{"id":930,"date":"2021-09-09T00:47:59","date_gmt":"2021-09-08T17:47:59","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=930"},"modified":"2021-09-09T01:39:48","modified_gmt":"2021-09-08T18:39:48","slug":"ap-xe-gan-o-tre-em","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/ap-xe-gan-o-tre-em\/","title":{"rendered":"\u00c1p xe gan \u1edf tr\u1ebb em"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>\u0110\u1ecbnh ngh\u0129a<\/strong><\/p>\n\n\n\n<ul><li>\u00c1p xe gan l\u00e0 s\u1ef1 t\u00edch t\u1ee5 m\u1ee7 trong gan th\u00e0nh m\u1ed9t \u1ed5 m\u1ee7 ho\u1eb7c th\u00e0nh nhi\u1ec1u \u1ed5 m\u1ee7 r\u1ea3i r\u00e1c, th\u01b0\u1eddng c\u00f3 \u00e1p xe gan do vi tr\u00f9ng, \u00e1p xe gan do amip v\u00e0 do n\u1ea5m.<\/li><li>\u00c1p xe gan do vi tr\u00f9ng: chi\u1ebfm g\u1ea7n 80% \u00e1p xe gan \u1edf tr\u1ebb em, t\u1ea7n su\u1ea5t thay \u0111\u1ed5i t\u1eeb 11-79\/100.000 tr\u1ebb t\u00f9y theo n\u01b0\u1edbc.<\/li><li>\u00c1p xe gan do amip chi\u1ebfm 10 &#8211; 20% c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u00e1p xe gan, \u00edt g\u1eb7p \u1edf tr\u1ebb em h\u01a1n ng\u01b0\u1eddi l\u1edbn. V\u1ecb tr\u00ed \u1edf gan ph\u1ea3i, th\u01b0\u1eddng l\u00e0 \u1ed5 m\u1ee7 l\u1edbn \u0111\u01a1n \u0111\u1ed9c (tr\u00ean 80%), v\u00e0 n\u00f3 c\u00f3 xu h\u01b0\u1edbng ph\u00e1t tri\u1ec3n v\u1ec1 ph\u00eda v\u1ecf gan. Ch\u1ea5t m\u1ee7 trong \u1ed5 \u00e1p xe th\u01b0\u1eddng c\u00f3 m\u00e0u s\u00f4 c\u00f4 la, soi t\u01b0\u01a1i m\u1ee7 th\u1ea5y am\u00edp t\u1ec9 l\u1ec7 r\u1ea5t th\u1ea5p (d\u01b0\u1edbi 15%).<\/li><li>\u00c1p xe gan do n\u1ea5m: r\u1ea5t hi\u1ebfm g\u1eb7p, th\u01b0\u1eddng l\u00e0 m\u1ed9t \u1ed5 \u00e1p xe \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c nh\u1eefng vi \u00e1p xe nh\u1ecf \u1edf gan v\u00e0 l\u00e1ch, c\u00f3 th\u1ec3 g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n b\u1ea1ch c\u1ea7u c\u1ea5p, c\u01a1 \u0111\u1ecba suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>T\u00e1c nh\u00e2n c\u1ee7a \u00e1p xe gan tr\u1ebb em<\/strong><\/p>\n\n\n\n<ul><li>Vi tr\u00f9ng th\u01b0\u1eddng g\u1eb7p: Staphylococcus aureus, Enterobacteriaceae, Streptococcus milleri, Bacteroides, E. Coli, Klebsiella v\u00e0 vi khu\u1ea9n k\u1ef5 kh\u00ed.<\/li><li>Amip: th\u01b0\u1eddng g\u1eb7p Entamoeba histolytica,&#8230;<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a \u00e1p xe gan<\/strong><\/p>\n\n\n\n<ul><li>Vi tr\u00f9ng: sau vi\u00eam ru\u1ed9t th\u1eeba v\u1ee1, c\u01a1 \u0111\u1ecba suy nh\u01b0\u1ee3c, gi\u1ea3m b\u1ea1ch c\u1ea7u h\u1ea1t, h\u1ed3ng c\u1ea7u h\u00ecnh li\u1ec1m, suy gi\u1ea3m mi\u1ec5n d\u1ecbch b\u1ea9m sinh hay m\u1eafc ph\u1ea3i, b\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh g\u00e2y h\u1eb9p t\u1eafc \u0111\u01b0\u1eddng m\u1eadt, nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng m\u1eadt, nhi\u1ec5m giun s\u00e1n.