{"id":929,"date":"2021-09-09T00:38:00","date_gmt":"2021-09-08T17:38:00","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=929"},"modified":"2021-09-09T00:38:25","modified_gmt":"2021-09-08T17:38:25","slug":"viem-mu-mang-phoi","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/viem-mu-mang-phoi\/","title":{"rendered":"Vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>\u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/p>\n\n\n\n<ul><li>Vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i l\u00e0 s\u1ef1 t\u00edch t\u1ee5 m\u1ee7 trong khoang m\u00e0ng ph\u1ed5i, do nhi\u1ec1u nguy\u00ean nh\u00e2n nh\u01b0 vi\u00eam m\u00e0ng ph\u1ed5i, vi\u00eam ph\u1ed5i, ph\u1eabu thu\u1eadt l\u1ed3ng ng\u1ef1c, ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c k\u1ebft h\u1ee3p nhi\u1ec1u y\u1ebfu t\u1ed1 g\u00e2y n\u00ean.<\/li><li>Nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p c\u1ee7a vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i \u1edf tr\u1ebb em l\u00e0 do vi\u00eam ph\u1ed5i tr\u01b0\u1edbc \u0111\u00f3.<\/li><li>\u00a0Vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i chia l\u00e0m 3 giai \u0111o\u1ea1n: giai \u0111o\u1ea1n xu\u1ea5t ti\u1ebft, giai \u0111o\u1ea1n fibrin h\u00f3a, giai \u0111o\u1ea1n t\u1ed5 ch\u1ee9c h\u00f3a. T\u00f9y theo giai \u0111o\u1ea1n m\u00e0 c\u00f3 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c nhau.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"820\" height=\"332\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-1.jpg\" alt=\"\" class=\"wp-image-931\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-1.jpg 820w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-1-300x121.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-1-768x311.jpg 768w\" sizes=\"(max-width: 820px) 100vw, 820px\" \/><figcaption><strong>H\u00ecnh 1. H\u00ecnh \u1ea3nh vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i giai \u0111o\u1ea1n fibrin h\u00f3a<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>T\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh<\/strong><\/p>\n\n\n\n<ul><li>T\u00e1c nh\u00e2n th\u01b0\u1eddng g\u1eb7p: Staphylococcus aureus. T\u00e1c nh\u00e2n \u00edt g\u1eb7p: ph\u1ebf c\u1ea7u, Klebsiella, Mycoplasma.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/p>\n\n\n\n<ul><li>Nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p c\u1ee7a vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i \u1edf tr\u1ebb em l\u00e0 nhi\u1ec5m tr\u00f9ng li\u00ean quan \u0111\u1ebfn vi\u00eam ph\u1ed5i tr\u01b0\u1edbc \u0111\u00f3 n\u00ean tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng \u0111i\u1ec3n h\u00ecnh bao g\u1ed3m tri\u1ec7u ch\u1ee9ng vi\u00eam h\u00f4 h\u1ea5p nh\u01b0 s\u1ed1t, ho.<\/li><li>N\u1eb7ng h\u01a1n l\u00e0 suy h\u00f4 h\u1ea5p k\u00e8m m\u1ec7t m\u1ecfi, s\u1ed1t dai d\u1eb3ng, \u0111au ng\u1ef1c ki\u1ec3u m\u00e0ng ph\u1ed5i.