Ngu\u1ed3n : NT HN<\/p>\n
Quai b\u1ecb l\u00e0 m\u1ed9t b\u1ec7nh truy\u1ec1n nhi\u1ec5m do virus g\u00e2y ra v\u00e0 ph\u00e2n l\u1edbn c\u00f3 th\u1ec3 ph\u00f2ng ng\u1eeba b\u1eb1ng v\u1eafc xin. Th\u00f4ng th\u01b0\u1eddng, b\u1ec7nh kh\u1edfi ph\u00e1t v\u1edbi v\u00e0i ng\u00e0y s\u1ed1t, \u0111au \u0111\u1ea7u, \u0111au c\u01a1, m\u1ec7t m\u1ecfi v\u00e0 ch\u00e1n \u0103n, sau \u0111\u00f3 l\u00e0 vi\u00eam tuy\u1ebfn mang tai; b\u1ec7nh th\u01b0\u1eddng t\u1ef1 gi\u1edbi h\u1ea1n.<\/p>\n
Quai b\u1ecb x\u1ea3y ra tr\u00ean to\u00e0n th\u1ebf gi\u1edbi; t\u1ef7 l\u1ec7 m\u1eafc cao nh\u1ea5t th\u01b0\u1eddng v\u00e0o cu\u1ed1i m\u00f9a \u0111\u00f4ng \u0111\u1ebfn \u0111\u1ea7u m\u00f9a xu\u00e2n, m\u1eb7c d\u00f9 c\u00e1c \u0111\u1ee3t b\u00f9ng ph\u00e1t l\u1ebb t\u1ebb c\u00f3 th\u1ec3 x\u1ea3y ra v\u00e0o b\u1ea5t k\u1ef3 th\u1eddi \u0111i\u1ec3m n\u00e0o trong n\u0103m. B\u1ec7nh g\u1eb7p ph\u1ed1 bi\u1ebfn nh\u1ea5t \u1edf tr\u1ebb em \u0111\u1ed9 tu\u1ed5i \u0111i h\u1ecdc v\u00e0 thanh ni\u00ean trong \u0111\u1ed9 tu\u1ed5i \u0111\u1ea1i h\u1ecdc; hi\u1ebfm g\u1eb7p \u1edf tr\u1ebb d\u01b0\u1edbi 1 tu\u1ed5i, do \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 nh\u1edd kh\u00e1ng th\u1ec3 t\u1eeb m\u1eb9 truy\u1ec1n sang.<\/p>\n
Quai b\u1ecb c\u00f3 kh\u1ea3 n\u0103ng l\u00e2y nhi\u1ec5m r\u1ea5t cao v\u00e0 \u0111\u01b0\u1ee3c truy\u1ec1n qua gi\u1ecdt b\u1eafn \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp, ho\u1eb7c trung gian. B\u1ec7nh l\u00e2y lan nhanh ch\u00f3ng trong m\u00f4i tr\u01b0\u1eddng t\u1eadp th\u1ec3 nh\u01b0 k\u00fd t\u00fac x\u00e1 \u0111\u1ea1i h\u1ecdc. Nhi\u1ec5m b\u1ec7nh \u1edf tr\u1ebb em trong \u0111\u1ed9 tu\u1ed5i \u0111i h\u1ecdc c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn s\u1ef1 l\u00e2y lan ti\u1ebfp theo cho c\u00e1c th\u00e0nh vi\u00ean trong gia \u0111\u00ecnh.<\/p>\n
S\u1ef1 th\u1ea3i virus trong c\u00e1c d\u1ecbch ti\u1ebft \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p x\u1ea3y ra tr\u01b0\u1edbc khi kh\u1edfi ph\u00e1t tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng. Th\u1eddi gian \u1ee7 b\u1ec7nh th\u01b0\u1eddng l\u00e0 16-18 ng\u00e0y (dao \u0111\u1ed9ng t\u1eeb 12 \u0111\u1ebfn 25 ng\u00e0y) t\u00ednh t\u1eeb khi ph\u01a1i nhi\u1ec5m \u0111\u1ebfn khi xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng. Trong m\u1ed9t b\u00e0i t\u1ed5ng quan bao g\u1ed3m 15 nghi\u00ean c\u1ee9u theo d\u00f5i kh\u1ea3 n\u0103ng l\u00e2y nhi\u1ec5m c\u1ee7a virus quai b\u1ecb theo th\u1eddi gian, kh\u1ea3 n\u0103ng l\u00e2y nhi\u1ec5m c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n s\u1edbm t\u1eeb 7 ng\u00e0y tr\u01b0\u1edbc khi kh\u1edfi ph\u00e1t \u0111\u1ebfn 8 ng\u00e0y sau khi xu\u1ea5t hi\u1ec7n vi\u00eam tuy\u1ebfn mang tai. M\u1ee9c \u0111\u1ed9 l\u00e2y nhi\u1ec5m cao nh\u1ea5t xu\u1ea5t hi\u1ec7n ngay tr\u01b0\u1edbc khi kh\u1edfi ph\u00e1t vi\u00eam tuy\u1ebfn mang tai, sau \u0111\u00f3 viral shedding gi\u1ea3m nhanh ch\u00f3ng trong 5 ng\u00e0y ti\u1ebfp theo. \u0110\u1ebfn ng\u00e0y th\u1ee9 6-9 sau khi kh\u1edfi ph\u00e1t vi\u00eam tuy\u1ebfn mang tai, hi\u1ec7u gi\u00e1 virus v\u00e0 kh\u1ea3 n\u0103ng l\u00e2y nhi\u1ec5m r\u1ea5t th\u1ea5p.<\/p>\n
