Benh vien Y hgc co truyen cfla Bg (11,9%).
- Kdt qua kham va dieu tn bang y hpc co truyen, Sd benh nhan dupc kham banh bang y hpc cd truyen chiem tJ le rat thap. Sd l i M benh nhan dude didu tn bang y hoe ed b-uydn chiem tJ le 18,9% tdng sd luat benh nhan dieu trj. cao nhat la khdi cdng an tinh, thanh phd thap nhat la \i.ho\ trai giam,
- Tren 90% can bd y td khdi nghidn eflu tra ldi can thiet phai khoi phuc cac phuang phap y hpe eo truyen trong kham, chfls benh, Chi cd 17,9% benh xa to chflc kd thfla cae bai thudc, kinh nghiem chfla benh bang y hgc CO truyen, khdi trgi giam (11,1%). Cd 19,4% cae ddn vj tham gia hoat dpng y hpc cd truyen tai dia phuong. chfl yeu la tham gia Hpi Cham cflu.
TAI LIEU THAM K H A O
1. Vu Tue Anh (2005), "Y hpe ed bxiyen Tnjng Quoc thu hut dUde sp ua thfch tren toan the gidi", Bin tin dugc liiu. So 12] Tap IV. b-: 382.
2. Bo Cdrig an (2007), Quyet djnh si 1480/2007/QB- BCA(I-HI) ngiy 28/11/2007 ve viic phi duyit Ke ho§ch thuc hiin chlnh sich qu6c gia vi y hgc c6 tmyin trong luc Imng Cdng an nhan din din nim 2010.
' 3. Bp Qude phdng (2006), Chlthj so 46/2006^T-BQP ngSy 14/3/2006 ve viic phit triin y dugc hqc c6 tiuyin trong Quin ddi.
4. Bp Y td (1983), HutJng dan trdng va sd dung thuoc nam chim cdu, Nha xuat ban y hgc.
5. Bo Y te-Tdng cue thdng ke (2002). Dieu tra y tequic gia 2001-2002. Nha xuat ban Y hge Ha Npi, tr 186-550,
KET QUA KHAM SUTC KHOE CUA CAN BO. CONG NHAN DEN BIEN KHU VUC DONG BAC 80.
TONG CONG TY BAO DAM AN TOAN HANG HAI MIEN BAC NAM 2014
PhongY TOM TAT
Khao sSt sdc khoe dinh ky nam 2014 eia 427 dn bd vin phdng vS cdng nhin cQa khu vuc Ddng bic bd thudc Ting cdng ty Bao dim an toSn hang hii mien Bic, chOng tdi cd nhan xit sau: Nam chiem da sd 81,73, nd chiim 18,27%, t} Id nam /ndp: 4,47. CSn nang TB: 63.41 ± 8,98 kg, Chieu cao: 165,23 ± 5,84 cm, chi so BMI: 23.22 ± 1,34. Bien tam d6:TSng ganh thit trii 4,92%,. Cac rdi loan nhip tim: 4,91%,. Diu hieu thiiu mSu ca tim T(-) V5,V6 chiim 1,09%,. Mdt sd benh hay gap: THA 18,03%i. can thi - vien thj 31,85%,, benh rang miing 26,23%,, binh tai mui hgng 20,84%, benh tiit niiu - sinh due 24,82%, dai thao dudng type 2:
5,46%, roi loan dung nap glucose mau luc ddi: 9,28%, Ting cholesierole mSu 18,03%,, ting triglycerid mSu 48,09%,. Xip loai sdc khoe theo tCD 10: toai 1:
26,70%,, loai 2: 54,57%,. loai 3: 15,45%,, loai 4: 3,28%,, ioai 5: khdng.
Td khda: CSn bd vin phdng, cdng nhSn, Tong cdng ty Bao dam an toan hang hai miin Bic.
SUMMARY
RESULT FOR THE HEATH OF CADRES AND WORKWERS TO TAKE CARE OF SEA LAMP OF NORTHERN VIETNAM MARITIME SEFETY CORPORATION ON 2014
Objective: The study was conducted on 427 cadres and workers to take care of sea lamp of Northern Vietnam Maritime Safety Corporation on 2014.