<\/li><li>Th\u0103m kh\u00e1m:<ul><li>B\u1ec7nh nh\u00e2n v\u1ebb m\u1eb7t nhi\u1ec5m tr\u00f9ng, m\u00f4 kh\u00f4, l\u01b0\u1ee1i d\u01a1<\/li><li>Th\u1edf nhanh, co k\u00e9o c\u00e1c c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5, c\u00e1nh m\u0169i ph\u1ea5p ph\u1ed3ng<\/li><li>G\u00f5 \u0111\u1ee5c v\u00f9ng th\u1ea5p<\/li><li>Nghe th\u1ea5y \u00e2m ph\u1ebf b\u00e0o gi\u1ea3m b\u00ean khoang m\u00e0ng ph\u1ed5i b\u1ecb tr\u00e0n d\u1ecbch<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<ul><li>T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u, CRP: x\u00e1c \u0111\u1ecbnh c\u00f3 t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng<\/li><li>\u00a0X-quang ng\u1ef1c: m\u1edd g\u00f3c s\u01b0\u1eddn ho\u00e0nh ho\u1eb7c m\u1edd 1\/2 d\u01b0\u1edbi ph\u1ed5i ho\u1eb7c to\u00e0n b\u1ed9 ph\u1ed5i k\u00e8m \u0111\u1ea9y l\u1ec7ch trung th\u1ea5t v\u1ec1 ph\u00eda \u0111\u1ed1i di\u1ec7n, h\u01a1i v\u1eb9o c\u1ed9t s\u1ed1ng l\u00f5m v\u1ec1 ph\u00eda tr\u00e0n m\u1ee7 m\u00e0ng ph\u1ed5i. (h\u00ecnh 2)<\/li><li>Si\u00eau \u00e2m ng\u1ef1c: c\u00f3 d\u1ecbch m\u00e0ng ph\u1ed5i.<\/li><li>C\u1ea5y m\u00e1u.<\/li><li>D\u1ecbch m\u00e0ng ph\u1ed5i: sinh h\u00f3a, t\u1ebf b\u00e0o, soi t\u01b0\u01a1i nhu\u1ed9m Gram, c\u1ea5y v\u00e0 kh\u00e1ng sinh \u0111\u1ed3.<\/li><li>Ch\u1ec9 \u0111\u1ecbnh ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh:<ul><li>Th\u1ea5t b\u1ea1i sau 48-72 gi\u1edd \u0111i\u1ec1u tr\u1ecb n\u1ed9i, c\u1ea7n can thi\u1ec7p ph\u1eabu thu\u1eadt.<\/li><li>Nghi ng\u1edd d\u00e0y d\u00ednh m\u00e0ng ph\u1ed5i.<\/li><li>K\u00e8m b\u1ec7nh l\u00fd nhu m\u00f4 ph\u1ed5i: \u00e1p xe, vi\u00eam ph\u1ed5i ho\u1ea1i t\u1eed, c\u01a1 \u0111\u1ecba suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/li><\/ul><\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"822\" height=\"392\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-2.jpg\" alt=\"\" class=\"wp-image-935\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-2.jpg 822w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-2-300x143.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-2-768x366.jpg 768w\" sizes=\"(max-width: 822px) 100vw, 822px\" \/><figcaption><strong>H\u00ecnh 2: XQ ng\u1ef1c th\u1eb1ng (A) v\u00e0 nghi\u00eang (B) cho th\u1ea5y tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i ph\u1ea3i.<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u0110i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n<p>Vi\u1ec7c ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i \u1edf tr\u1ebb em gi\u00fap gi\u1ea3m t\u1ec9 l\u1ec7 vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i. \u0110i\u1ec1u tr\u1ecb vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i t\u00f9y v\u00e0o t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng, giai \u0111o\u1ea1n b\u1ec7nh m\u00e0 b\u1ec7nh nhi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n.<\/p>\n\n\n\n<p><strong>Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb: <\/strong>kh\u00e1ng sinh ph\u00f9 h\u1ee3p \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch \u00b1 ch\u1ecdc h\u00fat\/ d\u1eabn l\u01b0u \u00b1 can thi\u1ec7p ngo\u1ea1i khoa \u0111\u1ec3 l\u00e0m s\u1ea1ch khoang m\u00e0ng ph\u1ed5i.