Y HQC VlgT NAM THANG 6 - SO 2/2013
PHAT TRIEN THE UfO VA VAN DE THUTA CAN BEO PHJ a HOC SINH HAI TRUfiTNG TIEU HOC CUA HUYEN DONG ANH, HA NOI NAM 2011
Nguyen Oo Huy*
TOM T A T :
Nghien ciTu tim hieu tinh trang phat trien the IUc (can nang, chieu cao) va tinh trang thiici can beo phi d tre em ciia hai trUdng tieu hpc tren dia ban thanh pho Ha Noi. Thiet ke nghien cffu cSt ngang mo ta tren 492 dol tUdng hpc smh ciia hai tru'dng tieu hpc Dong Hgi va Thuy Lam huyen Dong Anh, Ha Noi tff thang 11 nam 2011 den thang 4 nSm 2012. Ket qua cho thay: Chieu cao va can n3ng trung binh ciia hpc smh tang dan theo nhom tuoi. Qua trinh phat then chieu cao va can nang d hai gidl la tUdng dUUng nhau, chieu cao tang trung binh mpt nam ciia nam 5,08cm, nff la 5,4cm. Tang can nang trung binh/nam ciia hpc sinh nam la 2,2kg, hpc sinh nff la 3,0kg.
Chieu cao va can nang hpc sinh hai trudng tieu hpc da gan dat so v6l quan the tham chieu(NCHS). Ty le thffa can, beo phi d hpc sinh tieu hpc la 10,2%. Ty le thffa can, beo phi ciia hoc sinh nam (12,5%) cao hon hpc sinh nff (7,7%).
Td khda: Phat tnen the li/c, thda can beo phi, hoc sinh tieu hgc.
SUMMARY:
PHYSICAL DEVELOPMENT. OVERWEIGHT AND OBESITY STATUS OF SCHOOL CHILDREN
AT TWO PRIMARY SCHOOLS OF DONG ANH DISTRICT HANOI CITY IN 2011 The research aimed to identify the physical development (weight and height), over weight and obesity status of school children of two primary schools in Hanoi city. A cross-sectional study was conducted with involvement of 492 school children of Dong Hoi and Thuy Lam pnmary schools of Dong Anh District, Hanoi City from November, 2011 to April, 2012. The results show that: the average of height and weight of school children increased gradually by age groups. Physical development of both boys and girls was similar. Height increased with speed of 5,08 cm/year in boys and 5,4 cm/year in girls. Weight increase with speed of 2.2 kg/year in boys and 3,0 kg/year in girls. Weight and height of school children In this two primary school were close to NCHS Reference. Prevalence of overweight and obesity in school children was 10.2% as In the whole,and 12.5%
In boys and 7.7% in girls In particularly.
Key words: Physical development, overweight and obesity, school children.
* Vi^n Dinh dudng QuSc gia
Phan Wm» bhr>^ b^f P « « TC I £. n=n,h T,,"or,
I.
OAT VANo i :
Ben canh sff phat trien ciia kinh te, cac djeh vu an udng cung phat trien mpt each nhanh chdng, cac dleh vy thffc an nhanh, thffc an dffdng phd ngay cang nhieu, cac loai dich vu nay da va dang hap dan tre em, dac biet la hoc sinh tieu hoc, tff dd lam thay doi thdi quen, va tap quan an udng ciia tre, day cung la mdt nguyen nhan quan trpng gay nen tinh trang thffa can beo phi 0 tre em tieu hoc. Ty le hpc sinh tieu hpc thffa can beo phi se ty le thuan vdi ty le thffa can, beo phi ciia ngffdi tru'dng thanh. Hau qua ddi vdi sffe khde eiia thffa can beo phi gay ra la lam gia tang cac benh man tinh khdng lay ed lien quan tdi dinh du'dng nhu' tieu dffdng, huyet ap eao, thffa md trong mau, eae benh ve tim maeh.
Trong nhffng nam gan day nhd cd chffdng trinh phdng chdng suy dinh dffdng quoc gia ty le tre bj suy dinh dUdng da giam dang ke nhu'ng ben canh do ty le hpe sinh beo phi dang cd xu hffdng tang cao.
