Tgp ch! Y Duvc hgc - Tru&ng Bqi hgc Y DUQC Hue •Tdp6,s64- thdng 8/2016
NGHIEN C&U OAC OIEM LAM SANG, CAN LAM SANG VA KET QUA QIEU TRj Dj VAT OPpNG AN
Vd Hoang Cu&ng', B§ng Thanh', TrSn Phuang Nam', Li Thanh Thai' (1) Tru&ng Dgi hgc Y BUCK Hui- Bgi hgc Hui
(2) Binh viin Trung uang Hui Tdm tat
D|t van de: Dj v i t du'png an l i mdt cap c&u trong ITnh vyc Tai Mui Hpng, kien th&c ciia quan chiing nhan dan ve dj vgt du'dng i n cdn mpt sd hgn ehe. Myc tieu- Nghien c&u dgc diem lam sing, cgn lam sang va kit qua dilu trj dj vgt dudng an tgi Bgnh vign Trung upng Hue va Bgnh vign Tru'dng Dgi hpc Y Dupc Hui. Ddi typng va phu'ang phap nghiin c&u: Nghien c&u cat ngang tiln c&u t& thing 6/2014 den thing 5/2016 cd tdng sd 137 bgnh nhin d i n kham va dilu tri. Kit q u i : Tudi trung binh la 35 tudi. Ty lg gidl: nam (51,8%), n& (48,2%).
Ngu'di Idn (84,7%) gap nhieu han tre em (15,3%). Nhdm tudi gip cao nhat la t& 16-30 tudi (32,8%). Cd 95,7%
la dj vit h&u ca, 4,3% la dj vat vd ea. Cd 90,5% bgnh nhan vio khim va dieu tn b giai dogn ehua viem, 8,0% b giai dogn viem va 1,5% b giai dogn bien eh&ng. Dj v|t mac d hpng (73,7%), di vgt mae d thyc quan (26,3%). Gap dl vgt tryc tilp 54%,gap dj vgt gian tiep qua guang 11,7% va ndi soi 8%, soi thye quan dng c&ng 17,5%, soi thyc quan dng mem 7,3%, md cgnh cd 1,5%. Ket lu^n: Doi vdi dj vgt hpng migng cd the lay dj vgt tryc tiep, vdi dj vat hpng thanh quan lay giin tiep qua guang v i n§i soi. Ddi vdi dj vat thyc quin phuang phap uu the l i soi l l y dj vgt bang npi soi dng c&ng.
Tir khda: Dj vgt dubng dn Abtract
CLINICAL AND PARACLINICAL CHARACTERISTICS AND RESULTS FROM TREATMENT OF FOREIGN BODIES INGESTION
Vo Hoang Cuong', Dang Thanh', Tran Phuong Nam', Le Thanh ThaP (1) Hue University of Medicine and Pharmacy - Hue University
(2) Hue Central Hospital Background: Foreign bodies ingestion is a emergency in otology, knowledge of people about foreign bodies ingestion is not enough. Objecti've: To study the clinical charaeteristi'es, paraelinieal characteristics and results of treatment from foreign bodies ingestion in Hue Central Hospital and Hue University Hospital.
Methods and patiens: A cross descriptive and prospective study over the period from 6/2014 to 5/2016, total are 137 patients come to be diagnosised and treatmented. Results: the average age is 35 years old, Gender:
male (51.8%) and women (48.2%). Adults (84.7%) having more than children (15.3%). Age group from 16-30 years is highest (32.8%). There are 95.7% of organic foreign bodies, 4.3% are inorganic foreign bodies. There are 90.5% of patients on diagnosis and treatment in stages less inflammation, arthritis 8.0% in the period and 1.5% in the period complicati'ons. Foreign body in the throat problems (73.7%), esophageal foreign bodies (25.3%). Pick up directly foreign bodies 54%, indirectly by the mirror 11.7% and endoscopy 8%, rigid esophagoscopy is 17.5%, flexible esophagoscopy is 7.3%, eervicotomy is 1.5%. Conclusion- Practing directi'on with in the oropharynx foreign body, using the larynx mirror or endoscopy with In the laryngopharynx for the esophagus foreign bodies, rigid esophagoscopy Is better.