Th\u1eddi gian \u1ee7 b\u1ec7nh th\u01b0\u1eddng l\u00e0 16-18 ng\u00e0y (dao \u0111\u1ed9ng t\u1eeb 12 \u0111\u1ebfn 25 ng\u00e0y) t\u00ednh t\u1eeb khi ph\u01a1i nhi\u1ec5m \u0111\u1ebfn khi kh\u1edfi ph\u00e1t tri\u1ec7u ch\u1ee9ng. Trong m\u1ed9t b\u00e0i t\u1ed5ng quan, m\u1ee9c \u0111\u1ed9 l\u00e2y nhi\u1ec5m cao nh\u1ea5t xu\u1ea5t hi\u1ec7n ngay tr\u01b0\u1edbc khi kh\u1edfi ph\u00e1t vi\u00eam tuy\u1ebfn mang tai, sau \u0111\u00f3 viral shedding gi\u1ea3m nhanh trong 5 ng\u00e0y ti\u1ebfp theo.<\/p>\n
Quai b\u1ecb th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u v\u1edbi v\u00e0i ng\u00e0y s\u1ed1t, \u0111au \u0111\u1ea7u, \u0111au nh\u1ee9c c\u01a1, m\u1ec7t m\u1ecfi v\u00e0 ch\u00e1n \u0103n; sau \u0111\u00f3 l\u00e0 t\u00ecnh tr\u1ea1ng s\u01b0ng tuy\u1ebfn n\u01b0\u1edbc b\u1ecdt, th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n trong v\u00f2ng 48 gi\u1edd.<\/p>\n
Vi\u00eam tuy\u1ebfn mang tai th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u1edf tr\u1ebb t\u1eeb 2 \u0111\u00ean 9 tu\u1ed5i; \u0111au, \u0111\u00f4i khi k\u00e8m \u0111au tai, th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n tr\u01b0\u1edbc khi tuy\u1ebfn mang tai s\u01b0ng. Vi\u00eam tuy\u1ebfn mang tai c\u00f3 th\u1ec3 m\u1ed9t b\u00ean ho\u1eb7c hai b\u00ean; trong 90% tr\u01b0\u1eddng h\u1ee3p, t\u1ed5n th\u01b0\u01a1ng ban \u0111\u1ea7u m\u1ed9t b\u00ean s\u1ebd lan sang b\u00ean \u0111\u1ed1i di\u1ec7n sau v\u00e0i ng\u00e0y. S\u01b0ng tuy\u1ebfn mang tai c\u00f3 th\u1ec3 k\u00e9o d\u00e0i t\u1edbi 10 ng\u00e0y.<\/p>\n
Khi kh\u00e1m l\u00e2m s\u1ea3ng, s\u01b0ng tuy\u1ebfn mang tai c\u00f3 th\u1ec3 l\u00e0m m\u1ea5t g\u00f3c h\u00e0m d\u01b0\u1edbi, v\u00e0 l\u1ed7 \u1ed1ng Stensen c\u00f3 bi\u1ec3u hi\u1ec7n \u0111\u1ecf v\u00e0 gi\u00e3n r\u1ed9ng. C\u00e1c x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 cho th\u1ea5y gi\u1ea3m b\u1ea1ch c\u1ea7u v\u1edbi lympho t\u0103ng t\u01b0\u01a1ng \u0111\u1ed1i v\u00e0 n\u1ed3ng \u0111\u1ed9 amylase huy\u1ebft thanh t\u0103ng.<\/p>\n
Quai b\u1ecb th\u01b0\u1eddng l\u00e0 b\u1ec7nh t\u1ef1 gi\u1edbi h\u1ea1n ; h\u1ea7u h\u1ebft ng\u01b0\u1eddi b\u1ec7nh h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n trong v\u00f2ng v\u00e0i tu\u1ea7n.<\/p>\n
