Y HOC VIET NAM THANG 2 - SO 2/2012 T h j IL/C k h a m lai s a u 01 t h a n q :
Thi Il/c Sd mat Tyle
ST(-) 1 0,47%
1 -4/10 23 10,90
5-7/10 108 51,18
8-10/10 79 37,44
Tong s d 211 100
Nhin chung thj li/c sau 01 thdng cu tang hdn so vdi 01 tuan tru'dc mo, t r d 01 tru'dng hdp phai khoet bd nhan cau da neu d tren.
IV. BAN LUAN
4 . 1 . V e p h a u t h u a t T N T T T : la mdt bude each mang trong phau thuat due TTT, thj life phuc hdi nhanh chdng, tranh eho benh nhan phai nam vien cung nhU phai kham lai nhieu lan sau phau thuat.
4.2. Ve c h i d j n h p h a u t h u a t .
Chi djnh m d s d m nhat thich hdp cho phau thuat TNTTT. Tuy nhien b Viet Nam benh nhan thudng den b giai doan qud mudn, can de dat khi ehi djnh TNTTT eho nhu'ng m i t TTT due dp V vd de gay bie'n chifng trong phau thuat. Trong s d 7 ca rach bao sau cd thoat dich kinh thi cd 01 ca la do due TTT ciic sau bam sinh, 01 ca do dao ranh qua sau gay thijng bao sau, cdn 05 ca la do due TTT d do
IV, V, nhan TTT to, mau den, thdi gian phaco keo dai, dong tCf co lai de gay bien chu'ng.
Dac biet trong Id benh nhan cua chiing tdi cd 3 benh nhan bj can thi nang ca hai rriat va due TTT bam sinh (2 anh em sinh ddi) va 1 ca due TTT bao sau. Ca 3 benh nhan dieu chinb kinh thi liic deu khdng tang. Chiing tdi da md phaco ca 6 mat va dat TTT nhan tao vJi cdng suat tir -3 de'n + 5dp. Tat ca 6 mat d i J tang thi liic tdt tir 5 - 7 / 1 0 chi/a chinh kinh, mkc dll cd tdn thu'dng hac vdng mac can thj nang.
V. KET LUAN
Ngay nay phau thuat T N T T T khdng cdn la mdi me vdi cac p h i u thuat vien Viet Nam cung nhu vdi ngirdi dan Viet N a m nOra.^ Tuy nhiea phau thuat vien va ki'p m d can phai dUde dao
tao mdt each bai ban, ed he thdng. De tranh eho nhi/ng bien chifng dang tiee xay ra nen chi djnh md phaco thfch hdp, tranh md tren nhu'ng mat nhan TTT qua ran va dong t d gian kem, nhat la ddi vdi nhu'ng phau thuat vien cdn ehUa cp nhieu kinh nghiem.
TAI UEU T H A M KHAO
1. Vu Quoc Lu'dng: Oiem bao nu'dc ngoai. Ky thuat Phaco Chop va Phaco Quick Chop - Npi san Nhan Khoa, so 5/2000, 107-109.
2. Thai Thanh Nam: Oanh gia ket qua dieu tn due thiiy tinh the bang ky thuat nhu tu'dng hoa - Luan an tot nghiep chuyen khoa cap II chuyen nganh Mat - TP HCM 2000.
3. Tran Thj Phi/dng Thu: Lu'dng gia phau thuat Phaco (Stop, Chop, Chop and Stuff) tren benh nhan due thiiy tinh the nhan cifng - Y hoc thu'c hanh, sd 7/2001, 57-60.
4. E. ESMENJUAD, J.L.FRAIMOUT: Phaco- Emulsification, les 300 premiers cas - Bull.Soc.opth, France 1994, 6-7, XCIV, 633-637.
5. S.MILA 220, PTURUT: Traitement de la luxation du noyau dans le vitre lors de la phacoemulsification - J.Fr.Opthamol, 1994, 17, 3, 214-216.
6. VASAVADA, SINGH R, DESAI J:
Phacoemulsification of white mature cataract - Journal of cataract and refractive surgery 1998, 24(2), 270-277.
