Y HOC VIET NAM THANG 5 - s 6 1/2013 Ty le ngat khi sinh la 8 % thap hdn so vdi
nghien cffu khac [6] la 30,8%. Mgt so nghien effu [ 6 ] , [8] da chi ra rang: khong phai tat ca tre bai nao co tien sff bi ngat khi sinh la do chfnh yeu to ngat gay nen ma cd the ehi la hau qua.
Cac yeu to khae gay ra tinh trang thieu oxy man ti'nh d thai nhi va lam ton thffdng nao trffdc sinh nhff: eac bien chiitig trong thai ky, cua nhau thai, benh maeh mau thai nhi, chuyen da bat thffdng [6]
2.4.3. Sau sinh (9,3%): Theo mot tai lieu [3] khoang 70% trffdng hdp bai nao xay ra trffdc khi sinh, 20% xay ra trong qua trinh sinh de va 10% xay ra trong hai nam dau ddi. Sff khae nhau nay ed the la do nghien effu ciia chung to! quy mo nhd hdn va quan diem ve ngat trong cd ehe benh sinh eiia bai nao van chffa ro rang.
V. KET LUAN
Ket qua nghien cffu 75 tre bai nao tff 0-5 tud'i benh vien Nhi Hai Dffdng nam 2012: Ty le nam/nff la 4 / 1 ; Tre bj bai nao > 1 - 2 tud'i la cao nhat (56%) va tre bai nao d nong thdn (62,7%)o hdn d thanh pho; Hau het la con dau long (80%). Ty le tre bai nao eao nhat ciia cae ba me tren 35 (14,7 % ) va la ndng dan (46,7%). Nguyen nhan gay bai nao eao nhat la trong khi sinh (65,3%), tiep den trffdc khi sinh: 14,7%, sau khi sinh (9,3
% ) ; cdn 10,7%. chffa ro nguyen nhan: Phat hien tre bai nao thong qua cac dau hieu nhan biet sdm: Tre cham phat tnen (94,7%); Khd be am (89,3%); Bu sac, bu kho (65,3%); Co cirng (61,3%); Mem nheo (38,7%).
TAI LIEU T H A M K H A O
1, Tran Thj Thu Ha ( 2 0 0 2 ) , "Nghien cuii mpt so' dSc diem dich te, lom sang va nhu cau phue hdi diik nSng dtre bai nao", Luan an Tien sy Y hoe, TrUdng Dai hoc YHa Noi.
i.. Tran Thi Thu Ha ( 2 0 0 5 ) , " Phat hien sdm, can tivep sdm mot so dang tan tat d Viet Nam", NXB y hoc, Ha Noi 2005.
J Tran Tr^ng Hai, "Bai nao va phue hoi ch&c nSng". NXB y hoc, 1993, trang 7, 8, 10, 64.
1. TS. Tran Trpng Hai, TS. Tran Thj Thu Ha, TS.
Tran Van Chu'dng ( 2 0 0 4 ) , "Nghien cud vehoat ddng Phue hdi chdc nang du'a vao edng dong tai Vietnam (1987-20(M)", Ha npi 2004.
5. Tran Trong Hai, "PKT^dua vao wngdong', NXBc^
due, trang 70, 71. 78
u. Nguyen Thi Hung, Nguyen Thj Thu Thao (2009), "Dac diem lam sang va phan loai cua 130 tru'dng hdp bai nao".
7. Pham Thj Nhuyen, "Glao trinh hoat dong tri lieu", Tru'dng Dai hoe Ky thuat Y te Hai Du'dng, 2011.
NGHIEN CUU NHIEM RUBELLA 0 PHU NUf MANG THAI TAI BENH VIEN PHU SAN TRUNG UONG NAM 2009 -2011
TOM T A T
Muc tieu: "Xae dinh ty IS nhiem mdi rubella d nhij'ng phu nd mang thai cd nghi ngd nhiem rubella tren iam S3ng".t)6\ tu'dng va phu'dng phap nghien ciru: c6 mau 777 phu nff mang thai c6 it nhat mot trong cac dau hieu nhU sot, phat ban va noi hach td 2009 den 2011: la thdi gian ngay tru'dc, trong va ket thiic dich; Phuong phap nghien cffu: mo ta tien cffu.
