TAP CHl Y HQC VIJT HAM TAP 450 - THAHG 1 - S6'2 - 2017 Oa SO rac benh nhan cd ket qua t d t nam
Tong nhdm benh nhan khdng liet hoac Het (hdng hoan toan. Nhdm benh nhan cd ket qua :rung binh thffdng la benh nhan cd khdi u kich Jiffdc Idn, khd lay. Benli nhan cd ket qua xau la Denh nhan thudc nlidm liet hoan toan, trieu :hffng dien bien lau nam, mac d u da 6iidc phau Jiuat lay u, glai phdng chen ep nhffng ton :hffdng tuy nang nen hau nhff khdng cdn kha iang hoi phuc.
Ket qua nay cua chung tdi cung phu hdp vdi n o t so tac gia Vu Hdng Phong (2001)[6i. Ket :5ua nay cung tffdng tff nhff ket qua ciia mdt so tac gia nffdc ngoai [ 7 ] .
3 . Ket qua b | n h nhan khi k h a m lai ( k e t qua x a ) .
Thdng qua kham lam sang, gpi dien phdng ran chung tei danh gia lal ket qua pliau thuat cua benh nhan sau mot nam. Tff ket qua nghien cffu, phan Idn benh nhan cd sff cai thien tinh ffang benh chiem ty le Idn trong cac benh nhan Ith^m lai. Nguyen nhan cua dieu nay I^ do hau het benh nhan den vien trong giai dogn sdm, khi cac bieu chutig d mffc do nhe, dau hieu dien ep hjy d mffc dp nhe tdi viia, kha nang bu trff cua tuy cdn tdt. Ket qua nay cua chung tdi phu hdp vdi k S qua nghien cuU cua mdt so tac gia [4,5,6].
V. KET L U A N
Nghien cffu 66 benh nhan cho thay ket qua phau thuat khi ra vien: Tdt 83,3% , Trung binh 15,2%, Xau 1,5%. k e t qua khi kham lai benh nhan; khdi 5 6 % , tien trien tet 3 2 % , nhir trffdc md 10%, xau di 2 % , hi" vong 0 % . Ket qua
nghien cffu 6a cho thay benh nhan phau thuat d giai doan benh sdm (khoi u chffa anh hffdng den chffe nang c d the) ttii cd t y le cai thien Ixit cao hdn so vdi nhffng benh nhan phau thuat d giai doan mudn (liet hoan toan), sff khac biet cd y ngliTa thdng ke vdi p<0,05. Vi vay, chan doan va dieu t r i sdm se mang lal ket qua t d t cho ngffdi benh va it di chuTig.
TAI LIEU T H A M KHAO
1 . Zozulya YP, Slynko Y I va Qashqish (2011}.
Surgical treatment of ventral and ventrolateral intradural extramedullary tumors of craniovertebral and upper cervical localization.
Asan J Neurosurg, 6(1), 18-25.
2. Cervoli L, CelH P va Fortuna A (1994).
Recurrence of Spinal Ependymoma. Risk factors and iong-temi survival. Spine, 15(24), 2838-2841.
3. Friedman DP, Tartaglio LM va Flanders AE (1992). Intradural schw/annomas of the spine:
MR findings with emphasis on contrast- enhancement characteristics. AIR Am J Roentgenol, 158(6), 1347-1350.
4. Gu R., Uu J.B. vh Xia P. ( 2 0 1 4 ) . Evaluation of hemilaminectomy use in microsurgical resection of intradural exbamedullary tumore. Ona^ Lett, 7(5), 1569 -1672.
5. Lei Peng, Sun Wenhai va Li Zhiyun (2005).
Surgical treatment of lateral and ventral tumors of cervical spinal cord. Chinese medicai joumai, 169(9), 543-547.
6. Vu Hong Phong (2001). Nghiin cuU chan doan va dieu tn u than kinh tuy tai binh viin Viet Di/t Tru'dng Dai hoc Y Ha Ngi.
7. Sun Wenhai, Lei Peng va Li Zhiyun (2005).
Surgical treatment of lateral and ventral tumors of cervical spinal cord. Chinese medical joumai, 116(9), p. 543-547.
