KET L U A N
PT cat be CGM cd hieu qua ha NA td't. Tuy nhien mac dil sau mo. ty Id d i l u chinh NA thanh edng eao (91%) nhung ty le thanh edng cua PT ehi dat 53,7%.
Cac y l u td ed anh hudng de'n k i t qua lau dai ciia PT la mirc NA, NATB sau mo, mUc % ha NA so vdi NA trudc mo, giai doan benh. Sau mo, mife NA edng tha'p, ty Id thdnh cdng ciia PT cdng cao. Mifc NA <18 mmHg la tUdng dd'i an todn dd'i vdi TTK vi cho ty Id thanh edng ciia PT cao (96,5%). Ty Id thdnh edng eiia PT dat dUdc cao hdn d giai doan sdm ciia benh. De PT thdnh edng, d giai doan mudn, NA sau mo can phai dupc ha thap hPn so vdi mUc NA d giai doan sdm.
T A I LIEU THAM K H A O
1. Anand N. MieIke C (2001), Trabeculectomy outcome in advanced glaucoma in Nigetia ". Eye. 15. 274- 278.
2. Ikeda H. Ishigooka H, Muto T (2004). Long-term outcome of trabeculectomy for the treatment of
developmental glaucoma '.Arch Ophthalmol. 12(8), 1122- 1128.
3. Josh W. Chen T (1996). Long term result of trabeculectomy in eyes that were initially successfull , Trans, Am, Ophthalmol Soc, 94, 147-164.
4. Kryzanowska P (2002)," The comparative analysis of change in optic disc morphology after trabeculectomy, measured by scaning laser tomography ", Klin Oczna, 104 (2), 122-127.
5. Lesk MR, SpaethG.L (1999), Reversal of optic disc cupping after glaucoma surgery analyzed with a scaning laser tomography ", Ophthalmology. 106(5), 1013-1018.
6. Marquardt D, Lieb W.E, Grehn F (2004) Restrospective long term analysis of 177 trabeculectomie", GraefesArch clinical Experience Ophthalmol, 242, 106-113.
7. Miyagawa Y, Satoh S (2006), " The long term outcome of trabeculectomy in advanced glaucoma "
Nippon Gankai Zansshi. 110(4). 300-306.
KET QUA CAN THIEP VE KIEN THl)C, THAI OO, THUt HANH
PHONG CHONG CAC BENH LAY TRUYEN QUA DUtTNG TINH DUC VA HIV/AIDS CUA THANH THIEU NIEN D A N TOC THAI TINH SON LA
v u V A N H O A N - Vien Chien iuac vd Chinh sach y ti N G U Y I N THANH H JONG - Trudng DHY ticdng cdng
LE LAN HUONG - Vu TichUc Can bd, Bd Yti TOMTAT
Nghien cUu trinh bay kit qua danh gia sU thay dot vi kiin thCfc, thai do va thuc hanh trong phdng ching cac benh lay truyen qua dudng tinh dtjc (LTQDTD) va HlV/AiDS thdng quan truyen thdng bing dia hlnh cho thanh thiiu nien (TTN) dan tdc That 14-24 tuit. chua cd gta dinh tai xa Tdng Lanh, huyen Thuan Chau, tinh San La trong thdi gian 3 thang cCta ndm 2007. Ddy la nghien cUu danh gia can thiep so sanh trudc - sau cd nhdm chUng tren 465 nam, nU TTN..
Kit qua phan tich da biin theo md hlnh hoi qui logic cho thiy cd su khac bidt cd y nghTa thing ke trong t^ Id dat kiin thUc, thai do phdng chong cdc bdnh LTQDTD (OR tuong Ung la 22,7 va 1,8; p<0,001) vd HIV/AIDS (OR tuang Ung la 9.5 va 2,5; p<0,001) trudc va sau can thiep cda dot tugng nghidn cUu (DTNC) sau khi kiim soat mdt so yiu to nhieu. Tuy nhidn, chua cd su thay dot dang ki ve t^ le dat thuc hanh phdng ching cac benh LTQDTD va HlV/AlDS glQa trudc va sau can thidp. Tmyin thdng qua phim bing tiing Thai da khac phuc dugc rao can ve ngdn ngU va vdn hda va mang lai nhOng thay doi dang ki ve kiin thUc va thai dd trong phdng chong cac benh LTQDTD va HjV cho TTN dan tgc Thai Tuy nhiin di cd thi thay dot dugc hanh vi can tien hanh cac chien lugc can thiep da dang va lau dai han.
