TAI LIEU THAM K H A O
1. Bg Y td (2004): Chi thj s6 04 ngdy 29/11/2004 ctia BO trudng Bg Y td ve viec tdng eudng cdng tde ehi dgo tuydn trong ITnh vye khdm ch&a bgnh,
2. So Y td Ha Npi (2008): Quyet djnh sd 121 ngdy 14/8/2008 cua Sd Y te Hd Ngi ve vigc Hudng d i n ctiuydn tuyen kham chu'a bgnh, phdn cong chi dgo tuyen.
3. Sd Y te Hd Npi (2006): Cdng tdc chi dgo tuyen
giai doan 2001 - 2005 vd phuung hudng giai dogn 2006 -2010.
4. Bgnh vign Vigt Nam - Cu Ba Ha Ngi (2009). Bao cdo cong tac chi dgo tuyen vd chuydn khoa dau nganh RHM ndm 2009
5. Bgnh vign Vigt Nam - Cu Ba Hd Npi (2012): Bao cdo cdng tdc ehl dgo tuydn vd chuyen khoa dau nganh RHM ndm 2012
TINH TRANG DINH DOBTNG CUA THE EM 6-60 THANG TUOI TAI KHOA NHI BENH VIEN DA KHOA TINH HAI DUONG NAM 2009
TOM T A T :
Nghien cim nhim mgc tidu so sdnh giwa cdc biin s6 Ildn quan tdi tinh trgng dmh dwdng(TTDD) trd em theo phwang phdp do cdc chf sd nhin trie vi bing phirang phip sw dgng cdng cu dinh gli todn dipn chu quan (Subjective Global Asessment)(SGA) (phuang phdp SGA). Thiit ki nghidn cdu dt ngang md ta trdn 330 ddi twang trd tw 6 din 60 thing tudi dugc diiu tri tai Khoa Nhi -bdnh vidn da khoa tinh Hit Dwang td thing 5-11/2009. Kit qui cho thiy: Dinh gii tinh trgng dinh dw&ng cda trd bPnh tmng bpnh vipn bdng phuong phip SGA khdng nhung xdc dinh dwae benh nhan cd nguy ca thiiu dinh dwdng md cdn xic dinh dwgc nguy CO thiiu dmh dwdng d ci nhdm ed cde chi sd nhdn trie trong gidi hgn binh thwdng.
Td khda: Tri em 6-60 thdng tudi, nhdn trie, phuang phdp SGA, tj lg SDD.
THE ISSUES RELATED TO NUTRITION STATUS OF HOSPITALIZED CHILDREN
The purpgse gf the study was to compam the difference on indicators related to nutrition status of hospitalized childmn by anthropometrical method and by SGA tool. A cmss-sectional study was conducted with involvement of 330 hospitalized children from 6- 60 mgnth of age in Pediatric Department of Hai Duong pmvince hospital from May to November, 2009. The msults show that: Assessment of nutrition status of hospitalized children by SGA togI not only identified the nsk of malnutrition of hospitalized children but also reveal out the risk of malnutrition of hospitalized children with normal anthropometric range.
Keywords: hospitalized children, anthmpometrical method, SGA tool, malnutrition
DAT VAN o e
Suy dinh duung (SDD) cua bgnh nhdn ndi chung, benh nhi ndi rieng (trong bgnh vign) liSn quan tdi tdng nguy co m i c benh, t& vong vd kSo ddi Ihdi gian ndm vien. SDD khdng ehi la bgnh dun thuin md hdn quan t&i nhidu v i n dd trong bgnh vien, b i n g eh&ng la nhieu benh nhan tidp tuc bi SDD trong thdi gian n i m vien[1].
