NGHIEN CUU
D A CDIEM
L A M S A N G , C A N L A M S A N GCUA BENH
N H A NDj IJING DIEU TRI TAI KHOA A21 - BENH VIEN 175 TUT 1/2001-1/2006
TOM TAT
Nghidn cdu h6i cdu 350 bdnh nhin di ufng diiu tri tgi khoa A21-Bdnh vidn 175 tit 1/2001-1/2006, cho thiy: Tf Id bdnh nhan di dng thudc la 40,86%o, trong dd di cmg khang sinh chiem 11,43%,, di dng thuoc khang vidm giim dau nonsteroids: 2,57% va di img thudc khdng rd loai: 26,86%). Tf Id bdnh nhan di dng thdc in li 20,00%o; dj dng cdn trung: 8,00%) va di dng khdng rd nguyen nhan la 31,14%a. Cac trieu chCmg lam sang thudng gip la met mdi, khd chiu, mi day, ngda, sdt khd thd, dau bung, tidu chiy. Ngoai ra cd thi cd ddp da va lodt niem mac. Cac ch! so can lim sing ea ban deu d trong gidi han binh thudng. Khdng cd mdi lien quan giita cac triiu chCtng lim sang va can lam sang vdi cac yeu todi nguydn.
TUkhda: dj cmg, Benh vien 175 SUMMARY
Studying on the clinical and paraclinical characters of the allergic patients treated at the A21 department of 175 hospital from 1/2001 to 1/2006.
Retrospective research on 350 allergic patients treated at A21 department of 175 hospital from 1/2001 to 1/2006, the results showed that the ratio of the dmg allergic patients is 40,86%o, in which, the allergy to antibiotic, NSAID and undistinguishable dmgs are: 11,43%o; 2,57%) and 26,86%o. The pmportion of patients have allergy to food, insectc and undistinguishable causes are 20,00%); 8,00%) end 31,14%). The usual cHnical symptoms are tired, uncomfortable, urticaria, itch, fever, dyspnea, stomachache, diarrhea. In addition, there can have blister and mucous membrane ulcers. The index of basic pamclinical symptoms are nonval. There is no significant relation between the clinical, paraclinical symptoms and the allergens.
Keywords: allergic, 175 hospital OATVANOi
Tinh hinh benh di irng ngay cang tang cung vdi sur gia tang tinh trang 6 nhilm moi tri/dng va sir phat tnen cdng nghiep hoa, do thj hoa. Theo nghien curu eua Eaton (1982) cho tha'y sd ngi/di mac cac benh di Lfng d mdt thanh phd tai Anh tang tuf 22,85%' nam 1794 len 29,79% nam 1979. Tai My cd khoang 60 triSu ngirdi mac mpt b§nh dj Ong (Reisman), d Phap ty la cung tOdng tU, d Thuy Oien 20% tre em diTdc kham bSnh cd cd dia dj ufng. Mat khac, cac bieu hiSn IStTi sing ciJa bdnh di umg cung r^t khac nhau, cd khi chi la nhufng ban s i n , ngtira tai cho, nhi/ng cd khi de doa tinh mang nhi/ sdc phan v§, hay hdi chifng Stevens Johnson, hpi chifng Lyell. Ddng thdi, cac di nguy6n ngay cang nhieu va phufC tap. Tif viec phat
MAI V A N Dliti - B$nh vl$n 175
trien nhilu loai thudc va hoa chat suf dung trong nhieu nganh nghe nhif y te, nong nghiep, bao quan thifc phim, my phim den suf bung nd cua dd thi hoa, lam cho viec phong tranh tiep xuc dj nguyen cang them khd khan hdn. Trong dieu tri cung gap nhieu khd khan, khong nhufng khd xac dinh difdc di nguyen de phdng tranh, ma khi tim difdc di nguyen, doi khi cung khd tif bd nhif trong di ifng vdi mot sd loai thifc pham yeu thich. Tuy vay, cac nghien cufu ve van de nay edn qua it va rai rac, chufa cap nhat difdc cac ty le mac cac benh dj ifng hien nay.