M\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh ch\u1ec9 xu\u1ea5t hi\u1ec7n c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00f4ng \u0111i\u1ec3n h\u00ecnh n\u00ean c\u00f3 th\u1ec3 kh\u00f4ng t\u00ecm \u0111\u1ebfn c\u01a1 s\u1edf y t\u1ebf \u0111\u1ec3 th\u0103m kh\u00e1m. Nhi\u1ec5m kh\u00f4ng tri\u1ec7u ch\u1ee9ng x\u1ea3y ra trong 15-20% c\u00e1c tr\u01b0\u1eddng h\u1ee3p; t\u00ecnh tr\u1ea1ng n\u00e0y g\u1eb7p \u1edf ng\u01b0\u1eddi l\u1edbn nhi\u1ec1u h\u01a1n tr\u1ebb em. Ng\u01b0\u1eddi l\u1edbn n\u1ebfu c\u00f3 nhi\u1ec5m quai b\u1ecb c\u00f3 tri\u1ec7u ch\u1ee9ng th\u00ec d\u1ec5 g\u1eb7p bi\u1ec3u hi\u1ec7n n\u1eb7ng h\u01a1n so v\u1edbi tr\u1ebb em c\u00f3 tri\u1ec7u ch\u1ee9ng.<\/p>\n
Hi\u1ec7n ch\u01b0a c\u00f3 b\u1eb1ng ch\u1ee9ng ch\u1eafc ch\u1eafn cho th\u1ea5y nhi\u1ec5m quai b\u1ecb trong thai k\u1ef3 c\u00f3 li\u00ean quan \u0111\u1ebfn c\u00e1c bi\u1ebfn ch\u1ee9ng.<\/p>\n
Quai b\u1ecb c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 vi\u00eam tinh ho\u00e0n v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n th\u1ea7n kinh (bao g\u1ed3m vi\u00eam m\u00e0ng n\u00e3o, vi\u00eam n\u00e3o v\u00e0 m\u1ea5t th\u00ednh l\u1ef1c); nh\u1eefng bi\u1ebfn ch\u1ee9ng n\u00e0y v\u1eabn c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf ng\u01b0\u1eddi \u0111\u00e3 ti\u00eam v\u1eafc xin nh\u01b0ng v\u1eabn m\u1eafc b\u1ec7nh. Bi\u1ebfn ch\u1ee9ng c\u1ee7a quai b\u1ecb c\u0169ng c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n kh\u00f4ng k\u00e8m vi\u00eam tuy\u1ebfn mang tai.<\/p>\n
Vi\u00eam tinh ho\u00e0n ho\u1eb7c vi\u00eam bu\u1ed3ng tr\u1ee9ng: Vi\u00eam m\u00e0o tinh ho\u00e0n l\u00e0 bi\u1ebfn ch\u1ee9ng ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a quai b\u1ecb; x\u1ea3y ra \u1edf nam gi\u1edbi sau tu\u1ed5i d\u1eady th\u00ec v\u1edbi t\u1ef7 l\u1ec7 15-30%. Tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n 5-10 ng\u00e0y sau khi kh\u1edfi ph\u00e1t vi\u00eam tuy\u1ebfn mang tai, bao g\u1ed3m s\u1ed1t cao \u0111\u1ed9t ng\u1ed9t (39-410C) v\u00e0 \u0111au tinh ho\u00e0n d\u1eef d\u1ed9i, k\u00e8m theo s\u01b0ng v\u00e0 \u0111\u00f3 b\u00ecu. T\u1ed5n th\u01b0\u01a1ng m\u1ed9t b\u00ean chi\u1ebfm 60-80% tr\u01b0\u1eddng h\u1ee3p.<\/p>\n
Vi\u00eam bu\u1ed3ng tr\u1ee9ng \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf kho\u1ea3ng 5% ph\u1ee5 n\u1eef sau d\u1eady th\u00ec m\u1eafc quai b\u1ecb, v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u01b0 \u0111au v\u00f9ng h\u1ea1 v\u1ecb, s\u1ed1t v\u00e0 n\u00f4n.<\/p>\n
Bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh: Nh\u1eefng bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh hay g\u1eb7p c\u1ee7a quai b\u1ecb bao g\u1ed3m vi\u00eam m\u00e0ng n\u00e3o, vi\u00eam n\u00e3o v\u00e0 m\u1ea5t th\u00ednh l\u1ef1c. Tr\u01b0\u1edbc khi ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng r\u1ed9ng r\u00e3i, quai b\u1ecb l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y vi\u00eam m\u00e0ng n\u00e3o v\u00e0 vi\u00eam n\u00e3o do virus, \u0111\u1ed3ng th\u1eddi l\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t g\u00e2y \u0111i\u1ebfc (sensorineural hearing loss) m\u1eafc ph\u1ea3i \u1edf tr\u1ebb em.<\/p>\n
