trong dd cd nhO'ng kieh thudc md theo chung tdi gifra hai gidi khdng ed sy ehSnh Idch dgng ke (nhu dgi ndn sp n-o) vg cd nhu'ng kich thudc ma kdt qua tiiy Ihudc vao phuong phap nghign eiru nhu dung tieh sp, vd Igi egc kieh thude dgi, rdng va eao sp da dCi dai dl$n eho dung tieh sp. Vi vay eae tigu chudn dua ra khdng dam bao mdt kdl qua chlnh xac. Trong khi dd egc d l x u l t cOa Nemeskeri vg Paskova Igl dya trgn cgc dge diem eOa sp ngudi Hungary vg Nga, ngn k i t qua se hgn e h l nhidu khi sir dgng d l xae dinh gldl llnh sp Vl$t.
K£T LUAN
cac tigu chuin dd phan bigt gidi tinh sp Vigt hidn dgi cua ehOng tdi duoc dya trdn cd hai dgc didm md ta va do dge trong dd ed 6 dac didm md ta va 14 kieh thudc. Cge kieh thudc sp duuc d l xudt la nhO'ng dge dilm do dge cd s y khae bidt rd rang giCra sp eua hai gidi, lai lg nhCrng kich thudc d l do, do d l chinh xgc, khdng phy thudc vgo chO quan ngudi nghien cCru.
Sy phli hop giO'a cgc dgc d\em md ta vg do dge d l chan dogn gidi tinh sp chae e h l n eho mdt kdt qug chlnh xgc hon va r l t edn thidt trong nghign eCru sp, trong phap y cung nhu trong khdo ed hpc.
TAI LIEU THAM K H A O
I.Alecxeev, V P„ Debes, G.F (1964).
Craniometria metodika anthropologhieheskie isledovani, 1_3d Nauka, Moskva
2 Nguygn Lgn Cudng (2006), Nghign ciru nhCrng hop sp vg rang cOa ngudi eo d Gd 0 Chiia
(Long an). Dd tai khoa hpc d p bd, 20-120 3. Nguygn Lan Cudng (2006-2007) Cgc nhdm logi hinh nhgn chung d Vidt nam vg v i n 3d nguin gde ngudi Vidt Vi$n Khoa hpc Xa hdi Vidt Nam. O l tai khoa hpc c i p bd, 86-475.
4. Nguydn Thign HCing (1984), Die d i l m hinh thai sp ngudl Vi$t Nam qua cae thdi dgi - Luan gn t i t nghl0p bae sT chuydn khoa d p I, Khoa Y Trudng dgi hpc Y Duye thgnh phd Hd Chi Minh, 52-71.
5. Ngd Xugn Khoa, Lg HO-u Hung (2012). Mpt s l dac didm md ta eiia sp ngudi Vigt hi$n dgi. Y hpc Vigt nam, thgng 7, sd 2, 59-62
6. Martin J. (1925). Lehrbuch der anthropologle, Jena Verlag
7. Nemeskeri J,, Harsanyi L,, Aesadi G. (1960).
Methoden zur Diagnose des lebensalter von skelettfunden; Anthopologiseher Anzerlger. Bd. 24, N.l,
8. Olivier G. (1960), Pratique anthropologlque.
Vigol Frgres Edit, Pans, 116-187
9. Paskova (1958). Opredelenie pola i vozrasta po cherepu Stavropol, (Tidng Nga)
10. Nguyin Quang Quyen (1974). Nhgn trie hpe va sy Crng dyng nghien cCru trgn ngudi Vigt Nam, Nhg xudt ban Y hpc, Hg ndi.
11. Nguygn Quang Quyen, Lg Hu'u Hung, Tham Hogng Digp, Nguyen Lgn Cudng, VO T h i Long (1970). Kich thude sp ngudi Vi$t Nam, Hinh thai hoc, tap 4, sd 2
CHUP CT PHAT HIEN U DAI TRUC TRANG VA HACH Dl CAN DE CO PHIAJNG HI/flTNG DIEU TRI VA TIEN LUONG
TOM T A T
Ta; Vidt Nam chin dodn ung thw dgi tnrc trang, ddc bidt ddi vdi nhdng trwdng hgp cd hgeh di cdn cdn nhiiu han che.
Phwang phip chtjp cit tdp vt tinh d bung kit hgp bom thudc dn quang tTnh mach kit hgp dwdng tidu hda dem Igi kdt qua chin dodn chinh xdc vd lgi ich tmng didu tq cung nhw ttdn Iwgng ddi vdi ngwdi bdnh.
