VIETNAM MEDICAL JOURNAL N''1 - MARCH - 2017 Co 4 trffdng hdp bi lech TTTNT chiem 6,9%, ca 2
trffdng hdp bi lech TTTNT nhffng mffc dp leeh khong dang ke va khong gay bien ehffng nen chung toi eung khong can thiep Iai. Theo nghien cull ciia tran thi phffdng thu va vu anh le [4] ghi nhan co 2/50 trffdng hdp leeh TTTNT ehiem 4 % , va ca hai trffdng hdp nay theo tae gia la do sot chat nhan va dinh mong mat cu do viem.
V . KET LUJSkN 1 . Oac d i ^ m l a m s a n g
- Nam ehiem 7 2 , 9 % ; do tai nan sinh hoat chlem t / le 69,5%.
- Chan thffdng xuyen thiing nhan cau ehiem 50,8%, chan thffdng xuyen kem di vat noi nhan chiem 5 , 1 % , ehan thffdng dyng dap nhan eau chiem 4 4 , 1 % .
- Due raeh bao trffdc the thiiy tinh chiem t / le 22%, due tieu the thiiy tinh chiem 20,3%, due sife ehiem 18,6%, due lech va due cang phong the thuy Unh ciing chlem ty le 15,3% va due rach hai bao the thiiy tinh ehiem t / le 8,5%.
- Thj Iffc vao vien: Dffdi dem rigon tay 3m chiem 84,7%.
- Nhan ap vao vien: Khong do dude nhan ap chiem 55,9%, nhan ap tren 25mmhg chi^m 8,5%.
- T o n thffdng ket mac 52,5%, giac mae ehiem 54,2%, mong mat ehiem 55,9%, dich kfnh vong mae ehiem 28,8%.
2. K e t q u a d i e u t r j
- Noi khoa 42,4%, ngoai khoa 57,6%. Trong do, 85,3% d3t the thiiy tinh nhan tao chiem 85,3%, 14,7% khong dat the thiiy nhan tao.
- Thi iffc ra vien t a n g , t h i iffc t f f 1/10 di 10/10 chiem 7 1 , 2 % , sau mpt tuan nhom ^^
tang len
- Bien chutig vi^m giac mac khia 41,2%, via mang bo dao 2 9 , 4 % , tien phong nong va si chat n h a n l l , 8 % . Due bao sau 17,2%, lech tli
thiiy tinh nhan tao 6,9%. | TAI UEU THAIVI K H A O
1 . Do Nhu* Htfn, N g u y i n Trung Kien: Nghien d bien chffng ciia phau thuat due the thuy tinh'c dat thetJiuy tinh nhan tao tren mat chan thuOnc tap chi nhan khoa viet nam, hoi nhan khoa vil nam,_2005, (4),tr. 2 4 - 3 0 .
2. Nguyen Ngoc Long: Nghien cffu dac di€m lam sa)^
va ket qua dieu trj chan thUOng nhan c3u tai bv ti hue, luan vSn Oiac syy hoc, tru'dng'dhyd hue, 2001 3. Le Thj Phu'dng Odng: Gop phan nghien cffuda the thuy tinh nhan tao tren mat due the thuy tin!
do chan thu'dng, iuan an den si y hoc, trUcfni DHYD Ha Ngi, 2001
4 . I r a n Thj Phu'cfng T h u , Vu Anh Le: Xff ly due thi thuy tinh chan thUOng va dat the thuy tinh nhar tao , noi san nhan khoa, hoi nhan khoa viet nam 1998J1), tr; 20 - 23.
5. Nguyen Thj Thu Yen: Nghien cuU lihg dung k? thu|'i cat djch kfnh trong dieu tri vet thu'dng xuyen nhan m.
luan an tien sy hex; tnidng DHYD Ha Noi, 2004 o. Abdie bejga: Vauses and wsual outoDmes of perfisreflre
ocular injuries among ethiopian patients, communiUefi health, 2001, volume 14 (39), pp. 45 - 46.
7, Laemanovie loncar v: surgical treatment, dinica outcome, and complications of traumatic catarae retrospective study, avatmedj, 2004,45 (3), pp. 310 - 3.
