TAP CHi Y HOC VlgT HAM T^P 453 • THAHG 4 • SO 2 • 2017
THI GIAC LAP THE vA ANH HU'6'NG COA TAT KHUC XA T a i
THI GiAc LAP T H E (y NGirai TRITC^NG THANH K H 6 E MANH Dang Thi H^ng Anh', Nguygn Thi Thu Hi§Il^ Le Dinh Tung'
refractive error. Results: The normative stereopsis in healthy adult was 25 arches; subjects without any refractive errorsretained better stereo acuity as compared to refractive error group (p< 0.05).Subjects with myopia in one eye retained better stereo acuity as compared to mixed refractive errors (myopia combine with astigmatism) (p<0.05); the difference was not significant with refracJive in one eye and mixed refractive errors in both eyes; the severity of nearsightedness did not impact on stereopsis.
Key words: Refractive errors, Stereopsis, Butterfly stereogram, myopia, astigmatism
TOM TAT
Thj gi^c l|p the phat tnen binh thudng di/a vao thj giac hai mSt va co the bj anh hffdng bdi cac tat khuc xa, nhUOc thi, lac. Nghien cffu nay dffOc thyc hien vdi muc tieu mo ta thj giac lap t h ^ d ngu'di binh thu'dng khoe manh la sinh vien nam thff nhat Tru'cfng Dai hgc Y Ha Noi va xac dinh anh hu'dng ciia tat khuc xa tdi thi giac lap the d nhom doi tu'cfng nai. PhUtmg phap:
457 sinh vien nam thff nhat Tru'dng Dai hpc Y Ha Ngi, tuoi 18 -22 dffOc lu'a chgn vao nghien cffu va dudc chia lam 2 nhom: nhom-khong co tat khuc xa (n = 210) va nhom ed tat khuc xa (n = 247), Nhom co tat khuc xa dffdc chia ttianh cac nhom nho hOn: can ttij, vien thj hay loan thj. T1i| giac lap the du'pc do blng bp dung cu Butterfly test de do thi lUc lap the dang cham va dang dffdng vien. Ketqua nghien cuir. Gia trj thj giac lap the d ngffcfi tru'dng thanh, khoe manh khong CO tat khuc xa ban^ 25 giay cung. Tat khijc xa lam giam thj giac lap the dang dffdng vien, mac dong thdi 2 tat khuc xa (can - loan) lam thj giac lap the dang (tu'cfng vien kem hon so vdi viec mac 1 loai tat khuc xa (can ttii) (p <0,05). Thi giac lap the dang dUcSng vien giffa nhom chi co mgt mat mac tat khuc xa va ca hai mat deu mac tat khuc xa khong cd sff khac biet (p>0,05). Tnang nhom can thj ddn thuan, mffc dp can thi khong anh hu'dng tdi thj giac lap the dang dUdng vien (p > 0,05).
T& khda: Thi giac lap the, tat khuc xa, ean thi, loan thi, vien thj
SUIVIMARY
STEREOPSIS I N NORMAL ADULTS AND IMPACT OF REFRACTIVE ERRORS ON STEREOPSIS Normal development of stereopsis is based on good binocular vision and might get disrupted by a number of factors like refractive errors, amblyopia and/or strabismus. The study was undertaken widi the aim to identify stereoptic values and analyze impact of refractive errors on stereopsis in Year 1 medical students of Hanoi r^edical University. Methods: 457 normal subjects aged between 18 - 22 years without any organic disorters were recruited in this study.
