y HOC VIET NAM THANG 1 • SO 2/2014 PNCT ndi rieng cQng da dffde thay doi va cai
thien khdng ngffng. Rieng tai Thanh phd Hd Chi Minh, tieu chuan hd ngheo hien nay la mu'c thu nhap binh quan t i f 12.000.000 ddng/ngu'di/nam trd xudng. Vi vay viee so sanh dffa tren tieu chi nay eung cd the ed sff khac biet.
V. KET LUAN
Ty le thieu mau cua PNCT trong 3 thang dau thai ky d huyen Cii Chi (2011) la 21,6%, khdng cd sff khac biet Idn giffa eac xa. Ty le nay cd xu hu'dng tang theo dp tud'i, ty le thieu mau eao nhat d nhdm ba me 35-39 tuoi (66,3%). 96,3% ddi tffdng thieu mau cd ham Iffdng Ferritin/mau thap.
Phu nff tff 35 tudi t r d len cd nguy cd bi thieu mau gap 6,52 lan so vdi phu nff dffdi 35 tudi. Ty le thieu mau trong 3 thang dau thai ky d nhdm phy nff sinh lan 2 t r d len la 30,5% cao gap ddi so vdi phy nff sinh lan dau (15,3%) (p<0,001), OR=2,42. Nguy ed thieu mau d nhdm phu nff sinh lan 3 t r d len cao gap 4,25 lan so vdi phu nff s i n h ^ n 1-2 (p<0,001),
TAI UEU T H A M KHAO
1. B? Y te (2012), Chien Idpc Quoc gia ve dmh du'dng gtai doan 2011-2020 va tam nhin den nam 2030, Nha xuat ban Y hpc Ha Noi.
2. Tran Thj Minh Hanh, Phan Nguyen Thanh Binh, Nguyin Nhan Thanh va cs (2009), "Tinh trang thieu mau, thieu sat d phu nii' ed thai t3i thanh pho Ho Chi Mmh", Tap chi Dtnh dudng va
Thdc pham, 5(1), tr 14-23.
3. V6 Thj Thu Nguyet, Banh Thanh Lan, Tran Thj Ldi (2008), "Khao sat tinh trang thieu s3t trong 3 thang giffa thai ky va cac yeu td lien quan tai Benh vien Oai hpc Y du'pc TP.HCM", Tap chiY hoc thanh pho Ho Chi Minh, 12(1), tr 162-170.
•4. Tru'dng Hong Sdn (2012), Hieu qua can thiip cong dong bang bd sung sdm da vi chit dititt dddng tren phu niy tai mot so xa thugc tinh Kon Tum va Lai Chau, Luan an Tien sT Dinh DuBng, Vien Dinh duQng.
5. Pham Thj Dan Thanh (2010), Ty le thleii mau, thieu sat d phu nO' 3 thang dau thai Icy va cac yeu td lien guan tai tinh Bac Lieu, Luan van chuyen khoa 2 ehuyen nganh San phu khoa, Tru'dng Dai hoe Y duoc TP.HCM.
6. Nguyen Nhan Thanh, Tran Thj Minh H^nh, Phan Nguyen Thanh Binh va cs (2010), "Tinh trang thieu mau dinh du'dng d phu nff eo thai, ba me eho con bu va tre dffdi 5 tuoi tai Thanh pho Ho Chi Minh", Tap chi Dmh dddng va Thdc pham, 6(3 + 4), tr 56-64.
7. Vien Dinh du'dng - UNICEF (2011), Tinh htnh dinh dddng Viet Nam 2009 - 2010, Nha xuat ban Y hoc, Ha Npi.
PHAN TICH NHU CAU KHAM CHU'A BENH VA VAI TRO BAC Sl GIA DINH TRONG QUA TRINH P H A T TRIEN NONG THON MCTI TAI VIET NAM
Phaim Hong Hal*
T O M TAT
Nghien CUXJ phan tich nhu rau kham chffa benh va vai tro bae si gia dinh trong qua trinh phat then ndng thon mdi Viet Nam dua tren so lieu thir cap, phffOng phap nghien cuU du'pc sff dung la phan tich he thdng.