<\/li><li>Amip: b\u1ec7nh th\u01b0\u1eddng x\u1ea3y ra tr\u00ean ng\u01b0\u1eddi b\u1ec7nh sau khi b\u1ecb nhi\u1ec5m tr\u00f9ng ti\u00eau h\u00f3a, sau b\u1ecb h\u1ed9i ch\u1ee9ng l\u1ef5 ( sau khi b\u1ecb ti\u00eau l\u1ecfng c\u00f3 \u0111\u00e0m v\u00e0 m\u00f3t r\u1eb7n, th\u01b0\u1eddng g\u1ecdi l\u00e0 ki\u1ebft l\u1ef5&#8230;).<\/li><li>N\u1ea5m: c\u00f3 th\u1ec3 g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n b\u1ea1ch c\u1ea7u c\u1ea5p, c\u01a1 \u0111\u1ecba suy gi\u1ea3m mi\u1ec5n d\u1ecbch.<\/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<p>C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p:<\/p>\n\n\n\n<ul><li>S\u1ed1t cao (39-40<sup>0<\/sup>C) k\u00e8m d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng (m\u00f4i kh\u00f4, l\u01b0\u1ee1i d\u01a1). \u0110\u1ed1i v\u1edbi \u00e1p xe gan do amip: c\u00f3 th\u1ec3 kh\u1edfi \u0111\u1ea7u s\u1ed1t cao (39- 40<sup>0<\/sup>C) sau \u0111\u00f3 gi\u1ea3m d\u1ea7n (37,5-38<sup>0<\/sup>C).<\/li><li>M\u1ec7t m\u1ecfi, ch\u00e1n \u0103n.<\/li><li>C\u00f3 th\u1ec3 ho, ho\u1eb7c n\u1ea5c c\u1ee5t do k\u00edch th\u00edch c\u01a1 ho\u00e0nh<\/li><li>\u0110au b\u1ee5ng (c\u00f3 th\u1ec3 khu tr\u00fa \u1edf h\u1ea1 s\u01b0\u1eddn ph\u1ea3i ho\u1eb7c kh\u00f4ng) \u0111au t\u0103ng l\u00ean khi ho, \u0111i l\u1ea1i, h\u00edt v\u00e0o s\u00e2u, n\u1eb1m nghi\u00eang ph\u1ea3i.<\/li><li>S\u1ee5t c\u00e2n<\/li><\/ul>\n\n\n\n<p>Kh\u00e1m:<\/p>\n\n\n\n<ul><li>Gan to, m\u1ec1m; rung gan (+) (r\u1ea5t c\u00f3 gi\u00e1 tr\u1ecb trong ch\u1ea9n \u0111o\u00e1n); \u1ea5n k\u1ebd x\u01b0\u1eddn (+) (d\u1ea5u hi\u1ec7u Ludlow (+): \u1ea5n k\u1ebd s\u01b0\u1eddn IX, \u0111\u01b0\u1eddng n\u00e1ch tr\u01b0\u1edbc gi\u1eefa \u0111au ch\u00f3i).<\/li><li>Ph\u1ebf \u00e2m gi\u1ea3m \u0111\u00e1y ph\u1ed5i ph\u1ea3i<\/li><li>C\u00f3 th\u1ec3 v\u00e0ng da (&lt;25%): do t\u1ebf b\u00e0o gan b\u1ecb h\u1ee7y ho\u1ea1i<\/li><\/ul>\n\n\n\n<p><strong>C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n\n\n\n<ul><li>X\u00e9t nghi\u1ec7m m\u00e1u<ul><li>B\u1ea1ch c\u1ea7u th\u01b0\u1eddng t\u0103ng cao<\/li><li>T\u1ed1c \u0111\u1ed9 l\u1eafng m\u00e1u t\u0103ng<\/li><\/ul><\/li><li>Ch\u1ee9c n\u0103ng gan: phosphatase ki\u1ec1m t\u0103ng, AST, ALT, Bilirubin c\u00f3 th\u1ec3 t\u0103ng<\/li><li>C\u1ea5y m\u00e1u d\u01b0\u01a1ng t\u00ednh trong 50% tr\u01b0\u1eddng h\u1ee3p<\/li><li>Huy\u1ebft thanh ch\u1ea9n \u0111o\u00e1n amip (+) trong 95% tr\u01b0\u1eddng h\u1ee3p&nbsp;<\/li><li>Soi ph\u00e2n: th\u01b0\u1eddng \u00edt g\u1eb7p amip trong ph\u00e2n.