{"id":22041,"date":"2023-04-17T12:36:27","date_gmt":"2023-04-17T05:36:27","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22041"},"modified":"2023-04-27T16:00:06","modified_gmt":"2023-04-27T09:00:06","slug":"duong-huyet","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/duong-huyet\/","title":{"rendered":"Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n COVID 19"},"content":{"rendered":"

Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n COVID-19 l\u00e0 r\u1ea5t quan tr\u1ecdng, b\u1edfi v\u00ec c\u00e1c b\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 \u0111\u01b0\u1eddng huy\u1ebft v\u00e0 s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n v\u00ec b\u1ec7nh COVID-19 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng m\u1ee9c \u0111\u01b0\u1eddng huy\u1ebft \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 m\u1eafc c\u00e1c b\u1ec7nh l\u00fd n\u1ec1n nh\u01b0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. Do \u0111\u00f3, ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n COVID-19 nh\u1ea7m \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o s\u1ee9c kh\u1ecfe to\u00e0n di\u1ec7n c\u1ee7a b\u1ec7nh nh\u00e2n. C\u00e1c bi\u1ec7n ph\u00e1p ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft ph\u00f9 h\u1ee3p c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n cho c\u00e1c b\u1ec7nh nh\u00e2n COVID 19.<\/strong><\/p>\n

1. Qu\u1ea3n l\u00fd m\u1ee9c \u0111\u1ed9 \u0111\u01b0\u1eddng huy\u1ebft li\u00ean quan \u0111\u1ebfn corticoid<\/strong><\/h2>\n

1.1. \u00a0\u0110\u00e1nh gi\u00e1 chung<\/em><\/strong><\/h3>\n

Tr\u01b0\u1edbc h\u1ebft c\u1ea7n lo\u1ea1i tr\u1eeb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 nhi\u1ec5m toan ceton v\u00e0 t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft c\u00f3 t\u0103ng \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u b\u1eb1ng x\u00e9t nghi\u1ec7m glucose m\u00e1u, kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch, creatinin v\u00e0 \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3. N\u1ebfu c\u00f3 nhi\u1ec5m toan ceton ho\u1eb7c t\u0103ng \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u th\u00ec s\u1ebd \u0111i\u1ec1u tr\u1ecb theo ph\u00e1c \u0111\u1ed3 c\u1ee7a toan ceton v\u00e0 t\u0103ng \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u.<\/p>\n

1.2. M\u1ee5c ti\u00eau v\u00e0 t\u1ea7n su\u1ea5t theo d\u00f5i glucose m\u00e1u mao m\u1ea1ch<\/em><\/strong><\/h3>\n

– M\u1ee5c ti\u00eau glucose m\u00e1u = 6 \u0111\u1ebfn 10 mmol\/L (c\u00f3 th\u1ec3 ch\u1ea5p nh\u1eadn < 12 mmol\/L)<\/p>\n

– \u0110o glucose m\u00e1u mao m\u1ea1ch 4 l\u1ea7n\/ng\u00e0y v\u00e0o tr\u01b0\u1edbc c\u00e1c m\u0169i ti\u00eam insulin (tr\u01b0\u1edbc \u0103n s\u00e1ng – tr\u01b0a – t\u1ed1i v\u00e0 l\u00fac \u0111i ng\u1ee7) v\u00e0 khi nghi ng\u1edd h\u1ea1 glucose m\u00e1u.<\/p>\n

\"\"
Ngu\u1ed3n:<\/strong> Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes <\/em><\/figcaption><\/figure>\n

2. Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft khi d\u00f9ng corticoid<\/strong><\/h2>\n

2.1. Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft khi b\u1eaft \u0111\u1ea7u d\u00f9ng corticoid<\/em><\/strong><\/h3>\n

–\u00a0<\/strong>N\u1ebfu HbA1C < 7% v\u00e0 glucose m\u00e1u b\u00ecnh th\u01b0\u1eddng, ng\u01b0\u1eddi b\u1ec7nh \u0111ang \u0111i\u1ec1u tr\u1ecb thu\u1ed1c u\u1ed1ng h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft: Ti\u1ebfp t\u1ee5c ph\u00e1c \u0111\u1ed3, tr\u1eeb \u1ee9c ch\u1ebf SGLT-2. N\u1ebfu glucose m\u00e1u t\u0103ng th\u00ec chuy\u1ec3n qua \u0111i\u1ec1u tr\u1ecb th\u00eam 1 m\u0169i insulin n\u1ec1n (NPH ho\u1eb7c Glargin) ti\u00eam d\u01b0\u1edbi da.<\/p>\n

