T\u00ecnh hu\u1ed1ng 1:<\/p>\n
Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n<\/p>\n
Di\u1ec5n bi\u1ebfn<\/p>\n
Y l\u1ec7nh<\/p>\n
7h00p<\/p>\n
12\/12\/2016<\/p>\n
B\u1ec7nh ng\u00e0y th\u1ee9 4<\/p>\n
Kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng tu\u1ed1c<\/p>\n
B\u1ec7nh t\u1ec9nh ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c<\/p>\n
DHST M\u1ea1ch 90l\/p, HA:130\/70mmHg Nhi\u1ec7t \u0111\u1ed9 :37 \u0111\u1ed9 C.<\/p>\n
Da ni\u00eam v\u00e0ng, kh\u00f4ng ph\u00f9 kh\u00f4ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da<\/p>\n
Gan to 2cm l\u00e1ch to 2cm<\/p>\n
XN: – X\u00e9t nghi\u1ec7m: HC 2.6 tr , Hb 8.9 g\/dL BC 5700 TC 90000 Bil m\u00e1u: 127 SGOT 68 SGPT 79 KSTSR Plassmodium falciparum +.<\/p>\n
Ch\u1ea9n \u0111o\u00e1n: S\u1ed1t r\u00e9t \u00e1c t\u00ednh th\u1ec3 gan m\u1eadt<\/p>\n
– Glucose 10% x500ml x 1 chai<\/p>\n
Truy\u1ec1n TM XL G\/P<\/p>\n
Gi\u1edd truy\u1ec1n 8h Gi\u1edd h\u1ebft : 12h10p<\/p>\n
– Natriclorua 0\/9% x 500ml x 1 chai<\/p>\n
Truy\u1ec1n TM XL G\/P<\/p>\n
Gi\u1edd truy\u1ec1n 8h Gi\u1edd h\u1ebft : 12h10p<\/p>\n
– Artesunate 60mg x 2 l\u1ecd x 2 l\u1ea7n<\/p>\n
Ti\u00eam t\u0129nh m\u1ea1nh 8h 20h<\/p>\n
– Chophytol 200mg x 2 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 8h \u2013 16h<\/p>\n
– Boganic x 2 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 8h \u2013 16h<\/p>\n
– Hemblood x 1 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 8h \u2013 16h<\/p>\n
X\u00e9t nghi\u1ec7m : Glucose m\u00e1u, ure Creatinin m\u00e1u, \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3, t\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u, SA gan m\u1eadt, XQ tim ph\u1ed5i th\u1eb3ng<\/p>\n
Ngh\u1ec9 ng\u01a1i t\u1ea1i gi\u01b0\u1eddng<\/p>\n
CS C2 \u2013 3<\/p>\n
C\u01a1m\/ Ch\u00e1o\/ S\u1eefa<\/p>\n
K\u00fd t\u00ean<\/p>\n
B\u00e1c s\u0129 L\u00ea V\u0103n Ph\u01b0\u1edbc<\/p>\n
T\u00ecnh hu\u1ed1ng 2:<\/b><\/p>\n
Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n<\/b><\/p>\n
Di\u1ec5n bi\u1ebfn<\/b><\/p>\n
Y l\u1ec7nh<\/b><\/p>\n
7h00p<\/b><\/p>\n
12\/12\/2016<\/b><\/p>\n
B\u1ec7nh ng\u00e0y th\u1ee9 8, ko c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng thu\u1ed1c tr\u01b0\u1edbc \u0111\u00f3<\/p>\n
B\u1ec7nh nh\u00e2n t\u1ec9nh t\u00e1o, li b\u00ec<\/p>\n
Nhi\u1ec7t \u0111\u1ed9: 400C<\/p>\n
M\u1ea1ch: 72 L\/p<\/p>\n
HA: 110\/70 mmHg<\/p>\n
Nh\u1ecbp th\u1edf: 20 L\/p<\/p>\n
