THUC TRANG NHAN LUG VA HOAT DONG CHUYEN MON MANG LU0IY TE CONG LAP CHUYEN KHOA RANG HAM MAT THUOC SOT Y TE HA N D I
DAO TH! DUNG, PHAN THANH TINH, PHAM TH] HOA MAI Bpnh vipn Vipt Nam Cu Ba Hd Npi
T 6 M T A T :
Nghidn cwu cie khoa rdng hdm mpt (RHM) hope khoa Ildn chuydn khoa RHM - tat mOi hgng, mit cOa 54 bdnh vidn vd tmng tim y ti (TTYT) eua hp thdng cdng ipp thuPc Sd Y ti Hi Npi trong cic nim td 2009 - 2012 cho thiy:
- 10/24 dan vj cda khu vyc Hd NPi cO. 2/30 dan vi Khu vwc Hd Tiy vi VTnh Phue cO cd bic sj RHM Idm chuypn trdch. Hogt dpng eua chuydn khoa RHM tgi cic dan vj chd yiu tpp tmng vio vipc khim, diiu tri cic bpnh ring mipng thdng thwdng. Sau 3 nim sip nhpp. tgi khu vwc Hi Tiy vd VTnh Phue eO d cdc dan vi chuydn khoa RHM sd ky thupt tdng rO rpt.
- Cdng tic ddo tgo, chl dgo tuyin cOa Diu ngdnh RHM cua bpnh vipn vipt Nam Cu ba Hd Npi cho tuyin dwdi Id rit thiit thgc tmng vide ning cao ning ti/c chuydn mdn cho cdn bp y ti, gdp phin quan trgng cit thipn chit lirang khim chira bdnh tgi tuyin dwdi
STATUS OF HUMAN RESOURCES, PROFESSIONAL ACTIVITIES OF DENTISTRY NETWORK OF PUBLIC HEALTH IN HA NOI
SUMMARY
We conduct a sun/ey on dentistry department or ENT department In total 54 hospitals and health centers of the public system of Hanoi health department fmm 2009 to 2012, the msults as follows.
10 of 24 units in fanner Hanoi area. 2 of 30 units in the former areas of Ha Tay and Vinh Phue had full time dentists. Activitivies of dental departments mostly focus on the examination and tmatment of common omi diseases. After 3 years of mergenng, the number of dental units in the former areas of Ha Tay and Vinh Phue deployed techniques increased markedly.
- Training activities, directive activities of head branch (Viet Nam - Cuba friendship hospital) for lower hospitals had been identified as very practical in impmving qualifications for medical staff, contrtbuttng significantly in improving the quality of medical care at lower levels
DAT V A N D £
Bgnh vign H&u nghj Vigl Nam - Cu Ba thugc S d Y td Ha Npi, ed d l u ngdnh chuyen khoa rdng hdm mdt (RHM). Nhieu ndm qua, Bgnh vign da tndn khai cdng tac chi dgo luydn va dao tgo chuygn mdn cho eae benh vign tuydn qudn/huygn, cdc Trung tdm y te trgn d\a bdn thdnh phd nhdm ndng eao c h i t luyng khdm, ch&a benh Irong ITnh vye RHM. Ndm 2008, sau khi thdnh phd Hd Ndi mu rpng dd cd them 15 qugn huyen mdi, ndng long sd don v\ hanh chlnh d p qudn huygn Ihanh 29 3an vi.
