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Ch???a tr??? c??c tri???u ch???ng m???t m???i, ??au nh???c, kh?? ng??? h???u COVID-19 th??? n??o?

COVID-19 ???nh h?????ng ?????n to??n b??? c?? th???, n??n c?? th??? d???n ?????n nhi???u tri???u ch???ng:- Virus SARS-CoV-2 t???n c??ng v??o nhi???u lo???i t??? b??o trong c?? th???, nh???t l?? c??c t??? b??o m??ng trong c???a m???ch m??u (Endothelial cell) v?? c??c c?? quan h?? h???p.
t???i xu???ng

t???i xu???ng

1. V?? sao c??c tri???u ch???ng h???u COVID-19 l???i k??o d??i?

Ph???c h???i COVID-19 v???n ????? l???i c??c tri???u ch???ng k??o d??i cho b???nh nh??n nh??: Kh?? th???, ho, tim ?????p nhanh, ??au nh???c kh???p, m???t m???i, y???u s???c, m???t m??i, kh?? ng???, mau qu??n...

Tri???u ch???ng h???u COVID-19 n???ng hay nh??? c??ng t??y v??o m???c COVID-19 n???ng hay nh??? (v??o b???nh vi???n hay khoa ICU), th???i gian nhi???m b???nh d??i hay ng???n.

COVID-19 ???nh h?????ng ?????n to??n b??? c?? th???, n??n c?? th??? d???n ?????n nhi???u tri???u ch???ng:

- Virus SARS-CoV-2 t???n c??ng v??o nhi???u lo???i t??? b??o trong c?? th???, nh???t l?? c??c t??? b??o m??ng trong c???a m???ch m??u (Endothelial cell) v?? c??c c?? quan h?? h???p, k??ch ho???t h??? mi???n d???ch, g??y ra c??c t???n th????ng do h??? mi???n d???ch g??y ra. Do m???ch m??u c?? ??? t???t c??? m???i n??i trong c?? th???, n??n b???nh COVID-19 c?? th??? g??y t???n th????ng ??? t???t c??? c??c c?? quan.

- Khi t???n th????ng m???ch m??u v?? vi??m s??ng t??? b??o ph???i th?? b???nh nh??n b??? vi??m ph???i. Khi t???n th????ng m???ch m??u kh???p g???i th?? b???nh nh??n b??? ??au kh???p. Khi t???n th????ng c??c m???ch m??u li ti v??ng n??o, b???nh nh??n c?? th??? m???t tr?? nh??? hay ch???m suy ngh??. Th???m ch??, b???nh nh??n c??ng c?? th??? b??? r???i lo???n c????ng d????ng (ED) khi m???ch m??u v??ng sinh d???c b??? t???n th????ng.

- Khi c??c t???n th????ng li??n quan ?????n m???ch m??u xu???t hi???n th?? qu?? tr??nh h???i ph???c m???t nhi???u th???i gian, th???m ch?? kh??ng th??? l??nh khi ch??a m???c COVID-19. V?? d??? nh?? vi??m ph???i l??u d??i c?? th??? d???n ?????n x?? h??a ph???i trong khi vi??m x????ng kh???p ??au nh???c l??u d??i do COVID-19 d???n ?????n vi??m tho??i h??a nhanh h??n. B???nh nh??n sau khi ph???c h???i COVID-19 v???n c??n c?? th??? b??? x?? ph???i m???n t??nh.