M\u00f4i kh\u00f4, l\u01b0\u1ee1i b\u1ea9n<\/p>\n
Gan to 2cm d\u01b0\u1edbi b\u1edd s\u01b0\u1eddn<\/p>\n
G\u00f5 \u00f3c \u00e1ch HCP (+) Thai 4 th\u00e1ng<\/p>\n
XN m\u00e1u: H\u1ed3ng c\u1ea7u 4,2 M\/\u00b5l<\/p>\n
B\u1ea1ch c\u1ea7u: 5.8 k\/\u00b5L<\/p>\n
N = 62%<\/p>\n
L = 38%<\/p>\n
Ph\u1ea3n \u1ee9ng widal TO = 1\/400<\/p>\n
Ch\u1ea9n \u0111o\u00e1n: b\u1ec7nh th\u01b0\u01a1ng h\u00e0n th\u1ec3 \u0111i\u1ec3n h\u00ecnh\/ thai 4 th\u00e1ng<\/p>\n
-Glucose 5% 500ml x 1 chai<\/p>\n
Truy\u1ec1n TM XXX g\/ph<\/p>\n
Gi\u1edd truy\u1ec1n 8h, gi\u1edd h\u1ebft 12h10p<\/p>\n
1) Cetriaxon 1g x 1 l\u1ecd x 2 l\u1ea7n<\/p>\n
Ti\u00eam TMC 8h \u2013 20h.<\/p>\n
– paracetamol 500mg x 1 vi\u00ean<\/p>\n
U\u1ed1ng 7h<\/p>\n
– Vitamin 3B x 1 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 8h \u2013 16h.<\/p>\n
Si\u00eau \u00e2m thai<\/p>\n
CSC 2,3<\/p>\n
C\u01a1m\/ ch\u00e1o \/s\u1eefa<\/p>\n
K\u00fd t\u00ean<\/p>\n
Tr\u1ea7n \u0110\u1ee9c Lai<\/p>\n
T\u00ecnh hu\u1ed1ng 3<\/b><\/p>\n
Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n<\/b><\/p>\n
Di\u1ec5n bi\u1ebfn<\/b><\/p>\n
Y l\u1ec7nh<\/b><\/p>\n
15h30p<\/p>\n
12\/12\/2016<\/p>\n
B\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng thu\u1ed9c tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n
B\u1ec7nh kh\u1edfi ph\u00e1t kho\u1ea3ng 3 ng\u00e0y nay v\u1edbi s\u1ed1t , nh\u1ee9c \u0111\u1ea7u, r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a, n\u00f4n. Ch\u01b0a \u0111i\u1ec1u tr\u1ecb g\u00ec n\u00ean xin v\u00e0o vi\u1ec7n<\/p>\n
B\u1ec7nh nh\u00e2n v\u00e0o vi\u1ec7n trong t\u00ecnh tr\u1ea1ng:<\/p>\n
-B\u1ec7nh nh\u00e2n t\u1ec9nh t\u00e1o.<\/p>\n
-D\u1ea5u hi\u1ec7u sinh t\u1ed3n:<\/p>\n
+ M\u1ea1ch: 90 l\/p<\/p>\n
+ Nhi\u1ec7t \u0111\u1ed9: 40 \u0111\u1ed9 C<\/p>\n
+ Huy\u1ebft \u00e1p: 110\/70 mmHg<\/p>\n
+ Nh\u1ecbp th\u1edf: 20 l\/p<\/p>\n
-M\u00f4i kh\u00f4 l\u01b0\u1ee1i b\u1ea9n.<\/p>\n
-D\u1ea5u c\u1ed5 c\u1ee9ng (+).<\/p>\n
-D\u1ea5u hi\u1ec7u Kernig (+).<\/p>\n
-XN m\u00e1u: BC 15800; NEU 82% LYM 18%.<\/p>\n
-XN DNT: m\u00e0u \u0111\u1ee5c, protein 2g\/dl, glucose 0,1mg%, t\u1ebf b\u00e0o 200 BC, NEU 80% LYM 20%.<\/p>\n
-Ph\u1ea3n \u1ee9ng Latex: S.pneumonia (+).<\/p>\n
Ch\u1ea9n \u0111o\u00e1n: Vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 do Streptocucus pneumonia\/ TD V\u00e1ch h\u00f3a m\u00e0ng n\u00e3o<\/p>\n
-Natriclorua 0,9% 500ml x 1 chai<\/p>\n
Truy\u1ec1n t\u0129nh m\u1ea1ch XL g\/p<\/p>\n
