{"id":22090,"date":"2023-04-18T18:14:07","date_gmt":"2023-04-18T11:14:07","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22090"},"modified":"2023-04-19T11:37:28","modified_gmt":"2023-04-19T04:37:28","slug":"huong-dan-dieu-tri-nguoi-benh-dai-thao-duong-mac-covid-19","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/18\/huong-dan-dieu-tri-nguoi-benh-dai-thao-duong-mac-covid-19\/","title":{"rendered":"H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1eafc COVID-19"},"content":{"rendered":"

H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1eafc COVID-19<\/a> l\u00e0 r\u1ea5t quan tr\u1ecdng v\u00ec ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 nguy c\u01a1 cao h\u01a1n m\u1eafc COVID-19 v\u00e0 ph\u00e1t tri\u1ec3n c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng h\u01a1n. Ngo\u00e0i ra, COVID-19 c\u0169ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u1ea3n l\u00fd \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u1ee7a b\u1ec7nh nh\u00e2n, do \u0111\u00f3 \u0111i\u1ec1u tr\u1ecb COVID-19 c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c t\u00ednh \u0111\u1ebfn c\u00e1c y\u1ebfu t\u1ed1 c\u1ee5 th\u1ec3 c\u1ee7a b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n

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\u0110i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1eafc COVID-19<\/a> l\u00e0 r\u1ea5t quan tr\u1ecdng<\/figcaption><\/figure>\n

1. M\u1ed9t s\u1ed1 \u0111i\u1ec3m c\u1ea7n l\u01b0u \u00fd v\u1ec1 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 Covid-19.<\/h2>\n

1.1. C\u01a1 ch\u1ebf khi\u1ebfn b\u1ec7nh <\/span>\u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng d\u1ec5 b\u1ecb bi\u1ebfn ch\u1ee9ng n\u1eb7ng v\u00e0 t\u1eed <\/span>vong khi\u00a0nhi\u1ec5m\u00a0<\/span>COVID-19<\/h3>\n

–\u00a0T\u00ecnh tr\u1ea1ng t\u0103ng n\u1ed3ng \u0111\u1ed9\u00a0<\/span>IL-6, TNF-a\u00a0v\u00e0 c\u00e1c\u00a0<\/span>cytokines\u00a0vi\u00eam kh\u00e1c\u00a0<\/span>trong\u00a0huy\u1ebft\u00a0<\/span>thanh ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 c\u00e1c th\u1eed nghi\u1ec7m tr\u00ean \u0111\u1ed9ng v\u1eadt <\/span>cho\u00a0th\u1ea5y \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng th\u00fac \u0111\u1ea9y t\u0103ng s\u1ea3n xu\u1ea5t <\/span>IL-6\u00a0d\u01b0\u1edbi t\u00e1c \u0111\u1ed9ng c\u1ee7a\u00a0<\/span>TLR4\u00a0l\u00e0\u00a0<\/span>1 trong\u00a0c\u00e1c c\u01a1 ch\u1ebf l\u00e0m n\u1eb7ng th\u00eam m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh\u00a0<\/span>COVID-19.<\/p>\n

–\u00a0C\u00e1c nghi\u00ean c\u1ee9u\u00a0<\/span>cho\u00a0th\u1ea5y\u00a0<\/span>coronavirus, bao\u00a0g\u1ed3m\u00a0<\/span>SARS,\u00a0nhi\u1ec1u kh\u1ea3 n\u0103ng \u0111\u00e3 ho\u1ea1t h\u00f3a\u00a0<\/span>TLR3\u00a0v\u00e0\u00a0<\/span>TLR4,\u00a0d\u1eabn \u0111\u1ebfn l\u00e0m gi\u1ea3m \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch, ti\u1ebfp \u0111\u00f3 l\u00e0m t\u0103ng d\u1eef d\u1ed9i c\u00e1c\u00a0<\/span>cytokin\u00a0m\u00e0 ch\u1ee7 y\u1ebfu l\u00e0\u00a0<\/span>IL-6\u00a0c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t\u00a0<\/span>trong\u00a0nh\u1eefng nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed\u00a0<\/span>vong do\u00a0vi\u00eam ph\u1ed5i\u00a0<\/span>do coronavirus.<\/p>\n

