{"id":6923,"date":"2020-04-26T05:34:57","date_gmt":"2020-04-25T22:34:57","guid":{"rendered":"https:\/\/yhoccongdong.org\/du-an-khac\/2020\/04\/26\/tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020\/"},"modified":"2024-03-17T05:52:05","modified_gmt":"2024-03-16T22:52:05","slug":"tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/du-an-khac\/tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020\/","title":{"rendered":"Tin t\u1ed5ng h\u1ee3p COVID \u2013 19 \u2013 C\u1eadp nh\u1eadt ng\u00e0y 12\/4\/2020"},"content":{"rendered":"<h2>C\u1ed5ng th\u00f4ng tin c\u1eadp nh\u1eadt d\u1eef li\u1ec7u h\u1eb1ng ng\u00e0y t\u1ea1i Vi\u1ec7t Nam<\/h2>\n<p>Vi\u1ec7t Nam \u0111\u00e3 c\u00f3 c\u1ed5ng th\u00f4ng tin c\u1eadp nh\u1eadt d\u1eef li\u1ec7u h\u1eb1ng ng\u00e0y:\u00a0<a href=\"https:\/\/ncov.vncdc.gov.vn\/viet_nam.html\" target=\"_blank\" rel=\"noopener\">https:\/\/ncov.vncdc.gov.vn\/viet_nam.html<\/a><\/p>\n<p>B\u1ed9 d\u1eef li\u1ec7u v\u1ec1 5F c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1:\u00a0<a href=\"https:\/\/l.facebook.com\/l.php?u=http%3A%2F%2Fshorturl.at%2FfghvX%3Ffbclid%3DIwAR1xxwZ7JlbETX_X_k6MkRmG8hvV4TnyfwJkoUMWj2CDio0fVYl-6dXtctU&amp;h=AT2fyqeoqaMHnSZV4CDq3ZLw3DG3gv9Q1yTTx3iBCj-tSUpkS7PZPyvYLUoT4HfXlu7gkogHhHwpEKXnr17Is-j-k1tJ60ktXjOE6MtMhD9ENhJW6gcf6yk3lzExk9ja6-JyhwgRF3hMwKGvqvmMqMR95-HZYZrw6AmUQZgi9xHq8NvRdywWh7Y\" target=\"_blank\" rel=\"noopener\">at\/fghvX<\/a><\/p>\n<p>C\u1ea3m \u01a1n nh\u00f3m t\u00e1c gi\u1ea3 \u0111\u00e3 k\u00ec c\u00f4ng x\u00e2y d\u1ef1ng, t\u1ed5ng h\u1ee3p<\/p>\n<h2>Vai tr\u00f2 c\u1ee7a tPA trong COVID-19<\/h2>\n<p>C\u00f3 BS h\u1ecfi vai tr\u00f2 c\u1ee7a tPA trong COVID-19? Gi\u1ea3 thuy\u1ebft li\u00ean quan \u0111\u1ebfn s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a c\u00e1c ti\u1ec3u huy\u1ebft kh\u1ed1i (microthrombi) \u1edf ph\u1ed5i \u0111\u01b0\u1ee3c 1 s\u1ed1 BS \u1edf Cali \u0111\u1ec1 xu\u1ea5t t\u1eeb cu\u1ed1i th\u00e1ng 3 (xem h\u00ecnh), c\u0169ng nh\u01b0 g\u1ea7n \u0111\u00e2y \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn trong kh\u00e1m nghi\u1ec7m 1 s\u1ed1 t\u1eed thi \u1edf New Orlean (c\u00f4ng b\u1ed1 h\u00f4m 10\/4):<\/p>\n<p><a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2020.04.06.20050575v1\" target=\"_blank\" rel=\"noopener\">https:\/\/www.medrxiv.org\/content\/10.1101\/2020.04.06.20050575v1<\/a>.