Results and conclusions: The men appropriate 81.72%,, The women 18.27%,. ratio M/W = 4.47. The tall is 165.23 ± 5.84 cm and the weigh 63.41 ± 8.98 kg, with BMI BMI: 23.22 ± 1.34. Result of ECG find left ventricular hypertmphy present 4.92%. Trouble of rythme is 4.91 %>, the sign of the ischemic cardiac 1.09%. Some frequent disease are hypertension present 18.03%, eye disease 31.85%, tooth disease 26.23%,, disease of ENT present 26.23%,, diabetes 5.46%, hypercholesterolemia 18.03%, hyperirigliceridemia 48.09%,, classification of health
HOANG KIM N G A N va CS
tiTdng cong ty Bao dam an toin hing hai mien Bic aedording to ICD 10: level 1: 26.70%, level 2: 54.57%, level 3:15.45%. level 4: 3.28%. level 5:0%.
Keywords: Cadres, workers. Northern Vietnam Maritime Sefety Corporation.
DATVA'NDE
Nude ta CO bd bidn trai dai 3.260km doc Bac - Trung - Nam, chu quydn bao quat hdn mpt bleu ki-16- met vudng tren vflng Bien Dong (gap ba lan dien tich dat lien), dgc bd bien vd tren bien Viet Nam ed 29 tinh, thanh phd, vdi 12 thanh phd ldn, 125 huyen, thi xa ven bien, 100 eang bien, khoang 238.000 cym cong nghiep va gan 1,000 ben ca,,, Nam 2007, kinh te bien va vung ven bien ddng gdp khoang 49% GDP ca nfldc, bong dd rieng kinh td tren bien chiem khoang 22%, cac nganh kinh te bidn quan trgng nhU dau khi, hang hai, thfly san, du Ijch bien ddu tang tru6ng vdi nhjp do cao^
Thd kJ XXI la "The kf cfla dgi dudng". Chien lupc va to chflc phat trien mgnh me kinh te vflng bien va kinh te bien, dao va bao ve an ninh qudc gia dang trd thanh nhiem vy ehien lupe efla Dang va Nha nudc ta. De thuc hien dupc nhiem vy nay, van Hi eham sde sflc khoe cho nhijtig ngudi dang sdng va iam viec ben bien dao da duac Dang, Chfnh phfl va Nganh Y te dae biet quan tam. Nam 2014, phdng Y te da ket hdp vdi Trung tam bao ve sflc khoe lao dpng va mdi truting giao thong van tai, kham sut khde djnh ky eho can bp, cdng nhan den dao khu vUC Dong tiac bp vdi myc tieu"fc/)ao sa(
md hinh binh tSt cOa can bd, edng ntiin den dao khu vue Ddng bic bd nSm 2014"
DOI TaONG VA PH JONG PHAP NGHIEN cCfU 1. Ddi tUdng, dja diem, thdi gian nghien cflu - Bao gdm can bp cfla cac phong, ban iam viec tai Tdng cong ty Bao dam an toan Hang hai mien Bac nam 2014.
- cae edng nhan lam viee tren cae tram den dao efla khu vye Ddng bac bo, cfla Tdng cdng ty Bao dam
Y HOC THlTC HANH (963) - S6 5/2015
an toan Hang hai mien Bac nSm 2014
- Dja diem va Bidi gian: Tai Tong cong ty Bao dam an toan Hang hai mien Bac, khu vyc Dong bae bp, va 19 tram dao den va tram quan li ludng tau bidn. Thdi gian' Nam 2014.
2, PhUdng phap nghien cflu Phuang phap nghien ctiu: Tien cflu.
Cac f j ^ chuan, cSc ky thuSt dupc sur dyng bong nghien cdu:
+ Phan loai sflc khde theo ICD 10 cfla Bd Y te [1].
+ Chan doan tang huyet ap theo JNC Vll efla My nam 2004 [2],
+ Chan doan rdi loan lipid mau theo NCEP -ATP III (My) [3]. ^
+ Chan doan dai thao dUdng type 2 theo Hpi Dai biao dudng Viet Nam [4],
+ Chan doan eac rdi loan nhjp tim, day that trai theo Tran Dd Trinh [5].
+ Tinh chi sd BMI = can nSng (kg) / (Chieu cao (met)', gia tri tmng binh (X), do lech chuan (SD) theo [6],
Cac chi tieu nghien cdU:
- cac chi tieu vd lam sang, ddi tupng nghien cflu duac kham iam sang toan dien do chidu cao, can nang bang can ban co gan thudc do, do huyet ap tam thu, huyet ap tam trUdng, dem mach/1 phflt, Kham eac benh ngi khoa: hd hap, bm mach, kham gan, than kinh, da lidu, kham tai mui hpng, rang ham mat, kham mat, khamtiet nieu...de phat hien cac benh cap va man tfnh - cae chi beu ve xet nghiem: Cac ddi tupng nghien cflu dupc iam 1 sd xet nghiem: glucose mau. ereabnin mau, Cholesterole toan phan. triglycerid mau, HDL-C, LDL-C, men gan GOT, GPT, xet nghiem nudc tieu, sieu am d bung, sieu am bm ndu nghi ngd...