– \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft t\u00e1c \u0111\u1ed9ng x\u1ea5u l\u00ean di\u1ec5n ti\u1ebfn c\u1ee7a <\/span>COVID-19.\u00a0Ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft kh\u00f4ng t\u1ed1t (t\u0103ng ho\u1eb7c h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft) l\u00e0m t\u0103ng <\/span>nguy\u00a0c\u01a1 t\u1eed\u00a0<\/span>vong,\u00a0di\u1ec5n ti\u1ebfn b\u1ec7nh m\u1eafc k\u00e8m n\u1eb7ng l\u00ean,\u00a0<\/span>k\u00e9o\u00a0d\u00e0i th\u1eddi\u00a0<\/span>gian\u00a0n\u1eb1m vi\u1ec7n\u00a0<\/span>khi\u00a0m\u1eafc c\u00e1c b\u1ec7nh kh\u00e1c, t\u0103ng\u00a0<\/span>chi\u00a0ph\u00ed v\u00e0\u00a0<\/span>COVID-19\u00a0kh\u00f4ng l\u00e0 ngo\u1ea1i l\u1ec7.\u00a0<\/span>Do\u00a0v\u1eady, m\u1ee5c \u0111\u00edch ch\u00ednh c\u1ee7a ki\u1ec3m so\u00e1t t\u1ed1t \u0111\u01b0\u1eddng huy\u1ebft l\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c <\/span>nguy\u00a0c\u01a1 n\u00e0y.<\/span><\/p>\n

1.2. C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y <\/span>dao\u00a0\u0111\u1ed9ng \u0111\u01b0\u1eddng huy\u1ebft \u1edf ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng nhi\u1ec5m <\/span>COVID-19.<\/h3>\n

–\u00a0Ch\u1ebf \u0111\u1ed9 \u0103n v\u00e0 gi\u1edd \u0103n\u00a0<\/span>thay\u00a0\u0111\u1ed5i<\/span><\/p>\n

–\u00a0Thi\u1ebfu ho\u1eb7c\u00a0<\/span>thay\u00a0\u0111\u1ed5i c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng <\/span>do\u00a0b\u1ecb c\u00e1ch\u00a0<\/span>ly<\/p>\n

–\u00a0Kh\u00f4ng ho\u1eb7c gi\u1ea3m v\u1eadn \u0111\u1ed9ng\u00a0<\/span>do\u00a0ph\u1ea3i \u1edf nh\u00e0 v\u00ec c\u00e1ch\u00a0<\/span>ly\u00a0x\u00e3 h\u1ed9i<\/span><\/p>\n

–\u00a0Nhi\u1ec5m khu\u1ea9n l\u00e0m t\u0103ng ti\u1ebft\u00a0<\/span>glucocorticoid<\/p>\n

– Lo\u00a0\u00e2u, s\u1ee3 h\u00e3i, c\u0103ng th\u1eb3ng l\u00e0m t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft<\/span><\/p>\n

–\u00a0\u0110i\u1ec1u tr\u1ecb\u00a0<\/span>glucocorticoid cho\u00a0m\u1ed9t s\u1ed1\u00a0<\/span>ng\u01b0\u1eddi b\u1ec7nh l\u00e0m t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft<\/span><\/p>\n

– COVID-19\u00a0l\u00e0m c\u01a1 th\u1ec3 t\u0103ng s\u1ea3n xu\u1ea5t c\u00e1c\u00a0<\/span>cytokine\u00a0vi\u00eam, g\u00e2y\u00a0<\/span>stress\u00a0n\u1eb7ng \u1edf c\u00e1c\u00a0<\/span>NB\u00a0n\u1eb7ng v\u00e0\u00a0<\/span>nguy\u00a0k\u1ecbch<\/span><\/p>\n

1.3. \u1ea2nh h\u01b0\u1edfng c\u1ee7a c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb <\/span>COVID-19\u00a0l\u00ean \u0111\u01b0\u1eddng huy\u1ebft.<\/span><\/h3>\n

–\u00a0C\u00e1c thu\u1ed1c h\u1ea1 s\u1ed1t, gi\u1ea3m \u0111au:<\/span><\/p>\n

+ Aspirin\u00a0li\u1ec1u\u00a0<\/span>cao\u00a0l\u00e0m gi\u1ea3m \u0111\u01b0\u1eddng huy\u1ebft<\/span><\/p>\n

+ Acetaminophen\u00a0c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 \u0111\u01b0\u1eddng huy\u1ebft <\/span>mao\u00a0m\u1ea1ch (g\u00e2y\u00a0<\/span>sai\u00a0l\u1ea1c k\u1ebft qu\u1ea3 ho\u1eb7c kh\u00f4ng nh\u1eadn \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3), v\u00e0 c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c\u00a0<\/span>cho gan,\u00a0th\u1eadn<\/span><\/p>\n