DANH GlA DO NANG 6* BENH NHAN BI RAN HO MANG CAN QUA D|NH LirONG NOC RAN TRONG HUYET THANH B A N G KY THUAT ELISA
Bl Hong Thu', Ngo Diic Ngoc"
noc r§n trong huy§t thanh bang ky thuit ELISA. Ooi tffdng va phu'dng phap nghien ci^u: Nghien cuti mo ta phan tich tren 76 benh nhan dude chan doan x5c djnh ran ho can tff 1/2013 den 12/2015. Ket qua:
a nhom benh nhan den sdm (fru'de 12h): Nong do noc ran giO^ cac mffc do nang lam sang khac biet coi nghia thong ke. NSng do CK, creatinin, procalcittgn khong co moi tUdng quan vdi nong do noc ran. So lUdng^bach cau co mdi tffdng quan thap vdi nong do noc ran. O nhom den mu6n (sau 12h): Nong do nOC ran giiJa cac mffc do n§ng khac biet co y nghTa thSq^
^-^P'^, 0-05). Nong dp npc ran c6 moi tu'dng quan thap cd\ mffc do lan xa va su-ng ne, bach cau, CK va procalcitonin. Ket luan: 0 ca 2 nhom benh nhan diu cho thay^ co the sff dung nong do noe ran trong huyet thanh^de danh gia mffc dp nang tren lam sang. "^
Tdkhoa: ran ho cSn, EIJSA, suYig nS, mffcdp lar T O M TAT
Ji%\. van de: Ran ho can la mpt tai nan gap pho bien d nffdc ta. Viec chan doan mffc dp nang tff tru'dc den nay chi dffa vao trieu chffng lam sang! Dinh lu'dng npc ran huyet thanh la mpt gia tri tien lu'dng chinh xac va dang tin cay hdn. Muc t i e u : Danh gia mu'c dp nang d benh nhan bi ran ho mang can qua djnh lu'dng
1- Trung tim Chdng doc Benh vien Bach Mai 2-Bg man HSCC Tn/dng Dal hoc Y Hi Noi 3- khoa Cap c&u Benh vien Bach t^ai Chiu trach nhiem chfnh: Ngo Dffc Ngpc Email: [email protected] Ngay nhan bai: 28.12.2016 NgSy phan bi?n khoa hpc: 8.2.2017 Ngay duyet bai: 16.2.2017
TjitP CHl Y HOC VIET NAM TAP 452 - THANG 3 - SO 1 - 2017 iUMIVIARY
EVALUATE SEVERITY OF PATIENTS W I T H COBRA BITES T H R O U G H MEASUREMENT OF SERUM SNAKE V E N O M BY ELISA Background: Cobra bite is one of the most Dmmon accidents in our country. How/ever, untii now, liagnosis of severity of cobra bite has just relied on Jinical symptoms. Measurement of serum snake 'enom can provide a prognostic value with more iccuracy and reliability than previous methods.
Objective: Evaluate severity of patients with cobra jites through measurement of serum snake venom by :LISA tedinique. Subjects and Methods: This iescriptive study analyzes over 76 patients diagnosed vith ODpperhead bites from January, 2013 to December, 2015. Results: In the group of patients flrfio anive earlier (before 12h): The difference Detween concentrations of snake venom at different evels of clinical severity is statistically significant with 3 <0.05. Concentrations of following semm jubstances: CK, creatinine, procalcitonin have no xjirelation with snake venom concentration in plasma, aemm white blood cell count has low correlation with
^^concentration of snake venom. In the group of K ^ ^ ^ w h o anive later (after 12h): The difference D^^^concentrations of snake venom at different ta^l^lcllnical severity is statistically significant with
|j£;^i!0^l There was low correlation between venom jerum level and swelling levels, spread of venom, leukocytes, CK, procalcitonin Conclusion: Results from both groups of patients shows concentrations of semm snal<e venom can be used for prognosis of dinicai severity.
