T3 v i T4 dp day tuOng Ung l i 14,63 + 6,4 mm v i 23,28 + 10,45 mm. Su khic biet nay cd y nghTa thdng ke vdi p < 0,001.
Dac diem cua hach khu vuc tren SANS: Trong nhdm cd hach khu vuc thi 40 trudng hdp la hach vung tmng that ~ rdn phdi (88,9%) v i 5 trudng hdp la hach viJng vanh vj-than tang (11,1%), khong cd tmdng h ^ nao x i c dinh cd hach viJng eo. Theo thong bao cua Hiep hdi ung thu Nhit Ban, khoang 60% cac tmdng hdp ung thu thuc quan c6 hach di can. Kajiyama va cdng sU trong mot nghiem cUu nam 2002 da ket luan vd su phan bd ciJa hadi di can trong ung thuthue quan nhu sau. 22% cr cd, 34% tmng that tren, 23% 6 tmng that giUa, 20% trong tmng that dudi va 38% ci khu vuc tang tren eCia bung [5].
Tinh chat di can cua hach: Cd 28/45 tnJdng hdp hach duae dinh gia la hach di can chiem 62,2%. Trang dd ed 23 trudng hdp l i hach viing tmng that - rdn phdi (89,3%); 5 trudng hdp hach di can vj tri vanh vi - than tang (10,7%). Hinh dang hach cd sir khic nhau gyita hai nhdm hach duoc dinh gia la hach viem hay hach di cin. Hau het cac hach di c i n la hach cd hinh bau due (19/28), nguac Iat sd hach tron nam eh^ yeu trong nhdm hach viem (13/22), su khie biet nay cd y nghTa thdng ke vdi gia tri p = 0,004. Kich thudc tmng binh ciia nhdm hach viem l i 6,95 ± 1,39 (4,50 - 9.55) mm, nho hdn kich thudc tmng binh cua nhdm hach di can 11,31 + 2,8 mm (7,30 - 19,00), sU khac biet nay ed y nghTa thdng ke vdi p < 0,001; dudng kinh dai cCia nhdm hach di cin 13,48 + 4,56 (9-29) mm, Idn hdn dudng kinh dai cOa nhdm hach viem 7,7+ 1,67 (5-11) mm; dudng kinh ngan cCia nhdm hach di can 13,48 + 4,56 (9-29) mm, Idn han dudng kinh ngan cOa nhdm hach viem 7,7 ± 1,67 (5 - 11) mm, c i c sU khac biet nay deu ed y nghTa thdng k i vdi gia tri p < 0,001. Ket qua nay cijng g i n gidng vdi ket qua trong nghien eUu eua Yoko Murata va cdng sU dupe eong bd nam 2003: kich thudc trung tilnh cOa nhdm hach viem la 6,4 ± 1,85 mm, kich thudc tmng binh ciia nhdm hach di can 9,6
± 5,05 mm [7]. Cung tuong tU nhu vay, mdt kdt qua duac mo ta nam 1995 bdi Heintz v i cdng su: Mch thudc cda hach di cSn 10,1 ± 5,3 mm Idn han s o ^ i
hach viem 7,4 ± 2,9 mm [8]. ^ KETLUAN
Sieu am noi soi cd vai trd quan trpng trong chan d o i n giai doan ung thu thut quan d chi tieu xam lan Bianh (T) va di can hadi (N). Da so cac tnjdng hop UTTQ bieu hien tren hinh anh SANS l i khdi giam dm khong ddng nhi't, da phan thudc 1/3 dudi thite quan (50,9%), ed dp day v i chieu d i i l i bung binh 13,3 j 7,42 mm va 55 ± 33.07 mm. Cd 86.5% benh nhSn duae x i c djnh ed hach khu vUC, trong dd 88,9% hach viJng tmng thi't - rdn phdi va 11,1% hach viing vanh vi - than tang. Dudng ki'nh tmng binh cQa hach l i 9,671 3,18 mm; toan bd c i c hach deu cd cau tnJc giam im, sd hach duac d i n h gia la di c i n chiem 62,2%.
T A I L I E U T H A M KHAO
1. F.Campbell, W.V.Bogomolets., and G.T.Williams,, Tumors of the esophagus and stomach. Diagnostic histopathology of tumors, 2000.1: p. 313-328.
