Đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị bệnh nhân phản vệ tại Bệnh viện Đa khoa Tâm Anh Hà Nội từ năm 2021 đến 2024=Clinical, paraclinical features and results of treatment in anaphylactic patients at Ha Noi Tam Anh General Hospital from 2021 to 2024

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Tác giả: Viết Ngọc Hà, Thị An Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.163-169

Bộ sưu tập: Báo, Tạp chí

ID: 243890

Thêm vào giỏ

Mô tả đặc điểm lâm sàng, cận lâm sàng, và kết quả điều trị ở những bệnh nhân phản vệ. Phương pháp nghiên cứu: quan sát mô tả. Kết quả: 99 bệnh nhân phản vệ gồm 40 nam (40,40%)
59 nữ (59,60%) với tuổi trung bình 37,23 ± 14,45. Lâm sàng hay gặp nhất là biểu hiện da: 20,20% đỏ da, 67,67% ban sẩn ngứa, 35,35% phù mặt, mắt hoặc môi
hô hấp: 33,33% cảm giác khó thở, 8,08% rít thanh quản
tiêu hóa: 22,22% đau bụng, 8,08% đi ngoài phân lỏng, 17,17% nôn hoặc buồn nôn
tim mạch: 14% đau ngực hoặc hồi hộp trống ngực, 19,19% tụt huyết áp, 12,12% tăng huyết áp, 33,33% mạch nhanh và 7,07% hoa mắt chóng mặt. Các mức độ phản vệ: 19,19% độ I
53,54% độ II và 27,27% độ III. Nguyên nhân phản vệ: 45,46% do thuốc, 10,10% do côn trùng
34,34% do thức ăn, 10,10% chưa rõ dị nguyên. Khoa điều trị: 38,38% tại ICU
15,15% nội CSGN
46,47% tại nội tổng hợp. Cận lâm sàng: giá trị IgE trung bình 299,61 ±344,59 (UI/ml)
lactate 4,14± 2,80 (mmol/l)
hematocrit 0,42±0,06 (L/L)
creatinin 73,65± 25,02 (mcmol/l). Toan chuyển hóa xuất hiện ở 18 (62,07%) trong số 29 ca được làm khí máu động mạch. Điều trị: Adrenalin được tiêm bắp ở 71,71% ,và được duy trì tĩnh mạch ở 15,15% bệnh nhân, 26,26% thở oxy, 2 ca (2,02%) cần đặt nội khí quản, thở máy. Số giờ nằm viện trung bình 39,93 ± 38,27 giờ. 84,85% bệnh nhân ra viện hết triệu chứng, 14,14% còn các triệu chứng nhẹ như phù mi mắt, đỏ da, ban sẩn ngứa và 01 ca (1,01%) còn tụt huyết áp, duy trì vận mạch, thở máy, gia đình xin chuyển viện điều trị.To describe the clinical, paraclinical features, and results of treatment in anaphylactic patients. Method: Observational descriptive study. Results: 99 patients with 40 male (40.40%)
59 female (59.60%) with the average age was 37.23 ± 14.45. Clinical features: skin 20.20% red skin, 67.67% itchy rash, 35.35% angioedema
respiratory symptoms: 38% feeling short of breath, 8% laryngeal wheezing
digestive symptoms: 22.22% abdominal pain, 8.08% loose stools, 17.17% vomiting or nausea
cardiovascular symptoms: 10.10% chest pain or palpitations, 19.19% hypotension, 12.12% hypertension, 33.33% rapid pulse and 7.07% dizziness. Grades: 19.19% grade I
53.54% grade II and 27.27% grade III. Causes of anaphylaxis: 45.46% due to drugs, 10.10% due to insects
34.34% due to food, 10.10% unknown allergens. Treatment department: 38.38% in ICU
15.15% in Palliative care dept
46.47% at general medicine dept. Paraclinical symptoms: average IgE value 299.61 ± 344.59 (UI/ml)
lactate 4.14 ± 2.80 (mmol/l)
hematocrit 0.42 ± 0.06 (L/L)
creatinine 73.65 ± 25.02 (mcmol/l). 18 patients had metabolic acidosis (62.07%) among 29 patients with arterial blood gas tests. Treatment: Adrenalin was injected intramuscular in 71.71% and had to maintain intravenous in 15.15% of patients, 26.26% needed oxygen, 2 cases (2.02%) needed endotracheal intubation and mechanical ventilation. Average number of hospital hours 39.93 ± 38.27 hours. 84.85% of patients discharge had no symptoms, 14.14% of patients still had mild symptoms such as swollen eyels, skin redness, and rash and one patient (1.01%), still had hypotension, had to maintain vasopressors, mechanical ventilation, and was transferred to another hospital according to family wihes.

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