4 Gido trinh bgnh ly vd Vdt ly trj lldu hd ca xuang (2012), Trudng Dgi hgc Ky thu§t Y t l H l i Duong.
5. Nguyin Th| Ngpc Lan (2004), " Dau cOng thit lung vd dau than kinh toa", B^nh hpc Cu xuung khdp nOi khoa. NXB Gido dye. Tr. 154-155.
6. Ddng Kim Thanh, Nguyin Vdn Hal (2008) "Nghidn
cOv tic dung cHa xoa bdp bim huydt d bdnh nhdn dau thin kinh toa", Tgp chi y hpc Vl$t Nam. tdp 346. Tr.48- 52
7. Amundsen T. Weber H, Lilleas F. Nordal HJ.
Abdelnoor M.Magnaes B. Lumbar spinal stenosis Clinical and radiologic features. Spine. 1995;20:1178-86.
KHAO SAT KIEN THUfC VE CHAM SdC CUA CAC BA ME CO CON Bj VIEM P H A TAI BENH VIEN NHI DONG CAN THd
T R A N o d HUNG, NGUYEN THj OAI TRANG T6M TAT
Trong thdi gian nghidn cwu tir thdng 12 nim 2012 din thing 3 nim 2013, chOng tdi dd tiin hinh nghidn cim trdn 100 trd tir 2 thing din 5 tudi bj vidm phdi vi 100 bi me cOa cic tri trin tai khoa Ndi tdng hgp, bdnh vidn Nhi ddng Cin Tha, chiing tdl di thu dwgc kit qud nhw sau: Tridu chimg lim sing chu yiu nhit Id khd khd chiim 98%, ho 94%, phdi cd rale 82%, sdt 71%, chiy nwdc mOi 67%. ndn di hodc QC sda 39%.
thd nhanh 32%, mt ldm ldng ngwc 24%, chwdng bung 2%, tim tdl chiim 2% Cdng thdc mdu ghi nhin cd 49% trwdng hop cd sd lirgng bach ciu trdn 10000/mm^. X-quang ghi nhdn tdn thwang 100% Id hdi chimg phd nang. Kiin (hire chim sdc tri vidm phdi: C6 96% bi m^ biit ring niu tri bj viim phdi thwdng xuydn kim theo khdng dn udng dwgc thi sd bj sut cdn cd thi din din suy dinh dwang Cd 64% bd me biit ring ndn cho tri dn udng hodc bO binh thwdng hodc nhiiu han khi tri bj viim phdi, 60% bi me biit ndn cho tre Sn loai thwc in nhw binh thwdng hoac bd dudng han khi trd bi bdnh, cd 61% cic bi me biit ndn cho tre udng nirdc trii ciy hodc udng thdm sda khi tri bi bdnh vidm phoi. Cd 97% bi m^
cho rang cin thiit phai theo ddi cdc diu hidu bdnh nang khi tri bi ho cim. Cd 64% bd m^ sd diing thudc ho tdy y di lim giim ho cho tri. ch! cd khodng 7% bi me dOng cdc lo^i thudc giim ho ddng y. Cd 29% bd me biit ndn lau sach mQi cho tri kht trd s6 mOi di Idm thdng thoing mui. Kiin thdc vi phdng binh cho trd. gid im co thi cho tri khi trdi lanh 87%, trdnh tiip xuc vdi nhQng ngwdi bi ho 74%, trinh tiip xuc vdi khdi bui, khdi thudc li, Idng sue vit li 52% vi cd 32%
bd md nghi cd thi phdng binh cho trd bing cich bii sda me, khdng di tri bi suy dinh dwdng
Tir khda: Viim phii, Idm sdng, c$n Idm sing, chdm sdc. kiin thirc.
SURVEY ON MOTHERS KNOWLEDGE ABOUT CARE OF PNEUMONIA CHILDREN AT CAN THO CHILDREN HOSPITAL
SUMMARY
During the study period from December 2012 to fJlarch 2013, we conducted a study on 100 children aged 2 months to 5 years with pneumonia and 100 mothers of children in the general intemal medicine, Can Tho Children's Hospital, we have obtained the
following results: Clinical symptoms of wheezing is mainly accounted for 98%, or 94%, pulmonary rale 82%, 71% fever, runny nose 67%, nausea and vomiting milk 39%, 32% shortness of breath, chest concave withdmw 24%, 2% distention, cyanosis 2%.
CBC mcorded 49% of cases of leukemia in 10000/mm3. X-rays mcorded 100% damage alveolar syndmme. Knowledge pneumonia care: 96% of mothers said that if children with pneumonia often accompanies eating will be weight loss can lead to malnutrition. Them are 64% of mothers know that children should eat or drink a Ixtttle or more often as children with pneumonia, 60% of mothers said children should eat normal foods or nutritious than when they am sick, have 61% of mothers said children shoubi drink juice or drink more milk when they are sick wi^
pneumonia. It said that 97% of mothers need to Mow the signs when a child Is ill or feeling. There are 64% of mothers will use westem medicine cough medicine to mlieve cough for children, only about 7% of mothers used dnjgs cough medicine. Them am 29% of women said so wipe your nose when young children to make clear runny nose. Knowledge about disease prevention for children: Children keep the body ivamj in coW weather 87%, avoid contact with people who are coughing 74%, avoid exposum to dust, cigarette smoke, animal fur is 52% and there 32% of mothers think children can help pmvent infection by breastfeeding, not to malnourished children.
