{"id":13489,"date":"2026-02-05T08:17:24","date_gmt":"2026-02-05T01:17:24","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=13489"},"modified":"2026-02-05T08:17:26","modified_gmt":"2026-02-05T01:17:26","slug":"cuu-song-truong-hop-sot-xuat-huyet-bien-chung-tan-huyet-cap-hiem-gap-o-benh-nhi-thieu-men-g6pd-tai-benh-vien-nhan-dan-gia-dinh","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=13489","title":{"rendered":"C\u1ee8U S\u1ed0NG TR\u01af\u1edcNG H\u1ee2P S\u1ed0T XU\u1ea4T HUY\u1ebeT BI\u1ebeN CH\u1ee8NG TAN HUY\u1ebeT C\u1ea4P HI\u1ebeM G\u1eb6P \u1ede B\u1ec6NH NHI THI\u1ebeU MEN G6PD T\u1ea0I B\u1ec6NH VI\u1ec6N NH\u00c2N D\u00c2N GIA \u0110\u1ecaNH"},"content":{"rendered":"\n

C\u00e1c b\u00e1c s\u0129 B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u1eeba \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng m\u1ed9t nam sinh 15 tu\u1ed5i trong t\u00ecnh tr\u1ea1ng nguy k\u1ecbch do s\u1ed1t xu\u1ea5t huy\u1ebft Dengue tr\u00ean n\u1ec1n b\u1ec7nh l\u00fd di truy\u1ec1n thi\u1ebfu men G6PD. Nhi\u1ec5m vir\u00fat s\u1ed1t xu\u1ea5t huy\u1ebft l\u00e0m kh\u1edfi ph\u00e1t tan huy\u1ebft c\u1ea5p h\u00e0ng lo\u1ea1t, l\u00e0m gi\u1ea3m nghi\u00eam tr\u1ecdng kh\u1ea3 n\u0103ng v\u1eadn chuy\u1ec3n oxy c\u1ee7a m\u00e1u v\u00e0 \u0111e d\u1ecda tr\u1ef1c ti\u1ebfp \u0111\u1ebfn t\u00ednh m\u1ea1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/em><\/strong><\/p>\n\n\n\n

Ng\u00e0y 26\/01\/2026, khoa C\u1ea5p c\u1ee9u, B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh ti\u1ebfp nh\u1eadn b\u1ec7nh nhi L.T.D (sinh n\u0103m 2011, ng\u1ee5 ph\u01b0\u1eddng B\u00ecnh Th\u1ea1nh, TP.HCM) trong t\u00ecnh tr\u1ea1ng s\u1ed1t cao k\u00e8m cho\u00e1ng v\u00e1ng, kh\u00f3 th\u1edf, t\u00edm m\u00f4i v\u00e0 \u0111\u1ea7u chi, ch\u1ec9 s\u1ed1 SpO\u2082 r\u1ea5t th\u1ea5p d\u00f9 \u0111\u00e3 \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 oxy. Tr\u01b0\u1edbc \u0111\u00f3 1 ng\u00e0y, em D. b\u1ecb s\u1ed1t, nh\u1ee9c \u0111\u1ea7u v\u00e0 \u0111\u01b0\u1ee3c d\u00f9ng thu\u1ed1c h\u1ea1 s\u1ed1t t\u1ea1i nh\u00e0. S\u00e1ng 26\/01, d\u00f9 c\u00f2n m\u1ec7t nh\u01b0ng em v\u1eabn c\u1ed1 g\u1eafng \u0111\u1ebfn tr\u01b0\u1eddng v\u00e0 b\u1ea5t ng\u1edd cho\u00e1ng v\u00e1ng, kh\u00f3 th\u1edf trong l\u1edbp h\u1ecdc, kh\u00f4ng th\u1ec3 di chuy\u1ec3n, bu\u1ed9c nh\u00e0 tr\u01b0\u1eddng ph\u1ea3i li\u00ean h\u1ec7 gia \u0111\u00ecnh \u0111\u1ec3 \u0111\u01b0a em \u0111i c\u1ea5p c\u1ee9u.<\/p>\n\n\n\n

