phu; Trang bi phdng tU van d i m bao tfnh neng tu tai cac cd sd san khoa, ddc bidt Id benh vien da khoa TP vd cac Tram Y t d xa, phudng va td ehdC tu van xet, nghiem HIV m i l n phf luu dpng tai cdc xa/phudng, ddc bidt d nhiimg xa vung sau, vung xa.
, TAI Lieu THAM K H A O
1. Tran Quang Hien vd Tran Thj PhUdng Mai (2010),
"Nghidn cClu kien thdc, thdt dd cda phu nd mang thai ve du phong Idy tmydn HIV tCf me sang con qua tu van xet nghiem tu nguydn tai tinh An Giang", Tap chl Y hoc thuc hdn/J.sd730,tr. 17-20.
2. Tmong Trong Hoang vd cdc cpng sU (2010), "Khao sat kien thitc, thdi dd, hdnh vl ve HIV/AIDS vd dU phong lay tmydn HIV ti^ me sang con cda phu nd mang thai va phu nd tudi sinh dd tai thdnh phd Hd Chf Minh ndm 2009", Tap chl Yhgc thuc hinh. S67A2-743, tr. 231-23S,
^ 3. Khuat Thj Hal Oanh (2007), BUOng diu vdi fllV/AIDS d Vi^t Nam tO gdc nhin cQa xa hdi din su, Vien iMildn cdu Phdt tiien Xd hoi.
^' 4. I . Nguyin Thi Thanh Tjnh va Nguyin Thj Thanh Tdm (2010), "Ddnh gia cac ydu Id anh hudng den viec xet
nghiem tu nguyen ciia bd me mang thai tai thj xa Dong Ha va thj xa Quang Trj -tinh Quang Tri ndm 2009", Tap c^l Y hoc ttiUC hinh. sd 742-743, ti". 394-403.
5. UNAIDS-UNFPA-UNIFEM (2004), Phu nO vi HIV/AIDS: Duang diu vdi khCing hoing.
6. Oy ban Qudc gia ph6ng chdng AIDS vd phPng chdng te nan ma tUy mai ddm (2008-2009), Bio cio Quic gia tin thO tu thgc hiin tuyin bi cam kit vi HIV/AIDS, Ha Npi.
7. Y. Luo & G. P. He (2008), "Pregnant women's awareness and knowledge of mother-to-child transmission of HIV in South Central China". Aria Obstet Gynecd Scand. 87(8), p. 831-6.
8. M. M. Mahmoud and et al. (2007), "Knowledge and attitude toward HIV voluntary counseling and testing sen/ices among pregnant women attending an antenatal clinic in Sudan", J Med Virol. 79(5), p. 469-73.
9 Nguyen Thu Anh and et al. (2009)," Availability and accessibili^ of counseling and testing services for pregnant women in Hanoi, Viet Nam", Access to Ck>mpmhensive Pmvention of Mother -to- child Tmnsmission Pmgram. Ha Noi, p. 67-89.
NGHIEN cdu THUt; TRANG MAC BENH HEN PHE QUAN VA M O T S O YEU TO UEN QUAN or HOC SINH TIEU HOC, TRUNG HOC LE HONG PHONG. NGO QUYEN, HAI PHONG
PHUNG CHl THI$N - Viin Yhgc bien Hal Phdng N G U Y I N X U A N B A I - D^i hgc Y Thai Blnh
PHAM V A N MANH, T R A N THj T H U Y H A D^i hoc Y Hai Phdng DiSkTVANDi
Hen la vdn dd sde khoe cpng ddng tren toan thd gidi. Tdc ddng nhidu ngudi, khdng phdn biet tudi tae, d nhieu qudc gia mac cdn benh man tfnh ndy. Khi benh
|en khdng dupc kiem sdat, anh hudng den chat lupng cugc sdng ngUdi bdnh, trd thdnh mdt trong nhiimg ganh ndng benh tat ddi vdi gia dinh, y te va xa hpi. T j Id mac hen dang tdng len d hau hdt qude gia, dae biet la tre em. Tan xudt mac bdnh HPQ dang cd xu hUdng tdng cao tren todn thd gidi. Hidn nay nhidu ndi tJ Id hen phd quan do d con so dang lo sd nhu d uc la 13 - 15%, Phap 8 - 10%; My 5 - 7%. Theo thdng kd cda Td chdc Y td thd gidi (WHO), c d 10 ndm, dp luu hanh cOa benh lai tdng 20 - 50%, nhdt Id 20 ndm v i ^ qua, tdc dp ngdy mot nhanh hdn. Tl Id td vong do HPQ tdng rat nhanh trong nhdng nam qua, chi sau ung thu, vuot tren cac benh tim mach, trung binh 40 - 60 ngudi/1 trieu ddn. 6 Viet Nam theo dieu tra cda Hpi Men, Dj dng m i l n djch tdm sang, trung binh cd 5%
ddnsdbj hen, trong do cd 11%tredUdi 15tudi,tUdng dudng vdi 4 trieu ngudi bj hen va sd ngudi t d vong hang ndm khdng dudi 3000 ngudi. Nhieu ngudi eon Jau bdnh, nen d l bj bd sdt trong dieu tra djch t l hoe cung nhu chan doan benh [2], Hdn nda hau qua cOa hen phe quan va tinh trang lam sdng ngdy cdng ndng [|.vdn de rdt cap thidt hien nay.