7 P.VOTAN: Chirurgie de la cataracte par Phacoemulsification le stop et chop - Reflexions ophtalmologiques. Tome 1. No 1. 1996, 9-10.
NHAN XET HIEU QUA DIEU TR! TUY VOI NITI PROTAPER CAM TAY
Bui T h i T h a n h T a m *
TOM T A T
Muc tieu: Nhan xet viee sifa soan dng tiiy bang tram tay Niti Protaper va Danh gia hieu qua eiia viee dieu tri noi nha bang tram tay Protaper. Doi tu'dng va phu'dng phap nghien cii'u: 50 rang cdi Idn (trir rang 8) da hinh thanh cudng co ehi dinh dieu tri tuy bao tdn khong phau thuat, tai khoa Noi nha BV RHM TW tirthang 4/2011 den Thang 12/2011. Nghien cifu
* Benh vien Rang Ham Mat Trung ddng Ha Npi
can thiep , theo doi doe, khdng co nhom chirng. Ket qua: Thdi gian trung binh sifa soan dng tiiy la 97,77±10,82 phiit; 2% thiing chop; 6% gay dung eu;
ty le han tdi cudng la 88%; sau han tiiy 1 tuan co 96% rang khong co trieu chifng dau; sau 3- 9thang ty le thanh cong la 86,67%. Ket luan: Dieu trj tiiy bang tram tay Protaper thiic hanh an toan, mat ft bu'dc, giam thdi gian dieu trj, phii hdp vdi kinh te eiia nu'dc
35
Y HQC VI$T NAM T H A N G 2 - SO 2/2012 ta Dac biet phii hdp vdi bac sy mdi ra trudng chu'a co
kinh nghiem ve dieu tri npi nha. Ty le thanh cdng eiia dieu trj la 86,67%. Tii' khoa; Protaper for hand.
ABSTRACT:
Reviews the effectiveness of endodontic treatment by Protaper for hand.
Aim: To evaluate the efficacy of Protaper for hand in root canal preparation. Objectives and Methods; A total of 50 molars (exclude the third molars) which need endodontic treatment were selected in the endodontic department of the National hospital of Odonto- Stomatology from April to December 2011. This is a follow- up study. Results;
Average time to prepare root canal is 97,77± 10,82 minutes, 2% perforation, 6% broken instruments, 88% obturation to the apex, 96% has no symptom after obturation 1 week, the success rate after 3 to 9 months is 86,67%. Conclusion; Root canal preparation with Protaper manual instruments is safe, less step, less time, and appropriate with our economy status. Moreover, it is especially suitable for doctors who have just graduated from the medical university and dose not have enough experience in endodontic treatment. The success rate is 86,67%. Keywords:
Protaper for hand
I.
OAT VAN OEYeu td then chdt trong dieu tri ndi nha la viec lam sach va tao hinh he thdng dng tuy [5].
Protaper la Hoai dung eu dung trong giai doan sifa soan dng tiiy, bat dau ap dung d nu'dc ta td nam 2004. Protaper cd hai hinh thifc chay may va cam tay [6]. Protaper cam tay se rat phii hdp
bdi gia re va thiic hanh an toan, mat ft bu'dc. Do dd ehiing tdi tien hanh nghien cifu de tai: "Nhan xet hieu qua dieu trj tuy vdi NitI protaper cam tay" vdi muc tieu : Nhan xet viec sda soan dng tuy bang tram tay Niti Protaper va Danh gia hieu qua cua viec dieu tri npi nha bang tram tay Niti Protaper.
II. OOI TUONG VA PHUONG P H A P NGHIEN CCfU l.Ooi tu'dng: Benh nhan cd rang ham Idn (trd rang 8) da hinh thanh cudng ed benh ly tuy va bien chifng eua nd, cd chi dinh dieu trj bao tdn ma khdng can phau thuat tai benh vien RHM TW Ha Ndi. Nhdm benh nhan gdm ca 2 gidi, trong dp tud'i t d 15-60 tudi. Vdi sd lu'dng la 50 rang cci Idn. Thdi gian tien hanh tir ngay 7/4/2010 den ngay 31/12/2010
Z.Phu'dng phap: Tao hinh dng tiiy bang tram tay Protaper theo phddng phap Crown down [1].