2. G. Lee Randall, Esc^hagus. Diagnostic Surgical PaUiology, 1999. 2: p. 1283 -1309.
3. Pham DUc Huan and Do Mai Lam, Cat thuc quin ndi SOI nguc phai vdi tu thi nkm sip trong diiu trj ungM thuc quan Nghien cUu Y hoc. 2006. 54(43): p. 30 - 33. ,F
4. Biii van Lenh, Do DUc Van, and Hoing Dill: Kit Trieu chUng lim sang vi die diim hinh inh ung thitt^^
quan trin chup c4t Idp vi ti'nh. Y hoc thUC hinh, 2006;'?.
39 - 42. ' :^
5. KajiyamaY and TsummamM., Esophagectomy l^i lymph node dissection through right thoracotomy. NipM' Geka Gakkai Zasshi, 2002. 103(343-347). '^
6. Zuecaro, G., Jr., et al., Endoscopic ultrasound enors in esophageal cancer. Am J Gastroenterol, 2005, 100(3). p 601-6.
7. Yoko Murata, et a l , Preoperative Evaluation of Lymph Node Metastasis in Esophageal Cancer Ann Thorac Cardiovasc Surg 2003. 9(2).
8. Heintz A, et al.. In vitro studies of lymph node analysis. Gastrointest Endosc Clin N Am 1995, 1995.5: p.
577-586.
HIEU QUA CUA CAY C H I (NHU CHAM) TREN BENH NHAN DAU COT SONG THAT LUNG
TOM TAT
Muc tieu: Danh gia tac dung cay chi catgut (nhu chim) trin benh nhan dau cdt song thit lung. Tim hieu tic dung khdng mong muon cOa phuang phap cay chi.
DOI tuang va phuang phap nghien cUu: 38 binh nhin dau cdt sdng thit lung duac dieu tri, bang phuang phip cdy chi catgut tai khoa Y hpc ci truyen Binh vien HOU Nghi tU thang 1/2014 ddn thang 12/2014. Kit qua:
MUc dd giam dau trung binh 4,48 diem (tU 6,16 diim xudng 1.68 diim). ket qui tdt: 28,95%,, kit qua kha:
47,37%, kdt qui tnjng binh: 23,68%. Trong qui trinh diiu tri khdng thay ed tac dung phu. Kit luan: Cay chi cd hiiu qua tmng diiu tri binh dau cdt song thit lung vi khdng cd tic dung phu.
VU NGOC VLTONG, HOANG V A N L V Benh vipn HOu Nghj
Tirkhoa: Dau cdt sdng thit lung. Cay chi catgut.
SUMMARY
EFFECTS EVALUATE OF CATGUT IMPLANWG IN THE TREATMENT LOW BACK PAIN m
Objective: Effects evaluate of catgut Implanting the treatment low back pain and study undesiral^
effects of catgut implanting. Subject and methods:^
low back pain patients are treated by catgut imf^t0^
at the traditional medicine department of Friendsm Hospital from January 2014 to December 2014. Rssrf Reduce average pain level was 5.4 points (from 6.SI points to 1.27points) a<xx)rding to Visual ana/ogw scale, good result: 54.6%, quite result: 32.3%,
Y HOC THirC HANH (953) - s 6 3/20iS
moderate result: 13.51%. Treat by catgut implanting doni cause undesirable effect. Conclusion: Catgut implanting effects of treatment low back pain and treat by catgut imf^anting don't cause undesirable effect.
Keywords: Low bac/t pain, catgut implanting.
O A T V X N D i
Hoi chUng dau cdt sdng that lung l i bieu hiin lam sang thudng g i p nhat. la nguyin nhan dUng hang thCr hai sau cani cum, l i m mat ngay cdng lao ddng. Dau cdt sdng that lung cd the cap h o i c man tinh, dau keo dai hay tUng ddt, dau cd the khu trt d that lung hay lan doc ttieo cot sdng h o i c lan xudng mot h o i c hai chin.