TUkhda: Kiin thUc; Thai do; Thuc hdnh; Benh lay truyin qua dudng finh due, HIV/AIDS; Can thiep tmyin thdng, Dan tgc That
SUMMARY
The reseach's objective is to evaluate the changes in knowledge, attitude and practices on the prevention of STDs and HtV/AlDS through video-based communication program for Thai youth aged between
14 and 24 who have not married, in Tong Lanh commune, Thuan Chau district. Son La province in 3 months tn 2007. This research compares pre- and post-interventions on the case control group of 465 males and females.
The result of multi-variable logical regression analysis shows a statistically significant difference in the proportion of people with adequate knowledge, attitude on prevention of STDs (OR 22.7 and 1.8;
p<0.001) and HIV/AIDS (OR 9.5 and 2.5; p<0.001) before and after interventions among the research subjects (with confounding control). However, the difference on STDs and HIV prevention practice before and after the interventions is not considerable. The communication intervention program using videos in Thai language solved the language and cultural barriers and noticeably improved the knowledge and attitude on STD and HIV/AIDS prevention among young Thai people at study settings. However, tt is necessary to have more diverse and long-term intervention strategies tn order to change the behaviors.
Y HOC THUC
H A N H(782) - SO 9/2011 39
Keywords: Knowledge. Attitude. Practice, Sexually Transmitted Diseases, HIV/AIDS, communication interventions, Thai ethnic minority
OAT VAN
Di
Tinh hinh Idy nhilm HIV/AIDS d khu vUc miln niii, ddng bao ddn tdc thilu sd gia tdng nhanh chdng trong nhi/ng ndm gan day, Nhilu tinh miln niii Id ndi sinh sdng chu y l u cua cac d i n g bdo ddn tdc thilu s l da nam trong danh sdch 10 tinh cd ty Id nhilm HIV/AIDS tren 100.000 ddn eao nhd't ca nUdc nhU Lang Sdn 242,96%0, Bae Can 244,09%0, Cao Bdng 252,07%0 [2]. Mdt sd tinh khac nhu Son La, Dien Bidn, Lai Chdu, Thai Nguyen deu cd ly Id nhilm HIV/AIDS mdi trong ddi tupng nghien chich ma tiiy gia ldng nhanh hdng ndm. Nam 2006, Son La dupe coi Id "hidn lupng" khi phat hidn them tren 3000 trudng hdp HIV dUdng tinh.
Thieu kiln thifc v l phdng ehdng eac bdnh Idy truyln qua dudng tinh due (LTQDTD) vd HIV/AIDS Id mdt trong nhimg nguydn nhdn Idm gia tdng nhanh ehdng ty id nhilm HIV/AIDS cua khu vUc miln niii. Trinh dd ddn tri thd'p, sU khdc bidl v l vdn hda, kha ndng sif dung tieng pho thdng kem dupe xac dinh Id rdo can Idn trong cdng tac pho bien kiln thire eho d i n g bdo ddn tde thieusd[1], [6], [12].
Tdng Lanh Id mdt xa d i l n hinh v l tinh trang Id nan tiem chich ma tiiy vd ty Id nhilm HIV/AIDS eao eua huyen Thuan Chau, tinh Sdn La. Ddn sd cua xa Id 8825 ngudi, trong dd dan tdc Thdi chilm 80%. Ndm 2006, Vien Chien lUdc vd Chinh sdch Y t l (Bd Y t l ) da trien khai DU an "Tmyin thdng giao due sUc khde sinh san cho thanh thiiu nien dan tdc Thai qua dTa hinh"
cho ddi lupng Id thanh thilu nien (TTN) ddn tdc Thdi trong dp tuoi 1 4 - 2 4 chUa cd gia dinh cua xd Tdng Lanh. Du an dupc triln khai tU thang 8/2006 d i n 9/2007 vdi mue tieu ndng eao kiln thifc, thai dp vd thifc hdnh (KT-TD-TH) v l SKSS cho nhdm dich v l cdc ndi dung chinh sau: kiln thifc v l day thi vd ve sinh kinh nguyet, v l phdng chd'ng cae benh LTQDTD vd HIV/AIDS, chdm sdc trude sinh, trong sinh vd sau sinh.
