C I E L A B T o o t h Colour M e a s u r e m e n t s C o m p a r i n g C o n t a c t a n d Non-Contact Clinical M e t h o d s , The 83rd General Session of the lADR.
5. Odioso L L , G i b b R.D., G e r i a c h R.W. (2000).
Impact o f d e m o g r a p h i c , b e h a v i o u r a l , a n d d e n t a l c a r e utilization p a r a m e t e r s o n t o o t h color a n d p e r s o n a l satisfaction. Compendium of Continuing Education in Dentistry. 2^, 35-4^.
6 C h o B.H., Lim Y.K., L e e Y.K. (2007), C o m p a n s o n o f the color o f natural teeth m e a s u r e d b y a colorimeter a n d S h a d e Vision S y s t e m , Dental Materials, 2 3 , 1 3 0 7 - 1312,
7. G o o d a c r e C.J., S a g e l P.A. (2011). Dental Esthetics
in Practice: Part 3 - Understanding Color & S/jacfe Selection, 2 - 1 1 .
8 . F o n d r i e s t J . ( 2 0 0 3 ) . S h a d e m a t c h i n g in restorative dentistry: t h e s c i e n c e a n d s t r a t e g i e s , The International joumal of periodontics & restorative dentistry. 23(5). 467 - 4 7 9 .
9. Z h a o Y . . Z h u J . ( 1 9 9 8 ) , In v i v o c o l o r measurement o f 4 1 0 maxillary a n t e r i o r t e e t h . The Chinese Joumal of Dental Research, 3. 4 9 - 5 1 .
l O . C h u S.J., D e v i g u s A . , P a r a v i n a R. e t a l (2010), Fundamentals of Color Shade Matching and Communication in Esthetic Dentistry, S e c o n d Edition, Q u i n t e s s e n c e P u b l i s h i n g . 2 3 - 7 2 .
MOT SO DAC DIEM LAM SANG, CAN LAM SANG UNG THI/PHE QUAN PHOI TAI BENH VIEN DAI HOC Y HA NOI
TOM T A T
Nghidn cuv dux?c thwc hiin nhim dinh gii mdt so dac diem lam sing, can lam sang ung thw phi quan phii tai Binh vien Dai hoc Y Hi Nfyi. Kit qui cho thay dau ngwc vi ho khan keo dai la trieu ch&ng lim sang chiem chO yiu v&i 75.9% va 34,5%. 62,5% giai nam hot thuoc; 69% u phdi phii, u kich thu&c 3-7cm chiim da so 55,2%; u giai do^n IV chiem cao nhit vdi 63,8%.
trong dd 49,5% di cSn phdi doi ben, 43,2% di can xuung, 16,2% di cin nao; Khdng cd swlien quan giifa the md b$nh hoc vdi tinh trang hut thuoc.
Tir khda: Ung thw phe quan phoi. lim sing, cin lim sing
S U M M A R Y
TO E V A L U A T E T H E C L I N I C A L - P A T H O L O G Y CHARACTERISTICS OF L U N G C A N C E R IN HANOI MEDICAL UNIVERSITY H O S P I T A L
The study was to evaluate some of clinical pathology characteristics of lung cancer The results showed that chest pain and cough were the most common with 75.9% and 34.5%. There were 62.5 % male smoker. 69% right lung cancer The majority diameter tumor was 3-7cm with 55.2%. Stage IV occupied highest with 63.8% inwhich 49.5%
contralateral lung metastases. 43.2% bone metastases, 16.2% brain metastases. There was no significant relation between histopathology with smoking status.
Keywords: lung cancer, non-small cell, clinic- pathology characteristis
DAT V A N De
Tai Viet Nam ung thu phe quan phdi ddng dau d nam gidi vd ddng thd 3 d nd gidi, ty le mac d nam vd ny tyang dng la 35,1 va 13,9/ 100.000 dan. UTPQP tien lyang x l u vdi nhyng dac diem t i l n trien nhanh, ty Id t d vong cao lai thydng chi phat hien d giai doan mudn. Vide chin doan benh t d giai doan sdm ddng vai trd quan trpng trong k i t qua d i l u tri.
