{"id":38720,"date":"2026-03-24T14:07:16","date_gmt":"2026-03-24T07:07:16","guid":{"rendered":"https:\/\/cdcangiang.vn\/?p=38720"},"modified":"2026-03-24T14:06:21","modified_gmt":"2026-03-24T07:06:21","slug":"benh-viem-mang-nao-do-nao-mo-cau","status":"publish","type":"post","link":"https:\/\/cdcangiang.vn\/index.php\/2026\/03\/24\/benh-viem-mang-nao-do-nao-mo-cau\/","title":{"rendered":"Th\u00f4ng tin v\u1ec1 b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u"},"content":{"rendered":"

ICD-10 A39.0: Meningococcal meningitis<\/strong><\/p>\n

B\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u thu\u1ed9c nh\u00f3m B <\/em>trong Lu\u1eadt Ph\u00f2ng, ch\u1ed1ng b\u1ec7nh truy\u1ec1n nhi\u1ec5m.<\/em><\/p>\n

1. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh<\/strong><\/p>\n

1.1. \u0110\u1ecbnh ngh\u0129a ca b\u1ec7nh:<\/em><\/p>\n

B\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u l\u00e0 m\u1ed9t b\u1ec7nh nhi\u1ec5m khu\u1ea9n c\u1ea5p t\u00ednh x\u1ea3y ra \u0111\u1ed9t ng\u1ed9t v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng s\u1ed1t, \u0111au \u0111\u1ea7u d\u1eef d\u1ed9i, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n, c\u1ed5 c\u1ee9ng, th\u01b0\u1eddng c\u00f3 ban xu\u1ea5t huy\u1ebft h\u00ecnh sao ho\u1eb7c c\u00f3 th\u1ec3 c\u00f3 m\u1ee5n n\u01b0\u1edbc. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng l\u01a1 m\u01a1 ho\u1eb7c h\u00f4n m\u00ea. C\u00f3 tr\u01b0\u1eddng h\u1ee3p bi\u1ec3u hi\u1ec7n m\u1ec7t l\u1ea3 \u0111\u1ed9t ng\u1ed9t, xu\u1ea5t hi\u1ec7n m\u1ea3ng xu\u1ea5t huy\u1ebft v\u00e0 s\u1ed1c. Ng\u00e0y nay, n\u1ebfu ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c th\u00ec t\u1ef7 l\u1ec7 t\u1eed vong t\u1eeb 5% \u0111\u1ebfn 15%.<\/p>\n

B\u1ec7nh c\u00f3 c\u00e1c th\u1ec3 l\u00e2m s\u00e0ng \u0111a d\u1ea1ng nh\u01b0 vi\u00eam m\u00e0ng n\u00e3o tu\u1ef7 c\u1ea5p c\u00f3 m\u1ee7, nhi\u1ec5m vi khu\u1ea9n huy\u1ebft do n\u00e3o m\u00f4 c\u1ea7u (meningococcemia), vi\u00eam kh\u1edbp do n\u00e3o m\u00f4 c\u1ea7u, vi\u00eam m\u00e0ng trong tim do n\u00e3o m\u00f4 c\u1ea7u. Ngo\u00e0i ra, c\u00f3 nhi\u1ec1u ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m n\u00e3o m\u00f4 c\u1ea7u nh\u01b0ng ch\u1ec9 c\u00f3 s\u1ed1t v\u00e0\/ho\u1eb7c vi\u00eam m\u0169i h\u1ecdng. \u1ede n\u01a1i c\u00f3 b\u1ec7nh l\u01b0u h\u00e0nh \u0111\u1ecba ph\u01b0\u01a1ng, s\u1ed1 ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m n\u00e3o m\u00f4 c\u1ea7u \u1edf h\u1ea7u, h\u1ecdng m\u00e0 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng chi\u1ebfm t\u1eeb 5%-10%. Th\u1ec3 nhi\u1ec5m khu\u1ea9n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng hay g\u1eb7p trong c\u00e1c v\u1ee5 d\u1ecbch v\u00e0 \u0111\u00f3 l\u00e0 ngu\u1ed3n l\u00e2y truy\u1ec1n d\u1ecbch r\u1ea5t quan tr\u1ecdng trong c\u1ed9ng \u0111\u1ed3ng.<\/p>\n

– Ca b\u1ec7nh l\u00e2m s\u00e0ng:<\/p>\n

+ S\u1ed1t cao \u0111\u1ed9t ng\u1ed9t, \u0111au \u0111\u1ea7u d\u1eef d\u1ed9i, bu\u1ed3n n\u00f4n, n\u00f4n, c\u1ed5 c\u1ee9ng, c\u00f3 th\u1ec3 c\u00f3 \u0111\u1ed1m xu\u1ea5t huy\u1ebft.<\/p>\n