NGUYEN DLTC VINH, Bp Yti NGUYiN e 6 HUY, Vipn Dinh Dw&ng Nhung nghign c&u gp dgng SGA cho bSnh nhan nhi da duyc thyc hign r l t phd b i l n vd dd duyc edng bd trgn cae tap ehi khoa hoe uy tin trgn Thd gidi. Mpt sd nghiSn c&u trSn Thd gidi da su dung cdng cu danh gia SGA trong TTDD ciia bgnh nhi va cho thdy day la edng cu ddnh gid TTDD eua bgnh nhi dae higu vd tin cdy^ do vgy duye khuyen nghj dp dyng cdng cu ndy de hd try, bd sung cho cdc phuung phdp nhdn trie trong danh gid tinh trang dinh duung Ire em [2], [3]. Kl. [5] Nghign euu tai bgnh vign "cho tre bgnh"
tgi Toronto, Canada nam 2006, dp dung edng cy SGA cho benh nhdn nhi cho thiy: SGA Id edng cy ddnh gid tinh trgng dinh dudng eho Ire em phu hyp, giup lien luung duyc cdc nguy cu bien ch&ng vd thdi gian ndm vien cua bdnh nhdn nhi [5],[7],
Nghign cuu ndy duuc thyc hien nhdm xac dmh thuc trang SDD tre em trong benh vien, so sanh duyc ty lg SDD cua bgnh nhi trong benh vidn bing cde phuang phap nhdn t r i e va phuung phap su dgng edng cy SGA.
D O I TU'ONG VA PHU'ONG PHAP NGHIEN CLTU 1. Ddi t u y n g nghien e u u : Cae bgnh nhdn nhi t&
6 thang den 60 thang luoi mdi nhap vign trong vdng 48 gid khdng m i c cdc bdnh d p tinh (tidu chay elp, viem dudng hd hdp e l p . .)
2. Thidt kS nghien e u u : Nghign e&u su dyng phuung phap nghien c&u cdt ngang, lien hanh l u thdng 5-11 ndm 2009 tai Khoa Nhi bgnh vign da khoa tinh Hai Duung
2.1.Cdmau:
Ca miu wdc Iwgng cho mpt tj Id [6]
_ Z , i . „ , „ p{\- p)
- n Id sd Iwgng cin diiu tra; 7? ji^^f Dd tin cay 95%, Z =1,96
- p Id ti Ip suy dinh dwdng trong bpnh vidn Id 35
% (nghidn cdu tnrdc ddy tgi Vien Nhi Tmng wang) (8],
- d li sai sd cho phdp Id 5%. cpng them 10%
dw phdng, ca miu n = 330 ddi twang.
VHQC THVC HANH (872) - S 6 6/2013
2.2.Cich chgn miu: Udc tlnh sd luyng trd vao trong thdi gian t& thang 5-11 tuung duung vdi eO- mdu, ngn chung tdi chpn loan bg cae ddi tuyng cd dCi ligu ehuin chpn m l u trSn.
3. P h u v n g phdp vd ky thu$t thu th^p sd ll^u:
cac ddi tuyng duye ddnh gid TTDD khi mdi nhgp vign (trong vdng 48 gid) b i n g phuung phdp nhdn t r i e va bing cdng eg SGA vdi s y try giOp trd ldi cae thdng lin ciia ngudi mg/ngudi cham sdc eua bgnh nhi.
' Thu thpp, dinh gid TTDD bing s6 do nhdn trie (can ngng, ehidu cao), bdng dyng cy tiSu ehuin, Cdn ngng, can SECA dign t& dg chlnh xac 0,1 kg, cdn duye didu ehinh, kidm tra trude khi s u dyng.
Chidu cao do ehidu cao b i n g thude gd UNICEF vdi dd chlnh xae 0,1 cm, TTDD cua trd duye phan logi theo tiSu chuin eiia Td ch&e Y id thd gidi ndm 2005, gdm SDD t h l p cdi (chidu cao/tudi), nhg cdn (cdn ngng/tudi) vd gdy cdm (cdn ngng/ehieu eao),
• Thu thpp, dinh gii TTDD bing cdng cy SGA:
SGA Id kT thugt iam sang dd danh gid SDD dya vdo, Thay ddi cdn ngng, thay ddi k h i u p h i n dn, cdc trigu ch&ng dg ddy rugt kdo ddi trdn 2 ludn, thay ddi eh&c ndng vgn dgng, cdc bgnh m i c phdi vd I n h hudng eua edc stress ehuydn hda, edc d l u higu suy dinh dudng lam sdng (mdt ldp md dudi da, phii, cd
tardng), TTDD duuc ddnh gid theo 3 loai: A (t& 11- 14 dilm): dinh du&ng binh thudng; B (6-10 didm):
SDD nh? vd tnjng binh; C (0-5 didm): SDD n^ng [3].