Do vdy, vide chan dodn, kiem soat HPQ tre em tai c6ng ddng Id mdt viee he't sdc can thidt trong eong tac phong chdng hen, Chung tdi tidn hdnh Si tdi vdi muc
tieu sau: Xie dinh tp li mic binh Hen Phi Quin vi mdt si yiu ti liin quan 3 hgc sinh tliu hgc, tmng hgc Li Hdng Phong nam 2009.
DOI TUONG v A PHUONG P H A P NGHIEN CCRJ 1. Do'i tuang, dja diem, thdi gian nghien cdu 1.1. Da fiAtfig
- Hpc smh tieu hpe, tmng hpe cd sd Ld Hdng Phong - Sd 4 dUdng Nguyin Binh - Quan Ngd Quyen - Tp Hai Phong.
1.2. Dja diem nghien cAt:
- Tmdng tieu hpc, trung hpc cd sd Le Hdng Phong -Nguyin Binh - Ngo Quyen - Hai Phong
1.3. Thdi gian nghien cdU: 10/2009 den 5/2010, 2. PhUdng phap nghien cUu
2.1. Thiet ke nghien cdU: Nghien cdu djeh t l hpc mo ta cat ngang kdt hpp vPi hdi cUu,
2.2. Cdmiu vi cich chgn miu:
- Cong thdc tinh c3 mdu: dUdc tfnh theo cong thdc
- Trong dd:
+ p: tJ le mac benh nghien cdu tai cong ddng, lay p
= 10%
+ A' khoang sai leeh mong mudn. 0,02 + Z: he so tin edy 95%
+ a: Mde J nghTa thdng ke: 0,05
- Vay eP m l u la. n = 864. De cd do chinh xac cao, chdng toi tien hdnh tren 1.520 hpc sinh
YHOC THVC HANH (878) - S 6 8/2013
- TISu chudn lifi chgn
* Lua chgn binh nhin: T o a n bp nhdng bdnh nhdn qua didu tra dUdc phat hien v d chdn doan mac H P Q
* Tidu chukn chdn doin BN HPQ difi theo tiiu chudn ciia GINA 2008:
+ C d Idn c d n khd thd tai phat nhidu ldn.
+ Thd khd khd c d c d hay tdi phdt.
+ Ho dai d i n g , khac d d m trang tdi phdt.
+ C d ddu hidu tde ndng nguc tdi phdt nhidu Idn.
- Tiiu chu^ lo^i &d:
+ Bdnh nhdn dudi 6 tudi.
+ Benh nhdn khdng do dupe chde ndng h d hdp.
2.3. Phuang phdp thu thip thdng tin.
• Didu tra sdng Ipc. To chde khdm d d phdt hidn bdnh nhdn tai tnidng ndu benh nhdn c d dd tidu chuan ehdn ddan mae H P Q t h d tidn hdnh didu tra s d u v d HPQ
- T d chdc phong vdn, kham, d o luu lupng dinh t h d ra cda bdnh nhdn theo phieu dieu tra vdi b d cdu hdi thidt kd sdn.
2.4. Cdng cg thu nh^ thdng Un - Khdm v d didu tra bdnh nhdn H P Q .
- Bang phdng vdn sdu v d kidn thdc, thdi dp, c d c ydu t d lien quan ddn bdnh hen, kham, do luu lupng dinh va kiem tra ket qua xet nghiem eda benh nhdn, b d hodc me, da cd.