Keyword: Foreign bodies ingestion
1. OAT V A N o l n& va chimg logi eiia dj vat cung het s&c phong phO.
Di vgt du'dng an la mpt d p e&u trong Tai Mui Di vat du'dng an chinh th&e bao gdm dj vgt hpng va Hpng, cd t h i gap d bat ky l&a tudi nao, ca nam lan dj vgt thyc quan. Dj vgt hpng thudng xay ra trong
- Bia chiliin hg: l i Thanh Thdi, email: [email protected]
- Ngay nhqn bdi-10/8/2016; Ngay ddngyddng: 12/9/2016, Ngdy xuat bdn: 20/9/2016
AND PHARMACY 631
Tgp cbl Y Dugc bgc - Truong Bqi hoc Y Duvc Hui- Tqp 6,sS4- thdng 8/2016 smh hogt vi dudng vao l i dudng migng. Da sd l i do nh&ng vgt nhd va nhpn: manh xuang, viy ca, dau tam, minh thuy tinh, xay ra d nguPi ldn do vd 9 nudt phai va cam lai b hpng. Cf tre em thuong la do dd chai. Dj vgt thuc quan d sau trong ed, trong ngyc va thudng ph&c tgp hPn v l mgt djnh bgnh, x& tri, dgc bigt cd nhilu nguy hiem trong dien bien [1], [2], [5].
Dj vgt duang an la mpt van d l phd bien trong fTnh vyc Tai Mui Hpng. 6 My moi nam cd han 100000 trudng hpp dj vgt dudng an dupe ghi nh|n [12].
Nguyin Dye Phu, Nguyen Tu ThI t& nam 2007 din nam 2009 nghien e&u di vat dudng an tgi Tai khoa Tai MOi Hpng, Benh vign Trung uang Hue va Khoa Tai Mui Hpng, Bgnh vign Trudng Dgi hpe Y Dupe Hue ghi nhgn ed 147 trudng hpp den kham v i dieu trj [4].
6 Vigt Nam, hau nhu 100% ngudi tru'dng thanh deu ed hoc xuang 1 lan trd lgn. Dj vgt cd t h i mac lai b viing hpng (di phat hien va logi bd di vgt, it nguy hiem) nhung cung cd the mac sau trong thyc quan (lgi rat giy nguy hilm, cd the de dpa ti'nh mgng) [5].
Tai cic khoa Tai Mui Hgng, Bgnh vien Trung uang Hue v i Bgnh vien Trudng Dai hpc Y Dupc Hue, benh nhan b| dj vat duPng i n den khim vin con phd biln, mdt sd bgnh nhin din khim b giai dogn mupn. Be gap phan trong edng tic chim sdc s&c khde ban dau, ehan doan va dieu tri kip thdi ehung tdi tien hanh nghiin c&u de tai: "Nghiin ciru dqc diim Idm sdng, cgn Idm sdng vd kit qua dieu tri di vqt dtfdng an"vb\ 2 muc Heu:
1. Nghiin cdu dgc diem Idm sdng, can lam sang dj vgt dubng dn.
2. Ddnh gid kit qua dieu trj df vgt dubng dn.
2. D6\ TU'ONG, PHU'O'NG PHAP N G H I I N CLTU 2.1. Odi tirpng nghign c&u
Tdng cpng 137 bgnh nhan dypc chan doan l i dj vat dudng i n vio dieu tri npi trii v i ngogi tru tgi Bgnh vign Trung uang Hue va Bgnh vign Trudng Dai hpc Y Dupc Hue t& thing 6/2014 den thing 5/2016.