1)Ceftriaxon 1g x 2 l\u1ecd x 2 l\u1ea7n<\/p>\n
Ti\u00eam t\u0129nh m\u1ea1ch ch\u1eadm l\u00fac 16h \u2013 22h<\/p>\n
1)Medrol 16mg x 1 \u1ed1ng<\/p>\n
Ti\u00eam TMC l\u00fac 16h.<\/p>\n
-Omeprazol 20mg x 1 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 16h \u2013 22h<\/p>\n
-Vitamin 3B x 1 vi\u00ean<\/p>\n
U\u1ed1ng 16h<\/p>\n
-Ngh\u1ec9 ng\u01a1i t\u1ea1i gi\u01b0\u1eddng, CSC 2,3<\/p>\n
C\u01a1m\/ch\u00e1o\/s\u1eefa<\/p>\n
K\u00fd t\u00ean<\/p>\n
B\u00e1c s\u0129 L\u00ea V\u0103n B\u1ea3y<\/p>\n
T\u00ecnh hu\u1ed1ng 4:<\/p>\n
Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n<\/b><\/p>\n
Di\u1ec5n bi\u1ebfn<\/b><\/p>\n
Y l\u1ec7nh<\/b><\/p>\n
15h00p<\/p>\n
10\/12\/2016<\/p>\n
Ti\u1ec1n s\u1eed: ch\u01b0a c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng thu\u1ed1c.<\/p>\n
Theo l\u1eddi khai BN, c\u00e1ch \u0111\u00e2y 9 ng\u00e0y BN c\u00f3 b\u1ecb th\u01b0\u01a1ng \u1edf g\u00f3t ch\u00e2n ph\u1ea3i, \u0111\u1ebfn c\u00e1ch \u0111\u00e2y 2 ng\u00e0y th\u1ea5y h\u00e0m h\u00e1 h\u1ea1n ch\u1ebf, ch\u01b0a \u0111i\u1ec1u tr\u1ecb g\u00ec, \u0111\u1ebfn nay h\u1ea1n ch\u1ebf nhi\u1ec1u n\u00ean xin nh\u1eadp vi\u1ec7n \u0111i\u1ec1u tr\u1ecb.<\/p>\n
T\u00ecnh trang BN nh\u1eadp vi\u1ec7n:<\/p>\n
T\u1ec9nh ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c<\/p>\n
DHST: m\u1ea1ch: 90 l\/p, T:37,<\/p>\n
HA 120\/70 mmHg, NT: 24 l\/p<\/p>\n
Co gi\u1eadt to\u00e0n th\u00e2n<\/p>\n
VT g\u00f3t ch\u00e2n ph\u1ea3i kh\u00e2u k\u00edn, s\u01b0ng<\/p>\n
H\u00e0m h\u00e1 3cm<\/p>\n
C\u00e1c c\u01a1 quan kh\u00e1c ch\u01b0a ph\u00e1t hi\u1ec7n b\u1ea5t th\u01b0\u1eddng.<\/p>\n
XN m\u00e1u: HC 3,9 tri\u1ec7u\/ mm3<\/p>\n
BC 6700\/mm3<\/p>\n
TC 300.000\/ mm3<\/p>\n
Ch\u1ea9n \u0111o\u00e1n: B\u1ec7nh u\u1ed1n v\u00e1n to\u00e0n th\u1ec3<\/p>\n
Ti\u00ean l\u01b0\u1ee3ng: N\u1eb7ng<\/p>\n
– Glucose 5% 500ml 1 chai<\/p>\n
Truy\u1ec1n TM: XL gi\u1ecdt\/ph\u00fat<\/p>\n
GT: 15h30p; GH: 19h40p<\/p>\n
-Ringerlactat 500ml x 1 chai<\/p>\n
Truy\u1ec1n TM XL g\/p<\/p>\n
GT: 15h30p; GH:19h40p<\/p>\n
– SAT 1500 UI x 10 \u1ed1ng<\/p>\n
TB 4 v\u1ecb tr\u00ed: 15h30p<\/p>\n
– Diazepam 10mg x 1 \u1ed1ng<\/p>\n
Ti\u00eam TMC: 15h30<\/p>\n
– Penicilin 1.000.000 UI 1 l\u1ecd x 2<\/p>\n
Ti\u00eam TMC: 15h30 \u2013 21h30<\/p>\n
– Vitamin C 500mg 1 \u1ed1ng<\/p>\n
Ti\u00eam TMC: 15h30<\/p>\n
– Diazepam 5mg x 2 vi\u00ean x 4 l\u1ea7n<\/p>\n
U\u1ed1ng 16h \u2013 22h \u2013 02h \u2013 08h.<\/p>\n
