{"id":2216,"date":"2018-11-19T13:23:18","date_gmt":"2018-11-19T13:23:18","guid":{"rendered":"https:\/\/robot.yeupet.vn\/benh-leptospira-tren-cho-meo\/"},"modified":"2018-11-19T13:23:18","modified_gmt":"2018-11-19T13:23:18","slug":"benh-leptospira-tren-cho-meo","status":"publish","type":"post","link":"https:\/\/robot.yeupet.vn\/index.php\/2018\/11\/19\/benh-leptospira-tren-cho-meo\/","title":{"rendered":"B\u1ec7nh Leptospira Tr\u00ean Ch\u00f3 M\u00e8o"},"content":{"rendered":"

1. Nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh<\/strong><\/p>\n

C\u0103n b\u1ec7nh do nhi\u1ec5m xo\u1eafn khu\u1ea9n leptospiral thu\u1ed9c lo\u00e0i Leptospira interrogans sensu Lato. Leptospires c\u00f3 h\u00ecnh s\u1ee3i, m\u1ecfng, linh ho\u1ea1t (\u0111\u01b0\u1eddng k\u00ednh 0,1-0,2 \u03bcm v\u00e0 d\u00e0i 6-12 \u03bcm) xo\u1eafn khu\u1ea9n t\u1ea1o th\u00e0nh h\u00ecnh xo\u1eafn \u1ed1c v\u1edbi \u0111\u1ea7u h\u00ecnh m\u00f3c<\/span><\/p>\n

\"benh-leptospira-tren-cho-meo\"<\/p>\n

H\u00ecnh m\u00f4 ph\u1ecfng leptospira<\/p>\n

2. D\u1ecbch t\u1ec5 h\u1ecdc<\/strong><\/p>\n

2.1 Lo\u00e0i v\u1eadt m\u1eafc b\u1ec7nh<\/strong>
\nT\u1ea5t c\u1ea3 lo\u00e0i \u0111\u1ed9ng v\u1eadt c\u00f3 v\u00fa (m\u00e1u n\u00f3ng) \u0111\u1ec1u c\u00f3 th\u1ec3 m\u1eafc b\u1ec7nh. Chu\u1ed9t \u0111\u01b0\u1ee3c coi l\u00e0 ngu\u1ed3n b\u1ec7nh.
\n\u1ede ch\u00f3: Ch\u00f3 khu v\u1ef1c n\u00f4ng th\u00f4n th\u00f4ng qua c\u00e1c ho\u1ea1t \u0111\u1ed9ng ti\u1ebfp x\u00fac ho\u1eb7c u\u1ed1ng n\u01b0\u1edbc \u1edf b\u1ec3, h\u1ed3, su\u1ed1i. \u1ede Hoa K\u1ef3, ch\u00f3 \u0111\u1ef1c kh\u00f4ng thi\u1ebfn ch\u0103n gia s\u00fac, ch\u00f3 s\u0103n, ch\u00f3 l\u00e0m vi\u1ec7c v\u00e0 ch\u00f3 ph\u1ed1i gi\u1ed1ng \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh c\u00f3 nguy c\u01a1 cao. S\u1ed1 l\u01b0\u1ee3ng b\u00e1o c\u00e1o ch\u00f3 khu v\u1ef1c th\u00e0nh th\u1ecb ho\u1eb7c ch\u00f3 l\u00e0m nhi\u1ec7m v\u1ee5 trinh s\u00e1t \u0111\u00e3 t\u0103ng l\u00ean, c\u00f3 l\u1ebd do ti\u1ebfp x\u00fac v\u1edbi lo\u00e0i g\u1eb7m nh\u1ea5m b\u1ecb nhi\u1ec5m b\u1ec7nh ho\u1eb7c n\u01b0\u1edbc ti\u1ec3u c\u1ee7a ch\u00fang.
\n\u1ede m\u00e8o: t\u1ef7 l\u1ec7 Leptospira tr\u00ean l\u00e2m s\u00e0ng r\u1ea5t th\u1ea5p (t\u1ef7 l\u1ec7 ph\u01a1i nhi\u1ec5m 10% ho\u1eb7c \u00edt h\u01a1n)<\/p>\n