Keywords: Pneumonia, clinical, subclinical, care, knowledge.
BAT VAN Dt
Vidm p h l i Id nguydn nhdn hang d l u dua 3^n nhdp vidn va tir vong d tre em < 5 tuoi Tr6n toan th^
gidi. cd khodng 156 tri$u tardng hap vidm phli tre em xay ra trong ndm 2000, han 95% cdc tnrdng hpp x l y ra d cac nudc dang phat t r i l n nhu cdc ninSt chdu Phi va khu vuc Ddng Nam A [33]. Theo Tfi Chirc Y T l T h i Gidi, hang nam tren t h i gidi c6 khoing 14 tridu t r i em dudi 5 t u l i tir vong, trong d6 khoang 4 tridu Id do vi6m p h l i [4].
0 Vidt Nam, ty 1$ t u vong do vidm p h i l d Ire em chilm khoang 33% so vdi ty l§ tCr vong chung. Chi llnh ndng trong nam 2011, mdi ngdy cd d i n 11 tre tir vong vl vidm p h l i [5] N l u tInh trung binh d cac nu'ii'C
Y HQC T H V C H A N H (872) - SO 6/2013
dang phat t r i l n eung nhu d Vidt Nam thi mdt tre ed the m i c bdnh viem p h l i t y 3-4 lln/ndm, thdi gian dieu trj tmng binh Id 5-7 ngdy, vl vdy viem phil r l t dnh hudng d i n sire khde trd em vd ngdy edng lao ddng eua ngudi me [2].
CQng nhu ede bdnh khae d tre nhd. vai trd cOa ngudi cham sde tre, thdng Ihudng la ngudi me ed y nghTa r l t quan trpng trong vl$c nhdn bilt vd d i l u trj benh cho trd Tre bj vidm p h l i chi cd t h i d i l u trj sdm nlu ngudi me nhdn b i l t sdm ede d l u hidu bdnh tdt d tre, b i l l cdch chdm sdc d nha khi trd bj bdnh nhg Khi tre bj bdnh n^ng, ngudi mg cQng c i n cd kha ndng nhdn bilt d l u hidu ndng hodc d l u hidu nguy hilm va dua dl khdm dung nai diing iiie d l cd I h l dieu tri sdm tranh nhO'ng b i l n chirng n§ng. Trong qud trinh d i l u tri, ddc biet id dieu trj ngoai trO, vide tuan thu dilu tn, sir dyng thudc dung va ehdm sde thieh hap cho tre hodn loan phy thudc vao ngudi chdm sdc.
Nhdn ra t l m quan trpng v l k i l n thirc chdm sde bdnh nhi vidm p h l i ciia cde bd mg, chimg tdi tien hanh nghien ciru vdi hai muc tidu cu t h i nhu sau'
- Xde 3\nh ddc d i l m ldm sdng vd cdn ldm sang eua b^nh vidm phoi d tre em tgi bgnh vign Nhi dong Cin Thu.
- xac ^ n h kien thuc cham sde bdnh nhi viem phli cua cdc bd me tai bgnh vidn Nhi ddng C i n Tha
0 6 i T U ^ N G VA PHU'aNG P H A P N G H I E N CLTU 1. Odi tuo'ng nghien c u u
1.1. Ddn so chgn mau
- T i t ca bdnh nhi t y 2 thdng d i n 5 t u l i dang n i m dieu tri tai khoa Ndi T i n g Hup, Bgnh Vign Nhi Dong Cin Tha, dupc chan dodn vidm phdi trong thdi gian tu thdng 12/2012 den thdng 03/2013.
- T i t ca cdc ba mg cOa cac bdnh nhi tren.
1.2. Tidu chuin lira chgn
- T i t ea cdc bdnh nhi t y 2 thdng den 5 tuoi vdo khoa Ndi hd h i p trong khoang thdi gian ndi trdn va cd bieu hidn cua vidm phli d p tinh: theo WHO ndm 1997
+ Ho + Thu khd khd + Sit eao > 38°C
+ Thd nhanh theo tuoi: t u 2 thang d i n <12 thang.
s: 50 lln/phiit; t u 12 thdng den 5 tuoi. a 40 lan/phiiL + Cd rale I m nhd hgt
+ X quang phli cd thdm nhilm.
+ Bgch d u da nhan ehiem uu I h l (chi Id diem gpi y) - Cdc bd mg d i n g "j tham gia ngliidn cuu.
1.3. Tieu chuin lo^i trd - Bdnh nhi khdng cd mdt tgi khoa.
- Ngudi nhd khdng d i n g '^ tham gia nghien ciru, - B|nh nhi m i e NKHHCT trdn hoac kdm thdm cdc bdnh ly phli hp'p khde: tieu ehay, tim b i m sinh, suy dinh duung, eogldt..
2. Phuang phap nghien ciPu 2.1. Thiet ke nghidn ciru
Nghidn cuu d t ngang md td cd phdn tich 2.2. Dja diem vd thdi gian nghien ci>u - Oja diem: khoa NOI t i n g hpp cua bdnh vidn Nhi Oing Cin Thu,
-Thdi gian' t y thang 12/2012 den thdng 03/2013 2.3. Cd miu
Mdu nghidn eyu dupc l l y theo tidu chuin lua chon trong khodng thdi gian nghien cuu.
