NGHIEN COU DAC DIEM LAM SANG VA CAN LAM SANG TREN BENH NHAN THOAT Vi DiA DEM COT SONG THAT LUNG DliU TRI TAI BENH VllN 103 NAM 2013
T6M TAT
Myc tidu: Md td t^c dlSm Idm sdng thAn Idnh, hinh dnh cdng budng tir (MRI) d benh nhan tiioat vi dia d$m cdt sdng tilSt lung (TVDDCSTL). Doi tuqmg vi phuvng phdp: Nghidn cdv tlSn eiru, phdn tieh, md td cSt ngang vd so sdnh d 50 bdnh nhan chin dodn TV£>DCSTL. B$nb nhdn diSu tq (g/ khoa Ngi tiian kinh, B$nh vl$n 103 td thdng 3/2013 dSn thdng 8/2013. Ket qud: Tu6l trung blnh cda b$nh nhdn trong nghien ciru Id 49,32± 9,52. T^ 10 nO/nam 1,5/1. Tneu cbung dau lan dQC theo thiin kinh bdng to g$p d 100% bdnb nhdn TVDDCSTL. Tri$u chdng eOa hoi chung cdt sdng tbit lung: Cd diSm dau cdt ^ng (96,0%). Tneu ebdng cda bgi c/idng r§ thin kinb thdt lung-cdng: ed diim dau canh sdng (chiim 88,0%). Trdn phim cdng budng tir.
t^ Id bdnh nhdn thodt vj 1 dia dem gdp nhieu nhit (62,0%>). Binh nhdn thodt vi nhieu dia d$m ehiim 38,0%, tmng dd chd yiu g$p thodt vi dia ddm L4-L5 vd L5-S1 (chidm 32,0%). Thi TVDDCSTL bay g$p Id tbi ra sau, l$ch bdn (ehiim 70,0%). ChO yiu g$p tdn thuang cd mOc dd bep ing song mdt phin. chiim 60,0%). Kit lu^n: Trtiu chdng ehd ydu cOa TV£>DCSTL gdm: Dau lan dge thin kinb hdng to, ed aim dau cdt s6ng, diim dau c^nh cdt sing. Trdn phim MRI: ChO yiu thodt vi 1 dia d$m, thi bay g$p nbit Id thi ra sau, l^ch bdn.
Tir khod: d$c diim ldm sdng, btnh dnh cdng hudmg td, thodt vi dia d$m edt s6ng thdt lung.
SUMMARY
STUDY ON CLINICAL AND PARACLINICAL FEATURES ON PATIENTS WITH LUMBAR DISK HERNIATIONS TREATED AT 103 HOSPITAL, 2013
Objective: to describe neurological clinical features, magnetic resonance imaging (MRI) in patients with lumbar disk herniations (LDH). Subjects and Methods: a prospective study with analysis, cross-sectional descriptive study and comparison among 50 patients diagnosed LDH. Patients treated at the Department of Neurology, 103 Hospital from Mar to Aug 2013. Results: mean age of patients in the study was 49.32 ± 9.52. Female/male ratio was 1.5/1. Pain spreading along the sciatic nerve was occurred in 100% of LDH patients Symptoms of lumbar spine syndmme: ^inal pain points (96.0%). Symptoms of lumbar - sacral nerve root syndrome: Paravertebral pain points (accounting for 88.0%). On magnetic msonance imaging (MRI): the rate of patient who had only a hemiated disc was the highest (62.0%). Patients with multiple hemiated discs accounted for 38.0%, mainly having hemiated disc at L4-L5 and L5-S1 (accounting for 32.0%). The most common type of LDH was Postero-lateral lesion (accounting for 70.0%).
Partially spinal stenosis was the most common level.
DUONG TIEN THANH* DIEM O A N G THANH**
* B f i Yte, **B$nh vl$n 110 accounting h)r 60.0%. Conclusions: mainly s^Tpt<Mns of LDH include: pain spreading along the saatie nerve, spinal pain poirits, paravertebral pain points. On MRI:
mostly only a hemiated disc, postero-lateml lesion was the most common.
Keywords: clinical featu'ms. magnetic resonance imaging, lumbar disk herniation.
