{"id":22054,"date":"2023-04-17T12:37:22","date_gmt":"2023-04-17T05:37:22","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22054"},"modified":"2023-04-17T16:51:55","modified_gmt":"2023-04-17T09:51:55","slug":"dinh-duong","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/","title":{"rendered":"Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID 19 – v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng ch\u00fa \u00fd"},"content":{"rendered":"

Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID-19 l\u00e0 v\u1ea5n \u0111\u1ec1 r\u1ea5t quan tr\u1ecdng, b\u1edfi v\u00ec b\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe v\u00e0 ch\u1ee9c n\u0103ng mi\u1ec5n d\u1ecbch c\u1ee7a b\u1ec7nh nh\u00e2n. Nhi\u1ec1u b\u1ec7nh nh\u00e2n COVID-19 c\u00f3 th\u1ec3 m\u1ea5t c\u1ea3m gi\u00e1c th\u00e8m \u0103n ho\u1eb7c kh\u00f4ng mu\u1ed1n \u0103n, g\u00e2y ra t\u00ecnh tr\u1ea1ng suy dinh d\u01b0\u1ee1ng v\u00e0 suy gi\u1ea3m mi\u1ec5n d\u1ecbch. Do \u0111\u00f3, vi\u1ec7c cung c\u1ea5p dinh d\u01b0\u1ee1ng \u0111\u1ea7y \u0111\u1ee7 v\u00e0 th\u00edch h\u1ee3p l\u00e0 r\u1ea5t quan tr\u1ecdng trong vi\u1ec7c qu\u1ea3n l\u00fd b\u1ec7nh nh\u00e2n COVID-19 \u0111\u1ec3 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 gia t\u0103ng h\u1ec7 mi\u1ec5n d\u1ecbch c\u0169ng nh\u01b0 h\u1ea1n ch\u1ebf c\u00e1c bi\u1ebfn ch\u1ee9ng do c\u00e1c v\u1ea5n \u0111\u1ec1 dinh d\u01b0\u1ee1ng g\u00e2y ra.<\/strong><\/p>\n

1. Dinh d\u01b0\u1ee1ng<\/strong><\/h2>\n

1.1. Nguy\u00ean t\u1eafc chung<\/strong><\/h3>\n

– Cung c\u1ea5p \u0111\u1ee7 n\u0103ng l\u01b0\u1ee3ng, c\u00e1c ch\u1ea5t dinh d\u01b0\u1ee1ng, n\u01b0\u1edbc \u0111\u1ec3 n\u00e2ng cao th\u1ec3 tr\u1ea1ng, mi\u1ec5n d\u1ecbch.<\/p>\n

– Dinh d\u01b0\u1ee1ng (DD) qua \u0111\u01b0\u1eddng mi\u1ec7ng cho ng\u01b0\u1eddi b\u1ec7nh c\u00f2n \u0103n u\u1ed1ng \u0111\u01b0\u1ee3c b\u1eb1ng th\u1ee9c \u0103n th\u00f4ng th\u01b0\u1eddng v\u00e0 b\u1ed5 sung t\u1ed1i thi\u1ec3u 1 b\u1eefa ph\u1ee5 b\u1eb1ng s\u1eefa\/s\u00fap dinh d\u01b0\u1ee1ng chu\u1ea9n\/ cao n\u0103ng l\u01b0\u1ee3ng, \u0111\u1ea1m cao.<\/p>\n

– Dinh d\u01b0\u1ee1ng qua sonde s\u1edbm (trong v\u00f2ng 48 ti\u1ebfng ngay sau khi ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c huy\u1ebft \u0111\u1ed9ng) \u1edf ng\u01b0\u1eddi b\u1ec7nh n\u1eb7ng \u0111\u1ec3 duy tr\u00ec ch\u1ee9c n\u0103ng ti\u00eau h\u00f3a v\u00e0 mi\u1ec5n d\u1ecbch c\u1ee7a ru\u1ed9t.<\/p>\n