2.4. Phwang phdp chgn miu
Chpn m l u thudn tidn nhung ddi lup'ng thulc tidu chuin lya chpn trong khoang thdi gian nghidn ciru
Djnh nghTa cdc b i l n s d :
- T u l i : Id s l ndm (thdng) cOa ngudi mg (con) tCr khi sinh ra llnh d i n thdi d i l m nghidn cuu,
- Nghi nghidp; n g h i dem Igl thu nhdp chlnh cOa d l i tupng
- Trinh dd hpe v i n : Id bde hpc cao nhit ciia d l i tuung nghidn cdu
- Dja chi. Id nai d hidn tgi eiia d l i tupng - s l eon' la sd con hi^n tgi cdn s i n g cOa doi luyng.
- Gidi tinh: la gidi tinh ciia mdi tre.
- sdt: khi nhidt dd do d nach & 37,5°C - Thd nhanh (theo tidu ehuin ciia WHO) t u 2 den 12 thang: £ 50 lln/phOt; tCr 12 thang d i n 5 l u l l : £ 40 lln/phiit,
- Riit Idm Ilng ngyc - Thd khd khd
- Rale phdi: ed 4 logi rale phli - S l luung bach d u '
+ Binh thudng, tre < 1 tuoi. 11 x 10Vl; Ire >1 tuoi, 6 - 8 x 1 0 ^ / 1
+ Tang: tre < 1 tuoi: >11 x 10^/1; tre > 1 tuoi. 6 - 8 X 10^/1
- CRP : binh thudng < 5 mg/di, tang khi CRP >
5mg/di
- X quang: chia iam 3 loai: vidm phli thCiy, viem phoi md ke, vidm phe qudn p h l i
3. Phan tieh s d lieu
Cdc s6 ligu sau khi thu thgp se dupc ting hpp va phdn tich bang phan m i m SPSS 16 0
KfiT QUA NGHIEN CLCU 1. D^c d i l m lam sdng 1.1. L'j' do nhdp vi$n Bang 1. L'^' do nhdp vidn cua tre Ly do nhap vi$n
Sot Ho Kh6 thd Khd khe Tim tai
Tan so 28 61 4 55 0
Ti le (%) 28 61 4 55 0 Nhin xdt Ly do khiln gia dinh dua tre den nhap vign chii y l u do ho (61%), k l den Id khd khd (55%), s i f (28%), khd thd (4%), ddc bigt khdng ed trudng hp'p ndo do tim tdi.
1.2. Cdc tri^u chdng Idm sdng cua viem phoi tre em
Bang 2. Tn$u ehung iam sang ciia vidm phli tre Tn^u chi>nq Iclm sSnq
sJt Chav nu'O'C mOi
Ho Non 6i ho5c pc sua
Tans6 71 67 94 39
Ti le (%) 71 67 94 39
Y HQC THVC H A N H (872) - SO 6/2013
TiSu chay Chi/6nq bgnq
Tho nhanh Tho kh6 khi Rut 16m lAnq nquc
Tim tdi Ph6i c6 rale
20 2 32 98 24 2 82
20 2 32 98 24 2 82 Nhdn xdt: Tndu ehung p h i b i l n nhit la khd khd chilm 98%. Ngodi ra cac tridu chyng khac: ho 94%, phoi cd rale 82%, s i t 7 1 % , ehdy nudc mOi 67%, ndn di hodc pc s&a 39%, thd nhanh 32%, riit ldm ldng ngyc 24%, ehudng byng, tim tai chilm 2%.
2. D$e d i l m edn idm sdng Bang 3. Phdn b l s6 lupng bgch e l u mdu S6 luyng bach c^u
10000-15000/mm^
T6n9 s6~
T^n s Ti ig (%)
Nh$n xdt: Da s l bgeh d u vdn cdn d gid tn binh thudng chilm 5 1 % , sd luung bgch c l u t y 10000 d i n 15000/mm^ chilm 32%, s l luyng trdn 15000/mm^
ehilm 17%,
Bang 4. Phdn b l gid trj CRP mdu CRP
< 20 mg/1
> 20 mq/l Tong s6
TAns6 30
2 32
Tl 1$ (%) 93 8
6.3 100 Nhdn xdt Gid tn CRP da s l d muc dudi 20 mg/l chiem 93,8%, chi cd 6,3% edc trudng hpp t u 20 mg/1 trd Idn
Bang 5. Phan bo ton thuung tren X quang Ton thu'ong Ir^n X quang
Tham nhiem phe nang Tham nhidm phi quan ThSm nhidm m6 ke Tr^n dich mging phoi
Tran khi m^ng phoi T6ng s
Tan s6 32
Ti 10 (%) 100
Nhan xdt: H l u nhu t i t ea cdc trudng hap ed ehi dinh chyp X quang d l u cd k i t qua id thdm nhilm p h i nang chilm 100%.
