{"id":3205,"date":"2023-01-03T09:43:00","date_gmt":"2023-01-03T02:43:00","guid":{"rendered":"https:\/\/benhvienthaihoa.vn\/?p=3205"},"modified":"2025-06-22T23:27:06","modified_gmt":"2025-06-22T16:27:06","slug":"bai-3-bieu-hien-lam-sang-va-chan-doan-ngo-doc-paracetamol-o-tre-duoi-18-tuoi","status":"publish","type":"post","link":"https:\/\/benhvienthaihoa.vn\/en\/bai-3-bieu-hien-lam-sang-va-chan-doan-ngo-doc-paracetamol-o-tre-duoi-18-tuoi\/","title":{"rendered":"B\u00c0I 3: Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n ng\u1ed9 \u0111\u1ed9c Paracetamol \u1edf tr\u1ebb d\u01b0\u1edbi 18 tu\u1ed5i"},"content":{"rendered":"<p>Paracetamol \u0111\u01b0\u1ee3c ra m\u1eaft v\u00e0o n\u0103m 1950 v\u00e0 d\u1ea7n tr\u1edf th\u00e0nh thu\u1ed1c gi\u1ea3m \u0111au \u2013 h\u1ea1 s\u1ed1t \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t Hoa K\u1ef3. Paracetamol c\u00f3 s\u1eb5n trong c\u00e1c ch\u1ebf ph\u1ea9m k\u00ea \u0111\u01a1n \u2013 kh\u00f4ng k\u00ea \u0111\u01a1n. \u0110\u00e2y l\u00e0 thu\u1ed1c r\u1ea5t an to\u00e0n khi s\u1eed d\u1ee5ng \u1edf li\u1ec1u \u0111i\u1ec1u tr\u1ecb, tuy nhi\u00ean khi qu\u00e1 li\u1ec1u s\u1ebd d\u1eabn t\u1edbi h\u1eadu qu\u1ea3 v\u00f4 c\u00f9ng nghi\u00eam tr\u1ecdng: ho\u1ea1i t\u1eed gan g\u00e2y t\u1eed vong\/ho\u1ea1i t\u1eed gan kh\u00f4ng t\u1eed vong.<\/p>\n<p>V\u00ec v\u1eady, vi\u1ec7c qu\u1ea3n l\u00fd s\u1eed d\u1ee5ng paracetamol v\u00e0 ph\u00f2ng ng\u1eeba ng\u1ed9 \u0111\u1ed9c paracetamol cho tr\u1ebb d\u01b0\u1edbi 18 tu\u1ed5i l\u00e0 \u0111i\u1ec1u quan tr\u1ecdng.<\/p>\n<p><strong>C\u00e1c tr\u01b0\u1eddng h\u1ee3p ng\u1ed9 \u0111\u1ed9c Paracetamol<\/strong><\/p>\n<p>&#8211; Ch\u1ee7 \u0111\u1ed9ng: U\u1ed1ng paracetamol c\u00f3 ch\u1ee7 \u0111\u00edch ph\u1ed5 bi\u1ebfn tr\u00ean tr\u1ebb l\u1edbn v\u00e0 thanh thi\u1ebfu ni\u00ean<\/p>\n<p>&#8211; B\u1ecb \u0111\u1ed9ng:<\/p>\n<p>+ V\u00f4 t\u00ecnh nu\u1ed1t ph\u1ea3i paracetamol ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf tr\u1ebb nh\u1ecf. Ph\u1ea7n l\u1edbn c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y, tr\u1ebb ch\u1ec9 b\u1ecb nu\u1ed1t ph\u1ea3i h\u00e0m l\u01b0\u1ee3ng th\u1ea5p v\u00e0 c\u00f3 th\u1ec3 t\u1ef1 x\u1eed tr\u00ed m\u00e0 kh\u00f4ng c\u1ea7n t\u1edbi b\u1ec7nh vi\u1ec7n. T\u1ef7 l\u1ec7 ng\u1ed9 \u0111\u1ed9c v\u00e0 t\u1eed vong hi\u1ebfm khi x\u1ea3y ra.