Keyword: cobra bite, EUSA, swelling, level of spread of venom
LDATVANDE
Ran cSn la mot cap effu npi khoa thffdng gap
& eac nffdc nhiet dc^ nhff Viet Nam. 6 Viet Nam ffdc tinh CO khoang 30 nghin nan nhan bj ran doc can moi nam, mien bac chii yeu do ran ho can khoang 9 3 % , mien nam chii yeu do ran luc can Wioang 7 4 % , chffa co so lieu ehinh thffc chung ca nffdc ve ran can, cung nhff t y le tff vong do ran can [ 1 ] [ 2 ] . Chan doan ran ho mang can d Viet Nam gap nhieu khd khan va viec ehan doan dda chu yeu vao iam sang. Co nhiieu phffdng phap da ap dung de giup viec ehan doan va djnh Iffdng nong dp npc doc ran ho mang banh, trong do xet nghiem mien djch gan Enzym (EUSA) CO nhieu ffU diem, giup cho viec chan doan ehinh xac, nhanh chong va dinh iffdng gia hi cu the nong dp ncc ran trong huyet thanh.
Tuy nhien ehu^ eo ngiiien cihj day dii nao chffng minh dffdc dinh Iffdng npc ran bang xet nghiem ELISA CO phan anh duUc chinh xac mffc do nang tren lam sang ciia benh nhan hay khong. Do do
ehung toi thffc hien nghien cffu nay nham "Sfanh gia mdc dp nang d benh nhan bi ran ho mang can qua dinh ludng ngc ran trong huyet thanh bang ky thuat EIJSA ".
II. OOI T i r p N G VA PHUOTSIG PHAP NGHIEN CUU 2 . 1 Ddi tu'dng nghi@n cu'u
Tieu chuan Iff^ c h o n : cac benh nhan dffdc chan doan xac dinh ran ho can
Tieu chuan loiai trii': Benh nhan ehan doan xac djnh ta ran ho mang banh can dffdc sff dung huyet thanh khang npe
2 . 2 Phu'dng phap nghien cu'u Nghien cu'u mo ta phan tich 76 benh nhan dddc ehan doan xac djnh bj ran ho can vao Trung tam chong dpe benh vien Bach l^ai tff ngay 1/2013 den 12/2015. Benh nhan dffdc chia thanh 2 nhom: nhom vao vien trffdc 12h (61 benh nhan) va nhom vac vien sau 12h (15 benh nhan).
Bien so nghien ciihi
Djnh Iffdng npe doe trong huyet thanh lay tai thdi diem vao vien, mffc dp nang lam sang kiii vao vien, cac xet nghiem: Cl<, creatinin, bach eau, procalcitonin va so Ip huyet thanh khang npc sff dung.
X e t nghi#m nong do noc ran trong mau tai thdi diem v a o v i e n .
Quy trinh dffdc tien hanh tai phong xet nghiem Trung tam chong dpe Benh vien Bach Via\ va tai bp mon Mien djch ciia Hpe vien Quan Y.
Cac bffdc tien hanh dinh Iffdng deu dffdc ehuan hoa theo quy trinh da dffde thong qua bdi hoi dong khoa hoe Hoc vien Quan Y thang 10/2015 [ 4 ] .
2.3 Phu'dng phap xu* ly so lieu Xff Iy so lieu theo phan mem thong ke y hpc vdi cac test tiiong ke thich hdp bang phan mem STATA. He so a=0.05, |3=0.2 Tinh he so tffdng quan r eiia 2 bien de biet dffdc moi tffdng quan.
III. KET QUA
3 . 1 Oac d i e m chung cua benh nhan Cd 76 benh nhan bi ran ho mang banh can, trong do co 65 nam (85,5%), 11 nff (14,5%). Do tuoi trung binh ciia benh nhan la 43.49 ± 14.6 (15-86). Cd 61 benh nhan (80,3%) do ran Naja atra can, 14 benh nhan (18,4%) do ran N.
kouthia can, con 1 benh nhan (1,3%) do ran N.
siamensis can.
