Cancer and 30% of Eariy-Onset Breast Cancer Patients among Ashkenazi Women. Am. J. Hum.
Genet. 60:505-514.
6. Neuhausen S, Gilewski T, Norton L, Tran T, McGuire P, et all (1996). Recurrent BRCA2 6174delT mutations in Ashkenazi Jewish women affected by breast cancer. Nat Genet May;13(1):126-8.
7. Pak Cheung R. Chan, Betty Y.L. Wong, Hilmi Ozcelik, and David E.C. Cole (1999). Simple and Rapid Detection of BRCA1 and BRCA2 Mutations by
Multiplex Mutagenieally Separated PCR. Clinical Chemistry 45, No. 8:1285-1287.
8. Scott D. Dufresne, MD; Dorothy R. et all (2006). BRCA1 and BRC/^2 Mutation Screening Using SmartCyder 11 High-Resolution Melt Cun/e Analysis. Arch Pathol Lab Med ; 130:185-187.
9. Sng JH , Chang J, Feroze F, et all (2000).
The prevalence of BRCA1 mutations in Chinese patients with eariy onset breast cancer and affected relatives. British Joumal of Cancer 82(3), 538-542.
3^
DAC DIEM D|CH TE HOC BENH THUY DAU TAI TINH TUYEN QUANG, 2005-2009
T O M T A T ''^ ""• '••' •!
Nghiin cifu hdi ciru kSt hgp tidn ciru sd lieu giam sit benh thdy diu dugc tien hanh tai tinh Tuyen Quang trong nim 2005-2009. Ket qua cho thay t^ le mic thCiy dau cd xu hudng ting len theo thdi gian, td
12,45/100.000 dan nim 2005 len 63,97 nim 2009.
Sd mic trung binh 5 nim phin bd khdng diu giira cic huyin thi, cao nhat d thi xa Tuyen Quang (162,9/100.000). Huyen Yen San cd t^ le mic eao nhat toan tinh trong nim 2009 (150/100.000). Tren 95% sdmic li tre em, trong dd Ida tudi mic cao nha't la tri td 1-5 tudi (50,9%,). Benh thudng d hinh thii tan phat (64,3%, sd ca benh), vdi 76% sd benh nhi duge ther. del diiu tri tai gia dinh, va 100% khoi benh khdng cd tCt vong vi di chifng.
Tdkhda: Dich te hoc; Benh thdy dau; tinh Tuyen Quang, 2005-2009.
S U M M A R Y • " " " -";' '
The retrospective study was conducted by reviewing surveillance data on varicella of Tuyen - Quang province for 5 years, 2005-2U09. The results show as followed: The trend curve of morbidity of varicella have been increased year by year, from 12.45/100.000 population in 2005 up to 63.97 in 2009. The distribution of average morbidity of 5 years was rather different among district to district of the province and showed remarkablely higher in Tuyen- Quang town (162.9/100.000) meanwhile Yen Son district has the highest morbidity rate in 2009 (150/100.000). In Yen Son however most of the varicella patients was a children (over 95% of total 171 patients), especially occured spontaneously in group of 1-5 ages (50.9%). Over 76% of varicella having children was isolated and treated at home. No deaths nor complicated cases of varicella were found in Yen Son 2009. -
Keywords: Epidemiology, Varicella, Tuyen - Quang province, 2005-2009.
N G U Y I N ANH T U A ' N , N G U Y I N DINH HUNG Trung tim YTDP Tuyen Quang
Lt HONG PHONG, N G U Y I N TH! TH JONG, PHAM NGQC OfNH Vi$n V$ sinh djch ti trung uang
DAT V A N DE
Thuy dau (varicella) la mpt benh truyen nhiem e6 ehl sd lay truyen eao va co the gay ra nhifng bien chimg nguy hiem cho tre em. Hang nam Viet Nam c6 khoang tU 3000 tdi 6000 trudng hdp thiiy dau lam sang dupe bao cao, gay ra nhuTig ganh nSng thifc sU cho xa hpi va gia dinh. Tuy nhien sU ehii y cho viee giam sat va phong chdng benh eon rat han che. Ty le ngUdi dUde dimg vaccin dU phong ehii dpng rat thap, khoang dudi 5% dan sd. Cong tae phat hien va phong ehdng dich benh thiiy dau d cac tinh mien niii, ndi he thdng y te dang con nhieu kho khan, lai cang yeu kem hdn.
