Tap chl Tai Mui Hpng Vi#t Nam - Volume (58-16). N°4 - June, 2013
NGHIEN c i r u THU'C TR^NG M A C Bf N H HEN PHE QUAN VA MpT S6 YEU TO LIEN QUAN 0 HQC SINH TIEU HQC, TRUNG HQC LE HONG PHONG NGO QUYEN H A I PHONG
Phdng Chl Thifn*, Nguyin Xuan Bdi**, Phfm Van Mgnh**
SUMMARY
STUDYING OF REALITY ASTHMA DISEASE AND SOME RELATED FACTORS IN GRADE-SCHOOLER, HIGH SCHOOLER IN LEHONGPHONG NGOQUYEN DISTRICT
HAIPHONG CITY
Phung Chi Thien, Nguyen Xuan Bai, Pham Van Manh Objective: The authors have researching the rale and describe some characteristic of Asthma in grade-schooler, high schooler in LeHongPhong. Materials and methods: The authors have used cross descriptive and retrospective study method, to be combinated interview derectly the pupil parental about knowledge, attitude and some relate factor with Asthma disease. The results obtained as follow: + The rale of Asthma disease in LeHongPhong is 10,46%. + Some characteristic of disease Asthma in LeHongPhong school. The most asthma patient have oneself allergic or family allergic. Main cause to make appear asthma disease in the fist that is inflammation of respiratory system (71,7%) The factor make stimulate attack of asthma disease include: change of the weather, catch cold, infiammalion of respiratory system,...
Key words: asthma disease
1. SAT VAN DE
Hen la van de sue khoe cpng dong tren toan the gicfi. Tac dpng nhieu nguoi, khong phan biet tuoi tac, a nhi^u qu6c gia mac can benh man ti'nh nay. Khi benh hen khong dugc kiem soat, anh huong d^n ch4t lupng cupc s5ng nguoi benh, tro thanh mpt trpng nhCrng ganh nang benh tat d6i voi gia dinh, y te va xa hpi. Ty le mjc hen dang tang len 6 hau hk quoc gia, dac biet la tre em.Tan xuat mac benh HPQ dang co xu huong tang cao tren toan thS gioi. Hien nay nhieu noi ty le hen phS quan do o con s6
* Dai hoc Y Hai Phong
*• Dai hoc Y Thai Binh Nhan bai 22/5. Duyet in 5/6/2013.
dang lo so nhu a Uc la 13 - 15%, Phap 8 - 10% ; My 5 - 7%. Theo thdng ko ciia To chuc Y ii thk gioi (WHO), cil 10 nam, dp luu hanh ciia benh lai tang 20 - 50%, nhat la 20 nam vija qua, toe dp ngay mot nhanh ban. Ti le tii vong do HPQ tang rat nhanh trong nhung nam qua, chi sau ung thu, vugt tren cac benh tim mach, trung binh 40 - 60 nguoi/ 1 trieu dan. 6 Viet Nam theo dieu tra ciia Hpi Hen, Di ung miln dich lam sang, trung binh co 5 % dan s6 bi hen, trong do co 11% tre ducri 15 tu6i, tuong duong voi 4 trieu nguoi bj hen va so ngum tu vong hang nam khong dual 3000 ngucri.
Nhieu nguoi con diu benh, nen de bi bo spt trong dieu tra dich tl hpc ciing nhu chin doan benh [2]. Hon nua hau qua cua hen 50
Tgp chl Tai MQi Hpng Vi$t Nam - Volume (56-16). N°4- June, 2013
phS quan va tinh trang Isim sang ngay cang nang la van de rat cap thiet hien nay.
Do vay, viec chdn dodn, kiem sodt HPQ tre em tgi cong dong Id mgt vi$c hit sue cdn thiit trong cong tdc phong chong hen. Chiing tdi tiin hdnh de tdi vdi muc tiiu saw.
