Y HOC VlgT NAM THAHG 6 - SO 2/2014 Nghiin eiru co ban che khong do ludng cac ehi
tieu de xac dinh nguyen nhan thieu mau nhU Fen-ibn huyet tiianh. Nhieu titfdng hdp_thieu mau ma khong ro nguyen nhan. Trong dieu kien cd the, ran xac d|nh nguyen nhan gay thieu mau nhU thieu sat bang xet nghiem Ferritin hjjyet thanh, thieu folate, giun mdc, ky sinh triing sdt ret.
Bang 3 cho thay nong dp Hb trung binh tang len khi tuoi ciia tre tang len, phii hdp vdi ket qua ciia MalkanthI va cpng su": nong dp Hb co mdi lien quan thuan chieu vdi tudi (r = 0 , 4 1 , P <
0,001) [ 5 ] . Tif'ket qua bleu do 2, ty le thieu mau cua tre trong 2 nam dau ddi cao hdn va nong dp Hb thap hdn so vdi tre Idn tuoi hdn. Nghien ciiu ciia VIeIra va cong sU cho thay nong dp Hb ciia tre dudi 24 t h i n g tuoi thap hdn YNTK so vdi tre t r i n 24 t h i n g tuoi [71. Ro rang tre trong 2 nam dau ddi la doi tUdng de bj ton thUdng doi vdi tinh trang t h i i u mau. Can thiep dinh dudng la can thiet d e j a l t h i i n tinh trang thieu mau eho tre nhom tuoi nay.
V. K I T LUAN
Nghiin eifu tai 5 xa ciia huyen Lac Sdn tren tre dudi 5 tuoi cho thay:
- Ty l i SDD nhe can la 31,8%, SDD thap cdi la 36,8% va SDD gay cdm la 1 0 , 1 % . Cd sif gia tang nhanh ty i? SDD d ea 3 the nhe can, thap col, gay edm trong glal doan t i f khi tre < 12 t h i n g tuoi tdl khi tre dUde 12-23,9 t h i n g tuoi.
Ty le thieu mau la 3 8 , 6 % , cao nhat d nhom dudi 12 t h i n g tuoi: 6 6 , 7 % , g i i m dan theo tuoi, thap nhat d nhom 48-59,9 t h i n g tudi: 19,0%.
TAI UEU T H A M KHAO
1. Bo Y te' - Vien Dinh duQng (2012). Chien luOc Qijoc gia ve Dinh du©nq giai doan 2011-2020 va tSin nhin den nam 2030. Nha xuat ban Y hgc Ha Npi.
2. B^ Y t e - V i e n Dinh duOng (2010). Tong dieu ba dmh duSng 2009-2010. Nha xuat ban Y hgc Ha Noi.
3. Nguyin Quang Dung, Le Danh Tuygn (2013). Thieu mau thieu sat va moi lien quan vdi tinh trang dinh du8ng, cSu true CO the 6 tte 3-5 tuoi tai 2 xa thuoc huyen Thanh Sdn, ti'nh Ptiu Tho. Tap chi nghien cirU y hpc, 84(4):93-100.
4. Pham V i n Thuy, Tran Thuy Nga, Le Thj Hgip (2012). Tinh trang vi chat ciia phu nii' va tre em Viet Nam. Tap clii nhi khoa, 5(2):6-14.
5. MalkanthI RLDK, Silva KDRR, and Udlth K.
Jayaslnghe-Mudalige (2010). Risk factors associated with high prevalence of anemia among children under 5 years of age In paddy-fanning households in Sn Lanka. Food Nub- Bull, 31(4):475-482.
D. Physical status ( 1 9 9 5 ) : The use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series No.854. Geneva: World Health Organization. It 7. Vieira AC, Diniz AS, Cabral PC, et al ( 2 0 0 S
Nutritional assessment of Iron status and anenJK in children under 5 years old at public daycare centers.: Pediatr (Rio J), 83(4);370-6.
DANH GIA MOT SO T A C DUNG KHONG MONG MUON CUA SONDE FOLEY V&I CAC KICH C& KHAC NHAU TREN BENH NHAN DU'O'C PHAU THUitT
0 BUNG Till BENH VIEN VIET D I J C - H A NOI, N A M 2 0 0 9
T 6 M TAT
Mvc tieu: Oanh gia mpt s6 phien nan va bien chifng do sonde Foley 6 cic kich c9 khac trong thdi gian luu va sau khi rut sonde d benh nhan sau phau thuat Phu'dng phip: nghien^ciru can tiilefi, tien ciru, mil ddn tren 90 benii nhan phau th^t beu hoa tai benii vien Viit Dire, 90 binh nhan chia thanh 3 nhom, moi nfiom dupc d§t 1 cd sonde khac nhau (14F, 16F, 18F).