– m\u1edf r\u1ed9ng v\u1ebft th\u01b0\u01a1ng v\u00e0 thay b\u0103ng.<\/p>\n
– \u0110\u1eb7t sonde d\u1ea1 d\u00e0y, sonde ti\u1ec3u<\/p>\n
– Theo d\u00f5i tr\u1ea1ng th\u00e1i co gi\u1eadt v\u00e0 co c\u1ee9ng<\/p>\n
– N\u1eb1m t\u1ea1i ph\u00f2ng ri\u00eang<\/p>\n
– CSC 1<\/p>\n
– Ch\u00e1o \/ S\u1eefa<\/p>\n
K\u00fd t\u00ean<\/p>\n
B\u00e1c s\u0129 Nguy\u1ec5n H\u1ea3i Long<\/p>\n
T\u00ecnh hu\u1ed1ng 5:<\/p>\n
Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n<\/b><\/p>\n
Di\u1ec5n bi\u1ebfn<\/b><\/p>\n
Y l\u1ec7nh<\/b><\/p>\n
8h30p<\/p>\n
11\/12\/2016<\/p>\n
B\u1ec7nh ng\u00e0y 7 kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng thu\u1ed1c tr\u01b0\u1edbc \u0111\u00f3<\/p>\n
B\u1ec7nh nh\u00e2n t\u1ec9nh t\u00e1o, Nhi\u1ec7t \u0111\u1ed9 37 \u0111\u1ed9 C<\/p>\n
HA: 150\/80mm Hg<\/p>\n
NT :20l\/p<\/p>\n
Da ni\u00eam v\u00e0ng, ng\u1ee9a nhi\u1ec1u, kh\u00f4ng ph\u00f9, kh\u00f4ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da. Gan to 2cm d\u01b0\u1edbi b\u1edd s\u01b0\u1eddn, m\u1ec1m.<\/p>\n
C\u00e1c c\u01a1 quan kh\u00e1c ch\u01b0a ph\u00e1t hi\u1ec7n b\u1ea5t th\u01b0\u1eddng<\/p>\n
XN m\u00e1u: HbsAg:+<\/p>\n
SGOT: 1200UI\/l<\/p>\n
SGPT: 1500ui\/l<\/p>\n
HbsAg(+)\/m\u00e1u; IgM HBc (+)<\/p>\n
Bilirubin tp: 340 umol\/l<\/p>\n
Ch\u1ea9n \u0111o\u00e1n: Vi\u00eam gan b c\u1ea5p m\u1ee9c \u0111\u1ed9 n\u1eb7ng\/ THA<\/p>\n
-Glucose 10% 500ml x 1 chai.<\/p>\n
Truy\u1ec1n TM : XL g\/p<\/p>\n
GT: 9h GH:13h10p<\/p>\n
-Glutathion 600mg x 1 \u1ed1ng<\/p>\n
Ti\u00eam TMC: 9h<\/p>\n
-Silymarin 70mg x 1 vi\u1ec5n 2 l\u1ea7n<\/p>\n
U\u1ed1ng 9h \u2013 22h<\/p>\n
-Cholestyramin 250mg 1 g\u00f3i x 2 l\u1ea7n<\/p>\n
U\u1ed1ng: 9h \u2013 22h<\/p>\n
-Hemblood x 1 vi\u00ean<\/p>\n
U\u1ed1ng: 9h<\/p>\n
-Amlodipin 10mg x 1 vi\u00ean<\/p>\n
U\u1ed1ng: 9h<\/p>\n
-XN m\u00e1u: PTT, t\u1ec9 l\u1ec7 prothrombin<\/p>\n
T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u<\/p>\n
SA gan m\u1eadt<\/p>\n
-Ngh\u1ec9 ng\u01a1i t\u1ea1i gi\u01b0\u1eddng<\/p>\n
CS 2,3<\/p>\n
Ki\u00eang bia r\u01b0\u1ee3u, \u0103n nhi\u1ec1u hoa qu\u1ea3 t\u01b0\u01a1i<\/p>\n
C\u01a1m\/chao\/s\u1eefa<\/p>\n
K\u00fd t\u00ean<\/p>\n
B\u00e1c s\u0129 Nguy\u1ec5n H\u1ea3i Nam<\/p>\n
T\u00ecnh hu\u1ed1ng 6:<\/b><\/p>\n
Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n<\/b><\/p>\n
Di\u1ec5n bi\u1ebfn<\/b><\/p>\n
Y l\u1ec7nh<\/b><\/p>\n
8h30p<\/p>\n
12\/12\/2016<\/p>\n