3.1.2. Th&i gian tir khi mac dj vgt den khi nhgp viqn
Bing 1. Thdi gian t& khi mac dj vgt din khi vao vign {n=137) 2.2. Phu'ang phip nghien c&u 2.2.1.Thiit ki nghien ahi
S& dung phuang phap nghien cyu tiln c&u, md ta, ed can thigp lim sing.
2.2.2. Phirang tiqn nghiin clhi - Dyng cy khim tai mui hpng thdng thudng, bd npi soi tai miii hpng
- Miy chup X quang
- He thdng soi thyc quan eyng eua Chevalier- Jackson
-Hg thong soi mem
- Bddyngey md thye quan, md canh cd - Phieu nghien c&u.
2.2.3.Cdc bu&c tien hdnh
• Khai thae tien s&, benh s& va each dieu tr; trude do - Khim lam sang tai mui hpng: trigu eh&ng ca nang, trieu ch&ng thye the, nhgn djnh ban dau ve vj tri dj vgt.
• Chi djnh eae xet nghigm cgn lam sang can thilt:
cdng thye mau, X quang ed nghigng.
- Tiln hanh dilu tri: lay dj vat bang cac cich khac nhau tiiy theo v| tri va chi djnh cu the, ghi nhgn v| tri, hinh dang, kich thude, ban chat ciia d| vgt.
- Theo ddi, eham sde bgnh nhan, ghi nhgn cic tai biln trong dieu tri.
- Theo ddi, dinh gii kit qua d thdi diem ra vign (ddi vdi nh&ng trudng hpp bgnh nhan nam vien).
3. KET QUA NGHIEN ClJU
Qua 137 bgnh nhan dupc khim va dilu tn dj vgt dudng an tai Bgnh vign Trung uang Hui vi Benh vign Trudng Ogi hpc Y Dupe Hue t& thing 6/2014 den thing 6/2016 chung tdi ed dupc mpt sd kit qua sau d i y
3.1. Dac diem lim sing, c|n lam sing 3.1.1. Dqc diim chung
- Nam cd 71 trudng hpp chiim ti Ig 51,8%; n&cd 40 trudng hpp ehiem 48,2%.
- Nhdm tudi ngudi Idn 84,7%, tre em 15,3%.
Thfri gian B?nli nhan T i l l
Ngay thu* 1 107 78,1%
Ngay thu* 2 20 14,6%
Ngay thO* 3 7 5,1%
Ngay thii* >3 3 2,2%
Tdng so 137 100%
- Bgnh nhan vio vign trong ngiy dau chiem ti Ig eao 78,1%
-Sau ngay thd 3 cd 2,2%
I 6 4 lOURNALOFMEDIClNEANDPHARMACV
Tap chl Y DUQC hgc - Truimg Bqi hgc YDuvc Hui- Tgp 6, sS4 - thdng 8/2016 3.1.3. Phdn loqi dj v^i
Bieu dd 1. Phan logi divat (n=137)
Dj vat h&u cp la cac loal xuang ehilm u'u the 95,7%. Dj vat vd eo cd 6 trudng hpp trong do ed 4 ham rang gia, 1 ddng xu, 1 cay kim.
3.1.4. Xd tri trw&c luc vdo vi0n
Bang 2. Cac phuang phip xu tri trudc lue vao vign (n=137) Phirang phap xir tri
An them com, rau Khge manh Mde hpng Khdng x& tri gi Ch&a phep
Nhd ban tay ngu'di de ngupe eao Udng thude khing sinh
So lu'png 80 65 32 32 5 4 2
Tilg%
58,4 47,4 23,4 23,4 3,5 2,9 1,5 Cich bgnh nhin s& dyng bign phip dan gian hay phin xa t y nhien la:
- An them cam, rau cd ti Ig Idn nhat vdi 80 trudng hpp ehiem 58,4%.