DATVAND^
Thoat vj dTa dfim cdt sdng t h i t lung fWDOCSTL) Id mdt bfinh ly tiiudng gdp. chilm da so cdc Imdng hgp phai d i l u tri do dau lifin quan tdi bgnh ly d t sing tiilt lung (CSTL). Nhieu tdc gia nhdn tiily TVDDCSTL gdp d mgi Ida t u l i . thudng tdp trung cao nhat d dd tudi < 50, day Id Ida tuoi con ngudi dang tiang thdi ky lao ddng nhieu nhlt. Dong thdi d t sing that lung giai dogn ndy thudng xuyfin phdi chju nhdng tai tigng Idn vd vdn ddng qud mdc vdi nhung t u U i l bat thudng ddt ngdt gay dnh hudng d i n chit lugng cude sing vd giam kha nang lao ddng.
TVDDCSTL ed bilu hifin Idm sdng r l t da dgng, ngdy nay vdi sg tiln bd cCIa khoa hgc ky thufit. y hgc dd cd nhilu phuang lign hifin dgi ( d n g hudng t d , d t Idp vi tinh, chgp bao r l ddy Ihln kinh...) giiip cdc bdc s? Idm sdng c h i n dodn sdm vd Iga chgn phuang phdp dilu tii dOnq d i n , hifiu qud cao tiong dd ed d n g hudng td eho Uiay hinh dnh tn/c tilp eCia thodt v\ dta dfim vd Id ky tiiudt d i l n dodn cd uu t h l nhlt d l i vdi TVDDCSTL. Vi vdy chung tdi tiln hdnh d l tdi'
"Nghidn cdv ddc diem Idm sdng vd cdn idm sdng trdn b§nh nhdn'thdat vj dia d^m c^t song that lung diiu tri tai Bdnh vien 103 ndm 2013", nhlm mgc tifiu:
- JWd ta d$c d/lm ldm sdng thin kinh, hinh dnh cdng hudng tir d b$nh nhdn thdat vi dia ddm cdt sdng thdt lung.
D 6 1 TUgUG, PHU'aNG PHAP NGHIEN CU'U 1. Bdi t u a n g nghien cuu : Gdm 50 b$nh nhdn chin dodn TVDDCSTL
Tidu chuin chgn b$nh nhdn nghidn cOv: Bfinh nhan chin doan TVDDCSTL vdi:
- Tieu chuin lam sdng (theo Sapo(aJ;BN ed t d 4 trieu chdng tid Ifin trong 6 trifiu chdng sau Ihl duge chan dodn la thoat vj dTa dfim'
. Cd yeu t l chan thuang CSTL
. Dau d t sdng tiilt lung lan theo dudng di cua rfi, ddy t h i n kinh hdng to.
. Dau CSTL cd tinh chat ca hgc.
Lfich, vgo d l sdng.
. D l u hifiu chudng bIm duang linh.
. D l u higu Lasfigue duang tinh.
- Tidu chuin chin dodn blnh dnh. (chijp edng hu'dng td) Tifiu chuan c h i n dodn TVDDCSTL tifin phim MRI g i m :
+ Hgp chieu cao khoang gian ddt
Y HOC THUC HANH (927) - S6 8/2014
+ Giam tin hifiu dTa dem trfin xung T2W + Nhdn nhay dTa dem di lfich khoi vj ti-i binh tiiudng - ra phia sau
+ Trifiu Chung lam sang phO hgp vdi hinh anh cdng hudng td v l i^nh khu.
2. Phuang phdp nghien c u u
Tien hdnh nghien cdu tiln cdu, phan tieh, md ta d t ngang, so sanh.
