VIETNAM MEDICAL JOURNAL H°2 - APRIL - 2018
3 4 5 X ± S D
P
96,64 96,64 96,64 96,64
95,78 96,01 95,12 95,63 ± 0,36 P> 0,05 Ket qua bang 2 cho thay: Vdi cac dieu kien toi u'u etja phan mem du'a ra thi hieu suat chiet mangiferin dat 95,63% thap hdn khong dang ke so vdi du' doan cua phan mem (vdi p >0,05).
Nhu' vay, cd the su" dung dieu kien toi u'u ma phan mem du'a ra de chiet xuat hoat chat tii bai thudc BHNST.
Tii' cac ket qua khao sat, ehtJng tdi du'a ra quy trinh chiet xuat mangiferin td bat thuoc BHNST d quy mo phong thi nghiem gom; Sij' dung phu'dng phap chiet sieu am, dung moi chtet la EtOH 40% vdi ty le 11/1, tien hanh chiet xuat 02 lan trong 30 phut d nhiet dp 55°C. Vdi eac dieu kien da chon hieu suat chiet xuat hoat chat dat 95,63%. Tii quy trinh quy mo phong thi nghiem da tien hanh nang quy md chiet xuat len 1,0 kg du'dc lieu/me, l<et qua eho thay quy trinh ehiet xuat on dinh, d l dang van hanh va trien khai va hieu suat thu diidc khong eo sii khac biet nhteu khi ehiet d quy mo nhd.
IV. KET LUAN
Da u'ng dung phan mem tin hpc t^odd'e 8.0 de khao sat, tiici chpn du'dc cae thong sd tdi u'u trong ehiet xuat mangiferin td bai thuoc BHNST.
Ket qua da tim du'dc cac dieu kien tdi u'u gom:
Sii dung phu'dng phap ehiet sieu am, dung moi chiet la EtOH 4 0 % vdi ty te 1 1 / 1 , tien hanh chiet xuat 2 lan trong 30 phijt d nhiet dp 65°C. Vdi cac dieu kien da lu'a ehon, hieu suat ehiet thu hoi hoat chat dat 95,63%. Quy trinh chiet dn dinh de trien khai trong nghien cu'u hten dai hoa ciing nhu' san xuat eac san pham tit' bai thudc Bach ho Nhan sam thang gia vi.
TAI LIEU THAIVl KHAO
1 . Bo Y t e ( 2 0 0 9 ) , Du'gt dieh Viet Nam 4. NXB Y hoc. Ha Not.
i . V u Binh D u ' d n g , N g u y i n X u a n T r u n g , Ngo X u a n T r i n h , P h a m V a n H i e n , N g o T h i TuyS M a i ( 2 0 1 7 ^ , "Nghien ciiu d m h lu'cfng mangiferin trong trt m a u (Rhizoma anemarrhenae) bang ^ c ky long hieu nang cao " Tap chf Dude hoc, 6/2017
tr. 29-33. ' 3 . R e n , L.X., L u o , Y . F . , L i , X . , W u , Y.L. (2007).
"Antidepressant activity o f sarsasapogenin from Anemarrhena asphodeloides Bunge (Liliaceaej' Pharmazie, 62, 7 8 - 7 9 .
4 . Y o u n , U.3., J a n g , J . E . , N a m , J . W . , Lee, Y . 1 , S o n , Y . M . , S h i n , H . J . , H a n , A.R., Chang, 1 , S e o , E.K. ( 2 0 1 1 ) . "Anti-respiratory syncytial wrus (RSV) activity o f ttmosaponin A I I I from the rhizomes o f Anemarrhena asphodeioide^', J. f^ed.
Plants Res., 5, 1 0 5 2 - 1 0 6 5 .
3 . C h i e n - J u n g L i n , Y i - C h a n g S u , Cheng-Hting L e e , T s a i - C h u n g Li Y u C h e n , a n d Sunny ( 2 0 1 3 ) "Bai-Hu- T a n g , Ancient Chinese Meidicitie Formula, May Provide a New CompletnentBry T r e a t m e n t Option f o r Sepsis"
h t t p : / / d x . d o i . o r g / 1 0 . 1 1 5 5 / 2 0 1 3 / 1 9 3 0 8 4 . 6 . S a r t o r i u s S t e d i m B i o t e c h c o m p a n y (2013).