<\/li><li>Xquang<ul><li>B\u00f3ng c\u01a1 ho\u00e0nh ph\u1ea3i n\u00e2ng cao<\/li><li>C\u00f3 th\u1ec3 c\u00f3 tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i ph\u1ea3i<\/li><\/ul><\/li><li>Si\u00eau \u00e2m: c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c \u1ed5 \u00e1p xe &gt;2cm. l\u00e0 ph\u01b0\u01a1ng ti\u1ec7n gi\u00fap ch\u1ea9n \u0111o\u00e1n v\u00e0 theo d\u00f5i di\u1ec5n ti\u1ebfn c\u1ee7a \u00e1p xe gan r\u1ea5t t\u1ed1t, x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed \u1ed5 m\u1ee7 v\u00e0 h\u01b0\u1edbng d\u1eabn ch\u1ecdc d\u00f2.<\/li><li>CT scan: c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c \u1ed5 \u00e1p xe &lt;1cm.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"646\" height=\"266\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/ap-xe-gan.jpg\" alt=\"\" class=\"wp-image-942\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/ap-xe-gan.jpg 646w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/ap-xe-gan-300x124.jpg 300w\" sizes=\"(max-width: 646px) 100vw, 646px\" \/><figcaption><strong>H\u00ecnh 1: \u00c1p xe gan tr\u00ean CT, (A) \u00c1p xe \u0111\u01a1n \u1ed5 do amip, (B) \u00c1p xe \u0111a \u1ed5 do vi tr\u00f9ng<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<ul><li>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng: \u0111au HSP, gan to m\u1ec1m \u0111au, rung gan, \u1ea5n k\u1ebd s\u01b0\u1eddn \u0111au.<\/li><li>X\u00e9t nghi\u1ec7m m\u00e1u, huy\u1ebft thanh ch\u1ea9n \u0111o\u00e1n (trong tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m amip).<\/li><li>Si\u00eau \u00e2m<\/li><li>Ch\u1ecdc d\u00f2 ra m\u1ee7 n\u00e2u socola (nhi\u1ec5m amip) ho\u1eb7c v\u00e0ng, xanh (vi tr\u00f9ng, kh\u00f4ng lo\u1ea1i tr\u1eeb amip b\u1ed9i nhi\u1ec5m), c\u1ea5y m\u1ee7.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/p>\n\n\n\n<ul><li>Nang gan b\u1ed9i nhi\u1ec5m<\/li><li>Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng m\u1eadt, vi\u00eam t\u00fai m\u1eadt, nang \u0111\u01b0\u1eddng m\u1eadt<\/li><li>\u00c1p xe gan do amip<\/li><li>Vi\u00eam ph\u1ed5i<\/li><li>Ung th\u01b0 gan<\/li><li>Vi\u00eam gan<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Bi\u1ebfn ch\u1ee9ng<\/strong><\/p>\n\n\n\n<ul><li>V\u1ee1 \u1ed5 \u00e1p xe:<ul><li>V\u00e0o m\u00e0ng tim g\u00e2y ch\u00e8n \u00e9p tim.<\/li><li>V\u00e0o \u1ed5 b\u1ee5ng g\u00e2y vi\u00eam ph\u00fac m\u1ea1c.<\/li><li>V\u00e0o m\u00e0ng ph\u1ed5i g\u00e2y tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i ph\u1ea3i.