"khoang tring" giua nhu c i u va thyc trang khdm sue khde tien hdn nhdn, dd id nam nff thanh nidn "ngai" di khdm do cdc yeu to vSn hda, chu quan v i sffc khde cua minh, s y tin tudng trong tinh yeu, dieu kidn kinh t i cung nhu s u han che ve thdng tin vd djeh vu [6].
K^T LUAN
Sy khac biet Idn giffa nhu' cau du-gc cung cap dich vu khdm sffc khde tien hdn nhdn vd thyc trang sff dyng djch vy dgt ra cdu hdi cho ede nhd nghien cffu vd hoaeh djnh chinh sdch y t i de lap dugc khang trong ndy.
TAI LIEU THAM KHAO
1 Thu tudng Chinh phu (2011). Quyit ^ n h s i 2013/QD-TTg ngdy 14 thang 11 nam 2011 cCia Thu tudng Chinh phii - Chien lugc din so va sffc khoe sinh san giai doan 2011-2020.
2. Quic hpi nudc Cdng hda xa hdi chu nghta Vipt Nam (2000). Luat hdn nhdn va gia dinh.
3. Luang Kim Phiic (2013). Nhu ciu eham soc sdc khoe Sin hdn nhin tai xa Kim Binh huyen Kim Bang b'nh Hi Nam nam 2012.
4. Dd Ngpc T i n (2004). Danh gid k i t qua triin khai md hinh kiem tra sffc khde vd t u v i n t i i n hon nhan tai Hung Yen va Hue. Dan s6 va phit triin.
5. Nguyin Hai Y i n (2013). Thgc trang sd dung dich vu eham sdc sdc khoe tien hdn nhan vi mdt s6 yeu to lien quan cda phu nu kit hon nam 2009 - 2012 tai 4 xa huydn Kim Bang tinh Ha Nam.
6. Le Thj Ma (2013). fl/lpt sd yiu td khd khin tmng viec tiip c$n va su dung dich vu cham sdc sdc khoe tiin hon nhan cua phu nd t^i xa Kim Btnh huydn Kim Bang tinh Ha Nam nam 2012.
NGHIEN CUfU OAC DIEM CAN THj HOG DIIVNG Of HOC SINH TIEU HOC VA TRUNG HOC C0 sh HA NOI NAM 2009
VU TH! THANH*, DOAN HUY HAU**, HOANG THj P H O C * * *
* Binh vien Mat Hi Ndi; ** Hpc vien Quin y; *** Benh vien Mat TW
TOM T A T
Muc dich nghien cuu: Khio sit tf Id tit khdc xa cda hoc sinh tai thinh phd Ha Ndi Phuong phip quan sit phin tich, cat ngang. Nghidn cdu trdn 6.184 hQC sinh (3.222 nam va 2.962 nu) tieu hoc vi tmng hoc co sd td 6-15 tuoi d 04 quin, huydn d Hi Ndi nim 2009. Kit qua nghien'cuu cho thay tf Id can thi li 33,7% (khdc xa ciu tuang dirang: >- 0,75D). Tf Id c$n thi d hQC sinh nu (35,0%) cao han hoc sinh nam (32,5%), (p<0,05). Tf le can thi d hoc sinh quin Ba Dinh (42,3%,), quin Thanh Xuin (41,0%) vi huyen Tu Liem (44,3%) cao han so vdi huydn Ddng Anh (18,8%), (p<0,001).
Tdkhda: T$t khdc xa, can thi.
SUMMARY
Aim- to study the prevalence of mfractive error of school children at Hanoi Methods: cross - sectional and pmspectlve study in 2009. The study carry out on 6.184 children (3.222 males, 2.962 females) from primary and secondary schools, of 4 districts in Hanoi, aged 7 -15 years. Results: the prevalence of myopia (SE at least - 0.75D): 33,7%. The mte of myopia in female children (35.0%) were than male children (32.5%), (p <0.05). The rate of myopia In Ba Dinh district (42.3%), Thanh Xuan district (41.0%) and Tu Liem (44.3%) were higher than the Dong Anh distnct(18.8%), (p<0.001).