Tren cd sd dd, chung tdi tien hanh nghien cufu de tai: "Nghien cifu dac diem lam sang, can lam sang cua benh nhan di ufng dieu tri tai khoa A21- benh vien 175 tif 1/2001 - 1/2006" nham muc dich:
- Xac djnh ty le cac benh dj ufng tai khoa A21 - Benh vien 175.
- Tim hieu cac dac diem lam sang va can lam sang, va mdi lien quan vdi dj nguyen cua cac benh nhan dj ufng dieu trj tai khoa A21 - Benh vien 175.
OOI TLTONG VA PHl/ONG P H A P NGHIEN CCfU 1. Do! tUdng nghien ciifu:
Bao gdm 350 benh nhan difdc chan doan dj ifng, dieu tri tai khoa A21- Benh vien 175 tuf 1/2001 -
1/2006.
2. PhUdng phap nghien cHru:
- Nghien cufu hdi curu, cd md ta va phan tich.
- Tat ca cac benh nhan cd hd sd benh an nhap vien day du cac yeu td:
+ Lam sang: met mdi, khd chju, sdt, ndi me day, ngiJfa, khd thd, phij mat, dau bung, tieu chay, dpp da, loet niem mac. Cac trieu chimg tren xay ra sau si!f dung thuoc, my phim, thifc an, hay do con trung ddt, thdi tiet, hoac khong ro nguyen nhan nhung tai diln nhieu lan.
+ Can lam sang: cd day du cac xet nghiem ed ban nhir huyet dd, chife nSng gan (AST, ALT), than (ure, creatinin), ion dd, dien tim, x-quang tim phdi.
- Cac hd so benh an du dieu kien tren se difdc lap thanh phieu thu thap sd lieu thdng nhat. So lieu difdc xur ly bang phifdng phap thdng ke y hpe, suf dung phan mem SPSS for Windows 12.0.
K^T QUA 1. Dac diem ve Ootu6i
<20 2 0 - 4 0
>40 Tdng c6ng P
Nam 24 95 86 205 (58,57%)
P>
gidi va tuoi: Bang 1:
Nil 24 75 46 145 (41,23%) 0,05
Tdng cong N
48 170 132 350
% 13,71%
48,58%
37,71%
100%
P P=0,012
Y HOC THl/C HANH (751) - S 6 2/2011 123
s d benh nhan nam nhieu hdn nuf, nhi/ng khdng cd sif khac biet cd y nghTa thd'ng ke (P>0,05). Tudi thifdng gap la 20 - 40, chiem 48,58%, tiep den la dp tudi > 40, chiem 37,71%, v6i sif khac biet cd y nghla thdng ke (P<0,05) giufa 2 gidi.
2. Dac diem doi tifdng chinh sach: Bang 2:
Doi tuong 350 Ty le %
P
BHYT 176 50,28 •
Quan 80 22,86
Dich vu y te 94 26,86 P* < 0,05
So ddi tifdng bao hiem y te chiem hdn mot nufa (50,28%), vdi sif khac biet cd y nghTa thdng ke (P<0,05), so vdi sd ddi tifdng la quan (22,86%), va djch vu y te (26,86%).
3. Phan nhdm dj ufng theo nguyen nhan: Bang 3:
Di nguyen n = 350 Ty le % Tdng cong P
Thuoc K. sinh
40 11,43
NSAID 9 2,57
Khac 94 26,86 143 (40,86%)
ThUc pham 70 20,00
Con triing
28 8,00
KRNN 109 31,14 207 (59,14%) P > 0,05
Di ufng thuoc chiem ty le 40,86%, trong dd: dj ufng thudc khong ro loai chiem 26,86%, khang sinh
11,43%, thudc khang viem giam dau (non steroids) chi cd 2,57%. Dj umg thifc an chiem 20%, dj ijfng cdn truing 8%, va di ufng khong ro nguyen nhan (KRNN) chiem ty le cao nhat 31,14%. Khong cd sif khac biet cd y nghTa thdng ke giufa cac nhdm (P>0,05).