Phdn tich thing kd: Sd ligu d u y c phdn Hch bInq phdn mdm SPSS 16.0. S& dyng edc tdt sdng lye d l ddnh gid tlnh hyp th&e, tlnh tin cgy vi higu x u l t eOa hai phuung phap. S& dyng Fisher's exact test 3d so sdnh eae ty Ig, Gia In p nhgn 3ugc t& Chi-Square test (hoae Fisher's exact test) cho edc ty Ig. Y nghTa thdng kS dgt d u y c vdi p-value < 0.05 cho 2 phfa.
Bgo fl&c nghign ciru- Trudc khi tidn hdnh nghign c&u, Cde cdn bg nghiSn e&u ldm vigc ehi tidt vd ndi dung, mgc dich nghiSn e&g vdi ianh dao Bdnh vign, ciing vdi can bd eua cae Khoa ldm sang, trinh bay va giai thleh ngi dung, mgc dIch nghiSn e&u vdi ngudi mp, ngudi chdm sdc bgnh nhi. Cdc ddi luyng tham gla phdng v i n mgt cdch t y nguygn, khdng b i t buOc vd cd quydn t& bd khdng tham gia nghidn e&u md khdng c i n b i t e& ly do ndo. Vdi bgnh nhi suy dinh dudng sd d u y c t u v i n dinh dudng, t u vdn s&e khod.
cac thdng tin vd ddi tuyng d u y c gi& bi mgt va chi duyc s& dgng vdi mye dich nghign c&u, dem lai lyi Ich cho cgng ddng.
K £ T QUA NGHIEN c i r u
Bdng 1. Lien quan gi&a TTDD theo SGA vg nhdn t r i e TTDD theo nhSn trac
TTDD (can /tuoi) TTDD (cao/tu6i}
TTDD (can/cao)
Binh thu<ynq,n(%) SDD, n(%) Binh thti6nq,n(%j
SDD, n(%) Binh lhu^nq.n(%t
SDD. n(%)
TTDD theo SGA Blnhthif6'ng(n=189)
189(100.0) 0(0,0) 189(100.0)
0(0.0) 178(94.2)
11(5.8)
SDD (11=141) 22(15.6) 119(84.4) 88(62,4) 53(37.6) 11(7.8) 130(92.2)
6/^ Inp
<0.001
<0.0O1
>0.05 Bdng 1 trinh bdy liSn quan gi&a TTDD ciia tre em theo SGA vd nhdn t r i e . Vdi cdn ndng/tudi, ed ldi 15,6%
Ire theo danh gia b i n g phuung phap nhan t r i e cd TTDD binh thudng nhung theo danh gid b i n g SGA lat bi suy dinh dudng (p<0,001) Vdi chilu cao/tuli, ed ldi 62,4% tre theo ddnh gid bdng phuong phdp nhdn trie cd TTDD binh Ihudng nhung theo ddnh gid b i n g SGA lgi b| suy dinh dudng (p<0,001). Rieng vdi edn ngng/ehllu cao, chi cd 7,8% tre Iheo ddnh gid b i n g phuung phdp nhan t r i e cd TTDD binh thudng nhung theo danh gid bdng SGA Igi bj suy dinh dudng (p>0,05).