Tuyen Quang la mpt tinh mien niii phfa Bae nam d giOra viing Tay bae va Dong bae ciia td qudc, co 22 dan tpc sinh sdng. Thuy dau eung dang la mpt van de sifc khoe cpng ddng vdi sd ngudi mac tang len hang nam, tai tat ca cae huyen thj trong tinh. Nghien cifu cua ehiing toi ed mue tieu tim hieu mpt sd dae diem djch td ed ban benh thijy dau d tinh Tuyen Quang va mpt huyen mien nui dien hinh la huyen Yen Sdn trong 5 nam qua, trpng diem la nam 2009, nham tao cd sd eho du phong ehii dpng loai benh truyen nhiem dang bi "lang quen" nay d Tuyen Quang ndi rieng, eac tinh mien niii phfa Bae noi ehung.
PHLfONG P H A P NGHIEN CUU
Dja diem nghien ciifu: tinh Tuyen Quang va huyen Yen Sdn eua tinh.
Dd'i tupng nghien ciiru:
Toan bp dan sd mac benh thuy dau dupe dua vao thdng ke giam sat va the hien trong bao cao hang thang cuaTrung tam Y te dU phdng tinh Tuyen Quang trong 5 nam (2005-2009) va Trung tam Y te huyen Yen Son trong nam 2009.
Mpt sd benh nhan thiiy dau theo d_6i tien eifu jai Benh vien huyen Yen Sdn dupe lay mau benh pham
Y HOC THUC HANH (741) - SO 11/2010
111
lam xet nghiem PCR tai Vien Ve sinh djch te trung UPng de xae dinh dau an di tmyen cija vi rut thuy dau.
PhUdng phap nghien cCfu :
Djch t l hpc md ta, vdi thiet ke nghien ciifU hdi cifU tu lieu thCf cap, va theo ddi tiep dien ca benh thijy dau mac mdi trong nam 2009 d benh vien huyen Y^n Sdn va tai cac xa trong huyen. Sd lieu duoc thu thap va xuf ly bang phan mem Epilnfo 6.04 tai Khoa Djch t l Vien VSDT tmng UPng va Tmng tam YTDP tinh Tuyen Quang.
Cac chi sd cho nghien cdli chfnh:
Sd lupng va ty le mac va tCf vong do thijy dau cua ddi tupng nghien cifu;
Su phan bd eua ty le mac thuy dau theo gidi tfnh, nhdm tudi, dja phuong va mot sd yeu td khac;
Dudng cong "ngUdng dich" theo thang, xae dinh tren co sd lay sd lieu mac trung binh thang tfnh trong 5 nam lien tue, cpng vdi 2 lan dp lech ehuan (2 SD) eua gia trj trung binh.
Ky thuat xet nghiem PCR: M i u benh pham djeh mun nude thuy dau lay vao ngay thiif 3-5 cua benh tU benh nhan ehua dupe dieu tri bang eac thudc khang vi rut dac hieu. Benh pham da dupe gi!ri ngay tdi Phong thf nghiem Cac Vi rut Herpes, Khoa Vi mt, Vien Ve sinh Djch te Tmng uong de chan doan khlng djnh bang phan ifng chudi polymerase (PCR) cd dien khuech dai mpt doan ADN dn djnh nhat cua gene ADN polymerase vims thuy dau vdi mpt cap mdi dac hieu.
K^T QUA v A BAN L U A N
1. Ty le mac, tuf vong va s\f phan bo bfnh thuy dau cua tinh Tuyen Quang trong 5 nSm (2005 - 2009)
Bang 1: Ty le mac va tiir vong do benh thOy dau
Chisd Sd m i c thiiy
dau T:^ 16 % tdng sd m i c 5 nam Ty 16 mac /100.000 dan
Sd tir vong Ty 16 tif vong
Nam nghi6n ciru 2005
91 6,1 12,45
0 0
2006 147 9,8 20,09
0 0
2007 226 15,1 30,89
0 0
2008 561 37,6 76,68
0 0
2009 468 31,4 63,97 0 0
Tdng s(5 1493
100 40,87
0 0 Nhan xet: Sd trt/dng hpp mac benh thiliy dau cd xu hudng tang dan tif nam 2005 (91 ca) tdi nam 2009 (468 ca), dinh cao la nam 2008 vdi 561 ca, chiem gan 40% tdng sd ca mac thuy dau ciia ca 5 nam. Ty le mac tfnh tren 100.000 dan cung tang dan tU 12,45 nam 2005 len tdi 63,97 nam 2009. Ty le mac tfnh trung binh toan tinh la 40,87/100.000 danlnim. Tuy nhien da khdng cd tijr vong do thuy dau tren pham vi toan tinh.
