CHAT LU'DNG GlAC NGO VA MOT S6 Y^U T 6 LIEN QUAN O NGU'ai BENH TANG HUY^T AP D\tU TRI NGOAI TRU
TAI B^NH VIEN DA KHOA TfNH NAM DINH
T6M TAT
Myc tiiu: Md ti thyc tryng chit Iwgng giic ngO vi xic dinh myt sd yiu td liin quan din chit lugng giic ngu cOa ngw&i binh tang huyit ap diiu tri ngoai trO tyi B$nh vi$n Da khoa tinh Nam Djnh.
ed/ tugng vi phwang phip nghiin cOv: Nghiin c&u md ti ngang dwgc tiiyc hiyn trin 400 nguoi binh.
Sir dyng thang do PSQI (Pittsburgh Sleep Quality Index) S dinh gii chit lugng giac ngO vi phin tich he so twang quan pearson (r) di xac dinh myt s6 yiu to liin quan.
Kit qua: Phin Idn ngw&i binh c6 cic van di vi giic ngu vai 67% ngw&i b^nh ed th&i gian ngd mdi dim it hon 5 tiing, 56,8%; 59.8%; vi 63.5% ngu&i bynh cd a 3 lin/tuan khdng thi di vio giic ngO trong vdng 30 phut; tinh ng6 liic niJa dem ho^ tinh ngO qui sdm; vi phai thOc diy di di tiiu trong dim, theo trinh ty. Hiu hit ngw&i binh diu cam thiy khd ngu, v&i 39% ngw&l binh cim tiiiy rit khd ngO vi ehi cd 20%o ngu6i b$nh dyt biiu suit giic ngO a 85%. Trong tdng so 400 ngw&i b$nh tham gia nghien cuu, 87,2% ngudr binh cd chat lugng giic ngO kim vi chl cd 12,8% ed ehit lugng giic ngu tdt (PSQI s 5 diim).
Cd ntdi tuang quan thu$n mOc dd yi^ ff'Q^ chit lugng giic ngu v&i tiiuc hinh vi sinh giac ngO (r = 0,182 vdrp = 0,000), twang quan nghjch mOc d? trung binh giOa chit lugng giic ngd v&i thii dd vi giic ngd (r = -0,479 vdi p = 0,000), vi tuung quan nghich mire dd yiu giOa thii dg vi giic ngO vdi thyc hinh vi sinh giicngO (r = -0,157 vcnp = 0.002).
Kit lu$n: Ngw&i bynh ting huyit ip trong nghiin cifu cd chit lugng giic ngO thip. Nhung hinh vi khdng dOng trong thyc hinh \4 sinh giic ngO. nhung sai iich trong thii dd vi giic ngO cua ngw&i bynh c6 inh hwdng khdng tdt din chat Iwgng giic ngu eua hg.
TO' khda: Chit lugng giic ngu. ting huyit ip.
SUMMARY
SLEEP QUALITY AND RELATED FACTORS OF OUTPATIENTS WITH HYPERTENSION IN NAM DINH GENERAL HOSPITAL
Objective: To describe the sleep quality and determine related factors among outpatiens with hypertension in Nam Dinh general hospital.
Method: The cross sectional study was conducted among 400 patients. PSQI (Pittsburgh Sleep Quality Chiu trich nhi$m: VQ Thi Minh Phugng Email: vuminhphuong2210@gm^l.com Ngiy nh$n: 09/11/2017
Ngiy phin biin: 05/12/2017 Ngiyduyytbii: 27/12/2017 Ngiy xuit bin: 20/1/2018
VU THj MINH PHU'giJG, N G G HUY H O A N G Trip&ng Dyl hgc Biiu dwSmg Nam Djnh
Index) was applied to assess tiie sleep quality and analysng pearson correlation (r) was used to determine related factors.
Result: The maioritv of patients had sleeping troubles, included sleeping durations less than 5 hours per niqht: more than 3 times per week with being unable to toll asleep within 30 minutes; being awakened at midnight or too eariy; and being gotten up to urinate, equal to tiie percentages of 67%; 56.8%:
59.8%o; and 63.5%, respectively. Almost all patients felt difficulty in sleeping. 39% of patients felt very difticutty in speepinQ. and there were only 20% of patients who had sleepinq effecA of a 85%. Amonq the total 400 patients who consented to participate in tiie study, the percentage of patients with poor sleep quality accounted for 87.2%, and there were only 12.8% of patients with good qu^ity of sleep (PSQI £ 5 pdnte).
