oxy hfla da duoe tim thay trong bdnh vay ndn. Theo nhdng khdm phd ndy, bdt thudng lipid trong b§nh vay nen vua khdi phdt hi$n tugng xo vda ddng mgch vua phdt tridn va duy tri phan dng vidm tai da. Tuy nhien trong nghidn cdu cCia chOng tdi, ca nong dd LDLc vd cdc logi lipid khdc khdng cfl sy lien quan vdi ehi s i PASI.
Ly do tai sao cd nhdng bidn d i i vd ehuydn hfla lipid trdn bdnh nhdn vdy nen v l n chya duoc giai thich mdt cdch thuydt phyc tren y vdn. S y boat hda he thing midn djch trong bdnh vay ndn cd thd ddn den mflt sd bidn d i i lipid eOa bdnh nhdn. Tuy nhidn nhdng bidn d i i ndy cfl Id con Iten quan ddn mflt s i bdt thudng eua hd tidu hfla. Hd tIeu hfla cfl vai trfl trong phdn gtai. bien d i i vd t i n g hop nhieu hop chdt hdu eo. trong dd cfl lipid. Trdn benh nhdn vay ndn, ngudi ta thdy efl nhdng bdt thudng ve edu tnic vd ehdc ndng d hdu h i t cae dogn ctia i n g tieu hfla [12].
T u nghien cdu ndy. chting tfli hy vong rSng trong tuong lai se efl nhieu nghien edu hon nua theo hudng khao sdt nhdng r i i logn ndi khoa nhu hfli ehdng chuyen hoa. ydu td nguy co tim mgch trdn b§nh nhdn vdy ndn d Vi#t Nam eung nhu ddnh gid vai trfl ctta cdc t h u i c hg lipid mdu trdn dien tien ldm sdng vay nen.
KtT L U A N
Qua nghidn cdu ndng dfl lipid mdu trdn 80 bdnh nhdn vdy ndn cho thdy ndng dd triglyceride cao hon vd HDLe thdp hon so vdi nhflm chdng. Do dfl edn tdm sodt va didu trj sdm rdi logn lipid mdu trdn bdnh nhdn v^y ndn nhdm phdng ngda xo md dflng maeh vd ede bien ehdng eua nfl. Ngodi ra, cdn cd thdm nhdng nghidn cdu sdu hon vd hdi chdng chuyen hfla, ydu t i nguy eo tim maeh tren benh nhdn vay ndn d Viet Nam cQng nhu ddnh gid vai trd eua ede thuoe ha lipid mdu tren d i l n tidn Idm sdng vdy nen.
TAI LIEU THAM K H A O
I.Phgm Vdn Hiln Bdnh vdy ndn. Da Uhu hoc NXB Gido dgc Vidt Nam. Hd Nfli 2009, tr 57 - 62.
2.Kremers HM, McEvoy MT, Dann FJ, Gabnel SE.
Heart disease in psonasis. J Am Acad Dennatot 2008;58:347-352.
3. Gilbert Thompson et al. Dysllpidaemia in Clinicat Practice, 2"^ edition, 2006
4.Gudjonsson JE, Elder JT Psoriasis. Fitzpatrick's Demiatology in General Medicine 2008. 169 - 193.
S.Akhyani M, Ehsani AH, Robati RM, Robati AM. The lipid profile in psonasis a controlled study. J Eur Acad Dermatol Venereol 2007,21.1330-32.
B.Javidi Z, Meibodi NT. Nahidi Y. Semm lipids abnormalities and psonasis. Indian J Dermatol 2007: 52:
89-92.
7.Malibris L et al. Psoriasis is associated with lipid abnormalities at the onset of skin disease. J Am Acad Dermatol 2006:54 614-21
S.Rocha-Pereira P, Santos-Silva A, Rebelo I, Figueiredo A. Quintanilha A, Teixeira F Dyslipidemia and oxidative stress in mild and in severe psoriasis as a risk for cardiovascular disease. Clin Chim Acta 2001;303:33-9
9-Tam LS, Tomlinson B, Chu TTW. et al. Cardiovascular nsk profile of patients with psoriatic arthritis compared lo controls - the role of inflammation Rheumatology 2008 47 718-723
10. Tekin NS, Tekin IO, Barut F. Sipahi EY Accumulation of oxidized low - density lipoprotein in psoriatic skin and changes of plasma lipid levels in psonatic patients Mediators Inflamm 2007: 2007: ID 78454, 5 pages.
11 Pietrzak A, Ka..dzielewski J, Janowski K, et al, Lipoproteid (a) in patients with psoriasis: association with lipid profiles and disease severity. Int J Dermatol 2009' 48:
379-387.