+ B\u1ea1ch c\u1ea7u \u0111a nh\u00e2n trung t\u00ednh t\u0103ng cao.<\/p>\n

+ N\u01b0\u1edbc n\u00e3o tu\u1ef7 \u0111\u1ee5c.<\/p>\n

– Ca b\u1ec7nh x\u00e1c \u0111\u1ecbnh: Ph\u00e2n l\u1eadp vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u (+) trong d\u1ecbch n\u00e3o tu\u1ef7 ho\u1eb7c trong m\u00e1u.<\/p>\n

1.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh t\u01b0\u01a1ng t\u1ef1 nh\u01b0: B\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 do vi khu\u1ea9n c\u00fam t\u00fdp b (Haemophilus influenzae b<\/em>), b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 do li\u00ean c\u1ea7u ph\u1ebf vi\u00eam (Streptococcus pneumoniae<\/em>).<\/p>\n

1.3. X\u00e9t nghi\u1ec7m:<\/p>\n

– Lo\u1ea1i m\u1eabu b\u1ec7nh ph\u1ea9m:<\/p>\n

+ Ngo\u00e1y h\u1ecdng l\u1ea5y ch\u1ea5t nh\u1ea7y \u1edf th\u00e0nh h\u1ecdng.<\/p>\n

+ L\u1ea5y m\u00e1u ho\u1eb7c ch\u00edch m\u1ee5n n\u01b0\u1edbc ho\u1eb7c ban xu\u1ea5t huy\u1ebft.<\/p>\n

+ L\u1ea5y d\u1ecbch n\u00e3o tu\u1ef7.<\/p>\n

– Ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m;<\/p>\n

+ Nhu\u1ed9m gram soi k\u00ednh hi\u1ec3n vi t\u00ecm song c\u1ea7u khu\u1ea9n h\u00ecnh h\u1ea1t c\u00e0 ph\u00ea, gram (-), th\u01b0\u1eddng n\u1eb1m trong b\u00e0o t\u01b0\u01a1ng c\u1ee7a b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n.<\/p>\n

+ Ph\u00e2n l\u1eadp vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u.<\/p>\n

2. T\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh<\/strong><\/p>\n

– T\u00ean t\u00e1c nh\u00e2n l\u00e0 Neisseria meningitidis,<\/em> c\u00f2n g\u1ecdi l\u00e0 meningococcus.<\/em> D\u1ef1a v\u00e0o nh\u1eefng kh\u00e1ng nguy\u00ean polyozit, ng\u01b0\u1eddi ta chia vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u th\u00e0nh 4 nh\u00f3m ch\u00ednh l\u00e0 A, B, C v\u00e0 D. N\u00e3o m\u00f4 c\u1ea7u nh\u00f3m A v\u00e0 B th\u01b0\u1eddng hay g\u1eb7p nh\u1ea5t. Ngo\u00e0i ra ng\u01b0\u1eddi ta c\u00f2n b\u1ed5 sung th\u00eam nh\u1eefng nh\u00f3m huy\u1ebft thanh g\u00e2y b\u1ec7nh c\u1ee7a vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u nh\u01b0 W-135, X, Y v\u00e0 Z. Nh\u1eefng vi khu\u1ea9n thu\u1ed9c nh\u00f3m huy\u1ebft thanh n\u00e0y c\u00f3 th\u1ec3 c\u00f3 \u00edt \u0111\u1ed9c l\u1ef1c nh\u01b0ng v\u1eabn c\u00f3 th\u1ec3 g\u00e2y b\u1ec7nh n\u1eb7ng.<\/p>\n

– H\u00ecnh th\u00e1i: Vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u th\u01b0\u1eddng \u1edf d\u1ea1ng 2 t\u1ebf b\u00e0o c\u1ea1nh nhau nh\u01b0 2 h\u1ea1t c\u00e0 ph\u00ea, gram (-), th\u01b0\u1eddng n\u1eb1m trong b\u00e0o t\u01b0\u01a1ng c\u1ee7a b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n.<\/p>\n

