You are on page 1of 5

Bnh quai b: triu chng v cch cha tr

Khnh Nguyn (TH)


Cp nht lc: 06:45 26/8/2014
Trang ch
>
Sc khe

(Sc khe) - Quai b tuy l bnh nh nhng nu khng bit cch iu tr s dn


n rt nhiu bin chng, li hu qu v cng ng tic.
Tm hiu nguyn nhn bnh au lng mi gi
Nhng bnh thng gp dn vn phng
Quan nim sai lm ca ph n v bnh ph khoa

Bnh quai b l loi bnh l v cc tuyn nc bt v c gy ra bi loi virus


c tn l Paramyxovirus c i tnh vi cc t chc tuyn v thn kinh. L loi
bnh thng gp v ch yu tc ng ln tr em c tui t 5 n 15 tui.
Bnh quai b thng hay xut hin nhiu vo ma h v cng c th xy ra
quanh nm vo nhng ma thu, ng. Bnh s pht trin thnh dch nhng ni
tp th ng nh trng hc, khu tp th.
Bnh quai b l loi bnh nh nhng nu khng pht hin v iu tr sm c th gy ra
nhiu bin chng nguy him n no nh: vim mng no v nguy him hn l sng
tinh hon, xy ra nam gii trng thnh vi nguy c mc phi l 20-30%.

Nguyn nhn
Bnh quai b l do virus gy nn v vy s nhanh chng ly lan qua ng h
hp, n ung v qua nhng git nc bt khi bnh nhn ho hoc ht hi. Bnh
xut hin nhiu cc tr nh, nhng tr ln cha tim phng quai b v nhng
ngi trng thnh cha c min dch quai b, ngi ln c th b nhng t l
rt thp. Thi gian ly lan bnh l t 6 ngy trc khi pht hin bnh hon ton
v n 2 tun sau khi c triu chng bnh.
Triu chng bnh quai b

Khi b nhim virus quai b, phn ln bnh nhn thy kh chu t 1 2 ngy
trc khi cc triu chng xut hin. Bnh nhn b st cao (39 400C) trong 3
4 ngy, chy nc bt, sng vng mang tai, du hiu d nhn bit nht l m
sng to, c th sng mt bn mt ri lan sang bn kia hoc sng hai bn cng
mt lc. Tuy nhin, c khong 25% ngi b nhim virus quai b m khng c
triu chng bnh l, y l nhng i tng c kh nng truyn bnh m ngi
xung quanh khng bit. Bnh thng t khi sau 1 tun n 10 ngy. Sau ,
bnh nhn c min dch sut i.
Bnh quai b ngi ln thng nng v c nhiu bin chng hn tr em nu
khng c pht hin sm v iu tr kp thi c th c cc bin chng nh:
vim tinh hon v mo tinh hon, nhi mu phi, vim bung trng, vim ty;
tn thng thn kinh; c bit bnh quai b ph n c thai trong 3 thng u
ca thai k c th gy sy thai hoc sinh con d dng, trong 3 thng cui ca
thai k c th sinh non hoc thai cht lu.
Mt trong nhng bin chng nguy him v li hu qu nng n ca quai b l
gy vim teo tinh hon nam gii (chim t l cao) hoc suy bung trng n
gii (chim % nh). Bnh quai b cn c pht hin v iu tr kp thi, v c
ch king hp l khng gy bin chng nguy him.
Di y l mt s li khuyn v ch n ung, ch sinh hot cho bnh
nhn quai b:

- H st, h thn nhit cho bnh nhn bng khn m.


- eo khu trang khi tip xc vi ngi khc phng trnh ly nhim bnh cho
ngi khc.
- Cch ly ngi bnh khong 2 tun t khi pht hin bnh.
- King nc lnh, king gi.
- Ngh ngi, hn ch vn ng (c bit l khi pht hin tinh hon c hin tng
sng au).
- V sinh rng ming, ung nhiu nc v sc ming bng nc mui sinh l
hay nc sc ming chng kh ming v trnh vi khun c mi trng
thun li pht trin
- n thc n mm, d nut, d tiu ha nhng vn phi y cht dinh dng.
Khng n np, c m, c chp.
- n a dng cc loi rau xanh v hoa qu ti, gip b sung cc loi vitamin v
khong cht cn thit cho c th gip tng kh nng min dch.
- Trong trng hp st cao lin tc, khng h st c hoc thy xut hin bin

chng cn a bnh nhn n bnh vin.


- Gi gn v sinh thn th sch s.
- Khng nn t s dng cc loi thuc ung, thuc bi, p ln vng b sng
trnh b nhim c.

Bnh quai b l g ?
1. Bnh Quai b l g ?

Nguyn nhn triu chng cch cha tr bnh quai b

Quai b (ting Anh: Mumps) dn gian cn gi l bnh m chm bm l mt bnh ton


thn biu hin bng sng mt hay nhiu tuyn nc bt, thng gp nht l cc tuyn
mang tai. Khong 1/3 cc trng hp nhim bnh khng gy nn cc triu chng sng
tuyn nc bt r rng trn lm sng. Trn 50% bnh nhn mcbnh quai b c hin
tng tng bch cu trong dch no ty. Mt s bnh nhn c biu hin vim mng
no r vi cc triu chng nhc u, nn ma, cng c...Vim tinh hon (orchitis) l
mt bin chng kh thng gp sau tui dy th nhng bin chng v sinh th khng
thng gp nh nhiu ngi vn lo ngi. Cc bin chng khc him gp hn gm
vim khp, vim tuyn gip, vim khp xng hm, vim cu thn,
(glomerulonephritis), vim c tim, x ha ni tm mc, gim tiu cu, tht iu tiu
no, vim ty ct ngang, vim a dy thn kinh lan ln, vim ty cp, vim bung
trng (oophoritis), v gim thnh lc.