Bang 2, M&c giam edn ciia trd theo TTDD
C&c bi^n
TTDD theo nhSn trac (can/tuii) (n = 330) Binh thiyfrng 1 Suy dinh du&ng
(n = 308) 1 (n - 22) Gl^ tn p
TTDD theo SGA (n = 330) Binh thuOing 1 Suy dmh du&ng
(n = 189) (n = 141) Gli trip MLFC giam can, n(%)
<5%
Tl> 5-10%
>10%
167(54.2) 70(22.7) 71(23.1)
8(36.4) 4(18.2) 10(45,5)
<0.05
105(55.6) 49(25,9) 35(18.5)
70(49,6) 25(17.7) 46(32.6)
<0.05
Bang 2 trinh bdy m&e gidm edn eua ddi tuyng nghien c&u theo tlnh trang dinh dudng. Ty lg g i l m edn >
10% eua nhdm tre suy dinh du&ng nhq cdn Id 45,5%, eao han tJ Ig ndy d nhdm tre khdng suy dinh dudng (23,1%) (theo nhan trdc), s y khdc biet cd y nghTa thdng kg vdi p< 0,05. Ty IS giam cdn > 10% ciia nhdm trd suy dinh dudng theo SGA Id 32,6%, eao hun ty Ig ndy d nhdm Ire binh thud'ng (18,5%), s y khde biet cd y nghTa thdng kg vdi p< 0,05.
Y H p c THVC HANH (872)-S6 6/2013
Bing 3. Tliay a6i khSu plian an vS thay ij6l cSc chu-c nSng cda CO th4 theo TTDD
Cdc bidn
TTDD theo nhdn trdc (can/tufli) (n = 330) Binh thup'ng | Suy dinh duong In = 308) 1 (n = 22) Chdt vd s6 luung ciia khdu phdn, n {%) Khong thay d6i 1 79(25,6) 1 7(31,8)
Giam 1 229(74,4) I 15(68,2) CSc chirc ndnq ciia cu th6, n(%) Khdngthayd6i 1 200(64,9) 1 10(45,5)
Giam 1 108(35,1) | 12(54,5) Gid trip
>0,05
>0,05
TTDD theo SGA (n = 330) Binh thu'dng
(n=189) 43(22,6) 146(77,2) 131(69,3) 58(30,7)
Suy dinh dudng (n=141) 43(30,5) 98(69,5) 79(56,0) 62(44,0)
Gi^ tn p
>0,05
<0,01 Bang 3 cho t h l y cd tdi han 74,4% trd khdng suy dinh du&ng vd 68,2 % tre em suy dinh dudng thd nh^ cdn c6 giam khdu phdn dn, s y khdc bigl khdng cd y nghTa thdng kS vdi p>0,05. Tuung ty, ed tdi han 77,2% trd khflng suy dinh dudng vd 69,5 % tre em suy dinh dudng theo SGA ed gidm khiu p h i n dn, s y khde bigt khdng c6 y nghTa thdng kg vdi p>0,05,
Nguuc Igi, tre suy dinh dudng nh? cdn cd ty Ig gidm ch&e nang chung ciia c u thd Id 54,5%, cao hun ty Ig nSy d nhdm trd khdng suy dinh du&ng (35,1%(p>0,05). Trd suy dinh dudng theo SGA ed ty lg gilm eh&e ndng Chung ciia ca thd Id 44,0%, cao hun ty Ig ndy d nhdm trg khdng suy dinh dudng (30,7%)(p<0,01).
Bang 4 X u l t hign ede trigu eh&ng da ddy-rugt vd thay ddi nhu e l u edc chdt dinh dudng khi mdc bgnh theo TTDD
C^c bidn Tn Khfinq
06
TTDD theo nhdn trac (cdn/tu60 tn = 330) Binhthufrng 1 Suy dinh duong
{n = 308) 1 (n = 22) u ch&ng dg ddy-ru^t, n (%)
95(30,8) 1 9(40,9) 213(69,1) 1 13(59,1) Thay ddi nliu cdu dinh dir&nq, n (%) Khftnq thav ddi 218(70,8) 1 11 (50,0)
Giam I 90(29,2) | 11(50,0) Gi^ trip
>0,05
<0,05
TTDD theo SGA (n = 330) Binh thufrng
(n=189) 69(36,5) 120(63,5) 142(75,1) 47(24,9)
Suy dinh dirdng (n = 141) 35(24,8) 106(75,2) 87(61,7) 54(38,3)
Gid tn p
<0,05
<0,01 Bdng 4 eho thay 69,1% tre binh thudng va 59,1% trd em suy dinh dudng nhe edn cd xult hign cac triSu Chiang da ddy rudt, khdng ed s y khac bigt cd y nghTa thdng kg vdi p>0,05. Nguye lai, ed tdi 75,2 % Ire suy dinh dudng theo SGA va 63,5% tre binh thudng ed xuat hign cac trigu eh&ng da day rugt, cd su khdc bigt ed y nghTa thdng ke vdi p<0,05. Ty Ig trd suy dinh dudng nhg can ed giam nhu e l u dinh dudng ndn tdi 50%, cao hon ty IS ndy d nhdm tre binh thudng (29,2%), sy khdc bigt cd y nghTa thong kS vdi p<0,05. Ty Ig tre suy dinh duxS'ng theo SGA ed giam nhu e l u dinh dudng la 38,3%, cao han ly Ig nay d nhdm tre binh thudng (24,9%), sir khdc biet cd y nghTa thdng kg vdl p<0,01.