– Kh\u1ea3 n\u0103ng t\u1ed3n t\u1ea1i trong m\u00f4i tr\u01b0\u1eddng b\u00ean ngo\u00e0i: S\u1ee9c \u0111\u1ec1 kh\u00e1ng c\u1ee7a vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u r\u1ea5t y\u1ebfu, m\u1eb7c d\u00f9 \u1edf trong d\u1ecbch n\u00e3o tu\u1ef7 nh\u01b0ng vi khu\u1ea9n c\u0169ng ch\u1ec9 s\u1ed1ng \u0111\u01b0\u1ee3c v\u00e0i gi\u1edd khi ra ngo\u00e0i c\u01a1 th\u1ec3 v\u00e0 s\u1ebd b\u1ecb di\u1ec7t b\u1edfi 56\u00b0C trong 30 ph\u00fat ho\u1eb7c 60\u00b0C trong 10 ph\u00fat, nh\u01b0ng vi khu\u1ea9n v\u1eabn c\u00f3 th\u1ec3 s\u1ed1ng \u0111\u01b0\u1ee3c -200C.<\/p>\n

3. \u0110\u1eb7c \u0111i\u1ec3m d\u1ecbch t\u1ec5 h\u1ecdc:<\/strong><\/p>\n

– B\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u l\u01b0u h\u00e0nh \u1edf m\u1ecdi n\u01a1i tr\u00ean th\u1ebf gi\u1edbi. B\u1ec7nh th\u01b0\u1eddng t\u1ea3n ph\u00e1t v\u00e0 c\u00f3 th\u1ec3 g\u00e2y d\u1ecbch. T\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh cao do vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u nh\u00f3m A t\u1ed3n t\u1ea1i l\u00e2u d\u00e0i \u1edf v\u00f9ng b\u00e1n sa m\u1ea1c Sahara \u1edf mi\u1ec1n trung Ch\u00e2u Phi. M\u1edbi \u0111\u00e2y, b\u1ec7nh d\u1ecbch n\u00e3o m\u00f4 c\u1ea7u nh\u00f3m A \u0111\u00e3 x\u1ea3y ra \u1edf Nepal, \u1ea4n \u0110\u1ed9 v\u00e0 m\u1ed9t s\u1ed1 n\u01b0\u1edbc kh\u00e1c \u1edf Ch\u00e2u \u00c1. Trong nh\u1eefng n\u0103m 90 c\u1ee7a th\u1ebf k\u1ef7 20, \u1edf nhi\u1ec1u n\u01b0\u1edbc ch\u00e2u M\u1ef9 La Tinh nh\u01b0 M\u1ef9, Canada, Cuba, Brazil, Chile, Argentina, Colombia v.v… \u0111\u00e3 x\u1ea3y ra c\u00e1c v\u1ee5 d\u1ecbch do vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u nh\u00f3m B v\u00e0 C chi\u1ebfm \u01b0u th\u1ebf.<\/p>\n

– Vi\u1ec7t Nam c\u00f3 b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u nh\u00f3m A l\u01b0u h\u00e0nh \u1edf nhi\u1ec1u n\u01a1i. B\u1ec7nh th\u01b0\u1eddng t\u1ea3n ph\u00e1t l\u1eabn trong h\u1ed9i ch\u1ee9ng vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 v\u00e0 \u0111\u00e3 x\u1ea3y ra d\u1ecbch \u1edf nhi\u1ec1u n\u01a1i, nghi\u00eam tr\u1ecdng nh\u1ea5t l\u00e0 \u1edf mi\u1ec1n n\u00fai. Theo s\u1ed1 li\u1ec7u c\u1ee7a Vi\u1ec7n V\u1ec7 sinh d\u1ecbch t\u1ec5 trung \u01b0\u01a1ng, t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh t\u1eeb 1991-2000 \u1edf Vi\u1ec7t Nam l\u00e0 2,3\/ 100.000 d\u00e2n v\u00e0 l\u00e0 b\u1ec7nh x\u1ebfp th\u1ee9 6 trong 10 b\u1ec7nh truy\u1ec1n nhi\u1ec5m c\u00f3 t\u1ef7 l\u1ec7 ch\u1ebft cao nh\u1ea5t (0,03\/100.000 d\u00e2n). B\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u xu\u1ea5t hi\u1ec7n t\u1ea3n ph\u00e1t trong su\u1ed1t n\u0103m. Tuy nhi\u00ean, \u1edf Vi\u1ec7t Nam c\u00f3 th\u1ec3 x\u1ea3y ra d\u1ecbch v\u00e0o th\u1eddi ti\u1ebft m\u00f9a thu, \u0111\u00f4ng v\u00e0 xu\u00e2n, nh\u1ea5t l\u00e0 \u1edf c\u00e1c x\u00e3 v\u00f9ng n\u00fai bi\u00ean gi\u1edbi. Nh\u00f3m tu\u1ed5i nguy c\u01a1 m\u1eafc b\u1ec7nh cao nh\u1ea5t l\u00e0 l\u1ee9a tu\u1ed5i tr\u1ebb v\u00e0 c\u0169ng \u1edf nh\u00f3m tu\u1ed5i n\u00e0y c\u00f3 s\u1ed1 ng\u01b0\u1eddi l\u00e0nh mang vi khu\u1ea9n nhi\u1ec1u nh\u1ea5t.<\/p>\n

