NGHIEN cCrU KHOA HC
TiNH HiNH BENH DA LliU
TAI PHONG KHAM DA L l i u BVTW HU^ NAM 2009
Le Viet K h a n h " , Nguyen Du-c Long". Tran Van Khoa**, Huang Due Yen*
TOM TAT
Muc t i e u : Khdo sdt tinh hinh bSnh da liiu tglphdng khdm Da llSu B^nh vi^n Trung Mng Hue2009, dixuat hi/dng phdt triSn cOa Khoa Da liiu trong tUcfng lai.
B o i tUtfng: Gdm 17.136 binh nhdn mac b&nh da liiu den khdm tCr 1/1/2009 -31/12/2009.
Thiet ke nghien ciifu: md td cdt ngang.
Ket q u i : 77'/^ fr^em Id 17,6%; ngi/di Idn 82,4%; thdnh thi Id 19,90%; ndng thdn Id 80,10%. Binh nhdn ngoai tinh 61,36%. Ndp phi fU nguyin 74,45%, ndp phi do sal tuyen 25,25%. Nhdm b$nh viim da di Ung vd viim da tiep xOc chiem ti I& cao 41% vdi 0,87%. Can xdc dinh nguyin nhdn gdy viim da tiep xuc do c6n trung Nhdm benh trCrng cd 10,50%, cdc binh nhiim khuan 24,31%.
I. DAT VAN OE
Trong nhUng nam gan day, ciing vdi sU phat trien cua xa hoi, t i n h hinh mac benh ndi chung vd cac benh da lieu c6 khuynh budng gia tang va c6 sUthay ddi v e c a c mat benh. Nham muc dich giup Ban chu nhiem Khoa Da lieu danh gia cac mat benh t h u d n g gap hien nay, qua do de xuat cho Ban Giam doc Benh vien Trung uang Hue phudng bUdng phat trien cua Khoa Da lieu trong thdi gian sap t d i . chung toi tien hanh t o n g ket "Tinh hinh benh da
Td do de xuat phuong hudng phat trien cCia Khoa Da li§u trong t u a n g lai.
II.OOI T l / O N G VA PHirONG PHAP NGHIEN CCfU 2.1.D6ititdng
Bao gom 17.136 benh nhan mac benh da lieu den kham tai Phong kham Da lieu tU 1/1-31/12/2009.
Doi t u a n g loai trd: bao g o m cac benh nhan da CO mac cac benh tam than va khdng d o n g y t h a m gia nghien cufu.
lieu tai Phong kham Da lieu Benh vien Trung uang 2.2. PhUdngphap Hue t U thang 1 den thang 12/2009" nham muc
tieu:
1. Md td mdt so dac diem chung cOa bfnh nhdn den khdm tqi phdng khdm Da liiu,
2. Khdo sdt tinh hinh binh Da liiu thUdng gap.
* Benh vien Trung ucmg Hue
**Dai hoc YDuac Hue
- Thiet ke: tien cUu, m o t a cat ngang - Cd mau: mau toan bo t r o n g t h d i gian nghien cdu.
- Cach t h d c t i e n hanh: benh nhan duac kham va tra Idi theo b g cau hoi da dUgc soan thao sdn.
2.3. Thai gian, dia diem: t d 1/1/2009-31/12/2009 tai Phong kham Da lieu Benh vien TW Hue.
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I I I . K ^ T Q U A
Qua k h i o s « 17.136 t r l / d n g h ^ p b^nh nhSn mSc b i n h da den k h i m tai p h 6 n g khSm Khoa Da l i i u nam 2009 chung toi g h i nhSn mot s6 k^t q u ^ sau;
S.I.Mitsidiedlim chung cia binh nhin din khim
Bing 1. Phin bo binh nhdn theo gl6t I S o l u a n g I Ti l e % I Nam i 7122 1 41,57 [ N U ^ 10014 I 58,43
N M n x ^ t : "rile benh n h a n n i J d e n kham 58,43%
cao hon nam 41,57%.