Nghien effu d Viet Nam cho thay ti le beo phi d tre tai cac thanh pho Idn la kha cao. Theo Tran Thi Hong Loan thi ty le hpc sinh beo phi tai mdt quan ndi thanh
' TPHCM(1998) la 18%[1]. Nam 2000 dieu tra tai eae thanh phd Idn eho thay ti le thffa can d Iffa tudi hpe sinh tieu hpc Ha ndi la 10%, thanh phd Ho Chi Minh la 12%. Rieng tai thanh phd Hd Chi Minh, dieu tra eiia Nguyen Thj Kim Hffng qua cac nam cho thay ti le thffa can 4-5 tudi vao eae nam 1995, 2000, 2001 tffdng ffng la 2,5%; 3 , 1 % va 3,3% [2],[3]. Oieu tra nam 2006 tai thanh phd Hd Chi Minh eiia Huynh Thj Thu Dieu eho thay d Iffa tud'i tien hpc du'dng ti le thffa can la 20,5% va beo phi la 16,3% [4].
II. o d l TUONG VA PHUONG PHAP NGHIEN CCOJ:
2 . 1 . Thdi gian va dia diem: nghien cffu tien hanh tff thang 11 nam 2011 den thang 4 nam 2012 tai hai trffdng tieu hpe Ddng Hdi va Thuy Lam huyen Ddng Anh, Ha Npi.
2.2. Thiet ke nghien cu'u: Nghien cffu du'dc tien hanh theo phffdng phap md ta cat ngang.
143
Y Hpc VlgT NAM THANG 6 - s6 2/2013 2.3. Doi tif^ng nghien cihi: Hgc sinh hai
trffdng tieu hoc Dong Hpi va Thuy Lam, cd dp tuoi tff 6-10 tuoi dong y tham gia nghien cffu.
2.4. Cd mlu du'^c tinh theo cong thu'c:
Ap dung cdng thffc ti'nh c9 mau cho ffde tinh mpt ty le trong quan t h i :
2 P(\~ P) n = Z ,-^; j2 p: Ty le tre bj thffa can, p=0,18(ty le hpe sinh nam thffa can cua Tran Thi Hong Loan 1998); chpn a=0,05; Z(l-a/2): Gia trj Z tff bang tffdng utig a=0.05; ehpn d=0,05; He sd thiet ke nghien culi (DE) = 2; tinh n= 452 lay trdn la 500, moi trffdng 250 tre
Phan tich thong ke: Sd lieu dffdc nhap va quan ly bSng phan mem EpiData. Sd lieu dffdc III. KET QUA NGHIEN COU:
Bang 1. Phan bd hpe sinh theo tudi va gidi
phan ti'ch bSng phan mem SPSS Version 16.0. Si?
dung kiem djnh Student T test de so sanh biSn dfnh Iffdng glQ'a hai nhdm va sff dung kiem djnli Khi binli phffdng (x2) hoSc Fisher's Exact Test de soscinh c^cty lg.
0^0 duTc nghiSn cu'u: De tai nghien cihi da tuan thii quy trinh xet duyet ciia Hpi dong dao dffc Vi§n Dinh Dffdng. Nghien euXi co sir dong y cua chi'nh quyen dja phffdng. Ooi tffdng tham gia hoan toan tff nguyen, dffdc boi duSng cho viec tham gia nghien ciiu. Doi tffdng du^
glal thich ve muc di'ch, npi dung, ldi ieh ciia cuoc dieu tra, dffdc tra Idi va tff van dinh du6ng va sffc khoe. C^c thong tin do doi tffdng chi duWc diing cho nghien effu sffc khde cpng dong, khong nhSm muc tieu nao khac.
Nhom tuoi Nhom 6 tuoi, n(%) Nhom 7 tuoi, n(%) Nhom 8 tuoi, n(%) Nhom 9 tuoi, n(%) Nhom 10 tuoi, n(%) 1 onq conq, n(%)
Nam 60(12,2) 54(11,0) 49(10,0) 53(10,81
41(8,3) 257(52,2)
Nu' 49(10,0) 41(8,3) 57(11,6) 47(9,6) 41(8,3) 235(47,8)
Chung 109(22,2)
95(19,3) 106(21,5) 100(20,3) 82(16,7) 492(100,0)
Nhan xit: Tong so hpc sinh dieu tra la 492 hpe sinh trong dd sd hpc sinh nam la 257 chiem 52,2%, so hpc sinh nti' la 235 chiem 47,8%. Nhdm 6 tudi ehiem ty le nhieu nhat (22,2%), nhdm 10 tudi ehiem ty le nhd nhat (16,7%).
