55 NI^M 6 0 KHSCN
NHUNG TIEN BO
TRONG GHEP TANG 6 VIET NAM ?^
THilu TLfdNG, PGS.TS HOANG MANH AN Htfn 20 ndm qua, ITnh vifc ghep t^ng d Vift Nam fla dat dirgic nhitng ke't qua rat dang tir hao, ghi ten Viit Nam vao ban do nhu'ng niTAc co ky thuat ghep tang phat trien tren th§' gidi. Dong gop vao thanh c6ng chung a'y, phii k l den vai tro cua Benh vien QuSn y 103 (Hoc vi^n Quan y), nhiT m9t vi6n g^ch diu tien xSy difng chuySn nganh ghep tang cua Vi@t Nam.
Ngay 4.6.1992, ca ghep th^n diu tl6n cua Vi|t Nam da dif^c tiS'n hanh thanh cong tai Bfnh vl^n Quan y 103. Day la m^t s^ kl^n cd y nghTa d^c bl^t dfi'i vdi nganh y te Viet Nam, mil difofng cho ky thu^t ghep tang phat triln t^i nirdc ta. 12 nam sau (thang 1.2004), cung tai day, ca ghep gan dau tien cua Viet Nam da dUdc thUc hien thanh cOng. Tilp do, ngay 17.6.2010, ca ghep tim da'u tiSn trSn ngirdi tai ViSt Nam mgt lan nDa dirgic tii'n hanh thanh cong tai ndi nay. Phat huy nhdng thanh tiru a'y, gin day nha't, ngay 1.3.2014, lai m$t iln nda ca ghep da tang (tyy - than) dau tien tren ngirdi td ngddi cho cha't nao da dddc thdc hien thanh cfing tai Benh vign Quan y 103. De'n nay, nddc ta da cd 13 cd sd (trong dd cd ch b$nh vlSn luyS'n tinh, b$nh vign nganh) cd du dilu kifin d l tiln hanh ghep tang.
Nhung moc son trong linh vtro ghep tango Viet Nam
Ke til ca ghep than dau tien cua Viet Nam duac ttii/c hien ttianh cong tdi nay, 22 nam qua, chuyen nganh ghep tang cua nu6c ta ngay cang phat trien va tmdng thanh, dat dUflc nhOng thanh tuu rat dang ti) hao.
Udc md ghep tang cua cac nha Ithoa hoc Viet Nam da bat dau til thap ky 60 cOa the k^ trudc, vdi cac ca ghep tim thi/c nghiem tai Benh vien Vi§t Dufc, sau do la ghep than thLfc nghiem tai Hpc vi§n Quan y (vao nhffng nam dau cCia thap l<y 70), nhung hoan c5nh chien tranh
l<hien mpi Udc mudn deu chua r^„i,- , „.- 7 ^ ^ ; — . „ . - . ^
^ Ca ghep tuy - tl}an dau ti4n ci)a Viet natn
S6 8 nam 20,4 54^6 NCHE VIET Nfflf "
55 NFIM 8 0 KH&CN
Ca ghep gan dau tien cCia Viet Nam thanh hidn thdc. De'n nhQng nam
dau thap k^ 90, sau khi doin can bd dau tien sang CuBa hpc tip ghep tgng trd vd nddc, vdi quyet tam cao cija nganh y td, sU ket hpp quin dan y va nhdng nd ldc ci!ia cic thay thuoc Benh vien Quan y 103 cung vdi sd giup dd cija cac chuyen gia Dai Loan, ngay 4.6.1992, ca ghep than diu tien d Viet Nam da dupc thdc hidn thanh cdng. Sd kien niy da viet len trang si!f mdi cho nen y hpc nddc nhi, dit vien gach dau tien, dinh di'u mdc son tren bin dd ghep tang va khdi dau cho mpt chuyen nginh mdi 6 nUdc ta - chuyen nginh ghep tgng.
Tiep dd, thing 12.1992, Benh vien Chp Riy - Tp Hd Chi Minh da tridn khai ghep than thanh cdng.
Den nay, day la cd sd y te cd sd ca ghep than nhieu nhit trong c i nddc.
Lin Idpt sau dd la cic ca ghep thin dau tien cilia Benh vien Viet Ddc (8.2000), Bdnh vien Trung ddng Hue (7.2001), Benh vien Nhan din Gia Djnh (1.2002), Benh vien nhin dan 115 (2.2004), Bdnh vidn Nhi Trung Udng (5.2004), Benh vien
Nhi ddng II (6.2004), Benh vien Bgch Mai (11.2005), Benh vien Da Ning (3.2006), Benh vien Kidn Giang (3.2007), Benh vien 19-8 (10.2008), Benh vien XanhPon (12.2013).