Bang 2: Ty le mac/100.000 dan theo dia ban huyen HuySn
Thj xa TQ YfinSon San Dirong
Hdm Y6n ChiSm HoS Na Hang
COng
\ j • ' '
S6 mic (Ty 16 mac/100.000) theo nSm 2005
30 (53,1)
30 (16,2)
14 (7,8)
1 (0,9)
11 (8,0)
5 (8,6)
91 (12,5)
2006 114 (199,9)
21 (11,3)
10 (5,6)
0 (0)
2 (2,7)
0 (0) 147 (20,1)
2007 114 (183,8)
21 (11,2)
10 (5,5)
79 (76,2)
2 (2,4)
0 (0) 226 (31,3)
2008 113 (124,4)
141 (98,8)
47 (25,8)
74 (61,0)
65 (45,8)
120 (204,1)
561 (76,7)
2009 92 (100,6)
171 (150)
92 (51,6)
31 (28,0)
15 (10,9)
67 (111,5)
468 (63,9)
Tdng s6 mic 5 nSm 463 385 173 185 95 192 1.493 (100)
Trung blnh/nSm 93 (162,9)
77 (41,1)
35 (19,4)
37 (33,6)
19 (13,6)
38 (67,0)
299 (40,9)
Nhan xet: Ty le mac thuy dau chenh lech Idn giCra cac huyen thj trong tinh. Cao nhat la Thj xa Tuyen Quang vdi sd mac trong 5 nam len tdi 463, chiem 3 1 % tdng sd mac cija ca tinh, va ty' le mac/100.000 dan la 162,9 ngudi. Tha'p nha't la huyen Chiem Hda vdi sd mac chi cd 95, chiem 6,4% tdng sd mac 5 nam CLJa ca tinh, ty le mac/100.000 dan la 13,6 ngudi.
NhOrng huyen thi ed ty le mae/100.000 dan eao hdn ty le tmng binh ciJa ca tinh (40,9) la Thj xa Tuyen Quang, Na Hang va Yen Son. Cac huyen eon lai ed ty le mac thap hon ty le trung binh cda tinh, gdm Ham Yen, Sdn DUdng va Chiem Hda.
Ty le mac/100.000 dan tfnh tmng binh trong 5 nam (2005 - 2009) cho tha'y thang cd ty le mac tmng
binh thap nhat la thang 2 (0,83/100.000), va thang cao nhat la thang 4 (13,31/100.000). Tren cd sd cua dudng phan bd trung binh chuan tren day, da xae djnh dupe dudng "Ngudng dich" benh thuy dau theo thang cOa tinh Tuyen Quang. Sif dung dudng cong
"ngudng dich" tren chung ta cd the xae dinh dupe cae mdc "canh bao djeh" hoac mdc "cd djch" khi ma ty le mac thuy dau/100.000 dan cua bat cCf dia ban nao trong tinh ngang bang hoac cao hdn dudng cong
"ngudng dich" da dupc xae djnh.
2. Phan tich si/ phan bo m^c thuy dau t^i huyen Yen Son, Tuyen Quang.
Yen Son la mdt huyen Idn, nam bao bpc quanh thj xa Tuyen Quang. Yen SPn cung la huyen mien nui cd
112
Y HOC THUC HANH (741) - S 6 11/2010nhGfng dae tn/ng ve dia ly dan s d hpe kha tieu bieu eho tinh Tuyen Quang. "^heo doi lap hd so eua 171 tn/dng hpp mac thuy d a u (khong c d tif vong) tren toan huyen Yen Sdn trong nam 2009, chung toi ed nhufng ket qua eu the dudi day.
c a n nguyen vi rut hpc: Sau (6) m i u Denh pham djch mun nude thuy d a u lay v a o khoang ngay thir 3-5 cua benh tren benh nhan thuy dau tai benh vien huyen Yen Sdn eho ket qua PCR dUdng tinh d 5 m i u . Day la ty le dUdng tfnh rat eao cho thay ket qua chan doan lam sang benh thuy d a u d tuyen tinh va tuyen huyen ed kha nang tuong dUdng vdi ke't qua chan doan phong thi nghiem.
