NGHIEN CUU DENH VIEM XOANG 0 DAN TOC E DE -DAK LAK
OAT V A N O ^
Cdc bpnh viem mui xoang (VMX) tdi di tdi Igi v l n edn Id noi dm anh cho benh nhdn vd Id v l n d l md thiy thude TMH phai ddi mat. Tir trudc tdi nay da cd nhilu cdng trinh nghien ciru (NC) bpnh viem xoang: d Dire viem xoang mgn tinh (VXMT) rit cao, khoang 5% cpng ddng ddn cu. Tan xuit VMX mgn d chdu Au udc tinh 5% vd sd lln khdm bpnh do viem xoang elp tinh (VXCT) g i p 2 lln VXMT. Nhirng NC d Hoa Ky trong thap nien gin nhit, VMX tang len. Nam 1997 d Hoa Ky viem xoang (VX) trong cpng ddng Id 15%, thipt hai hang nam khoang 2, 4 ti ddla.
Myc tieu eiia d l tdi: nghien ciru ty lp viem xoang d cdng ddng ddn tdc £ De.
D 6 | TU'O'NG VA PHLCONG P H A P NGHIEN CLCU Ddi tupng nghien eiru: cpng ddng ddn tpc £ Oe tinh Dak Lak.
Thdi gian nghien eiru tir thdng 1/2008- 5/2010.
Phuong phdp nghien ciru:
Thilt k l nghien ciru: la 2 nghien eiru d t ngang d l xdc djnh ty lp dang mde d cpng ddng ngudi dan tpc £ Oe: nghien ciru d t ngang thir nhit vdo miia mua, thir hai vdo miia khd
Cd miu; nghien ciru ngang dupe thyc hipn tren nhirng ngudi hipn ed mgt trong quin thi.
+ Cd mdu nghien eiru (n) dupe tinh theo d n g thu'c sau;
n - Z pq
Vol p gia djnh mde bpnh viem mui Id 0,5 => n= 385.
Thyc t l chiing tdi khdm 6760 ngudi Cdch thirc chpn mdu: ehpn ngau nhien, mau phan ting vd mau chiim.
Phuong tipn thdm khdm; mdy npi soi TMH, XQ phim Blondeu, Hirtz
sd lipu thu thgp dupe se dupe phdn tich xii' ly tren Epi-info 6.0.
K^T QUA VA B A N LUAN
1. Cdc yeu td lien quan vd'i viem xoang cdp tinh (VXCT)
Bang 1. So sdnh bpnh viem xoang d p tinh theo miia
Theo mua Mua Kho Mua Mua
Viem xoang cSp tinh n
6 1
%
0,42 0,07
Tong s6 khdm
1425 1425
OR_CI 95%
6,02 (0,72- 50,07) Nhgn xet: khdng cd sy khde bipt giii'a miia khd vd miia mua (p>0,05).
Miia mua VXCT 0,1%, miia khd 0,4%, OR_CI 95% = 6,02 (0,72- 50,07).
Bang 2. So sanh bpnh viem xoang cap tinh theo gioi
Gidi Nam Nu
Viem xoang cap tinh n
3 4
%
0,26 0,24
Tong so khdm
1158 1692
OR_CI 95%
1,04(0,12- 3,79)
PHUNG MINH Ll/ONG, Bg mon TMH, Dai Hgc Tiy Nguyen
Nhgn xet; khdng cd sy khac bipt gitra nam vd nir trong bpnh viem xoang d p tinh (p>0,05), (x^=0,11; bgc tu do = 1). Nam cd ty le viem xoang d p tinh 0,50%, Nu 0,50%; OR_CI 95% = 1,04 (0,12- 3,79).
2. Cac y l u td lien quan vd'i viem xoang mgn tinh (VXMT)
Bilu dd 1. dgc dilm mac benh VXMT theo miia Nhgn xet; ty lp d miia kho; VX trudc mgn tinh 31,7%;
VX sau mgn tinh; 44,4%. Miia mua: VX trudc mgn tinh Id 42,6%; VX sau mgn tinh Id 49,7%.