12 Pietrzak A, Jastrzebska I, Krasowska D et al. Semm pancreatic lipase [EC 3 1.1 3] activity, serum lipid profile and penpheral blood dendritic ceil populations in normolipidemic males with psonasis J Mol Catal B Enzym 2006.40 144-154
NHIEM DON BAO D I A N G RUOT 0 TRE EM HA NOI VA MOT SO YEU TO LIEN QUAN
N G U Y I N TH! H 6 N G L I ^ N , N G U Y £ N THU HUONG, TRAN THANH DUONG
Vien Sot rdt - Ky sinh trung - Cdn triing Trung uong TOM T A T
Nhiim dan bdo dw&ng mdt la mdt nguy&n nhdn hay gdp gdy roi lo^n ti&u hda. ddc bi$t trdn tri em.
Nghi&n ciru ndy dd tien banh xdt nghidm 1.288 miu phdn hoc sinh Ida tudi tliu hgc tai mdt sd qu$n huydn ndi ngo^i thdnh Hd Ndi Mue dich nhdm tim hiiu vi tinh blnh nhiim dan bdo dw&ng rudt trdn trd em.
Nghi&n cuv dd s d ayng hai phwang phdp x&t nghi&m phdn hay diing Id ky thudt tnrc tidp vd Ether-Fonvalin.
T^ Id nhiem dan bdo aw&ng tr&n trd em chung Id 5.12%. Cd 5 lodi dan bdo hgc sinh hay mic dd dwgc tim thiy nhw E. coli Id 2.25%, E. histolitica Id 1.55%, G. lambtia Id 1,16%. E. harmani Id 0.47 %, E. nana Id 0.08%. Tmng dd, hgc sinh tliu hgc tai ndi thdnh
nhiim dan bdo dw&ng mdt Id 3%, & ngogi thdnli li 6.98%. Mdt s6 yiu to lidn quan nhw mdi tnrdng sing, nghd nghidp cua gia dinh, s d ayng hd xl khdng hpp vg sinh. tlnh trgng suy dinh dw&ng. Kdt qud nghi6n cuv ndy cho thiy nhiim dan bdo thyc sy dnh hudng ddn sue khde cOa hoc sinh.
TCF khda: Nhidm dan bdo, hgc sinh tliu hgc, Hfl Ngi. ndi thdnh, ngogi thdnh.
SUMMARY
INTESTINAL PROTOZOAN INFECTION AMONG CHILDREN IN HANOI AND SOME HIGH RISK FACTORS
Intestinal pmtozoan Infection is a common cause of gastmlntestinal dlsoraers, especially in childi^
This stuay was conductea 1.288 stool samples ti
Y HOC THUC HANH (886) - s 6 11/2013
primary schorl childmn age in some suburiian ana urban aistricts of Hanoi The purpose of this stuay understana the situation of intestinal pmtozoan Infections In chiiamn. Two classification methods is tested using a direct method ana Fonnalln-Ether technique. The pmtozoan Infection rate in chiiamn Is genemlly 5.12 %. Them are 5 species of pmtozoan chiiamn Infection which have been founa as E. coll of 2.25 %, E. histollUca 1.55 %, G. lamblia 1.16 %. E.
harmani 0.47 % ana E. nana 0.08 %. In particular, chiiaem In inner-city elementary intestinal pmtozoan infection Is 3.00%, In the suburtjs is 6.98%. Them am some high nsk factors such as envlmnment. family occupation, use unhygienic latrines, malnutrition status. Results of this study showed that pmtozoan infection actually affect the health ofstuaents.
Keywords: Primary school chiiamn. intestinal pmtozoan infection.
OAT VAN Dt
Theo t6 chirc Y th Th^ gi6i (WHO) mOt trong nhO'ng y^u t6 chinh g6p ph^n ldm tre em mkc b§nh vd ti> vong cao t?i cdc nu'dc nhi#t ddi Id b$nh tieu chay do nhi§m khulln du-dng ru6t, ddy cdn Id nguyen nhdn ch|m phdt tri^n d tre em. Benh cung dd du-p-c xem x&t dwa vdo chu-ong trlnh k i l m sodt vd phdng ch6ng dich b$nh du-dng hd h^p vd tifiu chay cdp tlnh d cdc nudc dang phdt tri^n, Trong cdc nguySn nhan gdy ti6u chSy cap d tre em Id don bdo du'd'ng rudt thu-dng gdp nhw Entamoeba histolytica, Giardia instestlnalis. Blantidium coll.. B$nh c6 h^u h4t d cdc nu'dc trSn thi gidi, gdp ty 1$ cao d cdc nu'dc nhidt ddi. c$n nhifit ddi vd chu y^u phy thudc vdo tlnh hinh v$ sinh mOi tru'dng, vd sinh dn u6ng^ vd sinh thu-c ph^m kdm, mdi tru'dng ludn bj 6 nhidm vdi nhO'ng mSm b#nh don bdo, do dd chOng ta d§ bj tdi nhidm n^u khdng phdng b$nh t6t.