Dau cd the t i n g len do ddng tac nhu cui. nghieng, nang vac v i t n i n g . . .ed rat nhieu nguyen nhan g i y dau cot sdng that lung nhUng thudng g i p l i do thoii hda cpj sdng that lung, thoat vj dTa dem, viem cdt sdng, ..[1]
De ^ e u tri dau cdt sdng that luhg h i i n nay ed rat nhieu loai thudc, tuy nhien thudc gay nliieu t i c dung phu tham chi mdt sd benh nhan chdng chi djnh diing thudc [1], [6]. Y hoc cd tmyen da cd nhieu phuang phip dieu tn dau cdt sdng that lung nhu cae bai thudc ed phUdng, chim eUu, xoa bdp, bam huyet tuy cd hiiu qua nhurig thdi gian didu tri kha d i i , benh n h i n hang ngiy phai di lai hoic phai nam dieu trj ndi tru. PhUdng phap cay ehi v i o huyet la mdt phuang phip khdng dung thudc, da duac ap dung tU l i u v i cd hieu qua tren mot sd benh [2], [3]. Tai Binh vien HUu Nghi chung tdi d i i p dung phudng phap c^y chi dieu trj mdt sd benh thudng gap th^y kdt qua rat kha quan, d i e biet trong hdi ehurig dau cdt sdng that lung. Cay chi it tdn kem phCi hdp vdi thu nhap cCia ngudi Viet Nam, khdng phai di lai mi't thdi gian. 6 Viet Nam hiin nay, chua nhieu cdng trinh nghien cUu ve hieu qua cCia phuang phap Ci'y chi, d i e biet trong dieu trj benh dau cot sdng thit lung. Vi vay, chiing tdi tii'n hinh de tai nghien cUu ci'y chi trong dieu tii dau cdt sdng that lung nham cac muc tieu sau'
1. Dinh gii tac dung cdy ehi (nhu cham) trin binh nhin dau cdt sdng thit lung.
2. Tim hiiu tac dung khdng mong muin cQa phuang phBp cdy chi.
DOI TirONG VA PHliONG PHAP NGHIEN C(J\i 1. Dd'i tuang nghien cihi
Chiing tdi tien hanh nghien eUU tren 38 binh nhin duac chan doan la Dau cdt sdng that lung va duac dieu trj ngoai tru tai khoa Y hoc cd tmyen Benh vien Hun Nghi trong thdi gian tU thing 1/ 2014 den thing 12/
2014.
2. Phuong phap nghien cOu
Nghien cC(u duac thiet kd theo phuang phap thO nghiem l i m sing tidn cCfu, so sanh ket qua tnJde va sau dieu tn.
- Tieu chu^ chpn bpnh nhin:
Tat ca benh nhan dUde kham, chan doan theo y hpc hien dai cd trieu chUng dau cot sdng that lung.
- Tieu chudn lo^ b-Crb^nh nhin:
Benh nhan dau cdt sdng that lung do lao, binh ac tinh h o i c di c i n den cdt sdng.
Oau cdt sdng do nguyen n h i n npi tang (Viem tui mit, sdi t h i n , thOng loet da day...).
- Phuc/ng phap tidn hinh:
+ Phuang huyit: Dai tmdng du. Than du, Hoan khieu hai ben [4]. Neu dau lan xudng chin them huyet Duang ling tuyen, huyen chung hoac An mdn, t h i ^ sdn.
+ Dung cu cay chi: Kim Troea cd 18 hoac 20. Chi Catgut sd 2 hoic sd 3.
+ Uiu trinh: Mot ddt dieu tri cay 3 lan, mdi lan cay cich nhau 10 ngiy.
- Ky thuit cay chi:
Cat chi Catgut thanh doan 1-1,5em. Ludn doan ch!
v i o trong Idng kim. Xac djnh huyet, s i t trung da rdi dam kim nhanh qua da, sau dd day kim tU tU den v\ tri dat dac khi. Khi do dijng nong kim day sdi ehi catgut ra khdi ndng kim rdi nJt kim ra. Dat gac vd trung len ndt cay chi rdi eo dinh bang bang dinh.
- Cac chi tiiu theo ddi:
+ Danh gia diim dau:
Sit dung thUde do do dau VAS (Visual analogue scale) chia vach tU 0 - 1 0 .
+ Dinh gii vi tri dau:
Dau tai chd cot sdng that lung, dau tai chd Ian xudng mong dui.
