thdng). Nhu v$y, thO thuH Idm LEEP dd mang Igi Nfiu quS cao \iong vi#c ngdn chfin tiln t r i l n tiidnh u u fliu CTC a j a nhOng trvdng hgp cd tfin s i n ndi b i & md v i y (CIN). Rifing vdi cdc truflng hgp AGC.
vtfic c h ^ dodn trfin cdc phiin dd TBH can r i t cfin n h k vi nhdng b i l n ddi v l hinh thfii t l bdo khdng thyc sy rO rdng d l xfic nhfin mdt b i t tiiudng b i l u md tuyin ttiyc s y ( h l u h i t cdc tru-dng hgp trong nghien cdu ndy d i u lifin quan d i n tdn thuong phan irng).
Vific ngo kfinh dng cd Id c i n t h i l t d l cd c h i n dodn xfic^nh.
K £ T LUAN
Nghifin cdu mdc dfl phii hgp giO-a c h i n dodn TBH dia 24 trudng hgp cd t i bdo b i l u mo b i t thudng vdi kit q u i MBH, theo ddi sau 12 thdng vdi nhung tnrdng hgp ndy b i n g xfit nghifim TBH C T C - A D vd d^nh gifi hifiu qua d i l u trj vifim cua 438 tmdng hgp vifim C T C - A D trong chuang trinh sdng Ipc TBH phu khoa cho 850 phy n d tai 5 phudng cua thanh phd Hfla Binh, chiing tdi cfl mfit sd k i t Iuan sau:
- Mirc dd phO hgp gida c h i n dodn TBH vd MBH cao nhit ddl vdi HSIL (100%) vd SCC (100%), ty Ifi phi^ hgp tiilp d i n vdi LSIL (77,8%), ASC-H (66,7%), ASC (53,8%) vd AGC (33,3%).
- Tf Ifi khdi hofin tofin vifim do tgp khuin sau dieu trj (2 tuin) Id 69,6%, do Gardnereiia (GV) Id 81,2%, do nlm Candida Id 90,9%, do Trichomonas Vaginalis (TV) Id 100,0% vd do Actinomyces Id 87,5%. Rifing 2 trudng hgp vifim do Herpet d i u tdi phdt.
- Theo dfli sau 12 thdng cd 1 trudng hgp ASC khflng Uiay ddi, cdc trudng hgp dfi Ifim LEEP CTC diu khflng t h i y cd t l bdo b i t thudng.
T A I U E U THAM K H A O
1. Vu Bfi Quylt, Le Tmng Thp, BCii Thj My Hgnh, Trin Van Chuang (2013), Kfit qua sfing lpc t l t>ao hoc phy khoa cua phy nd thfinh pho Hoa Binh. Y hQC thu^
hSnh.so (899)12/2013,150-152.
2. Phan Thj Kim Anh (1993), Nghifin ciru birdc dau dfinh gid t i n suit mfic tifinh cua nhiem khuin dudng sinh duc dirm d phy nu- den khdm tgi Vien BVBMTSS.
ljj$n van fiSCK//. DHYHN
3. Duong Thj Cuang, Nguyfin Thin vd CS (1984), Dilu tra bfinh phy khoa thdng Uiudng vd ung thu dudng stnh dye dudi d phu nu nong thon mien Nam va miln B I C . Hpi nghj tdng ket nghifin cdu khoa hpc 1984.
4. NguySn Vugng, Tqnh Quang Difin, Trin Van Hgp, Lfi Oinh Hoe, Lfi Tmng Thi}, Nguyfin Thuy Huang, Dfing Van Du'ang, Tran Ddc Hudng, Biii Thj My Hgnh va CS (2000), Phfit hifin sdm ung thu cd t d cung qua sang Ipc t l bdo hoc. Be tai cap Nha nuac, Bd KH& CN, Tdng hgi y dugc hpc Viet Nam.
5. Dowd T.C, West R.R (1996). Evaluation of a rapid diagnostic test for bacterial vaginosis. Bristlsh Joumal of Obstetrics and Gynecology, Vol 103, 366-370.
6. Allen KA, Zaieski S, Cohen MB (1994): Review of Negative Papanicolaou Tests. Is the Retrospective 5- Year Reviewf Necessary? Am J Clin Pathol 101:19-21.
7. Aral S.O (1992), Sexual behavior as a risk factor for sexually transmitted disease. Reproductive tract infections: Global impact and priorities for women's repoductive health. 185-199.
