C\u00e2u 1: Tr\u00ecnh b\u00e0y chu k\u1ef3 giun ch\u1ec9 v\u00e0 n\u00eau c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng giun ch\u1ec9<\/p>\n
1. Chu k\u1ef3 sinh s\u1ea3n c\u1ee7a giun ch\u1ec9:<\/p>\n[\u200bIMG][\u200bIMG][\u200bIMG][\u200bIMG]Di\u1ec5n ra theo s\u01a1 \u0111\u1ed3 : Ng\u01b0\u1eddi Mu\u1ed7i<\/p>\n
Giun ch\u1ec9 k\u00fd sinh \u1edf h\u1ec7 b\u1ea1ch huy\u1ebft c\u1ee7a ng\u01b0\u1eddi. Giun c\u00e1i \u0111\u1ebb ra \u1ea5u tr\u00f9ng, \u1ea5u tr\u00f9ng theo h\u1ec7 b\u1ea1ch huy\u1ebft t\u1edbi tim r\u1ed3i v\u00e0o c\u00e1c m\u1ea1ch m\u00e1u. Ban ng\u00e0y \u1ea5u tr\u00f9ng \u1edf s\u00e2u trong c\u00e1c m\u1ea1ch m\u00e1u n\u1ed9i t\u1ea1ng (Ch\u1ee7 y\u1ebfu \u1edf c\u00e1c m\u1ea1ch m\u00e1u ph\u1ed5i), \u0111\u00eam m\u1edbi xu\u1ea5t hi\u1ec7n \u1edf m\u00e1u ngo\u1ea1i vi (T\u1eeb 24gi\u1edd \u0111\u1ebfn 4gi\u1edd ). N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c mu\u1ed7i h\u00fat \u1ea5u tr\u00f9ng s\u1ebd ch\u1ebft sau 10 tu\u1ea7n. N\u1ebfu \u0111\u01b0\u1ee3c mu\u1ed7i h\u00fat, \u1ea5u tr\u00f9ng v\u00e0o d\u1ea1 d\u00e0y mu\u1ed7i, xuy\u00ean qua th\u00e0nh d\u1ea1 d\u00e0y mu\u1ed7i, \u0111\u1ebfn c\u01a1 ng\u1ef1c mu\u1ed7i. \u1edf \u0111\u00e2y \u1ea5u tr\u00f9ng ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y nhi\u1ec5m sau 2 tu\u1ea7n (KT: 1000 \u00b4 20 mm), r\u1ed3i di chuy\u1ec3n \u0111\u1ebfn tuy\u1ebfn n\u01b0\u1edbc b\u1ecdt c\u1ee7a mu\u1ed7i. Khi mu\u1ed7i \u0111\u1ed1t ng\u01b0\u1eddi, \u1ea5u tr\u00f9ng v\u00e0o m\u00e1u r\u1ed3i sang h\u1ec7 b\u1ea1ch huy\u1ebft \u0111\u1ec3 k\u00fd sinh v\u00e0 ph\u00e1t tri\u1ec3n th\u00e0nh giun tr\u01b0\u1edfng th\u00e0nh, s\u1ed1ng 10 n\u0103m.<\/p>\n
Lo\u00e0i w th\u01b0\u1eddng k\u00fd sinh \u1edf h\u1ec7 b\u1ea1ch huy\u1ebft v\u00f9ng th\u00e2n v\u00e0 b\u1ed9 m\u00e1y sinh d\u1ee5c, n\u00ean c\u00f3 th\u1ec3 g\u00e2y \u0111\u00e1i ra d\u01b0\u1ee1ng ch\u1ea5p v\u00e0 ph\u00f9 \u1edf c\u01a1 quan sinh d\u1ee5c. C\u00f2n lo\u00e0i B th\u01b0\u1eddng k\u00fd sinh \u1edf h\u1ec7 b\u1ea1ch huy\u1ebft v\u00f9ng n\u00e1ch b\u1eb9n n\u00ean g\u00e2y ph\u00f9 \u1edf chi.<\/p>\n
2. Ph\u00f2ng b\u1ec7nh<\/p>\n
– Tuy\u00ean truy\u1ec1n, GDSK v\u1ec1 t\u00e1c h\u1ea1i v\u00e0 ph\u00f2ng ch\u1ed1ng b\u1ec7nh giun ch\u1ec9.<\/p>\n
– V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng: X\u00e2y d\u1ef1ng nh\u00e0 \u1edf cao r\u00e1o s\u1ea1ch s\u1ebd, tho\u00e1ng m\u00e1t \u0111\u1ec3 h\u1ea1n ch\u1ebf mu\u1ed7i v\u00e0o nh\u00e0. L\u1ea5p b\u1edbt ao t\u00f9, v\u0169ng n\u01b0\u1edbc \u0111\u1ecdng, kh\u01a1i th\u00f4ng c\u1ed1ng r\u00e3nh \u0111\u1ec3 l\u00e0m gi\u1ea3m s\u1ef1 sinh s\u1ea3n c\u1ee7a mu\u1ed7i, th\u1ea3 c\u00e1 \u1edf c\u00e1c ao b\u00e8o \u0111\u1ec3 di\u1ec7t b\u1ecd g\u1eady (c\u00e1 r\u00f4 phi, ch\u00e9p lai, s\u0103n s\u1eaft…).<\/p>\n
– V\u1ec7 sinh c\u00e1 nh\u00e2n: M\u1eb7c qu\u1ea7n \u00e1o k\u00edn khi lao \u0111\u1ed9ng ban \u0111\u00eam nh\u1ea5t l\u00e0 v\u00f9ng c\u00f3 ngh\u1ec1 th\u1ee7 c\u00f4ng nh\u01b0 l\u00e0m chi\u1ebfu, n\u1eb1m m\u00e0n tr\u00e1nh mu\u1ed7i \u0111\u1ed1t.<\/p>\n
– Ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi c\u00f3 b\u1ec7nh.<\/p>\n
– Th\u1ef1c hi\u1ec7n t\u1ed1t ch\u01b0\u01a1ng tr\u00ecnh qu\u1ed1c gia ph\u00f2ng ch\u1ed1ng b\u1ec7nh giun ch\u1ec9 b\u1eb1ng u\u1ed1ng DEC 1 th\u00e1ng 1 \u0111\u1ee3t 3 nga\u1ef3, m\u1ed7i ng\u00e0y 6mg\/ kg \u0111i\u1ec1u tr\u1ecb cho m\u1ecdi ng\u01b0\u1eddi l\u1edbn h\u01a1n 6 tu\u1ed5i trong v\u00e0i n\u0103m.T\u1ea9m m\u00e0n b\u1eb1ng thu\u1ed1c Permethrin 20% v\u1edbi li\u1ec1u 0,1g\/m2 \u0111\u1ec3 di\u1ec7t mu\u1ed7i.<\/p>\n
C\u00e2u 2: Tr\u00ecnh b\u00e0y chu k\u1ef3 giun kim va\u0300 n\u00eau c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng giun kim (Enterobius vermicularis).<\/p>\n
v Chu k\u1ef3 sinh s\u1ea3n c\u1ee7a giun kim<\/p>\n[\u200bIMG][\u200bIMG]Di\u1ec5n ra theo s\u01a1 \u0111\u1ed3: Ng\u01b0\u1eddi Ngo\u1ea1i c\u1ea3nh<\/p>\n
* Chu k\u1ef3 b\u00ecnh th\u01b0\u1eddng<\/p>\n
– Giai \u0111o\u1ea1n \u1edf ng\u01b0\u1eddi: Giun k\u00fd sinh \u1edf manh tr\u00e0ng, ng\u01b0\u1eddi nhi\u1ec5m giun kim l\u00e0 do \u0103n ph\u1ea3i tr\u1ee9ng c\u00f3 \u1ea5u tr\u00f9ng trong th\u1ee9c \u0103n ho\u1eb7c qua tay b\u1ea9n (tr\u1ebb em m\u00fat ng\u00f3n tay, c\u1eafn m\u00f3ng tay). V\u00e0o t\u1edbi ru\u1ed9t non, tr\u1ee9ng n\u1edf ra \u1ea5u tr\u00f9ng r\u1ed3i di chuy\u1ec3n xu\u1ed1ng manh tr\u00e0ng \u0111\u1ec3 k\u00fd sinh v\u00e0 ph\u00e1t tri\u1ec3n th\u00e0nh giun tr\u01b0\u1edfng th\u00e0nh. Giun tr\u01b0\u1edfng th\u00e0nh giao h\u1ee3p, con \u0111\u1ef1c ch\u1ebft ngay, con c\u00e1i b\u00f2 ra h\u1eadu m\u00f4n \u0111\u1ebb tr\u1ee9ng v\u00e0o bu\u1ed5i t\u1ed1i, \u0111\u1ebb xong con c\u00e1i c\u0169ng ch\u1ebft. Tr\u1ee9ng ph\u00e1t tri\u1ec3n \u1edf h\u1eadu m\u00f4n v\u00e0 ngo\u1ea1i c\u1ea3nh.<\/p>\n
– Giai \u0111o\u1ea1n \u1edf ngo\u1ea1i c\u1ea3nh: Tr\u1ee9ng giun kim t\u1eeb h\u1eadu m\u00f4n r\u01a1i v\u00e3i ra gi\u01b0\u1eddng chi\u1ebfu , s\u00e0n nh\u00e0, g\u1eb7p nhi\u1ec7t \u0111\u1ed9 th\u00edch h\u1ee3p (300C) s\u1ebd ph\u00e1t tri\u1ec3n th\u00e0nh tr\u1ee9ng c\u00f3 \u1ea5u tr\u00f9ng sau 6 gi\u1edd. \u1ede nhi\u1ec7t \u0111\u1ed9 >400C ho\u1eb7c <200C tr\u1ee9ng kh\u00f4ng ph\u00e1t tri\u1ec3n v\u00e0 b\u1ecb di\u1ec7t \u1edf nhi\u1ec7t \u0111\u1ed9 >600C. C\u00e1c h\u00f3a ch\u1ea5t di\u1ec7t \u0111\u01b0\u1ee3c tr\u1ee9ng l\u00e0 x\u00e0 ph\u00f2ng >2%, c\u1ed3n 90%, cresyl 10%<\/p>\n
Ng\u01b0\u1eddi nu\u1ed1t ph\u1ea3i tr\u1ee9ng giun kim c\u00f3 \u1ea5u tr\u00f9ng s\u1ebd b\u1ecb nhi\u1ec5m giun. Th\u1eddi gian ho\u00e0n th\u00e0nh chu k\u00ec l\u00e0 28 ng\u00e0y, \u0111\u1eddi s\u1ed1ng giun kim l\u00e0 2 th\u00e1ng.<\/p>\n
* Chu k\u1ef3 b\u1ea5t th\u01b0\u1eddng (hay hi\u1ec7n t\u01b0\u1ee3ng t\u1ef1 t\u00e1i nhi\u1ec5m): C\u00f3 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p, tr\u1ee9ng giun kim ph\u00e1t tri\u1ec3n, n\u1edf th\u00e0nh \u1ea5u tr\u00f9ng \u1edf ngay h\u1eadu m\u00f4n c\u1ee7a b\u1ec7nh nh\u00e2n r\u1ed3i b\u00f2 ng\u01b0\u1ee3c \u0111\u1ebfn manh tr\u00e0ng \u0111\u1ec3 k\u00fd sinh v\u00e0 ph\u00e1t tri\u1ec3n th\u00e0nh giun tr\u01b0\u1edfng th\u00e0nh.<\/p>\n
v Ph\u00f2ng b\u1ec7nh giun kim:<\/p>\n
– Tuy\u00ean truy\u1ec1n, gi\u00e1o d\u1ee5c s\u1ee9c kho\u1ebb v\u1ec1 ph\u00f2ng ch\u1ed1ng b\u1ec7nh giun kim. L\u00e0m cho ng\u01b0\u1eddi d\u00e2n \u00fd th\u1ee9c \u0111\u01b0\u1ee3c b\u1ec7nh n\u00e0y ph\u00e2n b\u1ed1 r\u1ed9ng kh\u1eafp n\u01a1i v\u00e0 m\u1ee9c \u0111\u1ed9 nhi\u1ec5m giun ph\u1ee5 thu\u1ed9c v\u00e0o tr\u00ecnh \u0111\u1ed9 v\u1ec7 sinh .<\/p>\n
– V\u1ec7 sinh c\u00e1 nh\u00e2n: R\u1eeda tay b\u1eb1ng x\u00e0 ph\u00f2ng tr\u01b0\u1edbc khi \u0103n, kh\u00f4ng n\u00ean \u0111\u1ec3 tr\u1ebb em m\u1eb7c qu\u1ea7n h\u1edf \u0111\u0169ng ho\u1eb7c kh\u00f4ng m\u1eb7c qu\u1ea7n \u0111\u1ec3 tr\u00e1nh tr\u1ebb g\u00e3i h\u1eadu m\u00f4n l\u00e0m tay b\u1ecb \u00f4 nhi\u1ec5m tr\u1ee9ng. Gi\u00e1o d\u1ee5c cho tr\u1ebb b\u1ecf th\u00f3i quen c\u1eafn m\u00f3ng tay, m\u00fat m\u00f3ng tay v\u00e0 th\u01b0\u1eddng xuy\u00ean c\u1eaft m\u00f3ng tay. R\u1eeda h\u1eadu m\u00f4n cho tr\u1ebb nh\u1ecf b\u1eb1ng x\u00e0 ph\u00f2ng v\u00e0o bu\u1ed5i s\u00e1ng \u0111\u1ec3 di\u1ec7t tr\u1ee9ng giun kim. Kh\u00f4ng \u0111\u1ec3 tr\u1ebb l\u00ea la \u1edf n\u1ec1n \u0111\u1ea5t b\u1ea9n.<\/p>\n
– V\u1ec7 sinh t\u1eadp th\u1ec3: lau r\u1eeda s\u00e0n nh\u00e0, b\u00e0n gh\u1ebf h\u00e0ng ng\u00e0y \u1edf c\u00e1c nh\u00e0 tr\u1ebb m\u1eabu gi\u00e1o. Qu\u1ea7n \u00e1o, ch\u0103n chi\u1ebfu th\u01b0\u1eddng xuy\u00ean \u0111\u01b0\u1ee3c g\u1ecb\u0103t v\u00e0 ph\u01a1i n\u1eafng \u0111\u1ec3 di\u1ec7t tr\u1ee9ng.<\/p>\n
– \u0110i\u1ec1u tr\u1ecb h\u00e0ng lo\u1ea1t cho c\u1ea3 gia \u0111\u00ecnh v\u00e0 t\u1eadp th\u1ec3 c\u00f3 tr\u1ebb nhi\u1ec5m giun kim 3 th\u00e1ng m\u1ed9t l\u1ea7n.<\/p>\n
C\u00e2u 3: Tr\u00ecnh b\u00e0y chu k\u1ef3 giun m\u00f3c\/m\u1ecfv\u00e0 n\u00eau c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng giun giun m\u00f3c\/m\u1ecf (Ancylostoma duodenale\/ Necatoamericanus)<\/p>\n
v Chu k\u1ef3 sinh s\u1ea3n c\u1ee7a giun m\u00f3c\/m\u1ecf<\/p>\n
Di\u1ec5n ra theo s\u01a1 \u0111\u1ed3:<\/p>\n[\u200bIMG][\u200bIMG] Ng\u01b0\u1eddi Ngo\u1ea1i c\u1ea3nh<\/p>\n
– Giai \u0111o\u1ea1n \u1edf ng\u01b0\u1eddi :<\/p>\n
Giun m\u00f3c, m\u1ecf k\u00fd sinh \u1edf t\u00e1 tr\u00e0ng. Ng\u01b0\u1eddi nhi\u1ec5m giun l\u00e0 do \u1ea5u tr\u00f9ng giun m\u00f3c, m\u1ecf xuy\u00ean qua da v\u00e0o ng\u01b0\u1eddi. Sau khi qua da \u1ea5u tr\u00f9ng v\u00e0o t\u0129nh m\u1ea1ch r\u1ed3i theo m\u00e1u v\u00e0o tim. T\u1eeb tim \u1ea5u tr\u00f9ng theo m\u00e1u \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i l\u00ean ph\u1ed5i, \u1edf ph\u1ed5i \u1ea5u tr\u00f9ng thay v\u1ecf 2 l\u1ea7n r\u1ed3i theo c\u00e1c ph\u1ebf qu\u1ea3n xu\u1ed1ng t\u00e1 tr\u00e0ng k\u00fd sinh v\u00e0 ph\u00e1t tri\u1ec3n th\u00e0nh con tr\u01b0\u1edfng th\u00e0nh. Giun tr\u01b0\u1edfng th\u00e0nh giao h\u1ee3p, con c\u00e1i \u0111\u1ebb tr\u1ee9ng, tr\u1ee9ng ph\u1ea3i ra ngo\u1ea1i c\u1ea3nh m\u1edbi ph\u00e1t tri\u1ec3n \u0111\u01b0\u1ee3c.<\/p>\n
– Giai \u0111o\u1ea1n \u1edf ngo\u1ea1i c\u1ea3nh:<\/p>\n
+ S\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a tr\u1ee9ng: Tr\u1ee9ng giun m\u00f3c, m\u1ecf ra ngo\u1ea1i c\u1ea3nh g\u1eb7p \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i (t0240-250C, j > 80% c\u00f3 O2) th\u00ec ch\u1ec9 sau 1 ng\u00e0y \u0111\u00e3 ph\u00e1t tri\u1ec3n th\u00e0nh tr\u1ee9ng c\u00f3 \u1ea5u tr\u00f9ng v\u00e0 n\u1edf th\u00e0nh \u1ea5u tr\u00f9ng I. \u1edf t0 >370C, <140C tr\u1ee9ng kh\u00f4ng ph\u00e1t tri\u1ec3n \u0111\u01b0\u1ee3c. T0 >500C tr\u1ee9ng b\u1ecb di\u1ec7t, c\u00e1c ch\u1ea5t s\u00e1t tr\u00f9ng th\u00f4ng th\u01b0\u1eddng di\u1ec7t tr\u1ee9ng t\u1ed1t v\u00ec v\u1ecf tr\u1ee9ng m\u1ecfng. Tr\u1ee9ng ph\u00e1t t\u00e1n \u1edf ngo\u1ea1i c\u1ea3nh nh\u1edd nh\u1eefng \u0111i\u1ec1u ki\u1ec7n nh\u01b0 c\u00e1c \u0111i\u1ec1u ki\u1ec7n ph\u00e1t t\u00e1n tr\u1ee9ng giun \u0111\u0169a<\/p>\n
+ S\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a \u1ea5u tr\u00f9ng: Trong \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i (t0 240-300, j > 80%, c\u00f3 O2) th\u00ec Sau 3 ng\u00e0y \u1ea5u tr\u00f9ng I ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng II v\u00e0 th\u00eam 5 ng\u00e0y n\u1eefa s\u1ebd ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng III. C\u00e1c lo\u1ea1i \u0111\u1ea5t th\u00edch h\u1ee3p cho \u1ea5u tr\u00f9ng ph\u00e1t tri\u1ec3n l\u00e0 \u0111\u1ea5t \u1ea9m, t\u01a1i x\u1ed1p, m\u00e0u m\u1ee1, \u0111\u1ea5t c\u00f3 nhi\u1ec1u b\u1ee5i b\u1eb7m. \u0110\u1ea5t s\u00e9t, \u0111\u1ea5t chua, \u0111\u1ea5t m\u1eb7n \u1ea5u tr\u00f9ng kh\u00f4ng ph\u00e1t tri\u1ec3n \u0111\u01b0\u1ee3c. \u1ea5u tr\u00f9ng s\u1ebd ch\u1ebft trong \u0111\u1ea5t c\u00f3 2% mu\u1ed1i NaCl, trong n\u01b0\u1edbc x\u00e0 ph\u00f2ng, c\u1ed3n 700, thu\u1ed1c t\u00edm, trong m\u00f4i tr\u01b0\u1eddng n\u01b0\u1edbc. C\u00f2n \u1edf \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i \u1ea5u tr\u00f9ng s\u1ed1ng \u0111\u01b0\u1ee3c 18 th\u00e1ng.<\/p>\n
+ \u1ea5u tr\u00f9ng III c\u00f3 kh\u1ea3 n\u0103ng xuy\u00ean qua da \u0111\u1ec3 v\u00e0o v\u1eadt ch\u1ee7 l\u00e0 nh\u1edd c\u00f3 c\u00e1c h\u01b0\u1edbng \u0111\u1ed9ng sau:<\/p>\n
