Đánh giá hiệu quả điều trị sẹo lồi bằng tiêm triamcinolone acetonid (TAC) trong thương tổn

DIEN OAN Y HOC

Nghien ciru khoa hpc

DAC DIEM LAM SANG VA DIEU TRI NGO DOC PARACETAMOL

TAI TRUNG TAM CHONG DOC - BENH VIEN BACH MAI

Pham Due*

TOM TAT

Muc tieu.' ddnh gid dgc diim ldm sdng, can ldm sdng vd nhdn xit dieu tri ngp dpc paracetamol tgi

Trung tdm Chdng dpc Binh viin Bgch Mai (TTCD). Phuong phap nghien ciru.- tiin cieu, quan sdt md td.

Ddi tuong nghien ciru.- gdm 49 BN udng ngp ddc paracetamol dieu d-i tgi TTCD tir 09/2003 din 09/2005.

Ket qua.- 98% BN udng liiu paracetamol > I50mg/kg cdn ndng nhimg chi cd 22,2%) cd ndng dp a mirc dp

ngd dpc vd 7 BN (14,3%) cd viim gan nhiim ddc. Ndn xudt Men trong vdng 1-3 gia sau udng a 40 (81,6%)

BN. Hpi chimg ldm sdng ciia viem gan nhiim dpc (gan to dau, vdng da) gap a 8,2%, sau 3 - 4 ngdy vdo

viin; hpi chung can ldm sdng bao gdm tdng AST (34,7%), ALT (24%) GGT (18,4%,) vd tdng bilirubin true

dip (26,5%), gidm ti li prothrombin (20,4%,); hg kali mdu cung thuang gap vdi ti li 63,3%. Tdng AST vd

ALT la 2 ddu hieu din sdm nhdt (sau 10-96 gid). Dieu tri chinh gdm rua dg ddy: 33 BN (67,3%): udng than

hogt: 34 BN (69,4%,) vd udng N-acetylcystein: 48 BN (98%), truyen dich. Kit qud dieu tri tot vai thdi gian

ndm viin ngdn (3,47 ngdy), tie vong 1 do hdn mi gan din mupn. Ket luan.- trieu chung ngp dpc paracetamol

sdm la ndn, cdc thay ddi can ldm sdng thuang gap nhdt la tdng AST, ALT, GGT, BLRB, gidm prothrombin

vd hg Kali Ndn sdm vd cdc biin phdp riea dg ddy, udng than hogt gop phdn ldm gidm hdp thu paracetamol.

N-acetylcysstein duang udng cd hiiu qud diiu tri ngp dpc paracetamol.

I. DAT VAN DE

Paracetamol la thudc ha sdt giam dau dugc

xep vao loai thudc khdng can don. Thudc nay cd

hang tram biet dugc khac nhau [2] va dugc sir dung

nhieu nhat vi vay cung trd thanh nguyen nhan gay

ngd ddc nhieu nhit tai cac nude phat trien [5], [6].

0 nudc ta, paracetamol cung dugc su dung rdng

rai va dugc mua ban tu do tren thj trudng va gay

ra nhieu vu ngd ddc. Bai bao nay la ket qua cua dd

tai cip Bd ve "Ngd ddc thudc thudng gap..." vdi

muc tieu:

Ddnh gid dgc diim ldm sdng (LS), can ldm

sdng (CLS) vd kit qud diiu tri cita ngp dpc parac￾etamol cd trong thudc chiea cdm cum tgi Trung tdm

Chdng dpc, Benh viin Bgch Mai

Trung tdm Chong dpc, Binh viin Bgch Mai

II. DOI TU'ONG VA PHU'ONG PHAP

NGHIEN cut !

1. Doi tuong

- Gdm 49 benh nhan (BN) ngd ddc paracetamol

dieu trj tai Trung tam Chdng ddc, Benh vien Bach

Mai trong thdi gian tir 09/2003 din 09/2005 va dat

cac tieu chuan sau:

+ Vao vien sau khi udng, tiem paracetamol.

+ Xet nghiem djnh tinh paracetamol (+) trong djch

da day hoac trong nudc tieu.

2. PhuoTig phap

- Nghien ciru quan sat md ta tien ciiru.

- Cac thdng sd nghien cii'u:

+ Theo ddi cac dau hieu lam sang, dac biet phat

44 I Y HOC LAM SANG So 53 (Thang 06 / 2010)