+ Ibuprofen\u00a0c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft c\u1ee7a <\/span>Insulin.<\/p>\n

–\u00a0C\u00e1c thu\u1ed1c ch\u1ed1ng\u00a0<\/span>xung\u00a0huy\u1ebft, ng\u1ea1t m\u0169i\u00a0<\/span>(decongestant)\u00a0c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft<\/span><\/p>\n

– Glucocorticoid:\u00a0l\u00e0m t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft<\/span><\/p>\n

– Cho\u00a0\u0111\u1ebfn th\u1eddi \u0111i\u1ec3m hi\u1ec7n t\u1ea1i c\u00e1c Hi\u1ec7p h\u1ed9i \u0111\u1ec1u khuy\u1ebfn c\u00e1o v\u1eabn ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb nh\u00f3m thu\u1ed1c \u1ee9c ch\u1ebf\u00a0<\/span>men\u00a0chuy\u1ec3n\/\u1ee9c ch\u1ebf th\u1ee5 th\u1ec3\u00a0<\/span>AT1 cho\u00a0c\u00e1c ng\u01b0\u1eddi b\u1ec7nh<\/span> \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng\u00a0m\u1eafc ho\u1eb7c <\/span>nghi\u00a0m\u1eafc\u00a0<\/span>COVID-19.<\/p>\n

2. \u0110i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh \u0110T\u0110 m\u1eafc COVID-19 n\u1eb1m vi\u1ec7n<\/h2>\n

2.1. \u0110\u1eb7c \u0111i\u1ec3m ng\u01b0\u1eddi b\u1ec7nh<\/span><\/h3>\n

– Trong\u00a0d\u1ecbch\u00a0<\/span>COVID-19,\u00a0c\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111i c\u1ea5p c\u1ee9u <\/span>do\u00a0nhi\u1ec5m\u00a0<\/span>toan ceton,\u00a0t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft c\u1ea5p t\u00ednh v\u00ec v\u1eady c\u00e1c b\u1ec7nh vi\u1ec7n\/khoa ph\u1ea3i c\u00f3 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft c\u1ea5p c\u1ee9u <\/span>theo\u00a0h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9\u00a0<\/span>Y\u00a0t\u1ebf, ho\u1eb7c c\u00e1c Hi\u1ec7p h\u1ed9i chuy\u00ean ng\u00e0nh.<\/span><\/p>\n

–\u00a0T\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng l\u00e0m vi\u1ec7c nh\u00f3m gi\u1eefa c\u00e1c chuy\u00ean khoa \u0111\u1ec3 ph\u1ed1i h\u1ee3p \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t ng\u01b0\u1eddi b\u1ec7nh\u00a0\u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng nhi\u1ec5m COVID-19 <\/span>do ng\u01b0\u1eddi b\u1ec7nh<\/span> COVID c\u00f3 th\u1ec3 n\u1eb1m \u0111i\u1ec1u tr\u1ecb t\u1ea1i khoa ph\u00f2ng kh\u00f4ng c\u00f3 b\u00e1c s\u1ef9 chuy\u00ean khoa n\u1ed9i ti\u1ebft. T\u0103ng c\u01b0\u1eddng h\u1ed9i ch\u1ea9n v\u00e0 tham kh\u1ea3o c\u00e1c ph\u00e1c \u0111\u1ed3 ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft c\u1ee7a B\u1ed9 Y t\u1ebf.<\/span><\/p>\n

–\u00a0T\u0103ng \u0111\u01b0\u1eddng huy\u1ebft ph\u1ea3n \u1ee9ng l\u00e0 t\u00ecnh tr\u1ea1ng ph\u00e1t hi\u1ec7n t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft l\u1ea7n \u0111\u1ea7u \u1edf b\u1ec7nh nh\u00e2n m\u1eafc COVID-19: ng\u01b0\u1eddi b\u1ec7nh c\u00f3 \u0110H > 7,8 mmol\/L (kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng) c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i \u0111\u01b0\u1eddng huy\u1ebft trong 24 – 48 gi\u1edd, n\u1ebfu \u0111\u01b0\u1eddng huy\u1ebft > 7,8 mmol\/L l\u1eb7p l\u1ea1i, c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ti\u1ebfp t\u1ee5c v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ebfu \u0111\u01b0\u1eddng huy\u1ebft kh\u00f4ng \u0111\u1ea1t m\u1ee5c ti\u00eau \u0111\u1ec1 ra.<\/span><\/p>\n