\u00a7 \u1ea5u tr\u00f9ng lu\u00f4n t\u00ecm \u0111\u1ebfn v\u1ecb tr\u00ed cao c\u1ee7a \u0111\u1ea5t: M\u00f4 \u0111\u1ea5t cao, \u0111\u1ee5n r\u1ea1, c\u1ecdc r\u00e0o, v\u00e1ch h\u1ea7m m\u1ecf…v\u1edbi chi\u1ec1u cao l\u00e0 1m.<\/p>\n
\u00a7 \u1ea5u tr\u00f9ng \u01b0a n\u01a1i c\u00f3 \u0111\u1ed9 \u1ea9m cao, ch\u00fang th\u01b0\u1eddng \u1edf c\u00e1c gi\u1ecdt s\u01b0\u01a1ng tr\u00ean l\u00e1 rau, ng\u1ecdn c\u1ecf.<\/p>\n
\u00a7 \u1ea5u tr\u00f9ng c\u00f3 kh\u1ea3 n\u0103ng ph\u00e1t hi\u1ec7n ra v\u1eadt ch\u1ee7 \u0111\u1ec3 di chuy\u1ec3n t\u1edbi (nh\u01b0ng kh\u00f4ng ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c v\u1eadt ch\u1ee7 th\u00edch h\u1ee3p hay kh\u00f4ng).<\/p>\n
\u00a7 Th\u1eddi gian ho\u00e0n th\u00e0nh chu k\u1ef3 l\u00e0 3-4 tu\u1ea7n, giun s\u1ed1ng t\u1eeb 10-15 n\u0103m .<\/p>\n
v Ph\u00f2ng b\u1ec7nh giun m\u00f3c\/m\u1ecf<\/p>\n
+ Tuy\u00ean truy\u1ec1n, gi\u00e1o d\u1ee5c s\u1ee9c kh\u1ecfe cho nh\u00e2n d\u00e2n v\u1ec1 t\u00e1c h\u1ea1i v\u00e0 ph\u00f2ng b\u1ec7nh giun m\u00f3c\/m\u1ecf \u0111\u1ec3 m\u1ecdi ng\u01b0\u1eddi c\u00f3 \u00fd th\u1ee9c t\u1ef1 gi\u00e1c tham gia ph\u00f2ng ch\u1ed1ng b\u1ec7nh giun m\u00f3c\/m\u1ecf + V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng: Qu\u1ea3n l\u00fd v\u00e0 x\u1eed l\u00fd ph\u00e2n th\u00edch h\u1ee3p. ~ S\u1eed d\u1ee5ng h\u1ed1 x\u00ed h\u1ee3p v\u1ec7 sinh, kh\u00f4ng ph\u00f3ng u\u1ebf b\u1eeba b\u00e3i ra ru\u1ed9ng v\u01b0\u1eddn, quanh nh\u00e0 nh\u1ea5t l\u00e0 c\u00e1c tr\u1ebb nh\u1ecf. Kh\u00f4ng \u0111\u1ec3 ch\u00f3, l\u1ee3n, g\u00e0 tha ph\u00e2n g\u00e2y \u00f4 nhi\u1ec5m m\u00f4i tr\u01b0\u1eddng. ~ Kh\u00f4ng d\u00f9ng ph\u00e2n t\u01b0\u01a1i \u0111\u1ec3 canh t\u00e1c, ph\u1ea3i \u1ee7 ph\u00e2n t\u1eeb 4 th\u00e1ng tr\u1edf l\u00ean m\u1edbi d\u00f9ng. + L\u00e0m t\u1ed1t c\u00f4ng t\u00e1c b\u1ea3o h\u1ed9 lao \u0111\u1ed9ng cho nh\u1eefng ng\u01b0\u1eddi d\u1ec5 b\u1ecb nhi\u1ec5m giun. C\u1ee5 th\u1ec3 ph\u1ea3i \u0111eo g\u0103ng tay v\u00e0 \u0111eo \u1ee7ng khi lao \u0111\u1ed9ng \u0111\u1ec3 \u1ea5u tr\u00f9ng giun m\u00f3c\/m\u1ecf kh\u00f4ng th\u1ec3 chui qua \u0111\u01b0\u1ee3c.<\/p>\n
C\u00e2u 4: Tr\u00ecnh b\u00e0y \u0111\u1eb7c \u0111i\u1ec3m d\u1ecbch t\u1ec5 h\u1ecdc c\u1ee7a giun m\u00f3c\/m\u1ecf(Ancylostoma duodenale\/ Necatoamericanus).<\/p>\n
\u1ede Vi\u1ec7t Nam trong 2 lo\u1ea1i giun th\u00ec giun m\u1ecf chi\u1ebfm 95%, giun m\u00f3c chi\u1ebfm 5% t\u1ed5ng s\u1ed1 ng\u01b0\u1eddi nhi\u1ec5m.- T\u1ec9 l\u1ec7 nhi\u1ec5m giun m\u00f3c\/m\u1ecf t\u01b0\u01a1ng \u0111\u1ed1i cao + Mi\u1ec1n B\u1eafc: \u0110\u1ed3ng b\u1eb1ng 3-60%, trung du 59-64%, v\u00f9ng n\u00fai 61%, ven bi\u1ec3n 67% + Mi\u1ec1n Trung: \u0110\u1ed3ng b\u1eb1ng 36%, mi\u1ec1n n\u00fai 66%, ven bi\u1ec3n 69% + Mi\u1ec1n Nam: \u0110\u1ed3ng b\u1eb1ng 52%, ven bi\u1ec3n 68%, T\u00e2y Nguy\u00ean 47%- V\u1ec1 l\u1ee9a tu\u1ed5i: M\u1ecdi l\u1ee9a tu\u1ed5i \u0111\u1ec1u c\u00f3 th\u1ec3 nhi\u1ec5m giun m\u00f3c\/m\u1ecf nh\u01b0ng \u00edt g\u1eb7p \u1edf tr\u1ebb em d\u01b0\u1edbi 2 tu\u1ed5i.- V\u1ec1 gi\u1edbi: T\u1ec9 l\u1ec7 nhi\u1ec5m kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t.\u0110\u1eb7c bi\u1ec7t b\u1ec7nh c\u00f3 t\u00ednh ch\u1ea5t \u0111\u1eb7c hi\u1ec7u v\u1ec1 d\u1ecbch t\u1ec5 \u0111\u00f3 l\u00e0 t\u00ednh ch\u1ea5t v\u00f9ng v\u00e0 ngh\u1ec1 nghi\u1ec7p: V\u00ec \u1edf c\u00e1c v\u00f9ng c\u00f3 t\u00ednh ch\u1ea5t \u0111\u1ea5t thu\u1eadn l\u1ee3i cho \u1ea5u tr\u00f9ng giun m\u00f3c\/m\u1ecf ph\u00e1t tri\u1ec3n nh\u01b0 v\u00f9ng tr\u1ed3ng rau m\u00e0u, v\u00f9ng \u0111\u1ea5t c\u00e1t ven s\u00f4ng v\u00f9ng ven bi\u1ec3n v\u00e0 v\u00f9ng m\u1ecf c\u00f3 t\u1ec9 l\u1ec7 nhi\u1ec5m giun cao h\u01a1n nh\u1eefng v\u00f9ng kh\u00e1c. \u0110\u1eb7c bi\u1ec7t tr\u1ea7m tr\u1ecdng \u1edf nh\u1eefng v\u00f9ng tr\u1ed3ng rau, tr\u1ed3ng hoa m\u1ea7u. B\u1ec7nh th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng ng\u01b0\u1eddi ti\u1ebfp x\u00fac v\u1edbi c\u00e1c lo\u1ea1i \u0111\u1ea5t th\u00edch h\u1ee3p v\u1edbi \u1ea5u tr\u00f9ng (n\u00f4ng d\u00e2n tr\u1ed3ng rau m\u00e0u, c\u00f4ng nh\u00e2n m\u1ecf).<\/p>\n
C\u00e2u 5: Tr\u00ecnh b\u00e0y chu k\u1ef3 giun \u0111\u0169av\u00e0 n\u00eau bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng giun \u0111\u0169a(Ascaris lumbricoides).<\/p>\n
v Chu k\u1ef3 giun \u0111\u0169a<\/p>\n[\u200bIMG][\u200bIMG]Di\u1ec5n ra theo s\u01a1 \u0111\u1ed3: Ng\u01b0\u1eddi Ngo\u1ea1i c\u1ea3nh<\/p>\n
Giai \u0111o\u1ea1n \u1edf ng\u01b0\u1eddi<\/p>\n
Giun \u0111\u0169a k\u00fd sinh \u1edf ru\u1ed9t non c\u1ee7a ng\u01b0\u1eddi. Ng\u01b0\u1eddi nhi\u1ec5m giun \u0111\u0169a l\u00e0 do \u0103n ph\u1ea3i tr\u1ee9ng c\u00f3 \u1ea5u tr\u00f9ng, v\u00e0o t\u1edbi ru\u1ed9t tr\u1ee9ng n\u1edf th\u00e0nh \u1ea5u tr\u00f9ng ( KT: 0,2 mm). \u1ea5u tr\u00f9ng chui qua th\u00e0nh ru\u1ed9t v\u00e0o m\u1ea1ch m\u00e1u m\u1ea1c treo tr\u00e0ng tr\u00ean r\u1ed3i theo m\u00e1u t\u1edbi gan, \u1edf gan 3 – 4 ng\u00e0y, \u1ea5u tr\u00f9ng theo t\u0129nh m\u1ea1ch tr\u00ean gan t\u1edbi tim v\u00e0 theo \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i l\u00ean ph\u1ed5i, \u1edf ph\u1ed5i kho\u1ea3ng 10 ng\u00e0y, \u1ea5u tr\u00f9ng thay v\u1ecf 2 l\u1ea7n ph\u00e1t tri\u1ec3n nhanh \u1edf c\u00e1c ph\u1ebf nang (d\u00e0i 1 -2mm). Sau \u0111\u00f3 n\u00f3 theo ph\u1ebf qu\u1ea3n, kh\u00ed qu\u1ea3n l\u00ean h\u1ea7u r\u1ed3i l\u1ea1i xu\u1ed1ng ru\u1ed9t non ph\u00e1t tri\u1ec3n th\u00e0nh giun tr\u01b0\u1edfng th\u00e0nh. Giun tr\u01b0\u1edfng th\u00e0nh giao h\u1ee3p, giun c\u00e1i \u0111\u1ebb tr\u1ee9ng, tr\u1ee9ng ph\u1ea3i ra no\u1ea1i c\u1ea3nh m\u1edbi ph\u00e1t tri\u1ec3n \u0111\u01b0\u1ee3c<\/p>\n
Giai \u0111o\u1ea1n \u1edf ngo\u1ea1i c\u1ea3nh<\/p>\n
– Tr\u1ee9ng giun \u0111\u0169a ra ngo\u1ea1i c\u1ea3nh g\u1eb7p \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i (nhi\u1ec7t \u0111\u1ed9 24-250C, j >80%, c\u00f3 O2) s\u1ebd ph\u00e1t tri\u1ec3n th\u00e0nh tr\u1ee9ng c\u00f3 \u1ea5u tr\u00f9ng sau 15 ng\u00e0y. Nhi\u1ec7t \u0111\u1ed9 >360C ho\u1eb7c <120C tr\u1ee9ng kh\u00f4ng ph\u00e1t tri\u1ec3n \u0111\u01b0\u1ee3c, \u1edf nhi\u1ec7t \u0111\u1ed9 > 600C, <-120C tr\u1ee9ng s\u1ebd b\u1ecb di\u1ec7t. C\u00f2n \u1edf nhi\u1ec7t \u0111\u1ed9 450C l\u00e0 nhi\u1ec7t \u0111\u1ed9 trong h\u1ed1 \u1ee7 ph\u00e2n th\u00ec ph\u1ea3i sau 4 th\u00e1ng tr\u1ee9ng m\u1edbi b\u1ecb di\u1ec7t. C\u00e1c ch\u1ea5t s\u00e1t tr\u00f9ng th\u00f4ng th\u01b0\u1eddng: Formol 6%, thu\u1ed1c t\u00edm, cresyl 10%, kh\u00f4ng di\u1ec7t \u0111\u01b0\u1ee3c tr\u1ee9ng tr\u1eeb dung d\u1ecbch iod 10%. Trong h\u1ed1 x\u00ed n\u01b0\u1edbc tr\u1ee9ng s\u1ed1ng \u0111\u01b0\u1ee3c 2 th\u00e1ng. N\u1ebfu ng\u01b0\u1eddi \u0103n ph\u1ea3i tr\u1ee9ng c\u00f3 \u1ea5u tr\u00f9ng v\u00e0o c\u01a1 th\u1ec3 n\u00f3 s\u1ebd ph\u00e1t tri\u1ec3n nh\u01b0 \u0111\u00e3 m\u00f4 t\u1ea3 trong giai \u0111o\u1ea1n \u1edf ng\u01b0\u1eddi – Th\u1eddi gian ho\u00e0n th\u00e0nh chu k\u00ec: 60 ng\u00e0y, \u0111\u1eddi s\u1ed1ng c\u1ee7a giun \u0111\u0169a l\u00e0 13 th\u00e1ng. v Ph\u00f2ng b\u1ec7nh giun \u0111\u0169a + Tuy\u00ean truy\u1ec1n, gi\u00e1o d\u1ee5c s\u1ee9c kh\u1ecfe cho nh\u00e2n d\u00e2n v\u1ec1 t\u00e1c h\u1ea1i v\u00e0 ph\u00f2ng b\u1ec7nh giun \u0111\u0169a \u0111\u1ec3 m\u1ecdi ng\u01b0\u1eddi c\u00f3 \u00fd th\u1ee9c t\u1ef1 gi\u00e1c tham gia ph\u00f2ng ch\u1ed1ng b\u1ec7nh giun \u0111\u0169a. + \u0110i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh. + V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng: Qu\u1ea3n l\u00fd v\u00e0 x\u1eed l\u00fd ph\u00e2n th\u00edch h\u1ee3p. ~ S\u1eed d\u1ee5ng h\u1ed1 x\u00ed h\u1ee3p v\u1ec7 sinh, kh\u00f4ng ph\u00f3ng u\u1ebf b\u1eeba b\u00e3i ra ru\u1ed9ng v\u01b0\u1eddn, quanh nh\u00e0 nh\u1ea5t l\u00e0 c\u00e1c tr\u1ebb nh\u1ecf. Kh\u00f4ng \u0111\u1ec3 ch\u00f3, l\u1ee3n, g\u00e0 tha ph\u00e2n g\u00e2y \u00f4 nhi\u1ec5m m\u00f4i tr\u01b0\u1eddng. ~ Kh\u00f4ng d\u00f9ng ph\u00e2n t\u01b0\u01a1i \u0111\u1ec3 canh t\u00e1c, ph\u1ea3i \u1ee7 ph\u00e2n t\u1eeb 4 th\u00e1ng tr\u1edf l\u00ean m\u1edbi d\u00f9ng. + V\u1ec7 sinh \u0103n u\u1ed1ng, v\u1ec7 sinh th\u1ef1c ph\u1ea9m: Th\u1ee9c \u0103n ph\u1ea3i \u0111\u01b0\u1ee3c n\u1ea5u ch\u00edn \u0111\u1eady l\u1ed3ng b\u00e0n kh\u00f4ng \u0103n rau s\u1ed1ng, kh\u00f4ng u\u1ed1ng n\u01b0\u1edbc l\u00e3. C\u00e2u 6: Tr\u00ecnh b\u00e0y \u0111\u1eb7c \u0111i\u1ec3m d\u1ecbch t\u1ec5 h\u1ecdc c\u1ee7a giun \u0111\u0169a (Ascaris lumbricoides). – T\u1ef7 l\u1ec7 nhi\u1ec5m giun \u0111\u0169a \u0111\u1ee9ng h\u00e0ng \u0111\u1ea7u trong c\u00e1c lo\u1ea1i giun truy\u1ec1n qua \u0111\u1ea5t \u1edf VN. T\u1ef7 l\u1ec7 nhi\u1ec5m chung trong c\u1ea3 n\u01b0\u1edbc l\u00e0 80%, ph\u00e2n b\u1ed1 ch\u1ee7 y\u1ebfu \u1edf v\u00f9ng c\u00f3 t\u1eadp qu\u00e1n d\u00f9ng ph\u00e2n b\u1eafc l\u00e0m ph\u00e2n b\u00f3n. – Mi\u1ec1n B\u1eafc: \u0110\u1ed3ng b\u1eb1ng 80-95%, trung du 80-90%, ven bi\u1ec3n 70%, v\u00f9ng n\u00fai 50-70% – Mi\u1ec1n Trung: \u0110\u1ed3ng b\u1eb1ng 70,5%, ven bi\u1ec3n 12,5%, v\u00f9ng n\u00fai 38,4% – Mi\u1ec1n Nam: \u0110\u1ed3ng b\u1eb1ng 45-60%, v\u00f9ng T\u00e2y Nguy\u00ean 10-25% – Theo \u0111i\u1ec1u tra c\u1ee7a C\u1ea5n Th\u1ecb C\u00fac (1980) t\u1ea1i Qu\u1ea3ng Ninh c\u00f3 t\u1ef7 l\u1ec7 nhi\u1ec5m giun \u0111\u0169a 88,39%, c\u1ee7a \u0110\u1ed7 Th\u1ecb \u0110\u00e1ng (1990) t\u1ea1i Th\u00e1i B\u00ecnh l\u00e0 87,71% (nam 85,72%, n\u1eef 87,01% ) – M\u1ecdi l\u1ee9a tu\u1ed5i \u0111\u1ec1u c\u00f3 th\u1ec3 nhi\u1ec5m giun \u0111\u0169a, tr\u1ebb em l\u1ee9a tu\u1ed5i h\u1ecdc sinh ph\u1ed5 th\u00f4ng c\u00f3 t\u1ec9 l\u1ec7 nhi\u1ec5m cao nh\u1ea5t. Theo \u0111i\u1ec1u tra c\u1ee7a Ho\u00e0ng T\u00e2n D\u00e2n v\u00e0 Tr\u01b0\u01a1ng Th\u1ecb Kim Ph\u01b0\u1ee3ng \u1edf h\u1ecdc sinh c\u00e1c tr\u01b0\u1eddng ph\u1ed5 th\u00f4ng c\u01a1 s\u1edf n\u1ed9i, ngo\u1ea1i th\u00e0nh H\u00e0 N\u1ed9i 1995 cho k\u1ebft qu\u1ea3 nhi\u1ec5m giun \u0111\u0169a 62,47% – V\u1ec1 gi\u1edbi: T\u1ec9 l\u1ec7 nhi\u1ec5m giun \u0111\u0169a c\u1ee7a nam v\u00e0 n\u1eef x\u1ea5p x\u1ec9 nhau, n\u1ebfu kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 sinh ho\u1ea1t v\u00e0 lao \u0111\u1ed9ng. – V\u1ec1 ngh\u1ec1 nghi\u1ec7p: N\u00f4ng d\u00e2n ti\u1ebfp v\u1edbi ph\u00e2n, \u0111\u1ea5t d\u1ec5 b\u1ecb nhi\u1ec5m giun \u0111\u0169a h\u01a1n c\u00e1c ngh\u1ec1 nghi\u1ec7p kh\u00e1c – M\u00f9a l\u1ea1nh \u1edf n\u01b0\u1edbc ta kh\u00f4ng \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n \u0111\u1ec3 di\u1ec7t tr\u1ee9ng giun \u0111\u0169a \u1edf ngo\u1ea1i c\u1ea3nh. Do \u0111\u00f3 \u1edf Vi\u1ec7t Nam tr\u1ee9ng giun \u0111\u0169a ph\u00e1t tri\u1ec3n quanh n\u0103m C\u00e2u 7: M\u00f4 t\u1ea3 giai \u0111o\u1ea1n chu k\u1ef3 v\u00f4 t\u00ednh c\u1ee7a k\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t \u1edf ng\u01b0\u1eddi. Di\u1ec5n ra 2 th\u1eddi k\u00ec k\u1ebf ti\u1ebfp nhau – Th\u1eddi k\u00ec ph\u00e2n chia trong t\u1ebf b\u00e0o gan ( th\u1eddi k\u00ec ti\u1ec1n h\u1ed3ng c\u1ea7u) : KSTSR khi \u1edf tuy\u1ebfn n\u01b0\u1edbc b\u1ecdt c\u1ee7a mu\u1ed7i c\u00f3 d\u1ea1ng h\u00ecnh thoi g\u1ecdi l\u00e0 thoi tr\u00f9ng hay thoa tr\u00f9ng. Khi mu\u1ed7i \u0111\u1ed1t ng\u01b0\u1eddi thoa tr\u00f9ng v\u00e0o m\u00e1u ngo\u1ea1i bi\u00ean c\u1ee7a ng\u01b0\u1eddi. Sau 