Ti\u1ec1n s\u1eed: ch\u01b0a d\u1ecb \u1ee9ng thu\u1ed1c tr\u01b0\u1edbc \u0111\u00f3<\/p>\n
B\u1ec7nh ng\u00e0y 3 v\u1edbi \u0111au qu\u1eb7n b\u1ee5ng t\u1eebng c\u01a1n, \u0111i c\u1ea7u ph\u00e2n nh\u1ea7y m\u00e1u 5l\/ng\u00e0y k\u00e8m m\u00f3t r\u1eb7n, kh\u00f4ng s\u1ed1t<\/p>\n
Ch\u01b0a \u0111i\u1ec1u tr\u1ecb g\u00ec xin nh\u1eadp vi\u1ec7n.<\/p>\n
B\u1ec7nh nh\u00e2n t\u1ec9nh t\u00e1o<\/p>\n
Nhi\u1ec7t \u0111\u1ed9 : 37\u00b0C<\/p>\n
M\u1ea1ch: 72l\/p<\/p>\n
Huy\u1ebft \u00e1p: 110\/70mmhg<\/p>\n
Nh\u1ecbp th\u1edf : 20l\/p<\/p>\n
Da ni\u00eam h\u1ed3ng<\/p>\n
Ng\u01b0\u1eddi m\u1ec7t m\u1ecfi<\/p>\n
\u0110i c\u1ea7u li\u00ean t\u1ee5c, ph\u00e2n nh\u1ea7y m\u00e1u<\/p>\n
C\u01a1 quan kh\u00e1c: ch\u01b0a ph\u00e1t hi\u1ec7n b\u1ea5t th\u01b0\u1eddng .<\/p>\n
XN m\u00e1u:<\/p>\n
HC: 4,2.106\/mm3<\/p>\n
HCT: 43%<\/p>\n
Hb : 12g\/dl<\/p>\n
TC: 290.103\/mm3<\/p>\n
BC: 5400\/m3<\/p>\n
(N: 62%, L: 38%)<\/p>\n
XN ph\u00e2n: E.histolytica magna (+)<\/p>\n
Ch\u1ea9n \u0111o\u00e1n: B\u1ec7nh l\u1ef5 amibe<\/p>\n
-Ringer lactac 500ml x 1 chai x 2 l\u1ea7n<\/p>\n
Truy\u1ec1n TM XL g\/p<\/p>\n
1)Metronidazol 250mg x 2 vi\u00ean x 3 l\u1ea7n<\/p>\n
U\u1ed1ng 8h45p \u2013 16h \u2013 20h ( sau \u0103n)<\/p>\n
-Papaverin 40mg x 2 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 8h45\u2019 \u2013 16h<\/p>\n
– Smecta x 1 g\u00f3i x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 8h45\u2019 \u2013 16h ( tr\u01b0\u1edbc \u0103n)<\/p>\n
– Medtrivit B x 1 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 8h45\u2019 \u2013 16h<\/p>\n
CLS: si\u00eau \u00e2m b\u1ee5ng t\u1ed5ng qu\u00e1t<\/p>\n
Ngh\u1ec9 ng\u01a1i t\u1ea1i gi\u01b0\u1eddng , CSC 2-3<\/p>\n
\u0102n ch\u00e1o , th\u1ee9c \u0103n m\u1ec1m d\u1ec5 ti\u00eau<\/p>\n
Ki\u00eang m\u1ee1 , cay , c\u00e1c ch\u1ea5t k\u00edch th\u00edch : bia, r\u01b0\u1ee3u, c\u00e0 ph\u00ea…<\/p>\n
K\u00fd t\u00ean<\/p>\n
B\u00e1c s\u0129 Tr\u1ecbnh Quang<\/p>\n
T\u00ecnh hu\u1ed1ng 7<\/b><\/p>\n
Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n<\/b><\/p>\n
Di\u1ec5n bi\u1ebfn<\/b><\/p>\n
Y l\u1ec7nh<\/b><\/p>\n
14 gi\u1edd 00<\/p>\n
12\/12\/2016<\/p>\n
– B\u1ec7nh ng\u00e0y 3 kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng b\u1ec7nh tr\u01b0\u1edbc \u0111\u00f3<\/p>\n
– B\u1ec7nh nhan t\u1ec9nh t\u00e1o, To : 39oC, M: 90 l\u1ea7n \/ph\u00fat, HA: 110\/70mmHg; NT: 20 l\u1ea7n\/ph\u00fat<\/p>\n
– Da ni\u00eam h\u1ed3ng<\/p>\n
– Gan to 2cm, \u1ea5n t\u1ee9c<\/p>\n
