ĐẶC ĐIỂM LÂM SÀNG VÀ ĐIỀU TRỊ SỐC SỐT XUẤT HUYẾT DENGUE Ở TRẺ EM TẠI BỆNH VIỆN NHI ĐỒNG 1 TỪ 2019-2020

Abstract

Introduction-Objective: The aim of the study is to determine epidemiological, clinical, subclinical characteristics and treatment of dengue shock syndrome (DSS) were admitted early at Children’s Hospital 1.Materials and methods: In this prospective, case-series study, all patients aged ≤ 16 years with DSS at Children Hospital 1 from 1 from July 1, 2019 to June 30, 2020. Results: A total of 35 patients were recruited into our research. The mean age of patients was 6.8 ± 3.9 years, the percentage of 5 – 10 age group was highest. Male / female ratio was 1 / 1.1. The obesity rate was 17.1%. Severe dengue shock rate was 17.1%, prolonged shock rate was 2,9%, recurrent shock rate was 2,9%. Common clinical manifestations were: hepatomegaly (88.6%), petechia (77,1%), abdominal pain (34.3%), gastrointestial bleeding (8.6%), neurological distubance (5.8%), gum bleeding (2.9%). Respiratory failure rate was 40%. 62.8% of patients had liver injury, 14.3% of patients had acute liver failure. Percentage of patients had deranged coagulation profiles was 83.9%. Disseminated intravascular coagulation was found in 45.2% of cases. The mean total fluid volume was 163,5 ± 43,8 ml/kg with mean infusion time was 31,3 ± 7,9 hours. Colloid therapy was needed in 60% of cases, 4 of 35 patients needed infusion of blood products, 2 of 35 patients had albumin infusion. Conclusion: The most common age group was 5 – 10 years. Severe dengue shock rate was 17.1%, recurrent shock and persistent shock wera 5,8%. Common clinical manifestations were: hepatomegaly, petechia, abdominal pain, gastrointestial bleeding, neurological distubance, gum bleeding. The respiratory failure rate was 40%, 1 of whom needed mechanical ventilation. The rate of hepatic damage and abdnomal coagulation profiles were high. Up to 60% of cases needed colloid therapy.