Xd If so lieu nghien cut/: Theo phudng phap thdng ke Y hpc.
Tinh tJ le phan tram (%), gia tri tmng binh (X), do lech chuan (SD) [6],
K^'T QUA NGHIEN CLfU VA BAN LUAN 1. Dja diem nghien cflu
- Tong cpng ed 427 ddi tUdng nghien eflu, trong do can bd thupc cac phong ban cfla Tdng cong ty la 183 ngudi,
- 19 b ^ m dao den va tram quan li ludng tau bien:
244 ngfldi, bao gdm cac tram:
STT 1 2 3 4 5 6 7 8 9 10 11 12 13 14
(^c Iram 6en bidn, c^c tram quSn ii lu6nq tau bi^n Tram d6n bi^n Long Chau Tram dfin bi^n Bach Lonq Vy Tram den biln VTnh Thuc Tram den bien Ha Mai Tram den bien Diem D\6n
Tram den biln Oao Tran Tram den bien Cfi T6 Tram den bien Ba Lat Tram d6n biln Hdn Dau Tram quan li lufinq Van Gia Tram quan li iu6nq Hdn Gai Tram quan li Iu6nq Vat C^ch Tram quan If ludnq Pha Rilnq Tram quan If lu6nq Bach Oang
Tram quan If lutfng Nam Tn6u Tram quan If Iu6ri3 Lach HuySn Tram quan li luong Hfti Gai - C6 Ngua
Tram quan li lu6ng S6ng C^m Tram quan li lu6ng SOng Chanh 2. Phan loai d o i t t / d n g n q h i e n c u u t h e o g i d i
D^tuonqNC S6 luonq [n]
T¥l«(%) Nam 349 81.73
NS 78 18,27
TiinqcSnq 427 100.00 Phan loai theo gldi b'nh efla hai khu vUC phong ban va khu v y c eac trgm den bien, tram quan li ludng tau bien, chflng tdi ed kdt qua sau:
D6i tuanq NC Ktiu VLTC ptidng l:an Ktiu VLtc tram den bi^n, Iu6ng
tau bi^n T6ng cflnq
Nam n 139 210 349
75.95
•/.
86.06 81.73
NO n 44 34 78
24.05
%
13.94 18.27
Tdng cflng M 183 244 427 Mpt sd chi so nhan trac cfla cae ddi tupng NC:
+ Can nSng tnjng blnh: 63.41 ± 8,98 kg Chieu cao bung binh: 165,23 + 5,84 cm, Chi sd BMI bung binh la:
23,22 + 1,34.
- Nhan xet: T^ le ddi tupng nghien cflu la nam chidm da so 81.73, nfl- chi chiem 18,27%, ty le nam / nfl"«;
4.47 lan. Chi sd khdi lUdng cd the efla cae ddi tudng NC da sd nam trong chi sd blnh thUdng.Khi so sanh t f le ddi tupng NC theo gidi d hai khu vyc phong ban va khu vyc cac tram den bien, chflng toi thay ty le nam gidi iam viec tgi cac b"am den bien cao hdn ^ le nam gidi b khu vUe phdng ban (86,06% > 75,05%) (p<0,01), trai lai ty le nfl d khu vye phdng ban Igi cao hon t^ le nfl lam viec tgi ede tram den bien. Didu ndy ed bid giai thich: cdng viee tren cac tram den lien va ludng sdng rat nang nhpc, sdng each xa dat lien, thieu nudc ngpt... nen ddi tupng lao dpng la nam gidi se thfch nghi tdt hdn, Trai lgi tJ le nu" lam viee tgi khu vye phdng ban, do tfnh chat nghd nghiep, cd cau td chfla nen tai cac phong Hanh ehinh. Td chflc, phong Y te, Ke toan tai chfnh... thl nfl gidi lai phfl hdp d c a c v i trf ndy. Sykhac biet ve gidi cung ia net dgc thu ve ngudn nhan lyc cfla Tong cdng ty Bao dam an toan hang hai ndi chung.