C\u00e1c h\u1ed9i ch\u1ee9ng th\u1ea7n kinh \u00edt g\u1eb7p h\u01a1n li\u00ean quan \u0111\u1ebfn nhi\u1ec5m quai b\u1ecb bao g\u1ed3m h\u1ed9i ch\u1ee9ng Guillain-Barre\/Vi\u00eam \u0111a r\u1ec5 d\u00e2y th\u1ea7n kinh ti\u1ebfn tri\u1ec3n, vi\u00eam t\u00f9y c\u1eaft ngang v\u00e0 li\u1ec7t m\u1eb7t.<\/p>\n
Vi\u00eam m\u00e0ng n\u00e3o v\u00f4 khu\u1ea9n l\u00e0 bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a nhi\u1ec5m virus quai b\u1ecb: x\u1ea3y ra \u1edf 1-10% b\u1ec7nh nh\u00e2n v\u00e0 g\u1eb7p \u1edf nam gi\u1edbi nhi\u1ec1u g\u1ea5p ba l\u1ea7n n\u1eef gi\u1edbi. Vi\u00eam m\u00e0ng n\u00e3o c\u00f3 th\u1ec3 x\u1ea3y ra tr\u01b0\u1edbc, trong ho\u1eb7c sau vi\u00eam tuy\u1ebfn mang tai do quai b\u1ecb. Trong m\u1ed9t lo\u1ea1t ca, t\u1edbi m\u1ed9t n\u1eeda s\u1ed1 b\u1ec7nh nh\u00e2n xu\u1ea5t hi\u1ec7n vi\u00eam m\u00e0ng n\u00e3o m\u00e0 kh\u00f4ng c\u00f3 vi\u00eam tuy\u1ebfn mang tai. C\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng th\u01b0\u1eddng bao g\u1ed3m \u0111au \u0111\u1ea7u, s\u1ed1t nh\u1eb9 v\u00e0 c\u1ee9ng g\u00e1y nh\u1eb9.<\/p>\n
X\u00e9t nghi\u1ec7m d\u1ecbch n\u00e3o t\u1ee7y c\u00f3 th\u1ec3 cho th\u1ea5y 10-2000 b\u1ea1ch c\u1ea7u\/uL. T\u1ebf b\u00e0o lympho chi\u1ebfm \u01b0u th\u1ebf, tuy nhi\u00ean neutro c\u00f3 th\u1ec3 \u01b0u th\u1ebf trong giai \u0111o\u1ea1n s\u1edbm. N\u1ed3ng \u0111\u1ed9 protein to\u00e0n ph\u1ea7n trong d\u1ecbch n\u00e3o t\u1ee7y th\u01b0\u1eddng b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng nh\u1eb9. N\u1ed3ng \u0111\u1ed9 glucose trong d\u1ecbch n\u00e3o t\u1ee7y c\u00f3 th\u1ec3 gi\u1ea3m nh\u1eb9. Vi\u00eam m\u00e0ng n\u00e3o v\u00f4 khu\u1ea9n do quai b\u1ecb th\u01b0\u1eddng c\u00f3 di\u1ec5n bi\u1ebfn l\u00e0nh t\u00ednh v\u00e0 h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n kh\u00f4ng \u0111\u1ec3 l\u1ea1i di ch\u1ee9ng v\u0129nh vi\u1ec5n.<\/p>\n
Vi\u00eam n\u00e3o do quai b\u1ecb v\u00e0o kho\u1ea3ng 1\/6000 ca b\u1ec7nh tr\u01b0\u1edbc khi ti\u00eam ch\u1ee7ng \u0111\u01b0\u1ee3c tri\u1ec3n khai r\u1ed9ng r\u00e3i. Vi\u1ec7c ti\u00eam ch\u1ee7ng r\u1ed9ng r\u00e3i \u0111\u00e3 g\u1eafn li\u1ec1n v\u1edbi s\u1ef1 bi\u1ebfn m\u1ea5t c\u1ee7a vi\u00eam n\u00e3o do quai b\u1ecb. B\u1ec7nh nh\u00e2n vi\u00eam n\u00e3o do quai b\u1ecb th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n s\u1ed1t, r\u1ed1i lo\u1ea1n tr\u00ec gi\u00e1c, co gi\u1eadt v\u00e0 li\u1ec7t m\u1ed9t ph\u1ea7n ho\u1eb7c ho\u00e0n to\u00e0n. C\u00f3 t\u1edbi m\u1ed9t ph\u1ea7n ba s\u1ed1 b\u1ec7nh nh\u00e2n xu\u1ea5t hi\u1ec7n vi\u00eam n\u00e3o m\u00e0 kh\u00f4ng k\u00e8m vi\u00eam tuy\u1ebfn mang tai.<\/p>\n
\u0110\u1eb7c \u0111i\u1ec3m d\u1ecbch n\u00e3o t\u1ee7y t\u01b0\u01a1ng t\u1ef1 nh\u01b0 trong vi\u00eam m\u00e0ng n\u00e3o v\u00f4 khu\u1ea9n do quai b\u1ecb.<\/p>\n
H\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n vi\u00eam n\u00e3o do quai b\u1ecb h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n.<\/p>\n
Ph\u1ea7n l\u1edbn b\u1ec7nh nh\u00e2n b\u1ecb gi\u1ea3m th\u00ednh l\u1ef1c li\u00ean quan \u0111\u1ebfn quai b\u1ecb kh\u1edfi ph\u00e1t c\u1ea5p t\u1ec9nh; \u0111\u00f4i khi m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 di\u1ec5n ti\u1ebfn t\u1eeb t\u1eeb h\u01a1n. C\u00f3 th\u1ec3 g\u1eb7p t\u1ed5n th\u01b0\u01a1ng m\u1ed9t b\u00ean ho\u1eb7c hai b\u00ean. Tri\u1ec7u ch\u1ee9ng c\u1ea3i thi\u1ec7n \u1edf nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p.<\/p>\n
C\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00e1c : Nh\u1eefng bi\u1ebfn ch\u1ee9ng \u00edt g\u1eb7p h\u01a1n \u0111\u00f4i khi li\u00ean quan \u0111\u1ebfn nhi\u1ec5m quai b\u1ecb bao g\u1ed3m vi\u00eam tuy\u1ebfn gi\u00e1p, t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim, vi\u00eam t\u1ee5y, vi\u00eam th\u1eadn k\u1ebd v\u00e0 vi\u00eam kh\u1edbp.<\/p>\n
B\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3u hi\u1ec7n \u0111i\u1ec3n h\u00ecnh : C\u1ea7n nghi ng\u1edd ch\u1ea9n \u0111o\u00e1n quai b\u1ecb \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng \u0111i\u1ec3n h\u00ecnh (vi\u00eam tuy\u1ebfn mang tai ho\u1eb7c s\u01b0ng c\u00e1c tuy\u1ebfn n\u01b0\u1edbc b\u1ecdt kh\u00e1c, vi\u00eam tinh ho\u00e0n ho\u1eb7c vi\u00eam bu\u1ed3ng tr\u1ee9ng) k\u00e8m theo y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5 li\u00ean quan (ti\u1ebfp x\u00fac \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p ho\u1eb7c ti\u1ebfp x\u00fac trong gia \u0111\u00ecnh v\u1edbi ng\u01b0\u1eddi b\u1ecb quai b\u1ecb \u0111\u00e3 x\u00e1c \u0111\u1ecbnh ho\u1eb7c nghi ng\u1edd). Nh\u1eefng ng\u01b0\u1eddi ch\u01b0a \u0111\u01b0\u1ee3c ti\u00eam ch\u00fang c\u00f3 nguy c\u01a1 nhi\u1ec5m b\u1ec7nh cao nh\u1ea5t; tuy nhi\u00ean c\u0169ng c\u1ea7n ngh\u0129 \u0111\u1ebfn quai b\u1ecb \u1edf nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u00eam vaccin n\u1ebfu c\u00f3 tri\u1ec7u ch\u1ee9ng, bi\u1ec3u hi\u1ec7n ph\u00f9 h\u1ee3p v\u00e0 ti\u1ec1n s\u1eed ph\u01a1i nhi\u1ec5m. C\u00e1c b\u1ec7nh nh\u00e2n \u0111ang \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 nghi ng\u1edd quai b\u1ecb c\u1ea7n \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng bi\u1ec7n ph\u00e1p c\u00e1ch ly gi\u1ecdt b\u1eafn.<\/p>\n
Trong b\u1ed1i c\u1ea3nh c\u00f3 vi\u00eam tuy\u1ebfn mang tai (ho\u1eb7c s\u01b0ng c\u00e1c tuy\u1ebfn n\u01b0\u1edbc b\u1ecdt kh\u00e1c), ch\u1ea9n \u0111o\u00e1n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh b\u1eb1ng x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng. X\u00e1c nh\u1eadn nhi\u1ec5m virus quai b\u1ecb :<\/p>\n