– DD t\u0129nh m\u1ea1ch s\u1edbm khi DD ti\u00eau h\u00f3a c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh ho\u1eb7c khi kh\u00f4ng \u0111\u1ea1t \u0111\u1ee7 nhu c\u1ea7u n\u0103ng l\u01b0\u1ee3ng, \u0111\u1ea1m.<\/p>\n

– B\u1ed5 sung vitamin, vi l\u01b0\u1ee3ng v\u1edbi t\u1ed1i thi\u1ec3u li\u1ec1u c\u01a1 b\u1ea3n \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o chuy\u1ec3n h\u00f3a t\u1ebf b\u00e0o, mi\u1ec5n d\u1ecbch.<\/p>\n

1.2. Ch\u1ea9n \u0111o\u00e1n suy dinh d\u01b0\u1ee1ng (SDD) v\u00e0 r\u1ed1i lo\u1ea1n li\u00ean quan dinh d\u01b0\u1ee1ng<\/strong><\/h3>\n

–\u00a0<\/strong>BMI <18,5 (SDD n\u1eb7ng khi < 16,0), ho\u1eb7c<\/p>\n

– S\u1ee5t > 5% CN trong v\u00f2ng 6 th\u00e1ng tr\u01b0\u1edbc v\u00e0o vi\u1ec7n (N\u1eb7ng khi > 10%) ho\u1eb7c<\/p>\n

– C\u00f3 teo c\u01a1, m\u1ee1 (N\u1eb7ng khi suy m\u00f2n n\u1eb7ng)<\/p>\n

– Albumin < 3,5g\/dL v\u00e0\/ho\u1eb7c prealbumin\/m\u00e1u < 20mg\/dL (Ch\u1ec9 s\u1ed1 n\u00e0y th\u1ea5p c\u00f2n do vi\u00eam, nhi\u1ec5m khu\u1ea9n n\u1eb7ng, suy gan, th\u1eadn)<\/p>\n

– Kh\u00e1c: Ion \u0111\u1ed3\/m\u00e1u (Mg2+<\/sup>, phospho, \u0111\u1ec3 ng\u0103n ng\u1eeba H\u1ed9i ch\u1ee9ng Nu\u00f4i \u0103n l\u1ea1i).<\/p>\n

1.3. Nhu c\u1ea7u dinh d\u01b0\u1ee1ng<\/strong><\/h3>\n

B\u1ea3ng 1. Nhu c\u1ea7u dinh d\u01b0\u1ee1ng theo ph\u00e2n lo\u1ea1i t\u00ecnh tr\u1ea1ng b\u1ec7nh<\/em><\/p>\n\n\n\n\n\n\n\n\n\n\n
<\/td>\nB\u1ec7nh nh\u1eb9<\/strong><\/td>\nB\u1ec7nh trung b\u00ecnh<\/strong><\/td>\nB\u1ec7nh n\u1eb7ng\/ h\u1ed3i s\u1ee9c<\/strong><\/td>\n<\/tr>\n
N\u0103ng l\u01b0\u1ee3ng (Kcal\/kg\/ng\u00e0y)<\/strong><\/td>\n27-30<\/td>\nTrong 3 ng\u00e0y \u0111\u1ea7u: 20-25<\/p>\n

C\u00e1c ng\u00e0y sau: 25-30<\/td>\n

Trong 3 ng\u00e0y \u0111\u1ea7u: < 20<\/p>\n

C\u00e1c ng\u00e0y sau: 25-30<\/p>\n

Tr\u00e1nh cung c\u1ea5p th\u1eeba n\u0103ng l\u01b0\u1ee3ng trong giai \u0111o\u1ea1n c\u1ea5p (trong v\u00f2ng 7 ng\u00e0y \u0111\u1ea7u) (Xem l\u01b0u \u00fd<\/em>)<\/td>\n<\/tr>\n

Protid (g\/kg\/ng\u00e0y)<\/strong><\/td>\n1-1,2<\/td>\n1,2-1,5<\/td>\n3 ng\u00e0y \u0111\u1ea7u: < 1.2<\/p>\n