Nam 57,3%
Bleu dd 2. Phin bd sd ca mic theo gidi tfnh
Gidi nam c6 ty le m a c thuy dau cao hon nCr gidi, chiem 57,3% tdng s d ca mac trong 5 n a m , tuy nhien SLf khae biet khong eo y nghla thdng ke, vdi p>0,05.
B^ng 3. Phan b d so ea m a c theo nhom tudi:
Tudi Sfi ca mic
<1 12
1-5 6-10 87 49
11-15 >15
15 8
Tren 9 5 % trud'ng h p p mac thCiy dau rdi vao lifa tudi tre em, trong do ty le m a c cao nha't d lUa tudi tU 1 tdi 5 tudi (50.9%). Nhdm tre dudi 1 tudi eung eo 12 trudng hdp mac, trong do c h i c d 1 trudng hdp dudi 6 thang tudi. NhU vay nhdm c d nguy c d eao vdi thuy d i u d khu vUe mien niii phia Bac la nhdm tre 1-5 tudi.
Bang 4. Ty le benh nhi c d tien sif tiem chung vac xin
T6n vie xin Thu9 dau Lao(BCG) Bach hiu - ho
gd - u6n vdn Sdi Vi6m Gan ViSm Ndo nhat
bin
Da ti6m dumui
2 168 169 168 156 148
Ty 16 % 1,1 98,2 98,8 98 91,2 86,5
KhOng ti6m
169 3 2 3 15 23
Ty 16 % 98,9
1,8 1,2 1,8 8,8 13,3 Trong sd 171 tre mac thuy dau thi s d dupe tiem chung day du cae loai vac xin trong chuong trinh tiem Chung dat rat eao tU 86,8% den 98,8%, trong khi dd ty le tre dUde tiem chung vaccin thuy dau lai rat tha'p, chi dat 1,8%. Day la mot phan nguyen nhan ty le mac thuy dSu cdn kha eao d Tuyen Quang ndi ehung, d Yen Son ndi rieng, trong khi eae benh tmyen nhiem cd vaccin TCMR da khong nd ra trong nhieu nam qua.
Bang 5. Ket qua dieu trj eae trUdng hpp mac K^tqul
Sd tmdng hop
Khdi 171
Di chimg 0
Tif vong 0 Nhu vay 100% cac ca benh thuy dau d Yen Sdn d^u dupe dieu trj khdi hoan toan, khong ed di chimg, tiJf vong.
ISO - 100 -
so -
0 - 130
35
n
0 6 0gia dinh T Y T yt tl*
Bieu dd 5. Dja diem theo ddi va dieu trj ca benh Da SO benh nhan thuy dau dupe cham sdc dieu trj tai gia dinh (76%). Ty le dieu trj tai tram YT xa va benh vien huyen chi ed 24%. Do dac thii khu vuc mien nui mien Bae y te t u nhan khong phat then nen khong eo trudng hpp nao benh nhan tdi y te t u hay cac CO sd khae.
Bieu dd 6. Phan tfch theo hinh thai dieh te.
Hinh thdi 36 tn/dng hop
Tan phdt 110
Vu dich 54
KhOng rO 7 Mdt ty le eao hdn (64,3%) sd trUdng hpp mac thuy dau d hinh thai tan phat, trong khi ed khoang 3 0 % xua't hien trong eae vu dich, tap trung chii yeu d dia ban dan c u thj xa Tuyen Quang va huyen Yen Sdn.
KET LUAN
Ty le mac benh thuy dau trung binh nam trong 5 nam (2005-2009) eua tinh Tuyen Quang la 40,87/100.000 va co xu hudng tang dan theo thdi gian (nam 2005: 12,45 va nam 2009: 63,97). Benh phan bd eao nha't d thj xa Tuyen Quang (162,9/100.000) va thap nha't d huyen Chiem Hda (13,6/100.000). Dudng cong the hien "ngudng djch"
thuy dau theo thang ed diem tha'p nhat vac iliang Hai (0,83/100.000) va eao nha't vao thang TU-thang N§m (19,14-14,68).