4. Cac trieu chumg lam sang chu yeu: Bang 4:
STT 1 2 3 4 5
Trieu chufng Met moi, kho
chiu Me day
Ngufa Sot Kho th6
Ty le % 100 96,85 95.63 76,57 54,71
STT 6 7 8 9 10
Trieu chimg Phil mat Dau bung Tieu chay Dop da Loet niem
mac
Ty\e%
22,56 17,82 5,74 4,86 2,51 Cac trieu chufng lam sang thifdng gap chu yeu la:
met mdi, khd chiu (100%), me day (96,85%), ngifa (95,63%), sdt (76,57%), khd thd (54,71%), phu mat (chu yeu phu 2 mi mat: 22,56%), va dau bung (17,82%). Ton thUdng dop da va loet niem mac chiem tyle thap (4,86 va 2,51%).
5. Cac chi so xet nghiem huyet hoc:
Di nguyen
Hong cau (K/nD Bach cau (K/^l) BCOA NHAN TT (%)
BC Lympho
(%) BCai toan (%)
P
Thuoc K.
sinh 3,95
6,42
61,76
35,06
2,60 NSAID
4,40
8,78
64,20
32,60
3,00 Khac 4,28
7,23
64,10
32,43
2,57 Thuc ph^m 4,02
7,80
64,37
33,03
2,17 Co tmng
4,16
7,82
66,92
30,23
2,63 KRNN
4,05
7,05
61,14
35,11
2,77 P > 0,05
Trung binh 4,14
7,52
63,75
33,08
2,52
Bang 5: Chi so huyet hgc d cac nhdm di dng thuoc Nhin chung, so lifOng hong cau, bach cau va cdng thifc bach cau cua cac nhdm di ufng deu d trong gidi han binh thifdng va khdng cd sif khac biet cd y nghTa thdng ke (P>0,05) giOfa cac nhdm. Tuy nhien, trong sd lieu cd 76 tnfdng hdp (26,03%) cd sd li/png bach cau > 9000 K/|il, va cong thufc bach cau xu hudng chuyen trai (N: 70,94%, L: 26,95%).
6. Cac ch! so sinh hoa:
Di nguyen
AST (mmol/l)
ALT (mmol/l)
URE (mmol/l) Creatinin (mmol/l)
P
Thuoc K.
SINH 38,33 48,56 5,83 96,50
NSAID 62,60 79,00 5,31 92,43
KHaC 75,07 62,00 5,50 85,25
Thuc phim 36,64 42,07 5,13 83,48
Con triing 41,88 30,71 5,04 87,18
KRNN
34,86 47,98 9,03 82,91 P > 0,05
Tnjng binh 48,23 51,47 6,02 87,96
Bang 6: Chisd sinh hoa d cac nhdm di Cmg thudc Nhin chung, hau het cac trUdng hpp deu cd chifc nang gan, than binh thudng d tat ca cac nhdm dj nguyen khac nhau. Tuy nhien, cd 20 trudng hdp (5,71%) cd men gan tang tren 2 lan (trung binh AST;
269 mmol/l; ALT; 236,4 mmol/l). Cac tafdng hpp nay phan bd chu yeu cl nhdm dj ufng thudc nhung khong ro loai thudc. Gac benh nhan nay thudng bj cam cum va tu mua thuoc udng (gon nhieu loai nhung khdng biet ten thudc). Cd 07 trudng hdp cd creatinin > 130 mmol/l (2,0%), trong dd cd 02 trUdng hdp creatinin
>300mmol/l, phan bd rai rac d tat ca cac nhdm dj nguyen. Cd 01 trudng hpp tdn thUdng ca gan va than, deu thupc nhdm dj ifng thudc khong ro loai.
7. Thdi gian dieu trj:
Thdi gian dieu tri
(ngay) Cao nhat Thap nhat Trung binh
P
Thudc K.
sinh 26
1 7,43
NSAID
15 2 9,40
Khac
35 1 8,17
ThUc phim
25 1 6,12
Con triing
6 1 3,30
Khac
60 1 11,32 P > 0,05
Tmng binh
7,62
Bang 7: Thdi gian dieu tri.