3. K i l n thue ehdm sdc trd viem p h l i cua ode ba me
3.1. Ngudn thdng tin nhan duwc ve bdnh vidm phoi
Bieu do 1 Phan bo nguin thfing tin ve bgnh viem phoi Nhan xdt: Cde bd mg duae biet cae thdng tin v l bdnh vidm p h l i chu y l u tir tivi chilm 64%, hp it duyc tiep cdn thdng tin t u bao chl nhat chilm khoang 12%
3.2. Kl4n thCK vi b^nh vlSm phoi BSng 6. Ki4n thu'c nh^n bi^t dSu hi^u cua bgnh
vi6m phoi ^ DSu hi^u t]$nh
Ho Tho nhanh
KhS thft Rut lOm I6ng ngu'c
S6t Tim tdi Tho kh6 khfe, tho rit
Bdbii KhSc
Tan so 77 13 20 1 30 4 69 1 1
T T I S M ! 13 '. . 20 aft 1 .?
30 -3 4 ,1 69 i 1 .!
1 Nhdn xdt: D l u hidu vidm p h l i dup'c cae bd m@
b i l l d i n nhilu n h i t la ho c h i l m 77%, k l d l i f la thd khd khd, thd rit eOng d u y c da sd cac ba mg bilt din nhilu c h i l m 69%. Tuy nhidn cac d l u hi$u nit Ifim l i n g ngyc, bd bii thi Igi cd r l t It ba mg bilt chilm 1%, Bdng 7. K i l n thyc v l myc dd ndng nhg giO'a ho
edm vd vidm p h i i w_
Mi>c do n3ng nh9 cua ho cam vd viSm ph6i Vr^m phOi n$nq hon ho cam
Vi6m ph6i nhe hon ho cam KhSc T6nq
TdnsO 92
2 6 100
•nis(%) 92
rm 6 » : mm Nh$n x6t: V1$ c^c bS me bi6t vi6m ph6i n$ng1)ii 10 cam chi^m ti 1$ cao (92%). ' •'•
Bang 8. KiSn thiJc ve dQ nguy hi4m ctJa viem ph^
Oo nquy hiSm cua vi6m phOi C6 th6 qSy ti> vonq Kh6nq the qSy ti> vong
TAnq
Tdnsft 95
5 100
TTie(s;|
9S"!i 5 " ^ looil Nhan x6t Ti 1$ c^c bi me b l i l b$nh viem | M I 9 ^ Ih^ gay 10 vong chiem t[ 1$ cao (95%). ^:
Bang 9. Kien thiJc v^ lAc dyng cua ph§n xa^hp"
tronq bgnh viSm ph6i. ^ Tdc dung cua phan xa ho
Ldm tre kh6 tho han Ldm tonq ddm qiup thong d(/6ng tho Tao ra nhi^u ddm Idm bdnh ndng hon
Khdo T6nq cOng
Tdn s i 12 57 15 16 100
Tiieot 12 » 57 » 1 5 * 16-»: lOOt* Nhan xdt: P h i n Idn cac bd me bilt dug'C phan « ho iam t i n g dam giup thdng dudng thd chilm 57%, tuy nhidn vdn cdn mdt s6 ba me nghT ring ho c6 &ih hudng x i u d i n tinh trgng bdnh ciia tre chilm 27%. ;;^:
3.3. Kien thipc ve chdm sdc tri vidm phdi Bang 10, Kiln thire v l dnh hudng eua vidm phot iJ^
phat tndn ca the cua tre
Anh hu'dng cua viem phoi flen - i t su phat triln the chat ^
Sgi can c6 the dua den suy dmh difdng
Tiie(%}
Tong cpng | 100 j .— _--J Nhan xit P h i n ldn cdc ba mg biet ring viem pWi thudng xuydn se anh hudng den s y phdt triln ciia Ire, cd the dua d i n suy dinh dudng (96%),
Y HQC THV'C HANH (872) - s 6 6 ^
Bang 11 Ki^n thfrc c h i m sOc t r i viem phSi vS cSch dn u6ng
Cdch chdm sdc An nhieu hon. u6ng hodc bii nhifeu hon An binh thu'd'nq. u6ng hodc bJ binh thtf&nq
An it lai, udnq hodc bU it lai An uonq theo nhu cdu cua tre
Tflng c$nq
Tdn s6 18 46 24 12 100
Tild
(%)
18 46 24 12 100 Nh$n xdt: Da s6 cdc ba mg se eho trd an binh thudng, uong hode bii binh thudng khi tre bj vidm phli chilm 46% vd vdn cdn mdt s6 nhilu ede bd mg nghT ring ndn cho trd an uong, bii It Igi chilm 24%.
Bang 12. K i l n thyc v l logi thirc dn md ede bd mg eho t r i an khi vidm p h l i
Loai thirc Sn Chi An chdo trSnq
Chdo thit cd Cho tre an thiPc Sn nhu binh thudnq
Cho an thiirc Sn b6 du'&ng hon T6nq cOnq
TdnsI 10 30 35 25 100
Tl Id (%) 10 30 35 25 100 Nhin xdt: Phan ldn cac ba mg bilt nen eho trd dn binh thudng hodc thue dn bd dudng hun (60%)
Bang 13. Kiln thi>c v l logi nudc ma cac bd mg eho tre u i n g khi vidm phli
Loai nudc udng U6nq nu6c trdi cdy
Udnq nu6cchin Udnq them sira
Khdc Tong cdng
Tdnsd 18 30 43 9 100
Ti Id (%) 18 30 43 9 100 Nh$n xit P h i n Idn cac ba mg b i l l nen cho tre uing nudc trai cay hoac u i n g thdm su-a khi Ire bj bdnh viem phli (61%).