Keywords: l^efmctive error, myopia.
BAT V A N B e
Tdt khOc xa ndi chung, cdn thi hoc dudng (CTHB) ndi rieng dang ngdy cdng tang, la moi quan tam eua tffng gia dinh vd toan xa hdi [1], [9], [12]. Cdn thj hpc
dudng Idm anh hu'dng den sue khde vd kha nang hpc tdp, smh hogt cua hpc sinh [2], [14]. (3 Vidt Nam, CTHB da_duac chCi </ tff nhffng nam 1960, nhung d i n nay vdn ehiem ty le khd cao vd ed xu hudng tdng nhanh, khdng chi d khu vuc thdnh thi md d ca khu vuc ndng thdn [3], [4], [5]. [7].
Be gdp p h i n ndng eao hieu qua cua chuang trinh phdng ching cdc b^nh hpc dudng. cdng trinh duac t i i n hdnh nham muc tieu. "Md ta die diim cin thj hgc dudng d hgc sinh tieu hgc va trung hgc eo so Hi Noi nam 2009 ".
D6\ TU'ONG VA PHU-ONG P H A P NGHIEN CLTU 1. Ddi tu'p'ng nghien ciPU
G i m 6.184 HS (3.222 nam vd 2.962 nu) t i i u hoc vd trung hpe ca s d (THCS) t u 6- 15 t u i i d 04 qudn, huy^n d Hd Ndi Id Ba Dinh, Thanh Xudn, Tff Liim vd Bdng Anh.
2. Phuang phdp nghien cu'u
- Thiet ke nghien cffu' Md ta cat ngang cd phdn tieh
- C d m i u nghidn cffu dugc tinh theo cdng thffc md ta c i t ngang, udc tinh id 5.780 HS Thyc t i dd nghien cuu 6.184 HS.
- Khdm mat, do thi lyc vd thu kinh xdc djnh TKX (cdn thi, v i i n thi, loan thj) cho t i t ca HS theo danh sach da ehpn. Bo khiic xa bdng mdy khOc xg ty ddng
- Mat dugc coi Id cdn thj Khi khuc xa c i u tuang duang (KXCTB) £- 0,75D). Ngudi dugc coi id c$n thj khi cd mdt mat hoac ca hai mdt cdn thi
So lidu dugc x u if theo phuang phdp thing kd y sinh hpc bdng p h i n m i m SPSS 13.0.
Y HOC THUC HANH (905) ~ s 6 2/2014
K £ T QUA NGHIEN C O u
Bdng 1. T^ 1$ c | n thj cua hpc sinh tiieo c i p hpc d Hd N$i
ciiis6 S6 HS mSc c^n thl
- can thi 1 mat - can thj 2 mSt -Ba deo kinh
Tl^u hgc (r= 3.1771 SL
811 25,5
%
P<£
190 621 204
23,4 76,6 25.2
THCS (n= 3.0071 SL
1.272 42,3
%
001 251 1.021
592 19,7 80,3 46,5
Tong so (n= 6.184) SL 2 083
441 1642 796
33.7
%
21,2 78,8 38.2 Kit qud d bdng 1 cho t h i y ty le cdn thj d HS Hd Ndi Id 33.7%. Ty le cdn thi d HS THCS (42.3%) cao han HS Tiiu hpc (25,5%). s y khdc bigt cd y nghTa thing ke vdi p<0,001 Trong s i 2.083 HS m i c c$n thi. tf 1$ cdn Ihj mdt mit Id 21,2%; cdn thj hai m i t Id 78,8% vd ehi cd 38,2% HS da deo kinh.