Tai Vigt Nam, nghien edu v l UTPQP khd nhieu
NGUYEN TH! THU HUdNG, LE V A N QUANG Truwig Dai hgc Y Hi Ngi song chu yeu tdp trung ddnh gid ket qua dilu tri vd gia tri cac phuang phdp chan dodn, nghidn cdu v l dac diem bgnh chya nhieu. Tai Benh vign Dai hpc Y HS Ndi vide c h i n dodn vd dieu trj ung thy phdi dang phat triln manh, vide thyc hien mot nghien cdu ddnh giS tinh hinh bgnh tai day la rat can thilL Vi the nghign cdu nay dypc thyc hien nhdm danh gid mdt so d§c
^ I m ung thy b i l u md p h i quan phdi tgi Benh vien Dai hoc Y Ha Npi,
D 6 | TU'ONG VA PHU'aNG P H A P Ddi t y p ' n g :
Bdnh nhdn (BN) dyp-c c h i n dodn md bdnh hpc IS ung thy b i l u md phe quan phdi.
Thiet kd nghien cu'u; nghidn cdu hdi cdu tren 58 benh nhan iSlu trj tai khoa Ung bydu -Chdm sdc giim nhe Bdnh vien dai hpc Y Hd Npi t d 2010-2012.
Phan tich s d lieu
Danh gid mgt sd dac diem: trieu chdng ca ndng, tinh trang hOt thudc, kich thydc u, tinh trang di cdn, hinh thdc sinh thilt, t h l md benh hpc, giai dogn b^nh theo phan loai UICC 2010.
Sd ligu duo'C x y ly bang phan mem SPSS 16.0 So sanh, kiem ( ^ n h s u khae bidt gida cdc b i l n dinh tinh gida 2 nhom b l n g test x^, eac so sdnh cd y nghia thdng ke khi p < 0,05.
K^T QUA VA B A N LUAN
58 BN d y p c chan doan UTPQP, trong dd nam chilm 82,8%, n d 17,2%, ty Id nam/ nu' Id 4,8/1, tuoi trung binh 59,4 ±11,0 (37-89)
Bang 1: IVlpt sd dac d i l m lam sdng, c^n Idm sdng N=58
Trieu chLpng
Ho khan keo ddi Ho mau D a u n q i f c
KhO thff Khan tienq Oau n h i j c xi^onq k h 6 p
Sut can Hach nqoai VI
S 6 B N 20
7 44 12 2 4 16 14
34,5
%
12,1 75,9 20,7 3.4 6,9 27,6 24,1
Y HOC THUC H A N H ( 9 2 7 ) - S 6 8 / 2 0 M
Ktch ttiirdcu
VIMu
Ttilmd b^nhhQc
s 3 a n (3-7 cm]
>70cm Phdi phai
Phdi trdi UTBM khe>nq td bdo nho
UTBM te bdo nho UTBM tuydn UTBM TB Icrn UTBM TB vay UT khac khong xep logi
21 32 5
55 3 43 1 8 3
36.2 55.2 8,6 69,0 31.0 94.8 5,2 74,1
1,7 13,8 5.2 Nhdn xdt Oau ngyc chilm tJ Id cao n h l l vdi 75,9%, tilp den Id ho khan kdo ddi, khd thd, U kich thydc 3 -7 cm ehiem da sd vdi 55,2%, u chu ydu d phdi phai 69%, UTBM tuyln chilm 741%.
Bdng 2: Tinh trang hut thude Ti6nsi>
hut thudc C6 Kh6nq Tfing
Nh$n>
Nam N 30 18 48 dt' 65,5
%
62,5 37.5 100 /o nam
NO N 0 10 10 idi hut
%
0,0 100 100 thude;
Tonq N 30 28 58 100%
%
51,7 48,3 100 l y gidi Bdng 3, Lien quan md benh hpc vdi tinh trang hiit thudc
M6 b^nh hoc Ung thy biSu mO
tuyln Ung thi^ bilu mo
vay
Hut thuoc N 20 5
%
46.5 62,5
KhOnq hut N 23 3
%
53,5 37,5
P 0,465
Nhdn xdt, 62,5% BN UTBM vay cd hiit thude so vdi 46,5% UTBM tuyln, sy khdc bidt khdng cd '^ nghTa thdng kd vdi p>0,05.