4. Ngu\u1ed3n truy\u1ec1n nhi\u1ec5m<\/strong><\/p>\n

– <\/strong>\u1ed4 ch\u1ee9a c\u1ee7a vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u trong t\u1ef1 nhi\u00ean l\u00e0 ng\u01b0\u1eddi. B\u1edfi v\u1eady, ngu\u1ed3n l\u00e2y b\u1ec7nh ch\u1ee7 y\u1ebfu l\u00e0 b\u1ec7nh nh\u00e2n v\u00e0 ng\u01b0\u1eddi l\u00e0nh mang tr\u00f9ng. Trong v\u1ee5 d\u1ecbch, c\u00f3 th\u1ec3 c\u00f3 tr\u00ean 25% s\u1ed1 ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m vi khu\u1ea9n kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng \u0111i\u1ec3n h\u00ecnh v\u00e0 c\u00f3 t\u1edbi tr\u00ean 50% s\u1ed1 ng\u01b0\u1eddi kho\u1ebb mang vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u. \u0110\u00f3 l\u00e0 nh\u1eefng ngu\u1ed3n l\u00e2y r\u1ea5t quan tr\u1ecdng c\u1ee7a b\u1ec7nh trong c\u1ed9ng \u0111\u1ed3ng.<\/p>\n

– Th\u1eddi gian \u1ee7 b\u1ec7nh t\u1eeb 2-10 ng\u00e0y, th\u00f4ng th\u01b0\u1eddng t\u1eeb 3- 4 ng\u00e0y. Vi khu\u1ea9n th\u01b0\u1eddng ch\u1ec9 g\u00e2y vi\u00eam ni\u00eam m\u1ea1c h\u1ea7u h\u1ecdng. Tr\u01b0\u1eddng h\u1ee3p vi khu\u1ea9n x\u00e2m nh\u1eadp v\u00e0o m\u00e1u v\u00e0 m\u00e0ng n\u00e3o tu\u1ef7 g\u00e2y b\u1ec7nh \u0111i\u1ec3n h\u00ecnh th\u00ec \u00edt x\u1ea3y ra h\u01a1n.<\/p>\n

– Th\u1eddi k\u1ef3 l\u00e2y truy\u1ec1n c\u1ee7a b\u1ec7nh tu\u1ef3 thu\u1ed9c v\u00e0o s\u1ef1 t\u1ed3n t\u1ea1i c\u1ee7a vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u \u1edf m\u0169i h\u1ecdng c\u1ee7a ng\u01b0\u1eddi nhi\u1ec5m khu\u1ea9n v\u00e0 vi khu\u1ea9n s\u1ebd bi\u1ebfn m\u1ea5t \u1edf m\u0169i h\u1ecdng sau 24 gi\u1edd \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh. Khi \u1edf ngo\u00e0i c\u01a1 th\u1ec3, vi khu\u1ea9n kh\u00f4ng t\u1ed3n t\u1ea1i l\u00e2u trong d\u1ecbch ti\u1ebft m\u0169i h\u1ecdng. Thu\u1ed1c Penicillin c\u00f3 t\u00e1c d\u1ee5ng k\u00ecm h\u00e3m s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u nh\u01b0ng kh\u00f4ng di\u1ec7t \u0111\u01b0\u1ee3c vi khu\u1ea9n \u1edf m\u0169i h\u1ecdng.<\/p>\n

5. Ph\u01b0\u01a1ng th\u1ee9c l\u00e2y truy\u1ec1n: <\/strong>Ph\u01b0\u01a1ng th\u1ee9c l\u00e2y truy\u1ec1n c\u1ee7a b\u1ec7nh b\u1eb1ng ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p v\u1edbi c\u00e1c h\u1ea1t n\u01b0\u1edbc mi\u1ebfng b\u1ecb nhi\u1ec5m vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u t\u1eeb ng\u01b0\u1eddi nhi\u1ec5m khu\u1ea9n sang m\u0169i h\u1ecdng c\u1ee7a ng\u01b0\u1eddi c\u1ea3m nhi\u1ec5m. S\u1ef1 l\u00e2y truy\u1ec1n c\u1ee7a b\u1ec7nh qua \u0111\u1ed3 v\u1eadt l\u00e0 hi\u1ebfm x\u1ea3y ra.<\/p>\n

6. T\u00ednh c\u1ea3m nhi\u1ec5m v\u00e0 mi\u1ec5n d\u1ecbch:<\/strong> M\u1ecdi ng\u01b0\u1eddi \u0111\u1ec1u c\u00f3 c\u1ea3m nhi\u1ec5m v\u1edbi vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u nh\u01b0ng t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng th\u1ea5p v\u00e0 t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh gi\u1ea3m d\u1ea7n theo l\u1ee9a tu\u1ed5i t\u0103ng l\u00ean. Sau khi b\u1ecb nhi\u1ec5m khu\u1ea9n, k\u1ec3 c\u1ea3 nh\u1eefng th\u1ec3 kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng v\u1eabn \u0111\u1ec3 l\u1ea1i mi\u1ec5n d\u1ecbch cho c\u01a1 th\u1ec3. Tuy nhi\u00ean, ng\u01b0\u1eddi ta v\u1eabn ch\u01b0a bi\u1ebft r\u00f5 th\u1eddi gian mi\u1ec5n d\u1ecbch \u0111\u1eb7c hi\u1ec7u nh\u00f3m sau khi m\u1eafc b\u1ec7nh k\u00e9o d\u00e0i \u0111\u01b0\u1ee3c bao l\u00e2u. \u1ede nh\u1eefng ng\u01b0\u1eddi b\u1ecb thi\u1ebfu h\u1ee5t b\u1ed5 th\u1ec3 th\u00ec c\u00f3 th\u1ec3 b\u1ecb m\u1eafc b\u1ec7nh t\u00e1i ph\u00e1t.<\/p>\n

7. C\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng d\u1ecbch<\/strong><\/p>\n

\u00a07.1. Bi\u1ec7n ph\u00e1p d\u1ef1 ph\u00f2ng:<\/em><\/p>\n

– Tuy\u00ean truy\u1ec1n gi\u00e1o d\u1ee5c s\u1ee9c kho\u1ebb: Cung c\u1ea5p nh\u1eefng th\u00f4ng tin c\u1ea7n thi\u1ebft v\u1ec1 b\u1ec7nh vi\u00eam\u00a0 m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u cho nh\u00e2n d\u00e2n, nh\u1ea5t l\u00e0 n\u01a1i c\u00f3 b\u1ec7nh l\u01b0u h\u00e0nh, \u0111\u1ec3 nh\u00e2n d\u00e2n bi\u1ebft ph\u00e1t hi\u1ec7n b\u1ec7nh s\u1edbm, c\u00e1ch ly v\u00e0 c\u1ed9ng t\u00e1c v\u1edbi ng\u00e0nh y t\u1ebf th\u1ef1c hi\u1ec7n ph\u00f2ng ch\u1ed1ng d\u1ecbch trong c\u1ed9ng \u0111\u1ed3ng<\/p>\n

– V\u1ec7 sinh ph\u00f2ng b\u1ec7nh.<\/p>\n

+ Nh\u00e0 \u1edf, nh\u00e0 tr\u1ebb, l\u1edbp h\u1ecdc ph\u1ea3i th\u00f4ng tho\u00e1ng, s\u1ea1ch s\u1ebd v\u00e0 c\u00f3 \u0111\u1ee7 \u00e1nh s\u00e1ng.<\/p>\n

+ T\u1ea1i n\u01a1i c\u00f3 \u1ed5 d\u1ecbch c\u0169, c\u1ea7n t\u0103ng c\u01b0\u1eddng gi\u00e1m s\u00e1t, ph\u00e1t hi\u1ec7n s\u1edbm c\u00e1c tr\u01b0\u1eddng h\u1ee3p s\u1ed1t, vi\u00eam h\u1ea7u h\u1ecdng \u0111\u1ec3 theo d\u00f5i. N\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n th\u00ec ngo\u00e1y h\u1ecdng b\u1ec7nh nh\u00e2n c\u0169 v\u00e0 nh\u1eefng ng\u01b0\u1eddi l\u00e2n c\u1eadn \u0111\u1ec3 x\u00e9t nghi\u1ec7m t\u00ecm ng\u01b0\u1eddi l\u00e0nh mang vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u.<\/p>\n

