service provision staff, and treatment of side effects in order to limit withdrawing rate of using DMPA found in this research was 18.5%.
Key words: DMPA, situation of use, withdrawing rate, side effects, contraceptive injections, A Luoi district
CAI NGHIEN HUT THUOC LA VA CAC HANH VI TIM KIEM DjCH VU CHAM SOC SLPC KHOE O NHU'NG NGLfQI HUT THUOC LA
TAI VIET NAM
Lu'ang Ngpc K h u e \ Hoang Van Minh, Kim Bao Giang^
^Bo Y ti; ^Trudng Dai hpc Y Ha Noi
Nghien cwu nhim md ta thwc trang cai nghien hiit thuoc la a ngwdi Viet nam va md ta hanh vi tim kiem dich vu cham soc sii'c khoe a nhi>ng ngudi hiit thuoc la tai Viet Nam. Thiit ki nghien cwu: Mo ta cat ngang. Doi twang: Tat ca nam va nCr tudi tW 15 trd len.tai Viet Nam. Kit qua: 55.3% ngwdi hiit thuoc la da cd nd Iwc bd thude. Trong sd 27.2%
nhung ngudi hut thude la tim din can bo y ti trong nam qua chi cd 34.9% dwac hdi vi tinh trang hiit thude hay khong va 29.7% dwac can bo y te khuyen bd thude. Ty le bd thude (tire ty le phin tram nhung ngudi da twng hut thuoc hang ngay hien nay khong cdn hiit thude nira) la 23.5%.
Tir khoa: Cai nghien hut thuoc la, tim kiim djch vu y t§, Viet Nam, GATS
I.
OAT VANDE
Hilt thuoc la la hanh vi r i t pho b i i n d ngudi Viet Nam. Theo k i t qua cua dieu tra Y t i Qudc gia nam 2001-2002, ty le hut thuoc cua nhO-ng ngudi tCr 15 tuoi trd len la 5 6 , 1 % d nam gidi va 1,8% d nO- gidi [1], Can day, cac hoat dpng phdng chdng t h u i c la (PCTHTL) d Viet Nam da va dang nhan dugc s u quan tam cua toan xa hpi. Cam k i t quoe gia v i PCTHTL dugc the hien trong Nghj q u y i t cua Thu tudng Chinh phu so 12/2000/NQ-CP v i "Chinh sach Qudc gia ve PCTHTL giai doan 2000-2010"
dugc thuc hien bdi mpt Uy ban do Bp trudng Bp Y t i dii-ng dau, vdi cac thanh vien tir hau h i t cac bp (bao gdni ca Bp Cdng thuang va Bp Tai chinh) va cac to chCrc doan t h i . Viet Nam ky cdng u d c khung v i phong chong thuic la vao ngay 08/8/2003 va phe chuan cdng udc khung vao ngay 17/12/2004, Nam 2007, Chinh phu ban hanh Chi thi so 12/2007 CT-TTg v i tang cudng cac hoat dpng PCTHTL d Viet Nam, trong do n h i n manh vai trd cua sau bien phap chinh: 1) d i y manh cdng t i e giao due sCrc khoe ve anh hudng cd hai cua viec sCr dLing thude la; 2) thuc thi nghiem lenh cam hut thuoc tai cac nai lam viec va nai cdng cpng trong nha; 3) ap dung canh bao sCrc khoe tren bao thude
la (chiem 30% dien tich mat bao chinh); 4) kiem soat nghiem viec kinh doanh thuoc la; 5) cim quang cao, khuyen mai va tai trg cua cac cong ty thude la; va 6) tang thud thude la. Chi thi nay hien dang d u g c thuc thi d u d i s u chi dao cua Bp Y te vdi s u tham gia cua h i u h i t cac bp nganh va cac to chu-c doan the tai Viet Nam [2].Gin day, ngay 21/8/2009, Thu tudng Chinh phu da ban hanh Q u y i t dinh so 1315/QO-TTg v i viec Phe duyet Ke hoach Hoat dpng n h i m Thuc thi Cdng udc Khung v i Kiem soat Thude la. Kd hoach hoat dpng nay cung cap npi dung, ljch trinh va phan cdng trach nhiem cho cac ca quan cd lien quan trong viec xay dung va tuyen truyen cac van ban phap luat trong nude de dap u-ng yeu c i u cua cdng udc khung [3].