- Khdng x& tri gi cd 32 trudng hpp chiem 23,4%.
3.1.5. Dqc diim vj tri di vgt
Bang 3. Phan loai vj tri di vgt b hpng va thuc quan (n=137) Vj tri
Amidan
Day lirdi - ranh \\,ct\ thanh thi^t XoangIe
Thanh sau hpng long CQng dj v | t hong lylilngttig'cquan Thyc quan co Thyc quan ngu'c T6ng c§ng di v | t thyc quan
long cong
So \Wffng 70 (69,3%) 21 (20,8%) 5 (4,9%) 5 (4,9%) 101(100%)
4 (11,1%) 27(75%) 5 (13,9%) 36(100%) 137
Til#%
51,1 15,4 3,6 3,6 73,7 3 19,7
3,6 26,3 100,0 - Dj vgt hpng chilm 73,7%.
- d thyc quan d| vat tgi thyc quan ed chilm 19,7%.
65|
Tgp cbi YDuvc hgc - Tru&ng Bai hgc Y DUQc Hui- Tdp 6, si 4 - thang 8/2016
3.1.6. Giai doqn lam sang
Bing 4. Giai doan lam sang (n=137) Giai dogn
Bgnh nhin Tllg
Chu'a viem 124 90,5%
Vigm nhilm 11 8,0%
Biln ch&ng 2 1,5%
Tdng cpng 137 100%
Giai dogn ehua viem chilm ti Ig 90,5%, giai dogn vigm cd 8,0%, giai dogn biln ch&ng cd 2 bgnh nhin ti Ig 1,5%.
3.1,7. Triqu chirng ca ndng
Bang 5. Trigu ch&ng ea nang (n=137) Trigu ch&ng
Nudt dau Khdng i n udng dupc Nudt vudng Ho Ndn Sdt Mieng chiy dai
Sd lu'png 119
65 34 3 7 5 7
Tile%
86,9 47,4 24,8 2,2 5,1 3,6 5,1 - Trigu ch&ng ca nang nudt dau chiem tl Ig Idn nhat 85,9%.
- Khdng an udng dupe ehiem ti Ig 47,4%.
3.1.8. Triiu chdng thyc the
Bang 6. Khim cic trigu chirng thyc t h i ddi vdi dj vgt thyc quin (n=36) Thyc the
An ed diem dau d e l
Dau higu Ipc cpc thanh quin cdt sdng mat Cr nudc bgt d xoang l§
Sungmingeanh
Sd lypng 25
6 5 2
Tilg%
69,4 16,7 13,9 5,6 Trigu ch&ng I n dau d ed ehiem ti Ig ldn nhat 69,
15,7% trudng hpp.
3.1.9. Cdng thdc mdu
Bang 7. Cdng th&c bgch cau (di vgt thyc quin n=36)
,4% trudng hpp. Lpc cgc thanh quin cpt sdng cd mat d
^ ^ ^ - . . . . ( a i a i dogn So lu'png ^~~~~--....^^
Sd lupng bgch cau trung binh (/mm^) DNTT X±SD Lymphd X±SD
Giai dogn chu'a vigm
8557+2782 51,96±1,23 24,06+1,31
Giai doan viem
14470±3438 75,77+9,90 17,03±8,97
Giai do^n bien ch&ng
15100±1410 82,75±1,77 13,15±1,20
P
< 0,05
< 0,05
<0,05 Cd sy gia tang cao dan sd lu'png bgch c l u
t& giai dogn chua viem cho den giai dogn bien ch&ng. Sy khac nhau nay cd y nghTa thdng ke (p<0,05).
I 6 6 lOURNAL OT MEDICINE AND PHARMACY
Cd sy gia tang tuan t y sd lupng bgch cau da nhan trung ti'nh va giam tuan t y sd lupng bgch eau lymphd t& giai dogn chua vigm din glai doan vigm va giai doan biln eh&ng (p<0,05).