Huyen Yen Son ed ty le mac thiiy dau nam 2009 eao nhat tinh (150/100.000 dan); trong d6 nam gidi mac eao hdn nuf (57,3 va 42,7/100.000); lUa tudi mac cao nha't la tre em tU 1-5 tuoi (50,9%) va ehu yeu thupe hinh thai benh tan phat (64,3%). Hau het benh nhi chua dupe tiem vaccin thuy dau (98,9%); hau het dupe theo doi dieu trj tai nha (76%), va 100% da khdi benh khong ed di chifng.
TAI LIEU THAM KHAO
1. Bo Y te - Cue YTDP (2009). Cam nang Phong chdng benh truyen nhiem: Benh Thuy dau. Nha xuat ban Y hoc, Ha Noi, 2009.
2. Nguy Chan Man, TrUdng VSn Can (1994). Phdng, tri benh Thuy dau va Benh Zona. Nha xuat ban Y hpc.
Ha Npi, 1994.
3. Tran vSn Tien (Chii bien) 2003. Giam sat va kidm soat cac benh truyen nhiim. Benh Thiiy dau. Nha xua't ban v a n hoa Ha Noi, 2003.
4. Centers for Disease Control and Prevention.
Prevention of varicella. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP) Morbid Mortal Wkly Rep 1999;48.
5. World Health Organization. Varicella. WHO position paper. Wkly Epidemiol Rec 1998;73:241-47.
Y HOC THUC HANH (741) - S 6 11/2010 113
Lffa tudi 10-18 19-24
>25 Tdng
Tans6 5 57 58 120
% 4,2 47,5 48,3 100 Nhan xet: V i e m nieu d a o xay ra d tudi thanh thieu nien (10-24 tudi) la 62 trUdng hpp, chiem ti le 51,7% , 4 , 2 % trudng hdp xay ra d lifa tudi 10-18.
Bang 2: Gidi tfnh
DAC DIEM DICH TE, LAM SANG VA YEU TO LIEN QUAN DEN VIEM NIEU DAO 0 LllfA TUOI THANH THIEU NIEN
KHLRJ BACH XUV^N - B$nh vi$n Da liiu Cin Tha HUYNH V A N B A - Tru&ng Dai hgc Y Dugc Cin Tha DAT VAN Di.
Viem nieu dao la mot trong cac benh lay truyen qua dudng tinh due (BLTQDTD) da va dang la nhiing van de dupe xa hpi quan tam trong nhieu nam qua.
Su xua't hien va tinh trang lay lan, eung nhu cae hau qua do ehung gay nen, da cd nhiJmg tac dpng khong nhd den sifc khoe con ngUdi va nhung anh hudng dang ke cho cpng ddng.
Cd ra't nhieu ye'u td anh hudng de'n tinh trang tren.
TU cac yeu td lien quan de'n xa hpi, kie'n thirc, trinh dp, dieu kien sdng, nhOrng anh hudng eua gia dinh, sU giao due, kien thifc y te trong viec phong benh, hay cac phUdng thifc dieu trj khong hdp ly, cho de'n nhufng tac dpng khae trong cupc sdng ed the la nhCfng yeu td CO lien quan de'n sU phat trien cua tinh trang tren trong cpng ddng.
Da ed rat nhieu chUdng trinh dUpc thuc hien trong nhieu nam trude day nham han che sU phat trien va khae phuc hau qua do eac benh ly gay nen. Ben canh nhiing thanh qua dat dupe, v i n con nhieu van de dang dupe quan .tam: Tinh trang khang thudc cua vi triing, sU han che trong cong tac tuyen truyen giao due y te, cung nhU y thUc va viec thUe hien eac bien phap phong benh chUa dupe triet de. Cd the do chfnh la nhirng yeu td ed the ly giai sU lien quan den tinh hinh viem nieu dao hien nay.
Chfnh vi the, viec nghien cifu eac dac diem lam sang va mpt sd ye'u td ed lien quan de'n viem nieu dao se ed y nghla tfch cue gdp phan hon nOra trong cong tae phdng chdng benh trong hien tai va tUdng lai.
De tai nham hai mue tieu:
- Md ta mdt sd die didm dich t& cCia viem nieu dao d Ida tudi thanh thieu nien tai BVDL. Can Tha.