3 . 2 . Moi lien quan giu'a dac fliem lam sang va can lam sang vdi nong do noc ran
Nhom v a o vien tru'dc 1 2 h
METNAM MEDICAL JOURNAL N°1 • MARCH • 2017
Bang 1. Nong 86 noc ran cua benh nhan vao viin tru'dc 12h
«K_ ^ : ^ _ • • "n ;; I Ti-iinn ui f n n / m l ^ NhO r
aac aiem
Mu'c do nang Jam
sang
Nhe Trunq brnh
Nang
Trunff vl fnq/mi) Lfln nhat
<o.os
Nhdn jr^f Nong i o ngc ran giiJa cac mifc do nang lam sang va mire do hoai W khac biet d nghTa thong Ice. , . ^ . - . ^ ^ ^ •..
Bang 2. Tu'dng quan gida mpt sdyeu to lam sang va chi so sinh hoa vdi nong to m ran dliSnh nhan den tru'dc 12h
Chi so CK ( U/L)
Trung vj 235
Trung binh I Nho nhat
iffl
Creatinin(|jmol/l) 82
Bach c^u (G/L) 11.13 ±4.8 Procalcitonin
Stfng ne tai cho Mu'c do ian xa I LOS om
Nh$n xet: Nong do cac chat trong huyet thanh CK, Creatinin, Procalcitonin khong co moi||
quan vdi nong do noc ran trong huyet tu'dng f^
Nhdm benh nlian vao vien mudn sau 12h 'i Bang 3. Nong do noc ran d benh nhan vao muon (sau 12h)
Mu'c do nang lam sang
Trung vj (ng/ml)
Nhd nhat (ng/ml)
Ldn nhat (ng/ml) Nhe
Trunq binh Nanq Tong
Nhan xet: Nong do npc ran giu^ cac mu'c dp nang khac bi§t co y nghTa thong ke vcii p = 0.003 < 0.01 Bang 4. Tddng quan gida mdt sdyeu id lam sang va chi sdsinh hda vdi ndng do m ran dbenh nhan den sau 12h
Chisd CK (JJ/L) Creatinln(pmol/l)
Bach c^u(G/L) Procalcitonin Sulig ne tai cho
Mdc do lan xa n 15 15 IS 14
Trung vi 1978
95 10.7 0.32
Trung binh 6124±10788 113.4 ± 91 11.3 ± 4.9 22.8 ± 41.5
Nhd nhat 120 52 6.1 0.02
Ldn nhat 42100 433 24.6 100
.
r 0.355 0.195 0.305 0.254 0.428 C.48B Nhan xet: A6ng dp noc ran trong huyet thanh co tu'cJng quan ttiap vdi nong dp CK va so luHl bach cau, Procalcitonin d benh nhan den muon
3.3 Dieu tr| huyet thanh khang noc ran
Bang 5: Mdc do nang lam sang luc vao vien va solo huyet thanh dieu tri ; Mdc do nang Trung binh (lo) Trung vi va khoang gia (•} •.
trj (lo) P 1 Nhe (1)
17.9 ± 12.4 15 (5 - 60) P I , <0.05"Trung binh (2)
28.12 ± 16.1 30 (3 - 60)P;i >0.05'
Nanji (3) 25 (3 - 50) _Eii
<0.05'tong I S^. I ^3.7 ± 15.5 I 20 (3 - eoT I /Vftanjre'f/Trung binh s5 Ip huyet thanh khang noc diing dieu tri tang dan tir kh6ng trieu chin den mu'c dp trung binh va sU khac biet nay co y nghTa thong ke vdi p < 0.05.