Cdc logi don bdo ndy gdy ra cdc tridu chi>ng v^
du'dng tidu hda. dau bung, rdi logn tidu hda. dl ngodi phdn ldng, c6 nh^y mdu; d i n d^n cdc bdnh tidu hda nhu' vidm dgi trdng Celp. mdn. ly amip..., cd thi d i n den suy dinh du*ng d trd em. ngodi ra cdn mdt s6 tridu chu'ng khdc nhu" dj u-ng. D$c bi$t d tre em lO-a tu6i ti4u hpc, li>a tu6i dang phdt triSn thS li,jx: r i t dd bj anh hu'dng t)di cdc b$nh du'dng tidu hda gdy ndn do don bdo d u ^ g mdt. Nghidn ci>u ndy nhSm mgc tidu: ddnh gid t h i ^ trgng nhidm don bdo du'dng aidt d trd em lu'a tu6i tilu hpc d mdt sd qu§n huydn nOi, ngogi thdnh Hd Ndi vd mdt s6 y l u t6 nguy co nhidm bidnh hay gdp.
D 6 | TU'O'NG VA PHU'ONG P H A P NGHIEN CLPU 1. Ddi t u ^ n g nghidn c f r u : Tre em b$c t i l u hpc (6 - 1 2 tuli)
2. Dja d i l m nghidn CIPU: B I C thdm n g i u nhidn cdc qudn ndi thdnh nhu- Thanh Xudn, Hodn K i l m vd ngogi thdnh Thanh Tri, My Ddc vd Chu'ong My
3. T h i l t k l nghidn ciPU Nghidn cO'U md td dt ngang
TLT qu$n/huydn chpn bde thdm n g i u nhidn mdt s6 tn/dng t i l u hpc. Phdn t i n g theo k h l i (ti> k h l i Idp 1 d i n khli Idp 5), sau dd chpn mSu n g i u nhidn theo danh sdch Idp.
4. Thdi gian nghidn c f r u : Thdng 10-11 ndm 2012
5. C d mdu
Ap dung cdng thu-c tinh c d mdu nghidn CLKU md / ' • g
Trong dd: n: c d mdu nghidn cdu; p: ty Id mac u'dc tlnh = 0,1; q = 1-p
z,.a/2: dd tin cdy mong muon =1,96; d sai so mong muln = 0,05
Thay vdo cdng thCrc vd Idm trdn. ta cd c d mdu Id 140 m l u cho mol diem dieu tra
6. Cdc ky thu^t su' dung trong nghien CCPU 6.1. Ky thudt xet nghi&m tr^-c t i l p bdng nu-d'C mudi sinh ly, lugol
Phu'ong phdp ndy Ihu'dng du'o'c dung de phdt hidn don bdo dgng hoat ddng. Sau khi lay phdn phai xdt nghidm ngay (thdi gian khdng qud 2h)
6.2. Ky thudt Ether - Formalin
DOng ky thudt Ether-formalin d l phat hien don bdo du'dng rudt trong phdn. Day Id phu-ong phap xdt nghie^m tdp trung tnJng cdc loai ky sinh tnjng, dac bidt tot d l phdt hidn bdo nang don bdo. Phu'ong phdp ndy da du'o'c T l chde Y t l T h i gidi gidi thieu.
6.3. Phdng vdn
Phdng v i n theo bd cdu hoi thiet k l san v l cdc thdi quen sinh hogt, vd smh, nghe nghidp cua b l me
7. Chi s l ddnh gid ty 1^ d i l u tra Ty Id nhilm don bdo chung Ty Id nhilm tdng loai don bdo Phdn bidt ty Id nhidm theo t u l i . gidi Phdn bidt ty Id nhidm theo vung, mua.
8. Phirong phdp xO ly s d l i ^ u ; S6 lidu du'o'c xd ly theo phu'ong phdp thing ke trong y sinh hoc vd p h i n m i m EPI-INFO 6.04.
9. Dgo dipc nghien ci>u
D l cu-ong da du'o'c thdng qua tai Hdi d i n g khoa hpc vd Y dire Vidn s6t rdt-Ky smh trung-Cdn trung Trung uong
K 6 T QUA
1. K i t qud didu tra tinh trang nhidm don bdo du'dng rudt d trd em t i l u hoc tai Hd Ndi:
Bang 1 Ty Id nhidm don bdo du-dng rudt d hpc sinh Hd Ndi
Dia dilm
N$i thSnh
Ngoai thanh
Tfing s l
Hoan Kidm (n=399) Thanh XuSn
(n=201) T6nq(n=600)
Thanh Tri (n=388) My DU'C (n=148) Chuong My
{n=152) Tfinq(n=688)
n=1288 S6ca difong
tlnh 13 5 18 29 8 11 48 66
Ty 1$ % 3,26 2,49 3,00 7,47 5,41 7.24 6,98 5,12
Old tn p
>0,05
>0.05
<0,01
Y HOC THUC HANH (886) - S6 11/2013
Hoc sinh t i l u hoc Ha Ndi nhilm don bdo chung Id 5.12%. Trong dd hoc sinh d ngoai thdnh nhiem don bao (6,98%) cao hon tai tai ndi thdnh (3.00%).