2.5. Tidu chuin dinh gii
* Danh gii mUc dd kl^ soit benh hen t^l c^ng ddng
Tieu chl Thi]t gilc tian dem
Con hen kich ph^t PhSl khSm cap cCni vl con lien Thayd6idigutndotdc
dunq phu dia thudc Bi gidi han hoat dOng t h i luc Trieu chirnq ban nq^V SUdung Ihudc cat con Luu lutmg dfnh budi sdng
Kilm sodt triet d l Khflnq KhOnq KhOng KhOng KhOng KhOnq KhOng
> 8 0 % Duytriitnhattr6n7-8tu^
Kilm sOat mdt phin Khflnq Khflnq l«iflng Khflng ' Khflng
< 2 n g d y f l u l n
< 2 nggy/tuan va <41an/luSn
> 8 0 % Khflng duoc
kilm sodt B i t k$ t u i n ndocOtriOu chCmgbfin, hole cfl dot hen cap > 1 lan/nam
> 2 ngSy/tuan
> 2 ngdy/luin
\A <4l3n/tuan
<eo%
n. theo doi 56 t u i n 3. PhUdng phap xur ly va phan tich s d lieu:
- Dua ti^en phan mdm SPSS 15.0 K i T QuA NGHI&N CLTU 1. Ty le HPQ cua hpc sinh tieu hpc Bang 1: TJ le mac benh cda cac doi tUdng nghidn cijfu:
GiA Ting stf ti^kh^m T6ng sfi tre bi mac
P
Nam 740 77
NO 780 82 p>0.05
Tdng 1520 159
T}IS(%) 100 10.46 Nhan xet: Ket qua nghien cdu cho thay ty Id tre mac Hen phe quan chidm 10,46%. Trong dd nam Id 77 tre, nd 82 tre, su khdc biet nay khdng cd J nghTa thdng ke p>0,05.
B i n g 2: T^ Id tr^ tndc bdnh HPQ theo tudi.
Tdng
B^h nhdn
Nh^n xdt: Trong 159 t r i mdc hen, ^ i ty Id mac hen phd qudn d trd 6 - <10 tudi Id 59,7%, trd trdn 10 t u d i #
40,3%. •• -fi Bdng 3: Phdn loai b d n h n h d n H P Q theo s d ndm
mde bdnh
Thfll flian mSc binii " — — — _ StfmAmfc<1 ndm
1-5 6-10
>10 Tfinflstf
n 18 103 30 8 159
Tm%).
I W •
• 64.7 • 18.9 5,1 100 Nhdn xet: Thdi gian m a c bdnh 1-5 n d m d i i d m tp Id eao nhdt Id: 6 4 , 7 % ^ ^ ^ ',
2. Mpt so d$c diem cua t>f nh Hen Phe* Quin 3 hpc sinh trudng Le Hong Phong.
Bang 4: Tidn sd dj dhg ca nhdn
— • —______^ KSqui TiSnsS "^ ———_^
Vi6m mQi xoanq di (ma Mdyday, slnngOa
Di img Uiudc Di ijng thOc Sn B6nh di Iimg Idi^
C6 tidn sir di Ong Khdng c6 lidn si^di Ong
Bdnh nlian n=159
109 45 10 8 11 120 39
Tf 16(51) 68.5 28.3 S2 5.0 6.9 75.5 245 NhSn x6t: Benh nh3n mac bgnli hen c6 M n sO dj (jmg chiSm 75.5% trong do co tien quan 64n nhom viem mui xoang dj Crng cao nhat 68.5%. ti^p d^n la may day. san ngijia 28.3%. dj Omg thuoc chiem 6.2%, di dng tilde dn 5,0%.
Bang 5: Tidn sd dj dhg gia dinh Mffl quan he "^— . _
bdtidv&me Bdhodcm^
Anh. chi em mdt Ong. lia Cd tidn si} dl i!mq qia dinh Khdng c6 tidn sir di Ong gia dinh
Hen n 11 53 23 14 102 57
hdquSn 6.9
%
33.3 14.4 8.8
DiOnqIdidc n 10 30 12 8
6.2
%
18« 7.5 5,0 64.1 35.9 ehiem 75,5%. Trong d d b d hodc m e mac hen chidm 33,3%, a n h chj e m m p t 14,4%, di d n g khac b d hodc m e chiem tdi 18,8%.
Bang 6: Mdi quan h e giiJia bdnh H P Q vdi cac mda trong n d m
BOng
Thu
Bfinh nhdn TJI6{%)
15,7 Nhdn xdt: Benh h e n c d lien q u a n tdi m u a b o n g ndm dde bidt la m d a xudn chiem 56,6%, tidp d d n mda ddng 4 4 % , m u a ha 15,7%, thap nhdt la mda thu 4,4%.
