VIETNAM MEDICAL JOURNAL N°2 - APRIL • 2018 - Vt the: Hinh thai vi the gan: Ld ehiTng va ca
2 Id trj: hinh anh gan binh thu'dng va thoai hda miTc dp nhe.
+ Hinh thai vi the than: Ld chu'ng va ea 2 id tri: hinh anh than dng lu'dn gan va cac cau true kliae binh thu'dng
IV. BAN LUAN
4 . 1 . Anh hu'dng cua vien nen Thanh nao I den chu'c nang gan, than cua tho thi nghiem: Tren ea hai Id thd, mpt Id uong vien nen Thanh nao I lieu thap (0,75 mLVkg) va mot Id udng vien nen Thanh nao I lieu cao (2,25 mL/kg) lien tuc trong 12 tuan, ket qua cho thay:
- Thanh nao lieu thap lam tang hoat dp AST, ALT so vdi Id chirtig va so vdi thdi diem tru'dc uong thudc (p < 0,05)
- Thanh nao lieu eao lam tang ndng dp albumin so vdi thdi diem tru'dc udng thuoc (p<0,05), tuy nhien khdng cd sii khac biet so vdi Id chirtig sinh hpc (p > 0,05)
- K h d n g lam thay ddi ket qua mpt sd xet nghiem danh gia chu'c nang gan; nong dp bitinjbin toan phan va cholesterol.
- Khdng lam thay doi ket qua xet nghiem creatinin trong mau thd sau 12 tuan udng thuoe thir lien tuc.
4.2. Anh hu'dng ciia vien nen Thanh nao Z den mo benh hoc gan, than ciia tho thi nghiem: Xet nghiem md benh hoc gan, than ciia thd khdng thay cd ton thu'dng rd ret ve mat
hinh thai cau true cae ed quan gan, than d thd thi nghiem. Khdng cd sir khae biet giu'a cae 16 va so vdi Id chirng.
V. KET LUAN
- Mau thuoe thir vien nen Thanh nao I khong gay ddc ti'nh ban tru'dng dien tren thd khi cho thd udng lieu 0,75 ml/kg/ngay (lieu cd tac dung tu'dng du'dng lieu dimg tren ngu'di) va lieu cao gap 3 ian (2,25ml/kg/ngay) trong 12 tuan lien tue uong thuoe.
- Cac chi sd theo ddt ve chu'c nang gan, chu'c nang than va md benh hpc gan, than deu nam trong gidi han binh thu'dng, khdng cd sir khac biet rd ret so vdi 16 ehutig.
TAI Ll|U T H A M KHAO
1. Ng^uyen Thanh Hien, Thu'dng Thanh Phii'(fng, Tran Du D^i "Di/ phong tien phat bien co fim mach do xd vQa - cap nhat cac khuyen cao hien hanh "ghuyin de tlm mach hoc2014TA tr 48-53' 2. Nguyen Huy Dung (2004), "Roi loan lipid
mau", Tlm mach hoc - Bai giing he noi ktioa, NXB Yhoc, tr 23-26. • - / 3. Pham TuT DUtfng (2007), "Cac thuoc dieu tri h6i Chung roi loan lipid mau", Thudc tim mach, NXB Y hpc Ha Noi, tr 647 - 688.
t. Pham TlT Du'dng, Nguyen Dinh Hai, Trtftfng Thanh Hu'dng va CS (2008), " Khuyen cao 2008 ciia Hoi Tim mach Viet Nam ve chan doan va flieu tii ra loaa lipid mau", NXB Y hoc Ha Noi, tr 476 - 502.