L\u01b0u \u00fd n\u1ebfu d\u00f9ng 1 li\u1ec1u corticoid v\u00e0o bu\u1ed5i s\u00e1ng th\u00ec c\u0169ng ph\u1ea3i ti\u00eam m\u0169i insulin n\u1ec1n v\u00e0o bu\u1ed5i s\u00e1ng<\/em><\/p>\n

– N\u1ebfu HbA1C < 7% v\u00e0 glucose m\u00e1u b\u00ecnh th\u01b0\u1eddng, ng\u01b0\u1eddi b\u1ec7nh \u0111ang \u0111i\u1ec1u tr\u1ecb thu\u1ed1c u\u1ed1ng h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft + insulin: ti\u1ebfp t\u1ee5c ph\u00e1c \u0111\u1ed3, tr\u1eeb \u1ee9c ch\u1ebf SGLT-2. N\u1ebfu glucose m\u00e1u cao: t\u0103ng li\u1ec1u insulin.<\/p>\n

– N\u1ebfu HbA1C > 7% v\u00e0 glucose m\u00e1u cao, ng\u01b0\u1eddi b\u1ec7nh \u0111ang \u0111i\u1ec1u tr\u1ecb thu\u1ed1c u\u1ed1ng h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft: Chuy\u1ec3n \u0111i\u1ec1u tr\u1ecb insulin theo ph\u00e1c \u0111\u1ed3 4 m\u0169i\/ng\u00e0y (3 m\u0169i nhanh tr\u01b0\u1edbc \u0103n + 1 m\u0169i n\u1ec1n).<\/p>\n

– N\u1ebfu HbA1C > 7% v\u00e0 glucose m\u00e1u cao, ng\u01b0\u1eddi b\u1ec7nh \u0111ang \u0111i\u1ec1u tr\u1ecb thu\u1ed1c u\u1ed1ng h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft + Insulin: Chuy\u1ec3n ph\u00e1c \u0111\u1ed3 Insulin t\u00edch c\u1ef1c 4 m\u0169i\/ng\u00e0y (3 m\u0169i nhanh tr\u01b0\u1edbc \u0103n + 1 m\u0169i n\u1ec1n), li\u1ec1u insulin c\u00f3 th\u1ec3 cao h\u01a1n b\u00ecnh th\u01b0\u1eddng.<\/p>\n

– N\u1ebfu kh\u00f4ng bi\u1ebft k\u1ebft qu\u1ea3 HbA1C v\u00e0 kh\u00f4ng bi\u1ebft \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc khi nh\u1eadp vi\u1ec7n: Ti\u00eam insulin n\u1ec1n v\u1edbi li\u1ec1u 0,3 UI\/kg\/ng\u00e0y.<\/p>\n

+ D\u00f9ng methylprednisolon 1 l\u1ea7n\/ng\u00e0y: Ti\u00eam 1 m\u0169i NPH.<\/p>\n

+ D\u00f9ng methylprednisolon 2 l\u1ea7n\/ng\u00e0y: Ti\u00eam 2 m\u0169i NPH (2\/3 s\u00e1ng v\u00e0 1\/3 chi\u1ec1u).<\/p>\n

+ D\u00f9ng dexamethason: Ti\u00eam 1 m\u0169i Glargin ho\u1eb7c 2 m\u0169i NPH.<\/p>\n

– N\u1ebfu ng\u01b0\u1eddi b\u1ec7nh \u0111ang \u0111i\u1ec1u tr\u1ecb 2 m\u0169i insulin h\u1ed7n h\u1ee3p\/ng\u00e0y: T\u0103ng li\u1ec1u 10 – 20% khi b\u1eaft \u0111\u1ea7u d\u00f9ng corticoid.<\/p>\n

2.2. \u0110i\u1ec1u ch\u1ec9nh li\u1ec1u insulin khi glucose m\u00e1u cao > 12 mmol\/L<\/em><\/strong><\/h3>\n