<\/p>\n<ul>\n<li>Hi\u1ec7n \u0111\u00e3 c\u00f3 <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jth.14828https:\/\/academic.oup.com\/qjmed\/advance-article\/doi\/10.1093\/qjmed\/hcaa121\/5818885\" target=\"_blank\" rel=\"noopener\">1 s\u1ed1 b\u00e1o c\u00e1o ca c\u0169ng nh\u01b0 chu\u1ed7i ca b\u1ec7nh (case series) v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c ly gi\u1ea3i huy\u1ebft kh\u1ed1i trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng<\/a>: &#8220;25 mg IV bolus then 25 mg over 22 hours &#8212;&gt; c\u1ea3i thi\u1ec7n t\u1ea1m th\u1eddi t\u1ef7 l\u1ec7 P\/F&#8221;<\/li>\n<li>Hi\u1ec7p h\u1ed9i World Society of Emergency Surgery (WSES) \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t vi\u1ec7c <a href=\"https:\/\/www.wses.org.uk\/wp-content\/uploads\/2020\/04\/covid-tPA.pdf.\" target=\"_blank\" rel=\"noopener\">s\u1eed d\u1ee5ng tPA nh\u1eb1m c\u1ea3i thi\u1ec7n t\u1ef7 l\u1ec7 t\u1eed vong khi b\u1ecb ARDS do Covid, d\u1ef1 \u0111o\u00e1n b\u1eb1ng m\u00f4 h\u00ecnh Markov<\/a> (khi ch\u01b0a c\u00f3 s\u1eb5n d\u1eef li\u1ec7u d\u00e0i h\u1ea1n).<\/li>\n<\/ul>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-full wp-image-32782\" src=\"https:\/\/yhoccongdong.com\/du-an-khac\/wp-content\/uploads\/sites\/6\/2020\/04\/tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020-1.jpeg\" alt=\"Tin t\u1ed5ng h\u1ee3p COVID \u2013 19 \u2013 C\u1eadp nh\u1eadt ng\u00e0y 12\/4\/2020-1\" width=\"1340\" height=\"1020\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"alignnone size-full wp-image-32748 aligncenter\" src=\"https:\/\/yhoccongdong.com\/du-an-khac\/wp-content\/uploads\/sites\/6\/2020\/04\/tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020-2.jpg\" alt=\"Tin t\u1ed5ng h\u1ee3p COVID \u2013 19 \u2013 C\u1eadp nh\u1eadt ng\u00e0y 12\/4\/2020-2\" width=\"573\" height=\"474\" \/><\/p>\n<ul>\n<li>C\u00e1c BS \u1edf Harvard c\u0169ng \u0111\u00e3 quy\u1ebft \u0111\u1ecbnh ti\u1ebfn h\u00e0nh th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111\u1ec3 ki\u1ec3m ch\u1ee9ng hi\u1ec7u qu\u1ea3 th\u1eadt s\u1ef1 c\u1ee7a tPA: https:\/\/www.bidmc.org\/about-bidmc\/news\/2020\/04\/covid-19-anti-clotting-medication<\/li>\n<\/ul>\n<p>T\u1ea1m k\u1ebft, th\u1eddi \u0111i\u1ec3m n\u00e0y n\u1ebfu c\u00f3 c\u00f3 c\u00e2n nh\u1eafc d\u00f9ng tPA th\u00ec \u0111\u00e2y l\u00e0 bi\u1ec7n ph\u00e1p c\u1ee9u c\u00e1nh (salvage therapy) khi kh\u00f4ng c\u00f3 \u0111\u1ee7 m\u00e1y th\u1edf ho\u1eb7c ECMO.<\/p>\n<h2>Th\u1eed nghi\u1ec7m s\u1eed d\u1ee5ng chloroquine (CQ)<\/h2>\n<p>Hi\u1ec7n r\u1ea5t nhi\u1ec1u th\u1eed nghi\u1ec7m tr\u00ean th\u1ebf gi\u1edbi \u0111ang ti\u1ebfn h\u00e0nh cho hydroxychloroquine nh\u01b0ng \u1edf VN th\u00ec OCRU \u0111ang \u0111\u00e1nh gi\u00e1 tr\u00ean chloroquine (CQ), do v\u1eady vi\u1ec7c so s\u00e1nh v\u1edbi c\u00e1c nghi\u00ean c\u1ee9u c\u00f3 \u0111i\u1ec3m chung l\u00e0 c\u1ea7n thi\u1ebft. H\u00f4m 