Cac ndi dung tren dugc chuyin tai thdng qua bd phim khoa giao tmyin thdng bang tieng Thai vdi thdi lUpng 60 phut. Bd phim dupc xay dung dUa trdn k i t qua ddnh gid nhu cau cdng ddng vdo thdng 9/2006. Qua trinh can thidp dupe triln khai tif thdng 4/2007 den thdng 9/2007 vdi sif tham gia. phoi hpp ciia Phdng Y t l huyen Thudn Chau, Uy ban nhdn ddn (UBND) vd Tram Y t l xa Tdng Lanh.
Cdch thUc can thiep Id chilu bd phim do du dn xdy dung ve sUc khde sinh san (SKSS) bang tilng Thai eho TTN trong xa. Cdc buoi chieu dugc to chifc tai cde ban bang ti vi vd dau dia VCD ciia ngudi dan. Vide thu hilt DTNC d i n xem dUpc thifc hien qua cd kenh hdnh chinh cua ehinh quyln vd sU van ddng cua dodn t h l , UBND xa giid gid'y mdi chung cho cde DTNC d mdi ban vd dupc trudng ban dpe tren loa phdt thanh cCia ban thdng bdo tdi cde gia idinh vd TTN trong dien nghien ciiru tham du. Ben canh dd, eac bi thU Dodn Thanh nien ban true tilp di thdng bdo lai vd van ddng TTN trong dien nghien cifu tham gia cdc buoi xem phim.
Trudc khi cde bull chilu bat d i u . vide thdng bdo lai dupe thuc hidn d l nhac nhd cdc DTNC den dung gid.
Cde hoat ddng ndy dupc thue hien trong cdc lan chieu phim d cde bdn trong ed dpi can thiep. Can thiep da thifc hidn tai 5 bdn vdi 5 dpt chilu phim tai mdi ban va cd 2 dilm chilu d mdi ban trong mdt dpt. Tong cdng ed chiln djch can thidp trong 3 thdng da thuc hien dUde 45 bull chilu vdi sd ngudi d i n xem tmng binh m^i buli khodng 30 ngudi. Bdi bdo ndy trinh bay mot phdn k i t qud eOa nghidn cifu ddnh gid can thiep tren vdi muc tidu: Xdc djnh mdt s l k i t qua can thiep truyen thdng thay d l i kiln Ihifc. thai dd vd thue hdnh phdng chdng cdc bdnh LTQDTD vd HIV/AIDS bang dfa hinh cho TTN ddn tdc Thdi 14 - 24 tuoi.
0 6 l T J p N G v A PHUONG P H A P N G H I § N CCTU
1. PhUdng phdp nghien ciiru: Nghien cifu imh lupng so sdnh trudc - sau can thidp. cd nhdm chifirig.
Trong chUdng trinh can thidp. cdc bdn dupc chia thanh nhdm ean thidp vd nhdm khdng ean thiep (nhom chimg). Nhdm ean thidp g i m 5 bdn phia Tdy Nam cOa xd dupe nhdn can thiep trong 3 thang (tU 1/4/2007 den ngdy 30/6/2007). Nhdm khdng can thidp Id 6 ban con lai d phia Bdc ciia xa. V l vi tri dja ly. hai nhdm ban nay cd vj tri khd ddc ldp vdi nhau bdi sU ngdn each cua cdnh d i n g rdng, con sudi vd niii. K i t thiic dpt can thidp. d i l u tra sau can thiep dUdc tien hdnh d tat ca cdc ban can thidp vd ede ban khdng nhdn can thiep de ldy sd lieu eho nghien cilu ndy. Sau khi k l l thiic dot dilu tra sau can thidp. 6 ban chua nhdn can thiep da tilp tuc dupc can thiep den h i t thdng 9/2007 theo ke hoacii ciiadudn.
2. Doi tUdng nghien cOru: 465 nam. nCr TTN dan tdc Thdi 14 24 tuoi chua lap gia dinh tai xa Tong Lanh, huyen Thudn Chdu. tinh Sdn La.
