Y HOC VIET NAM THANG 5 - SO 172014
NHAN XET TINH HINH SAU RANG SITA (y HOC SINH TRiraNG TIEU HOC THANH LIET
T O M TAT
Ham rang sOa gid vai tro guan trong trong sif phat trien cua ham r^ng vinh viin cung nhWcua toan cd the. Muc ti@u: Danh gia tinh trang sau rang sii'a d lu^ tuoi hoc sinh 7-11 tuoi tai tru'dng tieu hpc Thanh Uet. Do! tu'tfng va phu'dng phap nghien culi:
Nghien cillj mo ta cat ngang tren 778 hpc sinh. Ton thu'dng sau rang fluWc kham bang mat thu'dng theo he thong tieu cht phat hien va danh gia sau rSng ciia WHO (1997). Ket qua: Ty le sau rang d miit tu'dng doi cao chiem 55,9% trong do gap cao nhat 6 nhom 8 tuoi (88,28%), chi so sau mat tr^m la 4,87, ty le rang sau du'dc dieu trj thap (khoang 10%). Ket lufin: Sau rang sffa d hpc sinh tru'dng tieu hpc Thanh Uet 6 mu'c tu'dng doi cao.
Tu'khda: RSng su^, sau r3ng, sau-mat -tram
S U M M A R Y
Introduction: Primary teeth are very important to the health and the development of the permanent teetti and body. A i m : To describe primary caries status in children 7-11 ages who study at Thanh Uet primary school. Methods: Cross-sectional study on 778 children. Caries lesions were examined with the naked eye under the criteria system to detect and assess decay of WHO (1997). Results: The rate of decay is relatively high at 73.26%; the rate of decay is the highest In group of 8 age (88.28%); smt index is 4.87; the rate of decay with treated is low (about 10%). Conclusion: The primary decay in tiie Thanh Liet primary school is at the high level.
Keywords: Primary tooth, decay, decay-miss- filling tooth.
I.OATVXNOI
Rang sDS cua tre em co nhieu chu'c nang quan trong. Mot trong nhutig chu'c nSng do la chu'c n3ng an nhai, giup tre tieu hoa tot du'dc thu'c an de phat trien the chat va trf tue. Ngoai ra, chun^ con co chufc nang dac biet la giu" cho, hu'dng dan rang vTnh vien mpc dung vi tri, ki'ch thich tSng tru'dng xu'dng ham.
6 nu'dc ta, benh sau rang sife gap rat pho bien d tre em. Theo ket qua dieu tra siic khoe
TrSn Thj My Hanh*, Ha Ngflc Chieu*, Vo TriTOTig Nhu" Nggc*, Tong Minh Sow*
rang mieng toan quoc nam 2002 cua Tran Van Tru'dng va cpng sd cho thay ty le sau rang tang len ro ret, ty le sau rang sffa d tre em tii sau den tam tuoi tren toan quoc la 8 4 , 9 % , vung nui phia Bac la 8 0 , 7 % , mien Dong Nam la 88,2%, dong bang song Cu'u Long la 9 3 , 7 % [ 1 ] . Oe tang cu'dng cong tac du" phong, d nu'dc ta chu'dng trinh nha hpc du'dc da du'dc trien khai tu" nhij'ng nam 80 l35l nay, xa Thanh Liet cung la mpt xa da thu'c hien cong tac nha hpc du'dng difdc nhieu nSm. Vi v$y chung toi thi/c hien de tai nay nham muc tieu:
Oanh gia tinh trang sau rang sife d luS tuoi hpc sinh 7-11 tuoi tai tru'dng tieu hpc Thanh Liet
II. DOI T U O N G VA P H U O N G P H A P N G H I I N C O U 2 . 1 . Ooi tu'dng nghien cu'u: Tat ca hpc sinh tru'dng tieu hpc Thanh Liet, Thanh Tri, Ha Npi.