Hut thude la la hanh vi tuang ddi kho thay doi va s u ho trg doi vdi ngudi bd thude d i giiip hp cai hut t h u i c la het sCrc c i n thiit. Hien tai, Viet Nam chua cd nhieu c a sa y t i cd cung c i p cac dich vu ho trg cai hut thude. Oe cung cap cac bing chCrng khoa hpc cho viec xay dung k i hoach phit trien cac dich vu cai nghien hut thude la, nghien ciru nay n h i m muc tieu: 1) Md ta thuc trang cai nghien hut thude d ngudi Viet nam; 2) Md ta hanh vi tim k i i m dich vu cham sdc sCrc khde d nhu-ng ngudi hiit
thuic l i tai Viet Nam.
| | . D 6 I
TU'QNG VA PHU'QNG
P H A P' Doi twong nghien cwu: Oiiu tra GATS d Viet Nam duge thiit k i dudi dang mdt dieu tra dai didn quoe gia cua toin bd nam va nu- tuoi tir 15 trd len khdng sing trong cie ea sd t i p trung.
* Thiit ki nghien cwu: Nghien eCru md ta c i t ngang
*D/a diim nghien cwu: Toin bd 63 tmh/thinh tai Viet Nam
* C& mau va chon miu: Theo thiit k i chpn miu cua diiu tra GATS, miu c i n cd 8000 ngudi de du dp tin eiy cho udc tinh dugc sd lieu theo cac biin sd ea ban v i gidi v i khu vue thanh thj/
n6ng thdn. Dua vio eic diiu tra hd gia dinh qudc gia tuang ty trude diy, chung tdi gia su- ring ty Id ddi tugng khdng phu hgp va khdng tra Idi la 35%.
Sau khi tinh din ty Id tra Idi, quy md miu cudi cung la 11.142 hd. Cd 9.925 cude phdng van hoan thanh dai dien cho khoang 64,3 trieu ngudi trudng thanh tir 15 tuoi trd len d Viet Nam.
* Thu thap sd lieu: Tong cue Thing ke to chCrc thu thap sd lieu vdi su tham gia giam sit eua To chirc Y t i Thi gidi, VINACOSH v i trudng Oai hpe Y Ha Npi.
* Quan ly, xip ly v i phin tich sd lieu: Phan mem SPSS 17.0 dirge su- dung de tinh quyin so vi lap bang bieu. Phuang sai duge tinh sau khi d i hi§u ehinh theo phuang phap lay mau phirc tap cua cude diiu tra. Phuang phip tuyen tinh hda cua Taylor dugc su- dung trong SPSS de tinh phuang sai miu.