<\/li><\/ul><\/li><li>S\u1ed1c nhi\u1ec5m tr\u00f9ng (trong \u00e1p xe gan do vi tr\u00f9ng ho\u1eb7c amip c\u00f3 b\u1ed9i nhi\u1ec5m)<\/li><li>Ch\u1ea3y m\u00e1u \u0111\u01b0\u1eddng m\u1eadt<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u0110i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n<p><strong><u>\u00c1p xe gan do vi tr\u00f9ng<\/u><\/strong><\/p>\n\n\n\n<p><strong><em>Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/em><\/strong><strong><\/strong><\/p>\n\n\n\n<ul><li>\u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u: kh\u00e1ng sinh th\u00edch h\u1ee3p, d\u1eabn l\u01b0u.<\/li><li>Theo d\u00f5i, ph\u00e1t hi\u1ec7n, \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi c\u00e1c bi\u1ebfn ch\u1ee9ng<\/li><\/ul>\n\n\n\n<p><strong><em>\u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/em><\/strong><\/p>\n\n\n\n<ul><li>\u00c1p xe gan do vi tr\u00f9ng kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 \u0111\u00e1p \u1ee9ng v\u1edbi kh\u00e1ng sinh trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng th\u1ec3 ch\u1ecdc h\u00fat m\u1ee7 \u0111\u01b0\u1ee3c v\u00ec b\u1ec7nh nh\u00e2n qu\u00e1 n\u1eb7ng hay \u00e1p xe \u0111a \u1ed5.<\/li><li>Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh kho\u1ea3ng 4-6 tu\u1ea7n, c\u00f3 th\u1ec3 k\u00e9o d\u00e0i \u0111\u1ebfn 12 tu\u1ea7n trong tr\u01b0\u1eddng h\u1ee3p \u00e1p xe \u0111a \u1ed5.<\/li><\/ul>\n\n\n\n<p><strong><em>\u0110i\u1ec1u tr\u1ecb ngo\u1ea1i khoa:<\/em><\/strong><\/p>\n\n\n\n<ul><li>Ch\u1ecdc h\u00fat, d\u1eabn l\u01b0u d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn si\u00eau \u00e2m (ng\u00e0y nay \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ng\u00e0y c\u00e0ng nhi\u1ec1u) ho\u1eb7c ph\u1eabu thu\u1eadt d\u1eabn l\u01b0u<\/li><li>\u0110i\u1ec1u tr\u1ecb kh\u00e1ng sinh theo kh\u00e1ng sinh \u0111\u1ed3.<\/li><li>Ch\u1ec9 \u0111\u1ecbnh d\u1eabn l\u01b0u \u00e1p xe d\u01b0\u1edbi si\u00eau \u00e2m<ul><li>\u1ed4 \u00e1p xe l\u1edbn (th\u01b0\u1eddng &gt; 5cm) v\u00e0 c\u00f3 nguy c\u01a1 v\u1ee1 (\u0111\u1eb7c bi\u1ec7t \u1edf \u1ed5 \u00e1p xe th\u00f9y tr\u00e1i)<\/li><\/ul><ul><li>Kh\u00f4ng \u0111\u00e1p \u1ee9ng sau 48-72 gi\u1edd \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/li><\/ul><ul><li>C\u00f3 t\u00ecnh tr\u1ea1ng suy gan<\/li><\/ul><\/li><\/ul>\n\n\n\n<ul><li>Vi\u1ec7c d\u1eabn l\u01b0u d\u01b0\u1edbi si\u00eau \u00e2m c\u00f3 th\u1ec3 kh\u00f4ng hi\u1ec7u qu\u1ea3 \u0111\u1ed1i v\u1edbi nh\u1eefng \u00e1p xe th\u00e0nh d\u00e0y, c\u00f3 m\u1ee7 qu\u00e1nh \u0111\u1eb7c ho\u1eb7c c\u00f3 v\u00e1ch v\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong tr\u01b0\u1eddng h\u1ee3p \u1ed5 \u00e1p xe g\u1ea7n m\u00e0ng ph\u1ed5i. Nh\u00ecn chung, t\u1ec9 l\u1ec7 th\u1ea5t b\u1ea1i trong \u0111i\u1ec1u tr\u1ecb b\u1eb1ng d\u1eabn l\u01b0u d\u01b0\u1edbi si\u00eau \u00e2m kho\u1ea3ng 5-30%. Khi \u0111\u00f3, tr\u1ebb c\u1ea7n \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt d\u1eabn l\u01b0u.