ebf c\u00f4ng c\u1ed9ng.<\/p>\n\n\n\n

Ti\u00eau ch\u00ed<\/strong><\/td>S\u1ed1t r\u00e9t<\/strong><\/td>S\u1ed1t xu\u1ea5t huy\u1ebft<\/strong><\/td>M\u1ed1i li\u00ean quan\/T\u01b0\u01a1ng quan<\/strong><\/td><\/tr>
T\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh<\/strong><\/td>K\u00fd sinh tr\u00f9ng Plasmodium<\/em> (5 lo\u00e0i)<\/td>Virus Dengue (4 type huy\u1ebft thanh)<\/td>Kh\u00e1c bi\u1ec7t v\u1ec1 b\u1ea3n ch\u1ea5t sinh h\u1ecdc g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u00e0 ph\u00f2ng ng\u1eeba<\/td><\/tr>
Vect\u01a1 truy\u1ec1n b\u1ec7nh<\/strong><\/td>Mu\u1ed7i Anopheles<\/td>Mu\u1ed7i Aedes (ch\u1ee7 y\u1ebfu Aedes aegypti)<\/td>\u0110\u1ec1u l\u00e0 b\u1ec7nh truy\u1ec1n qua mu\u1ed7i, chi\u1ebfn l\u01b0\u1ee3c ki\u1ec3m so\u00e1t v\u00e9c t\u01a1 c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng cho c\u1ea3 hai<\/td><\/tr>
C\u01a1 ch\u1ebf b\u1ec7nh sinh<\/strong><\/td>\u2022 K\u00fd sinh tr\u00f9ng x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3 qua v\u1ebft \u0111\u1ed1t c\u1ee7a mu\u1ed7i Anopheles.
\u2022 Tr\u1ea3i qua chu k\u1ef3 ph\u00e1t tri\u1ec3n trong gan (giai \u0111o\u1ea1n ngo\u00e0i h\u1ed3ng c\u1ea7u) v\u00e0 trong h\u1ed3ng c\u1ea7u (giai \u0111o\u1ea1n trong h\u1ed3ng c\u1ea7u).
\u2022 S\u1ef1 ph\u00e1 v\u1ee1 h\u1ed3ng c\u1ea7u v\u00e0 gi\u1ea3i ph\u00f3ng merozoite g\u00e2y ra c\u00e1c c\u01a1n s\u1ed1t \u0111i\u1ec3n h\u00ecnh.<\/td>		\u2022 Virus x\u00e2m nh\u1eadp v\u00e0 nh\u00e2n l\u00ean trong t\u1ebf b\u00e0o \u0111\u00edch (t\u1ebf b\u00e0o \u0111\u01a1n nh\u00e2n, \u0111\u1ea1i th\u1ef1c b\u00e0o)
\u2022 Gi\u1ea3i ph\u00f3ng cytokine g\u00e2y ra h\u1ed9i ch\u1ee9ng r\u00f2 r\u1ec9 huy\u1ebft t\u01b0\u01a1ng
\u2022 Nhi\u1ec5m tr\u00f9ng th\u1ee9 ph\u00e1t v\u1edbi type huy\u1ebft thanh kh\u00e1c l\u00e0m t\u0103ng nguy c\u01a1 s\u1ed1t xu\u1ea5t huy\u1ebft n\u1eb7ng (thuy\u1ebft t\u0103ng c\u01b0\u1eddng ph\u1ee5 thu\u1ed9c kh\u00e1ng th\u1ec3 – ADE)<\/td>		Kh\u00e1c bi\u1ec7t v\u1ec1 c\u01a1 ch\u1ebf, nh\u01b0ng \u0111\u1ec1u c\u00f3 th\u1ec3 g\u00e2y bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng<\/td><\/tr>
Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/td>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng:
\u2022 Giai \u0111o\u1ea1n \u1ee7 b\u1ec7nh: 7-30 ng\u00e0y t\u00f9y lo\u00e0i.
\u2022 Giai \u0111o\u1ea1n kh\u1edfi ph\u00e1t: S\u1ed1t, \u1edbn l\u1ea1nh, \u0111au \u0111\u1ea7u, \u0111au c\u01a1.
\u2022 Giai \u0111o\u1ea1n to\u00e0n ph\u00e1t: -C\u01a1n s\u1ed1t \u0111i\u1ec3n h\u00ecnh: R\u00e9t run \u2192 S\u1ed1t cao \u2192 V\u00e3 m\u1ed3 h\u00f4i-Chu k\u1ef3 s\u1ed1t \u0111\u1eb7c tr\u01b0ng: 48 gi\u1edd (P. falciparum, P. vivax, P. ovale<\/em>) ho\u1eb7c 72 gi\u1edd (P. malariae<\/em>)<\/td>		\u2022 Giai \u0111o\u1ea1n s\u1ed1t (2-7 ng\u00e0y): S\u1ed1t cao \u0111\u1ed9t ng\u1ed9t, \u0111au \u0111\u1ea7u d\u1eef d\u1ed9i, \u0111au sau h\u1ed1c m\u1eaft, \u0111au c\u01a1 kh\u1edbp
\u2022 Giai \u0111o\u1ea1n nguy hi\u1ec3m (24-48 gi\u1edd sau h\u1ebft s\u1ed1t): Tho\u00e1t huy\u1ebft t\u01b0\u01a1ng, xu\u1ea5t huy\u1ebft, suy t\u1ea1ng
\u2022 Giai \u0111o\u1ea1n h\u1ed3i ph\u1ee5c: C\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng chung, t\u00e1i h\u1ea5p thu d\u1ecbch tho\u00e1t m\u1ea1ch<\/td>		C\u00f3 th\u1ec3 g\u00e2y nh\u1ea7m l\u1eabn trong ch\u1ea9n \u0111o\u00e1n ban \u0111\u1ea7u<\/td><\/tr>