30 ph\u00fat to\u00e0n b\u1ed9 thoa tr\u00f9ng chui v\u00e0o gan \u0111\u1ec3 ph\u00e1t tri\u1ec3n trong t\u1ebf b\u00e0o gan. Trong t\u1ebf b\u00e0o gan thoa tr\u00f9ng cu\u1ed9n tron l\u1ea1i r\u1ed3i ph\u00e1t tri\u1ec3n d\u1ea7n th\u00e0nh th\u1ec3 ph\u00e2n li\u1ec7t. Th\u1ec3 ph\u00e2n li\u1ec7t v\u1ee1 gi\u1ea3i ph\u00f3ng ra c\u00e1c m\u1ea3nh tr\u00f9ng. T\u1eeb m\u1ed9t thoa tr\u00f9ng t\u1ea1o ra m\u1ed9t l\u01b0\u1ee3ng l\u1edbn c\u00e1c m\u1ea3nh tr\u00f9ng (P.falciparum c\u00f3 kho\u1ea3ng 40.000 m\u1ea3nh tr\u00f9ng, P.vivax v\u00e0 P.ovale: 10.000-15.000 m\u1ea3nh tr\u00f9ng, Pmalariae: 2000 m\u1ea3nh tr\u00f9ng). Nh\u1eefng m\u1ea3nh tr\u00f9ng n\u00e0y s\u1ebd v\u00e0o m\u00e1u k\u00fd sinh trong h\u1ed3ng c\u1ea7u. + P.falciparum v\u00e0 P.malariae, to\u00e0n b\u1ed9 c\u00e1c m\u1ea3nh tr\u00f9ng v\u00e0o m\u00e1u c\u00f9ng m\u1ed9t l\u00fac, ch\u1ea5m d\u1ee9t giai \u0111o\u1ea1n t\u1ebf b\u00e0o gan. + \u0110\u1ed1i v\u1edbi P.vivax v\u00e0 P.ovale, do ch\u00fang c\u00f3 nh\u1eefng ch\u1ee7ng thoa tr\u00f9ng kh\u00e1c nhau v\u1ec1 c\u1ea5u tr\u00fac gen, ngo\u00e0i s\u1ef1 ph\u00e1t tri\u1ec3n t\u1ee9c th\u00ec c\u1ee7a c\u00e1c thoa tr\u00f9ng \u0111\u1ec3 tr\u1edf th\u00e0nh th\u1ec3 ph\u00e2n li\u1ec7t c\u00f2n c\u00f3 s\u1ef1 ph\u00e1t tri\u1ec3n mu\u1ed9n h\u01a1n c\u1ee7a m\u1ed9t s\u1ed1 thoa tr\u00f9ng kh\u00e1c. Nh\u1eefng thoa tr\u00f9ng n\u00e0y t\u1ea1o th\u00e0nh c\u00e1c th\u1ec3 ng\u1ee7 (Hypnozoites) \u1edf trong t\u1ebf b\u00e0o gan. C\u00e1c th\u1ec3 ng\u1ee7 n\u00e0y ph\u00e1t tri\u1ec3n t\u1eebng \u0111\u1ee3t th\u00e0nh ph\u00e2n li\u1ec7t, v\u1ee1 ra v\u00e0 g\u1ea3i ph\u00f3ng nh\u1eefng m\u1ea3nh tr\u00f9ng v\u00e0o m\u00e1u g\u00e2y nh\u1eefng c\u01a1n s\u1ed1t r\u00e9t t\u00e1i ph\u00e1t xa. – Th\u1eddi k\u00ec ph\u00e2n chia trong h\u1ed3ng c\u1ea7u ( th\u1eddi k\u00ec h\u1ed3ng c\u1ea7u) : C\u00e1c m\u1ea3nh tr\u00f9ng t\u1eeb gan x\u00e2m nh\u1eadp v\u00e0o h\u1ed3ng c\u1ea7u, l\u00fac \u0111\u1ea7u l\u00e0 th\u1ec3 t\u01b0 d\u01b0\u1ee1ng r\u1ed3i ph\u00e1t tri\u1ec3n th\u00e0nh th\u1ec3 ph\u00e2n li\u1ec7t. Th\u1ec3 ph\u00e2n li\u1ec7t ph\u00e1t tri\u1ec3n \u0111\u1ea7y \u0111\u1ee7 (Ph\u00e2n li\u1ec7t gi\u00e0) s\u1ebd ph\u00e1 v\u1ee1 h\u1ed3ng c\u1ea7u gi\u1ea3i ph\u00f3ng ra nh\u1eefng m\u1ea3nh tr\u00f9ng (merozoites). L\u00fac n\u00e0y t\u01b0\u01a1ng \u1ee9ng v\u1edbi c\u01a1n s\u1ed1t x\u1ea3y ra tr\u00ean l\u00e2m s\u00e0ng. H\u1ea7u h\u1ebft nh\u1eefng m\u1ea3nh tr\u00f9ng mang gen v\u00f4 gi\u1edbi quay tr\u1edf l\u1ea1i k\u00fd sinh trong nh\u1eefng h\u1ed3ng c\u1ea7u m\u1edbi, ti\u1ebfp t\u1ee5c ph\u00e1 v\u1ee1 HC g\u00e2y nh\u1eefng c\u01a1n s\u1ed1t ti\u1ebfp theo. M\u1ed9t s\u1ed1 \u00edt m\u1ea3nh tr\u00f9ng mang gen h\u1eefu gi\u1edbi bi\u1ec7t ho\u00e1 th\u00e0nh nh\u1eefng giao b\u00e0o \u0111\u1ef1c v\u00e0 c\u00e1i, m\u1ed7i giao b\u00e0o n\u1eb1m trong m\u1ed9t HC. Nh\u1eefng giao b\u00e0o n\u00e0y n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c mu\u1ed7i h\u00fat s\u1ebd t\u1ef1 ti\u00eau hu\u1ef7 trong th\u1eddi gian 45- 60 ng\u00e0y, n\u1ebfu \u0111\u01b0\u1ee3c mu\u1ed7i h\u00fat v\u00e0o d\u1ea1 d\u00e0y mu\u1ed7i s\u1ebd ti\u1ebfp t\u1ee5c ph\u00e1t tri\u1ec3n trong c\u01a1 th\u1ec3 mu\u1ed7i. C\u00e2u 8: M\u00f4 t\u1ea3 giai \u0111o\u1ea1n chu k\u1ef3 h\u1eefu t\u00ednh c\u1ee7a k\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t \u1edf mu\u1ed7i. Mu\u1ed7i h\u00fat m\u00e1u ng\u01b0\u1eddi c\u00f3 giao b\u00e0o t\u1edbi d\u1ea1 d\u00e0y mu\u1ed7i, giao b\u00e0o c\u00e1i thu g\u1ecdn nh\u00e2n v\u00e0 nguy\u00ean sinh ch\u1ea5t th\u00e0nh giao t\u1eed c\u00e1i tr\u01b0\u1edfng th\u00e0nh. Giao b\u00e0o \u0111\u1ef1c k\u00e9o d\u00e0i nguy\u00ean sinh ch\u1ea5t th\u00e0nh 4-8 roi, m\u1ed7i roi d\u00ednh m\u1ed9t \u00edt nh\u00e2n th\u00e0nh c\u00e1c giao t\u1eed \u0111\u1ef1c tr\u01b0\u1edfng th\u00e0nh. Giao t\u1eed \u0111\u1ef1c ho\u00e0 h\u1ee3p v\u1edbi giao t\u1eed c\u00e1i t\u1ea1o th\u00e0nh tr\u1ee9ng th\u1ee5 tinh (Zygote). Sau \u0111\u00f3 ph\u00e1t tri\u1ec3n th\u00e0nh tr\u1ee9ng di \u0111\u1ed9ng (ookynete) chui qua th\u00e0nh d\u1ea1 d\u00e0y mu\u1ed7i tao th\u00e0nh tr\u1ee9ng nang (oocyste). Khi tr\u1ee9ng nang ph\u00e1t tri\u1ec3n th\u00e0nh tr\u1ee9ng nang gi\u00e0 b\u00ean trong c\u00f3 kho\u1ea3ng 10.000 thoa tr\u00f9ng. Tr\u1ee9ng nang gi\u00e0 v\u1ee1, c\u00e1c thoa tr\u00f9ng m\u1edbi t\u1eadp trung v\u1ec1 tuy\u1ebfn n\u01b0\u1edbc b\u1ecdt c\u1ee7a mu\u1ed7i. Khi mu\u1ed7i \u0111\u1ed1t ng\u01b0\u1eddi thoa tr\u00f9ng s\u1ebd x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3 ng\u01b0\u1eddi \u0111\u1ec3 g\u00e2y b\u1ec7nh. C\u00e2u 9: So s\u00e1nh s\u1ef1 kh\u00e1c nhau v\u1ec1 chu k\u1ef3 c\u1ee7a Plasmodium falciparum, Plasmodium vivax,Plasmodium malariae. 1. Giai \u0111o\u1ea1n \u1edf gan: Giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n \u1edf gan c\u1ee7a P.vivax v\u00e0 P.ovale gi\u1ed1ng nhau: B\u00ean c\u1ea1nh s\u1ef1 ph\u00e1t tri\u1ec3n t\u1ee9c th\u00ec c\u1ee7a c\u00e1c thoa tr\u00f9ng \u0111\u1ec3 th\u00e0nh th\u1ec3 ph\u00e2n li\u1ec7t, c\u00f2n c\u00f3 s\u1ef1 ph\u00e1t tri\u1ec3n mu\u1ed9n h\u01a1n c\u1ee7a m\u1ed9t s\u1ed1 thoa tr\u00f9ng kh\u00e1c \u0111\u00f3 l\u00e0 nh\u1eefng th\u1ec3 ng\u1ee7 (Hypnozoites). V\u00ec v\u1eady, b\u1ec7nh nh\u00e2n m\u1eafc 2 lo\u1ea1i n\u00e0y g\u00e2y ra s\u1ed1t r\u00e9t t\u00e1i ph\u00e1t xa v\u00e0 b\u1ec7nh c\u00f3 th\u1ec3 k\u00e9o d\u00e0i dai d\u1eb3ng. Ri\u00eang \u0111\u1ed1i v\u1edbi P.falciparum do kh\u00f4ng c\u00f3 th\u1ec3 ng\u1ee7 \u1edf gan, n\u00ean b\u1ec7nh do lo\u1ea1i n\u00e0y kh\u00f4ng c\u00f3 s\u1ed1t r\u00e9t t\u00e1i ph\u00e1t xa. 2. Giai \u0111o\u1ea1n \u1edf h\u1ed3ng c\u1ea7u: Th\u1eddi gian \u0111\u1ec3 ho\u00e0n th\u00e0nh chu k\u1ef3 v\u00f4 t\u00ednh \u1edf h\u1ed3ng c\u1ea7u c\u1ee7a Plasmodium, P.vivax v\u00e0 P.ovale l\u00e0 48 gi\u1edd. Do v\u1eady, nh\u1ecbp \u0111\u1ed9 c\u01a1n s\u1ed1t c\u1ee7a 3 lo\u1ea1i KSTSR n\u00e0y l\u00e0 s\u1ed1t c\u00e1ch nh\u1eadt. C\u00f2n P.malariae c\u1ea7n 72 gi\u1edd \u0111\u1ec3 ho\u00e0n th\u00e0nh chu k\u1ef3 v\u00f4 t\u00ednh \u1edf HC n\u00ean g\u00e2y s\u1ed1t c\u00e1ch 2 ng\u00e0y m\u1ed9t c\u01a1n. 3. Giai \u0111o\u1ea1n \u1edf mu\u1ed7i truy\u1ec1n b\u1ec7nh. \u0110\u1ec3 th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c chu k\u1ef3 h\u1eefu gi\u1edbi \u1edf mu\u1ed7i, KSTSR c\u1ea7n ph\u1ea3i c\u00f3 nhi\u1ec7t \u0111\u1ed9 th\u00edch h\u1ee3p. Nhi\u1ec7t \u0111\u1ed9 t\u1ed1t nh\u1ea5t \u0111\u1ec3 thoa tr\u00f9ng ph\u00e1t tri\u1ec3n trong c\u01a1 th\u1ec3 mu\u1ed7i l\u00e0 28 \u2013 30oc. Nhi\u1ec7t \u0111\u1ed9 t\u1ed1i thi\u1ec3u c\u1ea7n thi\u1ebft cho s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1eebng lo\u1ea1i Plasmodium l\u00e0: – P.falciparum: 160c – P.vivax v\u00e0 P.ovale: 14,50c – P.malariae: 160c T\u1ed5ng s\u1ed1 nhi\u1ec7t \u0111\u1ed9 d\u01b0 t\u00edch lu\u1ef9 c\u1ea7n thi\u1ebft c\u1ee7a P.falciparum: 1110c, P.vivax v\u00e0 P.ovale: 1050c v\u00e0 P.malariae: 1440c V\u1eady theo c\u00f4ng th\u1ee9c Bodenheimer th\u00ec th\u1eddi gian ho\u00e0n th\u00e0nh chu k\u1ef3 h\u1eefu gi\u1edbi \u1edf mu\u1ed7i l\u00e0 S s\u1ebd thay \u0111\u1ed5i theo nhi\u1ec7t \u0111\u1ed9 m\u00f4i tr\u01b0\u1eddng v\u00e0 lo\u1ea1i Plasmodium. – P.falciparum: Sf = 111\/ t – 16 (ng\u00e0y) – P.vivax v\u00e0 P.ovale: Sv,o = 105\/ t- 14,5 (ng\u00e0y) – P.malariae: Sm = 144\/ t – 16,5 (ng\u00e0y) t l\u00e0 nhi\u1ec7t \u0111\u1ed9 trung b\u00ecnh c\u1ee7a nh\u1eefng ng\u00e0y theo d\u00f5i Nh\u1eadn x\u00e9t: – Nhi\u1ec7t \u0111\u1ed9 c\u00e0ng cao, th\u1eddi gian ho\u00e0n th\u00e0nh chu k\u1ef3 h\u1eefu gi\u1edbi c\u00e0ng ng\u1eafn – Nhi\u1ec7t \u0111\u1ed9 d\u01b0\u1edbi m\u1ee9c t\u1ed1i thi\u1ec3u, KSTSR kh\u00f4ng ph\u00e1t tri\u1ec3n \u0111\u01b0\u1ee3c trong c\u01a1 th\u1ec3 mu\u1ed7i. C\u00e2u 10: N\u00eau c\u00e1c ph\u01b0\u01a1ng th\u1ee9c nhi\u1ec5m b\u1ec7nh s\u1ed1t r\u00e9t 1. Do mu\u1ed7i truy\u1ec1n: L\u00e0 ph\u01b0\u01a1ng th\u1ee9c ch\u1ee7 y\u1ebfu. Do mu\u1ed7i Anopheles c\u00e1i \u0111\u00e3 nhi\u1ec5m KSTSR \u0111\u1ed1t ng\u01b0\u1eddi. M\u1ed9t con mu\u1ed7i c\u00f3 th\u1ec3 g\u00e2y nhi\u1ec5m nhi\u1ec1u l\u1ea7n v\u00e0 cho nhi\u1ec1u ng\u01b0\u1eddi. Th\u1ebf gi\u1edbi \u0111\u00e3 t\u00ecm ra 400 lo\u00e0i Anopheles, trong \u0111\u00f3 80 lo\u00e0i c\u00f3 kh\u1ea3 n\u0103ng truy\u1ec1n b\u1ec7nh. Vi\u1ec7t Nam \u0111\u00e3 x\u00e1c \u0111\u1ecbnh c\u00f3 61 lo\u00e0i Anopheles, trong \u0111\u00f3 g\u1ea7n 10 lo\u00e0i c\u00f3 kh\u1ea3 n\u0103ng truy\u1ec1n b\u1ec7nh. – Nh\u1eefng Anopheles truy\u1ec1n SR ch\u1ee7 y\u1ebfu: + An. minimus: Ph\u00e2n b\u1ed1 \u1edf mi\u1ec1n n\u00fai kh\u1eafp c\u1ea3 n\u01b0\u1edbc + An. dius: Ph\u00e2n b\u1ed1 \u1edf mi\u1ec1n n\u00fai, r\u1eebng r\u1eadm t\u1eeb ph\u00eda b\u1eafc S\u00f4ng Chu (Thanh Ho\u00e1) tr\u1edf v\u00e0o nam. + + An. sundaicus: ph\u00e2n b\u1ed1 \u1edf ven bi\u1ec3n n\u01b0\u1edbc l\u1ee3 (Nam b\u1ed9) T\u1eeb Phan Thi\u1ebft tr\u1edf v\u00e0o. – Nh\u1eefng lo\u00e0i Anopheles truy\u1ec1n SR th\u1ee9 y\u1ebfu: + An. jeyporiensis, An. aconitus, An. maculatus, An. vagus: Ph\u00e2n b\u1ed1 \u1edf mi\u1ec1n n\u00fai kh\u1eafp c\u1ea3 n\u01b0\u1edbc. + An. subpictus, An. sinensis: ph\u00e2n b\u1ed1 \u1edf \u0111\u1ed3ng b\u1eb1ng ven bi\u1ec3n n\u01b0\u1edbc l\u1ee3. 2. Do truy\u1ec1n m\u00e1u: Ng\u01b0\u1eddi cho m\u00e1u mang KSTSR kh\u00f4ng bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng, n\u01a1i nh\u1eadn m\u00e1u kh\u00f4ng x\u00e9t nghi\u1ec7m k\u1ef9 s\u1ebd d\u00f9ng m\u00e1u b\u1ecb nhi\u1ec5m. KSTSR t\u1ed3n t\u1ea1i \u0111\u01b0\u1ee3c trong m\u00e1u l\u01b0u tr\u1eef \u1edf nhi\u1ec7t \u0111\u1ed9 b\u1ea3o qu\u1ea3n 40c l\u00e0 15 ng\u00e0y. (Do \u0111\u01b0a tr\u1ef1c ti\u1ebfp m\u00e1u v\u00e0o t\u0129nh m\u1ea1ch n\u00ean d\u00f9 KSTSR thu\u1ed9c ch\u1ee7ng P.vivax c\u0169ng kh\u00f4ng bao gi\u1edd c\u00f3 s\u1ed1t r\u00e9t t\u00e1i ph\u00e1t xa, v\u00ec KSTSR kh\u00f4ng qua gan. Sau truy\u1ec1n m\u00e1u 4- 7 ng\u00e0y b\u1eaft \u0111\u1ea7u c\u00f3 c\u01a1n SR \u0111i\u1ec3n h\u00ecnh) 3. S\u1ed1t r\u00e9t b\u1ea9m sinh (S\u1ed1t r\u00e9t truy\u1ec1n qua rau thai nhi). – Ph\u1ee5 n\u1eef c\u00f3 thai mang KSTSR c\u00f3 th\u1ec3 truy\u1ec1n cho b\u00e0o thai qua d\u00e2y rau b\u1ecb t\u1ed5n th\u01b0\u01a1ng. – Thuy\u1ebft b\u00e0o thai h\u1ecdc: T\u1eeb khi c\u00f2n l\u00e0 b\u00e0o thai KSTSR \u0111\u00e3 t\u1eeb m\u1eb9 sang con, v\u00ec c\u1ee9 5-200 h\u1ed3ng c\u1ea7u b\u00e0o thai th\u00ec c\u00f3 1 h\u1ed3ng c\u1ea7u m\u1eb9 giao l\u01b0u v\u1edbi nhau. M\u1eb7t kh\u00e1c ng\u01b0\u1eddi ta \u0111\u00e3 quan s\u00e1t th\u1ea5y r\u1ea5t nhi\u1ec1u th\u1ec3 t\u01b0 d\u01b0\u1ee1ng P.falciparum t\u1eadp trung t\u1ea1i d\u00e2y rau. 4. Do ti\u00eam ch\u00edch: Ng\u00e0y nay y h\u1ecdc \u0111\u00e3 \u0111\u1ec1 c\u1eadp \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 nhi\u1ec5m b\u1ec7nh SR do ti\u00eam ch\u00edch ma tu\u00fd. C\u00e2u 11: Tr\u00ecnh b\u00e0y chu k\u1ef3 pha\u0301t tri\u00ea\u0309n va\u0300 n\u00eau ca\u0301c bi\u00ea\u0323n pha\u0301p pho\u0300ng ch\u00f4\u0301ng sa\u0301n d\u00e2y heo (Taenia solium). 