– \u0110i ti\u1ec3u nhi\u1ec1u<\/p>\n
– B\u1ec7nh nh\u00e2n c\u00f3 con so 8 tu\u1ea7n<\/p>\n
– C\u00e1c c\u01a1 quan kh\u00e1c ch\u01b0a ph\u00e1t hi\u1ec7n b\u1ea5t th\u01b0\u1eddng<\/p>\n
Ch\u1ea9n \u0111o\u00e1n:\u00a0<\/b>S\u1ed1t ch\u01b0a r\u00f5 nguy\u00ean nh\u00e2n \/ thai con so 2 th\u00e1ng.<\/p>\n
-Natriclorua 0.9% 500ml x 1 chai<\/p>\n
Truy\u1ec1n TM XXX gi\u1ecdt\/ph\u00fat<\/p>\n
GT:14 gi\u1edd GH: 19 gi\u1edd 30 ph\u00fat<\/p>\n
-Paracetamol 650mg x 1 vi\u00ean<\/p>\n
U\u1ed1ng 14 gi\u1edd 00<\/p>\n
-Vitamin 3B x 1 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 14gi\u1edd 00 – 20 gi\u1edd 00<\/p>\n
-Vitamin C 1g x 1 vi\u00ean<\/p>\n
U\u1ed1ng 14 gi\u1edd 00 (sau khi h\u00f2a tan)<\/p>\n
-ORS 27.9g x 1 g\u00f3i<\/p>\n
Pha trong 1 l\u00edt n\u01b0\u1edbc s\u00f4i ngu\u1ed9i u\u1ed1ng d\u1ea7n trong 24 gi\u1edd<\/p>\n
XN: c\u00f4ng th\u1ee9c m\u00e1u, SGOT, SGPT, GGT, Ure, Creatinin<\/p>\n
Test nhanh Ns1Ag<\/p>\n
T\u00ecm k\u00ed sinh tr\u00f9ng s\u1ed1t r\u00e9t<\/p>\n
Si\u00eau \u00e2m thai<\/p>\n
Lau m\u00e1t t\u00edch c\u1ef1c<\/p>\n
Ngh\u1ec9 ng\u01a1i t\u1ea1i gi\u01b0\u1eddng,<\/p>\n
C\u01a1m ch\u00e1o,<\/p>\n
CSC 2,3<\/p>\n
C\u00f3 k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m b\u00e1o l\u1ea1i b\u00e1c s\u0129 tr\u1ef1c<\/p>\n
( k\u00fd t\u00ean)<\/p>\n
Bs.Nguy\u1ec5n V\u0103n B\u1ea3y<\/p>\n
T\u00ecnh hu\u1ed1ng 8:<\/b><\/p>\n
Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n<\/b><\/p>\n
Di\u1ec5n bi\u1ebfn<\/b><\/p>\n
Y l\u1ec7nh<\/b><\/p>\n
8h00p<\/b><\/p>\n
12\/12\/2016<\/b><\/p>\n
-B\u1ec7nh ng\u00e0y th\u1ee9 3,v\u1edbi s\u1ed1t,nh\u1ee9c \u0111\u1ea7u,r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a v\u00e0 n\u00f4n.Ch\u01b0a \u0111i\u1ec1u tr\u1ecb g\u00ec tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n
-B\u1ec7nh nh\u00e2n t\u1ec9nh t\u00e1o,nhi\u1ec7t \u0111\u1ed9:400C,M\u1ea1ch:90l\u1ea7n\/ph\u00fat;HA:90\/60 mmHg;NT:20 l\u1ea7n\/ph\u00fat.<\/p>\n
-M\u00f4i kh\u00f4,l\u01b0\u1ee1i b\u1ea9n.C\u1ed5 c\u1ee9ng (+);d\u1ea5u Kernig(+).<\/p>\n
-XN m\u00e1u: RBC:4,2 tri\u1ec7u; WBC:10.800 (N:84% v\u00e0 L:16%).<\/p>\n
-D\u1ecbch n\u00e3o t\u1ee7y: \u0111\u1ee5c; Protein:1g\/l; Glucose: 0,1 mg% ;TB:1200; N80%,L:20%; Ph\u1ea3n \u1ee9ng Latex ;HI typb (b).<\/p>\n
Ch\u1ea9n \u0111o\u00e1n<\/i><\/b>:Vi\u00eam m\u00e0ng n\u00e3o m\u1ee7 do Haemophilus Influenza Typb b.<\/p>\n
-Ringer Lactate 500ml * 02 chai<\/p>\n
Truy\u1ec1n TM XL g\/p<\/p>\n