Tafdng tieu hoc Thanh Tri hoc sinh nhiem cao n h i t la 7,47%. hep theo Id Chu'ong My (7,24%). My Ddc (5.41%). Tai cac tru'dng ndi thdnh. hoc sinh tru'dng Hodn Kiem nhidm don bao 3,26% cao hon Thanh Xuan Id 2,49%. Ty Id nhidm don bdo giu-a cdc trudng noi thanh vd giO'a cdc tru'dng ngoai thdnh khdc nhau khdng co y nghTa thong ke (p>0.05). Nhu-ng giO'a tru'dng ndi thdnh vd ngoai thdnh cd sy khdc bidt cd y nghTa thong ke (p < 0.01)
Bang 2; Ty lg nhig nam v^ nO
Gi6i tinh Nam NCr trip
N6i thdnh
"
279 321
S6 10 8
%
3,b8 2.49 0,59
m do-n bSo dijifng mot giO-a fn Nqo^i thdnh
n 386 303
S4 2/
21
%
7,01 8,93 0,91
TSSB n 664 624
S6 3/
29
%
5,57 4.65 0,53 Ty id nhidm don bao d hgc sinh nam (5,57%) c hon hoc sinh nu- (4,65%). Nhu-ng s y khdc bi§t n ^ khdng cd y nghTa t h i n g kd (p > 0,05). Ty le nhilm a ca nam va nu' tai cdc trydng ngogi thdnh diu cao hon d cdc trydng ndi thanh, tuong Img la 7,01% vh 6,93% vdi 3,58% vd 2,49%.
Bang 3. Ty Khu vyc N^i th^nh
(n=600}
Ngoai thSnh {n=688) Tong (n^1288)
e nhiem cdc loai don bdo du-dnq rudt d tre em Ida tuoi t i l u hoc So lu-o-nq/ Ty 1$ nhi§m (%) E coli
8 (1,33%)
21 (3.05%)
29 (2,25%)
E histolitica 6 (1.0%)
14 (2,03%)
20 (1.55%)
6. lamblia 3 (0.5%)
12 (1.74%)
15 (1.16%)
£ harmani 2 (0,33%)
4 (0.58%)
6 (0,47%)
E. nana 1 (0.15%) 1 (0.08%)
Nhifim Chung 18 (3.0%)
48 (6,98%)
66 (5.12%) Ty le nhiem E.coli Id cao nhit (2,25%), sau dd Id
E.histolitica (1.55%), G. lamblia (1.16%), E- harmani (0,47%) va t h i p nhat \d_E.nana (0,08%). Trong tong so 66 tru'dng hp-p nhidm. cd 61 tru'dng hop don nhidm cac logi vd 5 tafdng hp'p nhidm phoi hop 2 logi don bdo (3 nhiem E. coli vd £ histolitica. 1 trudjig hop nhiem E.coli vd G.lamblia. 1 trudng hop nhiem E.harmani va G lamblia)
2. K i t qud didu tra phong vdn theo bg cdu hdi:
Bang 4: Moi hdn quan gida vd sinh vdi tinh trang nhilm don bdo d tre em
Tap quan sinh hoal, dieu ki?n song (n=1288) Khang h o p vg sinh (n=555)
Hp'p ve smh (n=733) OR, p
Nhiem do'n bao (n=66)
Khflng n h i l m "
d o n b^o (n=1222)
OR=4,84(2,61-9.1);
RR=4.49 (2,55-7,9), p<0.05 Trong tong so 1.288 hoc sinh du'o'c phong van cd 554 hoc smh (43.01%) tra Idi nha cd qudn sinh hoat, dieu kien song hop ve sinh, chu yeu tai cac huydn ngoai thanh. Cdn lai 734 hoc smh (56,99%) gia dinh dieu kien song chu'a hop ve sinh, Id hoc sinh song tai ndi thdnh.
Su khac biet nay co y nghTa thong kd p< 0.05.