DANH GIA HIEU QUA GIAM DAU COA HOI XUAN HOAN T R £ N B E N H NHAN LOANG xu'ffNG
T O M T A T
Muc tieu: 1. BUdc dau khao sat mdi lien quan gift trieu chtog Iam sang va mffc dp loang xffOng .2.
Danh gia hieu qua giam dau cua Hoi Xuan Hoan tren binh nhan ioang xudng . Ddi tu'tfng va phu'dng phap nghiin cffu: Nghien cffu tien cuXi thff nghiem
*Benh viin Yhgci^truyen Trung udng.
Qiiu trach nhiem diinh: Nguyin Thi Tam Thuan Quail: [email protected]
Ngay nhan bai: 21.10.2016 Ngay phan bien khoa hpc: 2.12.2016 Ngay duyet bai: 12.12.2016
Nguyin Thi Tam Thu?n*
lam sang md, so sanh tru'dc - sau dieu trj tren 45 benh nhan loang xUOng, thdi gian dieu h i 30 ngay.
Ket qua: 1.100% benh nhan loang xu'dng n|ng dau luhg, dau doc xu'dng dai dau chi; diem dau choi that Iffng chiem 60%, gu veo chiem 40%. l.Hoi Xuan Hoan cd tac dung cai thien cac trieu chiitig dau sau 30 ngay dieu t n , diem dau trung binh giam tff 3,60 ± 1,91 xudng 2,07 ± 1,66; khac biit cd y nghia thong k§
vdi p<0,05. Ket l u | n : l.Mffc dp loang xffdng cang ning thi trieu chffng lam sing cang n|ng. l.Hoi Xuan Hoin cd tac dung cai thien cac trieu chuTig dau sau 30 ngay dieu trj khac biet cd y nghia thong ke vdi p<0,05.
Tu'khoa: Hoi Xuan Hoan, loang xu'dng
VIETNAM MEDICAL JOURHAL H°2 - JANUARY - 2017 SUMMARY
EVALUATE THE ANALGETIC EFFECT OF "
HOI XUAN HOAN" IN THE TREATMENT OF OSTEOPOROSIS PATIENT Objective: 1. Preliminary investigate the relations between clinical symtoms and osteoporosis level. 2. Evaluate the analgetic effect of " Hoi xuan hoan" in the treatment of osteoporosis patient.
Su^ect and research method: The controlled dinicai trial, compared before - after 30 day treatment, involved 45 Osteoporosis patients. The study lasted for 30 ngay. Results: 1. 100% serious osteoporosis patients had back pain and long bone, sharp pain lumbar vertebrae: 60%, kyphoscoliosis:
40% . 2. "Hoi xuan hoan" had improved on analgetic symtoms after 30 treatment days.The average analgetic score decreased from 3,60 ± 1,91 to 2,07 ± 1,66 ; the difference is statistic significance with p<0,05. Conclusions: 1. Clinical symtoms are equivalent to Osteoporosis level . 2. "Hoi xuan hoan"
had improved on analgetic symtoms after 30 treatment days, the difference is statistic significance witii p<0,05.
Key words:" Hoi xuan hoan", osteoporosis I. OAT VAN OE
Loang xffdng thffdng dien biSn am tham trong thdi gian dai va chi xuat hien cac trieu chffng lam sang dac trffng khi cd bien chffng gay xffdng. Theo mdt sd nghien cffu, chi khoang 30% phu nff dffdc chan doan ehinh xac va 15%
trong sd dd dffdc dieu tri hdp ly [2], Loang xffdng dang thffc sff trd thanh mdt ganh nang benh tat khdng chl cho benh nhan, gia dinh ma cho toan xa hdi. Thdng qua tinh toan va so sanh sd nam tan tat anh hffdng den chat Iffdng cudc sdng (Disability - adjusted life year - DALYs) cua mdt sd benh, ket qua cho thay, chi sd benh nhan loang xffdng cao hdn nhieu so vc^ mdt sd benh nhff cao huyet ap, viem khdp dang thap...