Xac dinh ty li mic binh Hen Phe Qudn vd mot so yeu to lien quan o hpc sinh tieu hpc, trung hpc Le Hong Phong ndm 2009.
2. DOI TU*9fNG VA PHlTOfNG PHAP NGHIEN ClTU
2.1. Doi tirgug, dia diem, then gian nghi€n cuii
2.1.1. Ddi tuong
- Hgc sinh tieu hoc, trung hoc ca so Le Hong Phong - So 4 duong Nguyin Binh - Quan Ngo Quyen - Tp Hai Phong.
2.1.2. Dfa diim nghiin cuu:
- Truong tiiu hpc, trung hoc co so Le H6ng Phong -Nguyen Binh - Ngo Quyin - Hai Phong
2J.3. ThMgian nghiin cuu: 10/2009 din 5/2010.
2.2. Phinmg phap nghien cmi
2.2.1. Thiit ki nghien cuu: Nghien cuu dich tl hoc mo ta cat ngang ket hop voi hoi cuu.
2.2.2. Cd mdu vd each chpn mdu :
- Cong thirc tinh c& mSu : dugc tmh theo cdng thiic sau
- Trong do:
+ p : ty 1? mSc benh nghien cuu tai cgng dong, hiy p = 10%
+ A: khoang sai lech mong mu6n : 0,02 + Z: h? s6 tin cay : 95%
+ a: Muc y nghia th6ng ke : 0,05 Vay CO mau la: n = 864. D& co do chinh xac cao, chung toi tien hanh tren 1.520 hgc sinh
- Tiiu chudn li/ra chpn
* Lua chgn benh nhdn: Toan bg nhihig benh nhan qua dieu tra dugc phat hien va chan doan mac HPQ
* Tiiu chudn chin dodn BN HPQ dua theo tiiu chuin cua GINA 2008:
+ Co len con kho tho tai phat nhieu lan.
+ Tho kho khe co cu hay tai phat.
+ Ho dai d§ng, khac dam trang tai phat.
+ Co diu hieu tiic nang nguc tai phat nhieu lan.
- Tieu chudn loai trir:
+ Benh nhan duoi 6 tuoi.
+ Benh nhan khong do dugc chiic nang ho hap.
2.2.3. Phuong phdp thu thap thdng tin ' Diiu tra sang Igc: To chuc kham de phat hien benh nhan tai truang neu benh nhan co du tieu chuan chan doan mac HPQ tha tiin hanh dieu tra sau ve HPQ
T6 chuc phong van, kham, do Imi luang dinh tha ra ciia benh nhan theo phieu diiu tra voi bg cau hoi thiet ke san.
2.2.4. Cdng cu thu nhgp thung tin - Kham va dieu tra benh nhan HPQ.
- Bang phong van sau ve kien thiic,
Tgp ch! Tai Mui Hpng Vi0t Nam -Volume (58-16). N°4-June, 2013
thai do, cac yiu td lien quan din benh hen, qu^ xet nghi?m cua b?nh nhan, bo ho3c m?, kham, do luu lugng dinh va kiem tra ket d3 c6.
2.2.5. Tieu chuan ddnh gid
* Ddnh gid muc dp kiim soat b^nh hen tgi cpng ddng Ti§u chf
Thuc qiac ban dfim Ccn hen kich phSt Phai khSm c^p c u u vl con hen Thay doi dieu trj do tSc dyng phy cua thu6c
Bi gib-i han hoat dOnq the lye Trieu chLpng ban ng^y S u dung thuoc cat con Luu lup'ng dinh buoi sSnq
K i ^ m socit triet de
Kh6ng Kh6nq Kh6nq KhOng Kh6nq Kh6nq Khdng
£ 80%
K l ^ m s 6 a t m p t p h ^ n Kh6ng Kh6nq Khfinq Khdng Khflnq
£ 2 nqdy/tu^n
< 2 ngSy/tu^n vS s 4 l^n/tu^n
> 80%
K h d n g d u y c k i ^ m sodt
B i t ky tuSn ndo c6 tri$u chung b6n, ho^c cd d p i hen cJlp & 1 \knlr\Am
> 2 nqSy/tuan
> 2 ngdy/tuin vS £ 4 lan/tuan
£ 8 0 % Duy tri it nhat tr6n 7 - 8 tu^n, theo d6i 56 tu^n
2.3. Phirffng phap xv ly va phan tich so lieu: - Dua tren phin mSm SPSS 15.0 3. KET QUA NGHIEN ClTU 3.1 Ty le HPQ cua hpc sinh tiiu hoc
Bang 3-1" Ty le m^c benh cua cac doi tuong nghifen cuu
Bang 3 2. Ty 1$ tie mac b«nh HPQ theo tuoi.