RT-PCR tr\u00ean m\u1eabu huy\u1ebft thanh ho\u1eb7c ph\u1ebft ni\u00eam m\u1ea1c m\u00e1 mi\u1ec7ng<\/p>\n
Kh\u00e1ng th\u1ec3 IgM c\u1ee7a virus quai b\u1ecb d\u01b0\u01a1ng t\u00ednh trong huy\u1ebft thanh (th\u01b0\u1eddng t\u1ed5n t\u1ea1i t\u1ed1i \u0111a kho\u1ea3ng b\u1ed1n tu\u1ea7n).<\/p>\n
T\u1ea1i th\u1eddi \u0111i\u1ec3m th\u0103m kh\u00e1m ban \u0111\u1ea7u, c\u1ea7n thu th\u1eadp hai lo\u1ea1i b\u1ec7nh ph\u1ea9m ch\u1ea9n \u0111o\u00e1n :<\/p>\n
(1) Ph\u1ebft ni\u00eam m\u1ea1c m\u00e1 ho\u1eb7c mi\u1ec7ng (\u0111\u1ec1 l\u00e0m RT-PCR, nu\u00f4i c\u1ea5y)<\/p>\n
(2) M\u1eabu huy\u1ebft thanh giai \u0111o\u1ea1n c\u1ea5p (\u0111\u1ec3 x\u00e9t nghi\u1ec7m IgM quai b\u1ecb, IgG giai \u0111o\u1ea1n c\u1ea5p v\u00e0 PCR trong huy\u1ebft thanh)<\/p>\n
B\u1ec7nh ph\u1ea9m ph\u1ebft ni\u00eam m\u1ea1c m\u00e3 ho\u1eb7c mi\u1ec7ng n\u00ean \u0111\u01b0\u1ee3c l\u1ea5y c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t sau khi kh\u1edfi ph\u00e1t vi\u00eam tuy\u1ebfn mang tai (l\u00fd t\u01b0\u1edfng l\u00e0 trong v\u00f2ng 3 ng\u00e0y v\u00e0 kh\u00f4ng qu\u00e1 8 ng\u00e0y sau khi kh\u1edfi ph\u00e1t vi\u00eam tuy\u1ebfn mang tai) b\u1eb1ng c\u00e1ch xoa nh\u1eb9 tuy\u1ebfn mang tai tr\u01b0\u1edbc khi d\u00f9ng que ph\u1ebft.<\/p>\n
\u0110\u00e1p \u1ee9ng IgM trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 ch\u01b0a \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n cho \u0111\u1ebfn 5 ng\u00e0y sau khi kh\u1edfi ph\u00e1t tri\u1ec7u ch\u1ee9ng. Do \u0111\u00f3, n\u1ebfu m\u1eabu huy\u1ebft thanh giai \u0111o\u1ea1n c\u1ea5p \u0111\u01b0\u1ee3c l\u1ea5y \u2264 3 ng\u00e0y sau khi kh\u1edfi ph\u00e1t vi\u00eam tuy\u1ebfn mang tai v\u00e0 \u00e2m t\u00ednh v\u1edbi c\u1ea3 IgM l\u1eabn PCR th\u00ec c\u1ea7n l\u00e0m l\u1ea1i x\u00e9t nghi\u1ec7m IgM tr\u00ean m\u1ed9t m\u1eabu huy\u1ebft thanh kh\u00e1c \u0111\u01b0\u1ee3c l\u1ea5y 5-10 ng\u00e0y sau khi kh\u1edfi ph\u00e1t tri\u1ec7u ch\u1ee9ng.<\/p>\n
X\u00e1c nh\u1eadn x\u00e9t nghi\u1ec7m quai b\u1ecb \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed ti\u00eam vaccin l\u00e0 m\u1ed9t th\u00e1ch th\u1ee9c. Nh\u00ecn chung, IgM kh\u1ea3ng quai b\u1ecb trong huy\u1ebft thanh \u00e2m t\u1ec9nh \u1edf kho\u1ea3ng m\u1ed9t n\u1eeda s\u1ed1 ng\u01b0\u1eddi \u0111\u00e3 ti\u00eam ch\u1ee7ng (kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o th\u1eddi \u0111i\u1ec3m l\u1ea5y m\u1eabu). Ngo\u00e0i ra, PCR c\u00f3 th\u1ec3 \u00e2m t\u1ec9nh gi\u1ea3 v\u00ec ng\u01b0\u1eddi \u0111\u00e3 ti\u00eam vaccin th\u1ea3i virus v\u1edbi s\u1ed1 l\u01b0\u1ee3ng th\u1ea5p h\u01a1n v\u00e0 trong th\u1eddi gian ng\u1eafn h\u01a1n. Chuy\u1ec3n \u0111\u1ed5i huy\u1ebft thanh IgG hi\u1ec7n kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u01b0\u1eddng quy l\u00e0m d\u1ea5u \u1ea5n nhi\u1ec5m quai b\u1ecb trong b\u1ed1i c\u1ea3nh