Oe gdp phan nang cao chat Iffdng dieu tn va phdng benh bang xffdng, de cd them mot sff Iffa chpn thudc cho ngffdi benh loang xffdng, chung tdi tien hanh thffc hien de tai '^Danh gia tac dung dieu hi cua Hoi Xuan Hoan tren benh nhan bang xu'dng", vdi hai muc tieu:
^ 1. Bu'de dau i(hao sat moi lien quan gO^ trieu chij'ng lam sang va mu'c do loang xu'dng.
2. Danh gia hiiu qua giam dau cua Hdi Xuan Hoan tren benh nhan ioang xifdng
II. OOI TUONG VA PHUONG PHAP NGHIEN COU 2.1. Chat lieu nghien cu'u: Vien nang HXH dffdc san xuat tai Hpc vien Y Du'dc hpc co truyen
Viet Nam phdi hdp vdi cdng ty Co phan Dffdc liei Trung ffdng Mediplantex.
2.2. OSi tu'dng nghien cihi 2.2.1. Tieu chuan chon benh nhan:
+ BN tff nguyen tham gia vao nghien cffu.
+ Tudi > 40, khdng phan biet gidi t(nti, nghe nghiep
-H Benh nhan dffdc chan doan xac djnh Loang xffdng theo tieu chuan cua YHHD
Benh nhan cd chl sd T < -ISD. Du^ theo tieu chuan loang xffdng cua To chffe Y te The gidi nam 2004 (kbi sff dung ky thu$t DEXA bone scan) (WHO Ospeoporosis Criteria [DEXA Bone Scan]) theo thang diem cCia T - Score viJng cot sdng that Iffng.
-I- Tuan thu dung phac do va lieu trinh dieu tri.
2.2.2. Tigu chuan loai triV
- Loang xffdng thff phat do benh ly ndi ngoai khoa khac nhff tieu dffdng, sdi tiet nieu, cd tien sff cat buong trffng, Hpi chffng Cushing, benh nhan cd benh cffdng giap trang, da u tuy xffdng, ung thff di can xffdng,...
- Benh nhan bj cac benh nhff ung thff, HIV, lao...
- Benh nhan cd benh ly nghiem trpng d tim, gan, than
- Dang dung cac thuoc giam dau, thudc anli hffdng tdi chuyen hoa xffdng, man cam, di liYig mpt trong cac thanh phan cua thudc
2.3. Phu'dng phap nghiSn cu'u Thiet ke nghien cffu md theo md hinh thLf nghiem lam sang. So sanh trffdc va sau dieu tri.
- Benh nhan udng moi ngay 10 vien chia 02 lan luc 8h, 19h sau an sang, tdi.
- Thdi gian nghien cffu: 30 ngay - Cac chi fjeu theo ddi:
+ Tlnh trang dau Iffng, mdi Iffng, dau doc xffdng dai, dau chi, gu veo, tinh trang met moi
+ Thang diem VAS danh gia mffc dp dau 2.4. Phu'dng phap danh gia ket qua.
Dy^ vao cac thang diem VAS va sff thay doi cac trieu chffng chi'nh tren lam sang.
2.5. Thdi gian va ^ a diem nghien cChi^^
Thcfi gian : tff thang 2/2015 den thang 10/2015 Oja diem nghien cu'u : Benh vien Y hoc
cd truyen Tue TTnh. ''.
2.6. Phu'dng phap xuT I'/ so lieu
^Sd lieu thu dffdc trong nghien cffu du'dc phan tich, xff ly theo phffdng phap xac suSt thdng ke y sinh hpc. Cac sd lieu dffdc xff ly tren may vi tinh qua phan mem SPSS 16.0.