Theo doi v i danh gia t i e dung khong mong mudn
* Tmdng Cao ding Yte Hi Noi
"DHY Ha Ngi
"'BV Viit Ddc, Hi Noi
Phin biin khoa hgc: PGS.TS T r i n Binh Giang
Hoing Thj Xuan Huong*, Nguyen Hiin Tu**, Bui Thanh Phiic*"
tiong 2 tuan sau mo. Ket q u i : Sonde 14F it gay phlS nan va bien chiing hdn sonde 16F va 18F (p<0.05):]i tieu (6.7% sv. 23.3% va 30%); tieu buot theo thaiB diem VAS (5.8 ± 2.1 sv. 7.4 ± 1.0 va 8.33 ± 1.7); 88 r i t (24.1% nhom 14F sv. 50% nhom 18F); so ngjy Ji tieu buot (2.6 ± 1.7 nhom 14F sv. 5.2 ± 2.8 n h * 18F). Ket luin: oat sonde 14F it gay phien n?n M bien chutig hdn sonde 16F hoac 18F.
Td khda: sonde Foley, cd sonde, phien nan sau m5
S U M M A R Y
Introduction: The study assesses Inconvenient during the used time and alter removing of Fotey catheter with different sizes in patients v^ho underwent
Y HOC VlgT NAM THANG 6 - s 6 2/2014 abdominal surgeries. Method: a cohort study
conducted on 90 patients at Vietduc hospital. The patients were divided into 3 groups. In each group 14F or 16F or 18F Foley catheter was used with the same volume of balloon (10ml). Patients were foltowed up to 2 weeks. Results; 14F had less inconvenient tiian 16F and 18F (p<0.05): retention of urine (6.7%/14F vs. 23.3%/16F, 30%/18F); urinating pain (VAS) (5.8 ± 2.1/MF vs 7.4/16F ± 1.0, 8.33 ± 1.7/lSF); stinngury (24.1%/14F vs. 50%/18F); unnating pain days (2.6 ± 1.7/14F vs. 5.2 ± 2.8/18F). Conclusion: Using 14F Foley has less inconvenient than 16F and 18F.
Keywonis; Foley sonde, size. Postoperative Inconvenlents.
i.ei)iTV&Nc£
Sonde Foley la mpt loai ong thdng dude dua vio bing quang qua niiu dao de dan lUii nudc tiiu. Sdnde dUde phat minh bdi bac sy Fedric Foley (My) tif nhiilig nam 30. Sonde Foley 6iScSc su'dung r$ng rai trong nhiiu chuyen khoa tai cie b|nh viin vdi nhieu muc dich khic nhuhg chii yiu la dan luu nude tieu cho binh nhan.
TTiifc t i lam sang cho thay, eic dieu duSng vien (nhtiing ngu'di true tiep dat sonde cho benh nhin) ehi coi viic trinh bien ehuiig nhiem khuan tiit nipu l i quan trpng nhat trong khi cham sdc sonde. Viic \\fa chpn ed sonde cho benh nhan la dua vio cim tinh, binh nhan to cao thi dat eie sonde cd sd b) v i ngutfe lai. Cd sonde dUdc sii dving phS biin l i c8 tif 14F din 22F, trong dd nhieu hdn ca l i ed 14F va 16F [4]t5][6]. Vi vay c i t h i nil, chpn m§t ed sonde Foley hpp ly va it gay khd chju nhat cho binh nhin ehua dddc quan tam mpt cich diing niiic. i i l u nhu ehua cd tae gii nio nghien cu\i van de nay dUdi goc dp Oieu dudng. Xuat phat tif thifc te dd, ehung toi tiin hinh nghien ciJu d i tai: "Dinh gii mot sd tic di)ng khong mong muon cua sonde Foley d dc kk/t cdkhac nhau trin binh nhin dddc phau thu^t obyng". Vdi muc dich: Banh g/a mgt sd ph/en n^n vi b/en chiihg do sonde Fo/ey d cac kich cd 14F, 16F vi IBF kh/ bdm cuff (bong chin) vd/ cung the tich 10m/ trong thd/ g/an /du vi sau kh/ nit sonde d binh nhin sau phau dui$t.