5. Nguyen Nhu'dc Kim (2014): "Roi ioan lipid mau theo y hpc co truyen". Tap chf dong v, so 487, tr 12-13, 26-28; so 490 tr 28-29
NGHIEN CU'U HIEU QUA KIEM S O A T TIEN TRIEN CAN THI TREN BENH N H A N DAT KINH ORTHO-K
T O M TAT
Mgc tieu: Danh_pia hieu qua kiem soat tien trign e|n tiij va mpt so yeu td lien quan cua kinh tiep xuc cuVig tham khf chinh hinh giae mac. Ddi tddng va phu'dng phip nghien cdu: Nghien culi mo 'ta, tien cull, khong doi ehiing, so sanh doe trudc va sau dieu tri tren 75 mSt (41 benh nhan) tai Benh vien Quan Y 103 tir 09/2015 den 09/2017. Ket qiia vi ban luan:
Mue dp tien trien can tnrdc dat kfnh tmng binh la 1,23
± 0,34D, nhdm tiieo doi 24 ttiang va 36 thang deu
''Benh viin Quan Y103,
**Benh vien Mit Tmng udng Chju trach nhiem chinh: Nguyen Dinh Ngan Email: [email protected] Ngay nhan bai: 2.2.2018 Ngay phan bien khoa hoc: 29.3.2018 Ngay duyet bai: 12.4.2018
Nguyin Dinh Ngan*, Le Xuan Cung**
thay xu hudng tien trien can tang dan. Nhung sau dSt kfnh mu'c dp tien trien can trung binh la 0,04 ± 0,120, giam ed y nghTa thong ke so voi trUde dat (p<O,O01).
Co tat ca 13 mat (26,7%) ben trien can, 'S mSt sau 12 thang (n=75) va 8 mat sau 24 thang (n=40) theo dBI, trong do 1 mat tang 1,00D; 1 mat tang 0,5D, con 1^1 11 mat tang 0,25D. MiTc dd tien tnen can sau flat kir*
Ortho-K ed lien quan den do can tru'dc dat (r = 0,234;
p= 0,045), nhung khdng lien quan den Kl, K2 va tuoi.
Tnjc nhan cau sau khi dat kinh co xu hu'dng dai them, so vdi tru'dc flat kinh lan IUdt la 0,18 ± 0,3 mm (p=0,765) d 12 thang va 0,21 ± 0,37mm (p=0,047)cl 24 thanp. Kei luin: Oat kfnh Ortho-K la phudng pfiap hieu qua trong ngan ngira tien trien can thi
Tdkhda: Ortho-K, can tiij, tien tnen cin SUMMARY
STUDY OF MYOPIA CONTROL I N PATIENTS USING ORTHO-K 26
TAP CHi Y HOC V\tT NAM TAP 465 - THANG 4 - 30 2-2018 Objectives: to evaluate the efficacy of
progressive myopia control and some associated factors in orthokeratology treatment. Patients and methods: the longitudinal observative study was carried on 75 eyes (41 myopia patients) at 103 military hospital from October 2015 to October 2017.
Results: the average myopia progression before treatment was 1.23 ± 0.34 D. The groups with follow- up time 24 months and follow-up time 36 months were showed more progression of myopia power.
After treatment, the myopia progression was 0.04 ± 0.12 D and was reduced significantly (p<0.001). There were 13 eyes (26.7%) with increasing myopia power:
5 eyes after starting treatment 12 months and 8 eyes after 24 months, in which there was only one eye increasing ID, one eye increasing 0.5D and were 11 eyes increasing 0.25D. The myopia progression after weanng Ortho-K lens was associated with the power of myopia before treatment (r=0.234, p=0.045), however was not associated with keratometry and the age of patients. The axial length of eye ball after treatment was continue to lengthen comparing to before treatment, respectively 0.18 ± 0.3 mm (p=0.765) after wearing Ortho-K lens 12 months and 0.21±0.37mm (p=0.047) after 24 months.
Conclusion: Ortho-K is tihe effective treatment to control the myopia progression.
Key words: Ortho-K, myopia, myopia progression I. OfyT VAN OE
Can thj la mot tat khue xa thu'dng gap nhat trong xa hpi hien dai. Cac mat can thj nang eo the gay suy giam nghiem trpng chu'c nang thi giac do cac bien chiTng nhir raeh vong mac, bong vong mac, glocom, tan maeh vdng mac, thoai hoa hoang diem, to hoang diem, vet nut mang Bruch.... Dieu t n can den nay du'dc ehia lam hai nhom phu'dng phap: mot la ehinh quang gom giup phuc hoi thj li/c, cat thien tinh trang thi giac hai mat, hat la giam miTc dp tien trien ciia can thj (du'dc gpi la "kiem soat can thj") nham lam giam do tang nang ciia can thj, lam eham sir dai ra ciia nhan cau, han che bien chii'ng so vdi viec khong dieu trj. Tuy nhien den nay co rat it phu'dng phap dddc chulig minh la co tae dung trong kiem soat sir tien trien ciia can thj.