<\/li><\/ul>\n\n\n\n<ul><li>Ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt d\u1eabn l\u01b0u<ul><li>\u1ed4 \u00e1p xe v\u1ee1<\/li><\/ul><ul><li>Th\u1ea5t b\u1ea1i v\u1edbi d\u1eabn l\u01b0u d\u01b0\u1edbi si\u00eau \u00e2m<\/li><\/ul><ul><li>\u1ed4 \u00e1p xe c\u00f3 v\u00e1ch<\/li><\/ul><ul><li>\u00c1p xe v\u1edbi m\u1ee7 qu\u00e1nh \u0111\u1eb7c<\/li><\/ul><ul><li>\u0110a \u1ed5 \u00e1p xe<\/li><\/ul><ul><li>\u00c1p xe \u1edf th\u00f9y tr\u00e1i<\/li><\/ul><ul><li>C\u00f3 k\u00e8m b\u1ec7nh l\u00fd kh\u00e1c trong \u1ed5 b\u1ee5ng c\u1ea7n ph\u1eabu thu\u1eadt<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><strong><u>\u0110\u1ed1i v\u1edbi \u00e1p xe gan do amip<\/u><\/strong><\/p>\n\n\n\n<p><strong><em>Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/em><\/strong><\/p>\n\n\n\n<ul><li>\u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u: thu\u1ed1c di\u1ec7t amip.<\/li><li>Theo d\u00f5i, ph\u00e1t hi\u1ec7n, \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi c\u00e1c bi\u1ebfn ch\u1ee9ng.<\/li><\/ul>\n\n\n\n<p><strong><em>\u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/em><\/strong><\/p>\n\n\n\n<ul><li>H\u1ea7u h\u1ebft c\u00e1c \u00e1p xe do amip kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi thu\u1ed1c di\u1ec7t amip (95%): metronidazole, paromomycin.<\/li><li>K\u1ebft h\u1ee3p kh\u00e1ng sinh th\u00edch h\u1ee3p trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 b\u1ed9i nhi\u1ec5m.<\/li><\/ul>\n\n\n\n<p><strong><em>\u0110i\u1ec1u tr\u1ecb ngo\u1ea1i khoa<\/em><\/strong><\/p>\n\n\n\n<ul><li>\u00cdt khi c\u1ea7n can thi\u1ec7p ngo\u1ea1i khoa n\u1ebfu kh\u00f4ng c\u00f3 b\u1ed9i nhi\u1ec5m ho\u1eb7c bi\u1ebfn ch\u1ee9ng.<\/li><\/ul>\n\n\n\n<p><strong><u>\u0110\u1ed1i v\u1edbi \u00e1p xe gan do n\u1ea5m<\/u><\/strong><\/p>\n\n\n\n<ul><li>Thu\u1ed1c kh\u00e1ng n\u1ea5m nh\u01b0 amphotericin B, fluconazole.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ti\u00ean l\u01b0\u1ee3ng v\u00e0 theo d\u00f5i<\/strong><\/p>\n\n\n\n<ul><li>Tr\u01b0\u1edbc \u0111\u00e2y, t\u1ec9 l\u1ec7 t\u1eed vong c\u1ee7a \u00e1p xe gan kh\u00e1 cao l\u00ean \u0111\u1ebfn 40%. Hi\u1ec7n nay, nh\u1edd s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a thu\u1ed1c kh\u00e1ng sinh v\u00e0 s\u1ef1 h\u1ed7 tr\u1ee3 c\u1ee7a can thi\u1ec7p ngo\u1ea1i khoa, t\u1ec9 l\u1ec7 t\u1eed vong \u0111\u00e3 gi\u1ea3m c\u00f2n d\u01b0\u1edbi 5,5%.