Ket qua: Ty le nhilm mdi rubella IgM(+) 68,1%, sd nhiem IgM ( + ) IgG(-) la 7,2%, Ty le phat hien nhiem mbella theo tuo'i thai: 5 tuan: 40,8%; 6-12 tuan: 60,8%;
13-18 tuan: 77,7%. Ty le nhilm mdi rubella IgM(+):
Phu nu' mang thai co sot 81,0%, co phat ban 79,1%); noi hach 85,7% co ca 3 trieu chiilig 85,6%. Ty le dinh ehi
* Benh vien phu san trung UOng
Phan bien khoa hgc: PGS.TS. Dang Thi Minh Nguyet 122
Le Hoai Chu'dng*
thai nghen 81,9%, trong do thai > 18 tuan nhilm rubella IgM(+) 30,3%. Ty le thai nhilS tuan nhiem rubella vdi xet nghiem nudc 6i PCR(+) 46%. Ty le tre sa smh IgG(+) 98,6%, nhiem rubella IgM(-i-) 27,77o
SUMMARY
RESEARCH OF RUBELLA INFECTION IN PREGNANT WOMEN IN NH OF OB-GYN 2009 - 2011
Objective: "Determinate the rate of new rubella infection in pregnant women having suspected rubella symptoms". Material and method: sampling size; 777 pregnant women having at least one of the signs as fever, rash, lymphatic nodes; Study time from _2009 to 2011: before, during and after rubella
Y HOC VI^T NAM THANG 5 - SO 1/2013 epidemic outbreak; Methodology: descripbve
longitudinal study. Results: The rate of new rubella infection IgM(4-) 68,1%, initial rubella infection IgM (-(-) IgG(-) 7,2%. The rate of new rubella infection detected by gestational age: 5 weeks: 40,8%; 6-12 weeks: 60,8%; 13-18 weeks: 77,7%. Incidence of new rubella infection IgM(-H): by fever 81,0%, rash 79,1%);
lymphatic nodes 85,7%, having 3 signs 85,6%. The rate of pregnancy termination 81,9%, with GA >_ 18 week abortive fetus infected rubella IgM{+) 30,3%. The rate of fetus infected rubella based on amniotic liquid examination PCR{-H) 46%. The rate of newborns having IgG(-H) 98,6%, IgM(-f) 27,7%.
I. OAT V A N D E
Rubela dffcJc phat hien each day hdn 150 nam, dffdc tim ra bdi ngu'di Dffc, De Bergen nam 1752 va Orlow/ nam 1758. Den nam 1952, Parkman mdi phan lap dffdc vi rut rubella la nguyen nhan gay benh [ 6 ] . Sau mot thdi gian rubella it xuat hien, den nam 1970 rubella xuat hien trd lai hau het la xay ra d tre em va ngu'di tre tuoi. O Hoa Ky, theo McElhaney va cpng sd, ty le phu nff bi nhiem 2 5 % [ 7 ] , theo Amy Jonhson va Brenda Ross, ty le nhiem tff 10- 2 0 % [2]. Rubella CO the gay ra nhieu bien chffng, yeu to lien quan den sffc khoe cpng dong du'dc dat ra la rubella gay ra thai di tat bam sinh. 6 Viet Nam, tac gia Le Diem Hu'dng, da nghien cffu ve tinh trang phu nff nhilm rubella [1]. Noi chung nhffng nghien ciili ve rubella d Viet Nam con chffa nhieu, de phan anh mpt phan tinh trang nhiem benh d phu nff mang thai tai khi cd dieh xay ra trong nam 2010 - 2011, ehiing to! tien hanh nghien _cffu nay vdi muc tieu: "Xac dinh ty li nhiem mdi rubella d nhu'ng phu nd mang thai co nghi ngd nhiem rubella tren lam sang tai Binh viin Phu san Trung ddng nam 2009- 2011"
II. o 6 l TUONG VA PHUONG PHAP NGHIEN ClJU 1.1. Boi tddng nghlin cdu - I l l phu nff mang thai den kham va sinh de tai BVPSTW ed nguy cd eao nhiem rubella (sot, phat ban va noi hach thdi gian tff 2009 den 2011: la thdi gian ngay trffdc dieh, trong khi djch xayra va ket thiic dich.