+ Hi\u1ec7n nay \u0111\u00e3 c\u00f3 v\u1eafc xin polysaccharide c\u1ee7a nh\u00f3m A, C, Y, W135 ph\u00f2ng b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u. \u0110\u00e2y l\u00e0 v\u1eafc xin an to\u00e0n v\u00e0 mi\u1ec5n d\u1ecbch cao nh\u01b0ng r\u1ea5t \u0111\u1eaft. C\u1ea7u khu\u1ea9n nh\u00f3m A l\u00e0 t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh th\u01b0\u1eddng g\u1eb7p nh\u01b0ng ch\u01b0a c\u00f3 v\u1eafc xin. B\u1edfi v\u1eady, trong t\u00ecnh h\u00ecnh hi\u1ec7n nay \u1edf Vi\u1ec7t Nam, n\u00ean \u00e1p d\u1ee5ng bi\u1ec7n ph\u00e1p gi\u00e1m s\u00e1t d\u1ecbch t\u1ec5 h\u1ecdc m\u1ed9t c\u00e1ch nghi\u00eam ng\u1eb7t b\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u \u0111\u1ec3 ch\u1ec9 \u0111\u1ecbnh d\u00f9ng ho\u00e1 d\u01b0\u1ee3c d\u1ef1 ph\u00f2ng khi c\u1ea7n thi\u1ebft.<\/p>\n

7.2. Bi\u1ec7n ph\u00e1p ch\u1ed1ng d\u1ecbch:<\/em><\/p>\n

– T\u1ed5 ch\u1ee9c:<\/p>\n

+ Th\u00e0nh l\u1eadp Ban ch\u1ed1ng d\u1ecbch do l\u00e3nh \u0111\u1ea1o ch\u00ednh quy\u1ec1n l\u00e0m tr\u01b0\u1edfng ban, l\u00e3nh \u0111\u1ea1o y t\u1ebf \u0111\u1ecba ph\u01b0\u01a1ng l\u00e0m ph\u00f3 ban th\u01b0\u1eddng tr\u1ef1c v\u00e0 c\u00e1c th\u00e0nh vi\u00ean kh\u00e1c c\u00f3 li\u00ean quan nh\u01b0: Y t\u1ebf, Gi\u00e1o d\u1ee5c, C\u00f4ng an, H\u1ed9i Ph\u1ee5 n\u1eef, H\u1ed9i Ch\u1eef th\u1eadp \u0111\u1ecf v.v…<\/p>\n

+ C\u00e1c th\u00e0nh vi\u00ean trong Ban ch\u1ed1ng d\u1ecbch \u0111\u01b0\u1ee3c ph\u00e2n c\u00f4ng nhi\u1ec7m v\u1ee5 \u0111\u1ec3 ch\u1ec9 \u0111\u1ea1o v\u00e0 huy \u0111\u1ed9ng c\u1ed9ng \u0111\u1ed3ng th\u1ef1c hi\u1ec7n t\u1ed1t c\u00f4ng t\u00e1c ch\u1ed1ng d\u1ecbch.<\/p>\n

+ \u0110\u1ed1i v\u1edbi v\u1ee5 d\u1ecbch nh\u1ecf, c\u1ea7n gi\u00e0nh m\u1ed9t s\u1ed1 gi\u01b0\u1eddng b\u1ec7nh trong m\u1ed9t khu ri\u00eang \u1edf khoa l\u00e2y b\u1ec7nh vi\u1ec7n \u0111\u1ec3 c\u00e1ch ly v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n. N\u1ebfu c\u00f3 d\u1ecbch l\u1edbn th\u00ec c\u00f3 th\u1ec3 th\u00e0nh l\u1eadp b\u1ec7nh x\u00e1 d\u00e3 chi\u1ebfn trong c\u1ed9ng \u0111\u1ed3ng<\/p>\n

– Chuy\u00ean m\u00f4n:<\/p>\n

+ B\u1ec7nh nh\u00e2n ph\u1ea3i \u0111\u01b0\u1ee3c c\u00e1ch ly \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p trong 24 gi\u1edd sau khi \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh. Nh\u1eefng th\u1ec3 l\u00e2m s\u00e0ng vi\u00eam m\u00e0ng n\u00e3o, nhi\u1ec5m khu\u1ea9n huy\u1ebft ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb trong b\u1ec7nh vi\u1ec7n c\u00f3 \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n chuy\u00ean m\u00f4n, k\u1ef9 thu\u1eadt \u0111\u1ec3 ng\u0103n ng\u1eeba bi\u1ebfn ch\u1ee9ng v\u00e0 t\u1eed vong. Nh\u1eefng th\u1ec3 b\u00e1n l\u00e2m s\u00e0ng, vi\u00eam m\u0169i h\u1ecdng v.v\u2026 c\u0169ng c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb tri\u1ec7t \u0111\u1ec3 t\u1ea1i y t\u1ebf c\u01a1 s\u1edf v\u00e0 theo d\u00f5i s\u1ef1 di\u1ec5n bi\u1ebfn c\u1ee7a b\u1ec7nh.<\/p>\n