Bang 2. Tmh trang ehieu eao ciia hpc sinh theo tudi
Giofi tinhHoc smh nam (TB + SD) Hoc smh ni? (TB + SD) Gia tri p
Nhom tuoi 6 tuoi
116,0 ± 6,4 114,5 ± 4,0
<0,05
7 tuoi 119,3 ± 5,1 119,6 ± 6,3
>0,05
8 tuoi 126,4 ± 5,8 125,5 ± 5,8
>0,05
9 tuoi 129,2 ± 7,0 131,5 ± 6,6
>0,05
10 tuoi 136,3 ± 4,4 136.2 ± 6,5
>0,05
Nhan xit: Chieu cao eiia hpc sinh nam tang dan theo tuoi, ehieu eao trung binh cua hpc sinh 6 tudi la 116 cm, den 10 tuoi la 136,3 cm. Trung binh moi nam chieu cao tang khoang 5,08 cm. Chieu cao eiia hpe sinh nam tang ddt biet tff 9 - 10 tuoi (7,lem). Hpc sinh thap nhat co ehieu eao la 105, Iem, eao nhat 148,4cm. Chieu cao ciia hpc sinh nu" tang dan theo nhdm tudi, chieu cao trung binh cua hpc sinh nff 6 tudi la 114,5cm, den 10 tuoi la 136,2cm.
Gldl tinh Hoc sinh nam (TB + SD) Hoc sinh niJ (TB + SD) Gia tn p
6 tuoi 20,5±4,2 18,8±2,3
<0,05
7 tuoi 21,5±4,5 21,4±5,3
>0,05
Nhom tuoi 8 tuoi 26,8±6,3 24,6±5,2
>0,05
9 tuoi 27,5±5,5 27,7±5,5
>0,05
10 tuoi 29,3±6,4 30,8±5,8
>0.05
Nhan xet: Can nang ciia hpc sinh nam tang dan theo tuoi, can nang trung binh ciia hpc sinll^
tudi la 20,5kg, den 10 tuoi la 29,3kg. Trung binh moi nam tang khoang 2,2kg. Can nang tang dot biet
tff 7 - 8 tudi (5,3kg). Hpe sinh nhe can nhat la 14,5kg, cao nhat 54,8kg. Can nang cua hpc slnh nff
tang dan theo tudi, can nang trung binh ciia hpc sinh 6 tuoi ta 18,8kg, den 10 tuoi la 30,8kg.
Y HOC VIET NAM THANG 6 - SO 2/2013
Bang 4. Tinh tranq the lu'c
Nhom t u o i
6 tuoi, n(%) 7 tuoi, n(%) 8 tuoi, n(%) 9 tuoi, n(%) 10tu6L.n(%) Tonq, n(%)
cua hoc sinh hai tru'dng tieu hoc theo Bl^ll Tinh tranq the iUc Gay com (BMKSo/o)
Nam 6(10,0) 7(13,0) 8(16,3) 5(11,3) 5(12,2) 32(12,5)
KB 5(10,2) 6(14,6) 8(14,0) 4(8,5) 3(7,3) 26(11,2)
Binh thifdng (5%<BMI<85°/o) Nam 47(78,3) 43(79,6) 33(67,3) 41(77,3J 29(70,7) 193(75,0)
Ktt 41(83,7) 32(78,0) 43(75,4) 40C85,1_)_
35(85,4) 191(81,3)
Beo phi (BMI>85°/o) Nam
7(11,7) 4(7,4) 9(18,3) _..6(11,3) . 5(11,7)
31(12,5) Nil' 3(6,1) _ 3(i3)_
^ 0 , 5 ) . 3(6,4) __
3 a 3 ] _ .1817,?)^ ,_
Nhan xet;l</ le TCBP cua hpc sinh nam hai tru'dng tieu hoc la 12,5%. T'/ ie TCBP cua hoc sinh nu' hai tru'dng tieu hpc la 7,7%. Ty ie gay com cua hoc sinh nam la 11,2%. Ty le gay com cua hpc sinh nif la 12,5%.
raS
Bieu go 1. T'/ le TCBP ciia hoc sinh theo tuoi va gidi
Nhan xet: Theo ket qua dieu tra so hoc sinh TCBP la 49 hpc sinh, chiem 10,2%. Ty ie thira can d nam cap hdn nD' rp ret 12,5% vdi 7,7%. T'/ ie thifa can cap nhat d 8 tupi, nam 18,3%, nif 10,5%.