ill. K^T QUA
* Thye trang cai nghien hut thude l i
Nhu-ny ngudi hut thuoc ed nd lye cai nghier, hut thuic l i bao gdm nhung ngudi dang hut thude ed c6 ging cai nghidn trong 12 thing qua v i nhu-ng ngudi trude diy hut thuoc da ngCrng hut dugc du-di 12 thing. Trong sd nhCrng ngudi dang hut thuic v i nhO-ng ngudi trude diy hut thuoc nhung di khdng hut thude duge dudi 12 thing, 55,3% da c6 no lye cai nghien trong 12 thing qua. Ty Id niy 0 nam l i 55,6% v i d nu- l i 44,4%. Ba trong sd nim ngu-di hut thuoc tuoi tCr 15 24 d i ed nd lye cai nghidn (60,5%), ty Id niy giam din khi tuoi ting len vi chi edn 47,7% d nhung ngudi hut thuoc thude
TCNCYH Phu trwong 74 (3) - 2011
nhdm tuoi 65 trd len. Han mdt nu-a sd ngudi hut thuoc sdng d thinh thj (51,9%) v i ndng thdn (56,7%) da cd no lye cai nghien. Tinh theo trinh dp hpc vin, nhCrng ngudi hut thuoc trinh dp tiiu hpe hoic thip han ed ty Id nd lye cai nghien thip nhit (46,1%), trong khi ty Id niy tuang ddi gidng nhau d cie nhdm trinh dp hpc vin khic. Theo nghi nghidp, 2/3 sd nhin vien van phdng (66,7%) d i ed nd lye cai nghien so vdi 2/5 nhirng ngudi lim nghi lam nghiep/ngu nghiep (41,1%) da ed no lye cai nghien (Bang 1).
* Sw dung dich vu y ti
Ty le din ein bd y t i trong so nhirng ngudi hut thude la trong 12 thing qua l i 27,2%. Han 1/3 nu- hut thude (36,1%) va 1/4 nam hut thude (26,9%) d i tim den can bp y t i trong 12 thing qua. NhO-ng ngudi hut thude tuoi tCr 65 trd len ed ty Id din tham cin bp y te cao nhit (49,8%), ty Id nay khdng thay doi nhiiu giu-a cac nhdm tuoi khic. Ty Id din ein bd y t i eua nhu-ng ngudi hut thude d thinh thj l i 30,3%
so vdi 25,9% d vung ndng thdn. Theo trinh dp hpe vin, nhung ngudi hut thude ed trinh dp cao ding trd len ed ty Id den can bp y t i cao nhit (41,6%), trong khi ty le din can bd y te thap nhit d nhCrng ngudi tot nghiep trung hpc ca sd (24,0%). Theo nghi nghiep, ty le din ein bd y t i trong 12 thing qua dao dpng tir 45,7% d nhirng ngudi lim nghi quan ly/ehuyen mdn xudng 20,8% d nhCrng ngudi thude nhdm "nghe khic" (bang 2).
* Dwoc can bo y ti hdi ve hanh vi hut thuoc la Trong sd nhirng ngudi hut thude da din can bd y t i trong 12 thing qua, 34,9% duac hdi ve tinh hinh hut thude la. Han 1/3 ngudi hut thude nam (35,6%) v i 1/4 ngudi hut thude nu- (25,6%) dugc cin bd y te hdi v i hanh vi hut thuoc. Theo nhdm tuoi, ty le nay cao nhit dugc quan sit thiy d nhdm tuoi 45 - 64 (47,5%). Ty Id niy d thinh thj l i 40,9%
v i d ndng thdn l i 31,8%. Theo trinh dp hpe van, nhCrng ngudi hut thude ed trinh dp trung hpe pho thdng trd len cd ty Id duge hdi v i hinh vi hut thude cao nhit (47%), trong khi ty Id niy d nhung ngudi hut thude ed trinh dp tieu hpe hoic thip han v i tot nghiep trung hpe ea sd lan lugt l i 36,9% v i 33,3%. Theo nghi nghidp, ty Id duge hdi v i hinh vi hut thude dao dpng tir 40,7% d nhdm sin xuit v i lii xe din 27,9% d nhdm nghi xiy dyng v i khai md (bang 2).