3. Dja d i l m va t h d i gian nghien euu Bfinh nhan dieu tri tai khoa Ndi I h l n kinh Benh vifin 103 I d thang 3/2013 den thdng 8/2013
K t T QUA NGHIEN CU'U
1. Dac d i l m chung cua nhdm nghien c d u Bang 1. Phan bd tiieo tuoi
Nhom tuoi
< 2 0 2 1 - 4 0 4 1 - 5 0 5 1 - 6 0
>60 X ± S D
Nliom benli nlian c o T V D D
(n = 50) So lyp-ng
2 8 16 15 9
T y l ? {%) 4,0 16.0 32,0 30.0 18.0 49,32 ± 9,52
Nhom chung khdng cd TV£>D
(n =30) S6 l u a n g
22 3 2 3
T y l e
(%)
0 73,33
10,0 6.67 10,0 39,67 ± 8,04
P
<0,05
Nhan xdt: Tuoi trung binh nhdm bfinh nhdn TVDDCSTL trong nghifin cdu la 49,32± 9,52, trong do tudi eao nhat la 75, tudi thap nhat la 19. Benh nhan chu yeu d Ida tudi lao ddng, < 60 tuoi chiem ty lfi 82,0%, nhom tuoi > 60 cd ty le thap nhat 18,0%.
Tuoi trung binh nhdm chdng la 39,67 ±8,04, chu yeu Id Ida tudi lao ddng < 60 ludi chiem 90,0%, So sanh tudi giua 2 nhdm khdng cd su khdc biet co y nghTa thdng ke vdi p < 0,05.
Phdn bo theo gidi d bfinh nhan TVDD, Trong nhdm benh nhan: nam chiem 40,0% nu 60,0%
Bang 2. Phdn bd n g h l nghifip trong nhdm nghien cuu
Nghe nghiep
Lao dpng clian tav Lao dpng tri
6c Cgng
Nhom b$nh nhan cd T V D D
(n = 50) So lipgnq
29 21 50
T y l $
(%)
58,0 42,0 100,0
Nhom chLrng khong c6 T V D D
(n =30) So iLcanq
10 20 30
T y l e
(%)
33,33 66,67 100,0
P
>0,05
Nhan xet: Trong mau nghien cdu, nhdm bfinh nhan TV€)DCSTL cd nghe nghiep la lao ddng chan tay chiem ty le cao han 58,0%, lao dgng tri dc 42,0%. TT le nhom bfinh va nhdm chdng khac biet khdng cd y nghTa thong kfi,
2. Dae diem lam sang
Bang 3. Phan bd benh nhan TVDDCSTL theo thdi gian mdc benh (n = 50)
T h o i qian mac benh
< 6 thanq 6 t h ^ n g - 1 2 t h a n g 12 t h a n g - 2 4 thang
> 24 thanq Tonq
So i i r g n q 16 4 9 21 50
T y i $ ( % } 32,0
8,0 18,0 42,0 100,0
Nh$n xet TTidi gian mac bfinh < 6 tiidng g ^ 32,0%; benh nhan m l c benh > 6 tiidng gdp 68,0%.
Trong dd m l c bfinh >24 thdng gap 42,0%
Bang 4. Dac diem trieu chung dau (n = 50) 1 J Dge diem tri&u chiJng dau
Ban lan doc theo than kinh hong lo
Tinh chat dau
Cudng do dau tinh theo (VAS)
Dau khi nghi ngai
Ngng Rat ngng
S6 lugng I Ty Ifi (%
100,0:
6.0 Nhdn xet: Trifiu chdng ea nang noi bat la dau lan doc Itieo than kinh hdng to gap d 100% bfinh TVE)DCSTL, dau khi nghi ngai gap 72,0%, dau lifin tyc gap 52,0%, dau tang khi van ddng, ho h l l hoi g^p 84,0%
Cudng do dau tinh theo {VAS)ehu y l u gap d mi>c do dau vda chiem 76,0%, nang chilm 16,0% va rlt nang chi chilm 6,0%
Bang 5. Dac diem hdi chdng cdt sdng that lung Tri0u c h u n q that lunq
Oiem dau CS
1 diem
>1 diem C o ci>nq c a cgnh sfinq Thay ddi
du'd'ng cong smh
ly L§ch veo
CS Chi so Schober
(+)
Giam den mat d u d n g cong S L D u a n g cong S L d a o
nqu'gc V e o C S < 1 0 ' ' V e o C S a 1 0 ' ' - 2 0 "
V e o C S > 2 0 "
T u 1 2 / 1 0 d f i n < 1 4 / 1 0 TCF 10/10 d e n <12/10
So L u g n q 30 18 4 4 4 0 0 29 11 1 31 13
Ty L# % 60,0 36,0 88,0 80,0 0 58,0 22,0 2,0 62,0 26,0 Nhdn xet: Tneu chdng that lung thudng gdp nhSt la diem dau cdi song thdt lung cao nhlt (96.0%), c6 co cung cot song gap 88,0%. Thay doi dudng eong sinh ly CSTL gap d 80,0% deu la mdc dd giam din m^t dudng cong smh ly. Vd Ifich veo cot sdng ehii yeu gSp d mdc veo cdt song > 20° la 80,0%. veo d t song 22(r chi gap 2,0%. Chi so Schober (+) gdp 88.6% tiong (16 t d 10/10 - <12/10 ehilm 26,0%
Bang 6. Dac diem hdi chdng rfi t h i n kinh thit lirng - cung (n = 50)
Tneu chu'nq t h ^ c t h ^ Diem dau canh sonq Dau hieu chuonq bSm (+) D^u hi^u Vaiieix
(+) D l u hi^u Lasegue
(+)
B6n phai:
B§n tr^i.