Kk q u a \ Tong so tre khSm Tong so tre b| mac
P Nam
740
77 N u 780
82
p>0,05 Tong 1520
159 TylS
(%)
100 10,46
Nhan xet: Ket qua nghien cmi cho thiy ty le tre mac Hen ph6 quan chiem 10,46%.
Trong do nam la 77 tre, nir 82 tre, sir khac biet nay khong co y nghia th6ng ke p>0,05.
^ " • " • - - ^ K e t qua DO t u 6 i ~ - ^ ^
6 - < 1 0 10-15 Tong
B$nh nhdn 95 64 159
TylS(%) 59,7 40,3 100 Nh|in xet: Trong 159 tre mSc hen, thi ty le mac hen phe quan 6 tre 6 - <10 tuoi la 59,7%, tre tren lOtufii la 40,3 % .
Bang 3 3, PhSn loai b$nh nhan HPQ theo so nam m^c b$nh
~---...„^^^^ Ket qua Thdi gian r r ^ c T B & n h - ^ ^ ^ So m d i mac < 1 nam
1-5 6 - 1 0
> 1 0 Tong s6
n 18 103 30 8 159
Tyle
(%)
11,3 64,7 18,9 5,1 100
52
Tgp chi Tai MQi Hgng Vi$t Nam - Volume (58-16). N°4 - June, 2013
Nh?n xet: Thoi gian mSc benh 1-5 nam chiem ty le cao nhat la: 64,7 %
3.2 Mgt so dale diem cua benh Hen Phi Quan 0* hoc sinh trircmg Le Hong Phong
Bang 3 4 Ti^n si> dj ung cd nhSn
^ ^ ^ ^ K 4 t qua Tl^n si> ^ ^ ^
VI6m mOi xoang diiJng May day, sSn
nqi>a Dj Lpnq thu6c Dj i>nq thtjc an Bgnh dl Crnq khac C6 tifen si> d| Lpnq Khdng c6 tien s u
diu-ng
B^nh nhan n = 1 5 9
109 45 10 3 11 120
39
T y l $ ( % ) 68,5 28,3 6,2 5.0 6,9 75,5 24,5
Nhan xet: Benh nhan m5c benh hen co tiin su di ling chiim 75,5% trong do co lien quan den nhom viem miii xoang di ling cao nhat 68,5%, tilp den la may day, san ngiia 28,3%, di ling thulc chiim 6,2%, di ung thiic an 5,0%.
Bang 3 5 • Tien si> di i>ng gia dinh Benh
Moi quan he Ca b6 va me
86 hoac me Anh, chj em
mot Onq, ba C6 tidn si> dj Cpnq qia dinh Kh6ng co ti^n sO dj i>ng gia
ainh
Hen phe quan n 11 53 23 14 102
57
%
6.9 33,3 14,4
8,8
Dl Lfng khac n 10 30 12
8
%
6,2 18,8
7,5
5,0 64,1 35,9
Nhan xet: Benh nhan co tien su di ling gia dinh chiem 75,5%. Trong do b6 hoSc me m^c hen chiem 33,3%, anh chi em rugt 14,4%, di ling khac bo hoSc me chiem tai 18,8%.