Bing 2. Phdn b6 btnh nhdntheo ngitdi Idn vd tri em
_ j S o l u o n g j T l l e % ^ Treem _ 3016 17,6 N g u o i l a n _J_ 14120 ' 82,4
Nhdn x^t: Oa so ngi/Oi den kham la ngudi Idn 82.4%.
Bing 3. Phdn bo benh nhdn theo dia II
Bing 5. Phin 1)6 theo l( phi vi bio hllmyti
Thanh pho Nong t h o n
So lugng 3410 14120
T i l e % 19,9 80,1 Nhdnxif Hau het ngUdi d e n kbam d v u n g nong t h d n 80,1%.
Bang 4. Phdn bo benh nhdn theo aan vl hdnh chinh
ThdaThien-Hue Quang Tri I Quang Binh I Khac
Nhdn xiV Thda Thien Hue chiem ti le cao nhat 38,64%, cac t i n h Quang Binh va Quang Tri c6 t i le thu gan tUang d u a n g
So lucrng 6620 4215 3730 2571
Ti le % 38,64 24,59 21,77 15,00
Thu p h i BHYT
S j l i / f n g 11.250 5886
'Ille%
65,65 34,35 Nhin xit: Tl le chiem 65,65%; BHYT chiem 34,35%.
Bing 6. Phin logl thu phi Soluong Thu phi
T L / n g u y e n 6375 Virol t u y e n 2875 I -
T l l e % 74,45 25,55 Nhdn xH: TT 1^ vi/ot t u y e n chiem 25,55%.
3.2. nnh hinh binh da lliu
STT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Ten benh VIem da di u n g VIem da t i e p xuc Cham man/san ngijfa TrLfng ca MAy day V3y nen Sui m a o g a Hat com Nam da Not ruoi U b u d u tren da G h i Benh Zona
Benh herpes da niem mac Benh Thuy dau Tong
Tong 4230 1860 2796 1800 864 648 60 1248 1146 138 384 792 410 208 552 17.136
Tile%
24,68 10,87 16,32 10,50 5,04 3,78 0,35 7,29 6,69 0,80 2,24 4,62 2,39 1,21 3,22 100
16 I DA LIEU HOC S6
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IV. BAN LUAN
Phan benh t h e o gidi, t r o n g nam 2009 chung t o i da kham cho 17.136 benh nhan mSc benh da lieu, ket quS phan loai theo gidi dugc phan chia n h u sau: nam chiem 41,47%, nCT chiem 58,43%.
Nhin c h u n g , t i le nam nGf den kham hat khac biet vl t r o n g xa hoi chung ta nam gidi van \k lao dgng chinh t r o n g gia dinh. Do v | y , du mSc benh da lieu ho chi di kham khi benh gay ccin t r d cong vJec. Phu n d cd t h e quan tam den sdc khde nhieu ban nen t h u d n g kham sdm khi mSc benh.
Phan benh t h e o ngUdi Idn v^i t r ^ e m , cd 82,4%
ngudi Idn den kham, t i le t r e e m 17,6%. Phan Idn benh nban den kbam benh la ngudi Idn cung la dieu hgp ly vi benh nhan den kham de chong kh6i benh. B o i vdi tre em t i le mac benb 17,6% that sU cung chUa phan anh bet t i le mac benb da cua tre v i d t h a n h pho Hue da so la can b o - cong nban vien ban cong tac t r o n g gid kham benh nen it nhieu cung CO anh hudng den t i l e t r e e m den kham benh da.
Phan benh den kham theo dia li; thanh pho 19,90%; ndng t h d n 80,10%. Co mdt so van de c6 t h e g i a i thich cho sU khac biet nay.
-I- Benh nhan thanh pho c6 the den kham da lieu tai nhieu c a s d y t e khac t r o n g thanh pho Hue, dieu nay cung phan nao giai thich cho tl le den kham thap so vdi nong t h o n .