11\/4, <a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2020.04.07.20056424v1\" target=\"_blank\" rel=\"noopener\">m\u1ed9t th\u1eed nghi\u1ec7m ti\u1ec1n LS pha 2 \u1edf Brasil<\/a> \u0111\u00e3 c\u00f4ng b\u1ed1 k\u1ebft qu\u1ea3 s\u01a1 b\u1ed9, khi so s\u00e1nh li\u1ec1u th\u1ea5p v\u00e0 li\u1ec1u cao CQ (600mg BID for 10 days vs 450mg for 5 days):<\/p>\n<p>Nghi\u00ean c\u1ee9u ph\u1ea3i d\u1eebng s\u1edbm v\u00ec t\u1eed vong nhi\u1ec1u h\u01a1n \u1edf nh\u00f3m li\u1ec1u cao. Nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a NC n\u00e0y l\u00e0 \u0111\u1ed1i t\u01b0\u1ee3ng tham gia ngay t\u1eeb \u0111\u1ea7u \u0111\u00e3 \u201cvery sick\u201d, v\u00e0 theo k\u1ebft qu\u1ea3 \u0111\u1ec1 xu\u1ea5t t\u1eeb c\u00e1c m\u00f4 h\u00ecnh d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc tr\u01b0\u1edbc \u0111\u00f3 d\u00e0nh cho HCQ\/CQ th\u00ec vi\u1ec7c d\u00f9ng 600mg BID l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn c\u1ef1c k\u00ec r\u1ee7i ro, ch\u1ec9 n\u00ean d\u00f9ng loading dose 1 l\u1ea7n sau \u0111\u00f3 gi\u1ea3m xu\u1ed1ng 1 m\u1ee9c li\u1ec1u duy tr\u00ec. Ch\u01b0a k\u1ec3 so v\u1ec1 \u0111\u1ed9c t\u00ednh th\u00ec CQ cao h\u01a1n HCQ.<\/p>\n<p><img decoding=\"async\" class=\"alignnone size-full wp-image-32754 aligncenter\" src=\"https:\/\/yhoccongdong.com\/du-an-khac\/wp-content\/uploads\/sites\/6\/2020\/04\/tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020-3.jpg\" alt=\"Tin t\u1ed5ng h\u1ee3p COVID \u2013 19 \u2013 C\u1eadp nh\u1eadt ng\u00e0y 12\/4\/2020-3\" width=\"620\" height=\"338\" \/><\/p>\n<p><em><strong>C\u1eadp nh\u1eadt ng\u00e0y 24\/4\/2020: <\/strong><\/em>Nghi\u00ean c\u1ee9u tr\u00ean\u00a0121 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ph\u00e2n b\u1ed5 ng\u1eabu nhi\u00ean d\u00f9ng CQ 600mg BID x 10d vs. CQ 450 QD x 4d. K\u1ebft qu\u1ea3 cho th\u1ea5y t\u1eed vong cao h\u01a1n \u1edf nh\u00f3m d\u00f9ng li\u1ec1u cao. NC n\u00e0y ch\u1ec9 g\u1ee3i \u00fd v\u1ec1 kh\u00eda c\u1ea1nh an to\u00e0n, tr\u00e1nh d\u00f9ng li\u1ec1u cao; c\u00f2n c\u1ee1 m\u1eabu ch\u01b0a \u0111\u1ee7 \u0111\u1ec3 \u0111\u01b0a ra g\u1ee3i \u00fd v\u1ec1 hi\u1ec7u l\u1ef1c c\u1ee7a thu\u1ed1c.<\/p>\n<p>Xem t\u1ea1i:<a href=\"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2765270\" target=\"_blank\" rel=\"noopener\">\u00a0https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2765270<\/a><\/p>\n<h2>Qu\u1ea3n l\u00fd STEMI \u1edf b\u1ec7nh nh\u00e2n COVID-19<\/h2>\n<p>V\u1edbi c\u00e1c BS tim m\u1ea1ch quan t\u00e2m v\u1ec1 qu\u1ea3n l\u00fd STEMI \u1edf b\u1ec7nh nh\u00e2n covid c\u00f3 th\u1ec3 xem webinar m\u1edbi nh\u1ea5t t\u1ea1i \u0111\u00e2y: <a