- C6 mau nghien effu du'dc tinh theo cong thu'c sau:
7 : p{\- P)
n = Z \-„ '2 ^—
{psY
p: Ty le phu nff mang thai ed sot, phat ban va noi hach bl nhiem rubella {\idc Iffdng 15%) [2]
2^(1-6/2): He 50 gidi han tin eay d mffc xac suat 95% (=1,96)
£ : 0 6 sal leeh tu'dng ddi giffa ket qua nghien effu va thu'c te ( = 0,17).
Cd mau tfnh d^idc 754 phu nff mang thai.
Tren thffc te, toi da nghien cffu dffdc 777 phu nff Tliu chuan Ida chgn ddi tddng nghiin cdu:
Phu nff mang thai eo eac trieu ehutig lam sang nhu' sot, phat ban va ndi hach tuo'i thai tff 5-18 tuan theo doi thai va smh de tai BVPSTW,
- Du'dc lay mau xet nghiem dinh lu'dng IgG va IgM
Tuo'i thai phu xet nghiem mau tff 5 - 18 tuan.
Benh nhan dong y td nguyen tham gia vao nghien cffu.
Tiiu chuan loai trd:
- Benh nhan tff choi khong tham gia nghien eirtj.
- Benh nhan bo, khong theo doi trong qua trinh nghien effu,
- Benh nhan dang say thai.
1.2. Phu'dng phap nghien cdu - La phu'dng phap nghien cffu mo ta tien ciTu.
IN. KET QUA
3.1. Dac dli'm chung
- Tong so phu nff mang thai eo 1 trong 3 tneu chffng lam sang nghi nghd nhiem rubella mdi la sdt, phat ban, noi haeh: 777 benh nhan.
- Tuoi: <20: 3,0% ; 20-29: 77,6% ; 30-39:
18,8% ; 40-49; 0,6%
Ndi d : Thanh thi 42,6% ; Nong thon:
57,4%.
Hoe van: Du'di pho thong trung hpe:
12,2%; Pho thong trung hpc: 87,8%
- Tinh trang hon nhan: Cd ehong: 99,9%;
Chu'a/ khong ed chong: 0 , 1 %
- Thdi diem thai phu xet nghiem mau, 13-18 tuan: 50,3%, 6-12 tuan: 43,4%; 5 tuan: 6,3%.
Tuoi thai trung binh: 11,9±3,46 tuan.
Ty le phy nff mang thai cd bieu hien da nhiem eu la: tien sff sdt va phat ban: 1,4%; tiem vac cin phong rubella: 0,3%.
- Phan bd eae trieu chffng lam sang rieng re:
sdt; cd 64,4%, khdng 35,6%; phat ban: c6 84,6%, khong 15,4%; noi haeh: ed 44,9%, khdng 5 5 , 1 % .
Y HOC VigT NAM THANG 5 - SO 1/2D13 - Ba trieu chimg lam sang phoi hop sot,
phat ban va noi hach; co 34,9%, I<h6ng 6 5 , 1 % . 3.2. Tyle nhiem rubella cl phu nW CO thai - Ty le phu nff mang thai co khang the IgB(+):
87,5%, IgG {-): 12,5%.
- Ty le phu nif mang thai co khang the IgM (•+;.• i 5 » , i % , IgM (-): 31,9%.
- Ty ie phu nO' mang thai co ca 2 ioai khang the IgG(+) va IgM ( + ) 6 0 , 9 % ; Ige(-) va IgM (+): 7,2'/o
- Nong do IgG trung binh ciia phy niJ mang thai CO nghi ngd nhiem rubeiia tren iam sang ia 100,6(UI/mi) (dao dong trong khoang tir 0 , 1 - 1448,1 Ul/mi).