'Bang 1. Ty le nhu-ng ngu'd'i hut thude tudi tip 15 trd' len da co nd lire bo thude trong 12 thing qua theo mpt s6 d i e diim nhan khiu hpc
Cac die diim nhan khiu hpc Chung
% 55,3
Khoing tin cay 95%
(52,5 - 58,0) Gidi
Nam Nu
55,6 44,4
(52,9 - 58,3) (30,1 -59,6) Tudi (nam)
15-24 25-44 45-64 65+
60,5 55,2 54,2 47,7
(51,6-68,8) (51,6-58,7) (49,9 - 58,5) (39,4-56,1) Khu vyc cu tru
Thanh thi Ndng thdn
51,9 56,7
(48,4 - 55,4) (53,0-60,3) Trinh dp hpe vin
Tieu hpe hoac thap han Trung hpc ca sd Trung hpc pho thdng Cao ding trd len
46,1 56,2 59,0 56,2
(40,1 -52,2) (52,7 - 59,6) (52,3-65,4) (49,4 - 62,8) Nghe nghiep
Quan ly/Chuyen mdn Nhan vien van phdng Djch vu/Bin hing Ndng nghiep
Lam nghiep/Ngu nghiep Xay dung/Khai md San xuit/Lai xe Khac
60,3 66,7 49,7 55,0 41,1 60,5 56,5 54,3
(50,9-68,9) (46,8 - 82,0) (42,5 - 56,9) (50,4 - 59,5) (27,3-56,5) (51,6-68,7) (49,7-63,1) (39,8-68,1)
TCNCYH Phu trwong 74 (3) - 2011 Bang 2. Hinh vi tim kiim djch vu cham sdc sii'c khde d- nhipng ngu'ai hut thude l i
trong 12 thing qua theo mpt sd die diim nhan khiu hoc Du'ac hdi xem cd
Cac die diim nhan khiu hpc Din gap cin bd y t l ^^.^'' '^ "9""^' ''"* ^^^." '^' ^^""^^^ ^°
thude khdng bd-i cin thude tip can bd y t l boy t l
Chung 27,2 (25,0-29,5) 34,9 (30,9-39,1) 29,7 (25,8-34,0)
Gidi Nam NO-
26,9 36,1
(24,7 (25,2
-29,2) -48,6)
35,3 25,6
(31,2 (11,8
-39,7) -46,7)
30,2 20,3
(26,1 (8,1 -
-34,5) 42,4) Tuoi (nim)
15-24 25-44 45-64 65+
26,3 24,1 28,6 49,8
(20,1 (21,3 (25,0 (41,2
- 33,7) -27,1) -32,5) -58,3)
16,8 32,5 47,5 32,6
( 8 , 7 - (26,7 (40,2 (22,8
30,0) -38,8) -54,9) -44,3)
14,9 28,3 39,6 27,3
(7,3- (22,7 (32,5 (18,3
28,2) - 34,6) -47,1) -38,6)
• Khu vyc cu tru Thanh thj Ndng thdn Trinh dp hpc v i n
Tieu hpe h o i c t h i p han Trung hpc ca s d Trung hpc pho thdng Cao d i n g trd len
30,3 25,9
28,4 24,0 33,1 41,6
(27 4 (23,0
(23,5 (21,2 (26,8 (34,9
-33,4) -28,9)
- 34,0)
•27,1) -40,1) -48,7)
40,9 31,8
36,9 33,3 47,5 47,1
(35,2 (26,7
(28,2 (27,8 (34,9 (37,2
-47,0) - 37,4)
-46,6)
• 39,4)
•60,3)
•57,2)
33,8 27,7
28,9 28,1 45,9 37,4
(28,2 (22,8
(21,1 (22,8 (33,5 (28,0
-39,8) -33,4)
-38,1) - 34,0) -58,9) -47,8) Nghe nghiep
Quan ly/Chuyen mdn Nhan vien van phdng Djch vu/Ban hang Ndng nghiep
L i m nghiep/Ngu nghiep X i y dyng/Khai md San xuat/Lai xe Khic
45,7 40,0 23,5 25,7 26,8 21,7 25,0 20,8
(36,9 (22,4 (18,2 (22,4 (16,1 (15,1 (19,8 (10,9-
-54,8) -60,6) -29,8)
•29,4)
•41,2) -30,2) 31,0) 36,1)
34,0
~ 36,8 33,8
- 27,9 40,7
-
(23,9
(24,3 (27,1
(16,7.
