Y HOC VIET NAM THANG 4 - SO 2/2015
V. KET LUAN
Nghien cdu tren 43 benh nhan viem gan B man ti'nh va 48 ngu'di khde manh cho thay. Nong dp MICBs tnsng huyet tu'dng d benh nhan viem gan B man tinh ed nong dp trung binh 26,5ng/ml [0,1-41,3], cao hdn ro ret so vdi d ngu'di khde manh 5,60 ng/ml [0,1-25,04] vdi p <0,001.
TAI LIEU T H A M KHAO
1. Bahram S. and Spies T. (1996). "Nucleotide sequence of a human MHC class I MICB cDNA,"
Immunogenetics, 43, 230-233,
2. Cerboni C , Fionda C , Soriani A., Zingoni A., Doria M., Cippitelli M., et al. (2014). The DNA Damage Response: A Common Pathway in the Regulation of NKG2D and DNAM-1 Ugand Expression in Normal, Infected, and Cancer Cells,"
Frontiers in immunology, 4, 508,
3. Champsaur M. and Lanier L. L, (2010).
"Effect of NKG2D ligand expression on host immune responses," Immunological reviews, 235, 267-285.
4. Toan NL, Song le H, Kremsner PG, Duy DN, Binh VQ, Koeberlein B, Kaiser S, Kandolf R,
Torresi J, Bock CT. (2006). Impact of I3ie hepatitis B virus genotype and genotype mixtures on the course of liver disease in Vietnam Hepatology. 43(6): 1375-84.
Holdenrieder S., Stieber P., Peterfi A., Nagel D., Steinle A. and Salih H. R. (2006). "Soluble MICB in malignant diseases: analysis of diagnostic significance and correlation with soluble MICA,"
Cancer immunology, immunotherapy : Oil, 55 1584-1589.
Kohga K., Takehara T., Tatsumi T., Ohkawa K., Miyagi T., Hiramatsu N., et al. (2008). "Semm levels of soluble major histocompatibility complex (MHC) dass I-related chain A in patients with chronic liver diseases and changes during transcatheter arterial embolization for hepatocellular caranoma,"
Cancer Sci, 99,1643-1649.
Matusalj G., Tchidjou H. K., P o n ^ l l i G., Bernard! S., D'Ettorre G., Vullo V., et al.
(2013) "Soluble ligands for the NKG2D receptor are released during HIV-1 infection and impair NKG2D expression and cytotoxiaty of NK cells,"
FASE6 journal: official publication of the Federation of American Societies for Expenmental Biology, 27, 2440-2450.
NGHIEN CITU GlAl PHAU NHANH XUYEN DONG MACH MONG TREN VA DONG MACH MONG DU'C! CAP M A U CHO VAT NHANH XUYEN VUNG MONO
Nguyen Van Thanh*, Vu Minh Dire*, Tru-ong Van Tai*, H 6 Thanh Phong*, V6 Anh Quan*, Khu-ong Quoc Khoa*, Tran Van Anh**, Nguyen Van Huf**
T 6 M TAT
Tien hanh nghien ciru giai phau nhanh xuyen dpng mach mong tren va dpng mach mong dudl cap mau cho vat da can vCing mong tren 10 tieu ban (5 xac) tUdi naydi tru'dng thanh (4 nam, 1 nd) tai Bo mon Giai Phau, tru'dng 0?i hoc Y Ddde Thanh pho Ho Chi Minh t d 1/12/2014 den 10/1/2015. Chiing toi tap trung nghien cdu ve vi tri, so Idpng, dUdng kinh trung binh eiia nhanh xuyen d 3 viing theo eac du'dng chuan dich: vung 1 dupe xac djnh bdi 3 diem la gai chau sau tren, mSu diuyen Idn xu'dng dui, xu'dng cung cut (eye tren), vung 2 la dpc theo dddng noi mau chuyen idn xu'dng dill den diem giiia xdOng ciing cut, viing 3
* B?nh vi^n Nhan dan 115, TP, Ho Chi Minh
** Bp mon Bong - Hpc vien Quan Y Chju trach nhi^m diinh: Nguyin V3n Thanh Email: [email protected] Dt: 0903744344 Ngay nhan bai: 4/3/2015
Ngay phan bi?n: 16/3/2015 Ngay duyet bai: 18/3/2015
dupe xac dmh bdi 3 diem mau chuyen tdn, u ngoi, cut dudl xUOng ciing cut.
Tu'khda:g\m phau nhanh xuyen viing mong.
S U M M A R Y
STUDY ANATOMICAL OF SUPERIOR GLUTEAL ARTERY PERFORATOR AND INFERIOR GLUTEAL ARTERY
PERFORRATOR FLAPS Study anatomical superior and inferior gluteal artery perforator flaps on 5 (4 males, 1 female) Vietnamese adult fresh cadavers, which were dissected. The skin and subcutaneous tissue were removed to identify the muscule margins and to find the perforatoring branches that supply the subcutaneous tissue. The points of the perforating branches visible to the naked eye were marked using pins and photographed. Three areas were dassilied according the landmari<s of posterior supenor Iliac 5pine(PSIS)- greater trochanter of the femur(GT) line and coccyx, a line was drawn between the GT and a
' " 3 ^
Y HOC VIET NAM THANG 4 - SO 2/2015
point of middle coccyx, and the inferior gluteal fold.The number, location,diameter of the main vesels at the point of middlea line from the GT to coccyx.
Keywords: microvascular anatomy, gluteal perforator.
