﻿{"id":5075,"date":"2019-03-19T15:53:02","date_gmt":"2019-03-19T08:53:02","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=5075"},"modified":"2019-07-09T14:57:51","modified_gmt":"2019-07-09T07:57:51","slug":"su-dung-thuoc-trong-dieu-tri-viem-hong","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/su-dung-thuoc-trong-dieu-tri-viem-hong\/","title":{"rendered":"S\u1eec D\u1ee4NG THU\u1ed0C TRONG \u0110I\u1ec0U TR\u1eca VI\u00caM H\u1eccNG"},"content":{"rendered":"<h2>\u0110\u1ecaNH NGH\u0128A<\/h2>\n<p>&#8211; <strong>Vi\u00eam h\u1ecdng<\/strong> l\u00e0 c\u1ea3m gi\u00e1c ng\u1ee9a, v\u00e0\/ho\u1eb7c \u0111au r\u00e1t v\u00f9ng Cu\u1ed1ng H\u1ecdng, B\u1ea1ch H\u1ea7u. X\u1ea3y ra \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i, gi\u1edbi t\u00ednh\u2026 Trung b\u00ecnh ng\u01b0\u1eddi l\u1edbn b\u1ecb 2-3 l\u1ea7n\/ n\u0103m.<br \/>\n&#8211; Trong \u0111\u00f3 vi\u00eam h\u1ecdng c\u1ea5p chi\u1ebfm 90%.<\/p>\n<h2>NGUY\u00caN NH\u00c2N<\/h2>\n<p>&#8211; Ph\u1ea7n l\u1edbn do Virus g\u00e2y ra ( influenza virus, Adenovirus, EBV\u2026) chi\u1ebfm ( 60-80%) .<br \/>\n&#8211; Ph\u1ea7n c\u00f2n l\u1ea1i do Vi Khu\u1ea9n ( li\u00ean c\u1ea7u tan huy\u1ebft nh\u00f3m A,B,C,G, Haemophilus influenza, T\u1ee5 c\u1ea7u v\u00e0ng, Moraxella catarrhalis, vi khu\u1ea9n k\u1ecb kh\u00ed\u2026.) chi\u1ebfm 20-40%<br \/>\n&#8211; Nguy\u00ean nh\u00e2n kh\u00e1c: ch\u1ee9ng tr\u00e0o ng\u01b0\u1ee3c DD-TT ( GERD), vi\u00eam tuy\u1ebfn gi\u00e1p do virus, nhi\u1ec5m n\u1ea5m khoang mi\u1ec7ng do candiada ablicans, K thanh qu\u1ea3n, h\u1ea7u h\u1ecdng, thu\u1ed1c l\u00e1, s\u1eed d\u1ee5ng thu\u1ed1c g\u00e2y m\u1ea5t BC h\u1ea1t \u2026<\/p>\n<h2>SINH L\u00dd B\u1ec6NH<\/h2>\n<p>&#8211; C\u00e1c vi khu\u1ea9n \/ virus g\u00e2y ra \u0111\u00e1p \u1ee9ng MD t\u1ea1i ch\u1ed7 do tr\u1ef1c ti\u1ebfp x\u00e2m l\u1ea5n ni\u00eam m\u1ea1c h\u1ea7u h\u1ecdng, ho\u1eb7c k\u00edch \u1ee9ng ni\u00eam m\u1ea1c h\u1ea7u h\u1ecdng do d\u1ecbch ti\u1ebft \u0111\u01b0\u1eddng m\u0169i.<br \/>\n&#8211; C\u00e1c vi khu\u1ea9n streptococcus gi\u1ea3i ph\u00f3ng ngo\u1ea1i \u0111\u1ed9c t\u1ed1 v\u00e0 protease.