III. K ^ Q U A N G H I E N CO'U 3.1. DfcdlSm binh nhSn
Bing 3.1. Dae diem benh nhan
IL 001 TirpNe VA PHLTOfNG PHAP NGHIEN CUU 2.1. Odl tu'dng nghien cull
Benh nhan tham gia phau thuat tieu hoa co ke hoach tai BV Viet Oirc tif 07/2008 den 12^2008, CO cac tiiu chuan sau: nam; 18 - 65 tuoi; dUdc gay me npi khf quan, co chi dinh dat sonde bang quang; khong co benh gay kho khan tieu tiin nhu: benh ly tien liet tuyen, hep nieu dao -.^hoac cac benh tiet nieu sinh due khic;
tinh than on djnh, iidp tic tham gia nghien ciiu;
khong di iing vdi latex.
2.2. Phu'dng phap nghien ciili: Nghien cifu can thiep, tien cifu, mil ddn.
Mau nghien ctiu: 90 binh nhan 6\scsc chia thinh 3 nhdm
- Nhdm 14F: gom 30 binh nhan dUde dat sonde ed 14F (nhom ehiing)
- Nhdm 16F: gom 30 binh nhan dUde dat sonde c3 16F (nhdm doi chimg)
- Nhdm 18F: gom 30 binh nhan dUiJc dat sonde cd 18F(nhdm doi chutig)
2.3. Cich thifc tiin hinh nghiin ciiti:
Tien hinh dat sonde Foley tai phong mo va riit sonde tieu theo dung quy tl-inh dat va riit thong tieu (Quy trinh eiia Bp Y te)
Cae ehi tiiu nghiin cifu:
* Die diem binh nhan: tin, tudi, can ning, ehieu eao, tien sif tiet nieu.
* Cae ehi tieu nghiin cifu trong thdi gian binh nhan luu sonde:
- Thdi gian luti sonde tiiu (gid): tif iiic dit sonde cho din khi riit sone.
- Oanh gia cic chi tieu sau cho din khi benh nhan dupe rut sonde: Sonde c6 b{ tut ra ngoil hay khdng? C^ ri^nude tieu ra ngoil liay khong?
Tinh chat nude tieu: trong, due?
- Miic dp dau tai Bang quang, DUdng vat. Vet mp khi riit spnde (theo thang diem VAS)
* Cac chi tiiu nghiin eifu sau khi rut sonde:
Ngiy thd 1 (ngay liinh nhan dude nit sonde):
theo doi tinh bang bi tieu, tieu rit, tieu buot trong lan dau tien di tieu. Cac ngiy sau, theo do/
cic chi tiiu: ^\QU rat, tieu buot, bitleu.
2.4. Xu' ly so lliu: So lliu dUde xif ly bing theo chUdng trinh SPSS 16.0, dUde kiem djnh voi test t-student va test x^ vdi p< 6.05 dUde coi la cd y nghia thong ke.
Tuoi Chieu cao (m) Can ninq (kq)
1 4 F ( n = 3 0 ) ' 47.6 ± 14.8
(18 - 65) 1.65 ±0.06 (1.50 - 1.75)
S2.4±8.5
16F (n=30)~
50.1 ± 10.7 (24-65) 1.63 ± 0.06 (1.50 -1.75) 50.5 ±7.S
18F (n=30)~
51.2 ±9.6 (33-65) 1.62 ± 0.06*
(1.48 - 1.721 52.2 ± 7.4
Y HOC VIET NAM THANG 6 - SO 2/2014
Thdi gian lUu sonde (qld)
(40 - 79) 42.7 ± 20.8
f24 - 72)
(40 - 75) 34.5 ± 17.4
(24-72)
(42 - 65) 33.4 ± 16.4
(20 - 72)
3.2. Cac phien nan, bien chu'ng benh nhan gap phai trong tiidi gian luXi sonde tieu - Co 6.7% benh nhan nhom 14F ri ni/cfc tieu (tu'dng du'dng 2 benh nhan), nhom 16F va 18F khong co benh nhan nao (0%) p >0.05. Khong CO benh nhan trang nghien cuU bj tut sonde trong thdi gian lull (0%).