3. Thdi gian nghien cufU: D i l u tra trudc can thiep (TCT) dupc tien hanh vao thang 12/2006 vd danh gia sau can thiep (SCT) vdo thdng 7/2007.
4. Cd mau va phUdng phap chon mau: Nghien ciru dp dung cdng thite tinh cd m i u cija nghien ciu can thidp so sdnh trudc - sau.
^ ^,_j2P(l-7)->-Z,,,lP,{\-P,)+P,{\-P,)\
Cdc tham sd gia djnh: Mite y nghTa = 95%, hieu life (power) = 90%; Ty Id Udc tinh dat diem kiln thite cac benh LTQDTD vd HIV/AIDS vdo thdi diem dilu tra ban dau d l cd cd mdu td'i thieu Idn nhat: P, = 50%; Ty le Udc tinh dat diem kiln thijre, thai dd, thue hdnh cac benh LTQDTD vd HIV/AIDS cda dd'i tUdng nghien cilu (DTNC) vdo thdi diem d i l u tra SCT: Pj = 60%; Sif khjc biet ty Id dUde phdt hien (Khoang thay doi mong muon)
= 10%; L/dctinh ty Id tif chd'i trd ldi vd bd cudc la 10%.
Vdi ede tham sd neu tren, c3 m i u eua nghien ciru la 465. SiJr dung phUdng phdp chpn m i u ngiu nhien he thong k i t hdp vdi chpn m i u theo ty le.
5 PhUdng phdp thu thap so lieu: Thdng tin djnii lupng duoc thu thdp thdng qua phdng vd'n cde OTNC bang bang hdi chuan bj san de md ta KT-TO-TH phdng chd'ng cdc benh LTQDTD vd HIV/AIDS cOa DTNC tai hai thdi diem trUdc vd sau khi can thiep.
40
Y HOC THirC HANH (782) • S6 9/2011
6 PhUdng phdp phan tich so lieu: KT-TD-TH phdng chd'ng cde bdnh LTQDTD vd HIV/AIDS ciia DTNC dupe phan loai theo phUdng phap cho diem cde cdu tra ldi dung yd mdc phan loai dat ydu eau la dat tU 50 % so diem trd len d mdi^phan. Nghien ciru sir dung phan m i m EpiData 3.01 d l nhdp vd quan ly sd lieu vd phan m i m SPSS 13.0 de phdn tich Kiem dinh Khi' binh phUdng (x2) dupe sir dung de ddnh gia su khdc biet vd mdi tUdng quan gitfa cdc ty Id v l KT-tO-TH plidng chd'ng eac benh LTQDTD vd HIV/AIDS TCT vd SCT.
Kd't qua can thiep dupe danh gid thdng qua so sdnh sU tang ldn ed y nghTa thdng ke v l cac ty Id dat v l KT-TD- TH phdng chd'ng cde benh LTQDTD vd HIV/AIDS cua DTNC TCT vd SCT sau khi da kiem sodt mdt so y l u td nhidu bang md hinh hoi qui da bid'n.
KET QuA vA B A N LUAN 1. Thong tin chung ve OTNC
Sd DTNC tham gia vdo dilu tra khd tUdng ding d tmrde va sau can thiep (TCT Id 461 vdi 48,6% nam vd 51,4%^nif; SCT la 465 vdi 47.7% nam vd 52.3% nif).
Dp tuoi cua DTNC nhilu nhd't d nhdm tuoi 1 4 - 1 7 (60,5% TCT va 55,6% SCT). Dd'i tUpng nghien cifu ed trinh dp hpc van tU tmng hoc co sd trd xud'ng (79,6%
TCT vd 80,2% SCT). Nghi nghidp chilm ty Id cao nhd't cda DTNC la Idm nUdng r i y (57,9% TCT vd 55.3%
SCT). Ty Id DTNC nghe ndi thdnh thao tid'ng pho thdng d dilu tra SCT cao hdn dilu tra TCT (33,3% vd 29,9%). Tuy nhidn sU khde bidt trong cde thdng tin chung v l DTNC trUde va sau can thiep khdng ed y nghTa thdng ke.,.