Tgp ch! Y Duvc hqc - Truimg Bqi hqc Y Duvc Hui -Tgp 6, si 4- thdng 8/2016
3.1.10. Phim Xquang t/iyc qudn cdnghiing
Bing 8. Trigu eh&ng X quang (n = 36)
" - - ^ ^ ^ Giai doan Tri|u cho'ng ^ ~ ^ ^ - - ^ ^ Co hinh anh can quang Cot song CO mat chieu cong sinh ly
Day phan mem tryorc cot song co Dau minnegerod
Giai do9n chya viem 9 (25%)
0(0%) 1 (2,8%)
0(0%)
Giai do^n viem 6 (16,7%)
3 (8,3%) 4 (11,1%)
0 (0%)
Giai doan bien chuTig
2 (5,6%) 1 (2,8%) 1 (2,8%) 1 (2,8%)
Tong cpng 17 (47,2%)
4 (11,1%) 6 (16,7%) 1 (2,8%) - Cd 17 trudng hpp cd hinh anh cin quang tren
phim X quang chllm ti Ig 47,2%. Day la hinh anh ndi bgt nhat ddi vdi dj vgt thyc quan.
- Cac trigu ch&ng X quang khic (Cpt sdng cd mat 3.2. Kit q u i d i l u tr]
3.2.1. Pbuvng phdp tdy dj vgt
Bing 9. Phypng phip lay dj vgt
chieu eong sinh 1"^, day phan mem trUde ept sdng cd, dau minnegerod) it thay ban va ehii yeu xuat hign trong giai dogn mupn.
Phyang phap Gap di vat tryc tiep Gap di v l t qua n$i soi Gap di vat qua gyong Soi thyc quan ong cyng Soi thyc quan ong mem Mo' canh c6
TSng c^ng
Sobenh nhan 74 11 16 24 10 2 137
T4i«
54,0%
8,0%
11,7%
17,5%
7,3%
1,5%
100%
Gap dj vgt tryc tilp chiem ti le 54,0% ddi vdi d|
vit hpng. Sol dj vgt dng c&ng chilm ti le 17,5% ddi vdidj vgt thyc quan.
3.2.2. Th&i gian dieu trj ngi tru
Thdi gian dilu tri npi trii trung binh b glai dogn ehua viem l i 2,73 ± 2,01 ngiy, giai dogn viem 4,88 + 2,75 ngay va giai doan bien eh&ng 11,0 ± 5,65 ngay.
Thdi gian dieu trj trung binh la 3,67 ngay.
4. BAN LU^N
Qua nghien c&u 137 trudng hpp dj vgt dudng i n din khim v i dilu tn tai Bgnh vign Trung uang Hue va Bgnh vign TrUdng Dgi hpc Y Dypc Hue t& 6/2014 den 6/2015 ehung tdi dua ra mdt sd ban lugn nhy sau:
4.1. O^c diem lam sing, cgn lam sing 4.1.1. Dqc diim ldm sdng
Khdng cd sy khae bigt ve gidl. Ti Ig ngudi Idn
cao ban so vdi tre em. Tudi nhd nhit den kham la 2 tudi, Idn nhat la 87. Dd tudi trung binh l i 35,82.
T& Bing 1 thay ti lg bgnh nhan nhgp vign trong ngay dau la 78,1%, ngay th& 2 la 14,6%. So sinh vdi cae tac gii nudc ngoai eung cho tl Ig bgnh nhan nhgp vign trong 24 gid dau khi cao: theo Dereei (2015) cd 94% bgnh nhan nhgp vign sau 24-48 gid (9], theo Bale! ed 83,2% bgnh nhan den vign trong 12 gid dau, 9,1% t& 12-24 gid [8]. Nhin chung phan Idn benh nhan nhin th&e tot v l dj vgt du'dng i n .