Y HOC THirc HANH (878) - S 6 8/21>f3
."•' Bang 7 H o a n c a n h x u a t h i e n c d n k h o t h d _ _ _ ^ KSt q u i
TSc nhdn ^ ^ - ^ Thay ddi Ihdi tidt
l.anh Benh hd hdp
Gang sdc ' Khdi thudc IS. thudc Ida
Bui Cim xdc ThOc an
n = 159 137 98 68 51 43 18 8 4
TIie(%) 86.2 61,6 42.7 32,1 27.0 11,3 5,0 2.5 N h a n x e t H o d n c a n h x u a t h i e n c d n k h d t h d t h i d o thay d d i t h d i t i e t e h i e m t J l e n h i e u n h a t 8 6 , 2 % , t i e p theo td d o l a n h 6 1 , 6 % , x u d t h i d n c d n h e n s a u m a c benh h o h a p 4 2 , 7 , g d n g s d t 3 2 , 1 % . T J Id x u d t h i d n ktid t h d s a u a n c h i d m t J Id t h d p n h a t 2 , 5 % .
Bang 8 : T i e n t r i d u x u d t h i d n c d n k h d t h d
• NgCia hong Ngiia mOi H§thoi Ch§y nudc mQi
B0nh nhan
10
T9I$(%)
23.9 . TitenflUc I 10 I 6.3 ] F N h a n xdt: T i e n t r i e u x u a t h i d n c o n h e n p h d n Idn c d
dau hieu b a o tnJPc d d Id c h a y n u d c m u i ( 2 3 , 9 % ) s a u do la n g i j a m u i ( 2 2 % ) , h o ( 1 5 , 7 % ) , n g U a h o n g 1 5 % ) , tub nguc 6 , 3 % .
•" Bang 9 : C a e b i e u h i e n c h f n h c d a b e n h h e n p h e iuan tre e m
_ _ i N h d n xet: B i e u h i e n c h f n h c d a b e n h h e n k h o k h e (44%), n h i e u d p t k h o k h e t a i d i t a i lai ( 3 2 , 7 % ) , h o k h o khe sau h o a t d o n g t h e lUc ( 2 8 , 3 % ) , h o n h i d u d a i d d n g 15,7%.
Bang 10: T t n h c h a t , m d e d p p h d b i d n c u a c d n h e n
•
t
( )
^fdac b e n h n h a n
W Kdl q u i
._ Ttnh chat milcdO _ mdn trieu
IDfeibidn
^ ^ 3 con Tl hen TN khd thd
B^Ocdd
^ t h d
Hat hci, chiv nudc mQi, tdc nguc Con hen kdo ddi vdi phdt - vai gid
Cdn hen kdo ddi KhdthSlhithdra Khd thd thi thd vdo
K h d t h d c i h a i t h i Khd thd nhidu Khd thd irungbinh
Khd thd it PhaithdOxvkhicdccnhen
n=159 96 138 21 16 34 109 61 69 29 5
T(I6 60,4 86,8 13,2 10,1 22,6 68,5 38,3 43,4 18,2 3,1
Ddu hi^u dikdmcqn
hen
v a mdhdi Tim ldi Khd ndi Phdi ngdi dd Ihd
123 44 114 130
77,3 27.6 71,7 817 N h d n x e t : T f n h c h d t v d m d c d p c d n h e n r a t k h a c n h a u g i d a c a c b d n h n h d n . C d n h e n d i d n h l n h v d i c d e d d u h i d u t i d n t r i d u , v a m d h d i , k h d t h d c a h a i t h i , k d t t h d c s a u v d i p h d t - v d i g i d .
B A N LUiS^N
1 . T l 1 ^ m a c h e n p h e q u d n .