2. Cac ket q u a c a n t h i e p .
K i t qua phdn tich 2 bien trUde va sau ean thidp cho thay hau h i t cdc ehi s d v l KT-TO-TH phdng chd'ng cde benh LTQDTD v d HIV/AIDS d i u ed sif thay doi ed y nghTa thd'ng kd theo c h i l u hudng tich cue (Xem Bang dudi day).
Bang: Sif thay doi ty Id dat v l KT-TD-TH phdng chd'ng cae benh LTQDTD vd HIV/AIDS trudc vd sau can thiep
CaCCHiSfi
Kien thiJc phdng chong cac b€nh
LTQDTD' Kien thiJc phdng chdng HIV/AIDS Thai dd phdng chdng cac benh
LTQDTD' Thai dd phdng chdng HNIMDS Thifc hanh phdng chdng cac benh
LTQDTD' Thi/c hanh phdng
chdng HIV/AIDS
Ty le dat yeu cau TCT
(%) 5,5
14.7
42,7
41,7
4,6
4,6
SCT (%) 58,8
66,9
86,1
71,8
9,0
10,6
Tysdch6nh-i cay Phan tich 2
bidn OR = 24,5 (12,9646,19);
p<0,001;
OR =14.7 (7,43-18,64);
p<0,001 OR = 6,0 (3,92-9,09);
p<0,001 OR = 3,6 (2,41-5,24);
p<0,001 OR = 2,0;
p>0,05 OR = 2,5;
p<0,05
OR (khoang tin vap
Ph§n ti'ch da bidn OR = 22.7 (12,84-40.19);
p<0,001 OR = 9,5 (6,15-14,58);
p<0,001 OR =1,8 (1,25-2,60);
p<0,01 OR = 2,5 (1,79-3,43);
p<0,001 OR = 0,8 (0,42-1,60);
p>0,05 OR = 0,7 (0.35-1,40);
p>0,05
6 thdi d i l m TCT TTN cd nguy cd khdng dat kie'n thirc v l phdng chd'ng cac benh LTQDTD va HIV/AIDS tUdng img cao gap 24,5 va 11,8 lan so vdi thdi diem sau khi hp nhdn can thiep (p<0,001)d thdi diem TCT TTN cd nguy ed khdng dat thai dp v l phdng chdng cac benh LTQDTD vd HIV/AIDS tUdng img cao gap 5,9 va 3,5 lan so vdi thdi diem sau khi ho nhdn can thiep (P<0,001).
6 thdi diem TCT TTN ed nguy cd khdng dat thifc hdnh phdng chd'ng eac benh LTQDTD va HIV/AIDS lUdng Ung^cao gd'p 2,0 (p>6,05) vd 2,5 (p<0,05) lan so vdi thdi diem sau khi hp nhdn can thiep.
Qi kiem sodt mdt sd y l u td nhidu cd the anh hudng d i n k i t qua ddnh gid s u thay doi v l KT-TD-TH cua OTNC sau ean thidp so vdi trudc can thiep, ehiing tdi dd l i l n hdnh xdy dung eac md hinh hoi qui da bie'n vdi n h i l u b i l n s l trong dd cd bien sd so sdnh gitfa nhdm TTN dupc ean thiep vd nhdm khdng dupc can thiep.
K l l qua phdn lich da b i l n cho tha'y ty Id dat k i l n thifc vd Ihdi dp phdng chd'ng cac benh LTQDTD va HIV/AIDS trudc vd sau can thiep cua DTNC da cd sU tdng len cd y nghTa thd'ng ke (xem Bang tren). Tuy nhidn, sau khi k i l m sodt cac y l u td nhu tuoi, gidi, cd hay ehua ed ngudi yeu, kha nang nghe ndi tieng pho thdng, k i l n thUe vd thai dd vd ed hay khdng cd can thiep, ty Id dat thifc hanh phdng chd'ng cac benh LTQDTD vd HIV/AIDS trUdc va sau can thiep cua OTNC cd thay doi nhung chUa cd y nghTa thdng ke (xem Bang tren).
B A N LUAN
Nhin ehung, khdng cd su thay doi dang ke trong ede thdng tin ehung v l OTNC trude vd sau can thiep.
Sd OTNC tham gia vdo dieu tra kha lUdng dong d trudc vd sau can thidp (461 TCT vd 465 SCT). Day Id dieu kien tdt d l dam bao tinh lUdng dong cho viec so sanh k i t qua v l KT-TD-TH phdng chd'ng eac benh LTQDTD vd HIV giiira IrUdc vd sau khi cd can thiep.