IV. BAN LU^N la lao dpng chi'nh trong gia dinh va lien quan I
4.1. Dac diem chung; Trong nghien cu'u cd viec bat ran. ^ 85.5% benh nhan la nam. Ket qua nay giong vdi ^-Z. Nhdm benh nhan vao vien tru'dc 1 ^
nhu'ng tac gia trong nu'dc [7], Ly do vi nam gidi " Tu'cJng quan giu'a niong do noc ranj
mdc do nang
iwroni T rtu^jViEi WMW I/v'ta^ - i riMrm J - O<J I - ^
Vdi nhdm bieu hien nhe thi co 15/23 trffdng
3 nong do d trong mffc tff 1-24 ng/ml. Mffc do 1 sang trung binh co 21/26 benh nhan nong noc ran trong huyet ttianh trong Ithoang 28- J2 ng/ml. Va co 3 b$nh nhan nang vdi cac :u chirng lan xa ngoai doan ehi va co i benh an bi shock, nong do cua 3 benh nhan bieu n iam sang nang chi 6 trong khoang 3-123.5 'ml. Trong mpt nghien cdu ciia cac tac gia £)ai an [5] CO 27 benh nhan den sdm, trong do 9 ih nhan mffc dp lam sang nhe, nong dp ngc 1 dao dpng 0-24ng/m!, 10 benh nhan trung ih va nang co nong dp npc ran dao dpng 228- 70ng/ml. Sff khae biet co the, do c^ mau hien ciru ciia chiing t6i Idn hdn nen khoang I trj nong dp npe ran cung Idn hdn.
- Tu'dng quan giii'a nong dp noc ran va 'u hieu su'ng nH hoai tiir va mCfc d6 lan xa Ve sir Wdng quan giffa nong dp npe ran trong yet thanh va mffe dp sffng ne tai eho (qua vet n so vdi iDen doi dien, do bang cm) d cac benh H den sdm la khong co sff tffdng quan (r = )49). Tffdng tff doi vdi mffc dp lan xa eua vet n, Chung toi thay rang khong co sff tffdng an giO^ mffc dp lan xa va nong dp npc ran mg huyet thanh vdi he so tffdng quan r = 358. Ket qua cua nghien cffu ciia chffng toi ng phu h ^ vc^ nghien cuXi ciia tac gia Nguyen Tl Sdn(20b8) [6] ve ty le suTig ne va lan xa. Ly ii dio dieu nay theo ntiom nghien cffu thi sff ih hffdng cua tfianh phan gay phu ne cua npc II chu yeu la cae phospholipase A2 khong t^e mg nhanh, nhutig neu de lau thi dau hieu sffng
! va lan xa se nhanh ehong nghiem trpng, ben nh do nong dp npc ran trong huyet thanh ia anh phan npe chffa gay tac dung nen khi npc n trong huySt thanh eao c6 nghTa la nong dp le ran gay tae dung doc tren mo chffa nhiiu, 2U hien lam sang chu^ ro ret.
- Tiifdng quan giu'a nBng do noc ran va ic ket qua can lam sang
C6 43 benh nhan trong nhom den sdm tang
K, chiem 66.2%. Khong co trffdng hdp naong creatinin mau. Khong thay sff tffdng quan
la chi so CK, creadnin tai thdi diem vao vi^n1 nong dp npc ran liie vao vien. Vi CK la ket la ciia ton thffdng cac te bao cd do doe to trffe ip, do sffng ne chen ep, CK tang Iai gay ton ffdng than va tff do se gay tang creatinin huyet anh. Chinh vi vay trong giai doan benh nhan in sdm thi sff cac Ion thffdng nay chffa nhieu dac biet npc ran Iffu hanh trong huyS^t thanh 1 nong dp eao ma chu^ gay tae dung doc tren
mo nhieu, nen khong tim thay sff tffdng quan giu^ chi so CK, creatinin va nBng dp npc ran trong huyet thanh cf nhffng benh nhan den sdm.
Khong thay sff tffdng quan giffa so Iffdng bach cau vdi nong dp npe ran, con nong dp proealdtonin co moi tffdng quan thap vdi nong dp ngc ran (r= 0.28). Ket qua nay hdp ly ve cd sd sinh ly benh do qua trinh gay nliiem trung can CO thdi gian va dac biet gay tang cae ehi so bach eau va procacitonin.