Dau tai chd v i lan xudng mong dui, cang chan + Danh gia triiu chUng lim sang:
Diem dau cot sdng that lung, eo eUng ed eanh sdng, lech veo cot sdng, giam udn sinh ly cot sdng.
han che hoat dong cot sdng that lung, giam chi sd Chober.
+ Mdt so chi tieu khac: Tuoi, Gidi tinh, thdi gian bj benh.
- Phuang phap dinh gia kit qua:
Dau hieu dau: So sanh (Sem dau trung binh tai thdi diem N,, NioN^oVi N30.
Danh gia chung: Chia ra 4 mUc dp khac nhau nhU sau:
+ Tdt: Dau: Het dau (chi sd VAS = 0 diem). Di lai binh thudng, cac triiu chUng ed nang am tinh.
+ Kha: Dau' Giam nhieu, con dau nhe (Chi sd VAS
< 3 diem). Di lai k h i hdn, cac trieu chiimg cd nang dd nhieu.
+ Tmng binh: Dau: Giam it (Chi sd 3 < VAS < 7 diem). Oi lai edn dau, cac trieu chi^g cd nang dd I'L
+ Kem: Dau: Cdn nhieu (Chi sd VAS > 7 diem). Di lai dau tang hoac khdng giam, cac trieu chUng cd nang khdng dd.
- Xu" ly sd lieu: Xuf ly sd lieu theo phUdng phap thdng ke y hoc.
K E T Q U A N G H I E N CCTU
B a n g 1 . P h a n b d b e n h n h a n t h e o g i d i . t u d i v a t h d i g i a n bj b e n h
Qacdiem Nam
ND T l l « ( 5 0 - 5 9 ) T i i & ( 6 0 - 6 9 ) T11OI2 70 Bi benh < 6 (hang 81 benh 6-12 thang BibSnhs 12 thang
So iiMig BN {n=381 26 12 8 17 13 7 11 20
Tyie(%) 68,42 31,57 21,05 44.73 34.21 18.42 28.95 57.14
Y HOC THVC HANH (953) - S6 3/2015
- Ty le nam gap nhieu hdn nU, sU khac biit nay cd y nghTa thdng ke vdi p < 0,05.
- L(ta tudi tren 60 chiem da sd (ehiem 78,95%).
- Tudi tmng binh ciia binh nhan la: 67 ± 8,15.
- Thdi gian bi benh trin 6 thing chiem da sd (chiem 81,58%).
Bang 2. Phin bd benh nhin theo dac diem l i m sing.
Dacdi^m Dau tai chd cat song Ihat iung Dau tai ch5 va lan xudng mOng dOi Dautaichovalan xudng mdng dOi.
clnqchdn Coc0nqcocanhs6nq Oilm dau cot song that lung
Lech veo cot sfinq Giam, mat ducmg cong sinh ly CSTL
Giam chf sflSchober
Sd luong BN (n=38)
21 9 8 14 18 11 28 34
T}le
(%)
55.26 23.69 21.05 36.84 60.5(
47.37 73.68 89.47 - Vi tri dau thudng gap nhi't la dau tai chd cot sdng that lung (chiem 55,27%). tiep den la dau tai chd, lan xudng mong diji va lan xudng mdng dui, cling chin
- C a c d a u h i e u g i a m c h i s d S c h o b e r , g i a m , m a t u 9 n s i n h l y C S T L , c o eUng c a c a n h s d n g , d i e m d a u c o t s d n g ^ a t l u n g la h a y g i p n h a t .
B a n g 3. S u t h a y d d i mUe d d d a u ( t h a n g d i e m V A S ) t h e o t h d i g i a n d i e u trj.
^^^i<etqua T h d i ^ a 1 r \ N, N.
K N«
n 38 38 38 38
Bi«mVAS( / . ± S D ) 6.16 ±1.56 4.43 ±1.62 2.76 ±1.73 1.68 ±1.75
P P(N,-N,.)<0.05 P(N„-NJ < 0,05 P(N,.-NJ<0,05 - Diem tmng binh mUc dp dau cua benh nhan lien tuc giam dan trong nhUng ngiy sau, sU khac biet niy cd y nghta thdng ke vdi p < 0,05.
- S a u 3 lan d i e u trj d i e m t m n g b i n h mUe d o d a u c d n 1,68 d i e m , g i a m 4 , 4 8 d i d m (tU 6 , 1 6 d i e m x u d n g 1,68 d i e m ) .