Bi\u1ebfn ch\u1ee9ng<\/strong><\/td>S\u1ed1t r\u00e9t \u00e1c t\u00ednh (s\u1ed1t r\u00e9t n\u00e3o, suy th\u1eadn c\u1ea5p, ph\u00f9 ph\u1ed5i c\u1ea5p, h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft)<\/td>S\u1ed1c, xu\u1ea5t huy\u1ebft n\u1eb7ng, suy t\u1ea1ng<\/td>\u0110\u1ec1u c\u00f3 th\u1ec3 g\u00e2y t\u1eed vong n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi<\/td><\/tr>
Ch\u1ea9n \u0111o\u00e1n<\/strong><\/td>\u2022X\u00e9t nghi\u1ec7m t\u00ecm k\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t trong m\u00e1u: Gi\u1ecdt d\u00e0y, lam m\u00e1u nhu\u1ed9m Giemsa
\u2022K\u1ef9 thu\u1eadt PCR: Ph\u00e1t hi\u1ec7n DNA c\u1ee7a k\u00fd sinh tr\u00f9ng
\u2022Test nhanh kh\u00e1ng nguy\u00ean: Ph\u00e1t hi\u1ec7n protein \u0111\u1eb7c hi\u1ec7u c\u1ee7a Plasmodium<\/em><\/td>		\u2022X\u00e9t nghi\u1ec7m huy\u1ebft h\u1ecdc: Gi\u1ea3m ti\u1ec3u c\u1ea7u, t\u0103ng hematocrit
\u2022Ch\u1ea9n \u0111o\u00e1n huy\u1ebft thanh h\u1ecdc: NS1Ag, IgM, IgG
\u2022Ph\u00e2n l\u1eadp virus ho\u1eb7c PCR<\/td>		C\u1ea7n ph\u00e2n bi\u1ec7t ch\u00ednh x\u00e1c \u0111\u1ec3 c\u00f3 h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p<\/td><\/tr>
\u0110i\u1ec1u tr\u1ecb<\/strong><\/td>\u2022 Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u: Artemisinin v\u00e0 d\u1eabn xu\u1ea5t, Chloroquine, Primaquine
\u2022 \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3: H\u1ea1 s\u1ed1t, b\u00f9 n\u01b0\u1edbc \u0111i\u1ec7n gi\u1ea3i, truy\u1ec1n m\u00e1u n\u1ebfu c\u1ea7n<\/td>		\u2022 \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3: H\u1ea1 s\u1ed1t, b\u00f9 d\u1ecbch
\u2022 \u0110i\u1ec1u tr\u1ecb s\u1ed1c: Truy\u1ec1n d\u1ecbch, \u0111i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u
\u2022 Ch\u01b0a c\u00f3 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u<\/td>		Kh\u00e1c bi\u1ec7t trong ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u1ea3n l\u00fd b\u1ec7nh nh\u00e2n<\/td><\/tr>
Ph\u00f2ng ng\u1eeba<\/strong><\/td>\u2022 Ki\u1ec3m so\u00e1t vect\u01a1: Di\u1ec7t mu\u1ed7i, phun thu\u1ed1c t\u1ed3n l\u01b0u
\u2022 B\u1ea3o v\u1ec7 c\u00e1 nh\u00e2n: S\u1eed d\u1ee5ng m\u00e0n t\u1ea9m h\u00f3a ch\u1ea5t, kem ch\u1ed1ng mu\u1ed7i
\u2022 D\u1ef1 ph\u00f2ng b\u1eb1ng thu\u1ed1c: Mefloquine, Doxycycline cho ng\u01b0\u1eddi \u0111i v\u00e0o v\u00f9ng d\u1ecbch<\/td>		\u2022 Ki\u1ec3m so\u00e1t vect\u01a1: Lo\u1ea1i b\u1ecf \u1ed5 ch\u1ee9a n\u01b0\u1edbc \u0111\u1ecdng, di\u1ec7t b\u1ecd g\u1eady
\u2022 B\u1ea3o v\u1ec7 c\u00e1 nh\u00e2n: M\u1eb7c qu\u1ea7n \u00e1o d\u00e0i tay, s\u1eed d\u1ee5ng kem ch\u1ed1ng mu\u1ed7i
\u2022 V\u1eafc-xin: \u0110\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t \u1edf m\u1ed9t s\u1ed1 qu\u1ed1c gia, hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 c\u00f2n h\u1ea1n ch\u1ebf<\/td>		Chi\u1ebfn l\u01b0\u1ee3c ph\u00f2ng ng\u1eeba c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p cho c\u1ea3 hai b\u1ec7nh<\/td><\/tr><\/tbody><\/table>
B\u1ea3ng 1. <\/strong>M\u1ed1i t\u01b0\u01a1ng quan gi\u1eefa b\u1ec7nh s\u1ed1t r\u00e9t v\u00e0 s\u1ed1t xu\u1ea5t huy\u1ebft<\/em><\/figcaption><\/figure>\n\n\n\n

Ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 ch\u00ednh x\u00e1c<\/strong> l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t trong vi\u1ec7c qu\u1ea3n l\u00fd v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh truy\u1ec1n nhi\u1ec5m, \u0111\u1eb7c bi\u1ec7t l\u00e0 s\u1ed1t r\u00e9t v\u00e0 s\u1ed1t xu\u1ea5t huy\u1ebft. C\u1ea3 hai c\u0103n b\u1ec7nh n\u00e0y kh\u00f4ng ch\u1ec9 g\u00e2y \u1ea3nh h\u01b0\u1edfng nghi\u00eam tr\u1ecdng \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ed9ng \u0111\u1ed3ng m\u00e0 c\u00f2n \u0111\u1eb7t ra g\u00e1nh n\u1eb7ng l\u1edbn cho h\u1ec7 th\u1ed1ng y t\u1ebf.<\/p>\n\n\n\n

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2. Ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n b\u1ec7nh s\u1ed1t xu\u1ea5t huy\u1ebft<\/strong><\/h2>\n\n\n\n

B\u1ec7nh s\u1ed1t xu\u1ea5t huy\u1ebft Dengue \u0111\u01b0\u1ee3c chia l\u00e0m 3 m\u1ee9c \u0111\u1ed9 (theo T\u1ed5 ch\u1ee9c Y t\u1ebf th\u1ebf gi\u1edbi n\u0103m 2009).<\/p>\n\n\n\n

– S\u1ed1t xu\u1ea5t huy\u1ebft Dengue
– S\u1ed1t xu\u1ea5t huy\u1ebft Dengue c\u00f3 d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o
– S\u1ed1t xu\u1ea5t huy\u1ebft Dengue n\u1eb7ng<\/p>\n\n\n\n

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2.1. Ch\u1ea9n \u0111o\u00e1n c\u0103n nguy\u00ean vi r\u00fat Dengue<\/strong><\/h3>\n\n\n\n

a. X\u00e9t nghi\u1ec7m huy\u1ebft thanh<\/em><\/strong><\/h4>\n\n\n\n

– X\u00e9t nghi\u1ec7m nhanh: t\u00ecm kh\u00e1ng nguy\u00ean NS1 t\u1eeb ng\u00e0y 1 \u0111\u1ebfn ng\u00e0y 7 c\u1ee7a b\u1ec7nh (\u01b0u ti\u00ean trong 5 ng\u00e0y \u0111\u1ea7u).
– X\u00e9t nghi\u1ec7m ELISA ho\u1eb7c test nhanh t\u00ecm kh\u00e1ng th\u1ec3 IgM, IgG t\u1eeb ng\u00e0y th\u1ee9 5 c\u1ee7a b\u1ec7nh n\u1ebfu NS1 \u00e2m t\u00ednh.<\/p>\n\n\n\n

b. X\u00e9t nghi\u1ec7m PCR, ph\u00e2n l\u1eadp vi r\u00fat: l\u1ea5y m\u00e1u trong giai \u0111o\u1ea1n s\u1ed1t (th\u1ef1c hi\u1ec7n \u1edf c\u00e1c c\u01a1 s\u1edf x\u00e9t nghi\u1ec7m c\u00f3 \u0111i\u1ec1u ki\u1ec7n).<\/em><\/strong><\/h4>\n\n\n\n
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2.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/h3>\n\n\n\n