Bang 5. Tinh trang vidm loet migng vd nhuac, ydu ea ciia tre theo TTDD
Cac bidn
TTDD theo nhdn trac (cdn/tuoi) (/) = 330}
Binh thudng 1 Suy dinh duong tn = 308) [n = 22) Viem lo6t mi^ng, n(%) Khonq lo^t
Co lo6t
277(89,9) 1 14(63,6) 31(10,1) 8(36,4) Nhuyc, y^u co, n(%)
Khonq thav doi Giam
220(71,4) 1 13(59,1) 88(28.6) 1 9(40,9)
GiAtrip
<0,01
>0,05
TTDD theo SGA (n = 330) Binh thudng
(n=189) 169(89,4) 20(10,6) 142(75,1) 47(24,9)
Suy dinh dudng (/1 = 141) 122(86.5)
19(13,5) 91(64,5) 50(35,5)
Gid trip
>0,05
<0.05 Bang 5 cho t h l y ty Ig ed vidm lodt mieng eua
nii6m trd suy dinh duung nhg cdn la 36,4%, cao hun ty lg ndy d nhdm tre binh thudng (10,1%), s u khde bigt c6 y nghTa thdng kg vdi p<0,01. Ty lg cd vigm lo6t miSng eOa nhdm ire suy dinh dudng theo SGA la 13,5 %, eao hun ty Ig nay d nhdm tre binh thudng (10,6%), sy khae bigt khdng ed y nghTa thdng kg vdi P>0,05. Ty lg tre ed ddu higu nhuyc cu cua nhdm Ire suy dinh dudng nhg cgn la 40,9%, cao han ty Ig nay 6 nh6m trd binh thudng (28,6%), s y khae bigt khdng c6 y nghTa thdng kd (p> 0,05). Ty lg trd ed ddu higu nhu-yc cu cda nhdm tre suy dinh dudng theo SGA Id 35,5%, cao han ty lg ngy d nhdm Ire binh thudng (24,9%), su khdc bigt cd y nghTa thdng kS (p< 0,05),
BAN LUAN
Ty lg thidu dinh dudng ddnh gia b i n g phuung phap SGA d nhdm suy dinh dudng nhg can Id 84,4%
cao han ly lg ngy d nhdm ed edn ndng/tudi trong gidi hgn binh thudng la 15,6% (p <0,001) (bang 1). Dgc bigt, ty lg thidu dinh dudng ddnh gid b i n g phuung phdp SGA d nhdm suy dinh dudng thlp edi ehi Id 37,6%, t h l p han ty le ndy d nhdm cd chidu cao/tudi trong gidi han binh thudng la 62,4% (p <0,001). Nhu vgy vdi vigc su dyng cdng eu SGA khdng nh&ng xac dinh duyc bgnh nhan ed nguy ca ve thidu dinh dudng ma cdn xdc djnh duyc nguy ca thidu dinh dudng d ca nhdm ed cdc chi sd nhdn t r i e trong gidi hgn binh thudng Day ehinh Id uu didm ciia phuang
THVC HANH (872) - SO 6/2013
phdp SGA.
