T A I U | U THAM K H A O
1. Nguyen Thj Kim Anh (2003). Ddc diem hinh thai ciia bp rang sOa C$p nhat nha khoa thing 4- 2003..
Tnrdng Bai hgc Y Dwgc Thanh phd Hd Chi Minh. tr.5- 24.
2. Nguyen Thj Ngpc Diem (1985). Sue khde rang mipng hpc sinh mau gido va d p I. Ludn van tot nghidp bic sy chuyen khoa II, Trwdng Dai hgc Y Ha Ngi, tr 15.
3. Trln Thuy Nga, Phan Thi Thanh YPn, Phan Ai Hung, Dang Thj Nhan Hod (2001) . Nha khoa tre em.
Nha Xuat ban Y hgc thanh phd Ho Chi Minh. Tr.9- 252 . 4. Dao Th! Hong Qudn(2000). Kinh nghipm su dyng tren Idm sang glass ionomer. C$p nhit nha khoa, s6 2.,
tr.112-122.
5. Trln Van Trvang (2002). Dieu tra sue khoe rang mieng toin quoc d Viet Nam. Vien Ring Ham Mit Hi fjQi. tr 37- 50.
6. Cohen s.. Bums R C (1993). Pathway of the pulp 6'^ ed. Mosby pp 633- 671.
7. Fortier J.P., Demars Ch (1983). Abreger de pedodontie . Masson Paris, Chapter IV, pp127- 133.
8. George k. Stookey (2000). Current status of caries prevention, compedium, pp 862-868.
9. John M. Powers (2002), Glass inomer cement.
Restorative dental matenals, Mosby pp 232- 259.
THAI DO XlTTRi VA BIEN CHUNG CUA RAU TIEN DAU
or CAC SAN PHU CO SEO MO LAY THAI TAI BENH VIEN PHU SAN THANH HOA
T6M TAT
M{ic tieu nghidn cuv: Nhdn xdt vd thai dg xw tri vi biin chung cua rau tiin d$o d cic sin phu cd s$o md liy thai fp/ Bdnh vign Phij sin Thanh Hda. Ddi tu^g va phuvng phip nghidn c&u: Tit d sin phif cd tudi thai tir Idn han hoac bdng 28 tuin cd sgo md liy thai cD, dwgc chin dodn Id mu tiin dgo qua Idm sing vi siiu im. dS dwac md liy thai fp/ Bdnh vidn Phu sin Thanh Hda tO- ngiy 01/01/2012 din ngiy 31/12/2013. Phuxmg phdp nghidn cO'u: M6 ti, hoi cOv. Cd miu thuin tidn. khdng xic suit. Kit qua nghidn ciru: Diiu tri Ngi khoa trwdng hgp dwgc sir dung thudc giim co khi thai dwdi 37 tuan chiim tp Id 61,5%. Md dp cim 46 tnrdng hgp md dp ciru chiim 32.2%, trong dd md cip cOu do chiy mdu cd 32 trwdng hgp 69.6%. Mo chO ddng 97 trwdng hgp chiim 67.8%, thai du thdng 89 chiim 91,7%. Biin chdng cho mg: Ty id rau bdm m$t tnrdc chiim 51.7% Trong dd cd 13 ca rau di ring Iwgc. Tp 1$
bim mdt sau chiim 48,3%. Trong dd cd 3 ca rau di rdng Iwgc. Biin chOng ddi vdi con: Thai non thdng Id 37,8%, tmng dd gdp tudi thai 34-37 tuin nhiiu nhit chiim 29.4%; thai non thing gap nhiiu nhit trong rau tiin tfpo tmng tdm chiim 18,9%; ty id thai du thdng 62,2%. Kit lu$n:Ty Ig cat td cung Id 19,6%. Tdn thwong t^ng Id 4,2%. Can ning tmng blnh cOa trd sa sinh Id 2776 ± 608.23g. Tnrdng hgp c6 cin ndng dwdi 2500gr chiim 19,5%. Tp Id tw vong sa sinh la 2,1%. Tp Id md chu ddng chiim 67,8%.