<\/p>\n<p>+ Ng\u01b0\u1ee3c l\u1ea1i tr\u01b0\u1eddng h\u1ee3p tr\u1ebb em t\u1ef1 \u201cnu\u1ed1t\u201d ph\u1ea3i, \u0111\u1ed1i v\u1edbi tr\u1ebb em nh\u1eadn li\u1ec1u l\u01b0\u1ee3ng paracetamol kh\u00f4ng ph\u00f9 h\u1ee3p t\u1eeb \u201cng\u01b0\u1eddi ch\u0103m s\u00f3c\u201d (ba m\u1eb9\/\u00f4ng b\u00e0\/ng\u01b0\u1eddi ch\u0103m tr\u1ebb) th\u01b0\u1eddng g\u1eb7p h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng nh\u01b0 t\u1eed vong \u00e0 Li\u1ec1u paracetamol kh\u00f4ng ph\u00f9 h\u1ee3p c\u00f3 th\u1ec3 x\u1ea3y ra trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau:<\/p>\n<ul>\n<li>S\u1eed d\u1ee5ng paracetamol li\u1ec1u ng\u01b0\u1eddi l\u1edbn d\u00f9ng cho tr\u1ebb em. V\u00ed d\u1ee5: Thay v\u00ec cho tr\u1ebb s\u1eed d\u1ee5ng paracetamol vi\u00ean 80 \u2013 160mg, l\u1ea1i cho tr\u1ebb d\u00f9ng vi\u00ean 325-500mg.<\/li>\n<li>T\u1ef1 \u00fd t\u0103ng li\u1ec1u cho tr\u1ebb t\u1eeb \u201cng\u01b0\u1eddi ch\u0103m s\u00f3c\u201d khi nh\u1eadn th\u1ea5y thu\u1ed1c d\u00f9ng kh\u00f4ng hi\u1ec7u qu\u1ea3. V\u00ed d\u1ee5: T\u1ef1 t\u0103ng li\u1ec1u ti\u00eau chu\u1ea9n c\u1ee7a b\u00e9 t\u1eeb 10-15mg\/kg\/l\u1ea7n l\u00ean cao h\u01a1n, t\u0103ng t\u1ea7n su\u1ea5t s\u1eed d\u1ee5ng (ch\u01b0a t\u1edbi 4 ti\u1ebfng \u0111\u00e3 cho b\u00e9 l\u1eb7p l\u1ea1i li\u1ec1u th\u1ee9 2).<\/li>\n<li>Ti\u00eam t\u0129nh m\u1ea1ch paracetamol qu\u00e1 li\u1ec1u \u1edf tr\u1ebb em.<\/li>\n<\/ul>\n<p><strong>T\u1ed5ng quan v\u1ec1 ng\u1ed9 \u0111\u1ed9c paracetamol tr\u00ean tr\u1ebb em<\/strong><\/p>\n<p>Paracetamol c\u00f3 nhi\u1ec1u \u0111\u01b0\u1eddng s\u1eed d\u1ee5ng: thu\u1ed1c u\u1ed1ng, thu\u1ed1c \u0111\u1ea1n, thu\u1ed1c ti\u00eam t\u0129nh m\u1ea1ch.<\/p>\n<p>C\u00e1c d\u1ea1ng b\u00e0o ch\u1ebf paracetamol c\u00f3 th\u1ec3 k\u1ec3 \u0111\u1ebfn bao g\u1ed3m:<\/p>\n<ul>\n<li>D\u1ea1ng gi\u1ea3i ph\u00f3ng t\u1ee9c th\u1eddi (dung d\u1ecbch, vi\u00ean n\u00e9n, vi\u00ean nang)<\/li>\n<li>Thu\u1ed1c \u0111\u1ea1n<\/li>\n<li>Vi\u00ean u\u1ed1ng ph\u00f3ng th\u00edch k\u00e9o d\u00e0i (V\u00ed d\u1ee5: Paracetamol ER)<\/li>\n<li>Ti\u00eam t\u0129nh m\u1ea1ch<\/li>\n<\/ul>\n<p>\u0110\u1ed9c t\u00ednh: Ch\u1ee7 y\u1ebfu l\u00e0 paracetamol g\u00e2y nhi\u1ec5m \u0111\u1ed9c gan.<\/p>\n<p>C\u01a1 ch\u1ebf g\u00e2y \u0111\u1ed9c paracetamol<\/p>\n<p>Li\u1ec1u Paracetamol g\u00e2y \u0111\u1ed9c \u1edf tr\u1ebb:<\/p>\n<ul>\n<li>Li\u1ec1u \u0111i\u1ec1u tr\u1ecb cho tr\u1ebb d\u01b0\u1edbi 12 tu\u1ed5i: 10-15 mg\/kg\/li\u1ec1u, m\u1ed7i 4-6 gi\u1edd, li\u1ec1u t\u1ed1i \u0111a 75 mg\/kg\/ng\u00e0y.