IV. BAN lli^U:
Can nang va chieu cap trung binh cua tre 6- 10 tupl tang dan thep tuoi 6 ca 2 gidi. Trung binh moi tuoi chieu cao nam tang Ichoang 5,08 cm, nu' tang khpang 5,4 cm, ve phat trien can nang thi ta thay can nang tang trung binh mpi tupi ciia nu' cao hdn so vdi cac nam hpc sinh (3,01<g vdi 2,2kg). Neu sp sanh ket qua vdi sd iieu NCHS, cac nghien ci^u trong nu'dc ciia Ha Huy Khoi, Bui Nhu' Thuan 1985[2], Tran Thi Hong Loan 1998 [1] thi thay rang: Can nang va chieu cao trung binh ciia hpc sinh tieu hpc huyen Dong Anh deu cao hdn so vdi ket qua nghien cihj trUdc day (hpc slnh tieu hpc mpt quan npi thanh Ha npi 1985). Thep nghiSn ciru nay, sau 13 nam thi hpc sinh huyen Dong Anh cao hdn du'dc khoang 8cm va nang hdn dirdc gan 5kg doi vdi ca 2 gldl, nhimg khi so sanh vdi ket qua j i i i a Tran Thj Hpng Loan (1998) tren hpc slnh tieu hpc tai quan 1 thanh pho Ho Chi Minh thi chieu cao va can nang trung binh ciia hpc sinh huyen Bong Anh nam 2011 chi xap xi bang vdi hoc sinh thanh pho Ho
Chi Minh 1998 va phat trien tu'dng dUOng vdi quan the NCHS d nhdm tuoi 6 - 8 tuoi, va d nhdm tupi 9 - 10 tupi thi khpang each nay ngay cang xa hdn. Dac biet chieu cap va can nang tang dpt bien d nhdm 9 - 10 tupi vdi nam va 8 - 9 tuoi vdi nu'.
Ty ie thira can ciia hpc sinh 6-10 tuoi huyen Dong Anh ia 10,2% so vdi Le Thi Hai va cpng s^T (1997) [6] tai hai tru'dng tieu hoc noi thanh Ha Npi (4,1%), i<et qua ciia nghien cu'u nay cao hdn.
VQ Thi Thu Nga nghien ciru 785 hpc sinh 6-11 tupi tai tru'dng tieu hpc ban trii Trang An, quan Hoan Kiem, Ha Npi nam 1997 [4] cho thay ty le thira can ciia hpc sinh 6 - l l t u d i ia 7,4%, cung thap hdn ket qua nghien ciru nay ciia chung toi.
Neu SP sanh vdi ket qua nghien cifu cua Tran Thi Heng Lpan nam 1998[41, nghien ciru tren hpc sinh tieu hpc 6-11 tud'i quan 1 thanh pho Hp Chi Minh ia 12,2%, cao hdn ket qua ciia chung toi.
So sanh vdi ket qua nghien ciru ciia Le Thi HiTdng 1999 [6] tren hai tru'dng tieu hpc ngpal 145
Y H p c V I | T NAM T H A N G 6 - S6' 2/2013 thanh va ndi thanh Ha Ndi dddc ket qua la
0,57% tre qua can d trffdng tieu hpe Thffdng Cat va 4 % vdi trffdng tieu hpc Kim Lien, thi thay ro rang ket qua ciia chung tdi cao hdn rat nhieu.
Neu so sanh ket qua eiia chung tdi vdi mot so nghien cffu ciia mdt sd nffdc trong khu vffc, chiing tdi nhan thay ty le thffa can hpc sinh huyen Ddng Anh thap hdn ty le thffa can (15,6%) ciia hpe sinh 6-12 tud'i vung thanh thj Thai Lan 1999[6] nhffng eao hdn ty le thffa can (3,8%) ciia hoc sinh 7 - 17 tudi d thanh thj Trung Quoc 2000 [ 7 ] , cao hdn ty le thffa can cua hpe sinh Nhat Ban la (5-10%) [7] eung cao hdn ty le thffa can (2,7%) ciia hpc sinh Malaisia 1997, va thap hdn ty le thffa can (12,5 % ) eiia hpe slnh 6 - 1 6 tudi tai Singapore (1999).