Tir khda: Rau tiin d^o
THE ATTITUDE MANAGEMENT AND COMPLICATIONS OF PLACENTA PREVIA IN WOMEN WITH CESAREAN SCAR IN THANH HOA OBSTETRICS HOSPITAL
SUMMARY
Research Objectives: Comment on the attitude management and complications of placenta previa in
LE TH! HLTONG TriFdng Cao dang Y ti Thanh Hda women with cesarean scar in Thanh Hoa Obstetrics Hospital. Research subjects and methods: All women with gestational ages from 28 weeks or greater Previous caesarean section scar. Been diagnosed with placenta previa, through clinical and ultrasound.
Were cesarean section in Thanh Hoa Obstetrics Hospital from 01/01/2012 to 31/12/2013.Methods:
The study design using the method described, retrospectively. Sample size: Sample size is convenient, not probabilities. Research results:
Treatment of Internal Medicine cases used tocolytic agent when under 37 weeks gestational percentage 61.5% (88/143). Eergency surgery 46 cases accounted for 32.2% emergency procedures, including emergency surgery due to bleeding, 32 cases of 69.6%. Elective caesarean accounted for 67.8% of 97 cases, 89 full-term pregnancies accounted for 91.7%. Maternal complications:
Proportion of front grip placenta 51.7%. Including 13 cases of vegetables set of comb. The proportion accounted for 48.3% on the back stick. Including 3 cases of placenta set of comb. Complications for the baby: Pregnant prematurity was 37.8%. v\fhich met 34-37 weeks gestational age accounted for 29.4% at most; preterm birth is seen most frequently in the central placenta previa, 18.9%; full-term pregnancy rate 62.2% Conclusions: Percentage hysterectomy was 19.6%. Visceral lesions was 4.2%. The average weight of newborns was 2776 ± 608.23g. Case weighing less than 2500gr 19.5%. Infant mortality rate was 2.1% in women with placenta previa following cesarean section with 11.2% Placenta set of comb in women with placenta previa / after cesarean stick placenta front position is 81.2%. The average gestational age at surgery was 37.04 ± 2 56. The proportion accounted for 67.8% elective caesarean.
Keywords: Placenta previa
y HOC THVC HANH (948) - SO 1/2015
DAT VAN o e
Rau hen dpo Id mpt cap cO'u san khoa thuPng gdp. TruPe ddy khoang 0,5% [1], g i n ddy cd s y gia tdng. Tpi Bpnh vipn phy san trung uang tO' nam 2007 den ndm 2008 t j le rau t i l n dao Id 1,9% [5]. Dae biet Id rau tien dpo sau m l l l y thai chiem 19,8% [4] rau tiln dpo / sau m l l l y thai gay nhilu b i l n chung eho me vd eon. TruPe mpt sdn phu rau tien dpo cd sau mo l l y thai edu hdi dpt ra la c h i n dodn vd x u tri t h i nao d l giam b i l n ehii-ng eho mp vd eon. D l tdi n h i m myc tiPu nghiPn cii-u: Nhpn xet v l thdi dp x u tri vd bien ehO'ng cOa rau t i l n dao d ede san phu cd spo m l ily thai tai Bpnh vien Phu san Thanh HPa.
0 6 l TUONG v A PHU'aNG PHAP NGHIEN CU'U 1 D l i typ'ng nghiPn eipu
- Tidu chuin li/a chgn: Tat ca san phy cd tuoi thai ti> IPn han hode bing 28 tuan CP spo m l l l y thai cQ.
Dupe c h i n dodn Id rau t i l n dao qua lam sdng vd siPu dm. Dd dupe m l l l y thai tai Bpnh vipn Phu san Thanh HPa ti> ngdy 01/01/2012 d i n ngdy 31/12/2013.
_- Tidu chuin lo^i trir- KhPng dii cde thPng tin. sau mo khdng phai rau tien dpo, cd bpnh ly kPm theo.
