ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ TRẺ SỐT XUẤT HUYẾT DENGUE NẶNG CÓ TĂNG ÁP LỰC Ổ BỤNG TẠI BỆNH VIỆN NHI ĐỒNG CẦN THƠ NĂM 2016-2017

Abstract

Background: Severe hemorrhagic fever with intra-abdominal hypertension (IAH) cause respiratory failure and many complications, fatal risk is high. Objectives: 1) Identify the clinical,  laboratory of severe dengue hemorrhagic fever patients with IAH at Can Tho Children's Hospital; 2) Find out some related factor of the clinical and laboratory features with IAH; and 3) Evaluate the treatment outcome of IAH in children with dengue shock syndrome in 2016-2017. Method: A case series study among 50 pediatric dengue fever patients aged <15 years who were diagnosed with IAH. Result: All pediatric patients have respiratory failure (100%) due to peritoneal fluid, pleural effusion. There was a relationship between pleural effusion, prolonged shock, re-shock, CVP and IAH in pediatric patients. Treatment outcome: in 15 patients with IAH of grade I, 14 cases returned to normal (93.3%), 10 patients with IAH of grade II, 9 with abdominal pressure reduction (90%), 10 patients with IAH of grade III, 9 with abdominal pressure reduction (90%) and 15 patients with IAH of grade IV have 11 patients (73.3%) reduced abdominal pressure. Intravesical pressure (IVP) in the nonoperatived group decreased by 13.6 cmH₂O. IVP in 7 patients had indication of abdominal decompression decreased by 11.85 cmH₂O. There were 43 cases of IAH reduction (86%), 42 cases completely (84%), 1 death (2%). Conclusion: abdominal decompression have been shown to be effective in management of IAH in severe hemorrhagic fever patients.