<\/p>\n\n\n\n<p><strong>\u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/strong><\/p>\n\n\n\n<ul><li>Kh\u00e1ng sinh<\/li><li>Ch\u1ecdc d\u1ecbch (m\u1ee7) m\u00e0ng ph\u1ed5i \u00b1 d\u1eabn l\u01b0u: t\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 d\u1ecbch (m\u1ee7) trong m\u00e0ng ph\u1ed5i v\u00e0 t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p.<\/li><li>D\u1eabn l\u01b0u k\u1ebft h\u1ee3p thu\u1ed1c ti\u00eau s\u1ee3i huy\u1ebft: \u00edt d\u00f9ng, hi\u1ec7u qu\u1ea3 ch\u01b0a r\u00f5 r\u00e0ng, chi ph\u00ed cao.<\/li><li>\u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3: oxy, d\u1ecbch truy\u1ec1n\/ dinh d\u01b0\u1ee1ng, h\u1ea1 s\u1ed1t, gi\u1ea3m \u0111au.<\/li><\/ul>\n\n\n\n<p><strong>\u0110i\u1ec1u tr\u1ecb ngo\u1ea1i khoa<\/strong><\/p>\n\n\n\n<ul><li>Th\u01b0\u1eddng c\u1ea7n can thi\u1ec7p ph\u1eabu thu\u1eadt trong vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i giai \u0111o\u1ea1n fibrin h\u00f3a v\u00e0 giai \u0111o\u1ea1n t\u1ed5 ch\u1ee9c h\u00f3a.<\/li><li>Ph\u1eabu thu\u1eadt \u1edf \u0111\u00e2y bao g\u1ed3m: ph\u1eabu thu\u1eadt m\u1edf ng\u1ef1c, ph\u1eabu thu\u1eadt n\u1ed9i soi l\u1ed3ng ng\u1ef1c h\u1ed7 tr\u1ee3 (h\u00ecnh 3).<\/li><li>Ng\u00e0y nay, ph\u1eabu thu\u1eadt n\u1ed9i soi l\u1ed3ng ng\u1ef1c h\u1ed7 tr\u1ee3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ng\u00e0y c\u00e0ng nhi\u1ec1u trong vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i \u1edf tr\u1ebb em v\u1edbi nh\u1eefng \u01b0u \u0111i\u1ec3m: gi\u00fap ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c giai \u0111o\u1ea1n b\u1ec7nh, x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u, l\u00e0m s\u1ea1ch khoang m\u00e0ng ph\u1ed5i d\u01b0\u1edbi s\u1ef1 ki\u1ec3m so\u00e1t kh\u00e1 t\u1ed1t v\u00ec quan s\u00e1t \u0111\u01b0\u1ee3c ph\u1ea7n l\u1edbn khoang m\u00e0ng ph\u1ed5i, gi\u1ea3m \u0111au, th\u1ea9m m\u1ef9 h\u01a1n.<\/li><li>Tuy nhi\u00ean, ph\u1eabu thu\u1eadt m\u1edf ng\u1ef1c v\u1eabn c\u00f3 vai tr\u00f2 quan tr\u1ecdng trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh n\u1eb7ng (giai \u0111o\u1ea1n t\u1ed5 ch\u1ee9c h\u00f3a) ho\u1eb7c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt n\u1ed9i soi.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-3.jpg\" alt=\"\" class=\"wp-image-938\" width=\"359\" height=\"457\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-3.jpg 478w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/vmmp-3-235x300.jpg 235w\" sizes=\"(max-width: 359px) 100vw, 359px\" \/><figcaption><strong>H\u00ecnh 3: K\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt n\u1ed9i soi l\u1ed3ng ng\u1ef1c h\u1ed7 tr\u1ee3<\/strong><br><em>\u201cNgu\u1ed3n: Kurt B. 2006<\/em>\u201d.<\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u0103m s\u00f3c sau m\u1ed5<\/strong><\/p>\n\n\n\n<ul><li>Sau m\u1ed5 c\u00f3 th\u1ec3 n\u1eb1m ph\u00f2ng h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c n\u1ebfu tr\u01b0\u1edbc \u0111\u00f3 t\u1ed5ng tr\u1ea1ng b\u1ec7nh nh\u00e2n x\u1ea5u.