Tw khod: CT dai trang, cin quang dwdng tidu hda CT SCANNER IN COLON CANCER AND METASTASIS TUBO DISCOVERY FOR PROGNOSIS AND TREATMENT
SUMMARY
Rectum cancer diagnoses, especially for cases with metastatic anh denia, dc not develop much in VN. Colon CT method together with vein and alimentary tmck adiaphamous pumping has resulted in exact diagnoses and positive tmatment to patients.
Keyword: CT colon, alimentary tmck adiaphamous...
OAT VAN e e
Ung thu dgi trang la bgnh ung thu dirng hang thir ba trdn t h i gidi trong cgc ung thu hay ggp vg dCrng
NGUYEN DUY HAI hgng d l u trong ung thu dudng tieu hoa,
& Viet Nam, theo thdng kg, ung thu dgi true trang xep hang thu 5 trong ege bgnh ung thu hay ggp vg x i p hgng thu 3 trong ung thu tieu hda (sau ung thu da day va gan). Vige phgt hien sdm ung thu dgi true trang tgi Viet l*Jam cdn nhidu hgn che, chua ed tinh h$ thong.
Mpt s l phuong phgp nhu thgm khgm dgi true trgng ehi danh gig dugc mCre xgm ldn cua khdi u d dogn thlp hoge d dogn giO'a cua dai tryc trgng. Ndi soi dai trgng chi cd t h i quan sat hinh dgng khdi u, Sidu am ndi tryc trang khdng gp dung cho nhung khdi u dpa vd, chay mgu hay chit hgp, gay bit tae Idng true trgng.
Vigc gp dung ehyp CT trong ehdn doan ung thu dai true trgng vg danh gia hach di can, cQng nhu mO'c dd xam l l n eua khdi u 3i mang lai k i t qua tdt hun.
Nh&ng trudng hyp chua cd hgeh di can se duoc phlu thuat tridt can sau dd se hda xg tn, Cdn a l l vdi trudng hyp cd haeh di egn se duoe xa tn tordc mo
Tir dd ehiing tdi tiln hgnh d l tgi nham cgc myc tieu' - C h i n dogn hlnh thd, vi tri u dai tryc trgng.
- Phat hien hinh anh di can, mirc dd xgm lan ciia u.
Y H p c THV'C HANH (872) - SO 6/2013
D 6 | TU'gNG VA PHU'ONG PHAP NGHIEN CU'U 1. Odi t u y n g nghign ci^u:
30 bdnh nhgn d i l u tri lgi khoa B2 - Vi$n 103. Oa duoe ehln dogn K dgi tryc trgng, cd kdt q u i ndi soi va sieu am, khdng phan bidt lira tudi va gidi.
2. Phuong phgp nghidn CLFU.
Bdnh nhgn duye ehuin b|, thyt thgo sgch dgi trang tm-dc khi ehyp b i n g thulc Fleet.
• May chyp CT. scanner tgi khoa CDHA vign 103,
• Thudc cgn quang Telebrix 300.
• Mgy bom thulc d n quang.
• Sondepholeye&20, 22
• T i l n hgnh ehyp CT.scanner I byng khdng tidm thude d n quang, Sau dd chup ed bum thulc d n quang dudng tTnh mgch k i t hyp thyt thulc d n quang pha nudc qua dudng hau mdn (pha 5 0 - 1 0 0 ml can quang vdi 500 - 700 ml nudc),
• Tigm tTnh mgeh 50ml thudc can quang K^T QUA
Trong sd 30 bdnh nhgn, t u l i eao n h l l la 78, t h l p nhdt la 35 tudi (trong dd cd 24 ea trdn 40 l u l l )
• Trong sd 30 ea thi cd 09 ca m i c v\ tri khdi u tgi tnrc trang, tgi sigma la 11 ea, tai viing dgi trang xudng la 02 ea, gde lach 03 ea, gde gan 03 ca va d manh
rang lg 02 ca Vitri Vl tri true trSnq
Vl tri siqma Vl tri dgi trSnq xu6nq
Vl tri q6c ISch Vl tri q6c qan Vl tri manh trSnq
S6 lui^nq 09 11 02 03 03 02
Ty\i 30%
36,6%
6.7%
10%
10%
6,7%
' Trong sd 30 ca b$nh ly, phat hidn khdi u kich thude nhd hun 5em la 25 ca, tir 5 den 10 em la 03 ca edn iai lg 02 ea ed kich thudc khdi u ldn hon 10 em
Kich thuoc u
<5cm Tir 5 - 1 0 cm
S6ca 25 03
>10cm 1 02 Tvlg 83.3%
10%
6,7%
' Trong sd 25 ea khdi u cd kich thude nhd hon 5 cm thi hinh anh CT cho t h l y cd tdi 08 ca ed hinh anh cua di can hgeh (ehilm 24%).