Bang 3 6 Moi quan h6 giOa b^nh HPQ v6'i cSc mua trong nSm
T<4tqua Mua ^ \
Sdnq Xuan Ha Thu
B$nh nhan 70 90 25 7
Ty le (%) 44 56,6 15,7 4,4
Nhan xet : Benh hen co lien quan toi mua trong nam dac biet la mua xuan chiem 56,6%, tilp din miia dong 44%, miia ha 15,7%, thap nh4t la miia thu 4,4%.
Bang 3 7 Hoan canh xuit hien con kh6 tha
^~'""~^-..,^^ K i t qua Tac nhan ^'"----.,,
Thay doi thdi t i l t Lanh BSnh ho h i p
G l n q si>c Khoi thudc la,
thuoc lao Bui Cam xuc Thdc an
n = 1 5 9 137
98 68 51 43 18 8 4
Ti le (%) 86,2 61,6 42,7 32,1 27,0
11,3 5,0 2,5
Nhan xet. Hoan canh xuat hien con kho tho thi do thay ddi thdi tiSt chiem ty le nhi^u nhdt 86,2%, tiSp theo la do lanh 61,6%, xuit hien con hen sau mac b^nh ho hip 42,7, gSng siic 32,1%. Ty le xuit hien khd thd sau an chiSm ty le thip nhit 2,5%.
Tap chl Tai Mui Hpng Vi#t Nam - Volume (58-16) N°4 - June, 2013
Bang 3.8: Tien tridu xuit hi$n con khd thd
^ ^ \ K l t q u a T i i n t n $ u ^ ^ \ Nqija honq Ho Nqda mui Hat hoi C h l y nu'dc mui
Tu'C ngu-c
B$nh nhan n = 1 5 9
24 25 36 10 38 10
Ty le (%) 15 15,7
22 6,3 23,9
6,3
B3ng 3.10: Tinh ch^t, mi>c dO ph6 bi^n cua can hen 6" c^c b$nh nhSn
Nhan xet : Tien trieu xuat hien can hen phan Ion co dau hieu bao truac do la chay nuoc miii (23,9 %) sau do la ngiia mui (22%), ho (15,7 %), ngiia hong 15%), tiic nguc 6,3%.
Bang 3.9: C^c bieu hi$n chinh cua b6nh hen phe quan tre em
^~"---^^^ Ket qua Tneu churg^-^^^^^
Khd kh6
Da cd 1 hoac nhilu dot khd khe tai di tai lai
Ho n h i l u , dai d l n q Khd thd tdnq con Thdc giac v l dam vl khd thd
Ho, kho kha sau hoat ddng the lye Khd thd giam khi dung thuoc gian p h i quan
BSnh nhan n=159
70 52
25 20 15 45
10 T y l a
(%)
44 32.7
15,7 12,6 9,4
28,3
6,3
Nhan xet: Biju hien chinh cua benh hen khd khe (44%), nhiSu dot kho khe tai di tai lai (32,7%), ho khd khe sau hoat dong the lire (28,3%), ho nhiSu dai ding 15,7%.
. , „ ^ ^ ^ Kit qua Tinh c h i t m i > c d $ --...^^^^
tn$u
Diln bi4n cua con hen
Thi khd thir
WtdK d0 khd thd
Diu hi$u di
k^m con hen
Hat hoi, chay nifdc mOi, ti/c ngifc
C o n hen kao dai vai phCit - vai g i d Con hen kdo dai
Khd t h d thi t h d ra Khd t h d thi thd vao
Khd t h d ca hai thi Khd t h d nhieu Khd t h d trung binh Khd t h d it Phai t h d Oxy khi cd c o n hen v a mo hdi Tim tai Khd ndi Phai n g i i de t h d
n = 159
96
138
21
16 34
109 61 69 29 5
123 44 114 130
Tyia
(%)
60,4
86,8
13,2
10,1 22,6
68,5 38,3 43,4 18,2 3,1
77,3 27,6 71,7
81,7 1 Nhan xet: Tinh chat va miic do con hen rat khac nhau giua cac benh nhan. Con hen dien hinh vdi cac diu hieu ti& tri?u, va mo hoi, khd thd ca hai thi, kk thiic sau vai phiit - vai gid.
4. BAN LUAN
4.1 Ti If mac hen phi quan
Nghien ciiu xac dinh ty le mac hen tai trudng chiing toi da thu dugc kk qua ty IS mac hen cua hgc sinh la 10,46%. Ty 1? nay cao hon nghien ciiu cua Nguyen Trong Tai 54
T?p chf Tai Mui Hgng Vi$t Nam - Volume (58-16), N°4 - June. 2013
(2010) khi dieu tra ty 1? mac hen hpc duong tgi Thanh pho Vinh tinh Ngh? An dieu tra tren 4.963 doi tuong hgc sinh cac khoi cua 15 truang Tieu hpc, Trung hpc Ca so, Trung hpc pho thong thi ty le mic hen la 7,29%, cao hon nghien cuu cua Biii Diic Ducmg (2002) tre mSc hen tai 2 tinh Binh Duong, Thai Binh la 7,1% , 8,74% a 3 trufmg PTCS tai Ha Npi nghien ciiu ciia Phan Quang Doan (2006) , thap hon 12,56% o hpc sinh Ha Npi cua Pham Le TuSn (2006) . Dieu nay co the ly giai la do cac yeu to cu the ve dia ly, moi truang 6 day khac so voi cac khu vuc khac ma cac tac gia khac da nghien ciiu, cung co the do ca mhi dieu tra khac nhau, thoi diem dieu tra cua cac tac gia khac tien hanh truac chiing toi nen da anh huong den ket qua ty le mac hen. Tuy nhien ket qua nghien ciiu ciia chung toi thu duac phu hpp vai nhieu nghien ciru cua cac tac gia nuac ngoai nhu cua Dawson.S. 1999 tren 4% va phu hpp voi khuyen cao ciia GINA ve tinh hinh mac hen dang co xu huong gia tang trong nhung nam gkn day tren pham vi toan the gioi, dac biet la hen tre em. Ty le tre nam mac hen (48,42%) va tre nu (51,58%), su khac biet khong CO y nghia thong ke (p>0,05). Ty le mac hen khong co sir khac biet vl gioi tir ket qua nghien ciiu cua chiing toi ciing phii hap vdi nhan dinh cua cac tac gia khac nhu: Pham Van Thiic, Huurre T.M.
Phdn bd mdc HPQ theo nhdm tudi Qua diiu tra 159 BN chung toi thiy ty 1? mSc benh giira cac dp tuoi la tuong tu nhau. Benh xuit hien lin diu a bat cii tu6i nao tuy theo ca nhan, dieu nay khong the du bao truoc do lien quan co dia benh nhan, moi truang song, benh kem theo.
Di6u nay co th6 ly giai do benh hen hay
xuat hien sau nhiem tning ho hap tren mpt CO dia di ung ma chiing ta deu biet nhiem khuan ho hap cap hay gap 6 tre nho. Ket qua nghien ciiu ciia chiing toi phii hpp vdi nhan dinh cua nhieu tdc gia khac la benh hen xuat hien a mpi liia tuoi ciia Tran Quy, Phan Quang Doan, Nguyen Nang An, Pham van Thiic .
Ve so nam mic benh tinh den thai diem dieu tra chiing toi thay co cac nhom doi tuong benh nhan sau: nhom moi mac duoi 1 nam la chiSm ty le 11,3%, nhom mic benh tren 10 nam ty le it 5,1%, nhom tii 6-10 nam chiem 18,9% va da so con lai la nhung benh nhan mac benh keo dai tir 1- 5 nam. K§t qua nay phan anh tinh chat ca ban ciia benh hen la dien bien man tinh keo dai nhieu nam, tham chi suot dcri sau khi mac. Dieu nay cung gai y rang van de dieu tri hen cung phai theo nguyen tac dieu tri keo dai tiiy theo ti^n trien va dap ling dieu tri. Tinh chit dien bi^n ciia benh nhu tren cGng da duoc vdxihi tac gia va y van noi dSn nhu la mot quy luat pho bien ciia benh hen cung nhu nhieu benh di img khac.
