Bảng phân loại mới của WHO chia Sốt xuất huyết làm 3 nhóm: Sốt xuất huyết dengue (SXHD), SXHD có dấu cảnh báo (SXHDCB) và SXHD nặng. Mục đích của nghiên cứu này nhằm xác định các đặc điểm lâm sàng và cận lâm sàng của SXHD theo bảng phân loại mới, đồng thời đánh giá các dấu hiệu cảnh báo trong tiên đoán vào sốc. | ĐẶC ĐIỂM LÂM SÀNG VÀ GIÁ TRỊ CÁC DẤU HIỆU CẢNH BÁO TIÊN ĐOÁN SỐC Ở TRẺ EM MẮC SỐT XUẤT HUYẾT DENGUE THEO BẢNG PHÂN LOẠI MỚI CỦA WHO 2009 Nguyễn Ngọc Rạng Trương Thị Mỹ Tiến Dương Kim Thu Tôn Quang Chánh và Đinh Thị Bích Loan khoa Nhi Bệnh viện An giang. Abstract Title Clinical features and the values of warning signs to predict shock among children with dengue fever in An giang hospital according to the revised dengue case classification of WHO 2009. The revised dengue case classification of WHO classified dengue infection as dengue fever DF DF with warning signs and severe dengue. The objective of this study is to determine the clinical and paraclinical features according to the new WHO classification of DF and to evaluate the value of warning signs to predict shock among children with DF. METHODS A retrospective cohort study design enrolled all pediatric patients under 14 years of age admitted to Pediatric ward of An giang hospital in year 2003. The diagnosis of dengue infection was confirmed either by viral isolation or by Mac Elisa test detecting IgM antibodies. All clinical symptoms or signs laboratory and ultrasonography results were noted in case report form. RESULTS There were 610 patients with discharge diagnosis of DF including 227 37 DF 198 32 DF with warning signs and 185 30 severe dengue. Two patients with severe dengue without shock 1 encephalitis and 1 hepatic failure were unable to classify into the previous WHO classification system. The non-specific clinical symptoms headache myalgia rash and conjuctival congestion were not statistically different among 3 groups. The prevalence of positive tourniquet test was highest 80 in patients with severe dengue p . White blood cell count platelets hematocrit PT and APTT were statistically different among 3 groups. The frequency of ascites and pleural effusion on ultrasonography was approximately 35 in DF 45 in DF with warning signs and 90 in severe dengue. Five warning signs independently related to .