I. OAT V A N o t
Trong thap nien qua, vat nhanh xuyen 6\itSz tap trung nghien cdu tren the gidi va trong nddc trong tao hinh 6 loet viing ciing cut, u ngoi, mau chuyen idn cung nhu' dng dung vat ty do tao hinh vu. Thiet l<e vat nhanh xuyen vung mong phu thupc vao vi tri, sd lu'dng, kich thddc eua nhanh xuyen dam bao nguon cap mau cho vat dat yeu cau ky thuSt giai phau ve nhanh xuyen vung mdng va dng dung vat nhanh xuyen dieu trj 6 loet cung cut, Phau tich vat nhanh xuyen rat khd khan phii'c tap nen ddl hoi kien thdc ve giai phau nhanh xuyen, kinh nghiem phau thuat.
A. M. Verpaele va cong sd da thyc hien vat nhanh xuyen dpng mach mong tren dda tren nhanh xuyen [1], Tac gia Warren Matthew Rozen trang nhuhg nim 2009, 2011 Hen tiep nghien ciru giai phau nhanh xuyen dpng mach mong tren, mong dddi bang hinh anh hpc cong bu'dng td mach mau [1][2][7]. Vat nhanh xuyen viing mdng gom vat nhanh xuyen dpng mach mdng tren va mong dddi hoan toan phy thupc vao vj tri, ki'ch thddc, dddng kinh cua nhanh xuyen.
Chung toi tien hanh nghien ciru giai phau nhanh xuyen viing mong dy^ vao cac tieu chi ve sd lydng, vj tri, dydng kinh ciia nhanh chinh nam d vi tri diem gitte du'dng noi td mau chuyen Idn den diem giO^ xu'dng ciing, Td ket qua dat ddde bude dau trong nghlSn ciTu nay se xac dmh vj tri nhanh xuyen thddng ddde dng dung phii lidp cho thiet ke vat nhanh xuyen dpng mach mong tren va vat tai cho cd cuong vat d vi tri gan nep Ian mong giiip xac dinh chan chan nguon cap mau cho vat da can vung mong dng dung che phii khuyet hong viing ciing cut,
Nghien cdu thyc hien tren 10 tieu ban mong (5 xac) tutli ngddi Viet tru'dng thanh tai bp mon Giai phau hpc, tru'dng Dai hpc Y ddde Thanh pho Ho Chi Minh td thang i2/2014 den thang 1/2Q15.
II. 001 TU'(?WG VA PHUOTSIG PHAP NGHIEN CLTU 2.1. Odi tu'dng nghien cuTu
Gom 5 xac tirdi ngddi Viet Nam tru'dng thanh (10 tieu ban mong); 4 nam, 1 nff tal bp mon Giai
phau hoc, tru'dng Dai hoc Y ddde thanh pho Ho Chi Minh td 1/12/2014 den 1/1/2015.
2.2. Phu'dng phap nghien cu'u:
Tien hanh tren 10 tieu ban viing mdng ciia 5 xac tddi, cac tieu ban deu du'dc phau tich theo mot quy trinh thong nhat:
+ Muc dfch: xac dinh sd lu'dng trung binh ciia nhanh xuyen d 3 viing: phfa tren, dpc theo, phia dddi du'dng chuan dich noi td mau chuyen idn den diem giSa xu'dng cung cut, xac dmh khoang each td diem gida xu'dng eiing cut den vj tri nhanh xuyen cd du'dng kinh Idn nSm tren du'dng noi td diem giiJa xu'dng ciing cut den mau chuyen Idn,
^ + Phu'dng phap tien hanh: ap dyng ky thuat phau tich kinh dien,
+ Phddng tien:
- Cac dung cu phau tieh thong thddng - Kinh lup cd dp phong dai 4 lan cua Lien bang Ddc san xuat
Thddc kep Palmer ed dp chinh xac 0,1mm - Myc in tliong thu'dng
+ Cac bdde tien hanh:
- Xac tu'di 6\i6c chup hinh ma so va dat d td the nam ngu'a
- Phau tieh tim thay dpng mach chau trong tdng ben
- Tien hanh bdm myc in pha loang 10% khoang 10 ml vao dpng mach chau trong tdng b§n. Gid nguyen td the nam ngffa khoang 20 phut, - Dat xac d td the nam sap, lay mdc ciia diem gida xddng ciing cut, mau chuyen Idn, mao chau, nep lan mdng. Ke 1 dddng noi td diem glife xddng ciing cut den mau chuyen Idn lam moc giai phau,
- Rach da den Idp can ed mdng Idn theo bu'dng td gai chau sau tren doe theo mao chau ra ngoai di qua mau chuyen Idn xuong dddi theo nep lan mong den y ngoi,
- Xac dinh so lu'dng nhanh xuyen tren 3 viing glal phau du'dc xac dmh tren, dpc theo va dddi dddng chuan dich noi td trung diem xddng ciing va mau chuyen Idn xddng diii ciing ben, III. KFT QUA NGHIEN CU'U
Tien hanh phau tfch tim sd xuat hien cua nhanh xuyen vung mdng d 3 viing j<ac djnh bdi dddng chuan dich noi tir mau chuyen Idn xu'dng diii den diem giiJa xu'dng ciing cut theo thd ty;
viing nam tren du'dng chuan di'ch, dpc theo dddng chuan dich va viing nam dddi dddng chuan dich tren nep lan mong ciia 10 tieu ban xac tddi viing mong cd nhan xet sau:
