Nghien cira Y hpc ^ Hoc TP. Ho Chi Minh * T | p 20 * So 2 * 2016
KHAO SAT CHAT Ll/ONG CUOC SONG BENH NHAN CHAM THE TANG NGl/61 LCOV d BENH \ ™ ^ DA UEU THANH PHO HO c m MINH
Tritih Ngd Binh', Le Nggc Diep'
TOMTAT
Ma ddu: Chdm the tqng Id binh da thu&ng gap Hong da lieu, chimi 15-20% Heemvd 1-10% nguai l&n d cdc nuac phdt tri^ Chdm the tqng Id binh da mqn tinh, hay tdi phdt, gdy tmi hao to l&n vi'mqt zmt eked vd Hnh than vd dnh hu&ng deh chdi lugng cudc sdng.
Mac tieu: Ddnh gid dnh hu&ng chdi lugng cudc smg cim berth nhSn chdm the tqng.
Dot tiegng vd phucmg phdp: Bdo cdo hdng loqt ca. Birdi chdm the tqng dtegc chan dodn theo Hiu diuan Hanifin vd Rajka. Do rmng binh chdm dugc tinh theo thang dian SCORAD. Ddnh gid chdt lugng cuoc smg qua bg cdu h&i DLQL
Kei qud: 116 binh nhdn cham the tqng (53 nam, 63 nie) zm do tudi trung binh la 35,43 ± 13,4.43,2% biidi nhdn cd dian SCORAD miec do trung hinh. 40,5% binh nhan co chai lugng cuoc song bi anh huang nhieii Ngodi ra, co mm tuang quan khd ehqt giiea diem do nqng ciia chdm the tang v&i dimi cMl lugng cuoc song (r=
0,65).
Kei luqn: 40,5% binh nhdn chdm the tqng bj dnh huang nhieii dm chai lugng cudc song. Su dnh huang ndy (x> mm liin quan deh do nqng cim benh.
Tit khoa: chdi lugng cudc song, chdm ihe tqng ABSTRACT
ASSESSING QUALTTY OF LIFE R^ ADULTS PATIENTS WTTH ATOPIC DERMATUIS AT DERMATO- VENEREOLOGY HOSPTFAL OF HO CHIMINH CTTY
Trinh Ngo Binh, Le Ngoc Diep * Y Hoc TP. Ho Chi Minh * Vol. 20 - No 2 - 2016:40 - 44 Backgrcmttd: Atopic dermatitis is a common skin disease, accounting fin-15%-20% of childrm and 1~10% of adults in developed countries. Atopic dermatitis is a chronic, relapsing disease. This disease may cause physically and mentally enormous loss, therefore affeds on paHmts' quality of life.
Objectives: Assessing the impad cf atopic dermaHHs on the quality of life of paHmts.
Methods: A case series report was conducted in aver 16 years old paHents zvith atopic dermaHHs, who was diagnosed by Hanifin and Rajka criteria. The severity of disease was calculated by SCORAD. These patimts zoere interviewed by questionnaire of quality of life index (DLQl) to assess the quality of life.
Results: We observed 116 paHmts zvith atopic dermatitis. The mean age was 35.43 ± 13.48. Moderate atopic dermaHHs accounted for 43.2% according to SCORAD. Quality of life index (DLQI) showed 40.5% of patients have a large effed on their qimlity of life. Moreover, quality of life and severity of atopic dermatitis vxre correlated (r=0.65).
Conclusion: In this study, 40.5% paHmts zvere affeded on thdr quality of life. This effed was correlated zvith severity of the disease.