2.2 Ph\u01b0\u01a1ng th\u1ee9c truy\u1ec1n b\u1ec7nh<\/strong>
\nTr\u1ef1c ti\u1ebfp: x\u1ea3y ra qua s\u1ef1 ti\u1ebfp x\u00fac v\u1edbi n\u01b0\u1edbc ti\u1ec3u b\u1ecb nhi\u1ec5m, qua \u0111\u01b0\u1eddng sinh d\u1ee5c, nhau thai, v\u1ebft c\u1eafn, ho\u1eb7c \u0103n ph\u1ea3i c\u00e1c m\u00f4 b\u1ecb nhi\u1ec5m b\u1ec7nh.
\nGi\u00e1n ti\u1ebfp ( ph\u1ed5 bi\u1ebfn): qua s\u1ef1 ti\u1ebfp x\u00fac c\u1ee7a \u0111\u1ed9ng v\u1eadt nh\u1ea1y c\u1ea3m v\u1edbi ngu\u1ed3n n\u01b0\u1edbc, \u0111\u1ea5t, v\u00e0 th\u1ef1c ph\u1ea9m b\u1ecb \u00f4 nhi\u1ec5m
\nT\u1ef7 l\u1ec7 b\u1ec7nh gia t\u0103ng trong th\u1eddi k\u1ef3 l\u01b0\u1ee3ng m\u01b0a cao ho\u1eb7c ng\u1eadp l\u1ee5t trong v\u00f9ng.<\/p>\n

2.3 S\u1ee9c \u0111\u1ec1 kh\u00e1ng<\/strong>
\nLeptospira t\u1ed3n t\u1ea1i t\u1ed1i \u01b0u trong \u0111\u1ea5t \u1edf pH trung t\u00ednh ho\u1eb7c h\u01a1i ki\u1ec1m. Nhi\u1ec7t \u0111\u1ed9 m\u00f4i tr\u01b0\u1eddng xung quanh t\u1eeb 0\u00b0 C \u0111\u1ebfn 25\u00b0 C c\u00f3 l\u1ee3i cho s\u1ef1 t\u1ed3n t\u1ea1i c\u1ee7a leptospires. Trong m\u00f4i tr\u01b0\u1eddng \u0111\u00f4ng l\u1ea1nh, m\u1ea5t n\u01b0\u1edbc ho\u1eb7c ti\u1ebfp x\u00fac v\u1edbi tia c\u1ef1c t\u00edm l\u00e0m gi\u1ea3m s\u1ef1 s\u1ed1ng c\u1ee7a leptospires.<\/p>\n

3. Sinh b\u1ec7nh h\u1ecdc<\/strong><\/p>\n

\"benh-leptospira-tren-cho-meo-1\"<\/p>\n

C\u01a1 ch\u1ebf sinh b\u1ec7nh c\u1ee7a xo\u1eafn khu\u1ea9n\u00a0Leptospira<\/p>\n

\u00a0<\/p>\n

Leptospires x\u00e2m nh\u1eadp qua m\u00e0ng nh\u1ea7y c\u00f2n nguy\u00ean v\u1eb9n trong mi\u1ec7ng, m\u0169i, m\u1eaft ho\u1eb7c qua c\u1ecd x\u00e1t, tr\u1ea7y x\u01b0\u1edbc ho\u1eb7c da ng\u1ea5m n\u01b0\u1edbc. Sau khi x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3 \u0111\u1ed9ng v\u1eadt c\u00f3 v\u00fa, n\u00f3 thay \u0111\u1ed5i qu\u00e1 tr\u00ecnh sao ch\u00e9p nh\u1eb1m n\u00e2ng cao kh\u1ea3 n\u0103ng g\u00e2y b\u1ec7nh c\u1ee7a xo\u1eafn khu\u1ea9n. Xo\u1eafn khu\u1ea9n nh\u00e2n l\u00ean nhanh ch\u00f3ng sau khi v\u00e0o h\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u (h\u00ecnh 2). Trong m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u, th\u1eddi gian \u1ee7 b\u1ec7nh cho \u0111\u1ebfn khi xu\u1ea5t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng l\u00e0 7 ng\u00e0y, nh\u01b0ng \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 thay \u0111\u1ed5i theo li\u1ec1u l\u00e2y nhi\u1ec5m, \u0111i\u1ec1u ki\u1ec7n ti\u1ebfp x\u00fac t\u1ef1 nhi\u00ean, ch\u1ee7ng l\u00e2y nhi\u1ec5m v\u00e0 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 v\u1eadt ch\u1ee7.<\/p>\n

4. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng b\u1ec7nh<\/strong><\/p>\n

Ch\u00f3: ch\u00f3 nh\u1ecf, gi\u1ed1ng l\u1edbn, ch\u00f3 hoang th\u01b0\u1eddng b\u1ecb \u1ea3nh h\u01b0\u1edfng n\u1eb7ng n\u1ec1 h\u01a1n.
\nC\u1ea5p t\u00ednh: s\u1ed1t 39,5\u00b0 C \u0111\u1ebfn 40\u00b0 C (103\u00b0 F \u0111\u1ebfn 104\u00b0 F), run, \u0111au c\u01a1, n\u00f4n m\u1eeda, n\u1eb1m nghi\u00eang, m\u1ea5t n\u01b0\u1edbc, v\u1ee1 m\u1ea1ch m\u00e1u ngo\u1ea1i vi, th\u1edf nhanh, m\u1ea1ch nhanh b\u1ea5t th\u01b0\u1eddng, thi\u1ebfu m\u00e1u mao m\u1ea1ch, n\u00f4n ra m\u00e1u, ph\u00e2n c\u00f3 m\u00e1u, ph\u00e2n \u0111en , ch\u1ea3y m\u00e1u cam, xu\u1ea5t huy\u1ebft lan r\u1ed9ng, v\u00e0ng da, l\u1ed3ng ru\u1ed9t, thi\u1ec3u ni\u1ec7u ho\u1eb7c v\u00f4 ni\u1ec7u.
\nB\u00e1n c\u1ea5p t\u00ednh: s\u1ed1t, ch\u00e1n \u0103n, n\u00f4n m\u1eeda, m\u1ea5t n\u01b0\u1edbc, ch\u1ee9ng kh\u00e1t n\u01b0\u1edbc v\u00e0 \u0111a ni\u1ec7u, mi\u1ec5n c\u01b0\u1ee1ng di chuy\u1ec3n, t\u0103ng c\u1ea3m c\u1eadn x\u01b0\u01a1ng s\u1ed1ng do vi\u00eam c\u01a1, sung huy\u1ebft m\u00e0ng nh\u1ea7y, xu\u1ea5t huy\u1ebft \u0111i\u1ec3m ho\u1eb7c t\u1ee5 huy\u1ebft, vi\u00eam k\u1ebft m\u1ea1c, vi\u00eam m\u00e0ng b\u1ed3 \u0111\u00e0o, vi\u00eam m\u0169i, vi\u00eam amidan, thi\u1ec3u ni\u1ec7u ho\u1eb7c v\u00f4 ni\u1ec7u, ho ho\u1eb7c kh\u00f3 th\u1edf, v\u00e0ng da.<\/p>\n

\"benh-leptospira-tren-cho-meo-2\"<\/p>\n

Ho\u00e0ng \u0111\u1ea3n ni\u00eam m\u1ea1c \u1edf ch\u00f3 nh\u1ecf nhi\u1ec5m leptospira c\u1ea5p t\u00ednh<\/p>\n

M\u00e8o: Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng th\u01b0\u1eddng nh\u1eb9 ho\u1eb7c kh\u00f4ng bi\u1ec3u hi\u1ec7n tr\u00ean m\u00e8o khi nhi\u1ec5m leptospirosis m\u1eb7c d\u00f9 c\u00f3 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a leptospira m\u00e1u, leptospira ni\u1ec7u v\u00e0 bi\u1ec3u hi\u1ec7n m\u00f4 h\u1ecdc c\u1ee7a vi\u00eam gan v\u00e0 th\u1eadn.<\/p>\n