3.3. Cac phien nan va bien chu'ng sau Ichi rut sonde tieu:
/? < 0.05SO vdi nhom 14f 3.3.1. Thdi gian benh nhan tu" di tieu du'dc sau ichi rut sonde:
Thcfi gian benh nhan tu* di tieu du'dc sau rut sonde cua nhom 14F la 138.3 ± 12.5 phut, nhom 16F la 184.8 ± 18.7 phut va cua nhom 18F ta 223.0 ± 22.5 phut. Khac biet co y nghTa gife nhom 18F so vdi 14F.
3.3.2. Ty ie binh nhan hi bi tieu:
Bing 3.2. Ti le benh nhan bj bi tieu:
~ ~ - ^ _ C d sonde Bi tieu ^ ^ - ^ - ~ - _
Khong Phil ean thiep Phai dat lai sonde
14F (n = 30) 28 (93.3%)
1 i 3 . 3 % I 1 (3.3%)
16F (n = 30) 23 (76.7%) 6 120%)*
1 (3.3%)
ISF (n = 30) 21 (70%1 9 (30%)*
0
3.3.3. Binh gii mlUc dp tieu buai cua binh nhin trong Un di deii diu tien sau khi nit
Miic dp tieu buot theo diem VAS trong lan dl tieu dau tiin eiia benh nhan nhom 14F la 5.8 ± 2.1, nhdm 16F la 7.38 ± 1.02, nhom 18F la 8.33
± 1.68. Sif khae biet ed y nghTa giii:a mifc dp tieu buet ciia binh nhan nhdm 16F so vdi 14F (p<0.05) va dae biet ed y nghia giiia nhdm 18F so vdi 14F (p<b.01)
3.3.4. rf lp benh nhin tiSu dit trong lan a tiiu iBu Hen:
Nhdm 14F_cd 11 benh nhan (37,9%) tieu dat trong lan di tieu dau tiin, so lu'dng nay d nhdm 16F la 20 (69%) v i 18F la 19 (63.3%). SU khac biet cd ^ nghia ve ti le benh nhan tle'u dat trong lan di tieu dau tien glu:a benh nhan nhdm 16F va 18F so vdi nhom 14F (p<o'.05)
3.3.5. Ty le benh nhin tiiu dat trong 2 tuin diu sau rdt sonde:
Ti l i binh nhan bi tle'u dat sau riit d nhdm 14F la 24.1% (7 binh rihan), nhdm 16F la 37.9%
(11 binh nhan) v i nhdm 18F la 50% (15 binh nhan). SU khae biet mang y nghTa thong ke glDa ti l i IJinh nhan b| tieu dat sau rut giiJa nhdm 18F va nhom 14F (p<0.05)
Thdi gian di tieu dat trung binh cua nhdm 14F l i 0.6 ± 1.3 ngay, nhom 16F la 0.8 ± 1.1 ngay va nhdm 18F l i 1.3 ± 1.7 ngay. So ngay di tieu dit trung binh ciia nhom 18F nhieu hdn mot each CO y nghia so vdi nhom 14F (p<0.05).
3.3.6. Ty li binh nhin tiiu buot trong 2 tuan dSu sau rdt sonde
Ti l i binh nhan tle'u buot sau khi riit sonde d nhdm 14F la 89.7% (26 benh nhan), nhdm 16F
*: p<0.05 so vdi nhom 14f la 96.6% (27 benh nhan) va nhdm 18F la 100%
(30 benh nhan).
Tiidi gian tieu buot eua nhom 14F la 2.64,1 1.7 ngay, nhom 16F la 3.4 ± 1.9 va nhdm 1 8 ^ 5.2 ± 2.8. SU khac biet mang y nghla gliJa ti le benh nhan bi tle'u buot va thdi gian di tieu biBt giCJa nhdm 14F va 18F (p<C.05); giiia nhdm 16F so vdi 18F (p<0.05).
IV. BAN LUAN
4.1. Sac diem b|nh nhan
Tif ket qua bang 3.1 cho thay: nhin chung khong co khac biet ve tuoi trung binh, cin nang va so ngay luu sonde trung binh giiis eae nhom trong nghien cifu, p > 0.05. Khac biit duy nhSt tim thay la chieu cao trung binh ciia nhdm MF (1.65 ± 0.06 m) Idn hdn mot each ed y nghia so vdi 18F (1.62 ± 0.06), p < 0.05. Tuy nhiin chiing toi chua tim dUde tai lieu trong va ngoai nuiSc nio de cap den moi lien quan giiia chiilu cao v4- kieh thudc ciia du'dng nieu dao nam vi thUechS nieu dao cd tinh chat ehun qian, binh thudng till xep va chi cang ra khi di tieu. NhU vay dac diem benh nhan thupc cae nhom nghiin cifu tUdng dS dong deu.