Thdi gian dieu trj trung binh la 7,62 ngay, dai nhat la 60 ngay, va ngan nhat la 1 ngay. Khdng cd sUkhac biet cd y nghTa thong ke (P>0,05) giufa cac nhdm, nhung trong sd cac nhdm cd nguyen nhan ro rang thi dj ifng vdi thudc khang viem giam dau nonsteroids co thdi gian dieu trj dai nhat (9,4 ngay). Thdi gian dieu tri trung binh cCia nhdm dj ifng khong ro nguyen nhan la dai nhat (11,32 ngay) trong tat ca cac nhdm di nguyen khac nhau.
BAN LUAN
1. Dac diem ve tuoi, gidi va doi tUdng chfnh sach:
Tuy sd benh nhan nam nhieu hdn niJf, nhi/ng si/
124 Y HOC THirc HANH (751) - s 6 2/2011
khac biet khdng cd 'j nghTa thong ke (P>0,05). Dieu nay cung phu hpp vdi y van la di Ung khong phu thudc vao gidi. LUa tudi bj dj Ung nhieu nhat la tU 20 - 40 tudi, vdi ty le 48,58%. Ket qua nay cung tUdng dUdng vdi nghien cifu cuia Nguyin Nang An va Nguyin Quan Doan cho thay lUa tudi bj dj Ung thudc la tif 20-40. Nghien cifu cija Duong Thi Thu, Pham Thifc & cs cho thay benh nhan bj dj img hay gap b Mia tudi 30-39. PhiJng Minh Son & cs nghien cUu thay hay gap di ifng ci lUa tudi 25-29. Trong nghien cifu cua chiing tdi, ddi tUdng bao hiem y te chiem ty le nhieu nhat (50,28%). Day cung la dac diem chung ddi vdi tat ca cac loai benh vi benh vien ngay cang md rpng dien cham soc sUc khoe vdi ddi tUdng nay.
2. Ve nguyen nhan dj iifng:
Ty le benh nhan dj ifng khong ro nguyen nhan kha cao (31,14%). Trong dd, bao gdm ca nhufng benh nhan udng mpt sd thudc khang viem giam dau nonsteroids, vitamin khdng ro loai va ddng thdi cd an udng mpt sd thufc pham khong thudng xuyen, nen khong xae djnh dupc dj nguyen. Ben canh dd cung cd mdt sd benh nhan bj me day cap hay man tinh tu phat.
Dj Ung thudc chiem ty le gan nufa sd benh nhan dj ufng nhap vien dieu trj (48,86%). Trong dd, di Ung v6i khang sinh chiem 11,43%, va thudc giam dau nonsteroids chi cd 2,57%, trong khi nhdm benh nhan dj Lfng thudc khong ro loai chiem ty le kha cao (26,86%). Neu tinh rieng trong nhdm di Ung thudc thi ty le tUdng img la 27,97%, 6,29%, va' 65,73%. Hau het sd benh nhan dj Ung thudc khong ro loai, thudng bj cam cum va tu ra hieu thudc mua thudc ve dieu trj, ndn dUde ban cho mot tui thude khong co nhan hieu hoac mpt sd nhan hieu khong rd. Tuy nhien, khi tim hieu b cac hieu thude, chiing toi dupe biet cac thudc nay ehu yeu thupc nhdm ha nhiet giam dau va khang viem nonsteroids, mpt sd it ed them ea khang sinh.
Do vay ma ty le dj Ung vdi khang sinh va thudc khang viSm nonsteroids trong nghien cifu cua chiing tdi ed the se cdn cao hdn. Ty le dj ifng thudc khang sinh trong nghien eifU cuia chung tdi cung tUdng dUdng nhu nghien cUu cua A.D. Ado (25,98%), nhung thap hdn trong nghien cifu cua Nguyin Van Doan (71,2%), va Nguyin Nang An, Phan Quang Doan & cs (63,14%). Ty le dj lihg thudc khang viem nonsteroids trong nghien cifu cua chung toi tUdng dUdng vdi ket qua cua hai nghien cUu tren (5,3% va 4,09%).