C\u00e1c ng\u00e0y v\u1ec1 sau: 1,3-2,0<\/p>\n

D\u1ecbch truy\u1ec1n TM: AA 7-10%.<\/td>\n<\/tr>\n

B\u1ec7nh th\u1eadn m\u1ea1n, \u0110T b\u1ea3o t\u1ed3n<\/td>\n0,8-1,0<\/td>\n1-1,3<\/td>\n<\/tr>\n
B\u1ec7nh th\u1eadn m\u1ea1n c\u00f3 l\u1ecdc m\u00e1u<\/td>\n1,2-1,4<\/td>\n1,3-1,5<\/td>\n<\/tr>\n
Lipid<\/strong><\/td>\n\u2264 30% t\u1ed5ng n\u0103ng l\u01b0\u1ee3ng<\/td>\n0,7-1,3g\/kg\/ng\u00e0y (T\u1ed1i \u0111a 1,5g\/kg\/ng\u00e0y)<\/p>\n

N\u00ean d\u00f9ng lipid TTM (10%\/ 20%) v\u1edbi acid b\u00e9o h\u1ed7n h\u1ee3p g\u1ed3m omega 6 (d\u1ea7u n\u00e0nh), omega 9 (oliu), ho\u1eb7c omega 3 (d\u1ea7u c\u00e1) \u00b1 MCT<\/td>\n<\/tr>\n

Vi ch\u1ea5t dinh d\u01b0\u1ee1ng<\/strong><\/td>\n\u0110a vitamin, vi l\u01b0\u1ee3ng li\u1ec1u c\u01a1 b\u1ea3n<\/td>\n\u0110a vitamin, vi l\u01b0\u1ee3ng li\u1ec1u c\u01a1 b\u1ea3n (cao h\u01a1n cho vitamin C, B, k\u1ebdm, s\u1eaft, selen trong l\u1ecdc m\u00e1u, CRRT)<\/td>\n<\/tr>\n
N\u01b0\u1edbc\/ d\u1ecbch<\/strong><\/td>\n20-40 ml\/kg\/ng\u00e0y+ N\u01b0\u1edbc m\u1ea5t b\u1ea5t th\u01b0\u1eddng (da, h\u01a1i th\u1edf…) ho\u1eb7c 2,0-2,5l \/ng\u00e0y<\/td>\nC\u00e2n b\u1eb1ng d\u1ecbch t\u00f9y t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed3i s\u1ee9c<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

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

– B\u00e9o ph\u00ec (BMI \u2265 30): < 25 kcal\/kg\/ng\u00e0y (CN l\u00fd t\u01b0\u1edfng\/ hi\u1ec7u ch\u1ec9nh) ho\u1eb7c 11-14kcal\/kg\/ng\u00e0y (CN hi\u1ec7n t\u1ea1i\/ ti\u1ec1n s\u1eed CN) (BMI l\u00fd t\u01b0\u1edfng # 22)<\/p>\n

– SDD n\u1eb7ng: 35-40 kcal\/kg\/ng\u00e0y (trong giai \u0111o\u1ea1n h\u1ed3i ph\u1ee5c)<\/p>\n

– C\u1ea7n t\u00ednh n\u0103ng l\u01b0\u1ee3ng kh\u00f4ng t\u1eeb dinh d\u01b0\u1ee1ng (n\u1ebfu c\u00f3), tr\u00e1nh th\u1eeba n\u0103ng l\u01b0\u1ee3ng trong giai \u0111o\u1ea1n c\u1ea5p:<\/p>\n

+ Propofol (1kcal # 1ml), nh\u01b0 truy\u1ec1n 20ml\/gi\u1edd trong 24 ti\u1ebfng cung c\u1ea5p # 500kcal.<\/p>\n

+ Kh\u00e1ng \u0111\u00f4ng trisodium citrate (3kcal\/g).<\/p>\n

\"\"
Ngu\u1ed3n<\/strong>: The Role of Nutrition in Mitigating the Effects of COVID-19 from Infection through PASC<\/em><\/figcaption><\/figure>\n