8. De May.RM (2005). An oven/iew of the Bethesda System. The Pap test, pp.235-244.
9. Nguyen Vugng, Lfi Trung Thp (2001), T l bfio vay khflng (Sin hinh, y nghTa chua xfic djnh. Mflt v i n d l thdi sy trong sfing Ipc ung thu cd t u cung Thong tin Y hpc tim sang, trang 13-17
NHAN XET KET QUA DIEU TRj THOAI HOA KHOP GOI BANG P H A U T H U A T THAY KHflTR GOI TOAN BO
N G U Y I N VAN HOC*, N G 6 VAN T O A N * . TRAN TRUNG D U N G "
* Bdnh vi^n Vi^t Dire, ** TrirdTtg D^i Hgc Y Hi N^l T 6 M TAT
D$t vin di: Thoii hda kh&p (THK) li tin thuang thoSl hda sun kh6p, do qui trinh smh tdng hap cic chit CO bin cda f^ bio stjn cd s y bit thutmg. Thay Wiflp gii li phiu thudt thay ldp st/n bf bio mdn bing v$t lidu nhSn (go, diy IS phuang phip tridt di diiu tri THK giai Oo^n mudn. I^ijic dich cua nghidn c&u niy li dSnh giS kit qui thay khOp gii toSn phin tmng diiu tri OioSI hda khdp gdi Dil iuqmg vi phwong phSp nghUn cthi; ChOng tdi tiin hSnh nghidn cuv 50 bdnh nh&n (BN) (52 khOp gii) dUpc thay khdp gii toin phin (KGTP) (g/ Bdnh vidn Vidt Due (d 11/2010 din 4/2012.
Cic BN dypc dinh giS tnrCrc vi sau mi dwa vio thang diim KS vS KFS. Nghidn cOv hdi cOv vi thing k§ md ti (phin mim SPSS 16.0). Kit qui: V6i thtn gian theo dm tmng blnh 13 thing. Diim tmng blnh KS f/utic md li 48.14 ±8.12. sau mi IS 86±7,61. Diim tmng blnh
KFS tmryc mi li 401±9,61. sau md li 82±7,76 (p<0,05). Tim vdn dpng goi tmng blnh: 113,2 ±5,2. Tj?
Id rit tdt li 80,77%, tdt 13,46%, tmng binh 5,77%. Cd 1 truang hap dau khdp chd dui sau md. Ket lu$n:
Phiu thuit thay KGTP mang lai kit qui giSm dau tdt cho ngitOl bdnh thoii hda khdp goi glal ito^n mudn.
SUMMARY
Background: Osteoarihritis is degenemtive lesions of arilcular cariilage. due to the biosynthesis of basic pmperiies of cartilage cells am abnormal Total knee arihmplasty is the surgery that mptaces articular cartilage by artificial materials. This is the thomugh method to tmat late stage of osteoarthritis. The puqx)se of the present study was to evaluate the msults of total knee arthmplasty In the tmatment of knee osteoarihritis. Materials and method: We studied 50 patients (52 knees) wem total knee
Y HOC THUC HANH (916) - S6 5/2014
arthmplasty In Viet Duc hospital hom 11/2010 to 4/2012. The patients wem evaluated with the use of Knee Scorn (KS) and Knee Function Scorn (KFS) scale. Retrospective cohort study and descriptive statistics ( SPSS 16.0 soft-wam). Results: With the mean dumtion of follow-up was 13 months The mean pmoperative KS was 48.14 ±8.12, postopemtive KS was 86±7.61. The mean pmoperative KFS was 40.1±9.61, postopemtive KFS was 82±7.76 (p<0.05) The mean range of motion 113.2±5.2. Theproportkm of postoperative Knee Society Scom was 80.77% of excellent. 13.46% of good, 5 77% of fair There was one patient with pain of patellofemoml articular Conclusions: Total knee arthroplasty yielded good pain relief for patients with later stage of osteoarthritis.