C??c tr??? li???u COVID-19 n???ng khi nh???p vi???n c??ng c?? th??? d???n ?????n b???nh h???u COVID-19:

- Khi b???nh nh??n nh???p vi???n, c?? th??? ph???i d??ng m??y th???, thu???c kh??ng virus, thu???c ???c ch??? h??? mi???n d???ch, hay d??ng thu???c tr??? sinh do nhi???m tr??ng ch??o???T???t c??? ??i???u n??y ?????u c?? th??? d???n ?????n c??c t???n th????ng kh??c. B???nh nh??n n???m vi???n m???t v??i ng??y ???? c?? th??? l??m c?? b???p y???u ??i. N???m gi?????ng b???nh v??i tu???n c?? th??? l??m teo c??. ?????c bi???t l?? b???nh nh??n th??? m??y c??ng l??m h??? c?? x????ng y???u ??i, kh??? n??ng ??i l???i y???u h???n sau khi ph???c h???i COVID-19. C??c thu???c kh??ng virus hay thu???c ???c ch??? c?? th??? g??y t??c d???ng ph??? l??n gan ho???c th???n. Thu???c steroid c?? th??? l??m n???ng th??m c??c b???nh n???n nh?? ????i th??o ???????ng hay t??ng huy???t ??p.

- H???i ch???ng sau khi n???m khoa ICU g???m c??c tri???u ch???ng m???n t??nh. Kho???ng 1/3 b???nh nh??n v??o ICU s??? th??? m??y v?? c??c di ch???ng sau khi cai th??? m??y nh?? kh?? th???, ho, ?????i gi???ng, c?? th??? k??o d??i nhi???u th??ng sau khi b???nh nh??n ra kh???i ICU. C??c tri???u ch???ng kh??c nh?? ch???m suy ngh??, kh?? t???p trung, kh??ng nh???... c?? th??? k??m th??m sau khi xu???t vi???n.

2. ??i???u tr??? tri???u tr???ng h???u COVID-19 nh?? th??? n??o?

??i???u tr??? tri???u ch???ng h???u COVID-19 c??ng s???m c??ng t???t. Ti???p t???c ch???a tr??? ki??n nh???n v?? l??u d??i tri???u ch???ng sau khi h???t COVID-19. M???c ti??u l?? ????? gi???m c??c t???n th????ng, ng??n ng???a c??c t???n th????ng l??u d??i.

Tr??? li???u ph???c h???i ch???c n??ng l?? bi???n ph??p quan tr???ng v???i c??c b???nh nh??n ???? nh???p vi???n hay ph???i d??ng m??y th???. C??c tr??? li???u bao g???m v???t l?? tr??? li???u t???i ch??? trong b???nh vi???n nh?? t???p c??? ?????ng tay ch??n. T???p ph???c h???i ch???c n??ng ph???i qua b??i t???p th???, th???i Spirometry, hay t???p th??? b???ng.

- Tr??? kh?? th???: B???t ?????u b???ng c??c b??i t???p ????n gi???n nh?? h??t s??u th??? ra ch???m. C?? th??? t???p th??? b???t c??? l??c n??o: Khi ng???i, n???m, khi t???p ??i b???, k???t h???p d??ng m??y th???i Spirometry??? C??c b??i t???p thi???n (meditation) c??ng gi??p b???nh nh??n th??? ch???m v?? th??? s??u, gi??p ph???i ho???t ?????ng hi???u qu??? h??n.

- Tr??? ho m??n t??nh: Nhi???u b???nh nh??n t???n th????ng ph???i do COVID-19 b??? ho l??u hay ho c?? ?????m sau khi ph???c h???i b???nh. B??c s?? c?? th??? k?? ????n thu???c ho nh?? benzonatate, thu???c x???t proair, thu???c ch???ng ?????m mucinex, hay c??c thu???c kh??c ????? l??m t??ng ???????ng th???. Tuy nhi??n, c???n k???t h???p t???p th??? v?? thu???c ho ????? tr??? d???t ho m???n t??nh.

- Tr??? tim ?????p nhanh: Nhi???u b???nh nh??n b??? tim ?????p nhanh, lo???n nh???p, m???t nh???p sau khi ph???c h???i COVID-19. L??c n??y, b??c s?? chuy??n khoa s??? th??m kh??m, ki???m tra si??u ??m tim, xem k???t qu??? ??i???n t??m ?????. Sau ???? c?? th??? c?? th??? k?? ????n thu???c gi???m nh???p tim. B???nh nh??n c???n k???t h???p c??c b??i t???p th??? d???c nh??? nh??ng, t??? t??? ????? c???i thi???n nh???p tim.