User guide Bio Pat Modde,
DANH GIA KIEN THU'C, THirc HANH COA NGirai BENH DIEU TRI
NO! TRU VE QUYEN Lm BAO HIEM Y TE TAI KHOA NOI BENH VIEN DA KHOA TJNH NAM DINH NAM 2017
Dang Thi Mai Linh', Vu Trung Kien^ Vu Phong Tiic'
T O M TAT
Muc tieu: Danh gia kien thii'c, thtJc hanh ctJa ngUdi benh dieu trj not triJ ve quyen Idi Bao hiem y t e tai khoa Hpi Benh vten Da khoa t i n h Nam Oinh nam 2017. Ddi tUdng^ nghien cdu: ngUdi benh dieu t r i npi t r u tat khoa Npi Benh vten Da khoa t i n l i Nam Dinti n3m 2017. Phu'dng phap nghien cii'u: phu'Ong ptiap
'Bao hiem xa hoi tinh Nam Dmh
^Tru'dng Dai hoc YDWdc Thii Binh Chiu trach nhiem c h i n h : Dang Thi Mai Lmh Email: [email protected] Hgay nhan bai: 2,2.2018 Ngay phan bien khoa hgc: 30.3.2018 Ngay duyet bai: 11.4.2018
m o t a qua cuoc dieu t r a c a t ngang. Kit qui nghien cdu: Benh nhan n a m chiem t y le 5 4 , 9 % ; nhom tuS chiem t y le nhteu nhat la 60-69 t u o i (chiem 30,5%); ty le ngi/di benh biet ve luat b a o hiem y t e la 81,3%;
nguon t h o n g t i n biet v e bao hiem y t e nhteu nhatia phUdng tien t r u y e n t h o n g dai c h t i n g ; 8 9 % ngu'di benti cho raiig t a t ea ngUdi dan d e u du'dc tham gia mua bao hiem y t e ; theo ngUdi benh muc' dich de tham gia bao hiem y t e de chia se nit r o Idii 6 m chiem 52,1%;
d e gitip n g u d i d a n tiet kiem phong kht om chietn 4 9 , 5 % ; t y le d d i tUdng d a sii dung the bao hiem y ^ 2 lan t r o n g nam 2 0 1 7 la 3 1 , 3 % ; c d 6 5 , 7 % tigu'di benh phat tra t h e m t i e n kht sty dung t h e bao hiem y tede kham chu'a b e n h .
Td khda: Kham chUa benh b a o hiem y te, quy bao hiem y t e .
102
TAP CHi Y HOC VIET NAM TAP 465 - THANG 4 - SO 2 - 2018
SUIVIIVIARY
ASSESSMENT OF KNOWLEDGE AND PRACnCE OF INPAHEMTS ON HEALTH
INSURANCE BENEFITS AT INTERNAL M E D i a N E DEPARTMENT OF GENERAL HOSPHAL OF NAM DINH PROVINCE I N 2017
Objective: To assess the knowledge and practice of inpatients on health insurance benefits at Internal Medicine Department of General Hospital of Nam Dtnh Province tn 2017. Study subjects: Inpatients at the Department of Internal Medicine of General Hospital of Nam Dinh in 2017. Methodology: Descriptive cross- sectional survey. Research result: I^ale patients accounted for 54.9%; patients aged 60-69 years was the highest with 30.5%; The rate of patients knowing about health insurance law was 81.3%; Patients knew about health insurance mostly through the mass media. 89% of patients thought that all citizens were eligible to purchase health insurance. 52.1% of these patients said that the purpose of participating in health insurance was to share nsks when getting diseases, 19.5% of them said that purchasing health insurance helped people save when they got sick. The proportion of people using health insurance cards twice in 2017 was 31.3%; 66.7% of patients had to pay extra money when using health insurance cards for medical examination and treatment
Keywords. Medical examination, health insurance fund.