Kit qua phan tich da bie'n cho tha'y, sau khi kiem soat mdl sd ye'u td cd t h l anh hudng de'n k i t qua ddnh gid ean thiep, ty Id dat kiln thifc vd thai dp phdng chdng cde bdnh LTQDTD vd HIV/AIDS IrUdc vd sau can thidp eda DTNC d i u tang ldn ed y nghTa thd'ng ke, mac dil ty sd chdnh ed thay doi chiit it so vdi k i t qua khi phdn tich 2 biln. Trong khi dd. phdn tich da bie'n chua tim tha'y su thay dd'i ed y nghTa v l ty Id dat thUc hdnh phdng ehdng eac benh LTQDTD vd HlV/AlDS giOra trudc va sau can thiep. K i t qua nay eung cd diem khac biet so vdi k i t luan ne'u ehi dp dung phUdng phap phdn tieh 2 bien. Day ehinh la mdt uu dilm eda nghien edu ddnh gid ndy so vdi nhilu nghien cifu trudc day, do la da dp dung phdn tich da bid'n nham kiem soat anh hudng cda mdt sd y l u td dd'n k i t qua ddnh gia sif thay doi do ean thidp mang lai.
Vide chUa tha'y sU thay doi cd y nghTa ve hanh vi trofig phdng chd'ng cdc benh LTQDTD va HIV mpt phan CO the la do thdi gian can thiep eua nghien euu ndy chi keo dai trong 3 thang. Dd la khoang thdi gian khd ngan dd'i vdi mdt nghien ciru ean thiep nen k i t qua chUa dd de thay doi hanh vi vd cung chUa dam bao
Y HOC THIJC HANH (782) - SO 9/2011 41
dUdc tinh b i n vifng eua ean thiep. Mdc du vdy nhiimg thay doi ddng ke v l kiln thirc vd thdi dd da budc ddu eho thd'y hidu qua eda can^thidp truyln thdng. K i t qud ndy cung mdl Idn nifa khdng djnh ring vide thay d l i hdnh vi Id khdng d l ddng md edn phdi cd ean thidp thudng xuyen vd ddi hdi hdn vd cd t h l cdn phdi ed nhiimg chiln lupc can thidp da dang hdn. khdng chi tdp tmng vdo tmyin thdng gido due vdi mdt loai hinh duy nhdt Id thdng qua xem bdng hinh nhucan thidp ndy.
K^T LUAN
K i t qud nghidn cifu cho thd'y dp dung ean thi^p tmyin Ihdng thdng qua sd dung bdng hinh tilng Thai dd'i vdi dd'i iupng TTN ddn ldc Thai bUdc ddu dd mang lai k i t qua khd quan. Hoat ddng can thidp da lac ddng dang k l tdi thay d l i kien Ihifc, thai dd, phdng ching cdc benh LTQDTD vd HIV/AIDS cda TTN. Tuy nhidn, muln cd dupe nhimg chuyin bie'n ed y nghTa vd b i n vung v l hdnh vi can phdi cd lien hdnh can thidp ddi han va todn didn hdn. Nghidn eUu ndy cung cho thd'y tam quan trpng eda vide dp dung cdc ky thudl phdn lich da bien trong danli gid ehUdng trinh nham trdnh nhimg k i t ludn qua mifc v l hidu qud cda mdl dU an can thiep..
T A I U $ U THAM K H A O
1. B6 Y t l . Ting cue Thing kd. T l chdc Y t l T h l gidl.
Qui Nhi dong Lien hpp quic (ndm 2003). Dliu tra Quic gia vi vi thdnh nidn vd thanh nidn Vidt Nam (SAVY).
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5. Nguyin Trdn Hiln, Trjnh Qudn Huan, Nguyin Thanh Long vd cs (2005), Lugng gtd nguy co nhiim HIV/AIDS d nhdm thanh nidn 14 - 24 tuii tai 7 tinh Thanh Hod, Nghd An, Hd Tfnh, Binh Phudc, Binh Duang, Long An, Sdc Trdng, Cdc cdng trinh nghien ciru khoa hoc ve HIV/AIDS giai doan 2000 - 2005, Bd Y te. Ha Noi.