Bang 14. Kiln thyc ve theo dfii cdc d l u higu bdnh ndng Sl/ cin thiet cua vi$c theo doi cac dlu _ i * -riiA/o/^
hi$u ngng trong b^nh vi&m phli ' ^ " ^ ° nigt/oj Gin thi^t
Kh6ng c^n t h l i P T6ng cQng^
Nhdn xdt: Oa s6 cac ba mg cho ring c i n thilt phai theo doi cdc dau hieu bdnh nang trong bdnh vidm phoi chiem 97%.
Bdng 15. Kiln thO'c v l cdch iam giam ho cho t r i CSch cham siic
Dting thu6c tay Dung cdc loai thulc an toan quit hip duimg. mdt ong, ..
Tin s6 _jiiiI%L
Nh$n xit: Phan Idn cac ba mg sd diing thudc g i l m ho tay y cho tre 64%, mdt vdi bd me sir dyng cdc loai thudc ho ddng y: quit h i p dudng, mdt ong,...chilm 7%.
Bang 16 Kien thire ve each iam thdng thoang mOt cho Ire
Cach chSm sdc Di!ingthu6cnh6 mui
Lau sgch mOt Uonq thuoc s6 mGi
Khonq lam qi ca Khac Tonq cOng
T^nsd 53 29 11 2 5 100
Tri6(%) 53 29 11 2 5 100
Nh$n xdt: Da so cac ba mg se sir dyng thuoe nhd mOl cho trd 53%, k l d i n la 23% cac ba me lau sgch mui cho t r i , ddc bidt cd 2% ede bd mg khdng xir tri gi khi trd chdy nudc mOi.
3.4. Kien thiec ve phdng bdnh vidm phoi Bdng 17, Kiln thye eiia cdc bd mg v l phdng b^nh yldm phoi
each phdng b§nh | T^n s6 | Ti 1$ (%) Tranh tidp xOc vdi kh6i thu6c Id, kh6i
bIp, bgi, l&ng SLIC v^t GiO* dm cho tre khi trdi Ignh Cho tr6 bii sua me. nufli du'&ng t6t
a l trd khflnq bi suy dinh du'&ng Tranh ti^p xuc v&i nqu'&i b| ho
52 52 87 1 87 32 74
32 74 Nhin xdt. Da s6 ede bd me cho phuang phdp phdng bdnh cho trd Id giy I m ca t h i cho tre khi trdi Ignh 87%, k l d i n id ndn tranh t i l p xiic vdi nh&ng ngudi bj ho 74%, tranh t i l p xiic vdl khdi bui, khdi thulc Id, Idng sOc vdt Id 52% vd ed 32% bd mg nghT cd I h l phdng bdnh cho tre b i n g cdch bii sya mg, khdng d l tre bj suy dinh dudng,
BAN LUAN 1. D$c d i l m lam sdng 1.1 Lf do nhdp vi^n
Theo nghien euu ciia chung tdi ghi nhdn, \'jf do thudng gdp dua trd nhdp vidn Id ho (61%), khd khd (55%), s i t (28%) vd khd thd (4%) vd t i m t a i (0%).
Theo nghien eyu ciia Phan Huu Nguygt Diem (2011) tren 59 t r i tai bgnh vidn Nhi Bong 1 nhdn thly cd 3 \</
do chinh dua tre nhdp vidn do la: ho (46,8%), khd thd (31,9%), s6t (25,5%) [3]. Theo nghidn euu ciia tde gia Nguyin Thj Kim Anh, Pham Thi Minh Hing (2007) tren 331 bdnh nhi tai bdnh vien Nhi D i n g 2 nhdn thay ly do nhdp vIdn da so Id do ho, khd khd (40,5%), bdnh vidn khde chuyen (24,5%), khd thd (18,4%) vd do cdc nguyen nhdn khac nhu sdt, tim tai chilm ti lg nhd [1],
1.2. Tridu chdng Idm sang
Qua nghien eyu 100 tre viem phli ehiing tdi ghi nhdn dupe trieu chyng thudng gdp nhat la khd khd 98%, ho 94%, phoi cd rale 82%, s i t 7 1 % , chay nudc mQi 67%, ndn di hodc pe sua 39%, thd nhanh 32%, riit lom long ngyc 24%, quay khdc 2 1 % , tlm tai, ehudng byng 2%. Theo tdc gia Nguyin Thj Kim Anh, Phgm Thj Minh Hing (2007) trdn 331 bgnh nhi tgi bdnh vidn Nhi Dong 2 nhan thay tridu chyng hd h i p : phoi ed rale 79,3%, eo idm ngue 78%, ho 69,8%, khd khe 59,7%, thd nhanh 53,2%, tim tai 25,8% vd mdt s6 trieu Chung khdc bd bii hay bii kdm 68,5%, pc sQ-a 51,5%, s i t 26,4%, li bl 18,6%, ehudng bung 16,3% [1].
2. D$c d i l m cdn Idm sdng cua t r i viem phdi.
2.1 So Iwgng b^ch cau
Trong nghidn ciru cua chung tdi, k i t qua cdng thyc mau ghi nhdn cd 5 1 % trudng hyp s l luang bach c l u cd gia trj dudi 10000/mm^, 32% cd s l lupng bgch c l u tir 10000 - 15000/mm^ va 17%
trudng hyp cd s l luyng bach eau tren 15000/mm^.