4.2. Mot so dac diSm benh HPQ a hoc sinh
Cdc yiu td tdng nguy comae binh Vh yeu to co dia di ung ciia ca nhan va gia dinh, k6t qua nghien ciiu ciia chiing toi thiy CO toi 75,5% BN hen hien tai dang mic (hay trong tiin sir) mot hay nhieu cac benh di iing khac nhau. Dimg diu la viem mui di img 68,5%, ti6p theo la may day, sin ngiia 28,3%... co tai 22,0% s6 BN mac 2 benh di img tra len, dieu nay cho thay benh nhan hen c6 ca dia di img ca nhan ro ret. K^t qua nay phu hpp voi nh$n dinh ciia nhilu tac gia la hen c6 ngu6n goc di ling a
Tap chl Tai Mui Hong Viat Nam - Volume (58-16). N°4 - June, 2013
50% trudng hgp, dac biet la hen xuat hien sdm d tre em va thanh nien , nghien cihi cOa Nguyin NSng An, Pham Van Thiic, Vu Minh Thuc, Phan Quang Doan thSy ty 1$
benh nhan HPQ cd bfnh di ling kem theo 6 67% - 76,2% va trong nhCmg nghien ciiu khac cdc tac gia cling chi ra rang cd ty 1? rat cao ngudi than benh nhan mdc hen va cd tien sir mac benh di ling .
Ket qua nghien ciiu ciia chiing tdi ciing phu hgp vdi nhan dinh cua nhilu tac gia la:
benh hen cd lien quan den co dja di tniyln, tinh nhay cam cao vdi cac benh di ling, dac biet la vdi viem miii di ling, may day. Nhu Tran Van Dong cho rang 57,l%i BN cd tiSn sii di ling gia dinh. Biii Diic Duong nhan xet bd me cd tien sir di ling, mac hen thi con ciia ho cd nguy co mic hen cao hdn 1,5 lan so vdi tre cd bo me khong mic hen hoac di ling. Cac nghien ciiu ciia cac tac gia khac nhu Pham Van Thilc, Vii Minh Thuc, Koeppen-Schomerus ...cung diu cho rang cac BN hen cd ca dia gia dinh bd me, anh em rugt ciing mic hen khoang 26,3% - 3 P/o cac trudng hgp.
Cdc yeu to lien quan xudt hien can hen VS nhiing yeu td true tiSp kich phat su xuit hien cac con hen d cac benh nhan hen, chimg toi thiy cd rit nhilu yiu to kich phat con hen khac nhau, hay gap nhit la su thay doi thdi tiSt dot nggt gay xuit hien con d 86,2% sd BN, tilp din la nhiem lanh 61,6%, nhiem khuin hd hip cip 42,7%>, gang siic 32,1%, khdi bip than, khdi thudc la thudc lao 27,0% Vl vin de nay Nguyin The Hung cung cho mot nhan xet tuong tu la thay doi thdijilt gay xuat hien con hen 6 80% BN. Nhiem ianh la yiu to nguy co kich phat con hen d cac BN cua chiing toi vdi ty le cao (61,6%), Kit qua nay cOmg
phii hgp vdi n h ^ xet chimg cua nhieu tac gia la b?nh nhan hen cd eg dja nhay cam vdi lanh va nhieu tdc gia da dimg kich thich bang luong khdng khi lanh qua dudng ho hap nhu la m$t test de giup chan doan xdc djnh b?nh hen neu test cho ket qua duong tinh ciing vdi nhOng tieu chuan khac tren nhihig b^nh nhan nghi ngd hen .