N g h i d n c d u x a e d i n h t J Id m a c h e n t a i t r u d n g c h d n g t d i d a t h u d u p c k d t q u a t J I d m a c h e n c d a h p c s i n h Id 1 0 , 4 6 % . T J Id n d y c a o h d n n g h i e n c d u c d a N g u y d n T n a n g T d i ( 2 0 1 0 ) k h i d i e u t r a t J Id m a c h e n h p c d u d n g t a i T h d n h p h d V i n h t l n h N g h d A n d i d u t r a t r e n 4 . 9 6 3 d d i t u p n g h p c s i n h c a e k h d i c f l a 1 5 t n i d n g T i d u h p c , T m n g h p c C d s d , T m n g h o c p h d t h o n g thi t J Id m a c h e n Id 7 , 2 9 % , c a o h d n n g h i e n e d u eiHa B u i D d c D U d n g ( 2 0 0 2 ) t r e m a c h e n t a i 2 t i n h B i n h D u d n g , T h a i B i n h la 7 , 1 % , 8 , 7 4 % d 3 tnJPng P T C S t a i H d N p i n g h i e n e d u c d a P h a n Q u a n g D o d n ( 2 0 0 6 ) , t h d p h d n 1 2 , 5 6 % d h p e s i n h H a N p i c f l a P h a m L d T u d n ( 2 0 0 6 ) . D i e u n a y c d t h d IJ giai Id d o c a c y d u t d c u thi v d d j a 1 J , m d i t m d n g d d a y k h a e s o v d i c a e k h u v u e k h a e m a c a c t a c g i a k h a e d a n g h i e n c d u , c u n g e d t h e d o e d m l u d i d u t r a k h a c n h a u , t h d i d i e m d i d u t r a c u a c d c t d c g i a k h a c t i d n h a n h tnJPc c h u n g t o i n e n d a a n h h u d n g d e n k d t q u a t J l e m a c h e n . T u y n h i e n k e t q u a n g h i e n c d u eiHa c h d n g t d i t h u d u d e p h d h d p v d i n h i e u n g h i e n c d u cOa c d c t a c g i a n u P c n g o d i n h u c d a Davidson.S. 1 9 9 9 t r e n 4 % v a p h d h d p v d l k h u y e n c a o e i j a G I N A v e t i n h h i n h m a c h e n d a n g c d x u h u d n g g i a t a n g t r o n g n h d n g n d m g d n d d y t r e n p h a m v i t o a n t h e g i d i , d a e b i e t la h e n t r e e m . T j l e t r e n a m m a c h e n ( 4 8 , 4 2 % ) v d t r e n d ( 5 1 , 5 8 % ) , s u k h a c b i e t k h d n g c 6 y nghTa t h d n g k d ( p > 0 , 0 5 ) . T J l e m a c h e n k h o n g c d s U k h a c b i e t v e g i d i t u k d t q u a n g h i e n c d u c d a e h u n g t o i c u n g p h u h p p v d i n h d n (Snh c u a c a c t a e g i a k h a c nhU: P h a m V d n T h d b , H u u r r e T . M .
Phan bdmac HPQ theo nhdm turn Qua dieu tra 159 BN chCing toi thay tJ le mac benh gida cac do tudi la tUdng tU nhau. Benh xuat hien lan dau d bat ed tudi ndo tuy theo ea nhan, dieu nay khdng the du bao trudc do lien quan cd dia benh nhan, mdi trudng sdng, benh kem theo. Dieu nay ed the ly giai do benh hen hay xuat hien sau nhiim trung h6_ hdp tren mdt cd dia di dng ma ehung ta deu biet nhiem khuan ho hap cap hay gdp d tre nho. Ket qua nghien cdu cua ehung toi phu hdp vdi nhdn ^ n h eua nhieu tac gia khdc la bdnh hen xud't hien d moi Ida tuoi cfla Tran Quy, Phan Quang Dodn, Nguydn Nang An, Pham Vdn Thde.
Ve sd nam mac benh tfnh den thdi diem dieu tra ehung toi thdy cd cac nhdm ddi tupng benh nhan sau.
nhdm mdi mae dudi 1 ndm ta chiem tJ le 11,3%, nhdm mac benh tren 10 ndm ty Id ft 5,1%, nhdm td6-10 ndm chidm 18,9% va da sd cdn lai la nhdng benh nhan mac benh keo ddi t d 1-5 ndm. Ket qua nay phan dnh ti'nh chdt cd ban cfla benh hen la dien bidn man tinh keo
T H O C THI/C HANH (878) - s<5 8/2013
ddi nhidu ndm, thdm chf sudt ddi sau khi mac. Didu ndy eung gdi p rang van de dieu trj hen cung phdi theo nguyen tae dieu trj keo ddi tuy theo tien tridn vd dap dng didu trj. Tinh chdt d i l n bien efla bdnh nhU tren cQng da dudc nhidu tac gia va y vdn ndi ddn nhU Id mpt quy ludt phd bidn efla bdnh hen cQng nhu nhidu bdnh dj dng khdc.