There was a low degree po^tive correlation between the patients' sleep quality and their sleep hygiene practices (r=0.182, p value of 0.000). a moderate degree negative correlation between the patiente' sleep quality and their attitudes of sleep (r = - 0.479, p value of 0.000). and a tow degree negative conflation between the patients' attitudes of^eep and their sleep hygiene practices (r=-0.157, p value of 0 002).
Conclusion: The patiente within this study had poor quality of sleep. The wrong behaviors in patients' sleep hygiene practices, and patients' deviations in attitudes of^eep inffuenced badly on their quality of sleep.
Keywords: Sleep quality, hypertension.
OATV>^D£
Clilt lugng gilc ngu Id d n thilt cho sO'c khde t i l uu. sire sing vd cd t h i tg qudn 1;^ bdi tO'ng ed nhdn.
Vide tdng cudng chit lugng giac ngu trd thdnh mpt trang nhung ITnh vgc frpng tdm trong cham sdc todn diln cua dieu dudng, hd Xrg kilm sodt THA cOa ngudi bdnh. Mpt ddnh gid khdeh quan v l CLGN vd cdc y l u t l liSn quan d i n CLGN cOa ngudi bdnh se giOp dilu dudng thgc hidn mdt cdch toi uu chit lugng chdm sdc, vd to* dd giOp ngudi bdnh cd thd tg cdi thidn dugc chit lugng giac ngu gdp phin kilm sodt tdt han huylt dp eiia ngudi bdnh.
Nghidn ciru dugc tiln hdnhnhim myc tiSu: Md ti thyc tiyng ehit Iwgng giic ngu va xic dinh mdt sd yiu td liin quan din chat Iwgng giic ngO cOa ngw&i b$nh ting huyit ip diiu tn ngoyi tni tyi Bdnh vi$n Da khoa tinh Nam Dinh.
06\ TUVNG VA PHUX7NG PHAP NGHIEN CUU 1. Ddi tugng vd thdi gian nghidn cipu Nghidn eiru dugc thgc hlgn trong thdi gian tO- thdng 05 d i n thdng 10 ndm 2016 vdi d l i tugng tham gia Id 400 ngudi bpnh tdng huyet dp (THA) dugc dilu trj ngogi tn^ tgi Bdnh vipn Oa khoa finh Nam Djnh, t g
VH^CTHV^ HANH (1066) - SO 1/2018
nguydn tham gia vd khSng cd thdm cac bdnh ly mgn tinh n§ng ho#e cdc bSnh ly dnh hudng din gllc ngO.
2. Phuo-ng phdp nghlSn cu-u
NghiSn e^u m l td ngang, danh gid chat lugng gilc ngO, kiln thuc v l gilc ngu, thgc hdnh ve sinh gilc ngu vd thdi dp v l gllc ngii bdng cde bd cdng cy tuang irng phidn bing bin tilng Vidt dang duge dp dyng chinh thO'c bdi Vl$n SO'c khde Tdm thin Quie gia, duge kilm djnh dp tin d y trude khi ap dyng eho nghidn ciru vdi hp sd Cronbach Alpha trong khodng tO- 0.8 den 0,9, Xdc djnh mpt so y l u t l lidn quan den ehit lugng gile ngu thdng qua phdn tich hd s l tuong quan pearson (r).
3. XCF ly sd li^u: Sir dyng phin mIm SPSS phien ban 20.0.
K^T QUA NGHIEN CU'U
1. Ddc d i l m chung cua n g u ^ benh THA tham gia nghien ci>u
Ngudi bpnh THA trong nghien ciru chu yeu Id ngudi cao tudi, tuli trung binh Id 69,2 ± 6,94. Thdi gian dugc chin dodn vd dilu trj THA trung binh Id 7,64 ± 4,47 ndm. Ngudi bdnh nam ehilm 54% sd cdn lgi Id ngudi bdnh nu chilm 46%.