Ty le thii^ d eae gidi va eae nhdm tuoi cung khac nhau, thiia can d nam cao hdn d nff (12,5% d nam; 7,7% d nu^, ket qua eiia ehiing tdi eung tffdng tff vdi nghien eiilJ ciia Le Thi Hal, Vu Thi Thu Nga, Nguyen Thi Kim Huhg va Le Thj Khanh Hda va vdi nhiirig ngien eiilj eiia Yap va Tan nam 1999 d Singapore [7] va Ye nam 2000 d Trung Quoc.
V. KET LUAN:
Qua trinh phat trien chieu eao va can nang d hai gidi la tffdng dffdng nhau, chieu cao tang trung binh mpt nam ciia nam 5,08cm, nff la 5,4em. Can nang tang trung binh mdt nam ciia hoe sinh nam la 2,2kg, hpe sinh nff la 3,0kg.
Chieu cao va can nang hpc sinh hai trffdng tieu hoc da gan dat so vdi quan the tham ehieu (NCHS).
Ty le thu^ can, beo phi d hpe sinh tieu hpc la 10,2%. Trong dd ty ie thii^ can, beo phi ciia hoe sinh nam cao hdn hoc slnh nff (12,5% so vdi 7,7%).
Vt KIEN N G H | :
CSn tiep tuc dieu tia tren dien rdng de danh gia tinh trang phat tiiOT the Iffc cua hoc sinh tieu hpc; rac djnh ty le ttiuS can eung nhff cac yeu to lien quan.
Ldi cam d n : Ban giam hieu, cac thay/c6 giao va cac em hpc sinh va phu huynh ciia hai trffdng tieu hpc Dong Hpi va Thuy Lam huyen Dong Anh da tham gia va tao diieu kien eho nghien ciiu nay dffdc trien khai thuan ldi va hieu qua.
T A I UEU T H A M K H A O :
1. Tran Thj Hiong Loan. Thiici can va cac yeu ta nguy cd d hpc sinh 6-11 tuoi tai mot quan noi thanh,TP.HCM. Luan an thac sy dinh duQng cong dong. Ha Noi, 1998.
2. Tran Van Dan va cpng su* (2004). Sffc khoe liTa tuoi. Sach danh cho smh vien dai hpc va sau dai hpc. TrUdng Dai Hoc Y Ha Noi.
3. Vi^n Dao Tao Y Hgc Dd Phong Va Y Te Cdng Cpng, TrUdng Oai Hpc Y Ha Npi, Y hoc dff phong va y te cong cong thu'c trang va dinh hu'dng cl Viet Nam nam 2011. NXB Y hpc, 2011.
4. Le Thi Hai, Nguyen Thj Lam, Hoang The Y ^ Nguyen Thanh Ha, Pham Thu Hu'dng, Nguyen Lu'dng Hanh (2002), "Theo da tinh trang dinh d i ^ va sffc khoe ciia tre thda can beo phi d Ha Npi" Tap chi y hoc thUc hanh, (so 418), trang 55 - 61.
5 Le Thi Hu'dng. Tinh trang dinh dudng va mot so yeu to hen quan ciia tre em hai trUdng teu hoc npi, ngoai thanh Ha Npi. Luan an tot nghiep thac sy dinh dUSng cpng dong. Ha Npi 1998.
6 Mabel Y. Facors associated with obesity in pnmary school children in Singapore. Asia Pacific J Oin Nutr ( 1 9 9 9 ) 3 , 6 5 - 6 8 .
7. Lee A et al (2007). The status of health-Promotirtg Schools in Hong Kong and implications for further development. Health Promot Int. 2007. Dec;22{4);
316-26.
PHAU THUAT CAT THAN MAT CHllC NANG CO BIEN CHUTNG BANG P H A U THUAT NQI SOI SAU PHUC MAC
Le O i n h Khanh*
TOM T A T :
Muc tieu: Danh gia ket qua dieu tn cat than 2010 den 2012. Doi tu'dng va phi/tfng phap mat chffc nang co bien ehffng bang phlu thuat ndi soi nghien ctrti: 22 b-Udng hdp e3t than mat chiit nang sau phiic mac tai benh vien Dai hoc Y DUpc Hue va co bien ehffng b5ng phlu thuat ndi'soi sau phiic mac benh vien Trung l/ong Hue trong thdi gian tff nam tai khoa Ngoai Than Tiet nieu va klioa Ngoai Tong HflJ
* Trudng Dai hgc Y Dugc Hue
Phan bi^n khoa h^c: PGS.TS Nguyin Van L i l u 146