2.2. M\u1ee5c ti\u00eau \u0111\u01b0\u1eddng huy\u1ebft<\/span><\/h3>\n

\u00c1p d\u1ee5ng m\u1ee5c ti\u00eau \u0111\u01b0\u1eddng huy\u1ebft cho ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng n\u1ed9i tr\u00fa (theo AACE\/ADA n\u0103m 2009):<\/span><\/p>\n

–\u00a0M\u1ee5c ti\u00eau \u0111\u01b0\u1eddng huy\u1ebft tr\u01b0\u1edbc \u0103n < 7,8 mmol\/L<\/span><\/p>\n

–\u00a0M\u1ee5c ti\u00eau \u0111\u01b0\u1eddng huy\u1ebft b\u1ea5t k\u1ef3 < 10 mmol\/L<\/span><\/p>\n

–\u00a0Tr\u00e1nh h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, ph\u1ea3i \u0111\u00e1nh gi\u00e1 l\u1ea1i ph\u00e1c \u0111\u1ed3 insulin khi \u0111\u01b0\u1eddng huy\u1ebft xu\u1ed1ng < 5,6 mmol\/L<\/span><\/p>\n

–\u00a0\u0110\u00f4i khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 duy tr\u00ec n\u1ed3ng \u0111\u1ed9 \u0111\u01b0\u1eddng huy\u1ebft \u1edf tr\u00ean ho\u1eb7c d\u01b0\u1edbi ng\u01b0\u1ee1ng n\u00eau tr\u00ean. V\u00ed d\u1ee5 c\u00f3 th\u1ec3 \u0111\u1ec3 \u0111\u01b0\u1eddng huy\u1ebft cao h\u01a1n \u1edf ng\u01b0\u1eddi b\u1ec7nh cao tu\u1ed5i, c\u00f3 nhi\u1ec1u b\u1ec7nh n\u1ec1n, ng\u01b0\u1eddi b\u1ec7nh nguy k\u1ecbch.<\/span><\/p>\n

2.3. S\u1eed d\u1ee5ng thu\u1ed1c\/ph\u00e1c \u0111\u1ed3<\/span><\/h3>\n

–\u00a0N\u1ebfu t\u00ecnh tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh \u1ed5n \u0111\u1ecbnh, nh\u1eb9 v\u00e0 c\u00f3 th\u1ec3 \u0103n \u0111\u01b0\u1ee3c: c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c d\u00f9ng thu\u1ed1c u\u1ed1ng nh\u01b0 tr\u01b0\u1edbc khi nh\u1eadp vi\u1ec7n (c\u00f3 th\u1ec3 l\u00e0 thu\u1ed1c u\u1ed1ng, insulin ho\u1eb7c k\u1ebft h\u1ee3p) n\u1ebfu m\u1ee9c HbA1c \u1edf m\u1ee9c ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c (<8,0%). N\u1ebfu HbA1c tr\u00ean m\u1ee9c n\u00e0y, c\u1ea7n t\u0103ng c\u01b0\u1eddng thu\u1ed1c h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft so v\u1edbi thu\u1ed1c \u0111ang d\u00f9ng \u1edf nh\u00e0.<\/span><\/p>\n

–\u00a0Ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng nguy k\u1ecbch: \u0111i\u1ec1u tr\u1ecb insulin ti\u00eam d\u01b0\u1edbi da, t\u00ednh li\u1ec1u d\u1ef1a tr\u00ean li\u1ec1u ng\u01b0\u1eddi b\u1ec7nh \u0111ang \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa.<\/span><\/p>\n

– Ng\u01b0\u1eddi b\u1ec7nh<\/span>\u00a0nguy k\u1ecbch: Truy\u1ec1n insulin t\u0129nh m\u1ea1ch li\u00ean t\u1ee5c theo ph\u00e1c \u0111\u1ed3<\/span><\/p>\n

– Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng trong b\u1ec7nh vi\u1ec7n:<\/span><\/p>\n\n\n\n\n\n\n\n
Metformin<\/td>\nKh\u00f4ng d\u00f9ng cho NB n\u1eb7ng v\u00e0 nguy k\u1ecbch; c\u00f3 tri\u1ec7u ch\u1ee9ng r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a, thi\u1ebfu \u00f4 xy.<\/span><\/td>\n<\/tr>\n
Sulfonylureas\u00a0(SU)<\/span><\/td>\nNB nh\u1eb9\/trung b\u00ecnh c\u00f3 d\u00f9ng\u00a0<\/span>glucocorticoid:\u00a0giai \u0111o\u1ea1n s\u1edbm d\u00f9ng lo\u1ea1i t\u00e1c d\u1ee5ng ng\u1eafn; giai \u0111o\u1ea1n sau ch\u1ecdn lo\u1ea1i t\u00e1c \u0111\u1ed9ng trung b\u00ecnh v\u00e0 k\u00e9o d\u00e0i n\u1ebfu \u0110H \u0111\u00f3i v\u00e0 sau \u0103n t\u0103ng.<\/span><\/td>\n<\/tr>\n
\u1ee8c ch\u1ebf \u03b1-glucosidase<\/span><\/td>\nC\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u0111\u1ec3 ki\u1ec3m so\u00e1t \u0110H sau \u0103n. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh cho NB n\u1eb7ng, c\u00f3 tri\u1ec7u ch\u1ee9ng ti\u00eau h\u00f3a.<\/span><\/td>\n<\/tr>\n
\u1ee8c ch\u1ebf DPP-4<\/span><\/td>\nKh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng cho NB n\u1eb7ng, nguy k\u1ecbch<\/span><\/td>\n<\/tr>\n
\u1ee8c ch\u1ebf SGLT-2<\/span><\/td>\nKh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

–\u00a0C\u00e1 th\u1ec3 h\u00f3a ph\u00e1c \u0111\u1ed3\u00a0<\/span>insulin cho\u00a0t\u1eebng ng\u01b0\u1eddi b\u1ec7nh.<\/span><\/p>\n

–\u00a0\u0110\u1ed1i v\u1edbi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type <\/span>1:\u00a0Ph\u00e1c \u0111\u1ed3 t\u1ed1i \u01b0u l\u00e0 b\u01a1m ti\u00eam\u00a0<\/span>insulin\u00a0ho\u1eb7c\u00a0<\/span>insulin\u00a0n\u1ec1n-nhanh. \u01afu ti\u00ean ch\u1ecdn\u00a0<\/span>insulin analogues.<\/p>\n

– \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng\u00a0li\u00ean\u00a0<\/span>quan\u00a0\u0111\u1ebfn\u00a0<\/span>glucocorticoid:<\/p>\n

+\u00a0T\u0103ng \u0110H\u00a0<\/span>do glucocorticoid\u00a0th\u01b0\u1eddng x\u1ea3y\u00a0<\/span>ra sau\u00a0b\u1eefa tr\u01b0a v\u00e0 tr\u01b0\u1edbc b\u1eefa \u0103n t\u1ed1i. V\u00ec v\u1eady, ch\u1ecdn l\u1ef1a\u00a0<\/span>insulin\u00a0l\u00e0 \u01b0u ti\u00ean h\u00e0ng \u0111\u1ea7u v\u00e0 ph\u1ea3i ki\u1ec3m\u00a0<\/span>tra \u0111\u01b0\u1eddng huy\u1ebft<\/span>\u00a0<\/span>sau\u00a0b\u1eefa tr\u01b0a v\u00e0 tr\u01b0\u1edbc \u0103n t\u1ed1i.<\/span><\/p>\n

+ Khi\u00a0gi\u1ea3m li\u1ec1u\u00a0<\/span>glucocorticoid,\u00a0n\u00ean ch\u00fa \u00fd\u00a0<\/span>dao\u00a0\u0111\u1ed9ng \u0111\u01b0\u1eddng huy\u1ebft v\u00e0 ch\u1ec9nh li\u1ec1u <\/span>insulin\u00a0t\u01b0\u01a1ng \u1ee9ng.<\/span><\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1eafc COVID-19 l\u00e0 r\u1ea5t quan tr\u1ecdng v\u00ec ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 nguy c\u01a1 cao h\u01a1n m\u1eafc COVID-19 v\u00e0 ph\u00e1t tri\u1ec3n c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng h\u01a1n. Ngo\u00e0i ra, COVID-19 c\u0169ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u1ea3n l\u00fd \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u1ee7a b\u1ec7nh nh\u00e2n, do […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[3],"yoast_head":"\nH\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1eafc COVID-19<\/title>\n<meta name=\"description\" content=\"H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng m\u1eafc COVID-19 l\u00e0 r\u1ea5t quan tr\u1ecdng v\u00ec ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 nguy c\u01a1 cao h\u01a1n m\u1eafc COVID-19 ...\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, 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