Yeu td bui gay kich phat con hen trong cac BN ciia chiing toi vdi ty 1? thap hon so vdi ket qua nghien ciru cua Nguyen Nang An va cgng sir (11,3% so vdi 25%) . Cd the dieu do phan anh tinh trang moi trudng khong khi d ndng thdn trong lanh hon c^
khu vuc khac, ching han nhu do thi noi cic tac gia do nghien ciiu vdi ndng dg bui va di nguyen trong khdng khi cao hon.
Trong nghien cihi cua chiing toi sd BN xuat hien con hen gap nhilu nhit la miia xuan chiim 56,6%., tilp din la mua dong 44%, miia ha chiim ty le dang kl la 15,7%.
Dieu do cd lien quan tdi yiu td thay ddi thdi tiet va nhiem lanh va mdi quan he chat giiia yiu td khdi phat con va tinh trang xuit hien con d cac b$nh nhan. Nhilu nghi&i ciiu ciia cac tac gia khac cung chd kit qua tuong tu la con hen xuit hi$n tang len vl miia ddng, nhu nghien ciiu cua VO Minh Thuc 54,93% BN xuit hien con hen miia ddng va 54,1% theo nghien ciiu ciia Pham Van Thirc.
Ve thai gian xuat hien con hen trong ngay, ket qua nghien cira thiy 65,4% bjnh nhan la con hen xuit hien vao dem, thdi gian xuit Men con hen bit ky 23,9%. Yeu to xuat hien can hen va tang nang miic do benh vao ban dem la yiu td tin cay giiip cho chin doan mic benh, nhung ddng thdi cung cho thay dac tinh xuit hien con pM hgp vdi y van la con hen hay xuat hien ve 56
Tap chl Tai MQi Hpng Viat Nam - Volume (58-16). N°4-June, 2013
dem gan sang va phu hgp vdi kSt qua nghien ciiu ciia Vu Minh Thuc thdi gian xuit hien con hay gap vao dem 70,42%, nghien ciru cua Biii Diic Duong la 74,8%i, hay nghian ciiu cua Phgm Van Thitc con xuit hien ban dem 52,46%, ngay -t- dem 32,79%.
KiTLUiiN
1. Ty K mic bfnh HPQ tai tnrong IA Hong Phong
- Ty le mic HPQ tai trudng Le Hdng Phong la 10,46%), ty le mac benh giiia hai gioi (nam 48,4%, nii 51,6%).
2. Mot s^ yen to lien quan den benh Hen Phi Quan tai trudng Le Hong Phong
- Tiin su di itng ban than, gia dinh gap d hiu hit cac benh nhan hen.
- Nguyen nhan chu yeu gay HPQ lan diu la nhilm trimg dudng ho hap nhieu lan 71,7%.
- YIU td kich phat con hen d cac BN bao gdm di nguyen kha da dang, diing dau la do thay ddi tiidi tilt, tilj) din la nhilm lanh, nhilm khuin hd hip, ging siic.
TAI LIEU THAM KHAO 1. Nguyin Nang An (2006), Tmh hinh thuc
hien kiim sodl hen theo GINA a Viet
nam, Sinh hdat khda hgc chuyen de 2/2006, tr 1-10'
2. Phan Quang Doan, Tdn Kim Long (2006), iip luu hdnh hen phe qudn trong hQC sinh mot so trudng hQC d Hd NQI vd linh hinh su dung Serilide du phong hen Irong cdc doi tuong ndy. Tap chi Y hgc thuc hanh (547) sd 6/2006, tr 15 - 17.
3. Vu Minh Thuc, Pham Van Thiic (2004), Nghien ctru bieu hien Idm sdng vd cdc yeu Id lien quan gdy HPQ lai phuong lach Tray - Hdi phdng. Tap chi y hgc thuc hanh s6 ID 2004, tr 31 -36.
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