- Oja diem nghien cu\i: Tru'dng Tieu hpc Thanh Liet, Vien Dao tao Rang Ham Mat- Tru'dng Oai hpc Y Ha Npi.
- Thdi gian nghien CLTU: tu' thang 4/2012 den thang 10/2012.
1.1. Tieu chuan l u ^ chpn:
- Hpc sinh tru'dng tieu hpc Thanh Liet, liJa tuoi 7- 11 tuoi.
1.2. Tieu chuan loai tru*
- Hpc sinh co dp tuoi ngoai d5 tuoi nghiSn cu\i tren, tCrc la nho hdn 7 tuoi hoac ldn hdn 11 tuoi.
- Cac hpc sinh c6 khong day du bp phieu thu thap thong t i n .
2.2. Phu'dng phdp n g h i e n cu'u
2.2.1. Thiit ke nghiin C&U [2]
Nghien cu'u mo ta cat ngang, khong can thiep.
2.2.2. Cdmau
Chia ddi tu'dng kham lam 5 tSng tuoi: nhom 7 tuoi, 8 tuoi, 9 tuoi, 10 tuoi, 11 tuoi
Theo cong thu'c tinh c3 mau cho moi tang tuoi [ 2 ] .
^{\-al2) ' p^
* Vien Dao tao RSng Ham M$t
Phan bign khoa hgc: TS. Phgm Hoang Tuan
(epf
Chon p = 0,6, E = 0.2; Z: dp tin cay 6 mile xac suat 9 5 % ; Z(i.o/2)=l,96.
Thay so vao cong thiJc tinh dirac n =128.
Y HOC VlgT NAM THANG 5 • S01/2014
Nhi/ vay, so hoc sinh lOiam d moi tang tuoi
phai dat toi thieu 128, tong so hoc sinh ran l(ham toi thieu la 128x5=640. TTiut te da icham 778 hpc sinh.
2.3. Cdc bien so trong nghien cthi - Cac thong tin ve tuoi, gidi, thdi gian dieu tn va die yeu to l<len thCfc, thai dp thu'c hanh cham soc rSng mieng du'dc ghi nhan theo mau phieu phong van.
- Chi so S l ^ , so rang sau, so rang mat, so rang tram.
2.4. K ; thuat thuthip thong tin Tiiu chuan su'dung trong danh gia sau rang:
• Chdng tdl da xiy dv'ng cac tieu chuan danh gid va ghi nhdn sau rang diTa theo hu'dng dSn cCia WHO 1997 [3], [4]. '
- Chi sd smt (siu - mat - trim): La tdng sd rang siu + mat 4- trim trin moi tipnh nhin dlfdc kham trong do:
• l^ng sau (s): Cd io sau d bat cd mat nao tren than rang. Tieu chuan de xac djnh lo sau ia cd mac tham cham ichi tham icham.
. I^ng mat (m): Khong thay than rang tren cung ham hoac mat ca than rang va chan rang, ichdng ti'nh cac rang da rung khi den tuoi thay d tre em.
• Rang tram (t): Tat ca cac rang da du'dc tram bang bat cu' vat lieu gi.
2.5. Han che sai so trang nghien cufu Cac bac sy du'dc tap huan va chuan hda Icham lam sang, phong van theo quy trinh thong nhat de loai bd sai so he thong.
2.6. X'li \i so li|u; Phan tich so lieu bang phan mem SPSS 16.0 va phan mem R 2.15.
iii.KfrQuA
Bing 3.S.T\r\t\ hinh sau rang vTnh vien theo gidi Gidi
Nam 403
Sdu rang"
119 29,53 0,60 0,00 0,05
0,08 0,64 1,00
0,81I Tdng so I 778 I 257 I 33,03 I 0,75_ [ 0,00 I 0,06 i u,ai j Nh$nxit:Ty le s^u rSng vinh vien chung cho cac nhdm tuoi la 33,03%. Ty le sau rang vTnh vien va chl so DMFT d nif cao hdn nam cd ^ nghia thong ke (p<0,05)
Biiig 3.6. Tinh hinh sau rang vinh vien theo tuoi TuSi
145
Sdu rdng
32
17,05 31,87 40,20 49,33
0,31 0,44 0,71 1,56
~ JongsS I 778 | 257 I 33^03 I 0^81 j Nh$n xit:Ty le sau ring vnh vien va chi so SMT tang dan theo tuoi, cao nhSt d nhdm 11 tuoi va thSp nhat d nhdiii 7 tuoi.