Dd ddnh gid thuc trang nhan Iyc, hoat dpng chuygn
mdn vd hogt dgng ehi dgo tuydn, ddo tgo chuygn khoa RHM cua hg thdng y td edng Igp trgn dia bdn Hd Ngi sau khi sap nhdp, tren eo sd dd n h i m nang eao chit luyng hogt ddng mang ludi, gdp p h i n nang cao chit luyng khdm ch&a bgnh eho tuydn co sd", giam tai cho tuydn trSn, chiing tdi lidn hdnh nghign c&u dd tdi nhim mye tigu, Thye trgng nhdn Iyc vd hoat dgng chuydn mdn mgng ludi y td cdng Idp chuySn khoa RHM thugc Sd Y td Hd Ngi, hoat dgng chi dgo tuydn ehuySn khoa RHM cua Bdnh vign Vigt Nam - Cu Ba Hd Ngi khi mdi sdp nhgp va sau 3 nam sap nhgp
D61 TU'O'NG VA PHU'aNG PHAP NGHIEN CI>U 1. Ddi t u o n g nghiSn c & u : Cdc Khoa RHM hoac khoa lign chuygn khoa RHM - tai mQi hpng, m i t eiia edc bgnh vign, ede bdn khdm chuygn khoa tai cdc phdng khdm da khoa TTYT qudn/huygn. Tdi ligu thir d p bao gdm cdc vdn ban, bdo cdo hogt dgng cua ede don v] nqhiSn euu,
2. Dja diem nghidn cu'u: 54 bdnh vign va trung tdm y id eiia hS thdng cdng Igp thugc S d Y td Ha Ngi trong cdc ndm t u 2009 - 2012, cy the' 10 bgnh vign da khoa vd 14 TTYT qudn/huygn khu vye Hd Ndi eO, 15 benh vign da khoa va 15 TTYT qudn/huygn khu vuc Ha Tay cQ va VTnh Phiic cu.
3. P h u o n g phdp nghiSn e & u : Md ta d t ngang, kdt hyp djnh luyng vd tSnh tinh
- Nghign euu dinh luyng' Md ta nhdn Iyc vd hoat ddng chuygn mdn mgng ludi y td cdng Idp chuySn khoa rdng hdm mgl thugc S d Y te Hd.Ndi,
- NghiSn c&u djnh tinh: Phdng v i n sdu, thao lugn nhdm cdn bd Idnh dgo bgnh vien, bdc sy chuySn khoa RHM ciia cdc bgnh vign vd TTYT vd nhdn lue, hoat ddng chuygn mdn, khd khdn, thugn lyi trong qud trinh hoat dgng.
K^T QUA NGHIEN CCrU
1. ThM^ trang nhdn l i ^ mang \ird\ chuydn khoa RHM ( 2 0 0 9 - 2 0 1 2 )
Bang 1 Trinh dg ehuySn mdn can bg chuygn khoa RHM
Trinh ao chuy6n m6n
Tien s9 Thgc SV BSCK II BSCKI BSOK/BSCK (3inh hifdnq
Y sy. Y ts, BD, KTV Y SI Rang hSm mat Tine,
HS NOI CO 2009
1 11 7 18 36 (28%)
48 7 128
2012 1 11 6 19 33 (26%)
42 15 127
HS Tav CO 2009
0 2 1 4 12 (25%)
26 3 48
2012 0 2 1 9 20(30%)
31 3 66
Y HOC THVC HANH (872) - SO 6/2013
"#'Sau 3 nam ting s6 c i n ba chuySn khoa RHM khu wc nil TSy cQ t i n g ra ret (18 ngu'M). T6ng s6 c4n bo
^uySn khoa RHM khu vuc H4 N«i cO g i n nhu khang thay del. Ty 1$ c i n bO li b i c s } da khoa, b i c sy clluySn khoa ffinh hufrng RHM tai khu V(FC Ha N^i cO gin nhU' khang thay ddi, trong khi aa ty 1$ n i y 6 khu vfC HS TSy CO tang ttr 25% (2009) iSn 30% (2012).
S6 luong Y sJ RHM, dieu duong, KTV * khu vuc H i N6i cO va khu VLFC Ha Tay, VTnh PhOc cu d4u tang.
Bang 2. Tinh c h i t cang viae ciJa bac sy chuySn khoa RHM
Bang 3. Tlnh hinh thuc hISn cac kf thuat chuyen khoa
S6 iLfpng aon vi Tlnh chat cdng
VI^C Chuyen IrSch
Ki6m nhi^m
H i NOi cQ (n=24) 2009 10/24 12/24
2012 10/24 12/24
Hd TSy vd Vinh Phiic cu (n=30) 2009
1/30 29/30
2012 1/30 29/30 Kdl qua cho t h l y 100% khoa RHM tai cae b$nh vign ddu dd cd bae sJ {tdi thidu la bde s? djnh hifdng), cac TTYT Ha Ndi cQ, ngoai TTYT Dgng Anh vd Thanh Tri chua cd bac sy, cdn Igi ddu cd bae sy chuygn khoa RHM.
