{"id":33274,"date":"2024-03-13T02:13:14","date_gmt":"2024-03-12T18:13:14","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&p=33274"},"modified":"2025-02-11T13:39:40","modified_gmt":"2025-02-11T05:39:40","slug":"nhiem-trung-duong-tiet-nieu-tu-don-gian-den-phuc-tap","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/nhiem-trung-duong-tiet-nieu-tu-don-gian-den-phuc-tap\/","title":{"rendered":"Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u: T\u1eeb \u0111\u01a1n gi\u1ea3n \u0111\u1ebfn ph\u1ee9c t\u1ea1p"},"content":{"rendered":"\n

Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u l\u00e0 b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn v\u1edbi nhi\u1ec1u m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng kh\u00e1c nhau, t\u1eeb vi\u00eam b\u00e0ng quang kh\u00f4ng ph\u1ee9c t\u1ea1p cho \u0111\u1ebfn vi\u00eam b\u1ec3 th\u1eadn k\u00e8m bi\u1ebfn ch\u1ee9ng abscess th\u1eadn1<\/sup>. Y\u1ebfu t\u1ed1 nguy c\u01a1 li\u00ean quan \u0111\u1ebfn nhi\u00eam khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u bao g\u1ed3m t\u1eafc ngh\u1ebdn d\u00f2ng ra do t\u0103ng s\u1ea3n tuy\u1ebfn ti\u1ec1n li\u1ec7t l\u00e0nh t\u00ednh ho\u1eb7c h\u1eb9p ni\u1ec7u qu\u1ea3n, b\u00e0ng quang th\u1ea7n kinh, suy gi\u1ea3m estrogen, s\u00f3n ph\u00e2n hay s\u00f3n ti\u1ec3u v\u00e0 \u0111\u1eb7t catheter ni\u1ec7u.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

H\u00ecnh 1.<\/strong>\u00a0H\u00ecnh \u1ea3nh ch\u1ee5p c\u1eaft l\u1edbp \u0111i\u1ec7n to\u00e1n (CT \u2013 scan) cho th\u1ea5y b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh b\u00e0ng quang th\u1ea7n kinh \u0111\u00e3 h\u00ecnh th\u00e0nh s\u1ecfi b\u00e0ng quang (m\u0169i t\u00ean v\u00e0ng)<\/p>\n\n\n\n

Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u kh\u00f4ng ph\u1ee9c t\u1ea1p<\/strong><\/p>\n\n\n\n

E. coli<\/em> l\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t g\u00e2y nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u m\u1eafc ph\u1ea3i do c\u1ed9ng \u0111\u1ed3ng2<\/sup>. Nguy c\u01a1 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u cao h\u01a1n so v\u1edbi nam gi\u1edbi do ni\u1ec7u \u0111\u1ea1o ng\u1eafn h\u01a1n. B\u1ec7nh nh\u00e2n n\u1eef b\u1ecb nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u kh\u00f4ng ph\u1ee9c t\u1ea1p th\u01b0\u1eddng c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 ti\u1ec3u kh\u00f3, ti\u1ec3u ra m\u00e1u, \u0111au l\u01b0ng v\u00e0 \u0111au tr\u00ean kh\u1edbp mu1<\/sup>. Nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa v\u1edbi kh\u00e1ng sinh ph\u00f9 h\u1ee3p.<\/p>\n\n\n\n

Tuy nhi\u00ean, t\u1ef7 l\u1ec7 vi khu\u1ea9n \u0111\u1ec1 kh\u00e1ng kh\u00e1ng sinh ng\u00e0y c\u00e0ng gia t\u0103ng do s\u1eed d\u1ee5ng kh\u00e1ng sinh kh\u00f4ng h\u1ee3p l\u00fd, ch\u1eb3ng h\u1ea1n nh\u01b0 ciproloxacin v\u00e0 trimethoprim \u2013 sulfamethoxazole1, 2<\/sup>. Ch\u1ec9 trong n\u0103m 2003 \u2013 2012, t\u1ef7 l\u1ec7 \u0111\u1ec1 kh\u00e1ng ciprofloxacin t\u0103ng d\u1ea7n \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf ng\u01b0\u1eddi l\u1edbn (3.6 \u2013 11.8%)2<\/sup>.<\/p>\n\n\n\n

Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u li\u00ean quan \u0111\u1ebfn \u0111\u1eb7t catheter ni\u1ec7u<\/strong><\/p>\n\n\n\n

\u0110\u1eb7t catheter ni\u1ec7u c\u00f3 th\u1ec3 c\u1ea7n thi\u1ebft cho b\u1ec7nh nh\u00e2n b\u1ecb b\u00ed ti\u1ec3u, ti\u1ec3u ra m\u00e1u ho\u1eb7c cho c\u00e1c th\u1ee7 thu\u1eadt tr\u00ean \u0111\u01b0\u1eddng ni\u1ec7u1<\/sup>. Tuy nhi\u00ean, ch\u00ednh catheter ni\u1ec7u qu\u1ea3n l\u1ea1i l\u00e0m t\u0103ng nguy c\u01a1 nhi\u1ec5m khu\u1ea9n trong \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, c\u1ee5 th\u1ec3 nguy c\u01a1 t\u0103ng 10% cho m\u1ed7i ng\u00e0y c\u00f2n c\u00f3 catheter trong \u0111\u01b0\u1eddng ni\u1ec7u. Catheter l\u00e0 nguy\u00ean nh\u00e2n kh\u00f4ng li\u00ean quan \u0111\u1ebfn x\u00e3 h\u1ed9i g\u00e2y nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u th\u01b0\u1eddng g\u1eb7p nh\u1ea5t 1<\/sup>.<\/p>\n\n\n\n

