I Khoa hoc - Cdng nghe va Doi mdi sang tao
TP HO CHI M I N H :
Bv0c dau ung dung tri tue nhan tao trong y te
PGS.TS.BS Tang Chi ThUdng i,"i, Sl' "i leTP Ho Chi Minli
Trong nhQng nam gan day. v6i sU phat trien manh cua nganh khoa hpc may tinh, nhat a ^^^^J (machine learning) va tri tue nhan tao da m6 ra nhieu hUdng phat trien day tiem nang trong linn . y te. Bai viet tdng quan ve sU phat tri^n trong Unh viic nay tai cac ni/6c phat tnen va nhifng Ung aung bUdc dau 6 TP Ho Chi Minh - dia phi/dng dang di tien phong trong viec iJng dung tn tue nhan tao de giai quyet cac van de xa hpi.
tfng dung robot Hoc may va tn u i nhdn tao trong Itnh vuc y t6 tr6n ttiA gim
Ve dng dpng robot Mgt so nganh cdng nghiep d a n g chung kien tac ddng cua robot, va y hpc cung khdng ngoai le Mqic du tien dp cua cac Ung d g n g nay c6n chSm so vdi cac nganh cdng nghiep khac. nhung tac d p n g cd the rat ldn, robot trong y hpc c d th§ giup giam loi cua con ngudi, cai thien thdi gian phye hoi va giam thdi gian n 3 m v i ^ n . CUOI cung la nang cao ehat lupng cudc song eua benh nhan.
L/ng d u n g robot dau tien trong fTnh vuc y khoa xuat h:en vao nSm 1985. khi mot canh tay phau thuat robot ho tro phau thuat smh thiel than kmh 15 nSm sau, he thong robot phau thuat hpan chinh dau tien dUde Cue Quan ly thue p h ^ m va dUdc pham My (FDA) phe ehuan (he thong robot phau thuat Da Vinci). giup bac s i phau thuat ndi soi dieu khien d u n g cu phau ihuat gian tiep
Robot Da Vinci.
Ihdng qua ban dieu khien.
Nam 2013. cuoc each mang robot chinh hinh da khdi d d n g , VOI he thong robot Mako, cd the tao md hinh 3D cua khdp d u a tren CT scan, cho phep bac sT phau thuat len ke hoach trudc khi phau thuat cho tung benh n h a n , khi ke hoaeh dUdc thiet lap, eanh tay robot dat gdc va mat phSng cua cua phau thuat chinh xac de
n g a n vet eSt di q u a s a u . N a m 2018, he t h o n g M a k o da thUc hien gan 8 0 . 0 0 0 lan I h a y khdp goi va h d n g tai hdn 6 5 0 b e n h v i e n tren the gidi N g o a i ra, cae he t h o n g robot p h a u t h u a t t h a n kinh eung da duoc dua v a o Ung d u n g .
N a m 2 0 0 1 , ndi so, bi mg vien n a n g nuot v a o da duoc " D A c h a p t h u a n , quy trinh •>ao g o m
44 KHOA HOC 1 K
Khoa hgc - Cong nghe va Doi mdi sang tao I
viec dat mpt chiec may a n h n h o c6 vien thuoc. Khi b e n h nhan nuot vi§n ndi soi, no se di q u a dudng tieu hoa, may anh se c h u p
^nh d ^ bac sT phat hien nhQng bat thudng va dUa ra c h a n d o a n . Hien nay, c d n g nghe mdi d a n g tim each sao c h o cac bac sT cd the dieu khien s u di e h u y e n c u a vien nang npi soi tU xa, kiem soat chuyen d d n g eua n d , trai ngUdc vdi vi?c di ehuyen thy d g n g trong cd the, Neu c d n g nghe nay thanh c6ng, cac Ung d u n g tiem nang khac nhu sinh thiet hoac dieu tri bSng thuoc den tUng vi tri cu the cua cd the se de d a n g dUdc thUc hien,
Gan day, c d n g nghe robot da I g o r a d U d c c ^ c h a n . t a y g i a . C d n g ty Open Bionics cd try sd tai A n h da SLJ dung c d n g nghe in 3D de tao ra "ban tay bionic", hien bat dSu dupc sU d y n g d chau A u va My Ban tay bionic nhe va co the nhat cac vat nho, c a m va giU. Ke den la robot phye hoi chUc n a n g , robot nay dang duge sii d y n g de giup benh nhan phuc hoi s a u dot quy va cae chan thUdng so nao khac, cung n h u giup ngUdi d i m g
\^y lai sUc m a n h , kha n a n g phoi hdp va s u nhanh n h e n .