<\/p>\n<h2>D\u1ea4U HI\u1ec6U \u2013 TRI\u1ec6U CH\u1ee8NG<\/h2>\n<p>&#8211; Tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p: \u0110au h\u1ecdng, kh\u00f3 nu\u1ed1t, ch\u1ea3y n\u01b0\u1edbc m\u0169i, vi\u00eam thanh qu\u1ea3n, k\u1ebft m\u1ea1c, ho, s\u1ed1t &gt; 38 \u0111\u1ed9 C, vi\u00eam tai gi\u1eefa, s\u1ee5t c\u00e2n \u2026<br \/>\n&#8211; Tri\u1ec7u ch\u1ee9ng \u00edt g\u1eb7p : \u0111au \u0111\u1ea7u, vi\u00eam m\u00e0ng n\u00e3o, \u0111au b\u1ee5ng, n\u00f4n m\u1eefa\u2026<br \/>\n&#8211; Bi\u1ec3u hi\u1ec7n \u0111\u1eb7c tr\u01b0ng c\u1ee7a t\u00e1c nh\u00e2n kh\u00e1c nhau:<br \/>\n+ Vi\u00eam h\u1ecdng do vi khu\u1ea9n ( Streptococcus nh\u00f3m A) : vi\u00eam b\u1ea1ch huy\u1ebft v\u00f9ng c\u1ed5, s\u1ed1t cao, \u0111au \u0111\u1ea7u, \u0111au b\u1ee5ng, n\u00f4n m\u1eefa\u2026<br \/>\n+ Vi\u00eam h\u1ecdng do virus trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng HH, tr\u00ean : ho, vi\u00eam thanh qu\u1ea3n, vi\u00eam k\u1ebft m\u1ea1c\u2026<\/p>\n<h2>NH\u1eeeNG TR\u01af\u1edcNG H\u1ee2P C\u1ea6N H\u01af\u1edaNG D\u1eaaN C\u1ee6A B\u00c1C S\u0128<\/h2>\n<p>&#8211; Vi\u00eam h\u1ecdng &gt; 1 tu\u1ea7n , Kh\u00e0n gi\u1ecdng &gt; 2 tu\u1ea7n, Kh\u00f3 nu\u1ed1t ho\u1eb7c kh\u00f3 th\u1edf, th\u00e2n nhi\u1ec7t &gt; 38.3 \u0111\u1ed9 C, ch\u1ea3y n\u01b0\u1edbc b\u1ecdt qu\u00e1 m\u1ee9c ( tr\u1ebb s\u01a1 sinh\/ tr\u1ebb nh\u1ecf), s\u01b0ng c\u1ed5\/c\u1ee9ng c\u1ed5, kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng\/ kh\u00f4ng mu\u1ed1n an u\u1ed1ng, s\u01b0ng l\u01b0\u1ee1i, kh\u00f3 m\u1edf mi\u1ec7ng, xu\u1ea5t hi\u1ec7n m\u1ea3ng b\u00e1m tr\u1eafng \u1edf BH, ph\u00e1t ban da, c\u00f3 b\u1ec7nh m\u1ea1n t\u00ednh\/ d\u00f9ng thu\u1ed1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn MD. ( Xu\u1ea5t hi\u1ec7n 1 trong c\u00e1c bi\u1ec3u hi\u1ec7n tr\u00ean c\u1ea7n \u0111\u1ebfn chuy\u00ean khoa th\u0103m kh\u00e1m \u0111\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t)<\/p>\n<h2>PH\u01af\u01a0NG PH\u00c1P \u0110I\u1ec0U TR\u1eca<\/h2>\n<h3>KH\u00d4NG D\u00d9NG THU\u1ed0C<\/h3>\n<p>&#8211; S\u00fac mi\u1ec7ng = n\u01b0\u1edbc mu\u1ed1i ( 0.5 mu\u1ed7ng Caf\u00e9 mu\u1ed1i + 250ml n\u01b0\u1edbc \u1ea5m)<br \/>\n&#8211; U\u1ed1ng n\u01b0\u1edbc \u0111\u1ea7y \u0111\u1ee7, th\u1ee9c \u0103n m\u1ec1m, ng\u1eadm k\u1eb9o ( EUGICA k\u1eb9o c\u0169ng kh\u00e1 \u1ed5n), hi\u1ec7n t\u1ea1i c\u00f3 kh\u00e1 nhi\u1ec1u h\u00e0ng nh\u00e1i <a href=\"https:\/\/bimufa.com\/chuyen-muc\/tinh-dau\/\" rel=\"noopener\">tinh d\u1ea7u<\/a> n\u00ean c\u00e1c b\u1ea1n n\u00ean l\u1ef1a ch\u1ecdn h\u00e0ng uy t\u00edn th\u01b0\u01a1ng hi\u1ec7u l\u00e2u n\u0103m \u0111\u1ec3 d\u00f9ng tr\u00e1nh m\u1ea5t uy t\u00edn c\u0169ng nh\u01b0 m\u1ea5t ni\u1ec1m tin kh\u00e1ch h\u00e0ng.<br \/>\n&#8211; Ngo\u00e0i ra c\u00f2n 1 s\u1ed1 d\u1ea1ng tr\u00e0 gi\u1ea3i c\u1ea3m, thu\u1ed1c x\u1ecbt h\u1ecdng h\u1ed5 tr\u1ee3 vi\u00eam h\u1ecdng r\u1ea5t t\u1ed1t, nh\u01b0 Eugica x\u1ecbt h\u1ecdng, ho\u1eb7c d\u1ea1ng tr\u00e0 Eugica, ( Eugica hi\u1ec7n t\u1ea1i \u0111ang \u0111\u01b0\u1ee3c Mega We Care ph\u00e2n ph\u1ed1i)<\/p>\n<h3>D\u00d9NG THU\u1ed0C<\/h3>\n<p>&#8211; \u0110a s\u1ed1 nguy\u00ean nh\u00e2n do virus th\u00ec kho\u1ea3ng 4-5 ng\u00e0y t\u1ef1 kh\u1ecfi, thu\u1ed1c ch\u1ee7 y\u1ebfu d\u00f9ng l\u00e0 \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng v\u00e0 t\u0103ng \u0111\u1ec1 kh\u00e1ng.<br \/>\n&#8211; M\u1ecdi vi\u00eam h\u1ecdng \u0111\u1ecf c\u1ea5p \u0111\u01a1n thu\u1ea7n ho\u1eb7c c\u00f3 ch\u1ea5m m\u1ee7 tr\u1eafng ho\u1eb7c b\u1ef1a tr\u1eafng tr\u00ean b\u1ec1 m\u1eb7t ami\u0111an, xu\u1ea5t hi\u1ec7n \u1edf b\u1ec7nh nh\u00e2n tr\u00ean 3 tu\u1ed5i \u0111\u1ec1u ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb nh\u01b0 m\u1ed9t vi\u00eam h\u1ecdng \u0111\u1ecf c\u1ea5p do li\u00ean c\u1ea7u khi kh\u00f4ng c\u00f3 x\u00e9t nghi\u1ec7m \u0111\u1ecbnh lo\u1ea1i virus ho\u1eb7c vi khu\u1ea9n.<\/p>\n<h4>Kh\u00e1ng sinh:<\/h4>\n<p>+ Nh\u00f3m beta lactam:<br \/>\n&#8211; Iba-mentin 250mg\/Acid cluvulanic 31,25mg:<br \/>\nNg\u01b0\u1eddi l\u1edbn: 250 \u2013 500mg\/ l\u1ea7n x 3 l\u1ea7n\/24 gi\u1edd.<br \/>\n\u1ede tr\u1ebb em d\u01b0\u1edbi 40kg c\u00e2n n\u1eb7ng: 20mg\/kg\/ng\u00e0y, chia 3 l\u1ea7n<\/p>\n<p>&#8211; Amoxicilin 250mg d\u1ea1ng g\u00f3i<br \/>\nTr\u1ebb em d\u01b0\u1edbi 20kg c\u00e2n n\u1eb7ng: 20 \u2013 40mg\/kg\/ng\u00e0y<\/p>\n<p>&#8211; Amoxicilin 500mg d\u1ea1ng vi\u00ean<br \/>\nNg\u01b0\u1eddi l\u1edbn: 1000mg\/ l\u1ea7n x 2 ho\u1eb7c 3 l\u1ea7n \/ng\u00e0y<br \/>\nTr\u1ebb