Bang 3. Dgc dilm cac bpnh viem xoang mgn tinh ViSm xoang
Viem xoang trudc mgn tinh Viem xoang sau man tinh
Vidm da xoang mgn tinh n 44 55 19
%
37,29 46,51 16,10
T6ng s6 kham 2850
Nhgn xet; Viem xoang trudc mgn tinh 37,29%, Viem xoang sau mgn tinh cao nhit 46,51%, viem da xoang mgn tinh thip nhit 16,10%.
Bang 4. So sanh cde bpnh VXMT theo miia Miia
Miia khd Mua mua
P
VX Trudc man tinh n 20 24
%
31,7 42,6
VXSau mgn tinh n 28 27
%
44,4 49,1 0,04
Vi6m (Ja xoang mgn tinh n 15 4
%
23,9 7,3
Nhgn xet; cd sy khac bipt giira 2 mtia (p<0,05), (X^=6,237; bgc ty do = 2).
Miia khd viem xoang trudc mgn tinh 31,7%; viem xoang sau mgn tinh 44,4%; viem da xoang mgn tinh 23,9%.
Miia mua viem xoang trudc mgn tinh 42,6%; viem xoang sau mgn tinh 49,1%; viem da xoang mgn tinh 23,9%.
Bang 5. So sdnh dgc dilm bpnh VXMT theo gidi
Gib'i Nam NCr
Viem xoang mgn tinh n 54 64
%
4,53 3,85
T6ng s6 khdm
1158 1692
OR_CI95%
1,18(0,80-1,74)
Nhgn xet; khong cd sy khac bipt giira Nam va Nir trong viem xoang mgn tinh (p> 0,05), x^= 0,81, dd ty do
= 2). Nam gidi cd ty lp viem xoang mgn tinh 4,53%; Nu gidi 3,85%. OR_CI95% = 1,18 (0,80 -1,74^
80 Y HOC THl/C HANH (755) - S6 3/2011
DTrT«>c a Sau DOa xoang
Bieu do 2. dgc diem mde bpnh VXMT theo gidi d miia mua
Nhdn xet: nam: VX trudc mgn tinh 35,5%; VX sau mgn tinh 45,2%. Q nO-: VX trudc mgn tinh 40,6%; VX sau mgn tinh 50%.
Bang 6. So sdnh bpnh VXMT theo tudi Nhbm tu6i
NhS tre miu gido Ti6u hoc Trung hoc co so Trung hoc ph6 thOng
Tu6i truong thdnh Cao tu6i
Viem xoang man tinh n
4 41 21 10 36 6
%
0,78 6,33 5,41 6.02 3,72 3,53
Tong s6 khdm
512 648 388 166 965 171 Nhgn xet: khdng ed s y khdc bipt (x^=26,01; bgc t y do = 5), dp tin cgy 95%.
Nhdm Nhd tre m l u gido ty lp thap nhat; nhdm T i i u hpe eao nhat 6,33%.
Cdc y l u td anh hudng tdi bpnh viem xoang bao gdm cdc yeu td ngheo ndn, Igc hgu, ehgm phat triln, vp sinh moi trudng kem, nude thai, rdc thai khdng dupe thu gom xij ly. 0 nhiem khdng khi trong nhd, lao dpng ngng nhpc trong dieu kipn tdi tdn, Ige hgu, d n h i l m . Nhu'ng
thay ddi v l vi khi hdu noi d , noi lam vipc cd anh hudng Idn d i n sire khde vd ndng s u i t lao dpng, gay cac benh theo miia, thdi tilt.
0 nhiem khdng khi noi d , noi Idm viec, xu ly c h i t thai, thai ra khdi byi, hoi khi dpe, edc logi vi khuan nam mde gdy benh Idm gia tang benh viem xoang.