2. Thirc tr^ng c h i t lipgng g i l c ngd cua ddi tipgng tham gia nghien c m i
Bdng 1. Thgc trgng gilc ngii eiia ngudi b^nh (n = 400)
S l ngudi bdnh ed CLGN tdt (PSQI s 5 C\hm' chiem t j 1$ thIp chi 12,8%. Trong khi, da s l ngirti bpnh (87,2%) cd CLGN kdm, vdi g i n m$t ni>a si ngudi bdnh (49,5%) cd rli logn gile ngii d mO'e trung binh. Diem PSQI trung binh cua d m l u nghidn ci/u Id 10,2 ±3,6.
Bdng 3. Ting hgp dilm ddnh gid liSn quan a^n gilc ngO eOa ngudi bpnh
D$c diem 77)d! gian thuc ngd mdi t3§m:
< 5 g i 6 ' 5 - 7 gid S 7 g i d
Kh6 khan trong g / i c ngO:
£ 3 l^n/tuln khdng t h i ngO trong v^ng 30 phOt a 3 lan/tuan tinh ngu Iuc niia dem ho|c qud sdm
£ 3 lln/tudn thiPC dgy d l di tieu Cim nhSn v4 miK dg khd ngii;
Khflng cam thdy kh6 ngO Cdm thay hoi kh6 ngO Cdm t h ^ kh6 ngili Cdm t h ^ r l t khd ngii Hi$u suit giSc ngii T 6 I (a 85%) 75 - < 85% (Tnjng binh) 65 - < 75% (Tucrng dfii k6m)
< 65% (K6ml
S6 ngu'ai T9I§
benh %
180 20,0 13,2 45,0 Bdng 2. Phdn logi ehit lugng gilc ngu eOa nqudi bdnh (n = 400)
Phdn logi chdt lirgng giSc ngO (PSQI) So J^ l | % ngu'di b6nh Chdt lugngpiSc ngu tflt (s 5 di^m) 51 ^2fi C h ^ luvng gidc ngu k§m (6 - 21 iJi6m) 349 87,2
R6i lo^n giic ngO nh? (6 - 10 diim) 130 32,5 Rdi lo^n giic ngO tmng binh 198 49 5
(11-15 aim)
R6iloyngiicngun$ng(>15<Sim) 21 5,2 DiSm PSQI trung binh: T h i p Cao
10.2 ± 3 , 6 nhlt: 1 n h ^ . 19
Ngi dung ddnh gid
K i ^ thi>c ve Ddi diem
- 3 0 -
E)i6m dgt cUa ngu^j bOnh ThIp Cao Trung
nhlt nhlt binh (Mm) (Max) (x±SDl
-14 26 5.18±
g l l c ngu 30 Th^Fc hdnh ve sinh 13
g i l c ngii Thdi d$ v l g i l c ngO 20
C h i t luvng l i e ngd
100
10,221 3,e5 3. Mdt sd y l u t d liSn quan d i n chdt lugng^glk ngu cua ngud-i b f n h THA
Bang 4 t h i hidn k i t qua phdn tich mdi tuong aim glQa chat lugng gllc ngii cOa ngudi bdnh vol tu6l vi thdi gian dugc dieu trj THA ciia hg.