Keywords: Osteoarthritis, total knee arthroplasty, Viet Duc hospital
DAT V A N Dt
Hifin nay tai Viet Nam bfinh ly khdp gdi ngay cfing phd bien, trong do ty le bfinh nhan thofii hoa khdp tifin phat, thodi hod khdp sau ehan thuang, thap khdp, viem cflt sdng dinh khdp ngay cdng tfing anh hudng den sinh hoat eua ngudi bfinh. Cd nhieu phuang phap de dieu tri bfinh nhu dieu tri nfli khoa k i t hap phuehdi chdc ndng, giam cdn, nfli soi Ifim sach khdp, eat xuang sda true xuang chdy _va khi cfic phuang phdp dieu tri md ngudi benh van cfln dau, bien dang nhieu, co riit khdp, leeh trnc ca hpc, tren X-quang hinh anh thoai hda khdp rd thi benh nhdn co chi djnh thay khdp gdi
Tren the gidi phdu thuat thay khdp gdi todn phan da dugc tien hfinh t u nhung nam 1970 vd dem lai chat lugng cuflc sdng tot eho bfinh nhdn thodi hda khdp gdi Ngfiy nay su phat tnen cua khoa hoc ky thuat cho ra ddi nhieu the he khdp mdi cfl uu diem vugt trfli, cung vdi sy tien bfl ve vd khuin, gfiy me hdi sdc va dac biet la s y tien bp ve phfiu thufit ...Idm cho phdu thuat thay khdp gdi ngay cdng phd b i l n va dat dugc nhieu thanh cdng.
& Viet Nam phfiu thudt thay khdp gdi duge t i l n hanh han 10 nam nay d cac trung tdm Idn Tai Viet O&c phau thudt thay khdp gdi toan phan cijng dugc tiln hdnh tren 10 nam, cho den nay ngay cang nhilu benh nhan dugc thay khdp gdi tai vifin Chan thuang Chinh hinh
Chung tdi tien hdnh nghifin cii-u nay n h l m myc dich danh gid ket qua d i l u tri phdu thudt thay khdp gdi todn phan tai Bfinh vifin Viet Ddc
DOl TU'ONG VA PHU-ONG P H A P NGHIEN Cl>U 1. Ddi t u g n g nghien c d u :
La nhung BN duac p h i u thuat thay khdp goi tofin phan tai Benh vifin Viet Due Cdc BN nay cfl day du ho sa bfinh an, cfl phim chup X-quang trudc va sau md.
2. Phuo-ng phap nghifin c d u :
Nghien cdu mfl ta hoi cuu duac tien hanh theo cac budc,
- Lya chon tat ca cac hd sa bfinh an da md thay khdp gdi tai Benh vien Viet Ddc t d 11/2010 d i n 4/2012
Ghi day du thdng tin can thiet nghien cuu.
Hen kham lai BN 6i thu thap thdng tin.
Phdn tich va s u ly sd lieu bfing p h i n mil SPSS 16.0.
3. Ky thufit md:
- S u dung khdng sinh trudc md 30 phut, Garo ben vdi dp Iuc 450 mmHg,
- Rach da dudng giiJ-a gdi
- Boe Id khdp: rach bao khdp trong each bd trong xuang banh che 1 cm t d mao chay tdi ca thing dCii, sau do bpc Id va lam trat gdi ra trudc, Chu y trdnh iam tfln thuang day chang ben chay va mac.
Cdt phan loi c l u dui
niH
> 1
:^
[ ^
End of ra femur H removed H
/B'
% .^
^^^rj
Hinh 1: Clt bo ph^n mat khdp xi/ang dui bj tdn thi/vng Cat phan mam chay.
Hinh 2: Cat bo ph^n mat khdp xyo-ng chay bj t6n thu'cnj Dat dung cu thd danh gia xem cfl dudi hofin toan khdng, mdc dp vdng trong-ngoai va true gdi.
Dam bao khoang gap bfing khoang dufli.
• a ^
Hinh 3: Thd kho-p nhan t?o Dat khdp nhan tao, dfin luu ngoai khdp v i dong vet md
Hinh 4: Dat khdp nhan tao
I
Y HOC THl/C HANH (916) - S6 5/20M
[
KtT QUA - Dac difem ciia nh6m benh nhan nghien ctpu;Trong so 50 BN vai 52 khap, ty le nu-Znam la 33/1, TUOI trung binh la 64,2 ±11,03 (35-83), s6 BN ' 60 tuoJ tra len chiem 70%, Ty le BN beo phi va 8ii>a c i n chiem 30%
- Oac d i i m t6n thu'O'ng Jtho-p g6i
Trong nhom nghien cuu cua chiing toi THK tien phat chiem da so vm 94%, cac benh ly khac (VKDT, THK sau chan thuong) chi^m 6% Co 34 BN thay kho-p ben phai, 14 BN thay khap ben trai va 2 BN thay ca 2 ben -
- Thoi gian bj benh trung binh la 3,55 nam Ca kh6'pg6i 1,5 va 2_chiem da so vcci 68%.