+ Ng\u0103n ch\u1eb7n s\u1ef1 th\u0103m h\u1ecfi b\u1ec7nh nh\u00e2n, h\u1ea1n ch\u1ebf h\u1ed9i h\u1ecdp, t\u1ee5 t\u1eadp \u0111\u00f4ng ng\u01b0\u1eddi, h\u1ea1n ch\u1ebf s\u1ef1 \u0111i l\u1ea1i gi\u1eefa n\u01a1i c\u00f3 d\u1ecbch v\u1edbi n\u01a1i kh\u00e1c. \u0110\u1eb7t c\u00e1c tr\u1ea1m ki\u1ec3m so\u00e1t ra v\u00e0o v\u00f9ng d\u1ecbch v\u00e0 cho u\u1ed1ng ho\u00e1 d\u01b0\u1ee3c d\u1ef1 ph\u00f2ng.<\/p>\n

+ Qu\u1ea3n l\u00fd ng\u01b0\u1eddi l\u00e0nh mang khu\u1ea9n, ng\u01b0\u1eddi ti\u1ebfp x\u00fac: C\u1ea7n theo d\u00f5i nghi\u00eam ng\u1eb7t v\u1ec1 nhi\u1ec7t \u0111\u1ed9 v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c c\u1ee7a b\u1ec7nh \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi ti\u1ebfp x\u00fac v\u00e0 c\u00e1c th\u00e0nh vi\u00ean trong gia \u0111\u00ecnh b\u1ec7nh nh\u00e2n \u0111\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh s\u1edbm. D\u00f9ng kh\u00e1ng sinh nh\u00f3m beta lactam, phenicol, sulfamid \u0111\u1ec3 d\u1ef1 ph\u00f2ng cho ng\u01b0\u1eddi ti\u1ebfp x\u00fac, ng\u01b0\u1eddi ph\u1ee5c v\u1ee5 b\u1ec7nh nh\u00e2n, ng\u01b0\u1eddi ra v\u00e0o v\u00f9ng d\u1ecbch, ng\u01b0\u1eddi s\u1ed1ng trong c\u00e1c t\u1eadp th\u1ec3, tr\u01b0\u1eddng h\u1ecdc… c\u00f3 nguy c\u01a1 b\u1ecb l\u00e2y truy\u1ec1n v\u00e0 c\u1ea3 nh\u1eefng ng\u01b0\u1eddi l\u00e0nh mang vi khu\u1ea9n \u0111\u1ec3 ph\u00f2ng b\u1ec7nh r\u1ed9ng r\u00e3i trong v\u00f9ng d\u1ecbch.<\/p>\n

+ X\u1eed l\u00fd m\u00f4i tr\u01b0\u1eddng: S\u00e1t khu\u1ea9n t\u1ea9y u\u1ebf c\u00e1c ch\u1ea5t b\u00e0i ti\u1ebft \u0111\u01b0\u1eddng m\u0169i h\u1ecdng c\u1ee7a b\u1ec7nh nh\u00e2n. N\u00ean nh\u1ecf m\u0169i h\u1ecdng dung d\u1ecbch sunfamit ho\u1eb7c penicillin cho b\u1ec7nh nh\u00e2n v\u00e0 nh\u1eefng ng\u01b0\u1eddi ti\u1ebfp x\u00fac trong v\u00f9ng d\u1ecbch.<\/p>\n

7.3. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb:<\/em><\/p>\n

– Vi\u1ec7c d\u00f9ng sunfamit, penicillin v\u00e0\/ho\u1eb7c c\u00e1c kh\u00e1ng sinh kh\u00e1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 ph\u00f2ng ph\u1ea3i b\u1ea3o \u0111\u1ea3m ch\u1eafc ch\u1eafn l\u00e0 c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y c\u00f3 nh\u1ea1y c\u1ea3m v\u1edbi vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u.<\/p>\n