Ket qua: Nhu cau kham chffa benh tai tuyen y te xa huyen eao, ehiem % sd lu'Ot kham chffa benh BHYT so vdi ca nffdc; Chi phi kham chffa benh eho tuyen y te xa huyen thap da lam anh hu'dng den chat Iffpng ciia eac hjyen; Vai trd eiia bae sT gia dinh chua dUpc chu trpng va chua phat huy dffoe vai trd nay trong he thdng y te Viet Nam hien nay nhat la tai tuyen y te xa huyen.
Tu'khoa: Bac si gia dinh, nong thon mdi, bao iiiem y te
* Dai Hoc That Nguyen
Phan bign khoa hgc: PGS.TS Nguyen Khanh Doanh
S U M M A R Y
ANALYSING THE NEEDS MEDICAL E X A M I N A T I O N AND THE ROLE OF FAMILY DOCTOR I N THE PROCESS OF DEVELOPING
NEW RURAL I N V I E T N A M The study analyzed nedds madical examination and the roles of family doctor in the process of developing new rural in Vietnam based on the secondary data. System analysis metiiod was used in this report. Results: Hight needs medical examination in CHC (Center for Health Community), account for three - quarters of health care visit compared with the national health insurance. Low fee for treatment In CHC to have bad effectiveness on quality of medkal examination. The role of family doctor has not tieen
Y HQC VIET NAM THANG 1 - SO 2/2014 ftKUsed and not to promote this role in VietnamTiealth
system espedaly in CHC.
Keywords: famWy doctor, new rural, health insurance L DAT VAN DE
Trong qua trinh phat trien ndng thdn mdl, ngffdi ta phai quan tam dau tien viee phat trien con ngffdi. Trong viee phat trien eon ngu'di tai nong thdn mdi, ngu'di ta lai phai quan tam dau tien den sffc khde eua eon ngu'di tai day. Do do, viec cham sdc sffc khde ed vi tri UXJ tien trong qua trinh phat trien ndng thdn mdi. Sffc khde cpng ddng bao gid cung cd vj tri quan trpng trong he thong cham soc sffc khde. Hien nay, he thong gan 10 000 tram y te xa trong ea nffdc dang cd trach nhiem thyc hien cham sdc sffc khoe cpng dong tai ndng thdn [ 1 ] . He thdng nay da la niem t y hao cua Y te Viet Nam trong hdn nira the ky nay, da gdp phan quan trpng trong sff nghiep bao ve, nang eao sffc khde nhan dan.
Tuy nhien, khi he thdng kinh te xa hdi da chuyen tff mot he thdng kinh te bao cap ed dieu khien [2] sang mot he thdng kinh te thi trffdng theo djnh hffdng xa hdi ehu nghTa, nen Y te Viet Nam da chuyen tff mpt nen Y te bao cap kieu Semasko sang mdt nen Y te cdng tff ket hpp cd
yeu to xa hdi hda, he thong cae tram Y te da td ra thieu sffc hiit, thieu nhay ben dap img nhu cau eham sde sffc khde ngay eang tang eiia nhan dan.
Van de du'pc dat ra la: tiep can bae sT gia dinh ed the giup nang cao dich vu eham sde sffc khde cdng ddng ndng thdn hien nay khdng^ ean phai ddi mdi yeu t d nao trong eham sdc sffc khde edng dong de ed the dap ffng nhu eau ngay cang tang eua nhan dan trong qua trinh phat trien ndng thdn mdi [3],[4]. Cd nhieu each de tiep can vdi van de nay, tuy nhien trong khudn khd cac eae tieu chi ve ndng thdn mdi, eae hoat ddng cham sdc sffc khde eho nhan dan nhff the nao, ti le tham gia BHYT nhff the nao, vai trd eiia bac si gia dinh trong viee cham sde sffc khde nhan dan... la nhffng van de du'dc lya ehpn de phan tich trong bao cao nay.
IL PHU'aNG PHAP NGHIEN CU'U Phan tich sd lieu t h y cap theo bao cao cua BHXH Viet Nam [ 1 ] .
Phan tieh he thdng giup nhan xet sy thieh nghi va thich hpp eiia bae s? gia dinh trong dieu kien Viet Nam trong qua tinh xay dyng ndng thdn mdi [ 4 ] .