(28,7 -45,8)
-51,5) -41,2)
42,6) 54,0)
26,8 - 29,2 29,9
- 25,4 35,1
-
(18,0
(17,8 (23,6
(13,9 (23,9
•38,0)
-44,0)
•37,0)
42,0)
•48,1)
* Nhan dwgx: l&i khuyen cai thuoc la tw ngwdi cung cap djch vu CSSK
Ty Ip nhan dugc Idi khuyen cai thude tir can bp y te dugc djnh nghTa la ty Id nhirng ngudi dang hut thuoc v i mdi cai thuoc (< 12 thing) da tim den mpt bac si hay mdt ngudi cung cap djch vu CSSK trong 12 thing qua v i duge khuydn nen bd hut thude. it hon mpt phin ba so ngudi hut thuoc va mdi bd Ihu6c (29,7%) nhin dugc Idi khuyen bd thude cua c^n bd y t i trong 12 thing qua. Ty le nhin Idi khuyen
nen bo thuoc cua can bd y te d nam gidi la 30,2%
va d nir gidi la 20,3%. Ty le nhin dugc Idi khuyen bd thude theo cac nhdm tuoi dao ddng tir 39,6% d nhom tudi 45 60 xuong 14,9% d nhdm tuoi 15 24.Ty le nay cho nhCrng ngudi hut thuoc d thanh thj la 33.8% va d ndng thdn la 27,7%. Theo trinh dp hpe van, ty le niy tCr 45,9% d nhu-ng ngudi hut thude tdt nghiep trung hpc pho thdng xudng 28,1%
d nhCrng ngudi hut thuoc tdt nghiep trung hpc ea sd.
Tinh theo nghi nghiep, ty le nhan duge Idi khuyen
bd thuoc dao ddng trong khoang tir 35,1% d nhdm nghi san xuat va lai xe xuong d i n 25,4% d nhdm nghi xiy dung v i khai md (Bang 2).
IV. BAN LUAN
Cdng udc Khung Diiu 14 khuyin nghj cac ben thuc hien eic thye hanh tot nhit de khuyen khich cai'nghien thude l i va thye hien cac lieu phap diiu tri nghien nicotine trong Dieu 14 v i "Cie bien phap giam ciu lien quan din cai nghien thuoc la" [4].
MPOWER cung nhin manh ring "Cung cip ho trg cai nghien thude la" khuyin nghj ba loai diiu tri cai nghien thuoc l i : (I) tu vin cai nghien thude la duge kit hgp vao eic djch vu chim sdc su-c khde ban dau; (II) d i dang tiip cin vdi cac dudng dien thoai tu vin bd thude miin phi; va (III) tiip can vdi lieu phap dugc ly chi phi thap [5].
Oiiu tra GATS Viet Nam 2010 cho thiy 55,3%
da ed nd lye bd thude trong 12 thing qua. Chi 27,2% nhu-ng ngudi hut thuoc tim den can bd y t i trong nam qua, trong dd, chi co 34,9% duge hdi hp cd hut thuoc hay khdng va 29,7% dugc tu v i n bo thuoc. Ty le bd thuoc (ty le phin tram cua nhu-ng ngudi da tCrng hut thude la hang ngay nhung hien nay khdng hut nira) l i 23,5%.