- Phan bo nhiem rubella theo trlSu
chu'ng lam sang; „ + Sot: CO nhiem 8 1 , 0 % , khong nhiem
19,0%; khong sot: co n h i l m 4 4 , 8 % , khong n h i l m 55,2%.
+ Phat ban: co n h i l m 7 9 , 1 % , khong nhiem 20,9%; khong phat ban: co nhiem 7,5%, khong nhiem 9 2 , 5 % ,
+ Noi hach: co nhiem 85,7%, khong nhiem 14,3%; khong noi hach: co n h i l m 53,7%, khong nhiem 4 6 , 3 % .
+ Ba trieu chirng sot, phat ban va noi hacil*
phoi hop: CO nhiem 85,6%, khong n h i l m 14,4%;
khong CO ba trieu chirng phoi hop: co nhiem 54%, khong nhiem 4 6 % .
Bang 1, Phan bo phat hieri_n]iiem rubeiia tiieo tuqi tha Tuoi thai
5 tuan 6-12 tuan 13-18 tuan
Khong nh SL 29 132 47
em rubella
»/o 59,2 39,2 22,3
Nhiem rubella SL 20 205 304
Vo 40,8 60,8 77,7
P
<0,023
- Ty le phat hien nhiem rubeiia theo tuoi thai: 5 tuan: 40,8%; 6-12 tuan: 60,8%; 1 3 - l i i tuan:
77,7%
- Dinh chi thai nghen: 7 7 7 thai phu, co 6 3 6 trirdng hop OCTN chiem ty ie rat cao chiem 8 1 , 9 % , 141 thai phu tiep tuc giu thai chiem ty le 1 8 , 1 %
- Phan bo tuoi thai dinh chi thai nghen: i 12 tuan: 13,5%; tir 13- IStuan: 45,3%, > 18 tUiin;
41,2%.
- Phan ho DCTN theo st/ co mat ciia lihang thelgl^ va IgG:
+ IgM(-): CO DCTN: 48,0, Ithong: 52,0;
IgM(+): CO DCTN: 97,7, l<hdng: 2,3; (P: 0,001).
-1- IgG(-): CO OCTN; 61,9, khong: 3 8 , 1 ; IgG(-i-): CO OCTN: 84,7, khong: 15,3;(P: 0,001).
-1- IgM(-f) va IgG(-): co OCTN: 100%, khong: 0% (P: 0,001).
- Phan bo dinh chi thai theo cac trieu chutig lam sang:
-r Sot: CO OCTN 92,4%, khong: 7,6%; khong sot: CO OCTN 62,8%, khong: 37,2% (p = 0,001).
+ Phat ban: co DCTN 94,5%, khong:
5,5%; khong phat ban: co DCTN 12,5%, khong:
87,5% (p = 0,001).
+ Noi hach: co OCTN 98,3%, khong:
1,7%; khong noi hach: co OCTN 68,5%, khong:
31,4% (p = 0 , 0 0 1 /
+ Sot, phat ban va noi hach phoi hdp: th DCTN 98,3%, khong co ba trieu chirng phoi hdp;
1,7%; khong co ba tneu chirng phoi hdp: co OCTN 68,6%, khong: 3 1 , 4 % (p = 0,001)
3.3. Ty le nhiim rubella & thai nhi va tre so sinh: 63 thai phu du'dc choc 61 lam xet nghiem PCR (-1-) :46%, ket qua PCR(-): 54%.
Bang 2. Ty le thai nhi OCTN tren 18 tuan xet nghiem mau cuong ron
Xet nqhiem mau cuonq ronIqM (-I-) IqM (-) Tonq
So lirqng 40 92 132
Tv le Vo 30,3 69.7 100,0 Bang3. Phan bo khang the IgG va IqM ciia tre so sinh
IgG IgM
DUOng Am DUdng Am
So lu'dng 139
2 39 102
Tv le Vo 98,6
1,4 27,7 72,3
Y HQC VIET HAM THANG 5 • SO 1/2013 Co 39 tre sd sinh nhiem rubella (IgM du'dng
tinh) cua cac ba me nhiem rubella trong thdi ky mang thai (cd sdt hoac phat ban hoae noi haeh va ed IgM dffdng tinh) chiem ty le 27,7%, cd 139 tre sd sinh co khang the IgG {+), cliiem ty le 98,6%.