I l l K^TQuA NGHIEN CLTU
3 . 1 . Nhu cau chdm soc sii'c khoe va mu'c dap u'ng cua y t e trong kham chu'a benh Bao hi^m y te cho ngu'di dan nong thon
Bang 3 . 1 . Cd sd djch vu y te cho cac tinh mien niii so vdi 2 dd thi nam 2012 A. Tinh
Bac Can Ha Giang Dien Bien L^i Ciiau
S(Jn L^
Kon Tum Gia Rai H a N o i T P H C M
B. D a n so 295 300 727 000 493 000 371 400 1 082 800
432 900 1 277 600 6 472 200 7 165 200
C. So benii vien
15
3534 13 21 23 30
223 132D. So t r a m Y te
132 194 111
99
20591
222 549Dan s o / Beni) vien
19 687 20 771 14 500 28 569 51 561 18 821 42 856 29 023 54 281
Dan 5 0 / Tram Y te
2 237 3 747 4 441 3 751 5 281 4 757 5754 U 789
Nguon: Bao cao ctia Bao hiem xa hgi Viet Nam 2013\_ 1 ] Nh$nxet: Neu xet theo so the BHYT ma mdt benh vien hay mdt tram Y te/ phdng kham dam nhiem, bang 1 cho thay khdng cd chenh leeh nhieu giffa thanh thi va mien niii.
Y HOC VIET NAM THANG 1 - SO 2/2014
Bieu do 3.1. Sd Iffdt kham chffa benh bao hiem y te theo tuyen nam 2009-2012
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Bieu do 3.2. Chi phi kham chffa benh bao hiem y te theo tuyen nam 2009-2012
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Nhan xet: Sd Iffpt kham chffa benh BHYT tap trung tai tuyen huyen xa la chii yeu, nam 2012 sd li/dt kham tai tuyen huyen chiem tdi 52,9%, tai tuyen xa chiem towia 36,5% nhffng chi phi cho kham chiJa benh tai 2 tuyen nay rat thap 8,5% cho tuyen huyen va 1,5% cho tuyen xa
Bieu do 3.3. Sd Iffdt va chi phi kham chffa benh bao hiem y te npi trii va ngoai tru nam 2012
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Ngudn: Bao cao cua Bao hiem xa hgi Viet Nam 20l3ii]
Nh$n xet: Nam 2012, So Iffdt kham chu'a benh tai tuyen huyen xa chiem 3/4 (73,7%) nhffng kinh phi
cho tuyen nay chiem gan 1/3 (31,4%)
Y HOC VIET NAM THANG 1 - SO 2/2014
dong nonS^tho^n'"'' ^ ^ * * ^ ° " ^ ^ *^ " ^ ^^' * ™ ''^^ ''' ^'^ ^ ' " ^ ^ ' " " ^ *'*'^'" ^°*= '^'^'^ ^*'°^ *=^"9
^ ^ ^ Nha ciu chfch »6e wic khoe f..:. "•
A
1
B
Hinh 1. mo hinh phan tuyen ba cap theo each hiiu cu (A) va mai (B)Nhan xet; Mo hinh phan tuyen 3 cap theo each hieu phan cap ve ehuyen mdn va xa hdi da eho thay nhan thffc ve vai trd ciia cac tuyen nay rat khac nhau,
IV. BAN LUAN
4 . 1 . Ban luan ve nhu cau cham soc su'c khoe va mu'c dap ii'ng cua he thong y te
^ Bang 3.1 cho thay khdng cd chenh lech nhieu giUa thanh thj va mien nui ve so dan/i^enh vien hay sd dan/tram y te. Song, neu xet theo ehi se thay rd ngay sff khac biet ve chi phi giffa cac tuyen nay [1],
Neu phan tfch rieng ve ty le % Iffdt kham tai cac tuyen, bieu dd 3.1 eho tliay so Iffdt kham tang dan qua cac nam. Nam 2012, tai tuyen TW so Iffpt kham ehiem 4,1 % nhffng sd lu'dt kham CLia tuyen tinh gap 7 lan so vdi tuyen TW (27,7%), tuyen huyen gap 13 lan (52,9%) va tuyen xa gap 9 lan (36,5%). chenh leeh ehi phi dieu tri giffa cac tuyen la miSt thffe te dang dien ra, nhffng chenh leeh vdi ty le nao la hdp ly de chi phi dieu tri khdng lam anh hffdng den ehat lffdng dieu tri tai cac tuyen do. Phai chang, vdi sd lu'dt kham ngoai tru tai tuyen y te cd sd nhieu nhff vay (chiem VA) nhffng chi phi lai thap da khien cho chat Iffpng dich vu tai dd bi anh hu'dng, lam cho ngffdi dan khong dddc hffdng thu day dii ve CCSK?