Mot trd ngai ldn m a nhieu cong ty che tao robot d a n g phai doi mat la chi phi eho may mde.
Viec che tao robot cd the sao chep chinh xac each di c h u y e n tay, CO tay, ngdn tay eua mot bae slphau thuat rat ton k e m .
Ve dng dung hpc may va tri tue nhan tao
Vdi su phat trien c u a khoa hoc may ti'nh, dU lieu (6n (big data),
nhieu Ung d y n g hpe may va tri tue nhan tao da dUdc v a n d u n g vao ITnh vUc y te tai nhieu nude phat t n e n tren the gidi.
D a u tien phai ke den Ung d u n g tri tue nhan l a o Irong "Y hpc ca the". Hoc may de dieu tri ca the la mgt van de nghien eUu n d n g . Muc tieu cua Imh v y c nay la c u n g cap dieh vy tot hdn dua tren 60 lieu sUc khde ca n h a n vdi phan tich dU d o a n . Cac c d n g cy tinh toan va thong ke hge may dUdc SLf d u n g de phat trien mot he t h o n g dieu tn dUPc ca nhan hda d u a tren cac t n e u c h u n g c u a b e n h nhan va thong tin di truyen hpc.
Ke den la Ung d y n g tri tue n h a n tao trong c h a n doan va d y bao benh tat. Hien nay, phUdng phap hoc may dang dupe SL/dung de phat hien va phan loai cac khdi u Ngoai ra, hgc sau ( d e e p l e a r n i n g ) d d n g mdt vai tro q u a n trgng trong phat hien ung thu, khi cd th§ truy cap vao ngudn dO lieu cd sSn. Mgt nghien cUu cho thay, hpc sau giUp giam ty le loi trong c h a n d o a n ung t h u v u . SU d u n g phUdng phap hpe s a u , ung t h u c u n g cd the dUdc phat hien b a n g each trich xuat cac tinh nang tU dU lieu bieu hien g e n . Ngoai ung t h u , ehan doan benh tim m a c h , phat hien b e n h tieu dudng giai d o a n s d m . d y bao dien tien c u a b e n h gan eung la uu the cua Ung d y n g hoc may,
Mdt Ung d y n g thiet thUc khac c u a hgc m a y la tag r a " b a c s T c h a n d o a n hinh anh ac". Ung d y n g nay cd y nghTa thue tidn cao vi khdng p h a i dia p h u o n g nao c u n g cd bac
sy chan d o a n hinh anh. Vdi dU lieu ldn ve hinh anh X q u a n g , CT.
M R l , bang cac thuat toan dUa tren hoc may se giUp doc ket qua n h a n h hdn va c h i n h xae h d n . DU bao b u n g phat dich b e n h q u a cdng nghe hge may va tri tue nhan tao c u n g la Ung d y n g d a n g dUdc the gidi q u a n tam B&ng dU lieu ldn thu thap tU ve tinh.
phUdng tien truyen thdng thdi gian thuc, m a n g than kinh nhan tao giup doi chieu thong tin va dU bao tU dieh benh sol ret den cae loai benh truyen nhiem khac.