Bing 3.7, Phan tich chi so SMT Tuoi
7 8 9 10 11
S S
0,29 0,41 0,64 0,92 1,35
S/SMT('/o)
93,55 93,18 91,55 92,00 86,54
M T + I T M
0 0 0 0 0,01
0,02 r
0,03 0,06 0,08 0,2
M+r 0,02 0,03 0,06 0,08 0,21
(M+T)/SMT (Vo)
6,45 6,82 8,45 8,00 13,46
SMT
0,31 0,44 0,71 1,00 1,56 NhiniSir~
• So trung binh rdng duVc dieu tri rdt thap (M+T), difdi 10% cho cac nhdm 7, 8, 9 va 10 tuoi, d nhdm U tu5l cd cao hdn mpt chiit (12,82%).
• TV 1$ rdng sdu b! nho bo (M) d cac nhdm tuSi 7,8,9 va 10 bSng 0, rieng nhdm tuoi 11, c6 duy nhat 1
chau c6 rdng sdu b{ nho bd, chi so rdng sdu b| nho la 0,01.
Y HOC VlfT NAM T H A N G 5 • SO 1/2Q14
IV. BAN LUAN
Ket qua sau rang vTnh vien du'dc the hien d cac bang 2 chung toi thay ty le sau rang vTnh vien va chi so SMT tang dan theo tuoi. Dieu nay cung phu hdp vdi dac diem cua benh da du'dc WHO du^ ra la tuoi cang tang cang cd sd ti'ch jijy cua sau rang va rang vinh viin thay the cho rang su^ cang nhieu.
Qua bang 1 cho thay ty le sau rang d nff cao hdn nam co y nghla thdng ice (vdi p < 0,05). Hai nhom nay cung cd dieu kien song, cung moi
tru'dng >a hpi, cung hu'dng chu'dng trinh nha hoc du'dng, nhutig cd the do ^ p quan, thoi quen an uong Ithac nhau da lam nen sd khac biet nay.
Khi so sanh ket qua sau rang vTnh vien ciia chung toi vdi cac tac gia khac thay rang:
Qua so sanh cho ttiay ty le sau rang su^, sau rang vTnh vien va chi so dmf^, DMFT trong nghien ciru cua chung toi phiJ hdp vdi ket qua dieu tra toan quoc do Giao su" Tran Van Tru'dng cong bo nam 2000.
Bing 4.2. Ket qui Tac gid Trinh Binh Hai Vo the Quang Nguyen Thj Thu Bao Til! Ngpc Lan Nguyen Bdng Nhdn
Tran Thj My Hanh
dieu tra ciia mot so tac qia khac trong Khu vu'c
Hai Dudng Mien Bac Mien Nam Hal Phong Yen Bai Tuyen Quang
Thanh Uet, Thanh Tri, Ha Npi Nam 89/90 1991 1994 2003 2004
2006 Iddc
Tuoi 12 12 7 11 6 12 6 12 7 11 7-8 9-11
'Ty le sdu (%) 24,21 43,33 76,33 23,00 51,00 13,97 51,82 14,87 64,06 17,00 49,33 19,78 40,20
DMFT 1,02 1,15 2,93 0,45 1,27 0,23 1,70 0,22 1,67 0,31 1,56 0,38 1,05 Khi so sanh ket qua vdi cac tac gia khac, co sd kho khan do dg tuoi khong tddng dong nhutig cung cd si/xap xivetyle va xu hu^ng ^ng truing sau rSng.