M\u1ed9t v\u00e0i nghi\u00ean c\u1ee9u cho th\u1ea5y nguy c\u01a1 nhi\u1ec5m khu\u1ea9n sau 1 l\u1ea7n \u0111\u1eb7t catheter \u0111\u01b0\u1eddng ni\u1ec7u l\u00e0 1 \u2013 2% \u1edf ph\u1ee5 n\u1eef kh\u1ecfe m\u1ea1nh, nguy c\u01a1 n\u00e0y t\u0103ng l\u00ean \u1edf b\u1ec7nh nh\u00e2n n\u1ed9i tr\u00fa1<\/sup>. M\u1eb7c d\u00f9 nh\u1eefng b\u1eb1ng ch\u1ee9ng \u0111\u00e3 cho th\u1ea5y nguy c\u01a1 li\u00ean quan \u0111\u1ebfn catheter ni\u1ec7u, nh\u01b0ng s\u1eed d\u1ee5ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o do \u0111a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u do catheter th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng.<\/p>\n\n\n\n

K\u1ef9 thu\u1eadt v\u00f4 khu\u1ea9n khi \u0111\u1eb7t catheter ni\u1ec7u l\u00e0 bi\u1ec7n ph\u00e1p hi\u1ec7u qu\u1ea3 \u0111\u1ec3 ph\u00f2ng ng\u1eeba nhi\u1ec5m khu\u1ea9n li\u00ean quan \u0111\u1ebfn catheter. N\u1ebfu nghi ng\u1edd nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, l\u1ea5y m\u1eabu n\u01b0\u1edbc ti\u1ec3u r\u1ed3i c\u1ea5y \u0111\u1ec3 \u0111\u01b0a ra chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi kh\u00e1ng sinh h\u1ee3p l\u00fd.<\/p>\n\n\n\n

Vi\u00eam b\u1ec3 th\u1eadn<\/strong><\/p>\n\n\n\n

Vi\u00eam b\u1ec3 th\u1eadn c\u1ea5p th\u01b0\u1eddng kh\u1edfi ph\u00e1t \u0111\u1ed9t ng\u1ed9t, g\u00e2y \u0111au b\u00ean s\u01b0\u1eddn, s\u1ed1t v\u00e0 \u1edbn l\u1ea1nh1<\/sup>. B\u1ec7nh nh\u00e2n c\u0169ng c\u00f3 th\u1ec3 c\u00f3 bi\u1ec3u hi\u1ec7n \u0111au b\u1ee5ng, bu\u1ed3n n\u00f4n, n\u00f4n v\u00e0 ti\u00eau ch\u1ea3y. Ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u c\u00f3 t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u c\u0169ng l\u00e0 d\u1ea5u ch\u1ec9 g\u1ee3i \u00fd vi\u00eam b\u1ec3 th\u1eadn1<\/sup>.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

H\u00ecnh 2.<\/strong>\u00a0H\u00ecnh ch\u1ee5p CT b\u1ec7nh nh\u00e2n n\u1eef b\u1ecb vi\u00eam b\u1ec3 th\u1eadn c\u00f3 k\u1ebft qu\u1ea3 ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u d\u01b0\u01a1ng t\u00ednh<\/p>\n\n\n\n

Vi\u00eam b\u1ec3 th\u1eadn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u00e0 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u kh\u00f4ng ph\u1ee9c t\u1ea1p ho\u1eb7c nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u ph\u1ee9c t\u1ea1p. Tr\u01b0\u1eddng h\u1ee3p \u0111\u01b0\u1ee3c cho l\u00e0 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u ph\u1ee9c t\u1ea1p th\u01b0\u1eddng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh \u1edf ph\u1ee5 n\u1eef mang thai, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c c\u1ea5y gh\u00e9p th\u1eadn, suy gi\u1ea3m mi\u1ec5n d\u1ecbch, b\u1ec7nh nh\u00e2n m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ch\u01b0a \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t, b\u1ec7nh nh\u00e2n c\u00f3 b\u1ea5t th\u01b0\u1eddng c\u1ea5u tr\u00fac \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, b\u1ec7nh nh\u00e2n suy th\u1eadn v\u00e0\/ho\u1eb7c nh\u1eadp vi\u1ec7n do nhi\u1ec5m tr\u00f9ng.<\/p>\n\n\n\n