5. B\u1ec7nh l\u00fd do Leptospira <\/strong><\/p>\n

Ni\u00eam m\u1ea1c c\u00f3 th\u1ec3 sung huy\u1ebft v\u00e0 ho\u00e0ng \u0111\u1ea3n c\u00f9ng v\u1edbi xu\u1ea5t huy\u1ebft ph\u00e2n t\u00e1n. Th\u1eadn nh\u1ee3t nh\u1ea1t, m\u00e0u v\u00e0ng-x\u00e1m v\u00e0 ph\u00ecnh l\u00ean tr\u00ean b\u1ec1 m\u1eb7t c\u1eaft. Bao th\u1eadn c\u00f3 th\u1ec3 d\u00ednh v\u00e0o b\u1ec1 m\u1eb7t c\u1ee7a th\u1eadn v\u00e0 ph\u1ed5 bi\u1ebfn l\u00e0 xu\u1ea5t huy\u1ebft d\u01b0\u1edbi bao. \u0110\u1ed1m xu\u1ea5t huy\u1ebft v\u00e0 t\u1ee5 huy\u1ebft th\u01b0\u1eddng th\u1ea5y tr\u00ean m\u00e0ng ph\u1ed5i. Gan s\u01b0ng to v\u00e0 d\u1ec5 v\u1ee1, v\u1edbi nh\u1eefng m\u1ea3ng d\u00ednh th\u00f9y r\u00f5 r\u1ec7t v\u00e0 bi\u1ebfn \u0111\u1ed5i m\u00e0u v\u00e0ng n\u00e2u. \u0110\u1ed1m xu\u1ea5t huy\u1ebft v\u00e0 t\u1ee5 huy\u1ebft \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean kh\u1eafp m\u00e0ng n\u00e3o. D\u1ea1 d\u00e0y lo\u00e9t v\u00e0 xu\u1ea5t huy\u1ebft, ur\u00ea huy\u1ebft. V\u1ec1 m\u1eb7t m\u00f4 h\u1ecdc, c\u00e1c t\u1ed5n th\u01b0\u01a1ng th\u1eadn kh\u00f3 th\u1ea5y, bao g\u1ed3m c\u00e1c \u1ed1ng th\u1eadn ho\u1ea1i t\u1eed v\u00e0 ph\u00f9 k\u1ebd \u1edf m\u1ee9c \u0111\u1ed9 nh\u1eb9, r\u1ea5t \u00edt ho\u1eb7c kh\u00f4ng c\u00f3 vi\u00eam k\u1ebd. T\u1ed5n th\u01b0\u01a1ng th\u1ee9 c\u1ea5p c\u1ee7a nhi\u1ec5m \u0111\u1ed9c ni\u1ec7u, nh\u01b0 s\u1ef1 kho\u00e1ng h\u00f3a ph\u1ed5i, kho\u00e1ng h\u00f3a ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y, v\u00e0 ho\u1ea1i t\u1eed fibrin m\u1ea1ch m\u00e1u l\u00e0 ph\u1ed5 bi\u1ebfn.<\/p>\n

\"benh-leptospira-tren-cho-meo-3\"<\/p>\n

(h\u00ecnh tr\u00e1i) X-ray v\u00f9ng ng\u1ef1c con ch\u00f3 v\u1edbi leptospirosis c\u1ea5p t\u00ednh cho th\u1ea5y th\u00e2m nhi\u1ec5m ph\u1ed5i k\u1ebd. (h\u00ecnh ph\u1ea3i) \u0111\u1ed1m xu\u1ea5t huy\u1ebft v\u00e0 sung huy\u1ebft tr\u00ean b\u1ec1 m\u1eb7t m\u00e0ng thanh d\u1ecbch c\u1ee7a ph\u1ed5i t\u1eeb con ch\u00f3 b\u1ecb nhi\u1ec5m t\u1eed vong.<\/p>\n

\"benh-leptospira-tren-cho-meo-4\"<\/p>\n

(h\u00ecnh tr\u00e1i) Th\u1eadn teo v\u00e0 x\u01a1 h\u00f3a t\u1eeb ch\u00f3 8 th\u00e1ng tu\u1ed5i \u0111\u00e3 c\u00f3 v\u00e0ng da c\u1ea5p t\u00ednh v\u00e0 suy th\u1eadn. (h\u00ecnh ph\u1ea3i) Th\u1eadn s\u01b0ng ph\u1ed3ng t\u1eeb ch\u00f3 nhi\u1ec5m leptospira c\u1ea5p t\u00ednh \u0111\u00e3 ch\u1ebft<\/p>\n