2. Phuang phap nghlPn cu'u
- Thilt k l nghlPn euu: S u dyng phuang phap md td, hli ei>u.
- CP mdu nghien eii-u. M i u thudn tien, khdng xdc suit.
+ T i t ca cde d6i tupng dam bao tieu chuin lya chpn trong khodng thPi gian tO' 01/01/2012 d i n 31/12/2013
3. B i l n sd nghien cil'u: Biln so lidn quan d i n san phy. Biln s6 lien quan tPi con.
4 .Phdn tich vd x u ly s 6 lipu: Ap dyng p h i n mim SPSS 20.0
5 D90 due trong nghien cii-u: NghiPn ciru h l i cuu nPn khPng anh hud'ng d i n sue khde cup d i i tupng nghien cO'u. Mpi thdng tin duac giQ' bi m|t tuypt d l i .
K £ T Q U A NGHIEN CI>U VA B A N LUAN , I.Thdi d d x i > t r i va cdc b i l n Chiang
^ 1.1. Dieu trj n^i khoa Bang 1.Thu'dc i^lu trj giam co
Thuoc giam co Don lllu^n
hop
Giam CO b6p cctron est con Co Giam CO bdp vd cit can CO Khdng si> dung
thu6c
! T6nas6 Tuoi thai 28-
33 6 4 34 3 46
34- 37 9 2 34 19 64
>
37 0 0 0 33 33
T6nq s6 n 14 6 68 56 143
%
9,6 4,2 47,5 38,5 100 Nhpn xPt: Tn^Png hpp dupe s u dyng thuoc gidm CO khi thai duPI 37 t u l n chilm ty Ip 61,5% (88/143).
Trudng hpp phdi diing tO' 2 loai giam co vd e l t can CO chilm ^ Ip 47.5%. TruPng hpp khdng si> dyng thulc gidm eo ehilm ty ip 38,5%.
1.2. Diiu trj ngo^i sin khoa bing phiu thu^t
Bang 2. ChJ a n h mo lay thai Chidinhml Mo cap
cO'u
Chay mdu
flau v6t mS~
Mdchu
dpng I RTD Ly do kh^c Thai ail Ihdng Tdng
Tdng so
Nhdn xPt: M l eap cuu 46 truang hpp mo e l p ei>u ehilm 32,2%, trong dd m l e l p euu do chay mdu ep 32 truang hpp 69,6%. Mo chii dPng 97 tofpng hap chilm 67,8%, thai dii thdng 89 chilm 91,7%
2. Biln^chii'ng rau tiPn dao /sau m l Idy thai 2,1. Bien chung cho me
Bang 3. T i n thuang cdc tpng vPi rau cdi rdng lupc
Tin thi/ffng tgng Kh6ng t6n
thuanq RSch ti> cunq
Tdn thuong bdng quanq Tdn thu'ong
njQt Mautu Tdn thuong 2
2 tanq Tdnq s6
RTD RCRL n 12 2 2 0 0 0 16
75.0
%
12,5 12,5 0 0 0 100
Khfinq n 125
1 1 0 0 0 127
98,4
%
0,8 0,8 0 0 0 100
n 137
3 3 0 0 0 143
97,2
%
?1 2.1 0 n 0 100
95,8
%
%
4.2
100 Nhdn xPt: Cd 6 truang hpp ton thuang tpng ehilm 4,2%. 3 tarang hap rdch t u cung do spo dinh 6 vet m i l l y thai 2 l l n vd ngPi vai; 3 truPng hpp t i n thuang bdng quang do rau cdi rdng lupc 2 vd 1 do seo qud dinh. Cdn 127 rau t i l n dpo khPng cd ton thuang tang.
2.2. Biin chO-ng doi vdi con Bang 4. Tinh trang sa sinh:
~~Sii§i diem ddnh
^^^-^^^giS Tinh trang thSN-.^
Blnh thu'dng.
Ngat Ti> vong.