Stereoacuity was demonstrated on Butter fly stereogram under standard conditions. Subjects were divided into two groups: normal subject without any refractive errors (n = 210) and refractive errors (n = 247). Further subgroups were made as per the type of
Trddng Dai hoc YHa Ngi 'Binh vi$n MSt Trung ddng Chiu traeh nhiem chinh: Le Dinh Tiing Email: [email protected] Ngay nhan bai: 10.01.2017 Ngay phan bien khoa hpe: 27.3.2017 Ngay duygt bai: 4.4.2017
I.OiE^TVANOE
[^pt trong so nhffng thupc tfnh quan trpng nhat cua the gidi vat chat xung quanh ta la sff ton tai cua khong gian 3 chieu. Con ngffdi cd the trffc tiep earn nhan khong gian 3 chieu thong qua eac giac quan nhff thi giac, xue giac, khffu giac,... Kha nang cam nhan khong gian ba ehieu thong qua thj giae goi la thj giac lap the - mffc dp eao nhat cua thj giac hai mat[l].Tren the gidl, nghien cffu thj giac hai mat noi chung va thj giac lap the noi rieng da dffdc thffc hien tff rat nhieu nam trffdc day. Thj giac lap tihe dffdc cho la mpt trong nhffng yeu to quan trpng gop phan cho sff thanh cong trong xa hpi hien dai. Viee eo hay khong co thj giac lap the anh hffdng den chat Iffdng cong viee va lien quan trffc tiep den nghe nghiep: lai xe, phi eong, bac sT, kien true sff,...[2]. Co it nhat mffdl hoat dpng ma d do thj lffe hai mat tot hdn mot mat: nhan dien chff viet, phan biet mau sac, nhin theo mpt vat, xau chuoi hat, kiem soat mot tff the nao do, xau kim, do nffde, eham vat bang tay khi nhin thay ban tay, cham vat bang tay khi khong nhin thay ban tay [1]. Mffe dp thj giac lap the d ngffdi binh thffdng khoe manh rat khac nhau giffa eac nghien cffu.
Ooi vdl ngffdi Viet Nam trffdng thanh, khoe manh, gia trj thj giac lap the la bao nhieu, lieu co giong vdl cae nghien cffu da tffng thffc hien tren chiing tpc khae hay khong van con la mpt cau hoi chffa co ldi giai dap. Vdi mong muon tim hieuve ITnh vffc nay, chung toi thffc hien de tai nghien effu " 77?/ giac lap the va anh h&dng cua tat khuc xa tdi m&c do thj giac lap the d ng&di binh th&dng khde manh"\i6] muc tieu:
1. Mo ta mffc dp thj giac lap the d ngffdi binh thffdng khoe manh.
2. Xac dinh anh hffdng cua tat khuc xa tdi mffc dp thj giac lap the d nhom doi tffdng tren.
VIETNAM MEDICAL JOURNAL H°2 - APRIL - 2017 II. D 6 | TU'ONG VA PHU'OTMG PHAP NGHIEN CLTU
2.1 Ph&dng phap nghien cu&: md ta cat ngang, ehon mau khong xac suat.
2.2 Ddi t&dng nghien c&u: 457d6i tffdng nghien cuXi la sinh vien nam thff nhat Trffdng Dai hpe Y Ha Npi nam hpc 2015 - 2016, khoe manh, tinh nguyen tham gia nghien euXi. Cd mau dffde xae djnh bang eong thffe eho nghien effu mo ta eat ngang vdi sai lam loai I,o = 0,05 va sai lam loai I I , p= 0,2, sai so chap nhan trong nghien ciiu, A = 8 giay cung, dp lech chuan ciia o = 58,5 giay eung [ 3 ] . Doi tffdng dffdc ty^ chon tham gia nghien cffu co thj lffe tffng mat va hai mat sau chinh kinh > 8/10, khong bi lac, nhffde thj, khong co tien sff dieu tri eae benh ve mat, chan thffdng mat, ehan thffdng sp nao. Loai trff ra khoi nghien cffu eac doi tffdng co benh ly mat anh hffdng den thj Iffc va thi giac hai mat, roi loan van dpng nhan cau, doi tffdng khong hdp tac. Tieu chuan chia nhom doi tffdng dffa vao tat khucxa nhff sau:
+ Can thj dffdc phan loai theo mffc dp: nhe (<-3.00D), trung binh (-3.00-6.000) va nang ( > - e.ooD).^
+ Vien thj dffdc phan loai vien thi theo mffc dp: nhe (< -i-2.od D), trung binh (-1-2.00 - -^5.00 D) va nang (> -(-5.00 D).
4- Lo^n thj.