1. Chu k\u1ef3 sinh s\u1ea3n c\u1ee7a s\u00e1n d\u00e2y l\u1ee3n S\u00e1n tr\u01b0\u1edfng th\u00e0nh k\u00fd sinh \u1edf ru\u1ed9t non c\u1ee7a ng\u01b0\u1eddi. Tr\u1ee9ng s\u00e1n theo \u0111\u1ed1t gi\u00e0 r\u1ee5ng ra kh\u1ecfi c\u01a1 th\u1ec3 s\u00e1n theo ph\u00e2n ra ngo\u1ea1i c\u1ea3nh. Khi l\u1ee3n \u0103n ph\u1ea3i tr\u1ee9ng s\u00e1n, tr\u1ee9ng ph\u00e1t tri\u1ec3n th\u00e0nh nang \u1ea5u tr\u00f9ng s\u00e1n trong c\u01a1 l\u1ee3n (Cysticercus cellulosae). Nang s\u00e1n c\u00f3 \u0111\u01b0\u1eddng k\u00ednh 0,7-0,8 cm, d\u00e0i 1,5 cm g\u1ecdi l\u00e0 \u201c g\u1ea1o l\u1ee3n\u201d. B\u00ean trong nang l\u00e0 \u0111\u1ea7u s\u00e1n non n\u1eb1m trng m\u00f4i tr\u01b0\u1eddng l\u1ecfng m\u00e0u tr\u1eafng \u0111\u1ee5c. Nang \u1ea5u tr\u00f9ng s\u00e1n ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng tr\u01b0\u1edfng th\u00e0nh sau 2- 4 th\u00e1ng v\u00e0 s\u1ed1ng 3-10 n\u0103m, sau \u0111\u00f3 \u1ea5u tr\u00f9ng tho\u00e1i ho\u00e1 ho\u1eb7c v\u00f4i ho\u00e1. Ngo\u00e0i l\u1ee3n ra ch\u00f3, m\u00e8o, ng\u01b0\u1eddi \u0111\u1ec1u c\u00f3 th\u1ec3 l\u00e0 v\u1eadt ch\u1ee7 ph\u1ee5 c\u1ee7a s\u00e1n d\u00e2y l\u1ee3n trong tr\u01b0\u1eddng h\u1ee3p \u0103n ph\u1ea3i tr\u1ee9ng s\u00e1n d\u00e2y l\u1ee3n \u1edf ngo\u1ea1i c\u1ea3nh. Nang \u1ea5u tr\u00f9ng s\u00e1n d\u00e2y l\u1ee3n ngo\u00e0i k\u00fd sinh \u1edf c\u00e1c c\u01a1 c\u00f2n g\u1eb7p \u1edf m\u1eaft v\u00e0 h\u1ec7 th\u1ed1ng th\u1ea7n kinh trung \u01b0\u01a1ng c\u1ee7a ng\u01b0\u1eddi. Khi ng\u01b0\u1eddi \u0103n ph\u1ea3i th\u1ecbt l\u1ee3n g\u1ea1o kh\u00f4ng n\u1ea5u ch\u00edn, d\u01b0\u1edbi t\u00e1c d\u1ee5ng d\u1ecbch t\u00e1 tr\u00e0ng, \u0111\u1ea7u s\u00e1n tho\u00e1t ra kh\u1ecfi nang b\u00e1m v\u00e0o ni\u00eam m\u1ea1c ru\u1ed9t, ph\u00e1t tri\u1ec3n th\u00e0nh s\u00e1n d\u00e2y l\u1ee3n tr\u01b0\u1edfng th\u00e0nh. Sau 67-72 ng\u00e0y \u0111\u00e3 c\u00f3 nh\u1eefng \u0111\u1ed1t gi\u00e0. S\u00e1n tr\u01b0\u1edfng th\u00e0nh s\u1ed1ng t\u1edbi 25 n\u0103m. Nh\u1eefng ng\u01b0\u1eddi m\u1eafc s\u00e1n tr\u01b0\u1edfng th\u00e0nh k\u00fd sinh \u1edf ru\u1ed9t non, v\u00ec m\u1ed9t l\u00fd do n\u00e0o \u0111\u00f3 nh\u01b0 say t\u00e0u, say xe, ph\u1ee5 n\u1eef c\u00f3 thai, s\u1ed1t cao… b\u1ecb n\u00f4n o\u1eb9. \u0110\u1ed1t s\u00e1n gi\u00e0 r\u1ee5ng ra \u1edf ru\u1ed9t non theo nhu \u0111\u1ed9ng ng\u01b0\u1ee3c l\u00ean d\u1ea1 d\u00e0y, d\u01b0\u1edbi t\u00e1c d\u1ee5ng d\u1ecbch ti\u00eau ho\u00e1 tr\u1ee9ng t\u1eeb c\u00e1c \u0111\u1ed1t g\u00eca gi\u1ea3i ph\u00f3ng ra. Khi xu\u1ed1ng t\u00e1 tr\u00e0ng \u1ea5u tr\u00f9ng trong tr\u1ee9ng tho\u00e1t ra chui qua th\u00e0nh ru\u1ed9t theo tu\u1ea7n ho\u00e0n \u0111i kh\u1eafp c\u01a1 th\u1ec3 ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng s\u00e1n (Cysticercus cellulosae). Ng\u01b0\u1eddi c\u00f3 nang \u1ea5u tr\u00f9ng s\u00e1n c\u00f2n g\u1ecdi l\u00e0 \u201c ng\u01b0\u1eddi g\u1ea1o\u201d. – C\u00f3 tr\u01b0\u1eddng h\u1ee3p b\u1ecb t\u1ef1 t\u00e1i nhi\u1ec5m \u1ea5u tr\u00f9ng s\u00e1n: Nh\u1eefng ng\u01b0\u1eddi m\u1eafc s\u00e1n tr\u01b0\u1edfng th\u00e0nh k\u00fd sinh \u1edf ru\u1ed9t non, v\u00ec 1 l\u00fd do n\u00e0o \u0111\u00f3 nh\u01b0 say t\u00e0u, say xe, ph\u1ee5 n\u1eef c\u00f3 thai, s\u1ed1t cao,\u2026 b\u1ecb n\u00f4n \u1ecde. \u0110\u1ed1t s\u00e1n gi\u00e0 r\u1ee5ng ra \u1edf ru\u1ed9t non s\u1ebd theo nhu \u0111\u1ed9ng ng\u01b0\u1ee3c chi\u1ec1u l\u00ean d\u1ea1 d\u00e0y, d\u01b0\u1edbi t\u00e1c d\u1ee5ng d\u1ecbch ti\u00eau h\u00f3a, \u0111\u1ed1t s\u00e1n v\u1ee1 ra, tr\u1ee9ng t\u1eeb c\u00e1c \u0111\u1ed1t gi\u00e0 \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng. Sau \u0111\u00f3, tr\u1ee9ng s\u00e1n xu\u1ed1ng ru\u1ed9t non s\u1ebd ph\u00e1t tri\u1ec3n nh\u01b0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nu\u1ed1t ph\u1ea3i tr\u1ee9ng s\u00e1n. * Nh\u01b0 v\u1eady ng\u01b0\u1eddi c\u00f3 th\u1ec3 b\u1ecb 2 th\u1ec3 b\u1ec7nh c\u1ee7a s\u00e1n d\u00e2y l\u1ee3n – B\u1ec7nh \u1ea5u tr\u00f9ng s\u00e1n d\u00e2y l\u1ee3n do \u0103n ph\u1ea3i tr\u1ee9ng s\u00e1n – B\u1ec7nh s\u00e1n d\u00e2y l\u1ee3n tr\u01b0\u1edfng th\u00e0nh do \u0103n ph\u1ea3i \u1ea5u tr\u00f9ng s\u00e1n. 2. C\u00e1ch ph\u00f2ng b\u1ec7nh + Tuy\u00ean truy\u1ec1n, GDSK v\u1ec1 t\u00e1c h\u1ea1i c\u1ee7a SDL v\u00e0 c\u00e1ch ph\u00f2ng ch\u1ed1ng b\u1ec7nh SDL cho c\u1ed9ng \u0111\u1ed3ng + Ki\u1ec3m tra s\u00e1t sinh t\u1ea1i c\u00e1c l\u00f2 m\u1ed5 gia s\u00fac \u0111\u1ec3 lo\u1ea1i tr\u1eeb nh\u1eefng con l\u1ee3n b\u1ecb b\u1ec7nh l\u1ee3n g\u1ea1o + Kh\u00f4ng \u0103n th\u1ecbt l\u1ee3n t\u00e1i d\u01b0\u1edbi m\u1ecdi h\u00ecnh th\u1ee9c, tr\u01b0\u1edbc khi \u0103n c\u00e1c lo\u1ea1i rau qu\u1ea3 t\u01b0\u01a1i, s\u1ed1ng ph\u1ea3i r\u1eefa k\u1ef9 b\u1eb1ng n\u01b0\u1edbc s\u1ea1ch nhi\u1ec1u l\u1ea7n + Ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi c\u00f3 s\u00e1n d\u00e2y l\u1ee3n + V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng: Kh\u00f4ng \u0111\u1ea1i ti\u1ec7n b\u1eeba b\u00e3i, kh\u00f4ng nu\u00f4i l\u1ee3n th\u1ea3 r\u00f4ng C\u00e2u 12: Tr\u00ecnh b\u00e0y chu k\u1ef3 pha\u0301t tri\u00ea\u0309n va\u0300 n\u00eau ca\u0301c bi\u00ea\u0323n pha\u0301p pho\u0300ng ch\u00f4\u0301ng sa\u0301n bo\u0300 (Taenia saginata). 1. Chu k\u1ef3 ph\u00e1t tri\u1ec3n C\u00e1c \u0111\u1ed1t s\u00e1n gi\u00e0 r\u1ee5ng ra ngo\u1ea1i c\u1ea3nh, v\u1ee1 gi\u1ea3i ph\u00f3ng ra h\u00e0ng tr\u0103m ng\u00e0n tr\u1ee9ng. Tr\u00e2u, b\u00f2 \u0103n ph\u1ea3i tr\u1ee9ng s\u00e1n t\u1edbi ru\u1ed9t, tr\u1ee9ng s\u00e1n n\u1edf ra \u1ea5u tr\u00f9ng, \u1ea5u tr\u00f9ng theo tu\u1ea7n ho\u00e0n v\u1ec1 tim v\u00e0o \u0111\u1ea1i tu\u1ea7n ho\u00e0n \u0111i t\u1edbi c\u00e1c c\u01a1 v\u00e2n h\u00ecnh th\u00e0nh nang \u1ea5u tr\u00f9ng \u1edf c\u01a1 c\u1ee7a tr\u00e2u, b\u00f2 g\u1ecdi l\u00e0 \u201c G\u1ea1o b\u00f2\u201d (Cysticercus bovis). Ng\u01b0\u1eddi \u0103n th\u1ecbt tr\u00e2u, b\u00f2 c\u00f3 nang \u1ea5u tr\u00f9ng ch\u01b0a n\u1ea5u ch\u00edn, nang \u1ea5u tr\u00f9ng v\u00e0o ru\u1ed9t ng\u01b0\u1eddi, \u1ea5u tr\u00f9ng tho\u00e1t ra kh\u1ecfi nang, b\u00e1m v\u00e0o m\u00e0ng ru\u1ed9t ph\u00e1t tri\u1ec3n th\u00e0nh s\u00e1n d\u00e2y b\u00f2 tr\u01b0\u1edfng th\u00e0nh trong kho\u1ea3ng 8-10 tu\u1ea7n l\u1ec5. S\u00e1n d\u00e2y b\u00f2 c\u00f3 th\u1ec3 s\u1ed1ng trong c\u01a1 th\u1ec3 ng\u01b0\u1eddi 20-30 n\u0103m. 2. Bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng – Tuy\u00ean truy\u1ec1n gi\u00e1o d\u1ee5c s\u1ee9c kho\u1ebb v\u1ec1 ph\u00f2ng ch\u1ed1ng b\u1ec7nh cho c\u1ed9ng \u0111\u1ed3ng. – T\u0103ng c\u01b0\u1eddng ki\u1ec3m tra s\u00e1t sinh t\u1ea1i c\u00e1c l\u00f2 m\u1ed5 gia s\u00fac. Th\u1ecbt b\u00f2 c\u00f3 nang \u1ea5u tr\u00f9ng ph\u1ea3i hu\u1ef7 b\u1ecf. – V\u1ec7 sinh \u0103n u\u1ed1ng: Kh\u00f4ng \u0103n th\u1ecbt b\u00f2 t\u00e1i. – V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng: Kh\u00f4ng \u0111\u1ea1i ti\u1ec7n b\u1eeba b\u00e3i. – Ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb nh\u1eefng ng\u01b0\u1eddi c\u00f3 b\u1ec7nh. C\u00e2u 13: Tr\u00ecnh b\u00e0y c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng b\u1ec7nh s\u00e1n d\u00e2y heo v\u00e0 s\u00e1n d\u00e2y b\u00f2 (Taenia saginata). Tr\u00f9ng c\u00e2u 11,12 C\u00e2u 14: Tr\u00ecnh b\u00e0y chu k\u1ef3 pha\u0301t tri\u00ea\u0309n c\u1ee7a s\u00e1n l\u00e1 gan nh\u1ecf (Chlonorsis sinensis). S\u00e1n k\u00fd sinh trong c\u00e1c \u1ed1ng m\u1eadt \u1edf trong gan. S\u00e1n \u0111\u1ebb tr\u1ee9ng, tr\u1ee9ng theo ph\u00e2n ra ngo\u1ea1i c\u1ea3nh, g\u1eb7p n\u01b0\u1edbc ao h\u1ed3 ho\u1eb7c s\u00f4ng su\u1ed1i s\u1ebd ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng l\u00f4ng. \u1ea4u tr\u00f9ng l\u00f4ng t\u00ecm \u0111\u1ebfn k\u00fd sinh \u1edf c\u00e1c lo\u1ea1i \u1ed1c thu\u1ed9c gi\u1ed1ng Bithinia. Sau 21-30 ng\u00e0y trong c\u01a1 th\u1ec3 \u1ed1c, \u1ea5u tr\u00f9ng s\u1ebd ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng \u0111u\u00f4i. \u1ea4u tr\u00f9ng \u0111u\u00f4i t\u00ecm \u0111\u1ebfn k\u00fd sinh \u1edf c\u01a1 c\u1ee7a c\u00e1c lo\u1ea1i c\u00e1 n\u01b0\u1edbc ng\u1ecdt (ch\u00e9p, tr\u00f4i, r\u00f4 m\u00e8, ch\u1eafn,\u2026) \u0111\u1ec3 ph\u00e1t tri\u1ec3n th\u00e0nh nang tr\u1ee9ng. N\u1ebfu ng\u01b0\u1eddi ho\u1eb7c ch\u00f3, m\u00e8o \u0103n ph\u1ea3i nang tr\u00f9ng c\u00f2n s\u1ed1ng trong c\u00e1 ch\u01b0a n\u1ea5u ch\u00edn (\u0103n c\u00e1 g\u1ecfi) v\u00e0o t\u1edbi ru\u1ed9t \u1ea5u tr\u00f9ng s\u1ebd tho\u00e1t nang, 15 gi\u1edd sau s\u1ebd di chuy\u1ec3n t\u1edbi \u1ed1ng m\u1eadt v\u00e0 sau 26 ng\u00e0y s\u1ebd tr\u1edf th\u00e0nh s\u00e1n tr\u01b0\u1edfng th\u00e0nh, ho\u00e0n th\u00e0nh chu k\u1ef3. S\u00e1n s\u1ed1ng \u0111\u01b0\u1ee3c kho\u1ea3ng 20 n\u0103m. C\u00e2u 15: Tr\u00ecnh b\u00e0y chu k\u1ef3 pha\u0301t tri\u00ea\u0309n c\u1ee7a s\u00e1n l\u00e1 ph\u1ed5i (Paragonimus westermani). S\u00e1n k\u00fd sinh trong ph\u1ed5i, s\u00e1n \u0111\u1ebb tr\u1ee9ng, tr\u1ee9ng theo \u0111\u1eddm ho\u1eb7c ph\u00e2n (n\u1ebfu l\u00e0 tr\u1ebb em) ra ngo\u1ea1i c\u1ea3nh, g\u1eb7p n\u01b0\u1edbc ao h\u1ed3, s\u00f4ng su\u1ed1i s\u1ebd ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng l\u00f4ng. \u1ea4u tr\u00f9ng l\u00f4ng b\u01a1i l\u1ed9i trong n\u01b0\u1edbc t\u00ecm \u0111\u1ebfn c\u00e1c lo\u1ea1i \u1ed1c thu\u1ed9c gi\u1ed1ng Melania \u0111\u1ec3 k\u00fd sinh v\u00e0 ph\u00e1t tri\u1ec3n th\u00e0nh b\u00e0o \u1ea5u. T\u1eeb 1 b\u00e0o \u1ea5u ph\u00e1t tri\u1ec3n th\u00e0nh nhi\u1ec1u \u1ea5u tr\u00f9ng \u0111u\u00f4i (\u0111\u00e2y l\u00e0 h\u00ecnh th\u1ee9c sinh s\u1ea3n \u0111a ph\u00f4i). \u1ea4u tr\u00f9ng \u0111u\u00f4i r\u1eddi \u1ed1c, t\u00ecm \u0111\u1ebfn VCTG th\u1ee9 2 l\u00e0 cua, t\u00f4m n\u01b0\u1edbc ng\u1ecdt. Khi ng\u01b0\u1eddi ho\u1eb7c \u0111\u1ed9ng v\u1eadt c\u00f3 v\u00fa \u0103n ph\u1ea3i nang tr\u00f9ng c\u00f2n s\u1ed1ng v\u00e0o t\u1edbi ru\u1ed9t non, \u1ea5u tr\u00f9ng tho\u00e1t nang chui qua th\u00e0nh ru\u1ed9t, qua ph\u00fac m\u1ea1c, c\u01a1 ho\u00e0nh t\u1edbi ph\u1ed5i k\u00fd sinh. S\u00e1n s\u1ed1ng \u0111\u01b0\u1ee3c 6 \u2013 16 n\u0103m. C\u00e2u 16: N\u00eau c\u00e1c nguy\u00ean t\u1eafc v\u00e0 bi\u1ec7n ph\u00e1p ph\u00f2ng, ch\u1ed1ng b\u1ec7nh s\u00e1n l\u00e1 gan nh\u1ecf, s\u00e1n l\u00e1 ph\u1ed5i, s\u00e1n l\u00e1 ru\u1ed9t (Chlonorsis sinensis, Paragonimus westermani, Fasciolopsis buski). 