Sd benh nhan dj Ung vdi thifc pham va con trung cung chiem ty le kha cao (28%). Dieu dd chufng td, ty la dj ifng ngay cang tang, khong nhOfng vdi thudc va hoa my phim, ma dj Ung vdi cac nguyen nhan khac cung tang do tinh trang 6 nhilm moi trUdng, va suf dung tran lan cac loai chat bao quan thifc phim khdng dam bao. Trong dj Uhg thUc an, chu yeu la di ifng vdi cac loai hai san, mot sd ft vdi thjt bd, thit ga.
K^t qua nay cung tUdng tU cac nghien cUu cua cac tae gia Nhat Ban.
3. Cac trieu chumg lam sang va can lam sang:
Cac trieu chUng lam sang thudng gap la met mdi, khd chiu (100%), me day (96,85%), ngUa (95,63%), sdt (76,57%), khd jhcl (54,71%). Day la nhUng trieu chifng chung cho tat ca eae nguyen nhan dj ifng. Tuy nhien, ddi vdi mpt sd trUdng hpp c6 the gap phu mat, ma chu yeu la phu hai mi mat (22,56%). Nhifng trudng hdp dj ifng thUc an thudng ed dau bung, ndn, budn non va mot sd kem tieu ehay. Ty le benh nhan bj dpp da va loet niem mac chiem ty le thap (4,86%
va 2,51%), tap trung b cac benh nhan nang nhU hdi chUng Stevens-Johnson, Lyell.
Cac chi sd ve huyet hpc nhu hdng eau, bach cau, cong thUc bach eau, cung nhu cae ehi sd ve chUe nang gan than (AST, ALT, ure, creatinin) nhin chung deu nam trong gidi han binh thudng. Cd the do hau het benh nhan den benh vien b giai doan sdm chUa ed diln bien nang hay bien chifng.Tuy nhien, cd 26,03% trudng hdp ed sd lUdng bach cau >9000K/nl, va cdng thUe bach cau xu hudng chuyen trai. Oay deu la nhifng trUdng hdp cd bpi nhilm (phdi hoac da). Co 5,71% trudng hdp ed men gan tang tren 2 lan, va 2%
trudng hdp cd creatinin tang tren 130mmol/l. Nhifng trudng hpp nay gap b tat ea eae nhdm dj Ung nhung gap nhieu hdn d nhdm dj ufng thude khdng rd loai.
Trong dd c6 01 trUdng hdp co tdn thUdng ca gan va than. Cd the b nhom di Ung thudc khdng ro loai, benh nhan thudng udng nhieu loai thude khae nhau, rat cd the cd ca khang sinh va thudc khang viem nonsteroid, nen khi bj dj ufng cd the d l bi nang hdn. Trong cac yeu td anh hudng de'n sU phat sinh dj Ung thudc, thi viec suf dung nhieu loai thudc ciing mpt lue cung la yeu td hay gap.
4. Thdi gian dieu trj:
Nhin chung, thdi gian dieu tri trung binh chung la 7,62 ngay va giufa cac nhdm khdng cd sU khae biet cd y nghTa thdng ke (P>0,05). Tuy vay, ed nhieu benh nhan bj dj Ung nhe nen khi benh tam dn dinh la xin ra vien va dieu trj ngoai tru, nen thdi gian nam vien ngan (ehi 1-2 ngay). Mpt sd benh nhan ed bdi nhilm hay tdn thUdng gan, than thi thdi gian dieu trj lau hdn, thudng la tren 2-3 tuan. Ca biet eo mot sd benh nhan bj dj ifng thudc khong r5 loai, va dj Ung khdng ro nguyen nhan cd thdi gian dieu trj tdi 60 ngay. NhiJfng benh nhan nay, mUc dp dj ifng khong nang nhUng ktid dn dinh phai diing thudc khang histamine keo dai ket hdp vdi cortieoids ddt ngan. Ooi khi ed nhufng benh nhan, sau khi nhap vien dieu tri dn dinh chuin bj xuat vien lai xua't hien mpt ddt dj Ung mdi vdi nhieu yeu td dj nguyen thong thudng. Dieu nay cd the do benh nhan cl trang thai m i n cam vdi da dj nguyen.