- Ph&dng tien nghien c&u: Nghien cffu dffdc thffc hien tai Bp mon Sinh ly hpc - Trffdng Dal hoc Y Ha Noi. Phong nghien cffu sff dung nguon sang la anh sang trang. Bang thj Iffc Landolt. Bp dung cu: Butterfly stereo test gom hai bang: hinli eon bffdm, bang thj Iffc lap the dang cham ngau nhien va cac vong tron xep thanh 10 nhdm, bang thj Iffc lap the dang dffdng vien va kinh phan cffe giiip cho hinh anh girt den mat phai va mat trai la hai hinh anh tach biet tffdng ffng vdi goc Ieeh ben trai va ben phai. Bp phieu thu thap so lieu.
- Chi sd nghien c&u: Tan so cac gia trj thi giac lap the; trung binh, trung vj, phffdng saij dfi lech chuan, gia tri ldn nhat, nho nhat cua thj lift lap the va Hen quan giffa thj giac lap the vdi cac yeu to lien quan.
2.3 Phan tich va xuT ly so lieu: NhSpso lieu bang phan mem EpiData. Xff ly va phin tich so lieu bang phan mem SPSS 20. So lieu phan bo khong chuan, ket qua dffde trinh bay dff(S dang trung vj (gia tri nho nhat - gia tn Idn nhat). Xac djnh moi lien he giiJa thi glae lap the vdi cac yeu to lien quan giOa hai nhdm bang kiem djnh Mann-Whitney, giu^ 3 nhom tnil ten bang kiem djnh Knjskal- Wallis.
Vdi p < 0,05 diidc eho la co y nghTa thong ke.
III.KETQUA
3.1. Dac diem ddi t&dng nghiSn cihi: 457 doi tffdng nghien cffu gom 64% nff, 36% nam.
Tudi trung binh la 19,1 ± 0,2 (thap nhat la IB tuoi, cao nhat la 22 tuoi), co tat khiie xa 48% va khong cd tat khiic xa 52%. Trong nhom eo tat khuc xa, CO tat khuc xa d mot ben mat 2,8% va chi mac can thj; ca 2 mat co tat khiic xa 97,2%.
Trong nhom chi mac tat can ttij, ti le can nhe va can trung binh gan bang nhau va chiem chii yeu, can nang chiem t i le ft nhat (5%).
3.2. KSt qua do thj giac lap the 3 . 2 . 1 . Gia trj thj giac lap the dang cham ngau niiien tren toan bo doi tu'dng nghien cii'u: Ket qua nghien cuff cho thay toan bo doi tffdng dat gia trj thj giac lap the dang cham ngau nhien thap nhat la 700 giay cung, khong co d£
tffdng nao d mffc 2000 hay 1150 giay cung. ^ 3.2.2. Gia trj tlij giac lap tlie dang dffdnf vien tren toan bo doi tu'dng ngiiien cu'u: Ket qua dffdc trinh bay d bleu "do 3.1 cho thay phan Idn gia t n thj giac lap the tap trung d khoang dffdi 32 giay cung, chiem nhieu nhift la 25 g ^ eung, sau do lan Iffdt la 20 giay cung va 32 giay cung. Gia trj thj Iffe lap the rai rac khoang 40 den 160 giay cung.
3.2.3. Gia trj tiij giSc lap the giu'a cac niiom ngiiien cihi
Bang 3.1. Md ta gia trj thj giac lap the dang d&dng vien cua nhdm, phan nhdm doi tiTdng nghien c&u
Nhom
Trung vj (giay cung)
Gia trj trung binii (giay cung)
Klioang tin c$y
950/0
D o l k h chuan i S D ) .
Chung (n = 457)
25 38,36 - 45,19 J T ^ l ^
Khong CO tat khuc xa (n = 210) 25
33,79-44,01
_37i300_Co tat Ithuc xa (n = 247)
39,62 - 48,84 J6f934_,
Ket qua diidc trinh bay d bang 3.1 eho thay gia trj thj giae lap the dang dffdng vien eua m khong c6 tat khiic xa va nhom ehung la 25 giay cung, nhom co tat khuc xa la 32 giay cung.
TAP CHi Y HOC VIET HAM TAP 453 - T H A H G 4 - S 6 2 - 2017
3.3. Mdi t&dng quan gi&a m&c dp thi giac lap thS' va mdt sdyeu to
Do toan bp dol tffdng nghien cffu deu dat gia trj thj giac lap the dang cham ngau nhien thap nhat a 700 giay cung. Vi v?y, khi tim hieu moi tffdng quan giffa thj giac lap the va cac yeu to, ehung toi :hi thffe hien vdi thi giae lap the dang dffdng vien.