<\/li>\n<li>Li\u1ec1u \u0111i\u1ec1u tr\u1ecb cho tr\u1ebb t\u1eeb 12 tu\u1ed5i tr\u1edf l\u00ean: 325-1000 mg m\u1ed7i 4-6 gi\u1edd, li\u1ec1u t\u1ed1i \u0111a h\u00e0ng ng\u00e0y l\u00e0 4g.<\/li>\n<\/ul>\n<p>(*) L\u01b0u \u00fd: Li\u1ec1u g\u00e2y \u0111\u1ed9c c\u00f3 th\u1ec3 kh\u00e1c nhau gi\u1eefa c\u00e1c c\u00e1 nh\u00e2n t\u00f9y thu\u1ed9c l\u01b0\u1ee3ng glutathion m\u1ed7i ng\u01b0\u1eddi.<\/p>\n<p>C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y nhi\u1ec5m \u0111\u1ed9c gan do Paracetamol \u1edf tr\u1ebb em:<\/p>\n<ul>\n<li>U\u1ed1ng qu\u00e1 li\u1ec1u paracetamol<\/li>\n<li>C\u01a1 th\u1ec3 gi\u1ea3m kh\u1ea3 n\u0103ng chuy\u1ec3n h\u00f3a paracetamol \u1edf gan.<\/li>\n<\/ul>\n<p>Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng:<\/p>\n<ul>\n<li>Ng\u1ed9 \u0111\u1ed9c c\u1ea5p t\u00ednh<\/li>\n<\/ul>\n<table>\n<tbody>\n<tr>\n<td width=\"113\"><strong>STT<\/strong><\/td>\n<td width=\"151\"><strong>Th\u1eddi gian s\u1eed d\u1ee5ng thu\u1ed1c qu\u00e1 li\u1ec1u <\/strong><\/td>\n<td width=\"359\"><strong>Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"113\">Giai \u0111o\u1ea1n I<\/td>\n<td width=\"151\">Sau 24 gi\u1edd<\/td>\n<td width=\"359\">Kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng bu\u1ed3n n\u00f4n, n\u00f4n, th\u1edd \u01a1, kh\u00f3 ch\u1ecbu, v\u00e3 m\u1ed3 h\u00f4i.<\/td>\n<\/tr>\n<tr>\n<td width=\"113\">Giai \u0111o\u1ea1n II<\/td>\n<td width=\"151\">Sau 24-72 gi\u1edd<\/td>\n<td width=\"359\">\u0110au h\u1ea1 s\u01b0\u1eddn ph\u1ea3i, t\u0103ng men gan, th\u1eddi gian prothrombin (PT), t\u1ef7 l\u1ec7 PT chu\u1ea9n h\u00f3a qu\u1ed1c t\u1ebf, d\u1ea5u hi\u1ec7u t\u1ed5n th\u01b0\u01a1ng th\u1eadn (t\u0103ng ure m\u00e1u, creatinin, thi\u1ec3u ni\u1ec7u) ho\u1eb7c vi\u00eam t\u1ee5y (t\u0103ng amylase huy\u1ebft thanh, lipase).<\/td>\n<\/tr>\n<tr>\n<td width=\"113\">Giai \u0111o\u1ea1n III<\/td>\n<td width=\"151\">Sau 72-96 gi\u1edd<\/td>\n<td width=\"359\">Suy gan, tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng c\u00f3 th\u1ec3 d\u1eabn t\u1edbi suy \u0111a c\u01a1 quan v\u00e0 t\u1eed vong<\/td>\n<\/tr>\n<tr>\n<td width=\"113\">Giai \u0111o\u1ea1n IV<\/td>\n<td width=\"151\">Sau 4-14 ng\u00e0y<\/td>\n<td width=\"359\">Ph\u1ee5c h\u1ed3i<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<ul>\n<li>Ng\u1ed9 \u0111\u1ed9c m\u1ea1n t\u00ednh:<\/li>\n<\/ul>\n<p>Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh nhi\u1ec5m \u0111\u1ed9c paracetamol m\u1ea1n t\u00ednh kh\u00e1 kh\u00f3 kh\u0103n v\u00e0 \u0111\u00f2i h\u1ecfi s\u1ef1 k\u1ebft h\u1ee3p gi\u1eefa khai th\u00e1c b\u1ec7nh s\u1eed v\u00e0 c\u00e1c b\u1ea5t th\u01b0\u1eddng tr\u00ean x\u00e9t nghi\u1ec7m v\u00e0 l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh nh\u00e2n<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3206 size-full aligncenter\" src=\"https:\/\/benhvienthaihoa.vn\/wp-content\/uploads\/2023\/01\/z4008990362216_61ea251c44f47b190d72bf0e29a28d56.jpg\" alt=\"\" width=\"297\" height=\"382\" \/><\/p>\n<p><strong>Th\u1ef1c tr\u1ea1ng s\u1eed d\u1ee5ng paracetamol hi\u1ec7n nay<\/strong><\/p>\n<p>Hi\u1ec7n nay, sau \u0111\u1ea1i d\u1ecbch COVID-19, m\u1ecdi ng\u01b0\u1eddi \u0111ang t\u0103ng c\u01b0\u1eddng n\u00e2ng cao s\u1ee9c kh\u1ecfe v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng. Tuy nhi\u00ean, vi\u1ec7c m\u1ecdi ng\u01b0\u1eddi \u0111\u1ec1 cao c\u00e1c lo\u1ea1i th\u1ef1c ph\u1ea9m ch\u1ee9c n\u0103ng, thu\u1ed1c kh\u00f4ng k\u00ea \u0111\u01a1n nh\u1eadp kh\u1ea9u t\u1eeb n\u01b0\u1edbc ngo\u00e0i ch\u01b0a h\u1eb3n l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn \u0111\u00fang \u0111\u1eafn.<\/p>\n<p>Tylenol c\u1ee7a M\u1ef9 l\u00e0 s\u1ea3n ph\u1ea9m gi\u1ea3m \u0111au, h\u1ea1 s\u1ed1t \u0111\u00e3 t\u1eebng s\u1ed1t r\u1ea7n r\u1ea7n tr\u00ean th\u1ecb tr\u01b0\u1eddng thu\u1ed1c t\u00e2y t\u1ea1i Vi\u1ec7t Nam. Th\u1ef1c ch\u1ea5t, ho\u1ea1t ch\u1ea5t trong Tylenol l\u00e0 acetaminophen, t\u00ean g\u1ecdi kh\u00e1c l\u00e0 paracetamol. Hi\u1ec7n \u0111ang \u0111\u01b0\u1ee3c b\u00e0y b\u00e1n ph\u1ed5 bi\u1ebfn t\u1ea1i Vi\u1ec7t Nam v\u1edbi nhi\u1ec1u h\u00e0m l\u01b0\u1ee3ng kh\u00e1c nhau.<\/p>\n<p>\u0110\u00e3 c\u00f3 th\u1eddi gian, c\u01a1 quan y t\u1ebf c\u1ea3nh b\u00e1o v\u1ec1 t\u00ecnh tr\u1ea1ng ng\u1ed9 \u0111\u1ed9c paracetamol do t\u1ef1 d\u00f9ng thu\u1ed1c ch\u1eefa b\u1ec7nh COVID-19 theo h\u01b0\u1edbng d\u1eabn tr\u00ean m\u1ea1ng x\u00e3 h\u1ed9i. Ch\u1ebf ph\u1ea9m ng\u01b0\u1eddi ti\u00eau d\u00f9ng hay t\u1ef1 s\u1eed d\u1ee5ng l\u00e0 Tylenol t\u1eeb M\u1ef9 &#8211; \u0111\u01b0\u1ee3c th\u1ed5i ph\u1ed3ng l\u00e0 th\u1ea7n d\u01b0\u1ee3c gi\u1ea3m \u0111au, h\u1ea1 s\u1ed1t, tan bi\u1ebfn m\u1ecdi s\u1ef1 m\u1ec7t m\u1ecfi, ph\u00f2ng b\u1ec7nh covid-19,\u2026T\u1eeb \u0111\u00f3 d\u1eabn t\u1edbi t\u00ecnh tr\u1ea1ng l\u1ea1m d\u1ee5ng v\u00e0 \u0111em l\u1ea1i nhi\u1ec1u h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng.<\/p>\n<p>Hi\u1ec7n t\u1ea1i, Tylenol c\u1ee7a M\u1ef9 c\u0169ng nh\u01b0 c\u00e1c ch\u1ebf ph\u1ea9m paracetamol n\u01b0\u1edbc ngo\u00e0i \u0111\u1ec1u c\u00f3 d\u1ea1ng b\u00e0o ch\u1ebf ri\u00eang cho ng\u01b0\u1eddi l\u1edbn v\u00e0 tr\u1ebb em. Ng\u01b0\u1eddi ti\u00eau d\u00f9ng n\u00ean hi\u1ec3u r\u00f5 v\u1ec1 s\u1ea3n ph\u1ea9m bao g\u1ed3m c\u00f4ng d\u1ee5ng, ch\u1ec9 \u0111\u1ecbnh, li\u1ec1u d\u00f9ng tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng thu\u1ed1c. M\u1eb7c d\u00f9 \u0111\u00e2y l\u00e0 thu\u1ed1c kh\u00f4ng k\u00ea \u0111\u01a1n, tuy nhi\u00ean \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n cho ch\u00ednh b\u1ea3n th\u00e2n v\u00e0 gia \u0111\u00ecnh, ng\u01b0\u1eddi ti\u00eau d\u00f9ng n\u00ean tham v\u1ea5n th\u00eam \u00fd ki\u1ebfn d\u01b0\u1ee3c s\u0129 \u2013 b\u00e1c s\u0129 tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng thu\u1ed1c.<\/p>","protected":false},"excerpt":{"rendered":"<p>Paracetamol \u0111\u01b0\u1ee3c ra m\u1eaft v\u00e0o n\u0103m 1950 v\u00e0 d\u1ea7n tr\u1edf th\u00e0nh thu\u1ed1c gi\u1ea3m \u0111au \u2013 h\u1ea1 s\u1ed1t \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t Hoa K\u1ef3. Paracetamol c\u00f3 s\u1eb5n trong c\u00e1c ch\u1ebf ph\u1ea9m k\u00ea \u0111\u01a1n \u2013 kh\u00f4ng k\u00ea \u0111\u01a1n. \u0110\u00e2y l\u00e0 thu\u1ed1c r\u1ea5t an to\u00e0n khi s\u1eed d\u1ee5ng \u1edf li\u1ec1u \u0111i\u1ec1u tr\u1ecb, tuy nhi\u00ean khi qu\u00e1Leer M\u00e1s<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[57],"tags":[],"class_list":["post-3205","post","type-post","status-publish","format-standard","hentry","category-bai-viet-y-khoa"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/posts\/3205","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/comments?post=3205"}],"version-history":[{"count":2,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/posts\/3205\/revisions"}],"predecessor-version":[{"id":4302,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/posts\/3205\/revisions\/4302"}],"wp:attachment":[{"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/media?parent=3205"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/categories?post=3205"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/benhvienthaihoa.vn\/en\/wp-json\/wp\/v2\/tags?post=3205"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}