Trang khi dd, khu vyc Ha Tdy vd Vinh Phiie eu chi cd bgnh vign Ha Ddng vd bgnh vign MS Linh ed bdc sf RHM Idm chuygn trdch, cdc dun vj edn lai, bde s?
RHM ddu ldm kiem nhiem [6,7].
Ndm 2009, khdi edc Trung tdm y te khu vuc Hd TSy vd VTnh Phue cQ ehi 4 TTYT cd bde sy, dieu du&ng ehuydn khoa. Den ndm 2012, ed thSm 2 TTYT cd edn bd chuydn khoa. Cung gidng nhu khdi bgnh vign, cde TTYT cdn thidu nhdn Iyc nen sd bdc sy, dieu dudng ndy van phai kiem nhidm nhidu cdng vigc khdc.
Khdi didu dudng/y td chuyen khoa RHM hdu hdt la didu du&ng chung cho cd 3 chuygn khoa ( M i l , tai mui hpng va RHM), ehi mdt sd it duyc ddo tao sdu ve tre thii RHM ndn cQng chua giiip vigc eho bdc sy duyc nhidu. Tgi mdt sd bgnh vien tuyen huyen, do dieu duung hoac ky thudt vISn rang dam nhiSm kham vS dilu trj nSn eung han ehd trong cac hogt ddng chuygn mdn.
- Ket qud nghign c&u djnh tinh cung cho t h l y Bdc sy khoa RHM thudng phai kidm nhigm cdc cdng viSc khdc. Lanh dao Bgnh vign da khoa Syn Tdy °..2 nim nay nhdn Iwc Khoa lidn chuydn khoa bien dpng nhidu, rit khd khan tmng vipc tuyin dung biPn chi...".hodc Bdc sy RHM Benh vign Thgch T h i t " TPI vda la Tnrdng khoa ngogi, san.vda ring him mpt, tat mQi fjQng. Ngoai sin nguy hiim chet ngwdi chd rdng hdm inpt, tai mui hgng chwa chiy nhd, chit ngutn gi ndn
^i ndo cd thdi gian mdi quan tim den...".. Bdc sy
|HM Bgnh vign Thanh Oai: " Mdi ngiy tdt phdi khdm l^odng 100 bpnh nhdn ngogi khoa, khi nio cd bpnh nhan phiu thupt tdi Igi phii di gay md ndn ching cd MgianlimRHM"...
-jLdnh dgo Benh vign Qudc O a i ' Bpnh vipn cd miy ndi^soi mdi nhung chtra cd bic sj ndn phii dira bie s9 rdng di dio tgo ndi soi di tnin khai."
2. Tinh hinh hoat dpng chuyen mdn
Stt
1 2 3 4 b b
/
U 9 IU 11
Sd lu-yng dun vj Ky thuat tnin khai Ldy cao rdng bSng mdy
sidu dm Hdn rdng sdu ngd, mfin
rang Difeu tri tuv rdna bdna tay
Digu tn tuy rdng bang mSv Phgc hlnh c6 djnh Phue hlnh thdo ISp Chinh nha Ti6u ph^u Xu ly phSn mgm vCing
hSm m$t Phdu thudt hdm mgt
C^V qh6p implant
Hd NOI CO (n=24) 2009
24 24 24 2 8 6 2 21 10 3 3
2012 24 24 24 6 8 8 6 21 10 6 6
Ha TSy vd VFnh Phue cQ (n=30) 2009
19 19 19 0 0 0 0 13
1 0 1
2012 21 21 21 1 3 2 1 15 12 2 1 Cdc hogt dgng eua ehuyen khoa RHM tai cde dun vj chii y l u tgp tnjng vdo vigc khdm, d i l u In vd t u van cde bgnh rang migng thong thudng cho cde doi tuung bdo hiem y td nhu nhu l l y cao rdng, hdn rang sdu ngd, mdn rdng; didu trj tuy rdng b i n g dgng eg c l m tay ,,, Cae ky thugt thude ITnh vuc hdm mgt chua thye hign duyc nhidu Sau 3 ndm sdp nhap, edc ky thugt RHM da duyc tndn khai nhidu hun, sd dun vi chuygn khoa RHM tai khu vye Ha Tay va VTnh Phue cQ tnen khai duye eae ky thudt nhu tidu phlu (nhd rdng, nhd rang khdn Igeh bSnh chung, cat cudng rdng), xu ly p h i n mem hdm mgt.. tang rd ret.