2. Mpt sd'd$c diem b^nh HPQ b hpc sinh Cic ydu tdting nguy comic b^nh Vd ydu td cd dja di dng cua cd nhdn vd gia dinh, kdt qud nghien cdU cfla ehdng tdi thdy cd tdi 75,5% BN hen hidn tai dang mac (hay trong tidn sd) mdt hay nhidu cdc bdnh dj dng khdc nhau. Ddng ddu Id vidm mui dj dng 68,5%, tidp theo Id mdy day, sdn ngda 28,3%... cd tdl 22,0% sd BN mac 2 benh d| dng trd Idn, didu ndy cho thdy bdnh nhdn hen cd cd i^a dj dng cd nhdn ro rdt. Kdt qua ndy phu hdp vdi nhdn djnh cfla nhidu tac gia Id hen cd ngudn gdc dj dng d 50% trudng hpp, ddc bidt Id hen xuat hien sdm d tre em vd thanh nidn, nghien cdu cCia Nguyen Ndng An, Pham Vdn Thdc, Vu Mmh Thuc, Phan Quang Dodn thay tJ Id benh nhdn HPQ cd bdnh dj dng kdm theo d 67% - 76,2% vd trong nhdng nghien cdu khdc ede tac gia cung chl ra rang cd tJ Id rat eao ngudi thdn bdnh nhdn mac hen vd cd tien sd mac benh di dng.
Ket qua nghien cdu cfla chdng tdi cung phiJ hdp vdi nhdn dmh cfla nhieu tae gia la: benh hen cd lien quan den cd dja di truydn, tfnh nhay cam eao vdi cac benh di dng, ddc biet la vdi viem mui di dng, may day. Nhu Tran Van Ddng cho rang 57.1% BN ed tien sd d; dng gia dinh. Bui Ddc Dudng nhan xet bd me ed tien sd dj dng, mac hen thi eon ci!ia ho cd nguy cd mae hen eao hdn 1,5 lan so vdi tre cd tra me khong mac hen hoae dj dng. Cac nghien cdU cua eae tac gia khac nhu Pham Van Thde, Vu Minh Thuc, Koeppen-Schomems ...cung deu cho rang cac BN hen cd ed dia gia dinh bd me, anh em mot eung mac hen khoang 26,3% - 3 1 % cac trudng hdp.
Cic yiu tdliin quan xua't hign can hen Ve nhiJmg ydu td tn/e tidp kfch phat su xud't hien cac edn hen d cac benh nhan hen, chdng toi thd'y ed rat nhidu yeu td kich phat con hen khac nhau, hay gdp nhat la sUthay ddi thdi tiet dot ngpt gay xuat hien edn d 86,2% sd BN, tidp den la nhiem lanh 61,6%, nhidm khuan hd hap cap 42,7%, gang sUc 32,1%, khdi bep than, khdi thudc la thudc lao 27,0% Ve van de nay Nguyin The Hung eung cho mpt nhan xet tUdng tu la thay ddi thdi tiet gay xuat hien cdn hen d 80% BN.
Nhidm lanh la yeu td nguy co kfch phat con hen b cdc BN cfla ehung toi vdi tJ Id cao (61,6%), Kdt qua ndy cung phu hdp vdi nhdn xet chung cua nhidu tae gia Id benh nhan hen cd cd dja nhay cam vdi lanh va nhidu tac gia da dung kfeh thich bang ludng khdng khi lanh qua dudng hd hap nhu la mpt test de giup chan dodn xae t^nh benh hen neu test cho ke't qua dudng tfnh eung vdi nhdng tieu chuan khac tren nhung benh nhdn nghi ngd hen.
Yeu td bui gay kfch phat cdn hen trong cac BN cfla ehung tdi vdi tJ le thap hdn so vdi ket qua nghien cdu
efla Nguyin Ndng An vd cdng sU (11,3% so vdi 25%).
Cd thd didu dd phan dnh tinh trang mdi trudng khdng khl d ndng thdn trong Idnh hdn cae khu vup khac, chSng han nhu do thj ndi cde tae gia dd nghien edu vdi ndng dd bui vd dj nguydn trong khdng khf cao hdn.
Trorig nghidn cdu cda chdng tdi sd BN xudt hidn edn hen gdp nhidu nhdt Id mua xudn chidm 56,6%, tidp ddn Id mua ddng 44%, mda ha chidm tJ Id dang ke la 15,7%. Oidu dd ed lidn quan ^ i ydu td thay ddi thdi tidt vd nhidm lanh vd mdi quan hd chdt gida ydu td khdi phdt Cdn vd tinh trang xudt hidn edn d cac t}dnh nhdn.