Bang 5, Moi hen quan nghe nghiep cha me vdi tinh trang nhidm don bao d tre
Nghe nghi&p h$ gia dinh (n = 1288) Cdng nhan vien chO-c, buon
ban, thil cflnq {n=506}
Tr6ng lua, hoa mau, chan nufll (n=680) Thu gom phe lidu (n=102)
P
NhiSm do-n bdo (66) 10 (1,98%)
51 (7,5%)
5 (4,9%)
Khflng nhidm don bdo
(1222) 496 (98.02%)
629 (92,5%)
97 (95,1%) p=0,023<0,05
Bang trdn cho t h i y tre sdng tgi cac gia dinh mdng dan (trlng lua, hoa mdu vd chan nudi) cd ty Id n h i ^ don bao (7,5%) cao nhat, t i l p d i n Id gia dinh lam nghe thu gom p h i lidu (4,9%) vd t h i p nhat Id cdng nhdn vidn chu-c, budn bdn, thu cdng (1,98%). Si;
khac biet giO'a cdc ty le ndy cd y nghTa thong ke (vi^
p < 0,05).
Bang 6 Moi lien quan giij-a nhiem don bao du'dng rudt vdi tinh trang dinh dudng
Nguy CO Nhiem dan bdo
(n=66) Khflng nhigm den
bdo (n=1222) OR. p
Suy dinh di/dng 1 Khflng suy dmh (n=110) du'fl'ng(n=117B)
(91.9%)
(4.80%) 1121 (95.20%) OR = 1,75 (0,78-3,8)
,,_ p = 0.13 > 0,05 , So lieu bang trdn cho thay tre suy dinh duxJng nhiem don bdo (8.10%) cao hon tre khflng suydirtfi du'dng (4,80%) Tuy nhien, moi hdn quan Id khdng c6 y nghTa t h i n g ke vdi OR = 1,75 (0.78-3.8) vd p = 0,13
>0.05 BAN LUAN
1. Thirc trgng n h i l m d o n bdo du-dng ru$t d tri em t i l u hpc tai Hd Ndi
Nghidn cdu cua cliung tdi cho thiy k i t qud nhilm don bdo du'dng rudt d tre em t i l u hpc mdt s l ap^
huyen tgi Hd Nfli Id 5,12%, Con so ndy thip hon tgi Thdi Binh ndm 2006 theo nghidn cdu cua Ld Thj Tuy&
Id 13,75% tgi Ninh Binh ndm 2007 theo nghidn ci>u cua Nguydn Thanh San Id 16,59%. Theo bdo cdo hit qua hoat dflng phdng ching ky sinh tnjng khu v\«:
Nam Bd-Ldm Dong 2006-2011. ty Id nhidm don t)So Chung d thdnh p h i H i Chi Minh ndm 2006 id 10%. Ty Id nhilm don bdo dudng rudt d tre em t i l u hpc d W Ndi m i c du t h i p nhung v i n cdn Id tilm I n do bdng
Y HOC THirc HANH (886) - S6 11/2013
phdt cao Tgi cdc vung ngodi thdnh ty Id vdn cdn 7.36% Trong khi. chuogn trinh phdng ching giun san dd dwgc tndn khai tai Hd Ndi t u ndm 2006 d i n nay cung vdi cdc chuong trinh vd- sinh trudng hpc khdc nhu n>a tay sgch, tnjyen thdng y t l hoc dudng van dang duo'C duy trl. V l tinh trgng phdn b l cdc logi don bdo dudng njdt nhu sau: E.coli Id 2,25%; E.histolitica Id 1,55%; G.lamblla Id 1,16%; E.harmanl Id 0,47%;
E nana Id 0.08% So vdi nghidn cuu cua Ngd Thi Minh Chdu trdn hoc sinh trung hpc c o sd cua thdnh p h i H u l ndm 2007, E.coli Id 16,5%, E. histolitica Id 9 %; G.
lamblia Id 12,25%; E.harmanl \d 8%, E. nana Id 5,75%
thi ty 1$ nhidm don bdo trong nghidn cuu cua chung tfli t h i p hon nhieu, nhung ty Id nhidm cua cdc logi don bdo cQng theo thd ty. chilm ty Id cao nhit Id E. coli, tilp d i n Id E histolitica vd G. lamblia. thap nhit Id £ nana 0 day chung ta c i n luu y v l 2 loai £. histolitica vd G. lamblia dd gdy ra cdc tndu chdng bdnh dudng tieu hda' II amip, r l i loan tidu hda. do do chung ta c i n c6 bidn phdp phdng ching. t u v i n vd dieu tri kip thdi.