2 b S n Ben phai:
Ben [rdi- 2 ben
So l i f c n q 4 4 25 14 20 10 14 20 8
T ¥ l « % 88,0 50,0 28,0 40.0 20,0 28,0 40,0 16,0
Y HOC T H i ; c HANH (927>- S 6 8/2014
Nhin xii Didm dau canh s6ng (+) g$p chO yiu chiim 88,0%. Dliu hi$u Las4gue(+) c6 ty 1^ cao nhfc 84,0%, diu hi$u chuOng bSm c6 t^ 1$ (80,0%). Ddu hi^u Valleix (+) chidm 84,0%.
Bdng 7. C i c r i i loan chuc nanq r§ t h i n kinh (n=501 Tri$u chuTn rdi logn chdc ndng
rfi thin kinh Rfii k)gn v9n ddnq
Rdi k)an phan xg Rdi kign dinh dufrnq teo co
Rdi k)an cam gidc
S l luong 26 17 7 14
Tylfi%
52.0 34,0 14.0 28.0 Nh^n xdt: G$p nhilu nhat Id tiigu chdng r l i logn v$n ddng chilm 52,0%, vd r l i logn cam gidc chilm 28,0%. It g^p nhlt Id trieu chdng rdi loan dinh dudng teo ca chilm 14,0%
3.0$c d i l m c$n lam sang
Bang 8. Ddc d i l m till TVDDCSTL ti'dn hinh anh MRI (n = " "
O^c diem Ra sau trung tSm Ra sau ifdi pliai Ra sau lech trai
T6ng
Sd lup'ng 15 16 19 50
TylS(%) 30,0 32,0 38,0 100,0 Nhin xii: Thd TV BBCSTL hay gSp la thd ra sau
$ch bgn chidm 70,0% trong dd ra sau jgch trdi 1^
38,0%, ra sau Idch phSi 1^ 32,0%
Bdng 9. Sd luffng dTa a§m thoa vi trSn IMRI B$cai6m
£3(ITa
&2dia IdIa tdng
86 liro'ng 1 16 33 50
Tyl«(%) 2.0 32,0 66,0 100,0 Nhin xit: Chd ydu gap TVDOCSTL v i i 1 dia a ^m chidm 66,0% vin cac tnrd'ng hep thoat vj nhidu dTa ddm thl chu ydu la 2 dTa d#m chidm 32,0%
BSng 10. DSc d l l m vj tri TVDDCSTL tr6n hinh Snh MRI (n = 501
VitriaradSmTV IdladOm
2 dTa ddm 3 dia ddm
L3-L4 Li-U
u-s,
L3.4- L4,5 Lis. US, L3,4- L4.5-L5S1 Tdng
Sd iup-nq 0 23 8 2 16 1 50
Tyld(%) 0 46.0 16.0 4 32.0
2.0 100,0 Nh$n xdt: T9 Ifi bfinh nhdn thodt vi 1 dta dfim gdp nhilu nhlt chilm 62.0% trong dd ehu y l u Id thodt vj dTa d§m L4-L5 chilm 46,0%
B$nh nhdn thodt vj nhilu dTa dfim chilm 38,0%
trong dd chu y l u g$p tiiodt vj dTa dfim L4,5 vd LS-S1 chilm 32,0%.