2.1. Thu thap thong tin qua lam sang va xquang tru'dc dieu trj
2.2. Ghi nhan trong qua trinh dieu trj:
Thdi gian tao hinh dng tiiy, tai bien trong tao hinh dng tiiy.
2. 3. Ghi nhan ket qua dieu trj
* Kit qua sdm sau han dng tuy qua xquang:
* Danh gia kit qua dieu tri sau han tuy 1 tuan d lan han vinh vien.
* Kit qua dieu tri sau 3-9 thang-.kham lam sang, chup X quang danh gia.
III. KET QUA VA B A N LUAN
Chiing tdi da dieu trj tuy cho 50 rang ham Idn (trir rang sd 8) viem tuy cap va man cd chi djnh dieu tri tuy bang tram tay Niti Protaper. Trong dd cd 5 rang dieu tri lai, sau 3 - 9 thang kiem tra lai du'dc 45 rang. Nhdm benh nhan ciia chung tdi tudi tif 15 - 60.
1. Mot SO ket qua trong khi su'a soan dng tuy
1.1. Thdi gian sda soan dng tuy cua tdng rang
Rang Thdi gian
40-90( Phiit) 91-120( Phiit) 121-190( Phut)
Ham R7
3
tren R6
9
Ham d R6
11 11 2
u'di R7
7 7
Thdi gian trung binh su'a soan ong tuy rang ham Idn la:97,77±10,82.
Tram tay Niti Protaper trong nhdm benh nhan nghien cifu ciia chiing tdi, thdi gian sifa soan dng tuy trung binh ciia nhdm rang ham Idn la 97,77 so vdi nhii'ng dung cu cam tay truyen thdng giam 1/3 thdi gian (136,89 phut nghien
CLfu ciia Le Thj Hu'dng). Nhu'ng neu so vdi dung cu chay may nhu' Profile thi thdi gian sifa scan dng tuy lai keo dai hdn khoang 1/3 thdi gian (60 phiit cho 1 rang ham Idn theo nghien cifu cua Bui Que Du'dng [2].
1.2. Tai bien trong khi su'a scan ong fty/; Trong nghien cifu ciia chung tdi cd 1 tru'dng 36
Y HOC VIET NAM THANG 2 - SO 2/2012 hdp bi thii_ng chdp (2%), khdng ed tru'dng hdp
nad rach lo cudng rang, 3 tru'dng hdp (6%) gay dung CLi nhu'ng khdng gay cay tram tay Protaper nao. Oe tranh tai bien ddi hdi ngu'di nha sy phai
tdn trpng cae nguyen tac cung nhu" ky thuat trong sudt qua trinh lam viec ddng thdi cung phai ed nhu'ng dung eu chuyen biet, cd tfnh nang eao va liTa chpn dung eu theo diing chi djnh.
2. Ket qua t r a m bit ong tuy t r e n X Tinh trang dng tuy
Han tdi cudng
Han qua cudng (han thira) Han chu'a tdi cudng (han thieu)
quang
So lu'dng rang 44
1 5
Ty le % 88%
2%
10%
Theo ket qua nghien cifu eiia de tai, trong 50 rang dieu trj du'dc sifa sdan dng tuy bang tram tay Niti Protaper theo phu'dng phap Crown-Down thi thay rang ty le han tdi cudng dat 88%, cd nam rang chu'a den cudng, mdt rang han qua cudng. Nhin chung hinh anh xquang eiia eae dng tuy da du'dc han deu rat rd net, thanh khdng gd khae, do can quang ddng deu.