Keywords: Quality of life, atopic dermaHHs
* B6 mon Da Lieu, Dai hpc y dLri;rc TP. Ho Chi Minh
Tdc gid lien Iqc: TS. Le Ngoc Di?p DT 0938106969 Email [email protected]
Y Hoc TP. H$ Chi Minh * Tap 20 * S£» 2 * 2016 Nghien cmi Y hoc
D A T V A N D E
Cham ttie tang la benh da man tinh, hay tai phat anh huong deh chat luong cuoc song benh nhan va gia t&ih'"'. Benh gay ton that to ldn ve mat vat cha't va tinh thMi. Benh nhan cham the tang duoc ghi nhan co cha't luong cuoc song kem va anh huong Ion ve mat tam li. Ngoai ra, nhimg nguoi than trong gia finh ding bi anh huong do mat tfioi gian cham soc va chi phi dieu tri^-^. Vi vay, chung toi tieh hanh nghien cuu nay de danh gia cha't luong cuoc song cua benh nhan cham the tang va cac yeu to lien quan anh huong doi chat lugng cuoc song.
DOITlA^NG-PHl/CNGPHAPNGHIENCUtJ Nghien cuu bao cao hang logt ca dugc thuic hien tren benh nhan cham th^ tang de'n kham tai Benh vien Da lieu TPHCM.
Chon mau thuan tien, khong ngau nhien, Tieu chuan chpn mau: benh nhan tren 16 tuoi duoc kham va lam benh an theo mau. Benh chiun the tang dupe chan doan theo tieu chuan Hanifin va RajkaP'.
Dong y tham gia nghien cuoi.
Tieu chuan loai tru khi chan doan chua ro rang, benh nhan co cac benh da khac co the anh huong den chai luong cupc song.
Cac benh nhan dii tieu chuan nghien cuu duoc danh gia chat lupng cupc song qua phong van bang bang cau hoi chi so chat luong cupc song DQLP) tai cac phong kham va cac khoa lam sang.
Dimg phep kiem thcmg ke chi binh phuong (X^), Student t-test, One-Way Anova, Spearman Cac so thong ke duprc trinh bay voi khoang tin cay 95%. Cac kiran djnh p<D,05 duac xem la co y nghia thong ke.
KET QUA NGHIEN ClTu
Dac diem dich tc hpc cua mau nghien curu Trong khoang thai gian tir thang 9/2014 deh thang 3/2015 co 116 benh nhan ttiam gia nghien
cuu voi tuoi trung binh 35,43 tuoi, trong do nhom tuoi 16-35 chian ti le cao nhat (56,1%).
H le nam/nii la 0,84A. Ve dan tpc thi hau het la nguai kinh voi ty le 95,7%. Da so benh nhan (65,5%) d&i tu cac tinh thanh Idiac. 31% co trinh dp hpc van cap 3 va 26,7% co nghe nghiep la cong vien chik^
Dac diem lam sang
Tuoi khoi phat trung binh la 30,34 ± 13,83, thoi gian mSc benh trung binh la 5,14 nam.
Bdng 1: Cdc trieu chieng chinh Hong Hiu chuan Hanifin vd Rajka
E)^cdflm Wem eia man tinh tSiphat Tiin can
canhan
Tiin can giaiTmh
Khong Hen suyin ViSm mui dj irng Hen suyen va viem
mQi di i>ng Khong Cham the tgng
Hai suy&n ViSm mui dj i>ng Cham the tang va hen
suySn ChSm thi tgng vd
viem mui dj u-ng Ngira Phin t}6 esin hinh
Tlnsd(N) 116
81 4 29 2 75 13 7 19
1 1 116 115
Tir#(%) 100 69,83 3,45 25 1.72 64,66
11,2 6,03 16,38
0,86 0,86 100 99.1 Nhan xet: 100% benh nhan co tinh trang viem da man tinh va ngiia. 30,17% c6 tieh can bi dj ling khac, 35,34% benh nhan co Hen can gja dinh bi benh li di iing. 99,1% benh nhan co sang fliuong phan bo dien tunh.