em: 40 \u2013 60mg\/kg\/ng\u00e0y, chia 3 l\u1ea7n<\/p>\n<p>&#8211; Cephalecin:<br \/>\nNg\u01b0\u1eddi l\u1edbn: 50 \u2013 80mg\/kg\/24 gio72, chia 2 ho\u1eb7c 3 l\u1ea7n<br \/>\nTr\u1ebb em &lt; =12 tu\u1ed5i: 30 \u2013 50mg\/kg\/24 gi\u1edd, ng\u00e0y u\u1ed1ng 2 ho\u1eb7c 3 l\u1ea7n<\/p>\n<p>+ Nh\u00f3m macrolide:<br \/>\n&#8211; Erythromycin 500mg<br \/>\nNg\u01b0\u1eddi l\u1edbn: T\u1eeb 1 \u2013 2g\/ng\u00e0y, chia l\u00e0m 2 \u2013 4 l\u1ea7n.<br \/>\nTr\u1ebb em: T\u1eeb 30-50mg\/kg c\u00e2n n\u1eb7ng\/ng\u00e0y, chia 2 \u2013 4 l\u1ea7n.<\/p>\n<p>&#8211; Roxithromycin 150mg: D\u00f9ng tr\u01b0\u1edbc c\u00e1c b\u1eefa \u0103n trong ng\u00e0y<br \/>\nNg\u01b0\u1eddi l\u1edbn: 300mg\/ng\u00e0y, chia l\u00e0m 2 l\u1ea7n s\u00e1ng v\u00e0 t\u1ed1i<br \/>\nTr\u1ebb em: T\u1eeb 5 \u2013 8mg\/ng\u00e0y, chia l\u00e0m 2 l\u1ea7n (kh\u00f4ng d\u00f9ng qu\u00e1 10 ng\u00e0y)<\/p>\n<p>&#8211; Clarythromycin 250mg:<br \/>\nNg\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em tr\u00ean 12 tu\u1ed5i: 250mg x 2 l\u1ea7n\/ ng\u00e0y, \u0111i\u1ec1u tr\u1ecb 7 ng\u00e0y<\/p>\n<h4>Kh\u00e1ng vi\u00eam:<\/h4>\n<p>&#8211; Alphachymotrypcin 4,2mg: 2 \u2013 4 vi\u00ean\/ng\u00e0y<br \/>\n&#8211; Prednisolon 5mg: u\u1ed1ng sau b\u1eefa \u0103n.<\/p>\n<h4>\u0110i\u1ec1u tr\u1ecb t\u1ea1i ch\u1ed7:<\/h4>\n<p>&#8211; X\u00f4ng h\u1ecdng: 1 \u1ed1ng Gentamycin 80mg pha v\u1edbi 1 \u1ed1ng Dexamethason, x\u00f4ng ng\u00e0y 1 \u2013 2 l\u1ea7n.<br \/>\n&#8211; Dung d\u1ecbch Cineline: x\u00fac mi\u1ec7ng ng\u00e0y 3 \u2013 4 l\u1ea7n.<br \/>\n&#8211; U\u1ed1ng n\u01b0\u1edbc \u0111\u1ea7y \u0111\u1ee7, th\u1ee9c \u0103n m\u1ec1m, ng\u1eadm k\u1eb9o ( EUGICA k\u1eb9o c\u0169ng kh\u00e1 \u1ed5n), hi\u1ec7n t\u1ea1i c\u00f3 kh\u00e1 nhi\u1ec1u h\u00e0ng nh\u00e1i tinh d\u1ea7u n\u00ean c\u00e1c b\u1ea1n n\u00ean l\u1ef1a ch\u1ecdn h\u00e0ng uy t\u00edn th\u01b0\u01a1ng hi\u1ec7u l\u00e2u n\u0103m \u0111\u1ec3 d\u00f9ng tr\u00e1nh m\u1ea5t uy t\u00edn c\u0169ng nh\u01b0 m\u1ea5t ni\u1ec1m tin kh\u00e1ch h\u00e0ng.