B\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam b\u1ec3 th\u1eadn c\u1ea7n \u0111\u01b0\u1ee3c nh\u1eadp vi\u1ec7n \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng c\u1ea7n \u0111\u01b0\u1ee3c b\u00f9 d\u1ecbch v\u00e0 \u0111i\u1ec1u tr\u1ecb v\u1edbi kh\u00e1ng sinh \u0111\u01b0\u1eddng ti\u00eam t\u0129nh m\u1ea1ch trong v\u00f2ng 7 ng\u00e0y, sau \u0111\u00f3 ti\u1ebfp t\u1ee5c chuy\u1ec3n qua kh\u00e1ng sinh \u0111\u01b0\u1eddng u\u1ed1ng trong 7 ng\u00e0y \u0111\u1ebfn khi xu\u1ea5t vi\u1ec7n\u00a01<\/sup>. N\u1ebfu ph\u00e1c \u0111\u1ed3 ti\u00eau chu\u1ea9n th\u1ea5t b\u1ea1i, ti\u1ebfn h\u00e0nh x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh \u0111\u1ec3 lo\u1ea1i tr\u1eeb c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y \u1ea3nh h\u01b0\u1edfng (ch\u1eb3ng h\u1ea1n nh\u01b0 s\u1ecfi g\u00e2y t\u1eafc ngh\u1ebdn).<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

H\u00ecnh 3.<\/strong>\u00a0<\/em>H\u00ecnh \u1ea3nh g\u1eafp s\u1ecfi ni\u1ec7u qu\u1ea3n b\u1eb1ng n\u1ed9i soi \u1edf b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam b\u1ec3 th\u1eadn<\/p>\n\n\n\n

H\u00ecnh 3 l\u00e0 h\u00ecnh \u1ea3nh t\u1eeb m\u1ed9t b\u1ec7nh nh\u00e2n n\u1eef, 74 tu\u1ed5i \u0111\u1ebfn b\u1ec7nh vi\u1ec7n do \u0111au b\u00ean s\u01b0\u1eddn, s\u1ed1t 40.8o<\/sup>C v\u00e0 nhanh nh\u1ecbp tim. N\u1ed3ng \u0111\u1ed9 acid lactic huy\u1ebft thanh 7.8 mmol\/L, c\u00f3 kho\u1ea3ng 10 \u2013 20 t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u trong n\u01b0\u1edbc ti\u1ec3u d\u01b0\u01a1ng t\u00ednh v\u1edbi nitrite. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c gi\u1ea3m \u00e1p l\u1ef1c b\u1eb1ng th\u1ee7 thu\u1eadt g\u1eafp b\u1ecf s\u1ecfi ni\u1ec7u qu\u1ea3n v\u00e0 \u0111\u1eb7t stent ni\u1ec7u qu\u1ea3n.<\/p>\n\n\n\n

Hi\u1ec7p h\u1ed9i Ti\u1ebft ni\u1ec7u Ch\u00e2u \u00c2u (European Association of Urology \u2013 EAU) v\u00e0 Hi\u1ec7p h\u1ed9i Ti\u1ebft ni\u1ec7u Hoa K\u1ef3 (American Urological Association \u2013 AUA) cho r\u1eb1ng ph\u00e1c \u0111\u1ed3 ti\u00eau chu\u1ea9n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n s\u1ed1c nhi\u1ec5m khu\u1ea9n c\u00f3 s\u1ecfi g\u00e2y t\u1eafc ngh\u1ebdn l\u00e0 gi\u1ea3m \u00e1p c\u1ea5p c\u1ee9u b\u1eb1ng d\u1eabn l\u01b0u qua da ho\u1eb7c \u0111\u1eb7t stent ni\u1ec7u qu\u1ea3n. \u0110i\u1ec1u tr\u1ecb x\u00e1c \u0111\u1ecbnh s\u1ecfi c\u00f3 th\u1ec3 tr\u00ec ho\u00e3n cho \u0111\u1ebfn khi gi\u1ea3i quy\u1ebft \u0111\u01b0\u1ee3c nhi\u1ec5m khu\u1ea9n h\u1ec7 th\u1ed1ng 3, 4<\/sup>.<\/p>\n\n\n\n

Vi\u00eam th\u1eadn \u2013 b\u1ec3 th\u1eadn sinh kh\u00ed (emphysematous pyelonephritis)<\/em><\/strong><\/p>\n\n\n\n

Vi\u00eam th\u1eadn \u2013 b\u1ec3 th\u1eadn sinh kh\u00ed l\u00e0 t\u00ecnh tr\u1ea1ng hi\u1ebfm g\u1eb7p, c\u00f3 th\u1ec3 g\u00e2y nguy hi\u1ec3m t\u00ednh m\u1ea1ng. T\u00ecnh tr\u1ea1ng n\u00e0y s\u1ea3n sinh kh\u00ed \u1edf \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u tr\u00ean, nhu m\u00f4 th\u1eadn v\u00e0 c\u00e1c c\u1ea5u tr\u00fac h\u1ec7 th\u1ed1ng xung quanh5<\/sup>. Vi\u00eam th\u1eadn \u2013 b\u1ec3 th\u1eadn sinh kh\u00ed th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng (\u0111\u1eb7c bi\u1ec7t l\u00e0 n\u1eef gi\u1edbi). Y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng x\u1ea5u bao g\u1ed3m tu\u1ed5i cao, ch\u1ec9 s\u1ed1 kh\u1ed1i c\u01a1 th\u1ec3 cao, suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn, m\u1eafc b\u1ec7nh gi\u1ea3m ti\u1ec3u c\u1ea7u, bi\u1ebfn \u0111\u1ed5i t\u00e2m th\u1ea7n v\u00e0 s\u1ed1c khi nh\u1eadp vi\u1ec7n5<\/sup>.<\/p>\n\n\n\n