3. Ty If mpt s d benh thu'dng gap cua doi tUdng nghien cuu
Qua kham t>enh djnh ki nam 2014. chflng tdi da phat hien dUdc 1 so benh hay gSp, trinh bay trong bang dudi day:
stt 1 2 3 4 5 6 7 8 9 10
Tfln b6nh(n=427) Tang tiuy^t ap Viflm phfi qu^n man
\^flm-laflldaday.tatiBng Bflnh cin Itii * vign thi Bflnh vfl tai mui hcnq Bflnh hfl tiflt niflu - smh due
Bflnh vfl rflnq miflnq Bflnh hfl van dflnq
Bflnh da liflu Bflnhnflitifll-chuvflnhfla
Sfl luonq (n) 77
9 22 136 89 106 112 9 12 17
TJIflf/.) 18.03 2.11 5.15 31.85 20.84 2482 26,23 2.11 2,81 3,98
Y HOC THirc HANH (963) - S6 5/2015
4. Ket qua mpt s d xet nghiem sinh hda mau va nudc tieu
Cflc chi sfl smh hfla mflu (n=183) Giucose (mmol/l) Creatinin (pmolfl) G0T(U/1) GPT IU/1) Cholesterole tofln phan (mmol/l)
Tnolicend mflu (mmol/i) HDL-C (mmol/l) LDL-C (mmol/l) Axit uric (MmoW)
Kfltqufl((XtSD) 5,32±1,04 86,21 ±17,95 28,06 ±15,24 35,09 ±25,06 5,14 ±0,82 1,69±0,94 1,12 ±0,48 2,33 ±0,57 322,04± 91,06 N h a n x e t : R d i l o a n lipid m a u : T a n g c h o l e s t e r o l 3 3 / 1 8 3 c h i d m 1 8 , 0 3 % , t a n g t r i g l i c e r i d : 8 8 / 1 8 3 c h i d m 4 8 , 0 9 % , G i a m H D L - C k h o n g j , t a n g L D L - C : 4 / 1 8 3 c h i d m 2 , 1 8 % . N h u v a y t J l e r d i l o a n lipid m d u d d d i t u d n g N C la k h a c a o . T J l e d a i t h a o d U d n g t y p e 2 l a : 1 0 / 1 8 3 c h i e m 5 , 4 6 % , t J I d r d i l o g n d u n g n a p g l u c o s e m a u lflc d d i la 1 7 / 1 8 3 e h i e m 9 , 2 8 % .
K e t q u a d i e n t i m d d : T a n g g d n h t h a t trai 9 / 1 8 3 e h i e m 4 , 9 2 % , B l o c n h T - t h a t d p 1 : 2 / 1 8 3 ( 1 , 0 9 % ) , R d i l o a n n h i p t i m ( r u n g n h t c d n , n g o a i t a m t h u t h a t , n h a n h x o a n g , c h d m x o a n g : 7 / 1 8 3 c h i d m 3 , 8 2 % . D a u h i e u t h i d u m a u Cd b m T ( - ) V 5 , V 6 : 2 / 1 8 3 c h i d m 1,09%, e a c b a t t h u d n g t r e n d i e n t a m d d g a p d 2 0 / 4 2 7 b e n h n h a n , e h i e m 4 , 6 8 %
5. P h a n l o a i s y c k h d e c u a d o i t U d n g n g h i e n curu t h e o I C D 1 0 11]
Phfln toai siic kh6e 1 2 3 4 5 Tflng cong
Sfl luonq (n) 114 233 66 14 0 427
TJI6(%) 26,70 54,57 15,45 3,28 0,00 100,00 N h g n xet: K e t q u a c f l a c h f l n g t o i e h o t h a y 8 1 . 2 7 % s d c a n b o , c o n g n h a n c a c t r a m d e n b i e n c d siJfc k h d e
loai 1 v a l o a i 2 , l o a i 3 v a toai 4 c h i e m ty' l e thap 1 8 , 7 3 % , loai 5 k h d n g c d .
K E T L U A N
Q u a k h a o s a t s f l c k h d e d m h k y e f l a 4 2 7 c a n bp, c o n g n h a n v i d n e f l a k h u vUe D d n g b a c b p t h u p c Tdng c o n g t y B a o d a m a n t o a n h a n g h a i m i e n B a c , ehflng toi e d n h g n x e t s a u : C a n n a n g t r u n g b i n h - 6 3 , 4 1 ± 8,98 kg, C h i d u c a o ' 1 6 5 , 2 3 ± 5 , 8 4 c m , c h i s d B M I b u n g blnh 1^:
2 3 , 2 2 + 1.34, n a m c h i e m d a s d 8 1 , 7 3 , n f l chiem 1 8 , 2 7 % , t J l e n a m / ni^'» 4 , 4 7 l a n . T J te 1 s d b e n h hay g a p : T H A 1 8 , 0 3 % , c a n t h i + v i d n t h j 3 1 , 8 5 % , benh vk r a n g m i e n g 2 6 , 2 3 % , b e n h v e t a i m f l i h p n g 20,84%, b e n h v d b e t n i e u - s i n h d u e 2 4 , 8 2 % , d a i d u d n g type 2:
5 , 4 6 % , rdi l o a n d u n g n a p g l u c o s e m a u lflc d d i : 9,28%, T a n g c h o l e s t e r o l e m a u . 1 8 , 0 3 % , t a n g t r i g l y c e n d mau' 4 8 , 0 9 % . C a e b a t t h U d n g t r e n d i e n t a m d d chiem 1 0 , 9 2 % . X e p loai s f l c k h d e t h e o I C D 1 0 : loai 1 chiem 2 6 , 7 0 % , loai 2 : 5 4 , 5 7 % , l o a i 3 : 1 5 . 4 5 % , loai 4 : 3,28%, loai 5 ' k h o n g e d .