Tdng cpng Phut thu
nhit n 130
13 0 143
%
90,9 9,1 0 100
Phi3t thU 5 n % 134
9 0 143
93,7 6,3 0 100
Sau 24 gid n 134
6 3 143
%
93,7 4.2 2,1 100 Nhpn xet: Ty le sa sinh binh thuPng phut thu nhat Id 90,1%. Ty Ip sa sinh ngat phOt thO- nhit Jd 9,1%.
CP 3 sa sinh t u vong sau ngdy d i u ehilm 2 , 1 % do non yeu.
K t T LUAN
Si> dyng thuoe gidm co khi thai dual 37 tuan chilm ty Ip 61.5%. TruPng hpp phai dung Mr 2 lopi giam eo vd c i t can eo chilm \^ IP 47,5%. Ty Ip m l chu dpng ehilm 67,8% . Ty Ip phai truyin mdu Id 21,7%. Nguy ea phai truyen IPn han hode bdng 3 dan vj mau mdu trong mo e l p cO'u, cao g I p 4,46 lan so vPt mo chii ddng. Ty Ip thieu mdu sau m l la 81,2%. Ty Ip c i t t u eung Id 19,6%. T i n thuang tpng id 4,2%. Cdn npng trung binh eCia tre sa sinh Id 2776
Y HO : THUC HANH (948) - s 6 1/2015
± 608,23g. TruPng hpp eP edn ndng dudi 2500gr chilm 19,5% Ty IP tCr vong sa sinh Id 2,1%.
T A I LIEU THAM K H A O
1. Truang Dgi hoe Y Ha Npi - Bp mdn Phy san.
(1999/ Bii giang san phu khoa. Uha xult ban Y hpc, Ha Npi, tr.26-31.
2 Nguyen Hong Phuang (2000). Nghien cuv tinh hinh RTD vi cic yeu td lien quan tai Vidn BVBMTSS tmng 3 nam 1997-2000. Lugn van tot nghiep Thgc sT.
TorPng Dpi hpc Y Ha Ndi.
3. TruPng Dai hpe Y Duac Thdnh pho Hd Chi Minh - Bg mdn Phy san (1996), Bai giing sin phu khoa. Nha xult ban Y hoe. Ha Npi, tr. 405 - 410.
4 Nguyen Bi>c Hinh (1999). So sanh m l lay thai vi RTD d 2 giai dopn 1989-1990 va 1993-1994 tai vipn BVBMTSS. Tap chi Thong tin Y Dwgc, So ddc bi$t chuydn dd Sin phu khoa. 12, tr. 107-111.
5. LP Diem (1985). Tinh hinh m l lly thai tai Benh vipn Phy san Hai Phdng thdng 6/80 - 6/85. Cong trlnh NCKH 5 nam phu sin so sinh vi KHHGO, BVPS Hal phdng, 1. tr. 56-63 .
6. Pham Thu Xanh (2006). Nh$n xet tinh hinh sin phu cd seo md de cu dwgc xi> tri tai BVPSTW trong nam 1995 va 2005. Luan van tdt nghipp BSCK II, Tnjong Dgi hoc Y Hd Npi.
7. NguyPn Thj Thdm (2002). Nghien cuv cac yiu to lien quan den each de d san phu cd seo MLT mgt lin tai Benh vidn Phu san Tmng wong tmng 3 nam 2000-2002.
Lupn vdn tot nghipp thpc sy Y khoa TruPng Dgi hgc Y Ha Npi.