Trong s l 03 ca khdi u kich thude 10' 5 d i n 10 cm thi ed 01 trudng hyp cd hinh anh di cgn hgeh (33,3%)
Kgt hg>p eg hai Khdng c6 egn quang TM Hinh anh CT cua cimg bdnh nhgn u dgi trgng k i t hop bum thudc can quang dudng ITnh mach vg tiSu hda
Mdt s l hlnh anh u dgi tryc trgng tren phim CT su dung phuong phgp bom Ihudc can quang ITnh mach ket hop dudng li6u hda
Hinh anh K dai trang di can gan
Hinh gnh eua ciing benh nhan Dd Thj V dircrc xd ly d y n g MPR ^ ^ ^
BAN LUAN
Nhu vay 30 tnrdng hyp chgp CT dai trang, thi ket qua hinh anh thu duye phu hyp vdi ehan dogn ciia iam sang
Ty Id u dai trang sigma la nhidu nhit (11 c a - 36,6%), sau dd ddn u tryc trgng (09 ca - 30%), roi ddn u dgi trgng gde Igch vg gde gan (03 ca) vg cu6i eOng lg u manh trgng (02 ca),
oac biet d l i vdi 30 trudng hyp bgnh ly ngy, trif*i:
khi chyp CT da ed k i t q u i ndi soi. Nhung khong danh gig duoe tinh Irgng di cgn, mCrc dd xgm lln cua khdi u.
Theo n h i l u tac gia thi ty lg phat h i l n hach di cSn do ung thu dgi true trang do CT Id 27 den 73%.
Trong sd 25 ea k h l i u cd kieh thudc nhd hon 5 cm thi hinh anh CT eho thdy cd tdi 08 ea cd hinh anh cua di can hgeh (chiem 24%).
Trong sd 03 ea khdi u kich thude tir 5 ddn 10 cm thi ed 01 Irudng hyp cd hlnh anh di can haen
(33,3%) . oay la nhu'ng trudng hyp d k i t qua noi soi va
sigu am khdng danh gia va kdt luan duoe v l di can vg mirc dp xgm l l n cua khdi u
{ HOC TH^C HANH (872) - SO^I^
Viec c h i n dogn mi^c xgm l l n vg di can hgeh trgn CT cd y nghTa thye tidn vdi ngudi bdnh, nhd nhu'ng dgnh gig ngy mg phac dd d i l u trj dg thay ddi so vdi trudc khi chyp CT. Ddng thdi tidn luyng ciia bac s?
dli vdi nhung trudng hop ngy cQng vl thd mg thay ddi, Nhu vgy ehyp CT eho t h l y vide phgn tieh hlnh anh theo khdng gian ba chilu da cho phgp dgnh gig ro vg chinh xgc nhO'ng ton thuung u xgm ldn td ehO-c xung quanh, cae eu quan ian egn ddng thdi danh gia chidu eao, chilu rdng, bd ddy.
Dae biet cho phgp danh gia tdn thuong hgeh di can va xam l l n vdi dd dgc higu cao
Chup CT khdng gay khd ehiu, khdng ggy tdn thuong sang e h l n hay lai b i l n eho bdnh nhgn, nd gp dyng 3ugc cho tdt d mpi ddi l u y n g (trir phy nO' cd thai), mpi khdi u, d cac giai dogn khae nhau, kd ea cae tnrdng hyp khdi u ggy chit hgp, dpa ehay mau mg cgc can thi§p ehdn dogn bdng phuong phgp khge khdng tidn hgnh duyc Oge bigt ege khdi u d eao, khi thgm khgm tryc trgng khdng phat hidn duyc, hay nhu'ng trudng hyp hgeh di cgn d xa ma sigu gm khdng phat hign duye thi CT k h i c phye duyc nhO'ng
nhuyc didm dd, Ktl LUAN
Bdnh ly ung thu dgi tryc trang la ung thu hay gap, ehyp CT d byng cd bom thudc can quang dudng ITnh mgeh kdl hyp vdi thyt nude ed pha thudc cgn quang qua hgu mdn tryc trgng lg phuong phgp ehdn dogn duye vi tri, kieh thude, dge bigt d l i vdi nhO'ng trudng hyp cd di can, mCre dd xam l l n eOa khdi u eOng duyc phat hign
Day la phuong phap giCip Ieh trong vigc chdn dogn, dae bidt tl6n luyng tinh trgng ngudi bgnh, lya chpn phuong phgp didu tri phii hyp,
TAi LI$U THAM K H A O
1, Nguygn Duy Hud, Phgm Minh Thdng (2009).