GT: 8h30p; GH: 16h50p<\/p>\n
1)Ceftriaxone 1g * 1,5 l\u1ecd * 02 l\u1ea7n<\/p>\n
TMC 8h -20h<\/p>\n
-Paracetamol 650mg *2\/3 vi\u00ean<\/p>\n
U\u1ed1ng 8h<\/p>\n
-Vitamin 3B x 1 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 8h30p \u2013 16h<\/p>\n
-Vitamin C 1g x 1 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng 8h30p \u2013 16h (sau khi h\u00f2a tan)<\/p>\n
-Ch\u00e1o, s\u1eefa<\/p>\n
-CSC II<\/p>\n
K\u00fd t\u00ean<\/p>\n
B\u00e1c s\u0129 Nguy\u1ec5n V\u0103n An<\/p>\n
T\u00ecnh hu\u1ed1ng 9:<\/b><\/p>\n
Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n<\/b><\/p>\n
Di\u1ec5n bi\u1ebfn<\/b><\/p>\n
Y l\u1ec7nh<\/b><\/p>\n
14h00p<\/p>\n
12\/12\/2016<\/p>\n
B\u1ec7nh nh\u00e2n ch\u01b0a c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng thu\u1ed1c tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n
B\u1ec7nh kh\u1edfi ph\u00e1t kho\u1ea3ng 2 ng\u00e0y nay v\u1edbi s\u1ed1t, \u0111au b\u1ee5ng t\u1eebng c\u01a1n, \u0111i c\u1ea7u ph\u00e2n l\u1ecfng to\u00e0n n\u01b0\u1edbc m\u00e0u m\u00e1u c\u00e1 k\u00e8m nh\u1ea7y kho\u1ea3ng 20 l\u1ea7n\/ng\u00e0y, m\u00f3t r\u1eb7n nhi\u1ec1u. Ch\u01b0a \u0111i\u1ec1u tr\u1ecb g\u00ec, xin v\u00e0o vi\u1ec7n.<\/p>\n
B\u1ec7nh nh\u00e2n v\u00e0o vi\u1ec7n trong t\u00ecnh tr\u1ea1ng:<\/p>\n
-T\u1ec9nh t\u00e1o.<\/p>\n
-D\u1ea5u hi\u1ec7u sinh t\u1ed3n:<\/p>\n
+ M\u1ea1ch: 100 l\u1ea7n\/ ph\u00fat.<\/p>\n
+ Nhi\u1ec7t \u0111\u1ed9: 40 \u0111\u1ed9 C.<\/p>\n
+ Huy\u1ebft \u00e1p: 80\/50 mmHg.<\/p>\n
+ Nh\u1ecbp th\u1edf: 20 l\u1ea7n\/ph\u00fat.<\/p>\n
-M\u1ec7t m\u1ecfi, m\u1eaft tr\u0169ng, m\u1ea5t n\u01b0\u1edbc nhi\u1ec1u.<\/p>\n
– C\u00e1c c\u01a1 quan kh\u00e1c ch\u01b0a ph\u00e1t hi\u1ec7n b\u1ec7nh l\u00fd g\u00ec.<\/p>\n
– XN m\u00e1u: HC 4.2 tri\u1ec7u\/mm3, Hct 52%, Hb 14g\/dl; TC 290.000\/mm3; BC 15400, NEU 82% LYM 18%<\/p>\n
Ch\u1ea9n \u0111o\u00e1n: B\u1ec7nh l\u1ef5 tr\u1ef1c khu\u1ea9n<\/p>\n
-Ringer lactat 500ml x 2 chai<\/p>\n
Truy\u1ec1n t\u0129nh m\u1ea1ch XL g\/p.<\/p>\n
GT: 14h00p; GH: 22h20p<\/p>\n
1)Ciprofloxacin 500mg x 1 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng l\u00fac 14h \u2013 22h<\/p>\n
-Paracetamol 500mg x 1 vi\u00ean<\/p>\n
U\u1ed1ng l\u00fac 14h.<\/p>\n
-Vitamin 3B x 1 vi\u00ean x 2 l\u1ea7n<\/p>\n
U\u1ed1ng l\u00fac 14h \u2013 22h.<\/p>\n
-ORS 27,9 g x 1 g\u00f3i<\/p>\n
Pha trong 1000 ml n\u01b0\u1edbc s\u00f4i \u0111\u1ec3 ngu\u1ed9i u\u1ed1ng trong ng\u00e0y.<\/p>\n