Ong d u n g hpc may trong ho s d sUc khoe dien iCr c u n g dupe phat tnen m a n h . PhUdng phap phan loai tai lieu bang "vector m a c h i n e s " , ky thuat nhan d a n g OCR va cdng nghe nhan d a n g ChQ Viet tay dUa tren hpc may d a n g dUdc phat trien the he tiep theo cua ho sd sUc k h o ^ thong m i n h , giup c h a n d p a n , de xuat dieu trj.
Ngoai ra, c a n phai nhae den Ung d y n g tri tue nhan tao cho nhan vien dieu phoi cap cUu ngoai b e n h vien. P h a n m e m Ung dung ehuyen d u n g chg cac trung tam cap cUu tren the gidi ed ten la
"Pro QA" ("Professional Q u e s t i o n Ansvi'er"), giiip nhan vien y te tiep nhan cudc gpi cap cUu vUa tiep nhan cudc ggi q u a he t h d n g am thanh vUa v a n hanh m a n hinh VI tinh de sang loc t h d n g tin can thiet theo cac cau hoi va dUa ra ldi k h u y e n c h o ngudi b e n h hoac than nhan ngudi b e n h , d o n g thdi thdng tin dudc m a hoa va c h u y e n s a n g bp p h a n dieu h a n h de van hanh cac xe cUu thUdng den hien trudng.
KHOAHOC \!., K
45
I Khoa hgc • Cong nghe va Doi mdi sang tao
Nhtmg ang dong btffic flftD tat T? Ht Clii MInti
Lfng dung robot trong phau thuat
Robot Da Vinci (My) ra doi vao nam 1982 va b i l l dau duoc sir d y n g tren nguoi nhung cdn han che Mai den nam 2 0 1 0 . robot nay mdi duoc c h o phep s i i d u n g rOng rai. Tinh den thang 8/2017.
tren the gidi cd khoang 4.700 robot Da Vinci. My chiem nhieu nhat vdi 2 700 robot, chau Au gan 700 robot. N h a l Ban va Han Qudc gan 500 robot, con 800 robot hoat d p n g o cac nudc khac.
c a n h tay robot xoay dUdc 540 d d . tay phai, lay trai deu nhu nhau, di chuydn den mgi ngdc ngach cua c d th6 ma m6 npi soi hay mo hd theo thdng thuong deu khong iam dupc, cd kinh hien vi phong tp phan cd I h ^ can mo ma mat Ihudng, hay mo ndi soi thdng thudng khong the nhin Ihay. muc ti&u can md se dUdc thuc hien mpt cach Iri^t d ^ , tgn gdc.
Robot Da Vinci da duoc ung d y n g tai Benh vien Binh Dan tu thang 11/2016, d^n nay da phau thual cho g^n 700 b e n h nhan vdi nhieu benh ly phUc tap.
Robot than k m h M o d u s V S y n a p t t v e dUoc ung d u n g p h a u thuat tai My, C a n a d a tU nam 2 0 1 5 (robot the he 1). dUdc lich hop ehup c d n g h u d n g lu khuech lan sue c a n g . tu d d n g xu ly de nhin thay cac b d than k m h . tuy c h i n h tdi uu c a c h tiep can tdn thUdng trong phau thuat. lap ke hogch p h a u thuat, dmh hudng p h a u thuat. van h a n h n h a n h , c h m h xac h o n . p h a u Irudng md
Ih.iii kinh Modus V Synaptive trong phau
rat nho, khong gay tdn thUdng cac day than ^ nn phu hdp vdi thdng sd rieng cua tUng bpnh n h a n . TU dd giup bac si lUa chgn cach tiep can toi u u . giam thieu cac bien chUng. nguy cd gay tdn thUdng cac vung chUc nang q u a n trong nhu ngon ngQ, thi giac va van d d n g .