Ben canh cde k? thugt thdng thudng, nhidu bgnh vign d khu vye Ha Npi eu (Dong Da, Saint Paul, Thanh Nhdn, D&e Giang, Thanh Tri, Bde Thang Long, Hd Ddng), TTYT Ddng Da da tndn khai duyc mdt sd ky thudt cao nhu dieu trj tuy b i n g file mdy, Idm rang gia cd dinh, e l y ghSp rang implant, ndn chinh rang ed djnh, xu ly chin thuung vting ham mgt, eat u ianh vting ham mdt. Tuy nhien, cde ky thugt ndy khdng duuc c u quan bao hidm thanh todn nen cOng khdng thu hiit duyc nhieu benh nhdn.
Cae TTYT qugn huygn can bd RHM ngodi hogt dgng khdm chua bgnh, edn tham gia nhieu hoat ddng khdc nhu ehuung trinh nha hpc dudng, khdm sue khde rdng mieng dinh ky cho hpc sinh vd edn bp nhdn vien a cdc xi nghigp ddng tren d|a bdn, thyc hign cdng tdc truydn thdng gido due s&c khde tgi cgng dong...[6,7].
3. Cdng tdc ddo tao, hoat ddng chJ dao tuygn Bang 4. Ddo tgo theo Idp tdp trung tgi ddu ngdnh (2009-2012)
Nam 2009 2010 2011 2012 Tonq
Sdldp 4 3 4 3 14 ldp
So hpc vien 226 203 158 159 746 Iwcrt
So ngay dao t^o
8 4 6 6 24 ngay
VHQC THV'C HANH (872) - SO 6/2013
Trong glal dogn l& 2009 - 2012, Igl d l u ngdnh dd td ch&c 14 Idp tap hudn tgp trung theo cac ngi dung khdc nhau vdi 746 luyt hpe vign tham d y Ngi dung tdp huin, chuydn giao ky thugt cho tuydn dudi g i n vdi phan tuydn ky thugt,
Bdng 5, Ddo tgo khdng theo ldp tgi ddu nganh Nam
2009
2010
2011
Tdng
SA lu'ynq/nOi dunq dap tgo - 01 bac sy RHM
•02 try thii RHM cho didu du'&ng -01 bac s5 RHM - 05 tn? thii RHM cho didu
du'&ng -02bacsy RHM - 08 tnj'thti RHM chp didu
du'&ng
Thdi gian dao tgo 3 thdng 3 thdng 3 thang 3 thdng 6 thdng 3 thdng 21cdnbP -06 bac sy RHM -17 try thu RHM cho didu du'&nq/yta Ngoai hinh th&e tgp h u i n , bgnh vign cdn tidp nhgn can bg t& tuydn dudi vd hpe dudi hinh th&c ddo tao tryc tidp (cdm tay chl vigc), t& 3 ddn 6 thdng.
Cdng tde ddo tgo, chi dgo tuydn cua Bgnh vign duye tuydn dudi ddnh gid Id r l t thidt thyc trong vide ndng cao ehdt luyng khdm ehua bgnh tgi tuydn dudi, thdng qua dd, trinh dd chuySn mdn eiia cgn bg y td duyc nang eao, nhidu ky thuat duuc chuydn giao va duy tri lgi tuydn trude, trang thidl bi y te duyc bao dudng va hudng d i n s& dyng higu q u i , m&c dp sai Igch trong c h i n dodn duuc riit n g i n , ddng nghiep cdc tuyen xich lai g i n nhau hun.
