Vấn đề tiêm vắc xin ở trẻ em

Van de tiem uac xtn

6 tre em Tiem vie xin d tri em

de phdng ngCfa benh '

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Tfl xa xUa, ngudi ta da nhdn

tha'y nhiJng ngUdi lay mat

ong riftig va nhflng ngUdi

sdn rdn ddc deu quen dan vdi

dfic cha't khi nhilu ldn hi ong dot

hodc bi rdn cdn ma khfing nguy

hiem de'n tinh mang. BS. Edward

Jenner (Anh Quo'c) ciing cfl nhdn

xet tUtfng tu dfi'i vdi ngfl&i vdt sfla

bo, thfl&ng xuyfin tilp xflc vdi bo hi

bgnh ddu miia ma lai khong hi mac

bfinh nay. Cho nfin fing da tiem

eho ngU&i npe dgu bo dd hi lam

suy ylu, ddn dfi'n kit qua la ed the

phflng bfinh ndy dUtfe. Cfing trinh

nay dflde cfing bfi' tfl ndm 1798 dd

md ddu cho thdi dgi tigm chung

phong benh.

Mflt sfl' ldn cdc benh nhiem

khuan va nhiem sifiu vi thfldng gap

d tre em cfl thi phdng ngfla dUtfc

bang tifim phdng. Chifdng trinh

tifim phong md rgng cho tre em tai

Viet Nam vdi vdc xin ngfla lao, udn

vdn, ho gd, bach hdu, bai lifit vd sdi

dd gflp phdn quan trpng trong vigc

ha thdp ty lfi tfl vong tre em dudi

5 tuli. Mdt so vde xin mdi da dUdc

dfla thfim tfl ndm 1998 nhfl vde xin

viem gan B, vifim nao Nhdt Ban B,

vdc xin phflng nhiem Hemophilus

influenza (HiB), nao md cau, quai

bi, dai, thuy dau, vdc xin chfi'ng

tifiu chay do Rotavirus cung dd cd

mdt tai Vifit Nam gop phdn tang

ctfdng mien dieh chu dfing cho trd

em. Viet Nam dd thanh todn diidc

benh bai ligt (ndm 2000), va duy

tri dfldc ty lg tifim chung day du 6

loai vdc xin cho tre em dUdi 1 tuoi

dat 98%.

Chi dinh tidm vdc xin

• Trd em tfl 0 - 11 thdng tuoi

la doi tfldng chu yg'u chi dinh tiem

chung eua chUdng trinh tifim chung

md rpng. Cl nUdc ta 90 - 98% tre

em d dp tuli ndy dUffc tifim chung

day du dl cd mign dich ctf ban.

• Tr6 em tfl 12 - 23 thdng tuoi

la doi tfldng dflde ehi dinh dl tigm

nhae lai nham eung ed'mien dieh ctf

bdn da dat dUtfc luc dfldi 12 thdng.

• Tre em 24 - 36 thang cung la

dfi'i tUdng tifim nhde lai.

• Phu nfl cfl thai vd phu nfl tuli

sinh de (16 - 35 tuoi) la do'i tflcfng

tiem phflng ufin vdn de tao mien

dich thu dfing phflng chlng udn

vdn d tre Stf sinh.

Chong chi dinh tiem vdc xin

• Chfi'ng chi dinh tifim cdc lieu

vac xin kg' tie'p doi vdi tat cd cdc

logi vac xin nlu bi sic phan vp vdi

vac xin.

• Tre can ngng dfldi 2.000g.

Dfi'i vdi moi loai vac xin phdng

benh, tnidc khi chi dinh cho tre,

cdc bdc si thudng khdm vd ed

hudng ddn eu the. Cha me cde chdu

cd the yen tdm.

ft BS. NGd VAN TUAN

Bien chuing do vac xin

Tifim vac xin tflc Id dua khang

nguyfin vdo etf the kfch thich sfl

ddp flng mil n dich, hg thong

miln dich cua cd the ddp flng vd

hoat dpng tdng cudng d l sinh

mien dich. Qua trinh do lam sit

nhe, dau tai chd tigm, vd tri

thfl&ng qud'y hdn. Hai ngdy sau,

cdc phan iing trfin mdt di. Nhflng

bieu hifin trfin khdng dfldc gpi Id

bifi'n ehflng cua vdc xin. Nhiing

bilu hign ldm sdng ndng ngodi

nhflng phan flng thdng thudng

tren dUdc goi Id biln chflng do

vdc xin (ehdng hgn sit cao, co

gi^t, tim tdi, nli ban, hach to,

vifim ndo, soc phan vp.,.).

Soc phan vg sau khi tifim phflng:

Xay ra ngay sau khi tiem hogc vdi

gid sau khi tiem:

• Man dd vd ngfla tai cho tiem.

Ban dd vd phu todn thdn.

• Mgch nhanh nho, khd bat.

Tut huylt dp.

• Khd thd.

• Bdn ehln, hit hodng, sd hai,

ehflng mat, chodng vdng, vgt vd,

gidy dua, co giat, hon mfi.

• Dau qudn bung.

• Dai ddm.

Xfl tri cdp cflu sic phdn vfi tai

ntfi tifim: Ngifng ngay tiem vdc xin.

• Nam tai cho, theo doi dudng

thd, ldm thdng dfldng thd, thd oxy

neu cd. U dm nlu mach nhanh,

chi lanh. Ndm ddu thdp. Do mgch,

huyg't dp 15 phut/ldn.

• Tiem dfldi da, tifim bdp ngay

adrenalin 1/1.000 - 1ml. Lieu

adrenalin 0,01mg/kg.

• Tiem nhic lai lilu tren 15

phut/ldn cho tdi khi huyet dp trd

lai binh thfldng.

• Mdi kf p ho trd cdp cflu tai ch6.

• Chuyln bfinh nhi vl cdc trung

tam clip ctiu h&i sflc. W

THU6C & Sl?C KHOE sl510 (15.10.2014)