3. Trieu chu'ng lam sang sau han tuy 1 tuan Trieu chu'ng lam sang
Khdng dau
Oau nhirc sau 1-2 ngay Su'ng phong ngach Idi Cam giac chdi rang
So lu'dng rang 48
2 0 0
Ty le o/o 96%
4%
0 0
Ty le rang khdng ed trieu chifng dau sau han tuy la 96%. Trong dd nhiJng rang cd lo rd, thu'dng Id rd giam dan trong khi dat thudc sat khuan va mat han sau han tuy 1 tuan
4. Ket qua dieu trj sau 3-9 thang:kham lam sang, chup X quang danh gia theo tieu chf ciia Sender va Sentzer [4]
Tinh trang dng tuy Thanh cong
Nghi ngd That bai
Sd lu'dng rang 39
5 1
Sd lu'dng rang 86,67%
11%
2%
Trong nghien cifu ciia chiing tdi ty le thanh cdng sau 3 - 9 thang la 86,66%. Nghi ngd ve sif tien trien ciia benh la 11,11%. That bai 1 tru'dng hdp chiem 2.22%. So vdi ket qua ciia Le Thj Hu'dng (2000), ty le thanh cdng d nhdm dua tay cddienla71,43%[3].
IV. KET LUAN
Tif ket qua nghien cifu ve viec sifa soan dng tuy bang tram tay Niti Protaper tren 50 rang ham Idn chung tdi cd mdt so nhan xet sau:
1. Nhan xet viec su'a soan ong tuy bang tram tay Niti Protaper:
Thdi gian chuan bi ong tuy du'dc riit ngan (Thdi gian trung binh cho rang ham Idn la 97,77 phut;). Nhu' vay so vdi dung cu cam tay truyen thdng thdi gian sifa soan dng tuy rut ngan du'dc khcang 1/2 - 1/3 thdi gian.
Od thudn ciia dng tuy: Oat du'dc chieu dai lam vide chinh xac khdng lam rdng chdp hoae gd khac d thanh dng tuy. Chiing tdi thay rang khi sifa soan dng tuy vdi tram tay Niti Protaper neu
nhu' chiing ta tuan thii diing trinh tu" thi se cd mdt dng tuy tu'dng ddi hoan hao: dng tuy khdng bj gd, khae do dd chieu dai lam viec ciia dng tuy du'dc xac djnh mdt each chinh xac, tao du'dc nut chan (diem that) viing chdp rang giiip ehc viec tram bit cng tuy du'dc de hdn.
Oe hoan tat viee tao hinh dng tuy chiing tdi chi can thdng thu'dng la ba den bdn cay tram tay Protaper.
Ooi vdi tram tay Protaper trong nghien cifu cua ehiing tdi khdng cd hien tu'dng gay dung cu hay nhii'ng tai bien khac. Cd le do dae tfnh mem deo ciia Niti ket hdp vdi do thudn Idn (2 -19%) va thiet dien eat ngang hinh tam giac Idi lam giam viing tiep xiic giii'a tram va nga rang. Cung sir can bang dp dai mdi vdng xoan vdi cac gdc xoan de ma tram tao du'dc hieu qua cat Idn lai rat an toan. Odng thdi lam giam vun nga d viing chdp rang.
Vdi cay tram Niti Protaper cam tay chiing ta ed kha nang dieu khien toan bd qua trinh sifa soan dng tuy bang cam giae tay ciia minh.
37
Y HQC VI^T NAM THANG 2 - ^ 6 2/2012 2. Danh gia hieu qua dieu tri:
Trong nghien cifu ciia ehiing tdi ty le thanh edng sau 3 - 9 thang la 86,66%. Nghi ngd ve sif tien then eiia benh la 11,11%. That bai 1 tru'dng hdp chiem 2.22%.
TAI UEU THAM KHAO
1. Bui Que Du'dng (1998), "Nhu'ng phu'dng phap sifa soan dng tuy". Cap nhat nha l^hoa, thang 4 - 1998, tr. 125 - 126.
2. Biii Que Du'dng(2003), "Sifa soan ong tuy bSng tram tay Niti Protaper", Tai lieu cap nhat, thang 10/2003, tr. 1-3.
3. Le Thu Hu'dng (2000),"Nhan xet phu'dng phap chuan bi ong tuy bSng dua may Profile", Luan van tdt nghiep cao hgc, ^. 3-11.