Bang 6 Tdng hyp edng tdc chi dao tuyen eua ddu ngdnh (2009-2012)
Nam 2009 2010 2011 2012
TS CO so duyc dl tuydn
38 38 40 54
Giao ban luyfen TS lan giao ban
3 4 4 3
S6 ngu'6'i tham du 20 50 65 87 Hang nam, ddu ngdnh deu Igp ke tioach di luydn ddn cde cu sd tuydn dudi, sd luyng cdc c u sd luydn dudi duyc dau ngdnh di khdo sdt tang d i n . Ngi dung di tuydn nhim ddnh gia tlnh hinh nhan luc, trang thidt bi va higu qua sir dyng, cdng tae thye hign chuygn mdn ky thudt tgi cu sd, TrSn cu sd dd de xuat vdi ianh dao cdc dun vj vd cdng tde ddo tgo cdn bd, cae ky thugt ehuyen mdn vdi bae sy ehuydn khoa; t u vdn giiip cac sd cdch quan ly, mua s I m nh&ng trang thiet bi vd thudc thiet ydu, thao g d nhung khd khan trong cdng tae kham ehua bgnh vd ky thudt chuydn mdn vd khdm chua bgnh cho bgnh nhdn bao h i l m y td,
Cdng tic thdng tin 2 chieu vdi tuyin dwdi.
Hdng quy, ddu ngdnh td eh&e giao ban mgng ludi chuyen khoa edc cu sd qudn huygn, thdng qua dd, d l u ngdnh sg ldng kdt, ddnh gia vigc thuc hign nhidm vu chuygn mdn, riit kmh nghiem nhung vigc cdn thidu sdt Khi tuyen cu sd.cd vudng mdc vd mgt chuydn mdn, d l u nggnh deu cd thdng tin qua diSn thoai hoae trao doi tryc tidp, tham gia t u v i n giiip eu s d giai quydt kip thdi G&i len d l u ngdnh nhung ea benh
ph&e tgp, t i t cd cde bgnh nhan chuydn vign, ehuyin luydn cQng d u y c ddu ngdnh thdng bdo lai eho cu sd
4. Thu$n Ip*!, k h d khdn trong hoat ddng eua mgng 1^61 chuydn khoa RHM
- D u y c s y giup dd- eda d l u ngdnh qua cdng tdc ehl dgo tuydn, edc dun vj kham eh&a bdnh RHM irSn dja ban Ha Ngi (dgc bigt Id khu vye Hg Tay cQ) da hoan thign d i n . Nhu mgt Ldnh dgo Bgnh vign da khoa huygn Ba VI dd ndi: "Trwdc ddy, bpnh vipn Tlnh Hi Tiy cOng di tuyin nhwng khdng chl bio chung tdt nhdng vipc lim eg thd nhw Diu nginh bdy gid, ndn chdng tdi khdng biit phii lim gi dd cho chuydn khoa ndy phdt tridn tdt han...". hodc Lanh dao Bgnh vign da khoa huygn Dan Phuyng cOng n d i ' Td khi Sdp nhPp vdi Hi Ndt, qua mdi lin dtrgc Diu ngdnh dl tuyen. Khoa RHM cOa Bpnh vipn di thay ddi hin vi dipn mgo, trang thiit bi vi nhdn Iwc...".
Didu kign c u s d vdt c h i t , trang thidt bj y td vd nhdn Iyc cua mdt s6 c u s d tuydn dudi chua ddng bg (cd c u sd d l u t u trang thidt b| nhung thidu nhdn Iyc, khdng phdt huy hdt edng sudt) I n h hudng r l t ldn ddn hogt dgng eua chuygn khoa
Tuy the bdo hiem y td ddng ky tai cdc bdnh vign tuydn huySn r l t ddng nhung do gia thanh toan cua chuygn khoa RHM rat t h l p so vdi chi phi cac bgnh vidn ddu phdi bii Id, Ldnh dao benh viSn Phiic Thp ndi;" vl bio hiim thanh toin cic thu thupt RHM gii rit thip ndn khp triin khai. Mpt khdc eic phdng khim RHM tw nhin rit nhiiu nPn bdnh nhin it vio bpnh vipn".