Cdng cy SGA ehu y l u ddnh gid thidu dinh dudng eCia bdnh nhdn khi n i m vign. Cdn danh gid tinh trgng dinh dudng dya trdn cac chi sd nhan trdc (edn nang.
ehidu eao) theo tudi ngodi vide ddnh gid ty Ig thieu dinh dudng, edn cd thd eho t h l y e l ty Id th&a edn-bdo phi. Thidu dinh dudng d u y c ddnh gid b i n g SGA eho ty Ig 42,7%, cao han g i n 7 l l n ty Ig suy dinh dudng nhg cdn vd g i y edm (6,7%), g i p g i n 2 l l n ly tg suy dudng t h l p edi (26,7%) khi ddnh gid tlnh trgng dinh dudng b i n g chi sd nhdn trie. Nghidn c&u cOa Chalemiporn Pojratsirikul (2004) cho t h l y cdc tidu ehl nhu gidm cdn, trigu eh&ng dg ddy rugt cd dd nhgy cao nhdt, trong khi dd gidm k h i u phdn td ydu td phil hyp dd xdc djnh ty Id cudi ciing eiia SGA [3]. Do vgy, nh&ng bidu hign Idm sdng lign quan ndu trSn edn duye thu thgp trong qud trinh ddnh gid TTDD, gdp p h i n xde djnh trd ed nguy c u suy dinh dudng trong thdi gian bj bgnh d l t u dd ed nh&ng bign phap phdng trdnh SDD cd higu q u i ,
v l tinh trgng g i l m edn, gidm k h i u p h i n dn, g i l m eh&c ndng eung nhu xult hign ede trigu ch&ng tiSu hda vd d l u higu thye t h i suy dinh dudng, kdt q u i cho thly ed xu thd khae bigt vd khdc bigt cd y nghTa thdng kg (p<0,05) gi&a nhdm suy dinh dudng vd nhdm binh thudng khi dp dyng phuang phdp ddnh gia tinh trgng dinh dudng b i n g edng cy SGA so vdl phuang phdp ddnh gid tlnh trgng dinh dudng b i n g cde ehi sd nhdn t r i e Nhu vgy, each ddnh gid tlnh trgng dinh dudng b i n g SGA cd thd "nhgy" han edeh ddnh gid b i n g chi sd nhdn trie vdi cac dau higu nguy ca ve dinh dudng eua trd bgnh nhi trong bgnh vign
Phli ehdng edeh danh gia linh trgng dinh dudng theo nhan t r i e (can nang, ehidu cao) trong bgnh vign chua phan anh day dO cae ydu td nguy ca/anh hudng tdi tinh trgng dinh dudng ciia ngudi b g n h ' Trong bgnh vign, chi nh&ng bgnh nhan cd tinh trgng bgnh nhe, di lai duyc binh thudng mdi ed thd edn do nhdn trie dugc, sd bgnh nhdn n i n g , p h l i n i m hgt giudng vi phdu thugt Ihl khdng t h i can do cac chi sd nhan trie (can ndng, chidu eao). Nhu vgy. vigc khd khan trong can do nhan t r i e va ydu td bdnh Igt nhu phil, truydn djch, p h l u thugt da ly giai duye mdt p h i n ket qud vd ly tg suy dinh dudng theo nhdn trie, dgc biet Id suy dinh dudng nhg cdn(6,7%) t h l p han ty tg suy dinh dudng nhe cdn trdn cgng ddng (17,5%) [9]
vd t h l p han rat nhidu so vdi ty lg suy dinh dudng theo phuang phdp dp dyng cdng cy SGA cho bgnh nhi. Ngudi bgnh ndu do duyc cdc chi sd nhdn trie Ihudng ed tlnh trgng bgnh tuang ddi nhg hun do vgy nguy c u suy dinh dudng se t h l p han, Phuang phdp ddnh gid suy dinh dudng b i n g SGA ed nhidu cdc chi sd lien quan vd anh hudng tryc tidp eiia tinh trgng dinh dudng vd bSnh tdt ciia tre bgnh do dd giiip ddnh gid duyc mpi ddi tuyng bgnh nhi (kd ca bgnh nhdn cd linh trang bgnh ndng) vd do trong ddnh gid SGA dddd
Kdt qua l u nghien c&u nay eho t h l y thye trang ty le ddng kd benh nhdn thidu dinh dudng vd cd cde rdi
togn lidn quan ddn dinh dud'ng. R l t cdn cd s y ddnh gid va can thigp kjp thdi d l edi thign tinh trgng dinh dudng cho bgnh nhdn, t& dd giam d u y c ty tg bidn ch&ng cua bgnh, bgnh nhan se d u y c phyc hdi nhanh. Can thigp dinh dudng ddng thdi iam giam thdi gian n i m vign, gidm ehi phi eho ban than ngudi bgnh va eho xa hgi.