1. K^t qua phSu thuat
Truyen mau trong mo co 2 BN (4%), Thai gian mb (rung binh 89 phut, thai gian nim vien trung binh 9,3 ngay (3-28 ngay), Chup X-quang sau mo 100% diing vitri.
2. K i t qua sau m6
- Thai gian theo doi sau mo trung binh la 13,24±4,37 (6-23 th^ng). Bien 66 van dong goi trung binh 113,2° ± 5,2°, 100% so BN co bien dp gap goi tr&n 90°,
- K^t qua chung difOC danh gia theo thang diem Knee Scociety Scoring system gom 2 ph^n Knee Score (KS) va Knee Functional Score (KFS) fc + Theo KS: Diem trung binh tru-ac mo- 48,14 ± 18,12, sau mo la 86 ±7,61 Su khac b;et co y nghTa Ith6ng ke vd'i p<0,05
P + Theo KFS: Diem trung binh tru'dc mo: 40,1 ± f 9,61, sau mo l i 82 ±7,76, SLF khic biet co y nghla f th6ng ke vai p<0,05
I 3. B i l n chu'ng
I Truyen mau trong mo cd 2_tru'ang hap chiem 4%.
1 Khong co tru'ong hop nao t6n thu'ang mach mau, 1 thin kinh hay dat sai khap.
BAN LUAN
Tuoi trung binh la 64 tuoi, trong do so BN tren 60 I tu6i chiem 70%, dieu nay phu hop vai benh ly THKG i chil yeu gap a ngu'Oi lan tuoi Han nD'a khap nhan i tao cd tuoi thp nhat dinh nen chi dinh thay khap o i nhifng BN tre can can nh^c.
; BN niJ chiem da so 70%, do dac diem cua^THKG '•. lien quan den thay d6i npi tiet to nO' a tu6i tien man
; kinh, Dieu nay da du-pc chung minh qua nghien cu-'u '', trSn invitro va dich te hoc
So BN bl thu'a can va beo phi chiem 30%. Jheo Hart va Specter beo phi la yeu to quan trong nhat cua
• THKG, Theo ong neu trong lu'ang co the tang 5kg thi ' nguy ca m i c benh se tang 35%
Thoai hoa khap tien phat v i n la chi dmh chu yeu cua thay khap goi (94%) Di^u nay la do benh THKG tien phat ngay cang ph6 bien Phau thuat thay khap g6i la mot p h i u thuat Ion, chi phi cao va quan trong IS tuoi tho cua khop CO gioi han Chinh vi vay ma tren th6 giai cung nhu a Viet Nam thay KGTP chu yeu a nhO'ng BN THKG tien phit. ^ i Thoii hoa khop goi sau chan thuong chiem 2 / .
ha^^T^F^ui ( IIANII ( 9 1 6 ) - S O 5/2014
c6 1 BN THKG sau gSy mSm ch^y. 6" nhbrn BN ndy chiing tdi g^p kho khdn trong v i ^ cdn bdng phdn m^m ai tao sir vCrng chac cua khap do ph4n m6m cua kh^p goi sau chan thu'ong bi co nit vd bi^n dang nhilu. Nhdm BN vi6m da khd'p dang thdp chi^m 4%, Cf nhdm BN n i y kh6ng chi syn khd'p bj hdng ma bao khd'p bj vifem dong thd'i chilt lu^ng xuung cung khdng tdt vi vdy BN thu'd'ng dau sau mo nhieu han anh hu'dng den phuc hoi chtrc nang sau mfi, ddy Id nguygn nhdn Idm k i t qua KFS sau mo chi dat k i t qua trung binh
Trong nghien CLFU ty 1# BN thay khd'p goi bfin phai chilm da so 68%, cd 4% du'gc thay c^ 2 khdp.
THKG thudng bj ca 2 bdn, chi i^nh thay bdn ndo tuy thudc vdo ldm sang, neu thudn cinan phai thi viec chju luc trong thai gian ddi se ldm cho khdp ton thuang ndng han. Han nua, phdu thudt thay KGTP Id phdu thuat Idn, chi phi cao, ddi hoi cao ve phyc h l i chuc ndng cung nhu c h l dd sinh hoat sau mo nen chi djnh thay ca 2 khdp cdn han c h l
Gdc BN deu cd thdi gian dieu tn tu'ang d6i ddi k l ti> khi dau khdp gdi den khi du'ac thay khdp g6i (3,55 ndm) Khi benh khdng dd, d i l n b i l n ndng ddn, dau ngdy cdng tang, b i l n dang khdp g i i , khdng ddp ung thuoc hodc anh hu'dng d i n dg ddy Mdt v i n d l nda lam kdo dai thdi gian p h l u thudt la tdi chinh, Sd BN su dung cd khdp 1,5 vd 2 chiem 68% la phCi hgp vdi t^m vdc cua ngu'dl Viet Nam.