III. KET QUA NGHIEN CU'U
3.1. Oac diem doi tu'dng nghien cu'u
TAP CHi Y HOC VlgT NAM TAP 450 - T H A N G 1 - SO 2 - 2017 Bang 3.1. Oac die'm nhSn trac hoc dm tffdng nghien cu'u
T,
Chisd Truna binh ( A ± sp)
Tuoi (nam) 65,96 ±9,27
Can nanq (kg) 48,87 ± 6,18
Chieu cao (cm) 156 ±0,63 175
20,15 ± 2,45 14,57 26,64
/VAan Jfet Tuoi trung binh cua nhom nghien citu la 65,96 ± 9,27 (nam), tuoi cao nhat la 79, tuoi thap nhat la 43. Can nang trung binh cua nhom nghien ciru la 48,87 ± 11,39 (kg), ngu'di co can nang cao nhat la 5Bkg, ngufii co can nang thap nhat la 35kg. Chleu cao trung binh cua nhom nghien cull la 156 ± 0,63 (cm), ngu'cfi cao nhat la 175 cm, ngu'di thap nhat la 100 cm. BMI trung binh la 20,15 ± 2,45 cao nhat la 26,64, thap nhat la 14,57.
Bieu do 3.1. Oac digm gioli doi ttfdng nghien cihi
Nhan xet: Trong nhom nghien citu BN nu' chiem ty le cao hdn so v6i nam gidi, nff chiem 82,22%, nam chiem 17,78%.
Bang 3.2. Pac die'm BMI doi ttfdng nghien cuti Phan loai Bl^l
Gay Trung binh
Beo
n=45 13 25 7
BMI 28,89
%
55,56 15,56
/Vfta/; xef;Trong sd BN nghien cffu, t/ le b^nh nhan gay chiem 28,89%, by' le benh nhan cd mffc BI^I trung binh cao nhat chiem 55,6%.
Bieu tfp 3.2. Pac di^m tuoi doi tu'dng nghien cuti
1
• so - 5 93 6 0 - e5>
/VA^/ixi^£r Trong 45 benh nhan nghien cffu dp tuoi trung binh la 65,96 ± 9,27 (nam), do tuoi chiem ffu the cao nhat la >70 tuoi vdi ty ie 42,22%
Bang 3.3. Pac diem trieu chu'ng lam sang trffdc dieu trj Trieu chu'ng
Dau lu'ng Moi lu'ng Diem dau chdi that lu'ng Dau doc xu'dnq dai, dau chi
Gu veo
n 40 45 6 20
3
Ty le »/o 88,89
100 13,33 44,44 6,67
VIETNAM MEOICAL JOURNAI N'2 - JANUARY - 2017
Ka qua bang 3.3 cho thay, trong nghien cihi, 100»/i, BN 06 trieu * ^ 9 ™ ' ^ 9 ' « f / | ? ' ° ^ i j " '^
chiing dau lung. Dau doc xu'dng dai, dau chi cung la tri§u chimg kha_pho bien chiem ty le 66,67%.
Bieu dS 3.3. Mu'c d6 dautheo Jhang^diem VAS trtfdc dieu tn
Nhan xet: Trong 45 BN, sd lu'dng benh nhan dau vffa chiem ty le cao nhat la 57,8%
Bang 3.4. Chi so BMP va T-score ciia doi ttfdnq nghiSn ctfu Viing do
Cot sdng that luhg Co xtfdng dCii trai Co xtfdng dui phai
BMP (gr/cm' rdng I
±SD) 0,8017 ± 0,114 0,6714 ± 0,910 0,6720 ± 0,861
T-score ( ^ ±SD) - 2,63 ± 0,9 - 1,92 ± 0,76 -1,89 ± 0,8' Nhan xet: Mffc do T - score trung binh cot song that lutig cua benh nhan nam trong mffc dp loanc xudng. t - score trung binh cua co xffdng dui trai va cd xudng dill phai trong gidi han thieu xffdng.
Bieu do 3.4. Phan loai mii'c d6 loang xtfdng theo T - iscore CSTL
Nhan xeb Trong nhdm BN nghien cffu ti le BN nam thieu xffdng cao hdn ti le BN nff bj thiet xffdng. Trong nhdm BN nam khong cd nhdm loang xffdng va loang xffdng nang. Trong nhdm BN nu ty le so benh nhan thieu xffdng thap hdn so vdi ty le loang xffdng trong nhdm BN nay.