K^T LUAN
Ty lp viem xoang tgi cpng ddng dan tpc £ De Viem xoang e l p tinh 0,2%. Viem xoang man tinh 4,77%.
- Cde y l u td lien quan vdi viem xoang:
Miia khd: Viem xoang trudc mgn tinh 31,7%. Viem xoang sau mgn tinh 44,4%.
Miia mua: Viem xoang trudc mgn tinh 42,6%. Viem xoang sau man tinh 49,7%.
SUMMARY
Factors affecting sinusitis factors include poverty, backwardness, slow development, poor environmental sanitation, sewage, garbage collection is not processed.
Indoor air pollution, hard work in shabby conditions and backward contamination. Changes in microclimate in place, work can affect health and labor productivity, causing the disease seasonal weather.
Air pollution in place, work, waste treatment, emissions of dust, toxic gas, mold, bacteria that causes sinusitis increased.
The rate of sinusitis in Ede ethnic communities.
Acute Sinusitis 0.2%. 4.77% chronic sinusitis.
Keywords: sinusitis TAI LIEU THAM KHAQ
1. Nguyen Hiru Khdi (2005), Phau thupt ngi soi mui xoang, nhd x u i t ban dgi hpc qudc gia tp HCM, tr: 1- 83.
2. Nguyin Tdn Phong (1999), Phau thupt ngi soi chirc ning xoang, nhd xuat ban Y Hpc, Ha Npi, tr: 7- 200.
CAC YEU TO ANH HlATNG DEN TAI HEP TRONG STENT SAU CAN THIEP Of CAC BENH NHAN NHOI MAU CO TIM CAP
N G U Y I N Q U O C T H A I , N G U Y I N L A N VIET.
Vipn Tim mach Vipt Nam- Bpnh vipn Bpch Mai.
TOM T A T :
Myc tieu: Nghien cdu cic yiu to inh huong din til hpp trong Stent sau can thipp a nhOng BN bj NMCT (nhoi mau ea tim) cip.
Phwong phip va doi twgng nghien ciru: Nghien ciru dya tren phin tich 97 BN (bpnh nhin) NMCT cip tronq dd 54 tnr&ng hgp duoc can thipp bing Stent phu thuoc Simlimus (SES) vi 43 tnr&ng hgp dwgc can thipp bing Stent thuong (BMS), chyp Ipi DMV 12 thing sau khi can thipp (28 ca til hpp tmng ton thuong vi 69 ca khdng tii hpp).
Kit qua: Cic yiu td tien Iwgng dgc Ipp cua tai hpp DMV sau can thipp li tang huyet ip (THA) v&i OR=2,64 (95%CI: 1,06-6,55; p=0,049), dgng mpch thu phpm li ddng mpch lien thit tmoc (DMLTT) OR=3,36 (95%C/.
1.21-9.31, p=0,03), ton thuong nhieu DMV (OR=3,47;
95%CI: 1,31-9,22; p=0.019), ton thuong can xl hda
(OR=4,27; 95%CI: 1,46-12,33; p=0,013) vi lopi Stent (OR=3,96; 95%,CI: 1,55-10,08; p=0,006).
Kit lupn: Tiin sir THA, DM thii phpm la DMLTT, ton thuong nhiiu DMV, ton thuong can xl hda vi can thipp bang Stent thuong li yiu to tien Iwgng dgc Ipp ciia til hpp.
Tir khda: Stent, nhoi miu ea tim SUMMARY
PREDICTIVE FACTORS OF IN-STENT RESTENOSIS AFTER PERCUTANEOUS CORONARY INTERVENTION IN ACUTE MYOCARDIAL INFARCTION
Objectives: Risk factors of In-stent restenosis in acute myocardial Infarction.
Methods: We pedomned a pmspective trial of 97 patients with acute myocardial infarction assigned to receive SES or BMS. At 12 months angiography follow-up.
we find out the pmdictive factor of mstenosis after PCI.
Y HOC THl/C HANH (755) - SO 3/2011 81