- Tr??? m???t m???i v?? y???u s???c: T???p th??? d???c t??? t??? ????? t??ng s???c b???n v?? s???c m???nh c???a c?? b???p ch??n tay, ?????c bi???t d??nh cho c??c b???nh nh??n tr??? v??? t??? b???nh vi???n hay khoa ICU. C??c b??i t???p t??? nh??? k???t h???p v???i t???p th??? c?? th??? gi??p c???i thi???n s??? m???t m???i. N???u m???t m???i dai d???ng, b???nh nh??n n??n g???p b??c s?? chuy??n khoa tim hay ph???i ????? t??m nguy??n nh??n m???t m???i k??o d??i.

- Tr??? ??au nh???c kh???p: D??ng thu???c kh??ng k?? ????n nh?? ibuprofen (n???u kh??ng b??? ??au d??? d??y, b???nh l?? ??? th???n) ho???c acetaminophen ????? gi???m ??au. Sau ???? t???p v???t l?? tr??? li???u ????? ??i???u tr??? ph???c h???i cho kh???p b??? ??au. V???i b???nh nh??n l???n tu???i, c??c b??i t???p ph???c h???i ??au kh???p do COVID-19 c?? th??? l??u h??n, do ???? c???n ki??n tr?? luy???n t???p.

- Tr??? m???t m??i/m???t v???: D??ng c??c b??i t???p nh??? m??i hay nh??? v??? ????? c???i thi???n d???n tri???u ch???ng n??y.

- Tr??? m???t tr?? nh???, gi???m t???p trung, mau qu??n: ?????c s??ch, ch??i c??c tr?? ch??i k??ch th??ch tr?? nh??? nh?? ????nh c???, h???c th??m c??c m??n kh??c nh?? n???u ??n, l??m b??nh. Gi??? cho n??o b??? ho???t ?????ng tr??? l???i b???ng c??c k??ch th??ch ph???n x??? l??nh m???nh.

- Tr??? b???nh nh??n COVID-19: Ph???n l???n t??c r???ng sau khi m???c COVID-19 l?? do ch??ng ta b??? lo l???ng v?? stress. V?? v???y, ??a s??? b???nh nh??n s??? m???c l???i t??c trong v??i tu???n hay v??i th??ng sau khi h???t b???nh. C?? th??? d??ng c??c thu???c k???t h???p nh?? rogaine ????? x???t k??ch th??ch t??c m???c.

- Tr??? da n???i m???n sau COVID-19: Th?????ng l?? c??c b???nh vi??m da c?? ?????a, n???i m??? ??ay hay d??? ???ng. T??nh tr???ng n??y b??c s?? s??? k?? ????n thu???c thoa ngo??i da v?? b???nh s??? kh???i.

M???t s??? b???nh nh??n COVID-19 c?? m???c c??c b???nh tim, b???nh ph???i, b???nh ??au kh???p??? c?? th??? g???p nh???ng tri???u ch???ng t????ng t??? c??c tri???u ch???ng h???u COVID-19. ????? bi???t ch???c ch???n c??c tri???u ch???ng n??y l?? do b???nh l?? m???n t??nh c???a m??nh g??y ra hay tri???u ch???ng h???u COVID-19, b???nh nh??n c???n ??i g???p b??c s?? ????? ???????c kh??m t??m ra nguy??n nh??n g??y m???t m???i.

B???nh nh??n m???c ????i th??o ???????ng, t??ng huy???t ??p c???n ki???m tra ???????ng huy???t, ch??? s??? huy???t ??p??? ????? ki???m so??t t???t c??c b???nh l?? n??y.