3.2. ket qua giam dau cua Hoi xuan hoan
3.2.1. Stf thay d6l trieu chtfng lam sang trtfdc va sau di'Su trj Bang 3.5. Cai thien trieu chtfng la
Trieu chu'ng
Dau Iffng Mdi Iffng Diem dau chdi that Iffng Dau dgc xffdng dai, dau chl
Gu, veo
n
%
n%
n%
n%
n%
m sang trtf(
Trtfdc Dieu tri
40 88,89
45 100
6 13,33
20 44,44
3 6,67
Sc va sau die u tri Sau dieu tri Khonq ddi
1 2,50
5 11,11
4 66,67
3 15
3 6,67
Giam 17 42,50
8 17,78
2 33,33
9 45
0 0
Khdi 22 55 32 71,11
0 0 11 40 0 0
P
<0,05
Nhan xei: Csc trieu chutig dau Iffng, mdi Iffng, dau doc xffdng dai, dau chl va deu cai thien J
,1
diing thuoc cd y nghla thong ke vdi p < 0,05. Ty le mdi Iffng khdi la 71,11%, ty le dau Iffng khoi;
55%. Nhdm benh nhan gu veo, khdng cd hieu qua dieu tn. '
TAP CHi Y HOC V i e r NAM TAP 450 - T H A N S 1 - SO 2 - 2017
Bang 3.6. Mi^c dp dau theo thang diem Vas tai thdi diem Dova P15 Mu'c do dau
Khdng dau~
Oau It 28,89
Dau vffa 53,33
6,67 Dau nhieu
Dau khdnq the chiu ndi 17,78
Diem dau trunq binh 3,60 ± 1,91 2,71 ± 1,46
_ P H I <0,05
Nhan xet: Sau 15 ngay dieu tr, mffc dp dau giam, sd BN dau it tang dang ke va chiem ty le cao nhat 57,78%. Sff khac biet cd y nghTa thong ke vdi p <0,05.
Bang 3.7. MiJc do dau theo thang die'm Vas tai th6i diem Ppva P30 Mij'c do dau
Khdnq dau Dau it Dauvu^
Dau nhieu Dau khdnq the chiu ndi
Diem dau trung binh
Pon-Dio
P.
n 0 13 24 8 0
%
028,89 53,33 17,78 0 3,60 ± 1,91
I'm n 8 25 11 1 0
17,78
%
55,56 24,44 2,22
0 2,07 ± 1,66
<0,05
NhSn xet: Sau 30 ngay dieu trj, mffc dp dau giam rd ret, sd BN Ichdng dau tang dang ke chiem 17,78 %, tiep theo dau it tang dang ke va chiem ty le cao nhat 55,56 %. Sff ichac biet cd y nghTa thong ke vdi p <0,05.
IV. BAN LUAN
4.1. Ban luan ve dac diem benh nhan nghien cffu va moi lien quan giu'a triSu chutig lam sang vdi mu'c do LX
Trong tdng so 45 BN dijng thudc Hoi xuan hoan dffdc nghien cffu, do tudi trung binh 65,96
± 9,27. Trong dd, tudi cao nhat la 79, tudi tiiap nhat la 43. Nhdm tuoi tren 70 chiem ty le cao nhat la 42,2%. Ket qua nay cua chung tdi phu hdp vdi nghien cffu cua tac gia Pham Hong Hue vdi nhdm tudi tren 70 cd ty le cao nhat la 42,2% [3].
Ve dac diem gidi tinh, bleu do 3.1 cho ta thay nhdm BN nam chiem 17,8% va nff chiem 82,2%. Nhff vay ty le nam va nff trong nhdm nghien culJ la i:4. Ket qua nay phu hdp vdi ket qua nghien cffU cua tac gia khac [4].
Chieu cao trung binh cua nhdm dieu tri la 156 ± 0,63 (cm). Can nang trung binh cua nhdm dieu tri la 48,87 ± 6,18 (kg). BMI trung binh cua BN trong nhdm dieu trj la 20,15 ± 2,45.