Ra ddi tir nam 1960, qua rat nliieu nhu'ng eat tien ve chat lieu, thiet ke, phu'dng tien danh gia, kinh tiep xue eirng tham khi chinh hinh giae mac (orthokeratology, Ortho-K) da dddc nhieu nghien culJ khang djnh hieu qua trong viec lam triet tieu dp can hien mac tam thcJt va lam giam toe dp tten trien ciia can thj, giam toe dp keo dai ciia true nhan cau, chiieu sau buong djch kinh... [ 4 ] , [5],[6]. Tai Viet Nam, den nay da co mot so nghien cuii ve sd dung kinh Ortho-K tai Viet Nam nhu' nghien ciru ciia Ton Thj Kim Thanh (2014), Tran Anh Tuan (2014),... tuy nhien, cho den nay chu'a CO nghien CLTU theo dot dai vdi so lu'dng du
tdn BN de CO the danh gia chi'nh xae hieu qua hieu qua kiem soat tien trien can thj ciia phu'dng phap nay, do do chiing toi tien hanh nghien ciru de tai: ^'Danh gia hieu qua kiem soit can thj vi mdt so yeu to Uen quan cua kinh tiep xuc cdng tham khi chinh hinh giic mac".
II. DOI TU'pMG VA PHt/OTNlG PHAP NGHIEN CUU 2.1. Ddi iddng nghien cdu: Nghien cuXi du'dc tien hanh tren cac 75 mat (41 benh nhan) can thi thoa man tieu ehuan ItTa ehpn va loai trir dirdc kham va theo dot tai Benh vien Quan Y 103 tir 09/2015 den 09/2017.
Tliu chuan Ida chon
- Du'dc chan doan xac dinh can thi tir -6.5D trd xuong, loan thj tir 1,5D trd xuong.
- Chinh kinh gpng dat thi lyc tir 20/25 trd len.
- Tien trien can vcfi toe do tu" -0,75D/nam trd len.
- Tir 08 tuoi den 18 tuoi.
- Ttr nguyen tham gia nghien cu'u.
Tieu chuan loai trd
- BN CO do can tren -6,5D va/hoac ioan thi tren 1,5D.
- BN dang co hoae eo tien sir benh ly be mat nhan cau (kho mat, viem bd mi, viem ket mac, viem loet giac mac,...), tien sir chan thu'dng hoac phau thuat mat tru'dc do, co benh ly khae ve mat g a j anh hu'dng den viee danh gia thj \iic (due the thiiy tinh, glaucoma,...).
- Benh giac mac chop hoac loan thj khong deu, loan thi do the thiiy tinh, khue xa giac mae dudi 41,00D hoac tren 48,00D.
- Mat dj irng vdi thanh phan ciia kmh, ciia dung djch cham soc kinh.
2.2. PhUdng phap nghien cdu 2.2.1. Thiet ke nghien cdu vi (^ mau Nghien euli md ta, tien culJ, khong dot ehirng, so sanh dpc tru'dc va sau dieu tri.
Cd mau tinh theo eong thiTc la 35 mat, chiing toi nghien cuTu tren 75 mat (41 benh nhan)
2.2.2. Phddng phip tien hinh
- Kham benh nhan tru'dc khi dat kinh: Thu thap thong tin ve tat khue xa eiia benh nhan tru'dc day gom dp can va dp dai nhan cau (sieu am A) d diem dat ki'nh, va khue xa tru'dc do 12 thang, 24 thang, 36 thang (tiiy theo tat lieu thu thap du'dc). Cae so lieu ve dp can tru'dc day du'dc kham xac djnh bdi cac bae sT chuyen khoa mat vdt day dii cae thong so: khue xa co Net dieu tiet, khue xa eau tu'dng du'dng khi ehinh kinh toi da eho thi lu'c 20/20.