-I- Benh nhan ndng t h o n chiem t i le cao 80,10%
do ho quan tam den benh, tiep den la hg da den kham tai cac tuyen y te ca sd nhung khdng khdi va dugc chuyen theo tuyen. Ngoai ra, cung phai noi den s u t i n t u d n g cua ngUdi benh trong khu vUc mien Trung doi vdi Khoa Da lieu ndi rieng va Benh vien Trung uang Hue noi chung nen ho thUdng vUcft tuyen de rut ngan t h d i gian dieu tri benh.
- Phan theo dan vi hanh chinh, benh nhan den
lii Thda Thien Hue 1^ 38,64%; QuSng TTl 24,59%;
Qu^ng Binh 21,77%; c^c noi kh^c 15%.
6 day diem dang lUu ^ Ici so benh nhan den kham t d c ^ c t i n h QuJingTrj, Queing Binh d e u x a p x i 20%, dieu nay mot Ian nuTa ndi len s U t i n t U d n g vao tay nghecua Benh vien Trung u a n g Hue. D o n g t h d i , lanh dao nganh y te cung can c6 ke hoach dao tao lai cho can b g ciic tuyen ca sd de ho c6 t h e lam t o t cong teic chuyen khoa, phan nao g i l m t i n h trang quatSi cho Benh vien Trung u a n g Hue.
- Phan theo le phi vh bJio hiem y te: benh nhan nop le phi 65,65%, bSo hiem y te Id 34,35%. Sd d l t i le kham le phi cao \h do s u t i n t u d n g vao ddi ngu can bp y t e c6 trinh do cao n h u da de cap d tren, ngoai ra, cung do le p h i k h a m chufa benh cua benh vien qua thap so vdi cac c a s d k h a m chufa benh khac t r o n g khu vUc nen cung phan nao t h u hut mdt so lugng benh nhan ngheo
- Phan tich 11.250 trudng hap t h u phi, c h u n g t o i CO nhan xet nhusau: 8.375 t r u d n g hap t h u phithUc SU, t i le 74,45%. TTong khi do cd den 2.875 trUdng hgp chiu nop phi, t i le 25,25%. Ly do: (1) dien bcio hiem y te nhUng khdng duac tuyen dudi chuyen den; (2) mdt so trUdng hgp tre em do den kham sai tuyen, do dugc chuyen tuyen nhUng vi phai c h d dai lam thu tuc bao hiem y t e q u a phien ha nen gia dinh t U nguyen ddng phi de duac kham benh sdm ban.
- Phan tich cac mat benh den kham t r o n g nam, chung toi nhan thay c6 mot so diem can lUu y-
-I- Nhom benh viem da di dng va viem da man c o t i le mac benh cao nhat 4 1 % , dieu nay cung phu hgp vdi sU phat trien cua ddi song cong nghiep phat trien. O Benh vien Da lieu thanh pho Ho Chi fVlinh t i l e nay la 30,6% [1],
-I- Nhdm viem da tiep xuc c6 10,87%.Tile benh nay d benh da lieu thanh pho Ho Chi fVlinh la 6.8%
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[11. Trong so cSc b^nh nhan cija chung t 6 i c6 2/3 t r u d n g h o p viem da tl6p xuc nghi d o c6n t n j n g v^
b&nh nhan t h u d n g dugc chan d o i n vA dieu t r i t h e o h u d n g zona it nhKt 1.1 trong may n g i y dau khdi benh. Do trang t h i f t bi cSn lam sSng cua c h u y i n nganh Mien djch • D| Cfng vS Ki sinh t r i j n g chua phSt trien nen khong t h e x i c d i n h dugc c i c nguyen nhan gay di Cfng tiep x u c
+ Nhdm trLfng cS chiem 10,5%. TTen 30%trUdng hgp d o dieu tri sai hoac t u d i e u t r i nen da dan d e n bien churng seo Idm.
