M t s kinh nghi m ch n ộ ố ệ ẩ
đoán đi u tr SXHD t i tuy n ề ị ạ ế
huy nệ
BSCK2. NGUY N MINH TI NỄ Ế
NHÓM S T XU T HUY T BV NHI ĐNG 1Ố Ấ Ế Ồ
Handbook for clinical
management
of dengue
World Health Organization 2012
2012
Các “bẫy” trong chẩn đoán và
xử trí SXHD
•Không nghĩ tới SXHD
ở bệnh nhân sốtvà
không cho theo dõi
•Luôn nghĩ tới SXHD khi
bn có sốt
•Không XN máu khi
BN sốt N3
•Không hiểu diễn tiến
CTM
CTM bình thường
loại trừ SXHD
•CTM khi nghi ngờ SXHD
N3
•XN CTM sớm cung cấp
Hct nền để so sánh với
các kết quả tiếp theo
•Hct tăng trong giai đoạn
nguy hiểm.
•BC và TC giảm trong giai
đoạn sốt gợi ý SXHD
•BN có dấu hiệu cảnh
báo trong đêm nhưng
đợi đến sáng hôm
sau mới nhập viện
vào sốc, sốc nặng
•Giải thích, dặn dò có
dấu hiệu cảnh báo
NV ngay bất cứ giờ
nào, kể cả trong đêm
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