Bang 3.2. lAox tu'dng q u a n giu'a mu'c d o t h j giac lap t h e d a n g du'dng v i e n va dac diem idi t i n h cua n h o m d o l tu'dng n g i i i e n cu'u,
N h o m Nam g i d i (n = 165) N g g i d K n = 292) Gia t r j cua tiij g i a c l a p t h e
(giay cung) 32 (20- 200) 25 (20- 400)
0,021
Ket qua the hien d bang 3.2 cho thay gia trj thi giac lap the dang dffdng vien d nff gidi thap hdn z6 y nghTa thong ke so vdi b nam gidi (p<0,05).
Bang 3.3. Moi tu'cfng q u a n giu'a mu'c dp t h j giac lap t h e d a n g du'dng v i e n va viec co hay khong CO t a t Ithuc xa
Co t a t k h u c xa (n = 247) Khdng co t a t k h u c
xa (n = 210) Gia t r j t h j giac l a p t h e
(giay'cung) 25 (20 - 400) 32 (20 - 400)
0,009
Ket qua diicic trinh bay d bang 3.3 cho thay gia tri thj giae lap the dang dffdng vien d nhom khong :d tat khuc xa thap hdn cd y nghTa thong ke so vdi nhom co tat Ichiie xa (p<0,05).
Bang 3.4. Moi tu'dng q u a n giu'a mu'c do t h j giac lap t h e d a n g du'dng vfen giu'a n h o m chi 1 mat cd t a t k h u c xa va n h o m 2 mSt deu mac t a t khuc xa
N h o m Gia t r j t h j giac lap t h e (giay cung) Co t a t k h u c xa 6 1 m a t (n = 7) 25 (20 - 32) Co t a t k h u c x g d 2 m a t (n = 240) 25 (20 - 400)
0,074
Ket qua dffde trinh bay d bang 3.4 cho thay gia tri thj giae lap the dang dffdng vien giii^ nhom chl 1 mat cd tat kliuc xa va nhom 2 mat deu co tat khue xa la tffdng dffdng nhau (p>0,05).
Bang 3.5. Mu'c d o t h j g i a c lap t h e darig du'dng v i e n giu'a n h o m can vd can - loan t r o n g nhom ca 2 m a t d e u co t a t khOc xa
Nhom Can (n = 224) Can - loan fn = 19)
P
Gia tri tiii giac iap tiie (giay cung) 25 (20 -160) 50 (20 -160)
0,003
K§t qua dffdc trinh bay cf bang 3.5 eho thay gia trj thj giac lap the dang dffdng vien d nhom can - loan ldn hdn nhom can thi ddn thuan co y nghTa thong ke (p<0,05).
Elang 3.6. Tu'dng q u a n giu'a mu'c d o t h j giac l a p t h e d a n g du'dng v i e n va mu'c d o n a n g cOa can t h i
Gia t r j t h j giac lap t h e ( g i a y c u n g ) N h o m
Can nhe (n = 100)
25 (20 -160)
Can t r u n g b i n h (n = 113)
25 (20 -160)
Can n a n g (n = 11)
32 (25 -100)
0,340
Ket qua dffdc trinh bay 6 bang 3.6 clio thay gia trj thj giac lap the dang dffdng vien 6 nhom c3n nang (32 giay cung) Idn hdn nhom can nhe va can trung binh (cung 1^ 25 giay cung) khong co y ighia thong ke (p>0,05).
IV. BAN LUiShN
Dac diem cua ddi t&dng nghien c&u:d6\
ardng la sinh vien YlTrffdng Oai hpc Y Ha Noi, :hap nhat la 18 tuoi, cao nhat la 22 tuoi, day la 38 tuoi ma thi giac lap the dang dffdng vien da linh thanh day dii [ 3 ] . Mot so nghien cffu trffdc Jay cho thay nhin md do tat khuc xa anh hffdng :6i thj giac lap t h e [ l ] . Vi vay, chung toi chia doi ffdng nghien cffu thanh 2 nhdm: nhdm khong
CO tat khuc xa va nhom cd tat khuc xa. Nhom co tat khiic xa 6 mot ben mat chiem ti le rat thap (2,8%), trong do 100% tSt khue xa la can ihi.