<\/li><li>Nh\u1eefng y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng x\u1ea5u: v\u00e0ng da, suy gan, nhi\u1ec5m tr\u00f9ng huy\u1ebft, v\u1ee1 \u00e1p xe g\u00e2y vi\u00eam ph\u00fac m\u1ea1c, \u1ed5 \u00e1p xe l\u1edbn, \u0111a \u1ed5 \u00e1p xe, albumin m\u00e1u &lt;2mg\/dl, Bilirubin &gt;3,5mg\/dl.<\/li><li>Tr\u1ebb c\u1ea7n \u0111\u01b0\u1ee3c t\u00e1i kh\u00e1m theo d\u00f5i sau xu\u1ea5t vi\u1ec7n theo h\u1eb9n c\u1ee7a b\u00e1c s\u0129.<\/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>Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh vi\u1ec7n Nhi \u0110\u1ed3ng 1<\/li><li>Mishra K, Basu S, Roychoudhury S, Kumar P. Liver abscess in children: an overview. World J Pediatr. 2010 Aug;6(3):210-6. doi: 10.1007\/s12519-010-0220-1. PMID: 20706820.<\/li><li>Roy Choudhury S, Khan NA, Saxena R, Yadav PS, Patel JN, Chadha R. Protocol-based management of 154 cases of pediatric liver abscess. Pediatr Surg Int. 2017 Feb;33(2):165-172. doi: 10.1007\/s00383-016-4009-8. Epub 2016 Nov 8. PMID: 27826650.<\/li><li>Chaubey D, Pandey A, Kumar P et al. Liver abscess in children: challenges in management, Int Surg J. 2017 Jan;4(1):107-110. DOI: http:\/\/dx.doi.org\/10.18203\/2349-2902.isj20164051<\/li><li>Salahi R, Dehghani SM, Salahi H, Bahador A, Abbasy HR, Salahi F. Liver abscess in children: a 10-year single centre experience.&nbsp;<em>Saudi J Gastroenterol<\/em>. 2011;17(3):199-202. doi:10.4103\/1319-3767.80384<\/li><li>https:\/\/sannhiag.vn\/ap-xe-gan-do-amip-o-tre-em\/<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u0110\u1ecbnh ngh\u0129a \u00c1p xe gan l\u00e0 s\u1ef1 t\u00edch t\u1ee5 m\u1ee7 trong gan th\u00e0nh m\u1ed9t \u1ed5 m\u1ee7 ho\u1eb7c th\u00e0nh nhi\u1ec1u \u1ed5 m\u1ee7 r\u1ea3i r\u00e1c, th\u01b0\u1eddng c\u00f3 \u00e1p xe gan do vi tr\u00f9ng, \u00e1p xe gan do <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/ap-xe-gan-o-tre-em\/\" title=\"\u00c1p xe gan \u1edf tr\u1ebb em\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":4,"featured_media":942,"comment_status":"open","ping_status":"open","sticky":false,"template":"template-full.php","format":"standard","meta":[],"categories":[4,16],"tags":[],"_links":{"self":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/930"}],"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=930"}],"version-history":[{"count":8,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/930\/revisions"}],"predecessor-version":[{"id":948,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/930\/revisions\/948"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/942"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=930"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=930"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=930"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}