1. Ph\u00f2ng b\u1ec7nh s\u00e1n l\u00e1 nh\u1ecf \u1edf gan – Nguy\u00ean t\u1eafc: + Ph\u1ea3i k\u1ebft h\u1ee3p nhi\u1ec1u bi\u1ec7n ph\u00e1p v\u1edbi nhau. + Ph\u1ea3i c\u00f3 k\u1ebf ho\u1ea1ch c\u1ee5 th\u1ec3, c\u00f3 tr\u1ecdng t\u00e2m, tr\u1ecdng \u0111i\u1ec3m . + T\u00e1c \u0111\u1ed9ng v\u00e0o ngu\u1ed3n b\u1ec7nh b\u1eb1ng c\u00e1ch \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh + V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng, kh\u00f4ng \u0111\u1ec3 cho tr\u1ee9ng s\u00e1n xu\u1ed1ng n\u01b0\u1edbc + V\u1ec7 sinh c\u00e1 nh\u00e2n, v\u1ec7 sinh \u0103n u\u1ed1ng – Bi\u1ec7n ph\u00e1p: + Tuy\u00ean truy\u1ec1n, GDSK v\u1ec1 t\u00e1c h\u1ea1i v\u00e0 c\u00e1ch ph\u00f2ng b\u1ec7nh s\u00e1n l\u00e1 nh\u1ecf \u1edf gan + V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng, kh\u00f4ng d\u00f9ng ph\u00e2n t\u01b0\u01a1i \u0111\u1ec3 nu\u00f4i c\u00e1, kh\u00f4ng \u0111\u1ea1i ti\u1ec7n xu\u1ed1ng ao h\u1ed3, s\u00f4ng su\u1ed1i + V\u1ec7 sinh \u0103n u\u1ed1ng, kh\u00f4ng \u0103n c\u00e1 g\u1ecfi + Ph\u00e1t hi\u1ec7n v\u00e0 t\u00edch c\u1ef1c \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh 2. Ph\u00f2ng b\u1ec7nh s\u00e1n l\u00e1 ph\u1ed5i – Nguy\u00ean t\u1eafc: + Ph\u1ea3i k\u1ebft h\u1ee3p nhi\u1ec1u bi\u1ec7n ph\u00e1p v\u1edbi nhau. + Ph\u1ea3i c\u00f3 k\u1ebf ho\u1ea1ch c\u1ee5 th\u1ec3, c\u00f3 tr\u1ecdng t\u00e2m, tr\u1ecdng \u0111i\u1ec3m . + T\u00e1c \u0111\u1ed9ng v\u00e0o ngu\u1ed3n b\u1ec7nh b\u1eb1ng c\u00e1ch \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh + V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng, kh\u00f4ng \u0111\u1ec3 cho tr\u1ee9ng s\u00e1n xu\u1ed1ng n\u01b0\u1edbc + V\u1ec7 sinh c\u00e1 nh\u00e2n, v\u1ec7 sinh \u0103n u\u1ed1ng – Bi\u1ec7n ph\u00e1p : – Tuy\u00ean truy\u1ec1n, GDSK v\u1ec1 t\u00e1c h\u1ea1i v\u00e0 c\u00e1ch ph\u00f2ng ch\u1ed1ng b\u1ec7nh SLP trong nh\u00e2n d\u00e2n – V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng: Kh\u00f4ng d\u00f9ng ph\u00e2n t\u01b0\u01a1i \u0111\u1ec3 nu\u00f4i c\u00e1, kh\u00f4ng \u0111i \u0111\u1ea1i ti\u1ec7n xu\u1ed1ng ao h\u1ed3, s\u00f4ng, su\u1ed1i – V\u1ec7 sinh \u0103n u\u1ed1ng: kh\u00f4ng \u0103n cua ,t\u00f4m ch\u01b0a n\u1ea5u ch\u00edn . – Ph\u00e1t hi\u1ec7n s\u1edbm, \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c b\u1ec7nh ng\u01b0\u1eddi 3. C\u00e1ch ph\u00f2ng b\u1ec7nh s\u00e1n l\u00e1 ru\u1ed9t – Nguy\u00ean t\u1eafc: + Ph\u1ea3i k\u1ebft h\u1ee3p nhi\u1ec1u bi\u1ec7n ph\u00e1p v\u1edbi nhau. + Ph\u1ea3i c\u00f3 k\u1ebf ho\u1ea1ch c\u1ee5 th\u1ec3, c\u00f3 tr\u1ecdng t\u00e2m, tr\u1ecdng \u0111i\u1ec3m . + T\u00e1c \u0111\u1ed9ng v\u00e0o ngu\u1ed3n b\u1ec7nh b\u1eb1ng c\u00e1ch \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh + V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng, kh\u00f4ng \u0111\u1ec3 tr\u1ee9ng s\u00e1n xu\u1ed1ng n\u01b0\u1edbc. + V\u1ec7 sinh c\u00e1 nh\u00e2n, v\u1eb9 sinh \u0103n u\u1ed1ng. – Bi\u1ec7n ph\u00e1p + Tuy\u00ean truy\u1ec1n, GDSK v\u1ec1 t\u00e1c h\u1ea1i v\u00e0 c\u00e1ch ph\u00f2ng b\u1ec7nh s\u00e1n l\u00e1 ru\u1ed9t + V\u1ec7 sinh m\u00f4i tr\u01b0\u1eddng, kh\u00f4ng d\u00f9ng ph\u00e2n t\u01b0\u01a1i \u0111\u1ec3 nu\u00f4i c\u00e1, kh\u00f4ng \u0111\u1ea1i ti\u1ec7n xu\u1ed1ng ao h\u1ed3, s\u00f4ng su\u1ed1i + V\u1ec7 sinh \u0103n u\u1ed1ng, kh\u00f4ng \u0103n s\u1ed1ng th\u1ef1c v\u1eadt th\u1ee7y sinh d\u01b0\u1edbi m\u1ecdi h\u00ecnh + Ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh + Ph\u00f2ng b\u1ec7nh cho l\u1ee3n b\u1eb1ng c\u00e1ch kh\u00f4ng cho l\u1ee3n \u0103n b\u00e8o v\u00e0 rong, r\u00eau s\u1ed1ng. C\u00e2u 17: Tr\u00ecnh b\u00e0y nguy\u00ean t\u1eafc ph\u00f2ng ch\u1ed1ng ti\u1ebft t\u00fac y h\u1ecdc. – Ph\u1ea3i ti\u1ebfn h\u00e0nh ki\u00ean tr\u00ec, l\u00e2u d\u00e0i, th\u01b0\u1eddng xuy\u00ean v\u00e0 li\u00ean t\u1ee5c – Ph\u1ea3i c\u00f3 k\u1ebf ho\u1ea1ch, tr\u1ecdng t\u00e2m v\u00e0 tr\u1ecdng \u0111i\u1ec3m. Ch\u1ecdn l\u1ea1i ti\u1ebft t\u00fac nguy hi\u1ec3m \u0111\u1ec3 ph\u00f2ng ch\u1ed1ng tr\u01b0\u1edbc – D\u1ef1a v\u00e0o sinh th\u00e1i c\u1ee7a ch\u00fang \u0111\u1ec3 ph\u00f2ng ch\u1ed1ng – Ph\u1ea3i k\u1ebft h\u1ee3p t\u1ed5ng h\u1ee3p c\u00e1c bi\u1ec7n ph\u00e1p \u0111\u1ec3 ph\u00f2ng ch\u1ed1ng – Khi c\u00f3 d\u1ecbch kh\u1ea9n c\u1ea5p x\u1ea3y ra ph\u1ea3i d\u00f9ng ph\u01b0\u01a1ng ph\u00e1p ho\u00e1 h\u1ecdc \u0111\u1ec3 di\u1ec7t ti\u1ebft t\u00fac – Ph\u1ea3i ch\u00fa \u00fd \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 kh\u00e1ng ho\u00e1 ch\u1ea5t di\u1ec7t c\u1ee7a c\u00e1c lo\u1ea1i ti\u1ebft t\u00fac C\u00e2u 18: N\u00eau m\u1ed9t s\u1ed1 bi\u1ec7n ph\u00e1p c\u1ee5 th\u1ec3 \u00e1p d\u1ee5ng trong ph\u00f2ng ch\u1ed1ng ti\u1ebft t\u00fac y h\u1ecdc. \u00fc1. Nh\u1eefng bi\u1ec7n ph\u00e1p l\u00e0m gi\u1ea3m sinh s\u1ea3n c\u1ee7a ti\u1ebft t\u00fac – Tri\u1ec7t n\u01a1i sinh \u0111\u1ebb c\u1ee7a ti\u1ebft t\u00fac – Thay \u0111\u1ed5i m\u00f4i tr\u01b0\u1eddng s\u1ed1ng thu\u1eadn l\u1ee3i c\u1ee7a ti\u1ebft t\u00fac – L\u00e0m gi\u1ea3m sinh s\u1ea3n c\u1ee7a ti\u1ebft t\u00fac b\u1eb1ng ho\u00e1 ch\u1ea5t + D\u00f9ng ho\u00e1 ch\u1ea5t t\u1ea1o ra c\u00e1c gi\u1ed1ng \u0111\u1ef1c kh\u00f4ng sinh s\u1ea3n \u0111\u01b0\u1ee3c + D\u00f9ng ho\u00e1 ch\u1ea5t l\u00e0m ti\u1ec7t sinh m\u1ed9t s\u1ed1 ti\u1ebft t\u00fac + D\u00f9ng ph\u01b0\u01a1ng ph\u00e1p lai gh\u00e9p \u0111\u1ec3 t\u1ea1o ra th\u1ebf h\u1ec7 con lai b\u1ecb v\u00f4 sinh ho\u1eb7c kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng truy\u1ec1n b\u1ec7nh. 2. Kh\u1ed1ng ch\u1ebf s\u1ef1 ti\u1ebfp thu m\u1ea7m b\u1ec7nh v\u00e0o ti\u1ebft t\u00fac D\u00f9ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ec3 ph\u00e1t hi\u1ec7n s\u1edbm ng\u01b0\u1eddi b\u1ec7nh v\u00e0 \u0111i\u1ec1u tr\u1ecb tri\u1ec7t \u0111\u1ec3 cho ng\u01b0\u1eddi b\u1ec7nh 3. Kh\u1ed1ng ch\u1ebf s\u1ef1 x\u00e2m nh\u1eadp m\u1ea7m b\u1ec7nh t\u1eeb ti\u1ebft t\u00fac v\u00e0o ng\u01b0\u1eddi – Xua \u0111u\u1ed5i ti\u1ebft t\u00fac, hun kh\u00f3i ch\u1ed1ng mu\u1ed7i, n\u1eb1m m\u00e0n, m\u1eb7c qu\u1ea7n \u00e1o k\u00edn ch\u1ed1ng mu\u1ed7i \u0111\u1ed1t. – D\u00f9ng sinh v\u1eadt l\u00e0m h\u00e0ng r\u00e0o che ch\u1eafn \u0111\u1ec3 ti\u1ebft t\u00fac kh\u00f4ng \u0111\u1ed1t ng\u01b0\u1eddi (tr\u00e2u, b\u00f2, l\u1ee3n) 4. C\u00e1c bi\u1ec7n ph\u00e1p di\u1ec7t ti\u1ebft t\u00fac – Bi\u1ec7n ph\u00e1p ho\u00e1 h\u1ecdc : C\u00e1c ch\u1ea5t Chlo h\u1eefu c\u01a1, c\u00e1c ch\u1ea5t l\u00e2n h\u1eefu c\u01a1. – Bi\u1ec7n ph\u00e1p sinh h\u1ecdc : D\u00f9ng c\u00e1c lo\u1ea1i sinh v\u1eadt \u0103n m\u1ed3i nh\u01b0 c\u00e1 \u0103n b\u1ecd g\u1eady mu\u1ed7i, n\u1ea5m di\u1ec7t b\u1ecd g\u1eady, vi khu\u1ea9n di\u1ec7t b\u1ecd g\u1eady, giun di\u1ec7t b\u1ecd g\u1eady… C\u00e2u 19: Tr\u00ecnh b\u00e0y c\u00e1c nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb b\u1ec7nh n\u1ea5m va\u0300 n\u00eau c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng b\u1ec7nh n\u1ea5m 1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb – Ng\u0103n ng\u1eeba s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a n\u1ea5m : B\u1eb1ng c\u00e1ch l\u00e0m thay \u0111\u1ed5i m\u00f4i tr\u01b0\u1eddng ( ki\u1ec1m ho\u00e1 m\u00f4i tr\u01b0\u1eddng ), l\u00e0m m\u00e1t ch\u1ed7 b\u00e1m c\u1ee7a n\u1ea5m. – K\u1ebft h\u1ee3p vi\u1ec7c ch\u1eefa b\u1ec7nh v\u1edbi vi\u1ec7c ph\u00f2ng ch\u1ed1ng b\u1ec7nh v\u1ec7 sinh th\u00e2n th\u1ec3, qu\u1ea7n \u00e1o, \u0111\u1ed3 d\u00f9ng, d\u1ee5ng c\u1ee5. – S\u1eed d\u1ee5ng thu\u1ed1c v\u00e0 h\u00f3a ch\u1ea5t di\u1ec7t n\u1ea5m. 2. Ph\u00f2ng c\u00e1c b\u1ec7nh do n\u1ea5m – T\u0103ng c\u01b0\u1eddng v\u1ec7 sinh ng\u0103n c\u1ea3n n\u1ea5m x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3 B\u1eb1ng c\u00e1c bi\u1ec7n ph\u00e1p v\u1ec7 sinh chung – Kh\u1ed1ng ch\u1ebf c\u00e1c \u0111\u01b0\u1eddng l\u00e2y lan c\u1ee7a n\u1ea5m Vi\u1ec7c c\u00e1ch ly b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh n\u1ea5m, vi\u1ec7c ti\u1ec7t khu\u1ea9n \u1edf ng\u01b0\u1eddi b\u1ecb b\u1ec7nh n\u1ea5m, s\u1eed l\u00fd c\u00e1c ch\u1ea5t th\u1ea3i c\u1ee7a b\u1ec7nh c\u00f3 t\u00e1c d\u1ee5ng ng\u0103n ng\u1eeba n\u1ea5m l\u00e2y lan t\u1eeb ng\u01b0\u1eddi b\u1ec7nh sang ng\u01b0\u1eddi l\u00e0nh. – Ch\u1ee7 \u0111\u1ed9ng ph\u00f2ng b\u1ec7nh b\u1eb1ng c\u00e1ch \u0111i\u1ec1u tr\u1ecb cho nh\u1eefng ng\u01b0\u1eddi b\u1ecb b\u1ec7nh n\u1ea5m Ph\u00e1t hi\u1ec7n nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh, \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi v\u00e0 tri\u1ec7t \u0111\u1ec3 l\u00e0 bi\u1ec7n ph\u00e1p ch\u1ee7 \u0111\u1ed9ng ng\u0103n ng\u1eeba s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c b\u1ec7nh n\u1ea5m. C\u00e2u 20: Tr\u00ecnh b\u00e0y ph\u01b0\u01a1ng th\u1ee9c nhi\u1ec5m v\u00e0 \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a Larva migrans n\u1ed9i t\u1ea1ng do giun \u0111\u0169a ch\u00f3 m\u00e8o (Toxocara canis, Toxocara cati) B\u1ec7nh c\u1ea3nh do \u1ea5u tr\u00f9ng giun \u0111\u0169a ch\u00f3, m\u00e8o x\u00e2m nh\u1eadp v\u00e0 di chuy\u1ec3n trong c\u00e1c c\u01a1 quan n\u1ed9i t\u1ea1ng. 1. T\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh Th\u01b0\u1eddng l\u00e0 giun \u0111\u0169a k\u00fd sinh trong ru\u1ed9t non c\u1ee7a ch\u00f3 ( Toxocara canis ), m\u00e8o (Toxocara cati ); \u0111\u00f4i khi c\u00f2n c\u00f3 giun \u0111\u0169a c\u1ee7a l\u1ee3n ( ascaris suum suum ), ng\u1ef1a (ascaris equorum ), lo\u00e0i nhai l\u1ea1i ( Neoascarisvitulorum ) Toxocara canis g\u1eb7p \u1edf 80% ch\u00f3 v\u00f9ng nhi\u1ec7t \u0111\u1edbi v\u00e0 17 – 20% ch\u00f3 v\u00f9ng \u00f4n \u0111\u1edbi. Giun tr\u01b0\u1edfng th\u00e0nh s\u1ed1ng trong ru\u1ed9t non ch\u00f3 con d\u01b0\u1edbi 3 – 6 th\u00e1ng tu\u1ed5i; khi ch\u00f3 l\u1edbn h\u01a1n, do c\u01a1 ch\u1ebf mi\u1ec5n d\u1ecbch, giun trong ru\u1ed9t s\u1ebd b\u1ecb \u0111\u1ea9y ra ngo\u00e0i. M\u1ed7i ng\u00e0y giun \u0111\u1ebb kho\u1ea3ng 200.000 tr\u1ee9ng, tr\u1ee9ng giun c\u00f3 th\u1ec3 s\u1ed1ng nhi\u1ec1u th\u00e1ng \u1edf ngo\u1ea1i c\u1ea3nh. Ng\u01b0\u1eddi nhi\u1ec5m tr\u1ee9ng th\u01b0\u1eddng l\u00e0 tr\u1ebb em ch\u01a1i \u0111\u1ea5t, ch\u01a1i v\u1edbi ch\u00f3, ho\u1eb7c ng\u01b0\u1eddi l\u1edbn l\u00e0m nh\u1eefng vi\u1ec7c g\u1ea7n g\u0169i v\u1edbi ch\u00f3. T\u1ea1i ru\u1ed9t non, \u1ea5u tr\u00f9ng giai \u0111o\u1ea1n II chui ra kh\u1ecfi tr\u1ee9ng v\u00e0o v\u00e1ch ru\u1ed9t, theo m\u00e1u l\u00ean gan, ph\u1ed5i, n\u00e3o, tim v.v, s\u1ed1ng \u0111\u01b0\u1ee3c nhi\u1ec1u th\u00e1ng, th\u1eadm ch\u00ed nhi\u1ec1u n\u0103m. N\u1ebfu ch\u00f3 con nu\u1ed1t ch\u1ee9ng giun, m\u1ed9t s\u1ed1 \u1ea5u tr\u00f9ng l\u00ean ph\u1ed5i v\u00e0 ph\u00e1t tri\u1ec3n th\u00e0nh giun tr\u01b0\u1edfng th\u00e0nh \u1edf ru\u1ed9t non, m\u1ed9t s\u1ed1 kh\u00e1c ti\u1ebfp t\u1ee5c \u0111i lang thang trong c\u00e1c c\u01a1 quan n\u1ed9i t\u1ea1ng. Khi ch\u00f3 l\u1edbn l\u00ean v\u00e0 c\u00f3 thai, \u1ea5u tr\u00f9ng chui qua l\u00e0 nhau, nhi\u1ec5m v\u00e0o b\u00e0o thai, ho\u1eb7c v\u00e0o tuy\u1ebfn v\u00fa g\u00e2y nhi\u1ec5m cho ch\u00f3 con khi ch\u00fang b\u00fa m\u1eb9. 2. \u0110\u1eb7c \u0111i\u1ec3m 2.1. D\u1ecbch t\u1ec5 B\u1ec7nh ph\u1ed5 bi\u1ebfn kh\u1eafp n\u01a1i th\u01b0\u1eddng l\u00e0 tr\u1ebb 1 – 4 tu\u1ed5i, trong nh\u00e0 th\u01b0\u1eddng c\u00f3 nu\u00f4i ch\u00f3, m\u00e8o. 2.2. L\u00e2m s\u00e0ng \u1edf tr\u1ebb em, b\u1ec7nh kh\u1edfi ph\u00e1t t\u1eeb t\u1eeb. B\u1ec7nh nh\u00e2n s\u1ed1t nh\u1eb9, tho\u00e1ng qua, \u0103n \u00edt, g\u1ea7y y\u1ebfu, ti\u00eau ch\u1ea3y, bu\u1ed3n n\u00f4n \u00f3i m\u1eeda, \u0111au c\u01a1 v\u00e0 kh\u1edbp, ho kh\u1ea1c ra \u0111\u1eddm c\u00f3 b\u1ea1ch c\u1ea7u toan t\u00ednh, kh\u00f3 th\u1edf d\u1ea1ng suy\u1ec5n , th\u00e2m nhi\u1ec5m ph\u1ed5i,da n\u1ed5i r\u00e1t \u0111\u1ecf ho\u1eb7c m\u1ec1 \u0111ay, h\u1ed3ng ban \u0111a d\u1ea1ng, ph\u00f9 Quinck; gan to, c\u1ee9ng, b\u1ec1 m\u1eb7t nh\u1eb5n, kh\u00f4ng \u0111au, \u0111\u00f4i khi l\u00e1ch h\u01a1i to. B\u1ec7nh c\u00f3 th\u1ec3 t\u1ef1 kh\u1ecfi sau nhi\u1ec1u tu\u1ea7n l\u1ec5 (khi \u1ea5u tr\u00f9ng ch\u1ebft ). \u1edf ng\u01b0\u1eddi l\u1edbn \u0111\u00f4i khi nhi\u1ec5m kh\u00f4ng tri\u1ec7u ch\u1ee9ng, \u0111\u00f4i khi s\u1ed1t nh\u1eb9, m\u1ec7t, n\u1ed5i m\u1ea7m \u0111\u1ecf ng\u1ee9a, kh\u00f3 th\u1edf d\u1ea1ng suy\u1ec5n, c\u00f3 th\u1ec3 gi\u1ea3m th\u1ecb l\u1ef1c m\u1ed9t b\u00ean do vi\u00eam h\u1ea1t \u1edf v\u00f5ng m\u1ea1c ho\u1eb7c vi\u00eam n\u1ed9i nh\u00e3n m\u1ea1n t\u00ednh. 2.3. Ch\u1ea9n \u0111o\u00e1n Tri\u1ec7u ch\u1ee9ng \u0111\u1ecbnh h\u01b0\u1edbng: – B\u1ea1ch c\u1ea7u trong m\u00e1u t\u0103ng \u0111\u1ebfn 10. 