4.2. Cac phien nan v i bien chijfng trong khi lu'u sonde:
^ Trong thdi gian luu sonde d ca 3 nhdm benli nhan khdng cd benh nhan nao bl tut sonde. Ket qua tai phan 3.2.1 cho thay chi ed 6.7% benh nhan d nhom 14F ed hien tUdng ri nUdc tieu trong thdi gian lUu sonde, cic nhdm cdn Ial khong cd benh nhan nio. SU khac bl?t n i y t
Y HOC VltT NAM THANG 6 - SO 2/2014 thong CO y nghla thong ke (p > 0.05). Theo
Wilde va Cameron co khoang 5% so b^nh nhan 3St sonde Heu co hien tu'dng ri nu'dc tieu. Hien luUng nay 06 the khac phuc bang viec dat mot Kjnde khac co cd Idn hdn tuy nhien diSu nay chong nen thi/c hien d nhutig benh nhan dat
;onde tieu ngSn ngay (nhu* trong nghien ciTu ctia :hung toi) vi se lam^tang nguy cd gay nhiem chuan tiet nieu va ton thu'dng them niem mac lieu dao [7].
4.3. Cdc phi'en nan va bien chu'ng sau chi rCit sonde:
4.3.1. Thdi gian b$nh nhin tu' di tieu fudc sau ichi nit sonde:
Ket qua d phan 3.3.1 cho thay nhdm 14F co hdi gian td di tieu sau khi rut sonde la 138.3 ± .2.5 phut ngan hdn so vdi 2 nhdm jAn lai. Nhdm .6F cd thdi gian thdi gian td di tieu sau khi rut onde la 184.8 ± 18.7 phut] Nhdm 18F cd gian hdi gian ttr dl tieu sau khi rut sonde dai nhat
•rang 3 nhdm (223.0 ± 22.5 phut]. NhU vay, ionde cang Idn thi thdi gian tiT di tieu du'dc cua .}enh nhan cang dai. Su* khac biet ve thdi gian di u" di tieu lai ciia nhdm benh nhan 14F va 18F la p "i nghta thdng ke p < 0.05. Nguyen nhan cd jhe do^trong nhdm 18F cd den 30% benh nhan )\ bi tieu nhieu hdn nhdm 14F (chi cd 6.7%).
4.3.2. Bitie'u:
Ket qua tai bang 3.4 cho thay phan Idn benh 'ihan is cSc rihdm khong bi bi tieu, ty le binh ihan bi t l ^ t3ng theo kich c6 sonde: nhdm i4F 6.7%), nhdm 16F (23.3%) va nhdm 18F (30%).
'i I? benh nhan bl bi tieu phai dung cac bien ih^p can thiep: khac biet cd y nghla d nhdm 18F
!& 16F so vdi 14F la cd y nghTa thong ke p<0.05.
ilc|uyen nhan la do c6 sonde cang to cang gay on thuWng, phu ne, chit he^ du'dng nieu dao can ird ddng chay gay ndn bi tieu. Ket qua nay cung (hu hdp vdi mpt so nghien cuU trong va ngoai iju'dc. Theo Nguyen Thj Mao (2005) tl le benh j[hSn bi dai sau phau tiiuat la 15% trang dd cd j % phai dat lai sonde [2]. Theo Giang Thi Kieu i^nh (2008) cd 6.25% benh nhan sau khi rut liionde ti^u cd bi tieu va phan Idn cac benh nhan jji dai dSu la nam gidi [1], Theo tac gia toughill E
^^^005) cd sonde 18F ilm tang nguy cd gay bi dai
^b^nh nhan sau khi rut [6], Theo Gray M (2004) li c9 sonde Idn 16F lam can trd sy bai tiet nu'dc ,^u sau khi rut [3].
