ĐIỀU TRỊ VÀ PHÒNG BỆNH ÁP XE GAN DO AMIP

DANH MỤC CHIA SẼ
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1. Điều trị

Nguyên tắc điều trị

– Sử dụng thuốc đặc hiệu diệt amip.

– Theo dõi để phát hiện và điều trị kịp thời các biến chứng có thể xảy ra.

a. Sử dụng thuốc đơn thuần: Chỉ định trong những trường hợp: Nếu ổ áp xe ở giai đoạn sớm chưa hóa mủ, kích thước nhỏ (<5 cm), không nằm sát bao gan và thể trạng bệnh còn tốt, thì khả năng điều trị nội thành công rất cao.

– Metronidazole 30-50 mg/kg/ngày, chia làm 3 lần, truyền TM hoặc uống trong 10 ngày và không quá 500-750 mg/liều.

– Tiếp theo, sử dụng Paromomycin 25 mg/kg, chia làm 3 lần, uống trong 7 ngày và không quá 2 g/ngày.

– Sử dụng kháng sinh phối hợp, nếu bệnh bị bội nhiễm.

– Giảm đau và hạ sốt (nếu cần), như Paracetamol 30-70 mg/kg/ngày, chia làm 2-3 lần, truyền TM hoặc uống. Lưu ý, đối với liều cao, chỉ sử dụng trong 5 ngày.

b. Thủ thuật chọc hút ổ áp xe: dưới sự hướng dẫn của siêu âm hay CT-Scan ổ bụng. Các chỉ định bao gồm: điều trị bằng thuốc không khỏi; kích thước ổ áp xe > 5 cm; áp xe gan trái có thể vỡ vào tim; đến muộn > 1 tháng; bệnh không giảm sau 5-7 ngày điều trị.

c. Phẫu thuật:

   Ổ áp xe vỡ vào ổ bụng gây viêm phúc mạc.

   Ổ áp xe vỡ vào màng phổi: dẫn lưu kín màng phổi.

   Ổ áp xe vỡ vào màng tim: dẫn lưu màng tim.

2. Phòng bệnh

  Amibe là loài đơn bào nhiễm vào ruột qua đường ăn uống có thể sống trong ruột ở dạng kén nên không gây triêu chứng thuốc không tác dụng; ở dạng dưỡng bào amibe hoạt động rầm rộ gây bệnh cấp tính rầm rộ có thể thành dịch….phòng bệnh chính là thực hiện tốt An toàn vệ sinh thực phẩm…

– Rửa tay bằng xà phòng sau khi đi vệ sinh, và trước mỗi bữa ăn.

– Không nên uống sữa chua chưa tiệt trùng.

– Không nên ăn các loại rau sống và hoa quả chưa gọt vỏ.

– Không nên ăn các loại thịt chưa nấu chín như nem chua, chạo, gỏi, tiết canh… Đảm bảo các thực phẩm như thịt, gia cầm, hải sản… được chế biến chín trước khi ăn.

– Không nên dùng chung đồ dùng thực phẩm với người khác.

– Không nên uống nước chưa được đun sôi.

– Khi trồng rau màu, không được dùng phân tươi để bón cho cây.

– Khi bị bệnh lị amip, phải điều trị một cách tích cực, dùng đúng thuốc, đúng liều.

3. Tóm lại

  Khi nghi ngờ bị áp xe gan, phải đi khám bệnh càng sớm càng tốt để được chẩn đoán và điều trị kịp thời, tránh biến chứng nguy hiểm có thể xảy ra làm ảnh hưởng đến tính mạng của người bệnh.

BSCKII. NGUYỄN TRỌNG NGHĨA

apxegan
apxegan1

A : duỡng bào amibe

B:Nang ( kén) amibe

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