Theo bang 3.3, trong 45 BN nghien cffu mdi iffng va dau Iffng la trieu chffng thffdng gap nhat (chiem 100% va 88,89%). Mac du mdi iffng la trieu chffng cua rat nhieu benh ve xffdng, nhffng d day hau het nhffng BN bang xffdng deu cd bieu hien dau mdi Iffng, dac biet la nhffng benh nhan bj gu hoac bj lun dot sdng du tien sff cliffa tffng cd Chan thffdng cot sdng. £>iem dau chdi that Iffng xuat hien ft hdn d mgt sd benh nhan
bang xffdng chi chiem t/ le 13,33%. Trieu chffng nay thffdng xuat hien sau khi benh nhan thay ddi tff the dot ngot hoac sau mang vac nang. Dau hieu dau doc cac xffdng dai cung chiem ty le cao vdi 44,44 %. Bay cung la cac trieu chffhg kha dien hinh cua chffng loang xffdng la dau hieu gdi y loang xffdng.
Bang 3.4 cho thay mat do xffdng cua nhdm BN nghien cffu cua chung tdi vdi BMD trung binh; Vijng cot sdng that Iffng la 0,82 ± 0,114, vung cd xffdng diJi trai la 0,67 ± 0,91, BMD vung cd xffdng dui phai la 0,67 ±0,80. Tffdng ffng vdi mffc T - score trung binh vCing cdt song that Iffng la -2,63 ± 0,90, cd xffdng dui trai la -1,896
± 0,803, cd xffdng dui phai la -1,891 ± 0,697.
Can cff vao tieu chuan LX cua WHO chia lam ba mffc do thieu xffdng, loang xffdng va bang xffdng nang: Theo bang 3.5 nhdm BN bang xffdng nang thi trieu chffng dau Iffng t/ le 100%, mdi Iffng chiem 100%, dau doc xffdng dai dau chi chiem 100%, diem dau chdi that Iffng chiem 60%, gu veo chiem 40%. Tff dd, chung tdi nhan thay, cac trieu chffng lam sang tffdng ffng vdi mffc do bang xffdng cua BN. Mffc dp bang xffdng cang nang thi cang day du cac trieu chffng. Trieu chffng phd bien nhat cua LX la mdi Iffng, dau Iffng va dau doc xffdng dau chi. 6 nhffng BN ban dau cd cac trieu chffng mdi Iffng, dau Iffng^ cung da cd the la dau hieu cua tinh trang thieu xffdng roi.
VIETNAM MEDICAL JOURNAL N°2 - JANUARY - 2017 Dffa vao bieu do 3.3 phan loai mffc dp dau
cua BN theo thang diem VAS tai thdi diem ban dau khi BN vao vien. Chung tdi nhan thay mffc dd dau cua BN LX tap trung nhieu vao mffc dau viia vdi ty le 53,33%, dau it d mffc 28,89%, dau nhieu d mffc thap hdn vdi ty le 17,78%, sd BN dau d mffc khdng the chju ndi chl chiem 0%. Ket qua nay ciia chung tdi phiJ h ^ vdi cac tac gia [4],[6].
4 . 2 . Sff thay doi cua cac t r i e u chu'ng lam sang va hiSu qua g i a m dau tru'dc va sau dieu trj
4.2.1. Su" thay doi ciia cdc tTi$u chuhg lam sang bifdc va sau dieu trf
Tff bang 3.6 So sanh trieu chffng lam sang cua BN trffdc va sau dieu trj cho ta thay: Sd BN khdi trieu chffng dau Iffng chiem 55%. Trong khi do mdi Iffng khdi chiem t / le cao nhat la 71,11%. Nhdm ddi tffdng cd diem dau chdi that Iffng cai thien 33,33%. Nhdm ddi tffdng cd trieu chffng dau doc xffdng dai, dau chi cai thien 4 0 % . Rieng trieu chffng gij veo, vi thdi gian nghien cffu qua it nen chffa cd cai thien tren lam sang.
Bang 3.8 Diem dau trung binh theo thang diem VAS tai thdi diem D30 giam cd y nghia thdng ke vdi p<p,05 So BN hoan toan khdng dau dffdc tang len la 17,78%. Ket qua nay gan tffdng dffdng vdi tac gia Tran Bffu Qudc, nghien cffu dau that Iffng the than dffdng hff bang thudc "Bo than trang dffdng hoan" (mdt ten gpi khac cua
"Hdi xuan hoan") [ 6 ] .