Vi\u00eam b\u00e0ng quang sinh kh\u00ed<\/em><\/strong><\/p>\n\n\n\n

Vi\u00eam b\u00e0ng quang sinh kh\u00ed c\u0169ng l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng hi\u1ebfm g\u1eb7p v\u00e0 c\u00f3 th\u1ec3 g\u00e2y \u0111e d\u1ecda t\u00ednh m\u1ea1ng kh\u00e1c, th\u01b0\u1eddng g\u1eb7p \u1edf n\u1eef gi\u1edbi m\u1eafc k\u00e8m \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng 6, 7<\/sup>. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng \u0111a d\u1ea1ng, t\u1eeb r\u1ed1i lo\u1ea1n b\u00e0i ti\u1ebft ho\u1eb7c kh\u00ed ni\u1ec7u cho \u0111\u1ebfn \u0111au b\u1ee5ng c\u1ea5p v\u00e0 nhi\u1ec5m khu\u1ea9n h\u1ec7 th\u1ed1ng nghi\u00eam tr\u1ecdng. V\u1edbi \u0111a s\u1ed1 b\u1ec7nh nh\u00e2n nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, E. coli<\/em> l\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t g\u00e2y vi\u00eam b\u00e0ng quang sinh kh\u00ed 6, 7<\/sup>.<\/p>\n\n\n\n

Ki\u1ec3m so\u00e1t c\u00e1c t\u00ecnh tr\u1ea1ng n\u00e0y v\u1edbi ph\u00e1c \u0111\u1ed3 kh\u00e1ng sinh, gi\u1ea3m \u00e1p l\u1ef1c h\u1ec7 th\u1ed1ng thu th\u1eadp b\u1eb1ng d\u1eabn l\u01b0u ng\u01b0\u1ee3c d\u00f2ng ho\u1eb7c xu\u00f4i d\u00f2ng, ho\u1eb7c gi\u1ea3i ph\u1eabu c\u1eaft b\u1ecf th\u1eadn tr\u1ef1c ti\u1ebfp5<\/sup>. M\u1ed9t nghi\u00ean c\u1ee9u cho th\u1ea5y t\u1ef7 l\u1ec7 t\u1eed vong \u1edf b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam th\u1eadn \u2013 b\u1ec3 th\u1eadn sinh kh\u00ed l\u00e0 8%. Trong \u0111\u00f3, t\u1ef7 l\u1ec7 t\u1eed vong \u1edf b\u1ec7nh nh\u00e2n ch\u1ec9 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi thu\u1ed1c  l\u00e0 50 \u2013 70%, trong khi \u0111\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong \u1edf b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t v\u1edbi thu\u1ed1c k\u00e8m c\u1eaft b\u1ecf th\u1eadn c\u1ea5p c\u1ee9u l\u00e0 25%, t\u1ef7 l\u1ec7 n\u00e0y l\u00e0 13.5% \u1edf b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi thu\u1ed1c ph\u1ed1i h\u1ee3p d\u1eabn l\u01b0u qua da5<\/sup>. B\u1ec7nh nh\u00e2n vi\u00eam b\u00e0ng quan sinh kh\u00ed c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong th\u1ea5p h\u01a1n vi\u00eam th\u1eadn \u2013 b\u1ec3 th\u1eadn sinh kh\u00ed (7%) 6, 7<\/sup>.<\/p>\n\n\n\n

Vi\u00eam b\u1ec3 th\u1eadn h\u1ea1t v\u00e0ng (xanthogranulomatous pyelonephritis)<\/em><\/strong><\/p>\n\n\n\n

Vi\u00eam b\u1ec3 th\u1eadn h\u1ea1t v\u00e0ng c\u0169ng l\u00e0 t\u00ecnh tr\u1ea1ng hi\u1ebfm g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n vi\u00eam b\u1ec3 th\u1eadn m\u1ea1n t\u00ednh do nhi\u1ec5m khu\u1ea9n v\u00e0 t\u1eafc ngh\u1ebdn1, 8<\/sup>. T\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 t\u00edch l\u0169y c\u1ee7a lipid-laden foamy macrophage trong m\u00f4. Th\u1eadn b\u1ecb t\u1ed5n th\u01b0\u01a1ng d\u1eabn \u0111\u1ebfn m\u1ea5t ch\u1ee9c n\u0103ng m\u1ed9t ph\u1ea7n ho\u1eb7c ho\u00e0n to\u00e0n, th\u01b0\u1eddng c\u1ea7n can thi\u1ec7p c\u1eaft b\u1ecf th\u1eadn 1, 8<\/sup>. C\u00e1c \u0111\u00e1p \u1ee9ng vi\u00eam m\u1ea1nh m\u1ebd c\u00f3 th\u1ec3 g\u00e2y kh\u00f3 kh\u0103n cho qu\u00e1 tr\u00ecnh c\u1eaft b\u1ecf th\u1eadn, ti\u1ebfp c\u1eadp c\u1eaft b\u1ecf m\u1ee1 c\u00f3 th\u1ec3 c\u00f3 l\u1ee3i \u00edch h\u01a1n so v\u1edbi c\u1eaft b\u1ecf qua n\u1ed9i soi \u1ed5 b\u1ee5ng9<\/sup>.<\/p>\n\n\n\n