000 – 100.000\/ mm3, , trong \u0111\u00f3 b\u1ea1ch c\u1ea7u toan t\u00ednh chi\u1ebfm 50 – 80%. Nh\u01b0ng coi ch\u1eebng b\u1ea1ch c\u1ea7u c\u00f3 th\u1ec3 kh\u00f4ng t\u0103ng trong th\u1ec3 b\u1ec7nh \u1edf m\u1eaft. – Globulines t\u0103ng h\u01a1n b\u00ecnh th\u01b0\u1eddng 10 – 15 l\u1ea7n, nh\u1ea5t l\u00e0 IgE v\u00e0 IgG Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh: – Sinh thi\u1ebft gan c\u00f3 th\u1ec3 cho th\u1ea5y \u1ea5u tr\u00f9ng n\u1eb1m gi\u1eefa m\u1ed9t v\u00f9ng ho\u1ea1i t\u1eed, chung quanh l\u00e0 nh\u1eefng t\u1ebf b\u00e0o gi\u1ea3 th\u01b0\u1ee3ng b\u00ec, t\u1ebf b\u00e0o kh\u1ed5ng l\u1ed3, b\u1ea1ch c\u1ea7u toan t\u00ednh v\u00e0 t\u01b0\u01a1ng b\u00e0o ch\u1ec9 c\u00f3 gi\u00e1 tr\u1ecb trong 20% c\u00e1c tr\u01b0\u1eddng h\u1ee3p. – C\u00e1c k\u1ef9 thu\u1eadt c\u1ed1 \u0111\u1ecbnh b\u1ed5 th\u1ec3, ng\u01b0ng k\u1ebft h\u1ed3ng c\u1ea7u, mi\u1ec5n d\u1ecbch khu\u1ebfch t\u00e1n, mi\u1ec5n d\u1ecbch \u0111i\u1ec7n di, mi\u1ec5n d\u1ecbch hu\u1ef3nh quang c\u00f3 gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n \u00edt nhi\u1ec1u tu\u1ef3 theo ch\u1ea5t l\u01b0\u1ee3ng c\u1ee7a kh\u00e1ng nguy\u00ean. Th\u01b0\u1eddng c\u00f3 r\u1ea5t nhi\u1ec1u ph\u1ea3n \u1ee9ng ch\u00e9o. – Hi\u1ec7n nay kh\u00e1ng nguy\u00ean ngo\u1ea1i ti\u1ebft – ph\u00e2n ti\u1ebft ( Toxocara excretory – secretory antigen ) v\u00e0 mi\u1ec5n d\u1ecbch men ELISA cho k\u1ebft qu\u1ea3 \u0111\u1eb7c hi\u1ec7u h\u01a1n. – \u0110\u00e1p \u1ee9ng t\u1ed1t v\u1edbi \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u c\u0169ng l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ti\u1ec7n ch\u1ea9n \u0111o\u00e1n khi kh\u00f4ng c\u00f3 mi\u1ec5n d\u1ecbch h\u1ecdc. \u0110i\u1ec1u tr\u1ecb – Thiabendazole (Mintezol) 50mg\/ kg\/ ng\u00e0y trong 7 – 10 ng\u00e0y ho\u1eb7c diethylcarbamazinne ( Notezin ) 6 mg \/ kg \/ ng\u00e0y trong 3 tu\u1ea7n l\u00e0m gi\u1ea3m tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng trong 50% c\u00e1c tr\u01b0\u1eddng h\u1ee3p. – Albendazole ( Zenten ) 2 vi\u00ean 200 mg\/ ng\u00e0y trong 3 ng\u00e0y. – Corticoides hay thu\u1ed1c kh\u00e1ng histamin c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng v\u00e0o bu\u1ed5i chi\u1ec1u cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f3 th\u1edf nhi\u1ec1u, vi\u00eam n\u1eb7ng. D\u1ef1 ph\u00f2ng – Kh\u00f4ng cho tr\u1ebb ch\u01a1i v\u1edbi ch\u00f3, nh\u1ea5t l\u00e0 ch\u00f3 con; theo d\u00f5i s\u1ef1 s\u1ea1ch s\u1ebd c\u1ee7a b\u00e0n tay, ch\u1ed1ng m\u1ecdi h\u00e0nh \u0111\u1ed9ng nu\u1ed1t \u0111\u1ea5t c\u1ee7a tr\u1ebb. – C\u1ea5m th\u1ea3 ch\u00f3 ra c\u00f4ng vi\u00ean, b\u00e3i c\u00e1t, v\u01b0\u1eddn. \u0110\u1ecbnh k\u1ef3 x\u1ed5 giun cho ch\u00f3 con v\u00e0 ch\u00f3 c\u00f3 thai. C\u00e2u 21: Tri\u0300nh ba\u0300y chu ky\u0300 ph\u00e1t tri\u1ec3n c\u1ee7a giun xo\u1eafn (Trichinella spiralis) K\u00e9n \u1ea5u tr\u00f9ng s\u1ed1ng trong c\u01a1 c\u1ee7a v\u1eadt ch\u1ee7 1 (l\u1ee3n, chu\u1ed9t) \u0111\u01b0\u1ee3c nu\u1ed1t v\u00e0o \u1ed1ng ti\u00eau h\u00f3a c\u1ee7a v\u1eadt ch\u1ee7 hai. D\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a d\u1ecbch v\u1ecb, k\u00e9n v\u1ee1, gi\u1ea3i ph\u00f3ng ra \u1ea5u tr\u00f9ng. \u1ea4u tr\u00f9ng ph\u00e1t tri\u1ec3n th\u00e0nh giun tr\u01b0\u1edfng th\u00e0nh, k\u00ed sinh \u1edf th\u00e0nh c\u1ee7a \u0111o\u1ea1n ru\u1ed9t non \u1edf chu\u1ed9t, l\u1ee3n, c\u1ea7y, c\u00e1o, h\u1ed5, g\u1ea5y, b\u00e1o\u2026 v\u00e0 ng\u01b0\u1eddi (v\u1eadt ch\u1ee7ng 2). Giun c\u00e1i \u0111\u1ebb ra \u1ea5u tr\u00f9ng. Trung b\u00ecnh m\u1ed9t giun c\u00e1i \u0111\u1ebb ra 100 \u2013 1500 \u1ea5u tr\u00f9ng trong th\u1eddi gian 3 \u2013 16 tu\u1ea7n k\u00ed sinh tr\u00f9ng \u1edf ru\u1ed9t non. Sau 5 \u2013 7 ng\u00e0y (k\u1ec3 t\u1eeb khi nu\u1ed1t ph\u1ea3i k\u00e9n) \u1ea5u tr\u00f9ng v\u00e0o m\u00e1u v\u00e0 b\u1ea1ch huy\u1ebft. T\u1eeb ng\u00e0y th\u1ee9 t\u00e1m, \u1ea5u tr\u00f9ng chui v\u00e0o c\u01a1 th\u1ec3, th\u01b0\u1eddng l\u00e0 c\u00e1c c\u01a1 v\u00e2n nh\u01b0 c\u01a1 ho\u00e0nh, c\u01a1 nhai, c\u01a1 li\u00ean s\u01b0\u1eddn, c\u01a1 than qu\u1ea3n, c\u01a1 l\u01b0\u1ee1i, c\u01a1 v\u1eadn nh\u00e3n, c\u01a1 g\u00e1y, c\u01a1 ng\u1ef1c, c\u01a1 delta, c\u01a1 m\u00f4ng\u2026T\u1ea1i t\u1ed5 ch\u1ee9c c\u01a1, \u1ea5u tr\u00f9ng ph\u00e1t tri\u1ec3n th\u00e0nh h\u00ecnh d\u1ea5u ph\u1ea9y, sau \u0111\u00f3 cu\u1ed9n tr\u00f2n l\u1ea1i v\u00e0 t\u1edbi ng\u00e0y th\u1ee9 23 t\u1ea1o th\u00e0nh k\u00e9n. T\u1edbi th\u00e1ng 6 k\u00e9n b\u1ecb v\u00f4i h\u00f3a, \u1ea5u tr\u00f9ng \u1edf b\u00ean trong kh\u00f4ng ph\u00e1t tri\u1ec3n nh\u01b0ng s\u1ed1ng \u0111\u01b0\u1ee3c r\u1ea5t l\u00e2u, c\u00f3 tr\u01b0\u1eddng h\u1ee3p t\u1edbi 30 n\u0103m. Nh\u1eefng k\u00e9n c\u00f3 \u1ea5u tr\u00f9ng c\u00f2n s\u1ed1ng l\u1ea1i ti\u1ebfp t\u1ee5c b\u1ecb nu\u1ed1t v\u00e0o \u0111\u01b0\u1eddng ti\u00eau h\u00f3a c\u1ee7a v\u1eadt ch\u1ee7 2 v\u00e0 chu tr\u00ecnh c\u1ee9 th\u1ec3 x\u1ea3y ra. Do giun c\u00e1i tr\u01b0\u1edfng th\u00e0nh c\u00f3 th\u1ec3 k\u00ed sinh \u1edf ni\u00eam m\u1ea1c ru\u1ed9t non t\u1eeb 3 \u2013 16 tu\u1ea7n n\u00ean qu\u00e1 tr\u00ecn b\u1ec7nh l\u00ed c\u0169ng ph\u1ea3i sau 3 \u2013 16 tu\u1ea7n m\u1edbi b\u1ecb v\u00f4i h\u00f3a n\u00ean qu\u00e1 tr\u00ecnh b\u1ec7nh l\u00ed c\u0169ng ph\u1ea3i sau 6 th\u00e1ng m\u1edbi ph\u1ee5c h\u1ed3i ho\u00e0n to\u00e0n. C\u00e2u 22: Tri\u0300nh ba\u0300y chu ky\u0300 ph\u00e1t tri\u1ec3n c\u1ee7a giun l\u01b0\u01a1n (Strongyloides stercoralis) Chu k\u1ef3 b\u00ecnh th\u01b0\u1eddng c\u1ee7a giun l\u01b0\u01a1n Chu k\u1ef3 giun l\u01b0\u01a1n g\u1ed3m giai \u0111o\u1ea1n k\u00fd sinh v\u00e0 giai \u0111o\u1ea1n t\u1ef1 do \u1edf ngo\u1ea1i c\u1ea3nh. Giun l\u01b0\u01a1n k\u00fd sinh trong ni\u00eam m\u1ea1c ru\u1ed9t non. Dinh d\u01b0\u1ee1ng c\u1ee7a giun l\u01b0\u01a1n l\u00e0 \u0103n c\u00e1c sinh ch\u1ea5t \u1edf ru\u1ed9t. Giun c\u00e1i \u0111\u1ebb tr\u1ee9ng. Tr\u1ee9ng n\u1edf th\u00e0nh \u1ea5u tr\u00f9ng trong l\u00f2ng ru\u1ed9t r\u1ed3i theo ph\u00e2n ra ngo\u00e0i. Ra ngo\u1ea1i c\u1ea3nh, g\u1eb7p \u0111i\u1ec1u ki\u1ec7n nhi\u1ec7t \u0111\u1ed9, \u1ea9m \u0111\u1ed9 th\u00edch h\u1ee3p v\u00e0 s\u1ef1 c\u00f3 m\u1eb7t c\u1ee7a oxy, \u1ea5u tr\u00f9ng ti\u1ebfp t\u1ee5c ph\u00e1t tri\u1ec3n th\u00e0nh \u1ea5u tr\u00f9ng c\u00f3 th\u1ef1c qu\u1ea3n h\u00ecnh tr\u1ee5. \u1ea4u tr\u00f9ng n\u00e0y c\u00f3 kh\u1ea3 n\u0103ng x\u00e2m nh\u1eadp qua da v\u00e0o ng\u01b0\u1eddi \u0111\u1ec3 th\u00e0nh giun \u1edf th\u00e0nh k\u00fd sinh \u1edf ng\u01b0\u1eddi ho\u1eb7c \u1ea5u tr\u00f9ng c\u00f3 th\u1ec3 ph\u00e1t tri\u1ec3n th\u00e0nh giun tr\u01b0\u1edfng th\u00e0nh s\u1ed1ng t\u1ef1 do \u1edf ngo\u1ea1i c\u1ea3nh.Khi x\u00e2m nh\u1eadp qua da v\u00e0o ng\u01b0\u1eddi, \u1ea5u tr\u00f9ng giun l\u01b0\u01a1n theo \u0111\u01b0\u01a1ng t\u0129nh m\u1ea1ch v\u1ec1 tim ph\u1ea3i. T\u1eeb tim ph\u1ea3i, \u1ea5u tr\u00f9ng theo \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i \u0111\u1ec3 t\u1ed1i ph\u1ed5i. Sau m\u1ed9t th\u1eddi gian ph\u00e1t tri\u1ec3n \u1edf ph\u1ed5i, \u1ea5u tr\u00f9ng theo c\u00e1c nh\u00e1nh ph\u1ebf qu\u1ea3n t\u1edbi kh\u00ed qu\u1ea3n r\u1ed3i l\u00ean h\u1ea7u, \u0111\u01b0\u1ee3c nu\u1ed1t xu\u1ed1ng \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u00e0 d\u1eebng l\u1ea1i \u1edf ru\u1ed9t non \u0111\u1ec3 ph\u00e1t tri\u1ec3n th\u00e0nh giun l\u01b0\u01a1n \u1edf th\u00e0nh. Nh\u01b0 v\u1eady, v\u1edbi th\u1ebf h\u1ec7 k\u00fd sinh \u1edf ng\u01b0\u1eddi, giun l\u01b0\u01a1n c\u00f3 chu k\u1ef3 g\u1ea7n gi\u1ed1ng v\u1edbi chu k\u1ef3 c\u1ee7a giun m\u00f3c\/m\u1edf.Trong tr\u01b0\u00f2ng h\u1ee3p kh\u00f4ng g\u1eb7p \u0111\u01b0\u1ee3c v\u1eadt ch\u1ee7 l\u00e0 ng\u01b0\u1eddi, \u1ea5u tr\u00f9ng giun l\u01b0\u01a1n s\u1ebd ph\u00e1t tri\u1ec3n \u1edf ngo\u1ea1i c\u1ea3nh \u0111\u1ec3 tr\u1edf th\u00e0nh giun l\u01b0\u01a1n \u0111\u1ef1c, c\u00e1i \u1edf th\u00e0nh s\u1ed1ng t\u1ef1 do \u1edf ngo\u1ea1i c\u1ea3nh, dinh d\u01b0\u1ee1ng b\u1eb1ng c\u00e1c ch\u1ea5t h\u1eefu c\u01a1 c\u00f3 trong m\u00f9n, \u0111\u1ea5t \u0111\u1ec3 ti\u1ebfp t\u1ee5c sinh s\u00f4i, n\u1ea3y n\u1edf th\u1ebf h\u1ec7 t\u1ef1 do m\u1edbi \u1edf ngo\u1ea1i c\u1ea3nh. Chu k\u1ef3 b\u1ea5t th\u01b0\u1eddng c\u1ee7a giun l\u01b0\u01a1nTrong m\u1ed9t s\u1ed1 \u0111i\u1ec1u ki\u1ec7n nh\u1ea5t \u0111\u1ecbnh nh\u01b0 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c k\u00e9m \u1ea5u tr\u00f9ng giun l\u01b0\u01a1n tr\u00fa l\u1ea1i quanh h\u1eadu m\u00f4n chuy\u1ec3n d\u1ea1ng th\u00e0nh \u1ea5u tr\u00f9ng c\u00f3 th\u1ef1c qu\u1ea3n h\u00ecnh tr\u1ee5 r\u1ed3i g\u00e2y t\u00e1i nhi\u1ec5m ngay cho b\u1ec7nh nh\u00e2n.Khi \u1edf ru\u1ed9t, giun l\u01b0\u01a1n th\u01b0\u1eddng \u1edf ni\u00eam m\u1ea1c t\u00e1 tr\u1eb1ng, nh\u01b0ng ch\u1ee7 y\u1ebfu \u1edf ru\u1ed9t non, nh\u01b0ng c\u0169ng c\u00f3 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p giun l\u01b0\u01a1n k\u00fd sinh b\u1ea5t th\u01b0\u1eddng \u1edf th\u1ef1c qu\u1ea3n, \u1edf ph\u1ed5i, \u1edf h\u1ea1ch b\u1ea1ch huy\u1ebft, \u1edf gan (Torres). C\u00f2n c\u00f3 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm h\u01a1n l\u00e0 giun l\u01b0\u01a1n \u1edf trong c\u01a1 tim (Spindler). C\u00e2u 23: N\u00eau ca\u0301c thu\u00f4\u0301c \u0111i\u00ea\u0300u tri\u0323 giun sa\u0301n va\u0300 \u0111\u01a1n ba\u0300o \u0111\u01b0\u01a1\u0300ng ru\u00f4\u0323t g\u00e2y b\u00ea\u0323nh. Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb giun 1. Piperazin, hexahydrat 2. Levamisole 3. Mebendazole 4. Albendazole 5. Pyrantel 6. Thiabendazole 7. Diethylcarbamazin Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb s\u00e1n 1. Mebendazole 2. Albendazole 3. Niclosamid 4. Praziquantel 5. Triclabendazole Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u01a1n b\u00e0o \u0111\u01b0\u1eddng ru\u1ed9t Tinidazol, metronidazol, quinacrin ho\u1eb7c Furazolidon, omidazol, secnidazol Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb amip \u1edf t\u1ed5 ch\u1ee9c 1. Flagyl (metronidazole) 2. Tinadazol 3. Flagenty Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb amip do ti\u1ebfp x\u00fac 1. Bemarsal 2. Humatin C\u00e2u 24: M\u00f4 t\u1ea3 \u0111\u1eb7c \u0111i\u1ec3m sinh h\u1ecdc v\u00e0 chu k\u1ef3 c\u1ee7a Entamoeba histolytica v Amip l\u1ef5 c\u00f3 3 d\u1ea1ng t\u1ed3n t\u1ea1i nh\u01b0 sau: – Th\u1ec3 ho\u1ea1t \u0111\u1ed9ng \u0103n h\u1ed3ng c\u1ea7u (th\u1ec3 Manga). + K\u00edch th\u01b0\u1edbc 20- 40 , di chuy\u1ec3n nhanh theo 1 h\u01b0\u1edbng nh\u1ea5t \u0111\u1ecbnh. + C\u1ea5u t\u1ea1o g\u1ed3m n\u1ed9i nguy\u00ean sinh ch\u1ea5t v\u00e0 ngo\u1ea1i nguy\u00ean sinh ch\u1ea5t . Trong n\u1ed9i nguy\u00ean sinh ch\u1ea5t ch\u1ee9a nh\u00e2n v\u00e0 h\u1ed3ng c\u1ea7u do amip l\u1ef5 \u0103n v\u00e0o. + \u0110\u00e2y l\u00e0 th\u1ec3 g\u00e2y b\u1ec7nh v\u00e0 th\u01b0\u1eddng \u0111c t\u00ecm th\u1ea5y trong ph\u00e2n ng\u01b0\u1eddi b\u1ecb b\u1ec7nh amip l\u1ef5 c\u1ea5p t\u00ednh – Th\u1ec3 ho\u1ea1t \u0111\u1ed9ng nh\u1ecf kh\u00f4ng \u0103n h\u1ed3ng c\u1ea7u v\u00e0 kh\u00f4ng g\u00e2y b\u1ec7nh (th\u1ec3 Minuta). + K\u00edch th\u01b0\u1edbc 10-12 , th\u1ec3 Minuta kh\u00f4ng \u0103n h\u1ed3ng c\u1ea7u, th\u1ec3 n\u00e0y s\u1ed1ng h\u1ed9i sinh trong long ru\u1ed9t + Th\u1ec3 Minuta \u0111c t\u00ecm th\u1ea5y trong ph\u00e2n c\u1ee7a ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng. – Th\u1ec3 b\u00e0o nang hay th\u1ec3 k\u00e9n c\u1ee7a Amip. + K\u00edch th\u01b0\u1edbc 10-12 , b\u00e0o nang c\u00f3 1 ho\u1eb7c 2 nh\u00e2n. B\u00e0o nang gi\u00e0 c\u00f3 4 nh\u00e2n l\u00e0 th\u1ec3 l\u00e2y nhi\u1ec5m b\u1ec7nh + B\u00e0o nang \u0111c t\u00ecm th\u1ea5y trong c\u1ee7a ng b\u1ecb b\u1ec7nh l\u1ef5 amip m\u00e3n t\u00ednh ho\u1eb7c ng b\u00ecnh th\u01b0\u1eddng. c\u00f2n th\u1ec3 b\u00e0o nang 4 nh\u00e2n th\u01b0\u1eddng t\u00ecm th\u1ea5y trong ph\u00e2n kh\u00f4 v\u00e0 th\u00e0nh khu\u00f4n, kh\u00f4ng c\u00f3 trong ph\u00e2n l\u1ecfng v\u00e0 ph\u00e2n c\u00f3 m\u00e1u m\u0169. v Chu k\u00ec sinh s\u1ea3n c\u1ee7a Entamoe Histolytaca: Trong ru\u1ed9t ng th\u00ec amip c\u00f3 2 ki\u1ec3u chu k\u1ef3: – Chu k\u00ec h\u1ed9i sinh: B\u00e0o nang gi\u00e0 amip v\u00e0o ru\u1ed9t non ng\u01b0\u1eddi, d\u01b0\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a men trypsin , b\u00e0o nang gi\u00e0 n\u1ee9t v\u1ecf k\u00e9n -> gi\u1ea3i ph\u00f3ng ra th\u1ec3 xu\u1ea5t k\u00e9n (th\u1ec3 amip c\u00f3 4 nh\u00e2n). Sau \u0111\u00f3, th\u1ec3 xu\u1ea5t k\u00e9n xu\u1ed1ng manh tr\u00e0ng chia th\u00e0nh 8 th\u1ec3 Minuta (m\u1ed7i th\u1ec3 minuta c\u00f3 1 nh\u00e2n), th\u1ec3 n\u00e0y s\u1ed1ng h\u1ed9i sinh trong ru\u1ed9t v\u00e0 kh\u00f4ng g\u00e2y b\u1ec7nh<\/p>\n