Nhidu nghidn cdu eda cdc tde gia khae cung cho kdt qud tUdng tU Id cdn hen xudt hien tdng len vd mua ddng, nhu nghidn cdu cfla Vu Minh Thpg 54,93% BN xudt hidn cdn hen mda ddng va 54,1% theo nghien cdu cda Pham Vdn Thdc.
Vd thdi gian xudt hidn con hen trong ngdy, kdt qua nghidn cdu thdy 65,4% bdnh nhdn Id cdn hen xudt hien vdo ddm, thdi gian xudt hidn eon hen bat ky 23,9%.
Ydu td xudt hidn cdn hen vd tdng ndng mdC dp benh vdo ban ddm Id ydu td tin cdy giup cho chdn dodn mac bdnh, nhung ddng thdi cQng eho thdy dde tfnh xuat hidn cdn phu hpp vdi y vdn Id cdn hen hay xudt hidn ve ddm gdn sang vd phu hpp vdi kdt qua nghidn cijru cfla Vu Minh Thue thdi gian xudt hidn cdn hay gdp vao ddm 70,42%, nghidn cdu cfla Bui Ddc Dudng Id 74,8%, hay nghidn cdu cda Pham Vdn Tbdc edn xudt hidn ban dem 52,46%, ngdy + ddm 32,79%.
K^'TLUAN ^
1. Ty Id mac bpnh HPQ tai tnrdng Le Hdng Phong
- TJ Id mac HPQ tai trudng Ld Hdng Phong la 10,46%, t j Id mac bdnh gida hai gidi (nam 48,4%, nd 51,6%).
2. Mpt so ye'u to' lidn quan de'n benh Hen Phe Quan tai trudng Le Hong Phong
- Tien sd di dng ban than, gia dinh gdp b hdu het cac bdnh nhdn hen.
- Nguyen nhdn chfl yeu gay HPQ ldn dau la nhidm tnJng dUdng hd hap nhidu ldn 71,7%.
- Ydu td kfeh phat con hen d cac BN bao gdm dj nguydn kha da dang, ddng dau Id do thay ddi thdi tiet, tidp ddn Id nhilm lanh, n h i l m khuan hd hdp, gang sde..
SUMMARY
Objective: The authors have researched the rate and describe some characteristic of Asthma in grade- schooler, high schooler in Le Hong Phong.
Matenals and methods: The authors have used cross descriptive and retrospective study method, to be combined inten/iew/ directly the pupil parental about knowledge, attitude and some relate factor to Asthma disease.
The results obtained as follow/s:
+ The rate of Asthma disease in Le Hong Phong is 10,46%
+ Some characteristic of disease Asthma in Le Hong Phong school: The most Asthma patients have oneself allergie or family allergie
Y HOC THVC HANH (878) - sO 8/2013
Main cause to make appear Asthma disease in the fist that is inflammation of the respiratory system (71,7%)
' The factor makes stimulates attack of Asthma disease include: change of the vireather, catch cold , inflammation of the respiratory system,...
Keywords: Asthma, grade-schooler, high schooler, Haiphong
TAI LIEU THAM K H A O
1. Nguyen Ndng An (2006), Tmh hinh thUC hiin Idim soat hen theo GINA d Vl^t Nam, Sinh hoat khoa hpc chuyen d l 2/2006, tr 1-10
2. Phan Quang Doan, Ton Kim Long (2006), Dd lUU hinh hen phi quin tmng hgc sinh mdt si trudng tioc d Hd N^ vi Snh hinh sOdung SeriUde do phdng hen tmng cic doi tuang niy. Tap chi Y hoe thyc "hdnh (547) sd 6/2006, tr 1 5 - 1 7 .
3. VQ Minh Thuc. Pham Vdn Thflfc (2004), NghiSn cOu biiu hi$n lam sing vi cic yiu to liin quan giy HPQ tai phudng Lach Tray - Hii phdng. Tap chl y hoc thuc hdnh sd10 2004,tr31-36.
4. Pham LS Tudn (2006), Diiu tm sU liin quan giOa hen vi d nhiim khdng khl tmng hoc sinh tiiu hoe vi trung hgc t?i Hi Ndi. Tgp chf Y hoc du phong, tdp XVI /2006, sd 5(84), tr 32-39.
5. Chhabra S. A. (2007), Assessment of contml In Asthma: cunent scenario and Instmments for measurement,
6. Banac Srdan (2004), Pmvalence of Asthma and Allergic Dieases in Croatian is increasing sun/ey study, Croatian medical journal vol 45 Noi, 721-726.