Bing 4. Tuang quan giu-a CLGN vdi tuli vd M gian duge dilu trj THA (n = 400)
Chdt lu^ng F p ~ g i l c ngu
T6t K6m S6 NB So NB 67,0
21,0 12,0 56,8 59,8 63,5
Tufii
Thdi gian b|THA
s 60 tufli 61 - 70 tudi 71 - 80 tu&
^ 1 tudi
£ 5 nam 6 - 1 0 nam 1 1 - 1 5 nam
> 20 nam 21
34 -0,38 0,814 175 0,91 0,207 131 -0,30 0,719 9 -0,40 0,177 135 0,44 0,592 153 -0,31 0,676 39 -0,18 0,219 21 0.11 0.614
-1,00 Bdng 5. LiSn quan giO'a cde y l u t l vd vdi chSt lugng g i l c ngu
CLGN KTGN THGN TBGN Sig. (2-tailed)
N Sig. (2-tailed) r
N Sig. (2-tailed)
N r Sig (2-talled)
400 -.048 337 400 .182' .000 400 -.479 .000
1 400 -.094 .060 400 .052 .297 tuang quan c6 y nghTa vdip< 0,05 BAN LUAN
Tudi trung binh cua 400 ngudi b$nh THA trong nghiSn cuu Id 69,2 ± 6,9 vd khdng cd sg chinh Ijch dang k l ve ty Ip ngudi bdnh nam vd nO-. K i t qi^ n^
cho thiy sg tuang ddng vd xu hudng theo cdc mm thdng kd dd dugc d n g b l Id THA Id thudng giP * ngudi cao t u l i vd d dd t u l i £ 65, nam vd nu- c6 nguy
Y HQC THV'C HANH (1066)-SO WOJjj
ca THA ngang nhau [2]. Ngudi bdnh trong nghiSn eiru d thdi gian dugc qudn \)f va dilu trj THA tmng binh 7,64 ± 4,47 ndm vd ddy Id khodng thdi gian dO dai d l hp d m nhdn dugc d i y du ve gilc ngO c^a hp.
v l thiFc trgng chat liFpng gilc ngu:
Phin Idn ngudi bdnh THA trong nghlSn ciru d thdi gian thgc ngO mdi dSm ngin chi dudi 5 tilng. Da sd ngudi bdnh d l u cd cdc v i n dd gdy cdn trd gilc ngCi ban ddm nhu ed han 3 lln/tuln khdng thd di vdo giac ngu trang vdng 30 phiit (56,8%); flnh ngu Iuc nira ddm hay thO'c gilc qud sdm (59,8%); hodc phdi thO'c d$y d l di tllu (63,5%).
Trong tong so 400 ngudi bpnh THA thudc nghiSn ciru. sd ngudi bSnh ed ehit lugng pile ngii d muc kdm fPSQI: 6 - 2i^dilm) ehilm t j Id r l t cao tdi 87,2%.
Ve cdc y l u td lien quan d i n c h i t Ivgng g i l c ngO:
Cdc y l u t l nhu tudi vd thai gian bj bSnh tiiy thu$e tirng nghidn cu'u cd t h i cho ket qud cd sg tuang quan hode khdng ed sg tuang quan vdi chat lugng giac ngii d a ngudi bdnh. NghiSn ciru ciia chiing t l i khdng tim thiy mdi tuang quan d y nghTa thing k l giija chit lugng gilc ngii cua ngudi bpnh vdi tuoi vd thdi gian dugc chin dodn vd dilu trj tang huyet dp ciia hp.
K i t qua phdn tic^ cho thiy d m l i tuang quan cd if . nghTa thdng kd giO'a thgc hdnh vp sinh gilc ngu vd
chit lugng gilc ngO, tuy m l i tuang quan edn yeu vdi hd s l tuang quan r = 0,182 (Bdng 5) nhung gdp phin
£ing hg cho thgc t i l n ring ngudi bdnh cd thgc hdnh
; giac ngO tdt se cd Igi eho giac ngu ban, ndi each khdc d chat lugng gile ngO t i t han.
K£T LUAN
Ngudi benh THA trong nghidn cO'u cd chit lugng gilc ngii thdp vdi dilm trung binh chit lugng gilc ngii PSQI Id 10,22 ± 3,65 diem. Trong tdnd sd 400 ngudi b§nh cd tdi 87,2% ed ehit lugng gile ngu d muc kdm (PSQI: 6 - 2 1 dilm). Da s l ngudi bdnh ddu gdp phli ede v i n de v l gilc ngii nhu thdi gian thgc ngO mdi dSm ngIn dudi 5 tilng ddng h i g|p d 67%
ngudi bpnh, hidu suit gilc ngu thdp. Cd mdi tuang quan thu§n mire dp yeu giCra chit lugng giac ngii vdi thgc hdnh vd sinh gile ngii (r = 0,182 vdi p = 0,0001, tuang quan nghich mO'e dd trung binh giO'a chat lugng gilc ngii vdi thdi dd v l gllc ngu (r = -0,479 vdi p = 0,000), vd tuang quan ngich mO'e d l y l u giua thdi dd v l gilc ngO vdi thgc hdnh v$ sinh gile ngu (r
= -0,157 vdi p = 0,002). NhO'ng phdt hipn cua nghlSn ciru cho thay d n cd ntiCrng can thidp thay doi hdnh vl va thdi dp ve gilc ngii giup cdi thipn chit lugng gilc ngii eho ngudi bdnh.