- Md ta die didm lam sang va mdt sd yeu td lien quan de'n viem nieu dao 6 Ida tudi thanh thieu nien tai BVDL. Can Tha. '
DOI TUONG vA PHUONG P H A P NGHIEN CLfU 1. Dd'i tupng nghien ciiru: Cae benh nhan viem nieu dao trong dp tudi thanh thie'u nien den kham tai Benh vien Da liiu Can Thd.
2. PhUdng phap nghien ciiti: Md ta cat ngang va phan tfch s d lieu thu thap. C d mau dUpc Udc tfnh # 100 trudng hpp.
PhUdng phap xCf ly va phan tfch s d lieu: Diing phan mem SPSS 18.0.
KET QUA NGHIEN CLfU^ ' ' " ' "
1. Dac diem dich te, cua viem nieu dao d lufa tuoi thanh thie'u nien
Bang 1 ; Ti le viem nieu dao dUpc phan b d theo lifa tudi:
Gidi tinh Nam
Nff Tdng
Nhan xet: Trong 62 tr 5 8 , 1 % la nU chiem Uu the
Bang 3: Noi d Noid Thanh thi N6nq th6n Tdng
Tan so 26 36 62
%
41,9 58,1 100 Udng hpp viem nieu dao, cd
Tansd 28 34 62
%
45,2 54,8 100 Nhan xet: T i le benh d benh nhan d ndng thdn chie'm Uu the (54,8%)
Bang 4: Nghe nghiep Ngh6 nghi§p
Hoc sinh C6ng nhdn
N6ng ddn Nai tro Bu6n ban Ngh6 nqhi6p khac
Tdng
Tansd 8 14 13 5 11 11 62
%
12,9 22,6 21 8,1 17,7 17,7 100 Nhan xet: T i le benh d cong nhan chiem Uu the (22,6%), ke den la nong dan (21%), buon ban (17,7%), hpc sinh (12,9%), eon lai la eae nghe nghiep khac.
Bang 5: S u hieu bie't ve tac hai cua benh Hieu biSt v6 tac hai cija b6nh
KhSng hilu bi^t Co hidu biet
Tdng
Tansd 14 48 62
%
22,6 77,4 100 Nhan xet: C d 2 2 , 6 % trUdng hdp khdng hieu biet ve tae hai cua benh.
Bang 6: Hoc v a n Hoc van
<Ldp 12
>Ldp 12 Tdng
Tansd 37 25
fi?
%
59,7 40,3 inn Nhan xet: Phan Idn benh nhan c d trinh d d dudi Idp 1 2 ( 5 9 , 7 % )
.114 HOC THUC HANH (741) - S<5 11/2010
2. D^c d i e m l a m s a n g va m d t so' ye'u to' lien quan den v i e m nieu d a o a lura t u o i t h a n h t h i e u nien.
Bang 7: Chan doan nguyen nhan
Bang 11: SU lien quan giijra y thifc dieu tri va sU hieu biet ve tac hai ciia viem nieu dao(n=62)
Nguy6n nhdn Neisseria gonorhheae Clamydia Trachomatis Candida albicans
Tap khuan Nguy6n nhdn khde
Tdng
Tansd l l 19
2 5 25 62
%
17,7 30,6 3,2 8,1 40,3 100 Nhan xet: Nguyen nhan gay nen viem nieu dao bao gdm: Neisseria gonorhheae 17,7%, Clamydia Trachomatis 30,6%, Candida albicans 3,2%, tap khuan 8 , 1 % , eon lai la eae nguyen nhan khae
Bang 8: Sif dung bao eao su trong quan he tinh due
Sff dung bao cao su Kh6ng
C6 Tdng
Tansd 57
5 62
%
91,9 8,1 100 Nhan xet: Phan Idn benh nhan khong sif dung bao cao su trong quan he tinh due (91,9%), 8 , 1 % ed sif dung.
Bang 9: SU lien quan giifa sur dung bao cao su va noid (n = 62)
Sir dung bao cao su
KhOng 06 Tdng
Noid Thdnh thi
24 85,7%
4 14,3%
28 100%
Ndng thdn 33 97,1%
1 2,9%
34 100%
Tdng 57 91,9%
5 8,1%
62 100%
P
<0,05
Nhan xet: Cd 14,3% trU.dng hpp sdng d thanh thj CO sir dung bao eao su, eao hdn c6 y nghTa so vdi ti le nay sdng d nong thon, s u khae biet c d y nghTa thdng ke (p <0,05).