IV. BAN LUAN^
- T y le nhiem mdi rubella IgM(-h) 6 8 , 1 % , sd nhiem IgM {+) IgG(-) la 7,2%; Ty le da tiem vacxin phong rubellarat thap chi cd 0,3%.
- Ty le phat hien nhilm rubella theo tuoi thai: 5 tuan: 40,8%; 6-12 tuan: 6 0 , 8 % ; 13-18 tuan:
77,7%; mgt phan do thdi diem thai phu xet nghiem mau, 13-18 tuan: 50,3%, 6-12 tuan:
43,4% ; 5 tuan; 6,3%; mdt phan ty le eao d thdi diem 13 - 18 tuan la do cdng ddn khoang thdi gian da nhiem b|nh tru'dc dd.
- Ty le nhiem mdi rubella IgM(-f): Phu nff mang thai co sdt 81,0%, cd phat ban 79,1%); noi hach 85,7% cd ra 3 trieu chffng 85,6%.
Sdt, phat ban va noi haeh la 3 trieu chffng lam sang dien hinh eua rubella. Tuy nhien, nhffng ngu'di cd bieu hien trieu chffng nhiem rubella chiem ty le 50-70% [ 2 ] . Rubella thu'dng CO thdi gian u benh tff 14-17 ngay va co the den 21 ngay. Sau thdi gian u benh, se xuat hien sdt nhe, cd khoang 50-95% benh nhan cd sot nhe, rat it khi cd sdt cao. Dong thdi vdi sot, benh nhan thu'dng cd phat ban (khoang du'di 50%
benh nhan cd phat ban) hoae eae not phdng nho, CO the kem theo eae nhffe dau so mui, viem ket mac. Benh cd the keo dai tff 1-5 ngay. Dau hieu ro net nhat eua nhiem rubella la noi hach bach huyet sau tai, cham va day hach sau co [ 4 ] .
Vi rut rubella du'dc dao thai ra ngoai cd the ngu'di benh theo eac chat tiet mui hong ngay tff cuoi thdi ky u benh, khoang 1 tuan trffdc va 1 tuan sau khi xuat hien trieu chffng phat ban.
Nhffng ngffdi cd bieu hien trieu chffng nhiem rubeiia chiem ty le 50-70% [ 4 ] . Sau khi vi rut vao cdthe khoang 2-3 tuan le, benh nhan hoan toan binh thffdng. Tiep theo ed 3 trieu chffng chinh la sot, phat ban va ndi haeh. Sdt, dau dau, met mdi thffdng xuat hien 1- 4 ngay, sau khi phat ban thi sot giam, sot nhe 38,5''C. Phat ban la dau hieu lam ngffdi ta de y tdi. Ban bat dau xuat hien d tren dau, mat, roi mpc khap toan than, thu'dng khong tuan tff nhff sdi, Not ban cd hinh trdn hay bau due, dffdng kinh khoang l - 2 m m , cac not cd the hdp thanh tffng mang hay dffng rieng re.
Trong vong 24 gid ban mpc khap ngffdi, chi sau
2-3 ngay la bay het. Can phan biet vdi ban cua sdi: Ban sdi sd min, mpc thff tff tff tren dau, mat xuong, sau khi bay de lai cae vay nhu' phan rdm, tren da ed cae van mau sam. Noi hach d viing xffdng cham, khuyu tay, ben, co, sd hdi dau, Haeh thu'dng noi trffdc phat ban, ton tai vai ngay sau khi ban bay het. Dau khdp hoae dau khap minh may, hay gap d phu nff. Cac khdp ngdn tay, ed tay, gdi, co ehan dau trong khi phat ban, sau do khdng de lai di chffng [2], [4].
