NGHIÊN CỨU ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG Ở BỆNH NHI MẮC SỐT XUẤT HUYẾT DENGUE CÓ TỔN THƯƠNG GAN ĐIỀU TRỊ TẠI BỆNH VIỆN SẢN - NHI TỈNH QUẢNG NGÃI

Abstract

Introduction: Hepatic damage is a common manifestation of Dengue hemorrhagic fever (DHF). Elevated liver enzymes is one of the predictors of severe Dengue. Objective: Describe the clinical, paraclinical characteristics of Dengue hemorrhagic fever with hepatic damage in children and explore the factors associated with severe Dengue. Subject and Method:  Cross-sectional description of children from 1 month to under 16 years old are diagnosed DHF had hepatic damage (AST/ALT ≥120 U/L) and treated at Quang Ngai Obstetrics and Pediatrics Hospital  from 31/10//2021 to 31/10/2022. Result: There were 177 DHF children had hepatic damage. Most hepatic damage in the study was mild, accounting for 93.2% (165/177). The Dengue with warning signs accounted for the highest rate with 45.8% (81/177), followed by Dengue without warning signs (32.8%) (58/177) and severe Dengue (21.4%) (38/177). There were 14.2% (25/177) children with severe plasma leakage; 4 cases of severe organ impairment, of which 3 cases of hepatic failure and 1 case of encephalitis. Factors related to severe Dengue are: petechiae; lethargy or restlessness; nausea, vomiting; abdominal pain (liver region); hepatomegaly; platelet count <50x10⁹/L; rapid decrease in platelet count; increase in haematocrit (Hct); hyponatremia; Prothrombin time disorder; activated partial thromboplastin time (aPTT) disorder; classification of hepatic damage and plasma leakage determined on ultrasound. Conclusion: The rate of Dengue with warning signs and severe Dengue in DHF had hepatic damage is high. It is necessary to screen liver enzymes to detect early cases of hepatic damage and help timely management.