Theo tac gia Pham Xuan Huyen (2012) trdn 105 tre em tgi khoa Ndi t i n g hyp vd khoa Hoi syc long hup eua Bdnh vidn Nhi d i n g C i n Tha ghi nhan ed 44,8%
trudng hap ed bach e l u dudi 10000/ mm^, 32,4%
Y HQC THVC HANH (872) - S6 6/2013
trudng hyp ed bgch c l u tir 10000 - 15000/ mm^ vd 22,9% cd s l luyng bach c l u trdn 15000/ mm^ [5],
2.2. X-quang
Trong nghidn cuu ciia chiing t l i , X - quang p h l i thing duyc thyc hidn trdn 32 trudng hyp vd 100%
d l u cd k i t qua la t i n thuang p h i nang, Theo nghidn ciru cOa Nguyin Thi Kim Anh. Phgm Thj Minh H i n g (2007) trdn 331 bdnh nhi lgi bdnh vidn Nhi D i n g 2 ghi nhdn 79,2% trudng hyp thdm nhilm p h i nang, 11,8% trudng hyp ddng d§c p h l i , 6,3% tham nhilm p h i nang va md kd, 2,7% tham nhilm m l kd [11
3. K i l n thiPC v l chdm sdc trd vidm phdi cOa cdc bd mg
3.1. Kiin thuv vi bdnh vidm phoi
Khi duyc hdi v l d l u h i | u cua bdnh vidm phdi thi ho la d l u hidu Idm eho cdc bd mg lo l i n g va dua con di khdm nhilu n h l l (77%), k l d i n td d l u hidu thd khd khd (69%), s i t (30%), khd thd (20%1, thd nhanh (13%), ddc bidt cac d l u hidu rut Idm long ngyc, bd bii, tim Idl Id cde d l u hi$u cdnh bao bdnh n$ng nhung eae bd mg It bilt d i n (1%), Theo nghidn ciru cua Uv\/aezuoke SN vd es (2000) tgi Enugu, Nigena cd ghl nhdn cdc ba me nhdn bilt duuc bgnh vidm phli thdng qua d l u hidu khd thd 65%, thd nhanh 42%, ho nhieu 26,5%. Trong khi cdc d l u hidu b§nh rill Idm long ngyc chi cd 8,5% cde bd me bilt d i n vd tim tai 1 % [33].
3.2. Kien thirc vi chdm sdc tre vidm phoi Trong nghidn cuu ciia chiing tdi, da sd cdc bd me cho ring n l u tre bj vidm p h l i thudng xuydn kdm theo an udng khdng duyc se anh hudng xau d i n phdt trien ea the, syt can ddn d i n suy dinh dudng (96%), chl cd 4% cac ba me nght r i n g Ire se phdt tnen binh thudng va dae bigt khdng cd ba me ndo nghT ring Ire se phat tnen t i t han. Tuang t y nhu k i t q u i eiia chiJng toi, nghidn cuu ciia tac gia Le Thanh Huan cOng ghi nhan duyc 98,3% cac ba mg nghT ring viem phoi thudng xuydn se anh hudng khdng t i l d i n sy phat triln eua tre [13] Nhdn thyc duyc d i l u ndy cd the giiip cdc bd me cho tre dn uong t i t han
3.3. Kiin thd-c vi phdng benh vidm phdi Trong nghidn ciru cCia chiing tdi, cdc ba mg ehii yeu phdng b$nh cho tre b i n g each giy I m ca t h i cho tre khi trdi Ignh 87%, ke d i n Id nen trdnh t i l p xOc vdi nhyng ngudi bj ho 74%, trdnh t i l p xiic vdi khdi byi, khdi thudc Id, Idng sdc vdt la 52% vd ed 32% ba mg nghT cd the phdng bdnh cho Ire bdng each bii sua me, khdng d l tre bj suy dinh dudng. Theo nghidn cyu ciia I'if Thj Chi Mai vd cs (2011) trdn 600 ba me cd Ire bj viem phli ghi nhdn: cd 82% bd mg nghT ring cd I h l phdng bdnh cho tre bdng vide trdnh khdi thulc la, khdi bui vd Idng sue vdt, 97,8% cac ba me nghT ring e i n giu I m d l phdng bdnh, 81,3% bd mg nghT ring tranh t i l p xiic vdi ngudi bi ho d l phdng bdnh vd 76,3% cdc bd me nghT cd t h i phdng bdnh b i n g cdch bii sua me hoac khdng d l Ire bi suy dinh du&ng [6]
K^T LUAN
1. Dae d i l m lam sdng va edn idm sdng cua bdnh vidm p h l i
- Ly do nhdp vidn: ehu y l u do ho 6 1 % , khd kti6 55%, s i t 28%, khd thd 4 % vd khdng cd tnrdng h ^ nao do tfm tai,
- Tridu ehirng iam sdng ehO y l u n h i t Id khd khfi chilm 98%, ho 94%, p h l i cd rale 82%, s i t 71%, chSy nudc mOi 67%, ndn di hoac pe sQ-a 39%, thd nhanh 32%, rut lOm l i n g ngyc 24%, ehudng byng 2%, tim tai chilm 2%.
- Cdng thirc mau ghi nhdn c6 49% tnrdng hyp cfl s6 luyng bgeh e l u trdn 10000/mm^.