Blng 4: Giai doan bdnh vd ddc d i l m di edn xa Giai doan b$nh
(N=58)
OdcdiSmdi Ccinxa (N=37)
1 II III IV Di c3n nSo Di can xifcnq Dl can phoi d6i bdn
S6BN 2 4 15 37 6 16 17
Ty I& % 3,4 6,9 25,9 63,8 16,2 43,2 45.9 Nh§n xdf BN chii yeu d giai dogn IV vdi 63,8%, tilp din Id giai doan 111 vdi 25,9%
Di cdn phdi ddi bdn ehilm ty Id cao nhlt vdi 45.9%
BAN LUAN D$c didm Idm sdng
Trong nghidn cdu cua chOng tdi dau ngyc la tneu Chiang Idm sdng thydng gdp nhlt chilm 75,9%, tiep din Id cdc trigu chdng ho khan kdo ddi, khd thd, ho mdu vdi ty id tyang dng 34,5%, 20,7%, 12,1%, sd thly hgch ngoai vi chilm 24,1%, g l y siit cdn ehiem 27,6%, cdc tridu chdng khdc nhy khdn tilng, dau nhdc xyong khdp it gdp. Dau ngyc thudng id do u xdm l l n , trdn djch mdng phdi kdm theo ho$c bdnh nhdn ed t i c mgch phdi. Ket qua ndy c_Ong tuang ddng vdi cdc tdc gil trong nudc nhu Nguydn Minh Hyang Id 86,6% [1], Trong khi dd theo Hyde L vd Chute CG ty Id dau ngyc cht chilm 20%, ho 50-70%. ho mdu 25-50% [2,3]. Cd sy khdc bidt ndy cd t h l Id do tridu chdng ca ndng cua UTPQP rlt nghdo ndn vd d l n h l m vdi cde bgnh
dydng hd hap khdc, khi cdc tridu chdng rd rdng thudng d giai doan mudn, thdm vdo dd ngirdi ddn chya cd y thdc di kham sdng lpc vd phdt hidn bdnh sdm
58 bdnh nhdn nghidn cdu, tJ Id u phdi phdi cao hon u phdi trdi, tyong dn^ Id 69% vd 3 1 % , vd u chu y l u d thiiy tren bdn phai. Ket qua nay tyang dng vdi k i t qud ngliien cdu cCia da sd eac tae gia trong vd ngodi nydc nhy Nguyin Thi Minh Hyang (2005) Id 6 1 % , vd Hodng Trpng Tiing (2006) Khi ddnh gid v l kich thydc u, chiing tdi nhan thay kich thydc u tnjng binh Id 4,3 ± 1,9 cm, trong do khdi u nhd nhlt Id 1,5 cm vd ldn nhlt Id 9 em, ehiJ y l u u kich thudc tren 3 cm den 7 cm vdi 55,2%.
Ve ket qua md bdnh hpc: ung thy bieu md t l bdo nhd chl ed 3 tnfdng hap vdi 5,2%. cdn iai chu yeu Id ung thy bilu md khdng t l bdo nhd. Trong dd UTBM tuyen chilm da sd vdi 74,1% tiep d i n Id UTBM t l bdo vay vdi 13,8%, UTBM t l bdo Idn 1,7%. So sdnh ve ty le gida 2 loai UTBM tuyln vd UTBM vay vdi cdc nghien cdu cua cdc tdc gia Vigt Nam d cdc giai doan khdc nhau, chung tdi nhdn thly cd mpt xu hudng thay ddi theo chieu hydng UTBM tuyen ngdy cdng tdng vd chiem ty Id eao han d UTBM vay. Ty id ndy theo Hodng Dinli Chan (1996) la 22.4% so vdi 49.8%, theo Phan Ld Thang (1999 - 2001) Id 31,4% so vdi 31.4%, theo Nguydn Thj Mmh Hyang (2005) Id 41,4% so vdi 30,5%, ciia Nguyen Minh Sang (2010) Id 55% so vdi 24,2%; cdn trong nghidn cdu cua ehiing tdi ty Id ndy tyang ddi cao tdi 74,1% so vdi 13,8% [4, 5, 6 ], Cd sy thay ddi nay cd t h l do sy thay ddi d i n thdi quen hut thudc Id- nguydn nhdn chinh gdy ung thy p h i qudn phdi t h l trung tdm md da phln Id ung thy bilu md vay, Nhung khi ddnh gid mdi lien quan gida UTBM vdy vd tuyen vdi cd vd khong hut thudc Id chung tdi khdng nhdn thly sy khdc bigt ed y nghla, Theo phdn logi cua WHO ty Id UTBM tuyen chiem 38%, UTBM vay 20%.