href=\"https:\/\/pcronline.com\/tiny\/url\/477337\" target=\"_blank\" rel=\"noopener\">https:\/\/pcronline.com\/tiny\/url\/477337<\/a><\/p>\n<h2>L\u01b0u \u0111\u1ed3 \u0111\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n COVID-19 t\u1eeb\u00a0Vi\u1ec7n Tr\u01b0\u1eddng UCSF<\/h2>\n<p>Vi\u1ec7n Tr\u01b0\u1eddng UCSF ti\u1ebfp t\u1ee5c c\u1eadp nh\u1eadt l\u01b0u \u0111\u1ed3 \u0111\u00e1nh gi\u00e1, b\u00e0 con xem h\u00ecnh \u0111\u00ednh k\u00e8m.<\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-32783 aligncenter\" src=\"https:\/\/yhoccongdong.com\/du-an-khac\/wp-content\/uploads\/sites\/6\/2020\/04\/tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020-5.png\" alt=\"Tin t\u1ed5ng h\u1ee3p COVID \u2013 19 \u2013 C\u1eadp nh\u1eadt ng\u00e0y 12\/4\/2020-5\" width=\"673\" height=\"811\" \/><\/p>\n<h2>Ch\u1ee9ng c\u1ee9 v\u1ec1 truy\u1ec1n t\u0129nh m\u1ea1ch Vitamin C<\/h2>\n<p>H\u00f4m qua b\u00ean group c\u00f3 th\u1ea3o lu\u1eadn v\u1ec1 ch\u1ee9ng c\u1ee9 cho vitamin C IV \u1edf th\u1eddi \u0111i\u1ec3m hi\u1ec7n t\u1ea1i, Hi\u1ec7p h\u1ed9i D\u01b0\u1ee3c s\u0129 B\u1ec7nh vi\u1ec7n Hoa K\u1ef3 ASHP \u0111\u00e3 c\u00f3 \u0111\u00e1nh gi\u00e1 g\u1ea7n \u0111\u00e2y v\u00e0 k\u1ebft lu\u1eadn ch\u01b0a \u0111\u1ee7 c\u01a1 s\u1edf \u0111\u1ec3 truy\u1ec1n t\u0129nh m\u1ea1ch vitamin C th\u01b0\u1eddng quy. B\u00ean c\u1ea1nh \u0111\u00f3, trong sepsis th\u01b0\u1eddng bi\u1ebft \u0111\u1ebfn h\u1ed7n h\u1ee3p cocktail &#8220;Vitamin C, Hydrocortisone, and Thiamine&#8221; c\u00f3 r\u1ea5t nhi\u1ec1u k\u1ebft qu\u1ea3 m\u00e2u thu\u1eabn, \u0111\u1ea7u n\u0103m nay nghi\u00ean c\u1ee9u l\u1edbn tr\u00ean JAMA c\u0169ng cho th\u1ea5y l\u00e0 combo n\u00e0y kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3 trong sepsis.<\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-32784\" src=\"https:\/\/yhoccongdong.com\/du-an-khac\/wp-content\/uploads\/sites\/6\/2020\/04\/tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020-6.png\" alt=\"Tin t\u1ed5ng h\u1ee3p COVID \u2013 19 \u2013 C\u1eadp nh\u1eadt ng\u00e0y 12\/4\/2020-6\" width=\"1994\" height=\"918\" \/><\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p><a href=\"https:\/\/www.facebook.com\/khaipharm19\" target=\"_blank\" rel=\"noopener\">Facebook D\u01b0\u1ee3c s\u0129 Phan Quang Kh\u1ea3i<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u00e0i vi\u1ebft c\u1ee7a D\u01b0\u1ee3c s\u0129 Phan Quang Kh\u1ea3i t\u1ed5ng h\u1ee3p 1 s\u1ed1 ch\u1ee9ng c\u1ee9 quan tr\u1ecdng v\u00e0 chia s\u1ebb nh\u1eefng ngu\u1ed3n hay v\u1ec1 nh\u1eefng th\u00f4ng tin y h\u1ecdc \u0111\u01b0\u1ee3c c\u1eadp nh\u1eadt t\u1eeb nh\u00e2n vi\u00ean y t\u1ebf, chuy\u00ean gia t\u1eeb tuy\u1ebfn \u0111\u1ea7u v\u00e0 t\u1eeb t\u00e2m d\u1ecbch tr\u00ean kh\u1eafp th\u1ebf gi\u1edbi cho \u0111\u1ed3ng nghi\u1ec7p \u1edf Vi\u1ec7t Nam.