B\u1ea3ng 1. Ch\u1ec9nh li\u1ec1u v\u1edbi ng\u01b0\u1eddi b\u1ec7nh \u0111ang s\u1eed d\u1ee5ng 1 m\u0169i insulin n\u1ec1n\/ng\u00e0y<\/em><\/p>\n\n\n\n\n\n\n\n\n\n
Glucose m\u00e1u tr\u01b0\u1edbc ti\u00eam<\/strong><\/td>\nCh\u1ec9nh li\u1ec1u insulin<\/strong><\/td>\n<\/tr>\n
mmol\/L<\/td>\nmg\/dL<\/td>\n<\/tr>\n
\u2264 4.0<\/td>\n\u2264 72<\/td>\nGi\u1ea3m 20% li\u1ec1u insulin<\/td>\n<\/tr>\n
4.1 – 6.0<\/td>\n72 – 108<\/td>\nGi\u1ea3m 10% li\u1ec1u insulin<\/td>\n<\/tr>\n
6.1 – 12.0<\/td>\n108 – 216<\/td>\nGi\u1eef nguy\u00ean li\u1ec1u<\/td>\n<\/tr>\n
12.1 – 18.0<\/td>\n216 – 324<\/td>\nT\u0103ng 10% li\u1ec1u insulin<\/td>\n<\/tr>\n
\u2265 18.0<\/td>\n\u2265 324<\/td>\nT\u0103ng 20% li\u1ec1u insulin<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/em><\/p>\n

B\u1ea3ng 2. Ch\u1ec9nh li\u1ec1u v\u1edbi ng\u01b0\u1eddi b\u1ec7nh \u0111ang s\u1eed d\u1ee5ng 2 m\u0169i insulin h\u1ed7n h\u1ee3p\/ng\u00e0y (Premixed)\/ng\u00e0y: Ti\u00eam insulin tr\u01b0\u1edbc b\u1eefa \u0103n 30 ph\u00fat<\/em><\/p>\n\n\n\n\n\n\n\n\n\n
K\u1ebft qu\u1ea3 glucose m\u00e1u<\/strong><\/td>\nCh\u1ec9nh li\u1ec1u m\u0169i insulin*<\/strong><\/td>\n<\/tr>\n
mmol\/L<\/strong><\/td>\nmg\/dL<\/strong><\/td>\n<\/tr>\n
\u2264 4.0<\/td>\n\u2264 72<\/td>\nGi\u1ea3m 20% li\u1ec1u insulin<\/td>\n<\/tr>\n
4.1 – 6.0<\/td>\n72 – 108<\/td>\nGi\u1ea3m 10% li\u1ec1u insulin<\/td>\n<\/tr>\n
6.1 – 12.0<\/td>\n108 – 216<\/td>\nGi\u1eef nguy\u00ean li\u1ec1u<\/td>\n<\/tr>\n
12.1 – 18.0<\/td>\n216 – 324<\/td>\nT\u0103ng 10% li\u1ec1u insulin<\/td>\n<\/tr>\n
\u2265 18.0<\/td>\n\u2265 324<\/td>\nT\u0103ng 20% li\u1ec1u insulin<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Ch\u00fa \u00fd:\u00a0<\/strong>N\u1ebfu glucose m\u00e1u cao\/th\u1ea5p bu\u1ed5i s\u00e1ng th\u00ec \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u insulin bu\u1ed5i t\u1ed1i ng\u00e0y h\u00f4m \u0111\u00f3. C\u00f2n n\u1ebfu glucose m\u00e1u cao\/th\u1ea5p bu\u1ed5i chi\u1ec1u th\u00ec \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u insulin s\u00e1ng ng\u00e0y h\u00f4m sau.<\/p>\n