vd cung cd sy gia tdng nhanh chdng ty Id UTBM tuyln.
dilu nay duac cho Id do sy ra ddi thudc Id cd d l u Ipc td nhdng ndm 1960, m$c dii vdy mdi lidn quan ndy chya dyac chdng minh,
Trong 58 bgnh nhdn nghidn cdu, 63,8% bdnh nhdn d giai doan IV, 25,9% d giai doan III, ty Id giai dogn I vd 11 rlt t h l p tyang dng id 3,4% vd 6,9%, Dilu nay chdng td da phan bgnh nhdn den vidn d giai dogn mupn, cd t h l giai thich id do tridu chdng Idm sdng ung thy phdi khdng dde higu dd nhlm vdi tndu chdng cdc bdnli dydng hd h i p khde
Ve dac diem di cdn, trong sd 37 bdnh nhdn giai doan tv dl cdn phdi ddi ben chilm 45,9%, di cdn xaang 43,2%. di cdn nao 16.2%, Theo Toloza cd khoang 20% UTBM khdng te bdo nhd di cdn xyong, trong khi dd 30-45% ung thy te bdo nhd cd di cdn xyang [7,8], Doi vdi nhdng BN UTPQP khdng phai t l bdo nho, di can nao gdp ty Id cao d UTBM tuydn, nguy ea di cdn nao tdng d i n theo kieh thydc khoi u vd sy xult hidn hach viing [9],
K t T LUAN
Qua NC chiing tdi njt ra ra mdt sd k i t lu$n, UTPQP thydng gdp d giai dogn muOn, ho khan kdo ddi vd dau
V HOC THlJC HANH (927) - S 6 8/2014
ngyc Id tri$u chirng hay g | p , chu ySu u dr phdi phai, u (dch fhirdrc Idnn, d ^ p h l n Id UTBM t u y l n
TAI u l u THAM K H A O
i . Nguygn Thi Minh Huong (2005), 'Banh gid kit qua dliu bi ung thtrphi quin ph& khong phia ti bao nhd ^ dbgn U-llla bang phiu tfiugf phii hop xg trj h$u fOiiu'.
Luin vdn Thgc sy Y hpc. Dgi hpc Y Ha N ^ . 2. Hyde L, Hyde Cl (1974), 'Clinical manifestations of lung cancer" Chest, 65:299.
3. Chute CG, Gieenberg ER, Baron J, et al (1985), 'Presenting conditions of 1539 populatiovbased lung canc^ patients by cell type and stage in New Hamp^ire and Vemiont", Cancer, 56:2107.
4. Hodng Dinh Chdn (1996), 'NghiSn cijv kit qua diiu iii phiu lhu$t ung Oiwphi quin theo tip md t)$nh hgc vi cac giai doan". Lugn dn phd Tien sy Khoa hpc Y dygt:, OgihpcYHdNOi.
5. Phan Ld Thing (2002), 'Nghien cHu dge dfem lam
sdng, mO b^h hoc ung thw pha nguy§n phit t$i B$nh vi$n K1991 - 2001'. Lugn vdn Thgc s? Y hgc, Dgi hpc Y HaNdi.
6. Nguyen Minh Sang (2010), 'Nh$n xit d|fc dMm ISm sang, c$n lam sing vi dc phuimg phip phSu U}u$t ung Unrph^ khdng ph& te bio nho gra/ do^n I - Ilia fgi Sgn/) vvpn K". Lugn vdn tdt nghidp hac s9 Y khoa, Dgi hpc Y H d Ngi.
7. Toloza EM, Harpole L, McCrory DC (2003), "
Nonimrasive staging of non-small cell lung cancer a revi^iv of the current evidence', Chest, 123:137S.
8. Sc^umadier T, Brink I, Mbc M, et al (2001), FDG- PET imaging for the staging and follow-up of small cell lung cancer, Eur J Nud Med, 28:483.
9. Mujoomdar A, Austin JH, Malhotra R. et al (2007), 'Clinical predktors of metastatic disease to the brain from non-small cell lung carcinoma: primary tumor size, cell type, and lymph node metastases', Radiology, 242:882.
