I HC LC HNG

KHOA DC

KIM NGHIM CHT GY ST

Bin son: B mn Dc l

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 MC TIU
Hiu c mc ch v i tng ca vic
kim nghim cht gy st (KNCGS)

Bit cc iu kin ca mt th t tiu chun

KNCGS

Bit cc bc tin hnh KNCGS trn th

Bin lun c kt qu th nghim

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 NGUYN TC
i tng: Nc ct pha tim, dung dch tim
truyn khng c cha cht gy st (ch
nhit t).

Mc ch: Kim s c hin din ca cht gy

st trnh triu chng shock khi s dng
ch phm tim, truyn cho bnh nhn.

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 CHT GY ST
Cht gy st hay ch nhit t (pyrogen) l
nhng cht nhim vo thuc, sau khi tim, ch
yu theo ng tnh mch, gy phn ng tng
thn nhit c trng ngi bnh.

Ngun gc: Ch yu t vi khun Gr(-) (nm

men, vi sinh vt khc, t bo, sn phm mu,
bch cu ngi,)

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 CHT GY ST
Bn cht: hp cht cao phn t, c th l
lipopolysaccharid hoc lipoprotein

Hu qu: Bnh nhn rt => st => st cao (40

41 C) => hi phc/ nguy him n tnh
mng.

X l: Ngng tim truyn, iu tr h tr.

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C CH GY ST
 VT DNG TH NGHIM
Bm, kim tim (ra sch, trng nc ct, sy

250 C / 30 pht hoc 200 C / gi)

Nhit k: thy ngn, in t; chnh xc 0,1 C.

Hp, gi gi th: Gi c con vt, ph hp vi c

th th t th ngi

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 TH TH NGHIM
Th trng thnh, khe mnh.
C 2 ging
Nng khng di 1,5 kg
Khng s dng khng sinh, khng c du hiu
gim cn
Khng th nghim nu:
Th mi c th cht gy st (-) trong vng 3 ngy
Th th cht gy st (+) trong vng 3 tun.

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 TH NGHIM
Th nghim s b
Ch nn thc hin trn th cha th cht gy st

Thi gian: 1-3 ngy trc khi th nghim chnh thc

Tim tnh mch tai th NaCl 0,9% (khng c cht gy

st v c lm m 38,5 C), liu 10 ml/ kg th

Theo di nhit 90 pht trc khi tim v 3 gi sau

khi tim, ghi nhit 30 pht/ ln.

Khng dng th nu nhit thay i qu 0,6 C

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 TH NGHIM
Th nghim chnh thc
Chun b v tim mu th
3 th/ 1 nhm/ 1 mu th

Ha tan mu th trong dung mi ph hp

Lm m dd tim 38,5 C

IV chm dd mu th vo tai th ( 4 pht)

Th tch tim 0,5 10 ml/kg th

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 TH NGHIM
Th nghim chnh thc
Theo di nhit
90 pht trc khi tim, 3 gi sau khi tim
30 pht/ 1 ln
Khng dng vo th nghim nu
Chnh lch 0,2 C gia 2 ln lin tip/ 1 th
Nhit 3 th trong nhm khc nhau qu 1 C
Nhit > 39,8 C hoc < 38 C
Lu : Khi th b kch ng th nhit theo di s rt thay
i.
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 P NG
90 pht IV 3 gi

Nhit ban u: TB 2 gi tr ngay trc khi IV

Nhit cao nht: nhit cao nht / 3 gi

p ng = Nhit cao nht nhit ban u

(Nu p ng m th coi nh bng 0)

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 BIN LUN KT QU
S Mu th at nu tng ap Mu th khng at nu tng
tho ng khng vt qua ap ng khng vt qua

3 1,15 2,65

6 2,80 4,30

9 4,45 5,95

12 6,60 6,60

Nhng th co nhit tng cao qu 1,2 C thi loai v khng bao

gi dung lai cho phep th cht gy st.

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 BO CO KT QU
Ban: .........................Nhom: ..................... Lp: ........................ 2.2. Bin lun kt qua

Bin lun iu kin cua tho dung th nghim cht sinh nhit
BAO CAO THC TP
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KIM NGHIM CHT SINH NHIT
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I. NGUYN TC ..................................................................................................................................
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Bin lun kt qua v dung dich
th trn 3 tho
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II. KT QUA THC TP
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2.1. Kt qua theo doi tho ..................................................................................................................................
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Tho 1 Tho 2 Tho 3 ..................................................................................................................................
to1 ..................................................................................................................................
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to2
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to3 ..................................................................................................................................
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to4
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Tim thu c ..................................................................................................................................
to5 ..................................................................................................................................
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to6
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to7 ..................................................................................................................................

to8 ..................................................................................................................................
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to9 ..................................................................................................................................
to10
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QUY TRNH THC HNH
1. Nhn dng c, ha cht v th

2. mu th trong b cch thy 38,5 C

3. Theo di nhit trc trng th 30 pht/ ln

(khong 40 pht)

4. Tim mu th (1ml/ kg th)

5. Theo di nhit trc trng th 30 pht/ ln

trong 2 gi

6. X l kt qu, vit bo co

7. Tr dng c, th v v sinh
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Why me ?

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