<\/p>\n","protected":false},"author":491,"featured_media":6915,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4969,9995,4954,1],"tags":[4977,4628,4993],"series":[2842],"coauthors":[2894],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Tin t\u1ed5ng h\u1ee3p COVID \u2013 19 \u2013 C\u1eadp nh\u1eadt ng\u00e0y 12\/4\/2020 - D\u1ef1 \u00e1n kh\u00e1c<\/title>\n<meta name=\"description\" content=\"B\u00e0i vi\u1ebft c\u1ee7a D\u01b0\u1ee3c s\u0129 Phan Quang Kh\u1ea3i t\u1ed5ng h\u1ee3p 1 s\u1ed1 ch\u1ee9ng c\u1ee9 quan tr\u1ecdng v\u00e0 chia s\u1ebb nh\u1eefng ngu\u1ed3n hay v\u1ec1 nh\u1eefng th\u00f4ng tin y h\u1ecdc \u0111\u01b0\u1ee3c c\u1eadp nh\u1eadt t\u1eeb nh\u00e2n vi\u00ean y t\u1ebf, chuy\u00ean gia t\u1eeb tuy\u1ebfn \u0111\u1ea7u v\u00e0 t\u1eeb t\u00e2m d\u1ecbch tr\u00ean kh\u1eafp th\u1ebf gi\u1edbi cho \u0111\u1ed3ng nghi\u1ec7p \u1edf Vi\u1ec7t Nam.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/yhoccongdong.com\/du-an-khac\/tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tin t\u1ed5ng h\u1ee3p COVID \u2013 19 \u2013 C\u1eadp nh\u1eadt ng\u00e0y 12\/4\/2020 - D\u1ef1 \u00e1n kh\u00e1c\" \/>\n<meta property=\"og:description\" content=\"B\u00e0i vi\u1ebft c\u1ee7a D\u01b0\u1ee3c s\u0129 Phan Quang Kh\u1ea3i t\u1ed5ng h\u1ee3p 1 s\u1ed1 ch\u1ee9ng c\u1ee9 quan tr\u1ecdng v\u00e0 chia s\u1ebb nh\u1eefng ngu\u1ed3n hay v\u1ec1 nh\u1eefng th\u00f4ng tin y h\u1ecdc \u0111\u01b0\u1ee3c c\u1eadp nh\u1eadt t\u1eeb nh\u00e2n vi\u00ean y t\u1ebf, chuy\u00ean gia t\u1eeb tuy\u1ebfn \u0111\u1ea7u v\u00e0 t\u1eeb t\u00e2m d\u1ecbch tr\u00ean kh\u1eafp th\u1ebf gi\u1edbi cho \u0111\u1ed3ng nghi\u1ec7p \u1edf Vi\u1ec7t Nam.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/yhoccongdong.com\/du-an-khac\/tin-tong-hop-covid-19-cap-nhat-ngay-12-4-2020\/\" \/>\n<meta property=\"og:site_name\" content=\"D\u1ef1 \u00e1n kh\u00e1c\" \/>\n<meta property=\"article:author\" content=\"https:\/\/www.facebook.com\/khaipharm19\" \/>\n<meta property=\"article:published_time\" content=\"2020-04-25T22:34:57+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-03-16T22:52:05+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/yhoccongdong.com\/du-an-khac\/wp-content\/uploads\/sites\/6\/2020\/04\/tin-tong-hop-covid-19-cap-nhat.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"660\" \/>\n\t<meta property=\"og:image:height\" content=\"330\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"DS. 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