Cac phat hien cho thay nhu-ng dich vu diing d i dieu trj cai nghien thude la khdng d i tiep can vdi nhu-ng ngudi hut thuoc Viet Nam. Oiiu dd cho thiy tu van cai nghien khdng phai la mdi quan tam eua hiu hit nhirng can bp y te. Tren thye t i , Viet Nam chua cd mpt dudng dien thoai tu van bd thude mien phi nao cua qudc gia v i cac dich vu hd trg cai nghien thude chi dugc cung cap d mpt sd it benh vien chCr khdng cd d cac ca sd y t i cham sdc sCrc khde ban diu va cdng dong. Nhu-ng can bd y t i d cap cao trong he thong cham sdc sCre khde thudng phai thye hien ginh nang cdng vide vdi sd lugng benh nhan rit Idn, trong khi nhu-ng can hp y t i tai cac ca sd y t i cham sdc su-c khde ban dau chiu it sCre ep cdng viec han lai khdng dugc dao tao day du de nhan thu-c dugc t i m quan trpng cua vide tu vin ve kiem soat thude la va chua cd kha nang cung cap djch vu cai nghien thude la cho ngudi hut thuoc [6].
Nhu-ng phat hien nay the hien tinh cap thiet phai cd cac djch vu cai nghien thuoc la hieu qua d cie phdng khim va thuc hien eae dudng day hd trg cai
nghien thude la. Cie bien phap hd trg djch vu cai nghidn thuoc la d Viet Nam duge quy djnh ro rang trong Quyit djnh sd 1315/QO -"ITg eua Chinh phu nhu sau: "Tiip tue xay dyng va thye hien hieu qua cie chuang trinh cai nghien thuoc la. Oa dang hoa eae hinh thCre tu v i n cai nghien thude l i ; Hoat ddng hd trg cai nghien thude la phai dugc ling ghep trong cac chuang trinh, ke hoach v i chiin luge v i y te va giao due qudc gia vdi sy tham gia cua cac can bp y t i , can bd giao due v i can bp tai cdng ddng; Cho phep san xuat, nhip va su- dung eic thude dieu trj cai nghien thuoc l i vdi chinh sach thui uu dai theo quy djnh hien hinh cua Nha nude; Day manh cdng t i c nghien cu-u khoa hpc va Crng dung cac phuang phip cai nghien phii hpp vdi dieu kien kinh t i , xa hdi cua Viet Nam; v i Tao ngudn kinh phi de phat triin cac dich vu hd trg cai nghien thude l i tir ngin sach nhi nude, nguon tai trg qudc t i v i ddng gdp cua ngudi din dudi hinh thu-c vien phi va bao hiem y t i . " [7].
V. KET LUAN
55,3% ngudi hut thude da cd no lye bd thuoc Trong sd 27,2% nhO-ng ngudi hut thude tim din can bd y te trong nam qua chi cd 34,9% dugc hoi v i tinh trang hut thude hay khdng va 29,7% dupe can bp y t i khuyen bd thude. Ty le bd thude (tCrc ty Id phin trim nhirng ngudi da tirng hut thuoc hang ngiy hien nay khdng edn hut thude nira) la 23,5%.
TAI LIEU THAM KHAQ
1. Ministry of Health (2003). Vietnam National Health Survey (VNHS), 2001-02. Hanoi: Ministry of Health.
2. The Government of Vietnam (2007). Direc- tive No 12/2007/CT-TTg of the Prime Minister on strengthening tobacco control activities in Vietnam.
3. The Government of Vietnam (2009). Decision N°1315/QO-"ITg of the Prime Minister,on Ratification of the Action plan for the Implementation of the WHO Framework Convention on Tobacco Control.
4. World Health Organization (2003). WHO Framework Convention on Tobacco Control. Geneva, Worid Health Organization.
5. World Health Organization (2008). WHO Report on the Global Tobacco Epidemic, 2008: The MPOWER Packaged. Geneva: World Health
Organization. .^
6. Vietnam Steering Committee on Smoking
TCNCYH Phu truxyng 74 (3) - 2011 and Health (2010). Evaluation of National Tobacco and Health (VINACOSH) (2009) Hanoi Medical Control Policy 2000 - 2010. Hanoi: Vietnam Steer- University: Pre-intervention assessment: Implemen- ing Committee on Smoking and Health. ' tation of regulations of Smoke-free environment
7. Vietnam Steering Committee on Smoking and legal documents on Tobacco Control Hanoi.
Summary
SMOKING CESSATION AND HEALTH CARE SEEKING BEHAVIORS AMONG SMOKERS IN VIETNAM
The current situation of smoking cessation and health-care seeking behaviors among smokers in Vienam.