K^T LUAN
1. Thwc trang nhdn Igx: vd ho^t dgng chuydn mdn
- Sd edn bd chuygn khoa RHM khu vye Hd Tdy va VTnh Phiie eu tdng 18 ngudi, sd luung ndy d khu vye Hd Ndi cQ gan nhu khdng thay ddi.
- 10 /24 dun vj ciia khu v y c Ha Ndi cu, 2/30 dun vj Khu vyc Hd Tdy vd VTnh PhCic cu cd bdc sy RHM ldm chuyen trach
- Hoat dgng eua ehuyen khoa rang ham mdt lai cac dun vi chu ydu tdp trung vao vigc kham, dieu trj cac bgnh rang migng thdng thudng
- Sau 3 nam sap nhdp, tgi khu vye Ha Tay va Vinh Phiic cu a cae dun vi chuyen khoa RHM sd ky thuat tang rd rgL
2. Cdng tic ddo tgo, chi dao tuyen, Mdt sd thudn lgi. khp khdn
- Cdng tac ddo tgo, chi dao tuydn cua D l u ngdnh eho tuydn dudi la r l t thidt thyc trong viec ndng cao ndng lye chuyen mdn cho cdn bg y id, gdp phin quan trpng cai thi0n c h i t luyng khdm ehua bgnh tgi tuyen dudi, Hoat ddng chi dgo tuydn da giup ban gidm ddc cae c u s d quan tam hun ddn chuySn khoa RHM, giiip hodn thidn ddn he thdng.
- Nhdn lye chuygn khoa RHM tuyen qugn/huySn (dgc bigt Id khu v y c Hd Tay cO) cdn thidu, bien dgng nhieu. Bdc sy khoa RHM phai kiem nhiem cdc cdng vigc khdc eua bSnh vign nen anh hudng den hoat dgng ciia chuyen khoa.
Y HOC THVC HANH (872) - SO 6/2013
TAI LIEU THAM K H A O
1. Bg Y td (2004): Chi thj s6 04 ngdy 29/11/2004 ctia BO trudng Bg Y td ve viec tdng eudng cdng tde ehi dgo tuydn trong ITnh vye khdm ch&a bgnh,
2. So Y td Ha Npi (2008): Quyet djnh sd 121 ngdy 14/8/2008 cua Sd Y te Hd Ngi ve vigc Hudng d i n ctiuydn tuyen kham chu'a bgnh, phdn cong chi dgo tuyen.
3. Sd Y te Hd Npi (2006): Cdng tdc chi dgo tuyen
giai doan 2001 - 2005 vd phuung hudng giai dogn 2006 -2010.
4. Bgnh vign Vigt Nam - Cu Ba Ha Ngi (2009). Bao cdo cong tac chi dgo tuyen vd chuydn khoa dau nganh RHM ndm 2009
5. Bgnh vign Vigt Nam - Cu Ba Hd Npi (2012): Bao cdo cdng tdc ehl dgo tuydn vd chuyen khoa dau nganh RHM ndm 2012
TINH TRANG DINH DOBTNG CUA THE EM 6-60 THANG TUOI TAI KHOA NHI BENH VIEN DA KHOA TINH HAI DUONG NAM 2009
TOM T A T :
Nghien cim nhim mgc tidu so sdnh giwa cdc biin s6 Ildn quan tdi tinh trgng dmh dwdng(TTDD) trd em theo phwang phdp do cdc chf sd nhin trie vi bing phirang phip sw dgng cdng cu dinh gli todn dipn chu quan (Subjective Global Asessment)(SGA) (phuang phdp SGA). Thiit ki nghidn cdu dt ngang md ta trdn 330 ddi twang trd tw 6 din 60 thing tudi dugc diiu tri tai Khoa Nhi -bdnh vidn da khoa tinh Hit Dwang td thing 5-11/2009. Kit qui cho thiy: Dinh gii tinh trgng dinh dw&ng cda trd bPnh tmng bpnh vipn bdng phuong phip SGA khdng nhung xdc dinh dwae benh nhan cd nguy ca thiiu dinh dwdng md cdn xic dinh dwgc nguy CO thiiu dmh dwdng d ci nhdm ed cde chi sd nhdn trie trong gidi hgn binh thwdng.