3. Tr??? li???u t??m l?? sau khi h???i ph???c COVID-19

Nhi???u b???nh nh??n c?? c???m gi??c lo l???ng, tr???m c???m, hay c?? ????n sau khi ph???c h???i COVID-19. N???i s??? h??i v?? b???nh, ??au th????ng, m???t m??t v?? ng?????i th??n trong ?????i d???ch v?? lo l???ng v??? t????ng lai b???t ?????nh ph??a tr?????c l??m nhi???u b???nh nh??n c??ng th??m stress, d???n ?????n m???t ng???, s???t c??n, hay ho???ng s???.

L??c n??y, b???nh nh??n c?? th??? c???n d??ng thu???c ??i???u tr???. Nh??ng c??c thu???c ch???a tr??? t??m l?? v?? t??m th???n sau khi COVID-19 n??n d??ng v???a ph???i, tr??nh ????? b???nh nh??n tr??? n??n nghi???n thu???c.

V?? d??? nh?? thu???c ng??? ambien hay benzodiazepine, nhi???u b???nh nh??n sau khi h???i ph???c t??? COVID-19 kh??ng ng??? ???????c, d??ng c??c thu???c ng??? th?????ng v???n kh??ng h???t, cu???i c??ng ph???i d??ng thu???c ng??? n???ng c?? th??? g??y nghi???n.

C??c tr??? li???u t??m l?? bao g???m tr??? li???u giao ti???p, t?? v???n, gi???i th??ch cho b???nh nh??n hi???u r?? v??? c??c tri???u ch???ng COVID-19, c??c bi???n ph??p h???i ph???c tri???u ch???ng ????? gi???m b???t lo ??u.

N??m 2022 ch??ng ta c?? nhi???u tr??? li???u hi???u qu???, bao g???m vaccine, thu???c u???ng, ph??c ????? ch???a tr??? v?? c??ch ch??m s??c. Ch??ng ta c??ng quen d???n v???i c??c ???nh h?????ng c???a virus ?????n cu???c s???ng. Do ????, n??n h???n ch??? th???i gian d??ng ??i???n tho???i th??ng minh, m???ng x?? h???i??? m?? n??n t???p trung th???i gian v??o cu???c s???ng c???a m??nh, nh??: T???p th??? d???c, d??nh th???i gian th???c s??? cho c?? th???.

M???t s??? ng?????i tuy kh??ng m???c b???nh COVID-19, nh??ng c?? ng?????i th??n m???c b???nh hay t??? vong do COVID-19 c??ng c?? th??? b??? tr???m c???m, lo l???ng v?? ???nh h?????ng ?????n t??m l??. Tr?????ng h???p n??y n??n n??i chuy???n v???i b??c s?? ????? ???????c t?? v???n v?? hi???u th??m v??? COVID-19.

4. Dinh d?????ng h???u COVID-19

Dinh d?????ng chi???m vai tr?? quan tr???ng sau khi h???i ph???c COVID-19. B???nh nh??n c???n:

Ch??m s??c dinh d?????ng ?????y ????? ????? ph???c h???i t???t nh???t sau COVID-19. B??? sung ????? n?????c, ch???t x?? protein/tinh b???t v?? vitamin ????? ph???c h???i t???i ??a c??c m?? b??? t???n th????ng. Ch??? ????? ??n u???ng b???t ?????u b???ng nhi???u b???a ??n nh???, c?? ????? rau xanh, tr??i c??y, protein/tinh b???t. Nh??? u???ng n?????c ?????y ?????, c?? th??? dung n?????c l???c k???t h???p n?????c tr??i c??y ????? c?? ????? vitamin.

Khi c?? m???t ch??? ????? ??n u???ng ?????y ?????, c??n b???ng v???i rau c??? qu???, tr??i c??y t????i, th???t ??t ch??? bi???n, th?? kh??ng c???n ph???i u???ng th??m vitamin hay thu???c b???. Nh??ng h???n ch??? ??n ???????ng, kh??ng u???ng r?????u, h??t thu???c, kh??ng n??n nhi???u u???ng cafe/tr?? v?? c?? th??? g??y kh?? ng???.

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Tác giả: THCSNSL

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