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Nguy hiểm của bệnh lý thiếu vitamin A ở trẻ em  

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12:03 20/03/2013

Thiếu vitamin A là tình trạng bệnh lý được biểu hiện ở mắt, da và toàn thân, xảy ra khi cơ thể thiếu vitamin A (do chế độ ăn thiếu vitamin A hoặc do rối loạn hấp thu vita.. [..]

 1. Triệu chứng lâm sàng

1.1. Triệu chứng ở mắt

- Triệu chứng sớm: Quáng gà là dấu hiệu đầu tiên của thiếu vitamin A.

- Tổn thương giác mạc, kết mạc: Khô mắt, vệt Bitot.

- Cuối cùng là loét giác mạc.

- Tiến triển cuối cùng gây ra những biến chứng nhiễm trùng và mù do mờ giác mạc tiến triển hoặc là thủy tinh bị phá hủy.

Bổ sung vitamin A cho trẻ để phòng tránh các bệnh nguy hiểm!

1.2. Biểu hiện tổn thương da

Da bị khô do teo tuyến nhờn dưới da và các tuyến nhày, do vậy có hiện tượng tăng sừng hóa. Những tổn thương này tập trung  chủ yếu ở mặt ngoài của chi trên.

1.3. Biểu hiện toàn thân

Thiếu vitamin A sẽ dẫn đến dễ nhiễm sởi và các bệnh đường hô hấp.

1.4. Ở những trẻ SDD bị mắc sởi hoặc tiêu chảy kéo dài hoặc viêm phổi dai dẳng cần nghĩ đến thiếu vitamin A.

2. Xét nghiệm

2.1 Xét nghiệm sinh hóa:

 Bằng định lượng trực tiếp vitamin A, có thể thăm dò tình trạng sinh học của vitamin A bằng nhiều cách:

-Định lượng retinol trong huyết tương: bình thường > 300 Mg/l, ở bệnh nhân thiếu vitamin A thì định lượng < 100 Mg.

- Định lượng RBP của huyết tương: RBP gắn retinol ở người lớn 40-50 Mg/ml. Nếu thiếu RBP toàn phần giảm 50% và phần lớn tìm được ở dạng tự do.

2.2. Các test thăm dò chức năng

- Test tăng gánh: Bằng cách định lượng retinol huyết tương trước và sau 5 giờ sau khi dùng 1 liều 1500 UI vitamin A uống. Sự tăng retinol trong máu sẽ yếu khi dự trữ trong gan bình thường và tăng mạnh nếu dự trữ trong gan bị giảm.

3. Điều trị

2.1. Tổn thương ở mắt

Trẻ < 1 tuổi: Ngày 1: 100.000 UI

                      Ngày 2: 100.000 UI

                      Ngày 14: 100.000 UI

Trẻ > 1 tuổi: Liều gấp đôi so với trẻ dưới 1 tuổi

Chú ý: Trẻ có nôn, tiêu chảy dùng vitamin A bằng đường tiêm, liều tiêm bằng ½ liều uống.

3.2. Suy dinh dưỡng, tiêu chảy kéo dài, viêm phổi kéo dài (không có tổn thương ở mắt)

Cho một liều vitamin A duy nhất theo tuổi

Trẻ < 6 tháng (không có sữa mẹ): 50.000 UI

Trẻ < 1 tuổi : 100.000 UI.

Trẻ > 1 tuổi:  200.000 UI.

3. Phòng bệnh

-Ăn uống cân đối.

- Uống vitamin A liều cao:

+Trẻ < 6 tháng, nuôi nhân tạo: 50.000 một lần duy nhất

+ Trẻ > 1 tuổi                         : 100.000 UI/6 tháng/ lần.

+Trẻ >1 tuổi                           : 200.000 UI/ 6 tháng/ lần.

Chú ý: Nếu bạn có thắc mắc về triệu chứng thiếu vitamin A ở trẻ em hãy gọi điện đến tổng đài tư vấn sức khỏe trẻ em 1900.6180 để nhận được sự tư vấn cụ thể.

BS. Đoàn Hằng


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