<br \/>\n&#8211; Ngo\u00e0i ra c\u00f2n 1 s\u1ed1 d\u1ea1ng tr\u00e0 gi\u1ea3i c\u1ea3m, thu\u1ed1c x\u1ecbt h\u1ecdng h\u1ed5 tr\u1ee3 vi\u00eam h\u1ecdng r\u1ea5t t\u1ed1t, nh\u01b0 Eugica x\u1ecbt h\u1ecdng, ho\u1eb7c d\u1ea1ng tr\u00e0 Eugica, ( Eugica hi\u1ec7n t\u1ea1i \u0111ang \u0111\u01b0\u1ee3c Mega We Care ph\u00e2n ph\u1ed1i)<br \/>\n&#8211; Tyrotab ng\u1eadm ng\u00e0y t\u1eeb 2 \u2013 4 vi\u00ean.<\/p>\n<h4>H\u1ea1 s\u1ed1t, gi\u1ea3m \u0111au: Truy\u1ec1n d\u1ecbch, paracetamol, \u2026.<\/h4>\n<h4>N\u00e2ng \u0111\u1ee1 c\u01a1 th\u1ec3: y\u1ebfu t\u1ed1 vi l\u01b0\u1ee3ng, sinh t\u1ed1, vitamin&#8230;<\/h4>\n<p>&#8211; Ch\u00fa \u00fd: Khi vi\u00eam h\u1ecdng \u0111\u1ecf c\u1ea5p th\u1ec3 n\u1eb7ng ho\u1eb7c \u0111\u00e3 c\u00f3 bi\u1ebfn ch\u1ee9ng c\u1ea7n chuy\u1ec3n \u0111\u1ebfn chuy\u00ean khoa k\u1ecbp th\u1eddi.<br \/>\n&#8211; Th\u1eadn tr\u1ecdng v\u1edbi c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng tr\u1ebb em v\u00e0 PNCB, ho\u1eb7c CCB<\/p>\n<p>T\u00e1c gi\u1ea3: T\u00f9ng Pharma Ngu\u1ed3n Tham Kh\u1ea3o: D\u01b0\u1ee3c s\u0129 Nguy\u1ec5n Ph\u1ea1m Quang Vinh, B\u00e1c s\u0129 . T\u00e0i N\u0103ng S\u1ed1t b\u1ec7nh vi\u1ec7n giao th\u00f4ng v\u1eadn t\u1ea3i Th\u00e1p Ch\u00e0m<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u0110\u1ecaNH NGH\u0128A &#8211; Vi\u00eam h\u1ecdng l\u00e0 c\u1ea3m gi\u00e1c ng\u1ee9a, v\u00e0\/ho\u1eb7c \u0111au r\u00e1t v\u00f9ng Cu\u1ed1ng H\u1ecdng, B\u1ea1ch H\u1ea7u. X\u1ea3y ra \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i, gi\u1edbi t\u00ednh\u2026 Trung b\u00ecnh ng\u01b0\u1eddi l\u1edbn b\u1ecb 2-3 l\u1ea7n\/ n\u0103m. &#8211; Trong \u0111\u00f3 vi\u00eam h\u1ecdng c\u1ea5p chi\u1ebfm 90%. NGUY\u00caN NH\u00c2N &#8211; Ph\u1ea7n l\u1edbn do Virus g\u00e2y ra ( influenza virus, Adenovirus, EBV\u2026) [&#8230;]\n","protected":false},"author":1,"featured_media":5076,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5075","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\/5075","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=5075"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5075\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/5076"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5075"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5075"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5075"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}