Nhom doi tffdng ea 2 mat co tat khiie xa chiem dai da so (97,2%). Trong nhom mac dong thdi 2 loai tat khuc xa, nhom can - loan gap nhieu hdn 2 nhom eon Iai (nhom ean - vien, nhdm loan - vien). Nghien cffu ciia chung toi so sanh giffa nhdm chi ed mpt mat eo tat khuc xa va nhom ca
VIETNAM MEDICAL JOURHAL N°2 - APRIL - 2017
1
mg cu ^ hai mat deu ed tat khiie xa; giffa nhdm mae mpt giay eung, mffe gia trj nho nhat ma bp dung cu loai tat khiie xa va mae hai loai tat khiic xa; giffa Lang test cd the do dffdc. Nghien effu anh hudng cac nhdm cd mffc dp can ddn thuan khae nhau ciia tat khiic xa den thj giac lap the, ket qua (nhe, trung binh va nang). ^ nghien cffu eho thay nhom khong eo tat khucxaket qua tiii giac lap thS'dang Cham ngau eo thj giae lap the dang dffdng vien tot hdri nhien va dang d&dng vien cua ddl t&dng nhom co tat khue xa (p<0,05). Mpt vai cong bS nghiSn cuti: Thj giae lap the dang eham ngau trffde day chi ra sff md ciia hinh anh do tat khuc
xa chffa dffdc khac phue anh hffdng tdi thj giac lap the dang dffdng vien [1]. Trong nghien, ciilj eua Chung toi, cae doi tffdng da dffdc khac phuc tat khiic xa de dat thi lffe > 8/10 nhffng gia tn thj giae lap the van eo sff khae biet. Chiing toi eho rang ngoai yeu to hinh anh bi m6 do tat khiic xa, eon co anh hffdng ciia yeu to khac len mat CO tat khiic xa Iam giam mffe dp thi giac|p the. Thj giac lap the dang dffdng vien giu'a nhdi^
chi 1 mat mac tat khuc xa va 2 mat eiing mactSt khuc xa khong khae biet (p>0,05). So sanh tfij giac lap the giffa nhom can thj va nhdm can • loan thj, ket qua cho thay nhom can thi co thj giac lap the dang dffdng vien (25 giay cung) tot hdn vdi nhom ean - loan thj (50 giay cung}, Chung toi cho rang trong cac yeu to anh hu'dng den thj giac lap the dang dffdng vien thi tSUIoan nhien diicic xac djnh bang viec dol tffdng nhin
thay hay khong nhin thay hinh anh con bffdm.
Gia trj thj giac lap the dang cham ngau nhien d tat ea cac do! tffdng nghien cffu deu la 700 giay cung. Ket qua nay kem hdn so vdi nghien cffu sff dung dung eu TNO test xae djnh gia trj thi giac lap the dang eham ngau nhien [ 4 ] . Sff khae biet nay la do bp dung cu ciia chung toi ehi thiet ke de xae dinh dol tffdng eo hay khong co loai thj giac lap the nay vs co gia trj quan trpng de khang dmh thj giae lap the dang dffdng vien la do sff dung ca hai mat. Thj giae lap the dang dffdng vien eo the dffdc nhin bdi thi giac mpt mat hoae hai mat. 6 nghien ciiu nay, gia trj thj giac lap the dang dffdng vien d nhom khong eo tat khuc xa la 25 giay eung. Gia tri nay tot hdn so vdi eac nghien cffu trffdc day cong bo gia trj
binh thffdng cua thj giac lap the dang dffdng thi anh hffdng Idn hdn nhieu so vdi tatcan^jva vl3n la 40 giay eung [1],[4]. Sff khac biet nay ed
the do sff khac biet ve bo dung eu sff dung de do thj giac lap the. Chung toi sff dung bp dung cu Butterfly test, da dudc cai tien cd mffe thj giac lap the dang dffdng vien thap nhat la 20 giay cung, ghi nhan lai dffde nhffng doi tffdng co mffe thj giac lap the dang dffdng vien thifp hdn hay tot hdnso vdl bp dung eu Titmus test (40 giay eung) dffdc sff dung trong cac nghien cffu tren.