KET LUAN
Qua nghien cifu hdi cifu 350 benh nhan di ifng dieu trj tai khoa A21-Benh vien 175 tU 1/2001-1/2006, chimg toi rut ra mpt sd ket luan sau;
- Ty le benh nhan di Ung thudc la 40,86%, trong dd dj Ung khang sinh chiem 11,43%, di Ung thudc khang viem giam dau nonsteroids: 2,57% va di Ung thudc khdng ro loai: 26,86%. Ty le benh nhan dj Ung
Y HOC THUC HANH (751) - S 6 2/2011 125
thifc an la 20,00%; di ifng con trung; 8,00% va dj ifng khong ro nguyen nhan la 31,14%.
- Cac trieu chufng lam sang thudng gap la; met moi, khd chiu (100%); me day (96,85%); ngufa (95,63%); sdt (76,57%); khd thd (54,71%); dau bung (17,82%); tieu chay (5,74%). Ton thUdng dpp da va loet niem mac chiem ty le tha'p (4,86 va 2,51%). Gac chi sd can lam sang nhU; hdng cau, bach cau, cong thUe bach cau, chUc nang gan than (AST, ALT, ure, creatinin) nhin chung deu nam trong gidi han binh thudng. Khong cd mdi lien quan giiJfa cac trieu chUng lam sang va can lam sang vdi cac yeu td di nguyen (P>0,05).
TAI LIEU THAM KHAO
1. Nguyin Nang An, Le Van Khang, Phan Quang Doan, Vu Minh Thuc, 1997. Chuyen de dj ufng hpc, tap 1. Nha xua't ban y hpc.
2. Dao Van Chinh, Nguyin Qudc Tuan, 1988. Dj Ung hpc lam sang. Nha xuat ban y hpc.
3. Pham Van ThUc & cs, 1999. Nghien cUu dSc diem benh dj ifng miln djch cua nhifng thuyen vien di bien va nhufng ngudi song ven bien Hai Phdng. Tdm
tat bao cao khoa hoc - Hoi thao: Ngay g i p mat Hen vien hang nam ve giang day va nghien cufu mien dich hpc lan thU 9, 74-75.
4. Phung Minh Sdn. Pham ThUc, Ngd Van Oien, 1996. Budc dau nghien cUu dac diem benh dj img tai nha may ca hop Ha Long- Hai Phong. Tdm tat bao cao khoa hpc - Hpi thao; Ngay gap m|t lien vien hang nam ve giang day va nghien cUu miln djch hoc lan thU 6, 70-71.
5. DUdng Thj Thu, Pham ThUc & cs,1996. Mpt sd dac diem lam sang va xet nghiem cua sdc phan ve da gap trong 5 nam (1991-1995) tai khoa ndi benh vien Viet Tiep - Hai Phdng. Tdm tat bao cao khoa hpc -
Hpi thao; Ngay gap mat lien vien hang nam ve giang day va nghien cifu miln dich hpc lan thuf 6, 73-74.
6. Dean J. Naisbitt, 2004. Drug hypersensitivity reactions in skin; understanding mechanisms and the development of diagnostic and predictive tests.
Toxicology 194, 179-196.