Bdng 2: Cdc trieu chieng phu Hong Hiu chuan Hanifin vd Rajka
Tri#u chung Kho da B$nf} da viy c&
D ^ simg nang long l ^ g ban tay tran b6ng nhiaj difdng
kS TuSi khoi phSt som Khuynh huwng bj nhilm tiitng dafroi logn miln dich qua tmng gian t l \Ao Khuynh iwianq bj cham ban tay ban
chan khong dac hiSu Cham vu
ransa(N 69 41 47 76 16 29 40 2
Ti rs (%) 59,5 35,3 40,5 65,5 13,8 25 24,5
1,7
Nghien ciiru Y hpc Y Hoc TP. Ho Chi Minh * Tap 20 * Sd 2 * 2016
Tri^u chiing Chdm moi Viem ket mgc tai phat Nip Dennie-Morgan dufri mit
Quang tham quanh mat Vly phan ti^ng NepdacStTucrc NgCia khi IB m l hii Bit dung nap dung moi lipid vd len
San quanh nang long Bit dung nap thuc an Diintilntj^nhdnh huOTig boi yeu t l
moi truing/cam xilc Da ve nil tilng
Tin s6 (N|
9 13 26 26 4 22 34 40 21 57 28 7
•niB(%) 7.8 11,2 22,4 22,4 3,4
19 29.3 34,5 18,1 49,1 24,1 6 Nhan xet: Tat ca cac trieu chung phu d ^ xuat hien 6 benh cham ttie tang voi ti le khac nhau, trong do chiem ti le cao nha't la long ban tay tran bong nhieu duong ke (65,5%).
Do nang cham the t^ng theo thang d i ^ SCORAD.
Bdng 3: Miec do nqng nhe dia chdm the tqng iifluc dd t)#nh
Nhe Taing binh
Nang
Tlns6(N) 33 50 33
Til«(%) 28,4 43,2 28,4 Nhan xet: Dp nang trung binh la thuang gap nhat voi 43,2%, ke tiep la miic dp benh nhe (28,4%) va benh nang (28,4%).
Chat Ivfong cu6c song c^a b^nh nhan cham the tang.
Bdng 4: Ch^ lugng cuge sdng dm benh nhdn chdm thetqng
Hfluc d l dnh huvng din chit lirQug cu^c sdng
Khdng It Tmng binh
Nhilu RIt nhieu
Tin s i (N) 6 23 34 47 6
TIIe(%) 5,2 19,8 29,3 40,6 5,2 Nhan xet: 40,5% benh nhan cham the tang CO chai lupng cupc song bi anh huong nhieu, ke tiep la miic dp trung binh (29,3%) va miic dp it (19,8%).
Mdi tuomg quan giua d i « n dg nang cua cham the lang vdi diem chat luong cuge sdng
Diem dp ngng cao nhat la 99,5 va tong diem
chat lupng cupc song cao nhat la 25.
Mdi tuang quan ciia tung cau hoi trong bang chat lupng cupc song vai diem dp nang ciia benh kha chat 6 cau h6i ve miic dp ^nh huong cia benh deh ban be hoac nguoi Ihan.
Co tuong quan kha chat voi he so' tuong quan r =0,65.
Phuang trinh hoi quy dit doan:
Tdng diem chat lu^ng cupc sdng= 3,52 + 0,19 X diem dp nang.
Nhu vay, khi diem dp nang tang len 1 (td tdng diem chat lupng cupc song tang len 0,19.
Bim do 1: Mm tuang quan giua dirni do ndng cua binh zm di^ chai lugng cuoc sdng
B A N L U A N
Dac didm dich tl hgc cCia ddi tugng nghiSn CUTI
Tudi trung binh cua benh nhan trong nghien cuu nay la 35,43 (dp lech chuan la 13,48). Theo y van*'') thi benh thuong gap 6 tr^ em. Do nghien ciiu chi tieh hanh tren nguoi lan, nen chiing toi khong so sanh duoc ti le giiia tre em voi nguoi Ion. Benh plian bd nhieu a nhom 16-35 turn (56,1%) phii hap voi nghien ciiu<^"'.