^ Neu phan tfch ve chi phi KCB theo tuyen, bleu do 3.2 cho thay: Chi phf tai tuyen tinh gap 2 lan tuyen TW nhffng sd Iffdt kham gap 7 lan, tuyen huyen tffdng tffdng tuyen TW ve chi phi nhutig so Iffdt kham gap 13 lan, chi phi cho tuyen xa chi bang 1/10 tuyen tinh trong khi sd
Iffdt kham gap 132% so vdi tuyen tinh, neu so vdi chi phi tuyen huyen thi chi phf tai tuyen xa bang 1/5 nhu'ng sd Iffdt kham bang 70% so vdi tuyen huyen. Cd nhieu dich vu nhff md cat rupt thffa khdng bien chffng cd the dffpc thffc hien tai benh vien tuyen huyen, tuyen tinh, tuyen trung ffdng nhu'ng gia eho dich vu nay lai khac nhau, tai tuyen huyen BHYT ehi tra la 700 nghin dong/ea phau thuat, tuyen tinh la 1,5 trieu dong, tuyen trung u'png hPn 2 trieu dong. Viee neu ciing mpt bac si dffpc mdi di mo rupt thffa tai 3 benh vien ndi tren se dffpc BHYT thanh toan vdi eae mffc gia khae nhau [1]. Nhu" vay bat cap d day chfnh la sff ehi tra khdng dffa tren gdi dieh vu ma di/a tren phan tuyen he thdng, ThUe te cho thay, eae ehi phi tai tuyen huyen xa ed khi edn eao hdn tuyen tinh va trung u'png do yeu td dia ly, khoang each xa nen cac chi phf trung gian eao hdn.
Phan tfch so sanh ty le kham chffa benh ea ndi trii va ngoai trii, ket qua bieu dd 3.3 cho thay, tai tuyen huyen va xa cd tdi gan % Iffpt kham dddc thffe hien tai tuyen nay nhu'ng ehi phf chung chi chiem gan 1/3. Sd iffpt kham tai tuyen xa chiem 30% gap 9 lan so vdi tuyen TW nhu'ng ehi phi qua thap (4,8%). Tai tuyen huyen, so Iffdt kham gap 13 lan so vdi tuyen TW chiem 43,6%
nhffng ehi phi eung ehi tffdng dffdng tuyen TW (1,2). Tai tuyen tinh, so Iffdt kham gap 7 lan so vdi TW, nhffng ehi phf ehi gap hpn 2 lan. Tai
Y HOC VIET NAM THANG 1 - SO 2/2014
tuyen TW, ty le KCB chung chiem 1/30 (3,4%) nhffng chi phf chiem tdi hpn 1/5 qui. Nhff vay, cang len tuyen tren cae djch vu ky thuat cao cang dffpc sff dung, vdi mffc chi pinf chiem tdi 68,6% quT cham sdc sffc khde cho 26,3% Iffdt kham, trong dd rieng tuyen tinh chiem gan 50%
ehi phi. Trong khi dd, tai tuyen y te eP sd thi ngu'de lai, sd IffPt kham ddng (73,7%) nhu'ng chi phi it (31,4%).
4.1. Ban luan ve vai tro bac sT gia dinh trong cham soc su'c khde cong dong
Theo sd do phan each ve mat ehuyen mdn, he thdng y te dffdc phan thanh 3 cap khae nhau.
Trong dd y te tuyen ban dau bao gom eac tram y te, cac phdng mach tff, phdng kham da khoa dam nhiem viec cham sdc ban dau. Tuyen y te thff 2 bao gdm cac benh vien cua quan huyen, cae benh vien khu vffc. Va tuyen y te thff 3 la cac ddn vi y te ehuyen khoa sau, cac benh vien ciia tinh va trung ffdng, cac benh vien chuyen khoa.