B\u1ea3ng 3. Ch\u1ec9nh li\u1ec1u v\u1edbi ng\u01b0\u1eddi b\u1ec7nh \u0111ang s\u1eed d\u1ee5ng 4 m\u0169i insulin\/ng\u00e0y (ph\u00e1c \u0111\u1ed3 Basal – Bolus): ch\u1ec9nh li\u1ec1u insulin nhanh (regular) theo c\u00e2n n\u1eb7ng v\u00e0 m\u1ee9c \u0111\u1ec1 kh\u00e1ng insulin (d\u1ef1a v\u00e0o t\u1ed5ng li\u1ec1u insulin\/ng\u00e0y)<\/em><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
Glucose m\u00e1u<\/strong><\/td>\nT\u1ed5ng li\u1ec1u < 50<\/strong>\u00a0\u0111\u01a1n v\u1ecb<\/strong>\u00a0N\u1eb7ng < 50 kg<\/strong><\/td>\nT\u1ed5ng li\u1ec1u: 50 –<\/strong>\u00a0100 \u0111\u01a1n v\u1ecb<\/strong>\u00a0N\u1eb7ng 50 – 100 kg<\/strong><\/td>\nT\u1ed5ng li\u1ec1u > 100<\/strong>\u00a0\u0111\u01a1n v\u1ecb<\/strong>\u00a0N\u1eb7ng > 100 kg<\/strong><\/td>\n<\/tr>\n
mmol\/L<\/td>\nmg\/dL<\/td>\n<\/tr>\n
12.0 – 14.9<\/td>\n216 – 270<\/td>\n2 \u0111\u01a1n v\u1ecb<\/td>\n3 \u0111\u01a1n v\u1ecb<\/td>\n4 \u0111\u01a1n v\u1ecb<\/td>\n<\/tr>\n
15.0 – 16.9<\/td>\n270 – 306<\/td>\n2 \u0111\u01a1n v\u1ecb<\/td>\n3 \u0111\u01a1n v\u1ecb<\/td>\n5 \u0111\u01a1n v\u1ecb<\/td>\n<\/tr>\n
17.0 – 18.9<\/td>\n306 – 342<\/td>\n3 \u0111\u01a1n v\u1ecb<\/td>\n4 \u0111\u01a1n v\u1ecb<\/td>\n5 \u0111\u01a1n v\u1ecb<\/td>\n<\/tr>\n
19.0 – 20.9<\/td>\n342 – 378<\/td>\n3 \u0111\u01a1n v\u1ecb<\/td>\n5 \u0111\u01a1n v\u1ecb<\/td>\n6 \u0111\u01a1n v\u1ecb<\/td>\n<\/tr>\n
21.0 – 22.9<\/td>\n378 – 414<\/td>\n4 \u0111\u01a1n v\u1ecb<\/td>\n6 \u0111\u01a1n v\u1ecb<\/td>\n7 \u0111\u01a1n v\u1ecb<\/td>\n<\/tr>\n
23.0 – 24.9<\/td>\n414 – 450<\/td>\n4 \u0111\u01a1n v\u1ecb<\/td>\n7 \u0111\u01a1n v\u1ecb<\/td>\n8 \u0111\u01a1n v\u1ecb<\/td>\n<\/tr>\n
25.0 – 27.0<\/td>\n450 – 486<\/td>\n5 \u0111\u01a1n v\u1ecb<\/td>\n8 \u0111\u01a1n v\u1ecb<\/td>\n9 \u0111\u01a1n v\u1ecb<\/td>\n<\/tr>\n
> 27.0<\/td>\n> 486<\/td>\n6 \u0111\u01a1n v\u1ecb<\/td>\n9 \u0111\u01a1n v\u1ecb<\/td>\n10 \u0111\u01a1n v\u1ecb<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Ch\u00fa \u00fd:\u00a0<\/strong>N\u1ebfu b\u1ecb h\u1ea1 glucose m\u00e1u < 4,0 mmol\/L: x\u1eed tr\u00ed cho u\u1ed1ng\/truy\u1ec1n glucose v\u00e0 gi\u1ea3m li\u1ec1u 3-4 \u0111\u01a1n v\u1ecb c\u1ee7a m\u0169i insulin g\u00e2y h\u1ea1 glucose m\u00e1u.<\/p>\n

2.3. Ph\u00e1c \u0111\u1ed3 truy\u1ec1n insulin nhanh t\u0129nh m\u1ea1ch khi glucose m\u00e1u qu\u00e1 cao<\/em><\/strong><\/h3>\n