Ty Id hai logi don bdo thu-dng gdy benh dudng tieu hda Id E. histolitica vd G lamblia trong dieu tra cua chOng tdi Id 2,71% t h i p hon nhilu so vdi d i l u tra tai Didn Khdnh-Khdnh Hda ndm 2011 Id 16,52%
2. Ddnh gid m l i Men quan giu-a vd sinh mdi tru'dng, dn udng td-i tinh trang nhidm d o n bao vd dnh hu'dng cua nhidm d o n bdo t d i tinh trang sue khde cua tre em
Phdn tlch cdc y l u to lidn quan chung tdi thiy cd m l i lidn quan giua n g h i nghidp hfl gia dinh tdi tinh trang nhidm don bdo dudng rudt d tre em. Cf nhung hd gia dinh Idm n g h i trong lua, hoa mdu, chdn nudi, ty 1$ trd em nhidm don bdo chilm ty Id 7,5%; cao nhit so vdi ty Id nhidm d nhu-ng tre cd bo me ldm cac nghi nghidp khdc, vd su- khdc bidt ndy id cd y nghTa thing kd (p<0,01). B i l u ndy cd t h i lidn quan den tinh trgng rau xanh, nudc thai chua nhieu nguIn don bdo, mdc dO Id n g h i nghidp cua hd gia dinh nhung cung dnh hudng tdi dieu kidn dn d ciJa tre em. Dd cd nhilu nghien cdu v l cdc logi rau xanh. nudc thai chua nhilu logi don bdo khdc nhau Nghidn cuu cua Nguyin Khic Lyc. ty Id nhidm don bdo trdn rau qua trlng d ngoai thdnh Hd Ndi ndm 2009 Id 82,20%
Nghidn cdu cua Nguydn Vdn D l , ty Id nhilm don bdo trdn rau tgi Hd Ndi ndm 2009. ndi thdnh Id 30,6%;
ngogi thdnh Id 48,8%. Cdn d nhung hd gia dinh lam nghi thu gom p h i lidu (chu y l u Id phu_ huynh hpc sinh trudng Dai NghTa) ty Id hpc sinh nhiem don bao Id 4,9 % cao hon d nhung hfl gia dinh cdng nh_an vidn chuc vd mdt s6 n g h i khdc, ty Id hpc sinh nhidm don bdo Id 1,98% S y khac bidt ndy Id cd y nghTa thing kd (p<0,01) Chimg tdi thiy cd m l i hdn quan rd r$t gida d i l u kidn vd smh mdi trudng, vd sinh dn u l n g vdi tinh trgng nhiem don bdo d trd em Tdp qudn sinh hogt d i l u kidn s i n g khflng hp'p vd sinh ty 1$ nhilm don bdo Id 9,19%, khd cao so vdi ty Id nhilm don bdo d nhO-ng hpc sinh cd tdp qudn sinh hogt dilu kidn s i n g hp'p vd smh (2,05%) Ty Id nhidm tdng Idn 4,84 l i n d nhdm t i l p xuc yeu to nguy ca (0R= 4,84 vdi p<0,0001) D i l u kien smh hogt, vd
sinh mdi trudng. dn u l n g khdng dam bao thudng gdp d khu vuc ngoai thanh. d nhung hd gia dinh cd n g h i nghidp Idm ndng nghiep hoat t i l u thu cflng nghiep Dieu ndy phu hop vdi nhu-ng k i t qua phdn tich tren ve khu vuc ndi thdnh vd ngoai thdnh Hd Ndi, v l nghe nghidp ho gia dinh
Nhieu__nghien cdu da chi ra moi lien quan giua tinh trang nhidm giun dudng rudt vdi tinh trang suy dmh dudng d tre em Theo Nguydn Thi Vidt Hda, 2005 nhidm giun dudng rudt cd the la y l u t l khdi d i u quan trpng cho qud trinh t i l n triln suy dinh dudng Nhidm don bdo dudng rudt logi E histolitica, G.
lamblia cung gdy ra cac tridu chung ve dudng tidu hda li amip, r l i loai tidu hda va cung la mdt yeu t l gdp p h i n gdy ndn tinh trang suy dinh dudng d tre em Ty Id tre suy dinh dudng trong nghidn cuu cua chiing _tfli la 8,54%. trong do ty Id suy dmh dudng d tre nhiem don bdo la 13,64% cao hon ty Id suy dmh dudng d tre khdng nhiem don bao la 8,27% S u khac bidt ndy khdng cd y nghTa thong ke (p>0,05)- Nghien cuu ndy chua thay anh hudng rd ret cua tinh trang nhidm cac loai don bao ndi chung vdi linh trang suy dinh dudng d tre em.
K^T LUAN
Qua dieu tra 1288 hoc sinh cac trudng tieu hpc d 5 quan, huydn nfli thanh vd ngogi thdnh Hd Nfli ndm 2012 cho thay ty Id nhiem dan bdo dudng rudt d tre em lua tuoi tieu hoc d cdc diem dieu tra tai Ha Nfli Id 5.12%. Nhidm don bao dudng ruflt d tre em lua tuli tilu hpc khu vyc npi thanh Ha Nqi la 3% va ngoai thdnh Hd NOI Id 6,98%, Ty ie nhiem tung loat don bdo dudng ruflt Id £. coli Id 2,25%, E histolitica 1,55%, G Lamblia Id 1,16%. E harmani Id 0,47% vd E. nana Id 0,08%.