- X-quang ghi nhdn t i n thuang 100% la h|i chirng p h i nana
2. K i l n thO>c eua cdc ba mg vd chdm sdc binh nhi vidm p h l i
K i l n thOv v l b$nh vidm p h i i :
- cac ba mg nhdn b i l l cac d l u ht$u vidm phdi chu y l u la: ho 77%, thd khd khd, thd rit 69%, s i t 30%, kh6 thd 20%. thd nhanh 13%, tim tai 4%, nit ldm llngng^rc 1%, b d b u 1 % .
- Cd 92% ba mg b i l t v\dm p h l i n^ng han ho cam, 95% ba mg b i l l vidm p h l i cd t h i gdy tir vong chotrfi, 57% bd mg bilt p h i n xg ho Id d l t i n g dam ra ngodi.
K i l n thOc chdm sdc trd vidm ph6i - Cd 96% ba mg bilt r i n g n l u trd bj vidm pti&
thudng xuydn kdm theo khdng an u i n g duyc flit sfi bj syt cdn cd t h i ddn d i n suy dinh dudng.
- Cd 64% ba me b i l t r i n g ndn cho tre an u6ng hodc bu binh thudng ho^c n h i l u han khi tre bj viem p h i l , 60% ba me b i l t n i n cho tre dn logi thye dn rtw binh thudng hoac b l dudng han khi tre b| benh, c6 6 1 % cac ba mg bilt ndn cho tre udng nude trdi cdy hodc udng thdm sua khi tre bt bdnh viem phli.
- Cd 97% bd me eho r i n g c i n thiet phil theo da cdc d l u hidu bdnh ndng khi tre bj ho cam.
- Cd 64% bd me se dimg t h u l c ho tdy y d l ldm g i l m ho cho tre, chf cd khoang 7% bd mg diing ck logi thuoe gidm ho ddng y
- Cd 29% ba mg bilt ndn lau sgch mui cho tre khitrS s6 mui de idm thdng thoang mui.
K i l n thiPc v§ phdng bdnh cho tre: giu Im or I h l eho tre khi trdi Ignh 87%, trdnh t i l p xiic vfli nhO'ng ngudi b| ho 74%, tranh t i l p xOc vdi khdi byi, khdi thulc la, ldng sue vdt la 52% va cd 32% ba me nghT cd t h i phdng bdnh eho tre b^ng cdch bii siia mg, khdng de tre bj suy dinh dudng.
TAI LIEU THAM K H A O
1 Nguyen Thj Kim Anh, Phgm Thj Iwlinh Hfing (2007), "Ddc dilm viem phoi d tre su sinh tgi bdnh vien Nhi Dong 2 t u 03/2007 d i n 10/2007", Yhgc TP. Hd Clii IVIinh, tgp 13, s l 5/2009, tr.49 - 55,
2. Bp mdn Nhi (2009), Viem phli do vi khuin, G/flO trinh Nhi khoa, tgp I, tr.238 - 250.
3. Phan HO-u Nguy§t Diem. Chung Hu-u Nghj (2011),
"Dgc diem bgnh nhi t y 2 den 59 thang t u l i lu'u vong ci vidm phoi nhdp khoa hd hap bdnh vidn Nhi ding \°J hoc TP.Hd Chi fVlinh. tgp 15. so 1/2011. tr.288 - 295.^
4. Nguyin Kim Hd (2006), Nhilm khuin hd hap cap tinh tre em, Diiu dwdng Nhi khoa, Sdch ddo tao cao
ddng a l u dudng, tr.181-194. .*?
5 Phgm Xudn Huydn (2012). Khao sdt lim sM
Y HQC THV'C HANH (872) - SO »
cdn Idm sdng va cdc yiu td nguy ca d trd dudi 5 tudi dwgc chin dOin viem phdi ndng nhdp vien Bdnh vi$n Nhi ddng Cin Tha, lugn vdn tot nghigp Bdc sT da khoa.
Dgi hpc Y duyc Can Thu.
6, Li/ Thj Chi Mai, Hu^nh Thanh Liem (20111, Nghidn cdu tinh hinh mic bdnh nhiim khuin hd hip cap tinh vd mqt s6 yiu rf lien quan d trd em dudi 5 tudi tai huydn Chdu Thanh, tinh Tra Vinh.
^ 7. Nguyin Thj Thanh Nhdn (2012), Nghien cuu dgc diem t i n thudng X quang phli giua cdc nhom vi§m phoi epng ding tgi thdi dilm nhdp vign d tre t u 2 - 59 thang tgi khoa hd h i p bdnh vidn Nhi ding I, Tdp san nghien cuu khoa hpc trudng Dgi hpc Y Duyc C i n Thu, so 7
8. UNICEF (2006), Pneumonia The forgotten killer of children. New York, the United Nations Children's Fund.
TY SO GlOn TiNH KHI SINH VA M O T SO YEU TO LIEN QUAN TAI HUYEN TIEN LANG, THANH PHO HAI PHONG TRONG 5 NAM (2007-2011)
T R A N TH] KifM - Bdnh vi^n Bfich Mai TOM T A T :
Myc tidu: Xdc dinh tj' sd gidi tinh khi sinh vi md td mdt sd yiu td lidn quan t^i huydn Tidn Ldng. TP.