T A I L I E U THAM K H A O
1. Ljf Duy Hung (2008) Ngh'i&n ciru die diim lim sing rdi loan giic ngii trong cic rdi loyn liin quan din stress. Ludn van t i t nghi#p Thac sy Y hpe nam 2008.
Tnjd'ng Dgi hpe Y Hd N6i.
2. Nguyen Ldn Vipt (2012). Dich t§ hgc tang huyet ip vi cic nguy ca tim mych & Vi$t Nam 2001-2009. Dgi hdi Tim mgch toan quIe lan thir 13. Tp. Hg Long.
3. Trin Hiru Binh (2005). Rdi hyn giac ngii khdng ffiuc tdn. Tdi ti^u giang dgy sinh vien y 5, Bd mdn Tam than Tnrdng Ogi hpc Y Ha Npi, trang: 245-251.
ANH HU'ANG COA THU6C SINH MACH TAN D 6 I vai MQT S 6 CHJ S 6 HUY^T HOC VA HINH ANH MO BENH HOC GAN THAN
T R E N DONG VAT THLCC NGHIEM
N G U Y £ N VINH QU6C^ B A N H T H I T H U Q U Y i N \ NGHIDM H O U T H A N H ^
^Vi$n Yhoc cd truyin Quan d^i, ^Bynh viyn Cham cO'u Trung wang T6M TAT
Myc tiiu: Dinh gii inh hw&ng cOa thudc^Sinh mych tin fdf tinh trang c/iu/jg, mit sd ehlsd huyit hgc vi hinh inh md b$nh hgc gan thfn thd thyc nghi$m. Phuung phip nghiin ciru: Thudc Sinh mych tin dyng cdm tan liiu 0,9g/kg thi tryng/ngiy vi 2,7g/kg thi tryng/ngiy trin thd (twong dwang lieu lam sing vi gip 3 liiu lim sing) liin tyc trong tii&i gian 4 tuin bing dw&ng udng, tiidng qua theo ddi tinh tryng Chung, tiii tryng thd. mdt sd chl sd huyit hyc, hinh inh dyi thi cQng nhw ciu trOc vi thi gan. tiiin thd thyc nghi$m. Kit qui: Thudc Sinh mych tan khdng inh Chiu trich nhidm: Nguyin Vinh Qudc i Email- [email protected]
\ Ngiy nhyn: 16/11/2017 t Ngiy phin bi$n: 12/12/2017 I Ngiy duy$t bii: 25/12/2017 I Ngiy xuat bin: 20/1/2018
hw&ng tinh tryng chung cUa tho, khdng anh hw&ng ti&i ca quan teo miu thdng qua cic ehi tiiu xit nghiim huyet hyciyi cic then diim trunc vi sau 4 tuin udng thudc. hinh anh dyi tiii vi w the gan, tiiin khdng cd sw khic biit giua Id ddi chiing vi hai Id dung thudc thw.
Kit luin: Thude Sinh mach tin khdng khdng lim thay ddi t&i tiie tang ehung. khdng giy inh hw&ng t&i ca quan tyo miu. khdng tim thay ddi hinh inh md binh hgc gan. tiian tiid thwc nghi$m.
TCP khda: Sinh madi tin, thyc nghidm.
SUMMARY
THE INFLUENCE ON HEMATOLOGICAL INDEX AND HISTIPATHOLOGICAL IMAGE OF LIVER AND KIDNEY OF "SINH MACH TAN" ON EXPERIMENTAL ANIMALS
Objective: Studies was evaluating eftocts of "Sinh mach tan" on general conditions, haematological parameter and histopathologycal image of liver and kkiney of rabbits. Methods: "Sinh mach tan" at doses
Yu^CT^^^ H A N H f 1066^ - SO 1/2018~