- Dat kinh Ortho-K (hang Fargos): thir dat theo thong so ciia bang ma kfnh va chinh den kfnh phil hdp eho thi lu'c tir 20/25 trd ten. Hu'dng
VIETNAM MEDICAL JOURNAL N°2 - APRIL - 201B dan benh nhan dat kfnh d nha va kham dinh ky
3 thang/lan
2.2.3. Chi tieu nghien cdu
Mdc do den trien can tru'dc dat kfnh (D/
nam): theo dot 12 thang, 24 thang va > 36 thang (tinh theo gia trj tuyet doi).
- Mire dp tien trien can sau khi dat kinh (D/
nam): theo doi 12 t^ang va 24 thang (tinh theo gia trj tuyet dot).
- Do dai true nhan cau (mm): tru'dc dat va thay dot sau dat kinh
- Mpt so yeu to lien quan den mti'e dp tien trien can sau khi dat kinh:
+ Lien quan gtiTa mire do tien trien can va dp can tru'dc dat
+ Uen quan giu'a mii'c dp tien trien can va khiie xa giac mae
+ Lien quan giijS miTc dp tien trien can va tuoi I I I . KET Q U A V A B A N L U A N
3.1. Dac diem benh nhan nghien cuU:
Nghien cu'u tien hanh tren 75 mat eiia 41 BN (34 BN dat kinh 2 mat, 7 BN dat kinh 1 mat), trong do ed 22 nd, 19 nam. Dp tuoi tir 8 tuoi den 18 tuoi (trung binh 12,6± 2,4 tuoi), trong dd 46,3%
cd dp tuoi tir 12 trd xuong.
Vdi eac mSt theo dot du'dc 36 thang va 24 Uiang, mu'c dp bien dot toe do tten trien can qua theo dot nhu sau:
trien can -0,75D/12 thang trd ten, eao nhat la 2,25D/nam. Toe dp tten trien can trung binh tru'dc dat theo dot 12 thang, 24 thang va \ thang tan Iddt la 1,32 ± 0,37 D/nam; 1,21 f 0,36 D/nam va 1,23 ± 0,34 D/nam (bang 1). |
Bangl. Tdic dp t/^ trien can dieo ddi tnm dai kfnh 12 diang, 24 thing va 36 thang %
1,32
±0,37
2 4 thang ( D / n a m )
1,21
±0,36
72 36 thang (D/nam)
1,23
±0,34
51 3.2. Hieu qua kiem soat tien trien c$i cua kinh Ortho-K: Vdi thdi gian theo dot tir l £ thang - 24 thang (trung binh 16,2 ± 4,1 thangji bien dot dp can sau kht dat kinh du'dc mo ta il bang 2. Tat ca 75 mat deu du'dc theo dot tir 12 thang trd ten, nhuYig cd_ 1 benh nhan (2 m§t) khong dirng dat kinh de kiem tra mire dp ti^n trien can thdi diem 1 nam nen ehi cd 73 m§t du'dc danh gia d thdi diem nay, 40 mat hoan thanh theo doi va danh gla d thdi diem tren 24 thang. 6 bang 2 chijng toi so sanh toe dp tien trien can d ciing nhom benh nhan d thdi diem 2 nam, 1 nam trUde dat kinh va sau khi bat c^u dat kfnh 1 nam, 2 nam.
Bang 2. Tdc do tien iriS'n can trddc vi sau dat kinh Oriho-K
" \ ^ T h 6 i gian
^ t h e o doi T o c d p t i e n trien can ^ \
Tru'dc dat khi dat kfnh Sau dat kht
dat kfnh P
12 thang ( n = 7 3 )
1,18 ± 0,33 D 0,02 ± 0,08 D
<0,001 2 4 thang ( n = 4 0 )
1,21±
0,37 D 0,06 ± 0,15 D
<0,001 Trung
binh 1,19 ± 0,34 D 0,04 ± 0,12 D
<O,0Ol
T h a i gian tfaeo doi Bieu dd 1. Tdc dp den tridn can cua nhdm ddi tUOtg theo ddi 24 tJiang va 36 tJiang
Nhu* vay d ca nhdm theo dot du'dc 24 thang va 36 thang deu cho thay cac benh nhan dang cd xu hu'dng tang toe dp can theo thdi gian.