Abscess quanh th\u1eadn<\/em><\/strong><\/p>\n\n\n\n

Abscess quanh th\u1eadn \u0111\u01b0\u1ee3c cho l\u00e0 h\u1ec7 qu\u1ea3 c\u1ee7a vi\u1ec7c vi khu\u1ea9n ph\u00e2n t\u00e1n theo \u0111\u01b0\u1eddng m\u00e1u ho\u1eb7c v\u1ee1 v\u1ecf abscess \u0111i v\u00e0o trong khu v\u1ef1c quanh th\u1eadn1<\/sup>. Abscess th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/p>\n\n\n\n

Ki\u1ec3m so\u00e1t v\u1edbi kh\u00e1ng sinh ph\u1ed5 r\u1ed9ng, d\u1eabn l\u01b0u abscess l\u00e0 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u1ed1t l\u00f5i1<\/sup>. D\u1eabn l\u01b0u qua da ho\u1eb7c d\u1eabn l\u01b0u m\u1edf \u0111\u1ec1u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng, tuy nhi\u00eam d\u1eabn l\u01b0u m\u1edf \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n k\u1ebft c\u1ee5c l\u00e2m s\u00e0ng v\u00e0 gi\u1ea3m th\u1eddi gian n\u1eb1m vi\u1ec7n10<\/sup>.<\/p>\n\n\n\n

Vi\u00eam tuy\u1ebfn ti\u1ec1n li\u1ec7t do vi khu\u1ea9n v\u00e0 abscess tuy\u1ebfn ti\u1ec1n li\u1ec7t<\/strong><\/p>\n\n\n\n

B\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam tuy\u1ebfn ti\u1ec1n li\u1ec7t do vi khu\u1ea9n th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n ti\u1ec3u kh\u00f3, s\u1ed1t cao, \u1edbn l\u1ea1nh, \u0111au \u0111\u00e1y ch\u1eady v\u00e0 n\u01b0\u1edbc ti\u1ec3u \u0111\u1ee5c1<\/sup>. Th\u00f4ng th\u01b0\u1eddng, \u0111i\u1ec1u tr\u1ecb v\u1edbi kh\u00e1ng sinh h\u1ee3p l\u00fd c\u00f3 th\u1ec3 t\u1ea1o ra \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng nhanh ch\u00f3ng, tuy nhi\u00ean n\u1ebfu b\u1ec7nh nh\u00e2n s\u1ed1t cao dai d\u1eb3ng, th\u00ec c\u1ea7n ph\u1ea3i ti\u1ebfp t\u1ee5c t\u00ecm ki\u1ebfm \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh li\u1ec7u c\u00f3 abscess tuy\u1ebfn ti\u1ec1n li\u1ec7t hay kh\u00f4ng1<\/sup>.<\/p>\n\n\n\n


H\u00ecnh 4.<\/strong> H\u00ecnh \u1ea3nh CT c\u1ee7a b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam tuy\u1ebfn ti\u1ec1n li\u1ec7t do vi khu\u1ea9n, abscess tuy\u1ebfn ti\u1ec1n li\u1ec7t<\/p>\n\n\n\n

Chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb abscess tuy\u1ebfn ti\u1ec1n li\u1ec7t t\u1ed1i \u01b0u l\u00e0 c\u1eaft b\u1ecf tuy\u1ebfn ti\u1ec1n li\u1ec7t. M\u1eb7c d\u00f9 c\u00f3 th\u1ec3 th\u1eed v\u1edbi d\u1eabn l\u01b0u qua da tr\u01b0\u1edbc, nh\u01b0ng bi\u1ec7n ph\u00e1p n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o n\u1ebfu abscess l\u1edbn (ch\u1eb3ng h\u1ea1n tr\u01b0\u1eddng h\u1ee3p trong h\u00ecnh 4).<\/p>\n\n\n\n

Tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang ni\u1ec7u qu\u1ea3n (vesicoureteral reflux)<\/strong><\/p>\n\n\n\n

Tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang ni\u1ec7u qu\u1ea3n \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi d\u00f2ng n\u01b0\u1edbc ti\u1ec3u \u0111i ng\u01b0\u1ee3c d\u00f2ng t\u1eeb b\u00e0ng quang l\u00ean \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u tr\u00ean11, 12<\/sup>. T\u00ecnh tr\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 x\u1ea3y ra do b\u1ea5t th\u01b0\u1eddng c\u1ea5u tr\u00fac ni\u1ec7u qu\u1ea3n (ti\u00ean ph\u00e1t), c\u0169ng nh\u01b0 t\u1eafc ngh\u1ebdn hay h\u1eb9p c\u1ed5 b\u00e0ng quang ho\u1eb7c ni\u1ec7u \u0111\u1ea1o (th\u1ee9 ph\u00e1t)12<\/sup>. Tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang ni\u1ec7u qu\u1ea3n c\u00f3 th\u1ec3 g\u1eb7p \u1edf m\u1ecdi \u0111\u1ed1i t\u01b0\u1ee3ng nh\u01b0ng th\u01b0\u1eddng g\u1eb7p h\u01a1n \u1edf tr\u1ebb em v\u00e0 tr\u1ebb nh\u1ecf (\u2264 2 tu\u1ed5i), \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf b\u00e9 g\u00e1i 13<\/sup>. M\u1eb7c d\u00f9 tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang ni\u1ec7u qu\u1ea3n kh\u00f4ng ph\u1ea3i l\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t g\u00e2y nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u \u1edf tr\u1ebb em, nh\u01b0ng b\u1ec7nh l\u00fd n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra bi\u1ebfn ch\u1ee9ng tr\u00ean th\u1eadn v\u00e0 s\u1ee9c kh\u1ecfe c\u1ee7a tr\u1ebb 11, 12<\/sup>.<\/p>\n\n\n\n

Tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang th\u1ef1c qu\u1ea3n c\u00f3 th\u1ec3 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd sau khi b\u1ec7nh nh\u00e2n s\u1ed1t do nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u v\u00e0 \u0111\u01b0\u1ee3c si\u00eau \u00e2m th\u1eadn. Tuy nhi\u00ean, tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang ni\u1ec7u qu\u1ea3n x\u1ea3y ra \u1edf 17% tr\u1ebb em kh\u00f4ng m\u1eafc k\u00e8m nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u11<\/sup>.<\/p>\n\n\n\n

\u0110i\u1ec1u tr\u1ecb tr\u00e0o ng\u01b0\u1ee3c b\u00e0ng quang th\u1ef1c qu\u1ea3n t\u00f9y thu\u1ed9c v\u00e0o nhi\u1ec1u y\u1ebfu t\u1ed1, bao g\u1ed3m m\u1ee9c \u0111\u1ed9 tr\u00e0o ng\u01b0\u1ee3c, tu\u1ed5i vv11 \u2013 14<\/sup>. C\u00e1c l\u1ef1a ch\u1ecdn ki\u1ec3m so\u00e1t bao g\u1ed3m thu\u1ed1c \u0111i\u1ec1u tr\u1ecb, ph\u1eabu thu\u1eadt ho\u1eb7c \u0111\u01a1n gi\u1ea3n ch\u1ec9 theo d\u00f5i. M\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb c\u1ee7a tr\u00e0o ng\u01b0\u1ee3c b\u1ea3ng quang th\u1ef1c qu\u1ea3n l\u00e0 ph\u00f2ng ng\u1eeba nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u (g\u00e2y s\u1ed1t) t\u00e1i l\u1eb7p, t\u1ed5n th\u01b0\u01a1ng th\u1eadn v\u00e0 t\u1ed1i thi\u1ec3u h\u00f3a g\u00e1nh n\u1eb7ng b\u1ec7nh t\u1eadt 11 \u2013 14<\/sup>.<\/p>\n\n\n\n

Pyocystis<\/strong><\/p>\n\n\n\n

Pyocystis l\u00e0 t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u d\u01b0\u1edbi nghi\u00eam tr\u1ecdng, \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh khi thu th\u1eadp \u0111\u01b0\u1ee3c l\u01b0\u1ee3ng l\u1edbn m\u1ee7 t\u1eeb b\u00e0ng quang, th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i 15<\/sup>. K\u1ebft qu\u1ea3 c\u1ea5y th\u01b0\u1eddng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c nhi\u1ec1u vi khu\u1ea9n kh\u00e1c nhau.<\/p>\n\n\n\n

B\u1ec7nh nh\u00e2n m\u1eafc pyocystis th\u01b0\u1eddng c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u1eb7t catheter v\u00e0 r\u1eeda b\u00e0ng quang \u0111\u1ec3 \u0111\u1ea9y n\u01b0\u1edbc ti\u1ec3u v\u00e0 m\u1ee7 trong b\u00e0ng quang15<\/sup>.<\/p>\n\n\n\n

Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u t\u00e1i l\u1eb7p<\/strong><\/p>\n\n\n\n

Khi \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u t\u00e1i l\u1eb7p, b\u00e1c s\u0129 c\u1ea7n x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u l\u00e0 t\u00e1i l\u1eb7p hay dai d\u1eb3ng. Vi khu\u1ea9n dai d\u1eb3ng th\u01b0\u1eddng g\u00e2y nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, g\u00e2y ra b\u1edfi c\u00f9ng vi sinh v\u1eadt. Trong khi \u0111\u00f3 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u t\u00e1i l\u1eb7p th\u01b0\u1eddng do nhi\u1ec1u vi khu\u1ea9n kh\u00e1c nhau v\u00e0 x\u1ea3y ra trong nhi\u1ec1u giai \u0111o\u1ea1n kh\u00e1c nhau1<\/sup>.<\/p>\n\n\n\n