Qua th\u0103m kh\u00e1m v\u00e0 ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh cho th\u1ea5y ph\u1ed5i c\u1ee7a b\u1ec7nh nhi kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng, g\u1ee3i \u00fd t\u00ecnh tr\u1ea1ng gi\u1ea3m oxy kh\u00f4ng xu\u1ea5t ph\u00e1t t\u1eeb nguy\u00ean nh\u00e2n h\u00f4 h\u1ea5p \u0111\u01a1n thu\u1ea7n. B\u1ec7nh nhi \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n li\u00ean chuy\u00ean khoa v\u00e0 chuy\u1ec3n v\u00e0o khoa H\u1ed3i s\u1ee9c t\u00edch c\u1ef1c – Ch\u1ed1ng \u0111\u1ed9c.<\/p>\n\n\n\n

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K\u1ebft qu\u1ea3 kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch ghi nh\u1eadn t\u00ecnh tr\u1ea1ng t\u0103ng Methemoglobin (MetHb) \u1edf m\u1ee9c 15 – 20%, trong khi gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng d\u01b0\u1edbi 1%. \u0110\u00e2y l\u00e0 t\u00ecnh tr\u1ea1ng hemoglobin b\u1ecb b\u1ea5t ho\u1ea1t, kh\u00f4ng c\u00f2n kh\u1ea3 n\u0103ng v\u1eadn chuy\u1ec3n oxy \u0111\u1ebfn m\u00f4. C\u00e1c nguy\u00ean nh\u00e2n nh\u01b0 ng\u1ed9 \u0111\u1ed9c, s\u1eed d\u1ee5ng thu\u1ed1c kh\u00f4ng ph\u00f9 h\u1ee3p ho\u1eb7c ch\u1ea5t c\u1ea5m \u0111\u1ec1u \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb.<\/p>\n\n\n\n

B\u1ec7nh nhi c\u00f3 k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m d\u01b0\u01a1ng t\u00ednh v\u1edbi vi-r\u00fat Dengue, tuy nhi\u00ean, di\u1ec5n ti\u1ebfn l\u00e2m s\u00e0ng kh\u00f4ng ph\u00f9 h\u1ee3p v\u1edbi m\u1ed9t ca s\u1ed1t xu\u1ea5t huy\u1ebft th\u00f4ng th\u01b0\u1eddng. Trong qu\u00e1 tr\u00ecnh theo d\u00f5i, c\u00e1c b\u00e1c s\u0129 ghi nh\u1eadn em xu\u1ea5t hi\u1ec7n v\u00e0ng da, n\u01b0\u1edbc ti\u1ec3u s\u1eabm m\u00e0u, k\u00e8m thi\u1ebfu m\u00e1u ti\u1ebfn tri\u1ec3n. Tr\u01b0\u1edbc nghi ng\u1edd tan huy\u1ebft c\u1ea5p, \u00ea-k\u00edp \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 ch\u1ec9 \u0111\u1ecbnh \u0111\u1ecbnh l\u01b0\u1ee3ng men G6PD, cho k\u1ebft qu\u1ea3 r\u1ea5t th\u1ea5p (0,009 U\/gHb), gi\u1ea3m n\u1eb7ng so v\u1edbi gi\u00e1 tr\u1ecb tham chi\u1ebfu c\u1ee7a ph\u00f2ng x\u00e9t nghi\u1ec7m (7 – 20,5 U\/gHb), x\u00e1c \u0111\u1ecbnh thi\u1ebfu men G6PD m\u1ee9c \u0111\u1ed9 n\u1eb7ng.<\/p>\n\n\n\n