<\/li><li>Theo d\u00f5i sinh hi\u1ec7u, kh\u00e1ng sinh, gi\u1ea3m \u0111au<\/li><li>T\u1eadp v\u1eadt l\u00ed tr\u1ecb li\u1ec7u h\u00f4 h\u1ea5p \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n 1 ng\u00e0y sau khi \u0111\u1eb7t ODL m\u00e0ng ph\u1ed5i v\u00e0 k\u00e9o d\u00e0i \u00edt nh\u1ea5t 3 th\u00e1ng. M\u1ee5c \u0111\u00edch t\u1eadp s\u1edbm \u0111\u1ec3 m\u1ee7 tho\u00e1t ra ngo\u00e0i d\u1ec5 d\u00e0ng h\u01a1n v\u00e0 \u0111\u1ec1 ph\u00f2ng d\u00e0y d\u00ednh m\u00e0ng ph\u1ed5i v\u1ec1 sau<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>T\u00e1i kh\u00e1m<\/strong><\/p>\n\n\n\n<ul><li>Hai tu\u1ea7n trong 2 th\u00e1ng ho\u1eb7c s\u1edbm h\u01a1n n\u1ebfu c\u00f3 b\u1ea5t th\u01b0\u1eddng.<\/li><\/ul>\n\n\n\n<p><strong><em>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/em><\/strong><\/p>\n\n\n\n<ul><li>Tr\u01b0\u01a1ng Nguy\u1ec5n Uy Linh, L\u00ea Nguy\u1ec5n Ng\u1ecdc Di\u1ec5m, H\u1ed3 Trung C\u01b0\u1eddng (2018), \u201cVi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i\u201d, Ngo\u1ea1i Nhi l\u00e2m s\u00e0ng, Nh\u00e0 Xu\u1ea5t b\u1ea3n Y H\u1ecdc, tr. 374-378.<\/li><li>George W. Holcomb, J. Patrick Murphy, Daniel J. Ostlie. 2014. ASHCRAFT\u2019S PEDIATRIC SURGERY. London: Elsevier .<\/li><li>Tomoaki Taguchi \u2022 Tadashi Iwanaka. n.d. Operative General Surgery in Neonates and Infants. Japan: Sringer.<\/li><li>Kurt B., Winterhalter K. M., Connors R. H., et al. (2006), &#8220;Therapy of parapneumonic effusions in children: video-assisted thoracoscopic surgery versus conventional thoracostomy drainage&#8221;, Pediatrics, 118 (3). pp. 547-53.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u0110\u1ea1i c\u01b0\u01a1ng Vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i l\u00e0 s\u1ef1 t\u00edch t\u1ee5 m\u1ee7 trong khoang m\u00e0ng ph\u1ed5i, do nhi\u1ec1u nguy\u00ean nh\u00e2n nh\u01b0 vi\u00eam m\u00e0ng ph\u1ed5i, vi\u00eam ph\u1ed5i, ph\u1eabu thu\u1eadt l\u1ed3ng ng\u1ef1c, ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c k\u1ebft h\u1ee3p nhi\u1ec1u <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/viem-mu-mang-phoi\/\" title=\"Vi\u00eam m\u1ee7 m\u00e0ng ph\u1ed5i\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":4,"featured_media":931,"comment_status":"open","ping_status":"open","sticky":false,"template":"template-full.php","format":"standard","meta":[],"categories":[4,11],"tags":[],"_links":{"self":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/929"}],"collection":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/comments?post=929"}],"version-history":[{"count":6,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/929\/revisions"}],"predecessor-version":[{"id":939,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/929\/revisions\/939"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/931"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=929"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=929"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=929"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}