T& Bleu dd 1 thay d| vit h&u ea m i cu the la cae logi xUPng ehilm da sd vdi 95,7%. Day la nhdm di vgt hay ggp b nubc ta va cung la nhdm dj vgt ed the giy nhilu nguy hilm neu khdng ditqfc x& tri kjp thdi Dj vgt vd CP chilm 4,3% trudng hpp, do la ham rang gia, dong xu, eay kim khau...
JOURNALOF MEDICINE AND PHARMACY 6 7 |
Tgp chi Y DUQC hgc - Truimg Dgi hgc Y DUQc Hui -Jqp6,sd4- thdng 8/2016
T& Bang 2 thdng k l cho thay bgnh nhin sau hde di vgt an them cam, rau ti Ig 43,8%, cd gang khac manh 27,7%, mdc hong 10,2% vdi hy vong d| vgt dupc tdng ra ngoii nhung da sd nh&ng dj vgt sac nhon cam sau them giy ph&c tgp eho dieu tri sau nay. Nhat la nh&ng d| vat mac d thuc quan dogn bat cheo eung dgng mgch chu, dj vgt cd the t& thyc quan cam vao mgch miu. Cd mpt ti Ig khdng nhd BN dieu tri bang cac phi/ang phip dan gian nhu nhd bin tay ngudi de ngupc eao 2,9%, ch&a phep 3,5%.
Ben cgnh dd ed 2 trudng hap (1,5%) benh nhan t u udng thudc khang sinh d nha. Oilu nay cho thay BN van ehua dinh gia dung dupe tam quan trpng ciia benh dj vat dudng an.
Theo Bang 3, vj tri mae dj vgt chiem ti le cao nhat la b hpng vPi 73,7%. Ve giai phau day la c&a ngd dau tien ciia dudng tieu hda, cac dj vgt sic nhgn thuang mac Igi tai diy, b nudc ta phan Idn dj vgt dudng an la xuang ci nen ti Ig dj vat d hgng ehiem da sd la phii hpp. d thye quan dj vat mac tgi dogn cd ehilm tl Ig Idn nhat vdi 19,7%. Ket qua nay phii hpp vdi nh&ng nghien c&u trude day eua Nguyin Tu The [6], Tran Phuang Nam [3], cang di xudng ti lg mle di vgt eang thap.
Kit qua d Bing 4 cho thay ed 90,5% bgnh nhan dgiai dogn chua vigm, ed8%bgnh nhan dgiai dogn vigm vi 1,5% d giai dogn biln eh&ng. Vdi phan ldn benh nhan nhip vign trong 2 ngay dau ngn benh canh lim sang phan Idn nam d giai dogn ehua viem ehiem 90,5% Giai dogn viem ehiem 8% va giai doan blln eh&ng la 1,5%. Vdi 2 trudng hap biln ch&ng chung tdi gap 1 trudng hpp abcess thyc quin do xuang ci dien tien qua 3 glai dogn. Trudng hpp edn lai l i ciy kim khau tryc tilp giy biln ch&ng thimg thyc quan ma khdng qua giai dogn viim.
Ti Ig bien ch&ng theo mpt sd nghien c&u ngoai nude:
- Altokhais l i 4/70 benh nhin cd ti Ig la 5,6% [7].
- Saki vdi 1,41% ti le biln ch&ng tim thiy va khdng xiy t& vong [11]
- Lim la 10/397 bgnh nhin cd ti Ig 5,1% vdi 11 biln ch&ng lien quan [10].
Chimg tdi nhgn thay ty Ig giai dogn viem va bien ch&ng ngiy eang giam theo chimg tdi thi y th&c cham sdc s&c khde ciia nhan din ngay eang cao, bgnh nhan den kham d giat dogn sdm.