V. KET L U A N I l.Benh nhan b a n g xffdng tram trpng deu d
day du cac trieu chffng lam sang gdi y Ioan(
xffdng. Benh nlian thieu xffdng va b a n g xffcfni thffdng gap trieu chffng dau mdi cd, dau Iffng dau khdp.
2.H0I xuan hoan cd tac dung giam dau cai trieu chffng tren lam sang d benh nhan Ioai|
xffdng. Diem dau trung binh theo thang dilri VAS tai thdi diem D30 giam giam tff 3,60 ± 1,91 xudng 2,07 ± 1,66; khac biet cd y nghia thonc ke vdi p<0,05.
TAI LIEU T H A M KHAO
1 . COOPER C, CAMPION G, MELTON L J (1992)
"3RD. Hip fractures in ttie elderly: a world-wid{
projection [J]. Osteoporos Int" 2(6): 285-289.
2. R. BARTL B F (2009), Osteoporosis [M]
Germany: Springer.
3. Pham Hong Hue (2004)" Nghien cull dpe dierr ISm" sang, can lam sar^ va dieu tn benh loanc xu'Ong d ngffcfl ldn tuoi blng Dudiig cot hoin, Luan an tien sy Y hoc.
4. Nguyen Thj Kieu Oanh (2012) "Md ta dSc dierr I3m sang va danh gia bu'de dau benh nhan loanc xffcJng the than am hu*. Luan an tiiac sy Y hoc. . 5. Nguyen Van Tuan, Nguyen Dinh Nguyeii
(2007), LoSng xu'dng nguyen nhan, chan doan, dieu tri va phdng ngCft, Hpi loang xu'dng Thanf phd Hd Chi Minh, Nha xuat ban Y hoc, ff 43-52. - 6. Tran Bffu Quoc (2011)" E)anh gia t^c dung dieu tr chuhg dau ttiat luhg the than du'dng hU bang thuoc bd than trang dffdng" Luan van thac sy Y hpc.
BAO CAO CA LAM SANG: U DA SITNG HOA KHONG LO HIEM GAP (S BENH NHAN Nir 8 3 TUOI
^ Nguyen XuSn Thirc*
T O M T A T
Ca lam sang dien hinh la benh nhan nff 83 tudi, CO khm u da sCmg hoa khong to d ma trai. KhSi u nay xuat hien each day khoang 5 nam, luc dau nhd, sau ldn cham dan. Tien SLT ban than va gja dinh khong co gi dae biet, thUdng ton cung khong gay trieu ehutig gi.
Kham lam sang la mot khdi sffng hda cffng ch§c, noi go tren b l mat da vung ma trai, gidng nhff chiec cUa ga khong lo vdi chlSu dai khoang 6cm. Da vung xung quanh thffdng tSn binh thffdng. Tien hanh phau thuat
*Binh vien Bach Mai
Oiju trach nhiem ehinh: Nguyen Xuan ThUc Email; thucrhmbmi§igmail.com Ngay nhan bai: 10.10.2016 Ngay phan blen khoa hoc: 12.12.2016 Ngay duyet bai: 26.12.2016
cat bo toan bp thu'dng tdn du'di gay te tai eho. Ket qui giai phau benh \^ la khdi u sffng hda lanh tinh.
SUMIVIARY
A G I A N T CUTANEOUS HORN OF 8 3 YEAR- OLD FEMALE PATIENT: A CASE REPORT. ^
A 83 year-old female patient presented wiWi giant cutaneous hom on the left eheek for the past I years, and had since slow/Iy increased in size. The pas and family histories w/ere not significant, without ani symtoms. Physical examination revealed a solitatv firm, hom like projection nearly 6 cm in length with 1 hyperkeratotie surface (look like cock spur). Skii surrounding the lesion was normal. A complete resection was primarily performed under IQG anaesthesia. Histopathological study disclosei thickening and hyperkeratosis suggestively of benig lesion.
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