Nghien cuff ciia chung toi cho thay eo sff khac biet ve thj giac lap the dang dffdng vien theogldi tinh. Thj giac lap the dang dffdng vien ciia nff tot hdn nam (p<0,05). Ket qua nay tffdng dong vdl ket qua eua cae tae gia khae [5],[6] nhffng khae vdi ket qua nghien effu d tre em tff 5 den 10 tuoi khi ket luan khong co sff khac blet giffa nam va nff [7]. Co le do chung toi sff dung bp dung cu la Butterfly test vdi gia trj thj giac lap the thap nhat do dffdc la 20 giay eung, trong khi cac nghien effu khac sff dung bp dung cu la Frisby test, va Lang test vdi ngffdng thj giac lap the thap nhat do dffdc lan Iffdt la 85 giay cung va 200 giay cung. Nghien cffu sff dung bp dung cu la Frisby test se thu dffdc gia tri thj giac lap the tot hdn va gan vdi gia trj eua chiing toi hdn.
Nghien cffu ciia chung toi chi cd 2 doi tffdng (chiem 0,43%) khong dat dffdc mffc gia trj 200
vien thj. O doi tffdng loan thi, dieu tiet delnhir ro khong the thffc hien dffdc ciing liic tren ca kinh tuyen chfnh va phu. Vi vay, mat lien tuc dieu tiet thay doi giti^ 2 kinh tuyen hoac co gang xoa di mpt kinh tuyen va sau do ehi nhin trenl kinh tuyen. Con doi vdi can thj ddn thuan t]ii2 mat chi can dieu tiet theo mpt true trffdc sau nen de dang tao anh ro net tren vong mac [1]. Oanh gia mffc dp can thj den thj glae lap the, chung tBi ehla doi tffdng thanh 3 nhom vdl mffc can till khac nhau (nhe, trung binh va nang), k^^quS cho thay nhom can nang co thi giac lap the (32 giay eung) kem hdn 2 nhom can nhe va c3n trung binh (25 giay eung), tuy nhien sff khac biet khong co y nghTa thong ke (p>0,05).
V. KET LUAN
1. Gia trj thj giac lap the d ngffdi truSng thanh, khoe manh khong c6 tat khiic xa bang 25 giay eung.
2. Tat khiic xa lam giam thj giac lap the d^ng dffdng vien, mac dong thdi 2 tat khue xa (can - loan) lam thj giac lap the dang dffdng vi^Sn kem hcJn so vdl viec mac 1 loai ^ t khuc xa (can m (p <0,05). Thj giac lap the dang dudng vien glQS nhdm chi co mot mat mac tat khiJc xa va ci hai mat deu mac t i t khiie xa khong co sff khac blet
15R
TAP CHl Y HOC VIET NAM TAP 453 - THAHG 4 - $6 2 • 2017 i>0,05). TnDng nhom can thi ddn thuan, mffc
3 can thi khong anh hffdng tdi thi giac lap the jng dffdng vien (p > 0,05).
ftl UEU T H A M KHAO
, William 3. Benjamin et al. {2Q06).Borish's Clinical Refraction 2nd edition„pp. 954-960.
, Merrick 3. Moseley, Alistair R. Fielder,et af.
(1996). Does stereopsis matter in human?, Eye Journal, pp. 233-238.
. G. Heron et al. (19S5). Stereoscopic Threshold in Children and Adults, American Joumal of Optometry and l^ysological Optks. 62, pp. 505-515.
4. James Kundart Hamed Momeni - Moghadam, Marzicti Ehsani, et al. (2011). The Comparison of Stereopsis with TNO and Titmus Tests in Symptomatic and Asymptomatic University Students, Joumal of Behavioral Optometry, pp. 35-39.
5. Ali Reza Jafari Daniai Shafiee, Ali Akbar Shafiee (2014). Correlation between Interpupillary Distance and stereo acuity. Bulletin of Environment, Pharmacology and Life Sciences, pp. 25 -33.
D. Vjekoslav Majdak (2015). Influence of Physiological Factors on Stereopsis, Aalen University.
7. Largo RH; Sctimid M (1986). Visual acuity and stereopsis between the ages of 5 and 10 years. A cross-sectional study.'; European Journal of Pediatncs.pp. 475 -479.