Bang 10: S u lien quan giiira sCf dung bao cao su va tinh trang hdn nhan (n = 62)
Sit dung bao caosu Khdng 06 Tdng
Tinh trang hdn nhdn C6gia
dinh 29 85,3%
5 14,7%
34 100%
Ddc thdn 28 100%
0 0%
28 100%
Tdng 57 91,9%
5 8,1%
62 100%
P <0,05
Nhan xet: Cd 14,7% trUdng hpp c d gia dinh sif dung bao cao su trong quan he tinh due, trong khi khong cd trudng hpp nao doe than sif dung bao eao su, sif khac biet ed y nghla thdng ke (p <0,05)
Sff hidu bidt v6 tde hai cua viem nidu dao
Khdng Cd Tdng
y thffc diiu tri Tff didu
tri 11 34,4%
21 65,6%
32 100%
Bidu tri tai CO sd y td
3 10%
27 90%
30 100%
Tdng 14 22,6%
48 77,4%
62 100%
P
<0,05
Nhan xet: Cd 9 0 % trudng hdp ed hieu biet ve tac hai cua viem nieu dao de'n dieu trj tai cac cd sd y te, trong khi d d c6 65,6% trudng hpp t u dieu trj. S u khac biet CO y nghla thdng ke (p <0,05).
B A N LUAN
1. Cac diem djch te, cua viem nieu dao d lUa tuoi thanh thieu nien
Trong 120 trUdng hpp nghien cUu dupe chan doan la viem nieu dao, da cho tha'y eo de'n 62 trudng hdp, chie'm ti le 51,7% xay ra d lira tudi thanh thieu nien (10-24 tudi), va dac biet ed 4,2% trudng hpp xay ra d lUa tudi tu 10- 18. Phii hpp vdi mpt ghi nhan gan day eua Thomas P. Habif (2010): Hau het cae trUdng hdp nhilm lau eau sinh due xay ra d lira tudi 15-19 [7].
Trong khi mdt sd bao eao khae trUde day eho thay viem nieu dao, dac biet do lau cau c6 the xay ra d tre em. Theo Binita R Shah, eac nhilm khuan tinh due do lau eau xay ra d tre em c6 the do viec lam dung tinh due va eae hoat dpng tinh due tu nguyen va cac benh lay truyen qua dudng, tinh due xay la 5 tre em xay ra tU2%-15% tre em bj lam dung tinh luc \5]. MgX sd y kien khae eho rang, Ddi vdi tre em, 'cudrg lav co the do tiep xiic quan ao eo nhilm lau hay do tiep xuc tinh due [4]. Ve gdc dd thUc te, sU xua't nien tinh trang viem nieu dao ndi rieng va eac benh lay truyen qua dudng tinh due noi ehung phu thudc vao rat nhieu yeu td: sU hieu biet ve tac hai cua benh, dieu kien tac dpng tu moi trudng xa hpi, trinh dp hpe van,...Trong nhien cifu nay, vdi ti le 59,7% trUdng hdp ed trinh dp dudi Idp 1'2, CO 22,6% trUdng hpp khong dupe hieu bie't ve tae hai eua benh, eung nhu 54,8% trUdng hpp sdng d ndng thdn, rat ed the thieu sU tuyen truen ve kien thifc y te',...ed the ly giai dUpc eac yeu td lien quan de'n ti le viem nieu dao xua't hien d lifa tudi tren .
Trong 62 trUdng hpp viem nieu dao, c6 58,1% la nif chiem Uu the. Phii hpp vdi mpt sd thong tin dupc ghi nhan trong thdi gian gan day, theo Thomas P.
Habif (i2010), nguy cd nhilm triing cua nhOmg ngudi dan ong tie'p xuc tinh due vdi mpt ngudi phu niir bj nhilm la 20%-35%. Trong khi, nguy ed mpt ngudi phu nOr tie'p xuc tinh due vdi mpt ngUdi dan ong bj nhilm len tdi tU 50%- 90%. Mpt ghi nhan khac eung da cho thay Cd khoang 30% phu nCr trong giai doan hoat dpng sinh due cd the tim tha'y Clamydia trachomatis d cd tCf cung , am dao, dii cd hay khong c6 bieu hien lam sang, v i n cd the lay truyen sang ngUdi tiep xiic
Y HOC THUC HANH (741) - SO 11/2010 115