4.3.3. niil budi trong fin di tieu diu tien K§t qua d phan 3.3.3 cho thay, miTc dp tieu Juot ti 1$ thuSn vdi kfch thu'dc ciia sonde. Diem
»AS cua c&c nhom giao dpng tii mu'c dp dau vCm
^ihdm 14F) den dau n^ng (nhdm 16F) va dau du"
•.^i (nhdm 18F). Su" khac biet ve mii'c dp tieu :j6t trong Bn di tieu dau tien giiHa cac nhdm la it cd y nghTa thong ke p < 0.05. Dieu nay cung
phil hdp vdi nghien cifu cua mpt sd tac gia nu'dc ngoai, cd sonde cang Idn cang gay nhieu ton thu'dng tai nieu dao gay ra tieu buot cho benh nhan. [3][4].
4.3.4. Tieu dat trong ian di tieu diu tiin Ket qua d phan 3.3.4 cho thay cd 37.9%
benh nhan d nhom 14F di tieu dat, 69% benh nlian d nhdm 16F va 63.3% benh nhan d nhdm 18F di tieu dat trong lan di tieu dau tien. Sif khac biet ve so lu'dng benh nhan di tieu dat d nhdm 16F va 18F so vdi nhom 14F la cd y nghTa thdng ke p < 0.05. Nguyen nhan la do c5 sonde 16F va 18F gay tdn thu'dng du'dng nieu dao nhieu hdn so vdi c3 14F khien cho benh nhan dau ddn khi di tieu^nen benh nhan ch! dam di tieu it mpt gay nen tieu dat.
4.3.5. Tieu dat ti-ong thdi gian 2 tuin sau rut:
Tinh trang tieu dat thudng lien quan den tieu buot, dp tieu buot benh nhan khdng dam ran tieu. Tieu dat cdn do benh ly tuyen tien liet va hpi chirng bang quang be. Trong nghien ciili nay chung tdi da loai trir cac benh nhan cd benh ly ve du'dng tiet nieu va cac benh nhan cd rdi loan tieu tien. Ty le benh nhan tieu dat t3ng cao cung ki'ch cd sonde 14F (24.1%), 16F (37.9%), 18F (50%).
Khac biet cd y ngh'a d nhdm 18F, 16F so vdi nhdm 14F, va khac biet cd y nghTa d nhdm 18F so vdi nhdm 16F vdi p<0.05.
Thdi gian di tieu dat trung binh ti le thuan vdi dp Idn cua sonde, nhdm 14F la 0.6 ± 1.3 ngay, nhdm 16F la 0.8 ± 1.1 ngay va nhdm 18F la 1.3
± 1.7 ngay. So ngay di tieu dat trung binh ciia nhdm 18F nhieu hdn mpt each cd y nghTa so vdi nhdm 14F (p<q.05).
4.3.6. Tieu buot tmng th^' gian 2 tuin sau riit:
Ket qua taijDhan 3.3.6 cho thay sd khac bi^t ve so ngay dl tieu buot ciia nhdm 18F (5.2 ± 2.8) so vdi nhdm 14F (2.6 ± 1.7), 16F (3.4 ±^1.9) la rat y nghTa (p < 0.05). Tl le benh nhan tieu buot sau khi rut sonde d nhdm 14F la 89.7% (26 benh nhan), nhdm 16F la 96.6% (27 benh nhan) va nhdm 18F la 100% (30 benh nhan), Ti le benh nhan tieu buot cua nhdm 18F nhfeu hdn m$t each cd y nghTa so vdi nhdm 14F (p<0.05). Ket qua nghien cull nhu" vay cung la phii hdp vdi cac ket qua trong va ngoai nu'dc. Theo Du'dng Quang Tri (1996) thi cd sonde 14F va 16F la khong anh hu'dng den nieu dao vi du'dng kinh ong thong nhd hdn du'dng kinh nieu d?o. Theo Toughtlll E (2005) ngu'di dieu duQng nen diing sonde 14F va 16F cho benh nhan, vi c3 sonde t\i 18F trd len gay ra nhieu phien toai^cho benh nhan hdn nhu' tang nguy cd gay nhiem khuan tiet ni^u, ktch thich lam dau rat va ton thu'dng dUdng nl^u d^o gay ra tieu buot [6].
Y HOC WET NAM THANG 6 - SO 2/2014
V. KET L U A N
Cd sonde 18F va 16F lam gay dau ddn cho bdnh nhan hdn khi rut mdt each cd y nghTa so vdi nhdm 14F, lam t§ng t i le benh nhan bj bi tieu (30% va 2 0 % so vdi 3.3%,), nang them tinh trang tieu buot va tieu dat sau k h i j i i t sonde cung nhu* keo dai them thcfi gian di tieu buot va tieu dat so vdi cS sonde 14F.