I. £>AT VAN DE
Cong bang trong cham soc su'c khoe nhan dan du'dc hieu la mpi ngu'di deu du'dc tiep can va sir dung cac djch vu y te ed ban co chat lUt^ng, khong phu thupc vao kha nang tai ehinh eua tiVng ca nhan. £)e dat du'dc mtjc tieu nay, eac nu'dc tren the gidi co hai \iia chpn: hoae sty dung cd che tai ehinh y te du'a tren thue (ngan saeh nha nu'dc) hoac ed ehe tai ehi'nh y te dy'a tren Bao hiem y te (BHYT) bat buoc. Chinh vi y nghla to Idn cua Bao hiem y te ma Oang va Nha nu'dc ta CO chu tru'dng thy'c hien BHYT toan dan. Tuy nhien, trong qua trinh thu'c hien van con cd nhihig bat cap trong viec phan blet dot xuf trong di§u tri, kham chda benh bao hiem y te vu'dt tuyen, lam dung bao hiem y te lam cho ngu'di dan not chung cung nhu' ngu'di benh ndi rieng IN. K f r QUA NGHIEN CU'U
Bang 3.5. Phin bdngUdi binh theo tuoi vi gidi
khong cdn "man ma" vdi bao hiem y te. Vdi mong muon tim hieu thy'c trang eung nhu" danh gia du'dc kien thu'c eua ngu'di benh ve BHYT lam ed sd de du'a ra giai phap, vi vay chting toi tien hanh nghien cu'u de tai nay vdi mue tteu: Danh gla kien thdc, thdc hanh cua ngddl benh dieu tri ndi tru ve quyen ldi Bio hiem y te iai khoa Ngi Benh vien Da khoa tinh Nam Dinh nam 2017.
IL £)6l TU'ONG VA PHU'aNG PHAP NGHIEN CUU 1. Etja diem, thdi gian, doi tu'dng nghien cihj - Dia diem nghien cu'u: Khoa Noi, Benh vten da khoa tinh Nam Dinh.
- DOI tu'dng nghien cult: Ngu'di benh dteu tri not tru tai khoa Npi BVOK tinh Nam Djnh nam 2017.
- Thdi gian nghien cu'u: Nghien etyu du'dc thye hien tiJf 10/2017 - 5/2018.
2. Phu'dng phap nghien cihi
2.1. Thiei ki'nghien cdu: Nghien cu'u du'dc tien hanh theo phu'dng phap dieh t l hpc mo ta thong qua cuoc dieu tra cat ngang.
2.2. Cd miu va phddng phap chgn mau - Ap dung cdng thiTc tinh ed mau:
„ = Z ' „ - . , „ p<-^-^p) Tinh du'dc n=384, tren thu'c te da dieu tra 390 ngu'di benh.
2.3. Ky ihuii ap dung irong nghiin cdu
*Phdng van: Phdng van tr^c tiep ngu'di benh dieu tri tai khoa Npi ctia Benh vien, du'dc thtyc hien bang bp cau tidi gom 05 cau ve thong tin ehung,^ 14 eau ve cong tae BHYT, npi dung cau hdi ngan gpn, d l hieu doi vdi benh nhan, chu de tap trung^vao nhu'ng thuan ldi, khd khan, ton tai vu'dng mac, du'dc eae dieu tra vien ed chuyen mdn da du'dc tap huan thong thao eae not dung tru'dc khi phdng van.
2.4. Xd ly sd lieu: Lim saeh so lieu tu"
phieu. So lieu dddc nhap bang phan mem Epidata 3.1. Cac so lieu thu thap du'dc xu* ly th^o thuat toan thong ke Y sinh hpe, sti" dung phan mem SPSS 16.0.
Gidi Nliom tuoi
<50 50-59 60-69 70-79
>80
Tong X±SD (min-max)N a m i l )
SL 25 31 62 61 35
2141,7 %
14,5 29,0 28,5 16,4
54,966,1±W,5
Nu- SL 13 27 57 40 39
1762) 7,4
%
15,3 32,4 22,7 22,2
45,167,5±14,3
Tonq
SL 38 58 119 101 74
3909,7 %
14,9 30,5 25,9 19,0
100,066,7±14,4
P(l,2)
>0,05
>0,05
VIETNAM MEDICAL JOURNAL N°2 - APRIL - 2018
Ket qua bang tren eho thay ty le nam gidi tham gia vao nghien cu'u ta 54,9%, nif gidi la 45,1%. Od tuoi trung binh ctia nam gidl la 66,1±14,5; dp tudi trung binh cua nd gidi la 67,5±14,3. Tuoi trung binh ctia doi tu'dng nghien etyu la 66,7±14,4. SU khae biet ve tudi trung binh giOa nam va nti' la khong cd y nghTa thong ke vdi p>0,05. Nhdm tuoi chiem ty le nhieu nhat la 60-69 tuoi (chiem 39,5%), tiep theo la nhdm tuoi 70-79 chiem 25,9%. Sii khac biet ve nhdm tud'i d 2 gidi la khong co y nghTa thong ke vdi p>0,05.