NGHIEN cdu THUC TRANG NGUON NHAN LUC Y TE
TAI BENH VIEN DA KHOA HUYEN LANG GIANG, TINH BAG GIANG NAM 2013
NGUYEN TUAN HIiNG', N G U Y I N DINH TOAN', DI^M D A N G THANH*
^Bo Yti, 'S& Yt4 Bac Giang, 'S^nh vi§n 110
TOM T A T
MIJC tiiu: md ti thtjc tr^ng nguon nhin lijc y tS t$i B$nh viin d^ khoa huy$n L^ng Giang, Snh B^c Giang vi di xuit mit sd khuyin nghl nhim ning cao nSng luc ho$t d$ng cOa b$nh viin. €>6i twtyng vi phuong phip: nghiin cOv md ti dt ngang c6 phin tich, thwc hi$n d 154 cin bi, nhin viin dang lim viic t$i BVDK huyin L^ng Giang, tinh Bic Giang. Thdei gian nghiin cdu fd' thing 1 <ren thing 5 nim 2013. Kit qui: Tmng s6 142 d6i twQTig tham gia nghiin cQv, ty li nam gidi thip han nOgiCn (tuxmg Cmg li 48,8% vi 58,2%). Trinh di? hoc vin: da s6 doi tw^ng nghidn ctiu cd trinh di tiung dp (chiim 63,4%), trinh di cao t^ng vi O^i hgc chiim 28,9%, trinh Oi sau cfg/ hgc ch! chiim 6%. Bic sp chiim tp 1$ cao nhit (22%). Ty li nhin vidn bi phin lim sing chiim 61%. Tf li nhin vidn bi phin quin Ip, hinh chinh <^iim 20%. Binh quin mil khoa phdng cd 12,8 nhin vidn. Khoa Khim binh cd nhlSu bic sp nhit (v(» 8 bic sp), dn l^i cic khoa khic chl cd 3(^n4 bic sp. Kit luin: So Iwvng bidn chi dn thiiu so vdn dwgc giao, mic dO v$y s6 bic sp vin chiim ty 1$ cao. S6 bic sp dUgc dao (go sau d$i hgc dn (^lim tpHthip.
Tip khia: thijc tr^ng, ngudn nhin lye. binh viin da khoa huyin L$ng Giang, tinh Bic Giang
SUMMARY
STUDY ON THE STATUS OF HEALTHCARE HUMAN RESOURCES IN LANG GIANG DISTRICT GENERAL HOSPITAL, BAC GIANG PROVINCE IN 2013
Objectives: to describe the status of healthcare human resources In Lang Giang district general hospit^, Bac Giang province and to propose some FBOimmendaUcms in order to improve the hospital operations. Subjects and meOtods: A cross-sectional
descriptive study with analysis was canied out on 154 he^th officers and staffs who are working in the Lang Giang district general hospital, Bac Giang province.
The study period was from Jan to May 2013. Results:
Among 142 study participants, rate of men was less than women (respectively, 48.8% and 58.2%).
Educational attainment: the maprity of the study participants had an intemiediate level (accounting for 63.4%), college and univers^ degree accounted for 28.9% and upper university degree a<xounted f<M'only 6%. Phy^cians accounted for the highest percentage (22%). The rate of healthcare staffs who were woriang in dinical departments accounted for 61%. The rate of healthcare staffs who were working in management, administration departments accounted for 20%.
Average number of healthcare staff was 12.8 foreach department. The outpatient department had the mo^' physicians (8 physicians), other departments had aity 3 to 4 physicians. Conclusions: number of healthcwB staff was less than standard level, but the perwntage of physians was high. The rate of physKians framed upper university degree was still low.
Keywords: Status, human resources, l-ang Giang distrt<^ general ho^ital, Bac Giang province
O A T V A N O e
Ngudn nhdn lye y td iuayc coi Id mdt trong nhQng thdnh p h l n ca ban vd quan trpng nhlt cOa h$ thdng y t l . Thyc hi$n cdng tdc chdm sdc sdc khde c l n nNeu logi ngudn lye khdc nhau nhyng nhdn li/c Id ngudn \\fc quan trpng nhlt; ngudn nhdn lye quylt djnh todn b9 s6 lypug cQng nhy c h i t lu^ng cdc hogt ddng vd djch vv chdm sdc sire khoe.
Vidt Nam cQng dang dycmg d l u vdi nhidu v l n d l
Y HOC THVC HANH (927) - SO 8/2014
