NGHIEN CCIU KHOA HOC
KIEN T H O C , T H A I DO VE NGUY CO HA DlTdNG MAU CUA NGUdi BENH DANG DIEU TRI DAI THAO DUOING TYP 2
ThS. D L / a N G VY D U Y E N ' , PGS.TS. NGUYEN THj BICH DAO^
l-Tntang Cao ding Yte Quang Nam;
2-Tnfang Dai hoc Y Dimx; TP HCM Ngurn thim dinh. TS D6 BINH XUAN
TdMTAT
Muc t i e u : Xac djnh m d c dp k i l n thdc, thai dp v l nguy c a ha du'dng mau (HOM) d ngipdi benh dang dieu tri dai thao d i f d n g (DTD) typ 2 va m l i lien quan vdi thdi gian chan doan DTD, tinh trang da b! HDM.
Phu'O'ng p h a p : Gdm 103 ngu-di benh du'p'c chan doan DTD typ 2 theo tieu chan ADA nam 2012 [3], dieu tri tai Benh vien Da khoa tinh Quang Nam t d 3/2013 - 5/2013.
Ket qua: Ty le ngu'oi benh nhan b i l t nguy co HDM la 56,3%; ty le ngu'di benh b i l t nguyen nhan d i n d i n HDM la 58,6%; ed tren 90% ngu'di benh cd thai dp cho rang c h l dp an udng, luyen tap phii hp'p la quan trpng de tranh nguy c a HDM; ty le ngu'di benh eo thai dp nhan b i l t cac trieu chdng sdm eua HDM, cung nhLf diing t h y c pham ehda n h i l u du-dng de XLP tri HDM nhe la quan trpng c h i l m 54,4%; CO 52,4% ngu'di benh cd thai dp luon mang thye pham ehda n h i l u du'dng trong ngiPdi d l x d tri HDM nhe. Cd moi lien quan gida thdi gian chan doan DTD, tinh trang da bj HOM vdi s y hieu b i l t v l nguy c a HDM cCia ngu'di benh; ddng thdi cd su' lien quan gida tinh trang da bi HDM vdi each x d tri HDM ciia ngu'di benh.
ABSTRACT
Objectives: Determine level of knowledge, attitude concerning hypoglycemic risk of patients with diabetes type 2 and relationship with duration diagnosed diabetes, hypoglycemic experience.
Population and M e t h o d : 103 patients are diagnosed type 2 diabetes basing on criteria for diagnosis of diabetes mellitus of ADA, 2012 [3] treating in Quang Nam hospital province from March, 2 0 1 3 t o May, 2013.
Results: The proportion of patients know related to hypoglycemic risk are 56.3%; the proportion of patients who know causes of hypoglycemia are 58.6%; larger 90% the proportion of patients who have attitude concerning the importance of appropriate diet and appropriate exercise to prevent hypoglycemic risk; the proportion of patients who have attitude concerning using food containing more glucose are to treat mild hypoglycemia, and ratio of patients have attitude concerning recognizing early symptoms hypoglycemia are important are accounted 54.4%; 52.4% patients who has attitude related to always carry food containing more glucose are the best rapid method to treat mild hypoglycemia. Has relationship between diabetes diagnosed time, hypoglycemic experience with understanding about hypoglycemic risk of patient; and has coordination between hypoglycemic experience with understanding about treating hypoglycemia in diabetes type 2 patients.
