Viêm Phổi Cộng Đồng

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    Dc Tr Hc Ca BnhVim Phi Cng ngHung Minh Le PharmD PhD MD

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    Ph!n L"#i Vim Phi

    Vim $hi m%c $h&i ' cng (ng C"mmuni)*+ac,uire- $neum"nia

    Vim $hi m%c $h&i ' .nh /in H"0$i)a1+ac,uire- $neum"nia

    Vim $hi m%c $h&i )2 m3* )h' Ven)i1a)"r+a00"cia)e- $neum"nia

    Vim $hi 1in ,uan .nh /in Hea1)hcare+a00"cia)e- $neum"nia

    Vim $hi -" h4) )h5c 6n 70$ira)i"n $neum"nia

    Vim $hi 8h9ng (i:n h;nh 7)*$ica1 $neum"nia

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    #i C=ng

    Vim $hi> )? 1 )@ /"ng A+ ThEng F&* ra /G" gia mIa 9ng /G (Ju Ku!n

    h9ng c NmIaO /im $hi

    Q+QR .nh nh!n c nhng .nh m#n )4nh Vim $hi nSng ' ngEi 1n )ui )rU em .nh )rin

    min Wchr"nica11* i11X Vim $hi 1G m) )r"ng nhng ngu*n nh!n hGng (Ju nhY$

    /in ca ngEi Z[

    Tr 1iu \ 0m )r"ng /]ng +Q giE 0au 8hi nhY$ /ingi&m )? 1 )@ /"ng

    A

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    h))$>^^___`_e.m-`c"m^1ung+cancer^F+ra*+"+a+n"rma1+che0)

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    T3c bh!n !* Bnh

    \)re$)"c"ccu0 $neum"niae> d[+[ Haem"$hi1u0 in1uenae> A+AQ M"raFe11a ca)arrha1i0> fd

    7)*$ica1 $a)h"gen0> Chlamydophila pneumoniae> +d Legionella0$ecie0> in1uena \V $arain1uena a-en"/iru0 dme)a$neum"/iru0

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    Pre-ic)i"n u1e0

    CB+[ C"nu0i"n WT!m )hJn 1= m=X + 8h9ng (nh r / ngEi n=i

    chjn )hEi gian Urea kl WBb k

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    Pneum"nia \e/eri)* qn-eF Ca1cu1a)"r` Decem.er ^^$-a`ahr,`g"/^$0ica1c`a0$

    l

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    PSI score, assign patients Class I - V

    Points total Risk Class Mortality RatesPatient Care

    Location

    f d q `d su)$a)ien)d )" l qq `[ su)$a)ien)

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    VqtM PHqCvb wb

    CURB65

    iu Tr bg"#i Tr iu Tr bi Tr

    Ch6m 0c Sc Bi) WqCX Ch6m 0c ThEng Wn"n+qCX

    CB[ x d CB[ Z "$)i"n0 "r C7P

    mg $" ,- F A- WTri+$a8X

    mg $" -d )hen

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    iu Tr bg"#i Tr W))X

    Bnh nh!n (} -Ing 8h3ng 0inh )r"ng /]ng A )h3ng

    7i)hr"m*cin ~ 7m"Fici11in dgm $" )i- 7ugmen)in K d^[

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    iu Tr Bnh Vin ng"Gi qC

    d

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    iu Tr Bnh Vin ng"Gi qC

    qD\7 ui-e1ine WC1in qnec) Di0 \u$$1 \

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    iu Tr Bnh Vin ng"Gi qCW))dX

    qD\7 ui-e1ine WC1in qnec) Di0 \u$$1 \

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    iu Tr Bnh Vin ng"Gi qCW))

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    iu Tr Bnh Vin T#i qC

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    iu Tr Bnh Vin qC

    Ce)riaF"ne d+

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    iu Tr Bnh Vin qCW))dX

    P0eu-"m"na0 aerugin"0a c A 1{a chn Ph chjng $neum"c"cca1 /G $0eu-"m"na1 .e)a+1ac)am

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    iu Tr Bnh Vin qCW))

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    Dc Tr Liu

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    Dc Tr Liu

    7i)hr"m*cin^C1ari)hr"m*cin Strep. pneumoniae( 8h3ng )6ng c1a/una1a)e ha* g!* ra )iu ch&*