1.4. Ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng<\/strong><\/h3>\n

1.4.1. Ng\u01b0\u1eddi nhi\u1ec5m kh\u00f4ng tri\u1ec7u ch\u1ee9ng\/m\u1ee9c \u0111\u1ed9 nh\u1eb9\/trung b\u00ecnh<\/em><\/strong><\/p>\n

– \u0102n 3 b\u1eefa ch\u00ednh trong ng\u00e0y b\u1eb1ng th\u1ee9c \u0103n th\u00f4ng th\u01b0\u1eddng (nh\u01b0 c\u01a1m, ch\u00e1o, s\u00fap) ph\u00f9 h\u1ee3p.<\/p>\n

– C\u00f3 1-2 b\u1eefa ph\u1ee5 (200- 250ml\/ b\u1eefa ph\u1ee5) v\u1edbi s\u1eefa\/s\u00fap dinh d\u01b0\u1ee1ng (d\u1ea1ng l\u1ecfng, d\u00f9ng ngay, chai, h\u1ed9p) chu\u1ea9n (1ml=1kcal) ho\u1eb7c cao n\u0103ng l\u01b0\u1ee3ng (1ml=1,25-1,5kcal), l\u01b0\u1ee3ng \u0111\u1ea1m cao (t\u1ed1i thi\u1ec3u 4g protid\/100kcal) \u0111\u1ec3 t\u0103ng th\u00eam n\u0103ng l\u01b0\u1ee3ng, \u0111\u1ea1m, n\u00e2ng cao th\u1ec3 tr\u1ea1ng, mi\u1ec5n d\u1ecbch, ng\u1eeba h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft:<\/p>\n

+ Ng\u01b0\u1eddi b\u1ec7nh b\u1ecb suy dinh d\u01b0\u1ee1ng: 2 b\u1eefa ph\u1ee5\/ng\u00e0y<\/p>\n

+ Ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng suy dinh d\u01b0\u1ee1ng: 1 b\u1eefa ph\u1ee5\/ ng\u00e0y.<\/p>\n

– \u0110\u1ee7 n\u01b0\u1edbc (kho\u1ea3ng 2-2,5L\/ng\u00e0y), nhi\u1ec1u h\u01a1n n\u1ebfu c\u00f3 s\u1ed1t cao, th\u1edf nhanh, ti\u00eau ch\u1ea3y. C\u00f3 th\u1ec3 b\u00f9 d\u1ecbch b\u1eb1ng Oresol.<\/p>\n

1.4.2. M\u1ee9c \u0111\u1ed9 n\u1eb7ng\/nguy k\u1ecbch<\/em><\/strong><\/p>\n

– Dinh d\u01b0\u1ee1ng qua \u1ed1ng th\u00f4ng s\u1edbm (trong v\u00f2ng 48 ti\u1ebfng) sau khi huy\u1ebft \u0111\u1ed9ng \u1ed5n \u0111\u1ecbnh. Kh\u00f4ng n\u00ean d\u00f9ng syringe \u0111\u1ec3 b\u01a1m th\u1ee9c \u0103n v\u00ec l\u00e0m t\u0103ng nguy c\u01a1 h\u00edt s\u1eb7c, k\u00e9m dung n\u1ea1p th\u1ee9c \u0103n.<\/p>\n

– N\u00ean th\u1eadn tr\u1ecdng trong DD qua \u1ed1ng th\u00f4ng cho ng\u01b0\u1eddi b\u1ec7nh h\u1ed3i s\u1ee9c \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c huy\u1ebft \u0111\u1ed9ng v\u1edbi v\u1eadn m\u1ea1ch li\u1ec1u cao, ECMO, n\u1eb1m s\u1ea5p:<\/p>\n