Viec phan cap nay nham xae dinh vai trd chuyen mdn ciia cae ddn vi nham cd dinh hffdng hoat ddng phu hdp. Theo each nghT thdng thffdng, eae tuyen chuyen khoa sau cd du cac nguon Iffc - dieu kien chuyen mdn de thu'c hien dffdc phan viec cua cac tuyen trffdc, dieu nay la diing. Tuy nhien, viec dien giai kha nang chuyen mdn da dffa den ngd nhan ve mat vai trd cae tuyen trong he thdng y te nhff gian do A. Vdi md hinh nay, tuyen y te ban dau da dddc ddn gian hda, xem nhff hinh thffc mot "benh vien qui md nhd" re tien Idng ghep vao edng ddng dan cff nham thffe hien nhffng phan viec ddn gian. Chinh vdi each suy nghT nay, hinh anh-vai trd cua y te tuyen cP sd bi meo md theo each danh gia chii quan ciia xa hdi dffa tren nang Iffc chuyen mdn nhff: trinh dp kem, trang bi kem, chat lffdng kem, ehi thffc hien chffe nang dff phdng, khdng chffe nang dieu trj.... Quan diem nay la khdng phii hpp. Cd 2 quan diem ve md hinh nay, da lam anh hffdng khdng nhd den kha nang hoat dpng cung nhff sff dau tff cho cac hoat ddng eham sdc sffc khde.
Sff phan cap 3 tuyen ve chuyen mdn dffdc khdi xffdng lan dau tien bdi Lord Dawson, bac sT CLia hoang gia Anh, trong bao cao nam 1920 ve tffdng lai cua dich vu y te quoc gia (Future Provision of Medical and Allied Services). Ong Lord Dawson da de xuat md hinh y te eua nffdc Anh dffdc phan lam 3 cap ehinh [3].
1. Tuyen mdt nham cham sdc nhffng van de sffc khde thdng thffdng ma chu yeu thffc hien bdi cac bac sT da khoa tong quat, bae sT gia dinh.
2. Tuyen hai nham cham sdc nhffng van de sffc khde phffc tap hdn dffdc thffc hien tai cac benh vien eua vimg.
3. Tuyen ba la tuyen dieu tri chuyen sau - ehuyen khoa, nghien cffu - dao tao - phat trien ky thuat mdi dffpc thffc hien bdi cac benh vien ehuyen khoa, cac vien-trffdng dai hpc.
Cd the ndi, tuyen y te ban dau la mpt bo phan khdng the thieu ciia he thdng y te mot nffde nham muc dich cung cap djch vu y te cho nhu cau sffc khde ban dau [2],[5]. Trpng do, tuyen ban dau ed vai trd thffc hien cac edng tac dff phdng, ehan doan, dieu trj nhffng mat benh thffdng gap tai cdng dong mot each toan dien va cd chat Iffdng.
Tai Viet Nam, vao nhffng nam 1960 - 1980, he thdng y te chung ta dffdc danh gia rat cao, dffdc xem la mdt he thdng y te dien hinh trong sd nhffng nffdc dang phat trien. Trong giai doan dd, mac du dat nffdc dang gap rat nhieu khd khan do chien tranh van dang dien ra keo dai cf ca 2 mien dat nffdc, chinh phu van quyet tam phat trien va cung co he thong y te tuyen cd sd (tram y te). Cac tram y te dffdc nhan rpng trong ra cac dja phffdng cho phep cung cap cac djch vu y te mien phi eho ngffdi dan. Chinh he thdng y te ed sd nay da giup giam nhanh ty le tff vong tre em va cac thdng so sffc khde khac [3],[4].
V. KET LUAN
Nhu cau kham chiJa benh tai tuyen y te xa huyen cao, chiem V4 sd Iffdt kham chu'a benh BHYT so vdi ca nffdc.
- Chi phi kham chffa benh cho tuyen y te xa huyen thap da lam anh hffdng den chat Iffdng eua cae tuyen.
- Vai tro cua bae sT gia dinh chu^ dffdc chii trong va chffa phat huy dffdc vai trd nay trong he thdng y te Viet Nam hien nay nhat la tai tuyen y te xa huyen.
VI. KHUYEN NGH!
- Nang cao vai trd cua y te tuyen huyen xa
- Chu trpng vai trd cua Bac sT gia dinh tai tuyen nay.