7. P. Demoly, J. Bousquet, 2002. Pathogenesis of drug-induced exanthems. Allergy: Volume; 57 (Suppl. 72): 3 7 ^ 0
NHAN THUnC VE TAG HAI CUA VIEC Slf DUNG THUOC LA CUA NGU&I DAN VA VAI TRO CUA TRUYEN THONG
PHAM THj QUYNH NGA, N G U Y I N T U A ' N L A M - VP TCYTTG t^lVH LUONG NGOC KHU£, PHAN THj H A I , B^ Yt^
HOANG V A N M I N H , KIM B A O GIANG. D?ihgc YHdN§l
T 6 M T A T :
Vigt Nam li mgt tmng nhung qudc gia ed ti lg hiit thude nam cao nhit trdn the gi&i. Mgc dii Vigt Nam trong nhQng nam gan day da chimg td cam kit mgnh me han tmng cudc chien chdng Igi bgnh djch do thuoc li vi da ed nhieu hogt ddng tmyen thdng phdng chdng tic hgi thudc li nhung kit qua thu dirge van cdn nhieu hgn che.
Mgc tieu: Bii bio niy sir dung kit qua dieu tm GATS 2010 tgi Vigt Nam de md ti kien thirc ve tic hgi cua hut thudc va hut thude thg ddng cung nhw sw tiip cgn t&i cic thdng tin ve tic hgi thude li eua ngw&i dan. Thiit ki nghien cu'u: GATS li mgt khio sit md ti cat ngang v&i miu dgi dign toin qudc. Doi twgng nghien cwu: Tit ea nam vi nw tudi tw 15tra Idn tgi Vigt Nam. Kit qua: Cic phit hign tw dieu tra GATS Vigt Nam 2010 eho thiy mgc du ti lg ngtr&i din tin rang hut thude vi hut thude thg dgng cd hgi li rit cao nhung hieu biit ve bgnh eg thi do thude li gay m cdn hgn chi. Chi mgt nira sd nguai tnr&ng thinh (55,5%,) biet ring hut thudc li ed the giy ra ba bgnh ung thw phdi, dau tim vi dgt quy. Vin edn t&i han 20%o ngw&i din (ca ngw&i hut thudc va khdng hut) tin ring mgt sd logi thude la it dgc hgi han cic logi thude li khic. Tren 90%, ngw&i hut thude nhin thay canh bio swc khde trdn vd bao thudc, chi hai phin ba sd ngw&i nhin thay canh bio nghT den y dmh bd thude. Kit lugn:
Viet Nam ein diy mgnh cdng tie tmyen thdng vi tic hgi thudc li siu rgng den cgng ddng de ngw&i din hieu eg thi ve tic hgi thudc li. Cae kenh thdng tin dgi chung
nhw tivi, dii bio cin tm tidn cho dc chwang trinh tuyin tmyen vi tie hgi thudc la. Mgt tmng nhung kdnh thdng tin higu qua de tuydn tmyin vi cic bdnh cg thi do hut thuoc gay ra chinh li canh bio sue khde bang hinh anh in tren vd bao thude li. Vi vgy, ehinh phu Vigt Nam c^n thgc hign s&m canh bio sue khde bing hinh anh tren vd bao thudc li di tang ctr&ng hieu qua cua tmyin thdng.
vi dm sw dgng cic tw ngCr giy hiiu nhim vi tic ttai thudc li trdn vd bao thudc nht/'nhg", "dm", "it hie in".
TCr khda: tmyin thdng, canh bio sue khde tren vo bao thude li, ngw&i tnr&ng thinh, diiu tm GATS
SUMMARY
KNOWLEDGE ON HARMFUL EFFECT OF SMOKING AND SECOND HAND SMOKE AMONG ADULTS AGED 15 YEARS AND OVER IN VIETNAM AND THE ROLE OF COMMUNICATION: FINDINGS FROM THE GLOBAL ADULT TOBACCO SURVEY (GATS), 2010
Viet Nam is one of countries having highest pmvalence of smoking males in the worid. The govemment has committed to combat the tobacco epidemic in Viet Nam and implement various tobacco contml measures but msults so far is still limitted.
Objective: Using msults of GATS survey 2010 in Viet Nam to describe the level of public awamness ort hannfui effect of smoking and second hand smoke and the mle of communications to awareness of public.
Design: GATS is a cmss-sectional survey with nationally mpmsentative sample of Viet Nam. Study subject all non-institutionalized men and women age 15 and older