+ Ng\u00e0y \u0111\u1ea7u: 50ml \u00d7 4-6 b\u1eefa\/ c\u1eef \u0103n b\u1eb1ng s\u1eefa\/s\u00fap DD chu\u1ea9n\/cao n\u0103ng l\u01b0\u1ee3ng, \u0111\u1ea1m cao (t\u1ed1i thi\u1ec3u 4,5g\/ 100kcal) (gi\u00e0u \u0111\u1ea1m peptide n\u1ebfu c\u00f3 suy ch\u1ee9c n\u0103ng ti\u00eau h\u00f3a), nh\u1ecf gi\u1ecdt 10g\/ph\u00fat ho\u1eb7c 10ml\/gi\u1edd trong 24 ti\u1ebfng.<\/p>\n

+ \u0110\u1ed3ng th\u1eddi b\u1ed5 sung DDTM v\u1edbi t\u1ed5ng glucose (ti\u00eau h\u00f3a v\u00e0 t\u0129nh m\u1ea1ch) # 2g\/kg\/ng\u00e0y; 0,8g acid amin\/kg\/ng\u00e0y (ti\u00eau h\u00f3a, TM).<\/p>\n

+ V\u00e0o c\u00e1c ng\u00e0y sau: T\u0103ng d\u1ea7n th\u1ec3 t\u00edch, t\u1ed1c \u0111\u1ed9 cho DD qua \u1ed1ng th\u00f4ng, n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh dung n\u1ea1p t\u1ed1t v\u00e0 \u0111i\u1ec1u ch\u1ec9nh DDTM ph\u00f9 h\u1ee3p theo t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd v\u00e0 nhu c\u1ea7u DD.<\/p>\n

– Trong DDTM to\u00e0n ph\u1ea7n\/ b\u1ed5 sung chi\u1ebfm ph\u1ea7n l\u1edbn: \u01afu ti\u00ean d\u00f9ng t\u00fai 3 ng\u0103n (ngo\u1ea1i vi, trung t\u00e2m). T\u00fai DDTM 3 ng\u0103n truy\u1ec1n trung t\u00e2m n\u00ean d\u00f9ng lo\u1ea1i 1000ml c\u00f3 1200kcal, 56 protid\/AA.<\/p>\n

2. Ph\u00f2ng ng\u1eeba bi\u1ebfn ch\u1ee9ng li\u00ean quan dinh d\u01b0\u1ee1ng<\/strong><\/h2>\n

2.1. Ph\u00f2ng ng\u1eeba h\u1ed9i ch\u1ee9ng nu\u00f4i \u0103n l\u1ea1i<\/em><\/strong><\/h3>\n

– Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u v\u00e0 trong qu\u00e1 tr\u00ecnh nu\u00f4i d\u01b0\u1ee1ng \u1edf ng\u01b0\u1eddi b\u1ec7nh COVID-19 b\u1ec7nh m\u1ee9c \u0111\u1ed9 trung b\u00ecnh\/ n\u1eb7ng, h\u1ed3i s\u1ee9c.<\/p>\n

B\u1ea3ng 2. H\u1ed9i ch\u1ee9ng nu\u00f4i \u0103n l\u1ea1i (Refeeding syndrome)<\/em><\/p>\n\n\n\n\n
Ti\u00eau chu\u1ea9n<\/strong><\/td>\n\u0110\u1ed1i t\u01b0\u1ee3ng c\u00f3 nguy c\u01a1 cao: C\u1ea7n 1 y\u1ebfu t\u1ed1<\/strong><\/td>\n<\/tr>\n
\u25cf Gi\u1ea3m b\u1ea5t k\u1ef3 1, 2 ho\u1eb7c 3 ch\u1ea5t (Phosphor, Kali, Magne\/m\u00e1u)<\/p>\n

\u25cf RF nh\u1eb9: gi\u1ea3m 10-20<\/p>\n

\u25cf RF trung b\u00ecnh\/ trung b\u00ecnh: gi\u1ea3m 20-30%<\/p>\n

\u25cf RF n\u1eb7ng: gi\u1ea3m > 30% v\u00e0 c\u00f3 suy t\u1ea1ng do gi\u1ea3m c\u00e1c ch\u1ea5t tr\u00ean v\u00e0\/ho\u1eb7c do thi\u1ebfu vitamin B1<\/sub><\/p>\n