4.2. Nhom benh nhan vao vien sau 12h - Tu'tfng quan giii'a nong do noc ran va mu'c do ning
Co 15 benh nhan den sau 12h. Cae t6n thffdng cua benh nhan den mupn co xu hffdng nang va nghiem trpng hdn cac benh nhan den sdm. Nong dp npc ran trong huyet thanh ciia nhom benh nlian co bieu hien lam sang d mffc dp nhe trong khoang 0.974-7.19 ng/mt, d mffc dp trung binh trong khoang 0.124-128ng/ml, va mffc dp nang la 219-799 ng/ml. Chung toi nhan thay rang nong dp npc rah trang huyet thanh eua benh nhan vao mupn ed xu hffdng tang cung vdi xu hffdng nang len d tren iam sang.
- Tu'dng quan giu'a nong dp npc ran va dau hieu sffng ne hoai tiir
C^ mcH tffdng quan thuan mffc dp tfiap (r=
0.428) gida nong do noc ran va mffc do suTig ne theo phffdng trinh Y = 0.002X + 2.39 vdi Y la mffc dp sffng ne (cm), X la nong dp npc ran (ng/ml). Dong thdi eung co sff tffdng quan thuan mffe dp thap ciia nong dp npc ran trong huyet thanh va dp sffng ne qua vet can d benh nhan vao mupn (r = 0.488) va theo phffdng trinh Y = 0.043X + 33.473 vdi Y la mffc dp Ian xa (cm), X la nong dp npc ran (ng/ml).
- Tu'dng quan giu'a nong do npc ran va cac ket qua c3n lam sang
Trong cac xet nghiem can lam sang, nong dp CK, so Iffdng bach eau, pracalcitonin trong huyet thanh eo sff tffdng quan thap vdi nong do npc ran trong huyet thanh tai tlidi diem vao vien.
Nong dp npc ran lue vao vien dffdng nhff khong
lien quan vdi cac chi so creatinin. Ly glal eho
dieu nay do nong dp npc ran la nBng dp tang dot
ngot trong mau sau khi bj ran can, cdn cae ehi so
can lam sang ke tren can eo qua trinh phan ffng
tff tff eua cd the va gay tac dung ciia npc ran
mdi bien doi. Ngoai ra, npc ran khi gay tac dung
va nong dp co the se giam dan so vdi iuc vao
vien, nhffng cac chi so can lam sang sau nay se
cang ngay cang tang sau khi bi ran can.
VrETNAM MEDICAL JOURNAL N°1 - MARCH • 2017 V . KET LUAN
a ea 2 nhom benh nhan deu cho thay eo the sff dung nong dp npe ran tnang huyet thanh de danh gia mffc dp nang b ^ n lam sang.
TAI UEU T H A M KHAO
1 . Trinh Kim Anh, Trinh Xuan Kiem (1998). Ran doc tai Viet Nam, tai lieu torn tat ve ran doc va dilu tii nah nhan ran d6c. 1998. tap chiy hoc dai hoc y dddc thanh phd lid Chi Nho nhat. p. 17.
2. t r a n Kien, N g u y i n Quoc Thang (1995). Cac loai ran doc 6 Viet Nam,. 1995, Nha xuat ban khoa hoc va kp thuat: Ha Ngi
D. Kaw RatanabanangloKm (1987). Immunodiagnosis of snalffl venom poisoning. Aaan Pac^ joumai of ali&gyandimmuncA)gy 1987.5: p. 187-190.
4. Ha Thj Hai (2015). nghiSn cffu che tao bo n§hi§m elisa dinh Iffdng ngc ran ho mang n bac vi?t nam (Naja atra). 2015, Hoc Vien Quai Thacsy yhoc. p. 31-37
5. Hung D2., Uau M.Y, Lin-Shiau S.Y (2003).
dinicai sgnifkanoe of venom detedion in patient- cobra snal^jite. Toxkxxi, 2003.41: p. 220-225 6. Pal M, Maiti A.K, Roydtowdhury U.B (199
Renal Pathological Oianges in Poisonous Snake B J Indian Acad forensic i^ed, 1998. 32(1): p. 19-33 M. N g u y i n Kim Sdn ( 2 0 0 8 ) . Nghien ciTu dac di
lam sang va dieu trj benh nhan bj mot so ran c tren can can thupc ho ran H 6 (Elapidae) 6 m Bac Vi§t Nam. 2008, Tien si Yhoc: Tnfdng Dai I Y Ha iVdi. 55-86.