TIM HIEU MOT SO YEU TO LIEN QUAN DEN SIT THAY DOI CHU'C NANG THAN TON DU" O BENH NHAN LOC M A N G BUNG LIEN TUC NGOAI TRU
D | n g Thi Viet H a ' ^ Nguyin Thi Hai'"^,D6 Gia TuySn'^, iVIai Thi Hien^
•6M TAT
Muc tieu. Tim hieu mpt so yeu to lien quan den u' thay doi chffc nang than ton dff d benh nhan lpc iang byng lien tue ngoai trO (CAPD). DoitUdng. 106 enh nhan dang dieu tri thay the than suy bang ihUOng phap CAPD. Phu'dng phap. mo ta tien ciru, tanh gia ehffe nang than ton dff d 2 thdi diem bat dau ighien cffu (MO) va sau 6 thang (Ml). Ketqua: chffc iang than ton dff M0:3,98 ± 2,22 va Ml:2,75 ± 1,95 il/ph/l,73m^da, giam dan theo thdi gian (p<0,001).
iu" thay dSi chffc nang than ton du sau 6 thangJtUcfng juanthuan vdi chffc nang than ton dff didi diem MO a add uric mau, tu'Ong quan nghich vdi thdi gian loe iang bung. Thdi gian Ipc mang bung, chffc nang than on dff ffi6i diem MO, huyet ap va acid uric mau tUdng juan doc lap vdi thay doi ehffe n3ng than ton dff p<0,05). ketluan-. Chffc n3ng than tBn du giam dan heo thdi gian, tiidi gian Ipe mang bung dai, HA cao, icid uric mau cao la cac yeu to lam ehffe nang than on dff giam nhanh hdn.
T&khda:OiiSc nang than ton dff lpc mang bung en tuc ngoai trii.
iUMMARY
EVALUATE SOME FACTORS RELATED TO THE CHANGE OF RESIDUAL RENAL FUNCTION OF PATIENTS W I T H CONTINOUS AMBULATORY
PERITONEAL DIALYSIS
Trddng Dpi hge YHa ngi
Khoa Th$n tiit niiu Binh viin Bach mai :hju trach nhiim chfnh: D5ng Th] Viet Ha imail: [email protected].
Ig&y nhan bai: 5.01.2017 Igay phan bien khoa hpc: 22.3.2017 Igay duyet b^i: 28,3.2017
Objective: Evaluate some factors related to the change of residual renal function (RRF) of patients with continuous ambulatory peritoneal dialysis (CAPD).
Methods. A prospective study was carried on 106 patients with CAPD. The study results were taken at the beginning of the study (MO) and after 6 months (Ml). Results. RRF at MO: 3,98 ± 2,22 and Ml: 2,75
± 1,95 ml/min/l,73m2, gradually reduced by time (p<0,001). The change in residual renal function after 6 months correlated with residual renal function point MO and uric aad, inversely correlated with peritoneal filter time. Time abdominal membrane filtrataon, residual renal function MO time, blood pressure and blood urie acid independently correlated with changes of residual renal ftjnction (p <0.05). Conclusions:
Residual renal function gradually reduced by time. The long duration of peritoneal dialysis, high BP and elevated blood uric acid was the independent factors that made RRF reduce faster.
Key Words: Residual renal function, continuous ambulatory peritoneal dialysis.
I.
OAT V^N DELpe mang bung la mot trong nhffng phffdng phap dffdc sff dung de dieu trj thay the than suy (MLCT < 15ml/ph/l,73m^da). O cac nffdc dang phat trien nhff Viet Nam, khi ghep than eon nhieu kho khan va than nhan tao chi dffdc thffc hien d cac trung tam y te Idn ttii Ipc mang bung la mot phffdng phap co hieu qua vdi chi phi idp ly. Nhieu nghien cffu da ehffng minh Ipe mang bung giiip benh nhan bao ton chffc nang than ton dff(chffc nang eon lai tff nhien cua 2 than) qua do glup cai thien dp thanh thai, tinh trang dao thai djch, giup kiem scat huyet ap, han ehe eac bien ehimg thieu mau, nhilm trung, cffdng