\u25cf V\u00c0 xu\u1ea5t hi\u1ec7n trong v\u00f2ng 5 ng\u00e0y b\u1eaft \u0111\u1ea7u ho\u1eb7c t\u0103ng cung c\u1ea5p n\u0103ng l\u01b0\u1ee3ng \u0111\u00e1ng k\u1ec3<\/td>\n

\u25cf BMI < 16,0<\/p>\n

\u25cf S\u1ee5t c\u00e2n 7,5% CN\/3 th\u00e1ng ho\u1eb7c 10%\/ 6 th\u00e1ng<\/p>\n

\u25cf Kh\u00f4ng ho\u1eb7c b\u1ecf \u0103n trong 7 ng\u00e0y<\/p>\n

\u25cf Thi\u1ebfu trung b\u00ecnh\/ n\u1eb7ng ho\u1eb7c thi\u1ebfu nh\u1eb9\/ b\u00ecnh th\u01b0\u1eddng nh\u01b0ng g\u1ea7n \u0111\u00e2y th\u1ea5p c\u1ea7n b\u1ed5 sung \u0111\u00e1ng k\u1ec3 ho\u1eb7c b\u1ed5 sung nhi\u1ec1u li\u1ec1u<\/p>\n

\u25cf Teo c\u01a1 n\u1eb7ng<\/p>\n

\u25cf B\u1ec7nh m\u1ea1n t\u00ednh n\u1eb7ng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

2<\/em><\/strong>.2. Ph\u00f2ng ng\u1eeba\/\u0111i\u1ec1u tr\u1ecb H\u1ed9i ch\u1ee9ng nu\u00f4i \u0103n l\u1ea1i<\/em><\/strong><\/h3>\n

– H\u1ea1 phosphor, kali, magne\/m\u00e1u n\u1eb7ng: Tr\u00ec ho\u00e3n nu\u00f4i d\u01b0\u1ee1ng (ti\u00eau h\u00f3a v\u00e0 t\u0129nh m\u1ea1ch) ho\u1eb7c kh\u00f4ng t\u0103ng cung c\u1ea5p n\u0103ng l\u01b0\u1ee3ng cho \u0111\u1ebfn khi \u0111i\u1ec1u ch\u1ec9nh \u1ed5n c\u00e1c \u0111i\u1ec7n gi\u1ea3i n\u00e0y.<\/p>\n

– B\u1ed5 sung 100mg vitamin B1\u00a0<\/sub>(ti\u00eam b\u1eafp) ho\u1eb7c 300-400mg (u\u1ed1ng): Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u nu\u00f4i d\u01b0\u1ee1ng ho\u1eb7c truy\u1ec1n glucose t\u0129nh m\u1ea1ch v\u00e0 trong 5-7 ng\u00e0y ho\u1eb7c l\u00e2u h\u01a1n n\u1ebfu c\u1ea7n thi\u1ebft.<\/p>\n

– Trong 24 gi\u1edd \u0111\u1ea7u: B\u1eaft \u0111\u1ea7u nu\u00f4i d\u01b0\u1ee1ng 100-150g dextrose ho\u1eb7c 10-20kcal\/kg\/ng\u00e0y (dinh d\u01b0\u1ee1ng qua ti\u00eau h\u00f3a, glucose TTM) ho\u1eb7c 50-100ml\/b\u1eefa \u00d7 4-6 b\u1eefa\/ng\u00e0y. T\u0103ng 33% n\u0103ng l\u01b0\u1ee3ng trong m\u1ed7i 1-2 ng\u00e0y v\u00e0 \u0111\u1ea1t nhu c\u1ea7n n\u0103ng l\u01b0\u1ee3ng, \u0111\u1ea1m trong 3-5 ng\u00e0y \u0111\u1ea7u (b\u1ec7nh nh\u1eb9\/ trung b\u00ecnh) ho\u1eb7c 5-7 ng\u00e0y \u0111\u1ea7u (b\u1ec7nh n\u1eb7ng).<\/p>\n

– \u0110a vitamin truy\u1ec1n TM pha v\u00e0o dung d\u1ecbch DD truy\u1ec1n TM, tr\u1eeb khi c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh. Trong DD qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a \u0111\u1ea7y \u0111\u1ee7, b\u1ed5 sung \u0111a vi ch\u1ea5t DD, 1 l\u1ea7n trong ng\u00e0y, trong 10 ng\u00e0y ho\u1eb7c l\u00e2u h\u01a1n n\u1ebfu c\u1ea7n thi\u1ebft.<\/p>\n

– Theo d\u00f5i d\u1ea5u hi\u1ec7u sinh t\u1ed3n, ion \u0111\u1ed3, tim m\u1ea1ch, h\u00f4 h\u1ea5p, c\u00e2n n\u1eb7ng (xu\u1ea5t nh\u1eadp, dinh d\u01b0\u1ee1ng).<\/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<\/p>\n","protected":false},"excerpt":{"rendered":"

Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID-19 l\u00e0 v\u1ea5n \u0111\u1ec1 r\u1ea5t quan tr\u1ecdng, b\u1edfi v\u00ec b\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe v\u00e0 ch\u1ee9c n\u0103ng mi\u1ec5n d\u1ecbch c\u1ee7a b\u1ec7nh nh\u00e2n. Nhi\u1ec1u b\u1ec7nh nh\u00e2n COVID-19 c\u00f3 th\u1ec3 m\u1ea5t c\u1ea3m gi\u00e1c th\u00e8m \u0103n ho\u1eb7c kh\u00f4ng mu\u1ed1n \u0103n, g\u00e2y ra t\u00ecnh tr\u1ea1ng suy dinh d\u01b0\u1ee1ng v\u00e0 suy […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[26,33],"tags":[3],"yoast_head":"\nDinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID 19 - v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng ch\u00fa \u00fd - Vinmec<\/title>\n<meta name=\"description\" content=\"Nhi\u1ec1u b\u1ec7nh nh\u00e2n COVID-19 c\u00f3 th\u1ec3 m\u1ea5t c\u1ea3m gi\u00e1c th\u00e8m \u0103n ho\u1eb7c kh\u00f4ng mu\u1ed1n \u0103n, g\u00e2y ra t\u00ecnh tr\u1ea1ng suy dinh d\u01b0\u1ee1ng v\u00e0 suy gi\u1ea3m mi\u1ec5n d\u1ecbch\" \/>\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=\"Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID 19 - v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng ch\u00fa \u00fd - Vinmec\" \/>\n<meta property=\"og:description\" content=\"Nhi\u1ec1u b\u1ec7nh nh\u00e2n COVID-19 c\u00f3 th\u1ec3 m\u1ea5t c\u1ea3m gi\u00e1c th\u00e8m \u0103n ho\u1eb7c kh\u00f4ng mu\u1ed1n \u0103n, g\u00e2y ra t\u00ecnh tr\u1ea1ng suy dinh d\u01b0\u1ee1ng v\u00e0 suy gi\u1ea3m mi\u1ec5n d\u1ecbch\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-17T05:37:22+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-17T09:51:55+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/5.webp\" \/>\n<meta name=\"author\" content=\"tdan tdan\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"tdan tdan\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/\",\"name\":\"Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID 19 - v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng ch\u00fa \u00fd - Vinmec\",\"isPartOf\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-17T05:37:22+00:00\",\"dateModified\":\"2023-04-17T09:51:55+00:00\",\"author\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/1fa8ba11a98f51cac7431f30b0e3fb3d\"},\"description\":\"Nhi\u1ec1u b\u1ec7nh nh\u00e2n COVID-19 c\u00f3 th\u1ec3 m\u1ea5t c\u1ea3m gi\u00e1c th\u00e8m \u0103n ho\u1eb7c kh\u00f4ng mu\u1ed1n \u0103n, g\u00e2y ra t\u00ecnh tr\u1ea1ng suy dinh d\u01b0\u1ee1ng v\u00e0 suy gi\u1ea3m mi\u1ec5n d\u1ecbch\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID 19 – v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng ch\u00fa \u00fd\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"https:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/1fa8ba11a98f51cac7431f30b0e3fb3d\",\"name\":\"tdan tdan\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/0.gravatar.com\/avatar\/307f4fd31b9736b391c626de946b25e4?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/0.gravatar.com\/avatar\/307f4fd31b9736b391c626de946b25e4?s=96&d=mm&r=g\",\"caption\":\"tdan tdan\"},\"sameAs\":[\"http:\/\/tdan\"],\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/tdan99102gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID 19 - v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng ch\u00fa \u00fd - Vinmec","description":"Nhi\u1ec1u b\u1ec7nh nh\u00e2n COVID-19 c\u00f3 th\u1ec3 m\u1ea5t c\u1ea3m gi\u00e1c th\u00e8m \u0103n ho\u1eb7c kh\u00f4ng mu\u1ed1n \u0103n, g\u00e2y ra t\u00ecnh tr\u1ea1ng suy dinh d\u01b0\u1ee1ng v\u00e0 suy gi\u1ea3m mi\u1ec5n d\u1ecbch","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID 19 - v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng ch\u00fa \u00fd - Vinmec","og_description":"Nhi\u1ec1u b\u1ec7nh nh\u00e2n COVID-19 c\u00f3 th\u1ec3 m\u1ea5t c\u1ea3m gi\u00e1c th\u00e8m \u0103n ho\u1eb7c kh\u00f4ng mu\u1ed1n \u0103n, g\u00e2y ra t\u00ecnh tr\u1ea1ng suy dinh d\u01b0\u1ee1ng v\u00e0 suy gi\u1ea3m mi\u1ec5n d\u1ecbch","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/","og_site_name":"Vinmec","article_published_time":"2023-04-17T05:37:22+00:00","article_modified_time":"2023-04-17T09:51:55+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/5.webp"}],"author":"tdan tdan","twitter_card":"summary_large_image","twitter_misc":{"Written by":"tdan tdan","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/","name":"Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID 19 - v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng ch\u00fa \u00fd - Vinmec","isPartOf":{"@id":"https:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-17T05:37:22+00:00","dateModified":"2023-04-17T09:51:55+00:00","author":{"@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/1fa8ba11a98f51cac7431f30b0e3fb3d"},"description":"Nhi\u1ec1u b\u1ec7nh nh\u00e2n COVID-19 c\u00f3 th\u1ec3 m\u1ea5t c\u1ea3m gi\u00e1c th\u00e8m \u0103n ho\u1eb7c kh\u00f4ng mu\u1ed1n \u0103n, g\u00e2y ra t\u00ecnh tr\u1ea1ng suy dinh d\u01b0\u1ee1ng v\u00e0 suy gi\u1ea3m mi\u1ec5n d\u1ecbch","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/17\/dinh-duong\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Dinh d\u01b0\u1ee1ng \u1edf b\u1ec7nh nh\u00e2n COVID 19 – v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng ch\u00fa \u00fd"}]},{"@type":"WebSite","@id":"https:\/\/noithathoaphat.in\/ctv\/#website","url":"https:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/1fa8ba11a98f51cac7431f30b0e3fb3d","name":"tdan tdan","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/0.gravatar.com\/avatar\/307f4fd31b9736b391c626de946b25e4?s=96&d=mm&r=g","contentUrl":"http:\/\/0.gravatar.com\/avatar\/307f4fd31b9736b391c626de946b25e4?s=96&d=mm&r=g","caption":"tdan tdan"},"sameAs":["http:\/\/tdan"],"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/tdan99102gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/22054"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=22054"}],"version-history":[{"count":4,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/22054\/revisions"}],"predecessor-version":[{"id":23028,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/22054\/revisions\/23028"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=22054"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=22054"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=22054"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}