+ Nhom c i c benh nhiem t r u n g : 24,31%; n h d m hat com vJ nam da t i le mSc la 7,29% v i 6,69%; tiep den ik ghi: 4,62%; thuy dau: 3,32% v i zona: 2,39%.
cac t i le nay cao hon nhieu so vdi t i le cua Benh vien Da lieu thanh p h o Ho Chi fVlinh [1],Trong khi so sanh vdi cac tac g\i Le Kinh Due, Nguyen Xuan Hien [2], Hablf T.[3], Nguyen Xuan Son [4), Oo Xuan Khoat [5], ket qua cua chung t d i thap h a n r l t nhieu, Trong nhdm benh nhiem t r u n g , dang lUu y nhat \i n h d m benh thuy dau, da so benh nhan dlLTa tuoi t i ^ 16-15.
Do vay, cong tac tuyen truyen chung ngi/a vSc-xIn thuy dau ta rat can thiet va nen nhanh chdng dUa vao Chiiong trinh TIem chung Qudc gia.
V.K£TLUANVACEXUAT
Qua k h i o s « 17136 b ^ n h nhan den kham trong nam 2009 tai p h d n g k h i m Khoa Da lieu, chung toi cd m d t s6 k^t luSn sau:
1 . M o t sci d i e tf! j m chung cua b^nh nhan den k h i m tai PhAng k h a m Da l i i u
- Tf le mSc b d n h da lieu giCra nam va nil Ian lupt la 41,47% vJ 58,43%.
• Tf le mSc b ^ n h giijfa t r ^ em v i ngUdi Idn \i 17,6% vSl 82,4%.
• Tf le bSph nhan den k h a m d t h a n h t h i l i 19,90%
va n d n g thdrv la 80,10%.
Tf le benh nhan ngoai tfnh den kham ti 61,36%.
• Tf le benh nhan t h u p h i la 65,65% so vdi b5o hiem y te la 34,35%.
- T f l e n p p phi t U nguyen l i 74,45%vandpphido sai tuyen la 25,25%.
2. Tinh hinh benh da lieu
- N h d m benh viem da d i Crng v i viem da tiep xOc chiem t i l e cao I a 4 1 % v a 10,87%.
- Nhdm b e n h trcrng c i v i c i c b e n h nhiem khuan cd t i l e la 10,50% va 24,31%.
TAI LIEU T H A M K H A O
I, Cham s6c da (2009), Ban vi Chdm sdc da, 4 Nguyin Xudn San (1999), Mdtio nhdnxitvi Dai hoc Y Dagc thdnh pho Hd chi Minh. tip 4 so I (dm sing vd aiu tri thuy Mu tgi Khoa Da liiu Bfntt thing2, trJl-12
2 iff Kinh Du6. Nguyin Xudn Hien (1979), Dieu tri hoc b&nh Da vd Hoa lieu. Nhd xuat bdn Y hoc.
tr.124-126.
3 HabifThomas P (2010). clinical Dermatology, Fifth Edition, pi 16,p450-4S4, p502-507.
viin M^t Tiep Hdi Phdng. "Ndi son Da Liiu' so 2, tr33.
5, Dd Xudn Khodt (2001), Tinh hinh benh Da toi Bfnh vien 198 ndm 1998, "Ndi san Da Liiu', so 1, tr.IS-21.
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THE SITUATION OF SKiN DISEASES ATTHE D E R M A T O L O G I C A L CLiNiC OF HUE CENTRAL HOSPITAL IN 2009
Objectives: To evaluate the situation of skin diseases at the dermatologlcal clinic of Hue Central Hospital from Jan.1st to dec. 31th in 2009: general characteristics of the patients, frequency of some skin diseases. To propose the development of Dermatologlcal Department In future.
Subjects: 17.137 patients who went to the dermatologlcal clinic from jan 1st to dec 31th in 2009 M e t h o d s : Cross sectional study.
Results: The percentages of skm diseases is 17.6% in adult and 82.4% in children. 19.90% of patients lived in Hue city and 80.10% lived in rural. 61.36% of patients lived in the other provinces. The allergic dermatitis and contact dermatitis groups account for41% and 10.87%. Prevalence ofacnes and infectious diseases is 10.50% and 24.31%. Preventions of these diseases are also important.
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