B a n g 4 . P h a n b o k e t q u a s a u d i e u tri b a n g c a y c h i K^lgua
T81 Kha Tmng binh
Kem Tdng s6 - Ket q u a d i e
56 luong (n) 11 18 9 0 37 u tri tot v a k h a c h
T9le(%) 28,95 47,37 23,68 0 100 e m ti le d a s o (76,32%).
- Khdng cd benh nhin ket qua kem.
Bang 5. Ket qua khdng mong mudn ci^a phUdng Phap cay chi.
Ketgua Chay mau NhiSm liung tai huydt
Sot Dau tai huygt San ngUa, m^v day
S6 luong (n) 0 0 0 0 0
T j l 6 | % ) 0 0 0 0 0 Khong gap benh nhan cd tic dung khdng mong
BAN L U A N
Nhieu nghien citu eho thi'y rang t j le mac benti 6 nam gidi cao hdn niJf gidi [5],[6]. Tuy cac sd lieu cu th^
khdng gidng nhau song tat ca cac t i i lieu ci^a cac tac gia trong va ngoai nude deu thdng nhdt vd xu huSng mac benh vudt trdi cua nam so vdi nu". Day la die diim ndi len vai trd cda nam gidi vdi cac cdng viec ning nhoc. Trong nghiin cUu cOa <±iing tdi cung phij hop vdi cae t i c gia b'en, ty le benh nhan nam la 68,42% vd benh n h i n ni^ la 31,58%. Dieu nay cung duQc gi&
thfch mdt phan la do ddi tuang benh nhan Benh ^^
HLAJ Nghi quan ly da sd l i nam gidi.
Nhieu t i c gia cho thay tudi hay gap tU 20-60 tuoi, d i y la dp tudi lao dpng sung sUc, cot sdng thudng xuyen chju t i c dong tai trpng [4],[5]. Tuy nhien, trong nghien cUu ciia chung tdi tudi mac tienh thijang gip la tren 60 tudi (ehiem 79,04%). Cd le mdt phin do c6t sdng va dTa d i m thoai hda ngay cang ting theo thfli gian, mat khac do dac tnjng benh nhan Benh vien HQ\i Nghj quan ly da sd tudi eao
Thdi gian mac b i n h duac tinh tU khi mac benh den khi dUdc kham xet, trong nghiin cUu cOa chOng loi thudng gap la tren 6 thang (chiem 86,09%), trong dd benh n h i n d i n k h i m sdm nhat la 1 thing va muon niii't la tren 10 n i m . B i n h nhan mac benh vdi thdi gian dai do benh nhan tuoi cao, cdt sdng va dia dem thoii hda n g i y c i n g tang theo thdi gian, benh nhgn da dUdc dung nhieu thude, nhieu phUdng phap dl dieu trj [1], [7].
Trong nghien cUu cOa chung tdi, vj tri chi dau tai chd d cot sdng that lung hay gap nhat, tidp ddn l i dau tai cdt sdng that lung lan xudng chan v i xudng diji.
Cac trudng hdp dau lan xudng mot hoic hai chSn thudng g i p nguyen nhan do thoat vi dTa dim, dau tSng khi ho, hat hai hoac khi dilng ngdi lau. Cae tnJdng hflp dau tai cot sdng that lung m i khdng lan xudng mong diii cing c h i n nguyen nhan thudng gap do thoai hoa cot sdng that lung, dieu n i y duac giai thfch do d5i tuong Benh vien HIAJ Nghj quan ly da sd l i ngUdi c6 tudi do v i y cot sdng v i dTa d i m thUdng cd thoai hoa.