Y HQC VIET HAM THANG 1 - SO 2/2014 T A I UEU T H A M KHAO
1- Bao cao so 1163/BC-BHXH cua Bao hiem xa hpi Vi|t Nam ve thi/c hien chinh sach phap luat Bao hiem y t e 2013
2. Quyet djnh so 45-HDBT/QD ngay 24-04-1989 cua Hpi dong Bp tn/dng ve thu mot phan vien phi tai benh vien cong lap.
Quyet dinh so 3447/QD-BYT ngay 22 thang 9 nam 2011 ciia Bg Y te ve viec Ban hanh tra deu chi quoc gia vey te xa giai doan 2011-2020 Quyet djnh s6'491/QD-TTg ngay 16/4/2009 ciia Thil tu'dng Chi'nh phu ve bo heu ehi qudc gia xay dutig nong thdn mdi va Quyet tJinh so 342/QD-TTg ngay 20/2/2013 ve viec sffa iJoi mpt so tieu chi ciia Bo heu chi quoc gia ve nong thon mdi Pham Le An (2011), Y hoc gia dinh Viet Nam
DANH GIA KET QUA BlTaC DAU DIEU TRI BENH NHAN U TE BAO HINH SAO TAI VUNG TIEU NAO 6" TRE EM
TAI BENH VIEN NHI TRUNG u a N G
T6M
TAT
U nao te bao hinh sao la loai u nao kha thu'dng g$p d VLing tieu nao tre em. Day la loai u cd tien lupng tot nhat so vdi cac loai khae.
Myc tifiu: Nghien effu a3e diem lam sang, can I3m sSng, danh gia bude dau ket qua dieu trj u te bao hinh sao vung tieu nao d tre em tai benh vien nhi trung u'dng.
Phu'dng ph^p nghien ciru: Mo ta hoi cffu ket h(?p tien cffu
DOI tiring: 21 benh nhan dffpc chan doan u te bka hinh sao viing tieu nao ciia tre em dUdi 16 tud'i.
Ket qua: Benh nhan cd do tudi tff 20 thang den 13 tudi, tuoi trung binh la 7.0. Ty le nam va nff mac tu'dng dUOng nhau. Trieu chffng thUdng gap d benh nhan la dau dau, non, hpi chffng tieu nao, phii gai thi, Hinh anh khdi u thu'dng g3p co kich thudc 3 - 5 em (76,2%), ranh gidi rd (71,5%), cd nang dich (76,2%), giin nao that III va ben (81%). Benh nhan cd ket qua mo benh hpe bac thap (low grade) la 90,5%. So benh nhan phau thuat ian dau lay toan bp khoi u la 47,6%.
Ty 1^ song sdt den den thdi diem ket thuc nghien ciru la 61,9%, chi sd IQ trong gidi han binh thu'dng d tre song la 100%.
Ket lu^n: U nao te bao hinh sao viing tieu nao chiem 1/5 so u tieu nao d tre em, chii yeu co do ac tfnh bac thap. Tien lu'png cho nhdm benh nhan cd dp
^c ti'nh thap kha tdt.
rd'khoa:\Jt\eu nao, u te bao hinh sao, tre em,
'8^nh vlgn Nhi Trung udng
" Tn/dng 0^1 hgc YHa Noi
Phan bign khoa hgc: PGS.TS Ninh Thj U'ng
Tr3n Van Hoc*, Nguyen Van Th5ng**, Nguyen Thanh Liem* va cs
SUMMARY
EVALUATION ON TREATMENT OF CEREBELLAR ASTROCYTOMAS I N CHILDREN AT NATIONAL HOSTPITAL
OF PEDIATING
Cerebellar astrocytoma is one of the fairly common postenor fossa tumours in children. This type of brain tumour has the best prognosis than other types.
Objectives: To study the clinical, imaging and histology features. To assess the initially results of treatment of cerebellar astrocytomas in children at the Nation Hospital of Pediatncs.
Methods: Restrospective and prospective observational studies
Subjects: 21 patients with diagnosis of the cerebellar astrocytoma under 16 years of age.
Results: There were 21 children pahents (male:
11, female: 10).The age of onset from 20 months to 13 years, mean age 7.0, The main signs are headache, volmiting, cerebellar syndrome, papiloedema.,.; The size of imaging tumors are the most of 3-5 cm (76,2%), dear boundaries (71.5%), cyst (76.2%), lateral and third ventricular dilatation (81%). The low - grade of pathology is common (90,5%). The first time of operation, there are 47,6% patients was total resection of tumour. Survival rates come to the end of the study was 61,9%. The IQ in the normal range is 100% among survivors.
Concfusions: The brain tumors of astrocytoma is one fifth of cerebellar tumors in children. The prognosis for patients with low • grade of pathology Is quite good.
Keywords: Cerebellar tumors, astrocytoma, children