So vdi mot sd tac qia nqhien cutr sau rang d lira tuoi 11 khu vu'c Ha Ndi Tdc gia
Bao Thi Dunq Nguyen Van Tin Tran Thj My Hanh
Khu vu'c Donq Oa C3u Giay Thanh Lilt
Ndm 2004 2004 2006
Ty le sdu (%) 1 55,10 53,60
49,33 1 DMIT
1,75 1,97 1,56
P
>0,05
>0,05
Ty 1^ sau rang vinh vien va chi so DMFT d hpc sinh Ida tuoi 11 trong nghien CLTU cua chung toi cung tu'dng tit ty Ie sau d cac khu vu'c khac cua Ha Npi.
Qua phan tich chi so SMT cho thay rdng so sdu rdng vinh vien du'dc dieu trj d mpi liJa tuoi van cdn thap khoang 10% (bang 3), chutig td
%d quan tam cua phu huynh hpc sinh den rdng mieng cua con chu^ cao. Ket qua nay cung tu'dng td ty le sdu rang vinh vien du'dc dieu tr|
trong dieu tra sifc khde rang mieng toan quoc nam 2000. Bleu tra cua Nguyen Van Tin tren hpc sinh 11 tuoi d CSu Giay cung cho thay chi cd 10,9% rang vinh vien sau du'dc dieu trj . Tuy nhien, khi xem xet cac rdng vinh vien du'dc dieu tri (tiJc la duVc han ho^c nho) thi thay rang ty le
rang sau bj nho bo la 0% d cac nhdm tuoi 7,8,9 va 10, rieng nhdm tuoi 11, chi co duy nhat 1 chau cd rdng sau bj nho bd (chiem 0,007%), dieu nay cd nghia la thai do cua phu huynh hpc sinh doi vdi ham rang vinh vien da Ichac han viS ham rdng sua.
V. K&r LUAN
Qua nghien cuU 778 hpc sinh lira tuoi 7 -11 tai tru'dng tieu hpc Thanh Lipt trong thdi gian til thang 4/2012 den thang 10/2012, chung toi nJt ra mpt so ket luan nhu' sau;
- Sdu rang suS d mii'c cao theo phdn loai ciia WHO - Gdp cao nhat d nhdm 8 tuoi (88,28%), smt la 4,87 - Ty le rdng sdu du'dc dieu tri thap (khodng 10%)
Y HQC VlgT HAM THANG S - s 6 1/2014
TAI LI|U THAM KHAO
1. 7rin Vimnfitng (2001), £m/tra Slit khoe rang mieng toin quoc 0 Viet Warn (1999-2000), Nha xuat ban Y hoc, tr. 33-42.
2. Sao Ngpc Phong va cgng sir (2004), PhuVng phap nghien cuU khoa hgc tmng y hoc va sue khoe cpng ddng, Nha xuat ban Y hpc, tr. 57 - 69.
3. Pretty IA ( 2 0 0 6 ) , "Review Caries detection and diagnosis: Novel tedinologies", Juomal of Dentistry, pp. 727-739.
4. K.G.Konig ( 2 0 0 4 ) , "Ginical manifestations and
treatment of caries from 1953 to global changes in the 20''' century". Canes Reseach. pp.168-172.
W.H.O (1997), Oral health surveys basic method^ 4*^ Edition, Geneva, pp. 25-28 Tran Thuy Nga, Phan Thj Thanh YSn, Phan M Hung (2003), "Giai phau rang siiS"; "Benh sau rang", l^ha khoa fre em, Nha xuat ban Y hoc thanh pho Ho Oii Minh, tr. 23-24; 164.
Ministry of Heaith Australia (1988), Nationai oral health survey {1987- 1988), pp. 102-105.