Bang 3.8. Kien thdc ctia ngudi benh vt muc d/ch cua BHYT(n=390)
DCo
• Khong Bleu do 3.1. Ty le ngu'di benh cd biet ve luit bao hiem ^ te (n=390)
Qua bieu do tren ta thay ed 81,3% ngu'di benh da biet ve luat bao hiem y te, con lai 18,7% ngu'di dan khdng biet ve luat bao hiem y te
Bing 3.6. Ty li cic ngudn thdng tin mi ngUdlbenh biet luit BHYT (n=390)
Nguon tiiong tin Thonq tin dai chunq Ngu'di than, ban be,
hanq xom Can bo y te Can bo BHXH
So iu'tfng
207 173 168 126
T y i e 53,1 44,4 43,1 32,3 Qua bang tren ta thay nguon thong tin ma ngu'di benh biet ve luat bao hiem y te nhieu nhat la qua thdng tin dai ehung chiem 5 3 , 1 % ; qua ngu'di than, ban be, hang xdm chiem 44,4%;
qua can bo y te chiem 4 3 , 1 % ; qua can bd BHXH ehiem 32,3%.
Bing 3.7. Kien thdc cua ngUdi benh vi ddi tddng dUdc tham gia BHYT(n=390}
Doi tu'dng du'dc tham gia So 1 Ty le BHYT lu'dng (°/oj Can bd, eong nhan, vien chu'c
Hulj tri, ngu'di cd eong Ngu'di ngheo Hpe sinh, sinh vien
Nhan dan 347 19,0
Ket qua bang tren eho thay kien thii'c eua ngydi benh ve doi tu'dng du'dc tham gia bao hiem y te. Ty ie ngu'di benh ctio rang dot tu'dng du'dc tham gia bao hiem y te la nhan dan (bat ky at cung ed the tham gia) chtem 89%.
Muc dicli cua BHYT Chia se rui ro i^hi 6m Giup ngifdi dan chii dgng ve
tai chinh l<hl 6m Giup ngUcfi dan tiet i^iem
phonq l<hi om Giup CSSK cho nhan dan
du'dc tot hdn Khonq biet, I<h6nq tra ldi
So lu'dng
203 138 193 102 15
(%)f
5 2 , l f 3 5 , 4 1 4 9 , s l 2 6 , 2 ! 3,8 Qua bang tren ta thay kien thiTc eua nguw' benh ve mue dich ctia tham gia bao hiem y te.
Ty le ngu'di benh eho rang muc dich eiia tham gia tjao hiem y te de chia se riit ro kht 6m chiem 52,1%; de gitip ngu'di dan tiet kiem phong Idii om chiem 49,5%;...
Bing 3.9. Sd lan ddi tUdng nghiin ci^' sddung the irong nam 2017 (n=390}
So Tan su'dung the trong nam 2 0 1 7
> 4 l a n
So Itfdnq
Tylf
31,3 27,2 Qua bang tren ta thay trong nam 2017 Co 2 1 % ngu'di benh dung the 1 lan; cd 31,3%
ngu'di benh dung the 2 lan; 20,5% ngu&i benh dijng the 3 tan va 27,2% ngu'di benh dung th&' tu'4 tan trd ten.
