Đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị bệnh nhân sốt xuất huyết dengue tại Bệnh viện Hữu Nghị Đa khoa Nghệ An=Clinical, subclinical characteristics and treatment results of dengue fever patients at Nghe An General Friendship Hospital

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Tác giả: Tiến Hoàn Bùi, Giang Sơn Đậu, Phúc Hòa Hà, Đức An Lê, Trí Hiệp Ngô, Anh Trâm Quế

Ngôn ngữ: vie

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

Mô tả vật lý: tr.348-353

Bộ sưu tập: Metadata

ID: 478042

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Mô tả đặc điểm lâm sàng, cận lâm sàng và đánh giá kết quả điều trị của bệnh nhân Sốt xuất huyết Dengue tại Trung tâm Bệnh nhiệt đới, bệnh viện hữu nghị đa khoa Nghệ An từ tháng 06/2022 đến tháng 06/2023. Phương pháp: Nghiên cứu mô tả loạt ca bệnh, thực hiện trên 223 bệnh nhân được chẩn đoán bệnh sốt xuất huyết Dengue theo hướng dẫn của Bộ Y tế năm 2019 nhập viện điều trị tại trung tâm Bệnh nhiệt đới, bệnh viện hữu nghị đa khoa Nghệ An. Kết quả: Về lâm sàng 100% bệnh nhân có sốt, đau đầu 41,7%, nôn 33,2%, đau khớp 24,2%, đau hạ sườn phải 65,9%, có biểu hiện xuất huyết 66,4% trong đó chấm xuất huyết 58,1%, chảy máu răng 36,5%, xuất huyết âm đạo 4,7%, đại tiện phân đen 2%. Sốt xuất huyết Dengue 10,3%, sốt xuất huyết Dengue có dấu hiệu cảnh báo 86,1% và sốt xuất huyết Dengue nặng 3,6%. Cận lâm sàng có HCT tăng >
48% chiếm 33,6%, 100% bệnh nhân giảm tiểu cầu trong đó 92,3% giảm dưới 100 G/L, 76,2% bệnh nhân có bạch cầu giảm <
4 G/L, có 43,5% bệnh nhân có tăng men gan, 22,4% có tràn dịch các màng, 7,6% bệnh nhân truyền tiểu cầu hoặc huyết tương tươi giàu tiểu cầu. Điều trị khỏi 97,8%, không có ca bệnh tử vong và 5 ca bệnh chuyển tuyến trên chiếm 2,2%. Kết luận: Bệnh nhân sốt xuất huyết Dengue nhập viện điều trị ở mức độ có dấu hiệu cảnh báo chiếm tỷ lệ cao 86,1% và nặng 3,6%. Điều trị khỏi 97,8%, không có ca bệnh tử vong và 5 ca bệnh chuyển tuyến trên chiếm 2,2%.To describe the clinical and paraclinical characteristics and evaluate treatment outcomes of Dengue fever patients at the Center for Tropical Diseases, Nghe An Friendship General Hospital, from June 2022 to June 2023. Methods: A descriptive case series study was conducted on 223 patients diagnosed with Dengue fever according to the Ministry of Health's 2019 guidelines, who were hospitalized for treatment at the Center for Tropical Diseases, Nghe An Friendship General Hospital. Results: Clinically, 100% of patients experienced fever, 41.7% had headaches, 33.2% experienced vomiting, 24.2% had joint pain, 65.9% had right hypochondriac pain, and 66.4% presented with hemorrhagic manifestations, including petechiae (58.1%), gum bleeding (36.5%), vaginal bleeding (4.7%), and black stools (2%). The proportions of patients with Dengue fever, Dengue fever with warning signs, and severe Dengue were 10.3%, 86.1%, and 3.6%, respectively. Paraclinical findings showed 33.6% of patients had hematocrit (HCT) levels above 48%, all patients had thrombocytopenia, with 92.3% having platelet counts below 100 G/L, 76.2% had leukopenia (<
4 G/L), 43.5% had elevated liver enzymes, 22.4% had pleural effusion, and 7.6% required platelet or fresh platelet-rich plasma transfusion. The treatment success rate was 97.8%, with no fatalities, and 5 cases were referred to higher-level hospitals (2.2%). Conclusion: Among the hospitalized Dengue fever patients, 86.1% had warning signs, and 3.6% were severe cases. The recovery rate was 97.8%, with no deaths, and 2.2% of cases were transferred to higher-level care.

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