\"benh-leptospira-tren-cho-meo-5\"<\/p>\n

Gan ho\u1ea1i t\u1eed s\u01b0ng l\u00ean t\u1eeb m\u1ed9t con ch\u00f3 v\u1edbi leptospirosis c\u1ea5p t\u00ednh.<\/p>\n

\"benh-leptospira-tren-cho-meo-6\"<\/p>\n

(h\u00ecnh ph\u1ea3i) Xu\u1ea5t huy\u1ebft ph\u1ed5i c\u1ea5p t\u00ednh \u1edf ch\u00f3 nhi\u1ec5m leptospira c\u1ea5p t\u00ednh. Ph\u1ebf nang c\u00f3 ch\u1ee9a m\u1ed9t s\u1ed1 l\u01b0\u1ee3ng l\u1edbn h\u1ed3ng c\u1ea7u tho\u00e1t m\u1ea1ch L\u01b0u \u00fd v\u00f9ng r\u00eca c\u1ee7a b\u1ea1ch c\u1ea7u trung t\u00ednh trong m\u1ea1ch m\u00e1u (m\u0169i t\u00ean)(nhu\u1ed9m H&E, \u00d7 400). \u00a0(h\u00ecnh ph\u1ea3i)T\u1ed5n th\u01b0\u01a1ng th\u1eadn khi nhi\u1ec5m Leptospira b\u00e1n c\u1ea5p t\u00ednh, ti\u1ec3u qu\u1ea3n th\u1eadn trong v\u00f9ng v\u1ecf \u0111\u01b0\u1ee3c chia c\u1eaft b\u1edfi nhi\u1ec1u t\u01b0\u01a1ng b\u00e0o, m\u1ed9t s\u1ed1 \u00edt \u0111\u1ea1i th\u1ef1c b\u00e0o v\u00e0 ph\u00e2n t\u00e1n c\u00e1c b\u1ea1ch c\u1ea7u trung t\u00ednh (nhu\u1ed9m E&H, \u00d7 400 ).<\/p>\n

6. Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh<\/strong><\/p>\n

6.1 K\u1ebft qu\u1ea3 th\u00ed nghi\u1ec7m l\u00e2m s\u00e0ng<\/strong>
\nHuy\u1ebft h\u1ecdc: t\u0103ng b\u1ea1ch c\u1ea7u, gi\u1ea3m ti\u1ec3u c\u1ea7u, k\u00e9o d\u00e0i th\u1eddi gian \u0111\u00f4ng m\u00e1u.
\nH\u00f3a sinh: h\u1ea1 natri, chlor, h\u1ea1 ho\u1eb7c t\u0103ng kali m\u00e1u, t\u0103ng phosphat, t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft; \u2191 ALT, \u2191 AST, \u2191 LDH, \u2191 ALP, \u2191bilirubin huy\u1ebft thanh; \u2191 acid m\u1eadt trong huy\u1ebft thanh; \u2191 amylase, lipase huy\u1ebft thanh, ch\u1ee9ng nito huy\u1ebft, \u2191creatinin huy\u1ebft thanh, \u2191 creatine kinase huy\u1ebft thanh, \u2191 C-reactive protein huy\u1ebft thanh, \u2191 tropinin cardiac I; \u2191cholesterol, \u2191globulin, \u2193 albumin huy\u1ebft thanh; thay \u0111\u1ed5i kho\u00e1ng ch\u1ea5t v\u00e0 r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i.
\nX\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u: tr\u1ecdng l\u01b0\u1ee3ng ri\u00eang \u2264 1,029, glucose ni\u1ec7u, protein ni\u1ec7u \u1edf \u1ed1ng ho\u1eb7c c\u1ea7u th\u1eadn, bilirubin ni\u1ec7u, \u2191 t\u1ebf b\u00e0o h\u1ea1t, m\u1ee7 trong n\u01b0\u1edbc ti\u1ec3u, m\u00e1u trong n\u01b0\u1edbc ti\u1ec3u, t\u0103ng t\u1ef7 l\u1ec7 protein\/creatinine n\u01b0\u1edbc ti\u1ec3u.<\/p>\n

6.2 Ki\u1ec3m tra huy\u1ebft thanh h\u1ecdc<\/strong><\/p>\n