B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 kh\u00e1c c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n g\u00e2y nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, bao g\u1ed3m b\u1ea5t th\u01b0\u1eddng gi\u1ea3i ph\u1eabu, t\u1eafc ngh\u1ebdn d\u00f2ng ra v\u00e0 s\u1ecfi th\u1eadn 16<\/sup>. C\u1ea5y n\u01b0\u1edbc ti\u1ec3u l\u1eb7p l\u1ea1i c\u0169ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o17<\/sup>.<\/p>\n\n\n\n

Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u th\u01b0\u1eddng x\u1ea3y ra do vi khu\u1ea9n g\u00e2y nhi\u1ec5m khu\u1ea9n \u0111i xu\u1ed1ng t\u1eeb \u0111\u01b0\u1eddng ti\u00eau h\u00f3a, \u0111\u1eb7c bi\u1ec7t th\u01b0\u1eddng g\u1eb7p \u1edf n\u1eef gi\u1edbi16<\/sup>. N\u1eef gi\u1edbi c\u00f3 th\u1ec3 b\u1ecb nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u do nh\u1eefng thay \u0111\u1ed5i v\u1ec1 h\u1ec7 vi sinh th\u01b0\u1eddng tr\u00fa \u1edf \u00e2m \u0111\u1ea1o sau k\u1ef3 kinh nguy\u1ec7t, t\u00ecnh tr\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi estrogen \u0111\u01b0\u1eddng b\u00f4i 1, 17<\/sup>. C\u00f3 th\u1ec3 k\u00ea \u0111\u01a1n kh\u00e1ng sinh d\u1ef1 ph\u00f2ng \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u \u1edf n\u1eefu gi\u1edbi c\u00f3 ti\u1ec1n s\u1eed nhi\u1ec1m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u t\u00e1i l\u1eb7p. Kh\u00e1ng sinh th\u01b0\u1eddng \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn bao g\u1ed3m nitrofurantoin, fossfomycin v\u00e0 trimethoprim \u2013 sulfamethoxazole17<\/sup>. Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u t\u00e1i l\u1eb7p c\u0169ng c\u00f3 th\u1ec3 c\u1ea7n \u0111\u01b0\u1ee3c can thi\u1ec7p b\u1eb1ng ph\u1eabu thu\u1eadt, t\u1eeb ph\u1eabu thu\u1eadt x\u00e2m l\u1ea5n t\u1ed1i thi\u1ec3u (n\u1ed9i soi ho\u1eb7c qua da) cho \u0111\u1ebfn x\u00e2m l\u1ea5n nhi\u1ec1u (n\u1ed9i soi \u1ed5 b\u1ee5ng ho\u1eb7c m\u1edf)16<\/sup>.<\/p>\n\n\n\n

B\u00e0n lu\u1eadn<\/strong><\/p>\n\n\n\n

B\u1ea3n t\u00f3m l\u01b0\u1ee3c b\u00e0n lu\u1eadn v\u1ec1 nh\u1eefng bi\u1ebfn ch\u1ee9ng c\u1ee7a nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, \u0111i t\u1eeb \u0111\u1ecbnh ngh\u0129a, \u0111\u1eb7c \u0111i\u1ec3m b\u1ec7nh h\u1ecdc v\u00e0 bi\u1ec7n ph\u00e1p ki\u1ec3m so\u00e1t. Khi ki\u1ec3m so\u00e1t b\u1ec7nh nh\u00e2n nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, c\u1ea7n l\u01b0u \u00fd lo\u1ea1i tr\u1eeb nh\u1eefng y\u1ebfu t\u1ed1 g\u00e2y ph\u1ee9c t\u1ea1p qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb nh\u01b0 s\u1ecfi, t\u1eafc ngh\u1ebdn\u2026 \u0110\u1ec3 c\u1ea3i thi\u1ec7n k\u1ebft c\u1ee5c \u0111i\u1ec1u tr\u1ecb, c\u1ea7n s\u00e0ng l\u1ecdc v\u00e0 ph\u00f2ng ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u.<\/p>\n\n\n\n

Ngu\u1ed3n<\/strong><\/p>\n\n\n\n

B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c l\u01b0\u1ee3c d\u1ecbch t\u1eeb: Josh Palka. Urinary Tract Infections: Pathologies and Challenges. Medscape. Updated 14 Feb 2024. Accessed date 27 Feb 2024.<\/em><\/p>\n\n\n\n