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    Dc Tr Liu W))dX

    D"F*c*c1ine Chjng Strep. pneumoniaenhng 8h3ng )hujc )6ng -Jn Chjng )j) /i 7)*$ica1 /G Legi"ne11a

    z )in /G Tin 1i /; ujng ngG* < 1Jn Tr3nh ch" )rU em fQ )ui /; /Gng r6ng Ph")"0en0i)i/i)*

    Penici11in "r V Thujc chn hGng (Ju chjng /im $hi -" S. pneumoniae.

    h"&ng R c3c -]ng 1G nh#* c&m /i )hujc MqC "r re0$ira)"r* i0"1a)e0 mi (i )2 `< ug^mL (n

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    Dc Tr Liu W)) d+

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    Dc Tr Liu W))AX

    e0$ira)"r* 1u"r",uin"1"ne0 W1e/"1"Facin m"Fi1"FacinX Ph chjng a)*$ica1 an- )*$ica1 .ac)eria1 $a)h"gen0

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    Le/"1"FaFin 1iu ca"

    Dun.ar LM un-erin8 e) a1` W

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    Dc Tr Liu W))X

    7m$ici11in^0u1.ac)am Wna0*nX Agm qV ,[h Ph chjng )j) \` $neum"niae an- H` in1uenae nhng

    8h9ng )3c -ng /i a)*$ica1 $a)h"gen0`

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    8h3 8m` !* 1G 0{ 1{a chn 8h9ng ha* 1%m`

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    Dc Tr Liu W))X

    Vanc"m*cin d mg^8g qV ,Q+d d+

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    Dc Tr Liu W))[X

    Da$)"m*cin Ph chjng /i \)a$h` 7ureu0 .a" gm M\7 h9ng nn 0@ -ng (: )r /im $hi -" )? 1 )h) .#i ca" bgu*n nh!n> -a$)"m*cin 8) h$ /i 0urac)an) )r"ng .

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    h3ng hun W7n)i.i"gramX

    h))$>^^___ ch0.ua1"`"rg^"rPh*0ician0^re0"urce0^/en)0^

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    h3ng hun W7n)i.i"gramX

    h))$>^^___`ch0.ua1"`"rg^"rPh*0ician0^re0"urce0^/en)0^

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    h3ng hun W7n)i.i"gramX

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    h3ng W7n)i.i"gramX

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    h3ng hun W7n)i.i"gramX

    A[

    Thai Thu* b` W

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    ThEi i:m DIng h3ng \inh

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    H"uc8 PM Bra)1er D b0a e) a1`W

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    Vai Tr] ca C"r)ic"0)er"i-0

    Vai )r] ca c"r)ic"0)er"i-0 )r"ng (iu )r /im $hi 8h9ngr rGng C3c nghin c5u ch" )h* 4ch 1i cha r rGng

    \ni-er0 D` Danie10 M -e raa C\ e) a1` W 8h9ng c&i )hin W$o`AQX T? 1 N1a)e ai1ureO Wl< giE 0au 8hi nhY$ /in c )riu ch5ng

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    ll> 8h9ng 8h3c .i) W$o`QX

    AQ

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    ThEi ian Tr Liu

    )ji )hi:u ngG* W1e/e1 q e/i-enceXh) 0j) (c Ql< giE /G 8h9ng c h=n d )riu ch5ng)hiu 9n (nh / 1!m 0Gng )rc 8hi ngng )hujc \W1e/e1 qq e/i-enceX

    n (nh / 1!m 0Gng bhi) ( xAl`QC bh$ )im x d .ea)0^$h) bh$ )h' x

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    Chu*:n )2 qV 0ang Ps

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    Ca0e d

    Bb sL l[) c&m )h* 8h )h' (n $h]ng C$ C5u` Bb 1" 1%ng` Th!n nhi) 1n dd`" /G c&m )h* 1#nh run` Tin 0@> (ang h) )hujc 13 mi )uJn d gi` h9ng ujng

    ru /G 8h9ng -Ing )hujc .) h$ $h3$ BP dd^lmmHg H R

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    Ca0e d

    CB+[ C"nu0i"n WT!m )hJn 1= m=X> Urea kl WBb k n^a

    Re0$ira)"r* ra)e + bh$ )h' kA 1Jn^$h)> QQ s< .&" h]a

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    Che0) Kra*> F!m nhY$ nhiu .n $hi Ph&i

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