2. Nguyn nhn gy nn bnh quai b


Quai b gy nn do mt loi virus ARN thuc Rubulavirus trong h Paramyxoviridae.
Cc nguyn nhn khc gy vim tuym mang tai gm virus vi ht c bo
(cytomegalovirus-CMV), virus cm type 1 v 3, virus cm A (influenza A virus),
coxsackievirus, virus rut (enterovirus), virus gy suy gim min dch ngi
(Human Immunodeficiency Virus-HIV), t cu khun, v cc Mycobacterium khng
gy lao khc. Cc nguyn nhn gy vim tuyn mang tai him gp khc c th k: do
n nhiu tinh bt, phn ng thuc (phenylbutazone, thiouracil, cc thuc cha it) v
cc ri lon chuyn ha (nh bnh i tho ng, x gan v suy dinh dng).c th
b 2 ln.
3. Triu chng ca bnh quai b
- Nhim trng khi u phn nhiu khng t ngt, bnh nhn thy kh chu, s gi,
nhc u, au trc tai. Sau mt bn tuyn mang tai bt u sng, ri 2 3 gny
hm sau lan sang bn kia. Ch sng au nhng khng ty , da bng ln, n khng
ln, khng ho m, hng hi , l ng Stenon hi ty ln.
- Cc tuyn nc bt khc cng c th c vim, nhng t khi n c. Trong thi gian
st c th n 40 . Phn nhiu lui bnh sau 1 tun.
- C th c vim tinh hon: phn nhiu hu pht 5 dn 10 ngy sau khi sng tuyn
mang tai, c th tin pht v ring l phi ngh n bnh quai b khi phi chn
on sai. Biu hin l c st tr li 39 40 d. Bnh nhn trn trc, c khi m sng.
Mt bn tinh hon sng to, au, ty ln, nu c hai bn b sng th c th gy v
sinh. Khi sau 10 ngy nhng phi sau 2 thng mi bt r c teo hay khng. Ph n
c th c vim bung trng.
- C th gp vim mng no, vim no v tu tng nhng phn ln u t khi khng
lli di chng trong vi ngy.
- Cn phn bit vi vim tuyn ho m do tp khun hay gp trong bnh thng hn,
nht ng tai, ni hch c, vim xng hm, si trong ng Stenon (him)
- Sau giai on khi bnh, hoc tim vcxin thng c th c min dch ko di. Hin
nay ngi ta c th dng test da pht hin tnh trng c min dch ( tng mc
bnh hay c tim phng vcxin). Nu test ny m tnh chng t c th thiu ht
min dch qua trung gian t bo vi virut quai b do cha c tim phng hoc
tim phng nhng c th cha to c khng th phng chng virut.
4. Cch iu tr bnh quai b
Khng c thuc c tr, ch yu iu tr triu chng.
Th vim tuyn mang tai

- Sc ming: Nc mui 0,9%, dung dch Axit Boric 5%.


- H st nu st qu cao, gim au (Paracetamol), An thn nh (seduxen,rotunda),
dng cc vitaminB,C ung nc chanh, cam, n lng.
- Nm ngh ti ging, hn ch i li, trong thi gian cn st, cn sng tuyn (thng
l 7-8 ngy u). Cch ly ti thiu 10 ngy.
Th vim tinh hon
- Nm ngh ti ging khi cn sng au. Mc si-lip treo tinh hon.
- Gim au: Chm , ung paracetamol 0,51 vin/ln, ung 2 n3 ln /ngy (ung
lc no, cch 6 gi ung 1 ln) dng 3-4 ngy. Nu au tinh hon nng dng
paracetamol khng c th dng thm codein vi liu 30 mg-60mg/ngy cho ngi
ln (ch dng 2-3 ngy) hoc efferalgan-codein 1vin/ln x 2-3 ln/ngy
- Gim vim: Cortanxyl 20mg-30mg/ngy chia 2 ln ung lc no, dng 3-4 ngy. Sau
khi tinh hon sng au c th dng vitamin E 400mg 1 vin/ngy t 1-2 thng
tng sinh tinh trng.
D phng
- Cch ly 10-21 ngy nu thy cn (thng l 10 ngy).
- eo mng khi tip xc vi bnh nhn.
- Ph n c thai b bnh nu c iu kin tim Globulin min dch c hiu, liu 0,3
mg/kg, dng 1 liu tim bp duy nht.
- Vacxin sng gim hot (thng kt hp vi cc vacxin khc nh si...).
- Liu 0,5 ml/tim di da mt ln duy nht phng bnh cho thanh, thiu nin nhi
ng cha c min dch (c bit cho ngi ch c mt tinh hon, nghe km). Vacxin
cho min dch tt, khng c tai bin. Bo v c 3 nm n 5 nm.