Bleu do 3.2. Ty le ngddl benh phil tri them tien khi sddung the BHYT(n=390)
Qua bieu do tren ta thay cd 66,7% ngiTcfi b^nh phai tra tien them khi sir dung the bao hiem y t& do kham chfe benh; cd 33,3% ngi0 benh khong phai tra them tien khi sd dung the bao hiem y te de kham chvia benh trong Sn gan nhat IV. BAN LUAN
Vdi muc dich Danh gta kten thife, thu'c hanti ciia ngu'di benh dieu tn not tru ve quyen Ipi Bao hiem y te chung tdi da tien hanh dieu tra 390 ngu'di benh dang dieu tri tai khoa Not Benh vien Oa khoa tinh Nam Djnh nam 2017. Ket qua clio thay ty le nam gidi tham gia vao nghien ciJu
TAP CHt Y HOC VigT HAM TAP 465 - THANG 4 - SO 2 - 2018 chtem 54,9%, niJ gldl chtem 4 5 , 1 % . Bp tuot
trung binh ctia nam gidi la 66,1±14,5; dp tudt trung binh eiia nd gidi la 67,5±14,3. Tuoi trung binh cua doi tu'dng nghien cihj la 66,7±14,4. Sy"
khac biet ve tuoi trung binh giCfa nam va nd la Widng cd y nghTa thdng ke vdi p>0,05. Nhdm tuoi chiem ty te nhteu nhat la 60-69 tudt (chiem 39,5%), tiep theo la nhdm tudt 70-79 chiem 25,9%. Sy" khac biet ve nhdm tuoi d 2 gldl la khdng cd y nghTa ttiong ke vdt p>0,05. Ket qua nay cung phu hdp vc^ ket qua eiia nhteu nghien cull h-Udc day cho thay dot tu'dng dieu trj tai khoa ndi thu'dng la nhu'ng ngu'di cao tuoi mac cac benh man tfnh va da so la nam gidi. Khi phong van ngu'di benh ve viec hieu the nao la bao htem y te va dng/ba cd biet ve luat bao hiem y te hay Ididng thi ed tdt 81,3% ngu'di benh tra Idi diing hoac cd biet la cd luat. Ket qua nghien cull ciia chiing tdi cao hdn so vdi eac ket qua nghien culi tru'dc day cho rang ngu'di benh khong biet gi ve bao hiem y te. Giai thi'ch ve dieu nay theo chung tdi cd the do ngu'di benh la nhiJng ngu'di dteu trj not trii, cd tudi va da diing the bao hiem y te lau nam, da su* dung the bao hiem y te nhieu tan nen da biet sd qua ve quyen ldi va nghTa vu cua ngu'di dung the bao hiem y te. Ngudn thdng tin ma ngu'di benh biet ve luat bao htem y te nhieu nhat la qua thdng tin dai Chung chiem 5 3 , 1 % ; qua ngu'di than, ban be, hang xdm chiem 44,4%; qua can bd y te chiem 43,1%; qua can bd BHXH chtem 32,3%. Oieu nay cho tiiay vai tro cua cac phu'dng tien thdng tin dai chung nhu" bao, dai, tivi van phat huy du'dc vat trd quan trpng ciia minh trong viec tuyen truyen hieu biet, kien thii'c cho ngu'di dan.
Qua day eung cho thay vai trd ciia can bd bao hiem xa hdi trong vtec tuyen truyen ve luat bao hiem y te cdn chu^ cao.
Su'c khde la von quy nhat cua eon ngu'di.
Oang, Nha nu'dc ta ludn quan tam den cong tac bao ve, cham sdc sii'c khde nhan dan va da ban hanh, chi dao thyc hien nhteu chu tru'dng, ch[nh saeh, trcing dd dac biet chu tnang BHYT nham giup ngu'di dan ktiac pliuc nhu'ng riii ro benh tat va giam ganh n3ng cht phi kham chu'a benh. chu tru'dng phat huy vat trd ciia BHYT va tien tdi BHYT toan dan du'dc the hien nhat quan trong cac nghi quyet ciia bang va tifng bu'dc du'dc the che hda tap trung chi dao thy'c hien. Nam 2008, lan dau tien Luat BHYT du'dc ban hanh, tao cd sd phap ly vffng chac cho trien khat thy'c hien tien tdt BHYT toan dan. Nhd sy" no \dc phan dau ciia cac nganh, cac cap, dac biet la nganh y te, nganh BHXH va sd ddng tinh hu'dng utig, tham
gia tieh cUc ciia cac tang Idp nhan dan, vtec thy'c hien chi'nh sach BHYT da dat du'dc nhffng ket qua quan trong. Ti le ngu'di tham gia BHYT tang nhanh, ttj" 5,6% dan so nam 1993 len 63,7%
nam 2011 va den nay la tren 82%. Pham vt, quyen ldi BHYT ngay cang md rdng, gan vdt nang cao chat tu'dng kham, chffa benh. Ket qua nghien etyu cua chiing tot eung chi ra cd 89%
ngu'di benh cho rang mpi ngu'di dan deu cd the tham gia mua bao hiem y te. Biet du'dc quyen ldi va mijc dfch ciia bao hiem y te se khien cho ngu'di benh yen tam hdn khi tham gia. Tuy nhien, chi ed 5 2 , 1 % ngu'di benh cd kien thffc dung kht nhan thtyc tham gta bao hiem de chia se riii ra khi dm; 49,5% ngffdi benh eho rang tham gia bao hiem de tiet kiem, phdng kht dm;
35,4% ngffcfi benh cho rang tham gia bao hiem de chil ddng ve tai chinh khi om.