BAN LUAN VA K£T LUAN
* D^c aim vi tuii vd gidi tinh.
Kit qud cho thly tuli tiung blnh nhdm bfinh nhdn TVDDCSTL tiong nghifin edu Id 49,32± 9,52, trong dd hj|i cao nhlt Id 75, tuli tiilp nhlt Id 19. Bfinh nhdn ChO y l u d Ida h j l i lao ddng < 60 t u l i chilm 82,0%.
nhdm h j l i > 60 cd ty Ifi tiilp nhlt 18%. K i t qua ndy phii h^p vdi Bill Quang Tuyln (77,7%), Nguyin Vdn Chuang. (67,7%), R. Prasad (89,4%). TJ Ifi nd/ nam 1,5/1. D$c dilm v l gidl khdng phdi Id d^c dilm rifing
cOa TVDDCSR. Nhu v§y. ca nam gidi vd nu gidi d l u cd nguy ea m l c b ^ h nhu nhau.
* D^ aim tridu chdng Oau d bdnb ty TVDDCSJl.
Trong nghifin edu ehung tdi thly dau lan dpc theo than kinh hdng to gap d 100% bfinh nhdn TVE)DCSTL.
Tinh chit dau gap bfinh nhdn TVDDCSTL dd Id: dau lifin ti,jc gdp chu y l u chilm 52,0%, dau tdng khi ho h i t hai chilm 84,0%, dau khi van ddng di Igi 16.0%
* Ddc aim hdi chdng cot song tbit lung.
Cdc tilfiu chdng cOa hdi chung cdt sdng tiiat lung da duvc xdc djnh Id: ed d l l m dau cdt sdng bong nghien ci>u (^a ehung tdi gap 96,0%, trong dd dau 1 diem chilm 60.0% vd dau >1 diem Id 36.0%.
Biln dang cdt s i n g tiiat lung: cd t h l mat hay dao nguve dudng eong sinh ly. gU. lech, vgo cdi sing tiilt lung d cdc t u the khdc nhau (thing, nghieng).Tuy nhifin trong nghifin edu ehung tdi cd gdp cac tiudng hap tiiay doi dudng eong sinh ly edt sing ehilm 80.0% nhung deu g$p cdc trudng hp'p vdi bilu hifin giam d i n mat dudng cong sinh IJ. khdng cd tiudng hap ndo ed b i l u hifin dudng cong sinh IJ dao ngup^.
* D$e aim hdi chdng ri than kinh that tung - cdng.
Trong nghifin cdu ehung tdi nhfin thly cde hdJ chdng trifiu chdng r l t h i n kinh tiilt lung - eOng g$p d nhdm bfinh nhdn TVDDCSTL dd Id: dilm dau cgnh sing (+) g^p ehu y l u chilm 88.0%.
Hdi Chung r l than kinh tiilt lung eOng da dug^ cdc tac gia tiling nhlt bao gdm tiang dd Id nhdm trifiu chdng, d l u hifiu kich thich r l (dilm dau cgnh cdt song, d l u hifiu "Chudng b I m ' . dilm dau Valleix. d l u hifiu Lasfigue...) vd t i n thuang chdc ndng r l Ihln kinh (giam v$n ddng, cdm gidc, phan xg, dinh dudng).
* Ddc aim vi td vd si lu%mg cffa d$m thodt vi trdn phim CHT.
Trong nghifin cdu chdng tdi g$p tJ lfi bfinh nhdn thodt vj 1 dTa dfim g$p nhilu nhlt chilm 62,0% trong dd chO y l u Id thodt vj dTa d^m L4-L5 chilm 46,0%.
Bfinh nhdn thodt vj nhilu dTa dfim chilm 38,0% trong dd ehu y l u g$p tiiodt vi dTa dfim L4-L5 vd L5-S1 chilm 32,0%
' Thi thodt vi aa d$m cdt sing thit lung trdn hinb dnh CHT.
Trong nghjfin cdu chOng tdi thly t h l TVDDCSTL hay g$p Id t h l ra sau lfich bfin chiem 70,0% trong dd ra sau Ifieh b^i Id 38.0%, ra sau Ifieh phdi Id 32,0%, t h l thodt VI dTa dem ra sau tmng tdm chilm 30,0%. Kit qua phCi hgp vdi cdc tde gia.