Cd m l i lidn quan giCra nghe nghidp cha me vdi tinh trang nhidm don bdo d tre em Ddng thdi, tdp qudn smh hogt, dieu kidn sing cung anh hudng d i n tinh trang nhilm don bdo d tre em.
TAI LIEU THAM KHAO
1, Ngo Th! Minh Chau va CS (2007), " Nghien CLKU tinh hinh nhilm don bdo tieu hoa d hoc smh trudng trung hoc co- sd Nguyen VSn Trdi, TP. Hue", Tap chi Y dugc hpc quan sy, 35 (4), tr. 108-114.
2. Nguydn Van De (2009), "Xac dmh mam benh ky smh trung gay benh cho ngudi trong rau vd thuy san duoc nufll trlng tu nguon nudc thai tai mgt sd thanh pho va nong thdn miln Bkc", cong trinh khoa hoc bao cao t^i hdi nghj ky sinh tnJnglan thir 38, tr 111-117
3 Nguyen Thj Vidt Hoa (2005), " Moi lien quan giii'a nhiem ky smh trung dudng ruflt, sy phat trien the lyc va tri lyc d tre lua tuoi mau gido va hpc sinh viing nong thdn Nicaragua", Tap chi phong chdng b&nh sot ret va cic b&nh ky sinh triing, (so 5), tr 81-88
4 Dgng Thanh Sen vd CS (2007), Xac dinh ty Id nhiem bao nang dan bao dudng rugt d lica tuoi hgc sinh tieu hoc lgi 3 viing dong blng, trung du. mien niii. Bao cao tong kit de tai nam 2007
5. Le Th| Tuyet (2007), " Thyc trang nhiem don bao dudng rupt cua hpc smh trudng tieu hpc xd Song Lang, huydn Vu Thu. Thai Binh nam 2006', Tdi lipu Hpi nghj Ky smh trting todn quic lan 34, tr 30-34
6. Anand AC, Reddy PS, Saiprasad GS (1997)
Y HOP THirr HANH (886t - S(") 11/2013
"Does non- dysenteris intestinal amoebiasis exist".
Lance/Vol: 349 Iss 9045. pp. 89-92.
7 Hague R. Faruque AS, Hahn P. Lyerly DM (1997). 'Entamoeba hystolytca and Entamoeba dispar infection in children in Bangladesh" Joumal infections Diseases Vol.175 Iss.3. pp, 734-736, Date: Mar.
8. Newman. R.D; Moor. SR; Lima, A.A.M;
Nataro.J.P; Guerrant.R.L; Sears.C (2002). "Alongitudinal study of G. lamblia infection in the North-East Brazinllan children", Tropical Medicine and International Health, 6 (8), pp. 623-634.
9 Perera.J. Jayawardenne.l, Mendis.L, Abyratne.K (2000). "Intestinal parasites and diarrhea in children hospital in Srilanka'. The Crylon Joumal of Medical Science. 42(1), pp. 7-12.
lO.Ravinder Kaul, Deepti Rawat, Manish Kakkar, Beena Uppal, VK Sharma (2002), "Intestinal parasites in children writh diarrhea in Dehi, India". The Southeast Asian Joumal of Tropical medicine and public Health, 33 (4), pp. 725-729.
II.Roch J (1999), "Prevalence of intestinal parasite infection with special reference to E. histolitica on the Island of Bioko", Am.J.Trop.Med.Hyg, 60 (2), pp.257 - 262.
12. Sung Tea Hong (1994)."lntestinal porotozoan Infection among popele in Korea". Paraste con^ol in Korea 1994 pp 113-120.
13. WHO (1987). Prevention and contnal of intestinal parasitic infection Report of WHO expert commite: technical report series, 86 (749).PP12.
NGHIEN Cilu DANH GIA KET QUA PHAU THUAT DUG THUY TINH THE a TINH HA GIANG
DAT VAN Gt
Due t h i thuy tmh (TTT) Id tinh trgng the thuy tinh ciia m i t b| md. T h i thuy tmh Id cau tnic giup cho m^t djnh thi vdo cdc vdt d cdc khoang cdch khdc nhau, binh thudng v l n r l t trong s u i t . Theo tilng La tinh, t d
"cataract" cd nghTa la mflt ngudi nhin qua hoi md cua thdc nydc. Bdnh due TTT chilm 48% ty Id mil lod trdn todn t h i gidi, duoc udc tinh khoang 18 tridu ngudi, theo To chuc Y t l the gidi. Tai nhilu nudc.