Chieu dai true nhan cau trung binh ciia cac mat tru'dc khi dat kinh la 24,62 ± 0,57 mm
Dp can tru'dc khi dat kinh ciia nhdm nghien cu^j tir - 0,75 D den -6,5 D, trung binh la -4,14 ± 2,02 D. Cd 50/75 mat cd dp can tir -2D trd ten, trong dd cd 34 mat dp can tren -2D la ciia BN dudi 12 tuoi. Tat ca cae BN deu cd toe dd tien
Bleu do 2. Xu hudng tang do can cua 28 mat iheo ddi 5 nam lien tuc.
Danh gta tdc dp thay doi dp can sau dat kinh nam thu' 1 va 2 khong khac biet (p=0,058), tuy
TAP CHt Y HOC VIST NAM TAP 465 - T H A N G 4 - SO 2 - 2018
nhien so sanh vdi tru'dc dat toe do nay deu giam eo y nghTa thong ke (p<0,001). Toe dp tien trien can trung binh la -0,02 ± 0,08D sau 12 thang va -0,06 ± 0,15D d thdi diem 24 thang tu'dng du'dng vdi nghien cihj ciia Davis (2015) [4] la 0,02 ± 0,53D. Trong 51 mat du'dc theo dot tien trien can tir tru'dc dat kinh 36 thang ed 28 mat tiep bjc dddc theo dot sau dat Ortho-K 24 thang. Danh gia bien dot dp can ciia 28 mat nay d bleu do 2.
Bang 3. Cac trUdng hdp tieh trien can sau dat kinh Oriho-K d tlidi diem 12 thang va 24 thing.
^ d i diem oanh gia O g c a h x , tang'(D)
-1,00
-0,50 -0,25 TongSau 12 thang ( n = 7 3 ) 0 (0,0%)
1 (1,4%)
5 (6,8%) I S WSau 24 thang ( n = 4 0 )
1 (2,5'
0 (0,0%)4 (5,5%) 7 (17,5%)
Tong
13
Nhu vay so benh nhan tien trien can cd xu hudng tang theo nam, d thdi diem nam thir 1 cd 6,8% benh nhan tien trien can, d thdi di^m sau 2 nam cd 20% tien trien can nhUng dp can tang rat thap, da so chi tang 0,25D (4/5 trudng hdp nam thU 1, 7/8 trUdng hdp nam thir 2). Trong so 13 mat tien trien can ciia nhdm nghien cUu chi cd 1 mat tien trien can d ca 2 lan kham. Nhu vay dat kinh Ortho-K d nhdm nghien eUu kiem soat can la 93,2% sau 12 thang va 80% sau 24 thang (trung binh 88,7%). Ket qua nay eung nam trong pham vi kha nang kiem soat can ciia mpt so ngliien ciTu tren the gidi la tir 85% - 93,5% [4], [5], [6], [ 7 ] .Bang 4. Thay ddi ve dp dai true nhan cau dcac thdi diem theo ddi.
fid dai true nhan cau ( m m ) TriTcTc dat
(n=75) Sau 12 thang
(n=73) Sau 24 thang
(n=40)
24,62 ± 0,57 24,77 ± 0 , 3 8 24,82 ± 0,42
Thay doi ( m m )
0,18± 0,30 0,21 ±
0,37 NhU vay nhan rau van eo xu hUdng dai ra nhUng so sanh sU thay doi giCTa eae thdi diem thi khac biet khong cd y nghTa thdng ke (p=0,765).
Tuy nhien so sanh dp dai thdi diem sau dat 2 nam vdi trUdc dat vdt thdi diem trUdc dat thi khac biet nay la cd y nghTa (p=0,047). Ket qua thay dot dp dai nhan rau cua chung toi ciing tUdng dong vdi mpt so nghien eiiu, Cho (2005) danh gia 35 dot tUdng dat kinh Ortho-K tai thdi diem 12 thang va 24 thang true nhan cau lan IUdt dai them la 0,16 ± 0,26mm va 0,29 ± 0,27mm [5].
Bieu dd 3. Phan bd dp can trUdc dat va ioc dp tien trien can.