-XN m\u00e1u: Ure, Creatinin, \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3.<\/p>\n
-XN ph\u00e2n: Soi t\u01b0\u01a1i: HC, BC; C\u1ea5y ph\u00e2n t\u00ecm Shigella<\/p>\n
-Ngh\u1ec9 ng\u01a1i t\u1ea1i gi\u01b0\u1eddng, CSC 2,3<\/p>\n
-Ch\u00e1o,s\u1eefa, ki\u00eang th\u1ee9c \u0103n chua cay<\/p>\n
K\u00fd t\u00ean<\/p>\n
B\u00e1c s\u0129 Tr\u1ea7n Thu H\u00e0<\/p>\n
Nh\u1eefng c\u00e2u m\u00e0 c\u00e1c b\u1ea1n th\u1eafc m\u1eafc \u0111\u01b0\u1ee3c c\u00f4 gi\u1ea3i \u0111\u00e1p (k\u00e8m theo h\u00ecnh up k\u00e8m theo)<\/b><\/p>\n
1. \u0110\u1ecbnh ngh\u0129a b\u1ec7nh truy\u1ec1n nhi\u1ec5m<\/p>\n
2. Ph\u00e2n lo\u1ea1i b\u1ec7nh tb<\/p>\n
3. \u0110\u1eb7c \u0111i\u1ec3m d\u1ecbch t\u1ec5 h\u1ecdc b\u1ec7nh d\u1ea1i<\/p>\n
4. Bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng b\u1ec7nh d\u1ea1i<\/p>\n
5. \u0110\u1eb7c \u0111i\u1ec3m dth b\u1ec7nh sxh-d<\/p>\n","protected":false},"excerpt":{"rendered":"
T\u00ecnh hu\u1ed1ng 1: Ng\u00e0y gi\u1edd v\u00e0o vi\u1ec7n Di\u1ec5n bi\u1ebfn Y l\u1ec7nh 7h00p 12\/12\/2016 B\u1ec7nh ng\u00e0y th\u1ee9 4 Kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng tu\u1ed1c B\u1ec7nh t\u1ec9nh ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c DHST M\u1ea1ch 90l\/p, HA:130\/70mmHg Nhi\u1ec7t \u0111\u1ed9 :37 \u0111\u1ed9 C. Da ni\u00eam v\u00e0ng, kh\u00f4ng ph\u00f9 kh\u00f4ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da Gan to 2cm l\u00e1ch to 2cm XN: …<\/p>\n","protected":false},"author":11,"featured_media":4495,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[121],"tags":[],"class_list":["post-2631","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-truyen-nhiem"],"_links":{"self":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2631","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\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/comments?post=2631"}],"version-history":[{"count":1,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2631\/revisions"}],"predecessor-version":[{"id":2632,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/2631\/revisions\/2632"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media\/4495"}],"wp:attachment":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media?parent=2631"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=2631"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=2631"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}