Study design: Cross-sectional survey. Study subject: The GATS of Viet Nam was designed to be a nationally representative survey of all non-institutionalized men and women age 15 and older who considered Viet Nam to be their primary place of residence. Results: Also, tobacco cessation counseling appeared to not be a concern of most of healthcare providers. 55.3% of smokers had made an attempt to quit in the past 12 months. Only 27.2% of smokers had visited a healthcare provider in the past year and of those, 34.9%
were asked if they smoked and 29.7% were advised by the healthcare provider to quit. The quit ratio for daily smoking (the percentage of ever daily tobacco smokers who currently do not smoke tobacco) was 23.5%. Medical prescription and counseling services were used at very low rates among those who successfully quit smoking (0.3% and 3%).
Keywords: Smoking cessation, health - care seeking behaviors, Vietnam, GATS
KHAO SAT GIA TRj CUA PROTHROMBIN TRONG CHAN DOAN THIEU VITAMIN K Q TRE SQ SINH SQM
TAI BENH VIEN PHU SAN TRUNG U'QNG
a • • •
Cung Thj Thu Thiiy Trudng Dpi Hpc Y Ha Npi Khao sit gii tri ciia Prothrombin trong chin doin thiiu vitamin K d tre sa sinh sdm (tuin diu sau de) tai Benh vien Phu san Tmng Wang. Ddi tuvng: 331 tre sa sinh dwac sinh tudi thai tw 28 tuin trd ten tren ea sd sw ddng y tw nguyen ffiam ga nghien ciru ciia cac bi mp (331 tre cd 2 xdt nghiem ti le prothrombin va PIVKAII tmng tdng sd 400 tre ed xet nghiem pmthiombin Leal trir: Sa sinh bpnh ly: bpnh gan mit, thiiu yeu td ddng miu bam sinh. Me diiu tri cie thude anh hwdng den chuyen hoa vitamin K Phwang phap nghien eiri-Md ta tien cwu Kit qua: PIVKAII cd twang quan chat che vdi PT.
Ty 1$ prothrombin < 60% vi PTs > 14,4 giiy; Ty le prothrombin < 55,6%, vi PTs > 14 giiy ed gii tri trong chin doin thiSu vitamin K vdi Dp nhay khdng cao, nhung Dp die hieu, gia tri tien doin dwang tinh va gii tri tien doin im tinh cd the chip nhin dwvc. Kit lupn: Cd thi ip dung ty le prothrrombin a tre sa sinh dwdi ngwang binh thwdng trong chin doan thiiu vitamin K d nhung ca sd y ti khdng du dieu kien kinh te vi ky thuit di anh iwpng chit chi aim dpc hieu khi thiiu vitamin K li PIVKAII.
Keywords: Prothrombin, thiiu vitamin K
it qua binh rau, thiiu ngudn vitamin K npi sinh tir I.OAT V A N D & vi khuin rudt [4]. Vitamin K la mdt chit cdng tie Tre sa sinh ngay sau de, ty Id prothrombin v i cua enzym carboxylase cin thiit cho sy carboxyl cSc yiu to ddng mau giam do ehCre ning gan chua hda d i biin mdt protein ed goc glutamat (giu) tru'ang thanh se khdng ed du nguon dy tru- vitam.,i K, khdng ed ehCre ning ddng miu thinh mdt protein hoic do thiiu vitamin K vi ehung duge vin ehuyin cd gdc dcartjoxylglutamat (gia) cd tie dung ddng miu.