{"id":7161,"date":"2024-10-11T09:49:54","date_gmt":"2024-10-11T02:49:54","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=7161"},"modified":"2024-10-11T11:20:00","modified_gmt":"2024-10-11T04:20:00","slug":"cuu-song-nguoi-benh-nguy-kich-do-nhiem-vi-khuan-an-thit-nguoi-whitmore","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=7161","title":{"rendered":"C\u1ee8U S\u1ed0NG NG\u01af\u1edcI B\u1ec6NH NGUY K\u1ecaCH DO NHI\u1ec4M VI KHU\u1ea8N \u201c\u0102N TH\u1ecaT NG\u01af\u1edcI\u201d WHITMORE"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u1eeba c\u1ee9u s\u1ed1ng m\u1ed9t c\u00f4 g\u00e1i 33 tu\u1ed5i, ng\u1ee5 TP.HCM b\u1ecb nhi\u1ec5m vi khu\u1ea9n \u201c\u0103n th\u1ecbt ng\u01b0\u1eddi\u201d Whitmore. Ng\u01b0\u1eddi b\u1ec7nh nh\u1eadp vi\u1ec7n trong t\u00ecnh tr\u1ea1ng h\u1ed9i ch\u1ee9ng nguy k\u1ecbch h\u00f4 h\u1ea5p c\u1ea5p do vi\u00eam ph\u1ed5i n\u1eb7ng.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Do b\u1ecb s\u1ed1t cao v\u00e0 kh\u00f3 th\u1edf k\u00e9o d\u00e0i 3 ng\u00e0y li\u00ean t\u1ee5c, c\u00e1ch \u0111\u00e2y g\u1ea7n 1 th\u00e1ng, v\u00e0o ng\u00e0y 13\/09\/2024, ch\u1ecb \u0110.T.M.L, 33 tu\u1ed5i, ng\u1ee5 \u1edf ph\u01b0\u1eddng 8, qu\u1eadn G\u00f2 V\u1ea5p, TP.HCM \u0111\u1ebfn kh\u00e1m t\u1ea1i m\u1ed9t c\u01a1 s\u1edf y t\u1ebf g\u1ea7n nh\u00e0. Sau khi nh\u1eadp vi\u1ec7n, do di\u1ec5n ti\u1ebfn b\u1ec7nh r\u1ea5t nhanh n\u00ean ch\u1ecb L. r\u01a1i v\u00e0o t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p, ph\u1ea3i th\u1edf m\u00e1y x\u00e2m l\u1ea5n. Sau 24 gi\u1edd nh\u1eadp vi\u1ec7n, b\u1ec7nh nh\u00e2n b\u1ecb s\u1ed1c nhi\u1ec5m khu\u1ea9n. L\u1eadp t\u1ee9c, ch\u1ecb L. \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n li\u00ean vi\u1ec7n v\u00e0 \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ebfn B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u00e0o ng\u00e0y 16\/09\/2024 \u0111\u1ec3 h\u1ed3i s\u1ee9c chuy\u00ean s\u00e2u v\u00ec t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i lan t\u1ecfa hai b\u00ean (g\u1ea7n 70% th\u1ec3 t\u00edch hai ph\u1ed5i).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; T\u1ea1i Khoa H\u1ed3i s\u1ee9c tim m\u1ea1ch, b\u1ec7nh nh\u00e2n L. c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a h\u1ed9i ch\u1ee9ng nguy k\u1ecbch h\u00f4 h\u1ea5p c\u1ea5p, gi\u1ea3m oxy m\u00e1u n\u1eb7ng, nguy c\u01a1 ph\u1ea3i can thi\u1ec7p oxy h\u00f3a m\u00e1u m\u00e0ng ngo\u00e0i c\u01a1 th\u1ec3 (VV-ECMO). B\u1ec7nh nh\u00e2n L. \u0111\u01b0\u1ee3c t\u1ed1i \u01b0u h\u00f4 h\u1ea5p b\u1eb1ng c\u00e1ch th\u00f4ng kh\u00ed b\u1ea3o v\u1ec7 ph\u1ed5i v\u00e0 th\u00f4ng kh\u00ed n\u1eb1m s\u1ea5p. Sau 48 gi\u1edd nh\u1eadp vi\u1ec7n, v\u1edbi k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u, b\u1ec7nh nh\u00e2n