Td khda: Tri em 6-60 thdng tudi, nhdn trie, phuang phdp SGA, tj lg SDD.
THE ISSUES RELATED TO NUTRITION STATUS OF HOSPITALIZED CHILDREN
The purpgse gf the study was to compam the difference on indicators related to nutrition status of hospitalized childmn by anthropometrical method and by SGA tool. A cmss-sectional study was conducted with involvement of 330 hospitalized children from 6- 60 mgnth of age in Pediatric Department of Hai Duong pmvince hospital from May to November, 2009. The msults show that: Assessment of nutrition status of hospitalized children by SGA togI not only identified the nsk of malnutrition of hospitalized children but also reveal out the risk of malnutrition of hospitalized children with normal anthropometric range.
Keywords: hospitalized children, anthmpometrical method, SGA tool, malnutrition
DAT VAN o e
Suy dinh duung (SDD) cua bgnh nhdn ndi chung, benh nhi ndi rieng (trong bgnh vign) liSn quan tdi tdng nguy co m i c benh, t& vong vd kSo ddi Ihdi gian ndm vien. SDD khdng ehi la bgnh dun thuin md hdn quan t&i nhidu v i n dd trong bgnh vien, b i n g eh&ng la nhieu benh nhan tidp tuc bi SDD trong thdi gian n i m vien[1].
NGUYEN DLTC VINH, Bp Yti NGUYiN e 6 HUY, Vipn Dinh Dw&ng Nhung nghign c&u gp dgng SGA cho bSnh nhan nhi da duyc thyc hign r l t phd b i l n vd dd duyc edng bd trgn cae tap ehi khoa hoe uy tin trgn Thd gidi. Mpt sd nghiSn c&u trSn Thd gidi da su dung cdng cu danh gia SGA trong TTDD ciia bgnh nhi va cho thdy day la edng cu ddnh gid TTDD eua bgnh nhi dae higu vd tin cdy^ do vgy duye khuyen nghj dp dyng cdng cu ndy de hd try, bd sung cho cdc phuung phdp nhdn trie trong danh gid tinh trang dinh duung Ire em [2], [3]. Kl. [5] Nghign euu tai bgnh vign "cho tre bgnh"
tgi Toronto, Canada nam 2006, dp dung edng cy SGA cho benh nhdn nhi cho thiy: SGA Id edng cy ddnh gid tinh trgng dinh dudng eho Ire em phu hyp, giup lien luung duyc cdc nguy cu bien ch&ng vd thdi gian ndm vien cua bdnh nhdn nhi [5],[7],
Nghign cuu ndy duuc thyc hien nhdm xac dmh thuc trang SDD tre em trong benh vien, so sanh duyc ty lg SDD cua bgnh nhi trong benh vidn bing cde phuang phap nhdn t r i e va phuung phap su dgng edng cy SGA.
D O I TU'ONG VA PHU'ONG PHAP NGHIEN CLTU 1. Ddi t u y n g nghien e u u : Cae bgnh nhdn nhi t&
6 thang den 60 thang luoi mdi nhap vign trong vdng 48 gid khdng m i c cdc bdnh d p tinh (tidu chay elp, viem dudng hd hdp e l p . .)
2. Thidt kS nghien e u u : Nghign e&u su dyng phuung phap nghien c&u cdt ngang, lien hanh l u thdng 5-11 ndm 2009 tai Khoa Nhi bgnh vign da khoa tinh Hai Duung
2.1.Cdmau:
Ca miu wdc Iwgng cho mpt tj Id [6]
_ Z , i . „ , „ p{\- p)
- n Id sd Iwgng cin diiu tra; 7? ji^^f Dd tin cay 95%, Z =1,96
- p Id ti Ip suy dinh dwdng trong bpnh vidn Id 35
% (nghidn cdu tnrdc ddy tgi Vien Nhi Tmng wang) (8],
- d li sai sd cho phdp Id 5%. cpng them 10%
dw phdng, ca miu n = 330 ddi twang.
VHQC THVC HANH (872) - S 6 6/2013