- ^ n * , DEU DUONG 31 I
N G H I E N C I J U KHOA HOC
IDATV^NOl
HDM d ngadi benh DTD la mpt v I n d l pho b i l n va cd the gay t d vong eho ngu'di benh. day la tac dung phy quan trpng khi d i l u trj. Mat khac, day eung ehinh la rao can cho viec dat muc tieu d i l u tn. B i l n chdng HDM gap d tat ca cac typ DTD, nhung dac biet du'p'c ehu trpng d OTD typ 2. Cho den nay phu'ang phap hieu qua nhat de han c h l HDM la phdng tranh. Va han ai het ehinh ngudi benh dong vai trd ehu dao trong phong tranh bien ehdng nay. Viec nay doi hdi ngu'di benh phai cd mpt k i l n thdc nhat djnh va thai dp dung v l b i l n chdng HDM
Vi vay, chiing tdi tien hanh nghien cdu " K i l n thdc, thai dp ve nguy ca HDM eua ngu'di benh dang dieu tn DTD typ 2". Vdi muc tieu:
1.1. Xac djnh mdc dp kien thde, thai dp ve nguy ca HDM d ngudi benh dang d i l u trj DTD typ 2.
1.2. Xac dinh moi lien quan giua k i l n thdc, thai dp v l nguy ca HDM vdi thdi gian chan doan DTD va tinh trang da bi HDM.
2. Bdi TlTdNG VA PHtfdNG PHAP NBHIlN Cmi
2.1. Doi tLi'O'ng nghien CLPU
Nhdng ngu'di benh du'p'c chan doan DTD typ 2 theo tieu chan ADA nam 2012 [3], dieu tri tai Benh vien Da khoa tinh Quang Nam trong thdi gian t d 3/2013 den 5/2013.
2.2. Phu-ang phap nghien cii-u Nghien edu mo ta c i t ngang.
2.3. Tieu chuan chpn benh
Ngu'di benh du'p'c chan doan DTD typ 2 theo tieu chuan ciia ADA nam 2012 d i l u tn tai Benh vien Da khoa tinh Quang Nam trong khoang thdi gian nghien cdu.
2.4. Tieu chuan loai trip
^Ngu'di b?nh nang hon me, ngudi benh cam dlec khong minh mSn v l tinh t h i n
2.5. Thu thap du' lieu
Dij' li^u du'p'c thu thap bang phu'ang phap phdng van tryc tiep ngu-di benh d y a vao bang
cSu hoi Igp san. So lieu du'p'c nh§p va x d ly tren phan m I m Medcalc 11.3.1.0.
3.KETQU^N6HIENCini
3.1. Cac dac d i e m c h u n g Bang 3 . 1 . Dac d i e m ve t u o i , g i d i Tuoi (nam)
Gioi {%)
X tSD Nam Nlj
63.03 ±10,62 56 (54,4%) 47 (45,6%) Bang 3.2. T h d i g i a n c h a n d o a n DTD cua nhom
n g h i e n ciJU
Tho'i gian chan doan (nam)
Gia trj Gia Trung vj nho trj \im
nhat nhat (25%) "•^"(^5%)
3.2. Cac kien t h d c lien quan d i n nguy cvHOM 3.2.1. Cac kien thwc eOa ngw&i benh ve nguy c c HDM
Bang 3.3. Cac kien thiipc cua ngu'di benh ve n g u y c c HDM
Kien thiFc Biet thong tin ve ctiam soc va dieu tr benh DTO
Biet nhOng iiru y ve thuoc dieu tri DTD Biet 6mc nguy co HDI^ khi diing thuoc dieu tn DTO
Biet dlKOC dinh nghia HDlyl Biet nguyen nhan HDIW (nhom bi4t ve nguy co HDM)
C6 95 (92,2%) 58 (56,3%) 58 (56,3%) 58 (56,3%) 34 (58,6%)
Khdng 8 (7,8%)
45 (43,7%) 45 (43,7%)
45 (43,7%) 24 (41,4%)
3.2.2. Ty le cac trieu chwng lam sang ngu^
benh nhan biet khi co biiu hien HDM Bang 3.4. Cac trieu c h i j n g lam sang thu'dng
gap d ngu'di benh HDM Cac trieu chi>ng Run; Hoa mit; H6i hop; Met moi;
Cam giac doi
Cam giac nong hoac lanh; H6n me;
Lu lin; Tai nhcrt
So lir^'ng
58 56
Ty t^ phin tram 56,3%
54,4%
I 32 %jtME»tU D U O t *
N G H I E N c i r u KHOA HOC
3.2.3. Cach xw tri cua ngwdi benh khi bj HDM
Bang 3.5. Cach XLF tri cua ngirdi benh khi b| HDM Cach xiF tri
U6ng hoac an thij'c an co nhieu diFong
Goi nhan vien y te Khong bilt
So lir^ng (n) 56 2 45
Ty le phan tram (%)
54,4%
1,9%
43,7%
3.2.4. Moi lien quan gii>a then gian chan doan DTD va sw hieu biet vi nguy cc HDM
Bieu do 3.1. MOI lien quan thai gian chan doan DTD va su hiiu biet vi nguy cc HDM.