Thdi gian ndm vi#n trung blnh dai (9,3 ngdy) do BN Idn tuoi, thu'dng cd bdnh ly npi khoa ph6i hpp vd chCing tdi cung mudn BN cd thdi gian dupc hudng ddn tap phuc hoi chdc ndng sau mo.
V l k^ thudt mo Thay KGTP Id p h l u thudt Idn n6n Chung tdi thao t i e het sdc c i n than (thdi gian m6 trung binh 89 phut). T i t ca cac khdp gdn vdo xuang cd xi mdng (fix bearing) Do SLF dyng garo hai ndn giam ddng k l m i t mdu trong md (cd 2 trudng hpp truydn 500 ml hong c l u khdi),
Thdi gian theo ddi sau m l trung binh Id 13 thdng, t i m vdn dpng khdp trung binh 113" Idm BN hdi ldng.
Mdt s6 yeu to nhu' khdp b i l n dang nhilu, t i m vdn ddng kem tru-dc mo, su kdm ndng ddng cua ngu'dl gid kdm theo benh ly ndi khoa phdi hop anh hu-dng den k i t q u i tren
Tran Nqpc Tuan Nguyfin Tien Son Tru'D'nq Chi Huu
Gap {") 110 105 105
M^tdu6i<10'' (n)
2 1 2
Du5i cCeng (n) 0 0 0 K i t qua phuc h l i chuc nang theo KSS Ty 1$ rdt tdt 80,77%, tdt 13,46%, trung binh 5,77% So sdnh vdi 1 sd tac gia nhu' Ranawat ty le rdt t i t 83%, Scott Id 88%
D i l u nay Id do da sd BN thudng d i n vi$n d giai dogn mudn, biln dang g l i nhilu, ddc bi§t Id nhdm BN vidm da khdp dang thdp vd thodi hda khdp sau chdn thu'ang, d i n g thdi trong giai doan ddu chung tdi thilu kinh nghiem v l cdn bdng phdn m i m khdp g i i vd d$c bi$t do hodn canh khdch quan vi0c phyc h6i chdc
nang cho ngud'i b$nh chu'a dong bd.
Trong nhdm nghifin cdu cd 1 tardng hp'p dau khdp chd dOi sau m6. Cac b i l n chdng khdc nhu- nhidm trting, tr^t khdp... khdng g$p tnfdng hcrp ndo, cd t h l do s6 luvng BN chu'a nhieu, thdi gian theo ddi sau md cdn ngSn.
KfeT LUAN
P h l u thu^t thay KGTP mang lai ket qua giam dau tot cho ngydi b#nh thodi hda khdp g6i giai dogn mupn, d i n g thdi mang lai chdc ndng van ddng khdp g i i t i t cho BN, t d dd cai thien chat lyang cudc s6ng.
TAI LIEU THAM KHAO
1. Nguyin Thj Ai (2006), 'Nghien CLFU die d?em lim sang, c$n lim sSng va ap dung cac tieu chuin chin doan benh thoii hda kh&p gii". Luan van thac sy Y hoc Trudng Oai hpc Y Hd Npi.
2. Nguyen Thj Ngpc Lan (2004), Thoai hda kh&p va cot sing". Benh hpc npi khoa T l . NXB Y hpc: tr. 422- 435.
3. Gunston F.H (1971), "Polycentric knee arthroplasty. Prosthetic simulation of normal knee movement; JBJS, 53-B: tr. 272.
4. Nguyin Thdnh Chan & Ngd Bao Khang (2005), "
Ket qua bu&c diu thay kh&p gii toin phin tai Bdnh vi$n
Chin thuong Chinh hinh Sil Gdn-ITO", Y hpc thdnh ph6 H i Chi Minh, 9(2): tr. 134-136.
5. Tm'ang Chi Hdu (2008), 'Kit qua ban dau thay kh&p goi toin phin t^i Bdnh vidn Chin thuang Chinh hinh minh pho Hi Chi Minh". Ky y l u Hpi nghj Chan thuang Chinh hinh thdnh ph6 H 6 Chi Minh lan thd XV:
tr. 69-71.