\n\n\n\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n\n\n\n

    \n
  1. Schaeffer AJ, Matulewicz RS, Klummp DJ. Infections of the urinary tract. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:ch 12.<\/li>\n\n\n\n
  2. Sanchez GV, Babiker A, Master RN, Luu T, Mathur A, Bordon J. Antibiotic resistance among urinary isolates from female outpatients in the United States in 2003 and 2012. Antimicrob Agents Chemother. 2016 Apr 22;60(5):2680-3.<\/li>\n\n\n\n
  3. Preminger GM, Tiselius HG, Assimos DG, et al, for the EAU\/AUA Nephrolithiasis Guideline Panel. 2007 guideline for the management of ureteral calculi. J Urol. 2007 Dec;178(6):2418-34.<\/li>\n\n\n\n
  4. Turk C, Petr\u00edk A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T. EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol. 2016 Mar;69(3):468-74.<\/li>\n\n\n\n
  5. Sokhal AK, Kumar M, Purkait B, et al. Emphysematous pyelonephritis: changing trend of clinical spectrum, pathogenesis, management and outcome. Turk J Urol. 2017 Jun;43(2):202-9. PMID: 28717547<\/li>\n\n\n\n
  6. Thomas AA, Lane BR, Thomas AZ, Remer EM, Campbell SC, Shoskes DA. Emphysematous cystitis: a review of 135 cases. BJU Int. 2007 Jul;100(1):17-20<\/li>\n\n\n\n
  7. Schicho A, Stroszczynski C, Wiggermann P. Emphysematous cystitis: mortality, risk factors, and pathogens of a rare disease. Clin Pract. 2017 Apr 28;7(2):930.<\/li>\n\n\n\n
  8. Kundu R, Baliyan A, Dhingra H, Bhalla V, Punia RS. Clinicopathological spectrum of xanthogranulomatous pyelonephritis. Indian J Nephrol. 2019 Mar-Apr;29(2):111-5<\/li>\n\n\n\n
  9. Campanario-Perez R, Saiz-Marenco R, Amores-Bermudez J, et al. Laparoscopic nephrectomy for the management of xanthogranulomatous pyelonephritis: still a challenging procedure. J Endourol. 2018 Sep 12;32(9):859-64. PMID: 30024301<\/li>\n\n\n\n
  10. El-Nahas AR, Faisal R, Mohsen T, Al-Marhoon MS, Abol-Enein H. What is the best drainage method for a perinephric abscess? Int Braz J Urol. 2010 Jan-Feb;36(1):29-37.<\/li>\n\n\n\n
  11. Khoury AE, Bagli DJ. Vesicourethral reflux. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:ch 137.<\/li>\n\n\n\n
  12. National Institute of Diabetes and Digestive and Kidney Diseases. Vesicoureteral reflux (VUR). June 2018. Available at: https:\/\/www.niddk.nih.gov\/health-information\/urologic-diseases\/urine-blockage-newborns\/vesicoureteral-reflux. Accessed February 12, 2024.<\/li>\n\n\n\n
  13. Ring P, Huether SE. Alterations of renal and urinary tract function in children. In: McCance KL, Huether SE, eds. Pathophysiology: The Biologic Basis for Disease in Adults and Children. 8th ed. St Louis, MO: Elsevier: 2019;1288-90.<\/li>\n\n\n\n
  14. Skoog SJ, Peters CA, Arant BS Jr, et al. Pediatric Vesicoureteral Reflux Guidelines Panel summary report: clinical practice guidelines for screening siblings of children with vesicoureteral reflux and neonates\/infants with prenatal hydronephrosis. J Urol. 2010 Sep;184(3):1145-51.<\/li>\n\n\n\n
  15. Kamel MH, Gardner R, Tourchi A, et al. Pyocystis: a systematic review. Int Urol Nephrol. 2017 Jun;49(6):917-26. PMID: 28265966<\/li>\n\n\n\n
  16. Bergamin PA, Kiosoglous A. Surgical management of recurrent urinary tract infections: a review. Transl Androl Urol. 2017 Jul;6(suppl 2): S153-62. PMID: 28791234<\/li>\n\n\n\n
  17. Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA\/CUA\/SUFU guideline. J Urol. 2019 Aug;202(2):282-9. PMID: 31042112<\/li>\n<\/ol>\n\n\n\n

    <\/p>\n","protected":false},"excerpt":{"rendered":"

    Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u l\u00e0 b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn v\u1edbi nhi\u1ec1u m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng kh\u00e1c nhau, t\u1eeb vi\u00eam b\u00e0ng quang kh\u00f4ng ph\u1ee9c t\u1ea1p cho \u0111\u1ebfn vi\u00eam b\u1ec3 th\u1eadn k\u00e8m bi\u1ebfn ch\u1ee9ng abscess th\u1eadn1.<\/p>\n","protected":false},"author":123,"featured_media":33293,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"default","ast-global-header-display":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"articles_categories":[1370],"articles_tags":[],"articles_topics":[1440],"articles_languages":[1375],"articles_filters":[],"class_list":["post-33274","articles","type-articles","status-publish","has-post-thumbnail","hentry","articles_categories-medical-content-vi","articles_languages-vietnamese-vi"],"_links":{"self":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/33274","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles"}],"about":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/types\/articles"}],"author":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/users\/123"}],"replies":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/comments?post=33274"}],"version-history":[{"count":0,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/33274\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media\/33293"}],"wp:attachment":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media?parent=33274"}],"wp:term":[{"taxonomy":"articles_categories","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_categories?post=33274"},{"taxonomy":"articles_tags","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_tags?post=33274"},{"taxonomy":"articles_topics","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_topics?post=33274"},{"taxonomy":"articles_languages","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_languages?post=33274"},{"taxonomy":"articles_filters","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_filters?post=33274"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}