* Mdc dd bep 6ng song theo tidu chuin Torg trdn binb dnh CHT
CJ bfinh nhan TV €)DCSTL trfin phim MRI chO y l u g^p t i n thuang cd mdc dd hgp mdt phan ehilm 60,0%, ed 32,0% dng s i n g khdng hgp vd cd 8,0% I n g sdng ti^p hodn todn, ddy Id dau hifiu cd tifin lup'ng bfinh n§ng.
TAI LIEU THAM K H A O
1. VQ Quang Bich (1992), 'Phong vd chda cdc chdng dau lung'. Nhd xuat ban Y hpc. Ha Npi, Trang 15-46.
2. Vu Quang Bich. Nguyin Xudn Than. Ngd Thanh Hoi (1985). DTa dfim cdt sing va phuang phdp chgp dTa dfim. Hoc Vifin Qudn Y, ti 12 - 17.
3. VO Quang Bich (1991). "Oau thit lung vd tiiodt vj
Y Hpc THVC HANH (927) - S6 8/2014
dia dfim CQt song that lung', (1), Bai grang den/i hoc than kinb sau dai hoc, Hpc \fifin Quan Y. tr. 341- 356.
4. Thdi Khdc^Chau (1997). "X quang cdt sdng" Cdc phuong pbdp chin dodn bo tia than kinb. Hoc Vien Quan Y, ti. 23- 52.
5. Thdi Khac Chau (2005),' Giao tiinh X guang'.
Gido tiinh giang dgy sau dai hoc, Nhd xult ban Quan dd' nhfin dan, Hd Npi. ti. 220-233.
6. Nguyin Ngoc Chdu (2012). Nghien cdv ndng dd TNF -a va IL -lfi tren b$nb nhdn thoai bda khdp
7. Nguyen Vdn Chuong ^004), ' T h u c hdnh ldm sdng than kinh hpc', (1). Khmi Idm sdng tiian kinb. Nhd xuat ban Y hpc.
8. Nguyen Van Chuang (2004), ' T h y c hfinh Idftf' sang tiian kinh hpc". (2), Tridu (^Ong bgc. Nhd xui* bSn Y hoc, Trang 218-223.
9. Nguyen Van Chuang (2008), 'Thue hanh lam sdng tiian kinh hpc', (3). Benh hoc thin kinh, Nhd xuat ban Y hpc. trang 320-337.
THlfC TRANG HOAT DONG CHAM SOC NGUldl BENH CUA DIEU DODNG VIEN TAI BENH VIEN NGUYEN DJNH CHIEU TINH BEN TRE. NAM 2014
N G U Y I N TH! THUY TRAM- BV Nguyin Dinh Chieu, tinh Bin Tre LA NGOC QUANG - Tnrdng Dai hgc Y te cong c^ng T6M TAT
Nghidn cdv md td cat ngang duae tien bdnh tu- tbdng 11/2013 din thdng 7/2014 tree 213 diiu duang vien tn/c tiip chdm sde ngudi bdnh tai 10 kboa Idm sdng cOa Bdnh vi$n Nguydn Dinh Chieu, tinh Ben Tre.
Phuang phdp quan sdt tnje tiip va gian tiep qua hi so b$nh dn ddQC sd dung de ddnh gid vide thuc bien 12 nhiem vu eOa diiu duang vidn.
Kit qud cho thiy, cd 7/12 nhiem vij duoc aiu dudng vidn thuc bidn dat tir 71,4%) din 89,2%i. Chiim f^
1$ thdp Id dii vdi nhidm vy tw van. birdng ddn gido due sdc khde vd cbSm sdc ve sinh cd nhdn cbo ngudi bdnh (20.2%, vd 27,2%); ddnh gid chung ve mdc dd hodn thdnh 12 nbi$m vy cOa aiu duang vien Id 60,6%.
Khuyin nghi ca bdn eOa nghidn cdu la benh vi$n cin cd ki ho^ch ddo (go de cap nhat kiin thuc, nang cao ky ndng thi/c hdnh cho diiu duang vien. chO trong ddi tuQfng aiu duang vidn tre. mdi duoc tuyen dung.