K£T LUAN
- Ty lg thidu dmh dudng theo phuang phap SGA d nhdm suy dinh dudng nhg cdn la 84,4% eao han ty Ig ndy d nhdm cd cSn ngng/tu6i trong gidi hgn binh thudng ta 15,6% (p<0,001).
- Ty tg t h l l u dinh dudng ddnh gid b i n g phuang phdp SGA d nhdm suy dinh dudng t h l p cdi chi Id 37,6%, t h l p han ty tg nay d nhdm cd chidu cao/tudi trong gidi hgn binh thudng Id 62,4% (p <0,001).
- Danh gia ttnh trgng dinh dudng cua trd bgnh trong bgnh vign bdng phuang phdp SGA khdng nh&ng xgc djnh d u y e bgnh nhgn cd nguy ca vd SDD ma edn xac djnh d u y c nguy c a thidu dinh dudng d nhdm cd cac chi sd nhdn t r i e trong gidi hgn binh thudng.
Khuydn nghj:
C i n dp dyng cde phuang phdp ddnh gid tinh trgng dinh dudng b i n g chi sd nhdn t r i e , kdt hyp vdi phuang phdp ddnh gid todn dign (SGA) cho bgnh nhdn nhi nhgp vign dd phat hign sdm nh&ng bgnh nhan cd nguy ca thidu dinh du&ng dd cd bign phdp can thiep k|p thdi.
TAI LI$U THAM K H A O
1. Phgm Thu Huang, Nguyin Thj Lam, Nguyen Bich Ngpc. Trin Chdu Quyen, Nghiem Nguygt Thu, Phgm Thlng(2006). TTDD eua bgnh nhdn nhgp wgn khoa tidu hda va npi tidt tgi bgnh vign Bgeh Mai. Tgp chl dinh dwdng vi thgc phim. Sd 3+4, tr 85-91.
2 Rosalind S. Gibson (1990). Principles of Nutrition Assessment, Oxford University Press, pp 155-186.
3 Chalemiporn Rojratsrikul (2004). Application of Generated Subjective Global /Assessment as a Screening tool for malnutrition in pediatrie patients. J Med Assoc. Thai 2004; 876(8): 939-46.
4. Fiaeeadori E et al (1999). Prevalence and clinical outcome associated with preexisting malnutrition in acute renal failure: a prospective cohort study. J Am Soc Nephmi, No.10(3):581-93.
5. Donna J. Seeker, Khursheed N. Jeejeebhoy (2007). Subjective Global Nutrition Assessment for Children Am J Clin Butr 2007;85:1083-9.
6. Hd Huy Khdi. LS Thj Hyp (2012). Phuang phap dieh te hpe dinh du&ng Nhi Xudt bdn Yhgc. tr. 57-61.
7. Prasong Tienboon (2002). Nutrition problems of hospitalized children in a developing country: Thai land.
Asia Pacific J Clm Nutr; 11 (4): 258-262.
8. Nguydn Thuy Hdng, Luu Thj My Thye. Nguyin Thj Yen (2011). "nghiSn cuu ty Ig suy dinh dudng ciia tre em dudi 5 tudi tgi khoa Hd hap bgnh vign nhi tmng uang ndm 2010'. Tgp chi yhgc Vipt Nam, sd thdng 7 so 1;tr 46-49.
9 Vign Dinh Du&ng, Quy Nhi ddng lien hyp qudc (2012). Bdo cdo tdng didu tra dinh du&ng 2009-2010.
Nhi xuit bin Y hgc. tr, 34-39,
Y H p c THVC HANH (872) - SO 6^013