Benh vien Nhan dan 115 da dua Robot Modus V Synaptive (Ihe he thu hai) vao hoat dgng tU Ihang 2/2019. den nay da phau thuat cho tren 10 benh nhan cd nhieu benh ly nao phuc tap
t / n g dung hpc miy va tri tue nhan tao trong chin doan dieu tri
Phan mem Ung dung tri tue nhan tao t r o n g e h a n d o a n d i e u t n p h o b i e n n h a l h i e n nay la "RAPID". dUoe phat trien bdi Dai hgc Stanford (My). Phan mem Ung dung nay se giup xac dmh rd the tich vung ldi hoai tCr, the tich nhu md nao c d nguy
cd ton thUdng, va hoai tCr trgng nhUng gid tiep t h e o , eon gpi la
"vimg tranh toi t r a n h s a n g " , giiip cho cac bae sT c h a n d o a n va can thiep dieu tri chinh xac h d n . T h e o thdi gian, eac te b a o nao se chet dan, cU mdi phut trdi q u a , se c d khoang 1,9 t n e u te b a o n a o bj hoai tCr NgUdc lai, neu dUdc tai thdng m a c h m a u kip t h d i , cac te bao nao trong " v u n g t r a n h tdi tranh s a n g " se co the hoi p h y c nhanh c h o n g . P h a n m e m R A P I D la giai phap da d u p c chUng minh hieu q u a va dd c h i n h xac q u a cae thU n g h i e m lam s a n g va dUdc FDA c h a p t h u a n sCf d u n g tai cac trung tam dot quy h a n g d a u d My C h o d e n nay, tren toan the gidi da CO tren 1.200 trung tam dgt quy sU d u n g p h a n m e m R A P I D .
B e n h v i ^ n N h a n dan 1 1 5 va B e n h v i e n G i a An 115 la d d n vj dau tien tai Viel N a m p h o i h d p trien khai l o a n bo p h a n m e m R A P I D trong c h a - doan va dUa ra eua so d i e u tn irong dot
46 KHOAHOC \ \ RMGNGHE'.CI Vtni
Khoa hgc - Cong nghe va Doi mdi sang tao I
quy nao cap, len den 2 4 g i d . Viet Nam la nUdc thU 3 t r o n g k h u vUc (sau Thai Lan va Indonesia) m u a dUdc bcin q u y e n eua p h a n m e m nay. Neu theo cQa s d dieu Iri thudng quy, chi c h o p h e p dieu tri tai thong trong cCfa so la 0 den 6 gid tinh tU lue khdi phat trieu chLfng. NhU vay, viec Qng d u n g tri tu# nhan tao c h u y e n biet c h o x d tri ddt quy chae ehan se m d ra cd hdi cUu s d n g va giam nguy cd bi tan phe cho b e n h n h a n , gdp phan dua ngUdi b e n h s d m tai hoa nhap c d n g d o n g .
Trong ehan doan va dieu tri ung thu, 2 b e n h vien tai TP H d Chi Minh la Ung budu va D a khoa Phil Thp da dupc B d Y te c h o n tham gia thCf n g h i e m Qng d u n g phan mem tri tue nhan tao t r o n g tu Vein va hd trd cae bac sT trong lya chpn phac do dieu tri b e n h ung thu tien tien va hieu q u a c h o ngudi benh. D d la p h a n m e m tri tue nhan tao " I B M W a t s o n for Oncology" do T a p d o a n IBM c u a My xay dung d u a tren nen t a n g 60 lieu ldn, hien nay da dude then khai ap d y n g d 2 3 0 b e n h vien cOa 13 nUdc tren the gidi nhu My, Trung Q u d c , A n D p , H a n Qudc, Thai Lan... P h a n m e m nay tap trung vao 2 loai b e n h ung t h u pho bien la ung t h u vu va ung thu dai true trang. B e n h vien Ung budu da thif n g h i e m p h a n m e m nay tren 103 b e n h n h a n ung thU vLiva 126 benh nhan ung t h u dai trye trang. Ket q u a eho thay, ty le tUdng dong giQa phac d d cua benh vien va phac dd c i i a p h a n mem dua ra la 8 0 . 3 % ; t r o n g dd tuong ddng ve phac do dieu tri ung thu vu la 71 °o, ung thU dai true Irang la 8 8 . 1 % .