Khi amip xu\u1ed1ng \u0111\u1ea1i tr\u00e0ng, g\u1eb7p ph\u00e2n kh\u00f4 d\u1ea7n, amip s\u1ebd co l\u1ea1i tr\u1edf th\u00e0nh b\u00e0o nang v\u00e0 ra ngo\u00e0i theo ph\u00e2n. N\u1ebfu ng \u0103n ph\u1ea3i b\u00e0o nang l\u1ea1i ti\u1ebfp t\u1ee5c c\u00f3 chu k\u00ec nh\u01b0 tr\u00ean<\/p>\n
– Chu k\u00ec g\u00e2y b\u1ec7nh:<\/p>\n
Khi s\u1ee9c \u0111\u1ec1 kh\u00e1ng c\u1ee7a c\u01a1 th\u1ec3 ng\u01b0\u1eddi gi\u1ea3m, th\u00e0nh ru\u1ed9t b\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u00ec th\u1ec3 minuta s\u1ebd chuy\u1ec3n th\u00e0nh th\u1ec3 manga (th\u1ec3 ho\u1ea1t \u0111\u1ed9ng \u0103n h\u1ed3ng c\u1ea7u) => men do amip ti\u1ebft ra s\u1ebd ph\u00e1 h\u1ee7y ni\u00eam m\u1ea1c ru\u1ed9t, amip chui v\u00e0o th\u00e0nh ru\u1ed9t l\u00e0m t\u1ed5n th\u01b0\u01a1ng c\u00e1c mao m\u1ea1ch g\u00e2y ch\u1ea3y m\u00e1u, m\u00e1u \u0111\u00f4ng c\u1ee5c s\u1ebd l\u00e0m t\u1eafc ngh\u1ebdn mao m\u1ea1ch l\u00e0m cho c\u00e1c t\u1ebf b\u00e0o xung quanh b\u1ecb ho\u1ea1i t\u1eed, c\u00e1c vi khu\u1ea9n s\u1ebd ph\u00e1t tri\u1ec3n c\u00e1c \u1ed5 \u00e1p xe trong th\u00e0nh ru\u1ed9t, \u00e1p xe v\u1ee1 -> ch\u1ea3y m\u1ee7, \u0111\u1ec3 l\u1ea1i c\u00e1c v\u00e9t lo\u00e9t \u1edf th\u00e0nh ru\u1ed9t.<\/p>\n
Trong \u1ed5 lo\u00e9t r\u1ea5t nhi\u1ec1u ch\u1ea5t dinh d\u01b0\u1ee1ng do \u0111\u00f3 amip ph\u00e1t tri\u1ec3n, sinh s\u1ea3n nhanh v\u00e0 h\u0111 m\u1ea1nh \u0111\u00f3 ch\u00ednh l\u00e0 th\u1ec3 h\u0111 l\u1edbn, \u0103n h\u1ed3ng c\u1ea7u g\u00e2y ra b\u1ec7nh l\u1ef5 c\u1ea5p t\u00ednh (th\u1ec3 Manga) . C\u00e1c v\u1ebft lo\u00e9t l\u00e2u ng\u00e0y c\u00f3 th\u1ec3 t\u1ea1o th\u00e0nh s\u1eb9o s\u01a1, s\u1eb9o l\u1ed3i t\u1ea1o th\u00e0nh c\u00e1c u \u1edf ru\u1ed9t.<\/p>\n
N\u1ebfu g\u1eb7p \u0111i\u1ec1u ki\u1ec7n kh\u00f4ng thu\u1eadn l\u1ee3i th\u00ec th\u1ec3 manga chuy\u1ec3n v\u1ec1 d\u1ea1ng ti\u1ec3u th\u1ec3 v\u00e0 b\u00e0o nang r\u1ed3i ra ngo\u00e0i theo ph\u00e2n. C\u0169ng c\u00f3 tr\u01b0\u1eddng h\u1ee3p th\u1ec3 ho\u1ea1t \u0111\u1ed9ng b\u1ecb \u0111\u00e0o th\u1ea3i n\u00ean x\u00e9t nghi\u1ec7m ph\u00e2n th\u1ea5y th\u1ec3 ho\u1ea1t \u0111\u1ed9ng.<\/p>\n
N\u1ebfu amip l\u1ecdt v\u00e0o c\u00e1c th\u00e0nh m\u1ea1ch b\u1ecb v\u1ee1 s\u1ebd theo m\u00e1u v\u00e0o gan v\u00e0 c\u00e1c t\u1ea1ng kh\u00e1c g\u00e2y b\u1ec7nh amip ngo\u00e0i \u0111\u1ea1i tr\u00e0ng<\/p>\n
C\u00e2u 25: L\u00fd gi\u1ea3i c\u00e1c t\u00e1c h\u1ea1i v\u00e0 bi\u1ebfn ch\u1ee9ng c\u1ee7a b\u1ec7nh b\u1ec7nh amip<\/p>\n
C\u01a1 ch\u1ebf b\u1ec7nh sinh<\/p>\n
K\u00e9n amip qua th\u1ee9c \u0103n, n\u01b0\u1edbc u\u1ed1ng… x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3 ng\u01b0\u1eddi qua \u0111\u01b0\u1eddng ti\u00eau ho\u00e1. Khi t\u1edbi d\u1ea1 d\u00e0y, nh\u1edd t\u00e1c d\u1ee5ng c\u1ee7a d\u1ecbch v\u1ecb ph\u00e1 v\u1ee1 v\u1ecf, b\u1ed1n nh\u00e2n trong k\u00e9n \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng ph\u00e1t tri\u1ec3n th\u00e0nh 4 amip nh\u1ecf (forma minuta) sau \u0111\u00f3 ch\u00fang di chuy\u1ec3n xu\u1ed1ng c\u01b0 tr\u00fa \u1edf h\u1ed3i manh tr\u00e0ng l\u00e0 n\u01a1i gi\u00e0u ch\u1ea5t dinh d\u01b0\u1ee1ng, pH th\u00edch h\u1ee3p v\u00e0 c\u00f3 nhi\u1ec1u vi khu\u1ea9n c\u1ed9ng sinh. B\u00ecnh th\u01b0\u1eddng amip nh\u1ecf kh\u00f4ng x\u00e2m nh\u1eadp \u0111\u01b0\u1ee3c v\u00e0o th\u00e0nh ru\u1ed9t \u0111\u1ec3 g\u00e2y b\u1ec7nh m\u00e0 theo ph\u00e2n xu\u1ed1ng \u0111\u1ea1i tr\u00e0ng th\u1ea3i ra ngo\u00e0i. M\u1ed9t s\u1ed1 amip nh\u1ecf co l\u1ea1i th\u00e0nh k\u00e9n v\u00e0 c\u0169ng \u0111\u01b0\u1ee3c th\u1ea3i theo ph\u00e2n ra ngo\u00e0i l\u00e0 nguy c\u01a1 l\u00e2y lan cho ng\u01b0\u1eddi kh\u00e1c.<\/p>\n
Khi th\u00e0nh ru\u1ed9t b\u1ecb t\u1ed5n th\u01b0\u01a1ng (do vi khu\u1ea9n kh\u00e1c ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng) amip nh\u1ecf m\u1edbi t\u1ea5n c\u00f4ng \u0111\u01b0\u1ee3c v\u00e0o th\u00e0nh ru\u1ed9t, sinh s\u1ea3n t\u1ea1i \u0111\u00f3 v\u00e0 ti\u1ebft ra c\u00e1c men ti\u00eau protein d\u1eabn \u0111\u1ebfn ho\u1ea1i t\u1eed t\u1ebf b\u00e0o ni\u00eam m\u1ea1c ru\u1ed9t. T\u1ea1i th\u00e0nh ru\u1ed9t, l\u00fac \u0111\u1ea7u amip g\u00e2y ra nh\u1eefng \u0111i\u1ec3m xung huy\u1ebft \u1edf ni\u00eam m\u1ea1c, sau \u0111\u00f3 t\u1ea1o n\u00ean c\u00e1c c\u1ee5c nh\u1ecf tr\u00ean m\u1eb7t ni\u00eam m\u1ea1c r\u1ed3i d\u1ea7n d\u1ea7n ho\u1ea1i t\u1eed v\u00e0 t\u1ea1o th\u00e0nh nh\u1eefng v\u1ebft lo\u00e9t. C\u00e1c v\u1ebft lo\u00e9t c\u00f3 th\u1ec3 r\u1ed9ng t\u1edbi 2-2,5cm, xung quanh b\u1edd c\u01b0\u01a1ng t\u1ee5, ph\u00f9 n\u1ec1 v\u00e0 xung huy\u1ebft. \u0110\u00e1y v\u1ebft lo\u00e9t s\u00e2u t\u1edbi l\u1edbp h\u1ea1 ni\u00eam m\u1ea1c v\u00e0 ph\u1ee7 b\u1edfi l\u1edbp m\u1ee7. Nh\u1eefng v\u1ebft lo\u00e9t g\u1ea7n nhau c\u00f3 th\u1ec3 th\u00f4ng v\u1edbi nhau t\u1ea1o th\u00e0nh v\u1ebft lo\u00e9t l\u1edbn h\u01a1n, s\u00e2u t\u1edbi l\u1edbp c\u01a1 v\u00e0 c\u00f9ng v\u1edbi c\u00e1c vi khu\u1ea9n t\u1ea1o n\u00ean c\u00e1c \u1ed5 \u00e1p xe s\u00e2u, c\u00f3 th\u1ec3 g\u00e2y th\u1ee7ng ru\u1ed9t v\u00e0 vi\u00eam ph\u00fac m\u1ea1c m\u1ee7. Amip c\u00f2n t\u1ea1o n\u00ean c\u00e1c u h\u1ea1t \u1edf th\u00e0nh ru\u1ed9t \u0111\u00f4i khi r\u1ea5t kh\u00f3 ph\u00e2n bi\u1ec7t v\u1edbi ung th\u01b0 \u0111\u1ea1i tr\u00e0ng.<\/p>\n
Khi c\u00e1c v\u1ebft lo\u00e9t g\u00e2y t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u th\u00e0nh ru\u1ed9t, amip c\u00f3 th\u1ec3 th\u00e2m nh\u1eadp v\u00e0o m\u00e1u v\u00e0 theo d\u00f2ng m\u00e1u \u0111i kh\u1eafp c\u01a1 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng c\u00e1c c\u01a1 quan kh\u00e1c ngo\u00e0i ru\u1ed9t nh\u01b0 gan, ph\u1ed5i, n\u00e3o v.v.. T\u1ea1i \u0111\u00e2y amip c\u00f3 th\u1ec3 t\u1ea1o th\u00e0nh c\u00e1c \u1ed5 \u00e1p xe.<\/p>\n
Bi\u1ebfn ch\u1ee9ng<\/p>\n
T\u1ea1i ru\u1ed9t<\/p>\n
Th\u1ee7ng ru\u1ed9t g\u00e2y vi\u00eam ph\u00fac m\u1ea1c, c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf th\u1ec3 trung b\u00ecnh hay th\u1ec3 n\u1eb7ng, b\u1ec7nh nh\u00e2n s\u1ed1t cao , \u0111au b\u1ee5ng d\u1eef d\u1ed9i, co c\u1ee9ng th\u00e0nh b\u1ee5ng.<\/p>\n
Xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a: do t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u, \u0111\u00f4i khi r\u1ea5t tr\u1ea7m tr\u1ecdng, \u0111\u00f2i h\u1ecfi ph\u1ea3i chuy\u1ec1n m\u00e1u v\u00e0 d\u00f9ng c\u00e1c thu\u1ed1c ch\u1ed1ng amip c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t.<\/p>\n
U amip, t\u1eafc ru\u1ed9t, l\u1ed3ng ru\u1ed9t, xo\u1eafn ru\u1ed9t do u.<\/p>\n
Vi\u00eam \u0111\u1ea1i tr\u00e0ng ho\u1ea1i t\u1eed.<\/p>\n
Sa tr\u1ef1c tr\u00e0ng.<\/p>\n
Ngo\u00e0i ru\u1ed9t<\/p>\n
Abces gan: giai \u0111o\u1ea1n \u0111\u1ea7u l\u00e0 vi\u00eam gan n\u1ebfu kh\u00f4ng \u0111i\u1ec1u tr\u1ecb th\u00ec chuy\u1ec3n sang abces gan.<\/p>\n
Amip ph\u1ed5i, m\u00e0ng ph\u1ed5i: amip t\u1eeb gan qua c\u01a1 ho\u00e0nh, c\u00f3 th\u1ec3 qua \u0111\u01b0\u1eddng m\u00e1u hay b\u1ea1ch m\u1ea1ch. L\u00e2m s\u00e0ng th\u01b0\u1eddng g\u1eb7p:<\/p>\n
Vi\u00eam \u0111\u00e1y ph\u1ed5i ph\u1ea3i c\u1ea5p hay b\u00e1n c\u1ea5p .<\/p>\n
Abces ph\u1ed5i r\u1ed3i th\u00f4ng v\u00e0o ph\u1ebf qu\u1ea3n g\u00e2y kh\u1ea1c \u1ed9c m\u1ee7 \u2026 ph\u1ea3n \u1ee9ng m\u00e0ng ph\u1ed5i, tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i.<\/p>\n
T\u1ed5n th\u01b0\u01a1ng ngo\u1ea1i t\u00e2m m\u1ea1c<\/p>\n
Do v\u1ee1 m\u1ee7 abces gan v\u00e0o m\u00e0ng tim.<\/p>\n
Vi\u00eam ngo\u1ea1i t\u00e2m m\u1ea1c ph\u1ea3n \u1ee9ng hay c\u00f3 m\u1ee7.<\/p>\n
B\u1ec7nh amip n\u00e3o<\/p>\n
B\u1ec7nh amip l\u00e1ch:<\/p>\n
Vi\u00eam quanh l\u00e1ch t\u01b0\u01a1ng \u1ee9ng v\u1edbi t\u1ed5n th\u01b0\u01a1ng amip \u1edf g\u00f3c \u0111\u1ea1i tr\u00e0ng tr\u00e1i.<\/p>\n
B\u1ec7nh amip da : xu\u1ea5t ph\u00e1t t\u1eeb 1 b\u1ec7nh amip ru\u1ed9t ho\u1eb7c gan .<\/p>\n
Quanh h\u1eadu m\u00f4n: v\u1ebft l\u00f3et n\u1ed5i g\u1edd, \u0111\u00e1y b\u1ea9n, ch\u1ee9a nhi\u1ec1u ch\u1ea5t ho\u1ea1i t\u1eed.<\/p>\n
Quanh c\u00e1c v\u1ebft m\u1ed5 abces gan hay m\u00e0ng ph\u1ed5i do amip.<\/p>\n
B\u1ec7nh amip sinh d\u1ee5c- ti\u1ebft ni\u1ec7u<\/p>\n
Vi\u00eam b\u00e0ng quang, abces quanh th\u1eadn do amip t\u1eeb gan \u0111\u1ebfn , b\u1ec7nh amip d\u01b0\u01a1ng v\u1eadt, \u00e2 m \u0111 \u1ea1 o, t\u1eed cung.<\/p>\n
C\u00e2u 26: Ch\u1ec9 \u0111\u1ecbnh c\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n b\u1ec7nh amip ru\u1ed9t v\u00e0 ngo\u00e0i ru\u1ed9t.<\/p>\n
+ X\u00e9t nghi\u1ec7m ph\u00e2n tr\u1ef1c ti\u1ebfp \u0111\u1ec3 t\u00ecm th\u1ec3 manga, th\u1ec3 minuta, th\u1ec3 k\u00e9n.<\/p>\n
X\u00e9t nghi\u1ec7m ph\u00e2n nhi\u1ec1u l\u1ea7n sau u\u1ed1ng sulfat magnesium, n\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n n\u00ean x\u00e9t nghi\u1ec7m l\u1ea1i sau \u0111i\u1ec1u tr\u1ecb 1 tu\u1ea7n\/l\u1ea7n trong 6 tu\u1ea7n, 1 th\u00e1ng\/l\u1ea7n trong 6 th\u00e1ng v\u00e0 6 th\u00e1ng\/l\u1ea7n trong 2 n\u0103m. C\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n ng\u01b0\u1eddi l\u00e0nh mang k\u00e9n, gi\u1ea3m t\u00e1i ph\u00e1t v\u00e0 gi\u1ea3m chuy\u1ec3n th\u1ec3 m\u1ea1n t\u00ednh .<\/p>\n
+ L\u00e0m ti\u00eau b\u1ea3n nhu\u1ed9m, soi t\u00ecm amip.<\/p>\n
T\u00ecm th\u1ea5y amip th\u1ec3 d\u01b0\u1ee1ng b\u00e0o \u0103n h\u1ed3ng c\u1ea7u di \u0111\u1ed9ng, h\u1ed3ng c\u1ea7u \u0111\u1ee9ng \u0111\u00e1m, b\u1ea1ch c\u1ea7u, k\u00e9n amip 1-4 nh\u00e2n, tinh th\u1ec3 Charcot Leyden.<\/p>\n
Th\u1ec3 d\u01b0\u1ee1ng b\u00e0o d\u1ec5 b\u1ecb ti\u00eau h\u1ee7y, tr\u00e1i l\u1ea1i k\u00e9n amip c\u00f3 s\u1ee9c s\u1ed1ng cao n\u00ean c\u00e1c th\u1ec3 amip ru\u1ed9t n\u1eb7ng \u00edt l\u00e2y h\u01a1n ng\u01b0\u1eddi l\u00e0nh mang k\u00e9n v\u00ec th\u1ea3i ra nhi\u1ec1u th\u1ec3 d\u01b0\u1ee1ng b\u00e0o ho\u1ea1t<\/p>\n