6. Vu Vdn Hodn, Le Lan HUdng (2006), "Kiin thdc.
thdi dd, thuc hdnh phdng ching cdc bdnh LTQDTD va HIV/AIDS cCia thanh thliu nidn ddn tdc Thai tai xa Tdng Lanh. huydn Thudn Chdu, tinh San La, ndm 2006', Bao cdo nghidn cifU. TrUdng Oai hpc Y t l cdng cdng Ha Noi.
7. Lidn minh Chdu Au - Quy Ddn so Lien Hpp qudc (2005), Bdo cdo diiu tra ban diu chuang trinh RHIYA Vi$t Nam.
8. Nguyin Thp Ld. Pham Hong Phuong, Lam Qudc Himg (2005), Ddnh gid thay dii nhdn thUc. thai 66, hknh vi d tdn binh tai mdt si dan vi qudn ddt sau 6 thang tham gta gido due nhdm ddng ding phdng ching HIV/AIDS/STI (thdng 3 - thdng 8/2004), Bdo cdo nghien ciftj tai Cac cdng trinh nghidn cifU khoa hoc v l HIV/AIDS giai doan 2000 - 2005, Bd Y te. Ha Ndi.
NGHIEN Cl)U DAC DIEM TON THOVNG DA DAY-TA TRANG 0 BENH
N H A N S U Y T H A NMAN TINH GIAI DOAN III, IV
TOM TAT
Nghidn cUu ddc diim lam sang va hinh inh ndi soi da day- ta trang d 75 bgnh nhan suy than man tinh glai doan ill. IV tuii trung binh la 38,8 ±14,5 tuii chung idt cd mdt si nhan xdt sau: Tridu chifng Idm sang cCia tin thuang hd tidu hoa la: chan dn 38.7%.
budn ndn 46,7%. ndn 22.7%. dau thugng vj 17.3%. g hgt 14.7%, diy bung 12.0%. a chua 9.3%. Iodt midng 8,0%. phan tao- ldng 10.7%. phan den 8,0%. Tin thuong da ddy- ta trdng qua hinh inh ndi sot cd t^ Id 100%, trong dd: vidm phu ni- xung huyit 86,7%. trpt phing 24.0%. trgt 161 4,0%, xuit huyit 12.0%. viim phi dai 9.3%. vidm tec 10,7%. trdo nguac dich mdt 5,3%, Iodt da day- td trdng 29.3%.
TCr khda: suy than man ttnh. ddc dtim Idm sdng.
hinh anh ndi soi, da ddy-td trdng SUMMARY
Studying on clinical and endoscopic features of gastrointestinal system of 75 III. IV stage chronic renal failure with 38.8 ±14.5 average ages, we have some following comments: The clinical symptoms of gastrointestinal lesions are arenoxia 38.7%, nausea
Lfe VI$T T H A N G - Spn/i viin 103 NGUYEN DUY NHAN - B^nh vi$n Bach Mai
46.7%. vomit 22.7%. epigastric pain 17.3%, gas 14.7%. dyspepsia 12.0%. sour 9.3%. mouth erosion and ulcer 8.0%, diarrhea and constipation 10.7%, melena 8.0%. By endoscopic fjictures. the gastrointestinal lesions are 100% patients in which edematous and erythematous gastritis 86.7%. M erotive gastritis 24.0%. rased erotive gastritis 4.0%, hemorrhage gastritis 12.0%. hypertrophic gastritis 9.3%, atropic gastritis 10.7%, bile reflux 5.3%. and gastro-peptic ulcer 29.3%.
Key vfords: chronic renal failure, clinical, pidure of endoscope, gastro-lntestinum
OAT VAN
o i
Benh cdnh Idm sang cda benh nhdn suy than man tinh rat phong phu va da dang. Nhung bilu hien ton thUdng dng lieu hod xua't hien sdm, mdc du nhieu khi chua cd b i l u hien lam sdng, de'n khi cd cac trieu chifng tieu hod rd net, thi benh da d mClc dp n?ng, nhilu khi xud't hidn nhumg bid'n chimg nguy iiiem nhu thdng o loet, xuat huyet tieu hod... NhOng benli
42 Y HOC THlJC HANH (782) - SO 9/2011