BS.CK1 \u0110\u00e0o Th\u1ecb Huy\u00ean, Khoa H\u1ed3i s\u1ee9c t\u00edch c\u1ef1c – Ch\u1ed1ng \u0111\u1ed9c, b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb tr\u1ef1c ti\u1ebfp cho em L.T.D cho bi\u1ebft thi\u1ebfu men G6PD l\u00e0 b\u1ec7nh l\u00fd di truy\u1ec1n li\u00ean quan \u0111\u1ebfn nhi\u1ec5m s\u1eafc th\u1ec3 X, khi\u1ebfn h\u1ed3ng c\u1ea7u d\u1ec5 b\u1ecb ph\u00e1 h\u1ee7y khi c\u01a1 th\u1ec3 g\u1eb7p c\u00e1c t\u00e1c nh\u00e2n oxy h\u00f3a nh\u01b0 nhi\u1ec5m tr\u00f9ng, \u0103n \u0111\u1eadu t\u1eb1m ho\u1eb7c s\u1eed d\u1ee5ng m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c. Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y, s\u1ed1t xu\u1ea5t huy\u1ebft Dengue \u0111\u01b0\u1ee3c xem l\u00e0 y\u1ebfu t\u1ed1 kh\u1edfi ph\u00e1t, d\u1eabn \u0111\u1ebfn tan huy\u1ebft n\u1ed9i m\u1ea1ch c\u1ea5p, g\u00e2y thi\u1ebfu m\u00e1u n\u1eb7ng, \u0111\u1ed3ng th\u1eddi l\u00e0m t\u0103ng MetHb, khi\u1ebfn kh\u1ea3 n\u0103ng v\u1eadn chuy\u1ec3n oxy c\u1ee7a m\u00e1u suy gi\u1ea3m nghi\u00eam tr\u1ecdng. \u0110\u00e2y l\u00e0 nguy\u00ean nh\u00e2n khi\u1ebfn t\u00ecnh tr\u1ea1ng t\u00edm t\u00e1i v\u00e0 SpO\u2082 th\u1ea5p kh\u00f4ng c\u1ea3i thi\u1ec7n d\u00f9 b\u1ec7nh nhi \u0111\u01b0\u1ee3c th\u1edf oxy n\u1ed3ng \u0111\u1ed9 cao.<\/p>\n\n\n\n

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Tr\u01b0\u1edbc di\u1ec5n bi\u1ebfn nguy k\u1ecbch, c\u00e1c b\u00e1c s\u0129 khoa H\u1ed3i s\u1ee9c t\u00edch c\u1ef1c – Ch\u1ed1ng \u0111\u1ed9c t\u1eadp trung \u0111i\u1ec1u tr\u1ecb v\u1edbi truy\u1ec1n m\u00e1u b\u00f9 l\u1ea1i s\u1ed1 l\u01b0\u1ee3ng h\u1ed3ng c\u1ea7u, h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p, \u0111\u1ea3m b\u1ea3o th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n, theo d\u00f5i s\u00e1t ch\u1ee9c n\u0103ng th\u1eadn, h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng gan v\u00e0 tuy\u1ec7t \u0111\u1ed1i tr\u00e1nh c\u00e1c thu\u1ed1c c\u0169ng nh\u01b0 y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y tan huy\u1ebft. B\u00ean c\u1ea1nh \u0111i\u1ec1u tr\u1ecb chuy\u00ean m\u00f4n, \u0111\u1ed9i ng\u0169 y b\u00e1c s\u0129, \u0111i\u1ec1u d\u01b0\u1ee1ng c\u0169ng d\u00e0nh nhi\u1ec1u s\u1ef1 quan t\u00e2m, \u0111\u1ed9ng vi\u00ean tinh th\u1ea7n, gi\u00fap b\u1ec7nh nhi an t\u00e2m \u0111i\u1ec1u tr\u1ecb trong m\u00f4i tr\u01b0\u1eddng h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c.<\/p>\n\n\n\n

Sau 6 ng\u00e0y \u0111i\u1ec1u tr\u1ecb, t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nhi \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n r\u00f5 r\u1ec7t: oxy m\u00e1u tr\u1edf v\u1ec1 m\u1ee9c an to\u00e0n, c\u00e1c ch\u1ec9 s\u1ed1 huy\u1ebft h\u1ecdc d\u1ea7n \u1ed5n \u0111\u1ecbnh, n\u1ed3ng \u0111\u1ed9 MetHb gi\u1ea3m d\u01b0\u1edbi 1%, ch\u1ee9c n\u0103ng gan v\u00e0 th\u1eadn d\u1ea7n c\u1ea3i thi\u1ec7n. Em L.T.D \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n trong t\u00ecnh tr\u1ea1ng \u1ed5n \u0111\u1ecbnh v\u00e0 ti\u1ebfp t\u1ee5c theo d\u00f5i ngo\u1ea1i tr\u00fa t\u1ea1i ph\u00f2ng kh\u00e1m H\u1eadu H\u1ed3i s\u1ee9c t\u00edch c\u1ef1c.<\/p>\n\n\n