L. d\u01b0\u01a1ng t\u00ednh v\u1edbi vi khu\u1ea9n <em>Burkholderia pseudomallei<\/em> (b\u1ec7nh Whitmore). \u0110\u00e2y l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m r\u1ea5t nguy hi\u1ec3m, t\u1ef7 l\u1ec7 t\u1eed vong cao. Sau 4 ng\u00e0y \u0111i\u1ec1u tr\u1ecb \u201ctr\u00fang \u0111\u00edch\u201d vi khu\u1ea9n Whitmore, t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i v\u00e0 t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p n\u1eb7ng c\u1ee7a ch\u1ecb L. d\u1ea7n \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n ngo\u1ea1n m\u1ee5c. Ch\u1ec9 sau 7 ng\u00e0y th\u00f4ng kh\u00ed x\u00e2m l\u1ea5n, n\u1eef b\u1ec7nh nh\u00e2n cai m\u00e1y th\u1edf th\u00e0nh c\u00f4ng. Sau 14 ng\u00e0y \u0111i\u1ec1u tr\u1ecb, ch\u1ecb L. ph\u1ee5c h\u1ed3i g\u1ea7n nh\u01b0 ho\u00e0n to\u00e0n.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; T\u00fac tr\u1ef1c b\u00ean con g\u00e1i t\u1eeb khi nh\u1eadp vi\u1ec7n \u0111\u1ebfn nay, nh\u00ecn con \u0111\u00e3 t\u1ef1 \u0103n u\u1ed1ng v\u00e0 \u0111i l\u1ea1i b\u00ecnh th\u01b0\u1eddng, b\u00e0 T.T.\u0110, m\u1eb9 c\u1ee7a b\u1ec7nh nh\u00e2n L. x\u00fac \u0111\u1ed9ng chia s\u1ebb: \u201cC\u00e1ch \u0111\u00e2y 2 tu\u1ea7n, m\u1ed7i l\u1ea7n nh\u00ecn con g\u00e1i n\u1eb1m h\u00f4n m\u00ea, b\u1ea5t \u0111\u1ed9ng, t\u00f4i ch\u1ec9 bi\u1ebft kh\u00f3c. Khi nghe b\u00e1c s\u0129 cho bi\u1ebft t\u00ecnh tr\u1ea1ng nguy k\u1ecbch c\u1ee7a con, gia \u0111\u00ecnh c\u1ee7a t\u00f4i \u0111\u00e3 chu\u1ea9n b\u1ecb tinh th\u1ea7n, ti\u1ec1n b\u1ea1c \u0111\u1ec3 lo h\u1eadu s\u1ef1 cho con, th\u1ebf nh\u01b0ng c\u00e1c b\u00e1c s\u0129 \u1edf B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh \u0111\u00e3 c\u1ee9u s\u1ed1ng con g\u00e1i c\u1ee7a t\u00f4i, mang \u0111\u1ebfn ph\u00e9p m\u00e0u cho c\u1ea3 gia \u0111\u00ecnh\u201d.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Th\u1ea1c s\u0129 &#8211; B\u00e1c s\u0129 Ph\u00f3 Thi\u00ean Ph\u01b0\u1edbc, khoa H\u1ed3i s\u1ee9c tim m\u1ea1ch, b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb tr\u1ef1c ti\u1ebfp cho b\u1ec7nh nh\u00e2n L. chia s\u1ebb: <strong><em>\u201cNhi\u1ec5m khu\u1ea9n Burkholderia pseudomallei hay c\u00f2n g\u1ecdi \u201cvi khu\u1ea9n \u0103n th\u1ecbt ng\u01b0\u1eddi\u201d l\u00e0 b\u1ec7nh Whitmore th\u01b0\u1eddng \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf c\u00e1c n\u01b0\u1edbc kh\u00ed h\u1eadu nhi\u1ec7t \u0111\u1edbi nh\u01b0 v\u00f9ng \u0110\u00f4ng Nam \u00c1, B\u1eafc \u00dac\u2026 Theo th\u1ed1ng k\u00ea g\u1ea7n \u0111\u00e2y t\u1ea1i c\u00e1c n\u01b0\u1edbc nh\u01b0 Th\u00e1i Lan hay Singapore cho th\u1ea5y t\u1ef7 l\u1ec7 b\u1ec7nh nh\u00e2n t\u1eed vong do nhi\u1ec5m khu\u1ea9n huy\u1ebft b\u1edfi t\u00e1c nh\u00e2n n\u00e0y l\u00ean \u0111\u1ebfn 40% &#8211; 