T A I L i e u T H A M K H A O
1 . B p Y t e ( 1 9 9 7 ) : P h a n loai sflb k h o e s d 1613/ByT- Q D ngay 15 t h a n g 8 n a m 1 9 9 7 .
2. J N C V l l ( 2 0 0 3 ) , T h e report o f t h e Joint National C o m m i t t e e o n d e t e c t i o n , e v a l u a t i o n a n d treatment of hight blood pressure", N i H p u b l i c a t i o n N " 9 8 - 4 0 8 0 .
3. Expert P a n e l o n D e t e c b o n , Evaluation, and T r e a t m e n t o f High B l o o d Cholesterol in Adults(2001), Execlulive S u m m a r y o f t h e T h i r d Report o f the National Cholesterol E d u c a t i o n P r o g r a m ( N C E P ) ; (Adulls T r e a t m e n t Panel III) ( A T P I l l ) . Circulation 2003; (106) 3 1 4 3 - 4 2 1 .
4. T h a i H d n g Q u a n g ( 2 0 0 1 ) , " B e n h Npi bet", Nha xuat b a n Y hoc, b a n g 2 5 7 - 3 8 4
5. T r a n O d T r i n h , T r a n V a n B d n g (2007) Hudng d i n d o c d i e n t a m d d , N h a x u a t b a n Y hoc 2 0 0 7 ,
6. b a n g D f l e H a u ( 2 0 0 8 ) , X a c suat t h d n g ke, Nha xult b a n Y hoc, Ir 30.
DUNG DiraC CHAT PHONG XA 99MTC XAC DINH HACH GAC TRONG PHAU THUAT DIEU TRj UNG THlT VU GIAI DOAN SdM (l,IIA)
T O M T A T
Mue dich- Xiy dung quy trinh va dinh gia kit qua xac dinh hach gae bang duac ehat phdng xa 99mTc trong phiu thuat dieu tri ung thu vu sdm (l,lla).
Bai tugng va phuang phap nghien cdu: Md ti tien edu. Khio sat 116 benh nhan ung thu vCi glai doan 1,11a dugc diiu tri phau ihuat theo phuang phap xac dinh hach gac bing dugc chit phdng xa 99mTc tai binh vidn Ung Budu Ha Ndi trong khoing thdi gian td thing nim 2008 din nim 2014. Phan loai giai doan benh TNM theo UlCC nSm 2002, giai phSu benh ia ung 'thu biiu md
Kit qua: Ong dung xac dinh hach gSc bing dugc chit phdng xa cho thiy t^ le phat hien hach gac la 98,3%. 7j? le xet nghiem hach gac bang cat lanh: Hach viim 71,6%, hach di eSn la 31%,. T^ IS kiim dinti iai
VU KIEN - BSnh vien Ung BuOu Hi Ngi
hach gac bing nhuim HE hach viem 69,8% hach di cSn 31,9%,. MOc dd p/jfl hop gida dt lanh va HE: hach viem 98,7%,, hach di cSn 94.1% vdi Kappa=0,87 p<0,001. cd sUphu hgp rat eao.
Kit ban: LS mdt phuang phap ed t^ IS xac dinh hach gac cao. khach quan Sp dgng t& tai cac benh vien chuyen khoa ung thu di giam thiiu cae biin chdng do vit hach triSt cSn gSy ra dii vdi nhdng binti nhan khdng cd hach di can.
Tdkhda: Duac ehat phdng xa 99mTc, ung thuvit.
SUMMARY
USING RADIOACTIVE 99MTC TO IDENTIFY SENTINEL LYMPH NODES IN THE SURGICAL TREATMENT OF EARLY STAGE BREAST CANCER (I, IIA)
Y HOC THUC HANH (963) - s6 5/2015