NGHIEN CtJ'U CHI SO VAN T 6 C DONG C H A Y C O A DOPPLER ONG TINH MACH (y THAI BINH THirCTNG TUOI THAI TIT 2 2 DEN 3 7 TUAN
Nguyen Thi H^ng*, Lg Hoang*, Nguyin Thi Tuyet Mai Dang Thi H^ng Thien*, Hoang Thj Ngoc Iran
circulation and fetal heart function. Objectives:
create establish, percentile chart of Ductus venos flow velocity waveform among normal fetuses.;frc 22 to 37 week. Subject and method: there m 480 pregnant women from 22 to 37 week of gestalic ail of them had Doppler ultrasound of Ductus venos indices. Methodology: this is a cross-sectional stut Results: a high correlation between flow veloc waveform Ductus venosus and gestational we Conclusions: This study have created percent chart for: flow velocity waveform o f Ductus ven^
Doppler indices among normal fetuses from 22 t ^ week of gestation. This chart will be useful for appli
to practice in ciinlcai ^ Keywords: Ductus venosus, Doppler, ultrasoyr
velocity, fetus, reference range. 1 t. OiCkT V X N O E
Sleu am Doppler mau eho thay hinh anh doi chay ciia mach mau tff do co the cho phep dai gia dude nhiJng thay doi huyet dpng ciia thai nhi, Ong tTnh mach Arantlus la cau true mach mi noi tff tfnh mach ron den tinh mach ehu dffdi ci thai, mang mau giau oxy ciia tinh mach ron:
tTnh mach chii dffdi. Oo dong chay Doppler o ong tTnh mach da dffdc nhieu nghien ciAi tn the gidi bao cao cho thay no co vai tro ng eang quan trpng trong viec danh gia IffU \di tuan hoan va tim eiia thai nhl dac biet la sff Iii dien ciiajJang song Doppler bat thffdng [IJ.T nhien, de danh gia tinli hieu qua ciia cac chi Doppler ong tTnh mach trong sieu am thai, Of can thiet ^ u tien phai xay dffng dffdc gia pham v| tham chieu binh thffdng ciia cae chi T O M T A T
Nghiin cffu chi so van toe dong chay cua Doppler ong tfnh mach d thai binh thudng tuoi thai tff 22- 37 tuan. Tham do Doppler ong tTnh mach cd vai tro ngay cang quan trong trong viec danh gia lull lu'dng tuan hoan thai nhi cho phep danh gia chffe nang tim thai.
Muc tieu: Xay di/ng bieu do bach phan vi chi so van toe cOa Doppler ong tlnh mach 6 thai binh thUdng tuoi thai 22 den 37 tuan de ffng dung trong lam sang. Doi tu'dng va phu'dng phap nghien cffu: 480 thai phu mang thai binh thu'dng co tuoi thai tff 22-37 tuaii dUdc do chi so Doppler ong ttnh mach. Phu'dng phap nghien cffu: Mo ta cat ngang. Ket qua: van toe dong chay cua Doppler ong tTnh mach 6 tuoi thai tff 22 den 37 tuan CO moi tu'dng quan chat che vcli tuoi thai. K ^ luan: Nghien cffu da thiet lap dffdc bieu t ^ bach phan vj chi so van toe ciia Doppler ong tTnh mach d thai binh thuflng tuoi thai 22-37 tuan de ffng dung tnang lam sang.
Td khoa: ong tTnh mach, sieu am,Doppler, van toe, thai, pham vi tham chieu
S U M M A R Y
SIUDYON FLOW VELOCITY OF DUCTUS VENOSUS DOPPLER INDICES OF NORMAL FETUSES FROM 22 TO 3 7 GESTATIONAL WEEK
Prenatal Doppier ultrasound of ductus venosus plays an important role in evaluation of fetal
^ e n h vien Phu san Trung l/dng Chju trach nhiem chi'nh: Le Hoang Email: [email protected] Ngay nhan bai: 12.12.2016 Ngay phan bien khoa hoc: 2.2.2017 Ngay duyet bai: 13.2.2017 78