Trong so 390 ngffdi benh tham gla nghien ciilJ cd 82 ngu'di benh sff dyng the bao hiem y te de kham ehffa benh lan dau tien trong nam 2017 chiem 2 1 % ; cd 31,3% ngu'di benh da diing den Ian thff 2; ed 20,5% ngffdi benh diing den lan thff 3 va cd tdi 27,2% ngffdi benh da kham chffa benh bang the bao hiem y te tiy 4 tan trd len. Ket qua nay cung phii hdp vdi thdc te khi cd kha nhieu ngffdt benh la ngu'di tren 60 tuoi mac cac benh man tinh phai dieu tn dai ngay (cd nhffng benh phai tat kham 1 thang 1 tan nhff dat thao dffdng, tang huyet ap,...).
Trong sd cac benh nhan tham gia nghien cffu cd tdi 66,7% ngffdt benh phat tra them tien khi sff dung the bao hiem y te de kham chffa benh trong tan kham gan nhat. Ket qua nay cung phu hdp vdt nghien eiili ciia Le Thj Minh Hue tai Benh vten da khoa tinh That Binh nam 2013 ctio thay cd tdi 64,6% ngffdi benh cung cht tra vien phi.
V. KET LUAN
- Benh nhan nam chiem ty le 54,9%; nhdm tudi chiem ty le nhteu nhat la 60-69 tuoi (chiem 30,5%);
- Ty le ngudi benh biet ve luat bao hiem y te la 81,3%; nguon thong tin biet ve bao hiem y te nhieu nhat la phffdng tien truyen tiidng dai chiing;
- 89% ngu'di benh cho rang tat ca ngffcfi dan deu dffdc tham gia mua bao hiem y te; tiieo ngffdi bSnh myc dich de tham gia bao hiem y te de chia se riii ro khi 6m chiem 5 2 , 1 % ; de giiip ngffdi dan tiet Idem phdng khi 6m chiem 49,5%;
- Ty le d6i tffdng da sff dung the bao hiem y te 2 tan trong nam 2017 la 31,3%; cd 66,7%
ngffdi benh phai tra them tien khi sff dung the bao hiem y te de kham ehiya benh.
VIETNAM MEDICAL JOURNAL N°2 - APRIL - 2018
TAI LIEU THAIVl KHAO
1. Bd Y te (2013), Bao cao chung t6ng quan nganh yte n3m 2013.
2. Benh vien da khoa tinh Nam Djnh (2017), Bao cao tong ket cong tac benh vien nam 2016.
3. Ta Van Dat (2010}, ThUc trang sff dung the bao hiem y te"cua ngUOt dan tai 4 phiicSnglxa thanh pho Phu Ly, tinh Ha Nam, nam 2010, Luan van thac sT y te cong cong, Tru'dng Dai hoc Y That Binh
^. L6 Thi Minh Hue (2014), Tht/c trang cong tac
kham chiJa bSnh bao hiem y te tat Benh vi^nijla khoa tinh Thai Binh nam 2014, Luan van thac sfy te cong cong, TrUdng Dat hoe Y Du'cfc Thai Bi'nIi.
5. Quoc hoi (2014), Luat so 45/2014/QH13 ve ' ^ doi, bo sung mpt so dieu cua Luat Bao hiem ytf"
6. Ngan Do, Juhwan Oh, and Jin-Seok tee (2013), Moving toward Universal Coverages Health Insurance in Vietnam: Barriers, FaciiitatB Factors, and Lessons from Korea, Korean Lessol for Universal Health Coverage in Vietnam.