trong dd cd Vidtnam, djch vy m l khdng d i y du va benh dyc TTT vdn bi coi Id nguyen nhdn gdy mu lod hdng d i u . Khi t u l i thg cua ddn chiing cao, s l lugng ngudi bi dyc TTT se tdng Idn. T u l i tho cao Id y l u to ldm cho ty le m l c due TTT cao. Tgi cdc nudc dang phdt triln, r l i logn thi gidc do due TTT edn p h i b i l n do bdnh nhdn ph^i chd dp-i m l ldu. cdc v i n d l kinh te-xd hdj vd ddn tri t h i p gdy anh hudng d i n can thidp phdu thudL
Dye TTT Id v i n d l duoc luu tdm trong cdc k l hogch quoc gia phflng ching mu lod vd tJ Id m l due TTT dd tdng cao d nhilu nudc tren the gidi. Tai cde q u i c gia dang phdt triln. ty Id dup'c m l dyc TTT thay d l l trong khoang 2000-2700 phau thudt/ 1 tndu ddn/
ndm, Cdc trd ngai cho phdu thudt dyc TTT tgi cdc cflng dong nghdo gom ed nhan thuc eua ddn, gid thanh phau thudt cao vd hgn che t i l p can. Cdc ky thudt m l gid thdnh t i l t kiem da dudc de ra vd thu nghidm cOng vdi vide dua vdo loai TTT nhdn tgo gid thdnh thap. Tuy nhien, tai cde viing nflng thfln nghdo, dich vy chdm sdc m i t bj t h i l u thon vd ngay ca khi cd thi chit luong ciJng khong duoc dam bao. Cdc k i t qua thi lyc sau m l kdm cung Id trd nggi quan trong ldm cho bdnh nhdn tiep cdn m l khd khdn.
C h i t luong mo due TTT vd v i n de theo ddi Id nhu'ng y l u t l anh hudng tn^c t i l p den ty 1$ thdnh cflng ldu ddi cua phdu thudt Tuy nhidn, chua cd nghidn cuu ndo ddnh gid cde y l u to dd d l n h i m cai
VU MANH HA, Khoa mat benh vi$n iinh Hd Giang PHAM TRONG WAU.Bp mdn Mat Dai hgcyHd Noi, N G U Y I N THj THU V i N , B$nh vi^n Mat Trung uong thidn mo dyc TTT tgi Hd giang. Nghien cdu ndy d§
duoc t i l n hdnh de giai quyet cdc v i n d l dd.
Hd Giang Id mdt tinh mien nCii phia b i c Vidt Nam.
Ddn so cCia todn tlnh Id 735.093 ngudi bao gim 30 ddn tflc. Hd Giang cd 180 xd phudng n i m trong 7 huydn. 1 thj xd va 1 thdnh p h i . T i n g sd hd gia dinh Id 143,397. Fred Hollow/s (FHF) dd tdi trp- cho dy dn chdm sdc m i t nflng thdn d Hd Giang dwgc 3,5 nSm (to thdng 7 ndm 2007). Cde mue tidu chinh cua nghien euu bao gom:
1. Xdc dinh cdc y l u t6 anh hudng d i n kit qui phdu thu$t m l dyc TTT nhu p h i u thu§t vidn, thdi gian phdu thudt vd d i l u tri, tinh sdn cd cOa djch vu, khS ndng t i l p cdn m l vd chi tra cho eudc m l cua bdnh nhdn.
2. Ddnh gid ty Id phuc h l i thj lyc sau m l . chit iwgng cude m l vd v i n d l theo ddi.
3. Ddnh g[d cdc hi$u qu^tdc dflng v l m$t kinh l l xd hfli eua phdu thudt dye TTT d l i vdi cdc b§nh nhdn dyc thuy tinh t h i . vd gia dinh/cdng d i n g cua hp.
D 6 | TU'CTNG VA PHU'aNG P H A P NGHIEN ClfU Nghidn cu-u c6 hai thdnh p h i n Id nghidn cuu dinh tlnh vd nghidn cuu d\nh iwgng Phln nghidn euu dinh tinh ddnh gid nhdn ttn>c cua ldnh dgo ede tnjng tdm m i t tinh y d ndng luc cua cdc bde sy chuydn khoa mit trong phdu thudt vd d i l u trj cdc bdnh nhdn bj dyc thujr tinh the t u l i gid. Phin nghien cuu dinh luong ddnh giS k i t qua p h i u thu$t dyc thuy tinh t f i l , cdc y l u t l anh hudng d i n k i t qua, eo s d ha t i n g vd trang thilt bj can thilt cho m l due TTT vd hidu q u i kinh te xd hdi cua phdu thudt dyc thuy tmh t h i d l i vdi bdnh nhdn.
Nghidn cdu i^nh tlnh
Cdc bdnh nhdn dd d u o c p h l u thu^t dyc thuy tinh t h i c u trCi tgi dja phuong nghidn cuu ( d l phIng van sdu).
Nghien cdu djnh \wgng
Tieu chuin chgn bdnh nhdn khdm' T i t c i cdc
Y HOC THV'C HANH (886) - S 6 11/2013