3.3. Mdt sd yeu to lien quan - Mdc do tien trien can vi do cin trddc dat Mire dp tien trien can cd lien quan den dp can trUde dat kinh (p = 6,045), vdi miTc dp tu'dng quan r = 0,234 (bieu do 3)
Ti le tien tnen can d nhdm trUde dat cd KXCTD dUdi -4D va tU-4D trd len d thdi diem 12 thang, 24 thang va tong so khdng khac biet eo y nghTa thdng ke (p>0,160) (bang 5).
- Mdc do tien trien can vdi khue xa giic mac.
Khdng ed mdj tUdng quan tuyen tinh nao gida vndc do tien trien can vdi khue xa giac mae K l , K2 hoac trung binh K l , K2 {p > 0,136).
Ti le tien trien can ciia cae nhdm trUde dat ed K l nam trong eac khoang khae nhau cho thay:
Tai thdi diem 12 thang, t i le tien trien can eiia eac nhdm khae biet khong cd y nghTa thong ke.
Tai thdi diem sau 24 thang dat kinh, nhdm cd K l tir 42D den dUdi 44D tang i l , 9 % khae biet ed y nghTa vdi nhdm ed K l tren 44D tang 5,9%
{p=0,041), cdn iai cac nhdm khac deu khae biet khdng ed y nghTa thong ke {p>0,08S) (bang 5).
- Mdc dg tien trien can vi tudi: Khdng cd lien quan cd y nghTa thdng ke giiTa mUc dp tien trien can va tuoi {p = 0,677).
Bang 5. Tild tien trien can sau
' Cac nhom chi so tru'dc d$t C^u tu'dng
du'dng (D)
Du'di -4 (n=35) T u ' - 4 t r d l e n ( n = 4 0 )
dat Ortho-K d cac nhdm ddi tddng nghien cdu Tien trien can
sau 12 thang ( m a t ) 2 (5,7%) 3 (7,5%)
Tien trien can sau 24 thang
( m a t ) 3 (8,6%) 5 (12,5%)
P 0,324 0,160
Tong 5 (14,3%)
8 (20%)
VIETNAM MEDICAL JOURNAL H''2 - APRIL - 2018
Kgiac mac det
(D) Tuoi (nam)
<42 (n=16) 42-<44 (n=42)
>44 (n=17) 8-12 (n=36) 13-18 (n=39)
1 (6,25%) 3 (7,5%) 1 (5,9%) 3 (8,3%) 2 (5,1%)
2 (12,5%) 5 (11,9%) 1 (5,9%) 5 (13,9%) 3 (7,7%)
0,333 0,160 1 0,160 0,324
3 (18,8%) 8 (19%) 2 (11,7%) 8 (22,2%) 5 (12,8%) Nhu vay tnang eae yeu to chi eo do can trUde kht dat kmh eo mdi tUdng quan cd y nghTa thdng ki vdi toe dp tien trien can sau dat kinh (p'<0,05). Tuy nhien he so tUdng quan rat thap r = 0,234 ehirng td hieu qua kiem soat toe dp eiia phUdng phap nay kha d'n dinh d tat ca eae dp can khac nhau. Mpt so nghien ciTu da trung tam khac cung eho thay rd ket qua nay.
IV. KET LUAN
- Mire dp tien trien can trUdc dat kinh trung binh la 1,23 ± 0,34 D, nhdm theo ddi 24 thang va 36 thang deu thay xu hUdng tang mUc dp tien trien can. NhUng sau dat kinh mUc dp tien trien can trung binh la 0,04 ± 0,12 D, giam cd y nghla thong ke so vdi trUdc dat (p<0,001).
^- Co tat ea 13 mat (26,7%) tien trien can, 5 mat sau 12 thang (n=75) va 8 mat sau 24 thang (n=40) theo doi, trong dd 1 mat tang 1,00D; 1 mat tang 0,5D, cdn lai 11 mat tang 0,25D.
- MUe dp tien trien can sau dat kinh Ortho-K ed lien quan den dp can trUdc dat (r = 0,234; p=
0,045), nhuTig khong lien quan den K l , K2 va tuoi.
- True nhan eau sau khi dat kinh ed xu hUdng dai them, so vdi trUde dat kfnh tan IUdt la 0,18 ± 0,3mm (p=0,765) d 12 thang va 0,21 ± 0,37mm (p=0,047) d 24 thang.
