문서 — 베트남

Nh~m phat hien tnrong hop bfit thuong c~n hru y dS quyet dinh cho tre tiem

chung, khong tiem chung, hoan tiem chung hoac chuyen kham sang loc tai benh

vien.

II. Kham sang IQctrurrc tiem chiing cho tre em ~ 1 thang tuAi:

1. Cac tnrong hop chong chi dinh:

a) Co tiSn sir s6c hoac phan irng nang sau tiem chung vAcxin l~n tnroc (co cung

thanh phan): s6t cao tren 39°C kern co giat hoac dfiu hieu nao/rnang nao, tim tai,

kh6 tho.

b) Suy giam miSn dich (benh suy giam miSn dich bam sinh, tre nhiem HIV giai

doan lam sang IV hoac co biSu hien suy giam miSn dich n~ng) ch6ng chi dinh

tiem chung cac v~c xin s6ng giam dQc h.rc.

c) Cac trucmg hqp ch6ng chi dinh khac thea huang d~n cua nha san xufit d6i vai

tUng lo~i v~c xin.

2. Cac trucmg hgp t~m hoan:

a) U6i v6i co sa tiem chung ngoai b~nh vi~n:

- Co tinh tr~ng suy chuc nang cac co quan (nhu suy ho hfip, suy tu~n hoan, suy

tim, suy th~n, suy gan, hon me ... ). Tiem chung khi suc khoe cua tre 6n dinh.

- M~c cac b~nh cfip Hnh, cac b~nh nhiSm trung. Tiem chung khi suc khoe cua tre

6n dinh.

- S6t ~ 37,SoC ho~c h~ than nhi~t:S 3S,SoC (do nhi~t dQt~i nach).

- Tre m6i dung cac san ph&m globulin miSn dich trong yang 3 thang (tru khang

huy~t thanh viem gan B): t~m hoan tiem chung v~c xin s6ng giam dQc h.rc.

- Tre dang ho~c m6i k~t thuc dgt diSu tri corticoid (u6ng, tiem) liSu cao (tuang

duong prednison ~ 2mg/kg/ngay), hoa tri, x~ tri trong yang 14 ngay: t~m hoan

tiem chung vAc xin s6ng giam dQc h.rc.

- Tre co can n~ng du6i 2000g: chuySn kham sang lQc va tiem chung t~i b~nh

vi~n.

- Co tiSn su phan irng tang d~n sau cac l~n tiem chung tnroc cua cung Ioai v~c

xin (vi du: l~n d~u khong s6t, l~n sau s6t cao tren 390C ...): chuyen kham sang

19C va tiem chung tai benh vien.

- M~c cac benh b~m sinh hoac benh man tinh a tim, phoi, h~ thong tieu hoa, tiSt