3.2.5. Lien quan giwa tinh trang da HDM va sw hieu biet cua ngw&i benh ve HDM Bang 3.6. Lien quan giiVa tinh trang da bj HDM
vdi SLf hieu biet ve nguy c c , nguyen nhan va each x d tri cua ngirdi benh khi bl HDM
Uen quan Hieu biet v^ Co InguycoHDM f — "
Hieu biet ve Co nguyen nhan " , ^ g ~
' Tmh trang da • I HBM I I Co IKhong I 48 I 10 ,
24 45
IXiKtn'khibi HDM
GOI nhan vien yie 2 Q , Dung thLPC an nhi§u 46 I 10 ' .dugng , I I
3.3. Cac thai do lien quan den nguy c v HDM Bang 3.7. Thai dp cua ngu'di benh lien quan
den nguy c a HDM Thai do Benh nhan co thai do theo ddi du'ang mau thu'ong xuyen Benh nhan c6 thai do ve chl do an hop ly la quan trong Benh nhan cd thai dp we che do tap luyen, iao ddng phu hop Benh nhan co thai dd nhan biet tneu chung som cua HDM Benh nhan cd thai dd su dung thu'C pham chua nhigu du'dng Benh nhan cd thai do ludn mang thuc pham cd nhieu dudng
Co 84(81,6%) 94(91,3%) 98(95,1%) 56 (54,4%) 56 (54,4%) 54 (52,4%)
Khong 19(18,4%)
9 (8,7%) 5(4,9%) 47 (45,6%) 47 (45,6%) 49 (47,6%)
Khong b 43
4. BAN I U A N 4.1. Cac dac diem chung
Do tuoi trung binh cua nhom nghien CLPU la 63,03 tuoi. Dp tuoi nay nho hon nghien eiJu eua N g u y i n Thi Bich Dao [1] va tipong dLrong vdi do tuoi trong nghien eCru eua Zubin Punthakee[10].
Tuoi cao cung la mgt yeu td nguy co cua HDM.
Hon nua, kha nang nhan biet cac trieu chiing sdm cua HDM a ngwai cao tuoi kem nen ho rat d^ chuyen sang HDM nang neu khdng xi> tri kip thdi. Cijng trong nghien ciJu, nam gidi chiem 54,4%, nQ' gidi la 45,6%. Ty le nam gidi trong nghien CLPU cua Nguyen Thj Bich Dao la 60% [1], va tu-ong ti/vd'i nghien CLFU etJa Zubin Punthakee vdi ty le nir la 46,6% (10]. Tho'i gian chan doan DTD trong nghien CLPU eua chung toi trung binh la 5 nam; mupn hon trong nghien cuu eua Zubin Punthakee la 10,39 nam [10] Thai gian mac benh eung la yeu to nguy co cua HDM, thoi gian cang lau th) bign chipng cang nhi^u, kha nang dung nap thuoe kem di nen nguy co HDM d§ xay ra hon.
4.2. Cac kien thu'C lien quan den nguy co- HDM Ty le ngu'd'i benh khdng biet nhung lu'u y v6 thudc cung nhLr khong biet den nguy c o HDM trong dung thudc dieu tri DTD la 43,7% Theo Tran Chieu Phong, ty le ngudi benh khong biet
^ a f c ' D I E U DUONG 33 I