TAI L l i u T H A M KHAO
1. Giang Thj Kieu Anh,"Oanh gia tac dung giam dau cua morphin ti§ni Unh mach ngSt quang d b?nh nhen chan thuWng ngu'c", luan van tot nghi^D tiiac s9 y khoa,2008,tran9 49 2. Nguyen th[ MSo, "Danh gia tac dung giam dau
sau mo blng hon hop buFriyacain va fentsn;^ bdm lien ti;c qua catheter ngoai mang cifhg'',luan van lat nghi?p bic sy nOi tru,2002,tiang 47
Gray M, "What nursing interventions redua t|
risk of the symptomatic urinary tract infection]
the patient with an indwelling catheter' ]WOCN,2004, pp 31,3,13
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M 6 I LIEN Q U A N GlfrA CAC YEU TO COA THUYET DONG LITC B A O VE VOI H A N H VI SAY RU'O'U BIA VA QUAN HE TINH DUC NGUY CO NHIEM HIV 6" NAM THANH N I E N CHU'A KET HON 1 8 - 2 4 TUOI 6" KHANH H6A
T6M TAT
Nghien ciHi mo cSt ngang du'^c tien hanh tiT thing 2/2009 d^n thdng 5/2010 vdi cd mau dieu tra djnh luUng 1.068 ngu'di nhdm xSc djnh mdi li€n quan giu^ cac yeu td ciia ThuySt dpng liTc bao ve (PMT) vdi hdnh vi say ru'du bia va quan he tinh dgc cd nguy cd nhiem HIV d nam thanh nien chu^a k ^ hdn tir 18 - 24 tu6i tai Khdnh Hda, Vlft Nam.
K€t qua nghien ciTu cho thay cd sir lien quan cd y nghTa thdng ke giu^ hanh vi quan h$ tjnh due ciia nam thanh nien vdi d c yeu to nhan thtfe ciia PMT do la (1) nh^n thifc ve khd nSng nhiem HIV/STO (vulnerability), (2) sy* thda mSn bSn trong (intrinsic rewards), (3) SLT tdn thudng tir bSn ngodi (extrinsic reward), (4) nhan thut ve khd ndng ty" phdng benh (self efficacy) va (5) nh|n thut hdnh vl phong ngira nhiem HIV (response cost). Ket qua cho thay nam thanh nien cd quan he tinh due khong sir dgrm bao cao su thi cd nhan thut kem ve m ^ nguy hiem eiia hanh vi say ri/^u bia (severity) dUci den quan he tinh due nguy cd HIV/STD (p<0,005), nhiin thiTc kem hdn vlS khd ndng phong l>$nh (self-efficacy) t u tiep can vd sii dung bao cao su (p<0.001), vd nh§n thu'c kem ve hdnh vi phdng ngu^
HIV/STD (response cost) den viec khdng sir dung bao
*Sd Yte khanh Hoa
Phan bi^tt khoa /rpc;TS NguySn Ddng VuHg
eao su (p<0,032) so vdi nhdm quan hg tinh due <^9l dung bao cao su. Nam thanh nien cd say r u ^ bia bj tdc d$ng nhieu hdn bdi nhuhg dp lut ben ngodi, W b^n be cilng tu6i tdn du'dng, tan thudng (p< 0,(ffi]
vd nhan thu'c kem ve cac hdnh vi bao v& nhu' sif dpS bao eao su trong quan h? tinh due (p=0,038).
Td'khoa: say ru'du bia, hdnh vi tinh dgc nguyol nhiem HIV, thuyet dpng luc bao v^.
S U M M A R Y
THE FACTORS O F P R O T E O I O N M O T I V A T I O N THEORY RELATED TO ALCOHOL DRUNKENNESS A N D H I V SEXUAL
R I K B E H A V I O R S AFFECT T O HIV I N F E C T I O N A M O N G U N M A R R I E D YOUNG MEN FROM 1 8 T O 2 5 YEARS OLD I N KHANH
HOA P R O V I N C E
Described research combined with longltudM quality research was conducted from February 2O09I May 2010. Sample size for baseline survey, 6 monft postline and 12 months postline were 1.068, 637 v' 820 subjects, respectively. This study aimed to acceS the relationship between the factors of ProloW Motivation Theory (PMT) with alcohol drinking i unsafe sex that can be the risk of HIV/AIDS Infcci
