- Phat hien da chan thtfdng: chan thtfdng so nao. CT ngtfc. bung — Giam dau bang thuoc: M orphine O.Olg, Feldene...
- Phong va chong soc bang truyen dich hoac mau (theo so ltfdng hong cau v& hematocrit).
5.2. Dieu trj gay than xifdng dui d tre em
Gay than xtfdng dui d tre em thtfdng la gay canh ttfdi, it di lech, thdi gian lien xtfdng nhanh nen thien ve dieu tri bao ton.
Tre sd sinh: nep thang true xtfdng bang bia cting 10-12 ngay Tre con bu den tre em dtfdi 3 tuoi: bo bot ech
Tre 4-12 tuoi: Gay me, keo nan va lam bot chau ltfng chan de bot 4-8-12 tu&n tuy theo do tuoi. Nhting ca gay phtic tap co the keo lien tuc, sau day bo bot tiep tuc.
Neu bo bot khong ket qua (di lech thti phat) phai md ket hdp xtfdng. Nep vit: benh nhan phai md lai lan hai de thao nep vit
Dinh dtfdi mSu chuyen: neu khong viing, phai tang ctfdng them bot d i bi cting khdp goi.
Phtfdng phap Metaizeau: dong mot chum dinh (dinh chiu dtfdc ltfc dan hdi) ttf tren cac loi cau di len.
Phtfdng phap Ender dong ttf tren loi cau trong, dinh ttfa vao thanh xtfdng ddi dien len cd xtfdng dui (hinh 23.4).
5.3. Dieu trj gay than xtfdng dui d ngtfdi ldn
• K eo ta
Dung dinh Steinm ann, K irschner xuyen qua loi cau dui hoac qua loi cu trtfdc xtfdng chay de keo vdi trong ltfdng 1/8-1/6 trong ltfdng cd the.
M uc dich: bat dong tam thdi, de chuan bi cho cuoc md sau. Hoac keo lien tuc trong nhtfng trtfdng hdp khdng cd chi dinh md (benh ve mau, nhtfng ndi khong co dieu kien phau thuat...) sau 3-4 tuan bd bot chau ltfng chan.
• M o k e t h op xitOng (h in h 23.5)
— Dinh noi tuy: sti dung tti 50 nam nay
Dinh K untscher md o gay: dong cho gay 1/3 gitia than xtidng dui + Uu diem: nan de, phat hien net thtfdng tdn, gh6p dtidc xtidng + Nhtfdc diem: mat stf lien xtfdng sinh ly, ti le nhilm khu£n cao.
Ddng dinh kin vdi m an huynh quang tang sang. Ng&y nay ngtfdi ta dong dinh kin cho moi doan gay than xtfdng dui, moi k ilu gay than xtfdng dtii.
- Nep vit: dtfdc dung nhieu ttf nam 1960-1970 chu yeu dung cho ndi ong tuy rong 1/3 tren, 1/3 dtfcli.
+ Uu diem: co dinh xtfdng vtfng, tap phuc hoi cd nang sdm
+ Nhtfdc diem: nhiem khuan cao, gay nep vit qua lo vit, sau khi lien xtfdng phai mo lay nep vit...
f \ \
Hinh 23.4. Dong dinh Ender cl tre em Hinh 23.5. Dinh co chot
• D ieu tri g a y hd xtfdng dui (xem p h a n dieu tri bien chtfng)
6. CAC BIEN CHLTNG VA PH l/O N G PHAP DIEU TRj6.1. Bien chtfng ngay 6.1. Bien chtfng ngay
• Soc c h a n thtfdng (d o m at m au, do dau)
- Bat dong tot cho benh nhan
- Boi phu khoi ltfdng tuan hoan (mau, dich thay the mau) theo mach, huyet ap, cong thtfc mau va hem atocrit.
- Dung thuoc giam dau: M orphine, Feldene... ltfu y cac benh nhan tre em, ngtfdi gia.
• G ay xtfdn g hd
Vdi gay hd do 1 do 2 den sdm trtfdc 6 gid, dieu kien (the trang benh nhan, trang thiet bi, gay me hoi siic, phau thuat vien chuyen khoa) cho phep ket hdp xtfdng ngay. Day la mot phtfdng phap tot nhtfng het stic than trong, danh gia that dung thtfdng ton va sau mo phai theo doi sat. (adsbygoogle = window.adsbygoogle || []).push({});
Gay hcl do 3 va gay hd den muon: c i t loc - rach rong - co dinh ngoai - de hd da. Ngoai ra con phtfdng phap: keo lien tuc, cit loc bo bot
• Ton thUdng mach mau, than kinh
Nguyen tic