Hii Phdng tmng 5 ndm (2007-2011) Ddi twqmg vd phwang phdp: Nghidn cdu md ti hdi cdu; dOng bing miu nghidn cdu thiit ki sin thdng kd cdc dd lidu thdng tin tai Tmng tdm Ddn sd - KHHGD, gdm todn bd si tri sinh ra vd sd gia dinh tai huydn Tidn Ling. TP Hdi Phdng tmng 5 nim (2007 - 2011). Kit qud va bdn lu$n: Tj? s6 gidi tinh (TSGT) cdc ct,im- 112.92. Cd 6 cum kinh ti cOa huydn Tidn Lang diu cd sw mit cdn bdng gidi tinh. tiAit cdn bing gidi tinh die bidt ting cao d cijm 4 -ddn si tmng binh khi cao, noi tip tmng nhiiu ddng bdo cdng gido. Xu hwdng TSGT khi sinh cua huydn Ttdn Lang lidn ttjc tmng tinh tr^ng mit cdn bing vi khdng ddng diu. Ty sd mit cdn bdng gidi tinh khi sinh cao nhit (ndm 2(p9) li 120.3 vi thip nhit (ndm 2011) Id 108,4. Ty sd gldi tinh d nhdm tritwO-6 tudi tmng huydn dao ddng tw 106.8% din 107,7% vi khdng thay ddi tmng vdng 5 ndm qua. Mdi lidn h$ giwa sd con, thw tw sinh vd TSGT thi hidn: lin sinh diu tidn, TSGT cOa trd (^u d mdc binli thwdng (92,9 - 108,6%); a cdc gia dinh sinh con thw 3 mdt bi gdi. TSGT tdng cao (tw 142.8% (nim 2007) ldn 248,2% (nim 2011) TSGT ddi vdi con thd 3 trd Idn nhdm nguydn nhan niy c6 chiiu hwdng tdng cd y nghia thdng kd vdi p = 0,073.
Nhdm cip vg chdng cd con bi dj tdt hodc mdc bdnh hiim nghdo khdc: moi nim chi cd tw 2 - 5 trwdng hgp, khdng dO phdn dnh tinh tr^ng mit cdn bdng gidi tinh khi sinh. Kit ludn: Tj? sti gidi tinh khi sinh gida 1 trd em nam/ nd khi sinh ra cdn sdng (01/01/2007 - I 31/12/2011) d ddi tirgng tri em tw 0 - 6 tuoi chung ' cho todn huydn li 112,9, vwc^ ngwdng binh thwdng 103 -105. Tj sd gidt tinh cd sw khdc nhau ddi vdi thw 1 tw sinh con vd sd lin sinh: tri Id con diu Idng Id
101.2% -101,4%; nhdm trd Id con thdhai li 104,8% - 1108.4%; nhdm tri Id con thd ba trd ldn cd TSGT tw 1175.8% -190%. Cd mdi lidn quan vdi nhau glQa thd S tw s6 con. sd iin sinh vi mit cdn bing gldi tinh.
Tie khda: Tj sd gidi tinh khi sinh, Din sd ki
• hoach hda gia dinh, can bing gidi tinh.
• SUMMARY:
Objective: Determine the sex ratio at birth and
describes some of the factors involved in Tien Lang distnct. Haiphong city waste m 5 years (2007-2011).
Subjects and Methods: Retmspective descriptive study; use the sample table designs available statistical data infonnation on population and family planning centers. Includes whole number of births and the number of households in Tien Lang district, Haiphong city in 5 years (fmm 2007 to 2011).
Results and discussion: The sex mtio of the 6 clusters: 112.92. Both the 6 clusters of Tien Lang district economic have an imbalances sex.
Imbalances in the special high avemge cluster 4 relatively high concentration of ethnic Catholics.
Tmnds in the sex ratio at birth of Tien Lang district in a state of constant imbalance and uneven Sex ratio imbalance at birth in 2009 was the highest and the lowest 120.3, in 2011 was 108.4. The sex ratio in the 0-6 age gmup children in this district ranged fmm 106.8% to 107.7%, It did not change in the last 5 years in children 0-6 years of age group. Relationship between the number of children, which birth order and sex ratio: in the first birth, the sex ratio ofchildmn were within the normal range fmm 92 9 to 108.6%. In the 3rd child families a giris high sex mtio increases from 142.8% in 2007 to 248.2% in 2011. Sex mtio for children 3 th. causes this group tends to incmase with a statistical significance (p = 0.073). Team couples have childmn with deformities or suffering fmm some other senous diseases each year only 2-5 cases, not enough to mflect the imbalance in the sex ratio at birth Conclusions: The sex ratio at birth dehveen boys/giris being bom alive 01/01/2007 at 31/12/2011 in mspect of children fmm 0-6 years of age for the whole district is 112 9, beyond the normal range 103- 105. This ratio can vary the order of birth and the birth, the firstborn child is 101.2% - 101.4%, is the second group of childmn. a third child mtio corresponding to 104.8% - 108.4% and 175.8% to 190% Between order of child, birth order and gender imbalance may be associated with each.
Keyword: the sex ratio at birth, population and family planning, gender balance.
OAT V A N o e
Ty s6 gidi tinh Id mdt chi s l nhdn khau hoc phan
,Y Hpc THV'C HANH (872) - SO 6/2013