Trong giai doan cap tinh, xet nghiem lay dieh mtji, hau hpng de nudi eay phan lap vi rut, hoac xet nghiem PCR de ehan doan. Tuy nhien giai doan nay de bi bd qua vi ngu'di benh thu'dng den mupn. Xet nghiem mien dieh hay dffdc ap dung nhat. Chan doan thu'dng dffdc dinh Iffdng bang huyet thanh IgG va IgM. Mau cd the dat du'dc sdm sau 2 tu'an bi nhiern va neu can thiet 4 tuan sau se dinh lu'dng lai. Mau mau huyet thanh dffdc xet nghiem luc nhiem va sau khi nhiem tang gap 4 lan hoae eao nhat. Khi bi lay nhiem cap tinh, neu ngu'di ed huyet thanh du'dng ti'nh d lan thff dau tien khdng anh hu'dng den thai nhi.
Khang the khang rubella IgM ed the tim thay lan dau_ nhiem rubella va tai nhiem rubeiia. Tai nhiem rubella thu'dng khdng ed tneu chffng Iam sang. Thu'dng dddc chan doan bang xet nghiem can lam sang va it nguy ed lay nhiem rubella den thai nhl trong thdi ky thai nghen [ 7 ] . IgM: Khang the IgM dddc phat hien ra d tffng ea the vffa bi nhiem rubella hoae vffa dddc tiem phong. IgM thu'dng xuat hien 5 ngay sau khi ngu'di me bi phat ban va thu'dng ton tai tff 6 den 8 tuan. Tuy nhien, trong mot sd tru'dng hdp khang the rubella IgM chi tdn tai trong vdng 1 nam hoac dai hdn sau khi nhiem lan dau, tai nhiem khdng tneu chffng hoae tiem phong [4], [ 6 ] . Ti le khang the rubella IgG giu'a mau huyet thanh cap va trong thdi gian hoi phue tang len gap 4 lan
- Ty le thai nhil8 tuan nhiem rubella vdi xet nghiem nddc di PCR ( + ) 46%.Ty le tre sd sinh IgG (+) 98,5%, nhiem rubella IgM (+) 27,7%
Nhiem vi rut rubella d phu nff mang thai co the dan den nhiem vi riit d thai nhi do vi rut cd kha nang xam nhap qua rau thai. Tuy nhien, tan suat xuat hien nhffng bat thffdng d thai nhi do vi rut rubella gay ra phu thuoc vao tuoi thai bi nhiem [3].
- Chan doan thai nhi nhiem rubella thffdng dddc xae dinh bdi IgM trong mau mau thai nhi, dat dffdc d tuan thff 22 hoae mupn hdn. Sff cd mat khang the IgM rubella trong mau thai nhi
Y HQC VigT NAM THANG 5 - SO 1/2013 xae djnh dffdc nhiem rubella trong thdi ky thai
nghen, bdi vi IgM cua me khong qua hang rao rau thai [ 7 ] . Xet nghiem djnh Iffdng IgG va IgM tff mau cuong rdn thai nhl sau khi DCTN, tuoi thai > 18 tuan.
- Xet nghiem choc hut nffde di tim ARN cua vi oit rubella bang phffdng phap PCR, tud'i thai choc oi >
18 tuan, thdi gian choc 61 sau khi sdt phat ban 5 tuan.
- Nguy cd nhiem rubella cho thai nhi tuy thuoc vao tud'i thai khi ba me bi nhiem benh: thai
< 11 tuan ty le nhiem la 9 0 % , 11 - 12 tuan:
33%, 13 - 14 tuan: 1 1 % , 15 - 16 tuan: 2 4 % ,
>16 tuan: 0%, Ty le di dang thai nhi cQng phu thude vao tud'i thai khi ba me nhiem benh:
thang dau: 50%, thang thff hai: 2 5 % , thang thff ba: 10%, ba thang giffa 10%, 16 - 20 tuan:
< 1 % , 20 tuan: chi cd bi diec [ 5 ] . V. KET LUAN
- Ty le nhiem mdi rubella I g M ( + ) 6 8 , 1 % va Sd nhiem IgM {+) IgG(-)Ja 7,2%,
- Ty le phat hien nhiem rubella theo tuoi thai: 5 tuan: 40,8%; 6-12 tuan: 60,8%; 13-18 tuan:
77,7%.