THirC TRANG NHIEM KHUAN MAC PHAI 6" NGirai BENH SAU MO SO NAO VA CAC YEU TO ANH HU'OfNG
T6MTAT
Mvc tiSu: (1) X^c djnh ti 1$ viem miing nao mSc phcii sau m6 SQ nSo (2) M5 ta mOt so yeu to lien quan dSn vi6m m&ng nao mSc phai sau mo sp nSo. 061 Utifng v i phu'cfng phap nghiSn cuti: Nghien culi m6 ta cSt ngang du^c thi/c hi?n tren 154 b^nh nhan du^c phSu thuSt sp nao tai Khoa ngo^l b^nh vi^n A vci Khoa CSp ciiu b^nh vi|n Y hpc lam sang c^c Benh nhi$t ddi tii 01/01/2013 - 25/10/2013. Kgt qua: Nam gidi cao hdn nff, t^ l | m6 so nSo cao d nhdm tuoi 28- 49, thdi gian nSm vi§n cua binh nhSn viem mSng nao mSc phcil sau mo nhieu hdn 3 ngdy so vdi khong b|
viSm mdng nSo mSc phai, vi khuSn chiem ty le cao nhat g3y viSm mdng nSo mSc phai la A. Baumannii. Ty 1$ viem mdng nao mSc phai sau mo so nSo chiem 4,55%. Kgl qud chSm soc dat cao d mii'c t5t (88,96%), miic frung binh (6,5%), va mii'c kem chi co 4,5%. Kfft luan: Co 51/ khac bl^t ro ret vd cd y nghia thSng ke gliJa ngay nSm vien vdi viem mdng nao mSc phdi sau mi5 (p<0,01, OR:9,5). C6 sy" SLT khde biet ro r^t giuci s5 ^ n chdm soc ong dan lull, vet m6/ngdy vdi viem mdng ndo mdc phdi sau mo (p<0,001;OR:10,6)
Tu'khda: Nhilm l<huSn b$nh vi?n, chan thuWig so ndo, viem mdng nao mdc [^ai, d ^ m sdc, benh vi?n.
SUMMARY
STATUS ACQUIRED I N F E C T I O N S I N PAHENTS AFTER BRAIN SURGERY A N D
OTHER FACTORS AFFECTING
* Ban quin ly Di/in VNM8 -B$Yt€
"HQcvi$n Y Dupc hgc (^truySn Vi$tNam Phin b/^n khoa hgc: TS. TrSn Manh Mng
Nguyen Thi Hue*, Le Thj Binh**
Objective: of this cross-sectional study was to study 1) the prevalence of nosocomial acquired meningitis in brain post-operated patients and 2) the caring factors associated to nosocomial acquired meningitis in brain post-operated patients in two hospital. Research method: cross-sectional descriptive study performed on 154 patients in Department of Foreign cranial hospital A and hospital Emergency Department Clinical Medidne tropical diseases from 01/01/2013 - 10/25/2013. Resuit:
female is higher than that of male, yet tre^^ine high rate In the age group 28-49, the length of hospitalization of patients suffering from meningitis after open more than 3 days compared with non- acquired meningitis, bacterial highest proportion of Haemophilus make is A. Baumannii. The prevalence of nosocomial acquired meningitis in brain post-operated patients was 4.5S %, nursing care with high standard level was 88.96%, moderate level was 6,5% and low level was 4.5%. Conclusion: There Is a distinct difference and statistical significance between days in hospital with patients postoperative and acquired meningitis (p<0.01, OR: 9.5). There Is a distinct difference between the Issue of time drain care, wound/day to ojntracted meningitis alter surgery (p<0.001, OR: 10.6)
Keywords: Nosocomial Infection, brain trauma, acquired meningitis, nursing care, hospital.
!. DAT VAN o l
Hien nay, nhiem khuan benh vien da tr6 thanh mpt van de thdi sy" dang rat dUCc quan tam va cung la mot thach thCfc ldn cua nganh y te. Phau thuat sp nao ngav cang kha pho bien 6 Viet Nam bdi chan thu'dng do tai nan cung nhiT bj