TAI Lifu THAM KHAO
1. Nguyin Dinh Ng^n, Ph^m Thi My Hanh.
Nguyen Thi^Thu Hien (2015) "Danh gia hieu'qua budc dau dat kinh tiep xuc ehinh hinh giac mae ban dem dieu tri can thi". Tap chf Y hoc Viet Nam
thang 11 - so 2 -2015, trang 108-13.
z. Le Tbi Hong Nhung, Vu Thi Tue Khanli, Nguyen Du'c Anii va cs (2015), "Danh gia kS qua ciia phUdng phap chinh hinh giac mac bang kfnh tiep xuc qua dem cho ngU6i mac tat can thi", tap chi Yhoc VietNamthang 7 - s 6 2/2015', traiiq 101-4.
3. Vo Thj Thu Thao (2015); "Dieu tri can thi tmng binh vi cao hang kinh sat trong chinh hihh giic mac". Luan an chuyen khoa cap I I , trUdng Dai hoc y(JUc(cTPH6Chf Minh.
4. Davis R.L., Eiden S.B., Bennett E.S. et af.
(2015) "Stabilizing Myopia by Accelerating Reshaping Technique (SMART)-Stuidy Three Year Outcome and Overview", Adv Ophthalmol i/isSyst, 2(3): 00046.
5. Cho P., Cheung S.W., Edwards M. (2005). 'The longitudinal orthokeratDlogy research in children (LORIC) in Hong Kong: a pilot study on refractive changes and myope control", QjmEy^Res, (30): 71-80.
6. Kakita T, Hiraoka T, Oshika T (2011).
"Influence of overnight orthokeratology on axial elongation in childhood myopia", Inve^
Ophthalmol Vis Sci, 52: 2170-4.
7. Swarbrick H, Alharbi A, Watt K, Lum E (2010).
"Overnight orthokeratology lens wear slows axial eye growth in myopic children". Presented at Association fbr Research In Vision and Ophthalmology Conference, 1721/A178, Florida.
KET QUA DIEU TRI TRU-ffT DOT SONG THAT LU'NG L4L5 BANG P H A U T H U A T LAY DIA DEM, CO DINH COT SONG
VA GHEP XU-ffNG LIEN THAN DOT
T O M T A T
Tdng quan: Phau thuat co djnh cot song va han -khdp lien than dot qua lo li'en hdp da trcf nen pho bien trong dieu trUrUpt dot song that luTig ciing. Co nhieu nghien eUu ve ket qua dieu tn ciia phUdng phap phau
*Khoa chan thudhg chinh hinh vi cdt song - win Bach Mai
Chju trach nhiem chinh: Ho^ng Gia Du Email: [email protected] Ngay nhan bai: 9.01.2018 Ngay phan bien khoa hoc: 9.3.2018 Ngay duyet bai: 2.4.2018
Hoang Gia Du*, Nguyin Van Trung*, Vu XuSn Phudc*, Nguyin Dii-c Hoikng * thuat TUF tren toan the gidi. Muc dfch nghien eiiU ciia chung toi nhSm danh gia ket qua dieu tri phau thuat TUF 6 cac benh nhan trUOt L45. Ddi tupng va phUdng phip nghien cut/: Nghien cUu hoi cUu 30 bfnh nhan truUt L45 dUPc phau thuat TUF. Chung toi danh gta trieu ehiiYig lam sang, X quang va cong hudng tir cung nhu ket qua sau phau thuat. Kei qua:
Tuoi trung binh trong nghien eUu la 53,5 ± 15,20 tuoi, diem VAS trung binh dau cot song that luhg va dau kieu re cai thien tiT 5,2 ± 0,9 va 6,7 ± 0,5 trU6c mo tdi 1,3 ± 0,50 va 0,3 ± 0,40 sau md. ODI trung binh trUdc mo la 53,0 ± 7,18%, sau mo la 18,9 ± 11,01%.
Chieu cao dTa dem eai thien tir 8,0 ± 2,5mm (3 - 11mm) trudc mo sang 12,87 ± 0,68mm sau m6, co)/
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