B\u1ea3ng 4. Ph\u00e1c \u0111\u1ed3 truy\u1ec1n insulin nhanh t\u0129nh m\u1ea1ch khi ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 nhi\u1ec5m toan ceton<\/em><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
C\u1ed9t A<\/strong><\/td>\nC\u1ed9t B<\/strong><\/td>\nC\u1ed9t C<\/strong><\/td>\n<\/tr>\n
\u0110H<\/strong>\u00a0(mmol\/L)<\/strong><\/td>\nInsulin (U\/h)<\/strong><\/td>\n\u0110H<\/strong>\u00a0(mmol\/L)<\/strong><\/td>\nInsulin (U\/h)<\/strong><\/td>\n\u0110H<\/strong>\u00a0(mmol\/L)<\/strong><\/td>\nInsulin (U\/h)<\/strong><\/td>\n<\/tr>\n
\u0110H < 4,0 = h\u1ea1 \u0110H<\/strong><\/td>\n\u0110H < 4,0 = h\u1ea1 \u0110H<\/strong><\/td>\n\u0110H < 4,0 = h\u1ea1 \u0110H<\/strong><\/td>\n<\/tr>\n
4,0 – < 5,0<\/td>\nNg\u1eebng<\/td>\n4,0 – < 5,0<\/td>\nNg\u1eebng<\/td>\n4,0 – < 5,0<\/td>\nNg\u1eebng<\/td>\n<\/tr>\n
5,0 – 6,4<\/td>\n0,5<\/td>\n5,0 – 6,4<\/td>\n1,0<\/td>\n5,0 – 6,4<\/td>\n2,0<\/td>\n<\/tr>\n
6,5 – 9,9<\/td>\n1,0<\/td>\n6,5 – 9,9<\/td>\n2,0<\/td>\n6,5 – 9,9<\/td>\n4,0<\/td>\n<\/tr>\n
10,0 – 11,4<\/td>\n1,5<\/td>\n10,0 – 11,4<\/td>\n3,0<\/td>\n10,0 – 11,4<\/td>\n5,0<\/td>\n<\/tr>\n
11,5 – 12,9<\/td>\n2,0<\/td>\n11,5 – 12,9<\/td>\n4,0<\/td>\n11,5 – 12,9<\/td>\n6,0<\/td>\n<\/tr>\n
13,0 – 14,9<\/td>\n3,0<\/td>\n13,0 – 14,9<\/td>\n5,0<\/td>\n13,0 – 14,9<\/td>\n8,0<\/td>\n<\/tr>\n
15,0 – 16,4<\/td>\n3,0<\/td>\n15,0 – 16,4<\/td>\n6,0<\/td>\n15,0 – 16,4<\/td>\n10,0<\/td>\n<\/tr>\n
16,5 – 17,9<\/td>\n4,0<\/td>\n16,5 – 17,9<\/td>\n7,0<\/td>\n16,5 – 17,9<\/td>\n12,0<\/td>\n<\/tr>\n
18,0 – 20,0<\/td>\n5,0<\/td>\n18,0 – 20,0<\/td>\n8,0<\/td>\n18,0 – 20,0<\/td>\n14,0<\/td>\n<\/tr>\n
> 20,0<\/td>\n6,0<\/td>\n> 20,0<\/td>\n12,0<\/td>\n> 20,0<\/td>\n16,0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

L\u01b0u \u00fd:<\/strong><\/p>\n

– Lu\u00f4n b\u1eaft \u0111\u1ea7u t\u1eeb c\u1ed9t A.<\/p>\n

– Th\u1eed glucose m\u00e1u 2 gi\u1edd\/l\u1ea7n. M\u1ed7i l\u1ea7n th\u1eed glucose m\u00e1u c\u1ea7n \u0111\u00e1nh gi\u00e1 (1) glucose m\u00e1u c\u00f3 < 11 mmol\/L v\u00e0 (2) glucose m\u00e1u c\u00f3 gi\u1ea3m \u00edt nh\u1ea5t 3 mmol\/L so v\u1edbi tr\u01b0\u1edbc \u0111\u00f3 kh\u00f4ng.<\/p>\n

+ N\u1ebfu c\u00f3: gi\u1eef nguy\u00ean c\u1ed9t.<\/p>\n

+ N\u1ebfu kh\u00f4ng: Chuy\u1ec3n li\u1ec1u t\u1eeb c\u1ed9t A => c\u1ed9t B => c\u1ed9t C.<\/p>\n

– N\u1ebfu 2 l\u1ea7n th\u1eed glucose m\u00e1u li\u00ean ti\u1ebfp < 4 mmol\/L: chuy\u1ec3n li\u1ec1u t\u1eeb c\u1ed9t C \u2192 c\u1ed9t B \u2192 c\u1ed9t A.<\/p>\n

– N\u1ebfu 4 l\u1ea7n th\u1eed glucose m\u00e1u li\u00ean ti\u1ebfp v\u1eabn \u1edf c\u1ed9t C: H\u1ed9i ch\u1ea9n b\u00e1c s\u1ef9 chuy\u00ean khoa N\u1ed9i ti\u1ebft ngay.<\/p>\n

3. C\u00e1c bi\u1ec7n ph\u00e1p ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft kh\u00e1c<\/h2>\n

3.1. Duy tr\u00ec ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng<\/h3>\n

C\u00e1c b\u1ec7nh nh\u00e2n n\u00ean \u0103n ch\u1ebf \u0111\u1ed9 \u0103n \u0111a d\u1ea1ng v\u00e0 c\u00e2n b\u1eb1ng nh\u01b0 c\u00e1c khuy\u1ebfn c\u00e1o cho ng\u01b0\u1eddi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng n\u00f3i chung \u0111\u1ec3 gi\u1eef \u0111\u01b0\u1eddng huy\u1ebft \u1ed5n \u0111\u1ecbnh, v\u00e0 t\u0103ng c\u01b0\u1eddng h\u1ec7 mi\u1ec5n d\u1ecbch.<\/p>\n