4. Bender IB., Seltzers et al (1996), Endodontic success, a reappraisal of criteria; Oral Surg, pp.
22-270.
5. Joseph Grenn (U.S.A). A rapid and predictable technique for cleaning and shaping the root canal system using rotary NT files. The 3^ Viet Nam Dental congress and Intemation Expodent 2000 HaNoi, pp.
42^3.
6. Stephen H.Y.Wei., Franklin R.Tay (2003), "Ky thuat eao trong tay ban", Tai lieu dich ciia Dentsply Viet Nam-cap nhat thang 4/2003, tr. 1-4.
NGHIEN CUU DAC DIEM LAM SANG BENH ZONA DIEU TR| TAI KHOA DA UEU - Dj llTNO BENH VIEN TRUNG UUNG QUAN DO1108 TUT THANG 5-2010 DEN 6-2011
Tran Oang Quyet*, Nguyen Lan Anh**
TOM TAT
Nghien cifu 100 benh nhan Zona dieu trj npi trii tai khoa Da lieu-Dj ifng benh vien Trung u'dng Quan dpi 108 tir thang 5/2010-6/2011 cac tac gia eho thay:
Benh Zona chiem 14,39% sd BN dieu tri npi trii, da sd gap d ngu'di tren 40 tudi va d ngu'di mac cac benh gay suy giam mien djch.
70% BN ed trieu chifng dau tru'dc khi cd tdn thu'dng d da.
100% BN ed mang da dd, tren do ed eae phdng nu'dc xen lan cac phdng mii, ca biet cd phdng mau.
Vi trf tdn thu'dng hay gip nhat la viing ngife, viing dau mat ed va chi du'dl.
- Gan 100% BN ed trieu chirng dau d cae mire do khae nhau.
SUMMARY
THE STUDY OF OINICAL FEATURES OF HERPES ZOSTtR AT DERMATOLOGYCAL - ALLERGIC DEPARTMENT, HOSPITAL 108 SINCE 5-2010 TO 6-2011
The studying of 100 eases of Herpes Zoster. The authors showed that:
Herpes Zoster standed at 14,39% of IPD at dermatologyeal allergic department, hospital 108.
Mainly of them v^as on more than 40 ages old people, and on the people who got some chronic diseases.
70% of patients got skin pain befor skin lesions occured.
The common clinical symptoms was erythema with cluster of grouped vesicles.
Site of predilection was thoracic, trigeminal,
* Vien Quan y 103; ** Benh vien TW Quan dpi 108 Phan bien khoa rtpc.-PGS.TS. Pham Hoang Kham 38
lumbosacral and cervical.
Near 100% of patients got skin pain in different levels.
I.
OAT VANo l
Zona la mdt benh hay gap trong so cac benh da do vims, do mdt loai virus hudng da va than kinh eo ten gpi Varicella zoster vims (VZV) gay nen. Benh co the gap d mpi lu^ tudi d ea hai gidi. Benh thudng gay ton thu'dng dpc theo mpt day than kinh nao do, va thu'dng khu bu mdt ten cd tiie.
Nhihig nam gan day xuat hien Zona cd ton thu'dng rai rac d ca hai ben cd the, va thu'dng de di chifng dau than kinh keo dai.
Oe gdp phan tim hieu dac diem lam sang cua benh Zona, ehiing tdi nghien cifu 100 benh nhan Zona vdi muc tieu sau: Tim hieu tinh hinh, dac diem lam sang benh Zona dieu tri npi tru tai khoa Da lieu-Di uTig benh vien Trung ddng Quan dpi 108 tu'thang 5/2010-6/2011.
II. o d l Tl/pNG VA PHUONG P H A P NGHIEN COU 2.1 Ddi tu'dng nghien cihi: 100 benh nhan Zona dieu trj npi tru tai khoa Da lieu-Di u'ng benh vien Trung u'dng Quan dpi 108 tif thang 5/2010-6/2011.
2.2.Phu'dng phap nghien cu'u: Tien cifu, md ta cat ngang.