eAc DIEM HINH ANH CONG Hird-NG xir (y BENH NHAN Xa CITNG RAI RAC THE TOY SONG
T6IVI TAT
Cd sd: Benh xd cffng rai rac (XCRR) la mot benh vtem mat myelin ctia he than kmh trung Udng, xay ra ehu yeu d chat trang cija nao, ttly, hoac day than kinh tJii giac. Ton thUOng ttjy thu'dng gap trong benh XCRR nhuhg khong de de phat hien ton thu'dng tren cpng hifdng tff va phan biet vdi c^c ton diUdng tuy do cae nguyen nhan khac. Myc tieu: OUa ra mgt so dac diem ve hinh anh eong hu'dng tff (CHT}d benh nhan xd cffng rai rac c6 tonJ:hu'dng tuy song. Phu'dng phap: Nghien cffu dac diem lam sang va hmh anh hgc tren 33 benh nhan chan doan XCRR theo tieu chuan MacDonald 2010, du'dc dieu tn ngi tru tai Khoa Than kinh Benh vien Baeh Mai vi mot ddt tten trien co tan thu'dng ttJy song. Ket qua: Ton thu'dng tiJy co hay gSp hdn ton thu'dng tOy lurig. Hinh anh chup cong htJ^ng tff tuy co the binh thu'dng (15,2%) dii dmh khu ton thudng tren lam sang ro rang. Teo tuy co the gap (1/33) 6 benh nhan XCRR tai phat nhieu ddt. Da so cac ton thffdng tity trong XCRR eo chieu dai du'di hai than dot song (78,18%) va chieu rgng nho hdn nffa be ngang eot tuy (74,55%).PhLi tiiy ft gap trong ton diUdng tity cita XCRR (18,52%). SLT bat thuoc ctJa ton thu'dng tren phtm cgng hudng tff the hien ton thu'dng mdt xuat hien trung binh du'di 1 thang. Khong thay sU khac biet ve tinh trang tan tat d cac nhom benh nhan CO so iffdng va vi tri ton thu'dng tity khac nhau tren cpng hu'dng tff. ICet lu^n: Chtjp cpng hu'dng tff ttJy song CO tiem thuoe da quang tffcan thiSt de chan doan b|nh XCRR.
Tdkhdaixd cdng rai rac, ttjy song, cpng hu'dng tff SUMMARY
MRI CHARACTERISTICS I N PATIENTS WITH MULnPLE SCLEROSIS OF THE
SPINAL CORD
*Benh viin Badi Mai
**DaihgcY'HaNdi
Chju tracti nhiem chinh: Vo Hong KhSi Email: drvohongkhoiigiyahoo.com.vn Ngay nh|n bai: 3.2.2018 Ng^y phan bien khoa hoc: 30.3.2018 Ngay duyet bai: 9.4.2018
Vo Hong Kboi*, Ho Thi Dung**
Aim: multiple sclerosis (MS) is a demyelinating disease of the central nervous system which appears mainly in the white matter of tjrain, spinal coixl, or optic nerves. Spinal cord lesions are common in multiple sclerosis but it is not easy to detectand to distinguish them from other causes. Methods: To comment on magnetic resonance imaging(Hlil) characteristics of multiple sclerosis patients with spinal cord involvement. Results: Lesions incervtcal spinal cord are more common than in lumbar spinal cord, Spinal cord MRI can be normal (15.2%). Spinal cord atrophy might occur in patient who had many attacks.
Almost of spinal cord lesions were less in two vertebral bodies (78.18%)) and less in half width of the medullary canal (74.55%). Medulla edema was not common (18.52%). Enhancement on MRI showed n&v lesions with an average age of less than one month, No difference in clinical disability was found in ttie patient groups with the number and location of spinal cord lesions on the MRI. Conclusions:Magnetic resonance imaging (MFU) was very necessary to accurately diagnose multiple sclerosis.
Keywords: multiple sclerosis,sptnal cord, Magnetic resonance imaging (MRI)
I.DyBkTVANDE
Benh XCRR la mot benh viem mat myelin ciia he than kinh trung ffdng, xay ra chu yeu d ctat trang ciJa nao, tuy, hoac than kinh thj giac, gay nen nhieu trieu chiiVig than kinh tdn thffdng thanh nhieu ddt, man t i n h [ l ] .
Ton thffdng tuy thffdng gap trong lam san^
benh XCRR, dae biet d quan the ngffdi ch§u A.
Dd ta dang gay tan tat nhat cua benh do si/twi phuc thffdng khdng hoan toan va tau dai. Ton thu'dng tuy song cd the la ddt benh^dau tien, nhffng cung cd the la bieu hien cija mot ddt mdi trong tten trien cua benh. Trieu chffng lam sang cua ton thffdng tuy trong XCRR vo eiing da dang, bat ky hot chffng tdn thffdngJtuy kinh dien nao cQng cd the la bieu hien cua tdn thffdng tuy trong XCRR. Vi vay chup cong hffdng tff (CKT) tuv