7. Szefler S., Pedersen S. (2006): 'Childhood Asthma Edition'. Lung Biology in Health and Disease, vol 209, London, Taylor & Francis.
THUC TRANG SllTDUNG DICH VU T I T V A N XET NGHIEM HIV TRONG THCH KY MANG THAI CUA PHU NOTMCri SINH CON TAI RENH VIEN OA KHOA TINH BINH OINH NAM 2013
N G U Y I N THI H A I N A M - Trung tim PC HIV/AIDS tinh Binh Djnh D6 M A I HOA - Trudng Dal hgc Y ti'cong c^ng PHAM BCTC MANH - Cgc Phdng, chdng HIV/AIDS TOM TAT
TU van xit nghiem HIV (TVXN HIV) ddng vai trd quan trgng tmng chuang trinh du phdng liy tmyin HIV tdme sang con (PLTMC) mdt dieh vu trgn gdi hd trg, diSm sdc va diiu tri phu nO mang thai (PNMT) nhiim HNvitreem sinh m tdme nhiim HIV. Chung tdi tiin Mnh nghiin cOu dt ngang md ti thuc tmng sd dung dfch vu TVXN HIV cQa PNMT tai Binh Dinh nhim dua ra khuyen nghi xiy dung mdt chuang trinh PLTMC phii hop tren dja bin tlnh nim 2013. Dii tugng nghiin cOu
^TNC) li 300 sin phu sau khi sinh con tai khoa Sin B^h vien da khoa tlnh Binh Dmh. Kit qui nghiin cOu cho thiy: Ndi ding kp quin ly thai nghen cQa DTNC t§p tmng nhiiu nhit ii tai phdng kham tu nhin (48,7%), ki tiep li tai Tram Y ti (17%,); tp li DTNC duac tu vin (TV) tntdc xit nghiim (XN) rit thip (22,7%) vi tp li DTNC lim XN HIV tmng thdi gian mang thai cdn thip (39.3%,). gin mdt nQa trong si hg (42,4%) khdng duac tu vi'n trudc XN. Nguyin nhan Wang lim XN HIV khi mang thai chQ yiu li do khdng bat phai lam XN (52,9%,), khdng duac di nghj lim XN (24,4%) vi cd 22,7%, DTNC cho ring minh khdng cd nguy ea nhiem HIV; Chl cd 18,3%, sd dung dich vu TVXVHIV(JVtnJdcXN.XNHIV, TVsauXN).
Tdkhda: HIV, phu nOmang thai, ti/van xit nghiim HIV
SUMMARY
HIV Testing and Counseling (HTC) plays very imporiant mies in HIV Prevention Mother to Child Transmission (PMTCT) and is an important component in the service packet of tmatment, care snd support for HIV positive pregnant women and tiieir baby. We conducted a cmss-sectlonal study
describing the situation of HTC service use among pmgnant women in Binh Dinh in 2013 in order to make meommendatlons for improving the PMTCT in this province. Study subjects wem 300 post-childbirth women in the Obstetric Department of the Binh Dinh General HospitaL Findings shows that majonty of pregnant women went to private clinics for their pregnant management (48.7%o), next to commune health station (17%); low pementage of pmgnant women receiving HIV pm-test counseling (22.7%,);
low percentage of pmgnant women receiving HIV test during their pregnant (39.3%o). of those, half did not received HIV pre-test counseling (42.4%o). Reasons for not taking HIV test are they did not know that they should take it (52.9%), they were not recommended for HIV test (24.4%,) and 22.7%, subjects expressed that they have no risk of HIV infection; only 18.3%, use completed HTC services including pm-test counseling, test, and post-test
Keywords: HIV, pregnant women. HIV Testing and Counseling.
B^T VAN Di
6 Viet Nam, Udc tinh ed khoang 4.800 PNMT nhilm HIV va khoang 5.700 tre nhilm HIV vao nam 2012[7]. Tu vd'n xet nghidm HIV la mdt trong nhdng djch vu quan trong cilia ChUdng trinh PLTMC, djch vu da dudc trien khai tren pham vi toan qudc ndm 2007 vd dudc hb trp bang nhdng chinh sach, phap luat va chien lUdc qudc gia, nham tao dieu kien cho PNMT dudc tu van HIV/AIDS va phat hien tinh trang nhilm HIV sdm de dudc cham soc va dieu trj PLTMC. Nhung d Viet
V HOC THI/C HANH (878) - SO 8/2013