Bdng 2. TJ 1$ cdn thj cua hpc sinh thep gidi tinh Chi s i
S6 mile c^n ttij - C$n 1 mat -can 2 mdt
- Deo kinh
Nam (n SL 1047
= 3.222)
%
32,5
Nif (n=
SL 1036
2 962)
%
35,0 p<0,05
234 813 372
22,3 77,7 35,5
207 829 424
20,0 80,0 40.9 Kit qua d bdng 2 cho t h i y tf i$ cdn thj d HS nff (35,0%) cao han HS nam (32,5%), s y khdc bidt cd J nghTa thing kd vdi p<0,05.
Bang 3. T^ 1$ cdn thj cCia hpc sinh cdc qudn/huydn
Ch!s6 Sb mSc c$n thi
- can 1 mat - can 2 mat
- Beo kinh
Ba Oinh (A) (n=1 549) SL 1 % 656 1 42,3
Thanh Xuan (B) (n=919) SL 1 % 377 1 41,0
Ti> Liem (C)(n=1.376) SL 1 % 609 1 44,3
OflngAnh(D) 1 (n=2 340) SL 1 % 441 1 18,8 PA. B, C- D<0,001
92 564 441
14,0 86.0 67,2
92 285 117
24.4 75.6 31,0
137 472 147
22,5 77,5 24,1
120 321 91
27,2 72.8 20.6 Kit qud d bdng 3 eho t h i y ty lp CTHD d HS qudn Ba Dinh (42.3%), Qudn Thanh Xudn (41,0%) vd huydn Tff Lidm (44,3%) cao han so vdt huy^n Ddng Anh (18,8%), sy khdc bidt cd y nghla thing kS vdi p<0,001.
BAN L U A N
1.191$ c$n thj hpc du'dng cDa hoc sinh Hd Ndi so v d i m^t s d n u d c trdn thd g i d i
So vdi mdt s i nudc khdc d chdu My, chdu Au, chdu Phi vd chdu A thl ty 1$ cdn thi d HS Hd NOi tuang d i i cao, tLfong duang vdi Trung Quic, Malaysia, nhung t h i p han Singapore (bang 4).
Bdng 4. So sdnh ty Id cdn thj vdi mdt s6 nudc khac T^c gia
Morgan 1 vacs (2005)1131 Rushood A A va cs. (2013) 1141
Ghoshs (2012)191 KhaderY S v^ cs (2006)1121
GuoY vacs (2013) [11]
GohP. v d c s - ( 2 0 0 5 ) n 0 1 SawS. M . v d c s (2002) [151
Kat qua nqhien cffu (2009)
Qu6c qia My Sudan AnB6 Jordan Trunq Qu6c
Malaysia Singapore
Viet Nam n 14.075 671.119 2,570 1.777 681 4.634 6.184
Tu6i Ldp 4 6-15 6-14 12-17 9-15 11-12 Lap 1-9
can thi (%) 4.5 1,50 11,9 17,6 33,0 34.4 53,1 33,7 2.1} 1$ da t h | htjc d u * n g & hpc sinh HS N^i so vtri m0t s6 tinh v i thSnh ph6 khSc cila V i f t Nam Kit quj nghiSn cini cho t h i y ty 1$ can thi Chung cua 2 c i p (ti4u hoc va THCS) la 33,7%. Niu so v*i k i t quS njhiSn C4u ciJa T r i n V5n D i n (1978) ty [$ c?n thi cOa HS Hi Npi (7- 8%) thl ty 1$ nSy da tang ISn g i p IrSn 4 l£i va so viJi nghien ci>u cua H i Huy T i i n (1980) (5%) thi tang len g i p 6 l i n .
So sinh v * i cac nghiSn cCfu khac chiing tai t h i y ty IS CTHD a HS Ha HJi (nam 2009) tang cao so v6l cac l*i4nh phi khac trong ca nu/iK (bang 5).