– S\u1ed1t ph\u00e1t ban do vi r\u00fat.
– Tay ch\u00e2n mi\u1ec7ng.
– S\u1ed1t m\u00f2.
– S\u1ed1t r\u00e9t.
– Nhi\u1ec5m khu\u1ea9n huy\u1ebft do li\u00ean c\u1ea7u l\u1ee3n, n\u00e3o m\u00f4 c\u1ea7u, vi khu\u1ea9n gram \u00e2m, …
– S\u1ed1c nhi\u1ec5m khu\u1ea9n.
– C\u00e1c b\u1ec7nh m\u00e1u.
– B\u1ec7nh l\u00fd \u1ed5 b\u1ee5ng c\u1ea5p,\u2026<\/p>\n\n\n\n

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3. Nguy\u00ean t\u1eafc ch\u1ea9n \u0111o\u00e1n b\u1ec7nh s\u1ed1t r\u00e9t theo B\u1ed9 Y T\u1ebf<\/strong><\/h2>\n\n\n\n

3.1. Tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd s\u1ed1t r\u00e9t<\/strong><\/h3>\n\n\n\n

L\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u00f3 s\u1ed1t v\u00e0 c\u00f3 y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5.<\/p>\n\n\n\n

a) S\u1ed1t:<\/em><\/strong>\u00a0ng\u01b0\u1eddi b\u1ec7nh \u0111ang s\u1ed1t ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed s\u1ed1t trong 3 ng\u00e0y g\u1ea7n \u0111\u00e2y.
– C\u00f3 tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a c\u01a1n s\u1ed1t r\u00e9t: r\u00e9t run, s\u1ed1t v\u00e0 v\u00e3 m\u1ed3 h\u00f4i, c\u00f3 t\u00ednh chu k\u1ef3.
– Nh\u1eefng ng\u01b0\u1eddi b\u1ecb s\u1ed1t r\u00e9t l\u1ea7n \u0111\u1ea7u ti\u00ean th\u01b0\u1eddng kh\u00f4ng c\u00f3 c\u01a1n s\u1ed1t r\u00e9t \u0111i\u1ec3n h\u00ecnh m\u00e0 th\u01b0\u1eddng s\u1ed1t kh\u00f4ng th\u00e0nh c\u01a1n (ng\u01b0\u1eddi b\u1ec7nh th\u1ea5y \u1edbn l\u1ea1nh, gai r\u00e9t) ho\u1eb7c s\u1ed1t cao li\u00ean t\u1ee5c, s\u1ed1t dao \u0111\u1ed9ng.<\/p>\n\n\n\n

b) Y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5:<\/em><\/strong> \u0111\u1ebfn v\u00f9ng s\u1ed1t r\u00e9t, \u0111ang \u1edf ho\u1eb7c tr\u1edf v\u1ec1 t\u1eeb v\u00f9ng s\u1ed1t r\u00e9t l\u01b0u h\u00e0nh ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed m\u1eafc s\u1ed1t r\u00e9t.<\/p>\n\n\n\n

T\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd s\u1ed1t r\u00e9t \u0111\u1ec1u ph\u1ea3i l\u00e0m x\u00e9t nghi\u1ec7m \u0111\u1ec3 ph\u00e1t hi\u1ec7n k\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t. N\u1ebfu l\u1ea7n \u0111\u1ea7u x\u00e9t nghi\u1ec7m soi lam \u00e2m t\u00ednh, m\u00e0 v\u1eabn c\u00f2n nghi ng\u1edd ng\u01b0\u1eddi \u0111\u00f3 b\u1ecb s\u1ed1t r\u00e9t, th\u00ec ph\u1ea3i x\u00e9t nghi\u1ec7m l\u1ea1i lam m\u00e1u sau 8-24 gi\u1edd t\u1ed1t nh\u1ea5t v\u00e0o th\u1eddi \u0111i\u1ec3m ng\u01b0\u1eddi b\u1ec7nh \u0111ang l\u00ean c\u01a1n s\u1ed1t.<\/p>\n\n\n\n

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3.2. Tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh s\u1ed1t r\u00e9t x\u00e1c \u0111\u1ecbnh<\/strong><\/h3>\n\n\n\n

Tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh s\u1ed1t r\u00e9t x\u00e1c \u0111\u1ecbnh l\u00e0 tr\u01b0\u1eddng h\u1ee3p c\u00f3 k\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t trong m\u00e1u \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng x\u00e9t nghi\u1ec7m lam m\u00e1u nhu\u1ed9m Giemsa ho\u1eb7c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n nhanh ph\u00e1t hi\u1ec7n kh\u00e1ng nguy\u00ean ho\u1eb7c k\u1ef9 thu\u1eadt sinh h\u1ecdc ph\u00e2n t\u1eed.<\/p>\n\n\n\n

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