Tinh den nay, toan nginh y te da tidn hinh ghep than cho gin 800 trddng hdp vdi ket qui tdt, trong dd rieng Benh vien Quin y 103 da thdc hien thanh cdng gin 200 ca.
Nhieu npi da ap dyng md npi soi lay than ghep (qua ndi soi d bgng hoac npi soi sau phuc mge) va ky thuat ghep thin da dupc thuc hien thudng quy, cd the thuc hien ddng thdi 2-3 ca ghep trong cung mdt ngiy, thdi gian ghep trung binh 3 gid, thdi gian nam vien 8-10 ngay.
Gin 12 nam sau, vao thing 1.2004, Benh vien Quin y 103 da thUc hien thanh cdng trudng hdp ghep gan dau tien tren ngddi cho chiu Nguyen Thi Didp, 10 tudi bj teo dddng mat bam sinh, cd bien chdng xd gan v i chiy mau do gian vd tTnh mach thdc quin, ngudi cho gan la bd de ciJa chau. Ca md dUdc tien hanh vdi sd giup dd cua cac
chuyen gia Nhit Ban. Td do den nay da cd tren 20 trudng hpp ghep gan dUdc tidn hinh tai 5 trung tam la Hpc vien Quan y, Benh vien Niii Trung ddng, Benh vien Vidt Dilc, Benh vien Nhi ddng 11 Tp U6 Chi Minh va Bdnh vien Chp Riy. Trong sd dd cd 17 ca ghep gan td ngddi cho sdng, sd cdn lai l i td ngudi cho chet nao.
Ghep tim tren ngddi hidn nay dUdc chip nhan rpng rai, la mot bien phap dieu trj tdt nhit cho cic benh ly tim giai dogn cudi. 6 nddc ta, d i tien hanh nghien cdu ghep tim thi/c nghidm tU nim 2005, nghien cdu tridn khai ghep tim tren ngddi lay Xis ngddi cho chet nao nim 2009. Sau mdt thdi gian dai nghien cUu v i lim tdt mpi cdng tic chuan bi, ngiy 17.6.2010, ca ghep tim dau tien tren ngddi tgi Viet Nam td ngddi cho chdt nao d d ^ tien hanh thinh cdng tgi Benh vi^n Quan y 103. Bdnh vidn Quan y 103 da ddng thdi trien khai thinh cdng 3 ca ghep (1 ca ghep tim, 2 ca ghep than), tiep thep dd l i cac ca ghep tim thanh cdng tai Bdnh vien Trung ddng Hue va Benh vien Vidt Ddc (nam 2011).
Thdc hien de t i i KC.10.27/11- 15 thupc Chddng trinh khoa hpc va cdng nghd trpng didm cap nha nddc giai doan 2011 -2015: "Nghian cdu tridn khai ghep ddng thdi tgy - than td ngUdi cho chet nao", ngay 1.3.2014, mdt lan nOa ca ghep da tgng (tgy, thin) td ngddi cho chet nao lan dau tidn tren ngudi tgi Viet Nam da dupc thdc hien thinh cdng tgi Bdnh vien Quin y 103. Day khdng chl la tin vui, niem td hao cCia cac nha khoa hpc, cac bic si cua Hpc vien Quan y, Benh vi|n Quan y 103 ma dieu niy mdt l^n nOa khang dinh bUdc tien mdi cOa nen y hpc nUdc nha.
Nhu cau va khoang each
Theo cac thdng ke chua diy d6.
42 I . Top cK KHOA H M
S^n 8 nam 2014
55 NRM BO KH&CN
hien nay tren c i nudc cd khoing 6.000 ngudi suy than man can dUdc ghdp than. Cdn theo sd lieu dieu tra sd bd mdi dupc thUc hien tgi 5 benh vien Idn d H i Ndi vdi 4.143 ngddi mac benh gan thi cd den 1.353 ngudi dupc chi djnh ghep gan. Con sd nay q u i khdng Id so vdi sd ngUdi da ddpc ghep tgng, cic nhu cau ghep tang khic trong cd the ngUdi cung khdng he nhd.
Dieu dd cho thay sd chenh lech gida "cung" va "cau" trong hien - ghep tang 6 nudc ta. Tgi Benh vidn Quan y 103 cung nhu cac benh vien khic tren c i nddc, sd ngudi cd nguyen vpng ghep tgng la rat Idn.