V HQC THVC HANH (90S) - SO 2/2014
Bang 5. So sanh tv iS cSn thi vdi mot s6 tinh/thanh pho a V i i t Nam Tac qia
Le Thl Thanh Xuyen (20O9) [8]
Dang Anh Ngoc (2010) [4]
Nquyen VSn LiSn (1999) |31 Pham Hong Quang (2011) [6]
VO Quanq Dunq (2013) Ml [l/lai Quoc Tunq va cs. (2011) f7]
Trinh Thi Bich Nqoc (2009) [5]
Vu Thl Hoanq Lan (2012) [2]
Ket qua nghiSn cu'u (2009)
Bia phironq TP. H 6 Chi l«inh
Hai Phfing Nam Dinh Bac Ninh Th^l Nguyen
Bac Kan Ha Nai HaNOi HaNOi
n 2.747
757 3.580 322 6 184
Tu6i (I4p) 7-15 Lc>p1-12 L*p1-12 Ldp 6- 8 Ldp 6- 9 L6p 6- 9 Ldp 6- 9 Ldp 6- 9 Li»p1-9
can thi (%) 38,88 16,42 13,6 20,3 16,8 5,9 25,5 50,3 33,7 3. Ty le can thj hpc d u d n g cOa hoc sinh ngi
thdnh vd ngo^i thdnh
K i t qua nghidn cdu cho thay ty 1$ CTHD d HS qudn Ba Dinh (42,3%), Qudn Thanh Xudn (41,0%) vd huydn TLF Liem (44,3%) cao han so vdi huyen Dong Anh (18,8%). s y khdc biet co y nghla thong kd vdi p<0,001. D i i u nay cung tuang t y nhu nhdn xet cua nhiiu nghidn ci>u trong vd ngodi nudc Id HS d thdnh thi c6 ty 1$ cdn thi nhieu han vd mdc do n^ng han so vdi HS 6 nong thon [9], [10], [13], [14].
(y Viet Nam, nghidn cdu cua Nguydn Van Lien (1999) [3] d Nam Djnh cho thay ty le CTHD d HS ndng thon thap han so vdi HS thdnh pho (3,9% va 13,3%). Nghidn cdu cua Le Thi Thanh Xuydn vd cs.
(2009) [8] d TP. H i Chi Minh (7- 15 tuoi) cho thay ty le can thj theo viing Id 56,67% (trung tdm), 36,93%
(can tmng ldm), 38,88% (ven) vd 15,48% (ngoai thdnh). Pham Hong Quang vd cs (2011) [6] nghien cdu tai Bac Ninh thiy HS Idp 6 den Idp 8 d npi thanh m i c c$n thi cao han ngoai thdnh (0R= 3,6; 95% Cl=
2,3 - 5,6). Tai Bdc Kan, Mai Quoc Tung vd cs (2011) [7] cung thay HS thdnh thj c i nguy ca bj can thj cao hon d ndng thon.
Chung toi cho r i n g ty ie can thj d HS thdnh p h i cao han d nong t h i n Id do HS thdnh p h i ddnh thdi gian dpc vd viet d ngodi tru'dng hgc nhieu han so vdi HS nong t h i n . Gia tdng hoat dgnq nhin gan la nguydn nhdn g i p p h i n vao s u phdt then cdn thi.
KtT LUAN
Dieu tra 6.184 hpc sinh (3,222 nam vd 2 962 nd) tieu hgc vd trung hpc ca sd t u 6 - 1 5 tuoi d 04 qudn, huy#n d Ha N6i ndm 2009. Ket qua nghien cdu cho thiy ty le can thj Id 33,7% (khuc xa c i u tuang du-ang: > - 0,75D). Ty le cdn thj d hoc sinh nd (35,0%) cao han hgc smh nam (32,5%), (p<0,05). Ty le can thj d hgc sinh qudn Ba Dlnh (42,3%), qudn Thanh Xuan (41,0%) vd huydn T d Liem (44,3%) cao han so vdi huyen Dong Anh (18,8%), (p<0,001).