De d i n h gia khach quan trieu chdng dau chung tdt si!f dung thang diem tote quan tuang Uhg (Viaial Aniogue Scale - VAS). t r o n g 38 binh nhan nghiSn eUu, chung toi nhin thay benh nhin cd mUc dd dau vUa chiem t j le da sd vdi 60,53%, benh nhin mUcdfl dau n i n g chidm 23,68%, con b i n h nhin cd mtte 06 dau nhe chiem ty litUdng ddi thdp 15,79%. Cdthldo benh nhan bi b i n h lau ngay, trieu ehUng dau gSp nhieu ddt vi vay m i benh n h i n thdy chii yeu miJte d6 dau vUa. MUe do dau n i n g thudng gap d binh nhan ed thoat vj dTa dem, dau ed xu hudng lan lan xudng dudi theo dudng di cGa d i y than kinh hdng to. Mot s6 nghien ciTU eua tac gia trong va ngoai nudc da khIng djnh ngoai co che c h i n ep r i than kinh cdn cd SLf tham gia cOa phan Cfng viem khdng d i e hiiu do cac chat trung gian hda hoc xuat hien tai vi tri thoSt vj gSy Theo mdt sd t i e gia triiu ehUng lam sang cd the g i p trong benh dau cdt song that lung la co cUng cd canh sdng, diem dau tai cdt sdng, m^t dUdng cong
Y HOC THlTC HANH (953) - S 6 3/2015
sinh ly, han che tam hoat dong cOa cdt sdng that lung, giam chi sd schober. Trong nghien eUu ciia chung toi cung phu hap ve c i c trieu chOfng lam sang tren vdi tan suat g i p tU 36,84% - 89,47% [6].I71.
Trong nghien cUu eOa chung toi thi tmng binh mite dd dau giam ro r i t ngay sau \ir\ dieu trj cay chi d i u tien la 1,73 diem (tU 6,16 fflem xudng con 4,43 diem theo thang diem VAS), Su khac biit giua ^ I m dau tmng binh sau lan dieu trj cay chi dau tien cua benh nhin so vdi khi v i o vien cd y nghta thdng ke vdi p <
0,05. Sau 2 lan dieu trj cay chi diem trung binh mUc dp dau cQa benh n h i n so vdi khi vao vien da giam diiac 3,40 diem (tU 6,16 diem xudng cdn 2,76 diem).
TUdng tu, sau 3 lan dieu tn ci'y ehi didm trung binh mUc dp dau cdn 1,68 diem, so vdi khi vao vien mUc dd dau nay da giam duac 4,48 didm (tU 6,16 diem xudng cdn 1,68 didm). SU khac biet nay cd y nghTa thdng ke vdi p < 0,05.
Dieu nay cho thay hieu qua ro ret cOa cay chi trong dieu trj giam dau cho benh nhan dau cdt sdng thit lung. Theo YHCT phuang Ddng, con ngudi la mot chinh the thdng nhat. Viec phdng va ehija benh dUdc chu trong vao gdc benh. Nhieu nghien cUu khoa hoe chCmg minh duac ban chat cOa cham eUu, cija t i c dpng tren cac huyet dao bang nhieu each khic nhau nhutU c h i m , thfly c h i m , laze cham... Dudi tac ddng eCia chim, co thd tidt ra mot hoat chat npi sinh endorphin cd t i c dung giam dau gap 200 lan morphin.
D i y l i mot ly do chiimg minh duWc hieu qua eCia chim t i giam dau, cfla cham cUu cai nghien ma tOy. Nhieu nghiin cUu cho thciy c h i m cUu cd tac dung giam dau, chdng viem, dieu hda huyet ap, chdng tieo phi.., Cdy chi l i mdt phudng phap phat trien ciJa c h i m eUu d tam eao phuc vu cdng tac chim sdc v i o bao ve sUe khoe nhan d i n [2],[3].
Trong nghien citu ciia chung tdi ket qua tdt l i 11 BN (chiem 28,925%), ket qua kha l i 18 BN (chiem 47.37%), ket qua tmng binh l i 9 BN (chiem 23,68%), Khic vdi cham cCfu tmyen thong su tdn luu eua chi catgut trong huyet dao vdi mdt thdi gian dai da phat huy duac vai trd ki'ch thfch huyet dao nham tao duac su c i n bang am duang, dieu chinh chCtc nang tang phii.
hanh khf hoat huydt, khai uat tre, chi thdng. Theo y hpc hien dai cung nhU c h i m eUu, cay chi cung cd t i c dung kich thfch theo cd che than kinh va the djch. Nhieu nghiin eUu cho thay cay ehi cd tac dung giam dau, chdng viim, an than, dieu hda the djch, co gian mach mau, kich thfch phuc hdi than kinh, didu hda truang luc ca, ting cudng dinh dUdng tai chd. Benh t i t sinh ra l i do mat can bang am duang, ngUdi x i ^ cung cho rang
thdng bi't thdng, thdng thi bat thdng ed nghTa rang khi huyet trong ca the bj U t a c s e g i y d a u , khai thong duac sU (t tac dd thi se hdt dau. Tai Hungary, bac sT Le ThOy Oanh la ngudi da nghiin cUu, (tng dung phuang phap cay chi ^ e u tri phuc hdi chUc ning cho nhieu benh ehUhg khac nhau v i thu dUdc nhieu ket qua kha quan.