n\u00e0y, do \u1edf ng\u01b0\u1eddi \u0111\u00e3 ti\u00eam vaccin hi\u1ebfm khi ghi nh\u1eadn s\u1ef1 t\u0103ng g\u1ea5p b\u1ed1n l\u1ea7n hi\u1ec7u gi\u00e1. C\u00e1c x\u00e9t nghi\u1ec7m huy\u1ebft thanh h\u1ecdc kh\u00f4ng th\u1ec3 ph\u00e2n bi\u1ec7t gi\u1eefa \u0111\u00e1p \u1ee9ng sau ti\u00eam ch\u1ee7ng v\u00e0 ph\u01a1i nhi\u1ec5m quai b\u1ecb tr\u01b0\u1edbc \u0111\u00f3, v\u00e0 m\u1ee9c kh\u00e1ng th\u1ec3 IgG quai b\u1ecb c\u1ea7n thi\u1ebft \u0111\u1ec3 b\u1ea3o v\u1ec7 kh\u1ecfi nhi\u1ec5m b\u1ec7nh hi\u1ec7n ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh.<\/p>\n
C\u00e1c nguy\u00ean nh\u00e2n virus kh\u00e1c g\u00e2y vi\u00eam tuy\u1ebfn mang tai nh\u01b0 c\u00fam A, c\u1eadn c\u00fam, adenovirus, coxsackievirus, EBV, CMV, HSV, HIV…<\/p>\n
Vi\u00eam tuy\u1ebfn mang tai do virus c\u00f3 th\u1ec3 ph\u00e2n bi\u1ec7t v\u1edbi vi\u00eam tuy\u1ebfn mang tai m\u01b0ng m\u1ee7 (do vi khu\u1ea9n) nh\u1edd giai \u0111o\u1ea1n ti\u1ec1n tri\u1ec7u, sau \u0111\u00f3 l\u00e0 s\u01b0ng c\u1ea5p t\u1ec9nh c\u00e1c tuy\u1ebfn b\u1ecb \u1ea3nh h\u01b0\u1edfng, c\u00f3 th\u1ec3 k\u00e9o d\u00e0i 5-10 ng\u00e0y v\u00e0 th\u01b0\u1eddng x\u1ea3y ra hai b\u00ean. Vi\u00eam tuy\u00ean mang tai m\u01b0ng m\u1ee7 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t do Staphylococcus aerius \u0111\u1eb7c tr\u01b0ng v\u1edbi kh\u1edfi ph\u00e1t \u0111\u1ed9t ng\u1ed9t, s\u01b0ng ch\u1eafc v\u00e0 \u0111\u1ecf v\u00f9ng tr\u01b0\u1edbc v\u00e0 sau tai, lan t\u1edbi g\u00f3c h\u00e0m d\u01b0\u1edbi, k\u00e8m \u0111au d\u1eef d\u1ed9i, c\u00e1c bi\u1ec3u hi\u1ec7n to\u00e0n th\u00e2n nh\u01b0 s\u1ed1t cao, r\u00e9t rung v\u00e0 v\u1ebb m\u1eb7t nhi\u1ec5m tr\u00f9ng l\u00e0 th\u01b0\u1eddng g\u1eb7p.<\/p>\n
C\u00e1c nguy\u00ean nh\u00e2n kh\u00f4ng nhi\u1ec5m tr\u00f9ng g\u00e2y vi\u00eam tuy\u00ean mang tai bao g\u1ed3m s\u1ecfi tuy\u00ean n\u01b0\u1edbc b\u1ecdt, u tuy\u00ean n\u01b0\u1edbc b\u1ecdt, b\u1ec7nh Sjogren, sarcoidosis.<\/p>\n
Hi\u1ec7n nay ch\u01b0a c\u00f3 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1ng virus \u0111\u1eb7c hi\u1ec7u d\u00e0nh cho b\u1ec7nh quai b\u1ecb. Vi\u1ec7c x\u1eed tr\u00ed ch\u1ee7 y\u1ebfu l\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 t\u1ee3, c\u00f3 th\u1ec3 bao g\u1ed3m s\u1eed d\u1ee5ng thu\u1ed1c gi\u1ea3m \u0111au h\u1ea1 s\u1ed1t nh\u01b0 paracetamol. C\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu t\u1ea1i v\u00f9ng tuy\u1ebfn mang tai c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n b\u1eb1ng bi\u1ec7n ph\u00e1p ch\u01b0\u1eddm \u1ea5m ho\u1eb7c ch\u01b0\u1eddm l\u1ea1nh.<\/p>\n
Nguy\u00ean t\u1eafc chung : Vi\u1ec7c ki\u1ec3m so\u00e1t l\u00e2y truy\u1ec1n quai b\u1ecb g\u1eb7p nhi\u1ec1u kh\u00f3 kh\u0103n v\u00ec virus hi\u1ec7n di\u1ec7n trong n\u01b0\u1edbc b\u1ecdt nhi\u1ec1u ng\u00e0y tr\u01b0\u1edbc khi xu\u1ea5t hi\u1ec7n vi\u00eam tuy\u1ebfn mang tai tr\u00ean l\u00e2m s\u00e0ng, v\u00e0 s\u1ef1 th\u1ea3i virus c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf nh\u1eefng ng\u01b0\u1eddi nhi\u1ec5m kh\u00f4ng tri\u1ec7u ch\u1ee9ng.<\/p>\n