- Ty le nhiem mdi rubella I g M ( + ) : Phu nff mang thai cd sdt 81,0%, cd phat ban 79,1%; nd'i haeh 85,7% eo ea 3 trieu chffng 85,6%.
- Ty le dinh chi thai nghen 81,9%, trong do thai > 18 tuan nhiem rubella IgM(+) 30,3%.
- Ty le thai nhil8 tuan nhiem rubella vdi xet nghiem nddc di PCR(-H) 4 6 % .
- Ty le tre sd sinh IgG ( + ) 9 8 , 6 % , nhiem rubella IgM ( + ) 2 7 , 7 % .
TAI LIEU THAM KHAO
1. Le Diem Hu'dng, Du'dng Thj Le, Pham Vin Anh va cpng su" ( 2 0 0 4 ) , Nhan xet sd bp h'nh hinh nhiem rubella bao thai tren cac ba me co nguy cd eao trong 3 nam 2001 ~ 2003 tai Benh vien Phu San Quae Te Sai Gon, Hoi nghi Viet - Phap ve san phu khoa vung Chau a Thai Binh DUdngran4,tr 1 0 3 - 1 1 0 .
2. Amy Johnson and Brenda Ross. (2007),
"Perinatal infections", John Hopkins Manual of Gynecology and Obstetrics, pp. 136- 149.
3 Best JM, Banatvala JE, Morgan-Capner P, et al. ( 1 9 8 9 ) , "Fetal infection after maternal reinfection with rubella: criteria for defining reinfection", Br Med J, 299, pp. 712-17S.
-r. Gilles RG. Monif, David AB. (2005), Rubeiia, Infections diseases in pregnancy, Obstetnes and Gynecology, pp. 252- 265.
5. Jia-Yee-Lee and D, Scott Bowden. (2000), Rubeiia Virus Replication and links to Teratogenicity, Clinical Microbiology Reviews, October 2000, Vol. 13, No. 4, pp. 571-587.
6. Lorraine Oontigny, Marc-Yvon Arsenault, Marie-Jocelyne MarteJ et al. (2008), "Rubella in Pregnancy", J Obstet Gynecol Can, 30(2), pp. 152- 158.
7. McElhaney RD Jr, Ringer M, DeHart DJ, et aL (1999), Rubella immunity in a cc^xxt c^ pregmrt women. Infect Contnil Host Epidemiol 20, pp. 64.
DAC OrEM HiNH ANH CUA CHUP CAT LQfP TRONG VIEM TUY CAP
TOM T A T
De tai ben hanh v6i muc tieu nghien cffu dac cJie'm hinh anh cua chup eat Idp trong viem tuy cap. Tff 01/2011 den 12/2011 tai benh vien Viet Dffc, 130 benh nhan duac chi dmh chup cat Idp (CT) de chan doan viem tuy cap, trong do nam 101 (77.7%), niJ': 29 (22.3%); tuoi trung binh 47,3 ± 11.2 (tff 16 - 82 tudi.
Lam sang dau bung 100%, non va buon non 63,1%, bi trung dai tien 89.2%. Xet nghiem amylase mau
>660U/I: 33.8%; amylase nieu >1000U/1: 30.8%;
du'dng mau >6.4mmol/l: 54.6%; canxi mau <2mmol/l:
30.8%; bach cau >10.1o7mm^: 80.8%. Ket qua ehup
^ Benh vien Viet Ddc; ^ TrUdng Dai hoc Y Ha noi Phan bien i<hoa hoc: PGS.TS. Nguyin Du-c Ti4n 126
Tran Cong H o a n \ Trjnh Van Tuan^
CT de phan loai viem tuy cap theo tieu chuan ciia Balthazar: bac E 66/130 tru'dng hdp (50.8%); bac D 43/130 (33.1%); bac C 19/130 (14.6%); bac A va B chi ehiem 1.6%. Co 3 tru'dng hdp bac E va 1 tru'dng hdp bae D du'dc phau thuat.
Tir khoa: Viem tuy cap, Chup eat Idp.
SUMMARY
IMAGE CHARACTERISTICS OF TOMOGRAPHY IN ACUTE PANCREATITIS Study was conducted with the aim of studying charactenstics of imaging tomography in acute