6. Nguy«i Tien San & Dodn Vidt Qudn (2010), "
Dinh gii kit qua bu&c diu thay toin bp kh&p g& t^
Bdnh vi$n Viet DOc".
7. T D Spector & D J Hart (1994), 'Incidence &
prx}gmssion of osteoarffiritls in women with unilateral knee disease in general population: The effect of obesity". Ann-Rheum-Dis, 53: tr. 565-568.
8. Ranawat C S , Flynn W.F, Saddler S & KK Mansjai (1993), "Long stenn results of the total condylar knee arthmplasty 15-year survivorship sfudy".CIin, Orthop, 286: tr. 94-102.
9. W N Scott, M Rubinstein & G Scuderi (1988),
"Results after total knee arthmplasty", JBJS, 70(8): tr.
1163-1173.
10. Morrison J.B (1970), "The mechanics oftheknee joint in mlaSon to normal walking", J Bioech. 3: tr 51.
THUC TRANG VA MOT SO YEU TO LIEN QUAN DEN N H I I M KHUAN HO HAP CAP TINH CUA THE DUAl 5 TUOI TAI M O T S 6 XA HUYEN QUYNH LUU, TINH NGHE AN
DAM TH! TUYET - Tru&ng Dai hoc Y du&c Thai Nguyen TRAN TH! H A N G - BSnh viSn Da khoa huySn Qufnh luu, tinh Nghi An TOM T A T
SO- d(/ng phuang phip_ diiu tra cSt ngang di nghidn c(ni vi tlnh hinh nhidm khuin hd hip cip tinh vi mdt s6 yiu ti Udn quan den nhiem khuin hd hip cip tlnh & trd dw&l 5 tuil tai 2 xi huydn Qu^nh Luv.
tinh Nghd An chOng tdi thiy:
- TJ? 1$ tri mic nhiim khuin hd hip cip tlnh & dja diim nghiin cQv cdn cao (38,34%), tmng dd t^ Id khdng viim phii: Ho hoic cim lanh (34,54%); Vidm phoi: 3,8%.
- Ty Id mic nhiim khuin hd hip cip tinh cao &
lu^ tuoi to-12 - 35 thing tuii (41,04%).
- Cic yiu td Hdn quan din nhiim khuin hd hip cip tlnh & tri tai dia diim nghidn cuu li: Kiin thiic cOa bS me vi nhiim khuin hd hip cip tinh cho trd kdm, tidm chOng khdng diy du hoac du nhung khdng dung lich, tri cai st/a sdm, lam chudng gia sdc gin nhi. tinh trang nhi, bep dun trong nha, gia dlnh trd c6 ngu&i hOt thudc IS. thudc lio trong nhi.
TO? khda: Nhidm khuin hd hip cap tlnh, Nghd An.
SUIVIIMARY
Using a cmss-sectional survey to study on a situation of acute mspiratory infection in childmn and some nsk factors related to acute respimtory Infection Bt 2 communes in Quynh Luu district - Nghe An pmvlnce, we found that:
The prevalence mte of acute mspiratory infection In childmn In the study ama was still high (38.3%);
the rate of childmn suffering fmm cough and cold was 34.5%; the rate of childmn suffering fmm bmnchitis was 3.8%.
The prevalence rate of acute respiratory infection In children was still high fmm 12 -35 months old (43.8%).
Factors related to the acute respiratory infection In children in the study area are: Mother's knowledge on child cam was closely, Childmn who were not fully vaccinated or wem fully vaccinated but an incorrect schedule, children weaned eariy, animal sheds near the house, a housing condition, a indoor kitchen. Indoor smoking.
Keyv/ords: Acute mspiratory infection, Nghe An.
DAT V A N Dt
Nhidm khuan hd hdp d p Id b$nh p h i b i l n cd ^ 1$
mdc bfinh vd t d vong cao d iri em, d$c bifit do vifim phdi a tre dudi 5 t u l i tai cdc nu'dc dang phdt triln.
Tlieo s l lifiu cCia T 6 chdc Y t l T h l gidi, m6i tri tmng blnh trong 1 ndm m i c n h i l m khudn hd hdp cdp t d 4 - 9 Idn, U'dc tlnh trfin todn cdu m5i nSm c6 khodng 2 tJ l y p i tre mdc n h i l m khudn hd hdp cdp, trong dd khoang 40 trifiu lupt Id vifim p h l i [3].
Y HOC THirC HANH (916) - s6 5/2014