8. Phan TruPng Duypt - D i n h The My (1999) Ldm sang sin phu khoa. Nhd xult ban Y hgc Ha Ngi, 102-
DANH GIA KET QUA DIEU TRI VO BANG QUANG DON THUAN TRONG PHUC MAC B A N G PHAU THUAT NOI SOI 0 BUNG TAI BENH VIEN VIET TIER HAI PHONG
T6M TAT
Myc tieu. Dinh gii kit qui <fiiu tri khiu bing quang v& don thuin trong phuc m$c bdng phiu thudt ndi soi 6 bung. Doi twgng vi phuxmg phip nghidn cO'u: Nghidn cOv hdi ciru 25 tnrdng hgp vd bing quang don thuin trong phuc m$c dwac phiu thudt ndi soi tw thdng 08/2012 din thing 06/2014. Kit qui: Tudi trung binh ta 30,86 tudi. Thinh cdng chiim tp Id 92 %. Thdi gian md trung binh li 110±12 phOt Thdi gian nim vi$n tmng binh Id 7,8 ngiy. 06 3 trwdng hgp kdm tdn thwong rich thanh mac d^i tring Sigma, 2 trwdng hgp kdm vd bdng quang ngodi phOc mgc. 1 trwdng hgp v& khung chdu. Khdng tai biin vd biin ChOng tmng vd sau phiu thuit. Thdi gian rOt thdng nidu dgo - bing quang tmng blnh 9±1,5 ngdy, khdng cd bdnh nhdn ndo can md thong bing quang trdnxwangmusauphiu thudt. Kit lu$n:Phiu thuit ndi soi khiu 16 thung bdng quang li mdt phiu thudt an toan, hiiu qui, it xim lin, cd tinh wu vidt cao ndn dwgc ii/a chgn.
TIP khda: Bdng quang, phiu thudt ndi soi.
SUMMARY
Objectives: to evaluated treatment of traumatic isolated intraperitoneal bladder rupture by lapamscopic surgery. Materials and Methods:
Prospective study was conducted on 25 cases of intraperitoneal bladder rupture post trauma from april 2012 to June 2014 at Viet Tiep Hospital Results: The average age was 30.86 years. The Successesful rate is 92 %. Time operation is : 110±12 mins, gas after 12-36h. Postoperation stay was 7.8 days. There was no intra- or postoperative complications There is 3 cases with a torn at serosa of sigmoid colon, 2 cases
B O I VAN CHIEN Benh vien Vidt Tiep Hii Phdng with the bladder rupture extraperitoneal and one case broken pelvis. There aren't complications during and after surgery. Foley catheter were removed on 9±1.5 days, postoperation without any suprapubic catheter.
Conclusion: Treatment of traumatic isolated intraperitoneal bladder rupture by laparoscopic is safe and effective.
Keywords: Bladder, laparoscopic surgery.
DAT VAN De
Bdng quang dupe khung xuang ehpu bao vp n&n khi eP c h i n thuang viing bung, bdng quang Id tang It bj ton thuang nhat. Tuy vay. khi bdng quang P trang thdi cdng d l y . vPi mpt lye tac ddng trye tiep hodc gidn t i l p bang quang r l t d l vp vdo trong phiic mpc [9]. Bpnh nhan thuPng vdo vipn vpl benh canh eiia da c h i n thuang lam cho cdc tripu chii-ng eua vd bdng quang bj ehe l i p . Vi vay, c h i n dodn thuPng chpm. ^ l u trj chii yeu bdng mo mo'.
Tuy nhlPn vPi s y phdt then ciia phdu thudt npi soi hipn nay, dde biet Id phdu thupt npi soi t i l t nieu, khau bdng quang vP qua npi soi 6 byng da dpt dupe nhO'ng k i t qua t i t . Dd cd nhilu bdi bdo trong vd ngodi nuPe ve c h i n dodn vd d i l u trj vd" bdng quang bang p h i u thuat npi soi eho k i t qud r l t tot. Ddy Id mot p h i u thuat hipu qua. it xdm hpi, eP t h i kiem sodt duac ton thuang cdc tpng khac kdm theo ma khdng bo sdt t i n thuang.
Tpi Vipt Nam. NguyPn Tang MlPn Id nguPi d i u tiPn khdu bdng quang vd' b i n g npi soi vdo nam 2004 [11]. TO' ndm 2008. Bpnh vipn Vipt Tipp Hai Phdng eung dS dp dung ky thupt khau bdng quang qua npi soi 6 byng, nhung chua ed 6e tdi nghiPn euu hp thing ndo. Chinh vi v$y chiing tPi t i l n hdnh nghiPn
y HOC THVt HANH (948) - SO 1/2015