Vi\u1ec7c duy tr\u00ec ch\u1ebf \u0111\u1ed9 \u0103n c\u00f3 th\u1ec3 g\u1eb7p kh\u00f3 kh\u0103n do kh\u00f4ng c\u00f3 \u0111\u1ee7 ngu\u1ed3n cung c\u1ea5p rau xanh, ho\u1eb7c \u0103n nhi\u1ec1u \u0111\u1ed3 r\u00e1n, b\u00e1nh ng\u1ecdt do gia \u0111\u00ecnh ngh\u1ec9 \u1edf nh\u00e0 n\u00ean th\u01b0\u1eddng n\u1ea5u nhi\u1ec1u m\u00f3n chi\u00ean r\u00e1n, l\u00e0m b\u00e1nh ng\u1ecdt\u2026<\/p>\n

3.2. Ch\u1ebf \u0111\u1ed9 v\u1eadn \u0111\u1ed9ng<\/h3>\n

Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c b\u00e0i t\u1eadp trong nh\u00e0 d\u00e0nh cho ng\u01b0\u1eddi m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng nh\u01b0:<\/p>\n

\u2013 \u0110i b\u1ed9 nhanh tr\u00ean th\u1ea3m, \u0111\u1ea1p xe trong nh\u00e0\u2026
\n\u2013 Th\u1ef1c hi\u1ec7n c\u00e1c b\u00e0i t\u1eadp n\u00e2ng to\u00e0n th\u00e2n \u0111\u1ec3 duy tr\u00ec s\u1ee9c m\u1ea1nh c\u01a1 nh\u01b0 ch\u1ed1ng \u0111\u1ea9y, \u0111\u1ee9ng l\u00ean \u2013 ng\u1ed3i xu\u1ed1ng, c\u00e1c b\u00e0i t\u1eadp t\u0103ng s\u1ee9c c\u01a1 b\u1ee5ng ho\u1eb7c c\u01a1 th\u1eaft l\u01b0ng.
\n\u2013 T\u1eadp nh\u1ea3y d\u00e2y, l\u00ean xu\u1ed1ng c\u1ea7u thang\u2026
\n\u2013 L\u00e0m vi\u1ec7c nh\u00e0, l\u00e0m v\u01b0\u1eddn\u2026 c\u0169ng r\u1ea5t h\u1eefu \u00edch.
\n\u2013 \u0110\u1ed3ng th\u1eddi, h\u1ea1n ch\u1ebf xem TV < 1 gi\u1edd\/ng\u00e0y<\/p>\n

N\u00ean t\u1eadp t\u0103ng d\u1ea7n, v\u00e0 c\u00e1c b\u00e0i t\u1eadp c\u00f3 th\u1ec3 chia ra nhi\u1ec1u \u0111\u1ee3t trong ng\u00e0y, m\u1ed7i \u0111\u1ee3t k\u00e9o d\u00e0i 15 \u2013 20 ph\u00fat. \u0110\u1ed3ng th\u1eddi ph\u1ea3i theo d\u00f5i s\u1ee9c kh\u1ecfe c\u1ea3 tr\u01b0\u1edbc, trong v\u00e0 sau khi t\u1eadp.<\/p>\n

Ngu\u1ed3n:<\/strong> H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb COVID 19 c\u1ee7a B\u1ed9 Y t\u1ebf 2022<\/p>\n","protected":false},"excerpt":{"rendered":"

Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n COVID-19 l\u00e0 r\u1ea5t quan tr\u1ecdng, b\u1edfi v\u00ec c\u00e1c b\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 \u0111\u01b0\u1eddng huy\u1ebft v\u00e0 s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n v\u00ec b\u1ec7nh COVID-19 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng m\u1ee9c \u0111\u01b0\u1eddng huy\u1ebft \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[],"yoast_head":"\nKi\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n COVID 19 - Vinmec<\/title>\n<meta name=\"description\" content=\"Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n COVID-19 l\u00e0 r\u1ea5t quan tr\u1ecdng, b\u1edfi v\u00ec c\u00e1c b\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 \u0111\u01b0\u1eddng huy\u1ebft v\u00e0 s\u1ee9c kh\u1ecfe\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n COVID 19 - 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