P h a n m e m hd trp hau het cae giai d o a n dieu tri cua ung t h u vu va ung t h u dai true trang MUc d d tuong d o n g cao nhat giOa phac do dieu tri cua b e n h vien va p h a n m e m tri tue nhan tao trong ung t h u vu la d giai d o a n II. Ill, c d n t r o n g ung thU dai trye trang mUe do t u g n g d d n g eao nhat la giai d o a n IV. Oanh gia ve hieu q u a CLia p h a n m e m tri tue nhan tag nay, cac bac sy tai B e n h vien Ung budu c h o biet: p h a n m e m giup cac bac sy cap nhat cac phac do m d i , bo s u n g thdng tin va han che nhQng sai sdt trong q u a trinh dieu I n ; d u a ra dUge cac gdi y dieu tri cho hau het cac giai d o a n , cd hd trd kha c h u y e n sau ve cac phac dd hda tri. ndi tiet:
ho t r d tim kiem tai lieu m g l each nhanh nhat: phat huy toi uu hieu q u a khi ap d u n g md hinh hdi ddng e h u y e n gia (Tumor board).
IJfng dung hpc miy va dd lieu Idn trong ke dPn
Hien nay, hau het cac b e n h vien deu da trien khai ke ddn bang may vi tinh thay eho viel tay. Ngoai viec giup ngudi benh c d ddn thude rd rang, de dgc, viec ke ddn qua may vi tinh se cdn phat huy nhieu hieu qua khae neu chUdng trinh ke ddn dUde tich hpp he thong nhae. Nhieu b e n h vien da xay d u n g va cai dat he thdng nhae vd lieu lupng thude. nhae ke don nhQng thude cd c u n g hoat chat, nhae thude cd nhieu tac d u n g phu gdp p h a n giam nguy ed sai s o l trong ke don cua cae bac sT.
T h e e thdi gian, dQ lieu ke d d n cd the ndi la mdt trong cae n g u d n
dQ lieu lam s a n g Idn (big data) eua cac benh v i e n . neu khai thae dupc ngudn dQ lieu ldn nay se cdn khai thac dUde nhieu tipn ich khac.
Ong d y n g tri tue nhan tao trong ITnh vUc y te d a n g trong thdi ky phat tnen m a n h m e tai cac nUdc phat trien. Tuy n h i e n . de phat trien m g l Qng d y n g tri tup nhan tao ddi hdi phai hdi ty nhieu y ^ u td quan trgng, tQ c d n g n g h ^ may tinh c h u y e n s a u , cac c h u y e n gia khoa hpc may l i n h , c h o den ngudn dQ lieu ldn ed gia trj. T r o n g dieu kien ngudn IQC cua nude ta ndi Chung, TP H d C h i M m h ndi rieng, viec xay d y n g mdi cac phan m e m Ung d y n g tri tue nhan tao trong ITnh vuc y te c d n rat khd k h a n , do dd trUdc mat can trien khai Ung d y n g cac s^n p h a m Qng d u n g tri tue nhan tao de nang cao hieu qua va chat lupng c h a m sdc sUc khoe ngudi d a n . N h u vay, viec ddi hdi chgn lUa nhQng Ung d u n g da dUdc chUng m m h khoa hpc ve ldi ich eiia n d , va phu hdp vdi y e u cau phat trien t h y c tien eua nganh y te t r o n g nUdc c a n dUde q u a n tam h a n g d a u . Ben eanh dd, viec t h a m gia vdi cae doanh nghiep trong ITnh vUc c d n g nghe thdng tin ed uy tin trong nude va nUdc ngoai de tao ra cac dQ lieu Idn (big data), tU d d xay d y n g cac Qng d y n g tri l u e nhan tao mdi d a p Qng y e u c a u thuc tien cua n g a n h y te c u n g can dUde xel den trong thdi gian tdi ^
KHOAHOC