Ve gioi, nii chiem ini the hon nam (nam/nu la 0,84/1), tuong tir nhu trong nghien oiui*"^.
Co the do benh nhan nix ttiudng cham lo d&i tinh trgng benh cua minh rihieu han n&n di kham tai benh vien nhieu han.
Ve nghe nghiep va trinh dp hpc vsn tW phii hop voi y van'« la cham the tgng tiiuong xay ra 6 nguoi CO trinh d6 hpc v3h cao v^ co ngh§' nghi?p
Y Hgc TP. Hd CM Minh * T | p 20 * So 2 * 2016 Nghien cuu Y hpc
thu nhap cao.
Dac diem lam sang cua cham the t ^ g Thoi gjan mac benh trung binh la 5,14 nam phu hap voi cac nghien ciiu'^^^. Do do, cham the tang la benh man tinh keo dai va tai phat
Cac trieu chung chinh trong tieu chuan Hanifin va Rajka: trieu chiing viem da man tinh tai phat nhieu lan, ngiia va phan bo sang thuong dien hinh co dp nhay cao phu hpp vai^^^-^^\
30,17% benh nhan co tien can ca ntian, thap hon cac nghien ciiu khad^-^; 35,35% benh nhan co Hen can gja dinh mac cac benh di iing, thap hom cac nghien ciiu*'-'^. Do do, cham the tang la benh lien quan d&i di iing.
Cac trieu chiing phu trong tieu chuan Hanifin va Rajka: Cac so' lieu ciia chung toi ve ti^ chuan phu cua benh tuong doi phu hpp voi nhieu nghien ciiu khad^-'*'^* va giiip chung ta co cai nhin t&ig quan ve bieu hien benh cham tiie tang voi rat nhi&i trieu chiing da dang.
Dp nang cham the tang theo thang diem SCORAD
Miic dp benh tmng binh la thucmg gap nhat voi 43,2%, phu hpp vdi nghien ciiut"), khac voi nghien ciiuC'^. Dieu nay co the ly giai benh nhan ciia chung toi da phan la ngudi Ion nen thuang d a i vien mupn hon khi trieu chiing tra nang.
Chat lugmg cuge sdng b#nh nhan cham the tgng
Diem trung binh + dp lech chuan a i a tong diem chat lupng cupc song la 11,07 ± 6,22, co diem tuong ddng voi nghien ciiuP*.
Mdi tuong quan giiia diem do nang cua cham the tang voi diem chat lugng cudc sdng
Ve he so tuong quan trong nghien cuu la 0,65 cao so voi cac nghien ciiu'3.io), Nhin chung, chat lupng cupc song bi anh hudng nhieu boi benh.
Theo bieu do 1, chung toi dua ra nhan xet sau; viec xac dinh moi tuong quan giiia miic dp
ngng va chat lupng cudc song ci!ia cham tiie tang rat hihi ich trong cong tac cham soc y te, c6 y nghia trong thuc hanh lam sang, nhimg truong hpp benh nang can phat hien som va dieu tri tich cue phong tranh nhieu tac dpng tieu cue deh chat lupng cupc song nguoi benh.
KETLUAN
Kdt qua nghien ciiu danh gia cha't lupng cupc song tren 116 benh nhan cham the tang tgi b | n h vien Da Lieu TPHCM, chiing toi nhan thay su anh huong ciia benh Ien chat lupng cupc song ciia benh nhan kha nhieu (43,2%). Va quan trpng hon, sir anh huong nay co moi tuong quan voi dp ngng ciia benh. Qua do, chiing toi de nghi c&i dieu tri va ctiam soc benh nhan cham the tgng kip thai va thuong xuyen de cai tiiien chat luong cupc sdng, dam bao cham soc siic khoe toan dien.
TAI LIEU THAM KHAO
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