B\u1ec7nh nh\u00e2n b\u1ecb quai b\u1ecb ph\u1ea3i nh\u1eadp vi\u1ec7n c\u1ea7n \u0111\u01b0\u1ee3c c\u00e1ch ly gi\u1ecdt b\u1eafn cho \u0111\u1ebfn khi s\u01b0ng tuy\u1ebfn mang tai \u0111\u00e3 h\u1ebft. Ng\u01b0\u1eddi b\u1ec7nh quai b\u1ecb \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa c\u1ea7n h\u1ea1n ch\u1ebf ti\u1ebfp x\u00fac v\u1edbi ng\u01b0\u1eddi kh\u00e1c t\u1eeb th\u1eddi \u0111i\u1ec3m \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n cho \u0111\u1ebfn \u00edt nh\u1ea5t 5 ng\u00e0y sau khi b\u1eaft \u0111\u1ea7u xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng, b\u1eb1ng c\u00e1ch ngh\u1ec9 h\u1ecdc ho\u1eb7c ngh\u1ec9 l\u00e0m v\u00e0 \u1edf ph\u00f2ng ri\u00eang n\u1ebfu c\u00f3 th\u1ec3.<\/p>\n
Nhi\u1ec5m quai b\u1ecb ph\u1ea7n l\u1edbn c\u00f3 th\u1ec3 ph\u00f2ng ng\u1eeba b\u1eb1ng c\u00e1ch ti\u00eam ch\u1ee7ng tr\u01b0\u1edbc khi ph\u01a1i nhi\u1ec5m. Sau khi \u0111\u00e3 ph\u01a1i nhi\u1ec5m quai b\u1ecb, vi\u1ec7c ti\u00eam v\u1eafc xin c\u0169ng nh\u01b0 globulin mi\u1ec5n d\u1ecbch ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 th\u1ec3 ph\u00f2ng ng\u1eeba ho\u1eb7c l\u00e0m gi\u1ea3m m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh (trong \u0111i\u1ec1u ki\u1ec7n kh\u00f4ng c\u00f3 d\u1ecbch b\u00f9ng ph\u00e1t).<\/p>\n","protected":false},"excerpt":{"rendered":"
Ngu\u1ed3n : NT HN Quai b\u1ecb l\u00e0 m\u1ed9t b\u1ec7nh truy\u1ec1n nhi\u1ec5m do virus g\u00e2y ra v\u00e0 ph\u00e2n l\u1edbn c\u00f3 th\u1ec3 ph\u00f2ng ng\u1eeba b\u1eb1ng v\u1eafc xin. Th\u00f4ng th\u01b0\u1eddng, b\u1ec7nh kh\u1edfi ph\u00e1t v\u1edbi v\u00e0i ng\u00e0y s\u1ed1t, \u0111au \u0111\u1ea7u, \u0111au c\u01a1, m\u1ec7t m\u1ecfi v\u00e0 ch\u00e1n \u0103n, sau \u0111\u00f3 l\u00e0 vi\u00eam tuy\u1ebfn mang tai; b\u1ec7nh th\u01b0\u1eddng t\u1ef1 gi\u1edbi h\u1ea1n. […]\n","protected":false},"author":1,"featured_media":150788,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-150785","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/150785","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=150785"}],"version-history":[{"count":1,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/150785\/revisions"}],"predecessor-version":[{"id":150789,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/150785\/revisions\/150789"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/150788"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=150785"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=150785"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=150785"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}