Chdn dogn hlnh gnh, Nhg x u l t ban gigo dye Vigt Nam, Hg Nd|
2, Nguyen Khgnh Trgch, Pham Thi Thu Hd (1997), Ung thu dgi tryc trgng, Bgi gidng b§nh hpe ndi khoa, Nha xudt bgn y hpc, tap 1, tr 221 - 330.
3, Phgm Ngoc Hoa, Lg van Phudc (2007), CT byng vg chgu, Nha xult ban dai hpe qudc gia TP Ho Chl Minh, tr 2 4 5 - 2 7 9
Tir VONG DO UNG THlTTAI THANH PHO HAI PHONG, 2005-2007
LETRAN NGOAN - Trwdng D^i hgc YHd Npi TIWN QUOC BAO, PHAN TRONG LAN - Cue Yte dyphdng
TRAN THj OANH -BdYte LE HOAl CHUONG - Benh vidn Phu sin Trung wang v u TH! NGUY$T ANN - TT. Cham sdc sdc khde sinh sin Hd N6i
TOM T A T
Muc tidu: Md td thwc trang tw vong do ung thw theo ICD-10 vd gidi trong cgng ddng TP Hii Phdng, 2005-2007 Phwang phap: Thiit ki nghidn cdu vdn diJng phwang phip nghidn cdu md ti. Sd lieu dwac thu thdp bing 2 dgt diiu tm Idp vd phdn tich danh sdch td vong cic ndm 2005, 2006 vi 2007 do cic tnrdng Tram Y td xd hodn thdnh miu phiiu "Bdg cdo nguydn nhdn gdy td vong". Nghidn cdu dwgc trien khai tai 232 xd/phwdng thudc 14 qu$n/huydn cua TP Hai F'hdng. Tj Id td vong chuin hda/100.000 dwgc tinh theo ciu trdc din sd thi gidi. Ket qui: Ba loai ung thw phdi, gan vi da diy li nguydn nhin giy id vong cho 72,3% nam vd 61,6% nd ung thw. Tj lg td- vong do tit cd cic logi ung thw chuin hda theo tudi d nam vd nd ttrang Ong Id 183,1/100.000 vd 94.0/100.000. Ung thw bi tw vong cao nhit li phdi (ASR 60,2/100.000 a nam vi 27,7/100.000 d nw); thd nhi Id gan (ASR 46,2/100.000 d nam vi 14,2/100.000 dnd); thdba li dg diy (ASR 26,0/100.000 dnam vi 15,5/100.000 d nd). Kit ludn: Ung thw Id nguydn nhan td vong quan trgng cho ci 2 gidi vi nam bi ung thw cao han 1,9 lin nd.
Td khda: Td vong do ung thw, didu tm cdng ddng, dw phdng vd djch te hgc ung thw
SUMMARY
Cancer mortality in Hai Phong City, 2005-2007 Objectives: To desenbe cancer mortality by ICD-10 and sex in genemi population of Hai Phong City, 2005- 2007. Methods Descriptive epidemiology was applied for the study design. Data was collected by two munds to generate and analyse the lists of cases for year 2005.
2006 and 2007 which wem developed by tiie head of commune health stations applying the validated form of
"Mgrtality registmtion". The study was pertonned at 232 communes of 14 districts of Hai Phong City. Age- standardized mortality rate per 100.000 v/as estimated in using the Worid population stmcture. Results' Three cancer sites of lung, liver and stomach wem msponsible for 72.3% of mate and 61.6% of Ornate cancer Age- standardized mortality rates In males and females wem 183.0/100.000 and 94.0/100.000 mspectively. The leading cancer was lung (ASR 60 2/100.000 in male and 27.7/100.000 in female); followed by sliver (ASR 46.2/100.000 in male and 14.2/100000 in female) and stomach (ASR 26.0/100.000 in male and 15.5/100.000 in female). Conclusions: Cancer mortality was a senous pmblem in both sexes with mate to female ratio was 1 9 Keywords: Cancer mortality, population-based sun/ey, cancer epidemiglggy and pmvention
V HOC THV'C HANH (872) - SO 6/2013