TAI LIEU THAM KHAO
1. Vu Quang Dung (2013), Nghien cdu thyc trang va mot s6 giai phap phong chdng cgn thj d hgc sinh trung hgc co sd khu vyc trung du tinh Thai Nguyen, Ludn an Tien sT Y hgc, Dai hpc Y Duac Thai Nguyen.
2. Vij Thj Hoang Lan, Nguyen Thj Minh Thai (2012), "Thyc trgng cdn thj hgc du'dng va mgt so yeu to lien quan tgi trudng Trung hgc Ca sd Phan Chu Trinh, quan Ba Dinh, Ha Npi nam 2010", Tap chi Y te Cong cpng, 12.2012, S6 26 (26), tr. 23
3. Nguyen Van Lidn (1999), Ddnh gid tinh hinh can thj trong hoc sinh tinh Nam Djnh, Lugn van Thgc sJ Yhpc, Dai hpc Y H d Npi.
4. Dang Anh Nggc (2010), Tgt cgn thj d hpc sinh tieu hgc, trung hgc ca sd Hai Phong, y i u to anh hudng va giai phdp can thiep, Lugn an Tien sT y hgc, Vi#n V$
sinh djch t i Trung aang.
5. Trjnh Thj Bich Ngpc (2009), "Diiu tra djch t i hpc t|t khuc xa d hpc sinh Hd Npi nam 2009", Ky yiu Hpi nghj Nhan khoa Todn q u i c 2009, Dd NSng 09- 12/9/2009, tr. 24.
6. Pham Hong Quang, Phgm Van T i n (2011).
"Cgn thj d hpc sinh vd yeu to anh hudng tgi b i n trudng trung hgc ca sd thanh pho Bac Ninh ndm 2010", Tap chi Nghien cuu Y hoc, 73(2), tr, 112- 116.
7. Mai Quic Tung, Hodng Linh, Dinh Mgnh Cudng va cs. (2011), "Tgt khuc xg d hpc sinh pho thflng tinh B I C Kgn nam 2007". Tgp chi Nghien cdu Y hpc, 72(1), tr, 100-105.
8. Ld Thj Thanh Xuyen, Bui Thi Thu Huang, Phi Duy Tien vd cs (2009), "Khao sat ty le tat khOc xg va kien thuc, thdi dp, hdnh vi cua hpc sinh, cha mp hgc sinh va giao vien ve tgt khuc xg tgi TP. HCM", Tgp chi Y Hpc TP. Ho Chi Minh. Tgp 13, Phy b a n c u a S i l . t r . 5-12
9. Ghosh S., Mukhopadhyay U., Maji. D. et al (2012), "Visual impairment in urban school children of low-income families in Kglkata, India", Indian J Public Health, 56(2): 163-7.
10. Goh P. P., Abqanyah Y,, Pokharel G. P. et al (2005), "Refractive error and visual impairment in school-age children in Gombak District, Malaysia", Ophthalmology. 112 (4): 678-85.
11. Guo Y., Liu L. J , Xu L.. Lv Y. Y. et al. (2013),
"Visual impairment and spectacle use in schoolchildren in rural and urban regions in Beijing", Eur. J Ophthalmol, 0. doi: 10.5301/ejo.5000348.
12. Khader Y. S., Batayha W. Q., Abdul-Aziz S, M.
et al. (2006), "Prevalence and risk indicators of myopia among schoolchildren in Amman, Jordan". East Mediterr Health J., 12(3-4): 434-9.
13. Morgan i., Rose K. (2005). "How genetic is school myopia?", Prog. Retin Eye Res.. 24 (1), p. 1-38.
14. Rushood A. A , Azmat S.. Shariq M. et al (2013), "Ocular disorders among schoolchildren in Khartoum State, Suden", East Mediterr. Health J., 19(3):
282-8.
15. Saw S. M,, Andrew/ C , Kee S. C. et al. (2002),
"Component dependent risk factors for ocular parameters in Singapore Chinese children*.
Ophthalmology, 109 (11). pp. 2065-2071.
Y HOC THirc HANH (905)-S6 2/2014