– \u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng: Sunfamit d\u00f9ng trong 5 ng\u00e0y v\u1edbi li\u1ec1u cho tr\u1ebb em l\u00e0 1gam\/ng\u00e0y chia \u0111\u1ec1u 2 l\u1ea7n v\u00e0 ng\u01b0\u1eddi l\u1edbn l\u00e0 2gam\/ng\u00e0y chia \u0111\u1ec1u 2 l\u1ea7n. \u1edf tr\u1ebb d\u01b0\u1edbi 5 tu\u1ed5i v\u1edbi li\u1ec1u l\u00e0 0,05 gam\/kg\/ng\u00e0y chia \u0111\u1ec1u 2 l\u1ea7n trong 5 ng\u00e0y. N\u1ebfu Sunfamit kh\u00f4ng c\u00f2n nh\u1ea1y c\u1ea3m v\u1edbi vi khu\u1ea9n n\u00e3o m\u00f4 c\u1ea7u th\u00ec d\u00f9ng rifamycin v\u1edbi li\u1ec1u ng\u01b0\u1eddi l\u1edbn 600 mg\/ng\u00e0y chia \u0111\u1ec1u 2 l\u1ea7n trong 2 ng\u00e0y; tr\u1ebb > 1 th\u00e1ng tu\u1ed5i v\u1edbi li\u1ec1u 10 mg\/kg\/ng\u00e0y v\u00e0 tr\u1ebb < 1 th\u00e1ng tu\u1ed5i v\u1edbi li\u1ec1u 5 mg\/kg\/ ng\u00e0y, chia \u0111\u1ec1u 2 l\u1ea7n trong 2 ng\u00e0y.<\/p>\n

– \u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u: Tr\u1ebb s\u01a1 sinh \u0111\u1ebfn 3 th\u00e1ng tu\u1ed5i d\u00f9ng ampicillin 200 mg\/kg v\u00e0 cephalosporin th\u1ebf h\u1ec7 III 100 mg\/kg, ti\u00eam t\u0129nh m\u1ea1ch t\u1eeb 2 \u0111\u1ebfn 3 l\u1ea7n trong 24 gi\u1edd. Tr\u1ebb d\u01b0\u1edbi 10 tu\u1ed5i d\u00f9ng ampicillin 200 mg\/kg v\u00e0 chloramphenicol 25 mg\/kg ho\u1eb7c ampicillin v\u00e0 cephalosporin li\u1ec1u nh\u01b0 tr\u00ean ti\u00eam t\u0129nh m\u1ea1ch 4 l\u1ea7n trong 24 gi\u1edd. \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn d\u00f9ng penicillin G 2 tri\u1ec7u \u0111\u01a1n v\u1ecb, ti\u00eam t\u0129nh m\u1ea1ch c\u00e1ch 2 gi\u1edd\/l\u1ea7n ho\u1eb7c ampicillin 2 gam, ho\u1eb7c cephalosporin th\u1ebf h\u1ec7 III 2 gam, ti\u00eam t\u0129nh m\u1ea1ch 4 l\u1ea7n trong 24 gi\u1edd. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb trung b\u00ecnh 10 ng\u00e0y.<\/p>\n

7.4. Ki\u1ec3m d\u1ecbch y t\u1ebf bi\u00ean gi\u1edbi:<\/em> Kh\u00f4ng c\u00f3 quy \u0111\u1ecbnh<\/p>\n

Ngu\u1ed3n: C\u1ee5c Ph\u00f2ng b\u1ec7nh, B\u1ed9 Y t\u1ebf<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

ICD-10 A39.0: Meningococcal meningitis B\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u thu\u1ed9c nh\u00f3m B trong Lu\u1eadt Ph\u00f2ng, ch\u1ed1ng b\u1ec7nh truy\u1ec1n nhi\u1ec5m. 1. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh 1.1. \u0110\u1ecbnh ngh\u0129a ca b\u1ec7nh: B\u1ec7nh vi\u00eam m\u00e0ng n\u00e3o do n\u00e3o m\u00f4 c\u1ea7u l\u00e0 m\u1ed9t b\u1ec7nh nhi\u1ec5m khu\u1ea9n c\u1ea5p t\u00ednh x\u1ea3y ra \u0111\u1ed9t ng\u1ed9t v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng […]<\/p>\n","protected":false},"author":8,"featured_media":38699,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"limit_modified_date":"1","last_modified_date":"","footnotes":""},"categories":[380,401],"tags":[],"class_list":["post-38720","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-chu-de","category-nao-mo-cau-new"],"_links":{"self":[{"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/posts\/38720","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/comments?post=38720"}],"version-history":[{"count":4,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/posts\/38720\/revisions"}],"predecessor-version":[{"id":38725,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/posts\/38720\/revisions\/38725"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/media\/38699"}],"wp:attachment":[{"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/media?parent=38720"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/categories?post=38720"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/tags?post=38720"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}