\u0111\u1ed9ng d\u1ec5 ch\u1ebft trong ph\u00e2n. Do \u0111\u00f3 d\u1ecbch t\u1ec5 h\u1ecdc b\u1ec7nh amip ph\u1ee9c t\u1ea1p v\u00ec nh\u1eefng ng\u01b0\u1eddi mang k\u00e9n l\u00e0 ngu\u1ed3n truy\u1ec1n b\u1ec7nh ch\u00ednh l\u1ea1i kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng n\u00ean \u00edt \u0111\u01b0\u1ee3c s\u1ef1 quan t\u00e2m c\u1ee7a c\u00e1c t\u1ed5 ch\u1ee9c y t\u1ebf.<\/p>\n
+ L\u00e0m c\u00e1c ph\u1ea3n \u1ee9ng huy\u1ebft thanh h\u1ecdc.<\/p>\n
Amip x\u00e2m nh\u1eadp l\u00e0m xu\u1ea5t hi\u1ec7n kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u, ph\u00e1t hi\u1ec7n b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p mi\u1ec5n d\u1ecbch h\u1ecdc nh\u01b0 :<\/p>\n
Ph\u1ea3n \u1ee9ng khuy\u1ebfch t\u00e1n k\u1ebft t\u1ee7a tr\u00ean th\u1ea1ch.<\/p>\n
Mi\u1ec5n d\u1ecbch hu\u1ef3nh quang gi\u00e1n ti\u1ebfp .<\/p>\n
Ph\u1ea3n \u1ee9ng ng\u01b0ng k\u1ebft h\u1ed3ng c\u1ea7u gi\u00e1n ti\u1ebfp\u2026<\/p>\n
+ Chu\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh.<\/p>\n
Xquang ru\u1ed9t gi\u00e0: Kh\u00f4ng c\u00f3 h\u00ecnh \u1ea3nh \u0111\u1eb7c hi\u1ec7u, c\u00f3 th\u1ec3 th\u1ea5y c\u00e1c h\u00ecnh \u1ea3nh do bi\u1ebfn ch\u1ee9ng c\u1ee7a l\u1ef5 amip nh\u01b0 u amip, t\u1eafc ru\u1ed9t, l\u1ed3ng ru\u1ed9t, xo\u1eafn ru\u1ed9t\u2026<\/p>\n
+ Si\u00eau \u00e2m.<\/p>\n
+ Soi tr\u1ef1c tr\u00e0ng.<\/p>\n
H\u00ecnh \u1ea3nh vi\u00eam tr\u1ef1c tr\u00e0ng lan t\u1ecfa, r\u00f5 r\u1ec7t nh\u1ea5t \u1edf kho\u1ea3ng 13 \u2013 20 cm c\u00e1ch l\u1ed7 h\u1eadu m\u00f4n, ni\u00eam m\u1ea1c \u0111\u1ecf, xung huy\u1ebft, t\u0103ng ti\u1ebft m\u1ee7 nh\u1ea7y r\u1ea3i r\u00e1c t\u1eebng ch\u1ed7 c\u00f3 \u0111i\u1ec3m b\u1ea7m t\u00edm.<\/p>\n
T\u1ed5n th\u01b0\u01a1ng l\u00f3et \u0111i\u1ec3n h\u00ecnh: d\u1ea1ng v\u1ebft c\u1ea5u, c\u00fac \u00e1o, gi\u1eefa nh\u1eefng v\u00f9ng ni\u00eam m\u1ea1c t\u1ed5n th\u01b0\u01a1ng l\u00e0 v\u00f9ng ni\u00eam m\u1ea1c b\u00ecnh th\u01b0\u1eddng<\/p>\n
C\u00e2u 27: Tr\u00ecnh b\u00e0y nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb v\u00e0 bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng b\u1ec7nh amip.<\/p>\n
v Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb b\u1ec7nh amip<\/p>\n
\u00fc D\u00f9ng thu\u1ed1c \u0111\u1eb7c hi\u1ec7u<\/p>\n
\u00fc \u0110i\u1ec1u tr\u1ecb s\u1edbm<\/p>\n
\u00fc \u0110i\u1ec1u tr\u1ecb \u0111\u1ee7 li\u1ec1u<\/p>\n
\u00fc \u0110i\u1ec1u tr\u1ecb tri\u1ec7t \u0111\u1ec3<\/p>\n
\u00fc \u0110i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p kh\u00e1ng sinh<\/p>\n
v C\u00e1ch ph\u00f2ng b\u1ec7nh amip:<\/p>\n
– C\u00e1c bi\u1ec7n ph\u00e1p v\u1ec7 sinh chung ph\u00f2ng b\u1ec7nh cho t\u1eadp th\u1ec3:<\/p>\n
+X\u1eed l\u00ed v\u00e0 qu\u1ea3n l\u00ed ph\u00e2n \u0111\u00fang quy c\u00e1ch<\/p>\n
+ \u0110\u1ea3m b\u1ea3o ngu\u1ed3n n\u01b0\u1edbc s\u1ea1ch cho sinh ho\u1ea1t<\/p>\n
+ Di\u1ec7t ru\u1ed3i , gi\u00e1n<\/p>\n
+ V\u1ec7 sinh an to\u00e0n th\u1ef1c ph\u1ea9m<\/p>\n
– Ph\u00f2ng b\u1ec7nh c\u00e1 nh\u00e2n :<\/p>\n
+ Th\u1ef1c hi\u1ec7n \u0103n ch\u00edn u\u1ed1ng s\u00f4i<\/p>\n
+ Ch\u1ec9 \u0103n rau qu\u1ea3 \u0111\u00e3 \u0111c r\u1eeda s\u1ea1ch<\/p>\n
+ R\u1eeda tay tr\u01b0\u1edbc khi \u0103n v\u00e0 sau khi \u0111i ngo\u00e0i<\/p>\n
+ Kh\u00f4ng ph\u00f3ng u\u1ebf b\u1eeba b\u00e3i<\/p>\n
C\u00e2u 28: M\u00f4 t\u1ea3 \u0111\u1eb7c \u0111i\u1ec3m sinh h\u1ecdc v\u00e0 chu k\u1ef3 c\u1ee7a Giardia lamblia.<\/p>\n
v \u0110\u1eb7c \u0111i\u1ec3m sinh h\u1ecdc<\/p>\n
– S\u1ed1ng v\u00e0 k\u00ed sinh tr\u00ean ni\u00eam m\u1ea1c ru\u1ed9t non, t\u00e1 tr\u00e0ng, \u0111\u00f4i khi th\u1ea5y \u1edf \u0111\u01b0\u1eddng d\u1eabn m\u1eadt v\u00e0 t\u00fai m\u1eadt.<\/p>\n
– Ch\u00fang h\u1ea5p thu th\u1ee9c \u0103n b\u1eb1ng c\u00e1ch th\u1ea9m th\u1ea5u qua m\u00e0ng th\u00e2n. Th\u1ec3 ho\u1ea1t \u0111\u1ed9ng lu\u00f4n chuy\u1ec3n \u0111\u1ed9ng nh\u1edd c\u00f3 4 \u0111\u00f4i roi.<\/p>\n
– Sinh s\u1ea3n v\u00f4 gi\u1edbi b\u1eb1ng c\u00e1ch chia \u0111\u00f4i c\u01a1 th\u1ec3 theo chi\u1ec1u d\u1ecdc<\/p>\n
– Th\u1ec3 ho\u1ea1t \u0111\u1ed9ng ch\u1ec9 g\u1eb7p trong ph\u00e2n l\u1ecfng<\/p>\n
Chu k\u00ec c\u1ee7a Giardia lamblia<\/p>\n
M\u1ed9t s\u1ed1 th\u1ec3 h\u0111 theo ru\u1ed9t non t\u1edbi \u0111\u1ea1i tr\u00e0ng , ph\u00e2n d\u1ea7n d\u1ea7n tr\u1edf n\u00ean r\u1eafn , th\u1ec3 h\u0111 bi\u1ebfn th\u00e0nh th\u1ec3 r\u1eafn theo ph\u00e2n ra ngo\u00e0i. K\u00e9n l\u1ea1i theo \u0111\u01b0\u1eddng ti\u00eau h\u00f3a v\u00e0o c\u01a1 th\u1ec3 ng\u01b0\u1eddi , k\u00e9n \u0111\u1ebfn t\u00e1 tr\u00e0ng xu\u1ea5t k\u00e9n tr\u1edf th\u00e0nh th\u1ec3 h\u0111 ti\u1ebfp t\u1ee5c v\u00e0o \u0111\u1eddi k\u00ed sinh<\/p>\n
C\u00e2u 29: M\u00f4 t\u1ea3 \u0111\u1eb7c \u0111i\u1ec3m sinh h\u1ecdc v\u00e0 chu k\u1ef3 c\u1ee7a Trichomonas vaginalis.<\/p>\n
\u0110\u1eb7c \u0111i\u1ec3m sinh h\u1ecdc<\/p>\n
– Trichomonas vaginalis chuy\u1ec3n v\u1eadt ch\u1ee7 \u1edf th\u1ec3 ho\u1ea1t \u0111\u1ed9ng<\/p>\n
– G\u1eb7p nhi\u1ec1u \u1edf ph\u1ee5 n\u1eef tu\u1ed5i sinh \u0111\u1ebb, hi\u1ebfm g\u1eb7p \u1edf tr\u1ebb ch\u01b0a d\u1eady th\u00ec, \u00edt g\u1eb7p \u1edf ph\u1ee5 n\u1eef m\u00e3n kinh. Nam gi\u1edbi c\u0169ng m\u1eafc Trichomonas vaginalis<\/p>\n
– C\u00f3 th\u1ec3 nu\u00f4i c\u1ea5y Trichomonas vaginalistrong m\u1ed9t lo\u1ea1t m\u00f4i tr\u01b0\u1eddng t\u1ebf b\u00e0o \u0111\u1eb7c ho\u1eb7c l\u1ecfng. Trong nu\u00f4i c\u1ea5y th\u1ea5y Trichomonas vaginalis \u0103n vi khu\u1ea9n<\/p>\n
– C\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i \u1edf m\u00f4i tr\u01b0\u1eddng ngo\u1ea1i gi\u1edbi 1 v\u00e0i gi\u1edd<\/p>\n
– Sinh s\u1ea3n v\u00f4 gi\u00f3i b\u1eb1ng c\u00e1ch ph\u00e2n \u0111\u00f4i theo chi\u1ec1u d\u1ecdc c\u01a1 th\u1ec3<\/p>\n
– Ch\u1ec9 c\u00f3 1 v\u1eadt ch\u1ee7 l\u00e0 ng\u01b0\u1eddi<\/p>\n
– V\u1ecb tr\u00ed k\u00fd sinh ch\u1ee7 y\u1ebfu \u1edf \u00e2 m \u0111 \u1ea1 o, \u1edf c\u00e1c n\u1ebfp nh\u0103n \u1edf da, ni\u00eam m\u1eb7c b\u1ed9 ph\u1eadn sinh d\u1ee5c, ti\u1ec1n li\u1ec7t tuy\u1ebfn, ni\u1ec7u \u0111\u1ea1o<\/p>\n
– Trichomonas vaginalis \u01b0a pH h\u01a1i toan (6-6,5) Trichomonas vaginalis chuy\u1ec3n pH \u00e2 m \u0111 \u1ea1 o t\u1eeb toan sang ki\u1ec1m. B\u00ecnh th\u01b0\u1eddng \u1edf \u00e2 m \u0111 \u1ea1 o ng\u01b0\u1eddi ph\u1ee5 n\u1eefa kh\u1ecfe m\u1ea1nh pH 3,8-4,4<\/p>\n
– \u0110\u1ed9 pH m\u00f4i tr\u01b0\u1eddng \u00e2 m \u0111 \u1ea1 o thay \u0111\u1ed5i n\u00ean t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho vi khu\u1ea9n trong \u00e2 m \u0111 \u1ea1 o sinh s\u1ea3n v\u00e0 ph\u00e1t tri\u1ec3n<\/p>\n
– Trichomonas vaginalis d\u1ec5 d\u00e0ng t\u0103ng sinh v\u00e0 g\u00e2y b\u1ec7nh khi:<\/p>\n
+ pH \u00e2 m \u0111 \u1ea1 o t\u0103ng<\/p>\n
+ H\u00e0m l\u01b0\u1ee3ng Glycogen trong ni\u00eam m\u1ea1c \u00e2 m \u0111 \u1ea1 o t\u0103ng<\/p>\n
+ Follieulin gi\u1ea3m<\/p>\n
+ Vi khu\u1ea9n Doderlein trong \u00e2 m \u0111 \u1ea1 o gi\u1ea3m<\/p>\n
– Ngo\u00e0i v\u1ecb tr\u00ed k\u00fd sinh \u1edf \u00e2 m \u0111 \u1ea1 o ra, Trichomonas vaginalis c\u00f2n k\u00fd sinh \u1edf nhi\u1ec1u n\u01a1i kh\u00e1c trong c\u01a1 th\u1ec3 nh\u01b0 bu\u1ed3ng tr\u1ee9ng, v\u00f2i tr\u1ee9ng, t\u1eed cung \u1edf n\u1eef gi\u1edbi v\u00e0 tuy\u1ebfn ti\u1ec1n li\u1ec7t \u1edf nam gi\u1edbi<\/p>\n
– C\u00f3 th\u1ec3 th\u1ea5y Trichomonas vaginalis \u1edf \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u nam v\u00e0 n\u1eef nh\u01b0 \u1edf ni\u1ec7u \u0111\u1ea1o, ni\u1ec7u qu\u1ea3n, b\u00e0ng quang, b\u1ec3 th\u1eadn<\/p>\n
Chu k\u1ef3<\/p>\n
Trichomonas vaginalis c\u00f3 chu k\u1ef3 \u0111\u1eb7c bi\u1ec7t v\u1edbi 1 v\u1eadt ch\u1ee7 duy nh\u1ea5t l\u00e0 ng\u01b0\u1eddi. S\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a T. vaginalis \u1edf \u00e2 m \u0111 \u1ea1 o th\u01b0\u1eddng ph\u1ee5 thu\u1ed9c v\u00e0o chu k\u1ef3 kinh nguy\u1ec7t. Tr\u01b0\u1edbc ng\u00e0y th\u1ea5y kinh v\u00e0 sau ng\u00e0y th\u1ea5y kinh, T.vaginalis ph\u00e1t tri\u1ec3n m\u1ea1nh, n\u00ean l\u1ea5y d\u1ecbch \u00e2 m \u0111 \u1ea1 o v\u00e0o nh\u1eefng ng\u00e0y n\u00e0y d\u1ec5 th\u1ea5y k\u00fd sinh tr\u00f9ng. Trong th\u1eddi k\u1ef3 r\u1ee5ng tr\u1ee9ng kh\u00f4ng th\u1ea5y k\u00fd sinh tr\u00f9ng.<\/p>\n
C\u00e2u 30: Ph\u00e2n t\u00edch c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 v\u00e0 ngu\u1ed3n l\u00e2y nhi\u1ec5m Trichomonas vaginalis.<\/p>\n
– Ngu\u1ed3n b\u1ec7nh v\u00e0 m\u1ea7m b\u1ec7nh: L\u00e0 ng\u01b0\u1eddi l\u00e0nh ho\u1eb7c ng\u01b0\u1eddi b\u1ec7nh mang Trichomonas vaginalis. M\u1ea7m b\u1ec7nh l\u00e0 th\u1ec3 ho\u1ea1t mang Trichomonas vaginalis<\/p>\n
– \u0110\u01b0\u1eddng l\u00e2y nhi\u1ec5m<\/p>\n
B\u1ec7nh nhi\u1ec5m ch\u1ee7 y\u1ebfu l\u00e0 do quan h\u1ec7 t \u00ec n h d \u1ee5 c. Gi\u00e1n ti\u1ebfp qua n\u01b0\u1edbc r\u1ee7a, \u0111\u1ed3 d\u00f9ng, qu\u1ea7n \u00e1o, v\u1ec7 sinh.<\/p>\n
Ng\u01b0\u1eddi ta \u01b0\u1edbc t\u00ednh c\u00f3 kho\u1ea3ng 1\/4 \u0111\u00e0n \u00f4ng b\u1ecb nhi\u1ec5m Trichomonas vaginalis sau khi c\u00f3 quan h\u1ec7 t \u00ec n h d \u1ee5 c v\u1edbi nh\u1eefng ph\u1ee5 n\u1eef mang k\u00fd sinh tr\u00f9ng<\/p>\n
– Ph\u00e2n b\u1ed1 d\u1ecbch t\u1ec5:<\/p>\n
B\u1ec7nh do Trichomonas vaginalis c\u00f3 t\u00ednh ch\u1ea5t to\u00e0n c\u1ea7u, t\u1ef7 l\u1ec7 b\u1ec7nh thay \u0111\u1ed5i tu\u1ef3 theo t\u1eebng nh\u00f3m d\u00e2n t\u1ed9c, \u0111i\u1ec1u ki\u1ec7n v\u1ec7 sinh ph\u1ee5 n\u1eef v\u00e0 quan h\u1ec7 t \u00ec n h d \u1ee5 c, n\u1ea1n m\u1ea1i d\u00e2m \u1edf nam gi\u1edbi b\u1ec7nh kh\u00f4ng ph\u1ed5 bi\u1ebfn<\/p>\n
B\u1ec7nh ph\u1ed5 bi\u1ebfn \u1edf n\u1eef gi\u1edbi; \u1edf Vi\u1ec7t Nam, t\u1ef7 l\u1ec7 nhi\u1ec5m \u1edf ph\u1ee5 n\u1eef n\u00f3i chung kho\u1ea3ng 10 %, v\u1edbi ph\u1ee5 n\u1eef l\u00e0m ngh\u1ec1 m\u1ea1i d\u00e2m th\u00ec cao h\u01a1n v\u00e0 dao \u0111\u1ed9ng t\u1eeb 30 – 60% tu\u1ef3 \u0111\u1ecba ph\u01b0\u01a1ng.<\/p>\n","protected":false},"excerpt":{"rendered":"
C\u00e2u 1: Tr\u00ecnh b\u00e0y chu k\u1ef3 giun ch\u1ec9 v\u00e0 n\u00eau c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ch\u1ed1ng giun ch\u1ec9 1. Chu k\u1ef3 sinh s\u1ea3n c\u1ee7a giun ch\u1ec9: [\u200bIMG][\u200bIMG][\u200bIMG][\u200bIMG]Di\u1ec5n ra theo s\u01a1 \u0111\u1ed3 : Ng\u01b0\u1eddi Mu\u1ed7i Giun ch\u1ec9 k\u00fd sinh \u1edf h\u1ec7 b\u1ea1ch huy\u1ebft c\u1ee7a ng\u01b0\u1eddi. Giun c\u00e1i \u0111\u1ebb ra \u1ea5u tr\u00f9ng, \u1ea5u tr\u00f9ng theo h\u1ec7 b\u1ea1ch huy\u1ebft …<\/p>\n","protected":false},"author":10,"featured_media":2136,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30,38],"tags":[],"class_list":["post-2057","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-mon-co-so","category-ky-sinh-trung"],"_links":{"self":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2057","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/comments?post=2057"}],"version-history":[{"count":2,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2057\/revisions"}],"predecessor-version":[{"id":2329,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2057\/revisions\/2329"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media\/2136"}],"wp:attachment":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media?parent=2057"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=2057"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=2057"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}