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TS.BS Hu\u1ef3nh Quang \u0110\u1ea1i, Tr\u01b0\u1edfng B\u1ed9 m\u00f4n H\u1ed3i s\u1ee9c C\u1ea5p c\u1ee9u Ch\u1ed1ng \u0111\u1ed9c, Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TP.HCM, \u0111\u1ed3ng th\u1eddi ph\u1ee5 tr\u00e1ch khoa H\u1ed3i s\u1ee9c t\u00edch c\u1ef1c – Ch\u1ed1ng \u0111\u1ed9c, B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh c\u1ea3nh b\u00e1o, s\u1ed1t xu\u1ea5t huy\u1ebft Dengue tr\u00ean n\u1ec1n ng\u01b0\u1eddi b\u1ec7nh thi\u1ebfu men G6PD b\u1ea9m sinh l\u00e0 t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng \u0111\u1eb7c bi\u1ec7t nguy hi\u1ec3m, d\u1ec5 b\u1ecb b\u1ecf s\u00f3t n\u1ebfu ti\u1ec1n s\u1eed b\u1ec7nh kh\u00f4ng \u0111\u01b0\u1ee3c ghi nh\u1eadn \u0111\u1ea7y \u0111\u1ee7. Vi\u1ec7c nh\u1eadn di\u1ec7n s\u1edbm tan huy\u1ebft \u0111i k\u00e8m Methemoglobin th\u1ee9 ph\u00e1t v\u00e0 x\u1eed tr\u00ed k\u1ecbp th\u1eddi c\u00f3 vai tr\u00f2 quy\u1ebft \u0111\u1ecbnh \u0111\u1ebfn ti\u00ean l\u01b0\u1ee3ng s\u1ed1ng c\u00f2n c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n\n\n\n

TS.BS Hu\u1ef3nh Quang \u0110\u1ea1i khuy\u1ebfn c\u00e1o, tr\u1ebb c\u00f3 bi\u1ec3u hi\u1ec7n s\u1ed1t k\u00e8m v\u00e0ng da, n\u01b0\u1edbc ti\u1ec3u s\u1eabm m\u00e0u, kh\u00f3 th\u1edf c\u1ea7n \u0111\u01b0\u1ee3c nh\u1eadp vi\u1ec7n s\u1edbm. Tr\u1ebb \u0111\u00e3 bi\u1ebft thi\u1ebfu men G6PD c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd khi m\u1eafc c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng ho\u1eb7c si\u00eau vi, tr\u00e1nh \u0103n \u0111\u1eadu t\u1eb1m v\u00e0 c\u00e1c th\u1ef1c ph\u1ea9m, thu\u1ed1c c\u00f3 nguy c\u01a1 g\u00e2y oxy h\u00f3a. Ph\u1ee5 huynh n\u00ean th\u1ef1c hi\u1ec7n t\u1ea7m so\u00e1t thi\u1ebfu men G6PD cho tr\u1ebb ngay t\u1eeb s\u01a1 sinh v\u00e0 ch\u1ee7 \u0111\u1ed9ng th\u00f4ng b\u00e1o ti\u1ec1n s\u1eed b\u1ec7nh cho nh\u00e2n vi\u00ean y t\u1ebf khi kh\u00e1m ho\u1eb7c nh\u1eadp vi\u1ec7n.<\/p>\n","protected":false},"excerpt":{"rendered":"

C\u00e1c b\u00e1c s\u0129 B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u1eeba \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng m\u1ed9t nam sinh 15 tu\u1ed5i trong t\u00ecnh tr\u1ea1ng nguy k\u1ecbch do s\u1ed1t xu\u1ea5t huy\u1ebft Dengue tr\u00ean n\u1ec1n b\u1ec7nh l\u00fd di truy\u1ec1n thi\u1ebfu men G6PD. Nhi\u1ec5m vir\u00fat s\u1ed1t xu\u1ea5t huy\u1ebft l\u00e0m kh\u1edfi ph\u00e1t tan huy\u1ebft c\u1ea5p h\u00e0ng lo\u1ea1t, l\u00e0m gi\u1ea3m nghi\u00eam tr\u1ecdng 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