Cay chi phuc hdi chUc nang da mang lai hieu qua kinh te; mot giai phap giam tai cho nginh y t^ neu dudc phd cap d^n y te ca sd. Cay chi khdng nhUng thay the duae phuang phip c h i m citu tmyen thdng ma edn ning cao hiiu qua dieu trj, giam thieu thdi gian dieu trj cOa benh nhan va Uiay thudc [21,[3].
Trong qua trinh nghien cUu chung tdi khdng g i p bat ky t i e dung phu nao cQa cay chi (bang 5), dieu nay cung phu hap vdi nhieu tac gia trong v i ngoai nudc.
Cay chi da tao ra mdt cudc c i c h mang trong c h i m cUu. Thut te lam sang cho thay cd the danh gia phUdng p h i p dieu trj nay cd nhieu Uu diem hdn so vdi chim eUu tmyen tlidng, hieu qua dieu trj cao hdn c h i m cUu, ngudi benh khdng phai di lai nhieu lan, khdng phai nam vien, giup ngudi benh tiet kiem duae nhieu thdi gian.
KET LUAN
Qua nghien eijfu 38 binh nhan dau cdt sdng,that lung bang cay chi thay cd hieu qua:
- MUc dd giam dau tmng binh l i : 5,4 diem (tU 6,67 diem xudng 1,27 diem).
- Ket qOa tdt v i kha la 29/38 benh nhan (ehiem 76,32%),
Trong q u i trinh didu tri khong g i p bit ky tac dung khdng mong mudn n i o cfla cay ehi.
TAI U $ U THAM K H A O
1. Hd Huu LUdng (2005), Dau cot sdng that lung va thoat vj dia dim, Nxb Y hpe. Ha Npi, tr 144-186.
2 L i Thuy Oanh (2001), Cay chi chij^ beo toan than vacucbd. Tap chi Y Duoc hoc Co truyin Viit Nam, 01, tr.
3 8 - 4 0 . '
3. Nguyin Thai Sdn (2008), Nghiin cUU tac dung cCia cay chi catgut v i o huyet trong dieu tri hen phe quan. Tap chi Chim cUu Viit Narn, 01, tr.14 - 20.
4. Bill Quan^ Tuyen (2007), Phau thuat thoat vj dTa dem cot sdng thSt lung, Nxb Y hpc, Ha Npi.
5. tran Trung (2007), Nghien cifu gia trj ciia hinh anh eong hudng tU trong chan doan thoat vj dTa dem cot song thit lung, Luan an Tien sT Y hoc. Ha Ndi
6 Carragee E J., Hannibal M. (2004), Dianosgic evaluation of tow back pain, Orthop Clin N Am, 35, pp.
7-16.
7. Urban P.G., Roberts S. (2003), Review Degeneration of the intervertebral dies, Arthntis Res Ther.5, pp 120-130.
TONG QUAN MOT SO VAN DE VE HANH NGHE KEP 0 PHAM VI QUOC TE VA OT VIET NAM
N G U Y I N PHt/ONG MAI • Cue Quan i^Kham, chOa binh, Bp Y td T6M TAT
Jlnh trang cBc nhan win y te Nhi nudc kit hpp hanh nghi tunhin (trong tidng Anh li "Dual practice", tam dich li 'hanh nghi kip"), hiin diin d nhiiu node trin thd gidi. ca d nhOng nudc phit triin va dang phat
triin. Day la vdn di cd tic ddng nhiiu mit tdi khi nBng tlip can va chat luang cic dich vu y td cung nhu cic mdi quan hi phip ly va nghi nghiip trong hi thdng y ti cQa mdi nude. Cach giai quyit van de khdng
Y HOC THItC HANH (953) - S6 3/2015