Neu khdng cd ngudn tang ghep, benh cija hp se ngiy cang nang va tinh mang ludn bj de dog. Hidn cd hang tram benh nhin chd dupc ghep tim, hing nghin benh nhan chd ngudn thin hien. Cic benh nhin can ddpc ghep gan, tuy cung ri't nhieu nhUng cic benh vidn phii cho ve chd dpi, hy vpng vdi thdi gian khdng hen trddc vi thieu ngudn tang hien...
Cd the ndi, do ydu td phong tyc tip quin, vide hien tang 5 nddc ta cdn ri't hgn chd bdi quan niem "chet phii toan thay" cOa ngddi dan. Ben cgnh dd sd thieu hieu biet ve hidn - ghep tang cung l i mdt can trd Idn;
chi phi cho 1 ca ghep tgng hien nay cdn cao so vdi thu nhap cua dai da sd ngUdi benh cin dddc ghep tgng d nddc ta, khdng phai benh nhan nao cung cd the cd du dieu kien ghep tang.
De dip dng dddc nhu cau cda ngudi benh, mang lai cd hdi keo dii va nang cao chi't iddng cudc sd'ng cho cic benh nhan suy tang, trong nhijfng nam tdi chuyen nginh ghep tgng can phii dUpc phit trien hdn nOa. De thuc day chuyen nganh ghep tang tiep tuc phat trien, ddi hdi phii cd mdt he giii phap ddng bd, tU viec dio tao ngudn nhan lyc, dau tu kinh phi mua sam may mdc.
trang thidt bi, phUdng tien de'n viec chuan bj ngudn tang hien; dUa Luat hidn, cay, ghep md, bd phin CO the ngddi v i hien, lay xac thuc sd di vio ddi sdng, lim td't cdng tic truyen thdng va van dpng hidn tang...
Nguyen Van Minh... va nhieu nhi khoa hoc khic, nhdng ngudi da vach nen dddng di, td chdc, huan luyen dpi ngu va lam nen thanh cdng dau tien cua chuyen nganh ghep tgng. V i khdng the khdng nhac tdi sd no ldc cd gang cua cic
Ca ghep tim diu tien cua Viet Nam
Vung tin vao tirong lai Tuy vin cdn nhieu han che nhdng nhdng thinh tUu m i nganh y te ndi chung, Benh vien Quin y 103 ndi rieng da dat ddpc trong ky thuit ghep tang la rat to Idn va ding tU hao. Mgng sd'ng cua con ngudi l i vd gii, mdi sU sdng dUdc hdi'sinh la dieu tuyet vdi nhat, hgnh phuc Idn lao nhat ddi vdi nhOng ngUdi benh kem may man va c i cdng ddng xa hdi.
Td thanh tUu hdm nay, chung ta mil ghi nhd cdng lao cua nhdng ngudi md dddng, nhU: cd GS.VS Tdn That Tung, GS.TSKH Le The Trung, GS.TSKH Pham Mgnh Hung, GS.TS Pham Gia Khinh, cd PGS.TS Tdn That Bach, GS NguyIn DUdng Quang, GS BCfu Trieu, GS Dd Kim Sdn, PGS
nha khoa hpc, dpi ngu y bac sy cija cac benh vien, cac cd s6 y te, quydt tam cao cua nganh y te; sd nghien cUu, hpc tap v i chuan bj chu dio, sd doan ket hdp tic khoa hpc giUa cac chuyen nganh v i cac cd sd y te trong nddc, sd kdt hdp quan dan y va sd hdp tic qudc te.
Qua Chang dudng 22 nam dau cua chuydn nginh ghep tang vdi nhQng thinh tUu Idn lao, hy vpng va tin tddng rang, chuyen nganh ghep tang cija Viet Nam se tiep tyc phattriln nhanh hdn, gdp phan bao ve, cham sdc, ning cao sUc khde nhin dan ma trddc hdt la cac benh nhan cd ch? djnh ghep tang. Nhij'ng ngddi lam khoa hpc dUdc vi nhu
"thuyen tren nddc ngUdc" - "khong tien it phai \ui\ vi vay chung ta chi cd mdt con dddng, dd l i phk\ tien Idn phia trddc •
C O . .... TapcH KHOil HOC « S6 8 nam 2014 „i.^,t,\t^,,i,mmmwitQr M CONG NGHE VIET N J W