4.1.2. Dgc diem cqn tdm sdng
Tix Bang 7 chung tdi nhgn thay cd sy tang cao dan so lupng bgch cau t& giai doan ehua vigm den giai dogn biln ch&ng. Kit qua b bang 8 thay X quang
cd nghigng l i xet nghigm rat quan trpng trong chan doin dl vat dudng an dge bigt l i cie dj v|t cd ti'nh ehat can quang. Trong khi do diy phan mem trudc ept sdng ed chilm ty le 15,7%, cpt sdng cd mat chieu cong sinh ly chiem ti Ig 11,1%, ti Ig nay chiem phan ldn d nh&ng bgnh nhan trong giai dogn vigm hogc bien ch&ng.
4.2. Ket qui dieu trj
T& bang 9 ehung tdi nhgn thay ddi vdi dj vat hpng each x& tri hay ggp nhat la gap dj vgt tryc tiep chiem 54%, each nay dUpc thye hign de lay nh&ng dj vit d thinh sau hpng, try trude, try sau, nhu md amydal.
Ddi vdi dj vgt thye quin phuang phip uu the hign nay l i soi thye quan dng c&ng ehilm ti lg 17,5%.
ThPi gian dieu tri ndi trii trung binh eiia ehiing toi la 3,67 ngay ngan hPn so vdi nghien c&u trudc day ciia Tran Phuang Nam l i 6,27 ngay [3].
5. KET LU^N
Die diem lim sang, cgn lam sang - Khdng ed sy khac nhau ve gidl, ngudi idn mac nhieu han tre em.
- Tl lg bgnh nhan vao vign sdm trong vdng 48 gid la 92,7%.
- An thgm cam, rau la phuang phap x& tri hay ggp nhat (58,4%).
- Dj vat mae d hpng (73,7%), nhilu han di vat mae d thyc quan (26,3%).
- u hgng hay ggp theo th& t y : amidan 69,3%;
diy ludi 20,8%; xoang le 4,9%; thanh sau hong 4,9%.
- 6 thuc quan: di v i t mac ehii yeu d thye quan co 75%; khdng cd dj vgt b thyc quan bung.
- Trigu ch&ng ca nang nudt dau hay gap nhat chllm 86,9.
- Cd 95,7 % la dj vgt h&u ca, 4,3% la dj vgt vd ca.
Dj v i t hay ggp nhat la xuang ca chiem 87,6%.
- Cd 90,5% bgnh nhan vao kham va dieu tri d giai dogn chua vigm, 8,0% d giai doan viem va 1,5% d giai doan bien ch&ng.
Kit qui dieu trj
- Gap di vat tryc tiep 54%, gap dj vgt gian tiep qua guang 11,7% va npi soi 8%.
- Soi thuc quan dng e&ng 17,5%.
- Soi thye quan dng mem 7,3%
-Mdcanhedl,5%.
- Cd den 58,4% sd bgnh nhan khdng phii s&
dyng phuang phap vd cam nao
- Ti lg khdi hoan toan la 100%, khdng cd trUdng hpp nao t& vong hay phai chuyen vien.
lOURNAL OF MEDICINE Af
Tgp ch! YDUVC hgc- Tru&ng Dgi hgc YDugc Hue-Tgp 6, si 4- thdng 8/2016 T A I U E U T H A M K H A O
1. Nguyen Thi Nggc Dung (2008), "Di vgt d u d n g an va bien ch&ng a p x e thuc quan", Tai MQi Hgng nhgp mdn.
Nha xuat ban Y hoc Thanh phd Hd Chi Minh, tr 349-355, 2. Le Van Lyi (2001), "Dj vgt du'dng an". Cap cuv Tai Mui Hgng, N h i xuat ban Y hgc. Ha Ngi, tr. 426-438.
3. T r i n Phucmg Nam, Nguyin Tu The (2006), Nghien cii-u dgc diem Idm sang va kit qua dieu tri di vgt thuc quan tgi Benh viin Trung uong Hue. Lugn an chiiySn khoa d p II, Trudng Dgi hgc Y khoa Hue.
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