50%. \u0110\u1eb7c bi\u1ec7t, n\u1ebfu b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam ph\u1ed5i n\u1eb7ng th\u00ec nguy c\u01a1 t\u1eed vong c\u00f3 th\u1ec3 l\u00ean \u0111\u1ebfn 75%. B\u1ec7nh Whitmore th\u01b0\u1eddng l\u00e2y truy\u1ec1n qua ti\u1ebfp x\u00fac v\u1edbi \u0111\u1ea5t, n\u01b0\u1edbc b\u1ecb nhi\u1ec5m khu\u1ea9n v\u00e0 th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n \u1edf b\u1ec7nh nh\u00e2n c\u00f3 s\u1ee9c \u0111\u1ec1 kh\u00e1ng suy gi\u1ea3m nh\u01b0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, b\u1ec7nh th\u1eadn m\u1ea1n, nghi\u1ec7n r\u01b0\u1ee3u\u2026 Ch\u1ea9n \u0111o\u00e1n s\u1edbm, \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c \u0111\u00fang t\u00e1c nh\u00e2n ngay t\u1eeb \u0111\u1ea7u s\u1ebd gi\u00fap c\u1ea3i thi\u1ec7n ngo\u1ea1n m\u1ee5c ti\u00ean l\u01b0\u1ee3ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, tr\u00e1nh nguy c\u01a1 ph\u1ea3i can thi\u1ec7p c\u00e1c ph\u01b0\u01a1ng th\u1ee9c h\u1ed3i s\u1ee9c \u0111\u1eaft ti\u1ec1n v\u00e0 x\u00e2m l\u1ea5n nh\u01b0 ECMO\u201d.<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hi\u1ec7n nay, Whitmore ch\u01b0a c\u00f3 v\u1eafc xin ti\u00eam ph\u00f2ng, c\u0169ng ch\u01b0a c\u00f3 b\u1ea5t k\u1ef3 khuy\u1ebfn c\u00e1o n\u00e0o v\u1ec1 s\u1eed d\u1ee5ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng. Vi khu\u1ea9n Burkholderia pseudomallei th\u01b0\u1eddng s\u1ed1ng trong \u0111\u1ea5t, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u0111\u1ea5t \u1ea9m v\u00e0 n\u01b0\u1edbc \u00f4 nhi\u1ec5m. Khi c\u00f3 v\u1ebft th\u01b0\u01a1ng h\u1edf, vi khu\u1ea9n n\u00e0y d\u1ec5 d\u00e0ng x\u00e2m nh\u1eadp v\u00e0o c\u01a1 th\u1ec3, g\u00e2y nhi\u1ec5m tr\u00f9ng. Ban \u0111\u1ea7u, b\u1ec7nh c\u00f3 th\u1ec3 ch\u1ec9 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u1eb9 nh\u01b0 s\u1ed1t, ho, \u0111au c\u01a1. Tuy nhi\u00ean, n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi, b\u1ec7nh c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n n\u1eb7ng, g\u00e2y t\u1ed5n th\u01b0\u01a1ng nhi\u1ec1u c\u01a1 quan, th\u1eadm ch\u00ed d\u1eabn \u0111\u1ebfn t\u1eed vong. \u0110i\u1ec3n h\u00ecnh nh\u01b0 trong tr\u01b0\u1eddng h\u1ee3p c\u1ee7a ch\u1ecb L. cho bi\u1ebft : \u201c T\u00f4i c\u00f3 th\u00f3i quen \u0111i ch\u00e2n tr\u1ea7n tr\u00ean m\u1eb7t \u0111\u1ea5t khi t\u1eadp th\u1ec3 d\u1ee5c \u1edf c\u00f4ng vi\u00ean \u0111\u1ec3 t\u0103ng s\u1ef1 nh\u1ea1y c\u1ea3m c\u1ee7a ch\u00e2n v\u00e0 gi\u00fap c\u01a1 ch\u00e2n ch\u1eafc kh\u1ecfe. C\u00f3 l\u1ebd v\u00ec th\u00f3i quen n\u00e0y m\u00e0 t\u00f4i b\u1ecb nhi\u1ec5m vi kh\u1ea9n <em>Burkholderia pseudomallei<\/em>\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Tr\u01b0\u1edbc \u0111\u00f3 v\u00e0o th\u00e1ng 9, Khoa N\u1ed9i