Tii" khda: Diiu dudng vien, cham sdc ngudi benh, Binh vi$n NguySn Dinh Chiiu.
SUMMARY
PATIENT N U R S I N G C A R E O F N U R S E S A T NGUYEN DINH CHIEU HOSPITAL, BEN TRE PROVINCE IN 2014
Cmss-seetional descriptive study was conducted on 213 staff nurses fmm November 2013 to July 2014 at 10 clinical departments of Nguyen Dinh Chieu hospital. Ben Tre province. Direct observations and Indirect obseri/ations through patient records were used to assess the perfonnanee of 12 nursing tasks of nursing care.
Study msults showed that, nurses had completed 7/12 nursing tasks from 71.4%> to 89.2%. Health educational counseling and personal hygiene care for patients were completed with very low rate by nurses (20.2% vd 27.2%). Ovemll assessment of the level of completion of 12 tasks of nursing eare was 60.6%.
Main recommendation of study is that hospitals should have a training plan to upgrade knowledge, practical skills of nurses, with focused to young and new employed nurses.
Keywords: Nurse, patient nursing eare, Nguyen Dinh Chieu Hospital
DATVAND£
Niiifim vg chuyfin mdn eua DDV la ehu dpng tiong ehdm sdc n h l m ddp dng cdc nhu d u cDa ngudi bfinh vd p h i i hqrp vdi cdc nhan vifin y t l khde d l bao dam ngudi bfinh nhgn d u p ^ djch vu cham sde vdi chit lup'ng cao nhat, an loan va tien nghi nhat.
Trong chiln lug-c phdt trien cdng tac d i l u dudng, hd sinh ndm 2002-2008. T l chdc Y te t h l gidi (WHO) da khing ^ n h : djch vu do dieu dudng vifin, hd sinfi vifin cung e i p Id mdt trong nhung tnj cot cua hfi tiling djch vy y t l [2]. Kinh le ngay cdng phdt triln, nh|n thdc vd thdi dd v l sdc khde cua ngudi dan thay ddi, ddi hdi phai tdng cudng chuan muc chdm sdc cOa DDV. Thdng t u so 07/2011/TT-BYT Hudng d i n edng tde d i l u dudng v l chdm sdc ngudi bfinh trong bfinh vifin. dup'c ban hdnh ngdy 26/01/2011 vdi nguyfin tic:
Ngudi bfinh Id trung tam cua edng tdc cham sdc nfin phai dagrc ehdm sde loan difin. bao dam hdi Idng. chit lup'ng vd an todn [1]. Thdng t u cung quy djnh cy till v l 12 nhifim vy chuyfin mdn cham sdc ngudi bfinh cua DDV. d i l u ndy se tung budc cai thien edng tdc dieu dudng v l ehdm sde ngudi bfinh, gdp phln ndng cao c h i t lup'ng chdm sdc vd s u hai Idng cua ngudi bfinh.
Benh vifin Nguyin Dinh Chilu tinh Ben Tre Id bfinh vifin Da khoa tuyen tinh hgng 2. Nam 2013, sd giudng benh ke hogch Id 1000 giudng. sd giudng bfinh thyc kfi Id 1.094, vdl 06 phdng chdc nang, 18 khoa ISm sdng vd 09 khoa can Idm sdng. Bfinh vien bat dlu dp dung md hinh CSNB todn difin t u ndm 2003, chit lup'ng CSNB ngdy edng duae ndng Ifin. Tuy nhifin, do tinh trang Ihilu nhdn luc bac sT vd sy qud lai eye bd lgi mdl s i khoa Idm sdng dd lam tang dp lye cdng v l ^ eho ddi ngQ d i l u dudng, d i n den mdt s l nhu clu cln ehdm sdc d i l u dudng chua dugc DDV ddp dng dly dO. Bdi bdo nay n h l m md ta thyc tigng vific thyc hifin cdc nhi$m vy chdm sdc ngudi bfinh eija dilu dufing vien tgi Bfinh vifin Nguyfin Dinh Chilu finh Bin Tre ndm 2014.
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