C\u01a1 X\u01b0\u01a1ng Kh\u1edbp, b\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng cho m\u1ed9t b\u1ec7nh nh\u00e2n 38 tu\u1ed5i, ng\u1ee5 TP.HCM c\u0169ng b\u1ecb m\u1eafc b\u1ec7nh Whitmore nh\u1eadp vi\u1ec7n \u1edf trong t\u00ecnh tr\u1ea1ng v\u00f4 c\u00f9ng nguy k\u1ecbch, s\u1ed1t cao li\u00ean t\u1ee5c 39-40 \u0111\u1ed9 C, ki\u1ec7t s\u1ee9c. Kh\u1edbp g\u1ed1i tr\u00e1i s\u01b0ng \u0111\u1ecf, n\u00f3ng r\u00e1t, \u0111au nh\u1ee9c d\u1eef d\u1ed9i \u0111\u1ebfn m\u1ee9c b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 t\u1ef1 \u0111i l\u1ea1i. Tr\u01b0\u1edbc nguy hi\u1ec3m c\u1ee7a b\u1ec7nh n\u00e0y, ng\u01b0\u1eddi d\u00e2n ph\u1ea3i ch\u1ee7 \u0111\u1ed9ng bi\u1ec7n ph\u00e1p ph\u00f2ng tr\u00e1nh b\u1eb1ng c\u00e1ch Khi l\u00e0m vi\u1ec7c ngo\u00e0i tr\u1eddi, c\u1ea7n trang b\u1ecb \u0111\u1ea7y \u0111\u1ee7 b\u1ea3o h\u1ed9 lao \u0111\u1ed9ng nh\u01b0 g\u0103ng tay, \u1ee7ng \u0111\u1ec3 tr\u00e1nh ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi \u0111\u1ea5t v\u00e0 n\u01b0\u1edbc b\u1ea9n. N\u1ebfu kh\u00f4ng may b\u1ecb tr\u1ea7y x\u01b0\u1edbc ho\u1eb7c c\u00f3 v\u1ebft th\u01b0\u01a1ng h\u1edf, c\u1ea7n r\u1eeda s\u1ea1ch b\u1eb1ng n\u01b0\u1edbc s\u1ea1ch v\u00e0 x\u00e0 ph\u00f2ng, b\u0103ng b\u00f3 v\u00e0 \u0111\u1ebfn c\u01a1 s\u1edf y t\u1ebf \u0111\u1ec3 \u0111\u01b0\u1ee3c kh\u00e1m, \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi.<\/p>\n\n\n\n<div class=\"wp-block-uagb-image uagb-block-5d5a0483 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2024\/10\/1.png\" alt=\"\" class=\"uag-image-7162\" width=\"652\" height=\"608\" title=\"1\" loading=\"lazy\" role=\"img\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">H\u00ecnh Xquang ph\u1ed5i b\u1ec7nh nh\u00e2n l\u00fac nh\u1eadp vi\u1ec7n, t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i (tr\u1eafng) c\u1ea3 hai ph\u1ed5i<\/p>\n\n\n\n<div class=\"wp-block-uagb-image uagb-block-53449f27 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2024\/10\/2.png\" alt=\"\" class=\"uag-image-7164\" width=\"647\" height=\"609\" title=\"2\" loading=\"lazy\" role=\"img\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">H\u00ecnh Xquang ph\u1ed5i b\u1ec7nh nh\u00e2n l\u00fac \u1ed5n \u0111\u1ecbnh<\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u1eeba c\u1ee9u s\u1ed1ng m\u1ed9t c\u00f4 g\u00e1i 33 tu\u1ed5i, ng\u1ee5 TP.HCM b\u1ecb nhi\u1ec5m vi khu\u1ea9n \u201c\u0103n th\u1ecbt ng\u01b0\u1eddi\u201d Whitmore. Ng\u01b0\u1eddi b\u1ec7nh nh\u1eadp vi\u1ec7n trong t\u00ecnh tr\u1ea1ng h\u1ed9i ch\u1ee9ng nguy k\u1ecbch h\u00f4 h\u1ea5p c\u1ea5p do vi\u00eam ph\u1ed5i n\u1eb7ng. Do b\u1ecb s\u1ed1t cao v\u00e0 kh\u00f3 th\u1edf k\u00e9o d\u00e0i 3 ng\u00e0y li\u00ean t\u1ee5c, 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